Digital Commons Network^™

A Phenomenological Approach To Spastic Movement Disorders: An International Expert Panel Consensus, Bo Biering-Sørensen, Jörg Wissel, Raymond Rosales, Rajiv Reebye, Jorge Jacinto, Gerard E Francisco, Peter Sanderson, Per Ertzgaard

Faculty, Staff and Student Publications

Background and objectives: Hyperkinetic movement disorders, characterized by complex and overlapping motor patterns, present significant challenges in classification and treatment. The inconsistency in definitions and descriptors complicates both research and clinical communication. This study aims to provide an overview of current terminology and definitions related to spasticity and other hyperkinetic movement disorders associated with central nervous system lesions. We propose a unified terminology and classification system for spastic movement disorders (SMD).

Methods: In this scoping review, definitions of spasticity, dystonia, tremor, chorea, hemiballismus, athetosis, myoclonus, and dyssynergia were reviewed, with emphasis on overlaps and diagnostic challenges among these disorders. The …

Renin-Angiotensin-Aldosterone System In Preeclampsia: Pathophysiological Insights And Links To Vascular Dementia, Robin C. Finch, Jenny Lutshumba, Elizabeth Mirsky, Esther Ndashaala, Kelsey Bullens, Emma Smith

Pediatrics Faculty Publications

Pre-eclampsia, a condition characterized by new-onset hypertension during pregnancy and one or more indices of organ damage, is a major driver of both short and long-term maternal health outcomes. Individuals with a history of pre-eclampsia are at increased risk for cardiovascular, renal, and other chronic diseases. Recent studies have linked pre-eclampsia history with increased risk of dementia later in life, underscoring the importance of new guidelines emphasizing blood pressure control to reduce the risk of cognitive decline. Unfortunately, neither mechanisms underlying causes of pre-eclampsia nor their links with cognitive function are well understood. Vascular contributions to cognitive impairment and dementia …

Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish

Doctor of Nursing Practice Projects

Medication administration errors remain a persistent threat to patient safety in emergency department settings, where high acuity, rapid throughput, and workflow interruptions increase vulnerability to preventable adverse events. The purpose of this Doctor of Nursing Practice quality improvement project was to increase medication-safety knowledge scores by at least 10% and reduce medication administration error rates by 20% within eight weeks among registered nurses in a freestanding emergency department in South Texas. The project was grounded in Lewin’s Change Theory as the theoretical framework and implemented using the Plan–Do–Study–Act quality improvement model. A quasi-experimental, single-group pretest–posttest design was used with a …

The Neuroprotective Effects Of Alpha-Tocopherol As An Anti-Inflammatory Agent: Mechanistic Insights And Therapeutic Challenges, Megumi H Seese, Yuanzhong Xu

The Brown Foundation: Institute of Molecular Medicine

Vitamin E (alpha-tocopherol, αToc), an antioxidant fat-soluble vitamin that prevents lipid peroxidation and modulates pro-inflammatory cytokine production, is well-known to be critical for neuroprotection. However, the underlying mechanism remains poorly understood. Accumulating evidence demonstrates that αToc influences neuroinflammatory processes. Here, we review recent research progress on the effects of αToc on neuroinflammation. Preclinical studies included in this narrative review were identified through PubMed searches using the keywords "alpha-tocopherol AND neuroinflammation or alpha-tocopherol AND brain AND inflammation". While many studies support a neuroprotective role of αToc, the magnitude and direction of its effects vary substantially depending on dosage, route of administration, …

A Transcriptional Program Associated With Neurotransmission In The Living Human Brain, Alexander W. Charney, Lora E. Liharska, Eric Vornholt, Alissa Valentine, Anina Lund, Alice Hashemi, Ryan C. Thompson, Terry Lohrenz, Jessica S. Johnson, Nicole Bussola, Esther Cheng, You Jeong Park, Salman Qasim, Alisha Aristel, Lillian Wilkins, Kimia Ziafat, Hannah Silk, Lisa M. Linares, Brendan Sullivan, Claudia Feng, Beniamino Hadj-Amar Ph.D.

Faculty Publications

At the foundation of neurotransmission, and by extension at the foundation of brain function, are coordinated programs of gene expression involving many thousands of genes. These programs are poorly defined in humans because most modern studies that characterize human brain gene expression use tissue obtained in the postmortem state when neurotransmission and brain function have ceased. Here, to advance knowledge of the gene expression programs at the foundation of neurotransmission in the human brain, gene expression was characterized in 130 prefrontal cortex (PFC) samples obtained from participants of the Living Brain Project (LBP) during neurosurgical procedures in conjunction with intracranial …

The Cost Of A Healthy Diet And Its Association With Bmi In Crisis-Stricken Lebanon, Maha Hoteit, Myriam Abboud, Maroun Khattar, Rana Rizk

All Works

Objectives: This study aimed to determine the prevalence of Lebanese adults living with underweight, overweight or obesity, assess and compare the cost of the Mediterranean Diet (MD) with that of the current dietary consumption pattern and explore diet cost as a determinant of living with underweight, overweight or obesity. Design: Data for this nationally representative cross-sectional study were collected through sociodemographic questionnaires, anthropometric measurements, the Arab Family Food Security Scale and dietary assessments using a validated FFQ and 24-h recalls. Diet costs were calculated based on 2023 market prices using purchasing power parity. Logistic regression was used to assess associations …

Survival On Image Regression With Application To Partially Functional Distributional Representation Of Physical Activity, Rahul Ghosal, Sunwoo Emma Cho, Marcos Matabuena

Faculty Publications

Technological advancements in wearable devices and medical imaging often lead to high-dimensional physiological signals in the form of images or surfaces. To address these data structures, we develop a novel survival on image regression model with a specific focus on partially functional distributional representation of wearable data. The existing approaches for functional data and survival outcomes have been primarily developed for uni-dimensional functional predictors. Drawing on recent developments in distributional data analysis, we model temporally varying distributional patterns of physical activity (PA) as a partially functional distributional predictor within a semiparametric Cox model framework. We use tensor product splines to …

Environmental Chemicals And Maternal Depression During And After Pregnancy: A Scoping Review, Pengfei Guo, Yunyue Shi, Cindy Nguyen, Haoran Zhuo, Tormod Rogne, Zeyan Liew

Faculty Publications

Purpose of Review

There is increasing evidence that several environmental exposures may pose a risk for depression, including maternal depression. We conducted a scoping review of epidemiological evidence regarding maternal exposure to environmental chemicals and perinatal depression.

Recent Findings

We searched PubMed, Embase, Web of Science, Dimensions, and Scopus, and summarized the findings from 27 articles that examined environmental chemical exposures and maternal depression. Studies of ambient air pollutants (N = 11) showed exposure to NO₂ and PM10 to be most consistently associated with antenatal or postnatal depression. Studies of endocrine-disrupting chemicals, including phthalates (n = 6), …

Cardiac Output-Guided Vs. Mean Arterial Pressure-Guided Hemodynamic Management In Craniotomy Patients With Cardiovascular Disease: A Randomized Trial, Na Chen, Minjing Yang, Renhua Li, Chunyan Ye, Lu Wang, Xingyang Liu, Jinghan Wu, Daniel I Sessler, E Wang

Faculty, Staff and Student Publications

We tested the primary hypothesis that cardiac output (CO)-guided versus mean arterial pressure (MAP)-guided hemodynamic management reduces the fraction of patients with 90-day Glasgow Outcome scores ≤ 4 (on a 1–5 scale, 5 better) after supratentorial brain tumor resections in adults with cardiovascular disease. 202 adults were randomized to intraoperative hemodynamic management guided by either CO or MAP. In patients assigned to CO guidance, clinicians targeted CO > 4 L/min and > 90% of baseline values using a combination of fluids and vasoactive agents. In patients assigned to MAP guidance, clinicians targeted MAP within ± 20% of baseline and ≥ 65 mmHg. …

Adipocyte-Specific Deletion Of Sine Oculis Homeobox Homolog 1 Inhibits Lipolysis And Reduces Skin Fibrosis, Nancy Wareing, Tingting W Mills, Scott Collum, Minghua Wu, Lucy Revercomb, René Girard, Hui Liu, Alexes Daquinag, Mikhail Kolonin, Marka Lyons, Brian Skaug, Weizhen Bi, Meer A Ali, Haniyeh Koochak, Anthony R Flores, Yuntao Yang, W Jim Zheng, William R Swindell, Shervin Assassi, Harry Karmouty-Quintana

Faculty, Staff and Student Publications

Dermal fibrosis is a cardinal feature of systemic sclerosis (SSc) for which there are limited Systemic sclerosis (SSc) is characterized by dermal fibrosis accompanied by loss of dermal white adipose tissue (DWAT), yet the mechanisms linking adipocyte depletion to fibroblast activation remain unclear. Here we identify the transcription factor SIX1 as a central regulator coupling adipogenic repression with profibrotic signaling. SIX1 expression was increased in skin biopsies from two independent SSc cohorts and localized to fibroblast and perivascular stromal cells. In mice, ubiquitous or adipocyte-specific deletion of Six1 preserved DWAT, reduced collagen accumulation, and selectively decreased pro-fibrotic mediators. In cultured …

Cml-Like Biology Is A Unifying Feature Of Myeloid/Lymphoid Neoplasms With Tyrosine Kinase Fusions In Lymphoid Blast Phase Comment On: Multilineage Involvement In Abl-Class Fusion-Positive Pediatric B-Cell Acute Lymphoblastic Leukemia: Cml-Like Biology, Wei J Wang, Shimin Hu

Faculty, Staff and Student Publications

No abstract provided.

Quality Improvement Project: Reducing Test Anxiety: Faculty Training For Supporting Students, Chichi Markham

Doctor of Nursing Practice Projects

Test anxiety significantly affects nursing students’ academic performance and well-being. Emotional Freedom Techniques (EFT) offer a non-pharmacological method for alleviating anxiety; however, research on faculty-centered approaches in nursing education is limited. The purpose of this quality improvement project is to evaluate the impact of EFT training on nursing faculty’s knowledge, attitudes, and confidence regarding test anxiety, as well as on student exam performance. Guided by Lewin’s Change Theory, Stetler’s Model, and the Plan-Do-Study-Act (PDSA) cycle, the initiative aimed to enhance faculty capacity to identify and address test anxiety within a prelicensure nursing program. A pre-post quality improvement design involved faculty …

Unbalanced Chromatin Binding Of Polycomb Complexes Drives Neurodevelopmental Disorders, Rodrigo L Borges, Gretter González-Blanco, Harikumar Arigela, Yingyu Huang, Lucas D Caeiro, Nikolai Fattakhov, Stefano Lepore, Liliana Garcia-Martinez, Matea Maurice, Pushti D Mehta, Emily J Park, Kailynn Macgillivray, Jevithen Nehru, Matthew Chau, Maria C Robayo, Clemer Abad, Alicia Bilbao-Martinez, Fabiola Monteiro, Xi Luo, Song Tan, Daniel Bilbao, Simone Sidoli, Bruno Di Stefano, Katherina Walz, Arneet L Saltzman, Ramiro E Verdun, Ramin Shiekhattar, Lluis Morey

Faculty, Staff and Students Publications

The prevalence of neurodevelopmental disorders (NDDs) in children is increasing, yet their underlying causes remain largely unknown. We identified heterozygous mutations in the Polycomb repressive complex 1 (PRC1) E3 ligases RING1 and RNF2 in individuals with NDDs and revealed distinct mechanisms by which they compromise PRC1 activity. We developed cellular and mouse models carrying the Ring1b

Applications Of Chatbots In Improving Patient Care Outcomes: A Scoping Review, Mohammadhiwa Abdekhoda, Afsaneh Dehnad

Sultan Qaboos University Medical Journal

This review explored the application of chatbots in healthcare, focusing on patient monitoring, personalised care and medical services. It examined the potential of chatbots to improve patient outcomes through artificial intelligence-driven technologies, addressing challenges such as data security and system integration. This scoping review, conducted from January to March 2025, adhered to the PRISMA-ScR guidelines. A thorough literature search was performed across Web of Science, Scopus and PubMed, using keywords such as "patient care", "outcome", and "chatbot*". After screening for relevance and applying inclusion criteria, a total of 70 articles were analysed, focusing on chatbots' roles in improving patient care …

Staff Education On Evidence-Based Interventions To Improve Patient Engagement In An Outpatient Mental Health Clinic, Gloria Egeh

Walden Dissertations and Doctoral Studies

In this project, I implemented a staff education initiative at an outpatient psychiatric facility in Michigan to address gaps in clinicians’ and office managers’ knowledge of evidence-based patient engagement strategies. Limited understanding had hindered patient participation in treatment planning, symptom self-management, and shared decision-making, key components of recovery-oriented care. The education initiative was aimed at enhancing staff competencies to strengthen therapeutic alliances, improve treatment adherence, and support positive mental health outcomes. Guided by a practice-focused question, in the project I examined whether an evidence-based staff education program would improve patient engagement among adults receiving outpatient mental health services. A pre-/postintervention …

Management Of Alcohol Withdrawal Syndrome In The Emergency Department, Janet Fuller

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project involved development and approval of a clinical practice guideline (CPG) for management of alcohol withdrawal syndrome (AWS) in the emergency department (ED) of a large community trauma center in the southeastern United States. AWS is a common, potentially life-threatening condition requiring timely assessment and intervention to prevent. Variability in ED screening and treatment contributes to delayed intervention, increased rapid response activations, and intensive care transfers. The project purpose was to develop and obtain expert approval of an evidence-based CPG using the Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) tool to support standardized screening, symptom-triggered …

Sex-Specific Differences In Mediobasal Hypothalamus In Response To Nutritional States, Jonathan C Bean, Jinjing Jian, Tzu-Chiao Lu, Hailan Liu, Kristine Conde, Darah A Threat, Sanika V Jossy, Megan E Burt, Jingjing Cheng, Yue Deng, Xing Fang, Xiaoyu Geng, Junying Han, Yongxiang Li, Hesong Liu, Qingzhuo Liu, Yutian Liu, Yuhan Shi, Longlong Tu, Mengjie Wang, Xu Xu, Yuxue Yang, Meng Yu, Xinming Liu, Meixin Sun, Fuhui Wang, Olivia Z Ginnard, Yongjie Yang, Yang He, Chunmei Wang, Yanyan Qi, Hongjie Li, Yong Xu

Children’s Nutrition Research Center Staff Publications

The arcuate nucleus of the hypothalamus plays a central role in sensing and integrating nutritional, hormonal, and neural signals that regulate feeding, energy homeostasis, growth, and reproduction, all of which show pronounced sex differences. However, the cellular mechanisms underlying these responses remain poorly understood. We performed snRNA-seq of the mediobasal hypothalamus, focusing on the arcuate nucleus, in female and male mice under different nutritional states. Analysis of 42 cell types revealed that Agrp neurons were most sensitive to nutritional changes, dopaminergic neurons showed strong sex-specific differences, and KNDy neurons were highly responsive to both sex and nutrition. Pomc neurons displayed …

“From Compression To Closure: Efficacy And Safety Of Vascular Closure Devices (Vcd) Versus Manual Compression: A Comparative Analysis Of Hemostatic Strategies Of Obtura, Angioseal, And Proglide Vcd“, Praveen Shukla, Kumar Himanshu, Ali Mohammed, Mukesh Jitendra Jha, Santosh Kumar Sinha, Puneet Aggarwal, Mohammad Mahmodullah Razi, Mohit Sachan, Awadhesh Kumar Sharma, Umeshwar Pandey, Neeraj Prakash, Rakesh Kumar Verma

Journal of the Saudi Heart Association

Objective: Use of vascular closure devices (VCDs) for femoral artery puncture site hemostasis has increased but their safety and efficacy have remained unclear. This study was designed to compare safety and efficacy of Obtura, Angioseal, and Proglide VCD to manual compression (MC) and also between for femoral artery haemostasis.

Methods:This was prospective, randomized controlled study where patients were randomly assigned on 1:1:1:1 basis. Primary endpoints were time to hemostasis (TTH) and ambulation time (AT) while secondary endpoints were deployment success, device related adverse events and technical success rate. ANOVA and Tukey HSD was conducted to draw significant difference between …

Differences And Changes In Cross-Cultural Sensitivity Of German And Japanese Students Before And After Short-Term Exchange Programs, Kazumasa Nakagawa, Yuko Takahashi, Melanie Zwiorek

Journal of Educational Research and Practice

Since 2012, a Japanese and a German university have conducted exchange programs. This study examined the effects of a short-term exchange program in 2023, focusing on intercultural sensitivity. Nine Japanese students and nine German students completed a 24-item Intercultural Sensitivity Scale before and after the program using a 5-point Likert scale. We performed cross-tabulations and analyzed differences between countries and pre- and post-program changes using chi-square or Fisher’s exact tests. The results suggest that even a short-term exchange enhanced Japanese students’ confidence in intercultural interactions and encouraged German students to reflect on their own culture. However, Japanese students showed lower …

A Qualitative Analysis Of Progress, Successes, And Challenges Among Indiana Recipients As Part Of A National Initiative To Reduce Covid-19–Related Health Disparities, Marla Winters, Lily Darbishire

Purdue Journal of Service-Learning and International Engagement

In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) provided funding to states as part of the CDC Disparities Grant initiative. The aim of the funding was to reduce chronic disease and COVID-19–related health disparities among vulnerable communities through four unique strategies. Funding was awarded to the Indiana Department of Health (IDOH) to begin an Indiana chapter of this initiative, called Indiana Healthy Opportunities for People Everywhere (I-HOPE). From 2021 to 2023, the IDOH provided I-HOPE funding to local communities (subgrantees) to support the design and implementation of programs to improve community health. For example, …

Improving Medication Insecurity Through Community Events, Lauren Soohoo, Theresa Blanke, Faria Chaudhry, Courtney O'Keefe, Rakhi Karwa, Jasmine Gonzalvo, Gicella Garcia, Carlyn Kimiecik, Adriana Gardner, Yejin Seo

Purdue Journal of Service-Learning and International Engagement

In the United States, 58 million Americans have difficulty paying for prescription medications due to lack of insurance, high prescription costs, unstable employment, and competing financial demands. High prescription costs reportedly contribute to medication nonadherence for 60% of patients. Medication nonadherence accounts for 30% of hospital admissions, further exacerbating the detrimental impact of medication insecurity such as worsening patient outcomes, quality of life, readmissions rates, and overall health care expenditure.

To understand the prevalence and address medication insecurity among the communities served by the Center for Health Excellence, Quality, and Innovation (CHEQI), a survey was developed and disseminated via a …

2300 Ferry, Kylie Miskovic

Purdue Journal of Service-Learning and International Engagement

Gateway to Hope is the syringe service program located at 2300 Ferry Street that provides not only syringes and other sterile medical equipment for injections but also wound cleaning, medications, and even toiletries. People can also receive basic health services there, and for many people who access these services, this is the only time they interact with the health care system. Located in the same building is the Recovery Café, a welcoming space for anyone in recovery from substance use disorders and anything else. Available to members of either organization is the clothing closet, where people can come and get …

A Reflection On What Pharmacists In Different Countries Can Learn From One Another, Aaryaman Khurana, Patricia Darbishire

Purdue Journal of Service-Learning and International Engagement

What would be the first words that come to mind if you were asked about the US health care system? I asked that question to several of my friends and pharmacy peers and received mixed responses such as “expensive,” “confusing,” “hard to navigate,” and “best in the world.” This was not surprising considering the many options and the varying quality of medical procedures, medical devices, and pharmaceuticals available. I wondered how responses might differ if I posed the same question about their health care to those in a third-world country. So, I asked the same question of friends and family …

Changing Minds And Lives: A Substance Use Awareness Campaign, Alyssa Collins, Claire Wolfer-Jenkins, Rachel Isaac

Purdue Journal of Service-Learning and International Engagement

Introduction: In 2024, 48.4million Americans experienced a substance use disorder (SUD),with opioid use disorder representing a significant concern. In 2024, an estimated 8 million individuals misused opioids, contributing to 54,743 fatal overdoses. College students are particularly vulnerable, with 20% reporting illicit substance use within the past month, highlighting the urgent need for focused interventions in this population.

Project Overview: Boiler Substance Awareness Network (BSAN) is a campus initiative funded by the Lead Forward Fellowship grant. BSAN educates the Purdue community about SUD to reduce stigma and foster a recovery-friendly environment. The focus is on two objectives: preparing students to respond …

Bridging Gaps In Preventative Care: Pharmacy Students' Impact Through Point-Of-Care Testing And Education At Recovery Café Lafayette, Katherine Davis, Jailyn Jones

Purdue Journal of Service-Learning and International Engagement

Final-year student pharmacists Katherine and Jailyn served on the executive committee of Purdue’s chapter of the American Pharmacists Association–Academy of Student Pharmacists (APhA-ASP) as president and patient care vice president, respectively, during the 2023–2024 academic year. After striving for more community-based involvement with the APhA-ASP chapter, Katherine and Jailyn combined efforts and passions to serve the community by providing health services to a local community center. Preventative health services are vital for patients and also provide substantial benefit to students who are able to practice real-world counseling skills through these opportunities. Throughout the Doctor of Pharmacy curriculum at Purdue, Katherine …

Roseman University Research Symposium, Dustin Ruiz Edmonds, Nicholas Hill, Riley Grant Fisher, David Sant, Andrew Fisher

Annual Research Symposium

No abstract provided.

Cancer Treatment Induced Skeletal Muscle Loss As A Predictor Of Late Cardiotoxicity In Aya: A Pilot Study, Savannah V. Rauschendorfer, Efstratios Koutroumpakis, Behrang Amini, Juhee Song, Michelle Hildebrandt, Anita Deswal Md Mph, J. Andrew Livingston, Michael Roth, Eugenie S. Kleinerman Md

Cancer Survivorship Research Retreat

No abstract provided.

A Scarring Experience: Pelvic Floor Rehabilitation As A Novel Palliative Approach In Colorectal Cancer Survivorship, Aryan Dowlatshahi, Leanne Jackson, Mary Garcia

Cancer Survivorship Research Retreat

This is a discussion of the novel approach of pelvic floor rehabilitation in its utility specifically for colorectal cancer survivorship which will be additionally presented at the MD Anderson Survivorship Research Retreat conference.

Osteopathic Manipulative Medicine As An Adjunctive Approach To Improve Pelvic Perfusion And Fertility-Related Physiologic Markers, Ashton Dodd, Yanielisse Bellinger, Marsha Chevalier, Annaliese Taylor, Jacob Warner-Palacio, Aurora Jeanes, Nathan Barnhurst

Annual Research Symposium

No abstract provided.

Electronic Cigarette Use And Clinically Assessed Oral Mucosal Lesions In Adults: A Systematic Review, Kevin K. Zhang, Kamran Awan

Annual Research Symposium

Abstract

Background: Electronic cigarette (e-cigarette) use among adults has risen rapidly over the past decade, prompting concern about potential adverse effects on oral health. Although the systemic consequences of e-cigarette exposure have been increasingly studied, effects on the oral mucosa remain less clearly defined. Existing investigations describe a range of oral mucosal findings, but reported outcomes and assessment methods are inconsistent, making it difficult to draw clear conclusions.

Objectives: To systematically review the available evidence examining the association between electronic cigarette use and oral mucosal lesions/alterations in adults, compared with non-users or other tobacco exposure groups.

Methods: A systematic literature …