Digital Commons Network^™

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

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

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

Momentum For Healthy Births-Hardin County, Ky, Brittany R. Jackson

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

Maternal and infant health disparities in Hardin County, Kentucky, reflect persistent gaps in timely access to care, particularly among rural and underserved populations. Structural barriers, including transportation limitations and unmet social needs, contribute to delayed prenatal care initiation and low postpartum follow-up, increasing the risk of adverse outcomes. This capstone project proposes the MOMentum (Maternal Outreach and Monitoring for Mothers) Program, an integrated care model designed to strengthen access, improve care coordination, and enhance continuity across the prenatal and postpartum period.

The program combines a Community Health Worker (CHW)-led navigation model with enhanced postpartum care supported by telehealth services and …

Dual Regulation Of Osteogenesis And Inflammation By Pomegranate (Punica Granatum L.) Extract In Periodontal Ligament-Derived Stem Cells: Implications For Regenerative Medicine, Mai Hafez

Dentistry

Objectives

This article aims to compare the osteogenic along with anti-inflammatory activity of different concentrations of pomegranate extract (PG) on human periodontal ligament-derived stem cells (hPDLSCs) in vitro.

Materials and Methods

hPDLSCs were acquired from the root surface of removed molars, cultured, and then distinguished by flow cytometry analysis and several lineage differentiation potentials. To identify the effect of PG on hPDLSCs' viability, an MTT assay was performed. hPDLSCs were maintained in osteogenic induction medium with varying concentrations of PG. At the end of the induction period, osteogenesis was assessed using Alizarin Red staining, ALP assay, and qRT-PCR to determine …

Protein Intake Patterns, Health Profiles, Body Composition Among Us Adults By Physical Activity Levels: Nhanes 2017–2020, Jacqueline Vernarelli, Jessica R. Kiel, Christopher D. Coleman, Satya S. Jonnalagadda

Public Health Faculty Publications

Regular physical activity is known to provide numerous health benefits, including improvements in cardiovascular function, metabolic health, and mental well-being. This study aimed to assess the metabolic, behavioral, and physiological benefits of physical activity in US adults and compare the dietary intake of active versus inactive individuals, with a specific focus on protein consumption. This study used data from 7,910 adults (>18 y) who participated in the 2017–2020 NHANES Pre-Pandemic Survey. As part of the NHANES, height and weight were measured by trained examiners, dietary intake data was collected using 24-hour recall. Data analysis was conducted using SAS 9.4 …

Fusion, 2026, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Moving Forward Together For Cancer Recovery: Collaborative Guide For Researchers And Cancer Care Organizations, M. Madison Kindred, Karen E. Wickersham, Daneille E. Ostendorf, Bernardine M. Pinto

Faculty Publications

No abstract provided.

A Narrative Review Of The High-Carbohydrate Fueling Revolution (≥100 G/H) In The Professional Peloton, Patrick B. Wilson

Exercise Science Faculty Publications

High-carbohydrate fueling in cycling (defined as ≥ 100 g/h for this paper) has received significant media attention in recent years. Whether this practice improves performance, however, remains an unresolved issue in the scientific literature. The purpose of this narrative review is to provide an up-to-date analysis of the practice of high-carbohydrate fueling, with a specific focus on potential performance implications in professional cycling. Topics covered include historical carbohydrate intake guidelines, research directly comparing high-carbohydrate fueling with traditional fueling guidelines, theorized benefits of high-carbohydrate fueling specific to cycling, potential risks associated with high-carbohydrate fueling, and personalizing carbohydrate intakes. Among a small …

Improving Early Detection And Response To Clinical Deterioration Among Nurses Through Competency-Based Interventions, Courtney E. Miller

Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Clinical deterioration among hospitalized patients remained a significant contributor to preventable morbidity and mortality, often due to delayed recognition and response in general care settings (Choi et al., 2025; Chung & Jung, 2024).

PICOTS: For registered nurses working on a general level of care inpatient hospital unit (P), how did a competency-based training program bundle incorporating didactic educational intervention of learning how to use technology, machine learning (ML) based early warning system (EWS) of trends and patterns to identify at risk patients, and low-fidelity simulation-based education (SBE) (clinical readiness to improve confidence with education and coaching) (I), …

Metabolism As A Regulator Of Sleep And Cortical Activity In Health And Alzheimer’S Disease, Nicholas J. Constantino

Theses and Dissertations--Neuroscience

Metabolic flexibility is essential for maintaining normal physiological function, enabling an organism to sense, flux, utilize, and switch fuel sources in response to changing energetic availability, demand, and cellular needs. Energetic demands are state-dependent, with wake and sleep exhibiting distinct metabolic profiles. Sleep is highly sensitive to changes in metabolism and requires metabolic flexibility to both transition into and maintain sleep stability. Alzheimer’s disease (AD) is increasingly recognized as a disease of altered metabolism yet is often framed as a disease of energetic failure. We instead define AD as a disease of metabolic inflexibility, characterized not by insufficient energy availability, …

A Tale Of Two Serpins: Pathologic And Protective Roles Of Agt And Pai-1 In Metabolic And Cardiovascular Disease, Alex C. Pettey

Theses and Dissertations--Physiology

Metabolic and cardiovascular diseases are leading causes of morbidity and mortality worldwide. Conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), aortic aneurysm, and cardiac fibrosis have limited pharmacological therapies, underscoring the need for deeper mechanistic investigations. Serine protease inhibitors (serpins) have been implicated in these pathologies and represent potential therapeutic targets. Despite structural homology, serpins regulate diverse physiological processes through both protease inhibition and non-inhibitory mechanisms. This dissertation examines the roles of two serpins, angiotensinogen (AGT) and plasminogen activator inhibitor-1 (PAI-1), in preclinical models of metabolic and cardiovascular disease to identify novel mechanisms that may inform future therapeutic strategies. …

A Quality Improvement Project: Nurse-Led Nutritional Support To Reduce Missed Chemotherapy Appointments, Eva Balboa

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction/Background

Malnutrition affects approximately 43% of cancer patients nationally and is associated with missed chemotherapy appointments, treatment interruption, and poor clinical outcomes. At a 30-chair outpatient cancer center in South Texas, a retrospective chart review revealed that 45% of patients experienced malnutrition-related symptoms contributing to appointment disruptions. Despite evidence-based recommendations for routine nutritional screening and support, no standardized protocol existed at this site.

Objectives

 The purpose of this quality improvement project was to implement a nurse-led nutritional support protocol and evaluate its effectiveness in (1) reducing the missed chemotherapy appointment rate from 10% to 5%, (2) achieving 100% compliance with …

Optimizing Healthy Aging: A Preventative Approach To Support Community-Dwelling Older Adults, Jada Welke

Occupational Therapy Capstones

Introduction: Healthy aging is a complex and multidimensional process influenced by physical, cognitive, psychosocial, environmental, and lifestyle factors across the lifespan. Increasing evidence from researchers suggests that many health care systems continue to rely on reactive models that address decline only after functional limitations emerge. Preventive interventions initiated in midlife have the potential to significantly influence long-term health outcomes, independence, well-being, and quality of life. As a result, there is growing recognition that multidimensional, proactive screening and intervention should begin earlier, before age-related conditions become clinically significant.

Purpose: The purpose of this scholarly project was to address this need through …

From Play To Pressure: Understanding Early Sports Specialization Through An Occupational Lens, Kiley Jade Washnieski

Occupational Therapy Capstones

Background: Youth sport participation plays a significant role in the daily lives of children ages 6-12 (Lee et al., 2018). Participation in organized sports can offer numerous benefits; however, the expectations surrounding youth sports have evolved over time. Increased emphasis on early specialization has intensified training demands and performance pressures placed on youth athletes during critical developmental years (Brenner et al., 2019). Although occupational therapy is well positioned to address both the physical and psychosocial demands of youth sport participation, the profession’s role within this context remains underexplored (Bulan et al., 2025).

Purpose: The purpose of this scholarly project was …

Enhancing Leisure Opportunities For People With Disabilities In Rural Communities, Joslyn Mary Nordmark

Occupational Therapy Capstones

Purpose. The purpose of this scholarly project was to promote access to leisure opportunities for people with disabilities in rural areas. The author addressed unmet needs among this population considering personal, occupational, environmental, cultural, and socioeconomic factors. The goal was to develop a product that provided opportunities regardless of abilities to promote leisure exploration and participation, social engagement, and life skill development for people with disabilities

Methods. The author conducted a needs assessment through a literature review following the Model of Human Occupation (MOHO), collaborations with site staff, and an on-site observation and environmental analysis. Data was examined to identify …

Introduction Of Occupational Therapy Into A Suburban Supportive Housing Organization, Madeline Kuntz

Occupational Therapy Capstones

Abstract: Unhoused individuals experience compounded barriers beyond housing access and are often underserved within occupational therapy practice. This doctoral capstone project partnered with a nonprofit residential program to develop a research-informed onboarding manual grounded in the holistic occupational therapy framework, Model of Human Occupation (MOHO, O’Brien, 2017). The manual was designed to clarify expectations of the supportive housing program, address diverse resident needs, and promote independence as the organization expands. Development was informed by a comprehensive literature review and informal needs assessment of the organization, identifying anticipatory barriers and supports commonly experienced prior to program entry. Key areas of need …

Empowering Caregivers: An Occupational Therapy-Informed Educational Program For Dementia Care In Rural Communities, Maria Lynn Johnson

Occupational Therapy Capstones

Purpose: Hospitalization presents significant risks for individuals with dementia, including increased behavioral and psychological symptoms (BPSD), delirium, functional decline, and reduced occupational engagement (Boltz et al., 2023; Teichmann et al., 2019; Zwingmann et al., 2020). Acute care environments are often overstimulating, unfamiliar, and task-oriented, which can exacerbate cognitive impairment and contribute to caregiver distress. Despite strong evidence supporting nonpharmacological, occupation-based interventions, structured engagement opportunities are rarely integrated into acute care workflows (Burgdorf et al., 2023; Faeder et al., 2023). This doctoral capstone project aimed to develop occupation-based dementia activities for use during hospitalization while equipping formal and informal caregivers with …

Intermittent High-Fat, High-Sugar Access During Adolescence Drives Binge-Restriction Feeding And Reduced Weight Gain In A Food Unpredictability Model, Calvin G. Miller

CMC Senior Theses

Food insecurity affects nearly 48 million Americans and 318 million people worldwide, with very low food security disrupting normal eating habits through “feast-or-famine” episodes characterized by cycles of food overconsumption followed by restriction. This dietary pattern alters dopamine signaling within the mesocorticolimbic system — brain circuitry intimately linked to reward processing. This system includes the ventral tegmental area (VTA) and prefrontal cortex (PFC). Overstimulation can be promoted through sporadic high-fat, high-sugar diet (HFHSD) exposure, promoting dopamine neuron architecture alterations and binge-eating behavior. Adolescence represents a vulnerable window, as mesocorticolimbic dopamine projections undergo maturation during this period. Though evidence links food …

Politics Of A Silent Pandemic: Antimicrobial Resistance And State Capacity In India And Nigeria, Mia Kelly

CMC Senior Theses

Antimicrobial Resistance (AMR) has emerged as one of the most pressing yet widely underestimated health threats of the 21st century; this thesis explores the potentially devastating global impact of this “silent pandemic”, exposing how deeply health outcomes depend on political choices, regulatory capacity, and economic constraints. Although the danger of spreading drug-resistant pathogens is now widely acknowledged in both the scientific and political communities, states differ in their abilities to contain the issue, with low- and middle-income countries facing the greatest obstacles to national action plan implementation. This thesis investigates these disparities through a comparison of India and Nigeria, two …

Roles Of Cytokines In Modulating Trypanosoma Brucei Rhodesiense Infection Outcomes In Vervet Monkeys, Clarah Jebet, John Kibuthu Thuita, Daniel Masiga, Benedict Owino Orindi, John Oidho, Mark C. Field, Enock Matovu, Vincent Owino Adung’A

All Peer-Reviewed Publications

Introduction:

Human African trypanosomiasis (HAT), caused by Trypanosoma brucei rhodesiense, is categorized as acute due to rapid disease progression but presents varying clinical outcomes. Although the mechanisms underpinning differential clinical progression are poorly understood, both host and parasite factors are implicated. Therefore, we sought to elucidate roles of primate host factors in mediating varying T. b. rhodesiense infection outcomes.

Methods:

Here, we assessed the roles of selected host cytokines in disease progression using a tsetse-mediated infection in a non-human primate (NHP) vervet monkey model that closely mimics HAT and natural infection. We quantified eight cytokines, including TNF-α, IFN-γ, IL-10, IL-6, …

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Reducing School Absenteeism In Children With Avoidance Behaviors, Kimberly Carey

DNP Scholarly Projects

Background: Chronic absenteeism and school avoidance are a problem facing schools across the nation following the COVID-19 pandemic. Chronic absenteeism is financially, emotionally, and academically expensive for society. Purpose: This quality improvement project aimed to decrease absences by 50% over a 6-week timeframe when compared to the same timeframe from the previous year. Methods: Utilizing a Plan-Do-Study-Act framework, an intervention based on tracking multi-day consecutive absences and reaching out to families to provide education and support was implemented. At three days of absence, the school nurse would either call the family for absence with unknown etiology or email with an …

“Eres Mujer Y Te Tienes Que Aguantar”: Hispanic Maternal Wellbeing, Stephanie Reyes Bravo

CISLA Senior Integrative Projects

No abstract provided.

Exploring The Influence Of Quadriceps Peak Torque And Rate Of Torque Development On Running Mechanics After Anterior Cruciate Ligament Reconstruction, Amit M. Gohil, Gregory S. Hawk, Darren L. Johnson, Christopher S. Fry, Brian W. Noehren

Physical Therapy Faculty Publications

Background: After anterior cruciate ligament reconstruction (ACLR), chronic changes in knee joint biomechanics during higher level tasks, such as running, may negatively impact long-term knee joint health. Among the factors that contribute to these chronic changes, the influence of quadriceps strength on knee joint biomechanics during running is not well understood.   Hypothesis: Higher involved limb quadriceps strength (peak torque and rate of torque development [RTD]) and limb symmetry index (LSI) will be positively associated with greater peak knee flexion angle and peak knee extensor moment during running.   Study Design: Cross-sectional study.   Level of Evidence: Level 3.   Methods: Peak knee extensor …

The Influence, Dependency, And Targeting Of Fatty Acid Uptake In Er+ Breast Cancer, Abigail E. Goen

Dartmouth College Ph.D Dissertations

Estrogen Receptor-positive/ Human Epidermal Growth Factor 2-negative, breast cancer (ER+/HER2- BC) is the most prevalent subtype of BC, impacting millions of individuals. Although early screening and treatment with endocrine therapy has greatly enhanced survival, this subtype sustains a steady increase of risk for recurrent disease for decades after diagnosis, indicating the persistence of residual cancer cells that are capable of maintaining dormancy for >20 years prior to metastatic outgrowth. Dormant cells reprogram metabolic pathways which can be profoundly influenced by the tumor microenvironment in promoting quiescence or proliferation. Fatty acid oxidation dependency has been noted as a hallmark of drug …

Maesa Ramentacea Leaf Extract Protects Against Gentamicin-Induced Nephrotoxicity In Wistar Rats By Modulating Renal Oxidative Stress, Inflammation And Apoptosis, Fahmida Akter, Md Shafiqul Islam Sovon, Baizid Hossain, Md Ariful Islam, Subrato Das, Anik Biswas, Md Sohorab Uddin, Md Mahmudul Hasan

Faculty Publications

Background: Gentamicin-induced nephrotoxicity continues to be a significant clinical concern, while effective and safe protective options remain limited. The nephroprotective potential of Maesa ramentacea has not yet been explored. To address this gap, the present study investigated the ethanolic leaf extract of M. ramentacea (MR-LEE) for its effects on gentamicin-induced kidney injury in Wistar rats. Methods: GC-MS profiling was employed to identify bioactive metabolites. Rats were categorised into five groups: control, gentamicin (100 mg/kg), gentamicin combined with silymarin (100 mg/kg), gentamicin combined with MR-LEE (200 mg/kg) and gentamicin combined with MR-LEE (400 mg/kg). Renal biomarkers, oxidative stress indicators, inflammatory and …

Digital Technology And Women’S Health In Nigeria: A Feminist Sts Walkthrough Analysis Of Mdoc Digital Health, Edith Michael Ogbodo

Dissertations, Master's Theses and Master's Reports

This thesis critically examines how a Nigerian digital health platform, mDoc, represents and constructs women’s health. Drawing on Feminist Science and Technology Studies (STS) and Light et al.’s (2018) walkthrough method, the study interrogates the values, assumptions, and power relations embedded in mDoc’s design, language, and governance structures. The analysis reveals that mDoc, despite positioning itself as an equitable solution to Nigeria’s health crisis, reproduces and depoliticizes the structural inequalities it claims to address. Through its neoliberal emphasis on self-care, the individualization of structurally produced suffering, and the datafication of women’s bodies, the platform encodes gendered, colonial, and class-based assumptions …

Kinase Signaling In Liver Disease Via Clinical-Trial-On-A-Pamchip: A Distinctive Methodology For Drug Mechanisms And Personalized Medicine, Zachary A. Kipp, Evelyn A. Bates, Genesee J. Martinez, Wang-Hsin Lee, Sally N. Pauss, Terry D. Hinds, Jr.

Pharmacology and Nutritional Sciences Faculty Publications

The utilization of extensive datasets, such as those generated by DNA or RNA sequencing, has become a central focus in drug discovery and personalized medicine (PerMed). Nonetheless, these datasets are constrained by the absence of protein-functionality testing, which affects physiological responses. In this study, we employed PamGene PamStation technology to quantify protein function by kinase activity across more than 500 signaling pathways from patients with hepatocellular carcinoma (HCC). Using proteins derived from nine patients and five human HCC cell lines for drug discovery and the clinical trial-on-a-chip approach, we developed comprehensive PerMed scores from the PamStation data to differentiate individual …

Adipose Tissue-Derived Small Extracellular Vesicles In Plasma Reveal Molecular Circuitries Underlying Glucose Intolerance, Shalini Mishra, Yixin Su, Ashish Kumar, Sangeeta Singh, Brian S. Finlin, Fang-Chi Hsu, Jingyun Lee, Cristina M. Furdui, Philip A. Kern, Swapan K. Das, Gagan Deep

Internal Medicine Faculty Publications

Objective: Glucose tolerance (GT) is a major effector for adipose tissue (AT) remodeling in obesity, yet its molecular mechanisms remain incompletely defined. We hypothesized that the biophysical and molecular profiles of AT-derived small extracellular vesicles (sEV^AT) change in response to glucose availability and differ by GT status.

Methods: sEV^AT were isolated from plasma of individuals with normal GT (NGT) and impaired GT (IGT) (n = 5/group) at fasting (0 h) and 1 h post glucose challenge during oral glucose tolerance test (OGTT). sEV^AT were characterized for size, concentration, surface expression of insulin receptor-α (INSRα), proteome, …

Smarter Nutrition: Right-Sizing Nutritional Monitoring In Patients On Crrt, David Zolezzi, Elizabeth Journey, Jayne Walters

2026

No abstract provided.

Arfid, Children's Health School Services

School Guides

Educator guide about how to support students with avoidant restrictive food intake disorder or ARFID.