Digital Commons Network^™

Perceived Barriers And Recommendations To Improve Well-Child Visits Among Medicaid Enrollees: An Explanatory Sequential, Mixed-Methods Study, Shawnda Schroeder, Keona Manuelito

Indigenous Health Faculty Publications

Despite the critical role of well-child visits (WCVs) in preventive care, many Medicaid-enrolled children miss these appointments, leading to gaps in early intervention and immunization. Existing research has largely focused on either quantitative analyses of visit rates and predictors or qualitative insights into patient and provider experiences. This study employs a mixed-methods, community-based approach to examine barriers to WCV attendance among Medicaid-enrolled families in North Dakota who missed all WCVs in 2021. Through administrative data analysis (n=64,364), surveys (n=1,294), and focus groups (n=40), findings reveal structural, economic, and cultural obstacles, including cost concerns, lack of Medicaid transparency, and logistical challenges. …

Silver Leaves On The Prairie: Investigating What Prairie Sage Needs, Taylor Lau

OER Materials

In this place-based lesson, fifth-grade students investigate a living prairie sage (Artemisia ludoviciana) plant, native to the Moorhead, Minnesota area, during a curiosity walk at the MSUM Regional Science Center. Aligned to Minnesota benchmark 5L.1.2.1.3, students collect at least three pieces of evidence, including measurements and observations of sunlight and soil, to show that plants get the materials they need for growth chiefly from air and water. Using the 5E model, students connect their findings to photosynthesis and Van Helmont’s willow experiment, then write a claim, evidence, and reasoning response about the conditions prairie sage needs to grow …

Using A Multimedia Icu Diary To Support Patient Recovery And Enhance Family Engagement In The Medical Intensive Care Unit Primary, Eliza Palow

MaineHealth Maine Medical Center

The purpose of this project was to design and implement a multimedia ICU diary incorporating QR-coded educational tools to support patient and family engagement, improve understanding of the ICU environment, and enhance emotional orientation and recovery during and after hospitalization.

Supporting Clinical Readiness And Well-Being In New Graduate Nurses: A Scoping Review, Angela Cyr Msn, Rn, Rnc-Nic, Npd, Bc

MaineHealth Maine Medical Center

Objectives: To map and synthesize current evidence on orientation strategies that integrate clinical and psychosocial support for newly licensed nurses, with a focus on first-year retention outcomes.

Competency Campfire Stories: S'Mores & Skills, Competency & Curriculum, Sparks & Social Media, Emily Bovino Msn, Rn, Cnl, Ccrn, Michael Defrancisco Msn, Rn, Britney Meunier Msn, Rn, Ccrn, Amy Stafford Dnp, Aprn, Ccns, Kristen Stogsdill Bsn, Rn, Ccrn

MaineHealth Maine Medical Center

Learning Objectives

• Identify strategies to foster connections and build confidence among new nurses by creating a supportive, interactive learning environment.

• Describe how to design and facilitate the Camp Competency onboarding experience to engage new nurses through interactive learning.

• Incorporate social media tools to enhance learner interaction and community-building.

Evolving Practices From Fasting To Non-Fasting Before Cardiac Catheterization: A Scoping Review, Sungjun Park Bsn, Cvbc, Cmsrn, Rn, Kristiina Hyrkas Phd, Licnsc, Mnsc, Rn

MaineHealth Maine Medical Center

NPO before cardiac catheterization may overstate aspiration risk: evidence supports allowing clear liquids before catheterization.

From Evidence To Action: Optimizing Ards Care In The Icu, Amy Stafford Dnp, Aprn, Ccns

MaineHealth Maine Medical Center

Objectives

• Define ARDS using historical and current diagnostic criteria

• Explain the pathophysiology of ARDS and its impact on lung mechanics, including compliance, driving pressure, and recruitable lung

• Recognize limitations of common monitoring tools, including pulse oximetry, and incorporate this into clinical decision-making

• Apply evidence-based management strategies for ARDS, including lung protective ventilation, PEEP optimization, proning, and adjunctive therapies

• Analyze clinical case scenarios to make decisions related to ventilator management, oxygenation strategies, and escalation of care

Changing Culture Through Shared Passion: How We Found Our Identity In The Medical Icu, Lorrie Sluti Bsn, Rn, Ccrn, Alison Griffin Bsn, Rn, Ccrn, Megan Massey Bsn, Rn

MaineHealth Maine Medical Center

The purpose is to examine the cultural transformation of a Medical Intensive Care Unit after the COVID-19 pandemic; highlighting how the development of a Unit-Based Practice Council restored unit identity, nursing job satisfaction, and improved patient outcomes.

Aerocom: Winter 2026, John D. Odegard School Of Aerospace Sciences

Aerocom: John D. Odegard School of Aerospace Sciences Alumni Magazine

No abstract provided.

Examining Team Leader Visual Dynamics And Team Performance In Pediatric Emergency Simulations, Annamarie Brosnihan

Graduate Studies Theses and Dissertations 2026

Pediatric medical emergencies are dynamic, high-intensity clinical situations that demand coordinated interdisciplinary actions for optimal patient outcomes. Effective teamwork and leadership are critical, especially during the preparatory phase. Here, team leaders define task goals, assign individual roles, and maintain situational awareness. This phase directs attention, organizes team dynamics, and ensures medical interventions are deployed properly. Medical simulations provide a unique opportunity to capture dynamic leadership behaviors in a controlled low-stakes environment using multimodal data, such as eye tracking, to gain insight into team leader cognitive processes (i.e., attention allocation and information processing). Prior research suggests that leaders who visually attend …

Developing The Whole Child: A Retrospective Ethnographic Case Study Of Prosocial Learning Efforts At One Elementary School, Bevan Brown

Graduate Studies Theses and Dissertations 2026

An alarming trend among elementary-aged students in the United States exhibiting significant deficits in social-emotional competency development has intensified since the Covid-19 pandemic. Challenges in developing competent prosocial skills in the elementary-aged years have been associated with difficulties in emotional regulation and social interactions, which can result in compromising school readiness and long-term academic success. Existing school infrastructure provides a vehicle for early intervention, specifically in supporting students with poor social and emotional wellbeing. Thus, the need for innovative pedagogical and instructional approaches that address the complex challenges of the 21st century has become increasingly essential. Coordinated approaches to prosocial …

Do Fair Schedules Matter? Work-Home Conflict And Justice In Emergency Medicine, Maresca J. Brand

Graduate Studies Theses and Dissertations 2026

Emergency physicians work in a high-demand environment requiring irregular, around-the-clock schedules, which can contribute to elevated work-home conflict and burnout. While previous research has focused on objective schedule characteristics such as length of shift or time of day worked, less attention has been given to how emergency physicians perceive the fairness of the scheduling process itself. Drawing on Work-Home Resources Theory and Personal Resource Allocation Theory, this study examines whether perceptions of schedule justice influence work-home conflict via schedule satisfaction. I propose that perceived fairness in schedule creation functions as a contextual resource that shapes whether a schedule is experienced …

Case Report: Primed Dendritic Cell Immunotherapy For Multiple Solid Tumors, Jeffrey Jones, Aly Alrabaa, William Decker, Luis Ferbeyre, Gregorio Viramontes, Rafael Gonzalez, Elideth Angulo, Antonio Zamudio, Raul Hernandez, Stephen Noga, Susana Hernandez-Reyes, Paul Zhang, Darryl Smith, Ara Karamanian, Luis Tamara, Dalton Greenwood, Matthew Halpert

Faculty, Staff and Students Publications

Many patients with advanced solid tumors ultimately develop resistance to conventional therapies, with especially limited options for those experiencing rapid progression or poor performance status, highlighting the need for personalized immunotherapies capable of inducing durable responses. In this retrospective case series, we describe the clinical course and outcomes of five adults (4 male, 1 female; median age 51 years [range, 39-62]) with metastatic solid tumors who achieved complete and durable remission following doubly loaded autologous dendritic cell therapy after failure of standard treatments, such as immune checkpoint inhibition, radiation, surgery, or endocrine therapy. Five patients, including prostate adenocarcinoma (n=1), malignant …

Metabolites Produced By Agat+ Cells Support Regeneration In The Planarian Schmidtea Mediterranea, Aubrey M Kent, Carlos Guerrero-Hernández, Carolyn Brewster, Sean Mckinney, Jason A Morrison, Mary C Mckinney, Eric J Ross, Frederick G Mann, Blair W Benham-Pyle, Alejandro Sánchez Alvarado

Faculty, Staff and Students Publications

Planarians exhibit extraordinary regenerative abilities driven by pluripotent neoblasts, yet the roles of post-mitotic progenitor and differentiated cells in this process remain incompletely understood. Here, we investigate the function of agat+ cells, epidermal progenitors expressing members of the arginine:glycine amidinotransferase (agat) gene family, in the regeneration of Schmidtea mediterranea. Comprehensive analysis of all five planarian agat paralogs revealed that agat-1, -2, -3, and -4 are co-expressed in subepidermal populations enriched at wound sites, while agat-5 is minimally expressed. RNAi-mediated knockdown of agat-1 and agat-2 resulted in severe defects: agat-1 primarily disrupted tissue homeostasis, …

Inheriting Chromosome Conformation, Kyle P Eagen

Faculty, Staff and Students Publications

No abstract provided.

Personalizing Therapies Over The Course Of Hormone Receptor-Positive/Her2-Negative Metastatic Breast Cancer, Akshara Singareeka Raghavendra, Senthil Damodaran, Carlos H Barcenas, Suzanne A Fuqua, Rachel M Layman, Debu Tripathy

Faculty, Staff and Students Publications

The hormone receptor (HR)‐positive/human epidermal growth factor receptor 2 (HER2)‐negative breast cancer subtype accounts for most early and metastatic breast cancer (MBC) cases. HR‐positive/HER2‐negative MBC is characterized by a relatively prolonged, although variable, disease course and substantial intertumoral and intratumoral heterogeneity. Although endocrine‐based therapies remain the cornerstone of treatment, nearly all patients eventually develop resistance, which is increasingly addressed with biologically targeted agents and newer‐generation cytotoxic drugs. This review summarizes the current understanding of HR‐positive/HER2‐negative MBC biology, highlighting mechanisms of intrinsic and acquired resistance, including driver genomic alterations that, along with clinical factors, help guide therapeutic choices and sequencing. The …

Esr1 Fusions In Breast Cancer: Functions, Mechanisms And Therapeutic Opportunities, Xuxu Gou, Zoya Farooqui, Charles E Foulds

Faculty, Staff and Students Publications

Approximately 70% of all breast cancers are driven by estrogen receptor-alpha (ERα) that binds the predominant circulating female estrogen, 17ꞵ-estradiol (E2). Because of this, drugs collectively termed “endocrine therapy (ET)” that either suppress E2 level or inhibit the activity of ERα have been used as first-line therapy. While initially effective, resistance to ET drugs occurs with subsequent lethal metastasis. The most common genetic alterations are point mutations in the ESR1 gene within the last exon encoding the ligand-binding domain (LBD), resulting in constitutively active ERα proteins. Recently, new oral selective estrogen receptor degraders (SERDs) that effectively target these point mutants …

Surface Marker Identification To Capture Live Circulating Tumor Cells In Metastatic Triple-Negative Breast Cancer, Bree M Lege, Khushali J Patel, Brendan Panici, Ping Gong, Michael T Lewis, Matthew J Ellis, Chonghui Cheng

Faculty, Staff and Students Publications

Metastatic triple-negative breast cancer (TNBC) is highly aggressive and lacks targeted therapies. Circulating tumor cells (CTC) are invaluable for monitoring metastatic tumor progression and treatment response but are difficult to capture because of their rarity and heterogeneity. Surface-based staining for live CTCs is essential to preserve RNA quality in single cells, but current markers tend to perform poorly on more mesenchymal tumor cells such as TNBCs. To enhance live TNBC CTC detection, we developed a workflow for live CTC capture and single-cell RNA sequencing (scRNA-seq). Using a mouse model of metastatic TNBC, we identified four new CTC surface markers, AHNAK2, …

Lysine Demethylase 4a Is A Centrosome-Associated Protein Required For Centrosome Integrity And Genomic Stability, Pratim Chowdhury, Xiaoli Wang, Richard I Han, Manga Motrapu, Ashley G Boice, Yuya Nakatani, Sofia Vargas-Hernandez, Julia F Love, Claude Chew, Sandra L Grimm, Dereck Mezquita, Frank M Mason, Elisabeth D Martinez, Cristian Coarfa, Cheryl L Walker, Anna-Karin Gustavsson, Ruhee Dere

Faculty, Staff and Students Publications

Centrosomes play a fundamental role in nucleating and organizing microtubules in the cell and are vital for faithful chromosome segregation and maintenance of genomic stability. Loss of structural or functional integrity of centrosomes causes genomic instability and is a driver of oncogenesis. Here we identify lysine demethylase 4A (KDM4A), an epigenetic 'eraser' of chromatin methyl marks, as a centrosome-localized protein, visualized at the nanometer-scale resolution. We additionally uncovered that KDM4A demethylase enzymatic activity is required to maintain centrosome homeostasis and integrity; a previously unknown functionality unlinked to altered expression of genes regulating centrosome number. We find that KDM4A interacts with …

School-Level Gaps In Mmr Coverage As The Fuel For Measles Outbreaks, Meagan C Fitzpatrick, Chad R Wells, Abhishek Pandey, Lamia Ayaz, Peter J Hotez, Seyed M Moghadas, Alison P Galvani

Faculty, Staff and Students Publications

No abstract provided.

Priced Out Of Treatment: The Exorbitant Cost Of Antiparasitic Drugs In The United States, Cora Alperin, Nhi Nguyen, Megan Duffey, Eva H Clark

Faculty, Staff and Students Publications

Parasitic infections are often perceived as diseases of low-resource countries, yet they impose a significant and overlooked burden in the United States—especially among immigrants, low-income individuals, and other marginalized populations. This perspectives article examines the case of Mr. X, a landscaper in Houston diagnosed with neurocysticercosis, who faced unaffordable drug costs despite the availability of effective, off-patent treatments. Through his story, we explore the broader issue of pricing for commonly and not-so-commonly prescribed antiparasitic medications, highlighting the role of systemic market failures, regulatory hurdles, and restrictive assistance programs in limiting access to care. The consequences of incomplete treatment include long-term …

School-Level Gaps In Mmr Coverage As The Fuel For Measles Outbreaks, Meagan C Fitzpatrick, Chad R Wells, Abhishek Pandey, Lamia Ayaz, Peter J Hotez, Seyed M Moghadas, Alison P Galvani

Faculty, Staff and Students Publications

No abstract provided.

Clinical Outcomes Of A Multidisciplinary Pediatric Program For People With Type 1 Diabetes Experiencing Elevated A1c And Frequent Admissions, Shelley Watts, Katherine Doyle, Blanca Cruzescalante, Caitlin Dinh, Pamela Rodgers, Perrin White, Abha Choudhary

2026

No abstract provided.

Can You Hear Me Now?, Daniel Gonzalez, Amanda Moore

Faculty Publications

No abstract provided.

A Different Starting Point: Youth Discipleship For A New Generation, Rogelio Paquini

Faculty Publications

No abstract provided.

Adherence And Compliance With Exercise Training In Progressive Multiple Sclerosis: Rates And Correlates From The Cogex Trial, Cogex Research Team, Robert W. Motl, Andrew Argie, Roberto S. Hernandez, Brian M. Sandroff, Maria Pia Amato, Giampaolo Brichetto, Jeremy Chataway, Nancy D. Chiaravalloti, Gary Cutter, Ulrik Dalgas, John Deluca, Rachel Farrell, Peter Feys, Massimo Filippi, Jennifer Freeman, Matilde Inglese, Cecilia Meza, Maria A. Rocca, Amber Salter, Anthony Feinstein

School of Health Professions

Background: There is limited understanding of adherence and compliance rates for exercise training(ET) in people with progressive multiple sclerosis(PMS).Objectives: This secondary, exploratory data analysis examined rates of adherence and compliance for continuous, moderate intensity training and high-intensity intervaltraining(HIIT) and possible correlates among people with PMS from the CogEx trial.Methods: CogEx was a multi-site, multi-arm, randomized, double-blinded, and shamcontrolled trial undertaken by 11 sites in six di8erent countries. Participants(N=311) wererandomized into one of four conditions with di8erent combinations of ET and cognitive rehabilitation, including respective sham conditions, delivered twice weekly over 12 weeks.The analysis focused on adherence and compliance rates and …

Next-Generation Virtual Environment Training For Cybersecurity In The Maritime Logistics Industry: A Position Paper, Tyler Cheng, Rory Hopcraft, Kimberly Tam, Ji-Jian Chin

School of Engineering, Computing and Mathematics

The maritime logistics industry is the most dependent on it in the modern world, yet it is not well protected against cyber risks. Recently, the maritime industry has been transitioning into industry-specific tech, and threats of cyberattacks are increasing as the adoption of technology and automation continues. One of the most effective methods to protect industries and ships from such security incidents, is to train seafarers to mitigate and handle such incidents. However, to the best of our knowledge, we did not find anything that addresses this gap. This article will present the idea and benefits of using virtual environments …

Rapid Electrochemical Biosensor With Enhanced Accuracy And Repeatability Using Pyrene Nhs Ester Modified 3d Graphene Electrodes, S. Nazir, D. Jenkins, G. Pan

School of Engineering, Computing and Mathematics

A consistent and reproducible chemical modification of the transducer interface is essential to ensure effectiveimmobilization of bioreceptors, thereby improving the sensitivity and reproducibility of biosensors. Althoughnotable progress has been made in fabricating graphene-based biosensors, the effects of surface biofunctionalization on sensing performance remain not fully understood. This study shows that combining threedimensional (3D) graphene foam electrodes with a straightforward, single-step surface biofunctionalizationmethod is key to enhancing the performance of graphene-based biosensors. Specifically, it presents a single-stepapproach to functionalize the 3D graphene foam (Gii-Sens) with 1-pyrenebutyric acid N-hydroxysuccinimideester (Pyrene-NHS ester). Electrochemical techniques, including cyclic voltammetry (CV) and differential pulsevoltammetry (DPV), confirmed …

From Predictions To Explanations: Explainable Ai For Autism Diagnosis And Identification Of Critical Brain Regions: 18th International Joint Conference, Biostec 2025, Kush Gupta, Amir Aly, Emmanuel Ifeachor, Rohit Shankar

School of Engineering, Computing and Mathematics

Autism spectrum disorder (ASD) is a neurodevelopmentalcondition characterized by atypical brain maturation. However, the adaptationof transfer learning paradigms in machine learning for ASD researchremains notably limited. In this study, we propose a computeraideddiagnostic framework with two modules. This chapter presents atwo-module framework combining deep learning and explainable AI forASD diagnosis. The first module leverages a deep learning model finetunedthrough cross-domain transfer learning for ASD classification. Thesecond module focuses on interpreting the model’s decisions and identifyingcritical brain regions. To achieve this, we employed three explainableAI (XAI) techniques: saliency mapping, Gradient-weighted Class ActivationMapping, and SHapley Additive exPlanations (SHAP) analysis.This framework demonstrates that …

Right Child In The Right Place: A Mixed-Method Case Study Of Plymouth City Council’S Placement Decision Systems, Leetice Taylor, Sheena Asthana, Oliver Beer, Cath Quinn

School of Health Professions

This research aims to understand how to reduce the use, and cost of inappropriate placements for Plymouth’s children in care. The number of children in care in England is rising, and local authorities are under pressure to find a suitable home within their local area for children in care, where appropriate. Local authorities are paying unsustainable costs for placements where children are facing potential negative outcomes. This research will synthesise information from academic literature, financial and demographic data, council staff, children in care and carers to understand best practice in placing children in the right place and driving down costs. …