Digital Commons Network^™

Effects Of Probiotic Supplementation On Symptoms In Teenagers Ages 13-18 With Inflammatory Skin Conditions, Katelyn S. Walker, Jessica Rosen, Matilde Belfiore

Department of Nutrition Student Projects

Teenagers between the ages of 13 and 18 are particularly susceptible to inflammatory skin disorders such as acne vulgaris and atopic dermatitis, which can have a detrimental effect on their physical and mental health. Emerging evidence highlights the importance of the gut-skin axis, indicating that the makeup of the gut microbiota affects both skin health and systemic inflammation. Adolescent-specific research is still limited even though probiotic supplementation, especially Lactobacillus strains, has demonstrated anti-inflammatory effects in laboratory, animal, and small clinical studies.

The purpose of this experimental study is to determine whether oral probiotic supplementation improves inflammatory skin condition symptoms in …

Mplus Data For Campus Mental Health Study 2026 - Flourishing Paper, Alice Ann Crandall, Carl L. Hanson

ScholarsArchive Data

MPlus Data file, input file, and output file.

Patient Perception Of Pain Following Extraction And Bone Graft With Or Without Preemptive Ibuprofen: A Randomized Clinical Trial, Samah Rady

Master's Theses (2009 -)

Objective: The purpose of this randomized clinical trial is to investigate the effects of preemptive analgesia on postoperative pain following extraction and ridge preservation and to evaluate the association between dental care-related fear and anxiety, health literacy, fear of pain, and pain catastrophizing with post-operative pain and swelling perception as well as Oral Health Impact Profile-14 (OHIP-14). Materials and Methods: Ibuprofen 600mg (test; n=9) or placebo (n=13) were randomly given one hour prior to extraction and ridge preservation. Preoperatively, patients completed the following questionnaires: Modified Dental Anxiety Scale (MDAS), Oral health-related quality of life (OHIP-14), Fear of Pain (FPQ-III), Pain …

Moving From Pico To Ppco, Amy Six-Means

PPCO Resources & Education

No abstract provided.

Ms-Gator: Multi-Scale Graph Attention With Topological Reasoning For Segmentation And Classification Of Prostate Cancer Based On Gleason Scores Using Histopathology Images, Sujata Patil, Mahadeva Swamy, Kavitha Sooda, Rajanikanth Vadigepalli, Khalid Nazim Abdul Sattar, Md Rafeeq

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Prostate cancer is one of the prevalent and potentially fatal malignancies, affecting men globally. Accurate segmentation and classification of prostate cancer in histopathology images remain challenging due to complex tissue architecture, staining variability, and high inter-observer differences in manual diagnosis. To address these challenges, this research proposes a Multi-Scale Graph Attention with Topological Reasoning (MS-GATOR) for segmentation and classification of prostate cancer based on Gleason Scores (GS). The MS-GATOR incorporates topological reasoning with hierarchical biological structures by constructing a graph-based representation among three spatial scales such as nuclei, glands, and tissues using Delaunay triangulation to capture both geometric and photometric …

Dementia De-Escalation Staff Education Program, Gretchan Edwards

Walden Dissertations and Doctoral Studies

Behavioral and psychological symptoms of dementia (BPSD), including agitation and aggression, present significant challenges in acute care settings and contribute to increased staff injury risk and inconsistent patient care. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the impact of a structured dementia de-escalation education program on staff knowledge, confidence, and perceived ability to manage dementia-related behaviors. The guiding PICOT question asked: In acute care staff, how does participation in a structured de-escalation training program that incorporates environmental modifications and organizational support, compared with no formal de-escalation training, affect staff knowledge, confidence, and perceived impact …

Conserved Post-Odor Dynamics In The Olfactory Systems Of Mice And Locusts, Elizabeth H Moss, Doris Ling, Cameron L Smith, Feiyang Deng, Ryan Kroeger, Jacob Reimer, Baranidharan Raman, Benjamin R Arenkiel

Faculty, Staff and Students Publications

Interpreting chemical information and translating it into ethologically relevant output is a shared challenge of olfactory systems across species, but are olfactory computations conserved across species to overcome these common challenges? To investigate this, we compared neural activity in the locust antennal lobe (AL) and mouse olfactory bulb (OB) both during and after odor presentations. We found that odors activated nearly mutually exclusive neural ensembles during odor presentations ("ON response") and after the termination of the odor stimulus ("OFF response"). ON and OFF responses evoked by a single odor were anticorrelated with each other. Inverted OFF responses persisted long after …

Clustering Of Internet Behaviors And Associated Mental Health Outcomes Among U.S. Adolescents, Aakansha Singh, Timothy Grigsby, Miguel Fudolig, Ying Guo, Clariana Ramos De Oliveira

School of Medicine Research Poster Showcase

Poster: Clustering of Internet behaviors and associated mental health outcomes among U.S. adolescents

Patient's Age Impact On Stroke Risk And Intracranial Aneurysm Occlusion: Scent Flow Diverter Study-A Nonrandomized Clinical Trial On Large And Giant Aneurysms, Ajay K. Wakhloo, Paul Jenkins, Philip M. Meyers, Alexander L. Coon, Peter T. Kan, Ajit S. Puri, Joost De Vries, Giuseppe Lanzino, Mark D. Bain, Koji C. Ebersole, Babu G. Welch, Aclan Dogan, Pascal Jabbour, J. Mocco, Adnan H. Siddiqui, Aquilla S. Turk, Philipp Taussky, Ricardo A. Hanel

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: The prospective single-arm nonrandomized SCENT (Surpass Intracranial Aneurysm Embolization System Pivotal) trial on flow diverter treatment of large and giant intracranial aneurysms (IA) was analyzed for patients' age and IA characteristics affecting stroke and occlusion rates over 5 years (Trial registration NCT01716117).

METHODS: Impact on major ipsilateral stroke and IA occlusion was studied by stratifying age as 65 years and younger vs older than 65. Kaplan-Meier estimates of time to both endpoints, stratified by age, were created. Univariate predictors of time-to-stroke were analyzed using univariable proportional hazards regression models. Limited bivariable modeling was also attempted.

RESULTS: Of …

Predicting Clinically Significant Prostate Cancer With Or Without Digital Rectal Exam And Mri Data Using Claritydx Prostate Models, Robert J Paproski, Adam Kinnaird, M Eric Hyndman, Adrian Fairey, Leonard Marks, Christian P Pavlovich, Sean A Fletcher, Roman Zachoval, Vanda Adamcova, Jiri Stejskal, Armen Aprikian, Christopher J D Wallis, Desmond Pink, Catalina Vasquez, Perrin H Beatty, John D Lewis

Faculty, Staff and Student Publications

This prognostic study created optimized ensembles of calibrated random forest models to predict clinically significant prostate cancer (csPCa, grade group ≥2 PCa) using total prostate-specific antigen (PSA), free PSA, negative biopsy status, and age, with or without DRE and MRI data. Observational data were aggregated from cohorts in six organizations in Canada, the USA, and Czechia. Prostate biopsies were performed between 2009 and 2024. Risk models (ClarityDX Prostate + DRE, ClarityDX Prostate + MRI, and ClarityDX Prostate + MRI + DRE) were derived (training cohorts n = 1626 to 2191) and validated (validation cohorts n = 378 to 1318) from …

An Emerging Approach To Ibd Treatment: Personalized Nutrition Through Gut Microbiome Optimization., Kafayat Yusuf, Thomas M. Attard, Mazin Al-Kasspooles, Shahid Umar

Manuscripts, Articles, Book Chapters and Other Papers

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract characterized by relapsing and remitting disease activity. Despite decades of research, a definitive cure for IBD remains elusive, as cycles of remission and flare-ups mark the disease course and often relies on long-term pharmacologic and supportive strategies. Increasing evidence indicates that diet and nutrition play an important role in modulating the outcomes of IBD. Although a wide range of dietary interventions has been explored, no universally effective approach has been established. Investigations have also proven that different dietary interventions can significantly affect clinical outcomes by altering gut …

Evaluating The Impact Of Vosoritide On Complications Of Achondroplasia, Ravi Savarirayan, Jacqueline T Hecht, Kala Jayaram, Sheetal Ingole, Anne Dee, Julie Hoover-Fong

Faculty, Staff and Student Publications

Purpose: Impaired endochondral bone growth in people with achondroplasia causes complications that impair function, cause pain, require surgery, and contribute to mortality. Rates of complications in participants with achondroplasia enrolled in clinical trials of vosoritide, a targeted treatment, were analyzed and compared with published natural history (NH) rates.

Methods: Prevalence (medical history + new events post-treatment initiation) and incidence (new/worsening events posttreatment initiation) were calculated for complications across 6 clinical trials (2.5-30 μg/kg/day vosoritide) in children with achondroplasia, stratified by age at treatment initiation (< 5 years/≥5 years). Complication-related procedures and mortality rates were examined.

Results: By August 2024, 230 participants received vosoritide (68 aged < 5 years at treatment initiation [exposure, 289.1 person-years]; 162 aged ≥5 years at treatment initiation [exposure, 834.5 person-years]). Prevalence for most complications was consistent with or lower than NH rates. Incidence of leg malalignment; foramen magnum stenosis; spinal stenosis; kyphosis; lordosis; hydrocephalus; ear, nose, and throat complications; and pain was generally lower than NH rates. Foramen magnum decompression frequency was 3.0% overall (5.9% in participants who initiated treatment aged < 2 years). Crude mortality was lower than NH rates.

Conclusion: Vosoritide was not associated …

Assessment Of Undergraduate And New Graduate Nursing Confidence In Caring For Actively Dying Patients, Alyssa Boersma

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

Undergraduate nursing students and new graduate nurses frequently report feeling underprepared and uncomfortable when caring for actively dying patients. The purpose of this study was to identify potential gaps in the current curriculum and assess what improvements were needed to better prepare students. Dorothea Orem’s Self-Care Deficit Theory highlights the importance of providing holistic and self care needs when patients are not able to do it themselves. A cross-sectional, quality improvement design was utilized. A 17 item Likert-scale survey was administered to investigate the level of confidence that participants have when caring for actively dying patients. Senior level nursing students …

Servant Leadership In Undergraduate Nursing Students: A Concept Analysis, Ellie Bonanni

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

Leadership is necessary in the nursing profession and can be cultivated within undergraduate nursing programs. Servant leadership shows great promise as an appropriate leadership model for nurses. The purpose of this study was to complete a concept analysis of servant leadership (SL) and apply it in cases of undergraduate nursing students. The theoretical framework was Greenleaf’s Servant Leadership Model. This study was completed using Walker and Avant’s model of concept analysis, which clarifies the defining attributes, defining characteristics, antecedents, and consequences of a concept. A literature review was performed using CINAHL Plus (Cumulative Index to Nursing and Allied Health Literature) …

Human Interactions With Artificial Intelligence: A Pilot Study, Kjersten Heinlein

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

Emerging research shows that college students increasingly use artificial intelligence (AI) tools in academic and personal contexts; however, little is known about how factors such as computer literacy and digital comfort influence their communication with AI. This pilot study seeks to establish a protocol to investigate the influence that undergraduate students’ digital comfort and computer literacy has on the style, tone, and effectiveness of interactions with AI during socially-oriented tasks. Grounded in Margaret Newman’s Theory of Health as Expanding Consciousness, this work views students’ digital comfort and literacy as evolving factors that expand their awareness and enable more effective interactions …

Human Interactions With Artificial Intelligence: A Pilot Study, Miracle Yunana, Kjersten Heinlein

25th Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2026)

As artificial intelligence (AI) becomes increasingly integrated into daily life, understanding AI’s impact on human communication is essential for nursing education where both effective socialization and digital literacy are key components of professional development. This pilot study seeks to establish a protocol to explore the relationship between undergraduate students’ socialization and their communication styles when interacting with AI tools. Peplau’s Interpersonal Relations Theory serves as the foundation for this study, emphasizing the importance of social connectedness and communication, highlighting how interpersonal dynamics may extend to AI-mediated interactions. A mixed methods pilot study was conducted, consisting of structured sessions with seven …

A Backend Database Architecture For Persistent Epilepsy Classification Records, Attiksh A. Panda, Deep Desai, Artem Zabarov, Katrina D. Prantzalos, Satya S. Sahoo, Shuai Xu

Student Scholarship

Epilepsy affects over five million people globally each year, yet consistent clinical diagnosis remains a persistent challenge due to the lack of standardized classification workflows across medical institutions. The Four-Dimensional Epilepsy Classification (4D-EC) framework, developed by Lüders et al., provides a comprehensive structure for characterizing paroxysmal events across four dimensions: seizure semiology, epileptogenic zone, etiology, and comorbidities. Despite its clinical and educational value, no dedicated informatics platform existed to support its routine use until recently, limiting widespread adoption among clinicians and trainees. This project addresses that gap by implementing a full-stack web application that operationalizes the 4D-EC framework for clinical …

Education To Increase Students’ Knowledge, Perceptions, And Interest In Occupational Therapy, Brooke Hineman

Capstone Projects

In response to the declining program fill rates across all levels of occupational therapy (OT) education, this Doctoral Capstone Experience (DCE) aimed to promote the field through development of informational resources and delivery of educational sessions for high school and undergraduate students. The primary objective was to foster deeper understanding, accurate perceptions, and career interest among participants. A thorough literature review and needs assessment exploring current OT knowledge, promotion efforts, student characteristics, and underrepresented groups revealed a need for intentional education to address gaps in student knowledge regarding the field of OT among all students, especially those without exposure to …

Advocacy, Outreach, And Expansion Of The Michigan Occupational Therapy Association Mental Health Special Interest Section, Isabel Evola

Capstone Projects

The history of occupational therapy (OT) is rooted in supporting mental health, emerging in the United States during World War I. Over time, the practice of OT has evolved in its scope and emerging specialties. The role of OT in mental health is underutilized and misunderstood by professional organizations. However, OT remains a vital service in supporting mental health in psychiatric and non-psychiatric settings. The focus of this doctoral capstone experience (DCE) was to address this gap by advocating for the presence and understanding of OT in mental health through the expansion of the Michigan Occupational Therapy Association (MiOTA) Mental …

Refreshing Recess: An Every Moment Counts Initiative For Engaging Recess Participation, Paige Kuhn

Capstone Projects

Research supports the role of occupational therapy (OT) in school-based mental health promotion and the use of occupation-based interventions to enhance student participation, social-emotional learning, and self-regulation. However, there is limited evidence on the implementation of Every Moment Counts (EMC): Refreshing Recess in elementary school settings, particularly when adapted to real-world contexts. The focus of this doctoral capstone experience (DCE) was to address this gap through the development and implementation of an adapted recess-based program at Douglas Elementary School in Douglas, Michigan.

This project involved implementing a six-week Refreshing Recess program designed to promote inclusive play, peer interaction, and emotional …

Strengthening Leadership And Expanding Engagement: Enhancing Volunteer, Participant, And Donor Involvement In Michigan Victory Games, Abbey Smith

Capstone Projects

This doctoral capstone experience (DCE) addressed organizational development and community engagement within the Michigan Disability Sports Alliance (MiDSA), an adaptive sports nonprofit serving individuals with physical disabilities. The project is relevant to occupational therapy (OT) through its focus on promoting participation, health, and inclusion in meaningful occupations such as sport. A key gap identified was the lack of structured resources to support leadership, inconsistent outreach methods, and limited strategies to reduce barriers for participants, volunteers, and donors.

The objectives of this DCE included developing a centralized data management portal, creating a standardized community outreach presentation, establishing clear board role frameworks, …

Mapping Burdens And Inequalities Of Polycystic Ovary Syndrome In Young Females Across 953 Locations 1990–2040 With Deep Learning Forecasts, Yaling Wu, Wenxiang Cai, Mao Chen, Susu Luo, Robert J Norman, Mahnaz Bahri Khomami, Lisa Moran, Heping Zhang, Suhaniya N S Samarasinghe, Salman Rawaf, Davd A Ehrmann, Liming Pan, Kexin Ding, Shuxian Ma, Lili Zheng, Xian Shao, You Zuo, Baozhen Huang, Fei Li, Mingyang Xue, Tongrui Shang, Guangyao Cai, Yuanyuan Chen, Ying Wang, Yutong Lu, Dong Wang, Yuanyuan Wan, Ningning Wu, Ciqing Lin, Wei Pan, Rui Zhang, Tingting Yao, Yiming Xiong, Kai Chen, Jianli Zhao, Shunrong Li, Liling Zhu, Luyuan Tan, Yinduo Zeng, You Zeng, Lukasz Szarpak, Nadia M Hamdy, Claire Chenwen Zhong, Fa Yuan, Yihang Chu, Xiao Jia, Peng Wu, Linjiang Wei, Yanfang Ye, João Conde, Zimeng Wu, Jinjin Zhang, Yamei Tang, Pengpeng Ye, Dongzi Yang, Shixuan Wang, Azeem Majeed, Helena Teede, Wenyi Jin, Queran Lin

Faculty, Staff and Students Publications

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder impacting the health of young female populations. Using harmonized estimates from 953 locations, we assessed temporal trends, geographic inequalities, and forecasts of PCOS among individuals aged 10-24 years from 1990 to 2040. Between 1990 and 2021, global prevalence and disability burden increased by more than 30%, with the highest burden observed among those aged 20-24 years. Substantial geographic heterogeneity was identified, with particularly high prevalence in Europe and East Asia. While high-income regions carried the greatest absolute burden, low- and middle-income regions showed the fastest growth, accompanied by widening …

Vascular Burden Attenuates The Tdp-43-Tmem106b Pathological Relationship In Neurodegenerative Disease With And Without Alzheimer Disease Neuropathological Change, Matthew B. Dopler, Cole Corbett, Angelique D. Gonzalez, Ali Ghaseminejad-Bandpey, Mallory Keating, Kyra M. Clarke, Oluwaseun B. Ogunbona, Gladys Maestre, Sudha Seshadri, Shahroo Etemadmoghadam, Margaret E. Flanagan

School of Medicine Publications

TMEM106B, a lysosomal transmembrane protein, is a risk factor for neurodegenerative diseases, including Alzheimer disease (ad) and TDP-43 proteinopathies. TMEM106B pathology occurs in normal aging and is increased in TDP-43 proteinopathy but its role in dementia remains unclear. Cerebrovascular disease (CVD) is a driver and co-pathology of dementia, yet its contribution to TMEM106B accumulation in the context of TDP-43 and ad neuropathological changes (ADNC) has not been explored. We analyzed post-mortem human hippocampal sections spanning not-, low-, intermediate-, and high-ADNC. In secondary analyses, cases ≥65 years were stratified by TDP-43 immunopositivity and CVD severity; cases < 65 years were included to contextualize age-associated effects. TMEM106B immunoreactivity was quantified using digital pathology. Linear regression models demonstrated that age and sex (higher in females) were independent predictors of TMEM106B immunopositivity whereas Braak stage, CERAD-NP score, and Thal phase were not. The positive TDP-43-TMEM106B association was attenuated with increased CVD pathology severity, suggesting that vascular burden modifies this relationship. Sensitivity analyses restricted to LATE-NC attenuated several associations, indicating that pooled TDP-43 findings should be interpreted cautiously given possible disease heterogeneity. TMEM106B immunoreactivity was most strongly associated with age and sex, while vascular burden, rather than ADNC level, modified its relationship with TDP-43 proteinopathy.

Potential Applications Of Thymus Vulgaris In Dental Care: A Review Of Antimicrobial And Oral Health Benefits, Lakenzia Z. Ham

Undergraduate Research Conference

This research proposal focuses on how common thyme (Thymus vulgaris) can be used in dental care. There has been more interest in natural products for dental health because some common dental treatments can have side effects or lead to antibiotic resistance. Thyme contains natural compounds like thymol and carvacrol that help kill bacteria, reduce inflammation, and prevent buildup on teeth.

The purpose of this study is to investigate the current scientific literature to see the effectiveness of thyme in preventing common oral health problems like cavities, gum disease, and bad breath. Research shows that thyme can fight bacteria …

The Social Determinants Of Health And Cancer, Joshua Williams

Ex Sapientia Loqui

The social determinants of health, as defined by the World Health Organization (WHO), are “the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources.” Epidemiologists have long studied the nexus between social forces and disease and have widely agreed that such forces are directly causal of pathologies. This paper is an analytic review of the existing literature on several social determinants— namely socioeconomic status (SES), race and ethnicity, age, working and living conditions, and social integration— and how they pertain to the causation, progression, and treatment of cancer.

Galen Of Pergamum: Life, Literature, And Legacy, Elyse Rogers

Ex Sapientia Loqui

Galen of Pergamum was a second-century physician whose work had an enduring impact on the field of medicine. His extensive writings were the primary reference and teaching materials for the medical community for over a millennium. While his ideas were revolutionary for his time, they were eventually outdated. Nevertheless, there was a continued reliance on his authority, which hindered scientific advancement. Galen both advanced the world of medicine with his emphasis on observational analysis and constrained its progress through the profound dominance of his theories.

This paper aims to understand the life of Galen and the significance of his work …

Assessing The Aesthetic Responsiveness Among Patients In A Free Clinic Setting, Jack E. Pitts

Student Scholar Showcase

Art therapy has increasingly been recognized as a complementary intervention in healthcare settings, with demonstrated benefits for stress reduction and overall biopsychosocial well-being. However, limited research has explored aesthetic engagement within medically underserved and economically disadvantaged populations. This study examines aesthetic responsiveness among patients receiving care at the Free Clinic of Central Virginia using a standardized Aesthetic Responsiveness Assessment. The assessment consists of 14 Likert-scale questions assessing individuals’ cumulative aptitude across three domains: aesthetic appreciation, intense aesthetic experience, and creative behavior. Responses and data were collected voluntarily and anonymously, and they were analyzed to better understand how patients in an …

The Impact Of Customized Alarm Sounds On Reducing Alarm Fatigue In Icu Nurses, Abigail L. Kendrick, Elizabeth G. Dunkum, Carly F. Harris

Student Scholar Showcase

Within hospital care, particularly in intensive care units, alarm fatigue poses a major threat to patient safety. As a result of the constant sound of alarms, nurses become desensitized and overstimulated in the health care setting. Patient safety is threatened by an increased risk of errors in care, which may lead to complications and poor health outcomes. By systematically reviewing various research studies within the time span of 2020-2025 regarding interventions to decrease the relevance of alarm fatigue, research suggests that there are methods that can be applied via numerous approaches. By customizing alarm sounds by severity, it is believed …

Nitrous Oxide Use In Labor, Aimee Aberson, Janae Cam, Rylie Franken, Rachel Henriksen, Ben Robinson, Pam Hulstein

Celebration of Research

Effective pain management during labor is a critical part of maternal care. It influences the mother’s physical and emotional experiences of childbirth. Epidural anesthesia and intravenous opioids are commonly used as analgesia in laboring mothers, but nitrous oxide (N₂O) has proven to be a safe, noninvasive alternative. It allows mothers to maintain mobility and consciousness while still reducing some pain perception. The purpose of this evidence-based practice project is to evaluate the effectiveness, safety, and satisfaction associated with N₂O use during active maternal labor. It reviews current literature on N₂O use during labor, focusing on maternal and neonatal safety, effectiveness …

Role Of Dental Screening In Preventing Hip Prosthetic Joint Infections, Aidan Anderson, Cailee Dix, Emma Franken, Erin Keizer, Zavyr Metzger, Tyra Snyder, Pam Hulstein

Celebration of Research

Hip arthroplasty is a common procedure, but Periprosthetic joint infection (PJI) remains a serious postoperative complication associated with increased hospital stays, readmissions, and costs. Evidence suggests that poor oral health may contribute to PJIs through the spread of bacteria from the mouth to the surgical site. This project examined the relationship between preoperative dental health and postoperative outcomes in adults aged 50–90 undergoing hip replacement. A literature review using the Johns Hopkins Research Evidence Appraisal Tool evaluated 19 studies from databases such as PubMed and ScienceDirect. While no clear association was found between specific dental risk factors and PJIs, untreated …