Digital Commons Network^™

Extubation Decisions With Predictive Information For Mechanically Ventilated Patients In Icu, Guang Cheng, Jingui Xie, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Weaning patients from mechanical ventilators is a crucial decision in intensive care units (ICUs), significantly affecting patient outcomes and the throughput of ICUs. This study aims to improve the current extubation protocols by incorporating predictive information on patient health conditions. We develop a discrete-time, finite-horizon Markov decision process with predictions of future state to support extubation decisions. We characterize the structure of the optimal policy and provide important insights into how predictive information can lead to different decision protocols. We demonstrate that adding predictive information is always beneficial, even if physicians place excessive trust in the predictions, as long as …

Seasonal And Landscape-Driven Variations In Forage Resources Of Apis Mellifera Scutellata: Implications For Pollination Sustainability And Colony Health In Taita Taveta County, Kenya, Mary Chege, Mbatha B. Wambua, Wambua J. Kilonzo, Sevgan Subramanian, Beatrice T. Nganso

All Peer-Reviewed Publications

Seasonality and land-use change are key factors influencing forage availability for managed honey bee colonies, yet knowledge of forage identity and how these factors influence forage availability remains limited in Africa. To address these gaps, we used DNA metabarcoding to identify nectar and pollen plant species supporting the nutrition of the African savannah honey bee, Apis mellifera scutellata, across different land-use/land cover types and seasons in Taita Taveta County, Kenya. We identified 224 forage plant species from 65 families, with Asteraceae, Fabaceae, and Myrtaceae being the top contributors. Forage availability was significantly influenced by landscape and season, with honey bees …

Autologous T Cell Therapy For Prame, Martin Wermke, Dejka M Araujo, Manik Chatterjee, Apostolia M Tsimberidou, Tobias A W Holderried, Amir A Jazaeri, Ran Reshef, Carsten Bokemeyer, Winfried Alsdorf, Katrin Wetzko, Peter Brossart, Katrin Aslan, Linus Backert, Sebastian Bunk, Jens Fritsche, Swapna Gulde, Silvana Hengler, Norbert Hilf, Mohammad B Hossain, Jens Hukelmann, Mamta Kalra, Delfi Krishna, M Alper Kursunel, Dominik Maurer, Andrea Mayer-Mokler, Regina Mendrzyk, Ali Mohamed, Karine Pozo, Arun Satelli, Marilena Letizia, Heiko Schuster, Oliver Schoor, Claudia Wagner, Hans-Georg Rammensee, Carsten Reinhardt, Harpreet Singh-Jasuja, Steffen Walter, Toni Weinschenk, Jason J Luke, Cedrik M Britten

Faculty, Staff and Student Publications

In contrast to chimeric antigen receptor T cells, T cell receptor (TCR)-engineered T cells can target intracellular tumor-associated antigens crucial for treating solid tumors. However, most trials published so far show limited clinical activity. Here we report interim data from a first-in-human, multicenter, open-label, 3 + 3 dose-escalation/de-escalation phase 1 trial studying IMA203, an autologous preferentially expressed antigen in melanoma (PRAME)-directed TCR T cell therapy in HLA-A*02+ patients with PRAME+ recurrent and/or refractory solid tumors, including melanoma and sarcoma. Primary objectives include the evaluation of safety and tolerability and the determination of the maximum tolerated dose (MTD) and/or recommended dose …

Institute For Global Health And Development : Issue 11 - July 2025, Institute For Global Health And Development

IGHD Newsletters

• Climate Change, Water, And the Way Forward
• Dr. Zulfiqar Bhutta Joins Global Panel on CGTN America For World Health Day 2025
• IGHD Welcomes New Associate Faculty Members
• Dr. Zulfiqar A. Bhutta Named American Society For Nutrition (ASN) Distinguished Fellow 2025
• IGHD’s Dr. Ammad Qazi Delivers Keynote Address at AKU Climate Change Event
• New IGHD Research Project to Develop Sustainable Health Infrastructure in LMICS

CLIMATE CHANGE, WATER, AND THE WAY FORWARD

Struggling Access To Justice Through Mediation In Bangladesh: Headway Lessons From Australia, Jamila A. Chowdhury, Mehnaz Siddiqui

The Indonesian Journal of Socio-Legal Studies

Enormous case backlog and protracted delays in courts are hindering access to justice in Bangladesh. Consequently, an initiative to provide quick and low-cost consensual justice through mediation was first initiated in the family courts of Bangladesh in the year 2000. However, although after an initial success, the system has been struggling over the decades. While contemporary research has identified various constraints causing such meager disposal of cases in family courts, using expert interviews of family court judges and relevant literature review on Australian family courts, this Chapter reiterates such constraints to generate relevant headway lessons from Australia that has excelled …

I Belong Here And Am Thriving: Understanding Full-Time Graduate Student Well-Being And Belonging In An Msw Program, Lana Hart Elkins

Theses and Dissertations

Graduate-level social work students face high levels of stress that can impact their academic success and well-being. According to a national college health assessment, fulltime Master of Social Work (MSW) students at a southeastern university report significantly more academic, career-related, and financial stress than peers in other graduate programs. This study addressed the need to better understand full-time MSW student experiences and identify ways the program can mitigate stress, promote wellbeing, and foster a sense of belonging. Using a two-phase qualitative action research design, the study first analyzed responses to 12 open-ended questions from four student feedback surveys. These findings …

Academic Wellness In Health Professional Students: The Intersection Between Dietary Attitudes And Behaviors, Sleep Quality, And Mental Health, Kenya Shereece Moore

Theses and Dissertations

Academic success is strongly influenced by student well-being, with nutrition, sleep, and mental health emerging as critical and interconnected components. Health profession students often face significant mental and physical demands, as they navigate their educational training, which can challenge their ability to maintain healthy behaviors and access necessary support. Although these students are often trained to recognize, treat, and promote wellness in others, they may struggle to prioritize or seek care for themselves. This work aims to explore the health behaviors and care-seeking patterns of health profession students, with a focus on dietary habits, sleep, and barriers to mental health …

The Impact Of Adverse Childhood Experiences And Living With Hiv On Cardiovascular Health And Cardiometabolic Disorders In An African Population: An Analysis Of The Indepth Community In Rural South Africa, Samuel Gavi

Theses and Dissertations

Background: Adverse Childhood Experiences (ACEs) have been shown to be associated with cardiometabolic disorders (CMDs) and poor CVH; however, in Africa, this has not been well studied. Cardiovascular health (CVH) is an important measure of risk for cardiovascular diseases (CVD) developed by the American Heart Association (AHA). With the increasing prevalence of CVD in Africa, CVH is a potential upstream prevention approach. Africa also has the highest prevalence of HIV, and an increasing prevalence of comorbidities associated with it. Various mechanisms have been investigated to explain the relationship between CVD and chronic HIV infection. This study explores the potential relationship …

The Intersection Of Rurality And Wellness: A Multi-Manuscript Investigation Into Rural Well-Being, Lucas Perez

Theses and Dissertations

Rural communities face unique mental health and wellness challenges, including geographic isolation, provider shortages, and stigma surrounding help-seeking. This dissertation explores rural wellness through three interrelated studies, utilizing both qualitative and quantitative methods to examine disparities, perceptions of rurality, and demographic influences on well-being. The first study utilized the Five Factor Wellness Inventory (5F-WEL) to compare wellness scores between rural and non-rural individuals. The second study employed Interpretative Phenomenological Analysis (IPA) to explore rural definitions of wellness, as well as barriers and strengths related to mental health. The third study examined how perceptions of rurality and demographic factors predict wellness …

Exploring The Holistic Wellness Of Black Women Counselors, Shanta A. Jerideau

Theses and Dissertations

Counselor wellness is crucial for clinician longevity and ethical practice. However, there is limited literature on the holistic wellness of Black women counselors. This manuscript probes into the lived experiences of Black women counselors, particularly in relation to the sociopolitical climate and racial injustices in the United States. Utilizing Consensual Qualitative Research, we examine the experiences of 15 Black women counselors working in counselor education, private practice, and community agencies within the Southeast Region of the United States. We anticipate this approach will enhance counselor education literature and foster increased peer support.

Investigating Mechanisms And Day-Level Factors That Influence Children’S 24-Hour Movement Behaviors, Hannah Parker

Theses and Dissertations

Twenty-four hour movement behaviors (i.e., physical activity (PA), screen time (ST), and sleep) are associated with health outcomes, chronic disease (obesity, type 2 diabetes), and mortality. Most literature evaluating children’s 24-hour movement behaviors has focused on static person-level demographic information such as age or biological sex. Relatively less work has examined the variable factors that change day to day, such as environment or context. The Structured Days Hypothesis (SDH) suggests that when children are in structured environments, they have healthier movement behaviors compared to less structured environments where children have more discretionary time to engage in obesogenic behaviors. Besides school/childcare, …

Preventing Hospital-Acquired Pressure Injuries Using Turn Teams And Verbal Reminders, Joyce O. Blaboe

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) are a preventable, yet persistent issue in healthcare, particularly in the pulmonary and infectious disease unit of a Northeastern U.S. hospital. HAPIs prolong hospital stays, increase healthcare costs, and pose potential legal risks. Despite implementing evidence-based protocols, including the leaf patient monitoring system, the hospital reported six avoidable HAPIs cases in the early fiscal year 2025.

Aim: The quality improvement (QI) project aimed to reduce HAPIs incidents by 10% within 12 weeks by introducing turn teams and verbal reminders to enhance existing protocols.

Evidence Review: Regular turning and repositioning are essential to HAPIs prevention. Additionally, …

Enhancing Diabetes Care In Adult Patients With Type 2 Diabetes In An Outpatient Setting, Osayanmo Ojo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition associated with significant morbidity, particularly among underserved populations. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to improve diabetes care among adult patients with poorly controlled T2DM (A1C > 9%) in an outpatient primary care clinic by increasing referrals to the Diabetes Self-Management Education (DSME) program. Guided by the Plan-Do-Study-Act (PDSA) cycle and the OhioHealth Change Management (OHCM) model, the project implemented structured interventions including standardized DSME referral workflows, electronic health record (EHR) prompts, provider education, and culturally tailored communication strategies.

The 12-week initiative targeted 68 eligible patients. …

Utilizing The Patient Health Questionnaire In A Family Practice Clinic To Enhance Clinical Benchmarks, Dorothy Akaeze

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: About one-third of the 129 million chronically ill patients in the United States experience persistent depressive symptoms. Approximately 300 of 500 (60%) chronically ill patients treated at the project site each month show signs of depression, indicating a higher prevalence than the national rate of 33.33%. Despite the critical role of family practice in identifying and managing depression, many patients are not adequately screened, leading to missed opportunities for early diagnosis and treatment. The project site does not use the digitized PHQ screening tool to screen patients for depression. An analysis of patient charts revealed that, out of about …

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Behavioral Responses Of The California Two-Spot Octopus Octopus Bimaculoides To Changes In Color And Sound, Sofia I. Ramirez, Nathalie Reyns

McNair Summer Research Program

Recreational and commercial boat activity, military and construction operations, and seismic surveys among other human activities produce excessive sound that is classified as anthropogenic noise. Because the intensity and frequency of anthropogenic noise is often higher than that of natural underwater acoustic stimuli, marine animals may experience physiological damage to their sound-detecting organs which in turn, affects their communication and orientation abilities. In our study, we aimed to analyze the differences in behaviors exhibited by the California two-spot octopus (Octopus bimaculoides) when exposed to various volumes of noise at 54 Hz. To further investigate behavioral changes under varying conditions, we …

Functional Regulation Of Macrophages By Ces1d-Mediated Lipid Signaling In Immunometabolism, Long J Shao, Fathima Elizondo, Feng Gao, Rabie Habib, Xin Li, Katherine Pham, Jazmin Ysaguirre, Maryam Elizondo, Shirindokht Shirazi, Kristin L Eckel-Mahan, Sean Hartig, Huaizhu Wu, Kai Sun

Faculty, Staff and Student Publications

Objective: Macrophage accumulation in metabolically active tissues during obesity is common in both animals and humans, but the lipid signaling mechanisms that trigger macrophage inflammation remain unclear. This study investigates the role of Ces1d, an unconventional lipase, in regulating macrophage inflammation under nutritional stress.

Methods: A myeloid-specific Ces1d knockout (LysM-Cre-Ces1d floxed/floxed, KO) mouse model was used for the studies. For in vitro tests, bone marrow-derived macrophages (BMDMs) from control (Ces1d floxed/floxed, WT) and KO mice were assessed for migration, polarization, and activation. For in vivo experiments, WT and KO mice were induced to obesity via a high-fat diet (HFD) and …

Muscle Rev-Erb Controls Time-Dependent Adaptations To Chronic Exercise In Mice, Jidong Liu, Fang Xiao, Abhinav Choubey, Udhaya Kumar S, Yanxiang Wang, Sungguan Hong, Tingting Yang, Husniye Gul Otlu, Ege Sanem Oturmaz, Emanuele Loro, Yuxiang Sun, Pradip Saha, Tejvir S Khurana, Li Chen, Xinguo Hou, Zheng Sun

Center on Aging Staff Publications

The best time of the day for chronic exercise training and the mechanism underlying the timing effects is unclear. Here, we show that low-intensity, low-volume treadmill training in mice before sleep yields greater benefits than after waking for muscle contractile performance and systemic glucose tolerance. Baseline muscle performance also exhibits diurnal variations, with higher strength but lower endurance before sleep than after waking. Muscle-specific knockout of circadian clock genes Rev-erbα/β (Rev-MKO) in male mice eradicates the diurnal variations in both training and baseline conditions without affecting muscle mass, mitochondrial content, food intake, or spontaneous activities. Multi-omics and metabolic measurements reveal …

The Effect Of Integrating Augmented Reality (Ar) Technology In Science Education Teaching On Improving The Biological Concepts Learning Among Kindergarten Children, Kawthar Habeeb

Journal of Educational and Psychological Studies

This quasi-experimental study explored the impact of AR on acquiring biological concepts among kindergarteners. The sample comprised 30 second-level kindergarteners from a school in Farwaniya Educational Directorate, Kuwait. Participants were randomly divided into an experimental group (n = 15), taught using AR, and a control group (n = 15), taught traditionally. Results revealed statistically significant di erences in biological concept understanding, favoring the experimental group. Additionally, the experimental group demonstrated significant improvement from pre-test to post-test stages. These findings highlight the potential of AR to enhance learning outcomes in kindergarten biology education. The study emphasizes the importance of integrating AR …

Metabolic Clearance Rate Of Insulin Across The Glucose Tolerance Spectrum By Race And Ethnicity In Youth With Obesity, Wonhee Cho, Fida Bacha, Hala Tfayli, Sojung Lee, Sara F Michaliszyn, Joon Young Kim, Silva Arslanian

Children’s Nutrition Research Center Staff Publications

Objective: Despite β-cell failure in youth with dysglycemia (i.e., impaired glucose tolerance [IGT] and type 2 diabetes), fasting insulin (FI) concentrations are elevated. Herein, we examined the following: 1) metabolic clearance rate of insulin (MCRI) in youth with obesity and normal glucose tolerance (NGT) versus those with IGT versus those with type 2 diabetes; 2) racial and ethnic differences in insulin dynamics; and 3) metabolic/adiposity correlates of MCRI.

Methods: A total of 206 youth underwent assessment of fasting glucose, FI, MCRI and peripheral insulin sensitivity (PIS), first-phase insulin secretion, disposition index, body composition, and abdominal adiposity.

Results: In type 2 …

A Phase 2 Trial Of Short-Term Intravenous N-Acetylcysteine In Biliary Atresia After Kasai Portoenterostomy, Sanjiv Harpavat, Kristin A Borovsky, Michael E Scheurer, Laurel Cavallo, Franca E Erhiawarie, Sanjeev Vasudevan, Adam M Vogel, Dana Cerminara, Elizabeth M Tessier, Kalyani R Patel, Sridevi Devaraj, Benjamin L Shneider

Center for Medical Ethics and Health Policy Staff Publications

Background: For infants with biliary atresia, the only treatment that can establish bile flow and delay need for liver transplant is the Kasai portoenterostomy (KP). Unfortunately, the KP has variable success. In this study, we hypothesized that intravenous N-acetylcysteine (IV NAC) treatment following KP would improve bile flow.

Methods: This was a phase 2 study following the two-stage "minimax" trial design. Participants received IV NAC (150 mg/kg/day) for 7 days after KP, and the primary endpoint was achieving total serum bile acids (TSBA) ≤10 μmol/L within 24 weeks of KP. Secondary endpoints were clinical markers and the occurrence of sentinel …

Cardiac Rhythm Devices In Heart Failure With Reduced Ejection Fraction – Role, Timing, And Optimal Use In Contemporary Practice European Journal Of Heart Failure Expert Consensus Document, Biykem Bozkurt, Wilfried Mullens, Christophe Leclercq, Andrea M Russo, Gianluigi Savarese, Michael Böhm, Loreena Hill, Koichiro Kinugawa, Naoki Sato, William T Abraham, Antoni Bayes-Genis, Alexandre Mebazaa, Giuseppe M C Rosano, Shelley Zieroth, Cecilia Linde, Javed Butler

Faculty, Staff and Students Publications

Guidelines for management of heart failure with reduced ejection fraction (HFrEF) emphasize personalized care, patient engagement, and shared decision-making. Medications and cardiac rhythm management (CRM) devices are recommended with a high level of evidence. However, there are significant disparities: patients who could benefit from devices are frequently referred too late or not at all. Misconceptions about device therapy and the notion that the needs of patients (especially the prevention of sudden cardiac death) can now be met by expanding drug therapies may play a role in these disparities. This state-of-the-art review is produced by members of the DIRECT HF initiative, …

Dynamic Microbiome Responses To Structurally Diverse Anthocyanin-Rich Foods In A Western Diet Context, Mohammed F. Almatani, Giovanni Rompato, Eliza C. Stewart, Marcus Hayden, Jeremy Case, Samuel Rice, Korry J. Hintze, Abby D. Benninghoff

Animal, Dairy, and Veterinary Science Student Research

Background/Objectives: Anthocyanin (ACN)-rich foods are known to influence the gut microbiota composition, but the temporal dynamics and structural specificity of these effects remain poorly understood. This study investigated how distinct ACN-rich fruit supplements impact the gut microbiome over time in the context of a Western-style diet. We hypothesized that ACN-induced microbial shifts would occur rapidly, differ by ACN source, and require continued intake to persist. Methods: C57BL/6J mice were fed the total Western diet (TWD) supplemented with freeze-dried powders from bilberry (BB), tart cherry (TC), chokeberry (CB), elderberry (EB), black currant (BC), or black raspberry (BRB) for 0, 1, 3, …

Improving Health In Overweight Equines, Mikayla Joy, Karl Hoopes

All Current Publications

The primary treatments for overweight horses include diet modifications and incorporating exercise routines, with the most effective solution being a combination of both. There are special considerations and treatments for horses with equine metabolic syndrome (EMS), which is prevalent in obese equines. This fact sheet provides information on determining body condition, managing nutrition, and incorporating exercise to improve a horse's health.

Basic Rabbit Selection And Breeding Considerations, Joseph Okoh, Jessie Hadfield

All Current Publications

This fact sheet is designed to assist rabbit producers in understanding breed selection for a profitable enterprise. It can also serve as a training tool for new producers, aiding them in breed selection and breeding practices.

Defining Lipedema’S Molecular Hallmarks By Multi-Omics Approach For Disease Prediction In Women, Leon G Straub, Jan-Bernd Funcke, Nolwenn Joffin, Chanmin Joung, Sara Al-Ghadban, Shangang Zhao, Qingzhang Zhu, Ilja L Kruglikov, Yi Zhu, Paul R Langlais, Ruth Gordillo, Karen L Herbst, Philipp E Scherer

Children’s Nutrition Research Center Staff Publications

Lipedema is a chronic disease in females characterized by pathologic subcutaneous adipose tissue expansion and hitherto remains without druggable targets. In this observational study, we investigated the molecular hallmarks of lipedema using an unbiased multi-omics approach. We found adipokine dysregulation in lipedema patients participating in a cross-sectional clinical study (ClinicalTrial.gov, NCT02838277), pointing towards the adipocyte as a key player. Analyses of newly generated transcriptomic (SRA, PRJNA940039) and proteomic (ProteomeXchange, PXD058489) datasets of early- and late-stage lipedema samples revealed a local downregulation of factors involved in inflammation. Concomitantly, factors involved in cellular respiration, oxidative phosphorylation, as well as in mitochondrial …

Postoperative Delirium In Older Adults Undergoing Noncardiac Surgery, Heather L Lander, Andrew W Dick, Karen E Joynt Maddox, Mark A Oldham, Lee A Fleisher, Michael Mazzeffi, Stewart J Lustik, Jingjing Shang, Patricia W Stone, Marjorie S Gloff, Jacob Nadler, Isaac Wu, Raymond Zollo, Laurent G Glance

2020-Current year OA Pubs

IMPORTANCE: Understanding the association of postoperative delirium with adverse outcomes and the hospital-level variation of postoperative delirium is important for efforts to improve perioperative brain health.

OBJECTIVE: To examine (1) the association of postoperative delirium with 30-day mortality and complications and (2) hospital-level variation in postoperative delirium.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study examined hospitalizations among patients aged 65 years and older who underwent noncardiac surgery in US hospitals between January 1, 2017, and December 31, 2020. Data were analyzed between August 28, 2024, and April 10, 2025.

EXPOSURE: Postoperative delirium.

MAIN OUTCOMES AND MEASURES: The association of …

High-Frequency, At-Home Monitoring Of Drug Safety And Tolerability In Clinical Trials: Results From Studies Of Fluvoxamine For Covid-19 Treatment, Eric J Lenze, Madeline Nykamp, J Philip Miller, Angela Stevens, Julia Schweiger, Torie Gettinger, Michael Yingling, Yi Zhang, Ginger E Nicol, Charles F Zorumski, Angela M Reiersen

2020-Current year OA Pubs

Clinical trials are increasingly using remote monitoring techniques at the patient's home. We conducted a secondary analysis of remote safety and tolerability monitoring from two fully-remote clinical trials that tested fluvoxamine for the acute treatment of COVID-19. Both trials assessed pulse and blood pressure daily, and one study assessed symptoms daily via Ecological Momentary Assessment. On average, patients provided data on vital signs on 93% of the study days and provided data on side effects on 81% of the study days. With respect to safety, patients taking fluvoxamine had reduced pulse rate compared to placebo, with the greatest difference-5 points-at …

Transforming K-12 Classrooms: Ten Essential Strategies For Cultural Responsiveness, Sandra Johnson, Stephanie Johnson, Regina Reber

Journal of English Learner Education

Across the United States, in K-12 classrooms, diverse student populations continue to increase, challenging educators to meet student cultural, linguistic, and academic needs. The study examined the best practices related to culturally responsive teaching (CRT) strategies to better meet all students' needs. A qualitative approach was used to collect data from licensed K-12 educators in New Mexico and Colorado. The findings revealed three essential themes: culturally responsive pedagogy, the positive impact of CRT, and the creation of physical spaces to support inclusivity. The findings revealed the significance of building strong relational capacity, encouraging collaboration, supporting multilingualism, and creating effective physical …

Pushing Consumers To Plant-Based Milk Alternatives: What Drives Them?, Rabani Jannata Insani, Fatya Alty Amalia

ASEAN Marketing Journal

Manuscript type: Research Article

Research Aims: Describing the extent to which belief factors, supporting reasons, and opposing reasons can shape attitudes, thereby creating an intention to purchase plant-based milk products.

Design/methodology/approach: Using Behavioral Reasoning Theory. Data were collected through quantitative methods from 407 respondents using a questionnaire, targeting those who had consumed plant-based milk. Analyzed using the Partial Least Squares Structural Equation Modeling (PLS-SEM) method using SmartPLS 3.0.

Research Findings: The findings indicate that health beliefs, reasons for nutritional content, and supporting the environment significantly influence attitudes positively, while environmental beliefs have a positive but non-significant impact on attitudes. However, …