Digital Commons Network^™

Identifying Textual Predictors Of Early Termination In Clinical Trials In Medicine: An Explainable Machine-Learning Study, Rohan Ramnarain

Dissertations, Theses, and Capstone Projects

About one in five clinical trials in medicine ends early, wasting valuable resources and reducing the evidence available for developing life-saving medical treatments. This project uses a method called Trial2Vec, which is a self-supervised machine-learning method that converts clinical trial documents into dense numerical representations that capture their key design and clinical characteristics, to turn each proposed clinical trial’s written protocol into a compact numerical profile (a process referred to as embedding). These profiles are then paired with a predictive machine learning models to identify the words and phrases in the trial documents that can signal a higher risk of …

Lethal Autonomous Weapons Systems And The Principles Of Distinction And Proportionality, Nicholas Cromie

Dissertations, Theses, and Capstone Projects

Lethal Autonomous Weapons Systems (LAWS) challenge the core principles of International Humanitarian Law (IHL), distinction and proportionality, by delegating life-and-death decisions to algorithms rather than human judgment.  This dissertation examines whether LAWS can conform to these principles and, if so, under what conditions.  Through process tracing, the study traces the historical integration of disruptive weapons technologies, including chemical, biological, nuclear, and armed drones, into IHL-compliant frameworks or their exclusion via prohibition.  Each case reveals distinct pathways: outright bans for indiscriminate or inherently inhumane systems (chemical and biological weapons), normative restraint and limited acceptance despite destructive power (nuclear weapons) and phased …

Supramolecular Assembly In Short Peptide Systems For Selective Metabolite Recognition And Drug Nanoencapsulation, Maithreyi Ramakrishnan

Dissertations, Theses, and Capstone Projects

Short peptides can form adaptive supramolecular assemblies, and understanding how minimal sequences organize around neurometabolites or hydrophobic cancer drugs enables the rational design of functional materials. This thesis combines molecular dynamics with experimental validation to establish design rules linking peptide sequence to emergent structure and function. Chapter 1 outlines the molecular determinants governing peptide assembly. Chapter 2 reviews computational workflows that reveal sequence-dependent conformations and supramolecular organization. Chapter 3 applies these principles to Dynamic Peptide Libraries which identify tetrapeptides that selectively interact with neurometabolites. Chapter 4 extends the same interaction-driven framework to design tryptophan-rich pentapeptides that co-assemble with kinase inhibitors …

New York State Excelsior Scholarship Program: A Post-Implementation Analysis Of Student Success, Eligibility, And Indebtedness – An Intersectional Study Of Black And White Female Students, Marcus I. Richardson

Dissertations, Theses, and Capstone Projects

The New York State (NYS) Excelsior Scholarship Program, introduced in 2017, was designed as a “first-in-the-nation” tuition-free initiative intended to expand college affordability for undergraduate students attending public institutions in New York State. While the program aims to increase access to higher education, its eligibility requirements, particularly the expectation that students complete 30 credits annually through continuous full-time enrollment, may disadvantage students whose academic pathways diverge from traditional enrollment patterns. This study examined the relationship between structural, financial, and academic factors and students’ ability to retain Excelsior Scholarship eligibility at the City University of New York (CUNY). Using institutional data …

Radiotheranostics For Gynecological Pathologies, Joni Sebastiano

Dissertations, Theses, and Capstone Projects

Molecular imaging, specifically positron emission tomography (PET), is vital for detecting disease and understanding its biological makeup. The exploitation of radiolabeled antibodies for PET imaging has proven to be indispensable to the field of molecular imaging over the last several decades. The development of radioimmunoconjugates for use in immunoPET has not only allowed for the sensitive, specific, and high-resolution detection of disease, but has also enabled a deeper understanding of the disease biology, ultimately guiding more personalized therapeutic strategies. Most typically, this technology is harnessed for the diagnosis and treatment of cancer, however more recently, the field has explored the …

Computational Insights Into Nucleosome Dynamics In Epigenetics Using Molecular Dynamics Simulations, Rutika Patel

Dissertations, Theses, and Capstone Projects

Nucleosome core particles (NCP) are the building blocks that form a highly organized and compact chromatin structure. Nucleosomes package DNA in the nucleus of eukaryotic cells. The NCP consists of about 147 base pairs of DNA wrapped around the histone octamer, with 1.65 superhelical turns in a left-handed manner. The histone octamer is composed of two copies of H3, H4, H2A, and H2B. Together with histone H1 and linker DNA, they further assemble into a higher-order chromatin structure. The nucleosome complex is stabilized by electrostatic interactions between positively charged histone residues and the negatively charged DNA backbone. To effectively access …

A Comparison Of Manufacturers’ Claims Of Attenuation Rates In Non-Custom Earplugs, Skyler M. Shipley

Dissertations, Theses, and Capstone Projects

Recreational and social environments frequently expose individuals to high intensity noise environments; however, the use of hearing protection devices (HPDs) remains limited. This study evaluated whether non-custom, over-the-counter musicians’ earplugs provide attenuation consistent with manufacturers’ claims and whether cost is associated with performance. Six commercially available earplug models were tested using both human participants and a KEMAR manikin system. Attenuation was measured across frequencies from 250–8000 Hz (octave and inter-octave frequencies) and were tested using different ear tip sizes. Results indicated that several earplugs achieved attenuation levels comparable to or exceeding their advertised noise reduction ratings (NRR), though consistency varied …

Imagination And The Self: A Cross-Cultural And Cross-Disciplinary Study, Qianyi Qin

Dissertations, Theses, and Capstone Projects

This dissertation is an interdisciplinary investigation of the imagination and the self that engages with cognitive science, philosophy of mind, Buddhism, ethical theories, and a variety of perspectives from Asian and Western philosophy. I address the following questions in three interrelated chapters. First, what does it mean for the self to appear in imagination? In Chapter 1, against certain narrow understandings of the self in philosophy of language, I build a multidimensional model of the self in imaginative experiences to capture the rich phenomenology, drawing on empirical findings on memory and imagination. Second, can the self be removed from imagination? …

Essays On Health And Immigration Policy, Selen Ozdogan

Dissertations, Theses, and Capstone Projects

This dissertation consists of two essays in applied microeconomics, each examining how individuals and institutions respond to policy changes. Both essays leverage natural experiments and recent advances in difference-in-differences estimation to identify causal effects. Both also speak to a common theme in public policy: the gap between intended and actual consequences of government intervention, and the role that policy design plays in shaping those consequences.

The first essay examines the impact of state-level e-cigarette excise taxes on nicotine and tobacco exposure among adults aged 18 and older. A central contribution is its use of individual-level panel biomarker data from urine …

Urban Sacred Grove: A Visioning For Collective Care, Preservation, Environmental Justice, And Resilience, Oluwadara A. Ojugbele

Dissertations, Theses, and Capstone Projects

My capstone explores how the concept of sacred groves—a community-based practice of conserving forest areas for cultural, spiritual, or religious purposes—can be reimagined as a framework for urban environmental stewardship and community care. Sacred groves have historically varied across time and place but consistently serve as protected spaces that honor divine forces, ancestors, and community values. In the Yoruba context, groves demarcate lush forests as abodes for oriṣas (divine forces) and spiritual beings, often containing shrines and artifacts that embody cultural beliefs. My capstone draws on the sacred grove concept and aims to illustrate how urban communities might adopt sacred …

Race And The Enduring Logic Of Exclusion In U.S. Immigration Policy, 1882–2025, Kejda Nikollaj

Dissertations, Theses, and Capstone Projects

This thesis examines how immigration law in the United States has historically functioned as an instrument of racial exclusion and argues that this logic continues to shape contemporary policy and enforcement. Although overtly racist laws such as the Chinese Exclusion Act (1882) or the National Origins Act (1924) have long been repealed, their underlying rationales and structures continue to survive under the modern language of legality, security, and national interest. This study argues that restrictive immigration policies tend to emerge when racial and social insecurities intersect, allowing old hierarchies to be revived under new legal justifications. Through a comparative historical …

Gremlin Theory: A Film Art Of Joe Dante, Frank Falisi

Dissertations, Theses, and Capstone Projects

This thesis seeks to establish the work of the filmmaker Joe Dante as a catalyzing and anarchic force let loose inside larger, dumber superstructures: linear narrativity, Hollywood, America, etc. It works to read the genre films he worked on—many of them made as popular entertainment for mainstream movie studios—as moments of actual subversion, allocating status quo (studio system) resources to create a biting-back against American imperial norms in the lingua franca of Marx and the Marx Brothers: gummy leisure-seeking stupidity and Gremlin transformation. This thesis seeks to argue that to understand Dante’s work is to understand pop transfiguration itself. This …

Mapping Nucleosome Stability: Linking Oncogenic Structural Alterations To Long-Range Allosteric Communication, Augustine C. Onyema

Dissertations, Theses, and Capstone Projects

The nucleosome core particle (NCP) is essential for chromatin structure and function, serving as the fundamental unit of eukaryotic chromatin. Oncogenic mutations in core histones disrupt chromatin dynamics, altering DNA repair and transcription processes. How DNA communicates with histones, and how this information propagates through the histone, has been suggested to be a cooperative process. Here, I investigate the molecular consequences of two mutations, H2BE76K and H4R92T, using 36 µs of all-atom molecular dynamics simulations on Anton2. I also characterize the kinetic correlation within histone/DNA domains via conditional activity (CONDACT) using the dihedral angle as our degrees of …

A Predictive Coding Account Of Spatial Working Memory Following Prophylactic Levetiracetam Administration Prior To Traumatic Brain Injury, Omeima Mutwali

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) symptom prevention and remediation is an important area of research that would benefit vulnerable groups, including active-duty and veteran soldiers. These patients can sustain penetrative forces in fields of combat or in training, which result in focal lesions that trigger inflammatory and degenerative processes in the brain. Both primary and secondary injuries are associated with changes to cognition, behavior and affective state. This disease poses increased risk of epileptogenesis, as well. Given these outcomes, prior research has evaluated levetiracetam (LEV) as a prophylactic treatment for seizures, cognitive deficits and negative emotionality. LEV acts as a presynaptic …

The Exception: Refugee Camps And Governmental Control, Kyle L. Mans

Dissertations, Theses, and Capstone Projects

This capstone study examines the relationship between governmental control and the state of exception in refugee camps. This connection is analyzed by examining the control mechanisms employed by the nation state to erode the sovereignty of the individual within a refugee camp space. This study also examines how humanitarian organizations contribute to the perpetuation of the state of exception and how their involvement facilitates further state control. Included in this capstone are two case studies that examine both Libya and Kenya as examples of governmental control on the sovereignty of refugees and migrants. This research contributes to the overall understanding …

Investigating Individual And Group Level Mediators Of Fear Acquisition, Rachel S. Lese

Dissertations, Theses, and Capstone Projects

The ability to discriminate between cues predictive of threat vs. safety (fear acquisition) and subsequently update fear responding when contingencies change (fear extinction) is crucial to survival for all organisms. While these processes have been the subject of intense experimental scrutiny for several decades, most human fear learning studies have focused primarily on extinction learning and fear recovery processes, with less focus on fear acquisition itself. Indeed, researchers typically aim to minimize variability during fear acquisition in order to rule out differences in extinction being driven by variability during the initial learning phase. Thus, experimental protocols are often optimized to …

Theatrical Agency In The Constitution Of Logical Space, Esther Marveta Neff

Dissertations, Theses, and Capstone Projects

This dissertation takes advantage of our current moment of collapse and shifting episteme to move from resistance and critique into modes of position, prefiguration, and praxiocentricism, giving not only a critique of the colonial-modern logical space of Theatrum Mundi, but also aiming to configure the thetic consciousness that grounds “theatrical agency” in the logic of cognitive and social epistemological modelling.  In what ways do we “build our own worlds”? What does “theatricality” tell us about human agency, especially in the domain of “theoretical attitudes,” and “consciousness”? In what ways, and to what extent, are we responsible for constituting …

From Institutions To Families: Assessing The Progress Of Egypt’S National Strategy For Alternative Child Care Reform, Yasmine M. El Hagry

Theses and Dissertations

This study serves as a critical mid-term review of the Egyptian National Strategy for Alternative Care for Children and Youth without Parental Care (NACS) (2021-2030). The 10-year strategy overall goal is to shift from institutional care, such as orphanages, to family-based care, such as kafala, the Islamic alternative to legal adoption, for children deprived of parental care. While the global literature strongly advocates deinstitutionalization, empirical research on the operational risks and unintended harms that can arise during such complex transformations remains scarce.

Adapting the International Civil Service Effectiveness (InCiSE) Framework, this research uses a qualitative approach to diagnose the …

Volumetric Differences Of Thalamic Nuclei Are Associated With Posttrauma Psychopathology, Nick Steele, Ahmed Hussain, C. Lexi Baird, Courtney C. Haswell, Delin Sun, Leonel Rangel-Jimenez, Chadi G. Abdallah, Michael Angstadt, Geoffrey May, Hannah Berg, Jennifer U. Blackford, Josh M. Cisler, Judith K. Daniels, Nicholas D. Davenport, Richard J. Davidson, Maria Densmore, Seth G. Disner, Wissam El-Hage, Amit Etkin, Negar Fani, Jessie L. Frijling, Evan M. Gordon, Daniel W. Grupe, Ryan J. Herringa, Anna R. Hudson, Neda Jahanshad, Tanja Jovanovic, Anthony King, Saskia B.J. Koch, Ruth Lanius, Amit Lazarov, Gen Li

Psychiatry Faculty Publications

Background: Previous investigations of whole thalamus and thalamic nuclei volumes in posttrauma psychopathology have been sparse and limited in scope and have yielded inconsistent results. To address this, volumetric estimates of whole thalamus and thalamic nuclei were obtained from structural brain magnetic resonance imaging scans from 2058 participants across 20 worldwide sites in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Posttraumatic Stress Disorder (PTSD) working group. Methods: Thalamic volumes were compared in trauma-exposed participants with PTSD (n = 238), major depressive disorder (MDD) (n = 184), and comorbid PTSD+MDD (n = 618) and in trauma-exposed control participants (n …

Alterations Of Cerebral Extracellular Vesicle Microrna Profiling Potentially Disrupts Brain Homeostasis Following Myocardial Infarction, Md Monowarul Islam, Shouyi Liang, Lijun Sun, Guoku Hu, Neha Dhyani, Lie Gao, Tara L. Rudebush, Xue Xu, Jinpeng Liu, Irving H. Zucker, Changhai Tian

Markey Cancer Center Faculty Publications

Cognitive impairment (CI) is prevalent among heart failure (HF) patients. Although the brain injury in HF is multifactorial, oxidative stress and neuroinflammation are common pathological features of neurological disorders and are increasingly recognized as key mechanisms underlying CI. Extracellular vesicles (EVs) are well-established mediators of biological signaling in myocardial function and are widely recognized for transporting a variety of microRNAs. However, whether myocardial injury alters the miRNA profiles of brain EVs, potentially contributing to cognitive impairment (CI) by disrupting brain homeostasis, remains poorly understood. Using a rodent myocardial infarction (MI) model, we isolated brain EVs and characterized their miRNA profiling …

Antioxidant Therapy Reverses Hepatotoxicity Induced By Microcystin-Lr In A Cellular Model Of Metabolic Dysfunction-Associated Steatotic Liver Disease (Masld), Apurva Lad, Jason Kindle, Prajwal Hegde, Gabriel G. Kleer, Andrew L. Kleinhenz, Johnna A. Birbeck, Judy Westrick, Nicholas J. Peraino, Terry D. Hinds, Neeraja Purandare, Andrew M. Fribley, Steven T. Haller, David J. Kennedy

Markey Cancer Center Faculty Publications

Microcystin-LR (MC-LR) is a potent hepatotoxin that has been shown to cause liver damage even at doses lower than the established Low Observable Adverse Effect Level (LOAEL) of 200 μg/kg in animal models. We have previously observed that low-dose exposure to MC-LR in animals with diet-induced Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and subsequent treatment with antioxidants like N-acetylcysteine (NAC) and the Na⁺/K⁺ ATPase-Src kinase inhibitor pNaKtide significantly alleviated hepatic infiltration of immune cells, downregulated markers of inflammation and hepatotoxicity, increased the breakdown of the toxin molecule, and restored phase I and II drug metabolism pathways, including …

Chemical Structure Representation Standardization Is Needed To Generalize Metabolite-Pathway Involvement Prediction Across Kegg, Reactome, And Metacyc Knowledgebases, Erik D. Huckvale, Hunter N.B. Moseley

Markey Cancer Center Faculty Publications

Background/Objectives: Due to the utility of knowing the pathway involvement of metabolites detected in biological experiments, knowledgebases such as the Kyoto Encyclopedia of Genes and Genomes (KEGG), Reactome, and MetaCyc have annotated compound entries to specific pathways defined by the knowledgebase. However, these compound-pathway annotations are largely incomplete and are costly to obtain experimentally or curate from published scientific literature. This metabolite-pathway annotation incompleteness problem is amenable to machine learning (ML)-based solutions. But to date, no machine learning model has been trained on all three knowledgebases to maximize its performance and robustness. This may be due to inconsistencies in chemical …

GαQ Is A Heterotrimeric G-Protein Subunit That Directs The Selectivity Of Pparγ-Induced Gene Pathways Toward Energy-Related Processes Rather Than Adiposity, Evelyn A. Bates, Zachary A. Kipp, Wang Hsin Lee, Genesee J. Martinez, Sally N. Pauss, Philipp E. Scherer, Terry D. Hinds

Markey Cancer Center Faculty Publications

Background/Objectives: Signaling mediators of PPARγ influence pathways involved in adipogenesis, lipid storage, inflammation, energy-related processes, and glucose utilization. Recent research indicates that PPARγ coregulators, recruited or released during ligand binding, govern specific gene pathways. It was recently discovered that Gα_q, a heterotrimeric G protein subunit, also signals to PPARγ and may significantly affect adipogenesis and glucose sensitivity. Methods: To explore Gα_q’s role in adipocytes, we generated CRISPR-mediated Gα_q (Gnaq) knockout (Gnaq KO) and scramble control cells from 3T3-L1 preadipocytes. Results: The absence of Gα_q resulted in increased lipid accumulation and elevated serine 273 (but …

In Situ Molecular Organization And Heterogeneity Of The Legionella Dot/Icm T4ss, Przemysław Dutka, Yuxi Liu, Stefano Maggi, Debnath Ghosal, Jue Wang, Prashant P. Damke, Stephen D. Carter, Wei Zhao, Sukhithasri Vijayrajratnam, Joseph P. Vogel, Carrie L. Shaffer, Grant J. Jensen

Markey Cancer Center Faculty Publications

The Dot/Icm type IV secretion system (T4SS) is essential for Legionella pneumophila infection, but its in situ architecture and mechanism remain incompletely understood. Using cryo-electron tomography, we performed subtomogram averaging and 3D classification to resolve structural heterogeneity within the complex. We identified multiple assembly states of the inner membrane complex, including a fully assembled form with a hexamer-of-dimers DotO ATPase and symmetry mismatches between subcomplexes. A composite in situ model revealed a central channel above the inner membrane, likely used for substrate secretion. Imaging of infected macrophages showed T4SSs tethered to host vacuoles and extracellular vesicle release, suggesting additional effector …

The Phoenix Flora: Plant Survival, Succession, And Putative Adaptation In The Post-Atomic Landscapes Of Hiroshima And Nagasaki, Gian Marco Ludovici, Paola Amelia Tassi, Alba Iannotti, Colomba Russo, Fausto D'Agostino, Matilde Neble Segade, Timothy Mousseau, Andrea Malizia

Faculty Publications

The atomic bombings of Hiroshima and Nagasaki in 1945 created a unique environment of acute, high-dose ionizing radiation, contrasting sharply with the chronic low-dose rate exposure in the Chernobyl and Fukushima Exclusion Zones. This stands in stark contrast to the chronic, low-dose rate contamination that defines the Chernobyl and Fukushima Exclusion Zones. While the long-term ecological effects of the latter are well-documented, a systematic synthesis of the floral response to the atomic bombings is lacking. This review integrates historical data with modern radio-ecological principles to analyze plant survival and succession. We document the remarkable recovery of vegetation, from the resprouting …

Jurisdictional Waters, Jamison E. Colburn

Faculty Scholarship

No abstract provided.

Silk Vista Baby Versus Pipeline Embolization Device For Unruptured Distal Anterior Cerebral Artery Aneurysms: A Multicenter Propensity-Weighted Comparative Study., Valerio Da Ros, Frédéric Clarençon, Adam A. Dmytriw, Pascal Jabbour Md, Marios Psychogios, Peter Sporns, Ajit S. Puri, Ameer E. Hassan, Oktay Algin, Markus A. Möhlenbruch, Mauro Bergui, Oded Goren, Gregoire Boulouis, Takeshi Morimoto, Raoul Pop, Joanna Wk Ho, Virginia Pujol Lereis, Jared Cooper, Giancarlo Salsano, Alessandro Sgreccia, Arturo Consoli, Eytan Raz, Julien Burel, Khawaja Muhammad Baqir Hassan, Zhe Ji, Riitta Rautio, Maria Ruggiero, Federico Sabuzi, Stefania Proietti, Joseph Domenico Gabrieli, Michael Levitt, Antonio Armando Caragliano, Christophe Cognard, Gaultier Marnat, Nicola Limbucci, Mariangela Piano, Alexis Guedon, Andrea Romi, Fortunato Di Caterino, Mykola Vyval, Adrien Guenego, Mohamad Abdalkader, Thanh Nguyen, Vitor Mendes Pereira, Ocilio Ribeiro Goncalves, Erwah Kalsoum, Alessandro Pedicelli, Andrea M Alexandre, Luca Scarcia

Department of Neurosurgery Faculty Papers

BACKGROUND: Flow diversion is effective for unruptured distal anterior cerebral artery (DACA) aneurysms, yet comparative data between the Silk Vista Baby (SVB) and Pipeline Embolization Device (PED) in this challenging territory remain scarce.

METHODS: We conducted a retrospective multicenter study using the CRETA Registry, including consecutive patients with unruptured DACA aneurysms treated with SVB or PED. The primary endpoint was complete angiographic occlusion (O'Kelly-Marotta grade D). Secondary outcomes included procedural characteristics, clinical outcome (modified Rankin Scale), and complications. Overlap weighting was applied to account for non-randomized treatment allocation. Predictors of occlusion were explored using penalized logistic regression. A sensitivity analysis …

Can Generative Ai Make Farming Decisions? Current Status And Future Pathways: A Case Study In Row Crop Production With Chatgpt, Nipuna Chamara, Yufeng Ge, Joe Luck, Yu Pan, Saleh Taghvaeian, Cory Walters, Christopher Proctor, Daran Rudnick, Daren Redfearn

Department of Agricultural and Biological Systems Engineering: Faculty Publications

The agricultural decision-making process is experience-based, knowledge-dependent, time-sensitive, complex, and driven by historical data. Planting, fertilization, irrigation, and chemigation are key categories in farm decision-making, and currently there is no one-shot decision-support tool that covers all these activities. Generative Artificial Intelligence (AI) models are more advanced than traditional machine learning and deep learning models. These models have been trained on vast amounts of data from the internet, allowing them to accept unstructured data in various forms and generate human-like text, solutions to problems, and scenario predictions. Given this capability, we became interested in exploring the potential of generative AI in …

Routine Transfusion Of Rh(D)-Positive Rbcs To Rh(D)-Negative Patients Designated As Do Not Resuscitate Conserves Rh(D)-Negative Red Blood Cell Inventory, Julie Katz Karp, Jovanna Everetts, Juliana Guarente, Angelica Vivero, Tiffany Bohr, Mary Harach

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: A minority of blood donors are Rh(D)-negative, and Rh(D)-negative red blood cell (RBC) products are often overutilized. As such, Rh(D)-negative RBCs may be difficult to maintain in blood bank inventory.

Study design and methods: We changed our blood bank laboratory policy to approve non-alloimmunized Rh(D)-negative patients to receive Rh(D)-positive RBCs for routine transfusion under defined criteria. Those criteria included Rh(D)-negative males (all ages) and females (aged >50 years) who were designated as do not resuscitate (DNR), either with or without intubation, in the electronic medical record.

Results: From August 15, 2024 through August 15, 2025, a total of 204 …

Structured Telehealth Community Health Worker-Clinician Feedback And Diabetes Outcomes: A Randomized Clinical Trial, Elizabeth Vaughan, Xiaoying Yu, Amber Amspoker, Aanand Naik, Ashok Balasubramanyam, Craig Johnston, Christi Ballantyne, Salim S. Virani, Shelton Brown, Kristina Mena

Population Health, East Africa

Importance  Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited.

Objective  To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes.

Design, Setting, and Participants  This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025.

Intervention  Individuals were randomized 1:1 to the intervention …