Digital Commons Network^™

Mpox Insights: From Structure To Human Cell Interaction, Md. S. Zaman, Robert C. Sizemore, Draven Rodriguez, Emilio Lopez, S. M. Golam Alam, Suleyman Tufa, Juan C Lopez Alvarenga, Nuraly S. Akimbekov, Mohammed S. Razzaque

School of Medicine Publications

Mpox, a zoonotic viral disease, has emerged as a global concern due to outbreaks in both endemic and non-endemic regions in 2022. Rodents, including African squirrels and Gambian pouched rats, are suspected key reservoirs, with human infections occurring through direct contact with infected animals or bushmeat consumption. Previously confined to rural Africa, mpox has spread via international travel and the exotic pet trade. Human-to-human transmission occurs mainly via respiratory droplets and direct contact with bodily fluids or lesions. The virus has a double-stranded DNA genome within a lipid envelope. Despite lower mutation rates in DNA viruses, mpox has developed mutations, …

Exploring The Interplay Between Hypertension And Osteoporosis: A Narrative Review, Yolanda V. Gutierrez, Ronald Shaju, Alyssa A. Sepulveda, Seval Coban

School of Medicine Publications

Hypertension and osteoporosis are highly prevalent chronic conditions that have significant implications for global health, especially in aging populations. While these conditions have traditionally been viewed as separate, emerging research suggests a strong pathophysiological link between the two. Understanding these shared mechanisms may help improve screening and guide integrated management strategies. This narrative review was conducted between January 2024 and July 2025 using PubMed, ScienceDirect, and Google Scholar. The search strategy used the Boolean string: (“hypertension” OR “high blood pressure”) AND (“osteoporosis” OR “bone loss”), supplemented with pharmacologic terms (“ACE inhibitors,” “angiotensin receptor blockers,” “thiazide diuretics,” “beta-blockers”, “SERMS”, “Bisphosphonates”, “Denosumab”, …

Norms For Scaling Up Small And Sick Newborn Care: An Overview Of Reviews, Natalie A. Strobel, Georgia Whisson, Derek Swe, Amy Budrikis, Karen M. Edmond

Research outputs 2022 to 2026

Background: The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) currently have no benchmarks or 'norms' for scaling up small and sick newborn (SSN) service delivery in health facilities in low- and middle-income countries (LMICs). Our objective was to understand which systematic reviews had addressed the following norms in the last five years: number of SSN beds per live births in a district or similar administrative unit (admission beds); space requirements for SSN units, including mother-infant dyads (space); health workforce ratios in SSN units (workforce); and travel time to health facilities with SSN units (travel time). Methods: …

The Follow-Up Gap: Racial Disproportionality And Social Determinants Of Health In New Jersey’S Hearing Detection And Intervention Program, Maryrose Mcinerney, Wendy Zeitlin

Journal of Early Hearing Detection and Intervention

Objectives. To assess how race/ethnicity and social determinants of health are related to loss to follow-up (LTF) from NJ’s Early Hearing Detection and Intervention (EHDI) program.

Methods. All infants born in NJ between June 2015 and June 2017 referring for additional hearing healthcare after hospital discharge were considered for inclusion in this study. The sample consisted of 4,141 babies, 10.7% of which received no follow-up care. Step-wise multi-level logistic regression was used to determine how race/ethnicity, family-level, and community-level social determinants of health (SDOH) were predictive of LTF.

Results. In each model, the odds of being LTF were significantly higher …

Understanding The Lived Experience Of Mental Health Following An Alpha-Gal Syndrome Diagnosis: A Phenomenological Study Grounded In Maslow’S Hierarchy Of Needs, Heather L. Hargis

Dissertations

Alpha-gal syndrome is a tick-borne food allergy that triggers delayed allergic reactions to mammalian products and profoundly alters daily life. While growing research examines the physiological aspects of alpha-gal syndrome, little is known about its psychological impact. This phenomenological study explored the lived experiences of individuals with alpha-gal syndrome to understand how the condition influences mental health through the lens of Maslow’s Hierarchy of Needs. Data was collected through semi-structured virtual interviews with adults medically diagnosed with alpha-gal syndrome. Thematic analysis revealed significant challenges in meeting Maslow’s lower-tier needs—physiological, safety, and love/belonging—due to dietary restrictions, medical uncertainty, social isolation, and …

Unveiling The Clinical Profiles Of Critically Ill Covid-19 Patients: Insights From Ezhou During The Early Spread, Guohui Yang, Zewen Liu, Tabitha Abraham, Linwei Li, Tingyang Zhou, Qing Zhang, Li Zuo

School of Medicine Publications

The coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan. This article evaluated clinical characteristics, and imaging manifestations in Ezhou, an early locked-down city, 80 kilometers east of Wuhan. We analyzed data from 98 confirmed severe COVID-19 patients in Ezhou Central Hospital between February 1st and March 22nd, 2020. We compared patients' laboratory results, imaging manifestations, and treatments between survival and death groups. Of these 98 confirmed COVID-19 patients, 24 individuals (24.6%) had chronic diseases. The main symptoms of critically ill patients were fever (86.7%), cough (83.7%), and dyspnea (59.1%). Common complications were acute respiratory distress syndrome (ARDS; 49%), …

Perioperative Nutrition In Pediatric Patients With Congenital Heart Disease And Heart Failure., Jaime Silva-Gburek, Kelsey May, Bailey Walvoord, Catalina Lozano, Jorge A. Coss-Bu

Manuscripts, Articles, Book Chapters and Other Papers

Optimal nutritional therapy is important for infants and children with perioperative congenital heart disease and heart failure. Medical providers face physiological and metabolic challenges when administering enteral and parenteral nutrition to these patients. Complications related to enteral nutrition can increase morbidity and mortality, although outcomes are improved in those cases in which caloric and nutrient administration can be achieved. Consensus regarding feeding strategies and timing of nutritive care is lacking. This narrative review aims to summarize, analyze and discuss the most recent literature on nutritional therapy in perioperative congenital heart disease, heart failure and pediatric patients requiring mechanical circulatory support …

Comparison Of Depression Risk And Depression-Related Ambulatory Care Utilization In Sarcopenia Patients With And Without Chinese Herbal Medicine., Hang-Che Li, Hanoch Livneh, Wei-Chiao Chang, Yu-Han Wang, Ming-Hsien Yeh, Bo-Chyuan Chen, Ming-Chi Lu, Wei-Jen Chen, Tzung-Yi Tsai

Leadership, Learning and Counseling Faculty Publications and Presentations

The impact of psychiatric disorder, especially depression, on the prognosis of sarcopenic patients is gaining prominence. Yet, there have been very few studies focusing on this issue, let alone the related targeted mental health prevention. This cohort-based nested case-control study is geared to compare risk of depression and the depression-related ambulatory care utilization for sarcopenia persons with and without receiving add-on Chinese herbal medicines (CHMs) treatment.

Using Fermi Estimates Within Needs Assessments: An Extension Professional’S Guide, Emma Lonstrup, Carolyn D. Rider, Miranda R. Westfall

Journal of Extension

Needs assessments are an important activity for Extension professionals, as they identify community assets and guide decisions about programs and services. A common challenge is a lack of needs assessment data. The Fermi Estimate Framework can help Extension professionals overcome the challenge of missing data by producing reasonable estimates to answer questions of interest. Here we share detailed, step-by-step instructions for using the Fermi Estimate Framework, accompanied by a real-world Extension example.

Staff Education Workshop Focusing On Enhancing Nurse Knowledge And Adherence To The Time (Tissue, Infection/Inflammation, Moisture, Edge) Framework To Improve The Quality Of Wound Assessment And Care, Ijeoma G. Onyejiji

Walden Dissertations and Doctoral Studies

This staff educational project focused on implementing training on the tissue, infection/inflammation, moisture, edge (TIME) framework to address gaps in nurses’ knowledge and improve adherence to the TIME framework during wound assessment. Current evidence shows inconsistent use of standardized wound assessment among nurses, which can lead to inappropriate treatment, delayed wound healing, increased infection risk, and higher healthcare utilization. This project’s question sought to assess whether implementing a staff education workshop focusing on the TIME framework would enhance nurse knowledge and adherence to the TIME framework. Six nurses participated in the training. Pre/post questionnaires were used to evaluate knowledge before …

Food Insecurity, Educational Attainment, And Type 2 Diabetes In African Americans In Rural Southern Us, Dana Elaine Lowe

Walden Dissertations and Doctoral Studies

Abstract Rural African Americans experience a higher prevalence of Type 2 diabetes compared to their White counterparts, yet little research has explored the roles of food insecurity and educational attainment in this disparity. The purpose of this quantitative, correlational study was to examine whether food insecurity and educational attainment were associated with the prevalence of Type 2 diabetes among African Americans aged 18 to 65 years in rural Southern United States, using the World Health Organization’s social determinants of health framework. Data from the 2019-2022 IPUMS National Health Interview Survey (N=793) were analyzed both descriptively and using multiple logistic regression …

Efficacy And Safety Of Glibenclamide Compared With Insulin In Gestational Diabetes Mellitus: A Systematic Review And Meta-Analysis, Alifia Fauziyyah Haifa, Khairunnisa Qomariyanti, Ratu Ayu Dewi Sartika, Rani Sauriasari

Pharmaceutical Sciences and Research

Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication associated with an increased risk of maternal and neonatal complications compared with non-diabetic pregnancies. Pharmacological treatments, such as glibenclamide, are expected to provide optimal glycemic control and reduce these risks. However, concerns regarding its safety persist and some regulatory agencies have not approved glibenclamide for GDM treatment. This systematic review and meta-analysis aimed to synthesize the most recent evidence on the efficacy and safety of glibenclamide compared with insulin in the management of GDM, with a focus on maternal and neonatal outcomes based on the most recent RCT. The objective is …

Association Of Obesity Severity With Cardiometabolic And Renal Disease Burden In The United States, Florina Corpodean, Michael Kachmar, Shengping Yang, Steven B. Heymsfield, Peter T. Katzmarzyk, Philip R. Schauer, Michael W. Cook, Vance L. Albaugh

School of Medicine Faculty Publications

Objective This study examined the association between obesity severity and cardiometabolic and renal disease, using BMI as a surrogate for obesity severity. Methods This is a cross-sectional study using data from the United States Behavioral Risk Factor Surveillance System (BRFSS), 2011–2023. Survey-weighted logistic regression estimated odds ratios (OR) for the diagnosis of diabetes, hypertension, hyperlipidemia, kidney disease, myocardial infarction, stroke, and coronary artery disease among increasing BMI categories. Results Higher BMI was associated with increased odds of all conditions. For BMI ≥ 50 kg/m2, odds were notably elevated for diabetes (OR 8.32; 95% CI: 7.78–8.91), hypertension (OR 6.07; 95% CI: …

Nursing Students As Advocates: Addressing Social Determinants Of Health Through Service-Learning, Rebekah Mullins

Nursing Theses and Dissertations

Advocacy is at the heart of nursing practice, and advocating for the social determinants of health (SDOH) is crucial when providing care to patients from vulnerable populations. Service-learning is a strategy that can be used to teach students advocacy skills. Chapter 2 of this dissertation portfolio presents a concept analysis that explores the definition of advocacy using the Walker and Avant method (2019). The concept analysis informed the development of the case study presented in Chapter 3 and the research study presented in Chapter 4. The portfolio includes original, qualitative research that was guided by the interpretive descriptive method. The …

Role Of Endoscopy In The Diagnosis And Management Of Esophageal Cancer, Jennifer Ma, Sharon Pan, Rachel Mortan, Faisal Shaukat Ali, Nirav Thosani, Vaibhav Wadhwa

Faculty, Staff and Student Publications

Esophageal cancer cases are predicted to reach 957,000 by 2040. Prior mortality rates average 6.5% in men and 2.2% in women, with a poor 5-year prognosis of 20%. A deficiency in screening guidelines, an incomplete understanding of pathophysiology, and limited treatment options contributed to this poor prognosis. Now, as technology and knowledge evolve, endoscopy serves a primary role in improving morbidity and mortality around esophageal cancer, in which early detection and treatment play a profound role. Advances in diagnostic modalities, including higher frequency ultrasound, acquisition of larger specimens, and nodal characterization, all improve esophageal cancer diagnostic accuracy and treatment planning. …

Vitamin D Deficiency And Cardiovascular Health Disparities In High-Melanin Populations: A Scoping Review, Jalen K. Luter, Silver R. Kaylor, Michael S. Boyer

Doctoral Projects

Cardiovascular disease (CVD) remains a leading cause of mortality and disproportionately affect individuals with darker skin tones, partly due to vitamin D deficiency (Sabzmakan et al., 2014). This Doctor of Nursing Practice (DNP) project uses a scoping review methodology to examine the relationship between vitamin D deficiency and cardiovascular outcomes, with an emphasis on high-melanin populations. Guided by the Joanna Briggs Institute Framework, the review synthesizes existing evidence, identifies gaps in representation and biomarker use, and highlights social and biological contributors to disparity. Databases including PubMed, CINAHL, EMBASE, and Scopus were searched, and studies were screened using standardized inclusion criteria: …

Over Reliance On Antidepressant Medication In Long-Term Care Facilities: Rethinking Mental Health Approaches, Kaylene Elder

Walden Dissertations and Doctoral Studies

Depression is a prevalent mental health condition among older adults in long-term care (LTC) facilities and is often managed primarily through antidepressant medications. While these medications can be effective, their overuse in elderly populations increases the risk of falls, sedation, cognitive decline, and adverse drug interactions. This project addresses the need for safer, evidence-based alternatives by promoting non-pharmacological interventions that support holistic well-being. The proposed approach integrates gratitude journaling, vitamin D testing to identify deficiencies, and vitamin D supplementation for residents experiencing mild to moderate depressive symptoms. Implementation is led by nursing staff and supported by the interdisciplinary care team, …

From Nicu To Neighborhood: Supporting Premature Patients Beyond The Hospital, Bob Underwood, Jermine Harriet Romald

Pediatrics in Practice: A CME Podcast

In this episode, we chat with neonatologist Harriet Romald, MD, FAAP, to explore the critical role pediatricians play in the long-term care of premature infants. From NICU discharge to developmental milestones, we discuss how pediatricians and neonatologists collaborate to ensure continuity of care, monitor common health challenges and navigate social determinants that impact outcomes. Whether you're new to caring for former NICU patients or looking to deepen your understanding, this conversation offers practical insights and the latest updates in neonatal follow-up care.

Click here to stream the podcast episode.

Quality Improvement Project: Creation Of An Ebp Healthy Lifestyle Program: An Evidence-Based Development Program, Devanee Ray

Doctor of Nursing Practice Projects

Nursing education is the foundation of healthcare itself. However, several things influence nursing students’ academic success. A lack of overall health habits is a significant contributor. Generally, this lack is due to a lack of education. The goal of this quality improvement Doctor of Nurse Practice (DNP) project was to develop an educational program that addresses the identified knowledge gaps. The aim was to develop the program to promote student success and pilot-test the program to determine its impact among masters-level nursing faculty. Using Lewin’s Change Theory and Orem’s theory of self-care, the educational program was piloted over a seven-week …

The Edmonton Obesity Staging System For Pediatrics (Eoss-P) In Mexican Children And Adolescents Living With Obesity: Beyond Bmi Obesity Classes, Isabel Omaña-Guzmán, Roberto Carlos Rodríguez Quintero, Arturo Ruíz-Arroyo, Edith Prado Díaz, Juan Carlos Lopez Alvarenga, Ana María Hernández López, Zendy Fuentes Corona

School of Medicine Publications

Background/Objectives: The Edmonton Obesity Staging System (EOSS) was developed to stage the obesity in adult populations. Subsequently, this staging system was designed for pediatric populations (EOSS-P). This study aimed to describe obesity severity using EOSS-P and correlate it with BMI classes in Mexican children and adolescents living with obesity. Methods: This is a cross-sectional analysis carried out with data from school-age children and adolescents living with obesity who were referred to the Pediatric Obesity Clinic at the Child Welfare Unit at the General Hospital of Mexico “Dr. Eduardo Liceaga”. Obesity was staged using the EOSS-P. To evaluate the association between …

The Role Of Inflammatory Cytokines In The Bidirectional Relationship Between Periodontitis And Diabetes Mellitus, Andrew R. Witty

Oral Health

Periodontitis and type 2 diabetes mellitus are associated with each other in a bidirectional relationship. The mechanism by which diabetes affects periodontitis is understood to be due to the inflammatory effects of hyperglycemia (high blood glucose levels) and a hospitable environment for sugar-consuming bacteria. Periodontitis is known to be associated with higher levels of glycated hemoglobin (HbA_1c), a long-term measurement of blood glucose control, and treatment of periodontitis reduces HbA_1c. Inflammation caused by periodontitis induces insulin resistance (which leads to higher blood glucose levels), but due to the complex nature of inflammation it is difficult to …

Implementation Of A Standardized Diabetic Guide For Rn Outpatient Care Managers, Ceateetra Goard

MSN Student Capstones

No abstract provided.

Intersectional Stigma And Resilience In The Uptake Of Cervical Cancer Prevention Services In Nigeria: A Qualitative Study, Agatha Eileen Wapmuk, Titilola Abike Gbaja-Biamila, Ekenechukwu Kokelu, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Cervical cancer is one of the leading causes of death among women in Africa, but stigma often delays cervical cancer prevention. We explore the perceptions, enablers and nurturers through the lens of intersectional stigma in the uptake of cervical cancer prevention services in Nigeria.

METHOD: Indepth interviews and focus group discussions were conducted among women aged 30-65 years and girls aged 9-26 years in Lagos, Nigeria. Data were analysed thematically. Using the relationships and expectation domain of the PEN-3 cultural model, we identified perceptions, enablers and nurturers related to the uptake of primary and secondary cervical cancer prevention services …

The Potential Co-Occurrence Of Perfectionism, Food Insecurity, And Gpa With Orthorexia Nervosa Risk, Samantha Kay Gould

Master's Theses

There are indeterminate risk, prevalence, and correlation data on orthorexia nervosa (ON) as shown by current literature on disordered eating (Rodgers et al., 2021). As a roughly defined disordered eating pattern, ON may be better understood after identifying associations among other attributes in a college student sample (Abdullah et al., 2020; Mavrandrea & Gonidakis, 2023; Parra-Fernández, 2019; Rogowska et al., 2021). A cooccurrence and influence of perfectionism, food insecurity, and grade point average (GPA) with ON risk was hypothesized since current literature suggests college students exhibit each of these characteristics independently (Abdullah et al., 2020; Ambwani et al., 2019; Caferoglu …

Food Neophobia And Its Prevalence Among College Students In The United States, Joanne Mwendi Ponnappa

Master's Theses

Food neophobia “the reluctance to try unfamiliar foods” may influence diet variety and cultural food acceptance among young adults. College students represent a critical group for studying this behavior, as they are developing independent eating habits that can persist into adulthood. This study examined the prevalence of food neophobia among U.S. college students and evaluated how academic background, travel, cultural exposure, and demographic factors influence openness to trying unfamiliar foods. A cross-sectional online survey was administered via Qualtrics to 264 college students across the United States. The Food Neophobia Scale (FNS; Pliner & Hobden, 1992) was used to assess reluctance …

Evaluation The Awareness Of Using Brushing And Interdental Cleaning Aids Among Dental Students In Najaf City, Iraq, Ali Faisal Madhloom, Firas Bashir Al-Taweel, Mustafa Faris Shubbar, Ali Falah Rfysh

Maaen Journal for Medical Sciences

Background: The consensus is that overall health is significantly impacted by oral health. It is anticipated that dental students will have a strong understanding of oral health. The aim of this preliminary pilot study was to evaluate of the awareness of using tooth brushing and interdental cleaning aids between dental students from 1^st grade to 5^th grade in Najaf city, Iraq.

Methods: A cross-sectional study and questionnaire with 12 questions was based on the use of brushing tongue and interdental cleaning aids were conducted among 1^st grade to 5^th grade dental students in Alkafeel …

Repetitive Head Impacts: Definitional Challenges, Clinical Implications, And Research Directions, Amanda Rabinowitz, Allie Tracey, Yevgeniya Sergeyenko

Department of Rehabilitation Medicine Faculty Papers

Purpose of Review: Repetitive head impacts (RHI)—repeated head trauma that may or may not result in clinically identified injury—are a growing public health concern due to links with neurodegenerative disease and long-term dysfunction. This review aimed to synthesize current knowledge of RHI and evaluate methodological challenges that limit conclusions about its clinical consequences. Recent Findings: Emerging studies highlight associations between RHI and cognitive, emotional, and functional outcomes across vulnerable populations including athletes, military personnel, and survivors of intimate partner violence. However, definitional ambiguity, difficulties in measuring exposure, and population-specific confounds continue to hinder progress. Clinical approaches emphasize individualized assessment and …

Investigating The Effectiveness Of Technology On The Enhancement Of Independent Living Skills For Individuals With Intellectual Developmental Disabilities (Idd) In The Moka Smart Home., Kelsey Alexander, Jadyn Boogaard, Grace Mccartney, Madison Maziasz, Nicolette Werner

Masters Projects

This study explored the effectiveness of technology on the enhancement of independent living skills for individuals with intellectual developmental disabilities (IDD) in two MOKA smart homes. Using a quantitative research approach, the study examined how assistive technology can aid individuals with IDD to increase independence in their living skills. This research was conducted in two pilot residential homes, a men's home and a women's home. Three women and two men participated in the study. Data was collected through observation and client report utilizing the Routine Task Inventory Expanded version (RTI-E). RTI-E sections assessed for this study were the Physical (ADL), …

Mechanism Of Anticancer Action Of Bifidobacterium: Insights From Gut Microbiota, Hoang Do, Esther Asiamah, Mayanijesu Olorife, Arathi Pillai, Sakshi Patel, Ponniah Selvakumar, Sidhartha D Ray, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Bifidobacterium has captured major attention recently because of its health benefits and extensive research highlighting its potential in cancer treatment and prevention. Evidence suggests that bifidobacterium can actively fight against various types of cancer, including those of the colon, lungs, breast, and stomach. Research indicates that several species of bifidobacterium can potentiate the action of chemotherapy, immunotherapy and radiation therapy in battling tumors, and reducing their adverse effects. Bifidobacteria shows its multipronged effect by modulating various immunomodulatory and inflammatory signaling pathways, potentially leading to the suppression of tumor growth. Moreover, different species of bifidobacteria are known to regulate signaling molecules …

Staff Education Program To Improve Nurses' Knowledge Of Diabetes Self-Management Education (Dsme) Toward Reducing Readmissions, Vivian Adaora Okechukwu

Walden Dissertations and Doctoral Studies

This project was a staff education program to enhance nurses' knowledge and skills in Diabetes Self-Management Education (DSME) in reducing hospital readmission. Diabetes mellitus is a chronic metabolic disorder that occurs as a direct result of the body's inability to produce enough insulin or the inability to utilize insulin in the bloodstream effectively, consequently accounting for life-threatening health complications. At the local organization, where diabetes is the third leading cause of hospitalization, evidence shows that it critically affects about 25% of the patient population. Also, some care providers at the organization do not have the distinctive competencies to give DSME …