Digital Commons Network^™

Perceived Risks, Reasons For Use, And Barriers To Cessation Among Youth Who Use Multiple Tobacco Products, Sierra L. Patterson, Isabellle Duguid, Sonia A. Clark, Seth M. Noar, Allison J. Lazard, Jim F. Thrasher Ph.D., Ma, Ms, Adam O. Goldstein, Sarah D. Kowitt

Faculty Publications

Background

Many interventions aim to reduce youth tobacco use, but few have focused on youth who use multiple tobacco products (MTPs). This qualitative study sought to understand how youth who use MTPs view tobacco product risks, describe reasons for MTP use, and perceive barriers and facilitators to cessation.

Methods

We conducted seven virtual focus groups with 30 US youth ages 14–20 years who reported using e-cigarettes and smoking a combustible tobacco product in the past 30 days. We used a semi-structured focus group guide to ask youth about perceived health risks of tobacco products, reasons for MTP use, and thoughts …

Finding Solutions: Meeting Essential Needs To Overcome Health And Educational Inequities Among College Students, Nicholas Freudenberg, Rashida Crutchfield

Publications and Research

Many economic, academic, and social factors influence college completion, and scholars have documented that a significant cause of students leaving school before graduation is that many do not have their basic needs for food, housing, and health care met. These barriers undermine their academic success by forcing students to reduce the time spent on their studies, work more hours, or stop out of school to support themselves or their families. Unmet essential needs jeopardize academic and life success for students in higher education across the United States and widen racial/ethnic and class inequities in college completion and health. Our review …

The Association Between Physical Activity, Sedentary Time, And Sleep With Risk Of Hepatocellular Carcinoma In Patients With Cirrhosis, Samuel Ma, Yossef Alsabawi, Fasiha Kanwal, Hao Duong, Laith Elserag, Amit G. Singal, Nicole E. Rich, Saira Khaderi, Sumeet K. Asrani, Hashem B. El-Serag, Aaron P. Thrift

School of Medicine Publications

Background: The majority of hepatocellular carcinoma (HCC) cases arise in patients with cirrhosis, with known major risk factors of hepatitis B (HBV) or C (HCV) infection, metabolic dysfunction-associated steatotic liver disease (MASLD), and alcohol-associated liver disease (ALD). However, the impact of additional risk factors that act independently or jointly on the pathogenesis of HCC in cirrhosis patients is unknown. The aim of this study was to determine whether sleep, sedentariness, or physical activity levels play a role in the progression of cirrhosis to HCC.

Methods: We systematically collected data on sleep, sedentary time, and physical activity from the ongoing prospective …

Standardizing And Scaffolding Health Care Ai-Chatbot Evaluation: Systematic Review., Yining Hua, Winna Xia, David Bates, George Hartstein, Hyungjin Tom Kim, Michael Li, Benjamin Nelson, Charles Stromeyer Iv, Darlene King, Jina Suh, Li Zhou, John Torous

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Health care chatbots are rapidly proliferating, while generative artificial intelligence (AI) outpaces existing evaluation standards.

OBJECTIVE: We aimed to develop a structured, stakeholder-informed framework to standardize evaluation of health care chatbots.

METHODS: PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses)-guided searches across multiple databases identified 266 records; 152 were screened, 21 full texts were assessed, and 11 frameworks were included. We extracted 356 questions (refined to 271 by deduplication and relevance review), mapped items to Coalition for Health AI constructs, and organized them with iterative input from clinicians, patients, developers, epidemiologists, and policymakers.

RESULTS: We developed the Health …

Pathways And Challenges In The Clinical Translational Of Radiopharmaceuticals For Pediatric Investigations, Erik Stauff, Hanieh Karimi, Heidi H. Kecskemethy, Thomas H. Shaffer, Reza Vali, Lauren W. Averill, Xuyi Yue

Department of Radiology Faculty Papers

Radiopharmaceutical development and clinical translation face numerous scientific, ethical, and regulatory challenges, particularly within the pediatric population. Although molecular imaging holds significant promise for improving diagnosis and treatment across a spectrum of diseases, including pediatric-specific conditions like Kawasaki disease, autism spectrum disorders, attention-deficit/hyperactivity disorder, and neuroblastoma, the path from discovery to clinical application remains problematic. The U.S. Food and Drug Administration (FDA) provides three primary pathways-traditional Investigational New Drug (IND) applications, exploratory Investigational New Drug application (eIND), and the Radioactive Drug Research Committee (RDRC) mechanism-to facilitate clinical translation of radiotracers. However, these frameworks are not specifically tailored to pediatric needs. …

Applying The One Health Approach To Study The Policy And Institutional Determinants To Control And Prevent Zoonoses In A Low-Resource Setting, Lisset Dumet, Erin S. Kenzie, Veronika Merino, Vanessa Cruz, Ruth Atto, Percy Vilchez, Seth O'Neal, Julia Goodman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Zoonoses - diseases transmitted between animals and people - disproportionally affect low-resource countries (LRCs). The complex nature of zoonoses adds substantial barriers to implementing multisectoral policies to address them. Research on the policy process could help illuminate the significant factors influencing policy change among the complex systems involved in managing zoonoses. We applied the One Health (OH) approach to describe the policy process among the systems involved in preventing and controlling zoonoses in Peru. The study's purpose is to (1) describe the priority-making process and the driving or limiting factors, (2) describe the process for selecting policy solutions and (3) …

Use Of An Expert Panel For Symptomatic Patients With Grade I Degenerative Lumbar Spondylolisthesis: A Randomized Clinical Trial, Zoher Ghogawala, Tasneem Rizvi, Zhibang Lin, Adam Kanter, Praveen Mummaneni, Erica Bisson, Todd Albert, Daniel Resnick, Michael Wang, Steven Glassman, David Polly, Mohamad Bydon, Subu Magge, Luis Tumialan, Michael Fehlings, Michael Steinmetz, Robert Whitmore, Vedantam Rajshekhar, James Harrop, Roger Härtl, Elnasri Ahmed, Dom Coric, Paul Mccormick, Richard Assaker, Abdul Msaddi, Langston Holly, Yoshiharu Kawaguchi, Asdrubal Falavigna, Fred Barker, Edward Benzel

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: The appropriate utilization of lumbar fusion when performing laminectomy for lumbar spondylolisthesis is uncertain. The objective was to determine whether the use of a surgical expert review panel recommending fusion might improve patient selection, possibly reducing surgical failures.

METHODS: Randomized clinical trial of patients with symptomatic degenerative lumbar stenosis with spondylolisthesis enrolled from 14 North American hospitals was conducted with patients randomized to receive an expert panel review of their case or not. Spinal expert review consisted of 10 to 15 surgeons' review of patient images and clinical data with voting on the appropriateness of fusion. Primary …

The Barriers And Facilitators Of Maternal Influenza Vaccination, Rashida Karida Jones

USF Tampa Graduate Theses and Dissertations

Influenza remains a leading cause of morbidity and mortality in the United States, with Black individuals disproportionately affected. Pregnant women are particularly vulnerable due to their modulated immune state, placing them at increased risk of complications, hospitalization, and intensive care admission. Despite strong evidence supporting the safety and efficacy of maternal seasonal influenza vaccination (SIV), uptake remains suboptimal. This study employed a multi-method design to identify barriers and facilitators of maternal SIV uptake, with a particular focus on racial disparities.

Quantitative analyses utilized the Florida Pregnancy Risk Assessment Monitoring System (FL PRAMS) dataset from the years 2018–2022. In the fully …

Circulating Levels Of Insulin-Like Growth Factor I (Igf-I) And Risk Ofmultiple Myeloma: An Observational And Mendelian Randomisation Study, Yolanda Benavente, Sara Hermosa, Nikos Papadimitriou, Alyssa I. Clay-Gilmour Ph.D., Elizabeth E. Brown, Jonathan N. Hofmann, Nathaniel Rothman, Qing Lan, Sonja I. Berndt, Demetrius Albanes, Mark Purdue, Mitchell J. Machiela, Stephen J. Chanock, Parveen Bhatti, Wendy Cozen, Aaron Norman, Susan L. Slager, James R. Cerhan, Vincent Rajkumar, Shaji J. Kumar, Et. Al.

Faculty Publications

Evidence for an association between insulin-like growth factors (IGF) and multiple myeloma (MM) is inconsistent. We examined total IGF-I concentrations and risk of MM by combining baseline serological data among UK Biobank participants (n = 444 187; 732 incident MM) with a two-sample Mendelian randomisation (MR) analysis using identified genetic variants associated with circulating total IGF-I and IGF-binding protein 3 (IGFBP-3) in the InterLymph consortium (2434 MM and their 2567 controls). Finally, additional lymphoid neoplasm (LN) subtypes were included for comparison with the main hypothesis. Circulating IGF-I level was positively associated with MM risk Hazard ratio-HR-per one standard deviation-SD-increase …

Google Search Trends And Their Correlation With Covid-19 Cases And Vaccination Rates In Austria, Stefanie Wendell

Walden Dissertations and Doctoral Studies

Timely digital surveillance is essential because clinical reporting often lags. This quantitative, longitudinal correlational study tested whether weekly Google searches in Austria signal changes in COVID-19 cases and vaccination uptake, and short-term case-vaccination dynamics, guided by Rogers’ Diffusion of Innovations Theory. Weekly Google Trends indices (0-100) and nationally reported surveillance totals (weekly counts of new cases and vaccine doses) were aggregated; cases: N = 175 weeks (Feb 2020–Jun 2023); vaccinations: N = 132 weeks (Dec 2020–Jun 2023). Time series correlations and lagged growth models showed that symptom-related searches consistently rose 1 week before reported cases (Δlog cases_t on Δlog searches_{t−1}: …

Implementing Diabetes Education And Prevention Protocol, Lilyanna B. Conkle, Alyssa M. Woodall

Scholars Week

This Evidence-Based Practice project proposes the implementation of a diabetes education and prevention protocol in school systems to address the rising prevalence of diabetes among students. The initiative includes mandatory pre-academic year training for school staff to improve recognition and response to diabetes related emergencies. To support school nurses, often the sole healthcare provider on campus; a mobile app will be introduced to alert personnel during emergencies and provide evidence-based intervention steps. This approach aims to enhance student safety, improve health outcomes, and ensure timely, coordinated care.

Advancing Children's Mental Health In Nevada, Kelliann Beavers, Christopher Kearney

Lincy Institute Events

Nevada ranks 51st nationally in youth mental health access and services, underscoring persistent shortages and disparities across the state. Nearly one in four youths aged 12–17 (23.5%) experienced a major depressive episode in the past year, and 73% did not receive treatment. Approximately 34,000 Nevada youths have reported suicidal thoughts—an urgent call for prevention and coordinated support.

During the 2024–2025 school year, 31.3% of Clark County School District students were chronically absent (missing 10% or more of school days), a challenge closely linked to mental health struggles and socioeconomic barriers.

This community forum provided an opportunity to generate dialogue and …

Examining Longitudinal Associations Between Polysubstance Use And Firearm-Related Risk Behaviors From Adolescence Into Emerging Adulthood: A Group-Based Multi-Trajectory Modeling Approach, Mike Henson-Garcia, Sitara M Weerakoon, Melissa Peskin, Elizabeth Baumler, Alexander Testa, Lauren Malthaner, Yu Lu, Jeff R Temple

Faculty, Staff and Student Publications

Introduction: Firearm access and associated risk behaviors (i.e., firearm storage and carriage) are established factors that increase the risk of firearm-related injuries. While extant research has demonstrated associations between singular substance use and these risks, little is known regarding the impact of polysubstance use on these outcomes. The present study aims to investigate the relationships between polysubstance use in adolescence and four specific firearm-related risks manifesting in emerging adulthood.

Methods: Ten years of annual data from a cohort of 1,042 adolescents initially aged 13-18 years were analyzed to identify polysubstance use trajectories and their associations with firearm-related behaviors in emerging …

Situational Confidence And Recovery Capital Among Justice-Involved Adults Receiving Medications For Opioid Use Disorder In A Jail-Based Setting, Elizabeth O Obekpa, Xulei He, Alejandro Betancur, Kathryn R Gallardo, Serena A Rodriguez, Sheryl A Mccurdy, J Michael Wilkerson

Faculty, Staff and Student Publications

Background: Justice-involved individuals with opioid use disorder (OUD) face heightened relapse risks during the reentry period. While medications for opioid use disorder (MOUD) are effective, long-term recovery also depends on psychological and structural supports, including situational confidence (perceived ability to resist substance use in high-risk situations) and recovery capital (the internal and external resources that support recovery).

Methods: This cross-sectional study examined situational confidence and its association with recovery capital among 107 justice-involved adults receiving MOUD in an urban jail in Texas. Participants completed the Brief Situational Confidence Questionnaire (BSCQ) and the 10-item Brief Assessment of Recovery Capital (BARC-10). Mental …

Design Considerations For Conversational Agents To Assess The Social-Emotional Well-Being Of Young Children In Low-Income South African Communities, Lucretia A. Williams, Elizabeth A. Ankrah, Catherine E. Draper, Caylee J. Cook, Franceli L. Cibrian, Jesus A. Beltran, Kimberley D. Lakes, Gillian R. Hayes

Engineering Faculty Articles and Research

A variety of digital technologies have been used to support early childhood development (ECD) programs in low-income South African communities. Even though technology has provided opportunities to increase access to health interventions, the lack of trust and socio-economic constraints under which these tools would need to work pose complex challenges. We examine home visitors’ work processes, experiences, and preferences of a conversational agent to support their work of administering social-emotional well-being assessments to young children ages 0-5. Analysis of the results of focus groups with 51 home visitors indicates the need for designing conversational agents that support ECD in the …

Elucidating The Relationship Between Water Quality And Antibiotic Resistance Of Rainwater Microbes Across Western Humboldt County, Theo P. Murphy, Eve Wendley, Justice Laskowski, Tyler Paredes

Humboldt Journal of Microbiology

Limited studies have been conducted regarding the fecal contamination and microbial dispersal through rainwater, with no known studies investigating the potential connection between antibiotic resistant microbes and water quality in rainwater. This study seeks to identify the presence of a correlation between water quality and incidence of antibiotic resistance in rainwater microbes. We hypothesize that there will be a correlation between these two variables. We additionally anticipate a high incidence of fecal contamination across rural and urban collection sites alike, with fecal contamination being more prevalent in rural areas than urban locals. To determine water quality, we measured the concentration …

Giant Cell Arteritis After Mrna Covid Vaccines: Concerning Or A False Alarm?-A Retrospective Cohort Study, Syed M. F. Zabiullah, Rutwik Pradeep Sharma, Roshan Subedi, Viqarunnisa Faaiza Zahid, Yasir Loai, Sarathlal Mannumbethlal, Aatifa Aatifa

Advances in Clinical Medical Research and Healthcare Delivery

Background: The coronavirus disease (COVID-19) pandemic led to the first large-scale rapid deployment of novel messenger RNA (mRNA) vaccines. Although the effectiveness and safety of these vaccines were rigorously studied, post-vaccination adverse events such as giant cell arteritis (GCA) continue to be reported. More than two hundred and sixty three cases of new-onset GCA occurring after mRNA vaccine administration are listed in the Vaccine Adverse Events Reporting System as of October 2024. We aimed to explore the incidence of GCA after mRNA vaccines among patients in our health system and study their characteristics and outcomes.

Methods: We conducted a …

Validation Of A Risk Score For Cancer-Associated Thrombosis Using Nationwide Ehr Data, Ang Li, Omid Jafari, Barbara D Lam, Jun Y Jiang, Rock Bum Kim, Shengling Ma, Emily Zhou, Joyce W Tiong, Elizabeth C Chiang, Justine Ryu, Christopher I Amos, Jennifer La, Nathanael R Fillmore

Faculty, Staff and Student Publications

Importance: Venous thromboembolism (VTE) is associated with increased mortality and morbidity in patients with cancer. Existing risk prediction models are typically validated within individual sites, a fragmented approach that limits clinical adoption.

Objective: To validate the electronic health record cancer-associated thrombosis (EHR-CAT) score compared with the benchmark Khorana score in a contemporary cohort of patients with cancer across the nation, before and after treatment, excluding those at high risk of bleeding.

Design, setting, and participants: This prognostic study included patients in a nationwide longitudinal EHR database from January 2018 to December 2023 with follow-up continuing to April 2025. Patients with …

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Evaluation Of Integrative Oncology Modalities For Symptom Management: A Mascc/Sio Global Survey, Alexandre Chan, Reem Nasr, Daniela Arcos, Dalia Kagramanov, Chioma Asuzu, Ting Bao, Yin Ting Cheung, Jung Hye Kwon, Judith Lacey, Richard T. Lee, Maryam Lustberg, Beatrice M. Ohaeri, Santosh Rao, Enrique Soto-Perez-De-Celis, Claudia M. Witt, Ana M. Lopez

Kimmel Cancer Center Faculty Papers

BACKGROUND: With growing evidence pointing towards the potential of integrative oncology modalities (IOM) in addressing cancer and cancer-treatment related symptoms, research on IOM utilization and implementation is warranted. This study examines global stakeholder perspectives on integrative oncology (IO) utilization for supportive cancer care.

METHODS: Members of the Multinational Association of Supportive Care in Cancer (MASCC) and the Society for Integrative Oncology (SIO) completed a survey on the utilization of IOM for supportive cancer care. Descriptive statistics were used to assess demographic data, IOM usage patterns, IOM education, and financial considerations for utilizing IOM.

RESULTS: Among 344 participants representing eight geographical …

National Alliance Of Sickle Cell Centers Consensus Recommendations On Sickle Cell Disease Health Maintenance: A Consensus Statement, Seethal A. Jacob, Melissa Frei-Jones, Sana Saif-Ur-Rehman, Monica L. Hulbert, Andrew R. W. O'Brien, Crawford Strunk, Anthony Villella, Ravi Talati, Amma Owusu-Ansah, Francis Coyne, Patrick T. Mcgann, Parul Rai, Robin Miller, Angeli Rampersad, Vishwas Sakhalkar, Neha Bhasin, Deepa Manwani, Sophie Lanzkron, Julie Kanter

Cardeza Foundation for Hematologic Research

IMPORTANCE: The most common inherited blood disorder in the world, sickle cell disease (SCD) is a known global health concern. While survival of children into adulthood has improved significantly over the last few decades in high-resource countries, substantial gaps in care standards and limited practice harmonization persist.

OBJECTIVE: To provide up-to-date recommendations for preventive care and treatment of all people living with SCD and its related comorbidities.

EVIDENCE REVIEW: As part of the National Alliance of Sickle Cell Centers (NASCC), 41 pediatric and adult sickle cell disease experts developed consensus standards and recommendations based on available evidence and expert consensus …

A Temperature-Sensitive Crispr-Cas12a System For Sterile Insect Technique, Christina Nguyen, Ahmed Idowu Omotayo, Sara Sanz Juste, Xuechun Feng, Víctor López Del Amo

Faculty, Staff and Student Publications

The sterile insect technique (SIT) reduces population numbers by releasing sterile males that produce non-viable progeny. Specifically, CRISPR/Cas9-based precision-guided SIT (pgSIT) generates sterile males through genetic crosses of two transgenic lines: a Cas9 strain and a guide RNA (gRNA) strain targeting male sterility and female viability or infertility. However, pgSIT requires separate maintenance of the two lines and sorting to obtain sterile males, creating possible challenges for scaling. To overcome this, we propose using Cas12a nuclease, which is inoperative at lower temperatures but active at higher temperatures. Here, we develop a Cas12a-based pgSIT system involving a single strain containing both …

Losing Focus In The Age Of Tik Tok: Clinical Evidence For Policy Action On Social Media Use, Megan Conefrey, Robert Griffin

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Tracking Livestock Heart Rate & Location Using Long-Range Radio Networks. An Immediate Solution For Farms Without Reliable Wi-Fi, Dermott Harkin, Martin Bradley

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Voices Matter: Tackling Accentism In Ireland. A Study Addressing Accent-Based Discrimination Awareness In Education, Sadhbh Reddington, Victoria Graham, Holly Jordan, Mairead Moriarty

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Supporting Single Parents: How Loneliness And Self-Stigma Can Impact Single Parents And Their Quality Of Life, Alana Powell, David Mothersill

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Income Inequality And Attitudes Towards Immigrants – How Increased Inequality Drives Division, Niamh Anderson, Vincent O'Sullivan

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Ireland Blossoms Through Multiculturalism - Designing For Community Connection, Julia Kuczera, Shirley Casey, Hilary Kenna

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Unheard And Underserved: Exploring Support For Male Victims Of Partner Abuse, Michael Keenan, Colletta Dalikeni

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Assessing Demand And Simulating Feasibility For Commuter Rail In Lagging Regional Areas. Case Study: Sligo, Holly Briere-Edney, Brian Mccann

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.