Digital Commons Network^™

Hyperadhesive Von Willebrand Factor Contributes To Pathogenesis Of Preeclampsia, Yajuan Wang, Chenyu Wang, Katie L Houck, Xiaoli Gao, Yuanyuan Chen, Xin Xu, Xue Zhao, Miguel A Cruz, Shu Zhang, Chester Q Li, Fengxia Xue, Min Li, Swati Shree, Jing-Fei Dong, Cha Han

Children’s Nutrition Research Center Staff Publications

Background: Preeclampsia is the most common complication of pregnancy, significantly affecting maternal and fetal health, and is characterized by placental and systemic endotheliopathy. Patients with preeclampsia have elevated levels of VWF (von Willebrand Factor), which is associated with poor clinical outcomes. However, whether VWF serves as a marker for endotheliopathy or contributes to the pathogenesis of preeclampsia remains poorly understood.

Methods: We investigated the role of hyperadhesive VWF in the development of preeclampsia by studying patients, evaluating mouse models, and performing in vitro experiments.

Results: We show that patients develop VWF- and fibrin-rich thrombosis in the placenta and have significantly …

Bridging Models And Real-World Performance: Capturing Represented, Hidden, And Unrepresented Dynamics In Complex Systems, Dixizi Liu

All Dissertations

Complex systems often depend on adaptive performance that is difficult to capture using structured data or formal models alone. This dissertation asks how predictive modeling, coordination-cost measurement, and simulation can be integrated to better represent the visible, hidden, and unrepresented dynamics that shape real-world system performance.

Sterile Processing Departments (SPDs) provide the empirical context for this work because they support safe and timely surgical care while operating under high workload variability, time pressure, and tight coordination with operating rooms. Hospitals rely on SPDs to clean, assemble, sterilize, and deliver surgical instrument trays so surgeries can start on time and proceed …

Essays On Opioid Prescription Limit Policy Diffusion, Evaluation, And Opioid Use Disorder Treatment Utilization, Md Ashiqur Rab

All Dissertations

The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive …

The Rpm-1/Phr Signaling Hub Modulates Tau-Induced Neurodegeneration Through Regulation Of Microtubule Stability And Mapk Pathways In C. Elegans, Xinxing Ding

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's disease and frontotemporal dementia, are characterized by the accumulation of pathological tau proteins and progressive neuronal loss. Although research regarding tau-mediated toxicity is extensive, the specific pathology that determine whether neurons maintain homeostasis or succumb to collapse under tau-induced stress remain incompletely elucidated. A central, yet still insufficiently understood, feature of these diseases is the disruption of the microtubule (MT) cytoskeleton . The PHR protein family is evolutionarily highly conserved; within this family, RPM-1 in C. elegans functions as an intracellular signaling hub that regulates axon development, synapse formation, axon termination, and various microtubule-associated processes. This …

Regulation Of Müllerian Duct Mesenchyme Transcription During Mammalian Sex Differentiation, Haowen Li, Richard R Behringer, Rachel D Mullen

Dissertations and Theses (Open Access)

Sp7/Osterix (Osx) encodes a zinc-finger transcription factor of the Specificity-protein family discovered by Nakashima et al. at the MD Anderson Cancer Center. While primarily recognized for its role in osteogenesis, Osx has also been implicated in mammalian reproductive development, particularly in male sex differentiation, where Müllerian Duct (MD) regression occurs, mediated by anti-Müllerian hormone (AMH) signaling. AMH-induced regression signals are transduced by the mesenchymal tissue surrounding the ductal structure, known as the Müllerian Duct mesenchyme (MDM). It was discovered that AMH signaling is necessary and sufficient for driving Osx expression in MDM. A previous transgenic mouse reporter …

Exploring The Impacts Of Research Including Zealous Genz-Ers (Rizz), Afraah Hawa, Andrea Bradley-Ewing Mpa, Ma, Kimberly A. Randell, Md, Msc, Yesenia Montoya, Karynn E. Glover

Posters

No abstract provided.

Advancing Health Equity In Global Oncology: A Collaborative Academic-Cancer Society-Industry Program To Address Health Disparities In Sub-Saharan Africa, Kenneth Merrell, Ben Kamdem-Talom, Hannah Anie, Christine Wekesa, Nomsa Tsikai, Miriam Mutebi, Rakiya Saidu, Nwamaka Lasebikan, Adamu Bojude, Randiak Alaro

General Surgery, East Africa

Purpose Cancer care capacity in sub-Saharan Africa (SSA) is constrained by late diagnosis and limited treatment access. Few funding mechanisms support innovative, locally led programs to address these challenges. A collaborative initiative was developed to strengthen oncology care through quality improvement (QI) projects.

Materials and Methods The program was developed by Global Bridges Oncology (GBO) at Mayo Clinic, Pfizer Global Medical Grants, and the African Organisation for Research and Training in Cancer. A committee composed primarily of African oncology experts guided the process. An RFP was disseminated across SSA in English, French, and Portuguese, inviting applications to improve diagnostic and …

Enhanced Communication Is Fundamental In Providing Quality Care, Jacqueline Turcotte Rn, Msn, Ccrn

MaineHealth Maine Medical Center

No abstract provided.

Computable Phenotypes For Research Using Real-World Data: Experiences From The Nih Pragmatic Trials Collaboratory, Marisa L Conte, Judith M Schlaeger, Guilherme Del Fiol, James R Campbell, Andrea L Cheville, Keith Marsolo, Kari A Stephens, Miriam O Ezenwa, Andrew D Boyd, Juanita E Darby, Nadine S Matthie, P Michael Ho, Alice Pressman, Morgan Justice, Carol Reynolds Geary, Keturah R Faurot, Alex Fist, Karen Staman, Hulin Wu, Rachel L Richesson

Faculty, Staff and Student Publications

Objectives: Embedded pragmatic clinical trials (ePCTs) are conducted as part of routine clinical care and therefore use data collected from real-world data sources, such as electronic health record systems and administrative claims. A common approach for using these types of data across all phases of trial conduct is to create a computable phenotype (an explicitly defined data query data, including specified data types, data codes, and logical parameters) to capture patients with a clinical condition, exposure, symptom, characteristic, treatment, or outcome of interest.

Materials and methods: The Electronic Health Record (EHR) Core Working Group of the NIH Pragmatic Trials Collaboratory …

Fuimos Olvidados Y Descuidados [Forgotten And Neglected]: Lessons Learned And Findings From On-Farm Covid-19 Education And Vaccine Clinics For Agricultural Workers And Their Multigenerational Families In Texas, Anabel Rodriguez, David I Douphrate, Ana L Pineda Reyes, Susana Zavala, Lus Chavez, Sofia Nicole Lopez, Andrea V Cabrera Cruz, Annie J Keeney, Nora Hernandez, Brenda Berumen-Flucker, Eva M Shipp, Matthew W Nonnenmann, Shannon P Guillot-Wright, Bethany Boggess Alcauter, G Lopez Ixta, Paula M Cuccaro, Higinio Fernandez-Sanchez, David Gimeno Ruiz De Porras

Faculty, Staff and Student Publications

Background: Despite being deemed essential non-healthcare workers, agricultural workers were excluded from COVID-19 vaccine prioritization in Texas. This professional practice report describes the multifaceted worker health and safety approaches to protecting agricultural workers and their families during the COVID-19 pandemic.

Methods: Between March 2020 and January 2025, several outreach, education, and training grants from various funding agencies were leveraged to deliver training, personal protective equipment, vaccines, and economic relief to agricultural workers in partnership with community-based organizations, industry, local public health departments, and academic institutions.

Findings: Timely funding efforts led to the distribution of 1,000 PPE kits, with more than …

Emergency Medical Services Mental Health: Causes Of Providers Leaving The Industry, Brian C. Selke

Graduate Theses and Dissertations (2019 - present)

Employee resilience and mental health have become critical concerns in Emergency Medical Services (EMS) as workforce shortages increasingly threaten staffing stability and patient care. National Registry of Emergency Medical Technicians (NREMT) data indicates that more than 30% of eligible EMS providers did not recertify between 2020 and 2023, raising concerns about workforce sustainability. This study examines EMS providers’ intentions to leave the profession and identifies workplace factors associated with turnover. A statewide survey of more than 1,200 licensed EMS providers in Alabama was analyzed using regression techniques to evaluate the relationship between workplace conditions and turnover intentions. Results demonstrate that …

"I Can See Where This Is Taking Me": Medical Students' Perceptions Of Humanities Courses At Aga Khan University, Kenya, Catherine Gathu, Marthaclaire Zammit, Urvi Saboo, Robert Opoka

Family Medicine, East Africa

Background Humanities courses in medical training are increasingly recognized as essential for developing empathetic, reflective and socially responsive physicians. Although well-established globally, their integration into medical education in African contexts remains limited. In Kenya, humanities are often peripheral within curricula dominated by biomedical sciences and clinical medicine. Aga Khan University (AKU), Nairobi, has introduced a novel medical curriculum that embeds seven core humanities courses as central components of the initial phase of its MBChB program. This study explored students’ perceptions and lived experiences of these humanities courses.

Methods A retrospective descriptive study using an embedded mixed-methods design was conducted among …

The Effects Of Education And Training On Clinical Staff’S Knowledge, Perception, And Clinical Practice Of The Medication Reconciliation Process, Stephanie A. Williams

Doctor of Nursing Practice Projects

Medication-related harm affects approximately one in 30 patients in healthcare settings. Accurate medication reconciliation (MedRec) is essential for identifying medication discrepancies, preventing medication errors, and reducing adverse drug events. Clinical staff play a critical role in ensuring the accuracy of medication lists in primary care settings.

This evidence-based quality improvement project evaluated the effect of a structured MedRec training intervention on MedRec knowledge, perceptions, and practices among clinical staff in a primary care clinic in Southeast Texas. The project used a single-group, quantitative, quasi-experimental design. A convenience sample of 32 clinical staff members completed knowledge and perception assessments before and …

A Culturally Responsive Sexual Health Education Framework For Community Clinics In The Inland Empire, Lilianna Mora Ledezma

Electronic Theses, Projects, and Dissertations

Sexually transmitted infections (STIs) continue to disproportionately affect underserved communities, where barriers such as limited healthcare access, stigma, healthcare anxiety, medical mistrust, and language differences may discourage individuals from seeking routine screening and timely treatment. This project examined current public health literature, surveillance data, and federal guidance to identify evidence-based strategies that community clinics can implement to improve patient engagement in sexual health services. The findings demonstrated that effective STI prevention extends beyond testing alone and is strengthened through culturally responsive care, stigma reduction, patient-centered communication, standardized clinic workflows, and effective patient navigation. As a result, this project developed a …

The Effect Of Telehealth Expansion On The Health Equity Of Underserved Populations, Mansi B. Satani

Electronic Theses, Projects, and Dissertations

The rapid expansion of telehealth, during and after the COVID-19 pandemic, has changed healthcare delivery in the United States. The use of telehealth can potentially decrease disparities related to isolation, shortage of providers and barriers to transportation, however, its impact on health equity in underserved populations is unknown. This paper explores how telehealth expansion impacts rural populations' access to healthcare, health outcomes, and equity. It also examines its impact on populations with low income, racial, ethnic minorities, and Medicaid recipients who frequently encounter obstacles to healthcare and digital access (Nouri et al., 2020; Shah et al., 2024). A mixed-method design …

How Establishing "Duration Of Treatment" Guidelines Shortens Workers' Compensation Cases, Annette Marie Smith M.D.

Electronic Theses, Projects, and Dissertations

Jobs provide financial security for individual workers and their families in the community until a worker gets hurt on the job, and then things are up in the air until their workers’ compensation claim is approved. It is a well-known fact within the workers compensation literature that one third of all workers’ compensation (WC) claims are “low back sprains and strains” which are the leading cause of global disability (Ummey, 2023). This project proposed to explore the relationship of x-ray and MRI result interpretations by the physician and standardize the duration of treatment with a physical therapist and new concept …

Hope Kit Program, Monica Reuber

Capstone Experience: Master of Public Health

Suicide is a leading cause of death in adolescents and young adults, with a disproportionate burden of those deaths in rural areas such as Kansas. High rates of depressive symptoms, suicidal thoughts, and suicidal attempts, combined with a shortage of mental health providers, emphasize the need for community-based intervention.

This capstone is designed to develop a plan for Hope Kits, a proposed suicide prevention program, among youth in grades 7-12 in Sheridan County, Kansas to improve coping skills, promote help-seeking behavior, and reduce suicide risks.

A logic model guides the program development, which aligns with available literature and Social Cognitive …

Food Insecurity And Parent Engagement In Pediatric Therapy: A Comparative Study Of Feeding, Speech-Language, And Combined Services, Kendra Kendra Rosales

Open Access Theses & Dissertations

Pediatric feeding disorders and food insecurity represent two compounding challenges for families navigating pediatric therapy services, yet their intersection has received little empirical attention. This study examined food insecurity rates across three pediatric therapy groups and explored the relationship between food insecurity and parent engagement in therapy. A cross-sectional online survey was administered to 175 caregivers of children actively receiving feeding therapy only (n = 34), speech-language therapy only (n = 93), or combined feeding and speech-language therapy (n = 48). Food insecurity was assessed using the USDA Household Food Security Survey Module: Six-Item Short Form, and parent engagement was …

Behavioral And Dietary Associations Of Vitamin D Deficiency Among Landscaping Workers: An Analytical Cross-Sectional Study In El Paso, Texas., Cristela Anahi Avila

Open Access Theses & Dissertations

Background: Vitamin D deficiency is a persistent public health concern, even among outdoor workers who receive substantial sunlight exposure. Landscaping workers may still be at risk because sun-protective clothing, early work hours, behavioral practices, and low dietary intake can reduce effective vitamin D synthesis. Purpose: This pilot study examined dietary vitamin D intake, sun exposure behaviors, and serum 25-hydroxyvitamin D status among male landscaping workers in El Paso, Texas, to identify behavioral and nutritional factors associated with deficiency. Methods: Twenty participants completed a culturally adapted food frequency questionnaire and behavioral assessment and underwent capillary point-of-care testing for serum 25(OH)D. Descriptive …

Mda At Your Service: Updating Your Practice Roster With The Mda, Mda Membership Department Staff

The Journal of the Michigan Dental Association

This question-and-answer article provides practical guidance for MDA members on updating practice rosters, accessing continuing education opportunities, addressing staffing shortages through virtual assistants, and participating in the MDA LEAD Program. The article highlights available member resources and emphasizes professional development, workforce support, and leadership growth within organized dentistry.

The Power Of The Tripartite: Defending Fluoridation Together, Sarah Stuefen Dds

The Journal of the Michigan Dental Association

This article describes a successful grassroots effort to preserve community water fluoridation in Vinton, Iowa. The author details how local dental professionals, state dental associations, the American Dental Association, public health experts, and community stakeholders collaborated to educate decision makers and advocate for evidence-based public health policy. The experience demonstrates the importance of coordinated advocacy and organized dentistry in protecting oral health initiatives.

Exploring Public Perceptions Of Genetic Risk In Substance Use Disorders, Brooke A. Goodenow

All Dissertations

This dissertation examines genetic risk perception, with specific emphasis on substance use disorders (SUDs), through a collection of three manuscripts. The dissertation examines genetic risk perception for hereditary diseases in existing literature, describes a methodological framework for capturing genetic risk perception across social media discourse, and identifies themes and emotional tone associated with genetic risk perception for SUDs across two major social media platforms (X and Reddit).

Combined, these three manuscripts expand and support previous findings about genetic risk perception and its role in shaping health beliefs and associated behaviors. The dissertation findings reveal numerous similarities in genetic risk perception …

Balancing War And Peace In Taekwondo Athlete Development: A Multi-Criteria Coaching Decision Support Framework Using Leadership Scale For Sports And Fuzzy Ahp, King Harold A. Recto, Hazel Jade L. Antonio, Jhyrald Anthony P. Dalida

Electronics, Computer, and Communications Engineering Faculty Publications

Coaching effectiveness is frequently evaluated through competitive outcomes, with the assumption that coaching behaviors directly influence athlete performance. This study examined the relationship between perceived coaching behaviors and individual win percentage among collegiate Taekwondo athletes using the Leadership Scale for Sports (LSS). Descriptive statistics, correlation analysis, and regression analysis were conducted across five coaching dimensions: Training and Instruction, Democratic Behavior, Autocratic Behavior, Social Support, and Positive Feedback. Results showed that none of the coaching dimensions demonstrated a statistically significant relationship with win percentage. Although coaching behaviors did not significantly predict win percentage, the findings suggest that athlete development is shaped …

The Effect Of Cerebellar Transcranial Direct Current Stimulation On Anxiety, Shivangi Bhardwaj

All-Inclusive List of Electronic Theses and Dissertations

Anxiety is one of the most prevalent mental health disorders in the U.S. Individuals of all ages are affected by anxiety. Therefore, research into anxiety and its potential treatment has constantly been an area of interest. Newer approaches to managing anxiety include non-invasive stimulation techniques, such as Transcranial Direct Current Stimulation (tDCS), because of its accessibility and effectiveness. Past tDCS work typically focused on regions in the frontal lobe. However, tDCS over the cerebellum has not received as much attention compared to the cerebrum, despite recent work demonstrating cerebellar involvement in emotion processing. Thus, a better understanding of how cerebellar …

A Longitudinal Analysis Of Hospital Consumer Evaluation In Virginia, Tulay Akmandor Inac

Health Services Research Dissertations

Suboptimal patient experience signals a need to improve clinical efficacy, patient safety, and healthcare quality. The COVID-19 pandemic intensified hospital resource and staffing demands, reducing hospitals’ capacity to invest in patient experience improvement. Prior studies remain limited because many lack longitudinal structure and organized theoretical models, making temporal inference difficult and weakening analyses of patient experience disparities. To address these limitations, this dissertation incorporates three studies examining patient experience and pandemic-related effects.

In state-level markets comparable to Virginia, limited research has examined longitudinal patient experience trends across regional hospital systems using HCAHPS scores. The first study uses descriptive trend analysis …

A Qualitative Case Study Of Leadership Development In A Graduate Medical Laboratory Science Program, Demetra Castillo

EVMS School of Health Professions Theses & Dissertations

Leadership development is increasingly recognized as an essential component of healthcare education, particularly as medical laboratory professionals assume expanded responsibilities involving collaboration, decision-making, systems thinking, and organizational leadership. Despite this need, limited research has explored how leadership develops within graduate medical laboratory science (MLS) programs. This qualitative case study examined leadership development through the lens of Experiential Learning Theory (ELT). Two research questions explored how the program fostered leadership development through students’ professional biographies, leadership questionnaires, final reflection papers, and leadership credos and how leadership reflections demonstrated growth over time. Secondary data from five student cases were analyzed using deductive …

Early-Onset Colorectal Cancer With Liver-Only Metastases: A Retrospective Cohort Study Integrating Prospectively Collected Real-World Clinical And Molecular Data From An Australian National Database (2009–2024) To Guide Treatment Planning, Savio G. Barreto, Christos S. Karapetis, Shahid Ullah, Matthew Burge, Susan Caird, Angus Campbell, Azim Jalali, Ross Jennens, Muhammad A. Khattak, Belinda Lee, Stephanie H. Lim, Shehara Mendis, Louise Nott, Timothy J. Price, Jeremy D. Shapiro, Jeanne Tie, Javier Torres, Colin Williams, Rachel Wong, Vanessa Wong, Peter Gibbs

Research outputs 2022 to 2026

Objective: To leverage the Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) registry (an Australian cancer database) to explore the ideal timing and sequence of therapies and the factors influencing these decisions in colorectal cancer (CRC) patients with liver-only metastases to inform contemporary decision-making and future trials.

Study Type: Retrospective registry-based cohort study using the TRACC registry.

Setting and Participants: Consecutive patients with liver-only metastatic CRC enrolled in the TRACC registry.

Main Outcome Measures: To explore cancer biology, intended treatment at presentation, actual treatment received and the resultant outcomes for early-onset CRC (EOCRC) (≤ 50 years) and late-onset CRC (LOCRC) …

Gut Microbiome Changes In Preclinical Alzheimer’S Disease, D. M. Sithara Dissanayaka, Stephanie R. Rainey-Smith, Hamid R. Sohrabi, Thilini N. Jayasinghe, Vincent Ho, Vijay Jayasena, Kevin Taddei, Colin L. Masters, Ralph N. Martins, W. M.A.D.Binosha Fernando

Research outputs 2022 to 2026

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that develops many years before clinical symptoms appear. The biological changes involved in the earliest stages remain poorly understood, particularly during the preclinical stage. Our previous work has identified gradual gut microbial and metabolic changes during this stage, suggesting these may represent early biological shifts that precede disease progression. Recent studies suggest that the gut microbiome may contribute to early AD processes through its effects on immune regulation, metabolism, and gut–brain communication. Changes in gut microbial composition, including reduced levels of short-chain fatty acid (SCFA)-producing bacteria, such as Faecalibacterium, Roseburia, and Eubacterium, …

The Future Midwife: A Prisma Scoping Review Of Education, Transition, And Work Readiness Among Midwifery Students, Danielle Gleeson, Tracey Tulleners, Jessica Elliott, Dianne Stratton-Maher, Liz Ryan, Jillian Mcculloch, Geraldine Roderick, Thenuja Jayasinghe, Joanne Buckley, Jamie May Newman, Helen Nutter, Jo Southern, Lisa Beccaria, Georgina Sheridan, Tess Trinder, Haiying Wang, Tao Wang, Sita Sharma, Linda Ng, Jing Yu Tan, Daniel Terry

Research outputs 2022 to 2026

Background: Preparing midwifery graduates to be confident, competent, and resilient is essential for workforce sustainability, yet students report a disconnect between academic preparation and clinical realities. Increasing care complexity, workforce shortages, and variable clinical learning environments globally highlight the need to examine how educational strategies support effective transition to practice. Objective: To map and synthesise the evidence regarding educational approaches, learning experiences, and transition-to-practice factors that influence preparedness for professional practice among midwifery students, and to identify gaps in the existing literature to inform a coherent and future-ready educational framework.

Methods: A PRISMA-ScR-guided scoping review was conducted across seven databases. …

Yorga Moorditj Koort: Aboriginal And Torres Strait Islander Women’S Perspectives About Heart Health On Noongar Boodjar, Elia Bidgood, Cathy Garlett, Richard Chenhall, Amie Bingham, Francine Eades, Emily Banks, Melinda J. Carrington, Grace Joshy, Sandra Eades, Tabassum Rahman

Research outputs 2022 to 2026

In Australia, despite overall declines in cardiovascular disease (CVD)-related mortality, Aboriginal and Torres Strait Islander women develop heart disease earlier and experience more than twice the rate of related morbidity and mortality compared with non-Indigenous women. This study explores Aboriginal women’s understandings of the factors that shape their heart health and lived experiences of CVD. We spoke with 28 Aboriginal women aged ≥18 years—15 semistructured interviews and two yarning circles with an additional 13 Aboriginal women—with/without pre-existing CVD, and 10 healthcare professionals (HCPs) working with Aboriginal communities in the Perth metropolitan region, between May 2024 and April 2025. Data were …