Digital Commons Network^™

Source-Specific Nitrate And Nitrite Intake And Bladder Cancer: Findings From The Danish Diet, Cancer And Health Cohort, Dorit W. Erichsen, Cecilie Kyrø, Jörg Schullehner, Susanne Rosthøj, Catherine P. Bondonno, Liezhou Zhong, Ole Raaschou-Nielsen, Pratik Pokharel, Torben Sigsgaard, Peter Fjeldstad Hendriksen, Frederik Dalgaard, Christina Dahl, Jonathan M. Hodgson, Christina C. Dahm, Anja Olsen, Anne Tjønneland, Nicola P. Bondonno

Research outputs 2022 to 2026

Introduction Nitrate and nitrite, present in ground and drinking water, as well as foods, may contribute to bladder cancer through the formation of carcinogenic N -nitrosamines. However, risk likely depends on both the source and endogenous nitrosating factors. Methods Among participants of the Danish Diet, Cancer, and Health Cohort (N = 54,610) with no history of cancer, source-specific nitrate and nitrite intakes (drinking water, plant sources, naturally occurring animal sources, and additive-permitted meat sources) were estimated from national water monitoring data and food frequency questionnaires using food databases. Bladder cancer cases were ascertained through the Danish Cancer Registry. Multivariable-adjusted Cox …

Transplantation And Mortality As Competing Outcomes Among Patients On Dialysis With Newly Diagnosed Cancer: A Longitudinal Cohort Study, Ryan Gately, Eric A. Engels, Dharshana Sabanayagam, Armando Teixeira-Pinto, Scott Campbell, Carmel Hawley, Wai Lim, Germaine Wong

Research outputs 2022 to 2026

Rationale & Objective: A cancer diagnosis is associated with complex risks for patients that may influence survival and access to transplantation. This study characterized the probability and timing of cancer-related death, noncancer death, and transplantation among patients with an incident cancer diagnosis after dialysis initiation. Study Design: Longitudinal cohort study. Setting & Participants: In Australia and New Zealand, 2000-2021, 3,052 patients receiving dialysis, identified via the Australia and New Zealand Dialysis and Transplant Registry, with cancer diagnosed after they had started dialysis. Exposure: Cancer, categorized by type and stage. Outcome: Transplantation as well as cancer-related death and noncancer death for …

Updating The Prisma Reporting Guideline For Scoping Reviews: A Scoping Review, Andrea C. Tricco, Emily Robinson, Sharon E. Straus, Heather Colquhoun, Christina M. Godfrey, David Moher, Zachary Munn, Danielle Pollock, Sherrie Logan, Ellen B.M. Elsman, Sabira Hasanoff, Yonda Lai, James Mcmahon, Jasmeen Dourka, Dipika Neupane, Hanan Khalil, Micah D.J. Peters, Lyndsay Alexander, Romy M. Jia, Ashrita Saran, Catrin Evans, Dawid Pieper

Research outputs 2022 to 2026

Background and Objectives The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews (ScRs) (PRISMA-ScR) was published in 2018 to provide reporting guidance. A substantial increase in published ScRs in recent years coupled with the omission or lack of engagement of interest-holders, including patients and public partners, as research partners throughout its development necessitate updating PRISMA-ScR. Important methodological advancements have emerged since PRISMA-ScR 2018, including automation and data extraction, which need to be incorporated into this update and reflected in new reporting items. Aligned with PRISMA 2020, this ScR underpins the update by identifying potential new …

Characterising Manual Dexterity, Motor Cortex Neuroplasticity, And Intracortical Inhibition Long After Burn Injury, Grant S. Rowe, Alecia Wood, Mark Fear, Dale W. Edgar, Aleksandra Miljevic, Tyler Osborne, Natalie Morellini, Merrilee Needham, Ann Maree Vallence, Fiona Wood

Research outputs 2022 to 2026

Purpose: Persistent motor dysfunction after burn injury may be due to altered motor cortex and corticospinal tract function. This study examined manual dexterity, motor cortex neuroplasticity, and intracortical inhibition in former burn patients 1–3 years after minor injury (<10% TBSA). Method: Thirty former burn patients (TBSA: 0.78 ± 1.08%) and 30 non-injured controls participated. Manual dexterity was assessed using the Purdue Pegboard. Transcranial magnetic stimulation (TMS) was used to measure motor cortex excitability (motor evoked potential [MEP] amplitude) and short- and long-interval intracortical inhibition (SICI, LICI) before and after paired-associative stimulation (PAS) to induce neuroplasticity. Results: Former burn patients performed worse than controls on the bimanual assembly subtest of the Purdue Pegboard. PAS did not induce changes in MEP amplitude but increased LICI in both burn patients and control participants. In burn patients, baseline LICI was related to bimanual performance differently than controls. Conclusions: These findings suggest poorer bimanual motor function persists after minor burns, and differences in the association between inhibition and bimanual dexterity between burn and control groups. Further research should explore whether targeting motor cortex inhibitory circuits can improve motor performance following burn injury

Differential Effects Of Physical Activity Interventions On Gross And Fine Motor Difficulties In Children With Autism Spectrum Disorder: Insights From A Multilevel Meta-Analysis With Moderator Analyses, Changhui Peng, Jinrong He, Kai Xu, Xueping Wu, Dandan Wang, Lei Zhang

Research outputs 2022 to 2026

Background Difficulties in gross and fine motor skills negatively affect the healthy development of children with autism spectrum disorder (ASD), yet evidence for physical activity interventions (PAIs) remains limited and inconsistent. Therefore, this study aimed to investigate the differential effects of PAIs on gross and fine motor difficulties in children with ASD and to explore potential moderators. Methods Following PRISMA guidelines, empirical studies published from inception to April 21, 2026 were systematically searched across PubMed, Web of Science, Embase, the Cochrane Library, and SPORTDiscus. Effect sizes were synthesized using a three-level random-effects model and were expressed as Hedges’ g (g). …

Post-Vaccination Confidence In Covid-19 Vaccines And Associated Determinants In Post-War Context Of Tigray, Northern Ethiopia: A Mixed-Methods Study, Genanew Kassie Getahun, Yohannes Addisu Wondimagegne, Alemayehu Deressa, Barkot Tamiru, Trhas Tadesse Berhe, Moges Mekonnen, Tsegay Hadgu, Znabu Hadush Kahsay, Mussie Alemayehu, Gebrehaweria Gebrekurstos, Joy Kenyi, Eshetu Girma, Finina Abebe Ware, Nardos Gelana, Menen Tsegaw, Eyob Ketema Bogale, Asaye Alamneh Gebeyehu

Research outputs 2022 to 2026

Introduction It is widely recognized that access to and utilization of health services are negatively impacted by war. These effects worsen particularly when combined with pandemics such as COVID-19. Therefore, this study aimed to assess adults' COVID-19 post-vaccination confidence in the conflict-affected region of Tigray, Northern Ethiopia. Methods The study employed a concurrent parallel mixed-methods design, combining a quantitative survey of 1599 adults and six key informant interviews and six focus group discussions. Survey participants were selected using a multistage cluster sampling technique, while qualitative participants were purposively sampled. Quantitative data were collected using a pre-tested, structured questionnaire administered via …

Diabetter Together: Outcomes Of A Randomized Controlled Trial Evaluating A Peer Mentor Behavioral Intervention For Young Adults With Type 1 Diabetes During The Transfer From Pediatric To Adult Care, Marisa E Hilliard, Charles G Minard, Samantha A Carreon, Wendy L Levy, Sarah K Lyons, Randi Streisand, Tricia S Tang, Siripoom V Mckay, Sridevi Devaraj, Barbara J Anderson

Faculty, Staff and Students Publications

Objective: Transition between pediatric and adult health care is complex, with high risk for loss to follow-up and suboptimal health outcomes for young adults with type 1 diabetes. This trial evaluated the efficacy of DiaBetter Together, a 12-month strengths-based behavioral intervention delivered by trained peer mentors. The intervention aimed to help young adults navigate the transfer process to promote optimal glycemic outcomes, shorten time to adult care follow-up, and improve psychosocial outcomes.

Research design and methods: Using a single-site randomized clinical trial design, we compared the 12-month intervention to usual care among n = 100 young adults aged 17-25 years …

Navigating Undone Science: The Search For Adequate Endometriosis Care, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Endometriosis is an estrogen-dependent disease in which tissue similar to the lining of the uterus grows elsewhere in the body leading to a variety of symptoms including heavy and prolonged menstruation, chronic pain, cysts, infertility, and gastrointestinal issues. Despite being one of the most common gynecologic conditions, much remains unknown about potential risk factors for endometriosis, its etiology, and treatment options. First and second-line biomedical treatment options, complementary and alternative medicine, and lifestyle changes are all treatment options that people living with endometriosis (PLE) leverage to manage their symptoms. This article draws on in-depth interviews with 52 people living with …

Youth Agricultural Engagement And Its Association With Dietary Diversity, Household Food Insecurity, And Nutritional Status In Southwest Nigeria, Sherif Olasoji

All Graduate Theses and Dissertations, Fall 2023 to Present

Youth remain underserved in nutrition research, policy, and programming despite being an integral part of the food systems. While the nutrition-sensitive agriculture framework has been established, there is limited evidence demonstrating how youth engagement in agriculture can serve as a pathway to improve nutritional outcomes. The study assessed youth agricultural engagement and its association with household dietary diversity, household food insecurity, and nutritional status in southwest Nigeria.

Using a cross-sectional design, data on socio-demographic characteristics, agricultural engagement, dietary diversity, household food insecurity, body mass index, and skin carotenoids were collected from 143 youth aged 15 to 35 from Ekiti, Osun, …

The Effects Of Psychological Stress On Gut Health In Mice Fed Either A Healthy Diet Or The Total Western Diet, David Keenan Thomas Prescott

All Graduate Theses and Dissertations, Fall 2023 to Present

The Total Western Diet (TWD), a rodent diet designed to model the typical American dietary pattern, has been shown to worsen inflammation and colitis severity in mice. Psychological stress has also been associated with increased intestinal inflammation, barrier dysfunction, and alterations to the gut microbiome. The goal of this study was to determine whether combining the TWD with psychological stress would further worsen colitis severity and alter the gut microbiome. To investigate this, mice were fed either a healthy control diet or the TWD and exposed to psychological stress using a social disruption stress model. Colitis was induced using established …

Formulation And Analysis Of Physiochemical And Sensory Properties Of Ready-To-Mix Whey Protein Phospholipid Concentrate Beverage, Chris Jaquin

All Graduate Theses and Dissertations, Fall 2023 to Present

Whey protein phospholipid concentrate (WPPC) is commonly recovered as a coproduct in filtration process whose aim is to obtain whey protein isolate (WPI) from whey protein concentrate (WPC). Whey protein phospholipid concentrate is high in milk fat globule membrane (MFGM), which has been shown in rodent and human studies to have a variety of physiological benefits, including an increase in exercise capacity. Whey protein phospholipid concentrate is currently considered as an underused dairy coproduct, with most of it either being disposed of or used as animal feed. This research consisted of incorporating WPPC in a protein shake–like beverage at a …

Kindergarten Teachers’ Perceptions, Experiences, And Challenges Using Visual Supports For Children With Autism, Jasmine Mcnair

Electronic Theses and Dissertations

This qualitative case study examined kindergarten teachers’ perceptions, experiences, and challenges related to the use of visual supports for students with autism spectrum disorder in East Texas. Grounded in cognitive load theory, the study explored whether visual supports enhance learning outcomes by reducing cognitive overload. Four research questions addressed teachers’ perceptions of effectiveness, implementation challenges, the influence of teacher attitudes, and differences based on teaching experience. The researcher collected data through semistructured interviews with 10 kindergarten inclusion teachers and supplemented by classroom observations. Thematic analysis revealed five primary themes: emotional impact and student growth, visual supports as essential instructional tools, …

Genai-Assisted Podcasts To Support Nursing Students’ Research Literacy And Evidence-Based Practice: A Feasibility Study, Jennifer Hamilton, Lesley Barr, Martina Costello, Lukman Thalib, Martin Jones

Research outputs 2022 to 2026

Background: Nursing students often report difficulty understanding and applying research evidence, limiting evidence-based practice capability. Podcasts are an accessible method for research dissemination, and generative artificial intelligence (GenAI) may offer a scalable approach to developing research-focused podcasts within curricula. Aims: To assess the feasibility of integrating GenAI-assisted research podcasts into nursing curricula as supplementary learning resources. A secondary objective examined associations in students’ self-reported competencies. Methods: A nonrandomised pre-post study was conducted in two entry-to-practice nursing programs at one Australian university. Episodes were released weekly as additional resources. Students completed the Student Evidence-Based Practice Questionnaire at semester commencement and completion. …

Sarcopenic Obesity And Dementia Risk: Primary Associations And Landmark Analyses Of Muscle Strength And Body Composition Trajectories, Zhongyang Guan, Blossom C.M. Stephan, Lorenzo M. Donini, Justyna Godos, Giuseppe Grosso, Leticia Radin Pereira, Carla M. Prado, Carlos J. Toro-Huamanchumo, Jonathan C.K. Wells, Marc Sim, Mario Siervo

Research outputs 2022 to 2026

Background and aims: Sarcopenic obesity (SO) has been proposed as a risk factor for cognitive impairment. Yet evidence is inconsistent and often limited by heterogeneous definitions and lack of longitudinal assessments. This study aimed to examine associations of SO with all-cause and subtype-specific dementia, and to assess dose–response patterns and how longitudinal changes in body composition and muscle strength relate to dementia risk. Methods: We included 489,972 adults (mean age 56.5 ± 8.1 years) followed for a median of 13.6 years. SO was defined using the Sarcopenic Obesity Global Leadership Initiative (SOGLI) criteria. Cox models estimated hazard ratios (HRs) for …

Yorga Moorditj Koort: Aboriginal And Torres Strait Islander Women’S Perspectives About Heart Health On Noongar Boodjar, Elia Bidgood, Cathy Garlett, Richard Chenhall, Amie Bingham, Francine Eades, Emily Banks, Melinda J. Carrington, Grace Joshy, Sandra Eades, Tabassum Rahman

Research outputs 2022 to 2026

In Australia, despite overall declines in cardiovascular disease (CVD)-related mortality, Aboriginal and Torres Strait Islander women develop heart disease earlier and experience more than twice the rate of related morbidity and mortality compared with non-Indigenous women. This study explores Aboriginal women’s understandings of the factors that shape their heart health and lived experiences of CVD. We spoke with 28 Aboriginal women aged ≥18 years—15 semistructured interviews and two yarning circles with an additional 13 Aboriginal women—with/without pre-existing CVD, and 10 healthcare professionals (HCPs) working with Aboriginal communities in the Perth metropolitan region, between May 2024 and April 2025. Data were …

Future Prospects Of Pediatric Lung Transplantation, Ernestina Melicoff, David Moreno Mcneill, Christian Benden

Faculty, Staff and Students Publications

This special issue of the Journal of Heart Transplantation Open is dedicated to Pediatric Thoracic Transplantation. The authors will discuss subjects related to pediatric lung transplantation such as access to donor organs, allograft dysfunction and role of functional status in outcomes.

Pavlovian Conditioning And Self-Control: From Laboratory To Classroom Application, Saba Mahmoudi

All Graduate Theses and Dissertations, Fall 2023 to Present

Impulsive choice, the preference for a smaller-sooner reward (SSR) over a larger-later reward (LLR), is associated with various challenging behaviors (e.g., gambling and substance-used disorders). Many interventions can reduce impulsive choice but those that produce long-lasting effects typically require long training durations or are difficult to implement in applied settings. This dissertation evaluated a novel Pavlovian training approach designed to promote self-control. In Experiment 1, procedures from Mahmoudi and Madden (2024) were replicated in the laboratory with the addition of a truly random control group. The study also assessed whether presenting the conditioned stimulus (CS) before a choice would increase …

An Examination Of Lifetime Traumatic Brain Injury And Anti-Inflammatory Medication Use In The Risk For Alzheimer's Disease, Mikaela A. Drewel

All Graduate Theses and Dissertations, Fall 2023 to Present

Alzheimer’s disease (AD) is the leading cause of dementia in individuals aged 65 years and older. There are a number of lifestyle and genetic factors that affect one’s risk for AD including traumatic brain injury (TBI), and genes such as those for Apolipoprotein E (APOE) and brain-derived neurotrophic factor (BDNF). This study examined sex differences in how TBI history influences risk for AD, exploring genetic variants suspected to play a role in TBI recovery. Additionally, in following an inflammatory mechanism in TBI, the study also determined if nonsteroidal anti-inflammatory drug (NSAID) use reduced subsequent risk for AD. The study analyzed …

Annual Quality And Safety Summit Abstract Booklet 2026, Elizabeth A. Saunders, Amanda Jones, Paulette A. Wehner

Marshall Journal of Medicine

The Annual Quality and Safety Summit is a cornerstone event dedicated to advancing excellence in health care delivery, bringing together a diverse community of health care professionals, educators, researchers, and learners. Each year, the summit serves as a dynamic platform to showcase innovative initiatives, evidence-based practices, and transformative ideas that aim to enhance patient care, improve safety, and drive better system-wide outcomes across the health care continuum.

Jointly sponsored by the Joan C. Edwards School of Medicine and Marshall Health Network, the Summit features abstracts spanning a wide range of topics, including innovative care delivery models, quality improvement strategies, patient …

Professional Identity Changes During The Covid-19 Era Among Pre-Medical College Students: Insights For Medical Educators, William J. Crump, Jordan Harbin, Lauren Trout, Cierra Woodcock, Kristin Wickham, Craig Ziegler

Marshall Journal of Medicine

Abstract

Introduction

Professional identity formation is known to be responsive to outside forces. Previous longitudinal research has shown changes occurred pre-and post-COVID-19 pandemic among medical students. The purpose of this longitudinal study was to assess changes among pre-medical students.

Methods

With a 100% response rate, 85 Career Eulogies (CE) from 2015 through 2025 recorded a free text response to the prompt: "Imagine that you are ready to retire from medicine in the distant future. In about 50 words, write a short speech outlining what you would like to be said about you at the retirement ceremony."  The responses were coded …

The Effect Of Elevated Blood Pressure And Stage One Hypertension On Perinatal Outcomes In Appalachian Gravidas: A Retrospective Cohort Study, Caroline Briggs, Austin L. Loop, Grace E. Montgomery, David G. Chaffin, Jesse Cottrell

Marshall Journal of Medicine

Introduction:  There is literature in the obstetric population that suggests any degree of hypertension (blood pressures greater than or equal to 120 systolic or 80 diastolic) can lead to adverse maternal and fetal outcomes.  We sought to determine if pregnant patients in our Appalachian population with elevated blood pressure or stage 1 hypertension have an increased risk of gestational hypertension and preeclampsia.

Methods:  A retrospective chart review was performed on patients who received obstetric care with the Marshall University OB/GYN department and delivered at Cabell Huntington Hospital.  Delivery outcomes were obtained for 233 deliveries from March 30, 2020 to September …

Rare Case Of Subcutaneous Panniculitis-Like T-Cell Lymphoma In A Pediatric Patient, Jasmine Kaur, Omar Abdelaal, Ammar Masood, Aaron Mcguffin, Kathleen Martin

Marshall Journal of Medicine

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of primary cutaneous T-cell lymphoma that has clinical overlap with common benign conditions, thus making diagnosis challenging. SPTCL primarily affects younger adults with a female predominance. Pediatric cases are exceedingly rare and often misdiagnosed as bacterial infections, delaying proper clinical diagnosis and treatment.

In this case study, we report on a 9-year-old female who initially presented to an urgent care clinic with two weeks of an itchy, painful nodule on her right buttock and thigh. The nodule was initially misidentified as a skin abscess, and the patient was prescribed sulfamethoxazole/trimethoprim. The …

Clinical Perspective On The Timing Of Coronary Artery Bypass Grafting In Patients With Nstemi: Commentary On Tran Et Al., Anmol Multani, Sakshi Dixit, Fnu Anamika

Marshall Journal of Medicine

No abstract provided.

Finding And Using Validated Surveys In Health Science Research, Tracy Ashby

Library Class: Lunch & Learn

Join us as we introduce techniques for identifying and using validated surveys in health sciences research. Learn strategies for finding reliable, evidence-based measurement tools in the databases and gain tips on how to evaluate their quality and relevance.

Analysis Of Infectious Waste Management In Hospital X Based On The Minister Of Health Regulation Number 02 Of 2023, Carissa Gianika

Cities and Urban Development Journal

Background: Infectious waste management is a crucial aspect in preventing cross-infection and protecting the hospital environment. Hospitals, as healthcare facilities with high levels of medical activity, generate large amounts of infectious waste that can potentially pose health and environmental risks if not managed according to standards. Hospital X, South Jakarta, as a referral hospital with a high patient volume.

Aims: This study aims to analyze the implementation of infectious waste management at Hospital X, South Jakarta based on the provisions of Minister of Health Regulation Number 2 of 2023, and to identify the obstacles faced in its implementation.

Methods: This …

Evaluating Machine Learning Models On Classification Of Novel Cyber Attacks In The Healthcare Domain, Promise Ehimen

Dissertations, Theses, and Projects

The increasing adoption of the Internet of Medical Things (IoMT) has improved healthcare delivery through connected medical devices while simultaneously expanding the cybersecurity risks facing healthcare organizations. Although machine learning based intrusion detection systems have demonstrated high detection accuracy, their ability to respond reliably to previously unseen cyberattacks remains uncertain. This study investigated how a Neural Network model and a Logistic Regression model classified novel cyberattacks within the IoMT environment. The Neural Network and Logistic Regression models were both trained and tested using a subset of the CICIoMT2024 benchmark dataset. The Neural Network achieved 99.82% test accuracy and a 0.94 …

The Impact Of Enhanced Pediatric Asthma Simulation Prebriefing On Perceived Psychological Safety In Associate Degree Nursing Students, Amy G. Burtram

Theses

Background: Simulation is a core teaching strategy in nursing education, yet student anxiety may negatively impact learning outcomes. Psychological safety has been identified as a critical factor in effective simulation-based student learning.

Purpose: The purpose of this project was to examine whether an enhanced simulation prebrief improved perceived psychological safety among second-semester associate degree nursing students during a high-fidelity pediatric asthma scenario at a rural community college in Alabama.

Methods: A quasi-experimental one-group pretest–posttest design evaluated changes in psychological safety following a structured, evidence-based prebrief grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards …

Ethics Under Siege: The Conflict In Tigray Through The Lens Of Just War Theory, Daniela Widya Purba

Journal of Strategic and Global Studies

This research article explains the ethical principles of the conflict in Tigray based on the Just War Theory. By using the descriptive qualitative methodology, this research article draws data from secondary sources which includes; academic journals, news reports, as well as international legal instruments to analyze the moral trajectory of the conflict. This research begins with jus ad bellum, to assess Ethiopia’s government justification in declaring conflict within Tigray. While the government fulfilled the criteria of just cause and legitimate authority, the question stands on the ambiguous political intentions and the failure to enact peaceful alternatives before resulting in waging …

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

Systematic Review Of The Institutionalization Of Service Learning In Higher Education, Wilmer Hernan Cruz Gutierrez

ASEAN Journal of Community Engagement

An increasing number of universities are integrating service-learning (SL) to fulfill their social mission. However, sustainable institutionalization of SL remains a persistent challenge. This study identifies and analyzes the factors, actors, and strategies that drive and inhibit SL institutionalization in higher education. Using the PRISMA 2020 guidelines, a systematic literature review analyzed 52 documents from seven academic databases (including WoS, Scopus, and ERIC). The findings were grouped into three sections: cultural (integration into institutional values/missions), process (articulation within teaching, research, and outreach), and structural dimensions (dedicated support entities). The results obtained reveal a reciprocal relationship where cultural alignment enables processual …