Digital Commons Network^™

Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming To Enhance Quality Of Life For Aboriginal Australian Survivors Of Stroke And Traumatic Brain Injury, Elizabeth Armstrong, Tapan Rai, Judith M. Katzenellenbogen, Sandra J. Thompson, Meaghan Mcallister, Natalie Ciccone, Deborah Hersh, Leon Flicker, Dominique A. Cadilhac, Erin Godecke, Graeme J. Hankey, Neil Drew, Colleen Hayward, Deborah Woods, Mel Robinson, Ivan Lin, Sanita Kratina, Jane White, Juli Coffin

Research outputs 2022 to 2026

Objective: To determine the effect of cultural security training (CST) for health professionals and access to an Aboriginal Brain Injury Coordinator (ABIC) for Aboriginal Australians with stroke or traumatic brain injury (TBI). Design: A stepped wedge cluster randomised controlled trial; the intervention package consisted of CST for hospital professionals and 6-month access to ABICs providing education, support, liaison and advocacy; the commencement order of the intervention phase was randomised. Setting: Four urban and four rural hospitals in Western Australia, 2018–2022. Participants: Aboriginal adults ≥ 18 years hospitalised with stroke or TBI. Main Outcome Measures: Primary outcome was quality of life …

Minimizing Travel Burden Of Gynecologic Cancer Surveillance Through A Unique Multidisciplinary Telehealth Program, Avni Shridhar, Suzanne Viator, Tara Castellano, Holly Provost, Navya Nair, Elizabeth Neupert, Amma Agyemang, Amelia Jernigan

School of Medicine Faculty Publications

OBJECTIVE: STEEL MAGNOLIAS (shared telehealth for multidisciplinary gynecologic cancer survivorship) is a novel gynecologic cancer surveillance care-delivery program in which rural patients see a close-by gynecologist in person with simultaneous virtual gynecologic oncology consultation. This study assesses feasibility of STEEL MAGNOLIAS by examining travel burden reduction, cancer outcomes, visit activities, guideline adherence, and patient satisfaction. METHODS: We retrospectively reviewed charts of patients with gynecologic cancer in remission under the STEEL MAGNOLIAS program in rural south Louisiana (March 2020-September 2023). Travel metrics, patient satisfaction, cancer outcomes, survival status, reasons for visit, and adherence to follow-up as per National Comprehensive Cancer Network …

Sleep Eeg And Respiratory Biomarkers Of Sudden Unexpected Death In Epilepsy (Sudep): A Case-Control Study, Oman Magana-Tellez, Rama Maganti, Norma J Hupp, Xi Luo, Sandhya Rani, Johnson P Hampson, Manuela Ochoa-Urrea, Sudha S Tallavajhula, Rup K Sainju, Daniel Friedman, Maromi Nei, Brian K Gehlbach, Stephan Schuele, Ronald M Harper, Beate Diehl, Lisa M Bateman, Orrin Devinsky, George B Richerson, Samden D Lhatoo, Nuria Lacuey

Faculty, Staff and Student Publications

Background: Sudden unexpected death in epilepsy (SUDEP) is the most common category of epilepsy-related mortality. Centrally mediated respiratory dysfunction has been observed to lead to death in the majority of cases of SUDEP. SUDEP also mainly occurs during nighttime sleep. This study seeks to identify sleep EEG and sleep-related respiratory biomarkers of SUDEP risk.

Methods: In this case-control study, we compared demographic, clinical, EEG, and respiratory data from people with epilepsy who later died of SUDEP (the SUDEP group) with data from age and sex-matched living people with epilepsy, classified as high risk of SUDEP (with ≥1 generalised tonic-clonic seizure …

Influence Of Institutional Support And Organisational Culture On Hiv And Ncd Integration, David Njuguna, Caroline Kyalo, Eunice Muthoni, Daniel Mwai, Elvis Kirui, Wesley Rotich, Joy Mugambi, James Waweru, Nelson Muriu, Easter Olwanda

Population Health, East Africa

Background: The integration of services for human immunodeficiency virus (HIV) and noncommunicable diseases (NCDs) has gained increasing attention in recent years because of the overlapping prevalence and shared risk factors between these health conditions. However, successful integration requires more than just the alignment of clinical practices. The role of institutional support and organisational culture in promoting effective integration remains an underexplored area.

Aim: This study aims to fill this gap by examining how institutional structures and organisational values influence the integration of HIV and NCD care.

Setting: The study setting was Nakuru County in Kenya.

Methods: …

Food Insecurity And Social Connection Of Nicaraguan Refugees And Asylum Seekers In Costa Rica: A Qualitative Study, Keren Herran

Theses and Dissertations

Background

Given the physical and mental health consequences of food insecurity, solutions should be evidence-based and seek to prioritize vulnerable populations. This qualitative study adds to limited literature on how refugees and asylum seekers use their social connections to mitigate food insecurity by investigating how Nicaraguan refugees and asylum seekers in Costa Rica foster social connections and use these connections to acquire and manage food.

Methods

In fall 2024, 35 in-depth semi-structured interviews were conducted in San José, Costa Rica. Participants were recruited through six migrant-serving nonprofit organizations. For study inclusion, participants had to: 1) be 18 or older; 2) …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

Plasma Proteome Correlations With Liver Stiffness In Pediatric Cholestasis Implicate Epithelial To Mesenchymal Transition, Benjamin L Shneider, Rupa S Kanchi, Sandra L Grimm, Sridevi Devaraj, Juliet Emamaullee, Jeremy Schraw, Philip J Lupo, Jorge A Bezerra, Kathleen M Loomes, John C Magee, Ronald J Sokol, Kasper S Wang, Alyssa Kriegmeier, Evelyn Hsu, Jean P Molleston, Philip Rosenthal, Rohit Kohli, Saul J Karpen, Simon P Horslen, M Kyle Jensen, Arianna Barbetta, Cristian Coarfa

Faculty, Staff and Students Publications

Background: Pediatric cholestatic liver diseases can be characterized by rapidly progressive fibrosis. A multicenter cross-sectional analysis of vibration-controlled elastography in biliary atresia (BA), alpha-1 antitrypsin deficiency (A1AT), and Alagille syndrome (ALGS) was leveraged to interrogate the plasma proteome relative to liver stiffness measurements (LSM).

Methods: Slow off-rate modified aptamer scanning profiling of >7000 proteins in plasma from 187 children with BA (n=93), A1AT (n=31), ALGS (n=46), and healthy pediatric controls (n=17) was performed, and correlations with LSM were undertaken.

Results: There was an abundance of LSM correlated proteins (BA n=2720, A1AT n=694, ALGS n=5968). Interestingly, a distinct plasma proteome was …

What Community Members With Chronic Illness Teach Future Healthcare Professionals In A Longitudinal Interprofessional Education Program: A Focus Group Study, Rachel White, Maria Brucato, Amber King, Anne B. Mitchell, Nethra S. Ankam

Department of Medicine Faculty Papers

INTRODUCTION: Nearly 50% of Americans have at least one chronic illness. Preparing future healthcare providers for interprofessional collaborative practice (IPCP) and person-centred care through community-based interprofessional education (IPE) can improve outcomes for this growing population. Partial programme theories predict that patients' participation as teachers in health professions education contributes to students' development of patient-centredness. Role theory asserts that behaviours are shaped by assigned roles; therefore, community members with chronic illness who assume roles of health mentors in an IPE curriculum are predicted to teach students about their patient experiences. Yet, this teaching outcome and the lessons health mentors teach in …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Implementation Fidelity Of A Smartphone Application For Population-Based General Movement Assessment: The Early Moves Study, Caroline F. Alexander, Sarah E. Hall, Alison Salt, Alicia J. Spittle, Catherine Morgan, Tiffany Grisbrook, Alishum Ali, Natasha Amery, Sue Anne Davidson, Ashleigh Thornton, Mary Sharp, Emily Young, Robert S. Ware, Desiree Silva, Roslyn Ward, Nadia Badawi, Samudragupta Bora, Roslyn N. Boyd, Susan Woolfenden, Catherine Elliott, Jane Valentine

Research outputs 2022 to 2026

Objective: To describe the infant and maternal characteristics of the Early Moves cohort and to assess representativeness to the general population, and to evaluate the implementation fidelity of an application-based collection of General Movement Assessment (GMA) videos at writhing and fidgety age. Study design: Prospective observational study. Mothers who had recently delivered or were enrolled to deliver at maternity hospitals in Perth, Western Australia, were recruited from November 2019 to December 2023. Sociodemographic and infant clinical characteristics were extracted from hospital records. Parents were invited to record GMA videos using the Baby Moves smartphone application, which were assessed for scorability …

Evaluating The Impact Of The ‘Blow, Breathe, Cough’ Health Promotion Intervention In Resolving Otitis Media With Effusion In Children: An Adaptive Randomized-Controlled Trial Protocol, Jaimee R. Rich, Michael Dymock, Elke J. Seppanen, Elena Montgomery, Tanisha Cayley, Tamara Veselinović, Greta Bernabei, Anri Lester, Amy Hannigan, Nicole Irvine, Kerryn Gidgup, Edna Ninyette, Steph Bray, Tu Trang Tran, Valerie M. Swift, Melinda Edmunds, Natalie Strobel, Daniel Mcaullay, Julie Marsh, Evelyn Tay, Lea Ann S. Kirkham, Ruth B. Thornton, Robyn S.M. Choi

Research outputs 2022 to 2026

Introduction: Otitis media with effusion (OME) affects hearing, speech development, and quality of life (QoL) in children. The ‘Blow, Breathe, Cough’ (BBC) intervention promotes nasal, respiratory, and middle ear clearance through nose blowing, deep breathing, coughing, and hand hygiene. It shows promise in resolving OME but lacks randomized-controlled trial (RCT) evaluation. This paper presents a RCT protocol evaluating BBC's effect on OME resolution, hearing, speech, and QoL in children aged two to seven years. Methods: This parallel-group, 1:1, outcome assessor-blinded, individual adaptive RCT investigates whether completing the BBC intervention plus hand hygiene twice-daily at home increases OME resolution after 4-to-6 …

Focus Group Interview: Perspectives Of Virtual Dietary Counseling Method’S Post Covid-19 Pandemic, Maria Mendoza

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): Nicole Stendell-Hollis, PhD; Tafere Belay, PhD; Katy Williams; Jessica Tyrrell

The purpose of this study is to examine the perceptions related to different delivery methods of dietary counseling. This qualitative research study will examine the perceptions related to different methods of dietary counseling (telephone calls, video calls, or face-to-face visits). Focus group one contained provider participants (N = 7), which were all RDNs and focus group two hosted patient participants (N = 6). Semi structured interviews were performed asking subjects about any personal experiences related to receiving or providing nutrition education, positive or negative, as they participated in …

Prevalence Of Diabetes Related To Acculturation, Dietary Quality, And Sedentary Lifestyle In Mexican Americans: National Health And Nutrition Examination Survey 2011 To 2018, Kivima Acevedo

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): David Gee, PhD; Kathaleen Briggs Early, PhD, RDN, CDCES; Katy Williams, MS, RDN

Objective: This study examined the prevalence of diabetes in Mexican American adults (MA-adults) and how risk factors like acculturation, dietary quality, and sedentary lifestyle contribute to the rising rates of diabetes, using the National Health and Nutrition Survey (NHANES) 2011 to 2018 data. Methods: We analyzed the NHANES data of MA-adults and Non-Hispanic White adults (NHW-adults) (n= 10670) for the association of diabetes and its risk factors (dietary habits and sedentary lifestyle) by acculturation levels. Diet quality was assessed using the Healthy Eating Index (HEI). …

Exploring Workplace Mental Health And Counseling Needs In Open University Staff: A Mixed-Methods Study, Pathanin Sangaroon, Oranuch Kanjanaprakorn, Araya Prasertchai, Worrawit Nakpan

Journal of Health Research

Background: Workplace mental health is a growing concern in higher education, especially in open and distance learning (ODL) settings, where staff face unique stressors. This study examines the mental health and counseling needs of academic and support staff at Sukhothai Thammathirat Open University (STOU), Thailand, using a biopsychosocial lens.

Methods: An explanatory sequential mixed-methods design was used. In the quantitative phase, 332 staff completed a questionnaire on mental health and biopsychosocial factors. Twelve participants then took part in interviews to explore their experiences and counseling preferences. Quantitative data were analyzed using stepwise regression, and qualitative data through thematic analysis. …

Ready For Takeoff? Exploring United States Health Care Providers’ Pretravel Consultation Priorities, Gaps, Barriers, And Opportunities, Katherine A. Reifler, Swati S. Sharma, Nicholas A. Bergren, Elizabeth D. Barnett, Lin H. Chen, Jeffery A. Goad, William B. Macleod, Laura Kogelman, Davidson H. Hamer

Pharmacy Faculty Articles and Research

Pretravel consultation by healthcare providers (HCPs) with travel medicine expertise can mitigate travel-related health risks. This analysis aimed to understand US-based HCPs' pretravel consultation educational gaps, priorities, barriers, and opportunities. An electronic survey was conducted May–June 2024, using a convenience sample of HCPs identified through the Med Learning Group and travel specialists from the International Society of Travel Medicine and American Society of Tropical Medicine and Hygiene. In total, 205 HCPs completed the survey, including physicians (50 %), nurse practitioners (19 %), nurses (12 %), pharmacists (11 %), physician associates (7 %). Most (66 %) provided pretravel consultations and only …

Strongyloides Seropositivity Among Children Utilizing A Mobile Clinic, Lynda Aririguzo, Aditi Gupta, Norma Castillo, Cassandra Duran, Eva H Clark, Ankona Banerjee, Sanghamitra Misra

Faculty, Staff and Students Publications

Experts recommend screening for or presumptively treating strongyloidiasis in foreign-born immigrant children, though prevalence is unknown. Health care providers encounter barriers to following this recommendation. We aimed to describe Strongyloides seropositivity and risk factors among pediatric patients on a mobile clinic. Participants completed a written survey and provided blood for absolute eosinophil count (AEC) and Strongyloides IgG enzyme-linked immunosorbent assay (ELISA). From October 2022 to June 2023, 206 patients participated; 201 (97.6%) were born outside the United States; 97.1% (n = 200) were Hispanic. Most (68.9%) arrived less than 1 year before study enrollment. Four (1.9%) and 3 (1.5%) had …

Cyp1b1 Mediates Cigarette Smoke-Induced Lipid Accumulation In Alveolar Type 2 Cells, Yin Zhu, Siddhika Gamare, Francesca Polverino, Caroline A Owen, Payaningal R Somanath, Xiaoyun Wang, Duo Zhang

Faculty, Staff and Students Publications

Alterations in lipid profiles have been shown in patients with chronic obstructive pulmonary disease (COPD), but the underlying molecular mechanisms remain unclear. In this study, we aimed to investigate the role of cytochrome P450 family-1 subfamily B member 1 (CYP1B1) in cigarette smoke (CS)-induced lipid accumulation in alveolar type II epithelial (AT2) cells. We observed a steady increase in CYP1B1 protein levels in AT2 cells from COPD patients. Additionally, CS exposure induced CYP1B1 expression in AT2 cells of murine lungs. In vitro, treatment with cigarette smoke extract (CSE) not only upregulated CYP1B1 expression but also triggered lipid accumulation in AT2-like …

Early-Life Exposure To Organic Chemical Pollutants As Assessed In Primary Teeth And Cardiometabolic Risk In Mexican American Children: A Pilot Study, Vidya S. Farook, Feroz Akhtar, Rector Arya, Alice Yau, Srinivas Mummidi, Juan Lopez Alvarenga, Alvaro Diaz-Badillo, Roy G. Resendez, John Blangero

Human Genetics Publications

Early-life exposure to organic chemicals (OCs) may influence childhood obesity and associated cardiometabolic risk. These conditions have been shown to disproportionately affect minority populations such as Mexican Americans (MAs). However, information on the impact of organic chemicals on cardiometabolic risk in MA children is limited. Therefore, we conducted a pilot study to assess the extent to which exposure to organic chemicals influences cardiometabolic traits (CMTs) in MA children. We recalled 25 children from a previous study and collected 25 primary teeth from them. Chemical analyses of the teeth were performed using established protocols. Target analytes included acetaminophen (APAP); 3,5,6-trichloro-2-pyridinol (TCPy), …

Native Hawaiian Culturally Appropriate Substance Use Disorders Formative Program Evaluation, Kelly J. Penn

Walden Dissertations and Doctoral Studies

Substance use disorders (SUDs) disproportionately affects Native Hawaiians, yet conventional treatments often overlook the cultural, spiritual, and relational foundations of well-being for Native Hawaiians. This gap represents a human services problem, as it perpetuates health disparities, limits recovery, and slows social change within Native Hawaiian communities. The purpose of this qualitative single case study was to identify culturally relevant components for an SUD treatment program tailored to Native Hawaiians. The research question guiding this study was, what are culturally appropriate components for a SUD program for Native Hawaiians. The Nā Pou Kihi framework grounded the exploration of Indigenous approaches to …

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans., Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers' experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …

Examining Factors Influencing Ultra- Processed Food Consumption Among Liberty University Students Aged 18 And Older, Ginika Rosemary Muomah

Masters Theses

Ultra-processed foods (UPFs) are widely consumed among college students and are linked to adverse health outcomes including obesity, poor mental health, and cardiometabolic disease. Despite their rising prevalence, limited research has examined psychosocial and behavioral factors influencing UPF intake within Christian university settings. This study investigated demographic, behavioral, and psychosocial predictors of UPF consumption among Liberty University students, guided by the Health Belief Model (HBM). A cross-sectional survey of students aged 18 and older (N = 337) was conducted. After excluding incomplete or invalid responses, 276 cases remained. The 25-item survey assessed UPF intake, HBM constructs, and demographics. Descriptive statistics …

Parental Expectations Of Pediatric Care For Children, Brenan T. Cash, Jacquelyn D. Wiersma-Mosley, Donia Timby, Laura Herold

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Access to childhood pediatrics is a major factor for a full and healthy childhood for all children from adolescence to adulthood. However, the physical health aspect has been the main focus of most primary care clinics, and there is little focus on mental health. Mental health issues, which involve anxiety, depression, and post-traumatic stress, are more prominent than they have ever been, as up to 30% of children have experienced mental health issues that involve post-traumatic stress disorder, especially during the pandemic years. This study employed a non-experimental, quantitative analysis utilizing online closed-ended survey questions. Caretakers were offered an anonymous, …

Covid-19 Infection Prevention And Control Guidelines Of Philippine Physical Therapy Association (Ppta) And Rehabilitation Department Of Select Hospitals In The Philippines: Impact On Infection Trend, Ghiester Marc T. Estrellado, Venize Edanne F. Montecillo, Cristina Faye C. Panopio, Alexandra Marie V. Amistoso, Raymond M. Tosoc

Philippine Journal of Physical Therapy

Introduction: There is a paucity of evidence supporting the need for setting up hospital COVID-19 infection prevention and control (IPC) guidelines for Physical Therapists (PTs) that meet global standards. This study aimed to determine the consistency of IPC guidelines among different rehabilitation departments of hospitals within Region IV-A and the Philippine Physical Therapy Association’s (PPTA) recommendations with the World Health Organization’s (WHO) IPC guidance document. It also compared the hospitals’ consistency scores with the trend of infected PTs per month.

Methods: In this descriptive cross-sectional survey, an online checklist was developed and validated to examine the consistency of the IPC …

Lung Nr3c1+ And Cxcr6high T Cells Distinguish Immunopathogenesis Of Human Emphysema, Yun Zhang, Maor Sauler, David B Corry, Scott A Ochsner, Sarah Perusich, Li-Zhen Song, Joshua Malo, Raul San Jose Estepar, Francesca Polverino, Farrah Kheradmand

Faculty, Staff and Students Publications

There is a significant knowledge gap in how T cells promote emphysema in smokers with chronic obstructive pulmonary disease (COPD). Single-cell RNA sequencing (scRNA seq) analysis of human samples and relevant clinical data can provide new mechanistic insights into disease pathogenesis. We generated a human lung scRNA seq dataset with extensive disease characteristic annotation and analyzed a second independent scRNA seq dataset to examine the pathophysiological role of T cells in emphysema. Comparisons of pulmonary immune landscapes in emphysematous (E)-COPD, non-emphysematous (NE)-COPD, and control showed positive enrichment of T cells in E-COPD. Pathway analyses identified upregulated inflammatory states in CD4 …

Medical Guidelines For Fibrodysplasia Ossificans Progressiva, Frederick S. Kaplan, Mona Al Mukaddam, Genevieve Baujat, Alberto Hidalgo Bravo, Matthew Brown, Amanda Cali, Tae-Joon Cho, Corrie Crowe, Carmen L. De Cunto, Patricia L. R. Delai, Robert J. Diecidue, Elisabeth Marelise W Eekhoff, Lisa Friedlander, Clive S. Friedman, Zvi Grunwald, Nobuhiko Haga, Edward C. Hsiao, Richard Keen, Joseph A. Kitterman, Charles Levy, Vrisha Madhuri, Rolf Morhart, J. Coen Netelenbos, Christiaan Scott, Eileen M. Shore, Michael Zasloff, Keqin Zhang, Robert J. Pignolo

Department of Oral and Maxillofacial Surgery Faculty Papers

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic condition characterized by congenital malformations of the great toes and progressive heterotopic ossification (HO) in specific anatomic patterns. Present management summarized here is focused on early diagnosis, assiduous avoidance of injury and iatrogenic harm, symptomatic amelioration of painful flare-ups, and optimization of residual function. Twenty-one members of the International Clinical Council on FOP (ICC) and seven consultants from 15 countries, chosen for their clinical expertise in FOP, developed this summary statement. Further advances in therapeutics will be based on rigorous clinical trials to assess novel and emerging treatment and prevention strategies. A …

Allosteric Control Overcomes Steric Limitations For Neutralizing Antibodies Targeting Conserved Binding Epitopes Of The Sars-Cov-2 Spike Protein: Exploring The Intersection Of Binding, Allostery, And Immune Escape With A Multimodal Computational Approach, Mohammed Alshahrani, Vedant Parikh, Brandon Foley, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

Understanding the atomistic basis of multi-layer mechanisms employed by broadly reactive neutralizing antibodies of the SARS-CoV-2 spike protein without directly blocking receptor engagement remains an important challenge in coronavirus immunology. Class 4 antibodies represent an intriguing case: they target a deeply conserved, cryptic epitope on the receptor-binding domain yet exhibit variable neutralization potency across subgroups F1 (CR3022, EY6A, COVA1-16), F2 (DH1047), and F3 (S2X259). The molecular basis for this variability is not fully understood. Here, we employed a multi-modal computational approach integrating atomistic and coarse-grained molecular dynamics simulations, binding free energy calculations, mutational scanning, and dynamic network analysis to elucidate …

Experiences With Social Media Social Comparison In Women Ages 18-28: A Qualitative Study, Olivia Oakley Dr.

Dissertations

This qualitative study aimed to understand young women’s experience using social media and their reported mental health connections, such as self-esteem and comparison. As inferred in recent research, a wide range of social media content is being produced and consumed, from promoting the “thin ideal” to newer campaigns advocating for body positivity (Cohen et al., 2019, Grabe et al., 2008; Groesz et al., 2002). In a time where there is so much online content to consume, it is important to continue to evaluate the lived experiences of those using social media. This phenomenological qualitative research captured the lived experiences of …

Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld

Faculty Publications

Background Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

Objectives This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

Design We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Setting Antenatal care clinics in Dar es Salaam, Tanzania.

Participants Pregnant WLHIV and their offspring.

Interventions Daily 3000 IU …

Investigation Of The Optimal Length Of Discharge Summaries In Care Transitions: A Cross-Sectional Study, Taku Harada, Shintaro Kosaka, Aki Morishima, Seitaro Iguchi

Journal of Community Hospital Internal Medicine Perspectives

Introduction

Discharge summaries are essential documents that support continuity of care during patient transitions between inpatient and outpatient settings. They help ensure that crucial clinical information is conveyed accurately and completely. However, while their clinical significance is well established, there is little consensus on the optimal format, particularly in terms of length and structural clarity. Excessively brief summaries may omit key details, while overly lengthy ones can hinder efficient information transfer. Despite varied suggestions in the literature—ranging from half a page to four pages—empirical data on physician preferences are limited.

Methods

We conducted a cross-sectional, web-based survey among physicians who …

Barriers And Timely Postoperative Radiation Therapy In Head And Neck Cancer, Megan T Nguyen, Emily Kistner-Griffin, Reid Demass, Bhisham S Chera, Chanita Hughes Halbert, Katherine R Sterba, Elizabeth G Hill, Brian Nussenbaum, Anthony J Alberg, Vlad C Sandulache, David J Hernandez, Ryan S Jackson, Sidharth V Puram, Russel Kahmke, Nosayaba Osazuwa-Peters, Gail Jackson, Sue S Yom, Evan M Graboyes

Faculty, Staff and Students Publications

Importance: Initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is associated with improved outcomes among patients with head and neck squamous cell carcinoma. However, the relationship of barriers to care with timely PORT is unknown.

Objective: To categorize barriers to timely PORT, evaluate the association of barriers to care with initiation of timely PORT, and describe the primary reason for delay among patients without timely PORT.

Design, setting, and participants: This prospective cohort study at a US academic medical center included adults with head and neck squamous cell carcinoma undergoing curative-intent surgery with an indication for PORT. …