Digital Commons Network^™

Hematologic Markers And Machine Learning In Predicting Placenta Accreta: A Case-Control Study, Michael D Jochum, Kelly D Albrecht, Yamely Mendez Martinez, Victoria Zhang, Sanmay Sarada, Brian Burnett, Christina C Reed, Karin A Fox, Amir A Shamshirsaz, Michael A Belfort, Jessian L Munoz, Hennie A Lombaard

Faculty, Staff and Students Publications

Objective: This study aims to enhance antenatal detection of placenta accreta spectrum (PAS) and predict severe hemorrhage at delivery using machine learning by evaluating the association between antenatal hematologic index trends across trimesters, imaging markers, and patient history.

Methods: We retrospectively analyzed 2017-2023 data from a PAS referral center, including demographics, laboratory results, ultrasounds, and outcomes. Patients with confirmed PAS (cases) were compared to those with antenatal risk but no histopathologic evidence of PAS (controls). Statistical analyses and machine learning models were developed to predict PAS. We also used machine learning to predict severe hemorrhage (>1500 mL) in the …

The Effect Of Boosting Dietary Lactobacillus And Phytochemical Rich Foods On Biomarkers Of Longevity—A Phase Ii Randomised Placebo Controlled Trial, Robert J. Thomas, Madeleine Williams, Jeffrey W.F. Aldous, Stacey A. Kenfield, Robert U. Newton

Research outputs 2022 to 2026

As men age, systemic inflammation increases, whereas grip strength (GS) and testosterone levels tend to fall. This rate of decline is known to be influenced by gut microbial health, lifestyle and diet but the role for interventions to slow this decline are less well established. This double-blind randomised controlled trial evaluated the impact, and explored the synergistic potential, of boosting phytochemical rich foods and Lactobacillus probiotics on these physical and biological markers. Two hundred and eight men with untreated early prostate cancer managed with observation only (average age 74 years) received a phytochemical rich supplement (PRS) containing concentrated broccoli, green …

Viruses Causing Panleukopenia In Domestic Cats: A Review Of Feline And Canine Parvoviruses, Simon Colby

University Honors Theses

Parvoviruses remain among the most important viral pathogens in domestic cats today. Despite this, there is much confusion around which parvoviruses can infect cats, and what extent of disease they can cause. One of the two parvoviruses infecting cats, canine parvovirus type-2 (CPV-2), likely evolved from the other parvovirus infecting cats, feline parvovirus (FPV). These viruses differ at only a few places in their genomes, and share the method of cell entry via the transferrin receptor. The disease caused by FPV has been well characterized in cats, but disease caused by CPV-2 is more obscure. Additionally, current testing methods for …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Wayfindr: Investigating Feedback In Biological Pathways, Polina Bombina, Reginald L Mcgee Ii, Jake Reed, Zachary B Abrams, Lynne V Abruzzo, Kevin R Coombes

2020-Current year OA Pubs

Understanding biological pathways requires more than static diagrams. We present WayFindR, an R package that converts pathway data from WikiPathways and KEGG into graph structures using igraph, enabling computational analysis of regulatory features such as negative feedback loops. Rooted in control theory, negative feedback is essential for system stability, yet it is often underrepresented in curated pathway data. In this study, we systematically analyzed pathway information from both databases across multiple species and found that feedback loops-particularly negative ones-are rarely captured. This gap likely reflects both biological and technical challenges. Biologically, feedback mechanisms are inherently complex and often remain uncharted …

Human Stem Cell-Based Embryo Models: Innovation, Ethics, And Policy, Alfonso Martinez Arias, Thorold Theunissen, Et Al.

2020-Current year OA Pubs

The aim of this White Paper is to establish a foundational framework for research, technological development, and regulation in the emerging field of stem cell-based embryo models (SCBEMs). These models, generated from Pluripotent Stem Cells, are designed to recapitulate essential events in early stages of human development. They have the potential to illuminate the early stages of embryo development and implantation and hold promise as an avenue to address global health challenges, including infertility and pregnancy loss, congenital, neonatal and adult conditions, and the need for organ transplants. While SCBEMs are not a substitute for human embryos, their tractability for …

Routine Transfusion Of Rh(D)-Positive Rbcs To Rh(D)-Negative Patients Designated As Do Not Resuscitate Conserves Rh(D)-Negative Red Blood Cell Inventory, Julie Katz Karp, Jovanna Everetts, Juliana Guarente, Angelica Vivero, Tiffany Bohr, Mary Harach

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: A minority of blood donors are Rh(D)-negative, and Rh(D)-negative red blood cell (RBC) products are often overutilized. As such, Rh(D)-negative RBCs may be difficult to maintain in blood bank inventory.

Study design and methods: We changed our blood bank laboratory policy to approve non-alloimmunized Rh(D)-negative patients to receive Rh(D)-positive RBCs for routine transfusion under defined criteria. Those criteria included Rh(D)-negative males (all ages) and females (aged >50 years) who were designated as do not resuscitate (DNR), either with or without intubation, in the electronic medical record.

Results: From August 15, 2024 through August 15, 2025, a total of 204 …

Biomedgraphica: An All-In-One Platform For Joint Textual Biomedical Prior Knowledge And Numeric Graph Generation, Heming Zhang, Shunning Liang, Tim Xu, Wenyu Li, Di Huang, Yuhan Dong, Philip Miller, Peter Goedegebuure, Marco Sardiello, Jonathan Cooper, William Buchser, Patricia Dickson, Ryan C Fields, Carlos Cruchaga, Yixin Chen, Michael Province, Philip Payne, Fuhai Li, Et Al.

2020-Current year OA Pubs

MOTIVATION: Multiomics data analysis is essential for scientific discovery in precision medicine. However, translating analysis results of omics data analysis into novel scientific hypotheses remains a significant challenge. Human experts must manually review analysis results and generate new hypotheses based on extensive and interconnected biomedical prior knowledge, which is subjective and not scalable. While large language models can accelerate the discovery, their reasoning improves when grounded in structured, auditable, and comprehensive biomedical prior knowledge. However, biomedical knowledge is scattered across heterogeneous databases that use diverse and inconsistent nomenclature systems, making it difficult to integrate resources into a unified format for …

Synergistic Effects Of Diabetic Neuropathy And Kidney Function Decline On Second Metatarsal Skeletal Health And Foot Function: A Pilot Study, Victor A Cheuy, Saghi Sadoughi, Hasung Moon, Jalen Ellis, Rodney Gross, David R Sinacore, Mary K Hastings, Richard B Souza, Galateia J Kazakia

2020-Current year OA Pubs

A discouraging increase in diabetes-related nontraumatic lower-extremity amputations (NLEA) has occurred over the last decade. Individuals with diabetic neuropathy (DMPN) and CKD are at the highest risk for NLEA. Despite the critical implications, little is known about the factors that initiate the cascade of events leading to NLEA, limiting early and effective interventions. We aimed to develop and implement a technique for quantifying metatarsal bone density and microstructure using HR-pQCT. Twelve participants were enrolled:

Spatial Transcriptomic Profiling Of Decalcified Murine Musculoskeletal Samples Via Xenium Prime 5k, Lindsey Lammlin, Huong X Tran, Aanya Mohan, Michael D Newton, Scarlet C Howser, Stephen J Redding, Christina A Capobianco, Kurt D Hankenson, Alexander J Knights, Tristan Maerz

2020-Current year OA Pubs

Successful generation of high-quality spatial transcriptomics data from murine musculoskeletal tissues has been impeded by the challenge of preserving RNA integrity through the harsh tissue processing steps required for histological sectioning. In particular, the need to thoroughly fix and decalcify mineralized tissues has proven problematic. We detail a comprehensive sample processing pipeline for 3 common murine musculoskeletal tissue samples, enabling high-quality transcript detection via imaging-based spatial transcriptomics using the Xenium Prime 5K platform from 10x Genomics. Our protocol outlines methodological details for transcardiac perfusion, fixation, decalcification, paraffin processing, and a sample co-embedding strategy facilitating anatomically consistent and simultaneous sectioning of …

A Decade Of Leadership And Impact: Celebrating 10 Years Of The Ors Spine Section, Makarand V. Risbud

College of Life Sciences Faculty Papers

No abstract provided.

Socio-Ecological Models As A Framework For 21st-Century Genetic Counseling, Shana L. Merrill, Rebecca Mueller

College of Life Sciences Faculty Papers

Socio-ecological models and the related concepts of micro-, meso-, and macro-level practice are commonly used in the fields of social work and public health yet have not been thoroughly conceptualized for application to genetic counseling practice, research, and training. The field of genetic counseling is currently undergoing significant expansion with more genetic counseling training programs, greater variation in genetic counselor job roles, and genetic counselors practicing in more globally dispersed regions. It is therefore a critical time to conceptualize and tailor relevant theoretical frameworks to unify and guide the evolving field of genetic counseling. In this paper, we posit that …

Remote Hr-Guided High-Intensity Interval Training With Weekly Health Monitoring In Breast Cancer Patients During Chemotherapy: A Moderation Analysis Of Physiological Predictors, Madara Ketlīna Štarka-Rantiņa, Rudolfs Ceseiko, Martins Campa, Maksims Zolovs, Greta Franceska Jermolenko, Kristaps Eglitis, Alicia Llorente, Aija Linē, Aija Klavina

Baltic Journal of Health and Physical Activity

Background: The study aimed to investigate the effects of a six-month remotely monitored heart rate – guided high-intensity interval training (HIIT) program on aerobic capacity, functional performance, and weekly self-reported health outcomes in women with stage II–III breast cancer undergoing neoadjuvant chemotherapy. Materials and methods: Fifty-six women (mean age 47 ± 8 years) were randomly assigned (1:1) to a HIIT group or a control group (CG). Thirty-five participants were included in analyses (HIIT group = 17; CG = 18). HIIT group performed 4 × 4-minute HIIT sessions at the intensity of 85–95% of the peak heart rate, two to three …

Enhancing Tardive Dyskinesia Screening In An Outpatient Psychiatry Training Clinic: A Quality Improvement Initiative, Ariel Davalos

Doctor of Nursing Practice Final Manuscripts

Background: Tardive Dyskinesia (TD) is a debilitating, often irreversible movement disorder caused by prolonged exposure to dopamine receptor-blocking agents, affecting 15-30% of patients on long-term antipsychotic therapy. Despite endorsement of the Abnormal Involuntary Movement Scale (AIMS) as the gold standard for TD screening, the condition remains significantly under-diagnosed. Purpose: This quality improvement project evaluated whether a 45-minute educational intervention could improve PMHNP trainees’ confidence and competence in TD recognition and AIMS administration. Methods: Guided by the Iowa Model of Evidence-Based Practice, the project used a pre-post survey design with a planned one-month follow-up across two clinical training sessions. Ten PMHNP …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Improving Transition To Adult Care: Assessing Health Insurance Literacy In Adolescent Patients With Congenital Heart Disease, Kaitlyn V. Mudge

Doctor of Nursing Practice Final Manuscripts

Background: With advances in surgery and medical management, 95% of children with congenital heart disease (CHD) survive into adulthood. Transition to adult care is an intricate process. Up to 60% of adolescents fail to follow through with cardiology care, facing three times the risk of needing emergency services. Only 25% of young adults with CHD knew of the need to change their care to an adult provider and to acquire health insurance as an adult. One barrier to successful transition is a lack of insurance coverage and limited insurance health literacy. Higher insurance literacy is associated with increased utilization …

Intervention Levers For Stunting Reduction In Indonesia: Evidence From The 2023 Indonesian Health Survey Data, Iwan Ariawan, Hafizah Jusril, Zahra Izza Afifa, Azka Fitri, Elmarizha Sekar Utami, Mikail Hasan, Dwi Puspasari

Kesmas

Stunting remains the largest public health challenge among macro-nutrition problems in Indonesia, affecting almost a quarter of children under five in 2023. The prevalence is considered high according to the World Health Organization standard. This study analyzed 15 aggregated provincial variables from the 2023 Indonesian Health Survey using Structural Equation Modeling (SEM), focusing on determinants of stunting among children under two to identify primary intervention levers. Findings indicated that intervention urgency should focus on the first 1,000 days, particularly the steep increase in stunting prevalence observed in the 12–24-month age range. While the highest prevalence is in Eastern provinces (e.g., …

Pernicious Anemia Presenting As Pseudothrombotic Microangiopathy: A Case Report, Sai Sushrutha M Vemula, Shreeya Adhikari, Shreya Motkur, Alfarooq Alshaikhli, Borys Hrinczenko

School of Medicine Publications

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ dysfunction, with high untreated mortality that can be effectively reduced with timely plasma exchange (PLEX) and immunosuppressive therapy. However, several conditions can produce a clinically similar pseudo-TMA picture, among which severe vitamin B12 deficiency is an underrecognized and potentially treatable mimic that occurs due to ineffective intramedullary erythropoiesis, megaloblastic fragmentation of structurally abnormal erythrocytes, and pancytopenia in the absence of true endothelial injury or ADAMTS13 deficiency. We present a 74-year-old female patient who presented with altered mental status, bradycardia, and severe …

Parameter Density Estimation For Cardiac Electrophysiology Models Using Data Consistent Deep Learning, Michael Luo

Dissertations

Mathematical models of biological rhythms and excitable systems can provide insights into mechanisms underlying cardiac electrical dynamics. However, estimating the parameters of these models from experimental observations is often difficult due to noise, heterogeneity, and unobserved variables. For example, in an electrocardiogram (ECG) recording, information about the electrical properties of different regions of the heart is compressed into a single voltage trace. Additionally, variability within these signals may contain important information about population heterogeneity, regional differences in electrophysiology, and time-dependent modulation.

This dissertation develops, explores, and evaluates methods that perform feature-based distributional inference for complex nonlinear dynamical systems. The objective …

Transcranial Ac Modulation Of Cerebellar Nuclear Activity In Awake Animals, Nuran Kavakli

Dissertations

Entrainment of cerebellar nuclear (CN) cells via cerebellar transcranial alternating current stimulation (ctACS) has been reported in animals under ketamine/xylazine anesthesia. Our main objective was to demonstrate modulation of CN activity in unanesthetized, freely moving animals using ctACS. Multi-channel carbon-fiber electrodes were implanted into the interpositus nucleus for recording multi-unit (MU) activity, and thin-film electrodes were implanted subcutaneously over the posterior cerebellum for stimulation. A frequency-domain-based metric was developed to quantify modulation from MU signals. The results demonstrated modulation in a wide range of frequencies (4 Hz-300 Hz) as in anesthetized animals. In contrast, the amplitude of the peak in …

Enhancing Physiological Complexity Through Mindfulness: A Wearable-Based Intervention For First Responders And Their Partners, Thurmon Lockhart, Rahul Soangra, Christopher W. Frames, Sun-Kyung Lee, Amberlee Martin, Susanne Lee, Abigail H. Gewirtz

Physical Therapy Faculty Articles and Research

Background/Objectives: First responders frequently encounter high-stress environments that challenge physiological resilience and autonomic regulation. Heart rate variability (HRV) complexity is a critical marker of adaptive capacity and stress regulation. This study assessed the impact of a wearable-based mindfulness intervention on HRV complexity among first responders using a smartwatch. Methods: A total of 87 first responders participated in a one-month wearable-based intervention. Participants wore Garmin Vivosmart 5 devices to continuously collect PPG data (photoplethysmogram), focusing on beat-to-beat intervals (BBIs). The intervention involved daily Ecological Momentary Assessments (EMAs) and individual randomization to either a mindfulness message, a prompt to access an audio …

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …

Culturally Competent Nurse-Led Education To Reduce Delayed Diagnosis And Increase Awareness Of Polycystic Ovary Syndrome In Reproductive-Aged South Asian Women, Madeeha Syeda

Honors College Theses

Polycystic ovary syndrome (PCOS) is a common condition that affects hormones in women, especially in their 20s and 30s. Symptoms of PCOS include irregular periods, abnormal hair growth, acne, obesity, hyperpigmentation of the skin, cysts, skin tags, thinning hair, and infertility (Newin, 2023). While the exact cause of PCOS is unknown, it is linked to insulin resistance, higher levels of androgens, and low-grade inflammation (Newin, 2023). In regards to complications, PCOS can increase risk for gestational diabetes, preeclampsia, preterm term, and C-section deliveries. In terms of treatment, there is no cure but early diagnosis is key to reducing symptoms (Newin, …

Perinatal Mental Health Screening And Care Among Those With Pregnancy Complications, Alison N Goulding, Terri L Fletcher, Emily S Miller

Faculty, Staff and Students Publications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on …

Rethinking Flow: The Paradox Of Renoprotection Without Increased Renal Blood Flow In Cardiopulmonary Bypass, Shiksha Mohan, Ronald A Shaju, Sharan Misra, Titiksha Sharma, Veeraj K Sirivolu, Abhinav Rajkumar, Anthony Rodas-Camacho, Aizah Zaidi, Dhruv Dhingra, Ilma Khan, Rishav Bhattacharya, Vishal Pancholy, Shivam Banerjee, Shreyo Ghosh, Shiyi Li, Kenneth K Liao, Carl P Walther, Nandan K Mondal

Faculty, Staff and Students Publications

No abstract provided.

Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards

Population Health Leadership and Analytics Theses

Cardiovascular disease remains a leading cause of morbidity and mortality among adults in the United States, particularly during midlife and older adulthood. Periodontal inflammation and poor oral hygiene behaviors have been linked to increased cardiovascular risk through systemic inflammatory pathways. This exploratory cross-sectional study described patterns of self reported gum bleeding, oral hygiene behaviors, and cardiovascular risk factors among 29 adults aged 45 to 70 at a community dental clinic using the researcher-developed Oral and Heart Health Study Questionnaire. Fourteen participants reported both gum bleeding and at least one cardiovascular risk factor. Participants who reported inconsistent flossing and infrequent professional …

A Call To Action: Towards A Compendium For Culturally Responsive And Inclusive Pain Management, Arvie Vitente, Rob Sweet, Lester Jones

Philippine Journal of Physical Therapy

Introduction: Pain is a pervasive global health problem, yet its assessment and management remain shaped by biomedical, monolingual, and culturally narrow assumptions that do not fully reflect the lived realities of diverse populations. Although contemporary pain science recognizes pain as a personal experience influenced by biological, psychological, and social factors, inequities persist across racial, ethnic, linguistic, and cultural groups.

Main Body: These inequities affect how pain is expressed, interpreted, documented, and treated, particularly among Indigenous peoples, migrants, refugees, and patients with limited English proficiency. In this perspective, we call for the development of a comprehensive compendium on culturally responsive and …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Rocatinlimab As A Novel Treatment Strategy For Atopic Dermatitis, Haylee Whyde, Evan Blazek, Macy Davis, Parker George, Alex Lowery, Connor Dains, Brenna Hissong, David Koh

Pharmacy and Wellness Review

Atopic dermatitis is a common chronic inflammatory skin disease that affects millions of children and adults in the United States. Atopic dermatitis is characterized by recurrent pruritus, erythema, and relapsing symptoms that can significantly impair quality of life. The pathophysiology of atopic dermatitis involves epidermal barrier dysfunction, immune dysregulation, and genetic susceptibility. Atopic dermatitis guidelines follow a stepwise approach that begins with a severity assessment, trigger avoidance, and nonpharmacologic and pharmacologic treatments. First-line therapies include topical corticosteroids (TCSs), topical calcineurin inhibitors (TCIs), and emollients. Crisaborole and topical ruxolitinib are used for mild-to-moderate disease when prior therapy has been inadequate. Monoclonal …

Navigating Trust: The Impact Of Social Media Influencers On Gen Z Health Behaviors, Abigail Stelling

Honors Thesis

Social media plays a defining role in the daily lives of Gen Z, influencing how people communicate, access information, and make decisions. More than a form of entertainment, social media is a powerful source that shapes identity, perceptions, and behaviors. As the first generation to grow up fully immersed in a digital world, Gen Z is uniquely impacted by the content and interactions that occur on social media platforms. Within this digital landscape, social media influencers have emerged as powerful figures. These individuals use large online platforms to promote lifestyles, products, and behaviors. Influencers often have the ability to shape …