Medicine and Health Sciences Commons^™

Mid-Shift Huddle To Improve Icu Nurse Well-Being And Reduce Burnout, Jesse Cannizzo

Doctor of Nursing Practice Final Project Abstract

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Mid-Shift Huddle to Improve ICU Nurse Well-Being and Reduce Burnout

Purpose

Burnout among ICU nurses negatively affects well-being, job

satisfaction, and retention. This quality improvement project

evaluated a mid-shift support huddle to identify staff stressors

and improve nurse well-being.

Results

The mid-shift support huddle identified high-stress events during 44% of

completed huddles, with workload and unsafe assignments as the

primary concerns. ProQOL scores improved, while employee

engagement findings were mixed, with unchanged well-being and lower

perceived stress manageability.

Background

ICU nurses provide high-acuity care, manage heavy workloads, and

experience emotional fatigue. Brief team huddles and leadership

engagement may improve …

Implementing A Standardized Diabetic Retinopathy Screening And Education Protocol In An Optometry Clinic: A Quality Improvement Project, Jadaven Edmond

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose: The purpose of this quality improvement project was to improve adherence to standardized diabetic retinopathy screening among adults with diabetes at an outpatient optometry practice in the Greater Houston area.

Background: Diabetic retinopathy (DR) is a leading cause of preventable blindness among adults in the United States. The American Diabetes Association recommends annual dilated eye examinations for all patients with diabetes; however national adherence rates remain at only 50–60%.

Methodology: A 12-week quality improvement initiative was implemented using the Plan-Do-Study-Act model. Interventions included staff education, EHR prompts for the diabetic eye-care protocol, pre-visit identification of patients with diabetes, …

“Shaking The Ladder” Reveals How Analytic Choices Can Influence Associations In Nutrition Epidemiology: Beef Intake And Coronary Heart Disease As A Case Study, Colby J Vorland, Lauren E O'Connor, Beate Henschel, Cuiqiong Huo, James M Shikany, Carlos A Serrano, Robert Henschel, Stephanie L Dickinson, Keisuke Ejima, Aurelian Bidulescu, David B Allison, Andrew W Brown

Children’s Nutrition Research Center Staff Publications

Nutrition epidemiological models involve many analytic decisions, such as defining exposures, selecting which covariates to include, or configuring variables in different ways. We explored the impact of analytical decisions on conclusions in nutrition epidemiology using self-reported beef intake and incident coronary heart disease as a case study. We used REasons for Geographic and Racial Differences in Stroke (REGARDS) data, and selected covariates and their configurations from published literature to recapitulate common models used to assess associations between meat intake and health outcomes. Three model sets were designed: sets one and two used continuous and quintile-defined beef intakes, respectively, each with …

Examining Widely Held Propositions On Human Dietary Protein Needs And Benefits: A Critical Review Of The Science That Shapes Both The Data And Our Understanding Of An Essential Macronutrient, Mitchell M Kanter, Sally Aaron, Steven N Austad, Andrew W Brown, Nicholas A Burd, Wayne W Campbell, Mark Cope, Teresa A Davis, John W Erdman, Miguel Freitas, Kristen Hicks-Roof, Samuel Klein, Wantanee Kriengsinyos, Dudley W Lamming, Donald K Layman, Heather J Leidy, Kevin C Maki, Richard D Mattes, Shalene Mcneill, Daniel R Moore, Stefan M Pasiakos, Stuart M Phillips, David Raubenheimer, Wendy Reinhardt, Nancy R Rodriguez, Stephen Simpson, Hans H Stein, Luc J C Van Loon, Connie M Weaver, David B Allison

Children’s Nutrition Research Center Staff Publications

The essentiality of protein in the human diet is unequivocal. Yet researchers, clinicians, and lay people often believe numerous propositions about dietary protein despite insufficient supporting or refuting data in some instances. To address this disconnect, and to "pressure-test" current beliefs about dietary protein, the Indiana University School of Public Health-Bloomington convened a workshop in February 2025 titled "Human Dietary Protein Needs and Benefits: A Critical Assessment of Postulated Propositions." More than 20 international experts discussed (1) methodologic issues affecting data acquisition and interpretation; (2) "optimal" dietary protein intakes and effects on muscle protein synthesis rates, muscle protein accretion, …

Cross-Sectional And Longitudinal Relationships Between Abdominal Fat Depots And Cardiometabolic Risk In A Sample Of Mexican Adolescents, Luis Ortíz-Hernández, Erica G Soltero, Miguel Camejo, Jesús Valdes

Children’s Nutrition Research Center Staff Publications

Background: The relationship between abdominal fat depots and cardiometabolic risk among youth is inconclusive due to the cross-sectional nature of existing studies and limitations in assessment methods. In this study, we examined cross-sectional and longitudinal associations of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) with cardiometabolic risk indicators among Mexican adolescents.

Methods: Participants (n = 169 at baseline and 134 at follow-up) were assessed for diastolic or systolic blood pressure (DBP or SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, glucose, and insulin. VAT and SAT were measured using magnetic resonance imaging. Measures …

A Pragmatic Guide To Data Integration For Pediatric Researchers: The Nuts And Bolts Of Mixed Methods Analysis, Kathleen A Knafl, Janet A Deatrick, Veronica M Swallow, Yelena P Wu, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Objective: To provide pragmatic guidance on data analysis, integration, and reporting guidance for investigators new to mixed methods research.

Methods: Three core mixed methods designs (convergent, explanatory sequential, and exploratory sequential) are described. Key decision points related to data integration-specifying intent, data selection, data preparation, integration strategies, use of analysis software, reporting-are explained, including comparison of decision points across the different mixed methods designs.

Results: Recommendations for addressing key decisions during analysis are provided and supported with published examples from mixed methods studies focused on pediatric populations.

Conclusions: Integration of qualitative and quantitative data is the defining characteristic of mixed …

Sustainable Community-Wide Model To Enhance Cancer Data Usage And Utility, Emily S Boja, Mousumi Ghosh, Ying Huang, Tung-Shing Mamie Lih, Rawan Shraim, Gregory Wheeler, Diana Thomas, Rakesh Khanna, Stephanie Sandor, Jinghui Zhang, Sapna Oberoi, Nicolas J Llosa, Aditya Suru, Fernanda Silva Michels, Eric Durbin, Anna Fernandez, Lucy Han, James Galbraith, Yin Lu, Brian Furner, James H Tanis, Michael Watkins, David Higgins, Gavriel Matt, Xin Zhou, Yang Li, Marcin Cieslik, Jamie Estill, Michael Sierk, Yanling Sun, Weiping Ma, Joseph Flores-Toro, Freddie Pruitt, Subhashini Jagu, Elmer A Fernández, Daniela Orschanski, Stephanie J Spielman, Jaclyn Taroni, Trinh Nguyen, Brian Capaldo, Erin Beck, Tanja Davidsen, Johanna Goderre Jones, Minghong Ward, Anne Sturcke, Jennifer M Torres Del Valle, Sean Hanlon, Danielle Daee, Brandon Wright, Nathaniel Boyd, Heather Basehore, Liang Liu, Ying Hu, Daoud Meerzaman, Huiqing Li, Ying Wu, Gregory H Reaman, Erin Rudzinski, Jack F Shern, Brigitte Widemann, Warren Kibbe, Jaime Guidry Auvil

Children’s Nutrition Research Center Staff Publications

Despite vast investments in data collection, generation, and sharing from childhood cancer studies, for example, Gabriella Miller Kids First Research Program, Childhood Cancer Data Initiative, and other efforts, secondary use of data remains a challenge especially for rare diseases. The National Cancer Institute (NCI) Office of Data Sharing (ODS) aimed to promote FAIR (Findable, Accessible, Interoperable, Reusable) data sharing practices to enhance data utility, accelerate discovery, and foster interdisciplinary collaboration. NCI ODS launched its inaugural Data Jamboree focusing on childhood cancer alongside its third Annual Symposium in September 2025. Over 120 participants with diverse backgrounds coalesced into 23 multidisciplinary teams …

De Novo And Inherited Dominant Variants In U4 And U6 Snrna Genes Cause Retinitis Pigmentosa, Mathieu Quinodoz, Kim Rodenburg, Zuzana Cvackova, Karolina Kaminska, Suzanne E De Bruijn, Ana Belén Iglesias-Romero, Erica G M Boonen, Mukhtar Ullah, Nick Zomer, Marc Folcher, Jacques Bijon, Lara K Holtes, Stephen H Tsang, Zelia Corradi, K Bailey Freund, Stefanida Shliaga, Daan M Panneman, Rebekkah J Hitti-Malin, Manir Ali, Ala'a Altalbishi, Sten Andréasson, Georg Ansari, Gavin Arno, Galuh D N Astuti, Carmen Ayuso, Radha Ayyagari, Sandro Banfi, Eyal Banin, Tahsin Stefan Barakat, Mirella T S Barboni, Miriam Bauwens, Tamar Ben-Yosef, Virginie Bernard, David G Birch, Pooja Biswas, Fiona Blanco-Kelly, Beatrice Bocquet, Camiel J F Boon, Kari Branham, Dominique Bremond-Gignac, Alexis Ceecee Britten-Jones, Kinga M Bujakowska, Cyril Burin Des Roziers, Elizabeth L Cadena, Giacomo Calzetti, Francesca Cancellieri, Luca Cattaneo, Naomi Chadderton, Peter Charbel Issa, Luísa Coutinho-Santos, Stephen P Daiger, Elfride De Baere, Marieke De Bruyne, Berta De La Cerda, John N De Roach, Julie De Zaeytijd, Ronny Derks, Claire-Marie Dhaenens, Lubica Dudakova, Jacque L Duncan, G Jane Farrar, Nicolas Feltgen, Beau J Fenner, Lidia Fernández-Caballero, Juliana M Ferraz Sallum, Simone Gana, Alejandro Garanto, Jessica C Gardner, Christian Gilissen, Roser Gonzàlez-Duarte, Kensuke Goto, Sam Griffiths-Jones, Tobias B Haack, Lonneke Haer-Wigman, Alison J Hardcastle, Takaaki Hayashi, Elise Héon, Lies H Hoefsloot, Alexander Hoischen, Josephine P Holtan, Carel B Hoyng, Manuel Benjamin B Ibanez, Chris F Inglehearn, Takeshi Iwata, Brynjar O Jensson, Kaylie Jones, Vasiliki Kalatzis, Smaragda Kamakari, Marianthi Karali, Ulrich Kellner, Caroline C W Klaver, Krisztina Knézy, Robert K Koenekoop, Susanne Kohl, Taro Kominami, Laura Kühlewein, Tina M Lamey, Rina Leibu, Bart P Leroy, Petra Liskova, Irma Lopez, Victor R De J López-Rodríguez, Quinten Mahieu, Omar A Mahroo, Gaël Manes, Luke Mansard, M Pilar Martín-Gutiérrez, Nelson Martins, Laura Mauring, Martin Mckibbin, Terri L Mclaren, Isabelle Meunier, Michel Michaelides, José M Millán, Kei Mizobuchi, Rajarshi Mukherjee, Zoltán Zsolt Nagy, Kornelia Neveling, Monika Ołdak, Michiel Oorsprong, Yang Pan, Anastasia Papachristou, Antonio Percesepe, Maximilian Pfau, Eric A Pierce, Emily Place, Raj Ramesar, Francis Ramond, Florence Andrée Rasquin, Gillian I Rice, Lisa Roberts, María Rodríguez-Hidalgo, Javier Ruiz-Ederra, Ataf H Sabir, Ai Fujita Sajiki, Ana Isabel Sánchez-Barbero, Asodu Sandeep Sarma, Riccardo Sangermano, Cristina M Santos, Margherita Scarpato, Hendrik P N Scholl, Dror Sharon, Sabrina G Signorini, Francesca Simonelli, Ana Berta Sousa, Maria Stefaniotou, Kari Stefansson, Katarina Stingl, Akiko Suga, Patrick Sulem, Lori S Sullivan, Viktória Szabó, Jacek P Szaflik, Gita Taurina, Alberta A H J Thiadens, Carmel Toomes, Viet H Tran, Miltiadis K Tsilimbaris, Pavlina Tsoka, Veronika Vaclavik, Marie Vajter, Sandra Valeina, Enza Maria Valente, Casey Valentine, Rebeca Valero, Sophie Valleix, Joseph Van Aerschot, L Ingeborgh Van Den Born, Mattias Van Heetvelde, Virginie J M Verhoeven, Andrea L Vincent, Andrew R Webster, Laura Whelan, Bernd Wissinger, Georgia G Yioti, Kazutoshi Yoshitake, Juan C Zenteno, Roberta Zeuli, Theresia Zuleger, Chaim Landau, Allan I Jacob, Siying Lin, Frans P M Cremers, Winston Lee, Jamie M Ellingford, David Stanek, Susanne Roosing, Carlo Rivolta

Faculty, Staff and Student Publications

Small nuclear RNAs (snRNAs) combine with specific proteins to generate small nuclear ribonucleoproteins (snRNPs), the building blocks of the spliceosome. U4 snRNA forms a duplex with U6 and, together with U5, contributes to the tri-snRNP spliceosomal complex. Variants in RNU4-2, which encodes U4, have recently been implicated in neurodevelopmental disorders. Here we show that heterozygous inherited and de novo variants in RNU4-2 and in four RNU6 paralogs (RNU6-1, RNU6-2, RNU6-8 and RNU6-9), which encode U6, recur in individuals with nonsyndromic retinitis pigmentosa (RP), a genetic disorder causing progressive blindness. These variants cluster within the three-way junction of the U4/U6 duplex, …

Geospatial Disparities In Adolescent Mental Health Resources: School- And Community-Level Evidence From Travis County, Texas, Sharon V Munroe, Jingjing Gao, Gayla Ferguson, Muinat Abolore Idris, Eric C Jones

Faculty, Staff and Student Publications

Background: Adolescents in the United States face growing mental health challenges, with nearly one in three high school students reporting poor mental health in the past 30 days. Schools increasingly serve as key access points for mental health care. However, geographic disparities in access to school-based mental health services remain underexplored.

Purpose: This study examines the spatial distribution of adolescent mental health resources in Travis County, Texas, and evaluates how school- and community-level factors are associated with the presence of on-site school social workers.

Methods: School locations, enrollment data, and the presence of on-site social workers were mapped and analyzed …

Understanding Ehlers-Danlos Syndrome: A Claims-Based Analysis Of Healthcare Cost Patterns, Samson A Oyediran, Youngran Kim, Zhanna Novikov, Trudy M Krause

Faculty, Staff and Student Publications

Background: Ehlers-Danlos Syndrome (EDS) is a rare connective tissue disorder associated with substantial clinical complexity and healthcare utilization. Despite increasing recognition of EDS, little is known about its economic burden in the United States.

Objective: To assess the all-cause healthcare costs for individuals with newly diagnosed EDS during the pre-diagnosis year and the first 2 years post-diagnosis.

Methods: A retrospective cohort study was conducted using the Merative™ MarketScan® Commercial Claims and Encounters Database (2016-2022). Newly diagnosed patients were identified using ICD-10-CM codes, with the first observed diagnosis defined as the index date. Continuous enrollment for 12 months pre-index and 24 …

Latent Classification Of Time-Dependent Transition Rates In Longitudinal Binary Outcome Data, Joonha Chang, Wenyaw Chan

Faculty, Staff and Student Publications

Continuous-time Markov chain (CTMC) models and latent classification methods are commonly used to analyze longitudinal categorical outcomes in medical research. While CTMC models are popular for their simplicity and effectiveness, their assumption of constant transition rates presents limitations in capturing dynamic behaviors. To address this, non-homogeneous continuous-time Markov chains (NH-CTMCs) have been developed, incorporating time-varying transition rates to enhance model flexibility. In this study, we leverage closed-form transition probabilities for a fully ergodic two-state NH-CTMC model and propose a latent class clustering approach to identify heterogeneous transition rate patterns within the population. We emphasize the potential advantages of these models …

“If He Did It, I Can Do It, Too. I Can Change My Life Around”: The Social Model Of Recovery Within The Context Of Recovery Homes Accepting Residents Prescribed Medications For Opioid Use Disorder, Jodie M Dewey, Kathryn R Gallardo, Meenakshi S Subbaraman, Amy A Mericle

Faculty, Staff and Student Publications

Introduction: This paper provides an in-depth examination of examines four recovery residences, that serve individuals prescribed medications for opioid use disorder (MOUD). The study has two primary aims: first, to deepen understanding of how recovery residences adopt and operationalize Social Model of Recovery principles; and second, to identify gaps in staff integration of residents receiving MOUD-gaps that may either support or undermine the integrity of the social model within these settings.

Methods: We conducted semi-structured interviews with 17 residents receiving MOUD living in four participating recovery homes. The interviews were conducted between August 2022 and January 2024 using a semi-structured …

Corrigendum To 'Continuous Vital Sign Monitoring On Surgical Wards: The Cosmos Pilot, Nikola Anusic, Alper Gulluoglu, Elyad Ekrami, Edward J Mascha, Shuyi Li, René Coffeng, Alparslan Turan, Amber Clemens, Christine Perez, John W Beard, Daniel I Sessler, Cosmos Pilot Investigators

Faculty, Staff and Student Publications

Study objectives: Alerts for vital sign abnormalities seek to identify meaningful patient instability while limiting alarm fatigue. Optimal vital sign alarm settings for postoperative patients remain unknown, as is whether alerts lead to effective clinical responses reducing vital sign disturbances. We conducted a 2-phase pilot study to identify thresholds and delays and test the hypothesis that alerts from continuous monitoring reduce the duration of vital sign abnormalities.

Design: Two-phase pilot.

Patients: 250 adults having major non-cardiac surgery.

Setting: Surgical wards.

Intervention: All patients had routine vital sign monitoring by nurses at 4-h intervals. We initially continuously recorded clinician-blinded saturation, heart …

Pregnancy And Breastfeeding Are Associated With Less Later-Life Cognitive Decline In A Longitudinal, Prospective Cohort, Molly M Fox, Jennifer E Bramen, Dayoon Kwon, Mark A Espeland, Yijia Sun, Li Zhang, Aladdin H Shadyab, Ramon Casanova, Joann E Manson, Marcus Y Chang, Verna R Porter, Leslie V Farland, Qian Xiao, Robert A Wild, Prabha Siddarth, Carolyn J Crandall

Faculty, Staff and Student Publications

Introduction: The brains of female mammals evolved to undergo structural and functional changes during pregnancy and lactation, equipping them for motherhood. However, long-term cognitive health implications of these adaptations in women are poorly understood.

Methods: In the Women's Health Initiative (WHI) Memory Study (WHIMS; n = 7427) and WHI Study of Cognitive Aging (WHISCA; n = 2304), postmenopausal women completed reproductive history interviews, annual global cognitive assessment from mean age 70 for up to 13 years, and multi-domain cognitive testing for up to 8 years.

Results: Each additional month pregnant was associated with higher scores of global cognition. Each additional …

Artificial Light At Night Extends Pollen Season And Elevates Allergen Exposure, Brandt Geist, Lin Meng, Daniel S W Katz, Huidong Li, Franz Hölker, Qian Xiao

Faculty, Staff and Student Publications

Artificial light at night (ALAN), a growing environmental stressor in urban ecosystems, disrupts natural light-dark cycles and alters plant phenological events such as leaf-out and flowering. However, the extent to which ALAN influences airborne pollen season timing and exacerbates allergy-related health risks remains largely understudied. This study investigates how ALAN influences the timing and duration of the airborne pollen season across the Northeastern United States from 2012 to 2023 and the consequences of allergenic pollen exposure. Using daily pollen concentrations from the National Allergy Bureau, ALAN data from the Visible Infrared Imaging Radiometer Suite product, and gridded Daymet climate data, …

Plasma Proteomic Profile Of Dietary Potassium And Incident Ckd, Jiaqi Yang, Lauren Bernard, Jingsha Chen, Valerie K Sullivan, Bing Yu, Eugene P Rhee, Paul A Welling, Casey M Rebholz

Faculty, Staff and Student Publications

Background:: There is a need for objective biomarkers of dietary potassium. The mechanisms through which dietary potassium influences kidney health are incompletely understood.

Methods:: Atherosclerosis Risk in Communities study participants at visit 3 (1993–1995) with dietary and proteomics data were randomly divided into discovery (N=6,814) and replication (N=3,380) sets. We examined associations between dietary potassium and 4,955 aptamers using multivariable linear regression, adjusting for sociodemographic factors, health behaviors, and estimated glomerular filtration rate, with a false discovery rate of 0.05. Then, we tested the prospective associations between potassium-related proteins and incident chronic kidney disease (CKD).

Results:: …

Examining Tobacco Prevention And Cessation Among Dental Students In Southern Italy, Olga Di Fede, Samuel Tundealao, David Okuji, Gaetano La Mantia, Irene Tamí-Maury

Faculty, Staff and Student Publications

Background: Previous studies have reported that tobacco use among healthcare providers (HCPs) has a negative impact on their beliefs and attitudes toward tobacco prevention and control measures. However, little is known about these among Italian dental students. Therefore, this single-site study examined tobacco use behaviors and the knowledge, attitudes, and perceptions of dental students at a public university in Southern Italy regarding tobacco prevention and control.

Methods: A cross-sectional study through an online survey was conducted among 115 students aged 18 + years enrolled in dentistry and dental hygiene programs at a Southern Italy university. Chi-squared, Fisher's, t-tests, and …

Adapting A Smartphone-Based Auricular Point Acupressure Self-Management Program For Rural Chronic Musculoskeletal Pain: Qualitative Study, Jungkyung Min, Peiyin Hung, Jane N Bolin, Rupsikha Bora, Sarah Pace, Patricia Pitones, Hulin Wu, Jennifer Kawi

Faculty, Staff and Student Publications

Background: Chronic musculoskeletal pain is more prevalent in rural areas where access to pain interventions, including complementary approaches like Auricular Point Acupressure (APA), remains limited. APA is a non-invasive, needle-free approach, and its smartphone-based self-management delivery model has not been optimized for rural contexts.

Objectives: To explore the perspectives of rural partners on adapting a smartphone-based Auricular Point Acupressure-Self-Management (APA-SM) program to better meet rural needs. Study objectives were to: (1) refine the APA-SM program for rural adults, (2) identify implementation barriers, (3) understand practice workflows and engagement, and (4) identify strategies to integrate the APA-SM program into rural pain …

Subgroup Identification Of Disparities In Buprenorphine Discontinuation In Opioid-Use Disorder: A Virtual Twins Machine Learning Approach Using Nationwide United States Claims Data, 2006–2022, Kehe Zhang, Paula A Jaimes-Buitron, Wanru Guo, Yanmin Gong, Yuanxiong Guo, Carolina Vivas Valencia, Cici Bauer

Faculty, Staff and Student Publications

Buprenorphine retention is crucial for effective treatment of opioid use disorder (OUD), yet disparities in treatment discontinuation persist. This study aims to identify and quantify disparities in buprenorphine treatment retention using a machine learning framework adapted from Virtual Twins approach focusing on disparities related to sex, age, insurance type, geographic region, mental health status and community-level Social Vulnerability Index (SVI). Using a nationwide longitudinal cohort, we applied a two-stage machine learning approach. In Stage one, we trained classification models to estimate the counterfactual differences in treatment discontinuation across disparity types. Model performance was assessed using C-statistics and precision-recall curve. In …

Improving Overall Risk Ranking Via Subgroup-Level Information Borrowing In Survival Risk Stratification, Tia S Thomas, Jing Ning, Ruosha Li

Faculty, Staff and Student Publications

Effective risk stratification is essential for providing tailored therapies, improving patient outcomes, and optimizing healthcare resources by identifying sub-populations with similar health risks. However, accurate risk ranking is challenging in the presence of heterogeneous subgroups. Under these instances, subgroup-level information can be leveraged to refine the overall risk ranking. We propose a novel approach that integrates within-subgroup risk ranking percentiles to enhance the overall cohort risk stratification. This method uses both a global model and subgroup-specific models along with optimized weights to improve discriminatory performance across the entire cohort. The proposed method is validated through extensive simulations and applied to …

A Qualitative Examination Of Human Papillomavirus Vaccine Access, Beliefs, And Behaviors Among Adult Males Aged 18–35: Applying The Health Stigma And Discrimination Framework, Jacquelin I Cordero, Louis D Brown, Jesús M Alemán, María E Fernández, Serena A Rodríguez, Eva M Moya

Faculty, Staff and Student Publications

Background: Males, who disproportionately account for 83% of oropharyngeal cancer cases, are underrepresented in health promotion research, including human papillomavirus (HPV) vaccination studies. The initial exclusion of males in HPV vaccine research, policies, and interventions has negatively affected male vaccine uptake. Furthermore, stigma, a well-documented barrier to healthcare engagement, has been overlooked in HPV vaccination behaviors. This study aimed to provide a more contextualized understanding of HPV vaccine disparities among adult males by applying the Health Stigma and Discrimination Framework (HSDF) to examine how stigma is produced, enacted, and sustained across social systems, which may impact male vaccine uptake.

Methods: …

The Longitudinal Effect Of Repetition And Practice On The Accuracy Of Lay Anal Examinations For Detecting Perianal And Anal Canal Abnormalities: A Prospective Study, Alan G Nyitray, Timothy L Mcauliffe, Jenna Nitkowski, Cameron Liebert, Michael D Swartz, Ashish A Deshmukh, Jared Kerman, Ellen Almirol, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Duo Yu, Aniruddha Hazra, Elizabeth Y Chiao

Faculty, Staff and Student Publications

Background: While anal cancer screening is now recommended in several countries for high-incidence populations, barriers impede screening uptake. It is well known that patient recognition of symptoms increases cancer screening uptake, and we previously demonstrated that patients can detect small masses at the perianus and in the anal canal. In this current analysis, we aimed to longitudinally assess the effect of repetition and practice on patient self-recognition of small masses.

Methods: Individuals and couples of sexual minority men and transgender women were taught to conduct an anal self-examination or anal companion examination (ASE/ACE) at visit 1 and then randomized to …

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 …

Targeting Nuclear Receptors In Muscular Dystrophies And Regenerative Myogenesis, Eira Mann, Hoang Vu, Vihang A Narkar, Yu Liu

The Brown Foundation: Institute of Molecular Medicine

Skeletal muscle is a highly plastic tissue with a robust capacity for regeneration, largely driven by resident satellite cells. Muscular dystrophies comprise a heterogeneous group of inherited disorders characterized by progressive muscle degeneration, chronic inflammation, and impaired regenerative capacity. Despite well-defined genetic etiologies, effective disease-modifying therapies for these disorders, as well as many acquired myopathies, remain limited. Emerging evidence identifies nuclear receptors (NRs) as key regulators of skeletal muscle homeostasis, integrating hormonal, metabolic, and environmental signals to control transcriptional programs governing mitochondrial function, metabolism, inflammation, and myogenesis. In this review, we summarize the diverse roles and mechanisms of action of …

Immune Checkpoint Inhibitor-Induced Cardiotoxicity: From Immune Mechanisms To Clinical Surveillance And Targeted Therapies, Nathan K Chen, Kathryn D Hok, Narsi Chokshi, Anthony Shadid, Haydn E Rich, Lavanya Gunamalai, Marie-Francoise Doursout, Nirmal K Banda, Pooja Shivshankar

The Brown Foundation: Institute of Molecular Medicine

Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape across a broad range of malignancies by restoring antitumor immunity through blockade of key inhibitory immune pathways, including programmed death receptor-1 (PD-1), programmed death ligand-1 (PD-L1), and cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4). Yet the same widespread immune activation that drives their therapeutic benefit renders patients susceptible to immune-related adverse events (irAEs). Among these cardiovascular toxicities have emerged as a particularly critical concern, drawing growing attention within the evolving field of cardio-oncology. ICI-associated cardiotoxicity encompasses a broad clinical spectrum, ranging from myocarditis and pericarditis to arrhythmias, heart failure, and vascular complications. Of these, …

Implementation Of An Acute Critical Event Debriefing To Enhance The Quality Of Cardiopulmonary Arrest Resuscitation In The Cardiovascular Intensive Care Unit At A Safety-Net Hospital, Shara Baker

Doctor of Nursing Practice Final Project Abstract

Purpose

This scholarly project aimed to implement an Acute Critical Event Debriefing (ACED) program in an intensive care unit to improve resuscitation quality by increasing post–cardiopulmonary arrest debriefing completion rates and enhancing documentation of airway confirmation during resuscitation events. The project took place in a 12-bed intensive care unit at a large academic safety-net hospital in Dallas, Texas.

Background

Structured debriefing after cardiopulmonary arrest events was recommended to enhance team performance, clinical education, and resuscitation quality. However, debriefing following code events was inconsistently conducted across many intensive care units, limiting opportunities for team reflection and quality improvement.

Methodology

The Plan-Do-Study-Act …

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

Faculty, Staff and Student Publications

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

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

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

Faculty, Staff and Student Publications

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

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

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

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

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

Faculty, Staff and Student Publications

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

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

Faculty, Staff and Student Publications

No abstract provided.