Digital Commons Network^™

Id-More Vision: Real-Data Machine-Learning Assessment For A Digital-Twin-Inspired, Xr-Ready Rehabilitation Prototype, Rickey L. Clark

Master's Theses

Rehabilitation assessment often relies on periodic observation, while many XR prototypes show scripted rather than recorded-motion evidence. iD-MORE Vision is an offline pipeline trained on KIMORE and IRDS and linked through JSON packets to a two-mode Unity desktop prototype. Both datasets include controls and rehabilitation participants with neurologic, musculoskeletal, or mobility impairments. This improves relevance but does not clinically validate the system.

Under fixed subject-wise splits, the primary five-seed Random Forest predicted KIMORE clinician scores with MAE 6.087 ± 0.044 cTS and R² 0.568 ± 0.006; the subject-level R² interval crossed zero. The primary IRDS five-run CUDA GRU averaged 0.877 …

Weathering More Than Storms: Understanding The Mental Health Disparities Of Black Farmers In The Appalachian Region, Aliyah Smith

Electronic Theses and Dissertations

Black farmers in Appalachia represent a vital and historically marginalized population within one of America’s most economically distressed regions. Black farmers have endured generations of systemic racism, resulting in land loss, economic hardship, and mental stressors. This study examines the intersection of race, agriculture, and behavioral health to illustrate how structural barriers and cultural stigmas shape the mental well-being of Black farmers across Appalachia.

Findings from the analysis will guide the development of a conceptual model based on constructs from the Social-Ecological Model (SEM), Intersectionality Theory, and Critical Race Theory (CRT). This study will use Key Informant Interviews (KIIs) conducted …

A Longitudinal Multi‑Proxy Geospatial Classification Of Peri‑Urban Transitions Across Community Health Units In Coastal Kenya, Prissy Makena, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Urbanization is spatially heterogeneous in many sub-Saharan African settings. This complicates community health planning when rural and peri-urban labels are applied informally or updated inconsistently. We assessed whether multiple publicly available geospatial proxies could characterize settlement dynamics and support Community Health Unit (CHU) level classification within the Kaloleni Rabai Health and Demographic Surveillance System (KRHDSS) in coastal Kenya.

Methods We conducted a longitudinal ecological analysis across 10 CHUs in Kilifi County with annual observations from 2017 to 2024. Five geospatial proxy indicators of settlement intensity were summarized within CHU boundaries: Visible Infrared Imaging Radiometer Suite (VIIRS) nighttime lights radiance, …

Transfusion Intensity In The Icu: Reasons And Triggers, Merijn Reuland, Senta Raasveld, Jimmy Schenk, Claudia Oord, Sanne Bruin, Caroline Schaap, Andrew Flint, Jan Bakker, Maurizio Cecconi, Marcus Lance

Anaesthesiology, East Africa

Background The reasons and physiological triggers for blood transfusion in critically ill patients are not well characterized. Beyond hemoglobin levels, hemodynamic instability is frequently cited, but its role across clinical contexts remains unclear.

Aims (1) To determine whether reasons and triggers for RBC transfusion differ across intensive care unit (ICU) days with varying transfusion intensity. (2) To describe reasons for non-RBC transfusions across these intensity groups.

Methods This sub-study of the prospective International Point Prevalence Study of Intensive Care Unit Transfusion Practices (InPUT) classified ICU days by transfusion intensity: nonmajor (1 RBC unit), major (≥2 units), and massive (≥6 units …

From The Editor: Is Giving Actually Better Than Receiving?, Romesh Nalliah

The Journal of the Michigan Dental Association

This editorial examines the relationship between generosity, volunteerism, and well-being. Using the Michigan Dental Association Foundation’s Mission of Mercy as a focal point, the author highlights research suggesting that prosocial behavior can improve mental and physical health while benefiting communities in need. The article encourages oral health professionals to use their skills and resources to support underserved populations through volunteer service, mentorship, and community engagement.

J Mich Dent Assoc August 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The August 2026 (Volume 108, No. 8) issue of the Journal is published in print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The August 2026 issue of the Journal of the Michigan Dental Association explores clinical, professional, legal, leadership, and public …

Mission Of Mercy: Restoring Smiles With Dignity, Anne Berquist

The Journal of the Michigan Dental Association

This feature chronicles Michigan’s 2026 Mission of Mercy clinic, where more than 1,200 volunteers provided 5,656 procedures to 771 patients. The article describes patient experiences, volunteer contributions, and the extensive planning required to transform a sports arena into a temporary dental clinic. Beyond oral healthcare delivery, the program restored confidence, relieved pain, and highlighted the dental profession’s commitment to serving underserved populations.

The Power Of The Tripartite: Defending Fluoridation Together, Sarah Stuefen Dds

The Journal of the Michigan Dental Association

This article describes a successful grassroots effort to preserve community water fluoridation in Vinton, Iowa. The author details how local dental professionals, state dental associations, the American Dental Association, public health experts, and community stakeholders collaborated to educate decision makers and advocate for evidence-based public health policy. The experience demonstrates the importance of coordinated advocacy and organized dentistry in protecting oral health initiatives.

The Invisible Work: On Expertise, Showmanship, And The Trust That Makes Surgery Work, Anish Gupta D.D.S.

The Journal of the Michigan Dental Association

This commentary examines how clinicians can make their expertise more visible to patients through communication, education, and clinical narration. Drawing parallels to surgical checklists and professional mastery, the author argues that trust is built not only through excellent outcomes but also through helping patients understand the complexity and judgment behind treatment. The article emphasizes communication, transparency, education, and mentorship as important elements of patient-centered care.

The Back Page: A Toast To The Future: From Boomers To Gen Z Zoomers, George T. Goodis Dds, Gerald J. Halk Dds

The Journal of the Michigan Dental Association

This article highlights a leadership brunch that brought together multiple generations of dental leaders to encourage engagement in organized dentistry. The gathering emphasized mentorship, leadership development, and the transfer of institutional knowledge to younger dentists. Participants celebrated the future of the profession while discussing the importance of community involvement, leadership participation, and professional growth.

Baseline Nutrition Knowledge And Feasibility Of A Whatsapp-Delivered Nutrition Education Intervention Among California Wildland-Urban Interface Firefighters, Lauren E. Anderson

Master's Theses

Wildland firefighters perform physically demanding work under challenging environmental conditions that place substantial demands on nutritional health and occupational performance. Despite the importance of nutrition in supporting physical performance, recovery, and long-term health, limited research has examined nutrition knowledge and dietary behaviors among California wildland firefighters or evaluated the feasibility of remotely delivered nutrition education interventions within this occupational population. Therefore, the purpose of this pilot study was to assess baseline nutrition knowledge, nutrition self-efficacy, and dietary behaviors while evaluating the feasibility of a 12-week WhatsApp-delivered nutrition education intervention among California wildland firefighters.

Twenty-four firefighters completed the baseline assessment and …

A Culturally Responsive Sexual Health Education Framework For Community Clinics In The Inland Empire, Lilianna Mora Ledezma

Electronic Theses, Projects, and Dissertations

Sexually transmitted infections (STIs) continue to disproportionately affect underserved communities, where barriers such as limited healthcare access, stigma, healthcare anxiety, medical mistrust, and language differences may discourage individuals from seeking routine screening and timely treatment. This project examined current public health literature, surveillance data, and federal guidance to identify evidence-based strategies that community clinics can implement to improve patient engagement in sexual health services. The findings demonstrated that effective STI prevention extends beyond testing alone and is strengthened through culturally responsive care, stigma reduction, patient-centered communication, standardized clinic workflows, and effective patient navigation. As a result, this project developed a …

How Establishing "Duration Of Treatment" Guidelines Shortens Workers' Compensation Cases, Annette Marie Smith M.D.

Electronic Theses, Projects, and Dissertations

Jobs provide financial security for individual workers and their families in the community until a worker gets hurt on the job, and then things are up in the air until their workers’ compensation claim is approved. It is a well-known fact within the workers compensation literature that one third of all workers’ compensation (WC) claims are “low back sprains and strains” which are the leading cause of global disability (Ummey, 2023). This project proposed to explore the relationship of x-ray and MRI result interpretations by the physician and standardize the duration of treatment with a physical therapist and new concept …

The Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

Rural And Urban Availability Of Substance Use Treatment Facilities, Aaron P. Smith, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Rural counties have higher per capita numbers of substance use disorder treatment facilities than urban counties on average, but also greater variability and large pockets of unmet need.

• The highest proportions of residents living in counties without any treatment facilities are concentrated in rural areas within the Midwestern and Southern United States.

• Rural and urban treatment facilities offer medications for opioid use disorder (MOUD) at similar rates, with inpatient facilities most likely to provide MOUD, followed by residential and outpatient settings.

Bridging Models And Real-World Performance: Capturing Represented, Hidden, And Unrepresented Dynamics In Complex Systems, Dixizi Liu

All Dissertations

Complex systems often depend on adaptive performance that is difficult to capture using structured data or formal models alone. This dissertation asks how predictive modeling, coordination-cost measurement, and simulation can be integrated to better represent the visible, hidden, and unrepresented dynamics that shape real-world system performance.

Sterile Processing Departments (SPDs) provide the empirical context for this work because they support safe and timely surgical care while operating under high workload variability, time pressure, and tight coordination with operating rooms. Hospitals rely on SPDs to clean, assemble, sterilize, and deliver surgical instrument trays so surgeries can start on time and proceed …

Essays On Opioid Prescription Limit Policy Diffusion, Evaluation, And Opioid Use Disorder Treatment Utilization, Md Ashiqur Rab

All Dissertations

The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive …

Adamts13 And Von Willebrand Factor In Relation To Vascular Cognitive Impairment And Cerebral Small Vessel Disease: The Heart-Brain Connection Study, Amos C Pomp, Mathijs T Rosbergen, Moniek P M De Maat, Paul S De Vries, M Arfan Ikram, Mat J A P Daemen, Imo E Hoefer, Wiro J Niessen, Jeroen De Bresser, Esther E Bron, Charlotte E Teunissen, Geert Jan Biessels, Robert J Van Oostenbrugge, Frank J Wolters

Faculty, Staff and Student Publications

Background: Reduced activity of a disintegrin-like and metalloprotease with thrombospondin type 1 repeats 13 (ADAMTS13) is associated with an increased risk of dementia, independent of Von Willebrand factor (VWF) levels. Pathways underlying this association remain poorly understood.

Objectives: Investigate the associations of VWF levels and ADAMTS13 activity with vascular cognitive impairment (VCI) and cerebral small vessel disease (CSVD).

Methods: In this cross-sectional study, we included 147 participants with VCI and 120 reference subjects (mean age: 67.5 years, 41% women). Using multivariable logistic regression, we determined the cross-sectional association of ADAMTS13 activity and VWF levels in plasma with VCI. Additionally, across …

Ai-Driven Segmentation And Volumetric Response Modeling Of Liver Regions To Radiotherapy, Aashish Chandra Gupta

Dissertations and Theses (Open Access)

In liver-directed radiotherapy (RT), liver regions receiving higher doses typically undergo atrophy while contralateral/adjacent lower-dose regions may exhibit compensatory hypertrophy through regeneration of healthy tissue. Optimizing the RT plan to promote regional hypertrophy while minimizing the risk of developing atrophy has the potential to enhance post-RT liver function and long-term survivorship. However, current clinical practice largely relies on global liver dose-volume metrics during RT-planning, which may obscure favorable dose-response correlation and limit actionable guidance for clinicians. Therefore, we hypothesized that post-RT regional liver response is governed by a combination of region-specific dose-volume and patient clinical features, and that these responses …

Piloting Research In Action: To Act Or Not To Act?, Kosi Okuagu, Lauren Yan, Emily A. Hurley

Posters

No abstract provided.

“We’Re Just Always There For Each Other”: Examining Social Support For African American Caregivers Of Oncology Patients, Madeleine Lee, Keisha White Makinde

Posters

No abstract provided.

In Vivo Model Of Neurotropic Human Metapneumovirus Infection In Mice Brain, Joanna Yuen, Gage Greening, Eric S. Geanes, Dharitri Betha, Rebecca Mclennan Phd, Todd Bradley

Posters

No abstract provided.

Advancing Health Equity In Global Oncology: A Collaborative Academic-Cancer Society-Industry Program To Address Health Disparities In Sub-Saharan Africa, Kenneth Merrell, Ben Kamdem-Talom, Hannah Anie, Christine Wekesa, Nomsa Tsikai, Miriam Mutebi, Rakiya Saidu, Nwamaka Lasebikan, Adamu Bojude, Randiak Alaro

General Surgery, East Africa

Purpose Cancer care capacity in sub-Saharan Africa (SSA) is constrained by late diagnosis and limited treatment access. Few funding mechanisms support innovative, locally led programs to address these challenges. A collaborative initiative was developed to strengthen oncology care through quality improvement (QI) projects.

Materials and Methods The program was developed by Global Bridges Oncology (GBO) at Mayo Clinic, Pfizer Global Medical Grants, and the African Organisation for Research and Training in Cancer. A committee composed primarily of African oncology experts guided the process. An RFP was disseminated across SSA in English, French, and Portuguese, inviting applications to improve diagnostic and …

Expanding Cleft Surgical Workforce Capacity In Low- And Middle-Income Countries Through Competency-Based Training, Daniel Bradley, Jonathan Diaz, Emily Jones, Kealani Unkel, Atenas Bustamante, Zenebe Gebremariyam, Daniel Abate, Mamy Andriamanarivo, Mekonen Abebe, Armando Siu

General Surgery, East Africa

Objective To evaluate a competency-based cleft surgery training pathway designed to expand local surgical capacity in low- and middle-income countries (LMICs).

Design Prospective observational study of cleft surgery training outcomes between July 2022 and September 2024.

Setting Operation Smile cleft surgery programs and partner hospitals in LMICs, with integrated virtual education.

Patients/Participants Twenty trainee cleft surgeons from 11 countries.

Interventions A competency-based training pathway combining virtual education and mentored operative experience, with assessment using a validated surgical competency tool.

Main Outcome Measures Changes in self-reported surgical confidence and educator-rated surgical competency

Results Trainee cleft surgeons participated in 1168 cleft lip …

Global Prevalence Of Depression Among University Students: A Comprehensive Umbrella Review, Gilda Yun Kai Sam, Xun Ci Soh, Harshitha Balaji, Gabriel X. D. Tan, Shu Fen Diong, Meilan Hu, Andree Hartanto, Nadyanna M. Majeed

Research Collection School of Social Sciences

Depression has become a major concern for educational institutes due to its increasing incidence and detrimental impacts on students’ well-being. However, its global prevalence in the context of tertiary education remains unclear. This umbrella review summarised existing meta-analyses and systematic reviews to examine the worldwide prevalence of depression among university students. Several sociodemographic and methodological factors, including differences in depression prevalence before, during, and after COVID-19, were examined as moderators. Structured and exhaustive searches were conducted in five bibliographic databases and five journals, alongside two sources of grey literature. A total of 61 meta-analyses and systematic reviews were included in …

Understanding Hypertensive Renal Injury: A Well-Structured Approach, Peter A Doris

The Brown Foundation: Institute of Molecular Medicine

No abstract provided.

Clinical Machine Learning Model For Predicting Pathological Complete Response In Patients With Esophageal And Gastroesophageal Junction Adenocarcinoma After Trimodality Therapy, Kohei Yamashita, Evan Kwiatkowski, Matheus Sewastjanow-Silva, Jane E Rogers, Katsuhiro Yoshimura, Melissa Pool Pizzi, Qiong Gan, Jenny J Li, Rebecca E Waters, Mariela Blum Murphy, Masaaki Iwatsuki, Wayne L Hofstetter, Aileen Chen, Ying Yuan, Jaffer A Ajani

Faculty, Staff and Student Publications

Background: Accurate prediction of pathological complete response (pCR) after preoperative chemoradiation therapy, followed by surgery (trimodality therapy) in esophageal adenocarcinoma (EAC) and gastroesophageal junction adenocarcinoma (GEJAC) may improve clinical decision-making and patient counseling before esophagectomy. This study aimed to develop predictive models for pCR after trimodality using machine learning (ML) approaches.

Patients and methods: A total of 569 patients with EAC and GEJAC who received trimodality therapy at MD Anderson Cancer Center between 2002 and 2022 were included. Clinicopathological characteristics and survival benefit of patients who achieved a pCR were reviewed via descriptive and survival analyses. Subsequently, ML models based …

Safety And Efficacy Of Tranexamic Acid In Urologic Surgery: Results From The International, Randomized, Placebo-Controlled Poise-3 Trial, Kari A O Tikkinen, Maura Marcucci, Alex L E Halme, Sandra N Ofori, Flavia K Borges, Charlotte T B Kanstrup, Lily J Park, Farhad Tondroanamag, Tuomas P Kilpeläinen, Sara V Tornberg, Thomas W Painter, David Conen, Vladimir Lomivorotov, Daniel I Sessler, Matthew T V Chan, Maria Jose Martinez-Zapata, Chew Y Wang, Denis B Xavier, Michael K Wang, Wojciech Szczeklik, Kate Leslie, Luke T Lavallee, Rodney H Breau, Kumar Balasubramanian, P J Devereaux

Faculty, Staff and Student Publications

Background and objective: Perioperative bleeding is common. Evidence for tranexamic acid (TXA) in urology remains limited and conflicting, and major urologic guidelines provide no recommendations. In an a priori planned analysis, we evaluated TXA among patients undergoing urologic surgery in POISE-3.

Methods: POISE-3 was an international randomized trial of patients undergoing surgery with bleeding and cardiovascular risk factors. Participants received TXA (1 g intravenous bolus at surgery start and end) or placebo. The primary efficacy outcome was a 30-day bleeding composite (life-threatening/major/critical organ), and the primary safety outcome was a 30-day thrombosis composite (myocardial injury after noncardiac surgery [MINS], nonhemorrhagic …

Computable Phenotypes For Research Using Real-World Data: Experiences From The Nih Pragmatic Trials Collaboratory, Marisa L Conte, Judith M Schlaeger, Guilherme Del Fiol, James R Campbell, Andrea L Cheville, Keith Marsolo, Kari A Stephens, Miriam O Ezenwa, Andrew D Boyd, Juanita E Darby, Nadine S Matthie, P Michael Ho, Alice Pressman, Morgan Justice, Carol Reynolds Geary, Keturah R Faurot, Alex Fist, Karen Staman, Hulin Wu, Rachel L Richesson

Faculty, Staff and Student Publications

Objectives: Embedded pragmatic clinical trials (ePCTs) are conducted as part of routine clinical care and therefore use data collected from real-world data sources, such as electronic health record systems and administrative claims. A common approach for using these types of data across all phases of trial conduct is to create a computable phenotype (an explicitly defined data query data, including specified data types, data codes, and logical parameters) to capture patients with a clinical condition, exposure, symptom, characteristic, treatment, or outcome of interest.

Materials and methods: The Electronic Health Record (EHR) Core Working Group of the NIH Pragmatic Trials Collaboratory …

Fuimos Olvidados Y Descuidados [Forgotten And Neglected]: Lessons Learned And Findings From On-Farm Covid-19 Education And Vaccine Clinics For Agricultural Workers And Their Multigenerational Families In Texas, Anabel Rodriguez, David I Douphrate, Ana L Pineda Reyes, Susana Zavala, Lus Chavez, Sofia Nicole Lopez, Andrea V Cabrera Cruz, Annie J Keeney, Nora Hernandez, Brenda Berumen-Flucker, Eva M Shipp, Matthew W Nonnenmann, Shannon P Guillot-Wright, Bethany Boggess Alcauter, G Lopez Ixta, Paula M Cuccaro, Higinio Fernandez-Sanchez, David Gimeno Ruiz De Porras

Faculty, Staff and Student Publications

Background: Despite being deemed essential non-healthcare workers, agricultural workers were excluded from COVID-19 vaccine prioritization in Texas. This professional practice report describes the multifaceted worker health and safety approaches to protecting agricultural workers and their families during the COVID-19 pandemic.

Methods: Between March 2020 and January 2025, several outreach, education, and training grants from various funding agencies were leveraged to deliver training, personal protective equipment, vaccines, and economic relief to agricultural workers in partnership with community-based organizations, industry, local public health departments, and academic institutions.

Findings: Timely funding efforts led to the distribution of 1,000 PPE kits, with more than …