Digital Commons Network^™

Impact Of Prematurity On Nutrient Signaling And Protein Synthesis In Skeletal Muscle, Antonio C Ramos Dos Santos, Ki Beom Jang, Marta L Fiorotto, Teresa A Davis

Faculty, Staff and Students Publications

Preterm birth disrupts nutrient-responsive signaling pathways critical for skeletal muscle growth and long-term metabolic health. Despite improvements in neonatal care, preterm infants often experience postnatal growth failure marked by impaired lean mass accretion. This review examines how prematurity intrinsically alters insulin and amino acid signaling to mechanistic target of rapamycin complex 1 (mTORC1), a central regulator of translation initiation and protein synthesis. Evidence from translational models reveals blunted activation of mTORC1 and its downstream effectors, independent of birth weight or comorbidities. Defects in insulin-PDK1/mTORC2-Akt signaling and amino acid sensing, particularly leucine sensing, contribute to impaired mTORC1-dependent translation initiation and reduced …

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 …

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 …

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, …

Quantitative Imaging Of Pyruvate Metabolism In A Patient With Anaplastic Thyroid Cancer, James A Bankson, Joshua S Niedzielski, Collin J Harlan, Yunyun Chen, Christopher M Walker, Philip L Lorenzi, Lin Tan, Vikas Kundra, Matthew E Merritt, Mukundan Ragavan, Dawid Schellingerhout, Renjie He, Yao Ding, Sahana Datar, Qing Wang, Christine B Peterson, Clifton D Fuller, Vlad C Sandulache, Stephen Y Lai

Faculty, Staff and Students Publications

Purpose: Magnetic resonance imaging using hyperpolarized (HP) [1-13C]-pyruvate enables assessment of pyruvate metabolism in vivo and offers new insight into metabolic changes in response to cancer therapy. Widely used semi-quantitative metrics of pyruvate metabolism can be affected by physiological factors that are extrinsic to intracellular metabolism. A validated pharmacokinetic (PK) model for analysis of intracellular pyruvate metabolism is needed to enhance the accuracy of quantitative metrics and clinical translation of metabolic MRI using HP pyruvate.

Methods: A PK model with two physical compartments and two chemical pools was developed to analyze the conversion of labeled pyruvate into lactate in vitro. …

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 …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

Seeing The Unspoken: A Pilot Eye-Tracking Study Of Moral Injury Among Veterans, Eva M. Valdez

Dissertations

This pilot study examined associations between self-reported moral distress, state distress, combat exposure, deployment history, and maximum pupil reactivity among veterans diagnosed with PTSD. Participants viewed neutral and morally relevant images while pupil responses were recorded using eye-tracking technology. Self-report measures included moral distress severity, exposure to potentially morally injurious events, Subjective Units of Distress Scale (SUDS) ratings, total deployments, number of combat deployments, and Combat Exposure Scale scores. Maximum pupil reactivity was calculated by subtracting the mean z-scored maximum pupil response during neutral image presentations from the mean z-scored maximum pupil response during morally relevant image presentations. This variable …

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 …

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?” …

Computational And Ai Tools For Understanding Telomere-Associated Cancer Mechanisms, Eleni Adam

Computer Science Theses & Dissertations

Telomeres are the protective caps of the human chromosomes and are critical for genome stability. Dysfunctional telomeres caused by their erosion with age and cell proliferation as well as by defects in their maintenance is a major early event leading to genome changes and cancer. Subtelomeres possess the critical role of regulating adjacent telomeres. Due to their complex repeat structure and high variance from one person to another, these areas have not been analyzed in detail. We present a set of computational and machine learning tools to aid in the understanding of subtelomere structure and its rearrangements in cancer.

Initially, …

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 Association Between Prenatal Nicotine Exposure And Postpartum Depression, Reem Ali Sharaf-Alddin

Health Services Research Dissertations

Postpartum Depression (PPD) is the most common mental health complication of childbirth with 17% of women globally and 13% in the US experience PPD. The pathophysiology of PPD is not yet fully understood, with psycho-social, biological, and environmental factors, interplaying together and predisposing to PPD. One key modifiable risk factor is prenatal exposure to nicotine (PEN) including Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), and Electronic Nicotine Products (ENPs). Several studies investigated the association between prenatal ATS or SHS and PPD, however the findings were inconclusive. There is a lack of studies that assessed the overall PEN, and none of …

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 …

Pavlovian Conditioning And Self-Control: From Laboratory To Classroom Application, Saba Mahmoudi

All Graduate Theses and Dissertations, Fall 2023 to Present

Impulsive choice, the preference for a smaller-sooner reward (SSR) over a larger-later reward (LLR), is associated with various challenging behaviors (e.g., gambling and substance-used disorders). Many interventions can reduce impulsive choice but those that produce long-lasting effects typically require long training durations or are difficult to implement in applied settings. This dissertation evaluated a novel Pavlovian training approach designed to promote self-control. In Experiment 1, procedures from Mahmoudi and Madden (2024) were replicated in the laboratory with the addition of a truly random control group. The study also assessed whether presenting the conditioned stimulus (CS) before a choice would increase …

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 …

Formulation And Analysis Of Physiochemical And Sensory Properties Of Ready-To-Mix Whey Protein Phospholipid Concentrate Beverage, Chris Jaquin

All Graduate Theses and Dissertations, Fall 2023 to Present

Whey protein phospholipid concentrate (WPPC) is commonly recovered as a coproduct in filtration process whose aim is to obtain whey protein isolate (WPI) from whey protein concentrate (WPC). Whey protein phospholipid concentrate is high in milk fat globule membrane (MFGM), which has been shown in rodent and human studies to have a variety of physiological benefits, including an increase in exercise capacity. Whey protein phospholipid concentrate is currently considered as an underused dairy coproduct, with most of it either being disposed of or used as animal feed. This research consisted of incorporating WPPC in a protein shake–like beverage at a …

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 …

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 …

Ethics Under Siege: The Conflict In Tigray Through The Lens Of Just War Theory, Daniela Widya Purba

Journal of Strategic and Global Studies

This research article explains the ethical principles of the conflict in Tigray based on the Just War Theory. By using the descriptive qualitative methodology, this research article draws data from secondary sources which includes; academic journals, news reports, as well as international legal instruments to analyze the moral trajectory of the conflict. This research begins with jus ad bellum, to assess Ethiopia’s government justification in declaring conflict within Tigray. While the government fulfilled the criteria of just cause and legitimate authority, the question stands on the ambiguous political intentions and the failure to enact peaceful alternatives before resulting in waging …

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

Evaluating Machine Learning Models On Classification Of Novel Cyber Attacks In The Healthcare Domain, Promise Ehimen

Dissertations, Theses, and Projects

The increasing adoption of the Internet of Medical Things (IoMT) has improved healthcare delivery through connected medical devices while simultaneously expanding the cybersecurity risks facing healthcare organizations. Although machine learning based intrusion detection systems have demonstrated high detection accuracy, their ability to respond reliably to previously unseen cyberattacks remains uncertain. This study investigated how a Neural Network model and a Logistic Regression model classified novel cyberattacks within the IoMT environment. The Neural Network and Logistic Regression models were both trained and tested using a subset of the CICIoMT2024 benchmark dataset. The Neural Network achieved 99.82% test accuracy and a 0.94 …

The Effects Of Jasmine And Champaca Aromatherapy Combined With Acupressure On Sleep Quality In Older Adults With Non-Communicable Diseases: A Quasi-Experimental Study In Rural Northern Thailand, Sriwan Chutithamniti, Katekaew Seangpraw, Prapaporn Tulwattanakul, Manuchet Manotham, Parichat Ong-Artborirak, Nestor Asiamah, Wannita Sakulwattana, Surangkana Chairinkam, Phatcharee Pimalram, Wichida Larsomsri

Journal of Health Research

Background: Poor sleep is common among older adults and negatively affects physical and mental health. This study evaluated the effects of jasmine and champaca essential oil aromatherapy combined with acupressure on sleep quality and cardiovascular parameters among older adults.

Methods: A quasi-experimental study was conducted in rural Phayao, Thailand. Older adults aged ≥60 years with non-communicable diseases and poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] > 5) were assigned to either an intervention group (n = 54), receiving aromatherapy and acupressure for 6 weeks, or a control group (n = 54), receiving usual care. Sleep quality, blood pressure (BP), and …

Public Responses About Air Quality In The World’S Ten Most Populous Countries, Noah Lim, Alessandro Del Ponte, Lina Ang, Wei Jie Seow

Political Science Faculty Articles and Research

Understanding how people view and react to outdoor air quality is crucial to effectively managing and responding to air pollution, which is a major threat to global public health. Using a quota sample of 10,618 respondents from 1,372 localities across the world’s ten most populous countries (Bangladesh, Brazil, China, Indonesia, India, Mexico, Nigeria, Pakistan, Russia, and the United States), we assessed the association between exposure to fine particulate matter with diameter ≤ 2.5 micrometers (PM2.5) and people’s knowledge, attitudes, perceptions, practices, and concern about air quality. Overall, we find an inverse association between air pollution exposure and knowledge about air …

Knowledge, Attitudes, And Practices By Women In Cartagena Regarding Breast Self-Examination, Rafael Arnedo Martínez, Keidis Ruidiaz Gómez

Jurnal Keperawatan Indonesia

Breast self-examination (BSE), especially when adopted by vulnerable populations, serves as a vital mechanism for the timely detection of breast abnormalities indicative of cancer. As a result, this decreases the public health burden associated with treatment at advanced stages. Therefore, assessing knowledge, attitudes, and practices (KAP) regarding this simple early detection method is a priority. This study examines the relationship between KAP concerning BSE among women in Cartagena, Colombia. A cross-sectional correlational study was conducted with 322 women attending a healthcare facility. Data were gathered using two tools: a sociodemographic profile and a KAP questionnaire. Results showed that most participants …

Development Of Perineal Electric Massager Experience (Pem-X) To Improve Perineal Elasticity, Suryani Manurung, Amalia Mely, Yetty Mariani Tambun

Jurnal Keperawatan Indonesia

Perineal injury remains a common concern in vaginal childbirth, with a prevalence of 30.6%. Low maternal perineal massage practice is a contributing factor to decreased perineal elasticity and an increased risk of perineal trauma. This pilot study aimed to develop the Perineal Electric Massager Experience (PEM-X) to support mothers in self-guided perineal massage. The research employed a level 4 Research and Development (R&D) method with a one-group pretestposttest design. The study sample consisted of two parts: the PEM-X prototype and postpartum mothers who had vaginal deliveries. A purposive sampling technique was used to recruit 10 postpartum mothers who had vaginal …

Supportive And Palliative Care: Addressing The Unspoken Burden Of Cancer On Significant Others, Esmeraldo C. De Las Armas Iv

Jurnal Keperawatan Indonesia

A diagnosis such as cancer can cast a long-lasting gloom that affects not only the patient but also their loved ones. This concept analysis represents an effort to understand and explore the nuanced world of supportive and palliative care for significant others of cancer patients, a population that has often been overlooked. Rodgers’ evolutionary model of concept analysis was utilized to examine the concept of supportive and palliative care for significant others of cancer patients. Positive outcomes for both significant others and patients included improved coping mechanisms, reduced caregiver burden, enhanced communication, and better quality of life. However, several challenges …

Development Of A Culturally Tailored Care Model For Chronic Disease Management In The Coastal Community: A Modified Delphi Study, Laode Saltar, Heltty Heltty, Sitti Mikarna Kaimuddin

Jurnal Keperawatan Indonesia

Chronic noncommunicable diseases (NCDs), particularly hypertension and type 2 diabetes mellitus, are increasing in Indonesia’s coastal communities including the Bajo population in Southeast Sulawesi. Limited healthcare access, cultural barriers, and low preventive health engagement exacerbate the disease burden in these communities. Culturally tailored interventions are needed to enhance self-awareness and improve chronic disease management. This study aimed to develop and validate a culturally sensitive care model for chronic disease management in the Bajo coastal community. A three-round modified Delphi method was used with 26 panelists representing health professionals, community leaders, policymakers, and family members recruited through community health centers and …

Dosimetric Impact Of Eclipse’S Entrance Avoidance Tool On Salivary Gland Sparing In Head And Neck Vmat Plans, Shannon Diederichs

Masters Projects

Medical dosimetry is constantly evolving as new techniques emerge to improve plan quality. The Eclipse treatment planning system (TPS) is equipped with the entrance and exit dose avoidance tool commonly used to prevent beam interaction with implanted metals or steer the beam away from anatomical regions. Current literature shows this tool has not been thoroughly investigated for more fundamental applications such as routine organ at risk (OAR) sparing. Xerostomia remains a lasting side effect for head-and-neck cancer (HNC) patients after the salivary glands receive substantial radiation. This study takes a more detailed look at the tool’s effectiveness when applied to …