Medicine and Health Sciences Commons^™

Laparoscopic Versus Open Redo Anti-Reflux Surgery, Mohamed Barkok, Mohammed Said, Ahmed Shehta, Abdel-Raouf El-Geidie

Mansoura Medical Journal

Background

Gastroesophageal reflux disease (GERD) is common. Laparoscopic fundoplication became the gold standard for GERD surgery after medical treatment failed. If a previous anti-reflux surgery fails, redo surgery requires a thorough review to determine the cause and a skilled surgical team. Choosing the optimal approach during the redo surgeries, whether open or laparoscopic hasn’t been previously illustrated.

Aim

To compare the outcomes of laparoscopic versus open redo anti-reflux surgeries.

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Patients and methods

This study included 28 patients who underwent redo anti-reflux surgery. The patients were divided according to the approach into laparoscopic (n = 11) and open (n = …

Beyond The Square Pulse: Waveform Shape, Eeg Correlates, And The Pursuit Of Natural Sensation In Tens, Jason Whitson

Honors Undergraduate Theses

This study investigates the relationship between electrical stimulus characteristics of shape and charge on evoked sensations and electroencephalogram (EEG) data during multi-waveform transcutaneous electrical nerve stimulation (TENS) of the median nerve. Neuromodulation methods have traditionally had little control over the location and quality of their associated evoked sensation (e.g., electric, vibration, touch). This experiment utilized five unique stimulus waveforms during TENS stimulation. EEG data were collected concurrently to provide an introductory objective measure of the neural responses underlying these sensory changes. Eleven participants completed three tasks (thresholding, super-threshold stimulation, two-alternative forced choice) using a two-electrode TENS approach. Stimulus waveforms were …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Synthesis And Characterization Of Succinate Dehydrogenase Inhibitors H2/Z14 And C6/Z96 In Order To Combat Small Cell Lung Cancer, Lauren M. Graves

Honors Undergraduate Theses

The use of ubiquinone inhibitors to combat cancer is a recent development in medicinal science and procedures to efficiently synthesize these drugs remain limited. C6/Z96 and H2/Z14, two succinate dehydrogenase inhibitors, have been previously tested in vitro against NSCLC with positive results. Their similarity to ubiquinone is what makes them a strong candidate for a succinate dehydrogenase inhibitor at the ubiquinone binding site. The heterocyclic scaffolds and substituents are proposed to bind strongly through a combination of electronics, hydrogen-bonding, and fit, allowing them to bind well and prove to be more favorable than ubiquinone when competing for the Q-site. By …

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …

Establishment Of An In Vitro Dss-Induced Epithelial Injury Model To Investigate Il-6 Signaling And Microbial Metabolite Mediated Barrier Recovery, Srijal Kunwar

Graduate Studies Theses and Dissertations 2026

Dextran sodium sulphate (DSS) is widely used in vivo to induce epithelial injury; however, the molecular effects of DSS on intestinal epithelial cells, that investigate inflammatory and metabolic repair mechanisms remain unclear. Here, we establish an in vitro DSS-induced epithelial damage model using differentiated Caco-2 cell monolayer. Exposure to 2.5%(w/v) DSS for 24 hours resulted in significant upregulation of pore forming protein Claudin-2(2.677-fold) and oxidative marker, NOX-1(1.866-fold), accompanied by increased ROS production confirmed via DHE staining. Increased epithelial permeability was observed by TEER analysis, without significant cytotoxicity. Surprisingly, ELISA analysis revealed significant downregulation of IL-6 (p-value …

Comorbid Psychosis In The General Population, Mariam Sankoh

Theses and Dissertations

Psychosis is a complex psychiatric phenotype characterized by substantial heterogeneity in symptom presentation, psychosis diagnosis, comorbidity patterns, and genetic architecture across diverse populations in the general population. Despite advances in psychiatric epidemiology and genomics, important gaps remain in understanding how psychosis symptoms and psychosis-related diagnoses manifest across racial and ethnic groups and how evolutionary genomic factors may contribute to disease risk and cross-ancestry genetic prediction. This dissertation, Characterizing Comorbidity in Psychosis in the General Population, integrates epidemiological, psychometric, and evolutionary genetic approaches to examine psychosis across diverse populations.

Aim 1 examined racial and ethnic differences in psychosis comorbidity patterns …

24-H Circadian Rest-Activity Rhythms And Physical Frailty In Older Adults: A Biopsychosocial Perspective On Sex Differences And Social Capital, Jisu Kim

Theses and Dissertations

Physical frailty is a prevalent geriatric syndrome characterized by age-related decline across multiple physiological systems. Physical frailty is associated with an elevated risk of adverse health outcomes, including chronic disease progression and all-cause mortality, representing a significant and growing public health concern. Disrupted circadian rest-activity rhythms (RARs) are increasingly recognized as clinically meaningful markers of physical frailty in older adults. However, the extent to which biological sex and social determinants of health (SDoH), particularly social capital, contribute to or modify the associations between RARs and physical frailty remains underexplored.

Therefore, this dissertation summarizes the existing literature on age-related changes in …

Dietetic Guidance For Nutritional Management Of People With Phenylketonuria Receiving Sepiapterin, Anita Macdonald, Kirsten Ahring, Alexa Bledsoe, Hiroki Fujimoto, Sara Giorda, Christian Kogelmann, Jessica Kopesky, Laura Nagy, Sara O'Neill, Alex Pinto, Soraia Poloni, Paige Roberts, Annemiek M J Van Wegberg, Suzanne Hollander

Faculty, Staff and Student Publications

Background/objectives: Phenylketonuria (PKU) is an autosomal recessive inborn error of metabolism. If untreated, elevated blood phenylalanine (Phe) levels lead to neurological and behavioral impairments. Phe levels can be managed through a lifelong Phe-restricted diet; however, this can be challenging to maintain. Sepiapterin is an adjunct therapy for PKU that has shown efficacy in reducing blood Phe levels in both tetrahydrobiopterin (BH4)-responsive and BH4-non-responsive people with PKU in clinical trials. Practical guidance is needed for dietitians and other healthcare professionals supporting the dietary management of people with PKU who are initiating or receiving sepiapterin.

Methods: A group of international dietitians participated …

Evaluating Novel Targeted Combination Therapies For Gastrointestinal Cancers, Joseph A. Goode

Graduate Studies Theses and Dissertations 2026

Gastrointestinal (GI) cancers remain among the leading causes of cancer-related mortality worldwide, with therapeutic resistance continuing to limit the effectiveness of current treatments. Three complementary studies were conducted to identify therapeutic vulnerabilities and evaluate novel combination strategies in pancreatic ductal adenocarcinoma (PDAC) and colorectal cancer (CRC).  First, dual inhibition of fibroblast growth factor receptor 4 (FGFR4) and phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling was investigated in PDAC models. A combination of targeted drug treatments reduced viability, clonogenic survival, migration, and suppressed signaling pathways involved in translational control. This supported a functional interaction between FGFR4 and PI3K-mTOR co-activation in …

An Exploratory Analysis Of The Role Of Sex In Load Carriage, Rachel E. Perez, Dustin R. Slivka, Brent C. Ruby

Graduate Student Theses, Dissertations, & Professional Papers

Axially loaded weight may impose a metabolic demand equivalent to that of fat mass (FM) during load carriage. Males (M) typically have a lower body fat percentage than females (F), resulting in metabolic demand differences during load carriage that may be mitigated by accounting for FM in pack loads. PURPOSE: To determine whether normalizing pack load to FM equalizes metabolic cost across sexes during load carriage. METHODS: Twenty-eight participants (14M, 23 ± 5 y, 1.81 ± 0.07 m, 78.7 ± 10.0 kg, 12.7 ± 5.4% body fat, VO₂peak 4.18 ± 0.54 L·min^-1; 14F, 22 ± 4 …

A Complete Diploid Human Genome Benchmark For Personalized Genomics, Nancy F. Hansen, Nathan Dwarshuis, Hyun Joo Ji, Arang Rhie, Hailey Loucks, Glennis A. Logsdon, Mitchell R. Vallger, Jessica M. Storer, Juhyun Kim, Eleni Adam, Nicolas Alternose, Dmitry Antipov, Mobin Asri, Sofia Barreira, Stephanie C. Bohaczuk, Andrey V. Bzikadze, Sara A. Carioscia, Andrew Carroll, Kuan-Hao Chao, Yanan Chu, Arun Das, Peter Ebert, Adam English, Mark Fleharty, Laura E. Fleming, Giulio Formenti, Andrea Guarracino, Gabrielle A. Hartley, Katharine Jenike, Jenna Kalleberg, Yu Kang, Robert King, Josipa Lipovac, Mira Mastoras, Matthew W. Mitchell, Shloka Negi, Nathan D. Olson, Keisuke K. Oshima, Luis F. Paulin, Brandon D. Pickett, David Porubsky, Jane Ranchalis, Desh Ranjan, Mikko Rautiainen, Harold Riethman, Robert D. Schnabel, Fritz J. Sedlazeck, Kishwar Shafin, Mile Sikic, Steven J. Solar, Alexander P. Sweeten, Winston Timp, Justin Wagner, Dongahn Yoo, Ying Zhou, Erik Garrison, Evan E. Eichler, Michaeel C. Schatz, Andrew B. Stergachis, Rachel J. O'Neill, Karen H. Miga, Steven L. Salzberg, Sergey Koren, Justin M. Zook, Adam M. Phillippy

School of Medical Diagnostics & Translational Sciences Publications

Human genome sequencing typically relies on mapping reads to a reference genome to call variants, but this approach introduces technical biases, excluding duplicated and structurally polymorphic regions of the genome. To overcome this, we present a telomere-to-telomere genome benchmark with near-perfect accuracy across 99.4% of the diploid HG002 genome. This benchmark adds 701.4 Mb of autosomal sequence and both sex chromosomes (216.8 Mb), which were absent from prior benchmarks. We annotated genes and repeats on both haplotypes, including 19,956 protein-coding genes on the maternal haplotype and 19,190 on the paternal haplotype, and developed new methods to measure the accuracy of …

Predicting Tilt In Esports: A Psychophysiological Approach To Understanding Player Emotional Regulation, Nathan Rhea

University of the Pacific Theses and Dissertations

Emotional regulation and stress management are important to both casual and competitive esports players. When players become dysregulated, they experience a phenomenon known as “tilt” within the gaming community, where they often lose control of their emotions and their performance declines. This study aimed to investigate whether a psychophysiological variable in heart rate variability could predict tilt in college-age esports players. Additionally, the relationship between heart rate variability and emotions predicted by the Tiltometer system with gameplay performance and winning or losing was tested.

This study used a quantitative correlational research design. Participants for this study were college-age players (N=23) …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Examining Firefighter Perceptions Of Stress And Recovery Across A Shift And Engagement In Recovery Activities, Nathan T. Ebersole

College of Graduate Studies: Theses & Dissertations

The occupational demands of firefighting, such as fire suppression and rescue tasks, working in hazardous conditions, inconsistent sleep patterns, and exposure to traumatic events, can lead to work-related injuries, burnout, and feelings of isolation. To date, there is limited research on the impact of a single work-shift on firefighter perceptions of stress and recovery and the recovery activities that may influence these perceptions. Thus, the purpose of this study was to examine the effect of a single work-shift on firefighter perceptions of stress and recovery status as well as the recovery activities firefighters choose to engage in. Forty-three firefighters across …

Health And Nutrition In The First 1000 Days Of Life, Yaojiang Shi, Qi Zhang, Yiliang Zhu, Jingchun Nie

Health Behavior, Policy & Management Faculty Publications

Malnutrition and health issues remain persistent global crises, with developing regions bearing the brunt of the burden. According to the World Health Organization, nearly half of under-five deaths in low-and middle-income countries are linked to malnutrition, while stunting, wasting, and micronutrient deficiencies impair the development of millions of children annually. The studies in this special issue focus on countries facing distinct yet interconnected challenges: Sub-Saharan African nations grapple with high rates of stunting and maternal high-risk fertility behaviors; China confronts rural-urban disparities in dietary diversity and grandparenting practices; Colombia struggles with intersectional inequalities driving infant mortality; and Zambia faces unique …

Advancing Food Equity Through Explainable Ai (Xai): Identifying Place-Based Factors And Conditions Of Food Security, Leslie Hoglund, Hyoshin Park

Health Behavior, Policy & Management Faculty Publications

Food behaviors, food security, and their association with socioeconomic factors constitute a critical area of study with implications for public health, economic stability, and social equity. Understanding these relationships are essential for developing effective policies and interventions that promote sustainable, healthy food systems and greater food equity. This paper employs explainable artificial intelligence (XAI) methods to identify key features influencing household food behaviors. The insights gained from the XAI analysis are further utilized in conjunction with inverse reinforcement learning (IRL) to examine expert behaviors related to eating habits satisfaction. The XAI results reveal that household health conditions, spending patterns, and …

Association Between A Lifestyle Medicine Score And Stroke In U.S. Adults With Hyperglycemia: 2007- 2010 Nhanes, Swarnima Naithani

UNF Graduate Theses and Dissertations

The relationship between glycemic control and cardiovascular disease (CVD) is well- established, however, lifestyle modifications to prevent CVD warrant further investigation. Purpose: This study aimed to evaluate the relationship between adherence to the six lifestyle medicine pillars promoted by the American College of Lifestyle Medicine and stroke in U.S. adults with hyperglycemia. A lifestyle medicine composite score (LMS) was developed to quantify adherence with the hypothesis that a higher LMS (greater adherence to lifestyle recommendations) correlates with lower odds of stroke in adults with hyperglycemia. Methods: The study sample (n=2,079) included adult (≥ 40 years of age) participants in the …

From Molecules To Minds: Integrative Multi-Omics In Psychiatry, Hossein Abbasi, Sage E. Hawn, Arash Javanbakht, Soraya Seedat, Kyle Bourassa, Sinead M. Sinnott, Antonia V. Seligowski, Sian Hemmings, Nathan A. Kimbrel, Alicia K. Smith, Leslie Brick, Divya Mehta

Psychology Faculty Publications

Psychiatric disorders are biologically complex conditions arising from interactions across genomic, epigenomic, transcriptomic, proteomic, metabolomic, and metagenomic layers. Single-omics approaches rarely capture more than a fraction of the variance in complex conditions, underscoring the importance of integrative multi-omics frameworks. This mini-review summarizes key methodologies and their application in psychiatric research, with a focus on systems-level integration of genomic risk scores, transcriptomic networks, and neuroimaging data to advance biological understanding of disorders such as depression, schizophrenia, and Alzheimer’s disease. We also outline the infrastructural requirements for effective multi-omics research, including standardized biobanking, Laboratory Information Management Systems, adherence to FAIR data principles, …

Examining The Factor Structure And Subgroup Invariance Of The Deliberate Denial Of Disordered Eating Behaviors Scale, Lindsay Howard, Sage Hawn, Kayla D. Pitchford, Riley Mcgrath, Aubri Farniok, Arturo Sesma, Kristin E. Heron

Psychology Faculty Publications

The denial, concealment, or omission of disordered eating behaviors has received limited attention in the eating disorder literature, partly due to the lack of reliable and valid measures. This study re-examined the factor structure of the Denial of Disordered Eating Behaviors Scale (DDEBS-12) and tested measurement invariance across gender identity, racial identity, and levels of disordered eating in a non-clinical undergraduate sample (N = 3285). Confirmatory factor analyses did not support the original unidimensional structure. Instead, a seven-item model assessing denial of dietary restriction demonstrated the best fit and was renamed the DDEBS-restriction. The revised scale showed good internal consistency …

Best Practices For Using Biological Data In Psychological Research, Sage E. Hawn, Sinead M. Sinnott, Alicia K. Smith, Kyle Bourassa, Leslie Brick, Sian Hemmings, Soraya Seedat, Arash Javanbakht, Lauren Smith, Antonia V. Seligowski, Nathan A. Kimbrel, Divya Mehta, Hossein Abbasi, Erika Wolf

Psychology Faculty Publications

Advances in statistical techniques for analyzing biological data have driven the need for larger sample sizes, which are ultimately made possible through team science efforts. Findings from these efforts have led to a significant shift in approaches to biological data collection over the past decade, from traditional approaches relying on single measures or assays collected by individual investigators in small lab-based studies to high-dimensional methodologies embedded within large cohorts or multi-site studies. These recent large scale consortium efforts necessitate careful consideration across the full data pipeline, from pre-data generation and sample collection to processing and statistical analysis, while addressing challenges …

Differing Circulating Microrna Profiles Of Long-Lived Polish Populations, Fabrizzio Lijeron-Herrera

Honors Undergraduate Theses

Exceptional longevity, defined as a lower biological age relative to chronological age and maintenance of functional capacity or a slowing of functional decline, is a phenotype most readily observed in centenarians and nonagenarians. These individuals exhibit a phenomenon known as compressed morbidity, spending substantially less time in poor health compared to younger elderly populations, thus representing a unique human model of delayed aging. Circulating microRNAs (miRNAs), potent post-transcriptional regulators of molecular pathways, have emerged as important modulators of aging-related pathways; however, no study has comprehensively profiled miRNAs from serum in long-lived individuals from Central Europe. In particular, Polish populations present …

Acute Fatty Liver Of Pregnancy And Fetal Fatty Acid Oxidation Disorders: A Systematic Review, Dante Varotsis, Sarah Araji, Rebecca Horgan, Jennifer E. Powel, Rodney Mclaren Jr., Brian Kirmse, Mona Makhamreh, Huda B. Al-Kouatly

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between maternal acute fatty liver of pregnancy (AFLP) and fetal fatty acid oxidation (FAO) disorders and to define the clinical and genetic characteristics of mothers with AFLP and their fetuses affected by FAO disorders, we performed a systematic literature review of all reported cases of AFLP that underwent genetic testing for FAO disorders.

DATA SOURCES:

We searched PubMed, Ovid MEDLINE, Cochrane Library, CINAHL (EBSCO), Scopus, and ClinicalTrials.gov. Terms included were related to AFLP and FAO testing.

METHODS OF STUDY SELECTION:

We conducted a systematic literature review from inception through May 18, 2025, to evaluate the …

Biphasic Calcium Disturbance In Rhabdomyolysis: A Case Report Of Recovery Phase Severe Hypercalcemia, Maham Shahid, Jean C. Ramos-Cardona, Maria Toustsoglou, Gunjan Y. Gandhi

South Atlantic Division GME Research Days 2026

No abstract provided.

Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review, Ian P. Winter, Paul Sarac, Patrick B. Wilson

Exercise Science Faculty Publications

Sodium bicarbonate positively impacts performance, but its associated gastrointestinal symptoms (GIS) may limit use. This systematic review synthesized literature that has evaluated GIS with sodium bicarbonate supplementation. Literature searches were performed from February 2024-March 2026. Eligible studies provided ≥ 5 g of sodium bicarbonate within a 24-h period or, if a multi-day protocol, at least one day involving ≥ 5 g. Included studies had a placebo group/condition or a comparison group/condition that created a contrast related to delivery method, form, or dose. In total, 101 investigations were summarized in six categories: acute single dosing (n = 35); acute spread dosing …

The Role Of Full Femur Imaging For Early Detection Of Incomplete Atypical Femur Fractures, Ashley B. Humrickhouse, Donald Eagerton, Anne G. La Rochelle

South Atlantic Division GME Research Days 2026

No abstract provided.

Regrowth Of Thyroid Gland After Total Thyroidectomy, Amy Duff, Mikayla Kidd, Donald Eagerton

South Atlantic Division GME Research Days 2026

No abstract provided.

When Covid Unmasks More Than Infection: A Case Of Post-Viral Lada, Mikayla Kidd, Amy Duff, Reggie Skains Iii, Sahana Parthasarathy

South Atlantic Division GME Research Days 2026

No abstract provided.

Biological Dental Hygiene: Principles, Educational Pathways, And Clinical Practice Considerations, Tara Newcomb

Dental Hygiene Faculty Publications

Dental hygiene practice is rapidly evolving in response to emerging evidence on the oral–systemic health connection, advances in preventive technologies, and increased emphasis on individualized, minimally invasive care. A commitment to lifelong learning and continuing professional development is essential for maintaining clinical competence and integrating new scientific knowledge into practice. Biological dental hygiene has emerged as a complementary framework that emphasizes whole-body health, biocompatibility, reduction of toxic exposures, and prevention-centered care. This approach expands traditional dental hygiene practice by incorporating enhanced risk assessment, salivary diagnostics, targeted preventive strategies, as well as patient education focused on nutrition, inflammation reduction, and systemic …

Healthcare Provider Perspectives On A Clinical Decision Tool To Support Individualized Exercise Prescriptions And Discussions For Breast Cancer Survivors, Jinani Jayasekera, Oliver W. A. Wilson, Kaitlyn M. Wojcik, Eleanor M. Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K. Parson, Padma Sheila Rajagopal, Richard L. Street Jr.

Department of Medicine Faculty Publications

Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.

Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged >= 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.

Results: The sample consisted of …