Medicine and Health Sciences Commons^™

How Different Forms Of Exercise Affect Bone Mineral Density In Postmenopausal Women, Jonathan Mccanless

University Honors Theses

This paper analyzed 20 studies to understand how bone health in postmenopausal women is impacted by different forms of exercise. The primary aspect of bone health examined in this paper is bone mineral density (BMD). Resistance and impact training demonstrated clear signs of maintenance and increases in BMD, particularly in the lumbar spine and femoral neck. Aquatic exercise demonstrated mixed results in positively impacting BMD in a significant way, but it’s worth noting that there were still some signs of increased BMD. Impact exercise on its own can maintain BMD, and these effects can be seen in total hip BMD. …

Predictive Model For Hemoglobin Levels Using Multiple Linear Regression, Dien Gusta Anggraini Nursal, Muhammad Daffa Atthariq Winata, Nohan Arum Romadlona, Noura Rizki, Sabillah Nasitoh, Muhammad Sakhi Baretta

Journal of Health Research

Background: Anemia is a condition in which the number of red blood cells or hemoglobin (Hb) levels fall below normal, limiting the ability of blood to transport oxygen effectively. This study aimed to develop a predictive model for Hb levels by identifying significant risk factors.

Method: This observational analytic study was conducted among 103 randomly selected students of Bung Hatta University in Padang, Indonesia. Data were collected with a questionnaire and a hemoglobin test between April to May 2024. Pearson’s correlation analysis and multiple linear regression were performed in this study.

Results: Bivariate analysis showed significant correlations between Hb levels …

Embedding Mental Rehearsal In Surgery: A Comprehensive Review Of The Evidence, Josephine Walshaw, Bright Huo, Paul Barach, Philippa Banks, Adam Mcclean, Florent Lebon, Faisal Mushtaq, David Jayne, Danilo Miskovic, Marina Yiasemidou

College of Population Health Faculty Papers

BACKGROUND: Mental rehearsal (MR), the deliberate practice of skills specific to a procedure, has been successfully used in sports and music training for decades, but has not been adopted in surgery. This narrative review explores MR's role in surgical training and clinical practice, evaluating its effectiveness in motor skill acquisition, technical and non-technical skill development, and real world clinical implementation. Our aim was to assess MR's impact on both surgical education and clinical performance, while identifying the barriers to its routine adoption in surgical training.

METHODS: We searched for relevant studies on the topic and impacts of MR in surgery …

Risk And Protective Factors Associated With Teenage Pregnancy And Intergenerational Interventions: A Scoping Review Protocol, Zamasomi Luvuno, Wilbroda Hlolosile Chiya, Silingene Joyce Ngcobo, Deshini Naidoo, Serwaa Omowale, Tracy Zhandire, Elizabeth Musili Joseph-Shehu, Busisiwe Purity Ncama, Sinegugu E Duma

Faculty, Staff and Student Publications

Introduction: Teenage pregnancy remains a critical global health issue, particularly in low- and middle-income countries. The intergenerational transmission of teenage pregnancy underscores the need for targeted interventions. Existing research on intergenerational approaches is fragmented, with varying methodologies and outcomes. This scoping review seeks to address this gap by answering the following research questions: What are the available intergenerational interventions for teenage pregnancy, and what are the associated risks and protective factors for early and late teenage pregnancy?

Methods and analysis: This study does not involve primary data collection and therefore does not require ethical approval. The review will be conducted …

Enhancing Mental Health Through Mind-Body Exercises In Sedentary Students: A Systematic Review With An Indonesian Perspective, Izmi Alya Khairunnisa, Aditya Denny Pratama

Jurnal Sosial Humaniora Terapan

Sedentary Behavior (SB) among students is associated with increased risks of depression, anxiety, stress, and weakened immune function. According to the WHO, SB contributes to approximately two million deaths each year. This systematic literature review aims to evaluate the effectiveness of mind-body exercises in improving mental health outcomes—specifically stress reduction, anxiety management, and emotional regulation—among students with sedentary lifestyles. Using the PRISMA framework, 2,201 articles were identified from databases including Scopus, PubMed, and ProQuest, with six studies meeting the inclusion criteria. The review found that mind-body exercises such as yoga, tai chi, and pilates significantly reduce stress and anxiety, enhance …

Relocation Post-Dobbs Among Clinicians Providing Abortions, Dana Howard, Marta Bornstein Phd, Mph, Jocelyn Wascher, Alison H. Norris, Katherine Rivlin

Faculty Publications

Introduction

Intensifying state-level abortion restrictions following the Dobbs v Jackson Women’s Health Organization (2022) decision could lead clinicians to leave states that ban abortion.¹ While large-scale changes are not yet apparent among obstetrician-gynecologists, the abortion care workforce may be uniquely at risk.² We examined the proportion of abortion-providing clinicians who changed primary state of practice, comparing those who left states that banned abortion with those who left states that did not ban abortion after Dobbs, and the ban status of the states to which they relocated.

Methods

This survey study was approved by The Ohio State University …

Nafld Surveillance In The Alaska Native/American Indian Population, Wileina Saumara Rhodes

Walden Dissertations and Doctoral Studies

In the United States, the prevalence of NAFLD is estimated at 24% of the population, and by 2030, the incidence of NAFLD will increase to 100.9 million cases. This study aimed to determine the prevalence and rate of non-alcoholic fatty liver disease (NAFLD) progression in the Alaska Native/ American Indian population (AN/AI) with and without elevated liver function tests. Two research questions guided the study: Do outcomes (abnormal/normal) of LFTs, A1C, lipids, BMI, and inflammatory markers predict or have a relationship with NAFLD progression? Does NAFLD surveillance have a relationship with the patient’s outcome as measured by the NAFLD Fibrosis …

Citrullinated Eno1 Vaccine Enhances Pd-1 Blockade In Mice Implanted With Murine Triple-Negative Breast Cancer Cells, Ricardo A León-Letelier, Alejandro M Sevillano-Mantas, Yihui Chen, Soyoung Park, Jody Vykoukal, Johannes F Fahrmann, Edwin J Ostrin, Candace Garrett, Rongzhang Dou, Yining Cai, Fu-Chung Hsiao, Jennifer B Dennison, Eduardo Vilar, Banu K Arun, Samir Hanash, Hiroyuki Katayama

Faculty, Staff and Student Publications

Background/Objectives:Cancer vaccine targets mostly include mutations and overexpressed proteins. However, cancer-associated post-translational modifications (PTMs) may also induce immune responses. Previously, our group established the enzyme protein arginine deiminase type-2 (PADI2), which catalyzes citrullination modification, is highly expressed in triple-negative breast cancer (TNBC), promoting antigenicity.

Methods: Here, we show the workflow of designing citrullinated enolase 1 (citENO1) vaccine peptides identified from breast cancer cells by mass spectrometry and demonstrate TNBC vaccine efficacy in the mouse model. Immunized mice with citENO1 peptides or the corresponding unmodified peptides, plus Poly I:C as an adjuvant, were orthotopically implanted with a TNBC murine …

Food Environments And Mental Health: Analyzing The Impact Of Fast-Food Availability On U.S. Adults (2011-2016), Nicole Tenner

NYMC Student Theses and Dissertations

This study investigates the relationship between the availability of fast food in US territories and mental health outcomes. Utilizing a cross-sectional design, the study examines data from the 2011 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) from the CDC, along with data from the U.S. Department of Agriculture’s Food Environment Atlas. The analysis included a nationally representative sample of 351,823 participants across all 50 US states. Multiple regression models examined the association between fast food availability and two primary mental health outcomes: the number of self-reported poor mental health days and the likelihood of being diagnosed with a depressive …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Olfaction And Plasma Biomarkers Of Alzheimer Disease And Neurodegeneration In The Atherosclerosis Risk In Communities Study, Srishti Shrestha, Xiaoqian Zhu, Michael E Griswold, Priya Palta, Kevin J Sullivan, Honglei Chen, Andrea Lauren Christman Schneider, Abhay Moghekar, Megan L Grove, Bharat Thyagarajan, James Russell Pike, Rebecca F Gottesman, B Gwen Windham, Thomas H Mosley, Jennifer A Deal, Vidyulata Kamath

Faculty, Staff and Student Publications

Background and objectives: Investigation of olfactory impairment, an early manifestation of Alzheimer disease (AD), in relation to plasma biomarkers of AD and neurodegeneration could provide insights into the disease's pathophysiology. Because few such studies based on large, diverse, community-based populations exist, we investigated associations of odor identification ability with plasma biomarkers of AD and other neurodegenerative pathologies in community-dwelling Black and White older adults.

Methods: This cross-sectional investigation included participants from the Atherosclerosis Risk in Communities study who attended visit 5 (2011-2013) and who completed olfactory testing and brain MRI examinations and had plasma biomarkers measured (namely, amyloid-beta [Aβ]42/Aβ40 ratio, …

Enhancing Dementia Classification For Diverse Demographic Groups: Using Vision Transformer-Based Continuous Scoring Of Clock Drawing Tests., Mengyao Hu, Yi Lu Murphey, Tian Qin, Edmundo R Melipillán, Laura B Zahodne, Richard Gonzalez, Vicki A Freedman

Faculty, Staff and Student Publications

Objectives: Alzheimer's disease and related dementias significantly affect older adults' quality of life. The clock-drawing test (CDT) is a widely used dementia screening tool due to its ease of administration and effectiveness. However, manual CDT-coding in large-scale studies can be time-intensive and prone to coding errors and is typically limited to ordinal responses. In this study, we developed a continuous CDT score using a deep learning neural network (DLNN) and evaluated its ability to classify participants as having dementia or not.

Methods: Using a nationally representative sample of older adults from the National Health and Aging Trends Study (NHATS), we …

Adolescent Preventive Care Outcomes Before And After Covid-19 Onset: What Is The Role Of Telehealth?, Sarah Hayden Knipper

Dissertations and Theses

Adolescents are a developmentally distinctive population with unique primary health care needs; they comprise about 10% of Oregon's population and more than half are covered by the Oregon Health Plan (OHP). This dissertation investigated significant declines in preventive care utilization (well visits and HPV immunizations) among adolescents enrolled in OHP during the COVID-19 pandemic and the relationship between the decline in utilization and the rise in telehealth availability. The study focused specifically on the role of race/ethnicity, geography, and access to health systems in mitigating or exacerbating decreases in preventive care. A mixed methods approach was employed to understand not …

Community Perspectives On Cancer And Cancer Research: Findings From Listening Sessions With Diverse Groups In Philadelphia, Karen Glanz, Emma A. Soliva, Krista Scheffey, Yawei Song, Charnita Zeigler-Johnson, Evelyn T. González, Thierry Fortune, Nilsa Graciani, Amy E. Leader

Kimmel Cancer Center Faculty Papers

BACKGROUND: Listening sessions are useful for understanding community perspectives on cancer disparities. The Philadelphia Communities Conquering Cancer (PC3) coalition conducted listening sessions to identify community priorities for cancer prevention and control research among diverse communities in Philadelphia.

METHODS: Guided by a Stakeholder Advisory Committee, PC3 partnered with community-based organizations to conduct 8 listening sessions with diverse communities (including Black, Hispanic, Asian, Russian, LGBTQ + , and veterans) to learn about perceptions of cancer, research priorities, and training and communication preferences. Sessions were facilitated by community members or PC3 members in the primary language of participants. Sessions were audio recorded, transcribed, …

Regulation Of Myogenesis By Mechanomir-200c/Foxo3 Axis, Junaith S Mohamed, Aladin M Boriek

Faculty, Staff and Students Publications

Cyclic mechanical stretch has been shown to inhibit myoblast differentiation while promoting proliferation. However, the underlying molecular mechanisms are not well understood. Here, we report that mechanical stretch inhibits the differentiation of mouse primary myoblasts by promoting the cell cycle program and by inhibiting the expression of the myogenic regulator MyoD. Stretch alters the miRNA expression profile as evidenced by miRNA microarray analysis. We identified miR-200c as one of the highly downregulated mechanosensitive miRNAs (mechanomiRs) whose expression level was increased during differentiation. This suggests that mechanomiRs-200c is a myogenic miRNA. Overexpression of mechanomiR-200c revoked the effect of stretch on myoblast …

Adolescent Scoliosis In Autism Spectrum Disorder: Is It Idiopathic Or Syndromic??, Ravi Rajendra, Matthew B. Bratton, Claudia Leonardi, R. Carter Clement

School of Medicine Faculty Publications

Purpose: Minimal data exists on whether adolescents with both autism spectrum disorder (ASD) and scoliosis exhibit distinct curve types or require varying surgical management compared to neurotypical adolescents. Our study at a high-volume scoliosis center compares patterns of scoliosis in ASD patients with those of neurotypical patients. We hypothesized adolescents with ASD would present with atypical scoliosis curve characteristics compared to neurotypical adolescents. Methods: Using ICD-10 codes, we constructed an electronic database of adolescents aged 10 to 18 with diagnoses of both scoliosis and ASD. To avoid confounding with syndromic conditions, adolescents with a syndrome independently associated with scoliosis were …

Exploring Muslim American Attitudes Toward Genetic Testing: Perceptions, Barriers, And Ethical Considerations, Hannah Mahmoud

University Honors Theses

This thesis explores perceptions and attitudes toward genetic testing within the Muslim American community, a group often underrepresented in genomic research and public health discourse. Using a community-distributed digital survey, data was collected from 50 self-identified Muslim Americans on their familiarity with genetic testing, reproductive and ethical considerations, and the influence of religious factors. While only 18% had undergone genetic testing themselves, many were familiar through family or friends, and most expressed cautious interest—especially when results could influence future family planning. Education level, age, and religious values shaped both comfort and understanding.

A key theme was the desire for culturally …

Forecasting Influenza Rates Using Machine Learning: A Study Of Chatgpt's Predictive Accuracy, Sara Saleh

University Honors Theses

This study evaluates ChatGPT's ability to forecast influenza rates, such as the number of flu cases, hospitalizations, and death during peak season periods using CDC data, and comparing forecasts against actual results to calculate statistical accuracy and consistency. Influenza forecasting is essential for public health planning, but traditional methods may not always provide timely or accurate predictions. In this research study, ChatGPT was utilized to predict the influenza rates for the following week based on the previous week's data obtained from the FluView surveillance system. The predicted rates were compared to the actual influenza rates to assess the model's overall …

Fluorescence-Guided Ureteral Identification In Robotic Surgery For Advanced Endometriosis: A Comparison Of Junior Versus Senior Surgeons, Linda A Alpuing Radilla, Qiannan Yang, Daniel Y Lovell, Tamisa Koythong, Brooke Thigpen, Luis E Delgadillo Chabolla, Qianqing Wang, Xiaoming Guan

Faculty, Staff and Students Publications

Identifying the ureters in patients with advanced endometriosis and severe pelvic adhesive disease can be challenging. Adhesiolysis along the deformed pelvic sidewall may increase the risk of prolonged operative time and incidental ureteral injury. This study aimed to evaluate the safety and surgical outcomes of using Indocyanine Green (ICG) under near-infrared fluorescence for intraoperative ureteral localization and preservation during robot-assisted laparoscopic surgery (RALS) for advanced endometriosis, comparing procedures performed by two junior surgeons to those performed by one senior surgeon. This was a retrospective observational case series conducted by three minimally invasive gynecologic surgeons (X.G., T.K., B.T.) at a single …

The Effect Of Birthweight And Gestational Age On Cognitive Function In Midlife: The Bogalusa Heart Study, Eunsun Gill, David J Libon, Soo Jung Kang, Ileana De Anda-Duran, Lydia A Bazzano, Wei Chen, Camilo Fernandez-Alonso, Emily W Harville

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although the relationships between birthweight, gestational age (GA), and cognitive function (CF) before midlife have been demonstrated, the relationships after midlife and potential racial disparities remain inconclusive. This study examined the association between birthweight, GA, and midlife CF stratified by race.

METHOD: 1,032 subjects from the Bogalusa Heart Study (67% Whites, 33% Blacks, mean age 48.1 ± 5.3 years) were studied. Cognition was assessed with tests measuring verbal episodic memory, working memory, attention, graphomotor information processing speed, and global CF. Each test was standardized by sex and age, then averaged. The global CF was computed by averaging all cognitive …

Development Of Recommendations For The Future Of Telehealth Use Among Sexual And Gender Minorities (Sgm), Jeffrey A. Wilhite

Dissertations and Theses

It is now well-documented that sexual and gender minoritized individuals (SGMs) face consistent stigmatization from not just the health care system, but also from overarching community, federal, and societal entities. Subsections of the SGM community, like gay men for example, face higher rates of eating disorders, certain cancers, alcoholism, mental illness and even obesity, when compared to heterosexual counterparts. Many of these challenges could be exacerbated by current political administration efforts to silence the community. Ensuring access to clinical care is one way of preserving the health and livelihood of the community. Telehealth, or synchronous, remote based clinical care, can …

Prevalence And Predictors Of Intimate Partner Violence Against Men In Kisumu Slums, Kenya, Elizabeth Akello Odemba, Edward A. Frongillo Jr. Ph.D., Sheri D. Weiser

Faculty Publications

Background

Men in sub-Saharan Africa experience intimate partner violence, with few reporting their cases to the legal authorities or coming out for assistance. Consequently, data on the prevalence and drivers of intimate partner violence in different parts of sub-Saharan Africa are inadequate. Therefore, this study was designed to investigate the prevalence and predictors of intimate partner violence against men in Kisumu slums, Kenya.

Methods

This retrospective cross-sectional study included 398 randomly selected men in intimate relationships aged 18–54 years and residing in Kisumu slums. The sampling frame used was from Community Health Volunteers covering the area of study. Data collection …

The Ecology Of Gender-Based Violence For Syrian Refugee Women In Tripoli And Akkar, Dima Masoud

Dissertations and Theses

Lebanon is a country that suffers from multiple economic, political, and health crises. Additionally, the mass displacement of Syrian refugees to Lebanon after the war in Syria over a decade ago has left Syrian refugees vulnerable, including the vulnerability of Syrian refugee women to gender-based violence (GBV). While these conditions have affected all of Lebanon, this dissertation focuses on the regions of Tripoli and Akkar in northern Lebanon. Tripoli and Akkar are regions that border Syria, which means that an influx of Syrian refugees, mostly unregistered, comes in. While other regions in Lebanon also border Syria, Tripoli and Akkar are …

The Relationship Between Food Label Comprehension And Consumer Dietary Choices, Marline Denis

Walden Dissertations and Doctoral Studies

Poor dietary choices and limited understanding of nutritional information are ongoing public health concerns that contribute to the rise of chronic illnesses such as obesity, diabetes, and heart disease. This quantitative, cross-sectional, correlational study investigated the associations between health literacy and food label comprehension with consumer dietary choices and adherence to dietary guidelines among individuals aged 16 and older in the United States. Guided by the Nutrition Label Literacy (NLL) framework, this study explored whether components such as basic nutritional knowledge, numeracy skills, health motivation, and label usage predict healthier food choices. Age, education, and gender were included as covariates. …

Childhood Myopia Part I: Contemporary Treatment Options., Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

Childhood myopia is a growing global public health concern. Treatments to control myopia are a priority because myopia, particularly high myopia, poses significant lifelong risks of vision loss from myopia-associated ocular pathologies. Intensive research efforts over the past two decades have led to the development of several effective strategies for controlling myopia in children: increased time outdoors, atropine eye drops, dual-focus and multifocal contact lenses, orthokeratology lenses, and specialized spectacle lenses. While the efficacy of these strategies is variable, evidence is growing regarding the potential benefits of applying these interventions in children with myopia, although none completely halt myopia …

Childhood Myopia Part Ii: Treatment Mechanisms, Emerging Options, And Considerations, Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

The rapidly increasing prevalence of myopia and its association with vision-threatening complications in later life has intensified efforts to identify treatments that can prevent the onset and slow the progression of myopia in children. These efforts have led to the development of several optical, environmental, and pharmacological myopia control treatments. Investigations of additional treatment options are ongoing and have shown great promise for clinical translation. Although significant progress has been made in identifying potential pathways and modes of action of these treatments, a complete mechanistic understanding is still lacking. This critical review article explores the potential mechanisms underlying the …

Race, Resources, And American Adolescents’ Mental Health During The Covid-19 Pandemic, Chineze Nkemeh

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, African American adolescents experienced reduced access to needed resources and may have suffered poorer mental health outcomes as a result. The purpose of this quantitative study was to examine the association between race and the availability of mental health resources, food, medical health resources and mental health outcomes among African American adolescents in the United States during the COVID-19 pandemic compared to their White counterparts. The theoretical framework that grounded this study was the Socio Ecological Model. Secondary data from the Centers for Disease Control and Prevention’s Adolescent Behaviors and Experiences Survey database were analyzed. These …

Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman

Faculty Publications

Background

To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.

Methods

Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time …

Career Impact Of The National Interprofessional Fellowship In Patient Safety: An Alumni Evaluation, Bradley V Watts, Kathleen Carluzzo, Blake F Webb, Kelley Arredondo

Faculty, Staff and Students Publications

Background: There has been a proliferation of health professions training programmes focused on quality and patient safety, but little information regarding the outcomes of these programmes. The purpose of this study was to examine the impact of an interprofessional quality and patient safety curriculum on career outcomes of interprofessional healthcare learners for the Veterans Affairs Patient Safety Fellowship.

Method: We conducted a survey-based assessment of 117 alumni of the Interprofessional Fellowship in Patient Safety assessing their satisfaction with the training program and career impacts.

Results: 84 of 117 alumni were located and participated in the assessment. Fellows entered the training …

Impact Of Sociodemographic Determinants On Enrollment Into Contemporary Lymphoma Clinical Trials: A Systematic Review, Jun Yang Jiang, Ang Li, Alexis Romero, Christopher R Flowers, Chijioke Nze

Faculty, Staff and Students Publications

While the incidence and survival associated with lymphoma have improved in recent years, outcome disparities related to sociodemographic factors such as age, sex, race, ethnicity, socioeconomic status (SES), and other social determinants of health (SDOH) remain prevalent in the modern era. Clinical trials are crucial for further improving outcomes, yet not all sociodemographic groups are equally represented in contemporary lymphoma trials. We conducted a systematic review of the literature evaluating the impact of SDOH on enrollment into clinical trials in the United States and identified 21 relevant studies. We confirmed that Black and Hispanic individuals are underrepresented in lymphoma clinical …