Digital Commons Network^™

Asymptomatic Cryptococcal Antigenemia: A Multi-Clinic Cross-Sectional Study On The Prevalence, Associated Factors And Predictors Of Three-Month Outcomes Among Antiretroviralnaïve And Antiretroviral-Experienced Hiv Patients In Dar Es Salaam, Tanzania, Mandela Makakala, Mukasa Mohammed, Mabula Mabelele, Kamran Hameed, Philip Adebayo

Internal Medicine, East Africa

Background: Cryptococcal meningitis remains a leading cause of HIV/AIDS-related mortality, predominantly in Sub-Saharan Africa. Current screening and prevention efforts primarily target antiretroviral therapy (ART)-naïve patients, whereas strategies for ART-experienced individuals are less well defined.

Objectives: This study primarily aimed at determining the prevalence of asymptomatic cryptococcal antigenemia (ACA) among ART-naïve and ART-experienced patients, along with associated factors and predictors of three-month outcomes among HIV patients in three HIV clinics in Dar es Salaam, Tanzania. Secondarily, factors associated with serum cryptococcal antigen positivity in the overall study population were also assessed.

Methods: This cross-sectional clinic-based study recruited 273 HIV-positive participants (ART-naïve …

Why Doody's New Health Humanities List Is A Vital Catalyst, Sandra Y. Desjardins

Library Staff Publications

No abstract provided.

A Feasibility Study Of Sexual Organ-Dose Sparing Volumetric Modulated Arc Therapy In Female Low Rectal Cancer Patients Treated With Three-Dimensional Conformal Radiation Therapy, Margaret Downes, Victoria Olsen, Andre Williams, Rendi Sheu, Maria Thor, Lucy Greenwald, Vishruta Dumane, Kristin Hsieh, Ayesha Ali, Orly Morgan, Michael Buckstein, Deborah Marshall

Department of Radiation Oncology Faculty Papers

BACKGROUND: Sexual dysfunction is a significant toxicity of pelvic radiation therapy (RT) for female rectal cancer patients and may be more common with intensity-modulated techniques compared to three-dimensional conformal radiation therapy (3D-CRT). However, limited research has evaluated dose sparing of female sexual organs at risk (OARs), particularly erectile tissues that are critical for sexual function.

PURPOSE: This feasibility study aimed to demonstrate the practicality of contouring and sparing female sexual OARs in rectal cancer RT by generating sexual organ-sparing volumetric modulated arc therapy (SO-VMAT) plans from a small 3D-CRT cohort and comparing dose distributions to guide future planning.

METHODS: Nine …

Culture-Dependent Characterization Of Microbial Succession And Persistence In The Integrated Lunar/Martian Analog Habitat (Ilmah), Haley Olivia Boles

Theses and Dissertations

This study examines culture-dependent microbial monitoring in a closed lunar/Martian analog habitat, focusing on viable community dynamics relevant to long-duration missions. A standardized sampling and cultivation pipeline was implemented in ILMAH to track microbial succession and persistence under realistic operational conditions. Surface samples were collected across eight habitat zones at five mission timepoints (Days 0, 5, 10, 15, 20) during a 21-day crewed mission. Samples were concentrated post-collection and plated on chromogenic film media to quantify total aerobic bacteria (AC-R), fungi (YM-R), E. coli (EC), and S. aureus (SA). Plates were imaged and enumerated digitally; representative colonies were isolated and …

An Update On Novel Taxa And Revised Taxonomic Status Of Bacteria Isolated From Human Clinical Specimens Described In 2024, Arianna Carella, Karen C. Carroll, Erik Munson

Clinical Lab Sciences Faculty Research and Publications

Knowledge of novel and revised bacterial taxonomy facilitates routine operations in the medical microbiology laboratory and communication with important stakeholders. Notable new gram-positive taxa accepted in 2024 include the clinically significant Staphylococcus brunensis sp. nov., as well as Streptococcus suis subsp. hashimotonensis subsp. nov., which can be delineated from other Streptococcus suis subsp. by possession of the Lancefield group A antigen. Four novel Enterobacterales species are discussed, plus a novel eighth family Gallaecimonadaceae. One of these, Providencia huashanensis sp. nov. is clinically significant and harbors multiple genetic determinants that encode antimicrobial resistance mechanisms. Stenotrophomonas forensis sp. nov., derived from …

Living With Dementia In Kenya: Pathways To Care, Diagnosis And Management, Edna Bosire

Institute for Human Development, East Africa

Background: Sub-Saharan Africa (SSA) is experiencing a sharp rise in the size of theolder population; consequently, the incidence and prevalence of Alzheimer’s DiseaseRelated Dementias (AD/ADRD) is also expected to rise. There is limited research onAD/ADRD lived experiences have been conducted in SSA including Kenya. Our projectaimed to explore patient’s and caregivers lived experiences with Alzheimer’s disease inKenya.

Methods: This ethnographic study was conducted at the Aga Khan University hospital(AKUH), involving in-depth interviews with 21 health care providers, 26 patientswith mild cognitive impairment and 36 caregivers. We also conducted 10 homevisits and observations. Data were transcribed verbatim and thematically analysed.In what …

A Low-Power Mixed-Signal Potentiostat System-On-Chip With Integrated Dual-Slope Adc, Seth Mcrobert

Department of Electrical and Computer Engineering: Dissertations, Theses, and Student Research

This thesis presents the design and characterization of a low-power mixed-signal potentiostat that was integrated with a 65 nm core in a SoC for low-power electrochemical sensing applications. The system integrates a low-noise transimpedance-based potentiostat front end with a 12-bit dual-slope analog-to-digital converter (ADC) for accurate current-to-digital conversion. The potentiostat core—comprising the control amplifier, current-mirror network, and transimpedance amplifier—consumes 38.2 µA from a 2.5 V supply (95.5 µW) and achieves an input-referred noise floor of 113 µVRMS over a 330 Hz bandwidth, while having an input current range from 1 nA to 20 µA and a noise-limited sensitivity of 56.4 …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

Blood-Based Clinical Markers For Early Dementia Detection: Insights From Ad-Detect-Cohort, Benard Aliwa, Jasmit Shah, Olivera Nesic Taylor,, Samuel Nguku, Juzar Hooker, Dilraj Sokhi, Sylvia Mbugua, Litha Musili, Rachel Maina, Harrison Kaleli, Levi Muyela, Anne Njoki Gitere, Anne Nyambura, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Background: Over 55 million people worldwide live with dementia, with more than60% residing in low- and middle-income countries. Alzheimer’s disease, the mostcommon form of dementia, accounts for 60–70% of cases. Early and accurate diagnosisremains a global challenge, necessitating novel approaches to mitigate the diseaseburden. Biomarkers hold significant promise in improving diagnostic accuracy andpredicting disease progression. Validated biomarkers for the preclinical stages ofdementia are crucial for advancing diagnosis and therapeutic strategies. We aimedto identify potential clinical markers for early dementia detection and assess theirpredictive accuracy in identifying high-risk individuals.

Method: We analyzed blood samples from dementia cases (n = 30) and …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Reassessing Dementia Risk: Expanding The 2024 Lancet Commission Report For A More Accurate Global Understanding, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission Report analyzes 14 risk factors thataccount for 45 percent of global dementia cases. However, it overlooks four criticalrisk factors: poverty, wealth shocks, income inequality, and viral infections. This isparticularly concerning given that 57 percent of the identified risk factors in theLancet report are more prevalent in men, even though dementia predominantly affectswomen worldwide.

Method: In this policy paper, we used the recent global review studies and argue that itis essential to recalibrate and expand the 2024 Lancet Commission’s list of risk factorsto include poverty, wealth shocks, income inequality, and viral infections. Our analysissuggests that these …

Understanding And Willingness To Participate In Dementia Clinical Trials In Kenya: An Ethnographic Study, Edna Bosire, Lucy Kamau, Chinedu Momoh, Jasmit Shah, Karen Blackmon, Caroline Kiio, Irene Meier, Vaibhav Narayan, Olivera Nesic Taylor,, Zul Merali

Brain and Mind Institute

Background: Advancements in dementia research are in part contingent on participation in clinical research. Clinical trials can help researchers determine if new drugs, devices, or diagnostic procedures for dementia are safe and effective. However, little is known about clinical trials for dementia in resource constrained settings such as Kenya. The aim of our research was to explore people’s understanding of dementia clinical trials, their attitudes and perceptions towards dementia clinical trials and what can be done to enhance enrollments on such clinical trials.

Method: This was an ethnographic study involving 8 focused group discussions (FGDs; age and gender stratified; n=81) …

Perceptions And Attitudes On Biospecimen Sample Collection For Dementia Research In Kenya, Lucy Kamau, Chinedu Momoh, Karen Blackmon, Caroline Kiio, Jasmit Shah, Vaibhav Narayan, Irene Meier, Olivera Nesic Taylor,, Zul Merali, Edna Bosire

Brain and Mind Institute

Background: Biospecimen sample collection is crucial in dementia diagnosis and evaluation. Limited research exists from African Countries including Kenya on people's perception on biospecimen sample collection for dementia- a disease that is largely unknown. Our aim was to understand the public perceptions towards collection of biospecimen samples for dementia research in Kenya.

Method: We conducted 8 focused group discussions (FGDs; age and gender stratified) in Nairobi to understand people's perceptions about different biospecimens (urine, saliva, blood, tears, hair, cerebrospinal fluid (CSF) and the brain samples). An open-ended FGD guide was used for the discussions, each lasting about 90 minutes.

Result: …

From Pandemic Fix To Routine Care: How Can Telemedicine Be Effectively Implemented For Individual Health Services In The Philippines?, Dlsu Social Development Research Center

SDRC Projects

This policy brief presents findings from the 2024–2025 process evaluation of telemedicine implementation in the delivery of individual-based health services in the Philippines. Guided by the Organisation for Economic Co-operation and Development–Development Assistance Committee evaluation criteria and the World Health Organization health-system building blocks, the evaluation used policy and document reviews, key informant interviews, focus group discussions, and provider and patient surveys. The findings show that telemedicine remains relevant and can reduce travel and waiting times, improve continuity of care, and decongest health facilities. However, formal implementation remains limited and uneven. Many providers rely on commercial messaging and video platforms …

Closing The Gap Between Coverage And Care: Findings And Recommendations From The Philhealth Konsultasyong Sulit At Tama (Konsulta) Process Evaluation, 2021–2024, Dlsu Social Development Research Center

SDRC Projects

This policy brief presents the findings and recommendations of the 2021–2024 process evaluation of the Philippine Health Insurance Corporation’s Konsultasyong Sulit at Tama (Konsulta) Package. The evaluation examined the program’s relevance and coherence, effectiveness, efficiency, sustainability, and equity using policy and document reviews, national administrative data, fieldwork in selected regions, interviews and focus group discussions, and a stated-preference survey and costing exercise. The findings show that Konsulta expanded rapidly in terms of beneficiary registration, provider presence, and geographic reach. However, significant gaps remain in continuity of care, access to diagnostics and medicines, private-provider participation, payment efficiency, information systems, and implementation …

Piezoelectric Energy Harvesting From Roadways: Challenges, Advances, And Future Directions, Heba Mohamed Gaber, Mohamed Abdel-Raheem

Civil Engineering Faculty Publications

As the global demand for renewable energy intensifies, piezoelectric energy harvesting from roadways has emerged as a promising avenue for sustainable power generation. This systematic literature review analyzes 61 peer-reviewed studies to assess the feasibility, performance, and potential of integrating piezoelectric systems into roadway infrastructure. While technology faces challenges, such as high installation costs, limited energy output, and a scarcity of thorough economic evaluations, findings suggest it holds considerable promise as a supplementary renewable energy source. The review analyzes the operational characteristics and efficiencies of various piezoelectric transducers, identifies key factors influencing system performance, and evaluates recent technological advances. It …

Case Presentation: Unilateral Neuroforaminal Widening/Expansion On Cervical Radiograph, Mya J. Reese

Aurora GME

No abstract provided.

Mda At Your Service: A Deaf Person Wants To Become My Patient, Rachel Sinacola Dds, Ms

The Journal of the Michigan Dental Association

The column clarifies that under the Americans with Disabilities Act (ADA), dental offices must provide auxiliary aids or services for patients with hearing impairments, which may require a professional interpreter paid for by the dentist in complex visits. Members are encouraged to notify the MDA about practice/life changes (e.g., address changes or caseload shifts) to ensure proper benefits and dues discounts. New associates are strongly urged to utilize the MDA resource for contract review, which offers a 10% discount with Kerr Russell Attorneys. Additionally, the MDA Store provides free Labor Poster Packets, fulfilling state and federal employer requirements.

Mda Insurance: Offer Group Health Insurance To Entice Recruits, Retain Valuable Staff, Craig Start

The Journal of the Michigan Dental Association

Amidst a competitive labor market, offering group health insurance is critical for attracting and retaining qualified dental staff, as it is the most highly valued employee benefit. Dentists can establish an employment policy stipulating cost-sharing for premiums, rather than paying the entire cost. The MDA strongly encourages investigating the exclusive MDA Health Plan, which offers 11 distinct plan designs powered by Priority Health. For 2026, the MDA Health Plan is increasing rates by only 4%, significantly lower than commercial group plans requesting double-digit increases (10% to 18%). Plans can be started at any time during the year, requiring about 30 …

Back Page: 9th District Delegation Attends Ada House Of Delegates, Michelle M. Nichols-Cruz

The Journal of the Michigan Dental Association

The ADA 9th District delegation, representing Michigan and Wisconsin, attended the ADA House of Delegates meeting in Washington, D.C., in October, which coincided with the ADA SmileCon event. During the meeting, Dr. Deb Peters, former MDA president and MDA House Speaker, was elected Speaker of the ADA House. This historic election makes Dr. Peters the first female ADA speaker. Dr. Michele Tulak-Gorecki, outgoing 9th District ADA trustee, was unsuccessful in her bid for ADA president-elect. The next ADA House meeting is scheduled for October 10-13, 2026, in Indianapolis, Indiana.

J Mich Dent Assoc December 2025

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons. The December 2025 (Volume 107, No. 11) issue of the Journal is published in a digital-only format to provide updates and insights for Michigan's oral health community and MDA members. Print editions will resume in the new year.

This issue includes feature articles on the Michigan Dental Foundation, A Case for Credentialing Dental Assistants, and a feature …

The Case For Credentialing Dental Assistants, Michelle Godofsky

The Journal of the Michigan Dental Association

Credentialing dental assistants is presented as a method to enhance productivity and address workforce shortages; currently, only about 15% of Michigan dental assistants are Registered Dental Assistants (RDAs). A case study at Thunder Bay Community Health Service, an FQHC in Northern Michigan, illustrates success, where RDAs perform expanded functions—like placing restorations and monitoring nitrous oxide—boosting clinic productivity by 16%. The clinic supports its dental assistants by covering education and exam expenses and providing study time during work hours. This investment improves job satisfaction, confidence, morale, and patient communication among staff, strengthening employee retention.

Here’S What’S New — Coming To The 2026 Mda Annual Session, Andrea Sunderman, David Foe

The Journal of the Michigan Dental Association

The 2026 MDA Annual Session, held April 30 – May 2 at DeVos Place in Grand Rapids, will feature significant improvements. The major change eliminates cumbersome a la carte pricing for courses. Instead, attendees can purchase a one-day pass or a full conference package, granting access to any course without advance sign-up. The schedule is shortened to two-and-a-half days. Passes include a hot lunch in the Exhibit Hall on Thursday and Friday, and courses are streamlined to allow more time for vendor visits and socializing. The event will also feature three keynote addresses and a new Friday night social event, …

2025 Author/Title Index To The Journal Of The Michigan Dental Association, Jackie Hammond

The Journal of the Michigan Dental Association

This comprehensive resource indexes articles published throughout 2025 in the Journal of the Michigan Dental Association. The content covers a wide range of topics relevant to Michigan dentistry, practice management, and legal compliance. Articles include findings on dental utilization rates pre- and post-COVID, legal guidance on issues like covenants not to compete and dental records, and clinical topics such as treating children with special needs. The index also features reports on MDA membership, the Foundation’s work, and analyses of generational differences in the workforce.

Case Presentation: 40 Year-Old Female With Chronic Neck And Low Back Pain, Chloe Nilles

Aurora GME

No abstract provided.

Making Explanations Make Sense: Xai For Smishing Detection, Eleni Alexandra Katsarakes

Psychology Theses & Dissertations

Explainable Artificial Intelligence (XAI) is a key component of effective human-AI collaboration, particularly in high-stakes domains such as cybersecurity. While AI tools hold promise for mitigating threats such as SMS-based phishing (SMiShing), their real-world effectiveness may hinge not just on detection accuracy, but on whether users can make sense of the system’s outputs. As SMiShing attacks grow in both frequency and sophistication, so does the urgency of designing human-centered AI systems that support user decision-making under uncertainty. This study examined how four distinct AI explanation types - Normative (rule-based), Attributive (feature-based), Exemplar (case-based), and Recommendation-Only - influence user performance, confidence, …

Leading With All The Feels: Exploring The Perceptions Of Middle School Administrators' Implementation Of School-Wide Social-Emotional Learning Programming, Sabrina Smith Richardson

Teaching & Learning Theses & Dissertations

Middle school administrators have multiple responsibilities that range from ensuring the safety and security of staff and students to overseeing the curriculum and instructional foci of their buildings. At the same time, middle school students are experiencing the early stages of adolescence. Because it is a complex time for students to navigate, it creates anxiety, a decline in academic achievement and motivation, and peer and academic pressures (London, 2022; Schlund, 2021). Middle school students have social-emotional needs that are not typically met in secondary schools, which means programming is not typically a part of the instructional day. This study examined …

Exploring The Impact Of Identity-Based Bullying On Suicidal Thoughts And Behaviors Among 6th-12th Grade Youth In Virginia, Camille N. Johnson

Psychology Theses & Dissertations

Suicidal thoughts and behaviors (STBs) are a growing public health concern among youth. Bullying victimization is a robust risk factor for STBs and identity-based bullying (IBB) or bullying that occurs due to a person’s actual or perceived social-identity/identities that is ingrained in discrimination, prejudice, or bias, has been found to be more strongly associated with STBs compared to bullying that was unrelated to identity. The current study used data from the Virginia School Survey of Climate and Working Conditions (N=399,493) to examine associations between general bullying, adult-perpetrated bullying, and IBB with depression and STBs among 6th-12th grade youth. This study …

On The Scalability Of Anisotropic Mesh Adaptation On Distributed And Shared Memory Architectures For Numerical Approximations, Kevin Mark Garner Jr.

Computer Science Theses & Dissertations

Mesh generation is a critical component in numerical approximations of Partial Differential Equations (PDEs). One such example includes Computational Fluid Dynamics (CFD), as CFD simulations in turn are crucial for applications in many industries, such as personalized healthcare and the design of aerospace vehicles. Generating high quality meshes for large-scale CFD problems presents a significant bottleneck in the CFD workflow. This dissertation proposes “fast,” parallel 3D mesh generation methodologies that are designed to leverage the concurrency offered by emerging High-Performance Computing (HPC) architectures. First, a distributed memory method is presented that integrates a sequential state-of-the-art isotropic, advancing front local reconnection-based …

Unraveling The Links Between Substance Use And Academic Motivation In Higher Education, Melissa Lynn Goins

STEMPS Theses & Dissertations

Self-Determination Theory (SDT) posits that the quality of students’ motivation regulation (i.e., autonomous versus controlled) shapes both learning and health behavior, yet few studies have examined the relations among motivation regulation, alcohol and cannabis use, and achievement. In this study, I surveyed 459 undergraduates at a mid-sized public university in the southeastern United States. Participants completed the Academic Motivation Scale-College version 28 to assess autonomous and controlled motivation regulation, a typical-week alcohol grid, a seven-day cannabis grid, and self-reported grade point average (GPA). Results indicated that autonomous academic motivation was uniquely related to GPA; however, neither motivation variable related to …