Digital Commons Network^™

Oral Cancer Numerical Index (Ocni): Development And Validation Of A Cytology-Based Risk Assessment For Oral Lesions, Michael P Mcrae, Nadarajah Vigneswaran, Alexander Ross Kerr, Spencer W Redding, Martin H Thornhill, Craig Murdoch, Paul M Speight, Rachelle Wolk, Kritika S Rajsri, Pooja Gaikwad, Nancy Ruel, Nicolaos J Christodoulides, John T Mcdevitt

Faculty, Staff and Student Publications

Background/Objectives: Oral potentially malignant disorders (OPMDs) require accurate risk stratification to identify patients at the highest risk for severe oral epithelial dysplasia (OED) or oral squamous cell carcinoma (OSCC). We developed and internally validated the oral cancer numerical index (OCNI), a quantitative risk score derived from clinical features and deep learning-based brush cytology measurements.

Methods: This retrospective model development and internal validation study was conducted using data from the multicenter Grand Opportunity study. Prospectively recruited subjects with OPMD with complete data were divided at the subject level into a training set (n = 384) and a holdout test set …

The Association Of Daily Urinary And Bowel Incontinence With Emotional Functioning In Young Adults With Spina Bifida: An Ecological Momentary Assessment Study, Audrey I. Young '26, Devon J. Hensel, Konrad M. Szymanki

Student Research

Many young adults with spina bifida experience bladder and bowel leakage, but clinic visits often rely on people remembering and summarizing their symptoms over long periods. In this study, we asked participants to report their experiences each day for one month using simple phone-based check-ins. We found that leakage does not affect every day in the same way. On days when symptoms were more frequent or harder to manage, participants reported worse mood, more worry, and were more likely to avoid activities. These day-to-day experiences also related to over- all quality of life at the end of the month. For …

The Prevalence Of Moral Injury Among Veterans Diagnosed With Post-Traumatic Stress Disorder (Ptsd): Analyses By Combat Exposure, Gender, Age Group, And Military Service, Carl B. Forkner

Doctoral Dissertations and Projects

The attacks on the United States on September 11, 2001, and the ensuing wars in Afghanistan and Iraq, heralded in a new concept affecting our combat and support military personnel. This concept is known today as moral injury. Military personnel were already familiar with post-traumatic stress disorder (PTSD), whether from personal experience or from reading and training on the subject, but no training addresses the prevalence or effects of moral injury. The term moral injury (MI) was first coined by psychiatrist Jonathan Shay and his colleagues based on feedback from military and veteran patients in 1998; however, it remains that …

Placenta Accreta Spectrum Risk In Endometriosis: A Retrospective Cohort Study With Art Subanalysis, Madeline West, Amir Alsaidi, Michael A Belfort, Hendrik A Lombaard, Yamely H Mendez, Christina C Reed, Amir A Shamshirsaz, Jessian L Munoz

Faculty, Staff and Students Publications

No abstract provided.

Discourse Production And Its Relationship To Cognition In Mild Aphasia, Marcy D. Edwards

USF Tampa Graduate Theses and Dissertations

Objective:Standardized assessments such as the Western Aphasia Battery-Revised do not reliably detect subtle language impairments in mild aphasia (Dalton & Richardson, 2015). Discourse tasks may provide a more sensitive measure of impairment. Although discourse tasks differ in cognitive demands (Kim & Kintz, 2024), variation in discourse performance across tasks and the influence of cognition remains unclear. Therefore, this study examined (1) whether discourse performance differs across different discourse elicitation tasks, and (2) the extent to which cognition influences discourse performance in individuals with mild aphasia.

Participants & Methods: Fifteen participants with mild aphasia participated (mean age = 62.7 years). Discourse …

Exploring Menstrual Cycle Experiences And Well-Being In Young Women With Type 1 Diabetes, Yolanda Rotzinger Ballesteros

USF Tampa Graduate Theses and Dissertations

Young women with type 1 diabetes (T1D) navigate complex physical, emotional, and social challenges, being at a higher risk for mental health concerns (e.g., depression), as well as physical (e.g., fatigue) and cognitive (e.g., focus) symptoms related to the management of their chronic health condition (Dantzer et al., 2003; Northam et al., 2005). About one-third of young women with T1D experience some form of menstrual dysfunction (Griffin et al., 1994; Schweiger et al., 2011), which is associated with lower quality of life across several domains, including the educational setting (Knox et al., 2015). Nevertheless, there is a gap in the …

Treatment Times For Rural And Urban Patients With Aneurysmal Subarachnoid Hemorrhage In A Provincial Hub-And-Spoke Network, Alexander D. Rebchuk, Hugh Mchugh, Michael A. Rizzuto, David Chen, Kelsey Cruz, Erik N. Vu, Peter A. Gooderham

Department of Neurosurgery Faculty Papers

BACKGROUND: Following aneurysmal subarachnoid hemorrhage (aSAH), aneurysm rebleeding leads to very poor clinical outcomes. Ruptured aneurysms must be urgently secured either by open microsurgery or endovascular techniques to prevent re-rupture. The objective of this study was to compare time-to-treatment and functional outcomes following aSAH between rural and urban patients treated at a quaternary neurosurgical centre with a large geographical catchment.

METHODS: We analyzed patients enrolled in the Vancouver Ruptured Aneurysm Database (VRAD) between December 2022 and September 2025. Demographic, clinical, radiographic, treatment and functional outcomes were compared between groups. Time from ictus-to-presentation, ictus-to-neurosurgical centre, ictus-to-treatment and transfer times were collected. …

The Relationship Between Estimated Vo2max And Poor Mental Health: A Study Of Brfss Data, Angelina Somadina Oputa

Doctoral Dissertations and Projects

Mental health conditions are one of the leading contributors to the global burden of disease. Despite advancements in mental health therapies and psychiatric medications, significant numbers of patients continue to struggle with mental illness. Despite these challenges, exercise can serve as a powerful tool to address mental health concerns. Current literature has referenced the value of physical fitness to support mental health, however there is limited large-scale research assessing the estimated maximal oxygen uptake (VO2Max) as a predictor of poor mental health days. In response, this quantitative secondary analysis was conducted to examine the relationship between estimated VO2Max and poor …

Psycho-Behavioral And Psychosocial Factors Influencing Childhood Obesity In The United States, Nadia Ntori Nkansah

Walden Dissertations and Doctoral Studies

No abstract provided.

Comprehensive Geriatric Assessment Identifies Multidimensional Vulnerabilities In Older Adults With Heart Failure, Ci̇han Kiliç, Rengi̇n Demi̇r, Özlem Yilmaz Aykent, Zerri̇n Yi̇ği̇t, Pinar Küçükdağli, Banu Özulu Türkmen, Güli̇stan Bahat, Mehmet Aki̇f Karan

Turkish Journal of Medical Sciences

Background/aim: Heart failure (HF) in older adults is frequently accompanied by geriatric syndromes that remain unrecognized in conventional cardiac evaluations. The vulnerabilities of older adults with and without HF in terms of muscle strength, physical performance, functional capacity, frailty, nutritional status, cognition, mood, anxiety, polypharmacy, and comorbidity were investigated using comprehensive geriatric assessment (CGA).

Materials and methods: A cross-sectional study was conducted in two academic outpatient clinics, enrolling 420 adults aged ≥60 years, including 92 (21.9%) with HF. Data included sociodemographic characteristics, anthropometric measurements, and CGA parameters: handgrip strength, the Five-Times Sit-to-Stand Test (FTSST), the Short Physical Performance Battery (SPPB), …

Bridging The Methodological Gap In Multitrauma Literature: A Competency-Based Educational Framework And Clinical Appraisal Filter, Şaki̇r Hakan Aksu, Burcu Doğan, Merve Yazla

Turkish Journal of Medical Sciences

Background/aim: The statistical complexity of contemporary multitrauma literature has increased considerably in recent years, which may pose challenges for clinicians seeking to interpret high-impact research and apply evidence-based practices. Characterizing this methodological landscape and exploring education-oriented approaches may help to improve the interpretability of the literature and support informed clinical decision-making.

Materials and methods: A cross-sectional analysis was conducted on the 100 most-cited multitrauma studies published in Science Citation Index Expanded journals indexed in the Web of Science database between January 2018 and November 2025. The statistical methods used in each article were categorized into the three competency levels of …

Optimistic And Ambivalent Attitudes Toward Clinical Artificial Intelligence, Sevi̇l Uygun İli̇khan, Si̇nem Ülke, Mahmut Özer, Matjaž Perc, Yavuz Ayhan

Turkish Journal of Medical Sciences

Background/aim: Artificial intelligence (AI) is increasingly being integrated into healthcare systems; however, healthcare professionals’ knowledge, attitudes, and perceptions regarding AI remain insufficiently understood. This study aimed to evaluate healthcare professionals’ perceptions of AI in clinical practice.

Materials and methods: This descriptive cross-sectional study included 260 healthcare professionals, including physicians, nurses, and healthcare technicians working at a tertiary public hospital in Türkiye. Participants completed the Healthcare Professionals and Artificial Intelligence Questionnaire, which assessed demographic characteristics, AI knowledge, workplace AI use, attitudes toward AI applications, ethical and legal concerns, perceived professional impact, and educational needs.

Results: Most participants reported limited AI knowledge; …

Electronic Health Record Alerts To Improve Lipid Lowering After A Recent Myocardial Infarction, Dean G. Karalis, Benjamin Richter, Scott Hessen, Patrick Moeller, Laney K. Jones

Division of Cardiology Faculty Papers

BACKGROUND: This observational, quality initiative evaluated the impact of changing from a passive (dismissible) to an active (nondismissible without action) electronic health record alert on guideline-recommended lipid-lowering therapy (LLT) prescriptions in patients with recent myocardial infarction at risk for secondary events.

METHODS: We sequentially recruited a retrospective passive-alert (February 2018-July 2019; n=733) and a prospective active-alert (August 2020-January 2022; n=587) cohort of patients who triggered an alert to intensify LLT or order a low-density lipoprotein-cholesterol (LDL-C) test if they had a recent myocardial infarction (within 12 months) and elevated (≥70 mg/dL) or missing LDL-C. Prescribed LLTs and cumulative percentages of …

Sicker Americans Are More Likely To Misuse Prescription Medications, Esther Oshaji, Andrew S. London

Population Health Research Brief Series

Prescription medication misuse is a long-term population health problem in the United States. This data slice uses data from the National Wellbeing Survey (N=32,789, 2021–2025) of U.S. adults ages 18–64 to examine how the number of chronic health conditions a person has is related to their misuse of prescription opioids, tranquilizers, sedatives, or stimulants in the past 12 months. The authors find a dose-response pattern: misuse rises from 2.8% among those with no chronic conditions to 11.7% among those with three or more conditions. Mental health conditions show stronger associations with misuse than physical health conditions.

Implementation Of A Standardized Adverse Childhood Experiences Screening Process In A Primary Care Clinic, Tanya M. Wonnacott

Doctoral Dissertations & Projects

Adverse Childhood Experiences (ACEs) are associated with increased risks of chronic disease, mental health disorders, substance use disorders, and premature mortality. Despite growing evidence supporting ACE screening, it remains inconsistent in many primary care settings, particularly among underserved populations. The purpose of this quality improvement project was to evaluate whether implementation of a standardized ACE screening workflow increased ACE screening completion and behavioral health referral within a nonprofit primary care clinic serving uninsured, underinsured, and refugee populations.

This project utilized a pre–post quality improvement design guided by Lewin’s Change Management Model and the Chronic Care Model. Interventions included standardized ACE …

Reliability And Validity Of The Turkish Version Of The Barthel Index-Dyspnea In Patients With Pulmonary Hypertension, Pinar Merç, Rengi̇n Demi̇r, Meli̇h Zeren, Habi̇be Durdu, Ümi̇t Yaşar Si̇nan, Mehmet Serdar Küçükoğlu

Turkish Journal of Medical Sciences

Background/aim: The Barthel Index-dyspnea (BI-d) is a respiratory disease-specific tool developed on the basis of the Barthel Index (BI), which provides a simple and quick way to measure the degree of dyspnea in activities of daily living (ADL). Dyspnea is one of the most common symptoms of pulmonary hypertension (PH). The objective of this study was to explore the reliability and validity of the Turkish version of the BI-d in patients with PH.

Materials and methods: A total of 73 PH patients were included in the study. Criterion validity was explored using the modified Medical Research Council (mMRC) dyspnea scale, …

Postoperative Normocalcemic Hyperparathyroidism: A Comprehensive Analysis Of 510 Cases, Alparslan Ertenli̇ce, İbrahi̇m Kilinç, Mustafa Oruç

Turkish Journal of Medical Sciences

Background/aim: Postoperative normocalcemic hyperparathyroidism (NC-HPT) is defined as elevated parathyroid hormone (PTH) levels despite normal calcium levels after parathyroidectomy for primary hyperparathyroidism (PHPT). This study investigates the demographic, biochemical, and histopathological factors associated with NC-HPT in a large patient cohort and presents the follow-up outcomes.

Materials and methods: The initial study sample included 571 patients who underwent surgery for PHPT between January 2018 and January 2024, 510 of whom were analyzed retrospectively after the application of the exclusion criteria. Preoperative and postoperative biochemical parameters, bone mineral density, pathological findings, and follow-up data were evaluated. NC-HPT was defined as postoperative PTH …

Using In-Home Air Quality Monitoring To Reduce Cannabis Secondhand Smoke Exposure In Children: Quantitative Pilot Feasibility Study, Vincent Berardi, Bradley N. Collins, Laura M. Glynn, Eusabeia Silfanus, Darby G. Lyons, Stephen J. Lepore

Psychology Faculty Articles and Research

Background: An estimated 5 to 8 million US children live with a parent who uses cannabis, and most cannabis users report smoking cannabis inside their homes, placing children at risk for cannabis secondhand smoke (cSHS) exposure. Indoor air quality (IAQ) monitoring provides real-time feedback on airborne pollutants and has shown promise in reducing in-home tobacco secondhand smoke exposure, suggesting its potential as an effective harm reduction strategy for cSHS.

Objective: This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of using low-cost, off-the-shelf IAQ monitors to increase caregivers’ awareness of children’s cSHS exposure risk and to change …

Pancreatitis Risk Genes Play A Major Role In Pediatric Pancreatitis: Insights From The International Study Group Of Pediatric Pancreatitis: In Search For A Cure, Maisam Abu-El-Haija, Wenying Zhang, Fuchenchu Wang, Gretchen Cress, Brian Dawson, Xiaoping Su, Tyler Thompson, Nicole Kotha, Ankur Chugh, Reuven Zev Cohen, Elissa M Downs, Douglas S Fishman, A Jay Freeman, Cheryl E Gariepy, Matthew J Giefer, Tanja Y Gonska, Phil Greer, Amit S Grover, Andrew Y J Liman, Douglas Lindblad, Quin Y Liu, Asim Maqbool, Jacob A Mark, Brian A Mcferron, Megha S Mehta, Veronique D Morinville, Kenneth Ng, Robert A Noel, Chee Y Ooi, Emily R Perito, Michael Wilschanski, Yuhua Zheng, Ying Yuan, David C Whitcomb, Aliye Uc, Mark Lowe, Consortium For The Study Of Chronic Pancreatitis, Diabetes, And Pancreatic Cancer (Cpdpc)

Faculty, Staff and Students Publications

Background & aims: Clinical data show that genetic variants are significant risk factors for acute recurrent pancreatitis and chronic pancreatitis. To expand the understanding of the role of genetics in acute recurrent pancreatitis and chronic pancreatitis, high-throughput next-generation sequencing of 14 genes was completed in a multicenter pediatric cohort.

Methods: A cross-sectional study involving 944 pediatric patients with acute recurrent pancreatitis or chronic pancreatitis was conducted. CASR, CEL, CFTR, CLDN2, CPA1, CTRC, GGT1, PRSS1, PRSS2, PRSS3, SBDS, SLC26A9, SPINK1, and UBR1 were sequenced. The frequencies of identified variants were compared with frequencies in the genome aggregation database. Group differences were …

Comparative Effectiveness Of Olmesartan Medoxomil In Monotherapy And Combination Therapy With Other Arb Medications: Literature Review, Deepika Saini

University Honors Theses

Hypertension remains one of the leading health issues; however, the awareness and control remain limited, with approximately 1.4 billion people affected by hypertension, yet only one in five has the condition effectively controlled. Despite the availability of effective treatments, knowledge and awareness remain limited. Angiotensin II receptor blockers (ARBs) are widely used antihypertensive medications because of their efficacy and safety profiles. Among these, Olmesartan Medoxomil has emerged as a prominent option, demonstrating strong efficacy in lowering blood pressure, both as monotherapy and in combination with other antihypertensive agents.

This thesis examines the comparative effectiveness of Olmesartan Medoxomil versus other ARBs …

Hp1bp3 Loss Links Chromatin Reorganization To Metabolic Vulnerability In Glioma, Brittney Lozzi, Taylor A Gatesman, Pushan Dasgupta, Debosmita Sardar, Yeunjung Ko, Chenyu Mao, Hsiao-Chi Chen, Rachel N Curry, Dongjoo Choi, Carrie A Mohila, Melissa L Bondy, Ganesh Rao, Marco Gallo, Sameer Agnihotri, Benjamin Deneen

Duncan NRI Faculty and Staff Publications

High-grade gliomas (HGGs) are aggressive brain tumors with poor prognosis, driven in part by metabolic and epigenetic adaptations. Methionine metabolism supports HGG growth by supplying S-adenosylmethionine for methylation reactions, yet how nutrient availability influences chromatin organization in HGG remains incompletely understood. Using an immunocompetent mouse model of HGG, we found that dietary methionine restriction reduced tumor proliferation, extended survival, and induced partial nuclear inversion. We identified Hp1bp3 as a key regulator of tumor growth that functions by interacting with nuclear tethering proteins to mediate chromatin reorganization. Loss of Hp1bp3 results in the upregulation of histone demethylases leading to selective depletion …

Pa Dent J Mar 2018

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Jan 2018

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Sept 2016

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J July 2016

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Jan 2021

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Sept 2023

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J May 2023

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Nov 2022

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

The Pain Of Women And Femmes: A Multi-Session Class Activity On Generative Ai-Technology And Gender Norms, Bethany L. Johnson, Margaret M. Quinlan

Feminist Pedagogy

This unit helps students examine the societal implications of reproductive pain, focusing on healthcare settings and in post–Roe America. Through active listening, media analysis, and interactive research with ChatGPT, students examine how generative AI responds in a neutral tone; however, with additional data and correction, large language models (LLMs) produce more expansive and inclusive responses. Class activities include group discussions, research, and simulations. By using transcripts from the podcast “The Retrievals” and analyzing recent media, students evaluate how LLMs adjust their answers to identical questions, thereby calling into question their design, functionality, and benefits. The unit employs feminist pedagogy to …