Digital Commons Network^™

From Algorithm To Alarm: A Narrative Review On Insulin Delivery Innovation, Noor Ul Asaleem, Faraz Arshad, Maria Qadri, Muhammad Saqlain Mushtaq, Mishaim Khan, Pakeeza Shakoor, Tirath Patel, Anaya Noor, Nikhilesh Anand

School of Medicine Publications

Background and objective: The global rise in the incidence of diabetes mellitus necessitates innovative management strategies to mitigate the severity of the disease. The mainstay of diabetes treatment is still insulin therapy, although there are drawbacks, such as the need to maintain ideal glycemic control while lowering the risk of hypoglycemia and user fatigue. The development, clinical usefulness, and constraints of insulin delivery systems are examined in this narrative review, with particular attention to sensor-augmented and closed-loop technologies.

Methods: A thorough electronic database search was conducted to obtain pertinent data on major insulin delivery devices, including sensor-augmented and closed-loop systems. …

Rates Of, Reasons For, And Reactions To Discontinuation Of Glp-1 Receptor Agonists: A Narrative Review, Henry D Heisey, L Parker Gregg, Christopher D Verrico, Dennis T Villareal, Terri L Fletcher

Faculty, Staff and Students Publications

GLP-1RAs are increasingly used for their glucose-lowering and weight-management effects, but many patients discontinue them. In this narrative review we aim to review real-world, quantitative and qualitative GLP-1RA discontinuation, adherence, and persistence evidence as it aligns with an established conceptual framework for understanding medication adherence in noncommunicable chronic disease. Many inconsistencies exist in how discontinuation, adherence, and persistence are studied in this literature. Few qualitative studies have focused on discontinuation of GLP-1RAs. Quantitative approaches often focus on medication-related factors and more superficial aspects of socioeconomic and condition-related factors. Very few studies encompass all 5 dimensions of the medication adherence conceptual …

Diabetter Together: Outcomes Of A Randomized Controlled Trial Evaluating A Peer Mentor Behavioral Intervention For Young Adults With Type 1 Diabetes During The Transfer From Pediatric To Adult Care, Marisa E Hilliard, Charles G Minard, Samantha A Carreon, Wendy L Levy, Sarah K Lyons, Randi Streisand, Tricia S Tang, Siripoom V Mckay, Sridevi Devaraj, Barbara J Anderson

Faculty, Staff and Students Publications

Objective: Transition between pediatric and adult health care is complex, with high risk for loss to follow-up and suboptimal health outcomes for young adults with type 1 diabetes. This trial evaluated the efficacy of DiaBetter Together, a 12-month strengths-based behavioral intervention delivered by trained peer mentors. The intervention aimed to help young adults navigate the transfer process to promote optimal glycemic outcomes, shorten time to adult care follow-up, and improve psychosocial outcomes.

Research design and methods: Using a single-site randomized clinical trial design, we compared the 12-month intervention to usual care among n = 100 young adults aged 17-25 years …

An Evaluation Of Peer Mentoring In A Pre-Veterinary Science Program Within A College Of Forestry And Agriculture, Amy Neal

Electronic Theses and Dissertations

Mentoring is a tool utilized to improve the retention of college students and can serve as an effort to increase their willingness to persist despite challenges. Establishing mentoring relationships amongst first-year students and more-experienced students can create a sense of belonging. Mentorship programs may be developed within a particular major or program. Within this study, an online survey was formed to analyze the perceptions of first-year pre-veterinary students in Fall 2024 and Fall 2025. A peer-mentorship program was implemented amongst pre-veterinary students in Fall 2025. First-year students who completed the survey in Fall 2024 were not mentored. Many of the …

Feasibility And Acceptability Of An Occupation‑Based Telehealth Intervention For Cancer Survivors: A Pilot Randomized Controlled Trial, Bernard A. Muriithi, Milan Bimali, Mario Schootman

Occupational Therapy Faculty Scholarship

Introduction

Cancer survivors frequently experience occupational performance challenges during early survivorship, and telehealth may offer a feasible approach to deliver interventions during this period.

Methods

This pilot randomized controlled trial included 17 adults in the first year following breast or prostate cancer diagnosis, assigned to the ActiveHeal Cancer Program (ACP) or a control group. ACP consisted of six 75‑minute occupation‑focused virtual group sessions and weekly follow‑up telephone calls delivered by occupational therapists over 12 weeks. Control participants attended three brief virtual meetings without therapeutic intervention. Feasibility and acceptability were assessed using validated measures, attendance, and completion rates. The exploratory outcomes …

Parent Emotion Socialization And The Influence On Child Emotion Regulation In A Clinical Sample, Crystal Tracy

All-Inclusive List of Electronic Theses and Dissertations

This study aimed to contribute to existing literature by examining parent emotion socialization (i.e., parent orientation to child emotion) and its influence on child internalizing symptoms. Prior research suggests that parent emotion socialization impacts child emotion regulation and internalizing symptoms; however, there is little research at present focused specifically on the influence of parent orientation to child emotion on child internalizing symptoms through child emotion dysregulation. This study adds to the literature by considering the association between parent orientation to child emotion and internalizing symptoms in a sample of children referred for an ADHD evaluation. Participants included 161 children ages …

Dean's Research Newsletter, August 2026, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

The Joint Effect Of Bilingualism And Sleep On Executive Functions Among Children And Adolescents With Attention Deficit/Hyperactivity Disorder (Adhd), Yirou Jiang

Doctoral Dissertations

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that significantly impacts cognitive and behavioral functions, leading challenges for individuals across the lifespan. While extensive research has been conducted to understand the connection between executive functioning (EF) and ADHD, research findings related to the contributing factors of bilingualism and sleep still remains inconsistent (Bialystok et al., 2017). Investigating the joint effect between bilingualism and sleep on EF among children and adolescents with ADHD may help further clarify the connection between EF, language, and sleep, and facilitate the development of interventions from the perspective of these protective factors. EF encompasses cognitive processes …

Cost-Effectiveness Of Hes V2.0 And Galad For Hepatocellular Carcinoma Surveillance In Patients With Cirrhosis, Mert Sahinkoc, Gizem S Nemutlu, Hashem B El-Serag, Mary Linton B Peters, Ali Hajjar, Anthony E Samir, Leigh Anne Dageforde, Fasiha Kanwal, Jagpreet Chhatwal

Faculty, Staff and Students Publications

Background: Ultrasound-based surveillance for HCC is limited by suboptimal sensitivity and low adherence. Blood-based biomarkers are potential alternatives for routine HCC surveillance. We aimed to define optimal sensitivity, specificity, and cost parameters under which blood-based biomarkers could serve as cost-effective alternatives in patients with cirrhosis.

Methods: We developed a microsimulation model of the natural history of HCC in individuals with compensated cirrhosis. We compared the cost-effectiveness of biannual surveillance using 2 blood-based biomarkers-HES V2.0 and GALAD-versus ultrasound-based surveillance across a range of sensitivity, specificity, test costs, and adherence levels. Outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios …

Decision-Making Criteria In Polygenic Embryo Screening: A Survey Of Reproductive Medicine Physicians, Rémy A Furrer, Aayushi Gandhi, Dorit Barlevy, Shai Carmi, Todd Lencz, Stacey Pereira, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Polygenic embryo screening (PES) examines embryos for their genetic likelihood of developing complex conditions and traits. The commercialization of PES places reproductive endocrinologists and infertility specialists (REIs) as the primary decision-makers in its use, despite professional guidelines cautioning that PES is not ready for clinical use.

Methods: This survey examines how 152 US REIs perceive and approach potential clinical decision-making scenarios regarding the use of PES.

Results: REIs were more likely to offer PES for medical conditions (up to 62% for cancer) than for traits (eg, 0% for skin color, 10% for body mass index). When evaluating 11 potential …

The Relationship Between Depression And Cognitive Proficiency Index Across Biological Sex, Angela N. Ferdinardo

Dissertations

Depression is a widely studied mood disorder, and understanding its effect on cognitive functioning has become an important area of research. While research has examined relationships among depression, working memory, and cognitive deficits, limited research has explored depressive symptoms and cognitive proficiency across biological sex. Depression manifests similarly in men and women, though men are more likely to experience irritability, impulsivity, and anger, while women tend to experience sadness, stress, and sleep disturbances (Johns Hopkins Medicine, 2023). Women are also more likely to seek treatment and cope differently than men. This study examined the relationship between depression and cognitive proficiency …

Physiological, Cognitive, Behavioral, And Perceptual Contributors To Falls Risk Across Middle And Older Adulthood, Jacquelyn Moxey

Rehabilitation Sciences Theses & Dissertations

Falls are multifactorial events influenced by physiological, cognitive, behavioral, and perceptual factors. Although falls prevention research has traditionally focused on older adults and objectively measured physical impairments, less is known about how cognitive performance, physical activity, and perceptions of ability collectively contribute to falls risk vulnerability across middle and older adulthood. This dissertation examined these relationships through three complementary studies.

Study 1 examined associations between cognitive screening performance and physiological falls risk in 315 community-dwelling older adults. Lower global cognitive performance was associated with greater physiological falls risk. Performance on items reflecting attention and visuospatial/executive function demonstrated the strongest domain-level …

Engagement Of Understudied Populations As Community Change: The South Texas Adrc Model, Gladys E. Maestre, Neela K. Patel, Rosa V. Pirela, Robin C. Hilsabeck, Kendra Stine, Neyra García, Roberto Reyes, Omar Oropeza, Cristian Maestre, Jesus D. Melgarejo, Sarah Williams-Blangero, Ney Alliey Rodriguez

School of Medicine Publications

Many populations experiencing the highest burdens of Alzheimer's disease and related dementias remain understudied, in part because traditional recruitment and retention models are insufficient to support sustained engagement. The Outreach, Recruitment, and Engagement Core (OREC) of the South Texas Alzheimer's Disease Research Center reconceptualized participant recruitment as a long-term system change in a Hispanic-majority, urban–rural region. OREC institutionalizes shared power through community advisory governance, aligns research protocols with local lived realities (through patient navigators, community health workers/promotores, and decentralized access points), and employs a data-driven feedback loop for continuous improvement. In 1 year, 46 outreach events touched 10,134 individuals (71% …

Exploring The Experiences Of Women In Mental Health Therapy After The Occurrence Of Perinatal Loss, Courtney Allison Nishnick

Counseling & Human Services Theses & Dissertations

Perinatal loss encompasses losses of pregnancies at any gestational age, as well as deaths occurring within one year post-birth. In the United States, around 40 thousand stillbirths and infant deaths occur every year (Ely & Driscoll, 2025; Gregory et al., 2025), with about 23 million miscarriages also occurring annually worldwide (Quenby et al., 2021). Perinatal loss experiences lead to distressing mental health symptoms not limited to anxiety, depression, posttraumatic stress, and grief (Crockett et al., 2019; Wamser & Ferro, 2025). While there is extensive research on perinatal loss as it pertains to medical context, there is minimal research relating to …

Naturalistic Classroom And Home Practices To Support Executive Function And Self-Regulation Of Typically Developing Preschool Children Between The Ages Of 3-5 Years Old: A Mixed Method Study, Michelle Ann Burek

Rehabilitation Sciences Theses & Dissertations

Executive function (EF) and self-regulation (SR) are foundational developmental processes supporting young children’s participation in play, learning, social relationships, and everyday occupations. Although important to school readiness, social competence, health, and well-being, these skills are often examined in structured settings rather than the natural environments in which children develop. Guided by ecological, developmental, and occupational therapy perspectives, this dissertation examined EF and SR within children’s everyday participation and explored caregiver and teacher roles in supporting these processes.

This dissertation consists of three interconnected studies. The first was a systematic review of peer-based interventions to improve social participation among children and …

Counselors’ Training Needs In Effectively Engaging With Psychedelic-Assisted Therapy, Elif Bor

Counseling & Human Services Theses & Dissertations

As public and scientific interest in psychedelic-assisted therapy (PAT) continues to grow, counselors are increasingly encountering clients who are exploring or engaging in psychedelic use for therapeutic purposes. Such encounters introduce new ethical, clinical, and professional considerations. Counselors must develop an informed understanding of psychedelics and their effects, recognize the emotional and cognitive processes that may emerge during psychedelic experiences, and be prepared to respond to potential risks or adverse reactions (Aicher et al., 2025). They also need to competently answer client questions, assess risk and suitability, facilitate the integration of psychedelic experiences, and collaborate with medical and other professionals …

Strategies Black Male Students With Social Anxiety Use To Persist And Succeed At Rural Community Colleges, Gwendolyn F. Houston

Educational Leadership & Workforce Development Theses & Dissertations

Social anxiety, one of the more common types of anxiety, has been linked to poor concentration, impaired performance, and lower academic achievement (BlackDeer et al., 2021; Derakshan & Eysenck, 2009; Leigh et al., 2021). This study addresses the questions: “How do Black male students with social anxiety at rural community colleges in the Southeastern United States handle both academic and non-academic challenges and cope with these stressors?” and “How do Black male students with social anxiety navigate barriers during their journey at rural community colleges in the Southeastern United States, and what strategies do they use to manage these obstacles?” …

The Impact Of Hypoxia And Androgen Inhibition On Prostate Cancer Cell Dedifferentiation And The Dna Damage Repair Response At Telomeres, Arooba Ayaz

Biomedical Sciences Theses & Dissertations

Long-term Androgen deprivation therapy (ADT) is used to treat Prostate cancer (PCa) but is often met with resistance & the development of Neuroendocrine (NE) PCa which is rarer but more aggressive. Antiandrogens are a part of ADT that work to inhibit androgen receptor in PCa cells. In vitro, PCa cells under long-term antiandrogen treatment become NE-like and adopt stem-like characteristics. The disruption of androgen signaling though the use of antiandrogens impacts many cellular processes that play a major role in cancer cell proliferation such as the DNA damage repair response (DDR) and telomere dysfunction. In vivo, PCa tumors have disorganized …

Faculty Conceptualizations Of Recreational Therapy And Disability: Influences On The Formal, Hidden, And Null Curricula In Undergraduate Recreational Therapy Education, Shelly Lynne Beaver

Human Movement Studies & Special Education Theses & Dissertations

Undergraduate education is a bedrock of professional preparation for entry-level recreational therapists, shaping their scope of practice, philosophical orientations, and approaches to service delivery. While significant attention has been given to the development of a formal recreational therapy curriculum – explicitly taught knowledge, skills, and competencies – little is known about the hidden and null curricula that may implicitly or unintentionally shape students’ professional identities, values, and beliefs. While these less explicit curricular dimensions may have profound effects on how preservice recreational therapists conceptualize both recreational therapy and disability, their impact remains largely unknown. Therefore, the aim of this research …

The Mediating Role Of Hope In The Relationship Between Everyday Discrimination And Depression Among College Students, Busra Vurkun

Counseling & Human Services Theses & Dissertations

Research shows that marginalized populations experience disproportionately higher psychological distress (Budhwani et al., 2015; Bailey et al., 2019). Everyday discrimination, defined as chronic interpersonal mistreatment such as microaggressions and disrespect, is associated with greater depression and lower psychological well-being (Essed, 1991; Calabrese et al., 2015). Although the negative effects of discrimination are well established, less is known about protective factors that may reduce these outcomes. One such factor is hope, conceptualized by Snyder et al. (1991) as agency thinking and pathways thinking and linked to lower depression and greater resilience (Arnau et al., 2007; Banks et al., 2008). This study …

A Cooking Skills Intervention For Long-Term Weight Loss In Young Adults With Intellectual Disabilities: Rationale And Design For A Randomized Trial., Lauren T. Ptomey, Jessica C. Danon, Delwyn Catley, Richard A. Washburn, Amy Bodde, Francisco J. Diaz, Brian C. Helsel, Anna M. Rice, Joseph R. Sherman, Madison Koester, Walker S. Mckinney Ph.D., Joseph E. Donnelly

Manuscripts, Articles, Book Chapters and Other Papers

Young adults with intellectual disability (ID) are an underserved population with a high prevalence of obesity, obesity-related health conditions, and reduced ability to complete instrumental and basic activities of daily living (I/ADLs). After leaving the structured environment of public school, many young adults with ID spend more time at home or in day programs, begin living more independently, or enter the workforce. These transitions may increase reliance on fast or processed foods and reduce opportunities for physical activity, contributing to accelerated weight gain. Previous research has demonstrated clinically meaningful short- and long-term weight loss (18-24 months) in adults with mild-to-moderate …

Impact Of Trisomy 21 On Post Pull-Through Enterocolitis And Bowel Function In Children With Hirschsprung Disease: A Pcplc Analysis., Marshall W. Wallace, Scott S. Short, Rachel C. Crady, Ron W. Reeder, Hira Ahmad, Kelly Austin, Andrea Badillo, Casey M. Calkins, Megan M. Durham, Julie R. Fuchs, Christopher Gayer, Julia E. Grabowski, Jamie C. Harris, Charles R. Hong, Ankur Rana, Rebecca M. Rentea, Nelson Rosen, Payam Saadai, Caitlin A. Smith, K Elizabeth Speck, Cristine S. Velazco, Richard J. Wood, Michael D. Rollins

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: We evaluated whether Trisomy 21 (T21) affected bowel management use, ability to toilet train for stool, and rates of Hirschsprung-Associated Enterocolitis (HAEC) in children with Hirschsprung disease (HD). We hypothesized that T21 would be associated with increased rates of HAEC, bowel management program (BMP) use, and delayed toilet training for stool.

METHODS: Children with HD in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database who underwent primary pull-through were included and stratified by T21 status: HD only versus HD + T21. Children requiring a redo pull-through, initially managed with a stoma, or those who had inadequate follow-up were …

Youth Agricultural Engagement And Its Association With Dietary Diversity, Household Food Insecurity, And Nutritional Status In Southwest Nigeria, Sherif Olasoji

All Graduate Theses and Dissertations, Fall 2023 to Present

Youth remain underserved in nutrition research, policy, and programming despite being an integral part of the food systems. While the nutrition-sensitive agriculture framework has been established, there is limited evidence demonstrating how youth engagement in agriculture can serve as a pathway to improve nutritional outcomes. The study assessed youth agricultural engagement and its association with household dietary diversity, household food insecurity, and nutritional status in southwest Nigeria.

Using a cross-sectional design, data on socio-demographic characteristics, agricultural engagement, dietary diversity, household food insecurity, body mass index, and skin carotenoids were collected from 143 youth aged 15 to 35 from Ekiti, Osun, …

An Examination Of Lifetime Traumatic Brain Injury And Anti-Inflammatory Medication Use In The Risk For Alzheimer's Disease, Mikaela A. Drewel

All Graduate Theses and Dissertations, Fall 2023 to Present

Alzheimer’s disease (AD) is the leading cause of dementia in individuals aged 65 years and older. There are a number of lifestyle and genetic factors that affect one’s risk for AD including traumatic brain injury (TBI), and genes such as those for Apolipoprotein E (APOE) and brain-derived neurotrophic factor (BDNF). This study examined sex differences in how TBI history influences risk for AD, exploring genetic variants suspected to play a role in TBI recovery. Additionally, in following an inflammatory mechanism in TBI, the study also determined if nonsteroidal anti-inflammatory drug (NSAID) use reduced subsequent risk for AD. The study analyzed …

The Effects Of Psychological Stress On Gut Health In Mice Fed Either A Healthy Diet Or The Total Western Diet, David Keenan Thomas Prescott

All Graduate Theses and Dissertations, Fall 2023 to Present

The Total Western Diet (TWD), a rodent diet designed to model the typical American dietary pattern, has been shown to worsen inflammation and colitis severity in mice. Psychological stress has also been associated with increased intestinal inflammation, barrier dysfunction, and alterations to the gut microbiome. The goal of this study was to determine whether combining the TWD with psychological stress would further worsen colitis severity and alter the gut microbiome. To investigate this, mice were fed either a healthy control diet or the TWD and exposed to psychological stress using a social disruption stress model. Colitis was induced using established …

Kindergarten Teachers’ Perceptions, Experiences, And Challenges Using Visual Supports For Children With Autism, Jasmine M. Mcnair

Electronic Theses and Dissertations

This qualitative case study examined kindergarten teachers’ perceptions, experiences, and challenges related to the use of visual supports for students with autism spectrum disorder in East Texas. Grounded in cognitive load theory, the study explored whether visual supports enhance learning outcomes by reducing cognitive overload. Four research questions addressed teachers’ perceptions of effectiveness, implementation challenges, the influence of teacher attitudes, and differences based on teaching experience. The researcher collected data through semistructured interviews with 10 kindergarten inclusion teachers and supplemented by classroom observations. Thematic analysis revealed five primary themes: emotional impact and student growth, visual supports as essential instructional tools, …

Annual Quality And Safety Summit Abstract Booklet 2026, Elizabeth A. Saunders, Amanda Jones, Paulette A. Wehner

Marshall Journal of Medicine

The Annual Quality and Safety Summit is a cornerstone event dedicated to advancing excellence in health care delivery, bringing together a diverse community of health care professionals, educators, researchers, and learners. Each year, the summit serves as a dynamic platform to showcase innovative initiatives, evidence-based practices, and transformative ideas that aim to enhance patient care, improve safety, and drive better system-wide outcomes across the health care continuum.

Jointly sponsored by the Joan C. Edwards School of Medicine and Marshall Health Network, the Summit features abstracts spanning a wide range of topics, including innovative care delivery models, quality improvement strategies, patient …

Professional Identity Changes During The Covid-19 Era Among Pre-Medical College Students: Insights For Medical Educators, William J. Crump, Jordan Harbin, Lauren Trout, Cierra Woodcock, Kristin Wickham, Craig Ziegler

Marshall Journal of Medicine

Abstract

Introduction

Professional identity formation is known to be responsive to outside forces. Previous longitudinal research has shown changes occurred pre-and post-COVID-19 pandemic among medical students. The purpose of this longitudinal study was to assess changes among pre-medical students.

Methods

With a 100% response rate, 85 Career Eulogies (CE) from 2015 through 2025 recorded a free text response to the prompt: "Imagine that you are ready to retire from medicine in the distant future. In about 50 words, write a short speech outlining what you would like to be said about you at the retirement ceremony."  The responses were coded …

Rare Case Of Subcutaneous Panniculitis-Like T-Cell Lymphoma In A Pediatric Patient, Jasmine Kaur, Omar Abdelaal, Ammar Masood, Aaron Mcguffin, Kathleen Martin

Marshall Journal of Medicine

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of primary cutaneous T-cell lymphoma that has clinical overlap with common benign conditions, thus making diagnosis challenging. SPTCL primarily affects younger adults with a female predominance. Pediatric cases are exceedingly rare and often misdiagnosed as bacterial infections, delaying proper clinical diagnosis and treatment.

In this case study, we report on a 9-year-old female who initially presented to an urgent care clinic with two weeks of an itchy, painful nodule on her right buttock and thigh. The nodule was initially misidentified as a skin abscess, and the patient was prescribed sulfamethoxazole/trimethoprim. The …

The Impact Of Enhanced Pediatric Asthma Simulation Prebriefing On Perceived Psychological Safety In Associate Degree Nursing Students, Amy G. Burtram

Theses

Background: Simulation is a core teaching strategy in nursing education, yet student anxiety may negatively impact learning outcomes. Psychological safety has been identified as a critical factor in effective simulation-based student learning.

Purpose: The purpose of this project was to examine whether an enhanced simulation prebrief improved perceived psychological safety among second-semester associate degree nursing students during a high-fidelity pediatric asthma scenario at a rural community college in Alabama.

Methods: A quasi-experimental one-group pretest–posttest design evaluated changes in psychological safety following a structured, evidence-based prebrief grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards …