Digital Commons Network^™

Infective Endocarditis Hospitalizations In Kentucky, 2008-2018: Spatial And Temporal Trends, Meera Marji, Steve Browning, W. Jay Christian, Richard Charnigo, Steve W. Leung, Anna Kucharska-Newton

Journal of Appalachian Health

Introduction: Infective endocarditis (IE) hospitalization rates have increased significantly in the last decade, primarily due to the opioid epidemic. In 2016, Kentucky (KY) ranked among the top ten states for opioid-related overdose deaths, but limited data exist on IE trends in KY.

Purpose: This study seeks to examine county-level spatial and temporal trends in IE hospitalization rates in KY.

Methods: Hospital inpatient discharge data from 2008–2018 for KY residents aged 18 and older were analyzed. IE admissions and drug use status were identified using ICD-9 & 10 diagnosis codes. U.S. Census data calculated yearly IE hospitalization rates per 100,000 residents. …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Concurrent Meckel Diverticulum And Horseshoe Kidney In A Cadaver: Insights Into Developmental Field Effects, Kezia Itua, Nadine Belony, Josh Searles, Sophia Guo, Carl Yem, Jorgo Zi, Kavitha Vudatha, Shiv Dhiman, Rasheed Agboola

Research Day

Introduction: Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract and results from incomplete regression of the omphalomesenteric duct during early embryogenesis. Horseshoe kidney arises from abnormal fusion and arrested ascent of the metanephric kidneys during weeks 6–9 of development. Although both anomalies occur during overlapping gestational windows, their coexistence is rarely described. Recognition of such co-occurrence may provide insight into patterns of congenital variation and early developmental susceptibility.

Methods: During routine cadaveric dissection of a 74-year-old male donor, the abdominal cavity, small intestine, and retroperitoneum were systematically examined. A Meckel diverticulum was identified, measured (~60 cm …

Cardiometabolic Risk Factor Burden And Early Cardiovascular Disease Onset Among Asians: Insights From The Nih All Of Us Cohort And Georgia Oasis, Riya S. Patel, Anirudh Veludhandi, Thomas Last

Research Day

INTRODUCTION: Cardiometabolic risk factors including diabetes, obesity, and smoking are major contributors to cardiovascular disease (CVD), yet the cumulative impact of multiple risk factors on age of onset across cardiovascular phenotypes remains incompletely defined. Cardiovascular risk patterns in Asian populations may differ from those in the general population, and the influence of cumulative cardiometabolic risk burden on early disease remains insufficiently characterized. Understanding how cardiometabolic risk burden influences early cardiovascular disease among Asians may help identify high-risk individuals and guide prevention strategies.

OBJECTIVES: To determine whether increasing cardiometabolic risk factor burden is associated with earlier cardiovascular disease onset among Asians …

The Social Determinants Of Health And Cancer, Joshua Williams

Ex Sapientia Loqui

The social determinants of health, as defined by the World Health Organization (WHO), are “the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources.” Epidemiologists have long studied the nexus between social forces and disease and have widely agreed that such forces are directly causal of pathologies. This paper is an analytic review of the existing literature on several social determinants— namely socioeconomic status (SES), race and ethnicity, age, working and living conditions, and social integration— and how they pertain to the causation, progression, and treatment of cancer.

Psychometric Properties Of Ecological Momentary Assessment Of Psychosocial Functioning In Adults With Complications Related To Type 1 Diabetes, Hayley Centola, Melissa Plegue, Dana Albright, Kara Mizokami-Stout, Lynn Ang, Jennifer Iyengar, Emily Hirschfield, Anna Kratz, Evan L. Reynolds, Brian C. Callaghan, Rodica Pop-Busui, Joyce M. Lee

Health Services and Informatics Research

Objectives: Ecological Momentary Assessment (EMA) is a promising methodology for examining the contextual impact of psychosocial functioning on chronic disease management in individuals with type 1 diabetes (T1D). Little is known regarding psychometric properties of EMA of psychosocial functioning in adults with complications related to T1D. The aim of this study is to explore the feasibility, reliability, and validity of EMA psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia in a sample of adult individuals with complications related to T1D.

Methods: Fifty-one participants with T1D completed a 14-day EMA of symptoms of depression, anxiety, diabetes-related distress, and …

Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson

Walden Dissertations and Doctoral Studies

Gypsy, Roma, and Traveller women (GRT) in the United Kingdom face persistent maternal health disparities and show poor engagement with healthcare services. Exclusion, discrimination, and a lack of cultural competence from healthcare professionals contribute to poor health outcomes including preterm births; and GRT women have more babies born with congenital anomalies than non-GRT women in the United Kingdom. The purpose of this focused ethnographic qualitative study was to explore how self-identified GRT women living in the United Kingdom experienced maternal care and how cultural identity and social structures influenced their interactions with healthcare providers based on Madeleine Leininger’s cultural care …

Exploring Quality Of Life After Traumatic Brain Injury: Insights From The Peo Model, Natalie S. King, Bryan M. Gee, Mary Shotwell, Mark A. Campbell

The Open Journal of Occupational Therapy

Background: Traumatic brain injury (TBI) is a major global health concern, affecting millions of people each year. TBI often results in long-term physical, cognitive, and emotional impairments that can drastically reduce survivors' quality of life (QOL). These impairments influence daily activities, emotional well-being, social participation, and overall life satisfaction, highlighting the importance of a comprehensive approach to rehabilitation. This study seeks to provide deeper insights into the factors that influence the QOL for TBI survivors.

Methods: This research employed a phenomenological qualitative approach to understand how survivors navigate their post injury lives. Fourteen TBI survivors, aged 18 to …

Trends And Demographic Disparities In Septicemia-Associated Cardiac Arrest Mortality In The United States, 1999–2023, Muhammad Owais, Maham Mehfooz, Hamza Nazir, Preeti Advani, Roha Riaz, Khanij Arya, Javeria Nawaz, Syed Hadi Raza Rizvi, Murtaza Aslam, Usman Nazeer, Jairo Melo, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Coverage, Traits, And Geographic Distribution Of Online Surgeon Reviews: Large-Scale Cross-Sectional Analysis, Michael Geng, Carlos Riveros, Yash B. Shah, Sanjana Ranganathan, Kai Fok, Renil Sinu Titus, Vatsala Mundra, Eusebio Luna Velasquez, Dharam Kaushik, Allan S. Detsky, Angela Jerath, Benjamin N. Breyer, Yusuke Tsugawa, Christopher J. D. Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

BACKGROUND: The use of online physician rating platforms has significantly increased and has been shown to influence physician selection. There are limited data on the use of these platforms for rating surgeons.

OBJECTIVE: In this study, we sought to assess the geographic distribution of and patterns in rating scores of surgeons in the United States. Additionally, we examined rating volumes across different surgical specialties and the association between peer-nominated and patient-initiated ratings on online rating platforms in the United States.

METHODS: We conducted a cross-sectional study by identifying 201,154 surgeons in the United States via the National Plan and Provider …

Current Status Of Msk Diagnostic Ultrasound Education In Doctorate Of Physical Therapy Programs In The United States: A Survey, Lesley Parrish Dr., Heather E. Mount, Casey Charlebois

Innovations in Health Sciences Education Journal

Musculoskeletal ultrasound (MSK-US) is a dynamic, cost-effective imaging modality increasingly integrated into Doctor of Physical Therapy (DPT) curricula. Despite growing interest, variability exists in the integration and implementation of MSK-US in entry-level DPT programs. This study aimed to assess the current status of MSK-US education in accredited DPT programs across the United States. A cross-sectional survey was distributed to all 294 accredited DPT programs in the U.S. via email. The survey consisted of 32 questions that addressed curriculum content, instructional methods, faculty qualifications, and barriers to implementation. Participation was voluntary, and 44 programs responded. No experimental interventions were applied. The …

From Vision To Impact: Building A Sustainable Open-Access Peer Reviewed Medical Journal, Darshana T. Shah Phd

All Things Open

The Marshall Journal of Medicine (MJM) was created to strengthen scholarly exchange, clinical innovation, and health professions education in rural Appalachia while making that work openly accessible to readers worldwide. As West Virginia’s first fully open‑access, online, peer‑reviewed medical journal, MJM illustrates how a mission‑driven publishing effort can evolve from an initial idea into lasting scholarly infrastructure—and how publication activity can translate into measurable impact.

MJM’s development centered on three strategic pillars:

• a clearly articulated scope focused on clinically relevant and educationally innovative scholarship
• rigorous peer‑review and editorial practices that ensure credibility and quality
• operational partnerships—especially with academic …

Effects Of A Major Disruption On Mental Health Of Pregnant Women In South Carolina, Lizmarie Maldonado

MUSC Theses and Dissertations

Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, …

Identifying Major Sources Of Leptospira Interrogans In San Juan Bay And Río Grande De Loíza Estuaries Of Puerto Rico, Logan Mccullers, Dave Bachoon

Biology Theses

This study evaluated the presence of pathogenic Leptospira interrogans, potential carriers, and environmental factors influencing their occurrence in the San Juan Bay Estuary (SJBE) and Río Grande de Loíza (RGDL) watersheds of Puerto Rico from 2024–2025. Detection of this pathogen from water samples was performed using the lipL32 PCR assay. The likely hosts of L. interrogans were determined using fecal source tracking (FST) assays for human (HF-183), canine (BacCan-UCD), equine (HoF597), and rat mitochondrial DNA NADH dehydrogenase subunit 2 gene (RatMt) markers. In 2024, 91 samples were collected (March: 50; June: 41), and in 2025, 124 samples were collected …

Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray

Walden Dissertations and Doctoral Studies

Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological …

Is Home Birth A Choice? Racial And Geographic Differences In Unintended Home Births In The U.S., Anna De La Paz

Population Health Research Brief Series

Home births that happen without planning or medical support (i.e., unintended home births) carry a higher likelihood of adverse outcomes, such as low birth weight, preterm birth, and hypothermia. This data slice summarizes findings using data from CDC WONDER (2017–2023) on racial, regional, and metropolitan status differences in home births among women ages 15–44 in the U.S. Findings show that unintended home births are disproportionately concentrated among non-Hispanic Black women, with rates varying substantially by region and metropolitan status.

Community As Coping: Mental Illness And Homelessness Within A Tent Camp, Karen A. Snedker, Jennifer Mckinney

Sociology Faculty Articles and Research

"Drawing from interview data with residents of Tent City 3, a sanctioned homeless camp, we illustrate the complex connections between mental illness and homelessness from the residents’ perspectives to understand how living in this tent city helps residents manage mental health."

Facilitators And Barriers To Mobile Health Unit Implementation: A Qualitative-Dominant Mixed Methods Study Exploring Staff Perspectives And Service Outreach, Kelsey Hardin

MUSC Theses and Dissertations

Background: Health disparities are linked to rising healthcare costs in the United States, particularly related to healthcare accessibility. Mobile Health Units (MHUs) have proven to be an effective intervention in reducing barriers to healthcare services, for example, providing early access to prenatal care, thus reducing infant mortality rates. This study focused on the facilitators and barriers to implementing an MHU program, based on staff perspectives and service outreach, to improve maternal and infant health outcomes.

Methods: This study employed a qualitative-dominant mixed-methods research design. Data was collected through interviews to assess staff perspectives. Secondary data analysis of quantitative data was …

Balneotherapy For Sleep Improvement And Reducing Depression In Knee Osteoarthritis Patients, Anca Paula Ciurba, Alexandru Bogdan Ilieș, Ionel Haidu, Doriana Ioana Ciobanu, Theodora Ursu, Florin Mihai Marcu, Dorina Ianc

Baltic Journal of Health and Physical Activity

Background: Knee osteoarthritis (OA) is the most common chronic condition and a leading cause of global disability, often associated with pain, depression, and sleep disturbances. The purpose of this study was to investigate the effectiveness of warm mineral water combined with physical therapy on sleep quality, depression and pain intensity in patients with knee osteoarthritis. Materials and Methods: The study involved 101 subjects (68.78±6.92 years) who were assigned to  a control group (CG) or an experimental group (EG). All subjects benefited from physical therapy and electrotherapy for 10 days. The experimental group additionally benefited from therapy with hot mineral water. …

Development Of The U.S. Academic Ophthalmology Faculty Database (Us-Aofd): A Cross-Sectional Descriptive Analysis, Brenton T. Bicknell, Josephine M. Rudd Zhong Manis, Haley Chishom, Yejin Heo, Lance Dzubinski, Alvina Liang, Taylor L. Aaserud, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Emily Mccourt, Sruthi Arepalli, Beeran Meghpara, Ayan Chatterjee, Basil K. Williams, Janice Law, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Academic ophthalmology plays a critical role in advancing eye care and training the next generation of ophthalmologists. However, comprehensive data on the U.S. academic ophthalmology workforce remains limited. Existing databases focus on individual subspecialties or specific demographics, without capturing a national, integrated perspective.

Purpose: To develop and analyze the U.S. Academic Ophthalmology Faculty Database (US-AOFD), a comprehensive, national resource that characterizes the demographic composition, academic ranks, leadership roles, and research productivity of ophthalmology faculty at Accreditation Council for Graduate Medical Education (ACGME)–accredited programs in the United States.

Methods: This cross-sectional descriptive study compiled data for 4,028 …

Changes In 25(Oh)D Concentration, Bone Resorption Markers And Physical Performance Due To Sun Exposure, Diet And Training Load Among Professional Women Handball Players During The Half-Year Training Season, Sorin Dacian Buhas, Zbigniew Jastrzębski, Paul Florian Dragos, Marius Alin Marinau, Maria Skalska, Mirela Stef, Joanna Jastrzębska, Mihai Sandra, Dana Ioana Cristea

Baltic Journal of Health and Physical Activity

Background: The aim of the study was to demonstrate changes in 25(OH)D concentration, bone resorption indicators and physical fitness in female handball players as a result of their exposure to the sun, diet and exercise load during the six-month training period from mid-March to mid-September, i.e. the time when the sun exposure is the highest during the calendar year. Twenty-two women handball players participated in the study. Due to the random occurrences and exclusion criteria, 20 players completed the project. Biochemical analysis of blood, aerobic capacity, running speed and power tests (Wingate test, squat jump, counter movement jump, etc.) was …

Mental Health Under Pressure: A Scoping Review Of Suicide In The Dental Workforce, Man Hung, Spencer John, Nicholas Beasley, Amir Mohajeri, Connor Schwartz, Martin S. Lipsky

Institute on Aging Publications

Aims:

Suicide among healthcare professionals is a growing concern. Despite evidence of high psychological distress in dental practice, suicide in dentists remains underexplored. This scoping review systematically examined the literature on suicide and suicidal ideation among dentists, including prevalence, risk factors, and temporal trends.

Methods:

Searches of PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source identified English-language studies reporting suicide, suicidal ideation, or related mental-health risks in dental professionals. Duplicates were removed; titles/abstracts and full texts were screened against predefined criteria. Data were extracted and thematically analysed.Results Fourteen studies met the inclusion criteria and were mostly retrospective …

Innovator - Winter 2025

Innovator

06 - Message from the President

08 - Time Machine

10 - News

14 - New Leader for a New Century

18 - Fashion’s Fairy Godmother

22 - Diploma School of Nursing

26 - Question & Innovate

28 - Alumni Impact

30 - Ram Roundup

32 - From the Washington Ballet to Wimbledon

36 - Homecoming 2024 and Alumni Awards

42 - JCLS Alumni Day

44 - Class Notes

50 - Love Train

52 - In Memory

54 - Trivia

Innovator - Fall 2023

Innovator

06 - Get to Know Jefferson's Interim President

08 - Leadership Announcements

10 - Time Machine

14 - The Nexus

22 - Climate Change on Your Block

30 - Humana and Jefferson

34 - Question & Innovate

38 - Caffeinated Creativity

42 - Alumni Impact

46 - Ram RoundUp

50 - Brotherhood's Enduring Legacy

56 - Class Notes

60 - In Memory

62 - Trivia

Healthcare Systems & Policy Implications For The Impact Of State Medicaid Reimbursement Rates On Access To Primary Care Services In Rural Communities: Turning Knowledge Into Action, Miriam Martinez

Posters - 2026

• Where a child lives can determine whether they receive care or go without it. • Access to primary care is essential for prevention, early diagnosis, and treatment, but rural areas face persistent challenges such as provider shortages and geographic isolation. • Medicaid serves as the primary source of health coverage for low-income children; however, reimbursement rates vary by state and are often lower than other forms of insurance. • This study examines how Medicaid reimbursement policy contributes to disparities in access to care for rural children and reflects broader structural inequalities within the healthcare system.

Effects Of “Zero Sugar” Energy Drinks On Microbial Proliferation In Relation To The Gastrointestinal Microbiome, Madison Hines

Honors Theses

Energy drinks have rapidly increased in popularity and availability in recent years. With the rise of high-caffeine beverages, complications due to caffeine consumption have become more common in younger populations. The aim of this study was to use controlled laboratory methods to determine the effect of energy drinks on a variety of organisms commonly found in the gastrointestinal (GI) tract. The diverse and dynamic nature of microbes in the gut makes conditions of the GI tract difficult to replicate in a laboratory setting. As an alternative, isolates of bacteria commonly found as normal flora in the GI tract were plated …

2026 Research Day Program, Lincoln Memorial University

Research Day

This program contains abstracts and presentation summaries from LMU's 2026 Annual Research Day conference.

Overcoming Challenges With Rural-Related Health Data: Lessons Learned From Published Studies, Casey P. Balio, Margaret M. Francisco, Nicole Galler, Olivia A. Sullivan, Kate E. Beatty, Michael E. Meit, Chyanne Morrison, Christiana Keinath, Stephanie M. Mathis

ETSU/NORC Rural Health Research Center Policy Briefs

No abstract provided.

Developing Scenario-Based Strategies For Health, Climate, And Environmental Preparedness: The One Health, One Earth Approach, Azar M Abadi, Kyle D Brumfield, Moiz Usmani, Gemma Jiang, T C Chakraborty, Yuzhou Wang, Zhijie Zhou, Cenlin He, Minghao Qiu, Jennifer D Stowell, Douglas Fritz, Sunil Kumar, Qiang Guo, Ying Xiong, Georgia Destouni, Qian Xiao, Xindi C Hu, Kelvin C Fong, Yun Hang, John Nielsen-Gammon, Rima Habre, Jennifer R Bratburd, Christopher W Tessum, Antarpreet Jutla, Rita R Colwell, Gabriel M Filippelli, Thanh H Nguyen

Faculty, Staff and Student Publications

Climate change amplifies many threats to human health. Despite advances in understanding climate change dynamics and impacts, there remains a critical gap in translating scientific knowledge into equitable, and community‐driven health interventions. The inaugural One Earth, One Health workshop sought to explore this gap through human‐centered design exercises involving interdisciplinary researchers from climate and Earth sciences, engineering, epidemiology, microbiology, and environmental health. Although participants did not co‐develop solutions with affected communities, they used stakeholder role‐playing to guide ideation and lay groundwork for actionable plans. Through these methods, participants identified community needs and proposed prototype solutions to alleviate health threats …

The All-Payer Claims Database After The Gobeille Supreme Court Decision: Assessing The Impact On Fatal Opioid-Related Overdose Research, Jack Cordes, Cici Bauer, Dana Bernson, Marc R Larochelle, Wenjun Li, Jiahao Cao, Olaf Dammann, Thomas J Stopka

Faculty, Staff and Student Publications

Objective: To determine the consequences of the Gobeille v. Liberty Mutual Supreme Court decision on the representativeness of the Massachusetts all-payer claims database (APCD). The loss of individuals captured in the APCD may vary demographically, geographically, and in the capture of fatal opioid-related overdose (OOD).

Data sources and study setting: We used 2013-2021 data from the Massachusetts Public Health Data Warehouse (PHD), which links person-level APCD records to other datasets. The APCD includes commercially-insured health claims mandatorily reported pre-Gobeille. Post-Gobeille, reporting from self-insured plans, a subset of commercially-insured plans, became voluntary.

Study design: In a repeated cross-sectional design, we compared …