Digital Commons Network^™

Validation Of Longitudinal Biomarker Screening Algorithms For Hcc Detection In Patients With Cirrhosis, Neehar D Parikh, Anna S Lok, Camden Lopez, Stephanie Page-Lester, Lewis R Roberts, Rajender Reddy, Michelle Luster, Saira Khaderi, Sumeet K Asrani, Hashem B El-Serag, Fasiha Kanwal, Ziding Feng, Nabihah Tayob

Faculty, Staff and Students Publications

Background: Blood-based biomarker panels, including GALAD, have been proposed as an alternative to abdominal ultrasound for hepatocellular carcinoma (HCC) surveillance. Studies suggest longitudinal evaluation of biomarkers can improve test performance; however, no large studies have validated these findings.

Methods: We leveraged the HCC Early Detection Strategy (HEDS) study (n=1019 patients with cirrhosis; 99 incident HCC) and Texas HCC Consortium (THCCC) (n=2345 patients with cirrhosis; 126 incident HCC) to compare the performance of fixed-threshold GALAD (cutoff of -1.36), and 4 longitudinal algorithms: longitudinal GALAD, PALAD, mFB-ALAD, and mPEB-ALAD. The HEDS cohort was used to derive longitudinal algorithms, and external validation was …

Digital Pain Assessment: Patient And Family Perspectives, Rosemary Saunders, Kate Crookes, Kaoru Nosaka, Olivia Gallagher, Jeff Hughes, Caroline Bulsara, Max K. Bulsara, Seng Giap Marcus Ang, Beverley Ewens, Sue Haydon, Karla Seaman, Renée Graham, Debra Scaini, Karen Gullick, Michelle Gay, Christopher Etherton-Beer, Renée Graham

Research outputs 2022 to 2026

Background/Objectives: Pain is a common symptom for hospitalised older adults. Pain is not always adequately assessed, which can lead to inadequate pain management and adverse patient outcomes. Thus, new technology-driven pain assessment tools have been developed; however, little is known about patients’ and families’ experiences of nurses using them in acute care. This study aimed to explore the perspectives of older adult inpatients and their families’ regarding nurses’ use of the digital technology-driven pain assessment application PainChek^® Universal. Methods: A survey was undertaken as part of a stakeholder evaluation of a randomised control trial exploring the effectiveness of nurse-led …

A Comprehensive Biomechanical Material Characterization Of The Human Breast Fibro-Structural Support System, Aroj Bhattarai, Gregory P Reece, Kristy K Brock, Krishnaswamy Ravi-Chandar

Faculty, Staff and Student Publications

Breast surgery for aesthetic purposes, such as breast augmentation or breast reduction, and breast reconstruction after cancer treatment require an accurate structural (anatomical) and mechanical (functional) understanding of the breast components, including the fascial-ligamentous support system of the breast, to achieve optimal results. This paper aims to provide a comprehensive description of the mechanical behavior of the ligamentous and fascial connective tissues of the human female breast. Fasciae and ligaments obtained from 17 patients between 35 and 85 years of age who were undergoing mastectomy and three female cadavers were tested. Uniaxial tensile tests were conducted, and three constitutive models …

Entangled Transitions: How Covid-19 Widened Well-Being Gaps Among Youth In Singapore (2017–2022), Vincent Chua, Han Ei Chew, Isabelle Tan, Pamela Lee

Research Collection Office of Impact

COVID-19 was not merely a biomedical crisis but a deeply social phenomenon entangled with existing inequalities. Drawing on Peter Kelly's notion of entanglement, we conceptualise the pandemic as an intersectional crisis − where time, structural disadvantage and socio-emotional well-being became interwoven. Using six waves of longitudinal data (2017–2022) from Youth STEPS, a panel study of young people in Singapore, we track within-person changes in life satisfaction across key youth transitions before, during and after the pandemic. Our findings show that the negative effects of unemployment and insecure work on well-being were markedly more severe during the pandemic than in earlier …

Geographic Access To Pediatric Ecmo And Ecpr: A Geospatial Study Of Transport Networks And Disparities., Allan M. Joseph, Andrew J. Lautz, Carlie N. Myers, Ranjit S. Chima, Juan P. Gurria, Shafee Salloum, Wendy Hasson, Matthew P. Malone, Jenna Miller, Maya L. Dewan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND AIM: Extracorporeal membrane oxygenation (ECMO) can help children survive severe cardiac and/or respiratory failure, but it is only provided in specialized centers. There are disparities in access by ground transport to ECMO services, but it is unknown to what extent interfacility transfer systems can expand access. Additionally, the number of children who live in proximity to centers that perform extracorporeal cardiopulmonary resuscitation (ECPR) to be potential candidates in case of out-of-hospital cardiac arrest (OHCA) is unknown. We conducted a geospatial analysis to answer these questions.

METHODS: We conducted a geospatial analysis of the Extracorporeal Life Support Organization (ELSO) …

Trends In Alcohol Withdrawal With Relation To Race/Ethnicity, Angela Nguyen, Alexandra Amaducci Do

USF-LVHN SELECT

No abstract provided.

Educating To Exhaustion: Intention To Leave Among Us Full-Time Nursing Faculty, Jacqueline Christianson, Kathryn J. Malin, Jessica Leiberg, Lisa M. Grabert, Stephanie E. Moser, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

AIM 

The aim of this study was to examine the relationships between work efforts and rewards with intention to leave and burnout among full-time nurse educators.

BACKGROUND 

The nursing faculty shortage is a contributor to the nursing shortage. Poor balance between work efforts and rewards may contribute to intention to leave.

METHOD 

A cross-sectional survey of US nurse faculty examined work efforts, rewards, burnout, and intention to leave. Structural equation modeling was used to evaluate the relationships among variables.

RESULTS 

Among 588 participants, efforts and rewards both had significant effects on burnout. Burnout and rewards had significant effects on intention …

Student Mental Health: Screening For Stress, Anxiety And Depression Using Fitbit Data, Rebecca Lopez, Avantika Shrestha, Ml Tlachac, Kevin Hickey, Xingting Guo, Shichao Liu, Elke Rundensteiner

Information Systems and Analytics Department Faculty Conference Proceedings

College students experience many stressors, resulting in high levels of anxiety and depression. Wearable technology provides unobtrusive sensor data that can be used for the early detection of mental illness. However, current research is limited concerning the variety of psychological instruments administered, physiological modalities, and time series parameters. In this research, we collect the Student Mental and Environmental Health (StudentMEH) Fitbit dataset from students at our institution during the pandemic. We assess the ability of predictive machine learning models to screen for depression, anxiety, and stress using different Fitbit modalities. Our findings indicate potential in physiological modalities such as heart …

Optimizing Feasibility And Acceptability Of An Online Expressive Writing Intervention For Survivors Of Adolescent And Young Adult Cancer: A Pilot Randomized Trial Of Iterative Modifications And Outcomes, Eunju Choi, Yusi Aveva Xu, Celia Cy Wong-Meli, Michael E Roth, Yisheng Li

Faculty, Staff and Student Publications

Objective: To evaluate the feasibility of an online expressive writing (EW) intervention for survivors of adolescent and young adult (AYA) cancer and determine whether iterative, theory-driven modifications can enhance response, adherence, and completion rates.

Methods: In this randomized pilot trial, survivors of AYA cancer were recruited through a hospital-based AYA oncology clinic and an online community. Forty participants were randomly assigned to the EW intervention or control group. To improve on lower-than-expected adherence and completion rates in a previous cohort, the protocol was iteratively revised using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS). Modifications included …

Urinary Cotinine Cut-Offs For Tobacco Smoke Exposure In Pregnancy And Associations With Child Intelligence Quotient: A Multi-Cohort Analysis, Qi Zhao, Thomas F Northrup, Penelope J E Quintana, Eunha Hoh, Georg Matt, Catherine J Karr

Faculty, Staff and Student Publications

Background: Prenatal exposure to tobacco smoke may impair neurodevelopment in children. However, accurately characterizing this exposure remains challenging.

Methods: We pursued two objectives in this large population study. First, in 1708 pregnant women from the Environmental Influences on Child Health Outcomes (ECHO) cohort, we constructed Receiver Operating Characteristic (ROC) curves to determine urinary cotinine cut-offs to classify firsthand (FHS), environmental (ETS), and no exposure, and further distinguished secondhand (SHS) from thirdhand smoke (THS) exposure within ETS. Second, among 1593 participants in three pregnancy cohorts nested in ECHO, we fit multivariable linear regressions to examine the association between the newly defined …

Statistical Methods In Aging Research: Improving Current Practices And Embracing Emerging Approaches, Xi Rita Wang, Thirupathi R Mokalla, Olivia C Robertson, Wasiuddin Najam, Andrew E Teschendorff, Andrew W Brown, John R Speakman, Yisheng Peng, Bernard S Gorman, Heping Zhang, Luis-Enrique Becerra-Garcia, Colby J Vorland, David B Allison

Faculty, Staff and Students Publications

Aging research relies on varied statistical methods, and applying these methods appropriately is important for scientific rigor. However, proper use of these statistical techniques is a challenge. We discuss two categories of statistical methods in aging research: (a) emerging methods requiring further validation, including techniques to examine compression of morbidity, maximum lifespan, immortal time bias, molecular aging clocks, and treatment response heterogeneity, and (b) classic and existing methods needing reconsideration and improvement, such as stepwise regression, generalized linear models, methods for accounting for clustering and nesting effects, methods for testing for group differences, methods for mediation …

Physical Activity And Exercise Patterns Of Submariners In Land And Sea Environments, Benjamin Kirk, Georgios Mavropalias, Anthony Blazevich, Jodie Cochrane Wilkie, Aus Molan, Kazunori Nosaka

Research outputs 2022 to 2026

Introduction: Submarine environments pose unique challenges to maintaining physical activity and exercise routines due to confined spaces, demanding schedules, and limited resources. This study investigated submariners’ physical activity patterns, sleep quality, and perceived exercise barriers in both land- and sea-based settings, with the goal of informing targeted health interventions. Materials and Methods: Ethics approval was granted by the Defence Science and Technology Group and Edith Cowan University review panels. This cross-sectional study surveyed 21 Royal Australian Navy submariners (25-48 years; 18 male) using a modified version of the International Physical Activity Questionnaire. Participants reported weekly engagement in general physical activity …

A Joint Effort: Stakeholders' Perspectives Of Medication Management Reviews In Australian Residential Aged Care, Rajendra Gyawali, Marea O'Donnell, Rachel Jenkins, Amy D. Nguyen, Lalit Yadav, Rosemary Saunders, Fiona J. Clay, Johanna I. Westbrook, Karla Seaman, Magdalena Z. Raban

Research outputs 2022 to 2026

Objective: Residential Medication Management Review (RMMR) is a government-funded pharmacist-led service to address medication-related problems, such as polypharmacy, which are prevalent in aged care. Despite known benefits, concerns remain about the service's effective implementation to benefit residents. We aimed to explore stakeholders' perspectives of the service and identify challenges and improvement opportunities. Method: A qualitative study was conducted using individual interviews and focus groups with 21 stakeholders, including general practitioners (GPs), a nurse practitioner, registered nurses, pharmacists and consumers. Audio transcripts of the discussions were thematically analysed using inductive coding. Results: Seven interconnected themes were identified, highlighting complexities in RMMR …

Dietary Flavonoid Intake And Psychological Well-Being – A Bidirectional Relationship, Alysha S. Thompson, Nicola P. Bondonno, Yan Lydia Liu, Farah Qureshi, Laura D. Kubzansky, Claudia Trudel-Fitzgerald, Julia K. Boehm, Eric B. Rimm, Aedín Cassidy

Research outputs 2022 to 2026

Background and aim: Higher dietary flavonoid intake has been associated with lower risks of mortality and major chronic disease, yet its relationship with psychological well-being (PWB), a key contributor to health and quality of life, remains unclear. This study aimed to investigate bidirectional associations between dietary flavonoid intake and two PWB facets: happiness (positive emotional state) and optimism (generalized expectation of positive outcomes). Specifically, we examined whether (1) overall flavonoid-rich dietary patterns (flavodiet score), (2) intake of specific flavonoid-rich foods, and (3) total flavonoid and subclass intakes were each associated with happiness and optimism over time. Methods: Data were drawn …

Does Genetic Testing Influence Outcomes: Early Experience In Melanoma Case Series, Ryan Reyes, George Skenteris, Stella Coker Watson Self Ph.D., Ms, Christine Marie-Gilligan Schammel, Steven D. Trocha

Faculty Publications

Background:

The treatment and prognosis of melanoma have historically been based on histologic stage and Breslow depth; however, due to the increase in surveillance, melanomas are being identified at an earlier stage and lower Breslow depth. Advances in genetic testing, such as Decision Dx®, mean that melanoma diagnostic decisions and prognosis can now be directed by genetics. The purpose of this project was to assess the influence of a Decision Dx® high-grade (Class 2A/B) classification on the treatment of melanoma patients at a regional medical center, particularly those not deemed high risk by conventional classification methods, including Breslow depth and …

Large Language Models In Qualitative Analysis: Comparing Traditional And Researcher-Interpreted Approaches, Raihan K. Khan

Faculty Scholarship

Qualitative data analysis, particularly thematic analysis, is a widely used method for uncovering patterns and insights in narrative data but often faces challenges such as being resource-intensive and susceptible to researcher bias. In recent years, Large Language Models (LLMs) have emerged as promising tools to assist human coders in conducting thematic analysis, offering efficiency and scalability in processing large datasets. However, existing work primarily relies on tools like ChatGPT, raising privacy concerns—especially when analyzing sensitive healthcare data—and lacks systematic validation through comparisons with human coders. This study aims to evaluate the potential of open-source LLMs for qualitative data analysis. Semi-structured …

Association Between Tinnitus And Angina Pectoris In U.S. Adults: Evidence From Nhanes 2009–2018, Mitra Britton, Ishan Sunilkumar Bhatt

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Background/Objectives: Tinnitus has been increasingly associated with cardiovascular disease, and recent phenome-wide analyses have identified angina pectoris as a condition linked to tinnitus. This study aimed to replicate and quantify the association between tinnitus and angina pectoris in a nationally representative U.S. adult sample using NHANES, while adjusting for key demographic, cardiovascular, and tinnitus-related risk factors. Methods: Using data from four NHANES cycles 2009–2018, a cross-sectional analysis was conducted, which included 9185 participants, and used multivariate logistic regression analyses to investigate the association between tinnitus and angina pectoris. Results: Among 9185 adults, angina was associated with higher odds of tinnitus …

Alpha And Beta Emitters In Translational Nuclear Medicine: Clinical Advances, Challenges, And Future Direction, Hanieh Karimi, Thomas H. Shaffer, Erik Stauff, Vinay V. R. Kandula, Heidi H. Kecskemethy, Lauren W. Averill, Xuyi Yue

Department of Radiology Faculty Papers

Radiopharmaceutical therapy (RPT) has emerged as a transformative modality in oncology, particularly for patients with metastatic or inoperable tumors. By leveraging molecularly targeted carriers conjugated to cytotoxic radionuclides, RPT enables precise delivery of ionizing radiation to tumor sites while minimizing off-target effects. Central to this approach are alpha (α) and beta (β) particle-emitting radionuclides. This review aims to provide a comprehensive overview of all clinically relevant alpha and beta emitters and incorporates the most recent advances from 2017-2025, offering a comprehensive and up-to-date perspective. Alpha and beta emitters hold significant promises for the future, especially in nuclear medicine, energy, and …

Prenatal Stress Induces Changes In Behavior, Hpa Axis, Inflammation, And Oxidative Stress In Adult Rats Offspring, Jorge M Aguiar-Geraldo, Jefté Peper-Nascimento, José Henrique Cararo, Taise Possamai-Della, Alexandra I Zugno, João Quevedo

Faculty, Staff and Student Publications

Prenatal stress is related to the development of psychiatric disorders involving inflammation, oxidative stress, and hypothalamic-pituitary-adrenal (HPA) axis. Therefore, the aim of the present study was to evaluate the effects of prenatal stress on behavior, inflammation, oxidative stress, and the HPA-axis in the dams and their offspring treated with lithium. Thirteen pregnant Wistar rats were exposed to a prenatal chronic unpredictable stress protocol from the 14th day of gestation until birth. At the 60th postnatal day (PND), a treatment protocol was carried out in the offspring with lithium (intraperitoneally - 47.5 mg/kg) or saline for seven days (twice a day). …

Exploring The Attributes Of Varied Interventions To Reduce Firearm Violence Among Youth And Emerging Adults: A Systematic Review, Vickie Blakely Reed, Lashanda D. Brumfield, Maaz Ali, Traci Hayes

Journal of Public Health in the Deep South

The death rate among children and adolescents, 14-26 years old, from firearms has increased 46% from 2019 to 2021. Among this demographic population, Black and Latino youth account for most firearm deaths. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used in conducting this study. Studies from January 2020 to October 2025 were identified through a search of PubMed, Web of Science, and ProQuest databases. Searches for the review included but were not limited to terms and phrases such as “gun violence prevention interventions for youth” and “firearm violence prevention interventions.” The purpose of this systematic …

School Climate As Primary Prevention: Mental Health And Violence Outcomes Among Lgbtq+ Youth In The U.S. South (2015–2024), Latarsha H. Michael, Brieah D. Hudson, Kenya T. Horne

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Violence And Abuse Against Adult Stroke Survivors In The Deep South: Epidemiology, Risk, And Public Health Responses, Dawn S. Mclendon, Shaneka S. Patterson, Shreyas Gangadhara

Journal of Public Health in the Deep South

Adults living with neurologic disability, particularly stroke survivors, face disproportionately high rates of violence and abuse. This vulnerability is amplified in the Deep South due to elevated stroke burden, structural disadvantage, and persistent community-level disparities in both violence and health care access. We conducted a narrative review of peer-reviewed literature indexed in PubMed, along with relevant surveillance and policy reports, to synthesize current evidence on the burden, patterns, risk factors, and prevention opportunities related to violence among adult stroke survivors. The review focused on elder mistreatment, intimate partner violence, sexual violence, caregiver abuse and neglect, and financial exploitation. Findings indicate …

Socioeconomic Factors Affecting Length Of Hospital Stay And Discharge Disposition Among Male And Female Gunshot Injury Patients In Jackson, Mississippi., Okechukwu Erinne, Deanna Howington, Sarah Mcgraw, Jonathan B. Lowrie, Matthew Kutcher, Alyscia Severance, Masoumeh Karimi, Leila Seidfaraji, Lei Zhang

Journal of Public Health in the Deep South

Background: Gun violence remains a public health concern in the United States, with Jackson, Mississippi, ranking among the highest in gun violence rates. Understanding how sociodemographic factors influence clinical outcomes is essential for improving care delivery and resource allocation. 

Purpose: This study examined the association between age, education, employment, and insurance status with hospital length of stay (HLOS) and discharge disposition among adult male and female firearm injury patients residing in Jackson, Mississippi.

Methods: Data were obtained from the electronic health records of adults (≥ 18 years) presenting to the University of Mississippi Medical Center emergency department …

A Secondary Analysis Of Mississippi Domestic Violence Trends From 2019 To September 2025 Based On The Trace Atlas Of Gun Violence Archives, Lashanda D. Brumfield, Bernice Akinwande, Vickie Blakely Reed, Traci Hayes, Tanya Funchess

Journal of Public Health in the Deep South

Abstract

Background: Domestic violence remains one of the most heartbreaking yet overlooked public health challenges across the Deep South. Prevention programs and effective policies addressing domestic violence issues must be driven by translatable, applicable, and reliable data in order to see outcome-driven results. Purpose: The objective was to identify temporal, regional, and city-level patterns in the frequency and severity of domestic violence gun incidents. Methods: This study presents a secondary analysis of domestic violence gun incidents in Mississippi from January 2019 to September 2025. To examine geographic distribution, incidents were aggregated at the regional level: Central, Northeast, Northwest, Southwest, …

Community-Guided Adaptation Of Violence Prevention Strategies: Insights From The Mississippi Violence Injury Prevention (Ms-Vip) Program, Erin Dehon, Masoumeh Karimi, Leila Seidfaraji, Michelle Brassfield, Melinda Todd, Rukia Lumumba, Matthew Kutcher, Matthew Morris, Fredrick Womack, Roy Hart, Lei Zhang

Journal of Public Health in the Deep South

No abstract provided.

Training Mississippi Providers To Address Intimate Partner Violence In Maternal Care: Pilot Outcomes From The Simm Initiative, Xiaoshan Z. Gordy, Catherine Poehling, Saijun Zhang, Chinedu Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

No abstract provided.

Bridging Ipv And Sud For Pregnant And Postpartum Women: A Case Report Of Interdisciplinary Programming In Mississippi, Catherine Poehling, Masoumeh Karimi, Chinedu Chukwu, Jerome R. Kolbo, Xiaoshan Gordy, Saijun Zhang, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsanee Davis, Sonja Fuqua, Mary M. Wesley, Lei Zhang

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Gun Violence And Maternal Mortality In The Mississippi Delta: A Dual Public Health Crisis, Nelson Atehortua, Mary Shaw-Ridley

Journal of Public Health in the Deep South

No abstract provided.

The Mississippi Violence Injury Prevention Program (Ms-Vip): Building A Community-Driven Model For Healing And Safety, Rukia Lumumba

Journal of Public Health in the Deep South

No abstract provided.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keratosis Pilaris, Henry Lim, Reem Ayoub, Madelyn Richards, Marshall Hall, Christian Scheufele, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Keratosis pilaris (KP) is a common benign disorder involving hyperkeratosis of the skin. It is associated with other common dry skin disorders such as atopic dermatitis and ichthyosis vulgaris. Lesions are clinically characterized as symmetrically distributed, monomorphic, folliculocentric, hyperkeratotic papules with a variable degree of perifollicular erythema. The appearance can be likened to spikey bumps that are commonly located on the arms, legs, and buttocks. Awareness of KP is important as every primary care clinician will see patients with this disorder. Identification can support the diagnosis of other associated skin diseases. Education about KP and its treatment may alleviate psychological …