Digital Commons Network^™

Teaching Swimming To Children With Disabilities: A Qualitative Analysis Of Swim Instructorstea, Stephanie S. Garcia-Hidalgo, Martin E. Block

International Journal of Aquatic Research and Education

When teaching children with disabilities, swim instructors need to be able to assess the unique strengths and needs of each child to determine modifications needed to instruction, equipment, and the setting and then be flexible enough to make changes in real-time to ensure success for the child. Unfortunately, many swim instructors only work seasonally and have the occasional child with a disability, and as a result are likely to have limited training and experiences with children with disabilities. The purpose of this pilot qualitative study is to examine backgrounds, training, and experiences of six swim instructors who work with children …

Large Language Models As Information Providers For Appropriate Antimicrobial Use: Computational Text Analysis And Expert-Rated Comparison Of Chatgpt, Claude And Gemini, Marcello Di Pumpo, Maria Rosaria Gualano, Danilo Buonsenso, Francesca Raffaelli, Daniele Donà, Vittorio Maio, Patrizia Laurenti, Walter Ricciardi, Leonardo Villani

College of Population Health Faculty Papers

OBJECTIVES: Antimicrobial resistance is a critical public health threat. Large language models (LLMs) show great capability for providing health information. This study evaluates the effectiveness of LLMs in providing information on antibiotic use and infection management.

METHODS: Using a mixed-method approach, responses to healthcare expert-designed scenarios from ChatGPT 3.5, ChatGPT 4.0, Claude 2.0 and Gemini 1.0, in both Italian and English, were analysed. Computational text analysis assessed readability, lexical diversity and sentiment, while content quality was assessed by three experts via DISCERN tool.

RESULTS: 16 scenarios were developed. A total of 101 outputs and 5454 Likert-scale (1-5) scores were obtained …

Stereoelectroencephalography Reveals Neural Signatures Of Multisensory Integration In The Human Superior Temporal Sulcus During Audiovisual Speech Perception, Yue Zhang, John F Magnotti, Xiang Zhang, Zhengjia Wang, Yingjia Yu, Kathryn A Davis, Sameer A Sheth, H Isaac Chen, Daniel Yoshor, Michael S Beauchamp

Faculty, Staff and Students Publications

Human speech perception is multisensory, integrating auditory information from the talker's voice with visual information from the talker's face. BOLD fMRI studies have implicated the superior temporal gyrus (STG) in processing auditory speech and the superior temporal sulcus (STS) in integrating auditory and visual speech, but as an indirect hemodynamic measure, fMRI is limited in its ability to track the rapid neural computations underlying speech perception. Using stereoelectroencephalography (sEEG) electrodes, we directly recorded from the STG and STS in 42 epilepsy patients (25F, 17M). Participants identified single words presented in auditory, visual, and audiovisual formats with and without added auditory …

Silent Signals: Human Trafficking And The Dental Professional’S Duty To Act, Pamela Zarkowski

Journal of the American College of Dentists

Human trafficking is a global public health and human rights crisis that includes forced labor and commercial sexual exploitation. Dental professionals are uniquely positioned to recognize signs of trafficking, as many victims encounter healthcare settings, including dental offices, during their exploitation. This article introduces the types and prevalence of trafficking, outlines legal and ethical responsibilities, and provides clinical red flags, case scenarios, and actionable strategies for screening and reporting. Myths that hinder detection are also addressed. By recognizing their ethical duty to protect vulnerable patients, dental professionals can become vital allies in the identification and support of trafficking survivors.

21st-Century Dental Public Health: Revisiting The Role Of Community Water Fluoridation, Larry Williams, Preetha Kanjirath

Journal of the American College of Dentists

Community water fluoridation (CWF) has been celebrated as a major public health achievement, significantly reducing dental caries and narrowing oral health disparities. While historically effective, today’s fluoride exposure landscape has shifted, with multiple sources contributing to cumulative intake. This article reviews the scientific foundation, mechanisms of action, public health benefits, and ethical considerations surrounding CWF, alongside real-world outcomes from policy reversals. It examines contemporary concerns, including potential neurodevelopmental risks and vulnerable populations, and calls for recalibrated policies that maintain caries prevention benefits while monitoring total fluoride exposure to ensure safety in modern contexts.

J Am Coll Dent 2025 92 1

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

A Social Media Campaign And Web-Based Survey About Prostate Cancer Genetics: Mixed Methods Study, Amy Leader, Stacy Loeb, Preethi Selvan, Ashley Hunter, Rebecca Hartman, Scott Keith, Veda Giri

Department of Medical Oncology Faculty Papers

BACKGROUND: Germline genetic variants are important for prostate cancer (PCa) management and hereditary cancer risk assessment, but testing is underused. Furthermore, patients are often unaware of the genetic connections to PCa. Social media is increasingly serving as a source of awareness for health information and a method to gather data from a large population.

OBJECTIVE: There were three objectives: to (1) create and test social media messages related to PCa genetics and genetic testing, (2) determine which social media message was most engaging, and (3) assess knowledge of and attitudes toward PCa genetic testing through an online survey using the …

Predictors Of Parental Behavior And Child Weight Status, Fidelia Senayah, Heba M. Athar, Allison G. Litton

Journal of Social, Behavioral, and Health Sciences

Childhood obesity is a major health issue globally. The prevalence rate remains high in Ohio, with associated complications among affected children and adolescents. The current study examined the association among obesity risk knowledge, risk perception, feeding behavior, and child weight outcome while controlling for race, gender, income, and education. We collected quantitative data through an online survey of parents in Northwest Ohio (n = 71) using the obesity risk knowledge scale and factors from the Child Feeding Questionnaire. We analyzed data using multiple linear regression. The primary outcome measures were feeding behavior and child weight status. Parental obesity risk …

A Safety-Ii Approach To Learn From Practice Variation In The Diagnostic Process In The Emergency Department: An Action Research Study, Rick Roos, Laura Zwaan, Myrthe Maranus, Iwan A Meynaar, Vanessa J Valk, Cees Van Nieuwkoop, Gert-Jan Kamps, Hardeep Singh, Maarten O Van Aken

Faculty, Staff and Students Publications

Objectives: The focus on improving patient safety has mainly been by learning from errors and near misses (Safety-I). We applied a novel Safety-II approach to identify and learn from practice variations in the diagnostic process in the emergency department (ED), and subsequently design and implement practice changes.

Methods: In this single-center study, we used action research (cycles of micro-experiments to study and improve processes with active stakeholder involvement) in the diagnostic process. We used three subsequent observation cycles of the following six steps: observations, gathering of follow-up data, analyses, a co-creation session with involved stakeholders, sharing of best practices, and …

Revolutionizing Digital Health In Rwanda: Progress Toward Universal Health Coverage, Roméo Bananeza Mr

Journal Of Indian Physician Associates

Rwanda is an African country that is making rapid progress in all sectors, including digital health. This review explores Rwanda’s transformative journey in digital health, highlighting key achievements, ongoing challenges, community involvement, and future prospects. Rwanda’s commitment is evident in using electronic health records, telemedicine, and mobile health applications. Rwandan institutions, including Rwanda Biomedical Center, Rwanda Ministry of Health, Rwanda Health Information Exchange, Rwanda Development Board, Partners in Health, universities, and several nongovernmental organizations, have made significant contributions to revolutionize digital health in Rwanda. However, the country continues to face barriers, including limited digital infrastructure, financial constraints, and disparities in …

Assessing The Impact: Cerebral Palsy On Domains Of Quality Of Life, Sheetal Malhan

Journal Of Indian Physician Associates

Introduction Cerebral palsy (CP) is characterized by a group of permanent movement and posture disorders resulting from nonprogressive disturbances in the developing fetal or infant brain. CP is a chronic condition affecting approximately 1.2–2.5 per 1000 school-aged children, often accompanied by comorbidities such as visual, auditory, and feeding impairments, delayed language development, and epilepsy. These related challenges can markedly reduce a child’s quality of life (QoL), particularly when compounded by social and environmental limitations. Despite the importance of understanding QoL outcomes in this population, limited region-specific data exist. Understanding domain-specific QoL can guide targeted rehabilitation planning.

Methods A cross-sectional survey …

Ligand-Receptor Interactions Induce And Mediate Regulatory Functions Of Batf3+ B Cells, Hui Yan, Rui Wang, Suryavathi Viswanadhapalli, Christian Cervantes, Funan He, Shuai Wu, Azad Khosh, Weiwei Luo, Jingwei Wang, Maria J Fernandez, Uday P Pratap, Mustafa Khan, Karli Hinton, Sai Eashan Vankamamidi, Dariela Perez, Carlos E Rivera, Harshita B Gupta, Fushun Zhang, Zhenqing Ye, Yidong Chen, Xiao-Dong Li, Gangadhara R Sareddy, Hong Zan, Yue Li, Exing Wang, Evelien M Bunnik, Guangming Zhong, Christopher A Hunter, Ross M Kedl, Zhinan Yin, Booki Min, Diako Ebrahimi, Siyuan Zheng, Tyler J Curiel, Yan Xiang, Ratna K Vadlamudi, Paolo Casali, Zhenming Xu

Faculty, Staff and Student Publications

B cells express many protein ligands, yet their regulatory functions are incompletely understood. We profiled ligand expression across murine B sublineage cells, including those activated by defined receptor signals, and assessed their regulatory capacities and specificities through in silico analysis of ligand-receptor interactions. Consequently, we identified a B cell subset that expressed cytokine interleukin-27 (IL-27) and chemokine CXCL10. Through the IL-27–IL-27 receptor interaction, these IL-27/CXCL10-producing B cells targeted CD40-activated B cells in vitro and, upon induction by immunization and viral infection, optimized antibody responses and antiviral immunity in vivo. Also present in breast cancer tumors and retained there through CXCL10-CXCR3 …

Vaccine And Treatment Evaluation Units: A Historical Perspective, Robert B Belshe, David I Bernstein, Kathryn M Edwards, Sharon E Frey, Wendy A Keitel, Myron M Levine, John J Treanor, Peter F Wright

Faculty, Staff and Students Publications

On 27 February 1962, Surgeon General Luther Terry announced a new vaccine development program within the National Institute of Allergy and Infectious Diseases (NIAID). Initially, the plan had three components: (1) special laboratories and facilities for development of prototype vaccines; (2) pilot lot production facilities and preliminary vaccine trial sites; and (3) larger lot production capacity and expanded human testing. Respiratory viruses were targeted as the top priority for vaccine development. Over 5 decades, this program has evolved and expanded to include multiple academic vaccine evaluation sites within the network, now labeled as the Vaccine and Treatment Evaluation Units (VTEUs). …

A Quantitative Analysis Of Postmarketing Safety Events Of Breakthrough Medicines, Richard Judson Davis

Walden Dissertations and Doctoral Studies

Adverse events to medicines pose a risk to the public health of patients. Breakthrough therapy medicines are designed to address unmet medical needs and are often approved on an expedited timeline; however they are also criticized for lacking an adequate understanding of their risk profile at the time of approval. This study examined the relationship between the number of concomitant medicines, as well as the approved therapeutic indication, and the outcomes of reported adverse events associated with medicines approved under the breakthrough therapy designation. The conceptual framework applied in this retrospective, cross-sectional, quantitative study is the process of pharmacovigilance, which …

Dual Targeting Of Orphan Nuclear Receptors Nr4a1 And Nr4a2 For Nonhormonal Endometriosis Therapy, Wai Ning Tiffany Tsui, Yuri Park, Srijana Upadhyay, Da Mi Kim, Lei Zhang, Gus Wright, Amanuel Hailemariam, Arafat Rahman Oany, Sang Jun Han, Stephen Safe

Faculty, Staff and Students Publications

Previous studies show that orphan nuclear receptor 4A1 (NR4A1) regulates endometriotic cell growth, survival, estrogen receptor β (ERβ), mechanistic target of rapamycin signaling and fibrosis. NR4A2 is also expressed in epithelial and stromal derived endometriotic cells, and in this study the effects of 1,1-bis(3'-indolyl)-(3,5-disubstitutedphenyl)methane (DIM-3,5) dual NR4A1/nuclear receptor 4A2 (NR4A2) ligands and knockdown of NR4A1 and NR4A2 were investigated. The dual NR4A1/2 DIM-3,5 analogs inhibited previously identified proendometriotic pathways and gene products, and they also inhibited TWIST1 and multiple markers associated with epithelial-to-mesenchymal transition (EMT). The results show that both NR4A1 and NR4A2 regulate the same pathways, including endometriotic cell …

Higher Mortality Following Sars-Cov-2 Infection In Rural Versus Urban Dwellers Persists For Two Years Post-Infection, A. Jerrod Anzalone, Michael T. Vest, Makayla E. Schissel, Bradley Price, William B. Hillegass, Ronald Horswell, San Chu, Clifford J. Rosen, Lucio Miele, Susan L. Santangelo, Gordon S. Smith, Sally L. Hodder, Christopher G. Chute

School of Medicine Faculty Publications

Previous studies demonstrated higher short-term mortality among rural compared with urban residents infected with SARS-CoV-2. However, whether this difference persists remains uncertain. This retrospective cohort study analyzed two-year post-COVID-19 mortality by rurality using the National Clinical Cohort Collaborative COVID-19 Enclave, a United States-based longitudinal electronic health record repository. We analyzed mortality among patients infected with SARS-CoV-2 between April 2020 and December 2022, with follow-up until December 2024. Patients were categorized into urban, urban-adjacent rural (UAR), and nonurban-adjacent rural (NAR) groups based on residential ZIP Code. Mortality differences were assessed using Kaplan-Meier analysis and weighted multivariable Cox regression, with weights derived …

Interoperability As A Catalyst For Digital Health And Therapeutics: A Scoping Review Of Emerging Technologies And Standards (2015–2025), Kola Adegoke, Abimbola Adegoke, Deborah Dawodu, Akorede Adekoya, Ayoola Bayowa

Health & Biomedical Sciences Faculty Publications

Background: Interoperability is fundamental for advancing digital health and digital therapeutics, particularly with the integration of technologies such as artificial intelligence (AI), blockchain, and federated learning. Low- and middle-income countries (LMICs), where digital infrastructure remains fragmented, face specific challenges in implementing standardized and scalable systems. Methods: This scoping review was conducted using the Arksey and O’Malley framework, refined by Levac et al., and the Joanna Briggs Institute guidelines. Five databases (PubMed, Scopus, IEEE Xplore, ACM Digital Library, and Google Scholar) were searched for peer-reviewed English language studies published between 2015 and 2025. We identified 255 potentially eligible articles and selected …

Failure To Rescue After Surgery For Pancreatic Cancer: A Systematic Review And Narrative Synthesis Of Risk Factors And Safety Strategies, Masashi Uramatsu, Yoshikazu Fujisawa, Paul Barach, Hiroaki Osakabe, Moe Matsumoto, Yuichi Nagakawa

College of Population Health Faculty Papers

Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992-2025) identified 83 studies; after screening, 52 studies (2010-2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: …

Perceptions Of Whole Plant-Based Diets And Weight Among Hispanics In Miami, Florida, Zoraida Powell

Walden Dissertations and Doctoral Studies

Being overweight or obese poses major public health concerns and contributes to the development of chronic illnesses. While researchers have explored how a total plant-based diet impacts excess body weight or obesity, there is still a lack of clarity about how Hispanics living in Miami, FL, perceive or understand this diet concerning overweight and obesity. Using a generic qualitative approach, this study was conducted on how Hispanics in Miami, FL, understand and view a whole plant-based diet (WPBD) for preventing and reducing overweight and obesity. Through interviews with 14 diverse Hispanic participants, the study revealed that they see WPBD as …

Rurality’S Impact On Alaska Native Elders’ Levels Of Physical Activity And Obesity, Jessie Doherty

Walden Dissertations and Doctoral Studies

While there have been studies on obesity levels and physical activity levels across many populations and age groups, few studies have focused on Alaska Native Elders. The purpose of this study was to examine rurality (urban vs. rural counties), physical activity, and obesity level while controlling for sex, self-reported loneliness, and self-reported stress. The theoretical foundation for this study was based on the socio-ecological model (SEM), and the research questions in this study explored how rurality impacted obesity levels and how rurality impacted physical activity levels in Alaska Native Elders. The methodology of this study was a quantitative cross-sectional design …

Alternative And Traditional Schooling On Sexual Risk Behaviors Among Alaska Native Youth In The Lower Kuskokwim, Nathaniel Hebert

Walden Dissertations and Doctoral Studies

Alaska Native youth experience disproportionately high rates of sexual risk, yet disaggregated data and school-contextual analyses remain limited. Understanding how school type (alternative vs. traditional) and individual factors influence sexual risk among Alaska Native youth is essential for informing targeted, culturally responsive health interventions and addressing ongoing health disparities. This quantitative study aimed to examine the association between three behaviors (condom use, multiple sexual partners, and substance use) by school type, controlling for gender, grade level, body mass index, and afterschool activity. Guided by the social-ecological model, this cross-sectional study provided new insights into the relationship between school type and …

Lived Experiences Of Obese Women In Mississippi Concerning The Role Of Psychosocial Factors In The Development Of Obesity, Temitope Olabode

Walden Dissertations and Doctoral Studies

One of the highest rates of obesity in the United States is in Mississippi, where middle- aged obese women deal with a variety of social, cultural, and personal issues, including shame, discrimination, and stigma based on weight, mental anguish, cultural norms, financial limitations, and restricted access to healthcare. This study investigated the psychosocial factors that contribute to obesity in women aged 40- 60 years, and the effects of obesity on body image, self-esteem, health behaviors, and quality of life. A qualitative phenomenological study using the social ecological model (SEM) framework looked at the individual, interpersonal, and policy levels of the …

Determinant Factors Of Completeness Of Medical Resume Filling By Doctors At Pesawaran Regional General Hospital, Achmad Deza Farista, Aila Karyus, Abikusno Djamaluddin

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

A medical resume serves as a vital document that compiles essential information related to a patient’s clinical management. In 2019, the completeness rate of medical resume documentation at Pesawaran Regional General Hospital was only 37.4%. This study aimed to identify factors influencing the completeness of medical resume documentation by doctors through a quantitative, cross-sectional design involving 37 inpatient care doctors. Data were collected via questionnaires and direct observation, then analyzed using univariate, bivariate (Chi-Square), and multivariate (Logistic Regression) methods. Observation showed that 56.8% of medical resumes were incomplete. Questionnaire results indicated that 54.1% of respondents had negative perceptions of Standard …

Research On Identification And Evaluation Method Of Medical Experts' Expertise Domains In Online Health Community Based On Knowledge Graph, Yunjiang Xi, Qian Zhang, Man Li, Juan Yu

Journal of Scientific Information Research

[Purpose/significance] This study aims to identify the expertise domains of medical experts, and evaluates their domain levels to provide a basis for community expert recommendation.

[Method/process] This study utilized the improved OneRel model to structure community historical Q&A into entity relation triples. Then used the knowledge graph triples to test the consistency between the medical knowledge in the community Q&A and the domain knowledge, and finally obtained the doctor's domain levels by aggregating in each expertise domain.

[Result/conclusion] Using the data example from xywy.com website, 214 doctors in the community were ranked in terms of their average level of expertise …

Identifying Key Influencing Factors Of Elderly Health Information Search Based On Meta-Ethnography, Zhumei Sun, Zhibing Wang

Journal of Scientific Information Research

[Purpose/significance] Health information search is an important way for elderly people to actively cope with aging. Identifying the key factors affecting of their health information searching and exploring the correlation among these factors are of positive significance for promoting the elderly proactive health ability.

[Method/process] This paper firstly integrated the original research through a meta-ethnographic approach to form a set of factors influencing the elderly health information search. The DEMATEL method was then used to analyze the interrelationships among the influencing factors and identify the key influencing factors.

[Result/conclusion] The study finds that, the influencing factors of elderly health information …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

Fit For Success: Exploring Physical Activity Promotion And Effects On Students At The University Of South Carolina Through A Podcast Series, Maia Schwarzmueller

Senior Theses

College students face unique challenges when trying to maintain physical activity levels, such as time constraints, stress, and lack of proper facilities. The Fit for Success podcast will explore how physical activity is a powerful tool towards enhancing self-perception, academic success, and stress management as well as delve into the specific barriers that University of South Carolina students face to physical activity. The podcast will also explore different aspects of physical activity promotion including group fitness, competition, and built environment. The goal of the podcast is to help students to see physical activity as an important component of many facets …

The Home Visiting Referral Quality Improvement Initiative (Thrive) Change Package, Elizabeth Yakes Jimenez, Theresa Cruz, Rebecca Craig, Ivan De La Rosa

Population Health Research and Scholarship

Early childhood home visiting programs improve maternal and child health outcomes but remain underutilized. Healthcare providers are well-positioned to connect families to home visiting services; however, structural barriers in clinical settings limit consistent and effective referral practices. The Home Visiting Referral Quality Improvement Initiative (THRIVE) change package was developed to provide a starting point for addressing these challenges. The THRIVE change package outlines actionable improvement strategies to test, such as standardizing referral workflows, training clinical teams, and establishing relationships and feedback loops with home visiting programs. It offers a scalable approach to strengthening clinical–community linkages and improving family engagement with …

Venezuelan Migrants In Prostitution: A Personal Decision?, Yazmin Maria Lucila Cadena Camargo, Izara Maite Mondragon Moreno, Isabela Osorio Jaramillo, Paula Angélica Suárez Álvarez, Andrés Duarte Osorio, Carlos Gómez-Restrepo

Dignity: A Journal of Analysis of Exploitation and Violence

This paper explores the multifaceted experiences of Venezuelan migrant women engaged in prostitution, framed through three critical moments: the “decision to enter in prostitution,” the unique abuses faced, and the resultant consequences on mental, physical, and social health. The study highlights how socioeconomic vulnerabilities—exacerbated by migration and poverty—significantly influence the likelihood of entering prostitution. It also shows how traumatic experiences, particularly in childhood and adolescence, coupled with a lack of support networks, contribute to a heightened risk of exploitation. Eleven life stories were collected through a phenomenological approach, revealing a common narrative of abuse, poverty, and the search for survival …

Genetic Architecture Of Cerebral White Matter Hyperintensities In Diverse Hispanic/Latino Adults, Myriam Fornage, Rui Xia, Adriana Ordonez, Tamar Sofer, Carmen R Isasi, Richard B Lipton, Ariana M Stickel, Wassim Tarraf, Hector M Gonzalez, Charles S Decarli

Faculty, Staff and Student Publications

Background and objectives: Cerebral white matter hyperintensities (WMHs) on MRI are part of the spectrum of age-related brain vascular injury and are associated with increased risk of stroke and dementia. Genome-wide association studies (GWASs) conducted mostly in populations of European ancestry have identified several genetic loci. Although Hispanic/Latino adults have a greater burden of WMHs than their non-Hispanic White counterparts, they are vastly underrepresented in genetic studies. We sought to characterize the genetic architecture of WMHs in a Hispanic/Latino cohort by investigating the transferability of known WMH genetic loci and by leveraging Hispanic/Latino genetic diversity to map novel loci.

Methods: …