Digital Commons Network^™

Accuracy Of The Nestlé Mini Nutritional Assessment® (Mna®) Screen In Identifying Prealbumin–Defined Malnutrition Amongst Spine Surgery Patients, Stylianos Mysirlidis, Luke Fischbach, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden

SPARK Symposium Presentations

Abstract:

Background:

Malnutrition is a significant risk factor for patients undergoing surgery, including those receiving spine surgery. These patients are at greater risk of adverse postoperative outcomes, impaired wound healing, and spinal fusion failure. Therefore, it is essential to identify at-risk, malnourished patients prior to intervention to mitigate any complications such as surgical site infections, unplanned readmissions, and reoperations. The primary focus of this study was to assess the accuracy of the Nestlé Mini Nutritional Assessment® (MNA®) on identifying true malnutrition amongst those patients undergoing spine surgery.

Methods:

We conducted a retrospective cohort study of 674 consecutive …

Long-Lasting Impact Of Public Health Dentistry, Michal Herman Dds, Facd

Journal of the American College of Dentists

This article reflects on the enduring impact of public health dentistry through the author’s 25-year professional journey serving underserved and marginalized communities. It examines persistent barriers to equitable oral health care, including workforce shortages, inadequate insurance coverage, racial disparities, and limited access in rural and low-income populations. Drawing on experiences in nonprofit and community dentistry, the article highlights the importance of mentorship, advocacy, leadership, and community engagement in addressing oral health inequities. It argues that public health dentistry represents a form of professional altruism grounded in service and social responsibility, and calls on dental professionals to expand access, support workforce …

Fuel Your Focus: The Improtance Of Diet For Listening, Lauren Martins

A. The Science of Sound

This infographic presents an overview of the importance of diet for listening. Foods affect energy, memory, concentration, and other factors that influence listening.

Influence Of Serum Vitamin D Levels On Marginal Bone Loss Around Unsplinted Mandibular Implant Overdentures: A Retrospective Study, Rahma El Hussany Mohammed El Desouky, Fatma Ahmad El-Waseef

Mansoura Journal of Dentistry

Objective: To investigate the impact of serum vitamin D levels on marginal bone loss (MBL) in patients restored with unsplinted-mandibular-implant overdentures using LOCATOR attachments. Materials and Methods: Thirty participants rehabilitated with three-implant-mandibular overdentures were included. Based on serum vitamin D at the time of prosthetic loading, participants were categorized into two equal groups: a test group with deficient vitamin D (< 20 ng/mL) and a control group with sufficient levels (≥30 ng/mL). Patients with borderline levels (21–29 ng/mL) were excluded. Peri-implant vertical (VBL) and horizontal bone loss (HBL) were measured at baseline (T0), 6 months (T6), and 12 months (T12). Results: The vitamin D-deficient group exhibited significantly elevated VBL and HBLover the sufficient group at all-time points (P

Cephalometric Norms And Sexual Dimorphism In The Tanzanian Population: A Comparative Study With Caucasian And West African Norms, Ali K. Hamad, Ferdinand M. Machibya, Matilda M. Mlangwa, David N. Ngassapa

Mansoura Journal of Dentistry

Objective: This study aimed to establish cephalometric norms for the Tanzanian population, assess sexual dimorphism in cephalometric measurements, and compare these findings with established Caucasian and West African norms to enhance orthodontic diagnosis and treatment planning. Materials and Methods: A crosssectional study was conducted on 309 subjects (142 males, 167 females) at Muhimbili University Dental Clinic. Cephalometric radiographs were digitally traced using Quick Ceph Studio. Reliability was assessed using the inter-class correlation coefficient. The Kolmogorov-Smirnov test checked normality, while one-sample t-tests and Student’s ttests (p < 0.05) were used for comparisons. Data were analyzed with RStudio. Results: Tanzanians showed significantly smaller craniofacial measurements than Caucasians. Males had larger skeletal dimensions than females. Compared to West Africans, Tanzanians had generally higher values, with a few exceptions. Conclusion: Tanzanians display distinct craniofacial characteristics, differing from both Caucasians and West Africans. These findings support the need for population-specific cephalometric norms to guide accurate orthodontic diagnosis and treatment.

Not Biological, But Built: Structural And Metabolic Pathways Driving Black Maternal Health Disparities In The United States, Alexandra I. Umegboh

CMC Senior Theses

Black infants in the United States are more than twice as likely to die before their first birthday than white infants, a disparity often attributed to genetics, behavior, or individual health choices. However, this idea is challenged by a key contradiction: African immigrant women consistently experience better birth outcomes than U.S.-born Black women despite being similarly racialized. This thesis investigates the origins of this reproductive advantage and the factors contributing to its decline over time. By drawing on epidemiological data, metabolic health research, and literature on African diasporic healing traditions, it argues that the “healthy immigrant effect” is not biological, …

Clinico-Epidemiological Profile Of Iron Deficiency Anemia Among Egyptian Primary School Aged Children: A Hospital Based Study, Rabab Fathy Abdelhamid, Noha Essam, Mona Mohamed Taalab

Mansoura Medical Journal

Background: Iron deficiency anemia (IDA) is the most prevalent cause of anemia among Egyptian children and is associated with a range of hematologic and non-hematologic complications, some of which may be irreversible. This study aims to evaluate the clinical profile and identify factors associated with severe IDA in primary school–aged children.

Methods: This cross-sectional study included 420 primary school–aged children diagnosed with IDA who attended the outpatient clinic of Salamoun El-Qumash Family Medicine Centre. Data were collected through face-to-face interviews using a structured questionnaire. All participants underwent a thorough clinical examination and laboratory evaluation, including a complete blood count and …

Drug-Induced Sleep Endoscopy Findings In Obese Adolescents With Sleep Apnea, Timothy Kearney, Turaj Vazifedan, Cristina M. Baldassari

Department of Otolaryngology (ENT) Faculty Publications

Objective

Data regarding drug-induced sleep endoscopy (DISE) findings in obese adolescents with obstructive sleep apnea (OSA) are lacking; such information could be used to direct and improve management as there is controversy whether adenotonsillectomy (AT) or positive airway pressure is standard therapy for this population. Our primary objective is to describe DISE findings in obese adolescents.

Study Design

Case-control.

Setting

Tertiary care children's hospital.

Methods

A 10-year retrospective review was conducted of obese adolescents 12 to 21 years old with OSA (apnea-hypopnea index [AHI] ≥ 1) that underwent DISE prior to AT. All DISE procedures were scored utilizing a modified …

Factors Affecting Percentage Of Low Birth Weight In Ohio, Maureen Schmid, Mira Krishnan

Scholarship in Medicine - All Papers

A multitude of environmental factors correlate to negative outcomes on maternal and fetal health such as low birth weight. While studies reveal that housing quality, air pollution, and stress contribute to negative birth outcomes, it is unclear which housing factors have the greatest impact and how rural, suburban, and urban settings in the U.S. differ. The objective of this study was to delve into how environmental factors such as housing quality and community type impact low birth weight in Ohio. This study used publicly available data from County Health Rankings and Roadmaps to examine how different housing conditions correlate to …

Exploring Demographic Factors Relating To Low Birth Weight In Rural Vs Urban Ohio, Meghan Curran, Jessica Terrell

Scholarship in Medicine - All Papers

Although medical advancements have improved the outcomes for infants born with low birth weight (LBW), these interventions are very expensive and low birth weight still was attributed to 16.1% of infant deaths in the United States in 20201. By understanding the factors that influence the incidence of low birth weight in the United States, preventative measures can be implemented to reduce the need for costly interventions and enhance infant health outcomes. In this study, we focused on 38 counties in Ohio that had either 75% or greater rural regions or 30% or less rural regions. Additionally, we focused on four …

Communicating With The Virtual Patient: Student Perceptions Of Genai In Dietetic Training, Suzanne Doyle Dr, Aileen Kennedy Dr

Case studies: Digital Education

Background: Communication skill development is a key component of dietetic education. Traditional teaching methods such as role play and simulated consultations are effective but resource intensive. Generative artificial intelligence (GenAI) may provide an accessible supplementary tool for communication skills practice. This initiative aimed to explore dietetic students’ experiences of using a GenAI simulated patient consultation as a revision aid to support communication skill development.

Methods: This evaluation involved second-year BSc Human Nutrition and Dietetics students undertaking the Professional Practice and Communications module. Following six face-to-face communication workshops, students completed a GenAI simulated consultation involving a 56-year-old male recently diagnosed with …

The Role Of Ot In Enhancing Mental Health Outcomes For Primary Care Patients, Amorelle Upton

Occupational Therapy Capstones

Purpose. Primary care settings often serve as the first point of contact for individuals experiencing mental health concerns. However, occupation-based and function-focused interventions remain underutilized in these settings. The purpose of this Doctoral Experiential Capstone (DEC) was to implement an Occupational Therapy Mental Health Toolkit designed to support holistic and integrative mental health care in primary care settings.

Methods. This project was guided by the ecology of human performance (EHP) model. Methods included a literature synthesis, development of a Memorandum of Understanding (MOU) and structured learning objectives, contextual needs assessment through stakeholder collaboration and site observation, and a product design, …

Supporting Reentry: An Occupation-Based Approach, Savannah B. Ullyott

Occupational Therapy Capstones

Introduction: Individuals transitioning back into the community following incarceration need holistic care to support a successful reintegration process (National Institute of Justice [NIJ], 2023). There are a variety of supports and barriers to successful reintegration that should be considered when guiding programming for this population, as these individuals often face many challenges when transitioning back into the community (Galletta et al., 2021). Specific supports facilitating successful transitions back into the community includes those of basic or daily needs, often related to housing, employment, transportation, social supports, food security, and access to mental and physical health services (Galletta et al., 2021; …

Early Occupational Therapy Services: Addressing Health Disparities Following Discharge From The Nicu, Ellie Maree Schumacher

Occupational Therapy Capstones

Background and Purpose: One out of ten infants born in the United States are admitted to the Neonatal Intensive Care Unit (NICU); a status that has been directly linked to ongoing infant health disparities and disabilities, requiring continued support and education following discharge (Griffith et al., 2022; National Center for Health Statistics, 2025). NICU graduates and their families work with occupational therapy to address or prevent developmental delays and ensure well-being (Craig, 2018; Riley & de Sam Lazaro 2021).

Methodology: A literature review was conducted to determine the needs of the population and context and include NICU admissions, family needs, …

Achieving Successful Occupational Performance During Transitions In Eating Disorder Treatment, Elise Kay Ramberg

Occupational Therapy Capstones

Introduction: Individuals with eating disorders experience challenges in occupational engagement that stem from contributing meaning, value, and purpose to occupations that support eating disorder behaviors rather than promote quality of life (Mack et al., 2023). Recovery is highly dependent on the transition between both levels of care and back into the patient’s natural environment. Occupational therapists play an essential role in supporting patients as they transition and learn to re-engage in their lives outside of their eating disorder (Mack et al., 2023). The purpose of this project was to create materials for the occupational therapist to employ with eating disorder …

The Therapy Behind The Tractor: An Occupational Therapists’ Guide For Treating Farmers, Allison Haiby

Occupational Therapy Capstones

Background: Historically, farming is known as a highly laborious job, placing farmers at increased risk for injury. Despite an injury, the farm must continue to be cared for. Although occupational therapy cultivates client-centered care, many therapists have limited knowledge of farming culture and best practice methods to integrate the demands of farming into therapy.

Purpose: The purpose of this scholarly project was to develop an educational guide, Built for the Farm: An Occupation-Based Guide for Therapists Working with Farmers, to support therapists treating farmers. The guide promotes culturally informed, occupation-based strategies to strengthen therapeutic relationships and improve the healthcare experiences …

Mitigating The Effects Of Technology Use In The Classroom: An Occupational Therapy Approach, Hannah E. Ibach

Occupational Therapy Capstones

Background: The average child spends three times the recommended time on technology, which is leading to a wide range of consequences affecting education, such as fine motor, cognitive, and social deficits (Christensen, 2021; McGough, 2021; Qi et al., 2023). Parents and teachers play a crucial role in helping children be prepared for their education, yet many are not aware of the impacts of too much technology use (Srivastava, 2022). Developing strong foundational skills early in childhood is critical for setting the stage for long-term educational success. When skills are nurtured from a young age, children are better prepared to adapt …

Development Of Feed In Context: A Context-Responsive Pediatric Feeding Guide For Rural Practice Guided By The Ecology Of Human Performance Model, Jatin Lee Cranmore

Occupational Therapy Capstones

Background: Pediatric feeding participation is influenced by complex interactions among sensory processing, motor coordination, emotional regulation, caregiver routines, and environmental conditions. When feeding challenges occur, the impact extends beyond nutrition and may limit participation in family routines, school environments, and community activities (St. John et al., 2026; St. John & Ausderau, 2024). Access to specialized feeding services can be particularly limited in rural communities where healthcare workforce shortages and geographic barriers reduce the availability of pediatric rehabilitation services (Tak et al., 2022). Occupational therapy practitioners are uniquely positioned to address feeding participation because occupational therapy practice examines the interaction among …

Herbivore Identity And Species Richness Shape Fruit Chemical And Quality Responses To Foliar Herbivory, Xavier Ozowara, Taylor M. Sloey, Susan R. Whitehead

Biological Sciences Faculty Publications

The cascading consequences of foliar herbivory on fruit chemistry and quality remain relatively underexplored, with most existing studies focusing on the effects of only one or two attackers. In this study, we examine how increasing herbivore species richness during foliar herbivory alters strawberry (Fragaria × ananassa Duch) fruit quality and phenolic chemistry. We conducted a greenhouse experiment with single species feeding and different combinations of feeding by three generalist lepidopteran species: Spodoptera frugiperda, Heliothis virescens, Helicoverpa zea. Species fed on leaves for 72 h as fruits ripened, and fully ripe fruits were harvested 72 h after …

Non-Pharmacological Interventions For The Management And Prevention Of Hypertensive Disorders In Pregnancy: A Review Of The Literature, Shenelle K. Smith, Laurena E. Lepp

All Electronic Theses and Dissertations

Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE), are a leading cause of maternal and perinatal morbidity and mortality worldwide. In the United States, rates of HDP continue to rise and are associated with preterm birth, fetal growth restriction, and long-term cardiovascular disease. Current management focuses only on low-dose aspirin for prevention. Surveillance and timely delivery remain the only definitive treatment for preeclampsia. This highlights a critical gap in prevention. Emerging evidence suggests that non-pharmacological interventions–particularly nutrition, physical activity, and lifestyle modification–may reduce the risk and severity of HDP. These approaches align with midwifery models of care emphasizing prevention, education, …

What Does The Quality Of Life For Congenital Heart Defect Patients Look Like Across The Lifespan?, Kaylee F. Maynor

Undergraduate Honors Theses

Throughout history, birth defects have left a mark on patients and families across the world. From an infant's first few breaths to an elderly person's last breath, congenital heart birth defects play a major role in that person's life. There are many different types of birth defects that effect the heart. Each defect is unique and has different outcomes on the body. Some congenital heart diseases have multiple defects causing more than one complication. The treatment options for many of the common congenital heart birth defects have come a long way throughout decades of research. By diving into what heart …

Altered Natural Killer Cell Function In Children With Severe Malaria, Grace Turyasingura, Kagan A. Mellencamp, Ruth Namazzi, Robert Opoka, Chandy C. John, Geoffrey T. Hart

Paediatrics and Child Health, East Africa

Memory-like natural killer (NK) cells with enhanced antibody-dependent cellular cytotoxicity (ADCC) have correlated with protection from uncomplicated malaria in prior studies. However, the role of NK cells in severe malaria (SM) has not been characterized. In Ugandan sites with moderate and low malaria transmission, we evaluated NK cell (CD56bright, CD56dim, CD56neg) phenotype and ADCC function by flow cytometry in children < 5 years of age with SM (n = 21) and control community children (CC, n = 19). Children with SM had similar total NK cell counts to CC. Children with SM had a higher proportion of LILRB1+ NK cells than CC. The level of malaria transmission …

Elevated Bmi And The Effect On Breastfeeding Duration In Postpartum Individuals: An Integrative Review, Abigail E. Mobilia, Kirstin A. Wyly

All Electronic Theses and Dissertations

Introduction: It has been well documented that exclusive breastfeeding provides benefits for infants and postpartum individuals, yet rates remain suboptimal in the United States, particularly among those with elevated pre-pregnancy body mass index (BMI). Evidence suggests that elevated BMI is associated with shorter breastfeeding duration and may be influenced by physiologic, social, and structural factors. This integrative review synthesizes existing literature to clarify the relationship between elevated BMI and exclusive breastfeeding duration among postpartum individuals.
Methods: An integrative review was conducted following Whittemore and Knafl’s (2005) framework and PRISMA 2020 guidelines. A systematic search of PubMed, CINAHL, and Nursing & …

An Exploratory Study To Determine The Feasibility And Processes Needed To Implement The Immunization Neighborhood To Increase Hpv Vaccination Among African American Adolescents And Adolescents In The General Population: A Multi-Partner Perspective, Jennifer Cunningham-Erves, Freneka Minter, Pamela C. Hull, Amanda F. Dempsey, Alexandria Demons, Mariya Chalise, Consuelo H. Wilkins

Behavioral Science Faculty Publications

Limited education and healthcare access are major contributors to Human Papillomavirus (HPV) vaccination disparities among African American adolescents. The Immunization Neighborhood (IN) involves enhanced communication and collaboration among providers to address people’s needs by expanding access points and education to increase vaccination. Because needs of immunization providers and parents to effectively collaborate are unknown, this study explored the feasibility of and processes needed for IN utilization across key partners: pediatricians, pharmacists, school nurses, health department staff, and African American parent–child dyads. We conducted a semi-structured interviews in a qualitative, descriptive study with a purposive sample of 30 African American parent–child …

Feeding The Family—A Food Is Medicine Intervention: Preliminary Baseline Results Of Clinical Data From Caregivers And Children, Gabriela Drucker, Christa Mayfield, Elizabeth T. Anderson Steeves, Sara Maksi, Tabitha Underwood, Julie Brown, Marissa Frick, Alison Gustafson

Behavioral Science Faculty Publications

Background/Objectives: Food is Medicine (FIM) programs have been shown to be effective at addressing food and nutrition insecurity among individuals. However, more evidence is needed to determine effective interventions at the household level and their impact on child health outcomes. Feeding the Family is a randomized controlled trial which aims to determine whether the amount of food provided and the ability to select foods in FIM interventions have an incremental effect on child and caregiver clinical outcomes relative to nutrition counseling alone. The objective of this paper is to describe the population at baseline among those enrolled in Feeding the …

A Ubiquitous Organophosphate Flame Retardant Disrupts Energy And Glucose Homeostasis In Mice, Krystal M. Sewell, Kelly Oriakhi, Sara Y. Ngo Tenlep, Megan L. Weaver, Mansura Shahad Bawa, Se-Hyung Park, Shubh Saraswat, Xiaohua D. Zhang, Robert N. Helsley, Samir Softic, Cetewayo S. Rashid

Pharmacology and Nutritional Sciences Faculty Publications

Organophosphate flame retardants (OPFRs) are used in many consumer products, and their presence in our environment raises concerns about potential health dangers. In humans, exposure to OPFRs, such as tris(1,3-dichloro-2-propyl) phosphate (TDCPP) is associated with metabolic disorders such as obesity, hyperglycemia, and insulin resistance. Our current study seeks to determine how TDCPP exposure affects body composition, glucose homeostasis, and energy balance in a rodent model. C57Bl/6 J mice were divided into two weight-matched groups and fed purified low phytoestrogen diets containing either 0.1 % DMSO (control) or TDCPP 415 mg/kg resulting in an approximate exposure of 50 mg/kg/day. Both male …

Contribution Of Metabolism-Independent Glucose Sensing To Metabolic Homeostasis, Nadia Rashid, Kavaljit H. Chhabra

Pharmacology and Nutritional Sciences Faculty Publications

Glucose sensing and signaling are central to cellular metabolic machinery for the regulation of metabolic homeostasis. Glucose sensing has been almost always assumed to be coupled with glucose metabolism; however, recent findings have unraveled metabolism-independent sensing mechanisms. Here, we discuss whether glucose transporters (GLUTs) and sodium-glucose co-transporters (SGLTs) may also function as glucose sensors independent of their roles in transporting glucose. Moreover, we review the emerging roles of G protein-coupled receptors (GPCRs) in sensing glucose and, consequently, initiating its signaling pathways in a cell-specific manner. Altogether, this review offers insights into the newly identified glucose sensing mechanisms and highlights the …

Anatomical Atlas Of Kinase Responsiveness To Weight Gain: Adipose Depot Reprogramming In Diet-Induced Adiposity, Wang-Hsin Lee, Zachary A. Kipp, Sally N. Pauss, Genesee J. Martinez, Mei Xu, Terry D. Hinds, Jr.

Pharmacology and Nutritional Sciences Faculty Publications

Background/Objectives: Adipose tissue depots located at different anatomical sites exert differential functions in response to adiposity and glucose intolerance. These fat depots exhibit distinct metabolic signaling patterns that may influence pathological fat accumulation, thereby affecting the efficacy of anti-obesity interventions. Nonetheless, the mechanisms underpinning depot-specific signaling and pathway responsiveness remain insufficiently understood.

Methods: Kinase activity was characterized during the progression of adiposity across five adipose tissue depots in obese versus lean mice using the advanced PamGene kinome technology. Furthermore, kinase pathways in human preadipocytes and mouse 3T3-L1 preadipocytes were analyzed and compared with those in their differentiated, mature adipocytes. The …

The Effects Of Childhood Maltreatment On Executive Functioning: The Difference Between Cumulative Trauma, Abuse Severity, And Neglect, Kelly Krehbiel

Master's Theses or Doctor of Nursing Practice

Childhood maltreatment is prevalent in the United States with around 558,899 children being victims of abuse in 2022 (U.S Department of Health & Human Services, 2024). Neglect is the most common form of abuse with around 74 percent of abused children being neglected; however, neglect tends to be the least researched form of abuse. Childhood maltreatment has long-term effects on a person’s mental, physical, and cognitive health. Previous research suggests that childhood maltreatment leads to severe deficits in executive functioning skills such as working memory and cognitive flexibility. Executive functioning skills are important for almost every aspect of life including …

Stronger Starts: Advancing Maternal And Infant Health In Breathitt County, Kentucky, Madisyn Smith

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal and infant health outcomes remain significantly poorer in rural Appalachian communities, where structural and socioeconomic barriers limit access to timely and comprehensive care. Kentucky reports elevated rates of preterm birth and infant mortality, with counties such as Breathitt County facing challenges including limited obstetric services, transportation barriers, and high poverty rates. These factors contribute to delayed prenatal care, fragmented services, and increased risk of adverse outcomes.

The Stronger Starts Initiative is an evidence-informed public health program designed to improve maternal and infant health outcomes through a coordinated, multi-level approach. The program integrates nurse-led home visiting, telehealth obstetric consultations, community-based …