Digital Commons Network^™

Depression Due To Combined Dexamethasone And Cyproheptadine Abuse For Weight Gain, Sanjana Sateesh, Jatin Kumar, Dhananjay Ardawatia, Kishor M, Shashidhara Kc, Srikanth Ms

Digital Journal of Clinical Medicine

Cyproheptadine, an H1 antihistamine, and Dexamethasone, a long-acting steroid, are often misused in combination for addressing self-perceived body image issues and have become a popular but dangerous ‘weight gain cocktail’, often available over the counter without any prescription. This case describes a 25-year-old man who had self-prescribed the above-mentioned drugs in combination to address his self-perceived lean physique. This resulted in a significant weight gain, followed by an abnormal increase in appetite, which affected his daily life. Upon cessation, it resulted in rebound weight changes, depressive features, along with features of corticosteroid withdrawal, which required multidisciplinary management.

This case highlights …

Shifts In Antipsychotic Prescribing By Clinician Type For Medicare Part D Beneficiaries, 2013-2023, Youngran Kim, Xuan Zhou, Shilei Du, Trudy M Krause, Rafael Samper-Ternent, Antonio L Teixeira

Faculty, Staff and Student Publications

Importance: Despite safety warnings, antipsychotics remain commonly prescribed to older adults, particularly those with dementia, and for off-label indications. However, little is known about how prescribing patterns vary by clinician type over time.

Objective: To examine trends in antipsychotic prescribing by clinician type among Medicare beneficiaries from 2013 to 2023.

Design, setting, and participants: This repeated cross-sectional study used the Medicare Part D Prescribers by Provider and Drug dataset from 2013 to 2023. Participants included Medicare beneficiaries enrolled in Medicare Part D. Analyses were performed between November 2024 and June 2025.

Exposure: Prescribing clinician type, categorized as psychiatrist, primary care …

Apoe And Plasma Ad Biomarkers: The Role Of Genetic Ancestry In Hispanics/Latinos, Caitlin Cheung, Natasha Z Anita, Paola Filigrana, Myriam Fornage, Kevin A Gonzalez, Linda C Gallo, Carmen R Isasi, Robert C Kaplan, Xihao Li, Freddie Márquez, Humberto Parada, Krista M Perreira, Alberto R Ramos, Tatjana Rundek, Wassim Tarraf, Fernando D Testai, Charles Decarli, Hector M González, Tamar Sofer

Faculty, Staff and Student Publications

Background: Apolipoprotein E (APOE) alleles are well-established genetic risk factors for Alzheimer's disease (AD), but their effects on AD biomarkers (amyloid beta [Aβ]42/40, phosphorylated tau [p-tau]181, neurofilament light chain [NfL], and glial fibrillary acidic protein [GFAP]) may vary across populations due to ancestry-, age-, and sex-related differences. We hypothesized that these effects vary across Hispanic/Latino background groups with distinct ancestral admixture.

Methods: We analyzed ε2 and ε4 allele associations with AD biomarkers using survey-weighted linear regression models, adjusting for demographic covariates. Secondary analyses examined genetic analysis group- and ancestry-specific effects.

Results: ε4 was associated with lower Aβ42/40 and higher p-tau181and …

Does Genetic Testing Influence Outcomes: Early Experience In Melanoma Case Series, Ryan Reyes, George Skenteris, Stella Coker Watson Self Ph.D., Ms, Christine Marie-Gilligan Schammel, Steven D. Trocha

Faculty Publications

Background:

The treatment and prognosis of melanoma have historically been based on histologic stage and Breslow depth; however, due to the increase in surveillance, melanomas are being identified at an earlier stage and lower Breslow depth. Advances in genetic testing, such as Decision Dx®, mean that melanoma diagnostic decisions and prognosis can now be directed by genetics. The purpose of this project was to assess the influence of a Decision Dx® high-grade (Class 2A/B) classification on the treatment of melanoma patients at a regional medical center, particularly those not deemed high risk by conventional classification methods, including Breslow depth and …

Morphea With Seronegative Inflammatory Arthritis And Normal Acute Phase Reactants: A Case Report, Balakrishnan Navaneethakrishnan, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Localised scleroderma, also known as morphea, is an immune-mediated fibrosing disorder that primarily affects the skin and subcutaneous tissues. While traditionally considered purely a cutaneous disease, extracutaneous manifestations (especially inflammatory arthritis) are increasingly being appreciated. The combined presence of morphea and inflammatory arthritis is rare and can be difficult to diagnose, particularly when inflammatory markers and serological testing are non-contributory.

Case Summary : We describe a 41-year-old woman with long-standing biopsy-proven morphea who over 2 years developed chronic, asymmetric inflammatory arthritis of the left wrist and hand small joints. On examination, she had active synovitis with restricted movements of her …

Pseudo-Hallucinations: A Diagnostic Conundrum, Dr Sankram Nayak, Manju Aswath, Vathsalya S. Gowda

Digital Journal of Clinical Medicine

Background:

Pseudohallucinations are vivid, hallucination-like experiences that are internal, recognized as unreal. Distinguishing from true hallucinations remains a diagnostic challenge.

Case-report

33-year-old female with family history of psychosis presented with 10-year duration of delusion of infidelity and auditory experiences, with normal Biopsychosocial functioning. She had multiple psychiatric consultations, diagnosed as paranoid schizophrenia, treated with  various antipsychotics, ECT, current prescription of clozapine(350mg) with clozapine induced seizure.  Reported that her husband was emotionally unavailable. She described the voices in her head which were non-threatening, praising her for having qualities of an ideal-wife.  They were constant companions giving her solace and hence refrained …

Early Behavioral And Cognitive Changes In Patients With Pathologically Confirmed Alzheimer Disease, Lewy Body Dementia, And Mixed Dementia, Ming Wang, Hongke Wu, Aaron Bonner-Jackson, Yiming Chen, Wen Tang, Hao Feng, Lijun Zhang, Chixiang Chen, James B Leverenz, Jagan A Pillai

Faculty, Staff and Student Publications

Background and objectives: Alzheimer's disease pathology (ADP) and Lewy body pathology (LBP) are traditionally associated with distinct cognitive profiles. However, growing evidence highlights the role of behavioral and psychological symptoms of dementia (BPSD) in shaping clinical presentations. The combined influence of cognitive and behavioral symptoms across neuropathologically confirmed ADP, LBP, and mixed AD-LBP has not been systematically examined. This study aimed to identify clinically meaningful subtypes by jointly analyzing cognitive performance and BPSD profiles in individuals with autopsy-confirmed dementia pathology.

Methods: This retrospective longitudinal cohort study used data from the National Alzheimer Coordinating Center (NACC), collected across multiple U.S. Alzheimer's …

Implementation And Acceptability Of A Community Based Intervention For Cervical Cancer Screening Amongst Women Of Reproductive Age In Kiambu County, Kenya, Redempta Mutisya, Eliphas Gitonga, Molly Maundu, Rosebella Iseme

Population Health, East Africa

Objective In Kenya, cervical cancer is the top cause of cancer deaths and second most prevalent cancer among women aged 15–44. Despite the existence of screening programs, only 13.8% of women participate, with nearly 50% diagnosed late. Lack of knowledge and embarrassment is linked to low uptake. Post-intervention, uptake of screening and acceptability of SMS prompts and self-sampling were evaluated.

Methods Women (18+ years), who had never screened, were randomly chosen from a pre-existing database. They received either usual care (notification of availability of screening services at public health facility), text education, or interactive in-person sessions with self-sample training.

Results …

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

The Role Of Top-Down Appetite Self-Regulation In The Development Of Healthy Eating Behaviors Among Children: A Narrative Review And Socialization Framework, David J Bridgett, Sheryl O Hughes, Matthew Broussard, Daniela Mccourt, Christina M Croce, Jennifer O Fisher

Faculty, Staff and Students Publications

Appetite self-regulation (ASR) among children is thought to have a fundamental role in shaping the development of healthy eating behaviors, dietary intake, and growth during childhood. Parallel to developmental frameworks for understanding "general" self-regulation among children, ASR has been described as involving children's use of "top-down" cognitive processes to moderate "bottom-up" biological drives around food approach and avoidance in the interest of achieving desired eating behaviors or outcomes. Whereas bottom-up ASR processes during early childhood are well characterized, particularly in the context of dysregulation and obesity risk, the role of top-down ASR processes in the development of healthy eating behaviors …

Exploring The Attributes Of Varied Interventions To Reduce Firearm Violence Among Youth And Emerging Adults: A Systematic Review, Vickie Blakely Reed, Lashanda D. Brumfield, Maaz Ali, Traci Hayes

Journal of Public Health in the Deep South

The death rate among children and adolescents, 14-26 years old, from firearms has increased 46% from 2019 to 2021. Among this demographic population, Black and Latino youth account for most firearm deaths. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used in conducting this study. Studies from January 2020 to October 2025 were identified through a search of PubMed, Web of Science, and ProQuest databases. Searches for the review included but were not limited to terms and phrases such as “gun violence prevention interventions for youth” and “firearm violence prevention interventions.” The purpose of this systematic …

School Climate As Primary Prevention: Mental Health And Violence Outcomes Among Lgbtq+ Youth In The U.S. South (2015–2024), Latarsha H. Michael, Brieah D. Hudson, Kenya T. Horne

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Violence And Abuse Against Adult Stroke Survivors In The Deep South: Epidemiology, Risk, And Public Health Responses, Dawn S. Mclendon, Shaneka S. Patterson, Shreyas Gangadhara

Journal of Public Health in the Deep South

Adults living with neurologic disability, particularly stroke survivors, face disproportionately high rates of violence and abuse. This vulnerability is amplified in the Deep South due to elevated stroke burden, structural disadvantage, and persistent community-level disparities in both violence and health care access. We conducted a narrative review of peer-reviewed literature indexed in PubMed, along with relevant surveillance and policy reports, to synthesize current evidence on the burden, patterns, risk factors, and prevention opportunities related to violence among adult stroke survivors. The review focused on elder mistreatment, intimate partner violence, sexual violence, caregiver abuse and neglect, and financial exploitation. Findings indicate …

Socioeconomic Factors Affecting Length Of Hospital Stay And Discharge Disposition Among Male And Female Gunshot Injury Patients In Jackson, Mississippi., Okechukwu Erinne, Deanna Howington, Sarah Mcgraw, Jonathan B. Lowrie, Matthew Kutcher, Alyscia Severance, Masoumeh Karimi, Leila Seidfaraji, Lei Zhang

Journal of Public Health in the Deep South

Background: Gun violence remains a public health concern in the United States, with Jackson, Mississippi, ranking among the highest in gun violence rates. Understanding how sociodemographic factors influence clinical outcomes is essential for improving care delivery and resource allocation. 

Purpose: This study examined the association between age, education, employment, and insurance status with hospital length of stay (HLOS) and discharge disposition among adult male and female firearm injury patients residing in Jackson, Mississippi.

Methods: Data were obtained from the electronic health records of adults (≥ 18 years) presenting to the University of Mississippi Medical Center emergency department …

A Secondary Analysis Of Mississippi Domestic Violence Trends From 2019 To September 2025 Based On The Trace Atlas Of Gun Violence Archives, Lashanda D. Brumfield, Bernice Akinwande, Vickie Blakely Reed, Traci Hayes, Tanya Funchess

Journal of Public Health in the Deep South

Abstract

Background: Domestic violence remains one of the most heartbreaking yet overlooked public health challenges across the Deep South. Prevention programs and effective policies addressing domestic violence issues must be driven by translatable, applicable, and reliable data in order to see outcome-driven results. Purpose: The objective was to identify temporal, regional, and city-level patterns in the frequency and severity of domestic violence gun incidents. Methods: This study presents a secondary analysis of domestic violence gun incidents in Mississippi from January 2019 to September 2025. To examine geographic distribution, incidents were aggregated at the regional level: Central, Northeast, Northwest, Southwest, …

Community-Guided Adaptation Of Violence Prevention Strategies: Insights From The Mississippi Violence Injury Prevention (Ms-Vip) Program, Erin Dehon, Masoumeh Karimi, Leila Seidfaraji, Michelle Brassfield, Melinda Todd, Rukia Lumumba, Matthew Kutcher, Matthew Morris, Fredrick Womack, Roy Hart, Lei Zhang

Journal of Public Health in the Deep South

No abstract provided.

Training Mississippi Providers To Address Intimate Partner Violence In Maternal Care: Pilot Outcomes From The Simm Initiative, Xiaoshan Z. Gordy, Catherine Poehling, Saijun Zhang, Chinedu Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

No abstract provided.

Bridging Ipv And Sud For Pregnant And Postpartum Women: A Case Report Of Interdisciplinary Programming In Mississippi, Catherine Poehling, Masoumeh Karimi, Chinedu Chukwu, Jerome R. Kolbo, Xiaoshan Gordy, Saijun Zhang, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsanee Davis, Sonja Fuqua, Mary M. Wesley, Lei Zhang

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Gun Violence And Maternal Mortality In The Mississippi Delta: A Dual Public Health Crisis, Nelson Atehortua, Mary Shaw-Ridley

Journal of Public Health in the Deep South

No abstract provided.

The Mississippi Violence Injury Prevention Program (Ms-Vip): Building A Community-Driven Model For Healing And Safety, Rukia Lumumba

Journal of Public Health in the Deep South

No abstract provided.

Achieving And Sustaining Treatment Targets In Rheumatoid Arthritis: A Retrospective Cohort Analysis In Indonesia, Fara Fauzia, Rudy Hidayat, Suryo Anggoro Kusumo Wibowo, Sumariyono Sumariyono, Faisal Parlindungan, Anna Ariane, Johanda Damanik, Abirianty Priandani Araminta, Suci Damaratri

Kesmas

Achieving and sustaining low disease activity (LDA) and remission in rheumatoid arthritis (RA) remains challenging. This study examined the rates and predictors of LDA/remission and sustained LDA/remission in an Indonesian RA cohort. A retrospective study of newly diagnosed adult patients attending a rheumatology clinic in 2020-2021 was conducted. Patients were followed for 12 months to evaluate achievement of LDA/remission, defined as DAS28-ESR ≤3.2, and those meeting the target were observed for an additional 12 months to evaluate sustained LDA/remission. Cox regression was used to identify predictors of time to LDA/remission and loss of LDA/remission. Of 166 participants, 91 (54.8%) achieved …

Factors Associated With Antiretroviral Therapy Adherence In Patients With Hiv At A Public Hospital In Central Jakarta, Indonesia, Kareena Sari Fatimah, Laily Hanifah, Chandrayani Simanjorang, Nayla Kamilia Fithri

Kesmas

Patients with human immunodeficiency virus (HIV) are required to take antiretroviral therapy (ART) to suppress the virus. However, suboptimal adherence remains a critical barrier that can lead to treatment failure and persistent transmission risks. This study aimed to identify factors associated with ART adherence in patients with HIV. This quantitative study with a cross-sectional design consisted of patients with HIV aged >18 years who received care at the voluntary counseling and testing clinic of a public hospital in Jakarta, Indonesia. Purposive sampling was used. This study used HIV care and ART overview forms as instruments. Data were analyzed using multiple …

Navigating (M)Otherhood: Perception, Practice, & Policy Of Adolescent Pregnancy In The North Coast Of Perú, Mahir Rahman

USF Tampa Graduate Theses and Dissertations

“It’s a vicious circle”, the obstetricians of Huanchaco repeated time and time again after discussing a recently pregnant 13-year-old girl who had just moved to the North Coast of Perú. Adolescent pregnancy is an extremely stigmatized topic in global maternal and child health discourse. Pregnant adolescents are subject to educational policy, clinical protocol, and community practice. While global scholarship emphasizes adolescent pregnancy prevention, limited scholarship focuses on the conditions in which adolescent pregnancy is perceived, discussed, and managed. More importantly, these perspectives are even less documented amongst the North Coast of Perú.

This thesis serves as an ethnographic exploration of …

Social Support And Mental Toughness As Predictors Of Perceived Stress Among College Kinesiology Students, Jianmin Guan, Wan Xiang Yao, Xiaofen D. Hamilton, Gaofeng Lu

International Journal of Physical Activity and Health

Drawing on Lazarus and Folkman’s transactional theory of stress and coping, this study examined the associations of age, gender, three types of social support (family, friends, and significant others), and mental toughness with two dimensions of perceived stress (helplessness and coping inefficacy) among 666 college students majoring in Kinesiology. Hierarchical multiple regression analysis revealed that male college students, as well as those with higher levels of mental toughness and family support, reported significantly lower levels of helplessness and coping inefficacy in managing stress. Additionally, greater support from friends was significantly associated with lower levels of coping inefficacy, while younger students …

Gender Differences In College Students’ Physical Activity Self-Efficacy, Social Comparison Beliefs, And External Frames Of Reference, Ken Murfay, Sarah Pyszczynski, Sarah Collins

International Journal of Physical Activity and Health

This study examined whom college-aged individuals believe observing would more likely increase their physical activity self-efficacy (PASE) for a physical skill, whom they are more likely to compare their abilities to within a physical education (PE) class, how often they compare themselves to others in PE, and what students’ PASE scores were. Based on the mean scores for each question, students were more likely to compare themselves to a student than a teacher, friend than a non-friend, and similar or higher skilled peer than a lower skilled peer. To increase students’ confidence for a physical skill, students had higher levels …

Association Between Children’S Secondhand Co-Exposure To Tobacco And Cannabis Smoke And Elevated Urinary Cotinine Levels: A Cross-Sectional Analysis, Bradley N. Collins, Stephen J. Lepore, Vincent Berardi, Renee D. Goodwin, Karen Wilson, Mona Baishya

Psychology Faculty Articles and Research

Background Cannabis use is far more common among adults who smoke tobacco than adults who do not, and its use is increasing among people who smoke tobacco with children living in the home. Given the well-established evidence that caregiver smoking is the primary source of children’s secondhand exposures to these products, the increasing trend in caregiver co-use is raising public health concerns about children’s co-exposure. Emerging data indicates that adult co-use is linked to additive health consequences, such as elevated nicotine and other tobacco-related toxicant blood levels, relative to use of only tobacco. It is unknown whether children’s co-exposure leads …

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …

The Relationship Between Social Determinants And Primary Care Utilization Among Medicaid Recipients In A Managed Care Community Health Worker Program, Rachel Elaine Rosensteel

Walden Dissertations and Doctoral Studies

Community health worker (CHW) programs are an increasingly important strategy for addressing social determinants of health (SDOH) within Medicaid systems. However, evidence on how specific SDOH impact healthcare utilization remains limited. In this quantitative, correlational study, the relationship between SDOH factors like housing instability, food insecurity, and transportation barriers, and primary care utilization among adult Medicaid recipients aged 18–65 who participated in a Medicaid managed care organization’s CHW program in Clark County, Nevada, during 2023 were examined. Retrospective administrative data from 441 participants were analyzed using negative binomial regression to assess associations between SDOH factors and postintervention primary care visits …

Perceptions Of Healthcare Access Barriers Among Eritrean, Sudanese, And Somali Refugees And Asylum Seekers In Cairo., Ayan Musa Mohamed

Theses and Dissertations

As the world witnesses an increase in different displacements of individuals for various reasons, ranging from wars, civil conflicts, human rights violations, and natural disasters, refugees and asylum seekers, who are among those forcibly displaced, continue to face challenges in access to health care services in host countries. The topic of barriers to health care has been widely researched, with a large body of literature on refugees' interactions with health care systems. However, there is limited literature on the perceptions of Eritrean, Sudanese, and Somali refugees and asylum seekers' experience with healthcare access in host countries. Therefore, this thesis aims …

Facebook Interaction As A Potential Marker Of Cognitive Decline: Pilot Study, Esraa M. Qansuwa

Theses and Dissertations

One of the critical challenges in brain disorder research is the early identification of individuals with mild cognitive impairment (MCI) who may later develop Alzheimer’s disease (AD) or other dementias. MCI in older adults is frequently associated with diminished social engagement and observable behavioral changes. With the rapid expansion of social media platforms and advances in Machine Learning (ML), digital traces from online activity present a novel and scalable avenue for mental health screening. In particular, predictive ML approaches have demonstrated strong potential in building reliable classifiers for early detection of neurocognitive decline. This study introduces an innovative framework that …