Medicine and Health Sciences Commons^™

Centering Community Voices: Protocol For Qualitative Inquiry In A Produce Prescription And Chatbot Intervention, Yesmeena Mahmoud Shmaitelly

Summer Research Program Abstracts

No abstract provided.

Understanding Patient Reported Outcome Measures And Perceptions In Trauma, Jerome D. Scott

Summer Research Program Abstracts

No abstract provided.

Associations Between Trpm4 Gene Variants And Intracranial Pressure Dynamics Following Traumatic Brain Injury, Emily H. Saweris

Summer Research Program Abstracts

No abstract provided.

Assessing The Potential Risk Factors For Major Surgical Complications In Operative Fixation Of Patients With Pelvic Ring Disruptions, Benjamin Roberts

Summer Research Program Abstracts

No abstract provided.

Concurrent Gastroschisis And Biliary Atresia: Surgical And Supportive Management, Joseph M. Pydyn

Summer Research Program Abstracts

No abstract provided.

Assessing The Effects Of Tunicamycin In Trophoblast Stem Cell Differentiation, Kay Chi Pua

Summer Research Program Abstracts

No abstract provided.

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina

Faculty, Staff and Student Publications

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known.

Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e'/a'), and …

Smart Medical System Integrating Clinical Workflows For Robust Skin Cancer Detection Across Heterogeneous Pathologies, Ahed Abugabah, Prashant Kumar Shukla, Suchi Mishra, Abhishek Dwivedi

All Works

Skin cancer is among the most prevalent and life-threatening dermatological diseases worldwide, with melanoma responsible for a substantial proportion of skin cancer–related deaths due to delayed and unreliable diagnosis. Conventional clinical screening based on visual inspection and expert interpretation is inherently subjective and often affected by inter-observer variability, lesion heterogeneity, and imaging artifacts, highlighting the need for accurate and generalizable automated diagnostic systems. This study proposes a novel hybrid deep learning architecture for skin cancer classification that integrates an attention-guided autoencoder with a transformer-inspired global context modeling module, forming a unified and robust representation learning framework. The encoder–decoder structure is …

Co-Design And Feasibility Testing Of A Midwife-Led Birth Debrief: An Implementation Science Project, Kate Buchanan, Phoebe Backhouse, Leanne Graham, Amy O’Meagher, Sara Bayes

Research outputs 2022 to 2026

Background: The period spanning pregnancy, birth and postpartum is characterised by psychosocial as well as physiological changes: many women experience new or worsening mental ill-health during the perinatal period. Midwives play a critical role in supporting and promoting psychosocial health by providing mental health education, counselling and screening. Often this includes a post-birth conversation, guided reflection, or debrief. Information about the effectiveness and experiences of specific and structured midwife-led birth debrief is scant. Aim: Our study aimed to assess the perceived effectiveness, experiences and implementability of a midwife-led birth debriefing intervention in one Australian maternity unit. Methods: A Type II …

Comparative Performance Of Physiological Vital-Sign Forecasting Under Random And Patient-Wise Splitting Using Deep Learning, Lavanya Vasavi Chittem Reddy

Theses and Dissertations

Physiological vital-sign forecasting estimates future measurements based on recent temporal patterns and can support analysis of continuously recorded monitoring data. This study comparatively evaluated deep feedforward, recurrent, bidirectional recurrent, long short-term memory, and bidirectional long short-term memory architectures for one-step-ahead forecasting of peripheral oxygen saturation, heart rate, and pulse rate. Each model received consecutive observations of peripheral oxygen saturation, heart rate, pulse rate, respiratory rate, and age, while separate single-output models predicted the next value of the selected target.

Random and patient-wise data splitting were compared using identical input definitions, preprocessing procedures, model architectures, and training hyperparameters. The strongest architecture …

Primary Breast Sarcoma In Pediatric, Adolescent, And Young Adult Patients: A Single-Institution Retrospective Review, Amelie D. Perrier

Summer Research Program Abstracts

No abstract provided.

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Evaluating The Pulse Of Exercise Programs: Developing And Validating The Intervention Usability Scale For Exercise (Iuse) To Enhance Implementation And Adherence, Anne Inger Mørtvedt, Eva Ageberg, Steven Elmer, Kevin Trewartha, Erich Petushek

Michigan Tech Publications

Background: Adherence to exercise interventions is often suboptimal, despite numerous studies documenting barriers and facilitators. Usability may be a critical yet underexplored determinant of adherence. This study aimed to develop and assess the psychometric properties of the Intervention Usability Scale for Exercise (IUSE). Methods: Item generation and content validation involved cognitive interviews and feedback from eight exercise intervention stakeholders and ten target users from the general public. Subsequently, 526 target users from University, Qualtrics and Prolific participant panels assessed exercise programs through an online survey. Dimensionality was assessed using Principal Component Analysis (PCA), Exploratory Factor Analysis (EFA), and bifactor models. …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Phytochemical And In-Vitro Cytotoxic Analyses Of Flavonoid Species Isolated From Chromolaena Leivensis, Luke A. Bryant

Electronic Theses and Dissertations

As a leading cause of death worldwide, cancer and its treatments remain a primary source of interest among researchers. Modern studies are looking into bioselective cytotoxicity to create new chemotherapies that do not have the same harsh side effects as those we use today. Natural product research has a promising future for the development of such treatments. Specifically, polar flavonoids may be the key to a bioselective treatment. Such flavonoid species are native to plants, often within flower petals or within the body. A natural antioxidant, they are designed not to harm healthy cells. This study focuses on the plant …

Mtorc2-Nav1.2 Signaling Drives Early Hyperexcitability In Alzheimer’S Disease Mouse Model, Nolan M Dvorak, Jeffrey L Noebels

Faculty, Staff and Students Publications

Hyperexcitability is a biomarker of early-stage Alzheimer’s Disease (AD) and hastens cognitive decline later in its course. Mechanistic target of rapamycin (mTOR) signaling contributes to the slope of this trajectory, as evidenced by early increased brain expression and the rescue of hyperexcitability by genetic deletion of mTOR complex 2 (mTORC2); however, a molecular mechanism directly linking mTOR signaling to membrane hyperexcitability in early-stage AD remains elusive. Here, we show that hyperactive mTOR signaling stimulates the voltage-gated Na+ channel 1.2 (Nav1.2), a previously identified downstream phosphorylation target of mTORC2 and a key regulator of membrane electrogenesis. Augmented Nav1.2 channel function induced …

Impact Of School Nurse Education On Factors Influencing Hpv Vaccine Communication With Parents, Jihye Choi, Efrat K Gabay, Jeanette Deason, Elizabeth Baumler, Diane Santa Maria, Daisy Mullassery, Lara S Savas, Erika Thompson, Sanghamitra M Misra, Paula M Cuccaro

Faculty, Staff and Student Publications

Human papillomavirus (HPV) can cause six cancer types but can be prevented with timely vaccination in early adolescence. However, despite the wide availability of the HPV vaccine, uptake remains suboptimal among US adolescents. School nurses are invaluable resources to students and their families regarding adolescent immunization needs. As part of the All for Them vaccination program, we assessed the impact of the continued nurse education (CNE) intervention on school nurses’ HPV vaccine communication with parents. Seventy-two school nurses and nurse administrators in Texas participated in the study. Using a single-arm study design, we measured participants’ potential barriers to and self-efficacy …

Perspective: Improving Social Connection And Inclusion Through Equitable Digital Health Solutions, Dominika Kwasnicka, Jaimon Kelly, Eleanor Quested, Loretta Baldassar, Suzanne Robinson, Richard Sinnott, Paul O’Halloran, Anne Tiedemann, Paul Flatau, Rajna Ogrin, Jane Farmer, Abby C. King

Research outputs 2022 to 2026

In this Perspective, we address the critical intersection of digital health, social connection, and health equity. Taking an interdisciplinary and complex adaptive systems perspective, we highlight evidence-based digital solutions to improve social connection and inclusion and, consequently, health outcomes. We describe actionable strategies for ensuring that digital health innovations benefit all, highlighting how user-centered design can address diverse needs, particularly for structurally disadvantaged populations.

Methylated Cfdna May Distinguish Between High- And Intermediate-Risk Uveal Melanoma: A Pilot Study, Mike Wu, Daniël P. De Bruyn, Ruben G. Boers, Aaron B. Beasley, Daan M. Hazelaar, Stavros Makrodimitris, Joachim B. Boers, Jolanda Vaarwater, Ronald O.B. De Keizer, Robert M. Verdijk, Nicole C. Naus, Dion Paridaens, Saskia M. Wilting, Elin S. Gray, Wilfred F.J. Van Ijcken, Joost Gribnau, Annelies De Klein, Erwin Brosens, Emine Kiliç

Research outputs 2022 to 2026

Background: Uveal melanoma (UM) is a highly aggressive malignancy with a metastatic risk that depends on the molecular subclass. This subclass can be determined through molecular characterization of tumor-derived tissue. With eye-sparing treatments, tumor tissue is rarely available for molecular testing. We hypothesized that minimal invasive biomarkers such as methylated cell-free DNA (cfDNA) or circulating tumor DNA (ctDNA) can be used for prognosis and monitoring of patients. Methods: Plasma cfDNA was isolated from healthy blood donors (HBDs, N = 19) and UM patients (N = 22). Plasma was collected at baseline (localized disease, N = 13) and during follow-up (metastatic …

Sarcomerogenesis: Evidence, Context And Key Stimuli—Response To The Commentary By Power Et Al., Anthony J. Blazevich, Walter Herzog, João Pedro Nunes

Research outputs 2022 to 2026

No abstract provided.

Application Of The Paediatric Medical Traumatic Stress Model To The Mental Health Experience Of Young People Living With Type 1 Diabetes: A Qualitative Study, Rigel Paciente, Sara Coombs, Karen Lombardi, Helen Milroy, Keely Bebbington, Heather Roby, Craig E. Taplin, Nicole Wickens, Stella Rose, Alix Woolard

Research outputs 2022 to 2026

Despite the various traumatic events that a young person living with type 1 diabetes (T1D) may experience, little is known about the burden and manifestation of traumatic stress in this population. Though mental health outcomes have been explored generally, medical trauma-sensitive approaches to understanding these experiences remain limited. We utilised a qualitative descriptive approach to explore the impact of T1D on young people’s mental health through the paediatric medical traumatic stress model (PMTS). Young people aged 13–30 living with T1D were interviewed. These interviews were recorded, transcribed, and analysed using Reflexive Thematic Analysis. Three main themes were generated: (1) perceived …

Body Composition And Muscle Health Changes After Providing Vascular Imaging Results In Older Adults: Secondary Analysis Of A Randomised Controlled Trial, Jack Dalla Via, Simone Radavelli-Bagatini, Marc Sim, Abadi K. Gebre, Catherine P. Bondonno, Kun Zhu, Shelby Mullin, John T. Schousboe, Richard J. Woodman, Markus P. Schlaich, Moira Sim, Pawel Szulc, Douglas P. Kiel, Wai H. Lim, Robin M. Daly, Jonathan M. Hodgson, Joshua R. Lewis

Research outputs 2022 to 2026

Background: Provision of vascular imaging results has been investigated to prompt changes towards healthy lifestyle behaviours, but effects on body composition and muscle health are unknown. Aim: This secondary analysis of a 12-week parallel-group randomised controlled trial (RCT) aims to explore body composition and muscle health effects of providing healthy lifestyle education (Ed) with and without abdominal aortic calcification (AAC) results. Methods: A total of 240 Australian community-dwelling older men and women (mean ± SD age 68 ± 5 years; 58% female; 57.1% with evidence of AAC) were randomised to AAC + Ed (n = 121) or Control + Ed …

Discriminative Performance Of Externally Validated Dementia Risk Prediction Models: A Systematic Review And Meta-Analysis, Blossom C.M. Stephan, Jacob Brain, Kaarin J. Anstey, Tanya Buchanan, Claire V. Burley, Elissa Burton, Jennifer Dunne, Linda Errington, Matthew Gorringe, Zhongyang Guan, Bronwyn Myers, Serena Sabatini, Marc Sim, William Stephan, Eugene Yee Hing Tang, Narelle Warren, Mario Siervo

Research outputs 2022 to 2026

Background: Data on the external validation of current dementia risk prediction models has not yet been systematically synthesised. This systematic review and meta-analysis collated results from three previous reviews to evaluate the predictive discriminative performance of dementia risk models when validated in population-based settings. Methods: Embase (via Ovid), Medline (via Ovid), Scopus, and Web of Science were searched from inception to June 2022 with an updated search conducted up to November 2024. Included studies (1) had a population-based cohort design; (2) assessed incident late-life (i.e. ≥ 60 years) dementia; and (3) reported predictive performance of at least one dementia risk …

Progression Of Non-Radiographic To Radiographic Axial Spondyloarthritis: A Risk Model Based On A Chinese Cohort Study, Rui Ying Deng, Xiaojia Xu, Jian Hua Peng, Feng Cai Shen, Yao Gong, Dan Min Wang, Hong Jin Liang, Shu Xin Huang, Zhao Peng Chen, Wen Long Wu, Ze Xin Zheng, Ling Lin, Zhi Duo Hou

Research outputs 2022 to 2026

Objectives: To evaluate the progression from non-radiographic axial spondyloarthritis (nr-axSpA) to radiographic axial spondyloarthritis (r-axSpA) in a Chinese cohort, identify associated risk factors in both clinical and imaging arms, and enable risk stratification based on these factors. Methods: Overall, 572 patients with nr-axSpA were enrolled with a median follow-up of 5 years. Cox proportional hazard regression analyses were conducted to identify potential risk factors associated with the progression from nr-axSpA to r-axSpA in both clinical and imaging arms. A risk-scoring system was then developed by assigning each independent predictor a weight based on its regression coefficient. Patients were subsequently categorized …

Acute Effects Of Accentuated Eccentric Loading On Mean Concentric Velocity During Resistance Training: A Systematic Review And Meta-Analysis, Jiahao Yang, Tsuyoshi Nagatani, Paul Comfort, Kristina L. Kendall, G. Gregory Haff

Research outputs 2022 to 2026

Background: Accentuated eccentric loading (AEL) may acutely enhance the concentric (CON) barbell velocity after the additional eccentric (ECC) load is removed, however there are inconsistent results regarding the effectiveness of this practice within the scientific literature. Objective: The aims of the present study were to: (1) examine the acute effects of applying AEL, only on the first repetition of a set, on mean barbell velocity during the CON phase of the first 3 repetitions of the set and (2) investigate the influence of the magnitude of ECC load, loading differential and exercise selection on the acute effects of AEL. Methods: …

Body Mass Index, Prebiotic Supplementation During Pregnancy And Gestational Diabetes Mellitus Risk: An Effect Modification Analysis From A Randomised Controlled Trial, Rachelle A. Pretorius, Thomas R. Sullivan, Summer V.M. Walker, Johan Garssen, Jeffrey A. Keelan, Desiree Silva, Susan L. Prescott, Debra J. Palmer

Research outputs 2022 to 2026

Background: Prebiotic dietary supplementation has been shown to improve glucose homeostasis in type 2 diabetes patients. The aim of this analysis was to determine whether pre-pregnancy body mass index (BMI) modifies the effect of prebiotic supplementation from mid-pregnancy on reducing the risk of gestational diabetes mellitus (GDM). Methods: In a double-blinded, randomised controlled trial, pregnant women < 21 gestational weeks were randomly assigned (1:1) to consume daily prebiotics (14.2 g galacto-oligosaccharides and fructo-oligosaccharides) or placebo (8.7 g maltodextrin) powder. An effect modification analysis was performed to assess the heterogeneity of the effect of prebiotic supplementation in relation to pre-pregnancy BMI on GDM diagnosis. Results: Between June 2016 and November 2021, 329 women were assigned to the prebiotic group (50.4%), and 323 (49.5%) were assigned to the placebo group. Overall, 288 of 652 women (44.2%) were classified as overweight/obese prior to pregnancy (BMI ≥ 25 kg/m²). The distribution was balanced, with 146/329 (44.4%) randomised to the prebiotics group and 142/323 (44.0%) in the placebo group. Pre-pregnancy BMI modified the effect of prebiotic supplementation, with the intervention reducing GDM rates in women with a BMI ≥ 25 kg/m^{2 …}

Eccentric Exercise: Muscle Damage To The New Normal, Kazunori Nosaka

Research outputs 2022 to 2026

No abstract provided.