Digital Commons Network^™

Inappropriate Laboratory Testing: Significant Waste Quantified By A Large-Scale Year-Long Study Of Medicare And Commercial Payer Reimbursement, Dave Smart, Jeff Schreier, Ila R Singh

Faculty, Staff and Students Publications

Context.—: Laboratory testing, beyond what is essential for managing health, is considered low-value care, posing patient risks and wasting resources. Measuring excess testing on a national level is crucial to identify waste and optimize healthcare resource allocation for maximum impact.

Objective.—: To measure inappropriate laboratory testing and its cost across Medicare and many US commercial payers.

Design.—: A retrospective analysis on 2019 claims data measured the frequency of 4 commonly used laboratory tests among 64 million individuals with Medicare and 168 million with commercial insurance. Tests included 25-hydroxy vitamin D, prostate-specific antigen, lipid panel, and hemoglobin A1c. Clinical guidelines, medical …

Can Targeting The Fgf23-Αklotho Signaling System Delay Phosphate-Driven Organ Damage?, Mohammed S. Razzaque, Moosa Mohammadi

School of Medicine Publications

Introduction: Inexorable high serum phosphate levels in chronic kidney disease (CKD) patients deteriorate the functionality of the musculoskeletal, renal, and cardiovascular systems, thereby contributing to increased morbidity and mortality. Higher phosphate balance has also been correlated with increased mortality rates in individuals with normal renal function, independent of other comorbidities. Clinical and epidemiological studies of CKD patients and healthy subjects, alongside evidence of accelerated aging in murine models induced by excessive phosphate loading, indicate that phosphate toxicity is a driver of premature aging and age-related organ damage.

Area covered: This article briefly discusses the causes and consequences of phosphate toxicity …

Altered Thermal Preference By Preoptic Estrogen Receptor Alpha Neurons In Postpartum Females, Nan Zhang, Meng Yu, Qianru Zhao, Bing Feng, Yue Deng, Jonathan C Bean, Qingzhuo Liu, Benjamin P Eappen, Yang He, Kristine M Conde, Hailan Liu, Yongjie Yang, Longlong Tu, Mengjie Wang, Yongxiang Li, Na Yin, Hesong Liu, Junying Han, Darah Ave Threat, Nathan Xu, Taylor Smiley, Pingwen Xu, Lulu Chen, Tianshu Zeng, Yanlin He, Chunmei Wang

Faculty, Staff and Students Publications

OBJECTIVE: This study aims to investigate how reproductive experience (RE) alters thermal preference and thermoregulation in female mice, with a focus on estrogen receptor alpha (ERα)-expressing neurons in the preoptic area (POA).

METHODS: Thermal preference and body temperature were measured in female mice with and without RE, and virgin female mice with selective deletion of ERα from the POA (ERα

RESULTS: We showed that female mice prefer a cooler environment starting from late pregnancy and persisting long term postpartum. Female mice with RE (>4 weeks post-weaning) displayed lower body temperature and a lower thermal preferred temperature, and lost preference …

High-Dose Methotrexate Usage Without Drug-Level Monitoring In Advanced Pediatric Mature B-Cell Non-Hodgkin Lymphoma In A Resource-Limited Setting In Malawi, Rizine R Mzikamanda, Loviisa Mulanje, Casey L Mcatee, Apatsa Matatiyo, Zoe Mwale, Grace Chirwa, Watipaso Wanda, Atupele Miranda Mpasa, Stella Wachepa, Minke H W Huibers, Steve Martin, Tamiwe Tomoka, Maurice Mulenga, Yuri Fedoriw, Gugulethu Mapurisa, Julie M Gastier Foster, Nader El-Mallawany, Katherine D Westmoreland, Peter Wasswa, Carl E Allen, Nmazuo Ozuah

Faculty, Staff and Students Publications

Purpose: Excellent survival for advanced (stages II with high lactate dehydrogenase, III, and IV) pediatric mature B-cell non-Hodgkin lymphoma (MB-NHL) has been achieved with intensive regimens, but adoption in sub-Saharan Africa is limited by inadequate supportive care. We provide real-world data on treating advanced MB-NHL with high-dose methotrexate (HD-MTX; ≥1,000 mg/m2/cycle) where real-time serum MTX monitoring is unavailable.

Methods: We identified two cohorts-a retrospective (January 2017-December 2020) cohort treated with 1,000 or 3,000 mg/m2/cycle of HD-MTX and a prospective (July 2022-July 2023) cohort-with a modified LMB96 protocol containing 3,000 mg/m2/cycle of HD-MTX. All doses of HD-MTX were given over 3 …

Organizational Health Psychology: A Compilation Of Open Access Research For Future Industrial-Organizational Psychologists, Caitlin Lapine

Open Touro Created

2025

Organizational Health Psychology: A Compilation of Open Access Research for Future Industrial-Organizational Psychologists is a text designed for industrial organizational psychology graduate students and organizational practitioners working to make the workplace better for all employees. This open educational resource provides important scholarly journal articles that describe current findings in the occupational health space, including research conducted on the COVID-19 pandemic’s influence on current work.

Assessment Of Physiological & Biochemical Changes In Tomato Plants Treated With Plant Growth Promoting Rhizobacteria (Pgpr) Under Salinity Stress Conditions, Mohammed Sharif Alhosani

Theses

Plant growth-promoting rhizobacteria (PGPRs) can effectively mitigate the negative impacts of salt stress on plants. The present study reports the isolation of PGPRs from a high-saline mangrove ecosystem in Abu Dhabi, with isolates exhibiting ACC deaminase (ACCD) activity to reduce stress-induced ethylene, along with additional plant growth-promoting (PGP) characteristics, including phosphate solubilization (P+). A total of 57 salt-tolerant bacterial isolates from the mangrove rhizosphere were initially screened for ACCD and P+ activities. Of these, 24 isolates tested positive for PGP characteristics and were further evaluated for their ability to enhance salt stress tolerance in tomato seedlings. In addition, seedlings inoculated …

Food Self-Sufficiency And Building-Integrated Urban Agriculture: Lessons From Singapore, Tomoki Fujii, Christoph Waibel, Xinyi Du, Zhongming Shi

Research Collection School Of Economics

Singapore aims to achieve 30 percent food self-sufficiency by 2030, known as the 30-by-30 target, and this paper reviews Singapore’s changing landscape for urban agriculture and its recent progress towards the 30-by-30 goal, highlighting key challenges such as land constraints, high production costs, and resource limitations. Building-integrated agriculture (BIA), which utilizes building surfaces such as rooftops, façades, and balconies for food production within urban environments, is examined as a potential way to increase self-sufficiency through a simulation. Despite the BIA’s potential, practical issues—including regulatory concerns and infrastructure limitations—must be addressed before it can be implemented at scale. Insights from Singapore’s …

The Relationship Between Food Insecurity And Emotional Eating During The Coronavirus Pandemic In Northern California, Andreza S.B. Souza, Marcelle M. Dougan, Giselle A.P. Pignotti

Faculty Research, Scholarly, and Creative Activity

Objectives: This cross-sectional study examined the association between food insecurity and emotional eating and explored correlations between emotional eating and dietary behavior in the U.S during the pandemic. Methods: Participants (N = 515, 77.1 % female, 44.1 ± 14.7 years old) completed a validated online survey between August and November of 2020 including questions about food security and eating behaviors. A multivariable linear regression model was used to evaluate the association between food insecurity and emotional eating. Pearson correlations were calculated to assess the relationship between emotional eating and dietary behavior Results: Overall, 31.3 % of the participants experienced food …

Global Review Of Consumer Preferences And Willingness To Pay For Edible Insects And Derived Products, Zewdu Abro, Kibrom T. Sibhatu, Gebeyehu Manie Fetene, Mohammed Hussen Alemu, Chrysantus M. Tanga, Subramanian Sevga, Menale Kassie

All Peer-Reviewed Publications

The rising global demand for protein, driven by population growth, urbanization, economic development, and climate change, underscores the need for sustainable alternative protein sources. Edible insects have emerged as a viable solution to enhance foodfeed and nutritional security while contributing to waste management. This study reviews 128 peer-reviewed publications to assess consumer preferences and willingness to pay (WTP) for edible insects and their derivatives. Findings reveal that studies predominantly focus on Europe and insect-based foods, with limited research on insect-based feeds and derived products. Consumers in Africa, Asia, and Latin America show higher acceptance of insect-based food compared to those …

Anti-Suit Injunctions And Dispute Resolution Clauses, Adeline Chong

Research Collection Yong Pung How School Of Law

In two decisions decided within a fortnight of each other, the Singapore Court of Appeal considered anti-suit injunctions pursued to restrain proceedings allegedly brought in breach of arbitration agreements. The first case, Asiana Airlines, Inc v Gate Gourmet Korea Co, Ltd (‘Asiana Airlines’)[1] dealt with whether A could rely on an arbitration agreement between A and B to restrain B’s proceedings against C, a third party. The second case, COSCO Shipping Specialized Carriers Co, Ltd v PT OKI Pulp & Paper Mills (‘COSCO Shipping’)[2] considered whether an arbitration agreement covered a tortious claim. To put it in another way, Asiana …

Understanding Dairy Livestock Farmers' Intention To Adopt Sociocultural Dynamics For Food Security Using The Theory Of Planned Behaviour, Paresh Kumar Sarma, Mohammad Jahanghir Alam, Samiha Sarwar, Sadika Haque, Golam Rabbani, Ismat Ara Begum, Andrew M. Mckenzie

Agricultural Economics and Agribusiness Faculty Publications and Presentations

This study examines the impact of socio-cultural dynamics (SCD) on food and nutrition security in dairy farming households. Recognizing the role of cultural practices, social networks, and access to resources in shaping food security, we emphasize the need to incorporate these factors into interventions for dairy farming. Using a systematic random sampling technique, we surveyed 400 households in the Rajbari District of Bangladesh in 2024 and analyzed the data using the Theory of Planned Behavior (TPB) and the Partial Least Square-Structural Equation Model (PLS-SEM model). The results revealed a positive association between the intention to adopt socio-cultural dynamics and food …

Bridging Cognitive Psychology And Natural Language Processing: A Bias-Detection Framework For Large Language Models, Stephen Surles

Masters Theses & Doctoral Dissertations

Bias in large language models (LLMs) poses substantial risks to fair and accurate information processing, particularly in high-impact contexts such as news dissemination and content moderation. These models often learn and unintentionally amplify systematic biases, ranging from confirmation and negativity to anchoring and partisanship, present in the data on which they are trained, thereby distorting public discourse and potentially fueling misinformation. Building upon theories in cognitive psychology and AI-decision-making, the Cognitive Bias in Artificial Intelligence Theory (CoBAIT) becomes the interdisciplinary theoretical foundation of this work.

Drawing on both cognitive bias theory and a design science approach, this dissertation develops a …

Cinacalcet For Infants And Young Children On Maintenance Dialysis: Determining The Right Time, The Right Dose And The Right Patients., Kyle Ying-Kit Lin, Fiona Fung-Yee Lai, Eugene Yu-Hin Chan, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is a recognized complication of kidney failure, which can lead to short stature, bone deformity, slipped capital femoral epiphysis, and bone fracture in children. Despite the use of conventional therapies, a subgroup of patients receiving dialysis continues to experience secondary or even tertiary hyperparathyroidism. Cinacalcet, a calcimimetic agent, has been shown to be a promising therapeutic option to control hyperparathyroidism with reasonable safety profiles in adults and older children. Nevertheless, there is a paucity of data and guidance pertaining to its use among the younger children on dialysis, who are often the …

Insulin Clearance At Randomisation And In Response To Treatment In Youth With Type 2 Diabetes: A Secondary Analysis Of The Today Randomised Clinical Trial, Kristen J Nadeau, Silva A Arslanian, Fida Bacha, Sonia Caprio, Lily C Chao, Ryan Farrell, Kara S Hughan, Maria Rayas, Melinda Tung, Kaitlyn Cross, Laure El Ghormli

Children’s Nutrition Research Center Staff Publications

Aims/hypothesis: Insulin resistance and compensatory hyperinsulinaemia are core features leading to beta cell failure in youth-onset type 2 diabetes. Insulin clearance (IC) is also a key regulator of insulin concentrations, but few data exist on IC in youth-onset type 2 diabetes. In a secondary analysis of our Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) randomised clinical trial, we investigated potential sex-, race-, ethnicity- and treatment-related differences in IC in youth-onset type 2 diabetes and aimed to identify metabolic phenotypes associated with IC at baseline and in response to metformin, metformin plus a lifestyle intervention, and metformin …

Quantitative Profiling Ph Heterogeneity Of Acidic Endolysosomal Compartments Using Fluorescence Lifetime Imaging Microscopy, Dinghuan Deng, Youchen Guan, Ayse Sena Mutlu, Baiping Wang, Shihong Max Gao, Hui Zheng, Meng C Wang

Center on Aging Staff Publications

The endolysosomal system plays a crucial role in maintaining cellular homeostasis and promoting organism fitness. The pH of its acidic compartments is a crucial parameter for proper function, and it is dynamically influenced by both intracellular and environmental factors. Here, we present a method based on fluorescence lifetime imaging microscopy (FLIM) for quantitatively analyzing the pH profiles of acidic endolysosomal compartments in diverse types of primary mammalian cells and in live organism Caenorhabditis elegans. This FLIM-based method exhibits high sensitivity in resolving subtle pH differences, thereby revealing heterogeneity within a cell and across cell types. This method enables rapid …

The Relationship Between Irritable Bowel Syndrome And Metabolic Syndrome: A Systematic Review And Meta‐Analysis Of 49,662 Individuals, Yomna E. Dean, Jose J. Loayza Pintado, Samah S. Rouzan, Lucy L. Nale, Ahmed Abbas, Abdulla Aboushaira, Farah Alkasajy, Ahmed A. Ghanem, Vinayak Mahesh Patil, Yana Gordeyeva

School of Medicine Publications

Background

Studies have shown mixed results regarding the association between irritable bowel syndrome (IBS) and metabolic syndrome (MS); This study aimed to assess the susceptibility of IBS patients to MS and its individual components.

Methods

PubMed, Scopus, Embase, and Web of Science were searched on 1/1/2023. Eligible studies were screened, and data on study characteristics, IBS diagnostic criteria, and metabolic syndrome components were extracted. Data were analysed in RevMan 5.4, with results reported as relative risk (RR) or mean difference (MD) and 95% confidence intervals. Statistical significance was set at p <  0.05.

Results

IBS was associated with an increased risk of …

Treatment Of Osteoporosis And Osteoarthritis In The Oldest Old, Daniel Pinto

Physical Therapy Faculty Research and Publications

Osteoporosis and osteoarthritis are key diseases of musculoskeletal ageing and are increasing in prevalence and burden with the progressively ageing population worldwide. These conditions are thus particularly common in ‘the oldest old’, and there are complexities of managing them within the context of extensive multimorbidity, physical and mental disability, and polypharmacy, the rates for all of which are high in this population. In this narrative review, we explore the epidemiology of osteoporosis and osteoarthritis in the oldest old before examining trials and real-world data relating to the pharmacological treatment of these diseases in older adults, including anti-resorptives and bone-forming agents …

Poder Familiar: A Culturally Tailored Health Intervention For Latino Families Of Children With Intellectual And Developmental Disabilities, Amy Pei-Lung Yu, Yolanda Suarez-Balcazar, Vanessa L. Errisuriz, Deborah Parra-Medina, Mansha Mirza, Minyu Zhang, Pei-Chiang Lee, Weiwen Zeng, Jasmine P. Brown-Hollie, Nazanin M. Heydarian

School of Social Work Faculty Publications

Background: This two-site pilot study examined the feasibility, acceptability and preliminary outcomes of PODER Familiar, a culturally tailored intervention to promote the health and well-being of Latina family caregivers and their children with intellectual and developmental disabilities.

Method: Using the Promotora de Salud model and mixed-methods design, we co-developed PODER Familiar with Latina caregivers of children with intellectual and developmental disabilities and community stakeholders. Thirty Latina caregivers and their children with disabilities were recruited to participate in the intervention, which included 10 individual sessions and 3 group sessions.

Results: Twenty-six Latina caregivers completed all 10 individual sessions, with high intervention …

Revisiting Diagnostics: High Priority Tuberculosis Diagnostic Tests That Fill An Unmet Need: What We Need And What We Do Not Need, Christoph Lange, Anna Maria Mandalakas, Troels Lillebaek, Dumitru Chesov, Keertan Dheda, Francesca Saluzzo

Faculty, Staff and Students Publications

No abstract provided.

Epidemiology Of Diagnostic Errors In Pediatric Emergency Departments Using Electronic Triggers, Prashant Mahajan, Emily White, Kathy Shaw, Sarah J Parker, James Chamberlain, Richard M Ruddy, Elizabeth R Alpern, Jacqueline Corboy, Andrew Krack, Brandon Ku, Daphne Morrison Ponce, Asha S Payne, Elizabeth Freiheit, Gregor Horvath, Giselle Kolenic, Michele Carney, Nicole Klekowski, Karen J O'Connell, Hardeep Singh

Faculty, Staff and Students Publications

Objectives: We applied three electronic triggers to study frequency and contributory factors of missed opportunities for improving diagnosis (MOIDs) in pediatric emergency departments (EDs): return visits within 10 days resulting in admission (Trigger 1), care escalation within 24 h of ED presentation (Trigger 2), and death within 24 h of ED visit (Trigger 3).

Methods: We created an electronic query and reporting template for the triggers and applied them to electronic health record systems of five pediatric EDs for visits from 2019. Clinician reviewers manually screened identified charts and initially categorized them as "unlikely for MOIDs" or "unable to rule …

Economic Model Of Uridine Triacetate Versus Supportive Care For The Treatment Of Patients With Life-Threatening Early-Onset Severe Toxicity, Jorge Garcia

All Publications

No abstract provided.

Breakfast Of Champions: Steam In Action, Susan Abraham

Professional Learning Day

Teach your students the fun of STEAM while encouraging them to become future entrepreneurs. Students will learn to develop a cereal - create the cereal box (all 6 sides), market the cereal, price the cereal, and make a 3D model of the cereal from recyclable materials. Students learn how viewpoints can affect consumer costs. They also learn the idea of working for a company challenge as this is a competition based project. Educators will learn to incorporate all subjects (Science, Math, Art, Social Studies, Engineering, and Technology) into this project. Educators will also learn how to involve the whole school …

Build Your Own World!, Sarah Robertson, Felicia Maxa

Professional Learning Day

You will be introduced to an activity that allows you to create a unique planet and learn about earth and space science in the process! In making your planet, you will use knowledge of formation, plate boundaries, landforms, weather, climate, wind currents, and more. You will sketch out planetary details and create a raised relief map that shows aspects of your planet. If you love Earth Science and project-based learning, this is the session for you. Bring a pencil and a positive attitude!

Ethical Considerations Of Percutaneous Endoscopic Gastrostomy Tube Placement In A Patient With Creutzfeldt-Jakob Disease And Advanced Dementia, Toni Habib, Niamh Siobhán Mulrooney, Yisroel Grabie, Mohammad Maruf, Sophia Kasapira

HCA Healthcare Journal of Medicine

Background

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative condition that is not easily diagnosed and has no curative treatments available, essentially requiring palliative measures, including tube feeding. Nonetheless, data shows that the endoscope used for percutaneous endoscopic gastrostomy (PEG) tube insertion can be a vector for CJD transmission.

Case Presentation

We discuss the case of an elderly patient diagnosed with CJD, requiring tube feeding. Multiple specialists were consulted, and they were unable to reach an agreement on the best approach. Eventually, the hospital ethics committee intervened, and the family agreed to comfort measures only. This case report sheds light …

Lessons In Service, Eric F. Spina

President's Blog: From the Heart

What a beautiful evening celebrating two outstanding members of the University of Daytonfamily! Jen and Verb — you are such deserving recipients of the Lackner Award, and I amhonored to offer a few remarks about how I see your leadership.

Landlord Licensure: A Pathway To Improved Rental Housing In New Mexico, Stefanie N. Jock

New Mexico Law Review

Over a thousand different professions throughout the United States are subject to occupational regulations for the purpose of protecting public health, safety, and welfare. Yet, few professions are as crucial to public health, safety and welfare as the business that controls access to rental housing. The availability of rental housing is critical to the people of New Mexico due to the state’s high percentage of low-income households and the shortage of affordable housing units available in recent years. Thus, low-income renters in New Mexico are often left dealing with substandard housing conditions or paying a significant portion of their income …

Overview Of Mechanisms Related To Citrulline Malate Supplementation And Different Methods Of High-Intensity Interval Training On Sports Performance: A Narrative Review, Hadi Nobari, Laya Samadian, Saber Saedmocheshi, Pablo Prieto-González, Christopher Macdonald

Kinesiology

Regular exercise is a practical non-pharmacological approach to maintaining physical and mental health through rehabilitation and prevention of chronic diseases due to its cardiovascular, cardiorespiratory, neurological, and neuromuscular benefits. Despite awareness of the benefits of exercise, a “lack of time” has proven to be the most common impediment to regular activity. Thus, a time-efficient and potentially enjoyable training modality with growing popularity is high-intensity interval training (HIIT). HIIT incorporates intermittent bouts of work and recovery intervals performed at an intensity close to maximal oxygen consumption (VO2max). HIIT is considered to have equivalent or superior benefits compared to moderate-intensity continuous training …

Reduction Of Prostate Cancer Risk: Role Of Frequent Ejaculation-Associated Mechanisms., Mohamed Hassan, Thomas W. Flanagan, Abdulaziz M. Eshaq, Osama K. Altamimi, Hassan Altalag, Mohamed Alsharif, Nouf Alshammari, Tamadhir Alkhalidi, Abdelhadi Boulifa, Siraj M. El Jamal, Youssef Haikel, Mossad Megahed

School of Medicine Faculty Publications

Simple Summary: There is considerable evidence to suggest that frequent ejaculation reduces the risk of prostate cancer. The more frequently ejaculation occurs without risky sexual behavior, the lower the risk of prostate cancer. The mechanisms regulating the reduction in PCa risk associated with frequent ejaculations are attributed to the suppression of the sympathetic nervous system, resulting in a relief of tension and a slowing of the division of prostate epithelial cells. It is suggested that ejaculation frequency affects gene expression in prostate tissue and subsequently influences the susceptibility of the tissue to tumor formation, leading to a reduction in the …

Fructose Induces Inflammatory Activation In Macrophages And Microglia Through The Nutrient-Sensing Ghrelin Receptor, Zheng Shen, Zeyu Liu, Hongying Wang, Danilo Landrock, Ji Yeon Noh, Qun Sophia Zang, Chih-Hao Lee, Yuhua Z Farnell, Zheng Chen, Yuxiang Sun

Faculty, Staff and Student Publications

High fructose corn syrup (HFCS) is a commonly used sweetener in soft drinks and processed foods, and HFCS exacerbates inflammation when consumed in excess. Fructose, a primary component of HFCS; however, it is unclear whether fructose directly activates inflammatory signaling. Growth hormone secretagogue receptor (GHSR) is a receptor of the nutrient‐sensing hormone ghrelin. We previously reported that GHSR ablation mitigates HFCS‐induced inflammation in adipose tissue and liver, shifting macrophages toward an anti‐inflammatory spectrum. Since inflammation is primarily governed by innate immune cells, such as macrophages in the peripheral tissues and microglia in the brain, this study aims to investigate whether …

Annual Comprehensive Financial Report, Hamilton County, For The Year Ended June 30, 2025, Tennessee. Comptroller Of The Treasury.

Tennessee County Audit Reports

No abstract provided.