Medicine and Health Sciences Commons^™

Dietary Patterns And Factors Associated With Breast Cancer Risk In Ethnically Diverse Women: Observational And Full Plate Living Lifestyle Intervention Findings, Padma P. Tadi Uppala, Elmer C. Rivera, Sherri Isaak, Jean Cadet, Dixon Anjejo, Victoria Rios-Rivas, Michael Uppala, Nicole Bodetti

Faculty Publications

Background

Ethnic disparities in diet quality, adiposity, and previously identified factors contribute to metabolic dysregulation and breast cancer risk. However, integrated evidence linking dietary patterns, metabolic markers, and lifestyle intervention outcomes across diverse populations remains limited.

Methods

This study presents findings from three complementary investigations conducted within a broader research program and examined within a structured conceptual and comparative framework. Studies 1 and 2 are cross-sectional analyses conducted in ethnically diverse women recruited from community sites in California and Michigan, and Study 3 is a 16-week whole food plant-based, water and fiber-rich dietary intervention conducted in a university lifestyle medicine …

Bare Bones Medicine: A Young Physician Adapts To An Island Medical Practice, Chuck Radis

Faculty Publications

This is the story of Dr. Radis's introduction to his new job as an island physician in Maine.

Where Do Nurses Thrive? A Call For Healthy Work Environments, Adrianna Lorraine Watson, Carmel Bond, Rebecca Jarden, Michelle Cleart

Faculty Publications

No abstract provided.

Compassion In Mental Health Nursing: A Scoping Review, Carmel Bond, Adrianna Lorraine Watson, Hattie Painter, Debra Jackson

Faculty Publications

Compassion is widely recognised as a core component of mental health nursing, yet its meaning and application within this specialty remain underexplored. This scoping review examined how compassion is conceptualised, experienced, and enacted in mental health nursing practice, and the extent to which this aligns with existing models of compassion. A systematic search of CINAHL, Scopus, and PsycINFO identified peer-reviewed articles published in English between 2016 and 2026. Studies were included if compassion was a central focus and excluded if related to children’s services, student nurses, or general nursing contexts. Nine studies were included; seven qualitative and two quantitative designs. …

Terahertz Electromagnetic Effects And Chirality-Induced Spin Selectivity In Dna, F. Matthew Mihelic Md

Faculty Publications

The effects of terahertz electromagnetic stimulation of the DNA molecule can be understood through modeling of the quantum logical mechanics of the DNA molecule.  Coherent conduction of electron spin states along the aromatic nucleotide base pairs and chirality-induced spin selectivity are two characteristics of the DNA molecule that are involved in the precise separation of the double-stranded DNA molecule at a specific location.  Such modeling can inform predictions of DNA strand separation and has significant implications for understanding DNA transcription bubble formation.

What Drives Schoolchildren's Food Choices? Insights From A Gamified Stated-Preference Choice Experiment In Tunisia, Ali Chalak, Christelle Akl, Joanne Haddad, Nehmat El Helou, Sonia Sassi, Houda Ben Gharbia, Rawan Traboulsi, Marc Haber, Jalila El Ati, Hala Ghattas Ph.D.

Faculty Publications

This paper models the drivers of schoolchildren's food choices in urban Tunisia using a gamified Stated-Preference Choice Experiment (SPCE), which includes scenario attributes (food placement, preparation, and price) and contextual factors (parental/peer modeling eating behaviors). A representative sample of 2465 schoolchildren aged 8 to 12 years in Greater Tunis participated in a SPCE, which simulates real-life food choice scenarios on a typical school day. The game includes six nodes (breakfast, recess, lunch, snack on the road to/from school, afternoon snack, dinner) in various locations (home, school, neighborhood). Each choice task includes nine items to choose from (3 beverages, 3 side-meals, …

Perceived Effectiveness Of Cigar Warnings Among Young People In The U.S., Leah M. Ranney, Rime Jebai, Michael Jetsupphasuk, Sonia A. Clark, Kristen L. Jarman, Sarah D. Kowitt, Jim Thrasher Ph.D., Ma, Ms, Adam O. Goldstein, Jennifer Cornacchione Ross

Faculty Publications

Introduction: The effectiveness of warning size and format on cigar packaging in influencing youth and young adult smoking behaviors is not well understood. This study tested these cigar warning characteristics among youth and young adults who use or are susceptible to using little cigars or cigarillos.

Methods: The study recruited 506 U.S. youth and young adults, aged 15−20 years, between April and June 2023. Participants reported ever or past 30-day use of little cigars or cigarillos or were susceptible to using little cigars or cigarillos. A 2 £ 2 between-subjects online experiment was conducted where youth and young adults were …

Constructions Of Medical Misogyny: A Corpus-Assisted Study Of Women's Healthcare Narratives In Media Texts, Carmel Bond, Debra Jackson, Adrianna Lorraine Watson

Faculty Publications

Background: Internationally, women continue to report health inequities that are increasingly being framed as medical misogyny, yet the linguistic mechanisms underpinning them remain understudied.

Objective: To examine the discourse through which women's healthcare experiences are publicly framed and interpreted as medical misogyny.

Methods: A 37,327-word corpus was constructed and analysed using established corpus-assisted discourse study approaches. The software 'AntConc' was used to identify frequent and collocated words. Concordance line analysis identified four discursive patterns operating across the genres represented within the corpus.

Results: Four discursive patterns were identified: (1) professional authority and normalisation, (2) epistemic struggle, (3) communicative asymmetry, and …

Vaccination For Patients With Immunosuppression And Altered Immunity: A Workgroup Report From The Aaaai Adverse Reactions To Drugs, Biologics, And Vaccines Committee And The Autoimmunity And Altered Immune Response Committee, Sam Pope Phd, Jd

Faculty Publications

Abstract

Vaccination, a fundamental strategy for infectious disease prevention, presents unique challenges in individuals with altered immunity. These populations include individuals with inborn errors of immunity, autoimmune and inflammatory diseases, solid organ transplants, hematopoietic stem cell transplants, biologic and immunosuppressive therapies, and pregnancy. Despite concerns regarding variable vaccine responses, altered efficacy, and safety profiles, these groups remain under-represented in clinical trials. This review synthesizes current evidence on immunization outcomes in medically complex populations, highlighting strengths and limitations in existing research. We describe how altered immunity affects vaccine responses, summarize data on adverse reactions, and examine the influence of biologic therapies …

Parenting Stress And Nurse Workforce Sustainability: An Integrative Literature Review, Adrianna Lorraine Watson

Faculty Publications

Background

Parenting stress among clinical nurses has been associated with turnover-related outcomes. For many nurses, critical periods of career development and accumulated clinical responsibility overlap with reproductive and early parenting years. Features of nursing work may shape parenting stress through demands related to scheduling, workload, and limited flexibility.

Design

Integrative literature review.

Methods

An integrative literature review was conducted following the methodological framework of Whittemore and Knafl. The final searches across three databases (CINAHL Complete, Medline, and Embase) were completed on May 14, 2026. Eligible articles were published in English, addressed parenting stress, and, when empirical, included nurses as a …

Phenome-Wide Association Study Of P2rx7 Identifies Schizophrenia And Mood Disorders As Primary Associated Phenotypes, Ling Zhu, Qiao Mao, Zhixiong Luo, Bin Chen, Yong Zhang, Xiaowei Lu, Ping Liu, Jiawu Ji, Xiaoping Wang, Kesheng Wang Phd, Ma, Bs, Xinghua Pan, Yuping Cao, Na Liu, Jennifer Luo, Lingjun Zuo, Zhiren Wang, Xingguang Luo, Xiaoyun Guo

Faculty Publications

Objectives: P2RX7 has been implicated in bipolar disorder, major depressive disorder, schizophrenia, anxiety disorders, Alzheimer's disease, and Parkinson's disease. However, the specificity and comparability of these as sociations remain unclear. This study aimed to systematically evaluate multiple neuropsychiatric disorders to identify those most robustly associated with P2RX7.

Methods: We analyzed 1861 imputed SNPs spanning the P2RX7 gene in 1,087,925 individuals from 72 inde pendent cohorts across 18 neuropsychiatric disorders. SNP-disease associations were assessed within each cohort, followed by meta-analysis and false discovery rate (FDR) correction to identify significant disease-risk variants. P2RX7 mRNA and protein expression across tissues or cells …

Broken Links: Gender Disparities Across The Chain Of Survival In Out‐Of‐Hospital Cardiac Arrest, Rylie Rasmussen, Adrianna Lorraine Watson

Faculty Publications

Aim(s)

To examine gender-based disparities across each link of the American Heart Association's Chain of Survival for women experiencing out-of-hospital cardiac arrest, highlighting systemic, cultural and educational barriers that compromise equitable outcomes.

Design

A discursive review synthesizing epidemiological studies, public health data and qualitative research on cardiac arrest and gender disparities.

Methods

A comprehensive search of databases including PubMed and CINAHL identified studies on gender differences in out-of-hospital cardiac arrest recognition, bystander intervention, emergency response and post-arrest care. Literature was critically analyzed using constant comparative analysis and organized according to the five links of the American Heart Association's Chain of …

Exploring Capacity For Future Sustainability Of Healthy Eating Policy, Systems, And Environmental Change Strategies Previously Implemented Through Snap-Ed Programming, Carrie L. Draper, Nicholas Younginer Ph.D.

Faculty Publications

Objective

Design

Setting

Participants

Phenomenon of Interest

Analysis

Results

Does Patient History Influence Capsular Contracture? An Exploratory Analysis With Machine Learning, Thomas M. Johnstone, Daniel Najafali, Jennifer K. Shaw, Justin M. Camacho, Chancellor Johnstone, Rahim S. Nazerali, Gordon K. Lee

Faculty Publications

Background: Capsular contracture (CC) is a frequent and distressing complication of breast augmentation and reconstruction. Although numerous patient-, surgical-, and implant-related risk factors have been proposed, reliable population-level predictors remain inconsistent across studies. This study evaluates whether administrative medical history, as encoded by ICD and CPT codes, contains sufficient predictive signal to identify patients at risk for CC using machine learning. Methods: Patients were queried from the MerativeTM MarketScan® Research Databases from 2003 to 2017 with CPT codes for implant-based breast reconstruction and augmentation. ICD codes were then used to identify all events and conditions of a patient’s history. Hyperparameter-tuned …

Panda-Plus-Bench: A Clinical Benchmark For Evaluating The Robustness Of Ai Foundation Models In Prostate Cancer Diagnosis, Joshua L. Ebbert, Dennis Della Corte

Faculty Publications

Artificial intelligence foundation models are increasingly deployed for prostate cancer Gleason grading, where GP3/GP4 distinction directly impacts treatment decisions (active surveillance vs. intervention). However, these models may achieve high validation accuracy by learning specimen-specific artifacts rather than generalizable biological features, limiting real-world clinical utility. We introduce PANDA-PLUS-Bench, a curated benchmark dataset derived from expertly annotated prostate biopsies designed specifically to quantify this failure mode. The benchmark comprises nine carefully selected whole slide images from nine unique patients containing diverse Gleason patterns, with non-overlapping tissue patches extracted at both 512 × 512 and 224 × 224-pixel resolutions across eight augmentation conditions. …

Baby-Friendly Hospital Initiative: A Critical Analysis Within The Nursing Workforce, Adrianna Lorraine Watson, Debra Jackson, Carmel Bond

Faculty Publications

Healthcare systems routinely frame breastfeeding as an ethical and clinical priority requiring institutional protection, particularly in maternity and newborn services. The Baby-Friendly Hospital Initiative represents a global effort to embed these commitments through policy, practice, and environmental support. While these protections are well established for patient-mothers, far less attention has been given to how they are applied to the nursing workforce responsible for enacting them. The authors critically appraise an ethical contradiction experienced by lactating nurse-mothers. Breastfeeding is institutionally supported for patients but structurally constrained within nurses’ own workplaces. Using relational ethics as the primary interpretive lens, supported by clinical …

Translational Research On Peer-Led Reflective Practice Using Stress First Aid: A Qualitative Descriptive Study, Jeanette Drake, Adrianna Lorraine Watson

Faculty Publications

Background

Nursing students experience persistent academic and clinical stress that impacts mental health, learning, and readiness for professional practice. Peer support and structured reflection are increasingly recognized as essential to trauma-informed and sustainable nursing education. Yet, they remain inconsistently integrated into curricula.

Purpose

To explore undergraduate nursing students’ experiences of participating in a peer-led stress first aid reflective process.

Method

A qualitative descriptive design was used. Thirty-seven undergraduate nursing students participated in weekly peer-facilitated stress first aid check-ins and student-led reflective discussions over six weeks. Data from peer-led focus groups were analyzed using inductive reflexive thematic analysis.

Results

Four themes …

Modeling Individual Self-Protective Behavior During Epidemics, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Protecting public health from infectious diseases requires collective action, as individual behaviors—such as vaccination and mask-wearing—directly influence disease dynamics. During the COVID-19 pandemic, unexpected public responses often undermined the effectiveness of interventions, highlighting the need to understand collective behavioral patterns and motivations to design more effective mitigation strategies. This study presents an agent-based simulation model that captures how individuals adjust self-protective behaviors based on evolving opinions about disease risk and examines how these decisions interact with external factors, such as public health interventions, to shape collective outcomes. To improve the representativeness of the simulated population, multiple datasets were integrated to …

Association Between Cholinesterase Inhibitor-Overactive Bladder Antimuscarinic Prescribing Cascade And Risk Of Delirium And Falls Among Individuals Living With Dementia, Sarah Beth Tucker, Bryan L. Love Pharm D., Chijoke M. Okeke, Erin D. Zwick, Chengwen Teng Pharm.D., Ph.D., Jingkai Wei, Ibraheem M. Karaye, Saud Alsahali, Krithika Rajagopalan, Ismaeel Yunusa Ph.D.

Faculty Publications

Background

Prescribing cascades occur when cholinesterase inhibitor (ChEI)-induced urinary incontinence is misinterpreted as a new condition, leading to overactive bladder (OAB) antimuscarinic initiation. We evaluated whether the ChEI-OAB antimuscarinic prescribing cascade was associated with delirium or falls compared with mirabegron in older adults living with dementia.

Methods

We conducted a retrospective cohort study using the Anlitiks All-Payor Claims database (2015–2020). Participants were adults aged ≥ 65 years with dementia newly prescribed a ChEI with no prior ChEI or OAB therapy (180 days). A 60-day window identified OAB treatment initiation after ChEI therapy. Exposures were OAB antimuscarinics or mirabegron. Outcomes were …

Use Of Period- Or Fertility-Tracking Technologies Pre- And Post-Dobbs, Emily Neiman, Marta Bornstein Phd, Mph, Abigail Norris Turner, Megan L. Kavanaugh, Maria F. Gallo

Faculty Publications

Objectives

Study design

The Big Five Personality Traits And Perceptions Of Generative Ai In Higher Education: A Canonical Correlation Analysis For Sustainable Digital Education, Mei Jiang, Shifang Tang, Qingwei Wang

Faculty Publications

The purpose of this study was to examine the multivariate relationship between college students’ Big Five personality traits and their perceptions of generative artificial intelligence (AI). Guided by sustainable digital education and expectancy-value theory, this study investigated whether personality profiles were associated with students’ knowledge of AI, attainment value, intrinsic value, utility value, perceived cost, and intention to use AI. Using a cross-sectional survey design, data were collected from 375 students enrolled at a Southwestern doctoral-granting public university. Participants completed an adapted measure of generative AI perceptions and the Big Five Inventory, and canonical correlation analysis (CCA) was conducted to …

Sex Differences In Gene Regulation And Its Impact On Cancer Incidence, Camila M. Lopes-Ramos, Rebekka Burkholz, Marouen Ben Guebila, Biola Fanfani, Enakshi Saha, Katherine H. Shutta, Kimberly Glass, John Quackenbush, Dawn L. Demeo

Faculty Publications

No abstract provided.

Planning For The Transition To Adulthood: Parent Perspectives On The Planning Process And Experiences Of Young Adults With Fragile X Syndrome, Leonard Abbeduto, Jessica Klusek Ph.D., Ccc-Slp, Julie Lounds Taylor, Angela John Thurman

Faculty Publications

Objectives

Relatively few young adults with fragile X syndrome (FXS) meet the normative expectations of adulthood, although there is heterogeneity in this regard. The present study examined the preparation for the transition to adulthood experienced by young adults with FXS and their parents.

Methods

Thirty-nine young adults with FXS and their primary caregiving parents participated. Those with FXS were in their last year of, or had recently left, high school or a formal transition program. Parents completed surveys about the formal transition planning process. We examined the role of the young adults’ adaptive behavior skills in transition planning.

Results

Among …

Planning For The Transition To Adulthood: Parent Perspectives On The Planning Process And Experiences Of Young Adults With Fragile X Syndrome, Leonard Abbeduto, Jessica Klusek, Julie Lounds Taylor, Angela John Thurman

Faculty Publications

Objectives Relatively few young adults with fragile X syndrome (FXS) meet the normative expectations of adulthood, although there is heterogeneity in this regard. The present study examined the preparation for the transition to adulthood experienced by young adults with FXS and their parents.

Methods Thirty-nine young adults with FXS and their primary caregiving parents participated. Those with FXS were in their last year of, or had recently left, high school or a formal transition program. Parents completed surveys about the formal transition planning process. We examined the role of the young adults’ adaptive behavior skills in transition planning.

Results Among …

Psychosocial Mediators Of A Physical Activity And Dietary Intervention In Pregnant Women With Overweight Or Obesity, Meghan Baruth, Sarah Wilcox, Jihong Liu, Rebecca Schlaff

Faculty Publications

Background

Mediation analyses provide insight into both ‘pieces’ of the mediation chain; they allow us to look into the ‘black box’ that is behavior change. They allow researchers to better understand the ‘how’ of an intervention’s effects and/or the ‘why’ behind why an intervention worked or did not work. The lack of publications in pregnant populations highlights the need for additional studies to be conducted and published. The purpose of this study is to examine the psychosocial mediators of physical activity and dietary outcomes in a sample of pregnant women with overweight or obesity participating in the Health in Pregnancy …

Single State Agency Licensure Requirements For Substance Use Disorder Treatment Programs In The United States: Results Of A National Survey, Brooks Yelton Ma, Lmsw, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan, Olivia Hinds, Christina M. Andrews

Faculty Publications

Background

Substance use disorder (SUD) remains a critical public health crisis in the United States, with high prevalence and overdose mortality rates. Despite the availability of effective treatments, including medications that significantly reduce overdose risk, fewer than 20% of Americans with active SUD receive treatment annually. Single State Agencies (SSAs), which oversee federal funding and regulate SUD treatment programs, hold significant authority to impose licensure and reporting requirements intended to promote treatment quality.

Methods

This study presents findings from a national survey of SSAs across 50 states and the District of Columbia (94% response rate) conducted between 2020 and 2021, …

Implementation And Costs Of A Food Insecurity Resource Navigation Program For Primary Care Patients With Diabetes And Hypertension In South Carolina, Deeksha Gupta, Darin Thomas, Stella Coker Watson Self Ph.D., Ms, Edward A. Frongillo Jr. Ph.D., Alain H. Litwin, Joseph A. Ewing, Lynnette Ramos-Gonzalez, Lynnette Ramos-Gonzalez

Faculty Publications

Objective

To examine food insecurity resource navigation program costs and how navigation intensity relates to clinical outcomes, healthcare costs, and quality of life (QOL) for diabetes and/or hypertension patients.

Methods

This retrospective study included patients receiving resource navigation (July 12, 2021-December 31, 2022 with twelve-month follow-up) across three primary care practices in South Carolina's largest health system. Participants were 18+ years old (from electronic medical records/Epic), had food insecurity (from Hunger Vital Sign™), and diabetes and/or hypertension (from Epic registries). Matched controls came from food insecurity screening-only practices. Patients in each group (n= 219) had diabetes (9.13%), hypertension …

Factors Associated With Lapses In Care Among People Living With Hiv In South Carolina, Xueying Yang Ph.D., Fanghui Shi, Shujie Chen, Gavi Samuel, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Utilizing statewide electronic health records (EHR) data, this study aims to assess the factors determining the occurrence of lapses in HIV care among people with HIV (PWH) in South Carolina (SC). All adult (≥ 18 years old) PWH who were diagnosed with HIV between 2006 and 2018 with at least two HIV care encounters and at least 1-year follow-up record were included in the analysis. The outcome, a lapse in care, was defined as a repeated measure of HIV care encounter that occurs over a year following the previous visit. Generalized Estimation Equation models were employed. The study cohort had …

The Blurred Boundaries Of Care: A Qualitative Analysis Of Nurse-Doula Role Conflict, Curisa Mae Tucker Phd, Rn, Maria Mcclam, Kelly Russin Dnp, Rnc-Ob, Chse, Nansi Boghossian, Rachel Gulczinski, Lauren Workman

Faculty Publications

Introduction:

Methods:

Association Between The Dietary Index For Gut Microbiota (Di-Gm) And Colorectal Cancer In The Plco Cohort, Bezawit E. Kase, Angela D. Liese Ph.D., Jiajia Zhang Ph.D., Elizabeth Angela Murphy, Susan E. Steck Phd, Mph, Rd

Faculty Publications

Objectives: The study aimed to examine the association between a dietary index for gut microbiota (DI-GM) and the risk of incident colorectal cancer (CRC). Clarifying the role of diet-induced alterations in the composition and function of gut microbiota on the development of CRC can contribute to prevention efforts. Methods: Participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial enrolled in the intervention arm and who completed baseline assessments were included in the analysis (n = 55,685). The DI-GM is a literature-derived index used to score diet quality in terms of maintaining healthy gut microbiota. A time-dependent Cox model …