Medicine and Health Sciences Commons^™

Augmenting Large Language Models To Predict Social Determinants Of Mental Health In Opioid Use Disorder Using Patient Clinical Notes, Madhavi Pagare, Deva Sai Kumar Bheesetti, Inyene E. Essien-Aleksi, Mohammad Arif Ul Alam

Health Sciences Faculty Publications

Objective

Identifying social determinants of mental health (SDOMH) in patients with opioid use disorder (OUD) is crucial for estimating risk and enabling early intervention. Extracting such data from unstructured clinical notes is challenging due to annotation complexity and requires advanced natural language processing (NLP) techniques. We propose the Human-in-the-Loop Large Language Model Interaction for Annotation (HLLIA) framework, combined with a Multilevel Hierarchical Clinical-Longformer Embedding (MHCLE) algorithm, to annotate and predict SDOMH variables. Materials and Methods

We utilized 2636 annotated discharge summaries from the Medical Information Mart for Intensive Care (MIMIC-IV) dataset. High-quality annotations were ensured via a human-in-the-loop approach, refined …

Tricounty Vaccine Improvement Program (Tc-Vip): Enhancing Vaccine Confidence And Uptake In Rural Utah, Aaron Hunt, Yvette Rea, Annalyz Castro

Outcomes and Impact Quarterly

The Utah State University Extension TriCounty Vaccine Improvement Program addressed low rural vaccination rates across a three-county area through bilingual social media campaigns, health fairs, training in motivational interviewing, and neuromarketing. Evaluation results showed improved skills, broad community reach, and positive participant feedback, demonstrating a replicable model to reduce vaccine hesitancy and strengthen rural health systems.

Proceedings Of The 25th International Symposium On Adapted Physical Activity, Catherine Carty, Gerard Masdeu Yelamos

Publications

This volume presents the Proceedings of the 25th International Symposium of Adapted Physical Activity (ISAPA 2025), hosted by Munster Technological University under the Patronage of UNESCO. It is intended as a permanent scholarly record of the symposium, its themes, and its contributions across research, practice, policy, culture, and inclusion in line with CoARA principles.

Evaluation And Optimization Of Outpatient Parenteral Antimicrobial Therapy Laboratory Monitoring For Beta-Lactam Antibiotics., Stephanie Subart Pharmd, Trent Towne Pharmd, Bcps, Sarah Pehlke Pharmd, Bcps, Robert D. Beckett Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that among patients who experienced eosinophilia, only one exhibited signs of hypersensitivity, while seven required a change in therapy. This indicates that while eosinophilia is a concern, its direct clinical impact may be limited for the majority of patients. In the cohort experiencing elevated LFTs including AST, ALT, or alkaline phosphatase levels, fewer than 2% necessitated a change in therapy. This low rate suggests that routine LFT monitoring may not always correlate with significant clinical decisions, raising questions about the necessity of frequent lab draws.

Influence Of Rec-Connect On Youth Physical Activity: A Multi-Year Look At Behavior Change, Cailyn A. Van Camp, Bree Bode, Jocelyn Hayward, Lauryn Lin, Nicole Jess, Marci Scott

Michigan Journal of Public Health

Background: Physical activity (PA) engagement in youth is associated with numerous health benefits. However, youth PA behaviors are influenced by a complex set of factors including school and community environments and broader societal influences. Rec-Connect^TM is a community-based intervention that aims to impact PA behavior in youth. Purpose: To assess changes in youth PA behavior across multiple years of Rec-Connect^TM implementation. Methods: SNAP-eligible youth [aged 8 to 17 (n=261, matched)] who participated in Rec-Connect^TM completed a pre and post survey to assess PA knowledge and behavior change. Educators completed implementation fidelity logs. Descriptives were conducted to examine …

Studies On Curcumin-Glucoside In The Prevention Of Alpha-Synuclein Aggregation, Lakshmi Sowmya Emani, Jayanth K. Rao, Jagadeesha Kumar Dasappa, Marisín Pecchio, Johant Lakey-Beitia, Hansapani Rodrigo, Jessica Cruz-Mora, Priya Narayan, Nikhilesh Anand, Bharathi Gadad

School of Medicine Publications

Background: α-synuclein (α-syn) deposition in the mid-brain region is one of the hallmark pathologies of Parkinson's disease (PD). The key steps involve the transformation of α-synuclein into a toxic oligomer and insoluble fibrillar aggregates.

Objective: To understand the role of curcumin-glucoside in the prevention of α-syn aggregation, a mechanistic approach.

Methods: In the present study, we synthesized a novel molecule, curcumin-glucoside (Curc-gluc), to improve the water solubility and partition coefficient, making the molecule with high bioavailability. The present study is focused on understanding the α-syn aggregation kinetics in the presence and absence of Curc-gluc, curcumin (Cur), copper (Cu), and iron …

Nanotechnology Strategies For Endometrium Health: Are We On The Right Track?, Victoria Herrera, Dana Tarab-Ravski, Subhash Chauhan, Nikesh Narang, Mohammad Mirazul Islam, Dan Peer, Rajendra Prasad, Murali Yallapu

School of Medicine Publications

The endometrium is a vital mucosal tissue which undergoes cyclical regeneration, differentiation, and remodeling upon hormonal, cellular, and molecular signaling networks. Dysregulation of these processes can trigger a range of pathological conditions including chronic inflammatory disorders, hyperplastic lesions, malignancies, and infertility, necessitating the need for effective therapeutic interventions. Furthermore, we are still dependent on conventional treatment modalities which are often constrained by inefficient drug biodistribution, systemic toxicity, and emergence of therapeutic resistance. Recently, nanomedicines have gained tremendous attention in human healthcare, because they not only diagnose the disease but also deliver therapeutic agents to the targeted site without affecting healthy …

Cannabidiol And Beta-Caryophyllene: Chronic Inflammatory Pain, Mohammed Alnoud, Mohammad Hussain, Jose Rios, Emmanuel Franco, Justin D. Mills, Joshua Nwose, Maria Sophia Malbas, Hiram L. Garcia, Sophia Leslie, Manish Tripathi, Khalid Benamar

School of Medicine Publications

While chronic pain is challenging to manage, it always co-exists with depression. Currently, chronic pain and depression are usually treated separately with distinct approaches, yet effectiveness remains elusive. Consequently, the development of integrated therapeutic strategies for pain while addressing depression is a high public health priority and unmet need that affects millions of people. This study aims to determine if the combination of the two phytocannabinoids Beta-Caryophyllene (BCP) and cannabidiol (CBD) is effective for chronic pain while simultaneously showing antidepressant effects. We used a chronic inflammatory pain model (Complete Freund's Adjuvant, CFA) and a battery of pain and depression-like behavior …

From Molecules To Models: A Holistic Review Of Autism Spectrum Disorder Mechanisms And Research Tools, Sriya Gullapalli, Lois Baldado, Megan W. Szobody, Anesu K. Murambadoro, Kevin Garcia Valdez, Arjun Bellamkonda, Daniela Gonzalez, Usman Ghumman, Nikhilesh Anand, Kelsey A. Potter-Baker, Bharathi Gadad

School of Medicine Publications

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by persistent deficits in social communication and interaction, as well as restricted, repetitive patterns of behavior, interests, or activities. These features are associated with atypical early brain development and connectivity. While ASD has been traditionally associated with molecular genetic alterations, recent research highlights the significant contribution of various environmental factors to the pathophysiology of the disorder. Pathogenic genetic variations in key regulatory genes remain central to ASD risk; however, environmental influences such as advanced maternal or paternal age, poor maternal health during pregnancy, gestational diabetes mellitus, alterations in the early-life …

Evaluating The Efficacy Of Extracorporeal Shockwave Therapy In Postoperative Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Meta-Analysis, Maryam Salimi, Alireza Keshtkar, Seyedarad Mosalamiaghili, Walter Lowe, Aamir Ahmad, Arash Sharafatvaziri

School of Medicine Publications

Background: Recovering from anterior cruciate ligament (ACL) reconstruction can be challenging. While standard rehabilitation helps restore knee function, many patients still face a slow or incomplete recovery. Extracorporeal shockwave therapy (ESWT) has recently gained attention as a potential way to speed up healing and improve outcomes when added to traditional rehab.

Aim: To explore whether combining ESWT with standard postoperative rehabilitation truly leads to better recovery compared with rehab alone.

Methods: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, evaluating participant status following ACL reconstruction with standard rehabilitation and without …

Determinants Of Mental Health-Seeking Behaviour Among Upgrading Nursing Students At The Aga Khan University, Kenya, Cecilia Wanjiru Ndungu

MSc in Advanced Practice Nursing

Background: Mental health challenges are increasingly recognised, and nursing students often report higher stress and anxiety than other peers.Working nurses in upgrading programmes face additional pressure from balancing work, study and family,yet remain under-studied. At Aga Khan University in Kenya, the determinants influencing mental health-seeking behaviour among upgrading nursing students have not been documented, which is critical for addressing mental health needs. This study aimed to investigate the biological, psychological, and sociological factors influencing mental health-seeking behavior in this cohort.

Methodology: A descriptive cross-sectional study was conducted among 106 upgrading nursing students at AKU, utilizing structured questionnaires to …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Avaren-Fc's Effects On Lymphoma Cells., Jacob Hahn

Electronic Theses and Dissertations

This thesis investigates the therapeutic potential of Avaren-Fc (AvFc), a novel lectin fusion protein that integrates the Fc region of human IgG1 with the engineered lectin Avaren, specifically targeting lymphoma. The study delineates the in vitro binding capabilities of Avaren-Fc with a human B-cell lymphoma cell line, a canine B-cell lymphoma cell line, healthy canine peripheral blood mononuclear cells (PBMCs), and healthy human PBMCs. AvFc was shown to exhibit significant binding to human lymphoma cells. Furthermore, the direct cytotoxicity of Avaren-Fc against canine lymphoma cells, canine lymphoma cells and healthy canine PBMCs was assessed. It was found that there is …

Safety Evaluation Of Epicertin, An Oral Biotherapeutic Candidate For Treating Ulcerative Colitis: A 28-Day Repeated Dose Toxicity Study., Jimmy Fernando Cifuentes Jimenez

Electronic Theses and Dissertations

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic, relapsing inflammation of the colon and rectum with limited treatment options. Among them, immunosuppressive agents have a high rate of adverse side effects and do not cure the disease. EPICERTIN (EPT), a recombinant variant of the cholera toxin B subunit (CTB) with a C-terminal hexapeptide extension consisting of a KDEL endoplasmic reticulum (ER) retention motif, is a promising oral biotherapeutic candidate for the treatment of UC. EPT has demonstrated mucosal healing activity in mouse models of colitis and human colonic explants. EPT's mechanism of action involves binding to GM1 …

Congolese Mothers' Beliefs That Influence Health-Seeking Behaviors For Their Infants., Shawn Meiman

Electronic Theses and Dissertations

In 2024, approximately 100,000 refugees were admitted to the United States, with 20% coming from the DRC, while Kentucky continues to rank fourth in the country for refugee resettlement. The increasing number of Congolese refugee children in the United States and Kentucky necessitates a greater understanding of these beliefs and practices to ensure equitable, quality, and culturally informed health services. The purpose of this study was to explore Congolese refugee mothers’ culturally and socially situated beliefs, perceptions, practices, and resources related to health care that may influence their views and practices of preventive well-child health care for their infants in …

The Role Of Psychological Capital And Case Management Intensity In Patient Activation In Permanent Supportive Housing Residents., Sarah J. Carter

Electronic Theses and Dissertations

This dissertation explores patient engagement with health, or patient activation, in the formerly homeless population housed in Permanent Supportive Housing (PSH) and receiving case management support. Research is limited on patient activation in PSH residents; consequently, there is minimal understanding of factors contributing to one’s attitudes and behavior towards health care in this group. Psychological Capital refers to the components of hope, self-efficacy, resilience, and optimism. Research in other marginalized groups indicates increasing psychological capital may improve health behaviors. Case management provides support to PSH residents and forms of social support have been associated with improved health outcomes. Applying the …

Reducing Operating Room Turnover Times Through Standardized Workflow, Trinity H. Darnell

Doctor of Nursing Practice Final Project Abstract

Prolonged operating room (OR) turnover times (TOTs) contribute to surgical delays, decreased case volume, and inefficiencies that negatively affect patient care and hospital operations. Lack of coordination in turnover processes and communication among staff are common contributors to extended TOTs. The purpose of this project was to reduce turnover times by implementing a standardized workflow carried out by efficiency teams composed of OR float staff. This project took place in the surgical department of a hospital in Sugar Land, Texas, using a single group pretest-posttest design. Baseline data was collected for 12-weeks prior to implementation and compared to 12-weeks of …

Objective Structured Clinical Examination (Osce) For Interscalene Brachial Plexus Block Utilizing Ultrasound Guidance And Landmark Technique, Madison Mize, Mckayla Moore, Peyton Shell

Doctoral Projects

The purpose of this doctoral project was to create learning and evaluation tools for interscalene brachial plexus blocks (ISBPB) to be used by certified registered nurse anesthetists (CRNAs) and students in the Nurse Anesthesia Program (NAP) at The University of Southern Mississippi (USM). ISBPB is a regional anesthesia technique used to provide anesthesia for procedures of the shoulder and upper arm. CRNAs and students can use these tools to refresh their current knowledge and enhance their regional anesthesia skills.

The objective structured clinical examination (OSCE) and cognitive aid for ISBPB utilizing landmark and ultrasound-guided techniques were evaluated by the USM …

A Subdural Hemorrhage, Marianne Koleng

be Still

This piece attempts to weave together an understanding of medicine, healing, trauma, and neuroscience through an exploration of past injury and how pivotal moments as such can influence a future career pursuing medicine. This piece also demonstrates how seeking attention can lead to deleterious health impacts and investigates the importance of tempering pride with humility.

Attention - Volume 10

be Still

No abstract provided.

Abstract Attention, Colorized, Marianne Koleng

be Still

This vibrant abstract painting that explores the fluidity of human feelings through bold, sweeping brushstrokes and a contrasting color palette. Bursts of red and orange suggest intensity and passion, while cooler blues and grays add a sense of introspection and calm. The lack of defined forms invites viewers to project their own interpretations, making the piece a dynamic reflection of chaos and beauty in the search for attention.

I Want You To Want Me, Marianne Koleng

be Still

This piece calls to the theme of "attention" through a mixed media piece incorporating collage, ink, and colored pencil. It embraces the nuances of both anatomy and popular music, rock-and-roll, to be specific. The title is taken from the popular song by Cheap Trick, of the same name in an effort to elude to the desire for human attention in a human form.

Even Flow, Marianne Koleng

be Still

This piece attempts to connect the "ebb and flow" of music and art with the sometimes strict interpretation of anatomy. It calls to attention what often seem as opposites - the cold nature of medicine and science with the seemingly warm and free nature of music and art. While many see them as opposites, this piece attempts to convey they are really two sides of the same coin.

Pick & Choose, Sana Lulu

be Still

To me, attention goes hand in hand with patience and is a core part of my creative process. When it comes to my art, I generally ride inconsistent waves of inspiration, meaning I often churn out pieces all in one session, finessing a piece until I am satisfied. In that span of time, all that matters to me is getting my piece as close to how I picture it in my mind as possible, giving it my full undivided attention. I tend to fixate on projects and have a hard time revisiting them once I decide to end the session. …

Anne-Katrine, Tiffany Tran

be Still

I wrote “Anne-Katrine” in memory of my late cousin. The poem explores how our attention lingers on those who have shaped us, reflecting the quiet, persistent act of remembering someone across time and space. It examines how mindful attention allows us to honor the past and keep cherished moments alive, even when we cannot hold them.

Book Review On Joan Didion's "The Year Of Magical Thinking", Antea Garo

be Still

This essay and review explores how Joan Didion's memoir The Year of Magical Thinking connects mourning with attention, and analyzes how the healthcare system struggles to deal with grief.