Digital Commons Network^™

Trust In Cancer Information Sources And Awareness Of Human Papillomavirus As A Cause Of Cervical Cancer Among Us Adults, Olajumoke Ope Oladoyin, Paula Cuccaro, Lara S Savas, Robert Yu, Joel Fokom Domgue, Sheryl Mccurdy, Sanjay Shete

Faculty, Staff and Student Publications

Importance: Religiosity, trust in physicians, and trust in government health agencies influence individual decision-making and behavior toward public health programs. However, trust in information about cancer from these sources and their association with public awareness of human papillomavirus (HPV) as a cause of cervical cancer remain understudied.

Objective: To assess the association of trust in cancer information sources with awareness that HPV causes cervical cancer among US adults.

Design, setting, and participants: This cross-sectional study used the nationally representative 2022 Health Information National Trends Survey (HINTS) data on noninstitutionalized US adults aged 18 years or older collected between March 7 …

Global Youth Development: Challenges And Remedies, Raymond Chimezie

Faculty Publications and Presentations

Young people have enormous potential for growth and innovation, but not all have access to resources and opportunities to explore, achieve their dreams, and contribute immensely to society. Absence or limited opportunities and resources pose great challenges to young people’s aspirations. Through a review of literature and study of some countries young people globally face challenges, though at varying degrees like unemployment, limited access to healthcare, social services, and education; lack of professional support, skills acquisition and retraining, and political exclusion; judicial inequity, loneliness, and poor parenting. There still exist policies, structures, or regulations that encourage racial and ethnic or …

Cytosignal Detects Locations And Dynamics Of Ligand-Receptor Signaling At Cellular Resolution From Spatial Transcriptomic Data, Jialin Liu, Hiroaki Manabe, Weizhou Qian, Shion Orikasa, Javid Ghaemmaghami, Yichen Wang, Yichen Gu, Angel Ka Yan Chu, Gaurav Gadhvi, Yuxuan Song, Patrick Mcclinden, Vibha N Lama, Noriaki Ono, Joshua D Welch

Faculty, Staff and Student Publications

Cells communicate through ligand-receptor (LR) signaling interactions, but identifying when and where these interactions are active remains challenging. We developed CytoSignal to infer the locations and dynamics of cell-cell communication at cellular resolution from spatial transcriptomic data. Here we show that our cellular resolution, spatially resolved signaling scores enable several important analyses-identifying spatial gradients in signaling strength, quantifying the locations of contact-dependent and diffusible interactions, detecting signaling-associated genes and identifying differential signaling across multisample data. Additionally, we can predict the temporal dynamics of a signaling interaction at each spatial location. We experimentally validate our results in situ by proximity ligation …

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …

Detecting Cognitive Impairment Early In Hispanic And Black Older Adults: Community Voices From South Central Texas, Robin C. Hilsabeck, Stephanie Santiago-Mejias, Tara L. Fletcher, Shanae L. Rhodes, Gladys Maestre, Sudha Seshadri, Neela K. Patel, Fayron R. Epps

School of Medicine Publications

Background: Alzheimer disease and related dementias (ADRD) are more prevalent in Black and Hispanic older adults and are also more likely to be undetected and misdiagnosed. The purpose of this study was to engage with Black and Hispanic communities about interest in and support needed for memory screening.

Methods: Participants were recruited from established community partners of the South Texas Alzheimer's Disease Research Center to engagein a 90-minute listening session. The session was recorded with participants' permission, and a thematic analysis was conducted by 2 independent coders.

Results: Sixteen individuals (81% female, 88% Hispanic or Black) from various perspectives participated …

The Impact Of A Single Session Of Sprint Interval Training (Sit) On Pain Pressure Threshold (Ppt) In Healthy Adults, Francesco Pacenza, Gary Brickley, Umberto Crainich, Francesco Bettariga, Anthony Turner, Luca Maestroni

Research outputs 2022 to 2026

Different forms of aerobic exercise lead to Exercise-Induced Hypoalgesia (EIH). The aim of this study was to investigate the acute effect of a single session of Sprint Interval Training (SIT) on EIH. A total of 44 recreationally active young adults participated in a single SIT session on a cycle ergometer, consisting of a 2 min warm-up, 3 × 20 s “all-out” cycling bouts interspersed with 2 min of active recovery, and a 3 min cool-down. Pain Pressure Threshold (PPT) measurements were taken on the quadriceps (working muscle) and thenar eminence (resting muscle) before and after the session. Additionally, average power …

Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal

Center for Medical Ethics and Health Policy Staff Publications

Introduction: After a patient receives genetic test results that indicate an actionable health condition, cascade genetic screening (CGS) is the process of evaluating the patient's relatives for a potentially elevated genetic risk of disease. The United States primarily relies on patients to communicate with their relatives, resulting in suboptimal rates of risk communication, familial genetic testing uptake, and risk-reducing interventions. There is ongoing debate about whether and how best to inform relatives of a potentially increased genetic risk.

Methods: We conducted a nationally representative survey of US adults to assess attitudes toward informing at-risk relatives, acceptability of system-mediated communication, and …

From The Editor: The Journal: Supporting Michigan’S Dental Community, Romesh Nalliah

The Journal of the Michigan Dental Association

Editor-in-Chief Dr. Romesh Nalliah explores the concept of "community" as a shared responsibility within the dental profession. He positions the Journal of the Michigan Dental Association as a vital tool for connecting practitioners and delivering rigorously reviewed scientific content to guide clinical decision-making. While acknowledging technological advances like artificial intelligence, Nalliah maintains that "soft skills"—including listening, empathy, and critical thinking—remain the most essential factors for success. He encourages members to utilize the Journal for mentorship and professional support.

J Mich Dent Assoc June 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The June 2026 (Volume 108, No. 6) issue of the Journal is published in digital format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The June 2026 issue of the Journal of the Michigan Dental Association provides association updates, legal advice, and clinical …

Outgoing President Newman: “The Future Of The Mda Is Defined By All Of Us”, David Foe

The Journal of the Michigan Dental Association

In her final address to the MDA House of Delegates, outgoing President Dr. Cheri Newman reviews the association's progress over the past administrative year. She highlights achievements in strengthening financial stability, advocating for solutions to dental workforce shortages, and expanding community access to care. Newman also discusses the ongoing strategic review of member values and a comprehensive governance review intended to position the association for the future of dentistry. She emphasizes that the organization's strength lies in the collective engagement of its membership.

Assessing Aflatoxin Knowledge, Perceptions, And Related Practices, In A Rural Coastal Community: A Population-Based Cross-Sectional Survey, Rosebella Iseme, Joseph Abuodha, Anthony Ngugi, Innocent Abayo, Mansoor Saleh

Population Health, East Africa

Background

Aflatoxin contamination is a significant yet under-addressed food safety challenge in low-resource settings, driven by a complex interplay of environmental, agricultural, and socio-economic factors. Limited access to agricultural inputs, inadequate post-harvest handling and storage, and weak regulatory enforcement alongside food scarcity and climate change heighten the risk of contamination and exposure. Human exposure is associated with serious health consequences, including hepatocellular carcinoma, immune suppression, and childhood stunting. Although aflatoxin is increasingly recognized as a global food safety concern, little is known about community-level knowledge, risk perceptions, and preventive practices. This study examined household heads’ awareness, perceptions, and behaviours related …

Full-Body Ai Agent: A Perspective On Multi-Scale Collaborative Ai For Systemic Biology And Precision Medicine., Aoqi Wang, Jiajia Liu, Jianguo Wen, Yangyang Luo, Zhiwei Fan, Liren Yang, Xi Hu, Ruihan Luo, Yankai Yu, Sophia Li, Weiling Zhao, Xiaobo Zhou

Faculty, Staff and Student Publications

Artificial intelligence (AI) is increasingly applied to biomedical research, but most current systems remain limited to specific tasks, data types, or biological scales. This makes it difficult to connect molecular alterations, organelle dysfunction, cellular behavior, tissue remodeling, organ physiology, systemic regulation, and whole-body phenotypes into coherent biological reasoning. In this Perspective, we propose the Full-Body AI Agent as a hypothetical multi-agent framework and conceptual blueprint for future systemic biology and precision medicine, rather than a fully implemented software platform. This framework envisions a supervisory Full-Body AI Agent coordinating seven biological-level agents, namely Molecule, Organelle, Cell, Tissue, Organ, Organ System, and …

Content Matters, Context Matters: Unraveling Behavior Dynamics In An Online Health Community For Tobacco Cessation, Tavleen Singh, Runzhi Zhou, Kayo Fujimoto, Sahiti Myneni

Faculty, Staff and Student Publications

Objectives: The objective of this research was to examine the content and context-specific information diffusion patterns underlying communication pertaining to tobacco use from online health communities (OHCs).

Materials and methods: We utilized a mixed-methods approach comprising multidimensional qualitative coding to identify themes and communication attributes, automated text analysis leveraging advances in large language models (LLMs) to classify message content and context, and social network analysis to examine the dynamics of peer interactions in this study. Using QuitNet, an online tobacco cessation forum (n = 64 632 members, n = 2.39 million forum messages spanning 2000-2015), we extracted message-level features …

Recurrent Upper Gastrointestinal Bleeding Due To Gastric Arteriovenous Malformation, Lavender Otom, Priyanka Panwar, Gerald Odong, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

We present the case of a 45-year-old male with repeated episodes of upper gastrointestinal bleeding due to a gastric arteriovenous malformation (AVM). The case underscores the diagnostic challenges, multidisciplinary decision-making, and management considerations associated with gastrointestinal vascular malformations. Given the rarity of gastric AVMs and their potential for serious complications, this report highlights the importance of an integrated approach to diagnosis and treatment, including advanced imaging and endovascular interventions.

Increasing Efficiency And Flow In Primary Care Clinics Using Triage Protocols Based On The Donabedian Model, Verneita Mun

Doctor of Nursing Practice Projects

Purpose

This project evaluated the effectiveness of triage protocols based on the Donabedian model in increasing efficiency and flow in primary care clinics. Patients experienced extended wait times in primary care clinics, resulting in aggravated outcomes and dissatisfaction with care delivery. Healthcare providers also experienced stress and burnout due to workload and operational inadequacies. These inefficiencies mandated a quality improvement approach that addressed patient satisfaction, workflow optimization, and resource management.

Methods

This project used structured triage protocol based on the Donabedian model, which addressed the dimensions of structure, process, and outcomes. The proposed solution was disseminated through a quality improvement …

A Survey Of Earable Technology: Trends, Tools, And The Road Ahead, Changshuo Hu, Qiang Yang, Yang Liu, Tobias Röddiger, Kayla-Jade Butkow, Mathias Ciliberto, Adam Luke Pullin, Jake Stuchbury-Wass, Mahbub Hassan, Cecilia Mascolo, Dong Ma

Research Collection School Of Computing and Information Systems

Earable devices, wearables positioned in or around the ear, are undergoing a rapid transformation from audio-centric accessories into multifunctional systems for interaction, contextual awareness, and health monitoring. This evolution is driven by commercial trends emphasizing sensor integration and by a surge of academic interest exploring novel sensing capabilities. Building on the foundation established by earlier surveys, this work presents a timely and comprehensive review of earable research published since 2022. We attempt to answer three core questions: (1) how has earable research evolved in recent years, (2) what enabling resources are now available, and (3) what opportunities remain for future …

Dementia, Advance Directives, And Second-Order Volitions, Rand Hirmiz

Research Collection School of Social Sciences

This paper contributes to the ongoing debate over the authority of advance directives in cases where patients with dementia express desires that conflict with their earlier wishes. Drawing on Harry Frankfurt’s concept of second-order volitions, I argue that the preferences of the pre-dementia self (the “then-self”) should, in most cases, take precedence over those of the post-dementia self (the “now-self”) –  particularly in instances where the now-self has lost the capacity to form second-order volitions and is no longer able to meaningfully repudiate prior values and commitments.

Plasma Biomarkers Of Brain Injury In Critically Ill Children Receiving Extracorporeal Membrane Oxygenation, Matthew L Friedman, Michael J Bell, Bonnie A Brooks, Adam S Himebauch, Asavari Kamerkar, Kerri Larovere, Laura L Loftis, Jose A Pineda, Ahmed Said, Hitesh S Sandhu, Martin Stengelin, Catherine Demos, Mark S Wainwright, Alina N West, Allan Barnes, Allen D Everett, Ryan J Felling, Sue J Hong, Jennifer L Roem, Cynthia F Salorio, Derek K Ng, Melania M Bembea

Faculty, Staff and Students Publications

Importance: Timely identification of acute brain injury (ABI) in children receiving extracorporeal membrane oxygenation (ECMO) support is critical for early neuroprotective interventions.

Objectives: To determine if elevations in plasma glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and tau levels in children receiving ECMO precede new ABI confirmed by neuroimaging, and if they are associated with mortality and functional outcomes.

Design, setting, and participants: This was a prospective observational cohort study conducted from 2019 to 2023, with 18-month follow-up completed in 2025. Children aged 2 days to younger than 18 years at ECMO cannulation were recruited from 11 US …

Assessing Family Planning Progress In Exemplar Countries: Development Of A Conceptual Framework And Case Study Methodology, Zahid Memon, Hina Najmi, Abeer Mian, Sacha Ahmad, Muhammad Islam, Kevin Samuel, Marleen Temmerman, Ali Mohammad Mir, Zeba Sathar

Centre of Excellence in Women and Child Health

Family planning (FP) is a critical component of reproductive health, enabling individuals to plan the number and timing of children through various contraceptive methods.

We outline the conceptual framework and country case study methodology used by the Exemplars in Family Planning (EFP) project. This was based on the wider Exemplars in Global Health programme, which uses mixed-methods to examine determinants of FP progress in countries that exceed expectations for health outcomes. The EFP project integrates findings from case studies on six such countries, including quantitative analyses of trends and drivers of modern contraceptive prevalence, systematic reviews, policy, programme and financing …

Calcium Signaling And Postsynaptic Density Dynamics: The Roles Of Calmodulin In Synaptic Protein Regulation, Keyaa Dilip Shah, Yonghong Zhang

School of Integrative Biological & Chemical Sciences Faculty Publications

Calcium signaling in neuronal cells is the principal mechanism underlying learning and synaptic plasticity, whereas the postsynaptic density (PSD) is an important center where calcium-dependent processes are organized and regulated. This review explores the roles of calmodulin (CaM) in facilitating calcium-dependent modulation of the activities of synaptic proteins in the PSD. We focus on the molecular processes through which CaM interacts with calcium signals to regulate the function, localization, and interactions of central synaptic proteins, including calcium/calmodulin-dependent protein kinase II (CaMKII), membrane-associated guanylate kinases (MAGUKs), and N-methyl-D-aspartate (NMDA) receptors. We aim to summarize recent advances in structural, biochemical, and imaging …

Understanding And Enhancing Suicide Prevention Strategies In The Military: The Roles Of Culture, Leadership, And Command Climate, Kelly Johanna Pires

Dissertations

Military service members are shaped and molded to fit a military culture that emphasizes mission readiness and continuous preparedness. Countless hours are spent training for various situations that can arise. Many trainings are geared toward worst-case scenarios that can cause an increase in stressors and traumatic events. They are expected to demonstrate resilience and overcome adversity to remain mission-ready. This expectation to be mission-ready creates the space for mental health difficulties as well as stigma and avoidance of help-seeking behaviors. In many cases, the desire to stay mission-ready creates a barrier for conversations around mental health. The military emphasizes qualities …

Diverse Families Navigating Mental Health At The Pediatrician’S Office: A Mixed Methods Exploration Of The Interplay Of Stress, Culture, And Child Mental Health In The Primary Care Setting, Sara B. Budowsky

Dissertations

Low-income and ethnic minority youth experience high psychiatric need but persistently low participation in traditional mental health care. General pediatricians are often the first and only healthcare providers with whom many families engage around their child’s emotional and behavioral development. Using both quantitative analysis of retrospective secondary data and Interpretative Phenomenological Analysis (IPA) of in-depth interviews with diverse caregivers, this project explored influencers of child mental health and family utilization of pediatric primary-care-based mental health services in the context of a uniquely multicultural clinic serving a predominantly Medicaid population. Three key findings include: 1) Caregiver Stress was a highly significant, …

Implicit Attitudes Toward Hearing Aid Visibility: Conspicuous Versus Inconspicuous Hearing Aid Colors, Orly R. Ames

Dissertations, Theses, and Capstone Projects

Hearing aid stigma remains a significant barrier to treatment uptake, with device visibility frequently identified as a contributing factor. Although prior research has examined visibility in relation to hearing aid size and style, the role of color as a distinct aesthetic dimension has not been systematically investigated. The present study assessed whether hearing aid color affects implicit and explicit attitudes toward hearing aids and whether such evaluations differ across contexts. Twenty-six adults who were not current hearing aid users participated in an online quantitative multi-method study consisting of an Implicit Association Test (IAT) and self-report questionnaires. The IAT measured implicit …

Strategies For High-Quality Community-Based Participatory Research Partnerships In Public Health Research., Emily M. D'Agostino, Rumour Piepenbrink, Lori Brand Bateman, Dana Keener Mast, Liliane Windsor, Debra Oto-Kent, Alan Wells, Jennifer Goldman, Jennifer E. Schuster, Rachel Kaufmann, Rachel Gurarie, Miriam Nuño

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Community-Based Participatory Research (CBPR) is grounded in trusting, reciprocal, and authentic relationships. We aimed to identify key strategies and actionable next steps to establish and sustain high-quality community-academic partnerships that foster community-based health equity.

STUDY DESIGN: Qualitative thematic analysis.

METHODS: We analyzed three recorded discussions from a roundtable session with community and academic partners from the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program (2020-2025), which supported 142 community-engaged public health research projects aimed at reducing COVID-19-related health inequities.

RESULTS: Key themes identified as most fundamental to support CBPR included establishing a long-term commitment, mutual co-learning among partners, flexible and …

New Graduate Nurses' Experiences Of Leaving The Emergency Department, Gemma John

Walden Dissertations and Doctoral Studies

No abstract provided.

Reflections And Revisionism: Rethinking The U.S. Response To Covid-19, Wendy E. Parmet

Michigan Law Review

A review of In Covid’s Wake: How Our Politics Failed Us. By Stephen Macedo and Frances Lee.

Non-Isolated Dandy-Walker Malformation: Exome Sequencing Efficacy And Phenotypic Expansions, Sarah Araji, Xiaonan Zhao, Jill A Rosenfeld, Seema R Lalani, Daryl A Scott

Faculty, Staff and Students Publications

Dandy-Walker malformation (DWM) is a rare congenital abnormality of the posterior fossa and the cerebellum and has an incidence of 1 in 10 000 to 30 000 births. Although DWM can present in isolation, it is often associated with other central nervous system (CNS) abnormalities or extra-CNS anomalies (DWM+). A molecular cause is not identified in the majority of individuals with DWM+. This is due, in part, to uncertainty regarding optimal testing strategies and an incomplete understanding of the genetic causes of DWM+. In this study, we analyzed clinical exome sequencing (cES) data from 91 individuals with DWM+ to determine …

Curriculum Innovation: Neurocritical Care Eeg Rounds: A Model To Improve Neurology Resident Eeg Interpretation., Ellen Sylvie Sanchez Mas, Mitchell Lloyd Powell, Marco Malaga, Corey Elam Goldsmith, Rahul Damani, Lu Lin

Faculty, Staff and Students Publications

Background and purpose: Rural-urban disparities in neurological care have been well documented, but limited data exist regarding Guillain-Barré Syndrome (GBS). This study examines differences in patient demographics, hospital characteristics, and outcomes among GBS admissions to rural versus urban hospitals in the United States.

Methods: Using the 2021 National Inpatient Sample, we conducted a retrospective cohort study of adult hospitalizations with a principal diagnosis of GBS. Hospitals were classified as rural or urban based on U.S. census designations. Multivariate logistic and linear regression models were used to assess associations between hospital location and outcomes, adjusting for demographic, clinical, and hospital-level factors. …

How To … Coach Problem Representation To Strengthen Diagnostic Reasoning In Trainees, Cody Clary, Adam Cohen, Satid Thammasitboon

Faculty, Staff and Students Publications

Problem representation (PR) is a concise synthesis of clinical information that captures the core diagnostic problem in a single statement, often referred to as a 'one-liner'. Although central to diagnostic reasoning, this skill is frequently underdeveloped in medical training. Many trainees struggle to transform clinical data into meaningful representations, which can hinder communication, diagnostic reasoning and patient safety. The Assessment of Reasoning Tool-Reconstructed (ART-R) provides a structured framework that educators can adapt as a coaching rubric to strengthen PR during clinical teaching. Using the ART-R, faculty can guide trainees to refine their PR by focusing on three elements: (1) clarity …

Association Of Infection Frequency And Incident Clonal Hematopoiesis Of Indeterminant Potential, Ajibike Lapite, Vernon A Burk, James Decuir, Junichi Ishigami, Seyedmohammad Saadatagah, Pradeep Natarajan, Christie M Ballantyne, Elizabeth A Platz, Katherine Y King

Faculty, Staff and Students Publications

Clonal hematopoiesis of indeterminant potential (CHIP) is an age-related phenomenon associated with increased risk of hematologic malignancy. Preclinical studies have shown that infection is a driver of CHIP; clinical studies in people living with HIV suggest a relationship between chronic infection and CHIP, but the association between infection frequency and incident CHIP in the general population remains unknown. We leveraged the atherosclerosis risk in communities study to design a closed prospective cohort study. CHIP was determined based on whole-exome sequencing at 2 time points 20 years apart. Included were 3,367 individuals without cancer or CHIP at time 1 and without …