Digital Commons Network^™

Statewide Multi-Year Wastewater Sequencing Reveals Dual Origins Of Hiv-1 Signal, Justin R Clark, Dylan Chirman, Harihara Prakash, Austen Terwilliger, Marlene Mcneese, Matt Ross, Mike Tisza, Sara J Javornik Cregeen, Loren Hopkins, Jennifer Deegan, Catherine L Troisi, Eric Boerwinkle, Kristina Mena, Fuqing Wu, Jason T Kimata, Marc Johnson, Devon Gregory, Faith E Fletcher, Thomas P Giordano, Anthony W Maresso

Faculty, Staff and Students Publications

Human immunodeficiency virus 1 (HIV-1) is a retrovirus which has infected 90 million people and resulted in over 40 million deaths. Despite advances in diagnostics, treatment, and prophylaxis, HIV-1 continues to spread due to undiagnosed and untreated infections. Traditional monitoring methods are ineffective when access to testing is limited or people do not seek care, particularly given the long period between infection and symptom onset, allowing undetected transmission to continue. Here, we use a hybrid-capture sequencing approach to track HIV-1 signal in municipal wastewater in 15 different cities over nearly 3 years. We obtain near-complete genomic coverage of HIV-1, enabling …

Equine-Assisted Therapy For Dementia: A Pilot Rct On Standardizing Sessions To Improve Cognition, Mood, And Quality Of Life, Madeline Alford, Maria Dos Prazeres Da Silva Gonçalves Dr., Maria Manuela Da Silva Leite Dr.

People and Animals: The International Journal of Research and Practice

Objectives: This study aimed to evaluate the effects of incorporating equine-assisted therapy (EAT) into memory workshops for older adults with mild to moderate dementia. EAT is hypothesized to enhance cognitive function, promote physical activity, and improve mood through multisensory experiences. To ensure consistency and replicability, a standardized 8-session cognitive stimulation therapy (CST) protocol was developed, structuring interventions across cognitive, emotional, and motor domains.

Methods: A 3-arm, parallel-group, randomized controlled trial (ClinicalTrials .gov: NCT06662578) was conducted with 36 older adults diagnosed with mild to moderate dementia. Participants were randomly assigned to one of three groups: equine-assisted therapy workshop (EATW), traditional …

Cryoneurolysis Of Auriculotemporal Nerve For Treatment Of Otalgia, Nikit Patel, Shireen Rabiei, Daniel Moon, Yevgeniya Sergeyenko

Moss-Magee Rehabilitation Papers

Otalgia in adults is often secondary to non-otologic pathology, particularly with normal otoscopic examination. Auriculotemporal neuralgia (ATN) is a rare and overlooked cause of secondary otalgia. We present a case of an Army veteran with chronic right otalgia and dizziness following blast-related mild traumatic brain injury who was initially diagnosed with vestibular migraine. Despite significant improvement in headache symptoms with migraine-directed preventive and abortive treatments, otalgia persisted. Auriculotemporal nerve block produced complete but short-lived pain relief, confirming ATN. Cryoneurolysis of the auriculotemporal nerve resulted in complete resolution of otalgia for 2-3 months after first and second treatments. However, transient worsening …

Advancing Safe Iv Amiodarone Practices In Acute Care Settings, Ariel Lee

Walden Dissertations and Doctoral Studies

No abstract provided.

Targeting Inequities: Addressing Lung Cancer Care Challenges In Africa Through Drug Access, Radiotherapy, And Surgical Innovations, Elvis Obomanu, Chidiebube Ugwu, Muluken Megiso, Tarfa Verinumbe, Colton Jones, Verna Vanderpuye, Nazik Hammad

Division of Internal Medicine Faculty Papers & Presentations

Lung cancer remains one of the leading causes of cancer-related mortality in Africa, with survival rates starkly lagging behind global benchmarks because of systemic inequities in prevention, diagnosis, and treatment access. Despite representing only 6% of global smokers, the continent faces a disproportionate burden driven by environmental and occupational carcinogens, aggressive tobacco marketing, and fragmented health care infrastructure. Key challenges include prohibitive delays in accessing targeted therapies like epidermal growth factor receptor inhibitors and immunotherapies, a dire shortage of radiotherapy infrastructure-0.12 megavoltage units per million people versus the International Atomic Energy Agency's recommended five megavoltage units per million, and a …

Impact Of Maternal Covid-19 Infection Versus Vaccination On Mucosal Immunity In Breastmilk, Mymy Nguyen, Rupsa C. Boelig, Julie Jones, Wathsala Wijayalath, Gregory D. Gromowski, Zubair H. Aghai, Elke S. Bergmann-Leitner

Department of Obstetrics and Gynecology Faculty Papers

Background/Objectives: In the first months of their life, infants rely on maternal antibodies for immune protection. Breastmilk is a major source of these defenses, supplying secretory IgA, IgG, and IgM that help guard mucosal surfaces against pathogens such as SARS-CoV-2. Most studies on breastmilk immunity in the context of COVID-19 have emphasized circulating monomeric IgA, rather than the multimeric secretory IgA (sIgA) that is active at mucosal barriers. This study assessed in-depth the contribution of breastmilk antibody subtypes to SARS-CoV-2 neutralization capacity and how these profiles differ following maternal COVID-19 infection versus vaccination during pregnancy or postpartum.

Methods: …

Long Term Evaluation Of The Safety And Efficacy Of Local Cooling Anesthesia During Intravitreal Injections: The Cool-2 Trial, Arshad M. Khanani, Samir N. Patel, Charles C. Wykoff, Gun-Ho Kim, Ajay E. Kuriyan

Wills Eye Hospital Papers

BACKGROUND/OBJECTIVE: To evaluate the safety and effectiveness of a medical device providing cooling anesthesia to the eye as local anesthesia for intravitreal (IVT) injections.

SUBJECTS/METHODS: As a multicenter, open label, dose escalation clinical trial, subjects receiving at least 3 IVT injections in the study eye were recruited to participate. All patients received subconjunctival lidocaine as their anesthesia for previous IVT injections. Subjects receiving IVT injections were assigned (non-randomized) to four groups in which the cooling device was applied to the conjunctiva at the location of the intravitreal injection: Group 1: -10˚C for 20 seconds; Group 2: -15˚C for 10 seconds; …

The Effect Of Hunger On The Likelihood Of Glucose Excursions In Adults With Overweight Or Obesity: Continuous Glucose Monitoring And Ecological Momentary Assessment Observational Study, Byunggul Lim, Phrashiah Githinji, Yue Liao, Jacob Szeszulski, Alexandra L Macmillan Uribe, Rebecca A Seguin-Fowler, Jane Anderson, Chad D Rethorst

Faculty, Staff and Students Publications

Background: Maintaining stable glucose levels is important for metabolic health. Glucose excursions (GEs), which are marked increases in glucose following food intake, have been associated with a higher risk for cardiovascular disease and metabolic dysfunction. Individuals with overweight or obesity who do not have diabetes may still show impaired glucose regulation, as reflected in increased glucose variability. Hunger, as a real-time physiological cue, may be associated with subsequent glucose changes and represents a potential target for just-in-time adaptive interventions.

Objective: This study aimed to investigate the temporal relationship between self-reported hunger and subsequent glucose dynamics, including the likelihood of GE …

Whole-Genome Variant Detection In Long-Read Sequencing Data From Ultra-Low Input Patient Samples, Katherine Wang, Cera J Aex, Hayan Lee, Lucas Finot, Kevin Zhu, Julianna R Chang, Aaron M Horning, William J Rowell, Philip Li, Sarah B Kingan, Michael P Snyder, Graham Scott Erwin

Faculty, Staff and Students Publications

Long-read sequencing provides a more complete view of the genome than short-read sequencing, with improved detection of structural variants, tandem repeats, and small variants (single nucleotide variants and insertions and deletions) in difficult-to-map regions. One limitation of long-read sequencing has been high input DNA requirements, with several micrograms required per sample. Here, we evaluate two methods of amplification-based long-read, whole-genome sequencing: ultra-low input HiFi (ULI-HiFi) sequencing and droplet multiple displacement amplification (dMDA) sequencing. When benchmarked against the Genome in a Bottle reference set (NA24385), we observe high precision and recall of single nucleotide variants (SNVs) with ULI-HiFi compared to the …

Rare Pediatric Venolymphatic Malformations: Pericardial Cyst Mimickers, Shelby E Walcott, Joseph Burns, Juan Pablo Sandoval Jones, Neil Cambronero, David Brennen, Thomas M Glenn, Betul Yilmaz Furtun

Faculty, Staff and Students Publications

Background: Pericardial cystic masses are rare, and exceedingly so in pediatrics. The clinical course of such masses in children is poorly described.

Case summary: We report 2 cases in 3- and 7-year-old children. Both were initially thought to represent pericardial cysts on imaging, but surgical excision and histopathology confirmed diagnoses of a venolymphatic malformation and an epicardial cyst, respectively. The first patient presented with abdominal pain, and the second patient was asymptomatic. Both recovered well after an uncomplicated surgical intervention.

Discussion: A small number of patients with pericardial masses will have symptoms thought to be related to compression of adjacent …

Rare Pediatric Venolymphatic Malformations: Pericardial Cyst Mimickers, Shelby E Walcott, Joseph Burns, Juan Pablo Sandoval Jones, Neil Cambronero, David Brennen, Thomas M Glenn, Betul Yilmaz Furtun

Faculty, Staff and Students Publications

Background: Pericardial cystic masses are rare, and exceedingly so in pediatrics. The clinical course of such masses in children is poorly described.

Case summary: We report 2 cases in 3- and 7-year-old children. Both were initially thought to represent pericardial cysts on imaging, but surgical excision and histopathology confirmed diagnoses of a venolymphatic malformation and an epicardial cyst, respectively. The first patient presented with abdominal pain, and the second patient was asymptomatic. Both recovered well after an uncomplicated surgical intervention.

Discussion: A small number of patients with pericardial masses will have symptoms thought to be related to compression of adjacent …

Artificial Intelligence Policy Development In A Hybrid, Accelerated Dpt Program: Planning For Academic Integrity, Jennifaye V. Brown, Keiba Shaw, Otis L. Owens

Internet Journal of Allied Health Sciences and Practice

Purpose: Artificial intelligence (AI), particularly generative forms like ChatGPT, has rapidly grown across higher education. Institutions are developing policies for responsible/ethical use to preserve academic integrity, while acknowledging AI’s role in healthcare to confirm diagnoses and create personalized plans based on social determinants. In physical therapy education, AI can serve a valuable purpose despite documented misuse by Doctor of Physical Therapy (DPT) students during admissions and curricular activities. This paper describes the development of an AI policy following identified misuse and demonstrated knowledge gaps from student orientation essays. Methods: An AI task force was convened. Policy development was guided by …

Prevalence Of Hyperprolactinemia And Its Association With Menstrual Abnormalities And Hypothyroidism Among Infertile Women: A Cross-Sectional Study From Saudi Arabia, Aseel Y. Alwahhabi, Rahaf H. Labban, Maryam Y. Alshaikh, Amal M. Alanazi, Samaher S. Alfaraj, Fahad M. Alsalman, Hayat A. Alrabiea

Saudi Medical Journal

Objectives: To determine the prevalence of hyperprolactinemia among infertile women and assess its association with menstrual irregularities and hypothyroidism in a tertiary-care setting in Riyadh, Saudi Arabia.

Methods: A cross-sectional study was conducted between September 2022 and August 2023 at the Reproductive Endocrinology and IVF Unit, King Abdulaziz Medical City, Riyadh. Electronic medical records of 480 infertile women who met the inclusion criteria were reviewed. Data on demographic characteristics, infertility type, thyroid status, and serum prolactin levels were collected and analyzed using SAS version 9.4. Statistical significance was set at p < 0.05.

Results: Hyperprolactinemia was identified in 27.7% of infertile women, …

Prevalence And Risk Factors Of Surgical Site Infections In Hospitals Across Al Madinah Al Munawwarah, Saudi Arabia: A Retrospective Cohort Study, Atheer M. Aljohani, Danah O. Sandaqji, Rana A. Alahmadi, Raha Z. Ishqi, Manal A. Alanazi, Shouq N. Aloufi, Husain I. Sandugji

Saudi Medical Journal

Objectives: To determine the prevalence of surgical site infection (SSI) and identify associated risk factors in hospitals in Al Madinah Al Munawwarah, Saudi Arabia.

Methods: We conducted a retrospective cohort study of 363 adult surgical patients from major hospitals in Madinah between 2023 and 2024. We analyzed medical records using descriptive statistics, bivariate analysis, and multivariable logistic regression.

Results: The overall SSI rate was 5.2% (95% confidence interval [CI]: 3.3–7.9%). Infection types comprised superficial incisional (57.9%), deep incisional (36.8%), and organ/space infections (5.3%). Significant risk factors included younger age (adjusted odds ratio [aOR] = 0.94 per year, p = 0.014), …

A Predictive Model For Cytomegalovirus Infection Using Routine Hematological And Biochemical Parameters: A Pilot Study, Ahmad A. Shaikh, Mofareh H. Alabdaly, Nabil A. Ageeli, Sultan Z. Alasmari, Adel M. Abo Mansour, Mohammed H. Makkawi

Saudi Medical Journal

Objective: To examine whether hematological and biochemical parameters assist in diagnosing cytomegalovirus (CMV) infections and differentiating between CMV-G and CMV-M. Cytomegalovirus causes distinct hematological changes that can serve as markers for diagnosis.

Methods: A retrospective analysis was conducted on 54 patients infected with CMV (25 CMV-G and 29 CMV-M) and 82 healthy controls. Age, gender, and routine hematological and biochemical parameters were evaluated. Receiver operating characteristics (ROC) analysis and logistic regression were used for data analysis.

Results: In comparison to controls, laboratory findings of patients with CMV-G revealed characteristic decreases in red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), and …

Safety And Efficacy Of Adalimumab Biosimilar In Psoriasis And Hidradenitis Suppurativa: A Clinical Experience, Raneem H. Najjar, Sarah O. Alrashid, Rnda F. Almahfouz, Hadeel T. Alzahrani, Majed Y. Aleissa, Alanoud R. Hakami

Saudi Medical Journal

Objectives: To evaluate the clinical experience, safety, and effectiveness of adalimumab biosimilars in patients with psoriasis and hidradenitis suppurativa.

Methods: We conducted a retrospective, single-center observational study between March and September 2024 using electronic medical records from King Abdulaziz Medical City and King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia. Pediatric and adult patients with psoriasis or hidradenitis suppurativa who switched to adalimumab biosimilars between 2016 and 2022 were included. Variables included demographics, disease characteristics, prior therapies, biosimilar use, and adverse events.

Results: A total of 57 (93% adults; 50.9% female) patients were included. Obesity was present in 35.1%, and …

Immunoinformatic Based Development Of A Multi-Epitope Precision Vaccine Targeting Glycoprotein And Rdrp Of Oropouche Virus: An Innovative Approach To Counter Emerging Public Health Threats, Mohammed Alissa, Muhammad Suleman

Saudi Medical Journal

Objectives: To design high immunogenic vaccine against the Oropouche virus (OROV). The OROV is a neglected arbovirus endemic to Central and South America, causes oropouche fever, which can progress to severe complications such as meningitis and hemorrhagic symptoms.

Methods: We utilized immunoinformatic and molecular dynamic simulation approaches to design highly immunogenic vaccines against OROV. This observational study, carried out between January and August 2024 in Saudi Arabia. As it involves an in-silico method, ethical consent was not required.

Results: Docking analysis confirmed the stable interaction of the designed vaccines with human toll-like receptors (TLR)-3, producing binding scores of –300.78, –306.19, …

Etiology, Management, And Outcomes Of Hospitalized Heart Failure Patients: A Single-Center Study, Adil I. Jumani, Ghada A. Rashwan, Hadiza O. Ibrahim, Safaa M. Almohdar, Khaled M. Alfakih

Saudi Medical Journal

Objectives: To describe the clinical characteristics, etiologies, management patterns, and outcomes of hospitalized heart failure patients in a tertiary care military hospital in United Arab Emirates (UAE), and to benchmark guideline directed medical therapy (GDMT) uptake and care models against regional and international registries.

Methods: We retrospectively reviewed all consecutive patients admitted with a primary diagnosis of heart failure between January and December 2024, at Zayed Military Hospital, UAE. Clinical data were extracted from electronic medical records. The GDMT adherence was assessed according to the 2022 American Heart Association (AHA)/ American College of Cardiology (ACC) and 2023 European Society of …

Identification Of Risk Factors For Renal Insufficiency In Primary Membranous Nephropathy, Lin Qi, Bolong Fang, Xiao Fang, Yamin Yu, Yunqiang Wang

Saudi Medical Journal

Objectives: To identify possible evidence linking certain characteristics associated with primary membranous nephropathy (PMN) to renal failure progression in patients diagnosed with PMN and to establish probable evidence of an association between PMN and other risk factors leading to end-stage renal failure.

Methods: A historical investigation was carried out including 436 subjects with PMN, with or without renal insufficiency, who were treated at the No. 82 Division Defense Medical Center of the People's Liberation Army and Liaocheng People's Medical Center during January 2020 and December 2023. Binary logistic regression study was applied to determine possible hazard elements. Binary logistic regression …

Evaluation Of Raqeem Health Information System In Primary Healthcare Centers In Makkah, Saudi Arabia, Using The Delone And Mclean Information System Success Model, Ali M. Alzahrani, Holly C. Felix

Saudi Medical Journal

Objectives: To evaluate the implementation of Raqeem, a new Electronic Health Information Systems (EHIS) implemented at primary healthcare centers (PHCs) in Makkah. Implementing EHIS requires huge investments, making evaluation of systems success important.

Methods: In this cross-sectional survey design study, a developed questionnaire guided by DeLone and McLean Information System success model (D&M model) was used to collect data from PHCs' providers. Descriptive and structural equation modeling (SEM) techniques were performed to describe and examine the association between the model's constructs and assess Raqeem success.

Results: A total of 490 providers submitted completed records and were included in this study. …

Molecular Mechanisms Of Diffuse Large B-Cell Lymphoma And The Complexities Of Tumor Development, Wael I. Alzahrani

Saudi Medical Journal

Diffuse large B-cell lymphoma (DLBCL), the most prevalent aggressive non-Hodgkin lymphoma, exhibits substantial molecular heterogeneity and arises from germinal center or post-germinal center B cells through recurrent genetic and epigenetic dysregulation of critical signaling pathways. Aberrations involving BCL6, MYC, MYD88, and components of B cell receptor and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κ B) signaling play central roles in lymphomagenesis, treatment resistance, and clinical outcomes. Gene expression profiling has defined major molecular subgroups in DLBCL, including germinal center B cell–like and activated B cell–like tumors, that show distinct pathogenesis and prognosis. High-risk entities, such as double- and …

Integrating Traditional And Complementary Medicine Into Saudi Primary Care: A Literature Review In Light Of The Who 2025–2034 Strategy, Abeer Al Shahrani

Saudi Medical Journal

Complementary and alternative medicine (CAM) is widely practiced in Saudi Arabia, particularly for health promotion and chronic diseases management. Despite cultural acceptance and high utilization, CAM remains largely unintegrated within the formal healthcare system, particularly in primary care settings. The newly adopted World Health Organization (WHO) Traditional, complementary, and integrative medicine (TCIM) Strategy 2025–2034 offers a global framework for evidence-based, culturally appropriate integration of TCIM into national systems. This review evaluates the status of CAM in Saudi Arabia in light of strategic objectives outlined in the WHO Strategy: building the evidence base, ensuring quality and safety, integrating into health systems, …

Interleukin-6 Inhibition For Patients With Acute Myocardial Infarction: A Systematic Review And Meta-Analysis, Mohammed Y. Alasmary, Mohammed J. Almalki, Faisal H. Almalki, Waleed D. Khubzan, Mohammed H. Rajab, Mohammed S. Almalki, Hussam A. Almalki, Omar M. Alsuwat, Hussam M. Alghannami

Saudi Medical Journal

Objective: To explore the outcomes associated with interleukin-6 (IL-6) pathway blockade, using tocilizumab, in patients with ST-elevation myocardial infarction (STEMI) and non (NSTEMI). Acute myocardial infarction (AMI) denotes myocardial necrosis due to ischemia and presents in distinct electrocardiographic phenotypes. Inflammation driven by IL-6 contributes to ischemia-reperfusion injury, with tocilizumab showing promise in reducing myocardial damage and improving outcomes.

Methods: This work followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Framework and was registered in international prospective register of systematic reviews (PROSPERO). Relevant studies were identified through structured searches of PubMed, MEDLINE, the Cochrane Library, and Google Scholar up …

Effect Of Anesthetic Agents On Middle Ear Pressure: Systematic Review And Meta-Analysis, Nasser Almujaiwel, Reem Alkublan, Latifah Almakoshi

Saudi Medical Journal

Objective: To assess and compare the effects of these agents on middle ear pressure (MEP). Anesthetic agents can significantly alter MEP, which is a critical factor in middle ear surgeries that require stability to prevent complications. Different anesthetics, including inhalational and intravenous agents, have varying effects on MEP.

Methods: A systematic search was conducted across PubMed, Embase, the Cochrane Library, and Scopus, following preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Studies that evaluated MEP changes before and after anesthesia using tympanometry were included. Relevant data, such as anesthetic type, patient demographics, MEP measurements, and reported complications, were …

The Impact Of Exercise Intervention On Pulmonary And Physical Function In Patients With Cystic Fibrosis: A Comprehensive Systematic Review, Abdullilah Alghamdi, Muroj Al-Attas, Abrar Radhi, Amnah Alfaqih, Bashair Aljabri, Rawan Alharbi, Sumayyah Alsubaie, Raneem Aljawaied, Sarah Alenazi, Ahlam Mazi, Ebtehal Qulisy

Saudi Medical Journal

Objective: To evaluate the effect of various exercise interventions on lung function, specifically forced expiratory volume in 1 second (FEV₁), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), as well as on cardiorespiratory fitness (peak oxygen uptake [VO₂peak]), and muscle strength (handgrip strength). The review also considers factors such as patient adherence, follow-up duration, and statistical significance to inform clinical practice.

Methods: This systematic review followed preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines and was prospectively registered in international prospective register of systematic reviews. PubMed, Google Scholar, OVID, and Web of Science …

Cure Sickle Cell Initiative Recommendations On Common Data Elements For Sickle Cell Disease Gene Therapy Trials, Sophie Lanzkron, Victoria H. Coleman-Cowger, Alexis A. Thompson, C. Patrick Carroll, Traci Clemons, Michael Debaun, Julie Kanter, Punam Malik, Deepa Manwani, Francis John Pierciey, Mark C. Walters, Sherita Alai

Cardeza Foundation for Hematologic Research

The Cure Sickle Cell Initiative (CureSCi), created by the National Heart, Lung, and Blood Institute, has developed data standards to increase interoperability and meta-analysis of studies specifically investigating gene therapy for sickle cell disease (SCD). The aims of the CureSCi Common Data Elements (CDE) initiative are to facilitate the development of safe, effective, and accessible gene therapies. Five working groups (WGs) comprising people living with SCD, stakeholders, clinicians, and researchers reviewed current definitions used for SCD clinical studies, including those from the American Society of Hematology, US Food and Drug Administration, PhenX catalog of consensus measures for phenotypes and exposures, …

Disability Rates Among South Asian Immigrants In The U.S. Vary By Country Of Origin, Sobia Mushtaq, Marc A. Garcia

Population Health Research Brief Series

South Asian immigrants are often grouped together in U.S. health data, masking significant differences in health outcomes across subgroups. This brief uses data from the American Community Survey (ACS) 5-Year Public Use Microdata Sample (N = 6,643,738; 2020–2024) to describe disability rates among foreign-born adults from India, Pakistan, and Bangladesh residing in the U.S. The authors find that while South Asian immigrants as a group have lower disability rates than U.S.-born adults, this average is driven largely by Indian immigrants, who make up about 79% of South Asians in the U.S. Among adults aged 65 and older, Bangladeshi immigrants have …

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

Text Messaging Support For Patients Diagnosed With Impaired Glucose Tolerance During Pregnancy: Nonrandomized Pre-Post Implementation Study Assessing Impact On Postpartum Transitions Of Care, Natasha R. Kumar, Whitney Bender, Celeste Durnwald

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Patients with impaired glucose tolerance (IGT) identified during pregnancy who do not develop gestational diabetes mellitus (GDM) often do not receive additional interventions for their long-term metabolic risks.

OBJECTIVE: This nonrandomized pre-post implementation study reports the design process and initial program evaluation for Better Follow-up of Impaired Glucose Tolerance (BRIDGE), a 12-week text-based postpartum support program promoting hemoglobin A1c (HbA1c) completion and primary care provider (PCP) visit scheduling for patients diagnosed with IGT during pregnancy, assessing improvement in desired postpartum transition milestones. The 19-month program was divided into 2 arms lasting 9.5 months each, BRIDGE- (SMS text messaging support …

Trauma-Informed Conversational Agents For Mental Health: Understanding User Perspectives And Experiences, Xintong Lu, Shion Guha, Rachel Pfafman, Jessica Pater, Courtney L. Washington, Fayika Farhat Nova

Health Services and Informatics Research

Introduction:

Mental health conversational agents (MHCAs) offer scalable, accessible psychological support yet raise concerns about safety and appropriateness for trauma, exposed users. While trauma-informed care (TIC) principles, emphasizing safety, trust, empowerment, collaboration, peer support, and cultural sensitivity, are well-established in clinical practice, their application and user interpretation in chatbot contexts remain unexplored. This study aimed to explore (1) how users conceptualize trauma-informed care in the context of mental health chatbots and (2) what factors can help us predict whether users perceive their chatbot interaction as trauma-informed.

Methods:

A 59-item web-based survey (REDCap) assessed demographics, technology proficiency, adverse life experiences, chatbot …