Digital Commons Network^™

Improving Hpv Vaccination Decision-Making For Adolescents And Their Caregiver, Mary E. Hohman

Dissertations

Abstract

Problem: Human papillomavirus (HPV) is a viral infection associated with the development of certain cancers and is the most common sexually transmitted infection in the United States (U.S.) (Centers for Disease Control and Prevention [CDC], 2023). The CDC (2021) asserts that more than 90% of cancers caused by HPV infections could be prevented through the HPV vaccination. The CDC recommends the HPV vaccine series for children ages 11 or 12 years; however, this organization further submits that the HPV series could be initiated as early as 9 years of age through 26 years of age (CDC, 2024). Despite CDC …

Implementing A Turn Team Process To Reduce Hospital-Acquired Pressure Injuries On A Telemetry Unit At A Hospital In The Midwest, Sally Wang

Dissertations

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: …

The Psychological Impact Of Parenting Child Victims Of Trauma, Stephanie Faulkingham

Dissertations

Abstract

Research indicates that non-offending caregivers of traumatized children (NOC) is a population with an elevated risk for increased levels of depression and anxiety and are an underserved population for mental health services. The purpose of this quality improvement project was to determine if screening caregivers of traumatized children using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder (GAD-7) improves identification of depression and anxiety. Participants of this investigation were individuals enrolled in the Children’s Advocacy Services of Greater St. Louis’ 12-week parenting group, TASK (Trauma, Assessment, Skills, and Knowledge). Each participant was asked to complete the PHQ-8 and …

Depression Screening In The Adult Inpatient Oncology Population, Erica Bizub

Dissertations

Routinely screening oncology patients for depression is recommended due to the higher rates of depression in this population as well as the negative impact of untreated depression. The goal of this QI project is to implement a standard depression screening protocol for patients admitted to this hospital, where there is currently no standard screening protocol. There were 110 patients included in this study, and 67 (60.91%) of patients received a PHQ-9 screening. Of the patients who completed the PHQ-9, 21 (19.09%) had a positive screening, which was a score of seven or higher. While there were high rates of provider …

Structural And Solution Property Characterization Of Oat Β-Glucans, Hongli Zhang, Yaning Shi, Ming Miao

Journal of Food Science and Biotechnology

[Objective ] This study aims to characterize the structure and investigate the solution properties of oat β-glucan (OBG ).[Method ] Two soluble OBGs with different weigh-average molecular weights (Mw),number-average molar weights (Mn),and peak molecular weights (Mp) were prepared by hot water extraction and ethanol classification.The structures and solution properties were characterized by Fourier-transform infrared spectroscopy (FT-IR ),nuclear magnetic resonance (NMR ),X-ray diffraction (XRD ),scanning electron microscopy (SEM ),high performance size exclusion chromatography coupled with multi-angle laser light scattering (HPSEC-MALLS ),and rheology.[Result ] OBG- 1 and OBG- 2 showed the Mw of 80.73×104 g/mol and 8.05×104 g/mol,the yields of (4.86±0.55)% and …

Effects Of Tea Polysaccharides On The Properties Of Chestnut Starch, Lei Lei, Wenjun Fu, Lingling Yang, Haibo Liu, Daxi Sang, Qing Wang

Journal of Food Science and Biotechnology

[Objective ] This study aims to improve the properties of chestnut starch.[Method ] Tea polysaccharides were added to chestnut starch in different proportions,and the effects of tea polysaccharides on the water-holding capacity,digestive properties,textural properties,and other properties of chestnut starch were investigated.[Result ] The water-holding and oil-holding properties of chestnut starch were the largest when tea polysaccharides were added at 1% and then gradually decreased with the increase in the proportion of tea polysaccharides added.The transparency of chestnut starch gradually increased when tea polysaccharides were added from 1% to 8% and decreased significantly when tea polysaccharides were added at 16%.Adding tea …

A Study Of Machine Learning Techniques In Solving Biochemical And Chemical Problems, Kenneth Micheal Plackowski

Chemistry and Chemical Biology ETDs

Data-driven approaches to solving problems in biology and chemistry require utilization of reliable techniques and machine learning algorithms are the modern reliable approach. This work presents three problems that involve use of supervised learning techniques when classification is the goal and unsupervised learning techniques when global data representation is the goal.

In the first problem, we demonstrate the use of unsupervised clustering techniques, self-organizing maps and K-means, to ascertain analyte detection capabilities of carbon nitride dots. In the second problem, we add scalability features to a functional group classification model applied to infrared data and evaluate its ability to inform …

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …

Evaluation And Expansion Of Posttraumatic Avoidance Assessment: Proposal Of A Novel Measure Of Posttraumatic Positive And Negative Experiential Avoidance For Use In Research And Clinical Practice, Marissa A. Yetter

Dissertations

Avoidance is a well-established mechanism in the development and maintenance of posttraumatic stress disorder (PTSD) and a central treatment target in gold standard evidence-based interventions. While traditionally defined as avoidance of trauma-related distressing thoughts, emotions, and reminders, emerging research highlights the need for a broader conceptualization of posttraumatic avoidance that includes both negative and positive emotional experiences. The current study aimed to explore an expanded conceptualization of clinically relevant posttraumatic avoidance using an experiential avoidance framework, a more generally defined unwillingness to remain in contact with distressing thoughts, feelings, memories, and other internal experiences. A sample of non-treatment seeking U.S.-based …

Dysphonia In Division I Collegiate Sideline Cheerleaders, Anna Riley Reed

Student Theses and Dissertations

Many research studies have focused on voice disorders in occupational voice users (i.e., teachers, singers, coaches). However, there is limited research on voice disorders in cheerleaders. Therefore, this study investigated the presence of dysphonia in division I collegiate sideline cheerleaders before and after the 2023 football season. Participants included twenty-six collegiate sideline cheerleaders at a division I university. Participants completed a demographic survey and the Voice Handicap Index (VHI). In addition, their modal, high, and low pitch frequencies were measured, and voices were assessed using the Consensual Auditory-Perceptual Evaluation of Voice. This study found significant results regarding the alteration subjective …

Mohammad Qatanani V. Attorney General United States Of America

2025 Decisions

Agency

Nanoporous Gold Nanoparticles And Model Membrane Systems Applied To The Study Of Lipopolysaccharide (Lps), Dhanbir Lingden

Dissertations

Lipopolysaccharide (LPS), a key structural component of Gram-negative bacteria, is a major trigger of sepsis and septic shock, the systemic inflammatory conditions responsible for millions of deaths annually. Even at concentrations as low as 1 ng/mL, LPS can activate the immune system and initiate inflammatory cascades. According to the Global Burden of Disease Study 2017, sepsis accounted for 48.9 million cases globally, with 11 million deaths, emphasizing the urgent need for improved diagnostic and therapeutic strategies.

Accurate and rapid detection of LPS is vital for early intervention and improved clinical outcomes. While traditional detection methods are still widely used, modern …

Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo

Student Scholarly Projects

Practice Problem: Burnout Syndrome (BS) is a serious problem in emergency department (ED) nurses and is associated with higher nurse turnover rates. A burnout prevention toolkit is needed.

PICOT: The project was guided by the following PICO question: "For emergency department nurses (P), how does the development of the best practice burnout prevention toolkit (I), compared to the absence of a structured intervention (C), support the establishment of nurse burnout best practices when evaluated using the CDC Program Evaluation Framework? (O)".

Evidence: The analysis of the literature supported the implementation of active interventions in the form of workshops.

Intervention: A …

Research Progress In Thermo-Reversible Polysaccharide Gels, Dongxin Zhou, Ziao Zhang, Su Chen, Weimin Yang, Jiajun Sun, Shengzu Han, Anning Xie, Xiaoxiao Li, Yuxiang Bai

Journal of Food Science and Biotechnology

Thermo-reversible gels are widely applied in the processing of baking,meat,and snack products including cakes,candies,jelly,aspic,and steamed custard buns.Currently,the most effective thermo-reversible gel is gelatin,which can combine with water to form a transparent gel that melts when it is close to the temperature of the human oral cavity.However,gelatin is expensive.Therefore,researchers have turned their attention to polysaccharide gels,hoping to obtain more thermo-reversible food raw materials with different properties.The author reviews thermo-reversible polysaccharide gels from natural sources such as plants,algae,and microorganisms and those modified by physical,chemical,and enzymatic methods and summarizes the sources,structures,gelatinization mechanisms,and product applications of polysaccharide gels.It is expected to provide a reference …

Radial Velocities And Stellar Populations For A Sample Of Matlas Survey Dwarfs, Kate Southon, Jonah S. Gannon, Duncan A. Forbes, Arsen Levitskiy, Maria Luisa Buzzo, Aaron J. Romanowsky, Jean P. Brodie

Faculty Research, Scholarly, and Creative Activity

Spectroscopic observations are essential for confirming associations, measuring kinematics, and determining stellar populations in dwarf galaxies. Here, we present Keck Cosmic Web Imager spectra for 12 MATLAS survey dwarfs. For 9, we confirm recession velocities consistent with their literature-assumed host galaxies. We propose revisions of the host galaxy associations for MATLAS-631, 1494, and 1938. For MATLAS-1494, our measured redshift reclassifies it from an ultra-diffuse galaxy candidate to a dwarf galaxy that is of smaller physical size and places it in the field. It also appears old and passive, providing a challenge to models that invoke quenching by tidal effects. Additionally, …

Serum Metabolomic Profiling Of Incident Type 2 Diabetes Mellitus In The Multi-Ethnic Study Of Atherosclerosis And Rotterdam Study, Xuanwei Jiang, Fang Zhu, Gonçalo Graça, Xihao Du, Jinjun Ran, Fariba Ahmadizar, Alexis C Wood, Yanqiu Zhou, Denise M Scholtens, Ali Farzaneh, M Arfan Ikram, Alan Kuang, Carel W Le Roux, Meghana D Gadgil, Marilyn C Cornelis, Kent D Taylor, Xiuqing Guo, Mohsen Ghanbari, Laura J Rasmussen-Torvik, Russell P Tracy, Alain G Bertoni, Jerome I Rotter, David M Herrington, Philip Greenland, Maryam Kavousi, Victor W Zhong

Children’s Nutrition Research Center Staff Publications

Objective: This study aimed to investigate serum metabolomic biomarkers associated with incident type 2 diabetes mellitus (T2DM) and evaluate their performance in improving T2DM risk prediction.

Methods: Untargeted proton nuclear magnetic resonance (1H NMR) spectroscopy-based metabolomics analyses were conducted in the Multi-Ethnic Study of Atherosclerosis (MESA; n = 3460; discovery cohort) and The Rotterdam Study (RS; n = 1556; replication cohort). Multivariable cause-specific hazards models were used to analyze the associations between 23 571 serum metabolomic spectral variables and incident T2DM. Replicated metabolites required an false discovery rate-adjusted P < .01 in MESA, P < .05 in RS, and consistent direction of association. Pathway and network analyses were conducted to elucidate biological mechanisms underlying T2DM development. The utility of the replicated metabolites in improving T2DM risk prediction was assessed based on the Framingham Diabetes Risk Score. A 2-sample Mendelian randomization was conducted to assess causal associations.

Results: Nineteen metabolites were significantly associated with incident T2DM. Pathway analyses …

Design & Development Of Efficient Biometric Authentication And Key Agreement Schemes For Wireless Body Area Network, Aarthi S

Theses and Dissertations

Wireless Body Area Networks (WBANs) play a vital role in continuous health monitoring, where sensitive biometric and physiological data must be protected from privacy breaches and emerging quantum-based threats. Conventional security mechanisms are often inadequate due to resource constraints, scalability issues, and vulnerability to advanced attacks. To address these challenges, this research proposes a lightweight, scalable, and future-proof security framework tailored for WBAN applications, focusing on secure communication, privacy preservation, and quantum resilience.

An anonymous Certificate-Based Signcryption–Mutual Authentication and Key Agreement (CBS-MAKE) protocol is introduced to secure extra-body communications while ensuring patient anonymity. The protocol integrates Elliptic Curve Cryptography with …

Lichen Planopilaris With Pili Torti And Ectodermal Dysplasia: A Hair Curling Case Report, Collins Langley, Elena Plakotaris, Nicole E. Rogers

School of Medicine Faculty Publications

Introduction: Lichen planopilaris (LPP) is a well-known cicatricial alopecia with a frontal fibrosing variant. LPP has a prevalence rate of 13.4 per 100,000 persons. It is understood that LPP favors the female populations. What is not commonly known is that LPP can be preceded by other signs and symptoms such as pili torti. Case Report: We present a case report of a 70-year-old female whose initial flare of LPP was preceded by a flare of pili torti. This patient's case is also complicated by her history of ectodermal dysplasia. She experienced progressive itching, shedding, and mid-scalp hair loss along with …

Baseline Characteristics Of Newly Registered Diabetic Patients In Primary Care Settings In Oman, Fathiya Al-Shariqi, Shaima Al-Mazoori, Zaher Al-Kharusi, Mohammed Al-Hinai, Samira Al-Maimani

Sultan Qaboos University Medical Journal

Objectives: This study aimed to identify the baseline demographic characteristics, clinical profile and cardiovascular risk factors of newly registered diabetic patients in Muscat Governorate, Oman, in 2022. Methods: This cross-sectional study included newly registered diabetic patients attending all primary care centres in Muscat Governorate in 2022. Data regarding sociodemographic characteristics and clinical and laboratory parameters were collected from the national diabetic registry and Al-Shifa health information system. Results: A total of 1,309 patients were included and their data analysed, of which 51% were male and the mean age was 53.89 ± 12.47 years. Approximately 50% of the participants were obese …

How Multi-Scale Modeling Can Help Examine Social Determinants Of Health And Resulting Disparities, Kyoko Yoshida, Elsje Pienaar, Shalanda A. Bynum, Naomi Chesler, Mitchel J. Colebank, Jessie Heneghan, Nadra Tyus, Jasmine Miller-Kleinhenz, Bruce Y. Lee

Faculty Publications

Social determinants of health (SDOH) are the conditions in which people live, work, and play, and the wider set of factors (e.g., social and economic systems and policies) that shape a person’s daily life. SDOH can differ significantly across communities and populations, having positive impacts for some and negative impacts for others. Ultimately, this results in differences in health and disease distribution, that are known as health disparities. Despite the known impacts of SDOH and calls to characterize, address, reduce, and eliminate health disparities, they persist and, in some cases, have worsened. To address this challenge, a session at the …

Abstracts From The 2025 Health Care Systems Research Network (Hcsrn) Annual Conference, St. Louis, Missouri, Health Care Systems Research Network

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) comprises 19 learning health systems with integrated care delivery and embedded research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate project findings, explore scientific collaborations, and share insights about population-based research practices that can measurably improve health and health care for all. The theme of this year’s conference was “Optimizing Collaborations to Advance Health in a Dynamic Research Landscape.” Abstracts presented at HCSRN 2025 are published in this issue supplement of the Journal of Patient-Centered Research and Reviews, the journal of record for …

Exploring The Impact Of The Emergency Department Built Environment On Physician Workplace Stress: A Qualitative Study Utilizing High-Fidelity Virtual Reality, J Matthew Fields, Alan Price, Billie Faircloth, Eden Blas, Marah Sakkal, Sabrina Naumovski, Robert Ries, Callum Hamilton, Kit Elsworth, Morgan Hutchinson, Bon Ku, Christopher Connock, Jennifer Kahoud

Department of Emergency Medicine Faculty Papers

OBJECTIVES: Physician burnout in emergency medicine has serious consequences. An underrecognized stressor for physicians may be the emergency department (ED) environment itself. EDs can be noisy and chaotic, lack natural light, and have challenging layouts that create patient care and safety concerns. This study examines the relationship between the ED-built environment and physician workplace stress.

METHODS: A qualitative study of ED-attending physicians from a level I trauma center ED in Philadelphia was conducted. Participants underwent a semistructured interview followed by a walkthrough of a high-fidelity virtual reality (VR) simulation of the participant's ED. In the VR simulation, they rated the …

Ethnicizing Europe: Hate And Violence After Versailles, Éva Kovács, Raul Cârstocea, Gábor Egry

Central European Studies

Ethnicizing Europe focuses on the dynamics of interethnic violence in Europe between the two world wars. The new international system that was enshrined by the Versailles peace treaties after World War I did not bring stability to East-Central Europe. Rather, it resulted in a host of conditions like self-determination, international oversight, revolutionary political ideas, and democratic processes, which eventually gave new meaning to already established conflicts, as well as igniting new conflicts in the region. This book opens with a discussion of the theoretical scholarship on ethnicity before proceeding to specific case studies investigating the different ways in which ethnicity …

The Influence Of Family Literacy Playgroups On Early Childhood Development And Parent Efficacy In Hispanic Families: A Qualitative Phenomenological Case Study, Karen R. Loper

Graduate Theses, Dissertations, and Capstones

This qualitative phenomenological case study is focused on the engagement of Hispanic children between 18 and 36 months of age and their parents in a family literacy program. Participation in a family literacy program was associated with changes in the cognitive, social, and emotional development of children, as well as the self-efficacy of their parents in parenting skills. Grounded in the social theories of Vygotsky, Bandura, and Bronfenbrenner, this study relates the importance of language acquisition, literacy skills, and self-efficacy to a community setting where conversation is encouraged and reading engagement is modeled. The Hispanic population is underrepresented in the …

Participatory Science Newsletter Vol. 4 2025_07_15, Mairi Poisson, Malin Clyde, Alyson L. Eberhardt

Participatory Science News

In this edition of the UNH Participatory Sciences Newsletter, we offer news and resources on Learning From Each Other. Articles include one student's reflection on attending the national conference for the Association for Advancing Participatory Sciences in Portland, Oregon in May, 2025. UNH PhD student Mairi Poisson was both a presenter and a booth exhibitor, and shares her reflection on the people and topics that excited her during the conference. Additionally, this edition describes the upcoming opportunity to study participatory science as a topic at the UNH graduate school, as well as a winter, 2026 offering for a professional development …

Using Linear Programming And Game Theory To Optimize The Relation Between Us And China, Junhao Su

Student Works

This paper develops an optimization model to analyze U.S.–China bilateral trade dynamics and competition in artificial intelligence (AI). First, grounded in WTO tariff limits, we formulate a linear programming model to maximize the combined trade volume and conduct a comprehensive sensitivity analysis on tariff parameters. Second, we integrate zero‑sum and non‑zero‑sum game‑theoretic frameworks to identify the Nash equilibria governing both trade negotiations and technological rivalry. The model is implemented in Python using PuLP and is empirically validated with real‑world tariff data to highlight the policy relevance of the optimal solutions. Our results reveal a high concordance between the zero‑sum game …

Predictors Of Final Visual Outcome In Patients With Leber Hereditary Optic Neuropathy Treated With Lenadogene Nolparvovec Gene Therapy, Robert C Sergott, Valerio Carelli, Nancy Newman, Valérie Biousse, Patrick Yu-Wai-Man, Catherine Vignal-Clermont, Constant Josse, Magali Taiel, José-Alain Sahel, Piero Barboni

Wills Eye Hospital Papers

PURPOSE: This exploratory analysis aimed to identify predictive factors of final best-corrected visual acuity (BCVA) in patients with Leber hereditary optic neuropathy (LHON) harboring the m.11778G>A mutation who received lenadogene nolparvovec gene therapy.

METHODS: The following covariates were individually evaluated as possible factors associated with improved final BCVA: age, gender, timing of treatment, baseline BCVA value, and baseline optical coherence tomography (OCT) parameters. Univariate analyses were performed from three phase 3 studies (RESCUE, REVERSE, and REFLECT), using BCVA at 1.5 years post-treatment as the dependent variable.

RESULTS: In 113 eyes treated at least 6 months after disease onset, the …

Re: Comment Letter For The Butte Priority Soils Operable Unit (Bpsou) 2022 Draft Final Insufficiently Reclaimed Sites Sampling: Bres No. 32 Site Evaluation Summary Report (Dated December 11, 2024), Molly Roby

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Comparative Efficacy And Safety Of Cryoballoon Vs Laser Balloon Ablation For Pulmonary Vein Isolation In Patients With Paroxysmal Atrial Fibrillation, Mahmoud Ali, Dorota Magdon, Abdulghani Mounir, Lynn Erickson, James Adefisoye, Jim Kanani, Andy Kieu, Abdullah Malik, Ali Ali, Nour Ghosoun, Jodi Zilinski, Arshad Jahangir, M. Eyman Mortada, Imran Niazi, Atul Bhatia

Journal of Patient-Centered Research and Reviews

Purpose: Atrial fibrillation (AF), the most common arrhythmia in older adults, is often treated with cryoballoon ablation (CBA) or laser balloon ablation (LBA) when refractory to medication. We used real-world patient data to investigate differences in arrhythmia-free survival, procedure and fluoroscopy times, and complications between these techniques.

Methods: In this single-center, retrospective study of 178 patients with symptomatic paroxysmal AF referred for first-time pulmonary vein isolation (PVI), 103 underwent CBA, and 75 underwent LBA. Recurrence was defined as any atrial arrhythmia of > 30 seconds’ duration after a three-month blanking period. Complications at 30 days were recorded. Kaplan-Meier analysis was used …

Patient Information Needs During Ambulatory Medication Changes: A Qualitative Study, Elaine Giletta, Vanessa B. Hurley, Yushi Yang, Jessica L. Schwartz, Rabia Jalalzai, Nicole L. Mollenkopf, Raquel Mayne, Samantha I. Pitts

Journal of Patient-Centered Research and Reviews

Purpose: We performed interviews with patients and caregivers to explore whole-person, whole-regimen information needs at times of routine outpatient medication changes. We categorized information needs in this relatively unstudied context and identified which needs were commonly recognized as insufficiently met.

Methods: We explored the content of the semi-structured interviews, which involved nine patients and two caregivers of pediatric patients, all of whom experienced a recent medication change in the outpatient setting of a large urban academic healthcare system. We used inductive thematic analysis to organize information needs into categories to identify key information gaps.

Results: We identified five categories of …