The rollout of COVID-19 vaccines was a massive undertaking for Arizona’s healthcare providers. Clinics all over the state were tasked with ordering, storing, distributing, and administering the vaccines to protect Arizonans against the COVID-19 virus. Safety net clinics in particular were integral for getting the vaccine to the most vulnerable members of the population, both in urban and rural areas. Challenges faced by these clinics need to be quantified in order for effective support to be given in the future. Specific Aims: 1. To compare and contrast the identified challenges and opportunities described by FQHC clinics during the COVID-19 vaccine roll out in early 2021. 2. To make recommendations for future best practices in the event of another global pandemic.

The objective of this study was to assess the pattern of healthcare expenditures among United States (U.S.) adults aged ≥ 50 years with pain and annual total positive healthcare expenditures with different levels of perceived health. The study used the 2018 Medical Expenditure Panel Survey data. Unadjusted and adjusted linear regression models were used to compare logarithmically transformed total healthcare expenditures between those with excellent, very good, good, and fair/poor health. The a priori alpha value was 0.05. The study included 5123 U.S. adults aged ≥50 with self‐reported pain (excellent = 8.9%, very good = 28.3%, good = 36.2%, fair/poor = 26.6%). In adjusted analyses, compared to fair/poor health, those with excellent health had the greatest adjusted reduction in expenditures (55% lower), followed by very good health (36.5% lower) and good health (24.9% lower). In conclusion, total positive healthcare expenditures were comparatively lower among those with better perceived health status for older (≥ 50 years) U.S. adults with pain that interfered with normal work in the past four weeks.

Differential membrane trafficking and modulation of lipid domains establishes and maintains cellular polarity in epithelial cells – these events are controlled largely by small GTPases. We have shown previously that Rab14 acts upstream of Arf6 in the establishment of the apical membrane, but how it interacts with other trafficking machinery is unknown. Rab22 has a polarized distribution in activated T-cells, but its role in epithelial polarity is not known. Here we report the colocalization of Rab14 with Rab22a in endosomes of Madin Darby canine kidney (MDCK) cells. Interestingly, Rab22 localizes to the cell:cell interface of polarizing cell pairs, and Rab14 and Rab22 colocalize in adjacent endosomes. Knockdown of Rab22 results in a multi-lumen phenotype in 3D culture, and overexpression of Rab22 in Rab14 knock down cells, results in the production of Rab22-positive extensions. Because of the relationship between Rab14, Rab22, and Arf6, we investigated the interaction of Rab22 with Arf6 GEFs and found that Rab22 co-immunoprecipitates with the Arf6 GEF EFA6. Furthermore, EFA6 is retained in intracellular puncta in Rab22 KD cells. These results suggest that Rab22 acts downstream of Rab14 to regulate Arf6 activity in the establishment of polarity.

In the United States, the public uses 40 billion gallons of water daily (Moupin, 2015). Much of the water that is used domestically will remain in the centralized public water system and will require treatment at a wastewater treatment plant (WWTP). However, 20% of the US does not return the water directly to the centralized water system, instead utilizing onsite septic systems to treat and disperse their water (Septic Systems Fact Sheet, 2008). Disposal methods for septage, the waste pumped from the septic tanks, are more limited than wastewater disposal methods. Wastewater treatment plants often refuse septage haulers due to the variable and unknown nature of the septage contents. The septage accepted at WWTP faces the same disposal statistics as wastewater. Approximately half (45%) of wastewater is landfilled or incinerated and the other half (55%) is land applied (Shaddel et al., 2019). Each of these disposal methods poses a risk to the environment. Landfilling the septage decreases the life expectancy of the landfill site and increases the risk of polluting the soil and nearby water supplies. Incineration releases harmful gases and chemicals into the atmosphere, and land application increases the risk to human health via the movement of contamination and pollution.This study aimed to determine if treated septage is beneficial to crop growth and soil health when used as a fertilizer and irrigation source. Durum wheat was the crop that was chosen for this study. This crop was selected due to its dual-purpose uses. The seeds can be collected for seed production, and the rest of the crop can be used for fodder. Septage dispersal and treatment are regulated by the United States Environmental Protection Agency (EPA) under the same guidelines as sewage sludge and is referred to as biosolids when treated to reduce pathogen load. For this study, the septage was dewatered using a spiral filter press and then treated using a low-temperature dehumidification system to dry it to 90% total solids or higher to produce Class A septage that are then land applied. The dehumidification system operates at a temperature and time sufficient to result in Class A biosolids according to US Part 503 EPA Alternative 1 (EPA, 2018). The thermal treatment addresses the health concerns of direct land application. To reduce pathogen load, this experiment consisted of two parallel trials, each with eight treatments. Each trial included two different application rates of the Class A septage, one application of traditional chemical fertilizer, and a control that received no fertilizer treatment. These four treatments were the same across both trials. Trial 1 received canal water flood irrigation. The other half, trial 2, were flood irrigated with the filtrate removed during the dewatering stage that was aerated and treated using a bacterial blend specific to SludgeHammer, a water treatment company, and mixed with the condensate water collected during the thermal treatment process (SludgeHammer, 2023). The findings of the study show that Class A septage can be beneficially used as fertilizer to enhance plant growth and soil health. The application of the treated filtrate water, however, was found to improve plant growth but detrimentally impacted soil health. Due to elevated pathogen levels found in the soil after the experiment, using filtrate for irrigation is not recommended without further treatment. Further research is necessary to determine the optimal application rate of Class A septage and to assess the long-term effects of using septage-based fertilizers.

This dissertation presents an ethnographic exploration of the experiences of nontrans women professionals of color employed at U.S. medical schools, focusing on the intersectionality of gender and race and its influence on emotional labor. By conducting qualitative interviews, this research seeks to elucidate the multifaceted nature of emotional labor within the context of medical school environments and shed light on the participants' perceptions of their roles. The study's objective is to comprehend how the convergence of gender and race shapes the emotional labor of women professionals of color in medical schools, examining the intricacies of their experiences and the impact of these experiences on the broader mission of diversity, equity, and inclusion within these institutions. Thirteen women professionals of color were interviewed, encompassing various organizational positions and racial/ethnic backgrounds, to capture a range of perspectives. The findings underscore the integral role that emotional labor plays in the daily tasks and responsibilities of the women professionals interviewed. The participants' contributions to advancing diversity, equity, and inclusion initiatives within their respective medical schools were intricately intertwined with their emotional labor. Moreover, the data analysis revealed nuances that cut across both organizational positions and racial/ethnic identities, offering a deeper understanding of the distinct challenges faced by these professionals. A significant divergence was identified between groups with Black and Middle Eastern participants, as they reported experiencing racialized emotions in their roles. This aligns with existing scholarship on racialized emotions and supports the notion that the emotional labor of women professionals of color cannot be detached from the racial dynamics within medical institutions (Wingfield; Bonilla-Silva). Furthermore, the study illuminates the participants' agency in managing emotional labor. They exhibited self-awareness and adeptly performed their gender and race roles to navigate through the gendered and racialized landscape of medicine. Additionally, the importance of finding community emerged as a vital coping strategy, as these professionals leveraged collective support to overcome the challenges inherent in their roles. In summary, this ethnographic study contributes to the growing body of knowledge on emotional labor, gender, and race within organizational contexts, with a specific focus on U.S. medical schools. The findings emphasize the intricate interplay of emotional labor and diversity initiatives, while also highlighting the agency of nontrans women professionals of color as they negotiate their roles in a complex and dynamic environment.

Despite their prevalent use, online surveys are vulnerable to data quality problems that may be attributed to several factors, including respondent induced measurement errors that cause discrepancies between respondent attributes and their responses. This research explores how a respondent’s response generation data manifests in their human computer interaction (HCI) device usage; and how these fine-grained HCI data may be used to identify poor-quality responses in online surveys. The larger goal of this research is to establish a structured set of guidelines to address the presence, impact, and appropriate mitigation for poor-quality survey responses. To this end, this dissertation provides a framework that utilizes individual characteristics, survey characteristics, as well as other external factors to determine one's response generation process and consequently the usefulness of that response.This dissertation establishes the prevalence of poor-quality responses in survey research and examines how behavioral differences between respondents exhibiting previously known undesirable behaviors may be used to detect poor-quality responses. ‘Essay One’ examines the presence of poor quality data among professional survey respondents and how HCI based behavioral data can be used to identify them. ‘Essay Two’ examines the same problem among another common participant pool, university students. ‘Essay Three’ alleviates typical Type I concerns in ‘Essay One’ and ‘Essay Two’ by examining whether specific undesirable behaviors exhibited by respondents while answering a question may be captured using appropriate metrics. The overall results obtained suggest that behavioral differences during the response generation process may be captured through HCI devices to create appropriate metrics that identify poor quality responses.

Ionizing radiation is the collection of particles including photons, electrons, protons, andneutrons which have sufficient kinetic energy to remove bound electrons from an atomic nucleus. Thus, radiation effects can play a significant role in degrading the resiliency of technologies for a variety of applications, including those central to nuclear energy production and space travel. Radiation in these environments can be both acutely and chronically harmful to both humans and electronic and optical systems, hence the need for appropriate design of radiation protection measures and radiation resistance or hardness. In general, the three tenets of radiation protection are time, distance, and shielding. For many of these cutting-edge applications like space colonization and nuclear power generation via fission and fusion, the time within the radiation environment cannot be reduced nor the distance from the source increased, leaving radiation shielding as the primary method of exposure mitigation. The present work details and demonstrates a synergistic approach to radiation shielding design and implementation, focusing on the computation-based design of additively manufacturable composite radiation shielding materials. Monte Carlo simulations explore the shielding design space and inform optimization algorithms. The materials selected for these simulations are additively manufacturable via fused deposition modeling (FDM) into homogeneous and layered composite structures, the performance of which has been experimentally validated. Four publications are provided in the work (Chapters 4 – 7 respectively), in which the principles of this design approach have been demonstrated to address a range of radiation environments and shield design classes. The works are each presented with an assessment of their 16 contextual rationale and, when appropriate, a summary of subsequent follow-on efforts to extend the results and impact obtained beyond that of the original works. The first publication explored the effect of Cu loading on the radiation shielding performance of additively manufacturable homogeneous particle-loaded composites against monochromatic gamma and electron irradiation using GEANT4 Monte Carlo radiation transport code. Experimental validation of the GEANT4 simulations was performed for FDM printed Culoaded, Fe-loaded, and BaSO4-loaded composites. For gamma radiation between 0.1 and 15 MeV, shielding performance was essentially independent of composition because of the similarity of the mass attenuation coefficients of copper and PLA in that energy range and because the shield thicknesses investigated were less than the gamma mean free paths at each energy for each material. In contrast, for monochromatic electron radiation, the optimum composition was found to be dependent on both energy and shield areal density. This dependence was determined to correspond to the continuous slowing down approximation (CSDA) range for electrons, with pure Cu being optimal when the shield areal density is less than the CSDA range, and PLA with <10 wt.% Cu being optimal when the areal density is greater than the CSDA range. The second publication presented a material replacement case study. The total ionizing dose (TID) transmissivity of additively manufacturable homogeneous Cu-PLA composites was compared against 1 g/cm2 of aluminum (a prototypical radiation shielding for CubeSats in low earth orbit (LEO)) in the LEO trapped electron radiation environment. An optimization algorithm identified the required composite thickness to match the TID transmissivity of 1 g/cm2 of aluminum for each composite composition (increments of 10 wt.% Cu) and monoenergetic electron energy (0.1, 0.2, 0.5, 1, 2, 5 and 10 MeV). For all compositions except for pure PLA (0 17 wt.% Cu), there was at least a 60% shield mass reduction while achieving the same TID performance as 1 g/cm2 of aluminum, when the average mass reduction weighted by the LEO spectrum was calculated. A 10 wt.% Cu-loaded PLA homogeneous composite provided the same shielding effectiveness as 1 g/cm2 of Al while being 65% lighter and 24% thinner. Further volume reduction with similar mass improvements were achievable with higher Cu loaded compositions. The third publication demonstrated a simulation-based investigation of sensitive parameters for two-phase, multilayered radiation shielding against gamma and electron radiation. Similar to results of the first publication, gamma shielding is generally insensitive to number of layers, layer ordering, high-Z layer fraction, mean composition, and areal density compared to homogeneous compositions in the 0.1 to 10 MeV energy range. Experimental irradiation using a 60Co radioisotope source confirmed the gamma performance of the homogeneous composites and lack of improvement or reduction in performance from a layered composite shield. The sparce experimental results were used to reconstruct the most probable true center location of the gamma source. These results were used to determine the intrinsic mass attenuation coefficients of homogeneous composites at a mean gamma energy of 1.25 MeV. For monoenergetic electron radiation, an additively manufacturable hierarchical composite radiation shield provided the best TID reduction; 50 – 66% more than a homogeneous composite shield of identical composition. The optimum structure consisted of two layers, a PLA layer facing the incident radiation and an 83 wt.% Cu-loaded PLA layer behind, the latter being 0.3 of the entire shield thickness, resulting in a mean composition of 50 wt.% Cu. An areal density greater than or equal to 3x the CSDA range at the incident electron energy was required to observe significant performance enhancement with layered shielding. 18 The fourth and final publication was a culmination of all previous publications. It centered on simulation-based design of additively manufacturable radiation shielding consisting of 10 equal areal density layers of three possible materials, PLA, B4C-PLA, and CuPLA, for the deuteriumtritium fusion neutron (14 MeV) environment. An initial random search of the layer ordering– composition parameter space led to the selection of a compositional family with low yet largely varying TID transmissivity, depending on configuration. The TID transmissivity for every shield configuration within the compositional family consisting of 6 layers of PLA, 2 layers of B4C-PLA, and 2 layers of CuPLA (77.4 wt.% PLA, 16.6 wt.% Cu, and 6.0 wt.% B4C) was measured via simulation. A novel design parameter, Z-Grading Degree (?), which expresses how monotonically increasing (+) or decreasing (–) a shield configuration is, was found to correlate negatively with dose transmissivity. Further, position of the rear-most B4C-PLA layer was found to strongly correlate (in the negative sense) with dose transmissivity, i.e., the further back the B4C-PLA layer was within the shield, the more effective the shield was at reducing the transmitted total ionizing dose from 14 MeV neutron irradiation. These findings were confirmed with experimental irradiation testing using an uncollimated deuterium-tritium fusion neutron source. Anisotropies in the neutron flux data were used to confirm the spatial extent of the source and allowed for a novel reconstruction of its most probable true center location.

Diffuse traumatic brain injury (TBI) leads to complex pathophysiological processes that result in clinical symptoms. Neuroinflammation and associated microglia activation are hallmark pathophysiological processes of diffuse TBI and contribute significantly to both damage and ensuing repair. Microglia are the resident innate immune cells in the brain and microglia function is linked to cellular morphology. Inflammatory signaling after diffuse TBI initiates microglia activation where microglia go from a ramified morphology (small soma with long, highly branched processes) to an activated morphology (swollen soma with enlarged, retracted processes). We also report an abundance of rod microglia (elongated soma with polarized processes) in the cortex after diffuse TBI. Rod microglia were first described in the early 1900’s and have since been sporadically reported in neurological conditions such as chemical exposure, viral infection, Alzheimer’s disease, Lewy Body dementia, ischemia, and TBI. Despite their occurrence across injury and disease, very little is known about rod microglia. Investigations have been limited to post-mortem histology using general microglia markers. The objective of this dissertation was to identify markers and develop tools to differentiate rod microglia from other microglia morphologies and confirm rod microglia mechanisms after TBI with the central hypothesis that rod microglia have a unique molecular profile compared to other microglia morphologies. First, we applied phage display biopanning to isolate antigen-binding domains specific to rod microglia compared to other microglia morphologies. We modified a novel discovery pipeline to develop antibody-mimetics from antigen-binding domains that can be validated for rod microglia specificity and used for downstream applications such as immunohistochemistry. Next, we investigated gene expression of rod microglia pathology with single nucleus RNA sequencing to provide insight into rod microglia function. We identified three distinct subclusters of microglia within the somatosensory cortex and inferred that those with inflammatory and neurological disease pathways may represent rod microglia. Finally, we used diffusion magnetic resonance imaging (MRI) to refine a non-invasive imaging signature of rod microglia. Water restriction was visible by diffusion MRI in the somatosensory cortex and corresponding histology reported activated microglia in regions where water restriction was observed. While not a marker of rod microglia specifically, novel post-image processing was sensitive to detect changes in microglia. This dissertation is the first step in developing and validating tools to target rod microglia. Until rod microglia mechanisms can be investigated with new tools, their role in the evolution, progression, and resolution of diffuse TBI pathophysiology remains unknown.

As more communities work to create new speakers of their languages we are seeing a new linguistic environment develop and, from that, particular styles of language use emerge. This dissertation adds to the growing literature on studying and supporting the process of language revitalization (e.g. Stebbins et al. 2017, Zuckerman 2021), by describing the process of documenting and analyzing Tunica (tun ISO 639-3), a reawakening language spoken in central Louisiana, USA. ‘Reawakening languages’ are languages whose usual transmission has been interrupted and the community is looking to learn them through existing documentation, meaning looking at their revitalization process has the potential to be both incredibly illuminating and in- credibly disruptive to language learners and language workers. With these concerns in mind, this dissertation presents a method for documenting languages as they are being revitalized that minimizes disruption and maximizes support by centering the documentation around language revitalization activities and output. The first chapter introduces key terms and situates current research in language revitalization. Chapter 2 provides background on Tunica, the revitalization efforts in the community, and the language structure. Chapter 3 provides general recommendations for documenting the process of languages being reclaimed and reawakened. Chapters 4 and 5 focus specifically on documenting Tunica, with Chapter 4 describing the process of documenting Tunica in the classroom, through the creation of podcasts, and with more traditional elicitation. Chapter 5 turns to the types of questions we can look at using documentation of reawakening languages by considering trends in three morphological and syntactic phenomena in the language: the use of gender-number-agreement clitics, the use of overt subjects, and the structure of questions. Chapter 6 ties this all together and looks towards future projects.

The relationships between turbulence and interesting fluid structures like those near the poles of Jupiter and Saturn are still an open research topic. A minimal model for understanding fundamental behaviors is desirable for isolating the relevant parameter space with predictive power. Minimal models in liquids inspire us to look for a more minimal model in 2D Bose-Einstein Condensates. We have created a framework for quickly simulating and analyzing 2D Bose-Einstein Condensates in a rotating reference frame to test a wide range of parameter space via the MATLAB parallel computing toolbox, the utilization of a graphics processing unit, and the high-powered computing cluster available to us through the University of Arizona. In the development of these methods, we find that our novel application of qualitative analysis shows evidence that differential rotation leads to the observation of counter-rotating eddies consistent with the development of characteristic structures from turbulent fluid flow. This work sets up a platform for researching quantum turbulence in 2D Bose-Einstein condensates evolving under differential rotation in a rotating frame and gives direction for research that may have connection to classical phenomena seen in the atmospheres of the gas giants of our solar system and in liquid models here on Earth.