Digital Commons Network^™

Modeling Heterogeneous Trajectories Of Chronic Kidney Disease Progression With Finite Mixture Models Using The All Of Us Dataset, Yahaya Mumuni Musah

Electronic Theses and Dissertations

Background: Chronic kidney disease (CKD) does not progress uniformly across patients, and a single average trajectory often fails to capture this heterogeneity. Understanding variation in disease progression is important for improving risk stratification and clinical management. 
Objectives: This study aims to characterize the heterogeneity of chronic kidney disease (CKD) progression using longitudinal estimated glomerular filtration rate (eGFR) data and to identify factors associated with distinct progression trajectory patterns. 
Methods: A longitudinal cohort study was conducted using data from the All of Us} Research Program collected between April 23, 2002, and October 1, 2023. Adult participants with repeated eGFR measurements were …

Enzyme Susceptibility And Functionality Of High Protein Retentates And Reconstituted Ingredients, Khushi Dubey

Electronic Theses and Dissertations

This thesis explores the effects of processing history on the enzymatic susceptibility and functional properties of high-protein dairy ingredients, with a specific focus on ultrafiltered (UF) and microfiltered (MF) retentates and spray-dried powders. While retentates and powders are often used interchangeably in industrial applications, processing steps, such as drying, can induce structural and physicochemical changes that affect protein functionality and enzyme accessibility. Milk protein concentrates (MPC) and micellar casein concentrates (MCC) were standardized to 10% protein and subjected to enzymatic treatments, including proteolysis (Alcalase and rennet) and crosslinking (transglutaminase and laccase). Structural modifications were evaluated using capillary gel electrophoresis, non-protein …

Proof Techniques In Analysis, Francis Antwi Frimpong

Graduate Research Papers

No abstract provided.

Workforce Review Of Health Information Technology Associate-Degree Graduates: 2017-2024, Debra Hamada, Karima Lalani, Melanie Brodnik, Susan H Fenton, Angela Kennedy, David T Marc, Velma L Payne, Rebecca Reynolds

Faculty, Staff and Student Publications

Background: The career path of associate-degree health information technology (HIT) graduates continues to change quickly as quality and payment regulations, technology requirements, and workforce expectations evolve to meet the demands of the changing health care environment. Although HIT professionals play an essential role in accuracy, regulatory compliance, and the overall function of health information systems, there is limited research describing HIT workforce trends.

Methods: A mixed-methods approach was used with 587 survey responses. Quantitative data were standardized by job category, including a newly developed "health information management (HIM) operations" group, and career movement was visualized using a Sankey diagram. Qualitative …

Ai Privacy And Security In Healthcare: A Systematic Literature Review, Diane Dolezel, Karima Lalani, Valerie Watzlaf, Kerryn Butler-Henderson, Elise V Z Lambert, Mary Morton, Jamie Sand, David Gibbs, Susan Fenton

Faculty, Staff and Student Publications

Background: Artificial intelligence is expanding into telemedicine and telerehabilitation, yet significant privacy and security concerns persist.

Scope: To synthesize empirical evidence on privacy and security approaches in health care, particularly those relevant to distributed home care.

Methodology: A systematic review identified 80 studies (2019 to 2025), and Latent Dirichlet Allocation (LDA) topic modeling characterized the privacy and security themes.

Results: Sixty-six studies addressed privacy, only seventeen addressed security, and three studies addressed both. LDA identified four themes: patient data privacy, federated learning for medical imaging, encrypted training and secure computation, and healthcare data governance. Most studies emphasized privacy-preserving approaches, like …

A Structured Review Of Emerging Prompt Instability Indices (Piis) To Evaluate The Reproducibility Of Prompt-Driven Image Segmentation Models., Adib Shafipour, Deevakar Rogith, Zulfiia Ditto, Hien V Tran, Katie Stinson, Toufeeq Ahmed Syed

Faculty, Staff and Student Publications

Prompt-aware image segmentation has introduced new flexibility by allowing models to incorporate user-provided cues, such as points, boxes, or text prompts, to guide object delineation across diverse imaging domains. This flexibility introduces a fundamental challenge: ensuring segmentation results remain reproducible when prompts are altered. Minor variations in prompts produce substantially different outputs, raising concerns about the reliability and scientific validity of research and clinical applications. This paper conducts a structured review of emerging Prompt Instability Indices (PIIs), quantitative measures developed to assess the reproducibility of prompt-driven segmentation models. A systematic search of PubMed and arXiv (2020-2025) identified relevant studies, analyzed …

Designed Lands©Apes—Ar©Hitecture, Sculpture, Visual Art, Shape, Pi©Torial Work, Or . . . Nothing At All?, Richard H. Chused

Articles & Chapters

This article arises from the saga of the construction and eventual destruction of a landmark landscape architectural work by the well-known artist Mary Miss that was constructed adjacent to the Des Moines Art Center called Greenwood Pond: Double Site. The project’s demise is emblematic of the remarkably ambiguous copyright problems that surround such artistic creations. They do not neatly fit into any category of copyrightable works. Though they may contain sculptural works, their overall designs are rarely totally sculptural. While architects typically draw plans and “sculpt” a landscaped space, the results usually are not “buildings,’ as required by the definition …

Simple Guide To Research Integrity For Undergraduate Researchers, Julie Simpson

Integrity in Research and Scholarship

Involving undergraduates in research is valuable for their education and important for their career development, vital for science, and rewarding for supervisors. Instilling the importance of research integrity as fundamental to the advancement of knowledge may be challenging, particularly for first time trainees, as they learn the research process and their attendant responsibilities. This simple guide was developed to assist researchers who oversee the work of undergraduate trainees address basic concepts and topics. After the core values which establish the basis for the integrity of research and scholarship broadly, the ordering of concepts/topics does not represent a hierarchy; the sequence …

A Simple Guide For Researchers And Institutional Review Boards (Irbs) To Protect Data Integrity In Online Human Subjects Survey Research, Julie Simpson

Integrity in Research and Scholarship

Researchers have used the internet to collect data for over two decades. More recently, however, online research has become a target for fraudulent respondents, particularly when researchers offer monetary incentives for participation in a study. This guide will briefly outline the evolution of internet-based human subjects research, explore the current environment for online data collection from human participants, outline strategies for researchers and Institutional Review Boards (IRBs) to help minimize and identify fraudulent responses and protect data integrity in online surveys, and discuss the challenges of balancing data integrity with research participant welfare.

A Simple Guide To Responsible Authorship And Publication, Julie Simpson, Patricia B. Condon, Bonnie Brown, William C. Clyde, James J. Connell, Ramonda Kindle, Nathan A. Schwadron, John E. Sparrow, Xueting Sun, Engin Taze, May-Win Thein, Anita R. Tucker, Karen T. Van Gundy, James Wible

Integrity in Research and Scholarship

This guide examines the following aspects of responsible authorship and publication practices:

1. The significance and goals of publication
2. Publication mechanisms and responsible practices
3. The importance and guiding principles of authorship
4. The definition and responsibilities of an author
5. Responsible writing practices

Please note that throughout this document there are links to examples of concepts/issues within certain disciplines for illustrative purposes. The examples may not be relevant to all disciplines so check guidance specific to the applicable discipline before proceeding. This guide was adapted from an online training module that was part of the University of New …

Advancing Virus-Associated Lymphoma Research In Latin America: A Global Opportunity For Cancer Science, Irene Tamí-Maury, Bryan Valcarcel, Maria Alejandra Torres, Arlett Hernandez Chavez, Luis Malpica

Faculty, Staff and Student Publications

No abstract provided.

Food Delivery Services For Enhancing Participation In The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In The United States: Bridging The Wic-Eligible Access Gap, Jingjing Gao, Muinat Abolore Idris, Lilian O Ademu, Bryan Colby Griffin, Yue Zhang, Yun Hang, Gabriela A Gallegos

Faculty, Staff and Student Publications

Background: Diet-related health disparities among U.S. children persist despite the availability of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits to eligible women, infants, and children. Participation remains suboptimal: only 51.2% of eligible individuals were enrolled in 2021. Transportation and food-environment constraints pose salient barriers, especially for caregivers of infants in food deserts. Emerging online ordering and delivery options may reduce access frictions, but grocery delivery coverage is limited, and fees are often not covered by benefits.

Methods: We linked USDA Food and Nutrition Service state-level WIC participation data (November 2024 vs. September 2025) with demographic, …

“I Can’T Just Talk It. I Have To Live It”: The Roles, Needs, And Recruitment Of Recovery Home House Managers, I Niles Zoschke, Kathryn R Gallardo, Hannah L N Stewart, Serena A Rodriguez, Danielle Gillespie, Sheryl A Mccurdy, J Michael Wilkerson

Faculty, Staff and Student Publications

Introduction: Recovery homes are an increasingly important recovery support service for people with substance use disorders, yet limited research has examined the roles of house managers or how individuals are recruited into these positions. This study examines how house managers understand and enact their roles, how recovery home operators recruit for these positions, and how the demands and sustainability of the role are perceived in practice.

Methods: We conducted a qualitative thematic analysis of interviews with 29 operators and staff working in 10 Level II and Level III recovery homes across five Texas cities.

Results: Findings indicate that house managers …

Impact Of A Culinary Medicine Intervention On Diet And Health Metrics In Patients With Type 2 Diabetes And Elevated Body Mass Index, Natalia I Heredia, Logan R Thornton, Diana C Guevara, Natalia Williams, Grace Marcelo-Ramirez, Joanne Chow, Lorna H Mcneill, Karen Basen-Engquist, Ruth Rechis, Deanna M Hoelscher

Faculty, Staff and Student Publications

Purpose: Culinary Medicine (CM), an educational approach blending the art of cooking with the science of medicine, has shown promise in improving diet and health outcomes. We conducted a mixed-methods, quasi-experimental evaluation of a CM program to promote cooking and healthy dietary intake.

Methods: Patients with type 2 diabetes and elevated body mass index (>25) were recruited from primary care clinics in low-income neighborhoods. The program, delivered by a dietitian, includes five weekly 90-minute sessions on basic cooking skills with behaviorally-based nutrition education. An explanatory sequential mixed-methods pilot study with a pre-post survey design and post-program interviews was used …

Nasal Cavity Microbial Makeup And The Influence On Psychiatric Symptoms Following Fire Exposure In Firefighters, Paul Grunsted, Chao Xu, Amanda Janitz, Jessica Reese, Janis Campbell, Tasha M Santiago-Rodriguez, Sara J Javornik Cregeen, Joseph F Petrosino, Jooyeon Hwang

Faculty, Staff and Student Publications

Background: Firefighters experience high levels of occupational stress and trauma, increasing their risk of depression, anxiety, and post-traumatic stress disorder (PTSD). Although microbial communities may influence brain function and behavior through neural pathways, the nasal microbiome remains understudied. This study examined associations between nasal microbiome characteristics and psychiatric symptoms among firefighters.

Methods: We conducted a cross-sectional study of 34 firefighters recruited from Texas fire stations. Participants completed validated questionnaires assessing depression, anxiety, and PTSD. Nasal swabs were collected before and after fire suppression and 16S rRNA sequencing was used to characterize microbial communities. Alpha and beta diversity, relative abundance, and …

What Do Youth Need To Know About Puberty? A Scoping Review Protocol To Identify Puberty Education Competencies, Marie A Brault, Nanki Singh, Nikita Kakkad, Melissa Peskin, Anthony Betori, Gregory Laynor, Emily Naiser

Faculty, Staff and Student Publications

INTRODUCTION: Puberty is a key transition point in adolescents' lives that plays a foundational role in shaping health behaviors and outcomes across one's life course. This period holds significant potential to empower adolescents and support autonomy in health and well-being, but limited puberty education curricula exist for early adolescents (age 8-14), and those that do exist vary in content. There is a paucity of evaluations of puberty competencies and limited consensus on what competencies should be measured to assess effectiveness or even how to measure these competencies.

OBJECTIVE: The objective of this scoping review is to systematically map and characterize …

Building The Infection Prevention Workforce: Development, Implementation And Evaluation Of Texas Epidemic Public Health Institute Infection Prevention And Control 300 Series, Kayla E Ruch, Janelle Rios

Faculty, Staff and Student Publications

Background: The Texas Epidemic Public Health Institute (TEPHI) was established to strengthen infectious disease preparedness across Texas. The Infection Prevention and Control (IPC) 300 Series represents the third year of a multi-tiered educational initiative designed to provide free, accessible, evidence-based IPC training and continuing education credits for the healthcare workforce.

Methods: Registration and attendance data were collected through Zoom™ and Microsoft Teams™. Knowledge assessments, post-module surveys, and mid- and end-of-series evaluations were administered through QuestionPro™. Module content was informed by guidance from APIC, CDC, CMS, and OSHA. Descriptive statistics and the Kirkpatrick Model of Training Evaluation were used to assess …

Safety And Efficacy Of 6% Hydroxyethyl Starch In Patients Undergoing Major Surgery: The Randomised Controlled Phoneics Trial, Wolfgang Buhre, Óscar Díaz-Cambronero, Simon Schaefer, Martin Novacek, Marina Soro Domingo, Bjorn Stessel, Aurelio Rodríguez-Pérez, Torsten Richter, Georg Rohe, Bernard Cholley, Matthias Gruenewald, Gerhardus Kuiper, Samir Jaber, Dianne De Korte, Javier Belda, Marcelo Gama De Abreu, Robert Baronica, Thomas Scheeren, Carlos Ferrando-Ortolá, Wojciech Szczeklik, Dana Tomescu, Tomas Vyzamal, Zejka Gavranovic, María Pilar Argente-Navarro, Guido Mazzinari, Sarah Thaler, Nuria García-Gregorio, Jeroen Vandenbrande, Diane Zlotnik, Jakob Wittenstein, Sonja Schmier, Susanne Rohn, Christoph Glasmacher, Martin Holler, Cornelius Jungheinrich, Ulf Niess, Daniel I Sessler, Martin Westphal

Faculty, Staff and Student Publications

Abstract

Background: Hydroxyethyl starch (HES) is often used for maintaining vascular volume during major surgery. Long-term high-dose HES in septic patients promotes renal injury, whereas meta-analyses of current HES products in surgical patients do not show such effects.

Objective: We studied if the peri-operative use of HES is noninferior to crystalloids in terms of acute kidney injury. Secondary outcome was the noninferiority of HES on worsening of renal injury and/or the incidence of a composite endpoint of major complications and mortality until postoperative day 90.

Design: Randomised double-blind trial in patients undergoing elective abdominal surgery with expected blood loss at …

Feasibility And Preliminary Outcomes Of A Remotely-Delivered Exercise Training Intervention For English-Speaking Hispanics/Latinos With Multiple Sclerosis: Results From The Ferla Ms Study, Victoria A Flores, Stephanie L Silveira, David X Marquez, Dominique Kinnett-Hopkins, Augusto Miravalle, Fabian Sierra-Morales, Robert W Motl

Faculty, Staff and Student Publications

Background: There is limited evidence on the feasibility of remotely delivered exercise interventions for English-speaking Hispanics/Latinos with MS.

Objectives: To evaluate the feasibility and exploratory efficacy of a remotely-delivered, home-based exercise program for English-speaking Hispanics/Latinos with MS and to explore associations among feasibility metrics, outcomes, and social determinants of health (SDOH).

Results: Of 340 individuals contacted, 112 were eligible (33%), 33 enrolled (9.7%), 30 randomized, and 26 completed (87% retention). Adherence averaged 81% (exercise) and 89% (control). No serious adverse events occurred. Exploratory within-group improvements were observed in the exercise group for physical activity (p = 0.03, d = …

Heart Failure Hospitalization In Patients With And Without Type 2 Diabetes: A Population-Based Retrospective Cohort Study, Allison K Shay, Wei Tao, Soumya Patnaik, Delaney K Sullivan, Angelo Nascimbene, Xueying Wang, Joseph B Mccormick, Hulin Wu

Faculty, Staff and Student Publications

Purpose: Type 2 diabetes mellitus (T2DM) is a common comorbidity among patients with heart failure (HF). This study aims to describe how T2DM relates to HF hospitalization patterns across demographic groups and HF subtypes.

Methods: We conducted a population-based retrospective cohort study using 19 years of clinical data from Cerner Health Facts®, a nationwide electronic health record (EHR) database. Adult patients hospitalized with HF were identified using ICD-9/ICD-10 diagnosis codes and HF-related medications and were stratified by T2DM status. Measures included HF-related hospitalization count, length of first HF hospitalization, and age at first HF hospitalization. Comparisons were examined across HF …

Understanding Practices Of Lactation And Infant Feeding Together With Women With Hiv: The Uplift Observational Study Protocol, Christiana Smith, Emily Anne Barr, Karen Hampanda, Mark Trumbull, Hulin Wu, Jennifer Mckinney, Sarah Buisson, Carly Hoffmann, Ciarra Brown, Angela B Hutchinson, K Rivet Amico, Ifeyinwa V Asiodu, Elizabeth J Mcfarland, Margaret A Lampe, Preetam A Cholli, Olga Varechtchouk, Allahna Esber, Athena P Kourtis, Lisa Abuogi

Faculty, Staff and Student Publications

Introduction: There is a limited understanding of infant feeding decisions, practices, and outcomes for women living with HIV (WLHIV) and their infants since U.S. guidelines were updated in 2023 to support breastfeeding for virally suppressed women on antiretroviral treatment.

Methods and analysis: The Understanding Practices of Lactation and Infant Feeding Together with women with HIV (UPLIFT) study is a convergent mixed-methods, multisite, observational study designed to address key knowledge gaps. Twelve US sites will begin enrollment in early 2026 to accomplish three core activities (CA). In CA1, we explore infant feeding decision-making and experiences via in-depth interviews with pregnant/postpartum WLHIV …

Correction: Feasibility Of Conducting A Pilot Randomized Trial Of A Mindfulness-Based Intervention Among Sheltered Young Adults Experiencing Homelessness, Diane Santa Maria, Paula Cuccaro, Erica Sibinga, Kimberly Bender, Ethel Jacko, Widumini Liyanage, Jennifer Jones, Stanley Cron

Faculty, Staff and Student Publications

This corrects the article "Feasibility of conducting a pilot randomized trial of a mindfulness-based intervention among sheltered young adults experiencing homelessness" in volume 16, 1649664.

Front Matter, Michigan Law Review

Michigan Law Review

Front Matter for Volume 124, Issue 4 of Michigan Law Review

Standard Textualism, James A. Macleod

Michigan Law Review

For as long as legal scholars have been writing about the rules-versus-standards distinction, textualism has been understood to produce characteristically rule-like law. This Article argues for the opposite view. Far from generating the “law of rules” that Scalia famously envisioned, the rule of modern textualism produces a law of standards—much more so than anybody, proponent of textualism or critic, appears to have recognized.

Two aspects of today’s textualism produce this result. The first is its emphasis on ordinary language and communication. Modern textualism typically produces standards because ordinary language and communication are typically standard-like. The second is modern textualism’s drive …

The Law Of The Mid-Transition, Alison Gocke

Michigan Law Review

To address climate change, our energy systems need to transition from fossil fuels to clean energy resources. There is a tendency to think this transition will occur in a linear, seamless progression: We will move from the (old) fossil fuel system at Time A to a (new) clean energy system at Time B. But this belies the reality that an energy transition involves not just building a new energy system, but also unwinding an old one. Crucially, both processes will take time. That means there will be a significant period in which both energy systems coexist.

In the engineering literature, …

Algorithmic Medicine And The Duty To Disclose: Informed Consent Through The Lens Of Radiology, Lee Rodriguez

Michigan Law Review

Informed consent is the law’s mechanism for protecting patient autonomy by requiring disclosure of facts that bear on the decision to accept or refuse care. Artificial intelligence now helps decide what is medically true for patients, yet informed consent law still assumes that diagnostic judgment is rendered by a human mind whose reasoning is at least in principle communicable. Radiology has become the leading setting for this tension. AI systems triage worklists, flag suspected abnormalities, and anchor first-pass impressions in ways that guide radiologists’ attention and, in practice, can coauthor diagnostic conclusions while remaining invisible to patients. When patients are …

Understanding Motivations And Health Outcomes Of College-Aged Triathletes During Covid-19: A Mixed-Methods Study, Patrick Wilson, Eddie Hill, Justin Haegele, Xihe Zhu

Human Movement Studies & Special Education Faculty Publications

A triathlon is a multi-sport event that consists of three simultaneous events: swimming, biking, and running. This sport has experienced significant growth in the past few decades, with colleges and universities now participating. This exploratory mixed-methods study examined the motivations and perceived health benefits of college triathletes during the COVID-19 pandemic, using the Means-Ends of Recreation Scale and the Perceived Health Outcomes of Recreation Scale (N = 29), as well as semi-structured interviews (N = 4). Results indicate no difference in motives or health outcomes between male and female survey respondents. The thematic analysis of open-ended interview questions highlighted lived …

Inclusive Psychology Pedagogy Is Linked To Increased Belonging And Reduced Prejudice Toward Consensually Non-Monogamous Relationships, Rose Bern, Rachel Dinero, Kate Linenbach, Amy Moors

Psychology Faculty Articles and Research

Students enrolled in an elective psychology course entitled Relationship Science, which emphasized inclusive curricula focused on relationship diversity, completed pre- and postcourse assessments of attitudes toward consensually nonmonogamous (CNM) relationships, relationship skills (e.g., constructive communication), and classroom belonging. Given the established literature on lesbian, gay, bisexual, transgender, queer+-inclusive pedagogy, attitudes toward lesbian, gay, bisexual, transgender, queer+ individuals were also measured. Comparisons of pre- and postcourse assessments revealed significant reductions in stigma toward individuals engaged in CNM, alongside increased acceptance of CNM relationships more broadly. Students also reported increases in relationship skills and classroom belonging over the course of the …

Asynchronous Lgbtq+ Affirming Counseling Training With Early Career Counselors: A Mixed Methods Program Evaluation, Amber L. Pope, Kelli Hartzell, Matt B. Siroty, Jeff Moe, Noelle St. Germain-Sehr, Bianca R. Augustine, Amanda St. Germain-Sehr, Tai Lexumé

Counseling & Human Services Faculty Publications

A growing body of research shows that training in LGBTQ+ affirming counseling (LGBTQ+ AC) positively impacts counselors’ perceived knowledge and skills in providing mental health services to LGBTQ+ communities. Existing program evaluations of LGBTQ+ AC, however, have primarily used synchronous delivery formats and cultural competency models for the training design. This study is part of an action research agenda to develop an introductory training in LGBTQ+ AC, using asynchronous online delivery and cultural humility as the conceptual framework for the training design. We used a fixed convergent parallel mixed methods quasi-experimental design to examine the impact of our LGBTQ+ AC …

"Oh, You've Come To Visit The Yard?": Phenotypic Capital, Intragroup Marginalization, And The Gated Sanctuary In Black Lgbtq+ Communities, Keith J. Watts, Shawndaya S. Thrasher, Nicole Campbell, Laneshia R. Conner, Julian K. Glover, Janet K. Otachi, Dekeitra Griffin

Counseling & Human Services Faculty Publications

Identity-based communities that share common characteristics, beliefs, and experiences (e.g., Black LGBTQ+ communities) have historically been conceptualized as protective bubbles that buffer Black LGBTQ+ individuals against the deleterious effects of systemic racism and cisheterosexism. However, this monolithic narrative often masks the internal power dynamics that divide belonging. This study explores the exclusionary dynamics embedded within these safe spaces, examining how internal hierarchies of skin tone, socioeconomic status, and gender performance function as proximal stressors. Guided by a critical constructivist paradigm, this study utilized Reflexive Thematic Analysis to analyze open-ended survey responses from 74 Black LGBTQ+ adults. Data were drawn from …