Digital Commons Network^™

Investigating The Relationship Between College Students’ Sense Of Belonging And Graduation Rates At A Private, Predominantly White Institution, Jamie Symonette

All Electronic Theses and Dissertations

This quantitative research analyzed the association between a sense of belonging and academic achievement among 514 undergraduates in a small, all-white institution (PWI), based on the 2025 Campus Life Survey and institutional data. Although national graduation disparities persist (64% of White students graduate within six years versus 54% of Latinx, 44% of Black, and 39% of Native American students), limited quantitative research has investigated belonging in private PWI settings. Variables were perceived sense of belonging, institutional climate, demographic factors (race/ethnicity, sex), academic advancement signs (cumulative GPA, earned credit hours), and seriously considered leaving. Multi-Regression (hierarchical and binary) and binary logistic …

Integrating Self-Organizing Maps And Explainable Artificial Intelligence To Unravel Surface Water-Groundwater Hydrochemical Evolution And Drinking-Water Suitability Controls In A Data-Limited Arid Basin, Hui Tong, Ruizhong Gao, Yinlong Wang, Xixi Wang, Limin Duan, Guoqiang Wang

Civil & Environmental Engineering Faculty Publications

Study region

The Dahei River Basin, located in the semi-arid northern region of China's Great Bend of the Yellow River.

Study focus

This study integrates hydrochemical characterization, stable hydrogen-oxygen isotopes, Self-Organizing Maps (SOM), the entropy-weighted water quality index (EWQI), and explainable ensemble learning (XGBoost-TreeSHAP) to investigate surface water-groundwater evolutionary patterns and identify key hydrochemical contributors to drinking-water suitability in the Dahei River Basin.

New hydrological insights for the region

Waters in the basin are predominantly weakly alkaline and are characterized by HCO₃^--Ca-Mg and HCO₃^--Na facies, indicating the combined effects of carbonate weathering and cation exchange, with …

Vocational Education And Employment Outcomes For Individuals With Disabilities: Trends, Barriers, And Supported Employment Practices, Taylor John Peterson

All Electronic Theses and Dissertations

This thesis examines literature that focuses on vocational education and employment outcomes for individuals with disabilities. This paper includes current vocational practices, barriers to employment, and the effectiveness of supported employment for individuals with disabilities. The studies used for this thesis show that work-based learning, career and technical education (CTE), and instruction in employability skills positively affect students’ employment outcomes. There are also barriers to employment for individuals with disabilities. They include employer misconceptions, limited accommodations, and a lack of transition services. Individuals with disabilities who receive supported employment have a much greater chance of obtaining employment. The findings in …

Physics-Informed Temperature Prediction Of Lithium-Ion Batteries Using Decomposition-Enhanced Lstm And Bilstm Models, Seyed Saeed Madani, Yasmin Shabeer, Michael Fowler, Satyam Panchal, Carlos Ziebert, Hicham Chaoui, François Allard

Electrical & Computer Engineering Faculty Publications

Accurately forecasting the operating temperature of lithium-ion batteries (LIBs) is essential for preventing thermal runaway, extending service life, and ensuring the safe operation of electric vehicles and stationary energy-storage systems. This work introduces a unified, physics-informed, and data-driven temperature-prediction framework that integrates mathematically governed preprocessing, electrothermal decomposition, and sequential deep learning architectures. The methodology systematically applies the governing relations to convert raw temperature measurements into trend, seasonal, and residual components, thereby isolating long-term thermal accumulation, reversible entropy-driven oscillations, and irreversible resistive heating. These physically interpretable signatures serve as structured inputs to machine learning and deep learning models trained on temporally …

The Gut-Heart Axis: Exploring The Role Of The Gut Microbiome In Cardiovascular Health-A Focused Systematic Review, Yahya Makkieh, Haider Hussain Shah, Sakan Binte Imran, Shadman Mahmood Mahmood Khan Pathan, Anagha Chirayath Saju, Mounica Majooju, Aastha Garg, Tarun Naag, Rabeeul Islam, Cheeranthodika Fahima, Ramsha Ali

Electrical & Computer Engineering Faculty Publications

This focused systematic review examines the role of the gut microbiota in cardiovascular disease (CVD). The review explores mechanisms linking gut dysbiosis with CVD via microbial metabolites such as trimethylamine-Noxide (TMAO) and short-chain fatty acids (SCFAs), which affect inflammation, endothelial function, and lipid metabolism. Interventions including dietary modifications, probiotics, prebiotics, fecal microbiota transplantation, and pharmacological agents such as statins, rifaximin, and empagliflozin are evaluated for their impact on microbial composition and cardiovascular outcomes. Probiotic strains and fiber-rich diets demonstrated modest improvements in blood pressure, lipid profiles, and inflammatory markers. Studies revealed that gut microbiome alterations influence drug metabolism and bleeding …

Interpretable Battery Soh Prediction: A Comparative Interpretability Framework For Multi-Architecture Ml Models, Shafiyee Islam, Gon Namkoong

Electrical & Computer Engineering Faculty Publications

This work introduces a unified interpretability-efficiency framework for lithium-ion battery state of health (SOH) prediction using hybrid deep learning architectures. We comparatively analyze four hybrid models: CNN LSTM MultiHead, CNN Feature Extractor LSTM, DNN LSTM, and DNN BiLSTM to disentangle how network topology, feature composition, and computational design influence both predictive fidelity and physical interpretability. By integrating Monte Carlo Shapley (MC Shapley), background occlusion SHAP (BoSHAP), and ablation analysis, we quantify the contribution and robustness of five electrochemical feature groups: time, capacity, voltage, dQ/dV and peaks of dQ/dV from NASA battery dataset. The results reveal a consistent dominance of differential …

Generative Ai-Driven Optimization In Flexible And Reconfigurable Manufacturing Systems, Salah Hammedi, Hicham Chaoui, Lotfi Nabli

Electrical & Computer Engineering Faculty Publications

Flexible and Reconfigurable Manufacturing Systems (FRMSs) are essential for coping with variability in modern production environments; however, efficient scheduling and rapid reconfiguration remain challenging. This paper presents a hybrid optimization framework that integrates Colored Petri Net (CPN) modeling with Generative Artificial Intelligence (GenAI) to enhance scheduling performance and system adaptability. The CPN formalism ensures verifiable modeling of system dynamics, while a transformer-based generative model produces candidate scheduling and reconfiguration strategies. Simulation experiments were conducted under static, dynamic, and adaptive scenarios, including machine breakdowns and dynamic job arrivals. Performance was evaluated using makespan, mean flow time, machine utilization, and reconfiguration latency. …

Fault Tolerance Of Accelerated Asynchronous Fixed-Point Iterations On Flexible Computing Infrastructure, Evan Coleman, Masha Sosonkina

Electrical & Computer Engineering Faculty Publications

Asynchronous iterative methods tolerate straggling processors by allowing workers to proceed with stale data, but at a cost: the iterates become inconsistent, potentially degrading convergence. We investigate whether convergence accelerators such as Anderson acceleration compensate for this degradation. We experimentally study three fixed-point iterations: the Jacobi method for sparse linear systems, value iteration for the Bellman equation, and the Hartree–Fock self-consistent field (SCF) iteration. The experiments are conducted using a high-performance execution framework, Ray, which abstracts the complexity of distributed systems and enables code parallelization and fault injection with minimal changes.

We establish two main results. First, straggler tolerance is …

Statewide Corridor Evacuation Response And Re-Entry Behaviors In Florida During Hurricane Irma, Xin Wang, Yuan Zhu, Hong Yang, Kun Xie

Electrical & Computer Engineering Faculty Publications

Hurricane Irma stands as one of the most destructive tropical storms to make landfall in the United States, particularly impacting the State of Florida, where it prompted the largest evacuation in history with approximately 7 million residents. The profound consequences of mass evacuation underscore the critical need to understand travel behaviors during hurricane evacuation and the recovery process. This research analyzes statewide evacuation and re-entry patterns, leveraging diverse datasets, including TTMS data from main corridors and GIS data. A statewide corridor-based empirical analysis framework is constructed to characterize evacuation and re-entry response patterns using sensor-based traffic observations. The results show …

Epigenetic Crosstalk In Neuroblastoma Development And Progression, Nathan Drolet, Amber Wolf, Joanna Yi, Eveline Barbieri

Faculty, Staff and Students Publications

Neuroblastoma (NB), a pediatric malignancy of the peripheral nervous system, accounts for 15% of pediatric cancer deaths and remains a major challenge for cancer therapy. NB originates from sympathoadrenal (SA) progenitors of the neural crest (NC) cell lineage, whose formation and differentiation are controlled by epigenetic mechanisms. Although signaling pathways and epigenetic factors implicated in NB tumorigenesis have been well-described, a holistic understanding of how development and epigenetics overlap to drive NB is lacking. By exploring vital interplays and co-dependencies between key pathways and their epigenetic control in NC development, we have gained novel insights into the mechanisms governing NB …

Stat4-Dependent Regulation Of Neuroinflammation In Atherosclerosis, Natalie Stahr, Alina K. Moriarty, Shelby D. Ma, W. Coles Keeter, Woong-Ki Kim, Larry D. Sanford, Elena V. Galkina

Department of Biomedical and Translational Sciences Faculty Publications

Atherosclerosis is linked to an increased risk of cognitive decline, with chronic inflammation being a common feature of both pathologies. IL-12 activates STAT4 to regulate myeloid cell functions, and blockade of this pathway alleviates cognitive impairment in Alzheimer's models. However, the mechanisms connecting vascular pathology to neuroinflammation remain unclear. Here, we examine whether STAT4 functions as a common mediator of neuroinflammation in atherosclerosis. We demonstrate that LysM^Cre-specific STAT4 deficiency ameliorates deficits in long-term memory in low-density lipoprotein-deficient (Ldlr^-/-) mice fed a high-fat diet (HFD-C). STAT4 deficiency moderately reduces Ser199-phosphorylated Tau burden. Atherosclerosis alters brain immune …

Senescent Fibroblasts In Aging And Pulmonary Fibrosis, Sara B. Palega, Aiwei Y. Borengasser, Yan Y. Sanders

Department of Biomedical and Translational Sciences Faculty Publications

Aging is a major risk factor for many chronic lung diseases, including Idiopathic Pulmonary Fibrosis (IPF), a fatal and incurable disease characterized by progressive fibrotic remodeling. Age-associated structural alterations, impaired regenerative capacity, and dysregulated cellular signaling collectively create a pro-fibrotic microenvironment. A central driver of this pathological shift is the accumulation of senescent cells, which undergo irreversible growth arrest and develop a robust pro-inflammatory senescence-associated secretory phenotype (SASP). Emerging evidence identifies senescent lung fibroblasts as critical mediators of IPF pathogenesis. These cells promote excessive extracellular matrix deposition, myofibroblast differentiation, and tissue stiffening, while simultaneously impairing epithelial regeneration. Together, these effects …

Inhibition Of Histone Demethylase Lsd1 Suppresses Cd47 Expression And Enhances Efficacy Of Cd47 Blockade In Breast Cancer, Fengjie Jiang, Yu Shen, Bing Li, Michael Henry, Nancy Davidson, Yi Huang

Department of Biomedical and Translational Sciences Faculty Publications

Background CD47 functions as a “don’t eat me” checkpoint, inhibiting macrophage-mediated phagocytosis in triple-negative breast cancer (TNBC). While anti-CD47 therapies can restore immune surveillance, their efficacy in TNBC is often limited by immune evasion and drug development challenges.

Methods We investigated the crosstalk between the histone demethylase lysine-specific demethylase 1 (LSD1) and CD47 signaling in TNBC using in silico datasets, isogenic cell lines, conditional BRCA1 knockout models, and syngeneic mouse models. Techniques such as immunohistochemistry, multiplex immunofluorescence, immunoprecipitation, protein ubiquitination, chromatin immunoprecipitation, chemotaxis, flow cytometry, and phagocytosis assays were employed to examine the epigenetic regulation of CD47 by LSD1 and …

The Effects Of Abused Drugs On Ferroptosis Pathways: Potential Therapeutic Targets For Substance Use Disorders, Tamara Bouchard, Brooke Russell, Liam Liyang Guo, Tina Nguyen, Yan Cheng, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

Substance use disorders (SUDs) remain major public health concerns worldwide, particularly in developed countries. SUDs are characterized by persistent neuroinflammation and synaptic dysfunction in the brain. Despite decades of extensive investigation, the detailed mechanisms underlying SUDs remain elusive. Ferroptosis is a highly regulated cell death process deeply affected by iron metabolism, lipid peroxidation, reactive oxygen species (ROS) production, and antioxidant systems. It has been implicated in multiple neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and ischemic stroke. Recently, emerging evidence has highlighted the role of ferroptosis in drug-induced pathological changes. Various types of abused substances including alcohol, cocaine, …

The Effects Of Abused Drugs On Ferroptosis Pathways: Potential Therapeutic Targets For Substance Use Disorders, Tamara Bouchard, Brooke Russell, Liam Liyang Guo, Tina Nguyen, Yan Cheng, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

Substance use disorders (SUDs) remain major public health concerns worldwide, particularly in developed countries. SUDs are characterized by persistent neuroinflammation and synaptic dysfunction in the brain. Despite decades of extensive investigation, the detailed mechanisms underlying SUDs remain elusive. Ferroptosis is a highly regulated cell death process deeply affected by iron metabolism, lipid peroxidation, reactive oxygen species (ROS) production, and antioxidant systems. It has been implicated in multiple neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and ischemic stroke. Recently, emerging evidence has highlighted the role of ferroptosis in drug-induced pathological changes. Various types of abused …

Multi-Isotope Tracing Reveals Nitrate And Sulfate Sources And Fate Across Contrasting Activity Zones In A Semi-Arid Basin Of Northern China, Chang Yue, Ruizhong Gao, Limin Duan, Tianke Su, Xixi Wang, Tingxi Liu, Guoqiang Wang

Civil & Environmental Engineering Faculty Publications

In semi-arid surface water-groundwater systems, nitrate (NO₃^–) and sulfate (SO₄²^–) are jointly influenced by natural processes and anthropogenic activities, yet how their sources, transformations, and export vary across contrasting activity zones remains insufficiently understood. Integrating hydrochemistry, multiple stable isotopes, a Bayesian isotope mixing model, and representative-section flux analysis, this study investigated the source compositions, transformation processes, and export differences of NO₃^– and SO₄²^– in the Dahei River Basin.   New hydrological insights for the region: Results showed greater SO₄²^– enrichment in high-activity zones, whereas NO₃^– exceedance was more prominent in low-activity zones. In …

Resilient Built Environment: An Overview On Design Strategies For Coastal Adaptation To Sea Level Rise, Farzaneh Soflaei, Gelareh Abdolzadeh, Navid Ziaee, Mohammad Amin Jafari, Faeghe Borhani

Civil & Environmental Engineering Faculty Publications

This paper delves into the escalating risks faced by urban coastal communities due to tidal and storm flooding, exacerbated by climate change-induced Sea Level Rise (SLR). Projections indicate a potential increase in sea levels by at least 3 feet by 2100, with historical data revealing an average annual rise of 1.2-1.7 mm since the 1900s. With over 300 million individuals inhabiting coastal areas, low-lying regions emerge as particularly vulnerable to the impacts of SLR. This accelerated rise amplifies the significant challenge of nuisance flooding, a local-scale issue aggravated by high tide and winds, leading to inundation, road closures, infrastructure deterioration, …

Physics-Based Multi-Hazard Fragility Modeling Of Low-Rise Wood-Frame Buildings Under Hurricane-Induced Wind And Surge, Mumtasirun Nahar, Abdullah M. Braik, Mohammad Syed, Maria Koliou, Petros Sideris

Civil & Environmental Engineering Faculty Publications

Coastal buildings are exposed to concurrent hurricane-induced wind and storm surge, yet their vulnerability is commonly assessed using separate single-hazard models that neglect hazard interaction. This study developed a physics-based finite element framework to evaluate the performance of a low-rise light wood-frame building under simultaneous wind and surge-wave loading. A detailed three-dimensional model was constructed using a sub-assembly strategy that explicitly represented framing members, sheathing systems, and critical connections. Structural response was evaluated across a hazard space defined by wind speed, still-water depth, and flow velocity, and component- and system-level fragility functions were derived using Monte Carlo simulation and generalized …

The Association Between Maternal-Fetal Medicine Physician Density And Pregnancy Outcomes, Tetsuya Kawakita, Rula Atwani, Misa Hayasaka, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective

We sought to examine the association between maternal-fetal medicine (MFM) physician density and adverse pregnancy outcomes at the state level.

Study Design

This was a cross-sectional analysis of publicly available, state-level data from 2018 to 2021, including Natality, Multiple Cause-of-Death, and Fetal Death databases. The number of active MFM physicians per year was obtained for each state from the American Medical Association Masterfile. The primary exposure was the density of MFM per state, categorized into three groups: (1) low density (< 30 MFM physicians per 100,000 live births), (2) moderate density (30-59 MFM physicians per 100,000 live births), and (3) high density (≥60 MFM physicians per 100,000 live births). Our primary outcome was maternal mortality during pregnancy and up to 42 days postdelivery. Our secondary outcomes were pregnancy-related mortality up to 365 days postdelivery and stillbirth. We calculated adjusted incident rate ratios (aIRR) and average marginal effect (AME) with 95% confidence intervals (95% CI) using multivariable negative binomial mixed effects regression models.

Results

Overall, there were 14,792,743 live births, 3,440 maternal mortalities, 4,980 pregnancy-related mortalities, and 90,848 stillbirths included. The …

Association Between Neighborhood Social Determinants Of Health And Stillbirth, Tetsuya Kawakita, Misa Hayasaka, Ann M. Harper, John Brush, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To examine the association between neighborhood-level social determinants of health and stillbirth.

METHODS:

We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative …

Mediating Effect Of Social Determinants Of Health Between Race And Phthalate Biomarkers In Pregnancy, Tetsuya Kawakita, Misa Hayasaka, Carole Barake, Trinity Soto, Jillian Fleming, Amir Lueth, Stevens Danielle, Alfred Abuhamad, Ann Pryzybylska, Elena Sinkovskaya, Kelly K. Ferguson, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Introduction

Prenatal phthalate exposure is linked to adverse reproductive and developmental outcomes and is consistently higher among non‐Hispanic Black compared to non‐Hispanic White pregnant individuals, yet the factors responsible for these disparities are poorly characterized. We sought to quantify Black–White differences in repeated urinary concentrations of phthalate biomarkers during pregnancy and to estimate the extent to which neighborhood‐level social determinants of health (SDoH) mediate these disparities.

Methods

This secondary analysis used data from the Human Placenta Project Study, a prospective observational cohort study conducted at two academic institutions between 2016 and 2018. Eligible participants had singleton pregnancies, were recruited before …

Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To quantify the extent to which rising rates of severe maternal morbidity (SMM) in the United States from 2016 to 2022 are attributable to increasing prevalence of maternal risk factors, including advanced maternal age, obesity, pregestational diabetes mellitus, gestational diabetes, chronic hypertension, and hypertensive disorders of pregnancy (HDP).

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022, representing more than 25 million weighted delivery hospitalizations. The primary outcome of SMM was identified with the Centers for Disease Control and Prevention's 21-condition algorithm; a secondary outcome excluded transfusion to improve specificity. Temporal trends …

Biomechanical Integrity Of The Female Pelvic Floor: A Comparison Of Military And Civilian Women, Vladimir Egorov, Peter Takacs, Vincent Lucente, Heather Van Raalte, Joy A. Greer, Noune Sarvazyan

Department of Obstetrics & Gynecology Faculty Publications

Introduction

The health of the pelvic floor depends on the integrity of its muscles, connective tissue, ligaments, and their innervation. The female pelvic floor may be more vulnerable to repetitive heavy loads in a military environment than the male pelvic floor because of anatomical and physiological differences. The study aim was to identify and explore possible differences in the female pelvic floor conditions between active military and civilian women with similar demographics.To identify and explore possible differences in the conditions of the female pelvic floor between active military women and civilian women with similar demographics.

Materials and Methods

Military active …

Consensus And Controversies Of International Guidelines For The Diagnosis, Surveillance, And Management Of Fetal Growth Restriction: An Updated Comparison, Daniele Diane Mascio, Suneet P. Chauhan, Tullio Ghi, Asma Khalil, Juliana G. Martins, Sara Sorrenti, Tamara Stampalija, Fabrizio Zullo, Francesc Figueras

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To compare areas of consensus and disagreements across contemporary international and national guidelines on the diagnosis, surveillance, and management of fetal growth restriction (FGR).

DATA SOURCES: Electronic searches of MEDLINE from database inception up to March 2026 using MeSH terms and keywords related to FGR and guidelines. STUDY ELIGIBILITY CRITERIA: Critical, structured comparison of national or international guidelines on FGR published since 2010. Final inclusion required unanimous agreement from all authors.

STUDY APPRAISAL AND SYNTHESIS METHODS: Pre-specified extraction across domains: definition; prediction/prevention; surveillance tools and frequency; delivery timing and mode; and labor induction methods. Dual data …

The Taper Sign: Sonographic Representation Of Uterine Dehiscence In Severe Cases Of Placenta Accreta Spectrum, Uma Deshmukh, Anna M. Modest, Alfred Abuhamad, Alireza A. Shamshirsaz, Jonathan L. Hecht, Scott A. Shainker

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Prenatal diagnosis of placenta accreta spectrum (PAS) depends on reliable ultrasound markers and skilled image interpretation. Existing PAS markers emphasize placental features suggestive of abnormal adherence and require advanced image optimization. However, emerging hypotheses suggest that uterine dehiscence—not placental invasion—is the central mechanism underlying PAS, particularly in severe (Grade 3) disease. Despite this, few established ultrasound markers address this uterine dehiscence. We describe a novel ultrasound marker, the taper sign, which uniquely represents the uterine dehiscence in severe PAS with anterior placenta previa, and outline a standardized technique for image acquisition and interpretation.

Methods: This descriptive report details the …

Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas

Department of Obstetrics & Gynecology Faculty Publications

Introduction and Hypotheses

Pelvic floor disorders (PFDs) affect women's quality of life through physical, psychological, and social domains. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) are validated tools for assessing symptom severity and quality of life impact. The current study aim to investigate the reliability and validity of the Hungarian versions of these questionnaires in women with PFD symptoms.

Methods

This validation study was carried out at the University of Debrecen among women with clinically confirmed pelvic floor disorders. The PFDI-20 and PFIQ-7 questionnaires were translated into Hungarian using independent native English speaker in …

Risk Of Gestational Diabetes By Aerobic And Resistance Exercise During The First And Second Trimesters, Takaki Tanamoto, George Saade, Leryn J. Reynolds, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

While some studies have shown that exercise reduces the incidence of gestational diabetes mellitus (GDM), there is limited evidence on whether aerobic or resistance exercise is more beneficial. This study aimed to examine the rate of GDM according to the type of exercise during early pregnancy.

Study design

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), a prospective cohort of individuals enrolled during the first and second trimesters. We excluded participants with pregestational diabetes or delivery < 20 weeks. The primary exposure was either aerobic or resistance exercises in the first or second trimester. For each trimester, the metabolic equivalent of task hours per week (MET-h/week) was calculated for each exercise. Participants were grouped as follows: "Aerobic exercise" (≥7.5 MET-h/week from aerobic exercises), "Resistance exercise" (≥2 times/week from resistance exercises), "Both types of exercise" (≥7.5 MET-h/week from aerobic exercise and ≥2 times/week from resistance exercises), and "Insufficient exercise" (≤7.5 MET-h/week from aerobic exercise and ≤2 times/week from resistance exercises). Our primary outcome was GDM. Adjusted relative risks (aRRs) with 95% confidence intervals (95% CIs) were calculated using modified Poisson regression, adjusting for potential confounders.

Results

In both the first and second trimesters, analyses included 9049 individuals. In the first trimester, individuals who performed …

Sleepiness In Pregnancy And Adverse Perinatal Outcomes, Rachel Friedlander, Xiaoning Huang, Phyllis Zee, Sadiya S. Khan, Philip Greenland, Francesca L. Facco, Judith Chung, William A. Grobman, Shalini Manchanda, Uma M. Reddy, George R. Saade, Robert M. Silver, Lynn M. Yee

Department of Obstetrics & Gynecology Faculty Publications

Background

Sleep disorders in pregnancy have been associated with adverse pregnancy outcomes including hypertensive disorders of pregnancy, preterm birth, and gestational diabetes mellitus, yet these findings are largely from retrospective studies. Using data from a prospective study that used validated tools to assess sleepiness in pregnancy, we aimed to assess the association of sleepiness in pregnancy with adverse pregnancy outcomes.

Methods

In this secondary analysis of data from a large, diverse prospective cohort of nulliparous individuals conducted at eight United States medical centers, those with self-reported sleep data were included. Sleepiness was evaluated in early (6-13 weeks) and mid-pregnancy (22-29 …

The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam

Department of Obstetrics & Gynecology Faculty Publications

Objective

Maternal anemia in pregnancy is associated with many adverse maternal, fetal, and neonatal outcomes. The role of social determinants of health (SDOH) in the development of maternal anemia and other adverse outcomes is continually evolving. One such newer tool, the Social Vulnerability Index (SVI), measures an individual's community-level SDOH, with higher SVI denoting higher vulnerability. Our objective was to evaluate the association between SVI, maternal anemia, and other adverse perinatal outcomes.

Methods

Retrospective cohort study of pregnant individuals delivering singletons at a gestational age ≥23 weeks at a single center from 2014 to 2018. Patients with sickle cell disease, …

The Association Between Social Vulnerability And Racial Disparities In Preterm Birth, Anita Pershad, Gabby Adams, Lindsay Robbins, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the association between county-level social vulnerability and preterm birth and assess whether racial disparities vary across levels of vulnerability.

Methods

This cross-sectional study utilized restricted Centers for Disease Control and Prevention natality data from 2023. We included Black or White births with singleton pregnancies across 3123 US counties from 50 US states and the District of Columbia. Participants were grouped into quartiles based on the county-level Social Vulnerability Index (SVI), with quartile 4 representing the most socially vulnerable populations. The primary outcome was preterm birth, defined as delivery before 37 weeks. Secondary outcomes included small for gestational …