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2025

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Articles 5491 - 5520 of 24547

Full-Text Articles in Medicine and Health Sciences

Increased Circulating Th17 Cells And Altered Cd4 T Cell Maturation And Differentiation In Active Tuberculosis With Type 2 Diabetes: A Pilot Study, Paul Ogongo, Yoscelina Estrella Martinez-Lopez, Anthony Tran, Cecilia S. Lindestam Arlehamn, Alessandro Sette, Ilse A. Dominguez-Trejo, Genesis P. Aguillón-Durán, Esperanza M. Garcia-Oropeza, Blanca I. Restrepo Sep 2025

Increased Circulating Th17 Cells And Altered Cd4 T Cell Maturation And Differentiation In Active Tuberculosis With Type 2 Diabetes: A Pilot Study, Paul Ogongo, Yoscelina Estrella Martinez-Lopez, Anthony Tran, Cecilia S. Lindestam Arlehamn, Alessandro Sette, Ilse A. Dominguez-Trejo, Genesis P. Aguillón-Durán, Esperanza M. Garcia-Oropeza, Blanca I. Restrepo

School of Medicine Publications

Introduction: Type 2 diabetes (T2D) is a major risk factor for developing tuberculosis (TB). However, understanding the role of defective T cell responses in T2D and TB has been difficult, largely due to inconsistencies across studies. These discrepancies often stem from T cell subset classification primarily relying on cytokine expression profiles, which may not fully capture the complexity of T cell maturation, differentiation, and function in TB patients with T2D.

Objective and methods: In this pilot study, we sought to identify alterations in phenotypic and ex vivo responses of CD4 T cells to Mycobacterium tuberculosis (Mtb) antigens in people with …


Impacts Of Environmental Distractions And Interruptions On Unsupervised Digital Cognitive Assessments In Older Adults: Cognitive Ecological Momentary Assessment Study, Matthew Welhaf, Hannah Wilks, Andrew J Aschenbrenner, Samhita Katteri, John C Morris, Jason J Hassenstab Sep 2025

Impacts Of Environmental Distractions And Interruptions On Unsupervised Digital Cognitive Assessments In Older Adults: Cognitive Ecological Momentary Assessment Study, Matthew Welhaf, Hannah Wilks, Andrew J Aschenbrenner, Samhita Katteri, John C Morris, Jason J Hassenstab

2020-Current year OA Pubs

BACKGROUND: Unsupervised cognitive assessments are becoming commonly used in studies of aging and neurodegenerative diseases. As assessments are completed in everyday environments and without a proctor, there are concerns about how common distractions may impact performance and whether these distractions may differentially impact those experiencing the earliest symptoms of dementia.

OBJECTIVE: We examined the impact of self-reported interruptions, testing location, and social context during testing on remote cognitive assessments in older adults.

METHODS: Participants from the Ambulatory Research in Cognition smartphone study were classified as cognitively normal (n=380) or as having very mild dementia (n=37). Participants completed daily tests of …


Postoperative Fluid Restriction To Prevent Delayed Hyponatremia After Endoscopic Transsphenoidal Surgery, Doriann Klaassen, Shinghei Mok, Jenie Y Hwang, Kelley J Williams, Brendan M Fong, Ralph G Dacey, Nyssa F Farrell, Joshua W Osbun, Keith M Rich, Lauren T Roland, John S Schneider, Gregory J Zipfel, Chongliang Luo, Albert H Kim, Julie M Silverstein, Et Al. Sep 2025

Postoperative Fluid Restriction To Prevent Delayed Hyponatremia After Endoscopic Transsphenoidal Surgery, Doriann Klaassen, Shinghei Mok, Jenie Y Hwang, Kelley J Williams, Brendan M Fong, Ralph G Dacey, Nyssa F Farrell, Joshua W Osbun, Keith M Rich, Lauren T Roland, John S Schneider, Gregory J Zipfel, Chongliang Luo, Albert H Kim, Julie M Silverstein, Et Al.

2020-Current year OA Pubs

BACKGROUND: Readmission following endoscopic endonasal transsphenoidal surgery (EETS) for pituitary neuroendocrine tumor (PitNET) and other sellar pathology is most commonly due to delayed hyponatremia. Studies suggest postoperative fluid restriction (FR) reduces delayed hyponatremia. We present a prospective randomized controlled study evaluating post-EETS FR.

METHODS: 300 participants were scheduled for EETS (2016-2023) at a single institution. Patients with CKD, CHF, arginine vasopressin deficiency on postoperative day (POD) 3, chronic hyponatremia, and untreated adrenal insufficiency or hypothyroidism were excluded. Groups included control (ad-lib, n = 94), moderate FR (1.8 L/day or 2 L/day weight > 100 kg, n = 39), and strict FR …


Chemo-Rast With Bortezomib Inhibits Multiple Myeloma Relapse, Anchal Ghai, Alexander Zheleznyak, Christopher Egbulefu, Nicole Blasi, Kvar Black, Rui Tang, Matthew L Cooper, Kiran Vij, Ravi Vij, John Dipersio, Monica Shokeen, Samuel Achilefu Sep 2025

Chemo-Rast With Bortezomib Inhibits Multiple Myeloma Relapse, Anchal Ghai, Alexander Zheleznyak, Christopher Egbulefu, Nicole Blasi, Kvar Black, Rui Tang, Matthew L Cooper, Kiran Vij, Ravi Vij, John Dipersio, Monica Shokeen, Samuel Achilefu

2020-Current year OA Pubs

No abstract provided.


Leveraging Ai To Democratize The Hidden Curriculum In Medical Education: An Implementation Framework, James Keith Martin Ii, Mercedes Byrd Sep 2025

Leveraging Ai To Democratize The Hidden Curriculum In Medical Education: An Implementation Framework, James Keith Martin Ii, Mercedes Byrd

Libraries Scholarship

The “hidden curriculum” in medical education—comprising unwritten rules, values, and expectations—significantly impacts student success, yet remains inaccessible to students from underrepresented backgrounds. This paper presents a theoretical framework and practical implementation strategy for using artificial intelligence (AI) to democratize access to this hidden curriculum. We analyze how cognitive load theory and the Fast/Slow Thinking paradigm explain inequities in professional integration, then propose a comprehensive implementation approach to guide equitable AI integration. This model demonstrates how AI tools, when thoughtfully implemented, can reduce cognitive burdens on disadvantaged students, accelerate professional acculturation, and contribute to building an inclusive medical workforce.


Leveraging Academic Health Departments For Place-Based Disaster Response: Lessons From Helene In Western North Carolina, Danny Scalise Ii, Sarah B. Thach, Ellis V. Matheson Sep 2025

Leveraging Academic Health Departments For Place-Based Disaster Response: Lessons From Helene In Western North Carolina, Danny Scalise Ii, Sarah B. Thach, Ellis V. Matheson

Journal of Appalachian Health

This article examines the role of two Academic Health Departments (AHDs) in Buncombe and Burke Counties, North Carolina in responding to Hurricane Helene in 2024. The partnership between local health departments and the UNC Asheville – UNC Gillings Master of Public Health (MPH) Program fostered a place-based approach to public health. After the hurricane disrupted regional infrastructure, the AHDs integrated students and faculty into recovery efforts. This paper identifies key lessons for strengthening public health preparedness through academic-practice partnerships and highlights the importance of embedding education in local contexts.


Understanding Rural Health Through Rae Garringer's Country Queers: A Love Letter, Bradley A. Firchow Sep 2025

Understanding Rural Health Through Rae Garringer's Country Queers: A Love Letter, Bradley A. Firchow

Journal of Appalachian Health

Rae Garringer’s Country Queers: A Love Letter examines the experiences of queer individuals in rural America, emphasizing the relationship between place and identity. Through oral histories, the book presents perspectives on community, resilience, and healthcare access. While not centered on medical care, it highlights challenges in obtaining affirming services in rural areas. Garringer’s experience as a standardized patient provides additional context on healthcare gaps. For public health professionals, Country Queers offers insight into the structural and social factors affecting rural LGBTQ2+ populations, contributing to a broader understanding of community health and identity in Appalachia and similar regions.


Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying Sep 2025

Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying

Journal of Appalachian Health

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize …


The Status Of Children’S Dental Health In Rural Appalachian West Virginia, R. Constance Wiener, Gina Graziani Sep 2025

The Status Of Children’S Dental Health In Rural Appalachian West Virginia, R. Constance Wiener, Gina Graziani

Journal of Appalachian Health

Introduction: Non-metro/rural Appalachian West Virginia (WV) residents have been stigmatized for poor oral health (OH), despite many advances.

Purpose: The aims of this study were to examine current OH in children in WV, as compared to children in the greater United States (U.S.), and secondarily in subgroup non-metro/rural comparisons.

Methods: This observational study involved the U.S. National Survey of Children’s Health 2022–2023 data from parents/guardians who were asked about their child’s previous 12-month OH. Rao-Scott Chi-square and logistic regression analyses were used.

Results: Nationally, the mean age was 9.7 years; for WV children, it was 9.9 years. Nationally, 12.4% of …


Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland Sep 2025

Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland

Journal of Appalachian Health

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …


Intensive Telemedicine Transitions Of Care Clinic: A Prospective Feasibility Study Of A Novel Ambulatory Model Serving Appalachian Patients, Jessica Thayer, Brett Miller, Marcelino Mederos Liriano, Kathryn Hoffman, Gina Baugh, Jenna Sizemore Sep 2025

Intensive Telemedicine Transitions Of Care Clinic: A Prospective Feasibility Study Of A Novel Ambulatory Model Serving Appalachian Patients, Jessica Thayer, Brett Miller, Marcelino Mederos Liriano, Kathryn Hoffman, Gina Baugh, Jenna Sizemore

Journal of Appalachian Health

Introduction: Hospital discharge is a complex process plagued with medical errors and poor coordination. Disjointed discharges are detrimental to Appalachian patients with access barriers and multiple chronic diseases. Telehealth is a tool used to improve access within rural Appalachia. To address this high-risk transition period, an interprofessional team deployed telemedicine to improve post-hospital care for Appalachian patients.

Purpose: Patients with uncontrolled chronic medical conditions were enrolled into the Intensive Telemedicine Transition of Care Clinic (I-TTC) with a primary outcome of 30-day Emergency Department (ED) presentations and hospital readmissions. Secondary outcomes included improved control of chronic conditions and patient cost savings. …


Person-Centered Trauma-Informed Care (Pctic): A Training Needs Assessment For Home And Community-Based Services In West Virginia, Ranjita Misra, A. Brianna Sheppard, Natalie Wilson, Megan C. Govindan, Matthew Myers, Amanda Acord-Vira, Steven Wheeler, Heather Henderson, Christena Ross, Laura Cooper, Rachel A. Goff Sep 2025

Person-Centered Trauma-Informed Care (Pctic): A Training Needs Assessment For Home And Community-Based Services In West Virginia, Ranjita Misra, A. Brianna Sheppard, Natalie Wilson, Megan C. Govindan, Matthew Myers, Amanda Acord-Vira, Steven Wheeler, Heather Henderson, Christena Ross, Laura Cooper, Rachel A. Goff

Journal of Appalachian Health

Introduction: Person-centered, trauma-informed care (PCTIC) is a combined, holistic service model promoting the well-being and empowerment of trauma survivors.

Purpose: This study examined the PCTIC knowledge, skills, and abilities needed by West Virginia (WV) Medicaid Home and Community-Based Services (HCBS) direct service professionals (DSPs) to serve clients that may have experienced trauma.

Methods: Semi-structured interviews were conducted with diverse stakeholders (n = 32) from 19 organizations that provide HCBS services in all 55 counties. Interviews focused on identifying current training, needs and knowledge gaps, and priority areas for additional PCTIC training. ATLAS.ti software was used to manage and code. Validity …


Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson Sep 2025

Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson

Journal of Appalachian Health

Introduction: Radon, a radioactive gas, poses significant health risks, including lung cancer, and is prevalent in indoor environments. Understanding radon testing behavior and Environmental Health Literacy (EHL) is crucial for individuals to take appropriate preventive measures.

Purpose: This study assessed radon-related EHL among Health Council participants in seven Northeast Tennessee (NETN) counties and examined associations between sociodemographic factors and EHL levels. Understanding radon knowledge and behaviors within this influential group is critical, as they often serve as trusted public health advocates.

Methods: A cross-sectional survey was conducted from September – November 2023 among Health Council participants across seven counties in …


Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener Sep 2025

Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener

Journal of Appalachian Health

Introduction: Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.

Purpose: The purpose of this cross-sectional study is to determine the likelihood …


Finding Community: A Thematic Analysis Of Resilience During The Pandemic, Myles Kwitny, Quinn Richards, Grace Digirolamo, Shannon Freedman, Sophie Wenzel Sep 2025

Finding Community: A Thematic Analysis Of Resilience During The Pandemic, Myles Kwitny, Quinn Richards, Grace Digirolamo, Shannon Freedman, Sophie Wenzel

Journal of Appalachian Health

Introduction: The Covid-19 pandemic impacted those within rural Appalachian communities, particularly people with marginalized identities.

Purpose: Through interviewing 44 participants from New River Valley, an Appalachian community in Virginia, this study sought to understand how resilience impacted individuals' experiences during the pandemic.

Methods: Participants belonged to one of the following groups: African American, Hispanic, older adults, or people who use drugs. Participants were required to reside in the New River Valley and be older than 18. Each participant was interviewed either in person, by phone, or over video call. Interviews were recorded, transcribed, then thematically analyzed for themes of resilience. …


Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold Sep 2025

Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold

Journal of Appalachian Health

Introduction: The Southwest Virginia Health Authority (SWVHA) recently commissioned a community health needs assessment (CHNA) to reduce the high rate of preventable health problems in Virginia’s (VA) Appalachian Region. The CHNA took place over a two-year period from 2023 – 2025.

Purpose: This iterative, mixed-method CHNA informed the development of a new iteration of the regional Blueprint for Health Improvement and Health-Enabled Prosperity identifying and prioritizing health issues and develop strategic planning to address them in VA’s three westernmost regional health districts.

Methods: The CHNA followed a sequential mixed methods design to assess the regional health status, the contextual factors …


Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow Sep 2025

Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow

Journal of Appalachian Health

State and local governments across Appalachia are allocating opioid-settlement dollars over the coming years. This funding opportunity can support lasting public health infrastructure or be spent on short-term programs anchored in the opioid crisis of the past. Evidence indicates that emerging synthetic drugs such as nitazenes and xylazine are altering overdose risk patterns in ways that require urgent policy attention.


The Prophet's Medicine: How Mormon Doctrine And Medical Practices Evolved Along The American Frontier, Drew Robinson Sep 2025

The Prophet's Medicine: How Mormon Doctrine And Medical Practices Evolved Along The American Frontier, Drew Robinson

The Ozark Historical Review

Joseph Smith rejected both the religious and medical orthodoxies of his day and developed his own theological systems while learning to rely solely on herbs for his medical care. His medical convictions regarding herbal medicine were as authoritative and binding for Mormons to practice as his religious revelations. However, by the time Brigham Young had become leader of the Mormons, regular medicine had become both modern and superior to other medical practices, including the Mormons’ herbal medicine. Though the use of herbal medicine had been codified into religious law by Smith, the benefits and availability of modern medicine earned the …


Curricular Praxis: Preparing Athletic Trainers By Combining Formal Debriefing With Clinical Experiences, Christopher J. Hamlyn, Thalia Mulvihill Sep 2025

Curricular Praxis: Preparing Athletic Trainers By Combining Formal Debriefing With Clinical Experiences, Christopher J. Hamlyn, Thalia Mulvihill

Mid-Western Educational Researcher

Background: This study examined the integration of formal debriefing in athletic training clinical education, addressing a gap in understanding its role during the transition to professional master's programs. It focused on how formal debriefing can bridge the shift from traditional learning models, ensuring effective student learning and knowledge application in diverse clinical scenarios. The study specifically explored the perceptions of preceptors and students about the incorporation of debriefing in a Commission on Accreditation of Athletic Training Education accredited athletic training program.

Methods: This qualitative study used a purposive sample of five preceptors for an accredited athletic training program with training …


Cosine-100 Full Dataset Challenges The Annual Modulation Signal Of Dama/Libra, Nelson Carlin, Jae Young Cho, Jae Jin Choi, Seonho Choi, Anthony C Ezeribe, Luis Eduardo França, Chang Hyon Ha, In Sik Hahn, Sophia J Hollick, Eunju Jeon, Han Wool Joo, Woon Gu Kang, Matthew Kauer, Bongho Kim, Hongjoo Kim, Jinyoung Kim, Kyungwon Kim, Sunghyun Kim, Sun Kee Kim, Won Kyung Kim, Yeongduk Kim, Yong-Hamb Kim, Young Ju Ko, Doohyeok Lee, Eun Kyung Lee, Hyunseok Lee, Hyun Su Lee, Hye Young Lee, In Soo Lee, Jaison Lee, Jooyoung Lee, Moo Hyun Lee, Seo Hyun Lee, Seung Mok Lee, Yujin Lee, Douglas S Leonard, Nguyen Thanh Luan, Vitor Hugo De Almeida Machado, Bruno B Manzato, Reina H Maruyama, Robert J Neal, Stephen L Olsen, Byung Ju Park, Hyang Kyu Park, Hyeonseo Park, Jong-Chul Park, Kangsoon Park, Se Dong Park, Ricardo L C Pitta, Hafizh Prihtiadi, Sejin Ra, Carsten Rott, Keon Ah Shin, David F F S Cavalcante, Min Ki Son, Neil J C Spooner, Lam Tan Truc, Liang Yang, Gyun Ho Yu Sep 2025

Cosine-100 Full Dataset Challenges The Annual Modulation Signal Of Dama/Libra, Nelson Carlin, Jae Young Cho, Jae Jin Choi, Seonho Choi, Anthony C Ezeribe, Luis Eduardo França, Chang Hyon Ha, In Sik Hahn, Sophia J Hollick, Eunju Jeon, Han Wool Joo, Woon Gu Kang, Matthew Kauer, Bongho Kim, Hongjoo Kim, Jinyoung Kim, Kyungwon Kim, Sunghyun Kim, Sun Kee Kim, Won Kyung Kim, Yeongduk Kim, Yong-Hamb Kim, Young Ju Ko, Doohyeok Lee, Eun Kyung Lee, Hyunseok Lee, Hyun Su Lee, Hye Young Lee, In Soo Lee, Jaison Lee, Jooyoung Lee, Moo Hyun Lee, Seo Hyun Lee, Seung Mok Lee, Yujin Lee, Douglas S Leonard, Nguyen Thanh Luan, Vitor Hugo De Almeida Machado, Bruno B Manzato, Reina H Maruyama, Robert J Neal, Stephen L Olsen, Byung Ju Park, Hyang Kyu Park, Hyeonseo Park, Jong-Chul Park, Kangsoon Park, Se Dong Park, Ricardo L C Pitta, Hafizh Prihtiadi, Sejin Ra, Carsten Rott, Keon Ah Shin, David F F S Cavalcante, Min Ki Son, Neil J C Spooner, Lam Tan Truc, Liang Yang, Gyun Ho Yu

Faculty and Staff Publications

For over 25 years, the DAMA/LIBRA collaboration has claimed to observe an annual modulation signal, suggesting the existence of dark matter interactions. However, no experiment using different target materials has observed a dark matter signal consistent with their result. To address this puzzle, the COSINE-100 collaboration conducted a model-independent test using sodium iodide crystal detectors, the same target material as DAMA/LIBRA. Analyzing data collected over 6.4 years by the effective mass of 61.3 kilograms, with improved energy calibration and time-dependent background modeling, we found no evidence of an annual modulation signal, challenging the DAMA/LIBRA result with a confidence level greater …


Advancing Ckd Diagnosis: Race-Free Egfr, Cystatin C, And Genetic Insights, Halah Tariq Albar Sep 2025

Advancing Ckd Diagnosis: Race-Free Egfr, Cystatin C, And Genetic Insights, Halah Tariq Albar

Saudi Toxicology Journal

Globally, the rates of chronic kidney disease (CKD) are increasing due to the increasing incidence of hypertension, obesity, and diabetes mellitus. Early detection and treatment of kidney disease are essential in improving health outcomes. Estimate glomerular filtration rate (eGFR) is used to diagnose, stage, and manage CKD. CKD biomarkers are broadly categorized into traditional (serum creatinine), emerging (cystatin C), and disease specific (Interleukin-6). The purpose of this narrative review is to synthesize the current evidence regarding the use of eGFR in diverse populations. The initial eGFR equations included race variables, which created a controversial debate about their relevancy and has …


Evaluating The Active Learning Experience Of Prelicensure Nursing Students By Role And Level In Simulation, Delisa Flynn Sep 2025

Evaluating The Active Learning Experience Of Prelicensure Nursing Students By Role And Level In Simulation, Delisa Flynn

Dissertations

As the complexity of healthcare continues to grow, it is essential that nursing graduates enter the workforce with strong clinical judgment, confidence, and practice readiness. Simulation is an active learning strategy that creates a realistic, hands-on experiences for learners. Despite its widespread use, the impact of simulation roles within a simulated experience (participant versus observer) on student engagement remains unclear, particularly across different levels of nursing education. This study investigated differences in active learning engagement among sophomore and senior prelicensure nursing students (N = 161) based on their assigned role in a high-fidelity simulation scenario. Grounded in Kolb’s Experiential Learning …


Dynamical Regulation Of Blood Pressure And Cognitive Function, Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P. Sloan Sep 2025

Dynamical Regulation Of Blood Pressure And Cognitive Function, Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P. Sloan

Psychology Faculty Articles and Research

BACKGROUND

Blood pressure (BP) is not steady. It varies over intervals from months to consecutive cardiac cycles, and this variation contains meaningful information beyond mean BP. Variability over multiple clinic visits (VVV-BP) and during 24-h ambulatory monitoring (ABPV) is positively related to risk of stroke and coronary artery disease and negatively associated with cognitive performance. Beat-to-beat BP variation, often quantified as low frequency variability (0.04–0.15 Hz, LF-BPV), is less well-studied. Here, we examine the relationship between LF-BPV and cognitive outcomes in 1953 participants from the Midlife in the US study.

METHODS

Participants completed the Brief Test of Adult Cognition by …


Modeling The Impact Of Mmr Vaccination Strategies On Measles Outbreaks In Texas, Kaiming Bi, Thuy Nguyen, Boya Peng, Trudy Krause, Cecilia Ganduglia Cazaban, Janelle Rios, Cici Bauer, Catherine Troisi, Eric Boerwinkle, Aanand D Naik Sep 2025

Modeling The Impact Of Mmr Vaccination Strategies On Measles Outbreaks In Texas, Kaiming Bi, Thuy Nguyen, Boya Peng, Trudy Krause, Cecilia Ganduglia Cazaban, Janelle Rios, Cici Bauer, Catherine Troisi, Eric Boerwinkle, Aanand D Naik

Faculty, Staff and Student Publications

No abstract provided.


Advances In Indole Chemistry: Regiodivergent Annulations And Bridged Azacycle Synthesis, Zachary Tihomir Protich Sep 2025

Advances In Indole Chemistry: Regiodivergent Annulations And Bridged Azacycle Synthesis, Zachary Tihomir Protich

Dartmouth College Ph.D Dissertations

An important aspect for the research and development of new drug therapies is the ability to use modular synthetic methods to rapidly access structurally diverse drug-like building blocks. Nitrogen-containing heterocycles represent one of the most prevalent structural motifs found in pharmaceutical agents and biologically active natural products. However, despite their ubiquity, existing methods for accessing these structures often remain limited in scope, efficiency, and structural diversity, particularly when targeting densely functionalized or sterically demanding scaffolds from simple starting materials.

To address this problem, the research described in this dissertation focuses on the design and development of (3+2) annulation reactions for …


Association Between Body Mass Index And Uterotonic Use In Postpartum Hemorrhage: A Retrospective Cohort Study, Cece Cheng, Bryce T Munter, Michaela Y Lee, Claire D Sundjaja, Natasha D Paul, Margaret M Klausmeyer, Nastassia A Yammine, Patrick S Ramsey, John J Byrne Sep 2025

Association Between Body Mass Index And Uterotonic Use In Postpartum Hemorrhage: A Retrospective Cohort Study, Cece Cheng, Bryce T Munter, Michaela Y Lee, Claire D Sundjaja, Natasha D Paul, Margaret M Klausmeyer, Nastassia A Yammine, Patrick S Ramsey, John J Byrne

Faculty, Staff and Student Publications

Background/Objectives: Our primary objective was to determine whether patients with a higher body mass index (BMI) who experienced postpartum hemorrhage (PPH) required ≥2 uterotonics more often than those with lower BMI.

Methods: We conducted a retrospective cohort study that included all patients who experienced a PPH between 1 August 2020 and 31 July 2022. Extracted data included patient demographics, PPH risk factors, details regarding the labor course and hemorrhage management, and maternal and neonatal outcomes, such as mode of delivery, etiology of hemorrhage, need for nonpharmacological management, neonatal Apgar scores, requirement for phototherapy, neonatal intensive care unit (NICU) admission, and …


An Evolutionary Preamble Towards A Multilevel Framework To Understand Adolescent Mental Health: An International Delphi Study, Federica Sancassiani, Vanessa Barrui, Fabrizio Bert, Sara Carucci, Fatma Charfi, Giulia Cossu, Arne Holte, Jutta Lindert, Simone Marchini, Alessandra Perra, Samantha Pinna, Antonio Egidio Nardi, Alessandra Scano, Cesar A Soutullo, Massimo Tusconi, Diego Primavera Sep 2025

An Evolutionary Preamble Towards A Multilevel Framework To Understand Adolescent Mental Health: An International Delphi Study, Federica Sancassiani, Vanessa Barrui, Fabrizio Bert, Sara Carucci, Fatma Charfi, Giulia Cossu, Arne Holte, Jutta Lindert, Simone Marchini, Alessandra Perra, Samantha Pinna, Antonio Egidio Nardi, Alessandra Scano, Cesar A Soutullo, Massimo Tusconi, Diego Primavera

Faculty, Staff and Student Publications

Background/objectives: Adolescence is a sensitive developmental window shaped by both vulnerabilities and adaptive potential. From an evolutionary standpoint, mental health difficulties in this period may represent functional responses to environmental stressors rather than mere dysfunctions. Despite increasing interest, integrative models capturing the dynamic interplay of risk and protective factors in adolescent mental health remain limited. This study presents a holistic, multi-level framework grounded in ecological and evolutionary theories to improve understanding and intervention strategies.

Methods: A two-round Delphi method was used to develop and validate the framework. Twelve experts in adolescent mental health evaluated a preliminary draft derived from the …


Identifying Bio-Behavioural Signatures Of Persistent Opioid Use Risk In Trauma Injury Patients: A Protocol For A Prospective Cohort Study, Joy M Schmitz, Jin Ho Yoon, Bruno Kluwe-Schiavon, John A Harvin, Preethi H Gunaratne, Darrion Mouton, Kandice Motley, Erin E Fox, Jessica Vincent, Megan Tarbet, Consuelo Walss-Bass Sep 2025

Identifying Bio-Behavioural Signatures Of Persistent Opioid Use Risk In Trauma Injury Patients: A Protocol For A Prospective Cohort Study, Joy M Schmitz, Jin Ho Yoon, Bruno Kluwe-Schiavon, John A Harvin, Preethi H Gunaratne, Darrion Mouton, Kandice Motley, Erin E Fox, Jessica Vincent, Megan Tarbet, Consuelo Walss-Bass

Faculty, Staff and Student Publications

Introduction: Exposure to prescription opioids following traumatic injury can increase the risk of developing tolerance, persistent opioid use and opioid use disorder. The mechanisms underlying opioid tolerance or dependence are not well understood, and no biomarkers predict risk. Opioid exposure causes epigenetic modifications, including alterations in microRNA (miRNA) expression. Several miRNAs, which regulate synaptic plasticity, are hypothesised to underlie substance use disorders and influence µ-opioid receptor levels, modulating opioid tolerance. This project aims to develop a bio-behavioural signature to predict persistent opioid use and chronic pain up to 6 months post-discharge.

Methods and analysis: The study will use a prospective …


Upper Gastrointestinal Symptoms And Gulf War Illness In A Clinical Cohort Of Us Veterans: A Retrospective, Cross-Sectional Study, Abdelrahman Yousef, Sarah T Ahmed, Theresa H Nguyen Wenker, Alice B S Nono-Djotsa, Stephen H Boyle, Elizabeth J Gifford, Deeksha Malhotra, Helena Chandler, Sandhya Bandi, Drew A Helmer Sep 2025

Upper Gastrointestinal Symptoms And Gulf War Illness In A Clinical Cohort Of Us Veterans: A Retrospective, Cross-Sectional Study, Abdelrahman Yousef, Sarah T Ahmed, Theresa H Nguyen Wenker, Alice B S Nono-Djotsa, Stephen H Boyle, Elizabeth J Gifford, Deeksha Malhotra, Helena Chandler, Sandhya Bandi, Drew A Helmer

Faculty, Staff and Students Publications

Objective: Approximately 30% of the 700 000 US Gulf War Veterans (GWVs) report symptoms collectively termed Gulf War Illness (GWI), a multisymptom illness of uncertain pathophysiology. Prior studies in GWI focus on overlap with irritable bowel syndrome. This study examines the associations between upper gastrointestinal (UGI) symptoms, GWI and specialty GI care.

Methods: This cross-sectional study analysed GWVs referred to a Veterans Health Administration clinical War-Related Illness and Injury Study Center (2008-2020). Symptoms, demographics, military service and clinical history were obtained from self-reported intake packets. GWI was defined by the Centers for Disease Control and Prevention criteria requiring moderate-to-severe symptoms …


Establishing Best Practices Guidelines For Collaborative Research In Global Surgery: Developing A Delphi Survey, Ramitha Eshan Ruwanpathirana, Swati Deshpande, Sophia Abdulhai, Mathilde Djeneba Billau, Sumeja Catic, Theresa L Chin, Julia N Harrison, Pratyush Kumar, Maria Cecilia T Leyson, Helen W Li, Katayoun S Madani, Arthur Serumaga, Margaret Tarpley, Grayson Wright, Nia N Zalamea, Joshua S Ng-Kamstra Sep 2025

Establishing Best Practices Guidelines For Collaborative Research In Global Surgery: Developing A Delphi Survey, Ramitha Eshan Ruwanpathirana, Swati Deshpande, Sophia Abdulhai, Mathilde Djeneba Billau, Sumeja Catic, Theresa L Chin, Julia N Harrison, Pratyush Kumar, Maria Cecilia T Leyson, Helen W Li, Katayoun S Madani, Arthur Serumaga, Margaret Tarpley, Grayson Wright, Nia N Zalamea, Joshua S Ng-Kamstra

Faculty, Staff and Students Publications

Background: Collaborative research in global surgery has resulted in the rapid development of the field via knowledge creation and dissemination, research capacity building, and direct improvements in the delivery of clinical care. Yet the establishment and maintenance of trans-boundary collaborations carries significant risk to health systems, clinicians, patients, and researchers, particularly if such collaborations are not developed thoughtfully and with appropriate guardrails. In recent years, there has been significant growth in the literature on the pervasiveness and impact of neocolonialism on global health research.

Methods: To harness the benefits of global surgery research collaboration while mitigating these risks, we reviewed …