Digital Commons Network^™

Large Language Models Struggle In Token-Level Clinical Named Entity Recognition, Qiuhao Lu, Rui Li, Andrew Wen, Jinlian Wang, Liwei Wang, Hongfang Liu

Faculty, Staff and Student Publications

Large Language Models (LLMs) have revolutionized various sectors, including healthcare where they are employed in diverse applications. Their utility is particularly significant in the context of rare diseases, where data scarcity, complexity, and specificity pose considerable challenges. In the clinical domain, Named Entity Recognition (NER) stands out as an essential task and it plays a crucial role in extracting relevant information from clinical texts. Despite the promise of LLMs, current research mostly concentrates on document-level NER, identifying entities in a more general context across entire documents, without extracting their precise location. Additionally, efforts have been directed towards adapting ChatGPTfor token-level …

Barriers And Facilitators Of Digital Health Use For Self-Management Of Hypertensive Disorders By Black Pregnant Women, Morgan A Foreman, Angela Ross, Angela P H Burgess, Sahiti Myneni, Amy Franklin

Faculty, Staff and Student Publications

Although digital health tools are increasingly common for managing health conditions, these applications are often developed without consideration of differences across user populations. A reproducible framework is needed to support tailoring applications to include cultural considerations, potentially leading to better adoption and more effective use. As a first step, this study captures a snapshot of Black women's barriers and facilitators in using digital health products for self-management of hypertensive disorders of pregnancy (HDP). One-on-one semi-structured interviews were conducted with 17 Black pregnant women with HDP. We established a unique model for cultural tailoring with these experiences using Black feminist theory …

Differences In Connected Speech Outcomes Across Elicitation Methods, Tatiana T Schnur, Sharon Wang

Faculty, Staff and Student Publications

Background: Connected speech is often used to assess many aspects of an individual's language abilities after stroke. However, it is unknown the degree to which elicitation methods differ in generating structural and syntactic aspects of connected speech, two critical components of successful communication. Quantifying the degree to which elicitation methods differ in eliciting structurally, syntactically, and lexically complex connected speech at the earliest stage of stroke before reorganization and rehabilitation of function independent of clinical diagnosis of aphasia has not been examined to date. Addressing this gap has implications for early clinical intervention as well as empirical studies of connected …

Identifying Genomic Data Sources From Biomedical Literature, Xu Zuo, Ashley Gilliam, Yan Hu, Kalpana Raja, Kirk Roberts, Hua Xu

Faculty, Staff and Student Publications

Genomic research is becoming increasingly data-intensive, yet the proper reference of data remains a persistent challenge. Despite various efforts to establish and standardize data citation practices, scientists frequently fall short of accurately referencing data in their papers. This deficiency complicates the attribution of contributions to data providers and impedes the reproducibility of findings in genomic research. This study addresses this gap by introducing a gold standard corpus designed to identify mentions of genomic data sources and associated attributes, thereby offering insights into data source availability and accessibility. Within this corpus, we categorize entities into six classes, encompassing three primary entities …

The Effect Of A Culture Based Breast Health Education Program On Breast Self-Examination Practice Among High-Risk Adult Pakistani Women, Sumaira Naz

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study aimed to determine the effect of a culture-based breast health education program on breast self-examination practice (BSEP) in high-risk women through a randomized controlled trail (RCT). The participants of 72 high -risk women, aged 20-50 years from POF hospital, Taxila was taken on matched pairs with age and educational level and randomly assigned into an experimental and a control group. The program was developed on social cognitive theory (SCT) (Bandura, 1977, 1989), and the cultural identity concept of PEN-3 model (Airhihenbuwa,1989). The intervention group received the culture-based breast health education program, while control group received usual care. BSEP …

The Impact Of Language Status On Bilingual Language And Literacy Development, Ashley Ippolito

University of the Pacific Theses and Dissertations

This study investigated narrative and literacy differences between monolingual and bilingual children with Developmental Language Disorder (DLD) and examined caregivers' perspectives on their language and literacy development. This mixed methods project involved semi-structured ethnographic interviews and case histories for caregiver measures, and it included a narrative production task and a literacy skills assessment for child measures. There were two participant groups: monolingual children with a DLD in kindergarten to sixth grade (Group 1) and bilingual children (English + additional language) with a DLD (Group 2). Thematic analysis of caregiver interviews revealed that monolingual families engaged in storytelling and reading activities …

Impact Of A Culturally-Grounded And Interprofessional Approach To Managing Latino/Hispanic Patients At Risk For Or Diagnosed With Type 2 Diabetes Mellitus: A Pilot Study, Jahnavi Yalamanchili

University of the Pacific Theses and Dissertations

Background: Despite significant progress in diabetes research, there remain significant health disparities between Hispanic/Latino patients in the United States, particularly those with lower socioeconomic status, compared to non-Hispanic white patients. Previous studies have identified potential reasons behind these disparities, including the need for a multifaceted approach that addresses social determinants of health (SDOH) faced by patients. Social cognitive theory (SCT) stipulates that interventions that promote self-management by improving knowledge, self-efficacy, and problem-solving skills can be successful in improving health outcomes. However, there is a paucity of studies that have evaluated an interprofessional approach to providing culturally relevant care, in particular …

Patients With Floaters: Answers From Virtual Assistants And Large Language Models, Gloria Wu, Weichen Zhao, Adrial Wong, David A Lee

Faculty, Staff and Student Publications

OBJECTIVES: "Floaters," a common complaint among patients of all ages, was used as a query term because it affects 30% of all people searching for eye care. The American Academy of Ophthalmology website's "floaters" section was used as a source for questions and answers (www.aao.org). Floaters is a visual obstruction that moves with the movement of the eye. They can be associated with retinal detachment, which can lead to vision loss. With the advent of large language model (LLM) chatbots ChatGPT, Bard versus virtual assistants (VA), Google Assistant, and Alexa, we analyzed their responses to "floaters."

METHODS: Using AAO.org, "Public …

Expanding A Behavioral View On Digital Health Access: Drivers And Strategies To Promote Equity, Maura M. Kepper, Lauren A. Fowler, Isabelle S. Kusters, Jean W. Davis, Manal Baqer, Sarah Sagui-Henson, Yunyu Xiao, Adati Tarfa, Jean C. Yi, Bryan Gibson, Kristin E. Heron, Nicole M. Alberts, Marissa Burgermaster, Veronica Njie-Carr, Lisa M. Klesges

Psychology Faculty Publications

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for …

Grammaticality Judgements Of Tense By Young Adult Speakers Of Shona, Mcloddy R. Kadyamusuma

Faculty Publications – Communication Sciences and Disorders

This study examined grammaticality judgements of tense by 40 young adult native speakers of Shona during an online task. This study reports response accuracy and reaction times on the reading of time reference violations in which verb forms do not match a time frame previously set by an adverb. The judgements were elicited using 240 sentences with and without grammatical violations during an online reading task. Overall, in the experimental task, the native speakers performed below 78% across the four conditions, despite the sentences having received acceptability ratings of 1 = acceptable, 2 = unacceptable for grammatical and ungrammatical sentences, …

Exploring Cultural Humility Prevalence And Barriers In Masters Of Science In Athletic Training Education Programs, Nathalie Towchik

Antioch University Dissertations & Theses

The purpose of this study is to understand the prevalence of faculty members’ abilities to incorporate cultural humility into their Masters of Science in Athletic Training (MSAT) program curriculum and barriers they feel they face in implementing this into regular practice. There is a severe lack of focus on issues pertaining to social justice within the athletic training profession, and implementation of cultural humility skills into MSAT programs can help address the systemic injustices within athletic training healthcare delivery. While there has been a focus on cultural competency in athletic training education, there is little to no current research on …

From East To West: Exploring The Mental Health Of Punjabi Immigrants Residing In British Columbia, Jasleen Kaur

Antioch University Dissertations & Theses

Mental health has been a topic that is slowly gaining more acknowledgement and awareness over time. However, despite the elevation in awareness, there are many cultures where mental health issues remain subject to stigma, which discourages an individual from seeking, or even acknowledging, mental health treatment and services. This study focuses upon varying perceptions of mental health by exploring in-depth the perception of mental health within the Punjabi community and how Punjabi culture affects such perceptions. Specifically, this research study examines how young adults who immigrated from Punjab, India to British Columbia (B.C.) perceive and respond to mental health concerns. …

"The In-Betweeners": The Lived Experience Of Adult Cochlear Implant Users, Aylah Sroloff

Antioch University Dissertations & Theses

This phenomenological study explored the lived experiences of adult cochlear implant (CI) users, implanted prior to the age of 10-years-old. Seven adult CI users were recruited. In-depth, semi-structured, qualitative interviews were conducted to explore participants’ experiences and identities as CI users. Transcripts were analyzed using interpretative phenomenological analysis, through which six group experimental themes were generated: (a) CIs and identity,” (b) social isolation, (c) advocacy, (d), costs and benefits of integration into the hearing world, and (e) “the future of CIs.” This study’s findings highlighted participants’ perspectives on living with CIs, the challenges they face, their process of identity exploration, …

A Comparative Analysis Of The Interpretability Of Lda And Llm For Topic Modeling: The Case Of Healthcare Apps, Omar El-Gayar, Mohammad A. Al-Ramahi, Abdullah Wahbeh, Tareq Nasralah, Ahmed El Noshokaty

All Faculty Scholarship (Archived)

This study compares the interpretability of the topics resulting from three topic modeling techniques, namely, LDA, BERTopic, and RoBERTa. Using a case study of three healthcare apps (MyChart, Replika, and Teladoc), we collected 39,999, 52,255, and 27,462 reviews from each app, respectively. Topics were generated for each app using the three topic models and labels were assigned to the resulting topics. Comparative qualitative analysis showed that BERTopic, RoBERTa, and LDA have relatively similar performance in terms of the final list of resulting topics concerning human interpretability. The LDA topic model achieved the highest rate of assigning labels to topics, but …

Beyond Borders: Exploring The Lived Experiences Of International Migrant Women In Nigeria, A Deep Dive Into Healthcare Realities And Utilization, Juliet Nwafor, Rowland Edet, Ezebunwa Nwokoch

Department of Sociology: Faculty Publications

This study explored access to and utilization of healthcare facilities among migrant women in an urban slum community in Nigeria, focusing on factors influencing healthcare-seeking behaviors and the implications for public health interventions. A qualitative case study-oriented research design was employed, involving in-depth interviews with 21 migrant women of reproductive age and 4 key informant interviews with healthcare workers in the Ayobo community of Lagos State, Nigeria. Data collection occurred from June to September 2018, and thematic analysis was used to interpret the findings. Three main themes emerged: living conditions, pattern of healthcare utilization, and factors influencing accessibility and utilization …

Adapting A Telehealth Physical Activity And Diet Intervention To A Co-Designed Website For Self-Management After Stroke: Tutorial, Dina Pogrebnoy, Lee Ashton, Brian A. Beh, Meredith Burke, Richard Cullen, Jude Czerenkowski, Julie Davey, Amy M. Dennett, Kevin English, Erin Godecke, Nicole Harper, Elizabeth Lynch, Lesley Macdonald-Wicks, Amanda Patterson, Emily Ramage, Ben Schelfhaut, Dawn B. Simpson, Karly Zacharia, Coralie English

Research outputs 2022 to 2026

People who experience a stroke are at a higher risk of recurrent stroke when compared with people who have not had a stroke. Addressing modifiable risk factors like physical inactivity and poor diet has been shown to improve blood pressure, a leading contributor to stroke. However, survivors of stroke often experience challenges with accessing risk reduction services including long wait lists, difficulty with transportation, fatigue, impaired function, and diminished exercise capacity. Providing health interventions via a website can extend the reach when compared with programs that are only offered face to face or via real-time telehealth. Given global challenges of …

Parent Implementation Of A Treatment For Late Talkers Based On Cross-Situational Statistical Learning Principles: Treatment Fidelity And Acceptability, Suzanne J. Meldrum, Jennifer Fisk, Jennifer Stopher, Emily F. Hunt

Research outputs 2022 to 2026

Purpose:

Early intervention based on principles of cross-situational statistical learning (CSSL) for late-talking children has shown promise. This study explored whether parents could be trained to deliver this intervention protocol with fidelity and if they found the intervention to be acceptable.

Method:

Mothers of four English-speaking children aged 18–30 months who scored < 10th centile for expressive vocabulary were recruited to an 8-week group training program. Parents were taught principles of CSSL and asked to perform 16 home treatment sessions (30 minutes each) in total, providing auditory bombardment of target words in full sentences at high dose number and syntactic variability, using a range of physical exemplars. Home diaries and two videotaped sessions measured treatment fidelity. Pre- and post-treatment questionnaires measured acceptability. Result: One parent discontinued the study after the second group training session. Three parents completed 15/16 group training sessions and reported completing 87% of home sessions. Two parents demonstrated implementing the intervention as per the target dose number by the first fidelity session (Weeks 2/3), and the third parent was very close to meeting target dose number by the second fidelity session (Weeks 7/8).

Conclusion:

Parents can be trained to deliver an intervention based on cross-situational statistical learning principles.

Can Micro-Expressions Be Used As A Biomarker For Autism Spectrum Disorder, Mindi Ruan, Na Zhang, Xiangxu Yu, Wenqi Li, Chuanbo Hu, Paula J Webster, Lynn K Paul, Shuo Wang, Xin Li

2020-Current year OA Pubs

INTRODUCTION: Early and accurate diagnosis of autism spectrum disorder (ASD) is crucial for effective intervention, yet it remains a significant challenge due to its complexity and variability. Micro-expressions are rapid, involuntary facial movements indicative of underlying emotional states. It is unknown whether micro-expression can serve as a valid bio-marker for ASD diagnosis.

METHODS: This study introduces a novel machine-learning (ML) framework that advances ASD diagnostics by focusing on facial micro-expressions. We applied cutting-edge algorithms to detect and analyze these micro-expressions from video data, aiming to identify distinctive patterns that could differentiate individuals with ASD from typically developing peers. Our computational …

Training Underrepresented Minority Students For Careers In Public Health Leadership – Public Health Leaders Fellowship Program, Jigsa Tola

College of Graduate Studies: Theses & Dissertations

Background: Shortage and lack of diversity in the United States public health workforce is well documented and remains a challenge to meaningfully improving the health of the population. Although the diversity of the public health workforce has implications for access, care quality, and career opportunities in low-income communities, there is no strong mechanism by which minorities are trained to replenish the workforce. Morehouse College’s Public Health Leaders Fellowship Program (MC-PHLFP) is a cooperative program with the Centers for Disease Control and Prevention (CDC) to train undergraduate students for careers in public health leadership.

Purpose: The purpose of this research is …

Cultural Competency And “The Space Between Spaces”, Charles Wright, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Effects Of Cognitive And Social Demands On Linguistic Production For People With Moderate, Mild, Or No Aphasia, Tyson G. Harmon, Emily Mcdonald, Kyle Steele

Faculty Publications

Background: Most everyday communication occurs in situations where cognitive and social demands are present. These types of situations may compound language deficits for people with aphasia (PWA). An understanding of the language interference that may occur from cognitive and social demands is an important precursor for assessment and intervention that addresses everyday communication situations.

Aims: To determine how cognitively and socially demanding conditions affect micro- and macrolinguistic production for people with moderate, mild, or no aphasia during narrative discourse and to compare effects among groups.

Method: Thirty participants with mild (n = 9), moderate (n = 9), or no (n …

Body-Oriented Gesture Generation System For Medical Interpreter Robots Based On Reinforcement Learning From Human Feedback, Tung Ngo, Emma Murphy, Conor Mcginn, Robert Ross

Conference papers

Medical interpreters are crucial in facilitating communication between healthcare stakeholders who speak different languages. Body-oriented gestures convey critical information essential for accurate and high-quality interpretation in healthcare settings. This study introduces a body-oriented gesture generation system designed for medical interpreter robots based on reinforcement learning from human feedback (RLHF). The system allows robots to interpret more naturally and improve over time through interactions with humans. By adopting a human-centered development approach, we tailor our system to address the actual needs of healthcare stakeholders.

Infusing Machine Learning And Computational Linguistics Into Clinical Notes, Funke V. Alabi, Onyeka Omose, Omotomilola Jegede

Mathematics & Statistics Faculty Publications

Entering free-form text notes into Electronic Health Records (EHR) systems takes a lot of time from clinicians. A large portion of this paper work is viewed as a burden, which cuts into the amount of time doctors spend with patients and increases the risk of burnout. We will see how machine learning and computational linguistics can be infused in the processing of taking clinical notes. We are presenting a new language modeling task that predicts the content of notes conditioned on historical data from a patient's medical record, such as patient demographics, lab results, medications, and previous notes, with the …

Development, Implementation, And Evaluation Of Three Outreach Events To Improve Covid-19 Vaccine Uptake Among Racial And Ethnic Minority Communities In Houston, Texas, 2022, Carmin Munoz-Lavanderos, Abiodun Oluyomi, Omar Rosales, Norvin Hernandez, Nana Mensah-Bonsu, Hoda Badr

Faculty, Staff and Students Publications

OBJECTIVES: Lack of access to timely, accurate, and linguistically appropriate COVID-19 information has complicated the dissemination of evidence-based information and contributed to vaccine hesitancy among racial and ethnic minority groups in the United States. We developed community events that provided outreach, education, and access to COVID-19 vaccination to overcome vaccine hesitancy in these communities.

METHODS: Using spatial analysis techniques, we identified 3 communities with low vaccine uptake in Houston, Texas, in fall 2021; engaged 20 stakeholders from these communities via 4 focus groups to understand barriers to vaccination; and developed and implemented 3 COVID-19 vaccine education and outreach events tailored …

Impact Of Covid-19 On Individuals With Aphasia: Effects On Quality Of Life And Communication, Kaci L. Gammon

Honors College Theses

Speech-language pathologists (SLPs) help people with aphasia (PWA) manage their communication symptoms and become more independent by supporting them linguistically and emotionally. During COVID-19, speech and language services were not as readily available to PWA due to quarantine restrictions resulting in isolation within this population. Individuals with aphasia had to redirect and find a new way to function daily. This study explored factors that affected quality of communication and quality of life for PWA during the pandemic, including technology, living situation, timing of stroke, and speech-language pathology services. Through an online survey, PWA from across the country expressed how their …

Multimodal Prediction Of Obsessive-Compulsive Disorder And Comorbid Depression Severity And Energy Delivered By Deep Brain Electrodes, Saurabh Hinduja, Ali Darzi, Itir Onal Ertugrul, Nicole Provenza, Ron Gadot, Eric A Storch, Sameer A Sheth, Wayne K Goodman, Jeffrey F Cohn

Faculty, Staff and Students Publications

To develop reliable, valid, and efficient measures of obsessive-compulsive disorder (OCD) severity, comorbid depression severity, and total electrical energy delivered (TEED) by deep brain stimulation (DBS), we trained and compared random forests regression models in a clinical trial of participants receiving DBS for refractory OCD. Six participants were recorded during open-ended interviews at pre- and post-surgery baselines and then at 3-month intervals following DBS activation. Ground-truth severity was assessed by clinical interview and self-report. Visual and auditory modalities included facial action units, head and facial landmarks, speech behavior and content, and voice acoustics. Mixed-effects random forest regression with Shapley feature …

The Experiences Of Older Immigrants Living With Dementia In Australia: A Multi-Method Secondary Analysis, Pelden Chejor

Theses: Doctorates and Masters

The ageing immigrant population and rising dementia cases underscores the need for culturally appropriate dementia care services. However, accessing dementia care services can be challenging for immigrants due to cultural and linguistical differences including their health beliefs. Understanding the experiences and concerns of older immigrants living with dementia is imperative for the planning and delivery of culturally and linguistically appropriate care. The aim of this thesis was to explore and describe the experiences of older immigrants living with dementia, as well as to describe and compare (against non-immigrants living with dementia) the characteristics (neuropsychiatric symptoms and pain characteristics) of older …

Developmental Change In English-Learning Children’S Interpretations Of Salient Pitch Contours In Word Learning, Carolyn M. Quam, Daniel Swingley

Speech and Hearing Sciences Faculty Publications and Presentations

To efficiently recognize words, children learning an intonational language like English should avoid interpreting pitch-contour variation as signaling lexical contrast, despite the relevance of pitch at other levels of structure. Thus far, the developmental time-course with which English-learning children rule out pitch as a contrastive feature has been incompletely characterized. Prior studies have tested diverse lexical contrasts and have not tested beyond 30 months. To specify the developmental trajectory over a broader age range, we extended a prior study (Quam & Swingley, 2010), in which 30-month-olds and adults disregarded pitch changes, but attended to vowel changes, in newly learned words. …

Factors Affecting Users’ Satisfaction With Telehealth Apps: Analysis Of Users Reviews Using Bert, Abdullah Wahbeh, Tyler Howes, Omar El-Gayar, Raed Seetan, Mohammad A. Al-Ramahi, Ahmed Al-Omari

All Faculty Scholarship (Archived)

Telehealth mobile apps and telehealth services are increasingly used by patients, particularly, post-COVID-19. This study examines factors related to users’ satisfaction with these apps and services by analyzing reviews from actual telehealth app users. A total of 53,209 reviews were collected from nine telehealth apps on the Google Play store. Using BERT embeddings, UMAP, and HDBSCAN, topics were generated and labeled to identify these factors. Results showed that telehealth app users expressed several factors related to satisfaction with telehealth apps, which could impact the acceptability and adoption of such apps. These include usability (ease of use), usefulness, convenience and efficiency, …

Interventions Connecting Young People Living In Africa To Healthcare; A Systematic Review Using The Re-Aim Framework, Titilola Abike Gbaja-Biamila, Chisom Obiezu-Umeh, Ucheoma Nwaozuru, David Oladele, Alexis Engelhart, Thembekile Shato, Stacey Mason, Victoria Carter, Juliet Iwelunmor-Ezepue

2020-Current year OA Pubs

INTRODUCTION: Africa's young people are among the least focused groups in healthcare linkage. The disproportionally high burden of youth-related health problems is a burden, especially in developing regions like Africa, which have a high population of young people. More information is needed about factors that impact linkages in healthcare and the sustainability of health interventions among young people in Africa.

METHODS: A systematic literature search was performed from October 2020 to May 2022 in PubMed, CINAHL, Scopus, Global Health, and the Web of Science. Studies included in the review were conducted among young people aged 10-24 living in Africa, written …