Digital Commons Network^™

Toward A More Comprehensive Understanding Of Organizational Influences On Implementation: The Organization Theory For Implementation Science Framework, Jure Baloh, Manal Masud, Terry T-K Huang, Matthew Lee, Mary Wangen, Per Nilsen, Miriam Bender, Mimi Choy-Brown, Grace Ryan, Aliza Randazzo, Linda K Ko

Faculty, Staff and Student Publications

Introduction: Implementation is influenced by factors beyond individual clinical settings. Nevertheless, implementation research often focuses on factors related to individual providers and practices, potentially due to limitations of available frameworks. Extant frameworks do not adequately capture the myriad organizational influences on implementation. Organization theories capture diverse organizational influences but remain underused in implementation science. To advance their use among implementation scientists, we distilled 70 constructs from nine organization theories identified in our previous work into theoretical domains in the Organization Theory for Implementation Science (OTIS) framework.

Methods: The process of distilling organization theory constructs into domains involved concept mapping and …

Hpv-Related Oropharyngeal Cancer Early Detection In Gay And Bisexual Men Is An “Orphan” Practice: A Qualitative Analysis Among Healthcare Providers

Faculty, Staff and Student Publications

Introduction: Among US men, oropharyngeal cancer (cancer of the back of the mouth and throat) is the 8th most common cancer. If detected early, human papillomavirus (HPV)-16-associated oropharyngeal cancer has a high 5-year survival rate. Risk factors such as high numbers of oral sex partners, disparities in smoking and drinking, and low rates of HPV vaccination may put gay and bisexual men at even higher risk for oropharyngeal cancer.

Methods: We recruited 21 healthcare providers in Minneapolis-St. Paul, Minnesota and Houston, Texas to participate in semi-structured interviews. Nurses, physician assistants, dental hygienists, and dentists were asked about their clinical experiences …

Identification Of Microbiological Factors Associated With Periodontal Health Disparities

Faculty, Staff and Student Publications

The present study aimed at identifying risk factors associated with periodontitis development and periodontal health disparities with emphasis on differential oral microbiota. The prevalence of periodontitis is recently rising dentate adults in the US, which presents a challenge to oral health and overall health. The risk of developing periodontitis is higher in African Americans (AAs), and Hispanic Americans (HAs) than in Caucasian Americans (CAs). To identify potentially microbiological determinations of periodontal health disparities, we examined the distribution of several potentially beneficial and pathogenic bacteria in the oral cavities of AA, CA, and HA study participants. Dental plaque samples from 340 …

Influences Of Race/Ethnicity In Periodontal Treatment Response And Bacterial Distribution, A Cohort Pilot Study

Faculty, Staff and Student Publications

OBJECTIVES: Periodontitis disproportionately affects different racial and ethnic populations. We have previously reported the higher levels of

METHODS: This prospective cohort pilot study was carried out in an academic setting, at the School of Dentistry, University of Texas Health Science Center at Houston. Dental plaque was collected from a total of 75 African Americans, Caucasians and Hispanics periodontitis patients in a 3-year period. Quantitation of

RESULTS: The gains in clinical attachment levels after treatment significantly differed amongst the 3 groups-Caucasians responded most favorably, followed by African-Americans, lastly Hispanics, while numbers of

CONCLUSION: Differential response to nonsurgical periodontal treatment and distribution …

Application Of Implementation Mapping To Develop Strategies For Integrating The National Diabetes Prevention Program Into Primary Care Clinics, Catherine Pulicken, Pierre Fwelo, Grace E White, Belinda M Reininger, John W Mcwhorter, Roshanda Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Diabetes is considered one of the most prevalent and preventable chronic health conditions in the United States. Research has shown that evidence-based prevention measures and lifestyle changes can help lower the risk of developing diabetes. The National Diabetes Prevention Program (National DPP) is an evidence-based program recognized by the Centers for Disease Control and Prevention; it is designed to reduce diabetes risk through intensive group counseling in nutrition, physical activity, and behavioral management. Factors known to influence this program's implementation, especially in primary care settings, have included limited awareness of the program, lack of standard clinical processes to facilitate …

Application Of Implementation Mapping To Develop Strategies For Integrating The National Diabetes Prevention Program Into Primary Care Clinics, Catherine Pulicken, Pierre Fwelo, Grace E White, Belinda M Reininger, John W Mcwhorter, Roshanda Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Diabetes is considered one of the most prevalent and preventable chronic health conditions in the United States. Research has shown that evidence-based prevention measures and lifestyle changes can help lower the risk of developing diabetes. The National Diabetes Prevention Program (National DPP) is an evidence-based program recognized by the Centers for Disease Control and Prevention; it is designed to reduce diabetes risk through intensive group counseling in nutrition, physical activity, and behavioral management. Factors known to influence this program's implementation, especially in primary care settings, have included limited awareness of the program, lack of standard clinical processes to facilitate …

Developing And Pre-Testing A Digital Decision-Tree Smartphone Application For Smoking Prevention And Cessation Among Hiv Care Providers, Christine Markham

Faculty, Staff and Student Publications

OBJECTIVES: The diagnosis and continuous care of chronic conditions such as HIV infection present potential teachable moments for delivering smoking prevention and cessation interventions for patients. We designed and pre-tested a prototype of a smartphone application(app), Decision-T, specifically designed to assist healthcare providers when providing personalized smoking prevention and cessation services to their patients.

METHODS: We developed the Decision-T app based on transtheoretical algorithm for smoking prevention and cessation following the 5-A's model. We employed a mixed-methods approach among 18 HIV-care providers recruited from Houston Metropolitan Area for pre-testing the app. Each provider participated in three mock sessions, and the …

Do Breast Cancer Survivors With A Recent History Of Clinical Depression Report Worse Experiences With Care? A Retrospective Cohort Study Using Seer-Cahps Data, Melissa F Peskin

Faculty, Staff and Student Publications

PURPOSE: We examined whether breast cancer survivors' experiences with care differed by a recent history of clinical depression, and whether associations differed by race/ethnicity.

METHODS: Using the Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) dataset, we analyzed records of breast cancer survivors who completed a survey at least 12 months after their cancer diagnosis. We assessed clinical depression 12 months prior to survey completion using Medicare claims. We used separate multivariable logistic regressions to examine the associations between depression and excellent (vs. less than excellent) ratings of experiences with care (i.e., doctor communication, getting needed care, …

Susceptible Windows Of Exposure To Fine Particulate Matter And Fetal Growth Trajectories In The Spanish Inma (Infancia Y Medio Ambiente) Birth Cohort, Michael D Swartz, Albert Ambros, Marisa Estarlich, Aitana Lertxundi, Isolina Riano-Galán, Jordi Sunyer, Ana Fernandez-Somoano, Suneet P Chauhan, Jennifer Ish, Kristina W Whitworth

Faculty, Staff and Student Publications

While prior studies report associations between fine particulate matter (PM

Rf Coverage Planning And Analysis With Adaptive Cell Sectorization In Millimeter Wave 5g Networks, Md Maruf Ahamed

Theses and Dissertations

The advancement of Fifth Generation Network (5G) technology is well underway, with Mobile Network Operators (MNOs) globally commencing the deployment of 5G networks within the mid-frequency spectrum range (3GHz–6GHz). Nevertheless, the escalating demands for data traffic are compelling MNOs to explore the high-frequency spectrum (24GHz–100GHz), which offers significantly larger bandwidth (400MHz-800 MHz) compared to the mid-frequency spectrum (3GHz–6GHz), which typically provides 50MHz-100MHz of bandwidth. However, it is crucial to note that the higher-frequency spectrum imposes substantial challenges due to exceptionally high free space propagation loss, resulting in 5G cell site coverage being limited to several hundred meters, in contrast to …

Expanding Medicaid To Reduce Human Immunodeficiency Virus Transmission In Houston, Texas: Insights From A Modeling Study, Marlene Mcneese, Salma Khuwaja, Babak M Ardestani, Nicholson Collier, Jonathan Ozik, Anna L Hotton, Nina T Harawa, John A Schneider, Kayo Fujimoto

Faculty, Staff and Student Publications

CONTEXT: Medicaid expansion has been nationally shown to improve engagement in the human immunodeficiency virus (HIV) treatment and prevention continua, which are vital steps to stopping the HIV epidemic. New HIV infections in the United States are disproportionately concentrated among young Black men who have sex with men (YBMSM). Houston, TX, is the most populous city in the Southern United States with a racially/ethnically diverse population that is located in 1 of 11 US states that have not yet expanded Medicaid coverage as of 2021.

METHODS: An agent-based model that incorporated the sexual networks of YBMSM was used to simulate …

Which U.S. Executive Agency Is The Most Practical To Promulgate Space Debris Mitigation Regulations, And How Will The Space Debris Legal Framework Further Develop?, Tate Garvin Few

Theses and Dissertations

There is much dispute over which agency should take charge of creating and enforcingspace debris regulations. The controversy stems from the highly underdeveloped legal framework that is limited to the IADC guidelines, the Orbital Debris Mitigation Standard Practices (ODMSP), and Space Policy Directive-3. Currently, the Federal Communications Commission is attempting to take the lead role in this effort by establishing the new 5-year space debris disposal rule. However, it is argued that Congress did not declare it to be within their jurisdictional purview. Congress has not yet explicitly stated their intent to have a centralized authority in establishing relevant regulations …

Toward A More Comprehensive Understanding Of Organizational Influences On Implementation: The Organization Theory For Implementation Science Framework, Jure Baloh, Manal Masud, Terry T-K Huang, Matthew Lee, Mary Wangen, Per Nilsen, Miriam Bender, Mimi Choy-Brown, Grace Ryan, Aliza Randazzo, Linda K Ko

Faculty, Staff and Student Publications

INTRODUCTION: Implementation is influenced by factors beyond individual clinical settings. Nevertheless, implementation research often focuses on factors related to individual providers and practices, potentially due to limitations of available frameworks. Extant frameworks do not adequately capture the myriad organizational influences on implementation. Organization theories capture diverse organizational influences but remain underused in implementation science. to advance their use among implementation scientists, we distilled 70 constructs from nine organization theories identified in our previous work into theoretical domains in the Organization Theory for Implementation Science (OTIS) framework.

METHODS: The process of distilling organization theory constructs into domains involved concept mapping and …

From The National To The Local: Issues Of Trust And A Model For Community-Academic-Engagement, Sarah Piepenbrink, Desiree De La Torre, Shannon Guillot-Wright, Marshala Lee

Faculty, Staff and Student Publications

Inequities in health and health care in the United States have persisted for decades, and the impacts on equity from the COVID-19 pandemic were no exception. In addition to the disproportionate burden of the disease across various populations, the pandemic posed several challenges, which exacerbated these existing inequities. This has undoubtedly contributed to deeply rooted public mistrust in medical research and healthcare delivery, particularly among historically and structurally oppressed populations. In the summer of 2020, given the series of social injustices posed by the pandemic and highly publicized incidents of police brutality, notably the murder of George Floyd, the Association …

Transcription Factor E2f1 Regulates The Expression Of Adrb2, Jin Shu

Faculty, Staff and Student Publications

Adrenergic beta-2-receptor (ADRB2) is highly expressed in various tissue cells, affecting the susceptibility, development, and drug efficacy of diseases such as bronchial asthma and malignant tumor. However, the transcriptional regulatory mechanism of the human ADRB2 gene remains unclear. This study aimed to clarify whether E2F transcription factor 1 (E2F1) was involved in the transcriptional regulation of the human ADRB2 gene. First, the 5' flanking region of the human ADRB2 gene was cloned, and its activity was detected using A549 and BEAS-2B cells. Second, it was found that the overexpression of E2F1 could increase promoter activity by a dual-luciferase reporter gene …

Wastewater Pandemic Preparedness: Toward An End-To-End Pathogen Monitoring Program, Juwan Cormier, Kristi Louise Hoffman, Catherine Troisi, Blake Hanson, Joseph Petrosino, John Balliew, Pedro A Piedra, Janelle Rios, Jennifer Deegan, Cici Bauer, Fuqing Wu, Kristina D Mena, Eric Boerwinkle, Anthony W Maresso

Faculty, Staff and Student Publications

Molecular analysis of public wastewater has great potential as a harbinger for community health and health threats. Long-used to monitor the presence of enteric viruses, in particular polio, recent successes of wastewater as a reliable lead indicator for trends in SARS-CoV-2 levels and hospital admissions has generated optimism and emerging evidence that similar science can be applied to other pathogens of pandemic potential (PPPs), especially respiratory viruses and their variants of concern (VOC). However, there are substantial challenges associated with implementation of this ideal, namely that multiple and distinct fields of inquiry must be bridged and coordinated. These include engineering, …

Digital Solutions Observed In Clinical Trials: A Formative Feasibility Scoping Review, Hongfang Liu

Faculty, Staff and Student Publications

Growing digital access accelerates digital transformation of clinical trials where digital solutions (DSs) are increasingly and widely leveraged for improving trial efficiency, effectiveness, and accessibility. Many factors impact DS success including technology barriers, privacy concerns, or user engagement activities. It is unclear how those factors are considered or reported in the literature. Here, we perform a formative feasibility scoping review to identify gaps impacting DS quality and reproducibility in trials. Articles containing digital terms published in English from 2009 to 2022 were collected (n=4,167). 130 articles published between 2016 and 2022 were randomly selected for full-text review. Eligible articles (n=100) …

Contextual Variation Of Clinical Notes Induced By Ehr Migration

Faculty, Staff and Student Publications

The structure and semantics of clinical notes vary considerably across different Electronic Health Record (EHR) systems, sites, and institutions. Such heterogeneity hampers the portability of natural language processing (NLP) models in extracting information from the text for clinical research or practice. In this study, we evaluate the contextual variation of clinical notes by measuring the semantic and syntactic similarity of the notes of two sets of physicians comprising four medical specialties across EHR migrations at two Mayo Clinic sites. We find significant semantic and syntactic variation imposed by the context of the EHR system and between medical specialties whereas only …

Annotation And Information Extraction Of Consumer-Friendly Health Articles For Enhancing Laboratory Test Reporting, Yang Gong, Zhan Zhang, Xiao Luo, Mia Liza A Lustria

Faculty, Staff and Student Publications

Viewing laboratory test results is patients' most frequent activity when accessing patient portals, but lab results can be very confusing for patients. Previous research has explored various ways to present lab results, but few have attempted to provide tailored information support based on individual patient's medical context. In this study, we collected and annotated interpretations of textual lab result in 251 health articles about laboratory tests from AHealthyMe.com. Then we evaluated transformer-based language models including BioBERT, ClinicalBERT, RoBERTa, and PubMedBERT for recognizing key terms and their types. Using BioPortal's term search API, we mapped the annotated terms to concepts in …

The Health-Promoting Effects And The Mechanism Of Intermittent Fasting, Xiang Li, Zixian Xie, Shang Wang, Yu Cai

Faculty, Staff and Student Publications

Intermittent fasting (IF) is an eating pattern in which individuals go extended periods with little or no energy intake after consuming regular food in intervening periods. IF has several health-promoting effects. It can effectively reduce weight, fasting insulin levels, and blood glucose levels. It can also increase the antitumor activity of medicines and cause improvement in the case of neurological diseases, such as memory deficit, to achieve enhanced metabolic function and prolonged longevity. Additionally, IF activates several biological pathways to induce autophagy, encourages cell renewal, prevents cancer cells from multiplying and spreading, and delays senescence. However, IF has specific adverse …

Data Mining Pipeline For Covid-19 Vaccine Safety Analysis Using A Large Electronic Health Record, Guo-Qiang Zhang

Faculty, Staff and Student Publications

We developed a novel data mining pipeline that automatically extracts potential COVID-19 vaccine-related adverse events from a large Electronic Health Record (EHR) dataset. We applied this pipeline to Optum® de-identified COVID-19 EHR dataset containing COVID-19 vaccine records between December 11, 2020 and January 20, 2022. We compared post-vaccination diagnoses between the COVID-19 vaccine group and the influenza vaccine group among 553,682 individuals without COVID-19 infection. We extracted 1,414 ICD-10 diagnosis categories (first three ICD10 digits) within 180 days after the first dose of the COVID-19 vaccine. We then ranked the diagnosis codes using the adverse event rates and adjusted odds …

Child Psychological Well-Being And Adult Health Behavior And Body Mass Index, Julia Boehm, Farah Qureshi, Laura D. Kubzansky

Psychology Faculty Articles and Research

Objective: Psychological well-being (PWB) is linked with health behaviors among adults, but it is unclear if childhood PWB prospectively predicts healthy adulthood biobehavioral profiles. Such evidence may identify developmental windows for establishing positive health trajectories across the lifespan. Using data spanning 30 years, we investigated whether PWB at age 11 was associated with health behaviors and body mass index (BMI) at ages 33 and 42. We hypothesized children with higher versus lower PWB would engage in healthier behaviors, have lower BMI in adulthood, and be more likely to maintain optimal levels over time. Method: Data were from 4,728 participants of …

Minimax Estimation For Personalized Federated Learning: An Alternative Between Fedavg And Local Training?

Faculty, Staff and Student Publications

A widely recognized difficulty in federated learning arises from the statistical heterogeneity among clients: local datasets often originate from distinct yet not entirely unrelated probability distributions, and personalization is, therefore, necessary to achieve optimal results from each individual's perspective. In this paper, we show how the excess risks of personalized federated learning using a smooth, strongly convex loss depend on data heterogeneity from a minimax point of view, with a focus on the FedAvg algorithm (McMahan et al., 2017) and pure local training (i.e., clients solve empirical risk minimization problems on their local datasets without any communication). Our main result …

Efficient Federated Kinship Relationship Identification, Erman Ayday, Jaideep Vaidya

Faculty, Staff and Student Publications

Kinship relationship estimation plays a significant role in today's genome studies. Since genetic data are mostly stored and protected in different silos, retrieving the desirable kinship relationships across federated data warehouses is a non-trivial problem. The ability to identify and connect related individuals is important for both research and clinical applications. In this work, we propose a new privacy-preserving kinship relationship estimation framework: Incremental Update Kinship Identification (INK). The proposed framework includes three key components that allow us to control the balance between privacy and accuracy (of kinship estimation): an incremental process coupled with the use of auxiliary information and …

Towards Fair Patient-Trial Matching Via Patient-Criterion Level Fairness Constraint, Kai Zhang, Xiaoqian Jiang, Xia Hu, Na Zou

Faculty, Staff and Student Publications

Clinical trials are indispensable in developing new treatments, but they face obstacles in patient recruitment and retention, hindering the enrollment of necessary participants. To tackle these challenges, deep learning frameworks have been created to match patients to trials. These frameworks calculate the similarity between patients and clinical trial eligibility criteria, considering the discrepancy between inclusion and exclusion criteria. Recent studies have shown that these frameworks outperform earlier approaches. However, deep learning models may raise fairness issues in patient-trial matching when certain sensitive groups of individuals are underrepresented in clinical trials, leading to incomplete or inaccurate data and potential harm. To …

Split Learning For Distributed Collaborative Training Of Deep Learning Models In Health Informatics, Zhijun Yin, Xiaoqian Jiang, Bradley A Malin

Faculty, Staff and Student Publications

Deep learning continues to rapidly evolve and is now demonstrating remarkable potential for numerous medical prediction tasks. However, realizing deep learning models that generalize across healthcare organizations is challenging. This is due, in part, to the inherent siloed nature of these organizations and patient privacy requirements. To address this problem, we illustrate how split learning can enable collaborative training of deep learning models across disparate and privately maintained health datasets, while keeping the original records and model parameters private. We introduce a new privacy-preserving distributed learning framework that offers a higher level of privacy compared to conventional federated learning. We …

Federated Learning Based Futuristic Biomedical Big-Data Analysis And Standardization, Sukumar Rajendran, Saurav Mallik, Zhongming Zhao

Faculty, Staff and Student Publications

Medical data processing and analytics exert significant influence in furnishing dependable decision support for prospective biomedical applications. Given the sensitive nature of medical data, specialized techniques and frameworks tailored for application-centric processing are imperative. This article presents a conceptualization for the analysis and uniformitarian of datasets through the implementation of Federated Learning (FL). The realm of medical big data stems from diverse origins, necessitating the delineation of data provenance and attribute paradigms to facilitate feature extraction and dependency assessment. The architecture governing the data collection framework is intricately linked to remote data transmission, thereby engendering efficient customization oversight. The operational …

Commentary On Healthcare And Disruptive Innovation, Hilary Finch, Affia Abasi-Amefon, Woosub Jung, Lucas Potter, Xavier-Lewis Palmer

Electrical & Computer Engineering Faculty Publications

Exploits of technology have been an issue in healthcare for many years. Many hospital systems have a problem with “disruptive innovation” when introducing new technology. Disruptive innovation is “an innovation that creates a new market by applying a different set of values, which ultimately overtakes an existing market” (Sensmeier, 2012). Modern healthcare systems are historically slow to accept new technological advancements. This may be because patient-based, provider-based, or industry-wide decisions are tough to implement, giving way to dire consequences. One potential consequence is that healthcare providers may not be able to provide the best possible care to patients. For example, …

Recent Advances In Research And Management Of Human Monkeypox Virus: An Emerging Global Health Threat, Parveen Kumar, Benu Chaudhary, Nishant Yadav, Sushma Devi, Ashutosh Pareek, Sujatha Alla, Fnu Kajal, Behdin Nowrouzi-Kia, Vijay Kumar Chattu, Madan Mohan Gupta

Engineering Management & Systems Engineering Faculty Publications

In 2003, the United States saw an epidemic of monkeypox that was later traced back to rodents of West Africa infected with the monkeypox virus (MPXV). Disease in the United States seemed less severe than the smallpox-like disease in the Democratic Republic of the Congo (DRC). In this study, researchers analyzed data from Central Africa: two distinct MPXV clades were confirmed by sequencing the genomes of MPXV isolates from Western Africa, the United States, and Central Africa. By comparing open reading frames across MPXV clades, scientists can infer which virus proteins might account for the observed variation in pathogenicity in …

Past Challenges And The Future Of Discrete Event Simulation, Andrew J. Collins, Farinaz Sabz Ali Pour, Craig A. Jordan

Engineering Management & Systems Engineering Faculty Publications

The American scientist Carl Sagan once said: “You have to know the past to understand the present.” We argue that having a meaningful dialogue on the future of simulation requires a baseline understanding of previous discussions on its future. For this paper, we conduct a review of the discrete event simulation (DES) literature that focuses on its future to understand better the path that DES has been following, both in terms of who is using simulation and what directions they think DES should take. Our review involves a qualitative literature review of DES and a quantitative bibliometric analysis of the …