Digital Commons Network^™

Identifying Pregnant Women With Disabilities And Maternal And Newborn Outcomes, Thérèse A Stukel

Faculty, Staff and Student Publications

Importance: Pregnant women with disabilities are at higher risk of poor pregnancy and birth outcomes. Different methods for identifying disability may affect estimates of health disparities in this population.

Objective: To compare pregnancy and birth outcomes among pregnant women using different ways of identifying maternal disability.

Design, setting, and participants: Retrospective cohort study of linked vital records and maternal and newborn claims for Medicaid-insured live births from January 2010 to December 2014 in Texas. Data analysis was conducted from October 2023 to May 2024.

Exposure: Births grouped into 5 maternal cohorts: no identified disability, disability benefits enrollment only, disability diagnostic …

Epigenetic Landscapes Of Aging In Breast Cancer Survivors: Unraveling The Impact Of Therapeutic Interventions-A Scoping Review, Nikita Nikita, Zhengyang Sun, Swapnil Sharma, Amy L Shaver, Victoria Seewaldt, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

Breast cancer therapies have dramatically improved survival rates, but their long-term effects, especially on aging survivors, need careful consideration. This review delves into how breast cancer treatments and aging intersect, focusing on the epigenetic changes triggered by chemotherapy, radiation, hormonal treatments, and targeted therapies. Treatments can speed up biological aging by altering DNA methylation, histone modifications, and chromatin remodeling, affecting gene expression without changing the DNA sequence itself. The review explains the double-edged sword effect of therapy-induced epigenetic modifications, which help fight cancer but also accelerate aging. Chemotherapy and targeted therapies, in particular, impact DNA methylation and histone modifications, promoting …

Pleural Effusion: Shedding Light On Pleural Disease Beyond Infection And Malignancy, Hyeon-Ju R Ali

Faculty, Staff and Student Publications

Background and Objectives: Non-malignant pleural effusions (NMPEs) are the most frequently encountered pleural disease. They arise from various non-malignant, non-infectious clinical conditions, including cardiac, renal, and hepatic organ dysfunction. Despite their wide prevalence, there is a lack of literature for NMPE. This publication aims to provide an updated overview of the causes, diagnostic strategies, and management options for NMPE.

Materials and Methods: This review synthesizes findings from studies published on NMPE, focusing on the presentation, diagnosis (such as imaging and pleural fluid analysis), and management strategies. Studies were selected based on relevance and were analyzed to provide a comprehensive summary …

Somatic Acupressure For The Management Of The Fatigue-Sleep Disturbance-Depression Symptom Cluster In Breast Cancer Survivors: A Study Protocol For A Phase Iii Randomised Controlled Trial, Mengyuan Li, Tao Wang, Xian Liang Liu, Ren Li Deng, Wai Hang Kwok, Li Qun Yao, Jing Yu Benjamin Tan

Research outputs 2022 to 2026

Introduction The fatigue-sleep disturbance-depression symptom cluster (FSDSC) is commonly experienced by breast cancer (BC) survivors, leading to a deteriorated quality of life (QoL). Somatic acupressure (SA) has been recommended as a promising non-pharmacological intervention for cancer-related fatigue (the core symptom of the FSDSC) in the guidelines, showing its encouraging role in relieving cancer-related sleep disorders, fatigue and depression. This phase III randomised controlled trial (RCT) is designed to evaluate the effects, safety and cost-effectiveness of SA for managing the FSDSC in BC survivors. Methods This phase III RCT will be a partial-blinded, sham-controlled, three-arm, parallel clinical trial, involving a 7-week …

Clinical Performance Of An N-Terminal Pro-B-Type Natriuretic Peptide Assay In Acute Heart Failure Diagnosis, Carol L Clark, Deborah B Diercks, Gregory J Fermann, Sharon E Mace, Simon A Mahler, Peter S Pang, Zubaid Rafique, Michael S Runyon, James Tauras, Christopher R Defilippi

Faculty, Staff and Students Publications

Background: We evaluated the Vitros® Immunodiagnostic Products N-terminal pro B-type natriuretic peptide (NT-proBNP) II assay for aiding in diagnosis of heart failure (HF) in patients with acute dyspnea.

Methods: Serum concentrations of NT-proBNP were measured in patient samples from 20 emergency departments across the United States. Study endpoints included sensitivity, specificity, likelihood ratios, and predictive values for diagnosis of acute HF according to age-stratified cutoffs (450, 900, and 1800 pg/mL), and a rule-out age-independent cutoff (300 pg/mL). Additional measures were area under the curve (AUC) for receiver operating characteristic (ROC) curves. Results were also interpreted in patient subgroups with relevant …

Exploring The Impact Of Residential Proximity To Blue Spaces On The Occurence Of Diabetes, Justin Acala

NURS 502: Critical Inquiry and Scholarship in Nursing Practice

There is a commonly held belief among surfers in the healing properties of the ocean. Many report that simply visiting a beach has a positive effect on them, whether it is spiritually, mentally, or physically. According to Sandifer et al. (2021) “evidence suggests that living close to ‘blue spaces’ (water features), particularly coastlines, has salutary effects on human health” (p. 1), highlighting a potential benefit to coastal living. For some countries across Europe and Australia, research suggests that living by the coast in Europe and Australia is associated with better health (Geiger et al., 2023). Can similar health benefits of …

The Effects Of Bipap Masks While In Acute Care Settings, Drawbacks And Alternate Mask Options, Leanne Rider

NURS 502: Critical Inquiry and Scholarship in Nursing Practice

There are a variety of clinical masks used in hospital environments for respiratory treatments. One treatment used for acute care patients experiencing symptoms, due to chronic respiratory health issues such as COPD or sleep apnea, is referred to as a Bilevel Positive Airway Pressure (BiPAP) machine. The Cleveland Clinic defines this machine in simple terms as “…a type of noninvasive ventilation that helps you breathe. Providers can use it to treat you if you’re not getting enough oxygen or can’t get rid of carbon dioxide “(The Cleveland Clinic, 2023, BiPAP). To break it down further, bilevel in this case means …

From Past To Present: Tracing Africa’S Path To Universal Health Coverage, Evaline Chepchirchir Langat, Paul Russell Ward, Hailay Abrha Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

At the 58th World Health Assembly in 2005, the international community charted a course for universal health coverage (UHC), aiming to ensure access to health care for all in need, of sufficient quality, and without causing financial hardship. At the time, barriers to accessing health care were overwhelming, particularly in low-and middle-income countries like Africa. Currently, 50 of Africa’s 54 countries are in various phases of UHC implementation. Some are developing national UHC agendas, while others have made significant progress but still face gaps in meeting UHC targets. This mini review comprehensively examines the literature to understand the temporal and …

Evaluating The Effect Of Consumption Of Fermented Foods On Glycemic Control And Markers Of Cardiometabolic Risk Amongst Pre-Diabetic And Type 2 Diabetes Mellitus Adult Patients: A Systematic Review And Meta-Analysis, Alex Makau Muia

Master of Medicine in Family Medicine

Introduction 

Type 2 diabetes mellitus (T2DM) remains a major global health challenge, particularly in resource limited countries where conventional treatments are often inaccessible or unaffordable. While lifestyle interventions can reduce diabetes risk, their efficacy is moderate, highlighting the need for alternative strategies. Fermented foods (FFs), which are widely available and affordable, have been shown to improve glucose metabolism and may offer a promising adjunct in the prevention and management of T2DM and prediabetes.

Methods 

A systematic review and meta-analysis were conducted to assess the effects of fermented food consumption on glycemic control and cardiometabolic risk markers in adults with prediabetes …

Neurocognitive Gains Among Ugandan Children With Sickle Cell Anemia On Hydroxyurea: 18-Month Trial Interim Results, Shubaya Kasule Naggayi, Dennis Kalibbala, Vincent Mboizi, John M. Ssenkusu, Zhezhen Jin, Caterina Rosano, Deogratias Munube, Bill Wambaka, Ruth Namazzi, Robert Opoka

Paediatrics and Child Health, East Africa

Children with sickle cell anemia (SCA) frequently develop progressive neurocognitive impairment. We aimed to determine effects of hydroxyurea therapy on neurocognitive function in Ugandan children with SCA by comparing levels at enrollment to a planned 18-month interim assessment. Ugandan children (N=264) ages 3-9 years were enrolled from a SCA clinic and treated in a 30-month singlearm open-label trial with escalation to maximum tolerated dose (MTD). Primary outcome was the effects of hydroxyurea on cognition, attention and executive function, along with transcranial doppler ultrasound (TCD) blood flow velocity. Sibling controls (N=110) without SCA underwent neurocognitive testing in parallel to establish age-normalized …

Nursing News & Views - March 2025, Brenda Rocha Rn, Cno

Nursing Newsletters

Nursing News & Views Newsletter - March 2025

A Preliminary Report Of The Carotenoid Assessment In Adults 50 Years Of Age And Older In Louisiana, Mary-Catherine Feazell

Master's Theses

Fruits and vegetables are at the core of a healthy, balanced diet. They assist in preventing the development of chronic diseases such as hypertension, diabetes, cardiovascular disease, and cancer (Fadnes, et al., 2022). Aging is a natural biological process followed by disease, cognitive impairment, and a natural decline of the body’s ability to perform at its best. The older adult population is currently the fastest-growing population globally (El-Shebiney et al., 2022). Vitamin A is crucial for several parts of the body to function correctly. Despite the positive effects of Vitamin A on the body, the recommended dietary intake is not …

Stress Of Dental Students, Ellen Lee Dds, Ningshu Lyu Dds, Yixin Bao Dds, Yutong Fan Dds, Yueqi Gao Dds, Bryan Gu Dds, Vicky Quach Dds

The New York State Dental Journal

The purpose of this study is to assess what factors cause the most stress for students in dental school and to evaluate different ways to reduce stress. Our aim is to analyze the factors causing stress and offer strategies to help students overcome it.

Engineering A Novel Treg Population To Control Autoimmune Diabetes, Sofia Colon Guzman, Elly Puckett, Ryan T. Fischer, Mary Markiewicz

Posters

Purpose Type 1 diabetes (T1D) in an autoimmune disorder where T cells attack  islet cells, which are the pancreatic cells responsible for insulin production. T1D affects about 1 in 500 children in the United States and is one of the most common chronic diseases in pediatrics. Currently, insulin is the most effective treatment for T1D However, it does not change the underlying disease, and patients still experience many complications throughout their lifetimes. With a significant increase in the prevalence of T1D in children and adolescence in the past two decades, it’s important to explore therapies that alter the immune …

Mental Health Screening And Its Effects On Obese And Overweight Patients: Quality Improvement Project, Amanda Ivos

DNP Projects

Obesity is a growing, multifactorial epidemic. The CDC recommends a 5% weight reduction in order to prevent potential complications associated with overweight or obese status. Mental health, particularly depression, contributes to weight issues with obese individuals having an 18% greater risk of depression, and those with depression having a 37% greater risk of obesity. Both conditions may increase the risk of cardiovascular disease and mortality. Evidence suggests screening and managing depression in overweight/obese patient may lead weight loss and better health outcomes in this patient population.

Project Goals

1. To improve weight loss outcomes in obese or overweight patients with a …

Evaluating Dysphagia Duration And Severity After Acdf In Patients With Underlying Dysphagia - A Prospective, Multicenter Study, Aditya Mazmudar, Taylor Paziuk, Khoa Tran, Tyler Henry, Samuel Oh, Caroline Purtill, Daniel Habbal, Goutham Yalla, Quinlin Harrill, Brandon Sherrod, Erica Bisson, Darrel Brodke, Christopher Kepler, Gregory Schroeder, Alex Vaccaro, Alan Hilibrand, Jeffrey Rihn

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Prospective Cohort Study.

OBJECTIVES: The purpose of this study was to prospectively evaluate the impact of preoperative dysphagia on the postoperative incidence and severity of dysphagia in patients undergoing ACDF at multiple institutions.

METHODS: After IRB approval, patients over 18 years of age who underwent an elective ACDF for degenerative conditions were prospectively enrolled at two academic centers from 2018 to 2021. Preoperative dysphagia was self-reported by patients through a pre-operative questionnaire on a binary basis. Patients completed dysphagia surveys (Bazaz, Dysphagia Short Questionnaire, 10-item Eating Assessment Tool) to assess dysphagia severity during their preoperative visit, and these …

Early Diet Liberalization After Anterior Lumbar Interbody Fusion Improves Postoperative Recovery, Tiffany Bridges, Matthew Meade, Parker L. Brush, Yunsoo Lee, Rajkishen Narayanan, Michael A. Mccurdy, Mark J. Lambrechts, Alex Charlton, Eleanor Jenkins, Robert Juniewicz, Henson Destine, I. David Kaye, Mark Kurd, Jose A. Canseco, Alan S. Hilibrand, Alex R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Retrospective Cohort Study.

OBJECTIVES: The objective of this study was to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF).

METHODS: A retrospective review was performed for patients undergoing ALIF at our tertiary care center institution from 2010 to 2022. Electronic medical records were reviewed for demographics, surgical characteristics, and 90-day postoperative outcomes.

RESULTS: We included 515 patients in this study with 102 patients receiving a full diet on the same day as their operation. All other patients had a delay of at least 1 day (average 1.6 days) until …

Correlation Between Fetal Abdominal Wall Adiposity And Neonatal Outcomes, Elaine Murugi Nyaga

Master of Medicine in Obstetrics and Gynecology

BACKGROUND 

Fetal growth is a result of complex interactions between genetic, nutritional, environmental, uteroplacental, and fetal factors which impact on delivery and subsequent neonatal outcomes. Fetal abdominal adiposity serves as an important indicator of fetal growth and body composition. While gestational diabetes mellitus (GDM) can influence fetal fat deposition, understanding how adiposity correlates with birth weight and neonatal outcomes in both GDM and non-GDM pregnancies provides insight into the broader significance of fetal adiposity as a marker of fetal health.

Methodology 

A cross-sectional study was conducted on 269 pregnant women to examine fetal abdominal adiposity, measured as fetal abdominal subcutaneous …

Effects Of The Vitality Acupunch Exercise Program On Older Adults With Probable Sarcopenia: A Mixed Methods Pilot Study, Brittany Murley, Kuei-Min Chen, Christine S. Gipson, Kevin Gosselin, Jenna Thornhill, Allison Ross, Kennedy Gladding, Beth Mastel-Smith

Nursing Faculty Publications and Presentations

Purpose: Age-related loss of muscle mass and strength is a highly prevalent condition in older adults in long-term care (LTC) facilities. This pilot study aimed to test the effects of a vitality acupunch (VA) exercise program on muscle mass, muscle strength, muscle endurance, functional fitness, activities of daily living, quality of life, and sleep quality of older adults in LTC facilities with probable sarcopenia in the United States and understand the experiences of residents who participated in the VA program. Design: A mixed-methods experimental design was used for this study. Methods: The quantitative phase included a sample of 27 participants …

Cinacalcet For Infants And Young Children On Maintenance Dialysis: Determining The Right Time, The Right Dose And The Right Patients., Kyle Ying-Kit Lin, Fiona Fung-Yee Lai, Eugene Yu-Hin Chan, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is a recognized complication of kidney failure, which can lead to short stature, bone deformity, slipped capital femoral epiphysis, and bone fracture in children. Despite the use of conventional therapies, a subgroup of patients receiving dialysis continues to experience secondary or even tertiary hyperparathyroidism. Cinacalcet, a calcimimetic agent, has been shown to be a promising therapeutic option to control hyperparathyroidism with reasonable safety profiles in adults and older children. Nevertheless, there is a paucity of data and guidance pertaining to its use among the younger children on dialysis, who are often the …

The Clinical Phenotype Of Motor Neurone Disease In A Kenyan Hospital – Based Population, Effie Nailah Kamadi

Master of Medicine in Internal Medicine

Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.

Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed at AKUHN between …

The Prevalence And The Predictors Of Diabetes Distress In Patients With Type 2 Diabetes Attending Diabetes Clinics At A Tertiary Private Hospital In Nairobi, Kenya., Soulthy Azamkhan Mohamed

Master of Medicine in Family Medicine

Background Diabetes distress encompasses a spectrum of emotional and psychological challenges faced by individuals managing diabetes, including anxiety, stress, depression, frustration, and feelings of helplessness. This distress arises from the constant demands of monitoring blood sugar levels, managing medications, adhering to dietary restrictions, engaging in regular physical activity, and navigating potential complications. Social and emotional factors such as stigma, discrimination, and concerns about future health further contribute to this burden. Factors like fear of hypoglycemia, financial strain, fluctuating blood sugar levels, anxiety about complications, and impacts on personal relationships exacerbate diabetes distress. Left unaddressed, diabetes distress can lead to poor …

Dementia In A Resource-Constrained Sub-Saharan African Setting: A Comprehensive Retrospective Analysis Of Prevalence, Risk Factors, And Management At The Only Neuropsychiatric Facility In Northeastern Nigeria, Ibrahim Abdu Wakawa, Umar Baba Musami, Suleiman Hamidu Kwairanga, Placidus Nwankuba Ogualili, Mohammed Yusuf Mahmood, Muhammad Abba Fugu, Mohammed Mala Gimba, Muktar Mohammed Allamin, Zaharadeen Umar Abbas, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION: Dementia prevalence is increasing in sub-Saharan Africa, poten-tially due to population growth and aging. Resource-constrained settings such asNortheastern Nigeria face challenges in dementia management.

METHODS: We assessed dementia burden and management at the Federal Neuropsy-chiatric Hospital Maiduguri, the only neuropsychiatric facility in Northeastern Nigeria.This retrospective analysis included patient records from 1999 to 2023 for individuals60 year of age and older with a dementia diagnosis.

RESULTS: Of the 1216 cases reported, Alzheimer’s disease (60.5%) was the mostcommon subtype, followed by vascular dementia (24.5%). Hypertension (41.6%) wasthe most frequent comorbidity. Memory loss was present in all cases, whereasbehavioral …

Applications Of Archaeal Antioxidant Coenzyme M As An Agricultural Biostimulant, Jeremy Hunter Brown

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

As the demand to meet global food security goals continue to increase, the need to increase efficiency and productivity of agricultural output also rises. This calls for innovative and cost-effective methods for improving plant growth and yield. Here we explore how antioxidants, molecules that inhibit oxidation and are necessary for redox based signaling and redox homeostasis, can be utilized as chemical biostimulants. Specifically, we investigated Coenzyme M, an antioxidant from archaea that holds potential economic advantages over other antioxidants. Chapter 1 provides a comprehensive review of antioxidants and how exogenously application of them affects plant growth and biology, highlighting the …

Spotting And Responding To Health Misinformation And Disinformation, Michael J. Mcgee, Jean-Philippe Berteau

Open Educational Resources

Three one-hour lessons. In these lessons students will learn to identify health misinformation which spreads rapidly through social media, search engines, and online platforms. By generating false health news stories with AI and critically analyzing them, students will develop essential skills for public health literacy and ethical responsibility. These activities equip future health professionals with the tools to discern evidence-based information from deceptive content and provide guidance to ensure accurate and authentic communication in the field.

Assessment Of Parents’ Awareness About The Care Of Their Neonates With Neural Tube Defects, Asmaa Salah Khamis, Hayam Salah Tanatwy, Safaa Salah Ismail

Nursing

Background: Neural Tube Defects are one of the most congenital anomalies of the Central Nervous System that may happen in the neonatal period. Aim of the study: this study aimed to assess parents’ awareness about the care of their neonates with neural tube defects. Research design: A descriptive study design was used. Setting: the study was conducted at the outpatient clinic for pediatric Neurology at Ain Shams Educational Hospital. Methods: A convenient sample of 40 parents accompanied by their neonates who suffered from neural tube defects. Tools: Data was collected using three tools. Tool (I) A structured questionnaire sheet composed …

A Study Of Secondary Traumatic Stress In Health Care Professionals In Long-Term Care., Bethany Proudfoot

Doctor of Social Work Capstone Projects

Secondary traumatic stress (STS) is a significant concern for healthcare professionals in long-term care (LTC) settings. This study explores the impact of STS on clinical staff, addressing the research question: How has STS affected employees within the LTC sector, and what resources or support can be provided to mitigate its effects? The study utilized a mixed-methods approach, combining survey data from clinical staff across five LTC facilities in Ohio, incorporating the survey data measuring levels of STS and qualitative responses. Findings revealed that 64% of participants experienced high to severe levels of STS, with symptoms including anxiety, depression, sleep disturbances, …

Insulin Receptor Responsiveness Governs Tgfβ-Induced Hepatic Stellate Cell Activation: Insulin Resistance Instigates Liver Fibrosis, Wang-Hsin Lee, Evelyn A. Bates, Zachary A. Kipp, Sally Pauss, Genesee J. Martinez, Cheavar A. Blair, Terry D. Hinds Jr.

Markey Cancer Center Faculty Publications

The insulin receptor (INSR) has been shown to be hyperactive in hepatic stellate cells (HSCs) in humans and rodents with liver fibrosis. To explore HSC cellular mechanisms that INSR regulates during pro-fibrotic stimulation, we used CRISPR-Cas9 technology. We knocked out a portion of the INSR gene in human LX2 HSC cells (INSRe5- 8 KO) that regulates insulin responsiveness but not the insulin-like growth factor (IGF) or transforming growth factor-β (TGFβ) signaling. The INSRe5- 8 KO HSCs had significantly higher cell growth, BrdU incorporation, and lower TP53 expression that suppresses growth, and they also exhibited increased migration compared to the Scramble …

Exploring Oxylipins In Host–Microbe Interactions And Their Impact On Infection And Immunity, Robert J. Neff, Christopher D. Radka

Markey Cancer Center Faculty Publications

Plasma lipids are essential components of biological systems, transported through interactions with proteins to maintain cellular functions. These lipids exist in various forms, such as fatty acids, glycerolipids, glycerophospholipids, sphingolipids, sterols, and prenol lipids, derived from dietary intake, adipose tissue, and biosynthesis. While the association between certain fatty acids and cardiovascular diseases has been widely recognized, polyunsaturated fatty acids (PUFAs) exhibit cardioprotective effects, reducing risks of arrhythmias and heart-related mortality. This is due to their role in the production of eicosanoids, which modulate inflammation. Chronic inflammation, particularly in obesity, is significantly influenced by fatty acids, with saturated fatty acids promoting …

Caloric Restriction And Telomere Preservation In Tert Knockout Adipocyte Progenitors Does Not Rescue Mice From Metabolic Dysfunction Due To A Tert Function In Adipocyte Mitochondria, Zhanguo Gao, Yongmei Yu, Kristin Eckel-Mahan, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

Inactivation of telomerase (TERT) in adipocyte progenitor cells (APC) expedites telomere attrition, and the onset of diabetes in mice fed high-fat diet (HFD), which promotes APC over-proliferation and replicative senescence. Here, we show that time-restricted feeding or caloric restriction in the postnatal development of mice subsequently subjected to HFD prevents telomere attrition but not glucose intolerance. This metabolic effect of dietary intervention was not observed for mice with TERT KO in endothelial or myeloid cells. To characterize the telomere-independent effects of TERT in the APC lineage, we analyzed mice with TERT knockout in mature adipocytes (AD-TERT-KO), which do not proliferate …