Digital Commons Network^™

The Impacts Of Sports Specialization On Youth Development, Madison M. Allen

Honors Thesis

To this date, there has been a rise in the professionalism of youth sports, which has increased the competitiveness and likelihood of early specialization in young athletes. While this allows youth athletes to have recognition at a young age, many athletes experience negative effects that inhibit their ability to make it to the elite level at a later age. Sports specialization can be defined as the participation and/or training of one sport year-round, typically excluding participation in all other sports. Current research suggests that sports specialization can contribute to injury and musculoskeletal disorders, impact motor skills and coordination, and cause …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Spatiotemporal Modeling Of Maternal Mortality In South Carolina 2018-2023, Leah Wood, Ray Bai, Emily Mann

Senior Theses

Maternal death serves as a public health indicator due to fact that it is considered preventable with the availability of modern biomedicine, however, it persists broadly throughout the United States. Current literature outlines national trends in maternal mortality with complicating, preexisting conditions, and structural upstream factors often cited as being the largest contributors to increased risk. This study utilizes publicly available, county-level data for maternal death in addition to demographic and descriptive data in order to estimate maternal mortality rates in each of South Carolina’s 46 counties from 2018 to 2023. In order to address sparsity in the outcome variable …

Assessment And Management Of Magnesium And Trace Element Status In Children With Ckd Stages 2-5, On Dialysis And Post-Transplantation: Clinical Practice Points From The Pediatric Renal Nutrition Taskforce., Jetta Tuokkola, Caroline E. Anderson, Sheridan Collins, Pearl Pugh, Molly R Wong Vega, Matthew Harmer, Lyndsay A. Harshman, Christina L. Nelms, Barry Toole, An Desloovere, Fabio Paglialonga, Nonnie Polderman, José Renken-Terhaerdt, Rukshana Shroff, Evelien Snauwaert, Stella Stabouli, Johan Vande Walle, Bradley A. Warady, Vanessa Shaw, Larry A. Greenbaum

Manuscripts, Articles, Book Chapters and Other Papers

Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were …

Metabolic Acidosis And Cardiovascular Disease Risk In Children With Ckd., Denver D. Brown, Jennifer Roem, Kimberly Reidy, Susan Furth, Bradley A. Warady, Michal Melamed, Tammy Brady, Ckid Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

KEY POINTS: Metabolic acidosis may be associated with adverse cardiovascular disease risk. Prospective studies of the benefit of alkali therapy on cardiovascular disease risk are needed.

BACKGROUND: The link between metabolic acidosis (MA) and cardiovascular disease (CVD) outcomes has been studied in adults but not in children with CKD where MA is a common and early finding. Using longitudinal BP and cardiac measurement data, we evaluated whether low serum bicarbonate (a surrogate for MA) is associated with adverse CVD risk.

METHODS: This study used data from children age 1 year and older with eGFRs between 30 and 90 ml/min per …

Sharksrx Newsletter Fall 2025, Nova Southeastern University

NSU Sharks Rx

No abstract provided.

Global Transfusion Practices In Septic Patients In The Intensive Care Unit: Insights From The Input-Study Sub-Analysis, Vincent Kurucz, Andrew Flint, Alexis Poole, Merijn Reuland, Claudia Oord, Caroline Schaap, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Marcus Lance

Anaesthesiology, East Africa

Background Transfusion practices among intensive care unit (ICU) patients with sepsis vary widely. While restrictive hemoglobin thresholds for red blood cell (RBC) transfusion are well studied, the indications and thresholds for platelet and plasma transfusions remain uncertain.

Methods We performed a sepsis-specific sub-analysis of the International Point Prevalence Study of Intensive Care Unit Transfusion Practices, a prospective, multicenter, observational study capturing all adult ICU admissions during four pre-scheduled weeks between March 2019 and October 2022. Patients admitted with sepsis or septic shock, or who developed sepsis during their ICU stay, were included. We recorded demographics, daily laboratory values, and transfusion …

Loma Linda Nurse - Vol. 34, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Jordan Robison Profile

6 | LLUSN Mission Service— A Living Legacy

10 | Steps to a New School

12 | Entry Level Master’s at Murietta

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-27 | ACADEMICS

28-33 | HOMECOMING

34-37 | FACULTY UPDATES

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Une Com Research And Scholarship Fall Forum October 2025, Une Com Research & Scholarship

Osteopathic Student Research Symposia

Program including abstracts from the University of New England College of Osteopathic Medicine’s 2025 Research and Scholarship Fall Forum.

Supplemental content: List of award winners.

Combating Obesity: Creating A Comprehensive Wellness Plan For Uninsured & Low-Income Populations, Kayla C. Berrios

Doctor of Nursing Practice Scholarly Projects

Aim: The aim of this project was to research the specific barriers encountered by obese patients that are low-income and uninsured. The goal of this data collection was to inform the stakeholders involved in creating a comprehensive wellness plan for obese patients.

Background: The staff at Good Neighbor Clinic have struggled to support their support their obese patients with weight reduction. Many of the ailments that patients seek care for correlate to their obesity. Health promotion in this community clinic needs a more comprehensive program to support patients during their weight loss experience, providing support and resources to allow for …

Exploring Barriers To Patient Care In A South Carolina Free Clinic, Jonathan G. Green

Doctor of Nursing Practice Scholarly Projects

Access to healthcare remains a persistent challenge for medically underserved populations who rely on free medical clinics for primary care services, particularly in non-Medicaid expansion states such as South Carolina. Free clinics serve as critical safety-net providers, yet patients frequently encounter barriers that limit access, continuity, and quality of care. The purpose of this Doctor of Nursing Practice (DNP) project was to explore and identify the structural, social, and interprofessional barriers to patient care within a South Carolina free medical clinic to inform targeted, evidence-based interventions. A mixed-methods needs assessment design was used, combining a retrospective chart review of forty …

Empowering Mothers: A Digital Intervention For Perinatal Mental Wellness, Morgan Edmunds

Doctor of Nursing Practice Scholarly Projects

Aim: The aim of this project was to develop a smartphone application prototype for peripartum mental health. The goal of this application was to enhance access to education and quality mental health care.

Background: Currently, in the United States, peripartum mental health conditions are the leading cause of maternal morbidity and mortality (The Joint Commission, 2023). There is a gap in education, screening, and treatment for peripartum mental health due to distrust and a lack of resources, including a lack of mental health providers (Dossette et al., 2024; Feldman & Perret, 2023). Therefore, there is a significant number of women …

Reducing Aspiration Pneumonia By Implementing An Enhanced Oral Care Toolkit, Jennifer London

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Oral care is essential for reducing bacteria and preventing aspiration pneumonia. The risk of aspiration pneumonia increases when protocols are not followed. In 2024, a regional hospital in the Midwest United States spent approximately one million dollars on the preventable healthcare-associated infection known as aspiration pneumonia. A pre-project chart audit of 100 random patient charts on a medical/surgical step-down unit revealed that only 1 of the 100 charts had oral care documented as completed.

Aim of the Project: The primary aims of this project were to increase nursing documentation of oral care by 50% and to decrease …

Improving Pain Assessment After Bedside Percutaneous Endoscopic Gastrostomy (Peg) Placement, Sherman Cotton

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Baseline audits at a 44-bed critical-illness recovery hospital showed low reliability in two post-PEG practices: (1) pain reassessment within 90 minutes of an intervention and (2) complete PEG-site documentation (skin, drainage, tube position/measurement). Baseline performance averaged 55% and 62%, both of which were below the organization’s 90% benchmark.

Aim of the Project: From May to July 2025 (12 weeks), improve on-time pain reassessment and ensure PEG-site documentation reaches at least 90%, maintaining this level for three or more consecutive weeks; monitor workload to prevent increases in perceived charting time and ensure safety by avoiding a rise in PEG-related …

Adipose Tissue Estrogen Receptor-Alpha Overexpression Ameliorates High-Fat Diet–Induced Adipose Tissue Inflammation, Marion C. Hope, Christian A. Unger, M Chase Kettering, Cassidy E. Socia, Ahmed K. Aladhami, Barton C. Rice, Darya S. Niamira, Ben P. Wiznitzer, Diego Altomare Ph.D., William E. Cotham, Reilly T. Enos

Faculty Publications

Context

We created an innovative mouse model that enables inducible overexpression of estrogen receptor-alpha (ERα), specifically in adipose tissue (Adipo-ERα↑). Objective

We aimed to investigate how elevated Adipo-ERα↑ influences the development of high-fat diet (HFD)-induced obesity in both male and female mice. Methods

Male and female Adipo-ERα↑ mice and littermate controls were fed a low-fat diet (LFD) or HFD for 13 weeks. Adipo-ERα↑ was induced at the initiation of dietary treatment. Body morphology and composition, hepatic lipid accumulation, glucose tolerance, fasting insulin concentrations, and adipose tissue mRNA profiling were assessed. Liquid chromatography–mass spectrometry was used to determine circulating and adipose …

A Scoping Review Of Oral Feeding Skill Development In Typically Developing Children Part Ii: Exploring Variability In Oral Feeding Skill Descriptions, Amy Delaney, Anna Flatt, Hannah Koepp, Alissa Fial, Katherine C. Hustad

Speech Pathology and Audiology Faculty Research and Publications

Purpose:

This scoping review is the second in a two-part series that aims to synthesize the literature on oral feeding skills development and to create a classification system of observable skills. Building on the findings from Part 1, this article compiles and analyzes the types of feeding skills reported across studies and proposes a framework for standardizing terminology.

Method:

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Of the 14 studies identified in Part 1 that focused on feeding skill development, 11 included unique skill descriptions. These skills were coded and …

Spinal Cord Injury, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Screen Time, Physical Activity, And Vo₂Max In Indonesian Vocational School Adolescents (Aged 15–17): A Cross-Sectional Study, Cahyo Wibowo, Yahya Eko Nopiyanto, Angkit Kinasih, Asarya Reno Kombong, Dian Pujianto, Bayu Insanistyo

Indonesian Journal of Research in Physical Education, Sport, and Health

Physical activity and screen time influence many adolescent' fitness problems. This research aims to determine the relationship between screen time and physical activity on adolescent students' cardio-respiratory endurance (VO2max). This research used observational analysis with a cross-sectional study involving 70 teenage students at an Information and Network Technology Vocational School consisting of male and female teenage students. The Screen Time of Adolescents (QUEST) questionnaire was used to assess screen time, the physical activity instrument used the Global Physical Activity Questionnaire (GPAQ v2.0) to assess physical activity levels, and the VO2max instrument used the 20-meter Multistage Fitness Test (MFT). The data …

Association Between Suboptimal Health Status And Academic Performance: A Cross-Sectional Study Of 1,028 Medical Students In Punjab, Pakistan, Maleha Asim, Misbah Malik, Aneela Jamil, Raheela Yasmin, Ghazala Jawwad, Wajahat Ullah Khan

Indonesian Journal of Research in Physical Education, Sport, and Health

Background: Suboptimal health status (SHS) refers to the transitional period between health and illness, characterized by unexplained symptoms and premature changes in functional status without a known medical diagnosis. Objective: The aim is to examine how often SHS occurs and how lifestyle factors influence both SHS and the academic success of medical students. Methods: A Cross-sectional survey was conducted from February 2024 to September 2024 with first- to fifth-year medical students from four randomly chosen medical colleges in Punjab, Pakistan. The Suboptimal Health Measurement Scale (SHMS V1.0), Pittsburgh Sleep Quality Index (PSQI), and Health-Promoting Lifestyle Scale (HPLS) were used to …

Associations Among Human Milk Polyunsaturated Fatty Acids And Infant Sleep Patterns: A Cross-Sectional Study, Ana M Palacios, Dominick J Lemas, Bridget E Young, Erik Parker, Stephanie Dickinson, Nandi Marshall, Kelly L Sullivan, Haley Wilt, Michelle I Cardel, David B Allison

Children’s Nutrition Research Center Staff Publications

Background: Infant sleep is critical for cognitive, emotional, and long-term health outcomes. Although diet-sleep relationships are established, limited research has explored how polyunsaturated fatty acids (PUFAs) in human milk (HM) relate to infant sleep.

Objectives: This study aims to examine associations between PUFAs in HM and sleep patterns in 2-mo-old infants exclusively fed with HM.

Methods: This cross-sectional secondary analysis used data from a lactation cookie trial involving 131 parents of healthy, term infants. Participants provided a fasting HM sample and completed sociodemographic and Brief Infant Sleep Questionnaire surveys. Multivariate linear models were adjusted for infant sex assigned at birth, …

All-Cause And Cause-Specific Mortality Among Patients With Narcolepsy., Chih-Wei Hsu, Yen-Shan Yang, Yang-Chieh Brian Chen, Liang-Jen Wang, Mu-Hong Chen, Yao-Hsu Yang, Chih-Sung Liang, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Importance: Narcolepsy is a sleep disorder potentially affecting mortality, yet evidence on this association remains sparse.

Objective: To examine whether narcolepsy is associated with an increased risk of all-cause and cause-specific mortality.

Design, setting, and participants: This retrospective cohort study used data from the Taiwan National Health Insurance Research Database (NHIRD) from 2001 to 2021, with patients followed up until death or December 31, 2022. Patients were aged 6 years or older with 2 or more narcolepsy diagnoses from psychiatrists or neurologists. Controls were selected from the NHIRD as a population-based sample. Controls without narcolepsy were matched in a 1:4 …

Menopause Factors And Alterations In Gut Microbiota And Insulin Homeostasis: A Cross-Sectional Analysis Of The Microbiome And Insulin Longitudinal Evaluation Study (Miles), Vincent J Maffei, Alain G Bertoni, Alexis C Wood, Jerome I Rotter, Osa Crago, Yii-Der I Chen, Joseph F Petrosino, Kristi L Hoffman, Mark O Goodarzi, Elizabeth T Jensen

Children’s Nutrition Research Center Staff Publications

Aim: To assess the risk for impaired insulin homeostasis as a function of menopause-related factors and gut microbiota dysbiosis in non-diabetic, post-menopausal women.

Materials and methods: Baseline data (n = 175 women) from the Microbiome and Insulin Longitudinal Evaluation Study (MILES) were used, including insulin and dysglycaemia indices calculated from a 2-h oral glucose tolerance test, untargeted peripheral metabolomics, targeted peripheral short chain fatty-acid levels and faecal bacterial microbiota surveyed by whole-metagenomic sequencing.

Results: After adjustment for covariates, menopause age < 50 years and use of hormone replacement therapy (HRT) were associated with lower Matsuda et al. insulin sensitivity index levels (β = -0.232, confidence interval (CI) = [-0.450, -0.014] and β = -0.275, CI = [-0.444, -0.107], respectively) but not pre-menopausal gynaecologic surgery. Pre-menopausal gynaecologic surgery was significantly associated with faecal microbiota beta diversity driven by a relative increase in diabetogenic Ruminococcus gnavus and Clostridium species and a decrease in protective Alistipes species and Akkermansia muciniphila relative abundances. A reduction in two glycerophospholipids in the plasmalogen class significantly statistically mediated an inverse association between gynaecologic surgery before menopause and insulin sensitivity.

Conclusions: Menopause age and history of HRT are more strongly associated with insulin resistance than gynaecologic surgery before menopause. However, …

Advancing University Student Health And Wellbeing Through Peer-Led Health Promotion: A Quality Improvement Project​ ​, Rojeda Merani, Elizabeth Page, Elizabeth Roth

DNP Projects

Background: Peer-led health promotion is widely recognized as an effective strategy for increasing engagement, trust, and health literacy among university students. However, few frameworks guide development and implementation of these programs.

Objective: To evaluate the feasibility, implementation process, and perceived effectiveness of a peer-led health promotion model supported by Doctor of Nursing Practice (DNP) mentorship at a mid-sized private university.

Participants: Thirteen undergraduate students from a diverse set of academic programs were recruited as Peer Health Ambassadors (PHAs) and paired with DNP student mentors.

Methods: Guided by the Implementation Research Logic Model, the project used a four-phase QI process: targeted …

Myplate For Healthy Diet And Physical Activity: A Pilot Project, Christin Sullivan

Doctor of Nursing Practice

Background: Over 100 million American adults are obese. This has increased from 38.5% in 2013-2016 to 41.8% in 2017-2020 and is predicted to keep rising. Significant health risks are linked to obesity, prompting weight loss movements at the local, national and global level. Recently, Semaglutide has been favored in weight loss programs but must be augmented by education on healthy diet and physical activity for weight reduction and maintenance.

Purpose: The purpose of this scholarly project was to pilot the MyPlate method on healthy diet and physical activity and determine its effects on patient knowledge of healthy diet and physical …

The Bulletin: Sidney Kimmel Medical College At Thomas Jefferson University, Volume 103, Issue 2, Fall 2025

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

This issue includes:

• 5 - Dean’s Column
• 6 - Time Machine
• 12 - ICYMI (In Case You Missed It)
• 18 - Medicine Rooted in Connection by Scott Orlov, SKMC Class of 2026
• 20 - All in the Family by Takami Sato, MD, PhD, and Rino Seedor, MD ’15
• 24 - When Jefferson and Medicine Struck Gold by Geno J. Merli, MD ’75, RES ’78 and ’80
• 28 - Alumni Weekend Recap
• 32 - Born a Jeffersonian by William Valentine Harrer, MD ’62
• 35 - Class Ambassadors
• 36 - A Message From the SKMC Alumni Board President
• 38 - Class Notes …

Investigating Machine Learning Algorithms To Classify Label-Free Images Of Pancreatic Neuroendocrine Neoplasms, Noelle Daigle, Shuyuan Guan, Suzann Duan, Thomas G Knapp, Eung-Joo Lee, Ali Azhdarinia, Sukhen C Ghosh, Solmaz Aghaamiri, Servando Hernandez Vargas, Naruhiko Ikoma, Jeannelyn Estrella, Martin J Schnermann, Tobias Else, Michelle Kang Kim, Juanita L Merchant, Travis W Sawyer

The Brown Foundation: Institute of Molecular Medicine

Significance: Pancreatic neuroendocrine neoplasms (PNENs) are an uncommon cancer whose incidence rate has increased dramatically in recent years. Surgery is the only potentially curative treatment, which relies on both preoperative tumor localization and postoperative margin definition using histopathological examination for decision making. If pathology could be automated, valuable time and resources could be saved.

Aim: In this study, we investigate the ability of machine learning (ML) with handcrafted features, as well as deep learning, to classify label-free microscopy images of PNENs as a first step toward automated pathology of such tumors.

Approach: Patient samples of two different preparation types were …

Mechanisms For The Age-Related Increase In Fatigability Of The Elbow Flexor Muscles In Healthy Adults, Blaine E. Arney, Andrew Kuplic, Mitchell D. Adam, Christopher W. Sundberg, Sandra Hunter

Exercise Science Faculty Research and Publications

The mechanisms for the age-related increase in fatigability of the elbow flexor muscles during dynamic contractions are unknown. The purpose of this study was to determine the contribution of supraspinal and contractile mechanisms for the age-related increase in fatigability of the elbow flexor muscles. Twenty-eight young (23.2 ± 2.6 years; 14 females) and 32 older adults (72.6 ± 5.6 years; 15 females) performed 80 maximal velocity contractions at 20% of maximal isometric strength. Voluntary activation and muscle contractile properties were assessed before and immediately following the fatiguing exercise using transcranial magnetic stimulation (TMS) and electrical stimulation. Fatigability (% reduction in …

Endoscopic Submucosal Dissection For Previously Attempted Colorectal Lesions: An International Multicenter Experience., Suchapa Arayakarnkul, Hiroyuki Aihara, Alessandro Repici, Roberta Maselli, Antonio Capogreco, Leonardo Da Rio, Fabio Shiguehissa Kawaguti, Fauze Maluf-Filho, Makoto Nishimura, Sera Satoi, Sayaka Nagao, Shai Friedland, Robert Bechara, Norio Fukami, Sonmoon Mohapatra, Amit Bhatt, Abel Joseph, Alex Schlachterman, Anand Kumar, Andrew Y Wang, Ross C D Buerlein, Louis M Wong Kee Song, Fnu Deepali, Dennis Yang, Muhammad K Hasan, Nikhil A Kumta, David L Diehl, Edward J Despott, Alberto Murino, Alessandro Rimondi, Laura Lucaciu, Neil R Sharma, Christina Zelt, Ashley Rumple Rn, Bsn, David Leslie Carr-Locke, Reem Z Sharaiha, Srihari Mahadev, Kamal M Hassan, Mohamad-Noor Abu-Hammour, Carlos Robles-Medranda, Martha Arevalo-Mora, Juan Alcivar-Vasquez, Vivek Kumbhari, Jongkyu Park, Salmaan Jawaid, Mai A Khalaf, Kasenee Tiankanon, Sarah S Al Ghamdi, Mohamed O Othman, Saowanee Ngamruengphong

PCI Publications and Projects

BACKGROUND & AIMS: Salvage endoscopic submucosal dissection (ESD) has been proposed for previously attempted colorectal lesions (PACLs), yet the extensive submucosal fibrosis impacts procedural difficulty and resection outcomes. The aim of this study was to evaluate the efficacy and safety of salvage ESD for the treatment of PACLs.

METHODS: This international, multicenter study enrolled consecutive patients who underwent ESD to manage PACLs. Rates of en bloc, R0 resection, and local recurrence were assessed for efficacy. Safety was assessed by adverse events (AEs), procedure-related mortality, and the need for surgical management.

RESULTS: Of 415 lesions, en bloc rate was 83.4%, the …

Healthcare Informatics October 2025, Aga Khan University

Department of Chief Medical Information Officer (CMIO) Archives

• Message from the CMIO
• Update by Workgroup Leads
• AKUH-Karachi, OneHealth Activities
• Office of CMIO collaborate in Allied Health Conference
• Department Engagement
• SIMPACT 2025; The First Hour: Sepsis Simulation in an EHR-Driven Workflow
• Upcoming Event
• Academics Research Scholarship