Digital Commons Network^™

Single-Level Anterior Cervical Discectomy And Fusion Is Associated With Higher Nonroutine Discharge Rates Compared To Cervical Disc Arthroplasty In Obese Patients, Paul G. Mastrokostas, Luke B. Schwartz, Eli Berglas, Aaron B. Lavi, Leonidas E. Mastrokostas, Jonathan Dalton, Christopher K. Kepler, Arya Varthi, Jad Bou Monsef, Afshin E. Razi, Mitchell K. Ng

Rothman Institute Papers

CONTEXT: Obesity is a recognized risk factor for adverse outcomes in cervical spine surgery. While cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF), comparative outcomes among obese patients remain underexplored.

AIMS: The aim of this study is to compare nonroutine discharge rates and other postoperative outcomes between obese patients undergoing single-level ACDF and CDA.

SETTINGS AND DESIGN: Retrospective cohort study using a national database.

SUBJECTS AND METHODS: The National Inpatient Sample was queried to identify obese patients who underwent single-level ACDF or CDA between 2016 and 2020. Inclusion and exclusion criteria were …

Examining The Association Between The Timing Of The First Antenatal Check; Number Of Antenatal Care (Anc) Visits During Pregnancy With Maternal Mortality In Nigeria, Kanayo Omonoju

Walden Dissertations and Doctoral Studies

Maternal mortality is growing at an alarming rate in Nigeria, ranking the second highest Maternal Mortality Rate (MMR) globally. This cross-sectional study examined the association between the timing of the first antenatal check and the number of Antenatal Care (ANC) visits during pregnancy and its impact on maternal mortality using the Nigerian Demographic and Health Survey (NDHS) 2018 among a study population of women 15 - 49 years old. The theoretical framework for this study was grounded in the socioecological model. Multiple logistic regression was used to determine if there are relationships between timing of first antenatal check, the number …

Intersectionality Gaps Among Multiple Social Determinants In U.S. Infant And Maternal Mortality Rates, Mary D. Kirkley

Walden Dissertations and Doctoral Studies

The purpose of this quantitative, cross-sectional study was to examine whether social determinants interactively influence U.S. maternal and infant mortality rates. Grounded in the Social Ecological Model, this study analyzed secondary data from the Centers for Disease Control and Prevention’s National Vital Statistics System were analyzed using multivariable logistic regression. The final sample included 110,402 maternal deaths and 55,839 infant deaths, with inclusion criteria requiring complete data on race, education, age, marital status, gender (for infants), residency, and year of death. Exclusion criteria included non-U.S. resident deaths or missing demographic data. Results revealed statistically significant interaction effects: race/ethnicity with education …

Modeling, Analysis, And Prediction Of Covid-19 Dynamics With Interacting Subpopulations And Implicit Behavior Using Physics-Informed Neural Networks, Naima Aubry-Romero, Alonso Ogueda-Oliva, Padmanabhan Seshaiyer

Spora: A Journal of Biomathematics

In this paper, we consider an extended SEIR compartmental model that incorporates young and old interacting subpopulations, allowing for cross-group transmission dynamics. Implicit behavioral changes are included to determine the influence of social behavior on coronavirus transmission dynamics. The basic reproduction number, the average number of secondary cases of infection produced by a single primary case, is derived for both the explicit and implicit model using the next-generation matrix method. We solve the associated differential equation systems and estimate useful parameters in the explicit model using physics-informed neural networks (PINNs). Our results point to how the PINNs approach offers an …

Positively Impacting Traffic Safety Culture For Indigenous Youth: A Heritage-Focused Approach, Jacob Steven Pehrson, Ahmed Abdel-Rahim, Logan Prescott

Journal of Community Engagement and Higher Education

This paper presents the development of heritage-focused outreach materials with the objectives of positively impacting traffic safety culture for Indigenous youth to reduce the number and severity of traffic crashes impacting these communities. The approach presented in this paper includes involving local community leaders in traffic safety education and incorporating culturally based material in outreach education. This could empower Tribal communities to preserve their cultural identities while acquiring the expertise needed to promote traffic safety.

Lsu Dental Students Provide Free Care To Homeless Through Ozanam Inn Partnership

New Orleans Dental Association News

LSU dental students provide free care to homeless individuals through a well-established student-run clinic at Ozanam Inn. Guided by faculty, the program offers hands-on experience, holistic service delivery, and compassionate outreach to New Orleans' underserved populations.

The Implications Of Alpha-Gal Syndrome For Dental And Medical Treatment, Adam Degenova Mba, Kristi Soileau

New Orleans Dental Association News

Alpha-gal syndrome (AGS) is a potentially life-threatening allergic reaction to a mammalian sugar molecule introduced through tick bites. With rising U.S. diagnoses, dentists must recognize AGS symptoms and understand its implications. Many dental medications and materials contain mammalian-derived ingredients, requiring providers to adapt treatment plans and remain vigilant for delayed allergic responses in undiagnosed patients.

Evaluating Nutrition, Exercise, And Education, On Mental Health And Quality Of Life In Menopause, Jill R. Stone

Walden Dissertations and Doctoral Studies

Physical inactivity, poor nutrition, and a lack of understanding of menopause adversely affect mental health and quality of life in women entering menopause. Metabolic changes during this period can lead to an increase in visceral fat, loss of muscle mass, depression, and anxiety. These metabolic changes are linked to a higher risk for cardiovascular disease, type two diabetes, and metabolic syndrome. This cross-sectional quantitative study, guided by the health belief model, explored the contribution of adopting specific nutrition strategies, exercise, and education in women during menopause transition to help manage mental health (as measured by depression and tension), and quality …

Assessment Of Functioning Using The Whodas 20 Among People With Myasthenia Gravis-Associated Disability: A Nationwide Follow-Up Study, Jia-Pei Hong, Chih-Hong Lee, Chien Tai Hong, Lung Chan, Chen-Chih Chung, Prangthip Charoenpong, Hou-Chang Chiu, Tsan-Hon Liou

Faculty, Staff and Students Publications

Background: Advancements in treatment have increased the life expectancy of patients with Myasthenia Gravis (MG), yet the understanding of functional changes in these individuals remains limited. In our study, we explored the functional abilities of individuals with MG using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).

Methods: This observational study analyzed data from 286 patients with MG, acquired from the Data Bank of Persons with Disabilities (TDPD) in Taiwan between July 11, 2012, and December 31, 2021. Participants were diagnosed with MG after the acute phase. The functional disability outcome was assessed using the WHODAS 2.0. Due …

Alfred Russel Wallace Notes 37. What About Wallace On Vaccination . . . ?, Charles H. Smith

Faculty/Staff Personal Papers

Best known for his natural history studies on evolution and biogeography, Alfred Russel Wallace (1823−1913) had a significant second career as a social critic. One of his most controversial stances was his position on (smallpox) vaccination. Anti-vaxxers of the present frequently bring up his name as a resource for their side, but the situation is not so easily reducible to that.

Common Sources, Perceived Communication Efficacy And Sufficiency Of Cervical Cancer Information, Education And Communication Materials For Women With Hiv/Aids In Rural Kenya, Scholastic Musakali Adeli, Elkanah Orang'o, Violet Naanyu, Ann Mwangi, Peter Itsura, Barry Rosen, Patrick Loehrer

Obstetrics and Gynaecology, East Africa

Introduction: Cervical cancer is the greatest cause of cancer-related death among women in Sub-Saharan Africa, with particularly high incidence and mortality rates in rural regions. In Kenya, Women with HIV/AIDS (WLHA) are at a greater risk of developing cervical cancer though screening rate remains low. Information, education and communication (IEC) materials play a crucial role in raising awareness, promoting screening, and supporting early detection and treatment; however, little is known about the accessibility, content, and perceived effectiveness of these materials from the perspective of WLHA.

Methods: The objective of this study was to determine the common sources, perceived communication efficacy …

The Effect Of Individual Variation On Epidemiological Dynamics: From Super-Spreaders To Landscapes Of Risk, Alexis Shannon Beagle

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Individuals that make up a population always display some level of variation between members. At the smallest scale, individuals always maintain genetic variation, but variation continues to arise at other scales of biological organization from physiological or immunological variation within individuals to variation in behavior between individuals that can be both genetically and environmentally mediated. The role of individual variation is particularly important in the context of infectious diseases because there is strong evidence that infections are highly heterogenous, indicating that patterns of individual variation drive a significant portion of the epidemiological patterns we observe. Individual variation leads to heterogeneity …

Evaluating The Impact Of The Occupation-Centered Intervention Assessment On Client-Centered Care In Inpatient Brain Injury Rehabilitation: A Pilot Study, Vanessa D. Jewell, Katherine Lally, Melinda Schultze, Yongyue Qi, Kendra Schnack, Madeline Mcgill, Rachel Vaughn

Translational Science in Occupation

Background: Occupational therapy practitioners (OTPs) recognize the value of evidence-based practice, however, incorporation of client-centered practice as a component of evidence-based practice is challenging, despite the known advantages. This pilot study evaluated the use of the Occupation Centered Intervention Assessment (OCIA) in increasing practitioner ability to provide client-centered care in inpatient rehabilitation facilities with adults with an acquired brain injury (ABI).

Method: A mixed methods design was employed, using four forms of data collection (OCIA, The Measure of Processes of Care for Service Providers [MPOC], MPOC- Service Providers [MPOC-SP], and interviews) to determine changes in observed and perceived …

Enhancing Diversity In Occupational Therapy Through A High School Internship Program, Alexis M. F. Morin, Brittany Adams, Vianni Gomez

Translational Science in Occupation

Abstract

The United States (US) is projected to become an increasingly diverse nation over the decades ahead, but there is a lack of racial, ethnic, and gender diversity in occupational therapy (OT). While the job outlook for occupational therapy practitioners continues to be strong and is expected to rise, OT education programs are facing enrollment crises nationally. It is crucial for academic programs to develop and implement innovative and methodical strategies to recruit and retain a diverse student body to promote diversity, inclusion, and equity within the profession. To promote diversity, inclusion, and equity in occupational therapy, a university partnership …

Chronic Illness Education 2025: Dealing Anxiety In Teenage, Aida Mouzoon, Emily Crisan, Emma Saito, Feeda Elahresh, Hussan Ali, Jackson Bennett, Noah Rollison, Shihabaldean Shalabi

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Hypertension And The Case Of Mrs.Dash, Brandon Brown, Charlotte Turner, Connor Mcginnis, Jacob Airas, Maria Awad, Pranav Nair, Shruthi Sunilkumar, Yusra Sannah

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Prevention And Management, Alyusuf Elnaggar, Brenna Hairston, Carly Ghanem, Fatima Bhatti, James Wairagu, Lucy Yu, Najeeb Baig, Ryan Murphy

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Risk Factors And Prevention Of Cardiovascular Disease, Christopher Matti, Clayton Kramm, Ghala Alhasan, Hadi Elmenini, Julia Miller, Maxine Kugelmas, Moshood Osinusi, Nievalinda Strong

Patient Education Projects

No abstract provided.

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Utilizing Text Messaging To Increase Annual Mammogram Screening Compliance, Lacey B. Santa Cruz

Doctor of Nursing Practice Projects

Background: Routine mammography can lessen breast cancer deaths, but many patients do not follow the current screening guidelines. Limited access to mammography and insufficient awareness lead to missed screening appointments.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to improve annual mammogram adherence among women aged 40-74 by implementing an electronic medical record (EMR)-based text reminder system.

Project Design: Secondary patient data was collected from a privately owned, rural family practice clinic. Using the Mobilize-Assess-Plan-Implement-Track (MAP-IT) quality improvement framework, the project implemented a text message reminder intervention through the EMR. Eligible patients received a text reminder …

Using The Observational Medical Outcomes Partnership Common Data Model For A Multi-Registry Intensive Care Unit Benchmarking Federated Analysis: Lessons Learned, Aasiyah Rashan, Daniel P Püttmann, Nicolette F De Keizer, Dave A Dongelmans, Ronald Cornet, Otavio Ranzani, Wangari Siika, Matthew Smith, Steve Harris, Abi Beane

Anaesthesiology, East Africa

Objective: Federated analysis is a method that allows data analysis to be performed on similar datasets without exchanging any data, thus facilitating international research collaboration while adhering to strict privacy laws. This study aimed to evaluate the feasibility of using federated analysis to benchmark mortality in 2 critical care quality registry databases converted to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM), describing challenges to and recommendations for performing federated analysis on data transformed to OMOP CDM.

Materials and Methods: To identify as many challenges as possible and to be able to complete the benchmarking phase, …

Investigating Environmental And Socioeconomic Contributors To Adult Obesity In The Rio Grande Valley, John Nicholas Cauba, Jihoo Woo, Russel Wiggins, Shizue Mito

School of Medicine Publications

Obesity in the Rio Grande Valley (RGV) of Texas remains a critical public health concern, with rates (46.9%) significantly exceeding those of Texas (36%) and the U.S. (34%) (p < 0.001). This study used 2024 County Health Rankings data to analyze environmental and socioeconomic contributors to obesity across 240 Texas counties, with a population-weighted focus on Hidalgo, Cameron, Starr, and Willacy counties. The RGV exhibited markedly poorer access to exercise, higher rates of physical inactivity, lower Food Environment Index scores (FEI = 4.3 vs. 5.7 in Texas), higher rates of uninsurance, worse patient-to–primary care physician (PCP) ratios (2152:1 vs. Texas 1660:1), and increased preventable hospitalizations. Multiple linear regression identified physical inactivity (β = 0.6, p = 0.01) and access to exercise (β = −0.02, p = 0.02) as significant predictors of obesity. Notably, higher uninsured rates were associated with lower reported obesity, likely due to underdiagnosis in the absence of routine care. These findings emphasize the need for targeted interventions addressing food access, environmental and recreational infrastructure, along with healthcare infrastructure in the RGV, where socioeconomic disadvantage and structural barriers magnify the impact of national obesity trends on the regional level.

Foundations And Strategic Vision Of The Canadian Translational Geroscience Network, Guy Hajj-Boutros, Andréa Faust, John Muscedere, Perry Kim, Gilles Gouspillou, Lea Harrington, James L. Kirkland, George A. Kuchel, Jeremy Van Raamsdonk, R. Jane Rylett, Chantal Autexier, Louis R. Lapierre, Michael Kobor, Mohammad Auais, Ann Beliën, Jeroen Aerssens, George Sutphin, Kenneth Rockwood, Alexandra Papaioannou, Marc Sim, Jamie Justice, Nancy Mayo, Gustavo Duque

Research outputs 2022 to 2026

Geroscience is an emerging interdisciplinary field that explores the biological connections between aging and the development of chronic diseases, with the ultimate goal of identifying interventions to extend healthspan and delay age-related conditions. Recognizing the growing importance of this field, the Canadian Translational Geroscience Network (geroscience.ca) was officially launched during a conference held in Montreal on September 5-6, 2024. Building on the momentum of successful Geroscience meetings in Toronto and Montreal in 2023, this milestone event marked a transformative step forward for geroscience in Canada. This event brought together key stakeholders, including the Canadian Frailty Network (CFN), the Canadian Institutes …

Systemic Exogenous Progestins With Or Without Estrogens Are Associated With Decreased Rates Of Venous Procedures For Varicose Veins, Paarth Jain, Adam M. Ostrovsky, Paul J Dimuzio, Luis H. Eraso, Michael Nooromid, Dawn Salvatore, Babak Abai

Department of Surgery Faculty Papers

OBJECTIVES: Risk factors for varicose veins (VVs) such as female sex, pregnancy, and obesity are high estrogen states, yet the role of systemic progestins with or without estrogens (SPEs) in VV management is not well characterized. This study investigates how SPE use affects rates of venous procedures for patients with VV.

METHODS: The TriNetX database was queried for subjects with International Classification of Diseases, 10th edition, diagnoses of asymptomatic VV, chronic venous insufficiency, and complicated VV (inflammation or ulceration). Patients were divided into a control cohort with no subsequent SPE use, a progestin-only cohort, and a combined estrogen-progestin (CEP) cohort. …

Exploring Covid-19 Vaccination Behavior: A Cross-Country Study Among Pregnant And Postpartum Women In Brazil, Ghana, Kenya, And Pakistan, Rupali Limaye, Berrhaun Fesshaye, Emily Miller, Prachi Singh, Saleem Jessani, Muhammad Asim, Ferdinand Okwaro, Sarah Saleem, Marleen Temmerman, Muhammad Asim

Centre of Excellence in Women and Child Health

Pregnant women infected with SARS-CoV2 are more likely to be hospitalized and require ventilation, compared to non-pregnant women. Although the development of the COVID-19 vaccine was regarded as a scientific breakthrough among many, the pace of development in combination with delayed and unclear recommendations for maternal vaccination led to slower vaccine uptake among this population. We explored the decision-making process for COVID-19 vaccination among pregnant and postpartum women in four countries: Brazil, Ghana, Kenya, and Pakistan through 201 in-depth interviews. A grounded theory approach was used for analysis, and a socio-ecological framework was used to synthesize emerging themes. Four levels …

Evaluation Of Snap-Ed New Mexico’S Pilot “I Choose H2o” Campaign To Increase Water Consumption, Theresa H. Cruz, Mahtab Soleimani, Camille R. Velarde, Belinda E. Vicuna

Reports & Documents

The “I Choose H2O” campaign is a school-based pilot initiative developed by the University of New Mexico Prevention Research Center with SNAP-Ed NM funding from the USDA. Designed as a three-week social marketing effort, the campaign aimed to increase daily water consumption and reduce intake of sugar-sweetened beverages (SSBs) among middle school students. The campaign engaged students and staff through activities such as water challenges, events, tastings, and prize incentives, while also encouraging broader school-level policy, systems, and environmental (PSE) changes.

This evaluation used direct observation before and after implementation to assess changes in water fountain usage and lunchtime beverage …

Author Reply: Investment Case For Mental Health, Cyprian Mostert

Population Health, East Africa

No abstract provided.

Medicaid Managed Care Organization Service Coverage And Diagnosis And Treatment Of Opioid Use Disorder: Evidence From Quasi-Random Auto-Assignment In Kentucky, Shelby R. Steuart, Miguel Antonio G Estrada, Christina Andrews Ph.D., Colleen M. Grogan, Olivia M. Hinds, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Melissa A. Westlake, Coady Wing, Amanda J. Abraham

Faculty Publications

Introduction

Opioid-related mortality continues to claim tens of thousands of American lives annually. Medicaid plays an outsized role in financing opioid use disorder (OUD) treatment, paying for almost 40% of all Americans who received OUD treatment in 2017. Methods

Using Medicaid T-MSIS Analytic Files data and a novel data set of Medicaid managed care organization (MCO) plan coverage, we examined the relationship between comprehensiveness of benefits for OUD treatment provided by Medicaid MCO plans and the likelihood of OUD diagnosis and medications for OUD (MOUD) receipt among newly enrolled Medicaid beneficiaries in Kentucky. We use two stage least squares to …

Functional Time Transformation Model With Applications To Digital Health, Rahul Ghosal Ph.D., Marcos Matabuena, Sujit K. Ghosh

Faculty Publications

The advent of wearable and sensor technologies now leads to functional predictors which are intrinsically infinite dimensional. While the existing approaches for functional data and survival outcomes lean on the well-established Cox model, the proportional hazard (PH) assumption might not always be suitable in real-world applications. Motivated by physiological signals encountered in digital medicine, we develop a more general and flexible functional time-transformation model for estimating the conditional survival function with both functional and scalar covariates. A partially functional regression model is used to directly model the survival time on the covariates through an unknown monotone transformation and …