Medicine and Health Sciences Commons^™

Molecular Classification And Association With Survival Outcomes In High-Intermediate And High-Risk Early-Stage Endometrial Cancers: Ancillary Analysis Of Gog-0249, Lindsay Kuroki, Danielle Enserro, Heather Lankes, Kyle Strickland, Rebecca Previs, Aine Clements, Matthew Powell, Ann Klopp, Elena Ratner, Paul Disilvestro, Casey Cosgrove, Guilherme Henrique Cantuaria, Nicola Spirtos, Michael Carney, Mitchell Edelson, Gottfried Konecny, Penny Anderson, Christopher Tarney, Britt Erickson, Meredith Newton, Krishnansu Tewari, Premal Thaker, David Warshal, Amy Armstrong, Xun Clare Zhou, Angeles Alvarez Secord

Abington Jefferson Health Papers

OBJECTIVE: Determine whether mismatch repair (MMR) and p53 expression predict recurrence-free survival (RFS) and overall survival (OS) in early-stage endometrial cancer (EC) patients treated with vaginal cuff brachytherapy plus chemotherapy (VCB/C) versus pelvic radiation therapy (RT).

METHODS: In the GOG-0249 trial, 601 patients with high-intermediate risk (HIR) early-stage EC were randomized to VCB/C (carboplatin/paclitaxel for 3 cycles) or pelvic RT. Molecular subgroups, deficient MMR (dMMR), p53 wildtype (p53wt), p53 abnormal (p53abn), were determined by immunohistochemistry. Five-year RFS and OS were analyzed using Kaplan-Meier curves and Cox proportional hazards models, adjusting for lymphadenectomy, planned VCB, and treatment group.

RESULTS: Among 315 …

Lessons Learned In Providing Infant And Early Childhood Mental Health Consultation During The Covid-19 Pandemic, Rashele Wade

Journal of Global Awareness

Access to quality childcare is a protective factor from lifelong issues such as school failure, school drop-out, and incarceration. Conversely, preschool suspension and expulsion are significant risk factors. Evidence-based interventions, such as Infant and Early Childhood Mental Health Consultation, aim to reduce and eliminate the incidence of preschool suspensions and expulsions. The COVID-19 pandemic disrupted access to quality childcare for many children across the country and globally. This study utilized a qualitative action research approach and generic qualitative inquiry to examine the research question, “How can we improve Infant and Early Childhood Mental Health Consultation through lessons learned during the …

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Slouching Towards Inefficiency? The Cardiometabolic And Cognitive Costs Of Poor Posture, Ava Mae Fitzenrider

Honors Projects

Posture affects all of our lives. It is both static and dynamic, adapting continuously to environmental demands. One postural alteration frequently observed in occupational settings is hyperkyphosis, which can be induced by sitting position. During computer use, individuals commonly adopt a slouched posture, which can exacerbate hyperkyphosis, and contribute to dis-ease within the body. Previous research has demonstrated that such postural deviations can negatively affect pulmonary function, as well as other bodily functions. Despite these findings, the effects of acute hyperkyphosis (“slouching”) on cardiometabolic function and cognition remain largely unexplored. Therefore, the purpose of this study was to examine the …

Psychological Strain And Infrastructure Deficit And The Decision To Migrate Among Healthcare Workers From Lagos, Nigeria, Fatima Adeboye

Walden Dissertations and Doctoral Studies

No abstract provided.

Somatic Prosthetics For Planetary Resonance, Disha Dharesh Kumar R

Masters Theses

This thesis investigates how industrial design can transcend extractive technological paradigms in favor of relational interfaces that foster planetary attunement. Framing the climate crisis as a 'crisis of imagination', the research challenges the Western bifurcation of nature and culture by drawing on Indic cosmologies- which recognize stones, plants, and ecosystems as conscious at different levels and participants in a shared cosmic field. By synthesizing research in Biosemiotics, Quantum Information Pansycishm, and Neuroscience, the project redefines intelligence as a distributed, more-than-human phenomenon.

The research materializes as a speculative design artifact: a device that functions as a somatic prosthetic for planetary resonance. …

Health Practices And Use Of Traditional Medicine Among Asian Indian Immigrants In The United States: A Pilot Study, Parita Patel, Anil N.F. Aranha

Medical Student Research Symposium

Title: Health Practices and Use of Traditional Medicine Among Asian Indian Immigrants in the United States: A Pilot Study

Authors

Parita Patel, MPH¹; Anil N.F. Aranha, PhD^1,2

Medical Education¹, Internal Medicine², Wayne State University School of Medicine, Detroit, Michigan

Abstract

Background and Purpose: Traditional and alternative medicine (TAM), including Ayurveda, Homeopathy, Naturopathy, and home remedies, remains widely used among Asian Indian (AI) immigrants in the United States alongside Western medicine. Cultural familiarity, family influence, and perceived safety shape these practices. This pilot study examined TAM prevalence, patterns, and perceptions among AI immigrants and …

Environmental Mercury Alters Immune Pathways Linked To Autoimmune Risk In Mice Mirroring Humans, Maurgan Lee, Paul Stemmer, Randall Gill, Allen Rosenspire, Anil Aranha, Heather Gibson

Medical Student Research Symposium

Background and Purpose: Mercury is a pervasive environmental contaminant, and human epidemiologic studies have linked chronic low-level exposure to increased autoimmune disease-risk. Dysregulated lymphocyte activation and impaired signaling tolerance are central mechanisms in human autoimmunity. Protein phosphorylation governs lymphocyte differentiation and function, alterations in phosphoproteomic networks may represent a signature of immune disruption. This study evaluates how low dose mercury exposure modifies B and T cell abundance and intracellular signaling patterns in BALB/c and Diversity Outbred (DO) mice.

Methods: BALB/c and DO mice were exposed to low dose HgCl2 in their water for two weeks or provided standard water controls. …

Impact Of Dietician Counseling On Outcomes In Newly Diagnosed Celiac Disease, Andreas Mozny B.A., Alyusuf Elnaggar B.A., James Mo M.D., Suraj Suresh M.D.

Medical Student Research Symposium

Title: Impact of Dietician Counseling on Outcomes in Newly Diagnosed Celiac Disease

Background: Dietician counseling is routinely recommended for newly diagnosed celiac disease (CD), yet its measurable impact is not well defined. This study examined whether early dietician involvement improves clinical symptoms or serologic outcomes.

Methods: We retrospectively reviewed adults with biopsy-confirmed CD at a single center from 2020–2024. Demographics, symptoms, and laboratory data were collected by chart review with ≥6 months of follow-up. Patients who met with a dietician formed the dietician group; all others were assigned to the non-dietician group. Fisher's Exact tests evaluated abdominal …

Evaluating The Association Between Chronic Health Conditions And Caregiver Burden For Male Dementia Caregivers, Dareion D. Hill-Smith

Walden Dissertations and Doctoral Studies

No abstract provided.

Indocyanine Green Focused Near-Infrared Fluorescence Lymphography Localization In Treatment Of Chyle Leak After Mastectomy With Targeted Left Axillary Sentinel Node Biopsy For Breast Cancer., Bradley C Kruithoff, Dawn Cox, Mark Cripe

Women’s Health Articles

We present a woman in her 60s who underwent bilateral mastectomy with left axillary targeted lymph node biopsy in the setting of high grade invasive ductal carcinoma of the left breast with metastasis to a left axillary lymph node. Her postoperative course was complicated by high output milky drainage from her left axillary surgical drain, consistent with a chyle leak, after confirmatory testing demonstrated drain fluid with high triglyceride content. The patient failed non-operative management consisting of low-fat diet and compressive measures. Ultimately, the patient returned to the operating room where indocyanine green near-infrared fluorescence lymphography was used to localized …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

Vol 6. May '26 Cover, Publishing, And Table Of Contents, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Community Engagement To Rebuild Confidence In Public Health, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Bayou Blueprint: Louisiana's Path To Ending Cervical Cancer, Cara Mccarthy

Journal of the Louisiana Public Health Association

No abstract provided.

Identifying Barriers To Pursuing Allied Health Careers- Findings From The Lsuhs Ahead Program, Adrienne Brecheen Davis, Laura E. Gray, Madeline F. Barclay, Hilary K. Bates

Journal of the Louisiana Public Health Association

Background: In Louisiana, underrepresented minorities (URMs) compared to the general population face significant disparities in representation within allied health professions.¹ Although Blacks/African Americans represent 31.4% of the state’s population, they comprise only 1.5% of physical therapists, 4.5% of occupational therapists, 2.7% of physician assistants, and 12.7% of speech-language pathologists. Similarly, while the Latinx population makes up 4.8% of Louisiana’s population, they represent only 0.5% of physical therapists and 2.7% of physician assistants. These persistent disparities point to systemic educational barriers and structural inequities that limit access to health profession programs. This study investigated the perceived barriers underrepresented students face when …

Mapping Youth Sexual And Reproductive Health Services In Orleans Parish, Louisiana: A Field-Tested Survey Methodology, Isabelle Jouve, Ryann Martinek, Zoey Ponder, Isabel Arce, Ryley White

Journal of the Louisiana Public Health Association

Background: Fragmented access to sexual and reproductive health (SRH) services is driving a sexual health crisis among the youth population in Orleans Parish, Louisiana. Rates of sexually transmitted infections, HIV, and teen pregnancy continue to rise while SRH education offerings decline. In response to these outcomes, a Sexual Health, Education, and Rights (SHER) Lab team presents a field-tested survey methodology to characterize the landscape of youth-accessible SRH service providers. Methods: In May 2025, the SHER Lab launched an SRH landscape assessment project to survey youth-serving organizations in Orleans Parish, Louisiana. The project team collected comprehensive feedback from community stakeholders to …

Geauxhealth.Org: A Technological Approach To Community Resources In New Orleans, Madelin Mlynczak

Journal of the Louisiana Public Health Association

Background: Connecting patients to appropriate community resources remains a significant challenge for healthcare providers in New Orleans. Existing resource guides have limitations in clinical workflows, highlighting the need for a tool tailored to healthcare professionals. The primary objective of this study was to evaluate the effectiveness of the GeauxHealth.org website in improving medical residents’ and fellows’ knowledge of community resources and decreasing perceived struggle in referring patients to community resources. Methods: We conducted a pre- and post-intervention survey among residents and fellows at two academic institutions in New Orleans. Participants were introduced to GeauxHealth.org, a locally developed and searchable online …

Vol 6. May '26 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Aubrey K Hubbard, Irenaeus C C Chan, Weiyin Zhou, Yasminka A Jakubek, Giulio Genovese, Wendy S W Wong, Rebecca L Kelly, Corey D Young, Derek W Brown, Wen-Yi Huang, Neal D Freedman, Kristine Jones, Amy Hutchinson, Belynda Hicks, Duc Tran, Donna Arnett, Kathleen C Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Michael H Cho, Pinkal Desai, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Nancy Heard-Costa, Marguerite Ryan Irvin, Andrew D Johnson, Sharon L R Kardia, Charles Kooperberg, Daniel Levy, Joshua P Lewis, Yun Li, Ruth J F Loos, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Kari E North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Albert V Smith, Jennifer A Smith, Adrienne Stilp, Yin Cao, Paul Scheet, Alexander P Reiner, Alexander G Bick, Stephen J Chanock, Paul L Auer, Kelly L Bolton, Mitchell J Machiela

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

Exploring The Impact Of Mental Health On Childhood Obesity In Southern African American Youth Ages 12-18, Shari Scott Robinson

Walden Dissertations and Doctoral Studies

No abstract provided.

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

Beyond Stabilization: Biological Healing, Structural Exclusion, And The Recovery Gap After Border-Fall Trauma At The U.S.-Mexico Border, Julia Robinson

Undergraduate Honors Theses

This honors thesis examines the biochemical, ethical, and public health consequences of insufficient post-operative follow-up care for undocumented immigrants injured in border falls. Discussing pathways of inflammation resolution, wound healing, and bone remodeling, this thesis argues that recovery depends on tightly regulated molecular and cellular processes that are highly vulnerable to disruption without continued monitoring and rehabilitation (Loi et al., 2016; Maruyama et al., 2020). When follow-up care is absent, these processes can be predicted to derail, leading to infection, impaired healing, and permanent disability (Chung & Sohn, 2025; Howard et al., 2020; Kruidenier et al., 2018). Framed through principles …

Determinants Of Pre-Exposure Prophylaxis Medication Use Among People Aged 18–29 Years Living In Florida, Jeremiah Magraubin Mchaka Wandabwa

Walden Dissertations and Doctoral Studies

No abstract provided.

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

Beyond Crisis: Patient Access And Sustainability, Miguel A. Mendoza

Doctoral Dissertations and Projects

Critical systems underwent drastic workflow adaptations during the COVID-19 pandemic. Many of these operational alterations persist today, while others have been reduced or eliminated. This is a qualitative study on the operational, technological, and human-centered challenges experienced by healthcare organizations providing primary care services in Southwest Ohio during and immediately after the pandemic. This flexible research design implements in-depth, semi-structured interviews with healthcare professionals leading primary care operations to capture a longitudinal perspective on pandemic-era service delivery, and the legacy systems still in place today. Thematic analysis revealed seven themes that determine the effectiveness of care delivery models. Social Determinants …

Examining The Link Between Adenomas And Early-Onset Colorectal Cancer In Adults Aged 20–44, Ijeoma F. Erondu

Doctoral Dissertations and Projects

Early-onset colorectal cancer (EOCRC) has increased among adults younger than 50 years, raising concerns regarding risk identification and screening practices in younger populations. This study examined the association between colorectal adenomas and EOCRC among adults aged 20–44 years in the United States and evaluated whether this relationship was influenced by selected demographic and behavioral factors. A cross-sectional analytic design was used to examine medical claims data from the Optum Partner Health database. The study population included 186,790 individuals aged 20–44 years who underwent colonoscopy procedures. Demographic variables included age group, sex, race/ethnicity, and body mass index (BMI). Smoking status was …

Exploring The Impact Of Cultural Beliefs On Death Anxiety: A Qualitative Study To Inform Healthcare Education And Practices, Sharon Sonnilal

Doctoral Dissertations and Projects

A hermeneutic phenomenological approach framed this qualitative study, examining how cultural beliefs, spiritual traditions, and relational contexts shape death anxiety and meaning-making among adults from diverse backgrounds. Terror Management Theory and Culturally Sensitive Grief Treatment guided the conceptualization of death anxiety as a culturally mediated and relational phenomenon rather than an isolated psychological response. A purposive sample of 13 adults aged 18 and older represented diverse cultural, racial, gender, and spiritual identities. Recruitment occurred via Instagram, and participants completed an open-ended demographic and narrative survey. Participants who provided rich survey narratives received invitations to complete semi-structured Zoom interviews to deepen …

Perceptions Of The Effects Of Launch Control Center Environmental Exposures And Alert Schedules Among Missile Operations Officers: A Mixed Methods Phenomenological Study, Dawnie Rae Ramie

Doctoral Dissertations and Projects

This mixed methods hermeneutic phenomenological study focused on an investigation of the perceptions of missile operations alert duty and the effects on health and sleep hygiene among Air Force missile operations officers. Questionnaires, interviews, and surveys were all used to gather data on subjects’ experiences and perspectives, including methods to mitigate the effects of poor sleep. Driving questions of research included how missile alert schedules affect sleep habits, as well as how missileers perceived alert duties may impact their health. Data was collected through a web-based Qualtrics Likert questionnaire (N=139), open-ended interviews with purposively selected subjects (N=17), and web-based Qualtrics …

Inadequate Access To Healthcare In Low-Income Hispanic Communities In Brooklyn, Joanna Marie Garcia

Doctoral Dissertations and Projects

The purpose of this qualitative research was to understand healthcare disparities using the Solar and Irwin conceptual framework and to shed light on healthcare disparities as the reason low-income Hispanic patients, male and female, from the ages of 20-90 in Brooklyn, New York, received inadequate access to healthcare. Healthcare disparities represented a critical issue in providing adequate patient care for adult Hispanic patients within the United States healthcare system. Research into healthcare disparities has been conducted; however, detailed information about the causes of the disparities was lacking, especially concerning inadequate access to healthcare in low-income Hispanic communities. This qualitative research …