Medicine and Health Sciences Commons^™

Hearing From Working Nurses: Incorporating Real-World Knowledge Practices Into The Framework To Better Instruct Tomorrow's Healthcare Professionals, Anne R. Diekema, Elizabeth (Betsy) S. Hopkins, Britt Fagerheim, Brandon Patterson, Nena Schvaneveldt

Faculty Publications

There is a certain duality to the role of librarians in higher education as the job requires preparing students for their current academic work, such as doing research for writing papers, while at the same time preparing students for their future professional information work. Librarians seeking guidance on teaching information literacy more comprehensively are left to study the professional standards of the targeted professional group, and find or carry out research on these practitioners. Synthesizing and translating these findings into instructional approaches while staying true to existing information literacy standards, however, can be challenging. In this chapter we demonstrate how …

Vascular Risk Factors And 1-Year Cognitive Change Among Individuals With Traumatic Brain Injury, Andrea L. C. Schneider, Katherine Hunzinger, Benjamin L. Brett, Danielle K Sandsmark, Sonia Jain, Xiaoying Sun, Raquel C. Gardner, Geoffrey T. Manley, Ramon Diaz-Arrastia, Lindsay D. Nelson, Patrick Belton, Shawn Eagle, Shankar Gopinath, Ramesh Grandhi, C. Dirk Keene, Vijay Krishnamoorthy, Christine Mac Donald, Michael Mccrea, Randall Merchant, Pratik Mukherjee, Laura B. Ngwenya, David Okonkwo, Claudia Robertson, David Schnyer, Sabrina R. Taylor, John K. Yue, Ross Zafonte

Department of Exercise Science Faculty Papers

IMPORTANCE: Traumatic brain injury (TBI) and vascular risk factors are associated with cognitive impairment, but it is unknown if individuals with vascular risk factors experience worse cognitive outcomes after TBI.

OBJECTIVE: To evaluate cognitive function among patients with TBI with vs without comorbid preinjury vascular risk factors.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study examined individuals with TBI enrolled in the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Study between February 26, 2014, and August 8, 2018, with a 1-year follow-up. Analyses were conducted February 26, 2024, to May 29, 2025.

EXPOSURES: Vascular risk factors (ie, hypertension, diabetes, …

A Tale Of Two Toxicants: Investigating The Interaction Between Hexavalent Chromium And Perfluorooctane Sulfonic Acid., Morgan Elizabeth Delnicki

Electronic Theses and Dissertations

Hexavalent chromium [Cr(VI)] and per- and polyfluoroalkyl substances (PFAS) are environmental contaminants of major public health concern. Despite commonly being found together in contaminated drinking water, no studies have considered the concomitant health effects of Cr(VI) and PFAS, specifically perfluorooctane sulfonic acid (PFOS). In vitro studies using CHO cells assessed the cytotoxicity and genotoxicity of Cr(VI) and PFAS both individually and in combination. Intracellular and extracellular Cr levels were measured with Atomic Absorption Spectrometry. PFOS was found to exacerbate Cr(VI) induced cytotoxicity and genotoxicity. Additionally, a novel in vivo model of studying the hepatotoxicity of Cr(VI) was established. Adult Hartley …

Exploring Hexavalent Chromium Exposure And Lipid Accumulation In Liver Disease., Gabrielle Celine Griffin

Electronic Theses and Dissertations

The prevalence of MASLD has doubled over the past 20 years and continues to rise. Hexavalent chromium [Cr(VI)], a top chemical hazard in U.S. drinking water, is emerging as potential risk factor for liver disease. To study the impact of Cr(VI) and high-fat diet on MASLD, we developed an in vivo model using Sprague-Dawley rats exposed to Cr(VI) in drinking water (0, 0.05, or 0.1 mg/L) and fed normal or high-fat diet for 90 days. High-fat diet significantly increased body mass, plasma lipoproteins, cholesterol, liver injury, and hepatic triglycerides, which were exacerbated by Cr(VI) exposure. Cr(VI) alone increased hepatic chromium …

Integrating Bulk And Single-Cell Transcriptomics To Investigate Intratumor Heterogeneity, Shuai Guo

Dissertations and Theses (Open Access)

Cancers are heterogeneous mixtures of tumor and surrounding cells, where each component comprises multiple distinct sub-types and/or states. Understanding the cell-type-specific contributions is critical for advancing cancer biology, yet high-throughput expression profiles from tumor tissues only represent combined signals from all diverse cellular sources. Bulk deconvolution with single-cell/nucleus (sc/sn) RNA-seq data has emerged as a powerful approach to dissect both cellular composition and cell-type-specific expression patterns, yet the technological discrepancy across sequencing platforms limits accuracy.

To systematically evaluate the impact of platform discrepancies on bulk deconvolution, we first generated a benchmark dataset of 24 healthy retinas with paired bulk and …

Chronic Cluster Headache Is A Rare Disease: Implications For Diagnosis, Treatment And Public Health, Hsiangkuo Yuan, Jan Hoffmann, Elena Ruiz De La Torre, Michael J. Marmura, Mario F. P. Peres

Department of Jefferson Headache Center Papers and Presentations

Cluster headache (CH) is a rare and painful primary headache disorder characterized by severe unilateral pain and cranial autonomic symptoms. This perspective examines the epidemiological evidence supporting the classification of chronic cluster headache (CCH) as a rare disease, noting a prevalence of CH of approximately 124 per 100,000 individuals, with only 3.5-13.7% manifesting CCH. This prevalence meets criteria established by both the US Food and Drug Administration and European Medicines Agency for rare disease designation. The rarity of CCH creates substantial clinical and research challenges, including prolonged diagnostic delays, limited research funding and a dearth of approved treatments. The economic …

College Students And Wearable Health Technology: A Study On Digital Health Literacy, Gavin Wright

Undergraduate Honors Thesis Collection

The market for wearable devices has seen significant growth in the last decade and is only expected to increase as the world enters a new age of health literacy known as digital health literacy. Digital health literacy, or eHealth literacy, is defined as “the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem.” The issue with this new age is that most consumers have access, but lack the ability to apply the knowledge that they must improve their health. The goal of this study is …

Therapeutic Potential Of Sglt2 Inhibitors In A Repeated Love Dose Cisplatin Model., Dianet C. Sanchez

Electronic Theses and Dissertations

Cisplatin is a potent chemotherapeutic, thirty percent of patients develop Acute Kidney Injury (AKI). These patients are ten times more likely to develop chronic kidney disease (CKD). Sodium-glucose-cotransporter-2-inhibitors (SGLT2i), FDA approved for diabetes, has shown protection in multiple mouse models of AKI-CKD. We hypothesize SGLT2i can protect the kidney in a model of repeated low dose cisplatin with/without cancer. B6:129 mice with/without lung adenocarcinoma (Lung-adeno) were treated daily with SGLT2i dapagliflozin (10mg/kg)/vehicle control. After seven days, weekly cisplatin (7mg/kg)/vehicle control was initiated for 3-4 weeks. Following final cisplatin dose, kidney function, injury, fibrosis, inflammation was assessed. SGLT2i treatment attenuated alterations …

More Arguments For The Weakness Of The Empirical Evidence Used To Support Spanking Bans: Rejoinder To Afifi Et Al. (2025) And Kraus De Camargo (2025), Marjorie Lindner Gunnoe, Robert E. Larzelere, Christopher J. Ferguson, Ronald B. Cox Jr.

University Faculty Publications and Creative Works

In this rejoinder we address 13 concerns elicited by our invited commentary “An update on the scientific evidence for and against the legal banning of disciplinary spanking.” In addition to defending assertions made in the initial commentary, we make several new substantive arguments. In response to dissenters’ equating of non-experimental evidence against spanking with nonexperimental evidence against smoking, we demonstrate that the two are very dissimilar. We question the purpose of spanking bans, providing stronger evidence that they do not seem to prevent child abuse. We review Canada’s association with the UN’s Convention on the Rights of the Child (CRC) …

Does Change In Faith Maturity Reflect Maturation? Establishing Strict Measurement Invariance For The Faith Maturity Scale Across Time, Hiroki Matsuo, Tyler Greenway, Grant B. Morgan, Sarah A. Schnitker

University Faculty Publications and Creative Works

Despite its early focus on religious development and faith maturation, the psychology of religion and spirituality field underutilizes longitudinal designs; work is needed to reduce barriers to the longitudinal study of the processes by which faith matures. As a first step, the present study examines the invariance structure of the Faith Maturity Scale across three time points to assess the reliability and structure of the scale over time. The confirmatory factor analytic method was used to examine data from 572 college students. Configural, metric, scalar, and residual/strict models were tested. Findings support the full strict residual longitudinal invariance model, providing …

Detection Of Activity Cliffs Produced By Anti-Cancer Drugs And An Algorithm For Reliable Predictions In Affected Areas, Sarah Josephine Aurit

Department of Statistics: Dissertations, Theses, and Student Research

An activity cliff (AC) occurs when drugs close in chemical space produce dissimilar biological results. We focus on developing an inferential procedure to detect the presence of ACs in a chemical landscape. If detected, we provide a distance-based procedure that can be used to identify regions of stability in the chemical landscape of interest and generate prediction with higher precision in those areas of stability. We conceptualize the chemical landscape as a spatial random field and use spatial models for prediction of efficacy for new drugs based on “distance” in chemical space. We argue that an AC manifests itself by …

Applications Of Preclinical Magnetic Resonance Imaging In The Treatment Of Traumatic Brain Injury And Understanding Carotid Artery Atherosclerosis, Evan Timothy Curtis

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Advances in magnetic resonance imaging (MRI) provide the opportunity to investigate research questions that have been left unanswered. In the cases of traumatic brain injury (TBI) and carotid artery atherosclerosis, MRI is a resource for non-invasively viewing the phenomena taking place. Additionally, potential interventions and treatments can be observed without harm to the subject. This dissertation expands the understanding of two preclinical applications of MRI: traumatic brain injury and carotid artery atherosclerosis in mouse models.

TBI is a leading cause of death and disability for individuals between 15–45 years of age and effective pharmaceutical interventions for treating the secondary damage …

Intergenerational Family Dynamics Among Caregivers And Children’S Social-Emotional Development In China, Weiman Xu

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The early years of a child’s life are pivotal for social-emotional development. While extensive research has explored the role of family settings in fostering children's social-emotional development (Bornstein, 2005), the impact of grandparental involvement, particularly the caregiving dynamics between generations, remains less well understood. This study aims to fill this gap by examining two critical aspects of intergenerational dynamics among caregivers (i.e. parent-grandparent coparenting and parent-grandparent relationship quality) and their associations with children’s social-emotional development (i.e. social skills and problem behaviors). Two specific aims were delineated: 1) examine the unique contribution of parent-grandparent coparenting, especially the power and authority domain …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

Complex Factors Impacting Smoking Behavior In Cancer Survivors With Food Insecurity, Madeline C. Castele, Kareena Shah, Avianna Thompson, Jin E. Kim-Mozeleski

Faculty Scholarship

Objectives: Tobacco use remains prevalent among people with social needs, such as food insecurity. In this study, we aimed to understand the complex experiences of low-income cancer survivors with food insecurity who smoke tobacco, to identify the unique smoking cessation needs for this group. Methods: We conducted in-depth, semi-structured qualitative interviews with 40 adults experiencing food insecurity who continued smoking after a cancer diagnosis. Interviews focused on smoking behaviors, cessation interest, cancer experiences, and financial circumstances. We analyzed the data using reflexive thematic analysis. Results: In this sample of cancer survivors (50% female, mean age 42 years, 60% black/African American, …

Effects Of Training With Different Set-Repetition Configurations On High-Intensity Exercise Endurance And Acute Recoverability, Wesley Gawel

Electronic Theses and Dissertations

This study aimed to evaluate how high- (3x10) versus low-repetition (3x2) resistance training affects (1) muscular strength-endurance and (2) immediate recovery after a high-intensity exercise effort (HIEE). Fourteen college-aged participants (10 males: 24.5 ± 4.9 yrs, 1.76 ± 0.05 m, 86.56 ± 6.90 kg; 4 females: 23.0 ± 2.8 yrs, 1.58 ± 0.09 m, 62.19 ± 5.96 kg) completed a 4-week training program and were divided into two groups: G2 (3x2; 5 males, 2 females) and G10 (3x10; 5 males, 2 females). All subjects performed back squats to failure at 67.5% of baseline 1RM. Repetitions (REPS) and volume load with …

The Lived Experiences Of Fathers With Postpartum Depression: A Qualitative Study, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Background:

Although parents may joyfully anticipate the birth of a child, it's impossible for them to know ahead of time just how profoundly their lives will change. Postpartum depression (PPD) can result. While there is a substantial body of research regarding maternal PPD, paternal PPD has received far less attention and is neither adequately understood nor diagnosed. This is exacerbated by outdated but persistent sociocultural masculinity norms and the stigmas around mental health issues.

Purpose:

This study sought to explore the lived experiences of new fathers with PPD in order to provide greater insight into their experiences.

Methods:

This qualitative …

The Effect Of An Acute Bout Of Rock Climbing On Cognitive Functioning And Cortisol Levels, Vanessa Steigauf

All NMU Master's Theses

Rock climbing is an understudied physical activity (PA) that demands active decision-making, integration of sensory and visual input, and continuous regulation of nervous system activity to produce complex motor outputs. The unique psychological demands of climbing warrant studying its effect on cognition and brain health. I recruited 26 generally healthy adults for a randomized-controlled study. Climbing experience, PA and perceived stress were self-reported. Each participant was randomly assigned to a climbing (10x2 minutes climb, moderate intensity) or control group (seated, watching climbing-related video). The primary outcomes, cognitive performance and salivary cortisol levels were assessed by the Stroop test. A linear …

If Alcohol Consumption Were Eliminated, Which Us Counties Would Still Experience High Rates Of Breast Cancer Among Women?, Hina Javed

Boise State University Theses and Dissertations

Background

Breast cancer is the most prevalent cancer among women in the United States, accounting for roughly one-third of all newly diagnosed female cancers (American Cancer Society, 2024). The risk factors for breast cancer include both non-modifiable and modifiable factors. Non-modifiable factors include age at menarche, early menstrual cycles and late menopause. Modifiable factors include smoking, diabetes, obesity and environmental factors such as air pollution. The interplay between lifestyle factors and environmental exposures in cancer development has long been debated. While alcohol consumption is widely recognized as a major breast cancer risk factor, the role of environmental exposure such as …

Trends In The Use Of Non-Nutritive Sweeteners Among Female University Students In The United Arab Emirates, Dalia Haroun, Aseel Ehsanallah, Wafa Mubarak

All Works

Objective: This study aimed to explore the consumption patterns of non-nutritive sweeteners (NNS) among female university students in the United Arab Emirates (UAE), in the context of rising health awareness. Methods: A cross-sectional survey was conducted from February to April 2023 among female university students in the UAE. A total of 192 participants aged 18 and above were recruited through convenience sampling. A structured, self-administered online questionnaire was used to collect data on NNS consumption, motivations for use, physical activity, dietary habits, and self-reported height and weight. Body Mass Index (BMI) was calculated and categorized using the World Health Organization …

Supervised Machine-Based Learning And Computational Analysis To Reveal Unique Molecular Signatures Associated With Wound Healing And Fibrotic Outcomes To Lens Injury, Catherine Lalman, Kylie R. Stabler, Yimin Yang, Janice L Walker

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Posterior capsule opacification (PCO), a frequent complication of cataract surgery, arises from dysregulated wound healing and fibrotic transformation of residual lens epithelial cells. While transcriptomic and machine learning (ML) approaches have elucidated fibrosis-related pathways in other tissues, the molecular divergence between regenerative and fibrotic outcomes in the lens remains unclear. Here, we used an ex vivo chick lens injury model to simulate post-surgical conditions, collecting RNA from lenses undergoing either regenerative wound healing or fibrosis between days 1–3 post-injury. Bulk RNA sequencing data were normalized, log-transformed, and subjected to univariate filtering prior to training LASSO, SVM, and RF ML models …

The Impact Of Culture And Language On Internal Communication And Patient Care In Small To Medium-Sized Black Immigrant-Owned Healthcare Practices In Texas., Chisom Nwosu

Dissertations

This qualitative phenomenological study explored how cultural competency in small to medium-sized Black immigrant-owned healthcare practices in Texas affects internal communication and patient care. Through semi-structured interviews with nine clinical and administrative leaders in Dallas and Houston, five themes emerged: culturally competent leadership, intentional communication structures, language and interpretation practices, patient-centered cultural sensitivity, and the use of technology for adaptation. Findings suggest that culturally aware leadership and inclusive communication strategies foster team cohesion and improve patient trust and care. Participants reported adapting workflows to meet religious, language, and communication needs through human and technological tools. The study underscores embedding cultural …

The Relationship Between Total Serum Cholesterol And Hypertensive Outcomes Among Women 50-60 Years Old: Findings From The Framingham Heart Study, Sierra Smith

Capstone Experience: Master of Public Health

Objective: To assess whether total serum cholesterol (TSC) among middle-aged women is associated with subsequent hypertension while accounting for potential confounders.

Methods: A sample of 853 adults who identify as women, aged 50-60, from the Framingham Heart Study 1948-1972 cohort was selected for this study. Participants' TSC was measured at baseline, and they were followed for 24 years for cardiovascular disease outcomes or death. The outcome of interest in this study was hypertension. A multivariable logistic regression was used to analyze the relationship between TSC and hypertension while controlling for age, glucose, systolic, and diastolic blood pressure.

Results: Compared to …

Analysis Of The Clinical, Socioeconomic, And Sociodemographic Characteristics Of Virally Unsuppressed Children Aged 2-14 Living With Hiv/Aids In The Region Of Abidjan 2 – Côte D’Ivoire (Region Supported By Usaid), Maman Fathim Kamagate

Capstone Experience: Master of Public Health

Background: Viral suppression among children living with HIV (CLHIV) remains suboptimal in Côte d’Ivoire. This study assessed clinical, socioeconomic, and demographic characteristics associated with viral non-suppression among CLHIV aged 2–14 years in Abidjan 2 to inform targeted interventions under the U.S. Agency for International Development (USAID)-supported Reaching Impact, Saturation, and Epidemic Control (RISE) project.

Methods: A retrospective analysis was conducted using routine program data from 1,203 CLHIV across 73 health facilities. Descriptive, bivariate, and multivariate analyses were performed to examine associations with viral load suppression status. Findings guided the development of a multi-level implementation plan using Kotter’s Change Management Framework, …

Pediatric Occupational Therapists’ Perception On How Nature-Based Play Affects Fine Motor Development, Abbi M. Rosenow

Human Development and Family Sciences Undergraduate Honors Theses

This study aimed to explore the benefits of nature-based pediatric occupational therapy and the influence of nature and nature-based play on fine motor development. It was hypothesized that nature and nature-based play would positively impact a child’s fine motor skills, and that nature-based occupational therapy would offer unique benefits to a child’s therapeutic experience. To examine these relationships, a survey was distributed to pediatric occupational therapists across the United States. The survey was designed to gather insights into how occupational therapy supports fine motor development, how nature-based play/therapy enhances these skills, and the perceived benefits of incorporating nature into therapeutic …

Cholesterol Crystal Embolization Induced Kidney Disease, Shohan Pervaze, Shreya Mohandas, Pushkas Gopalan, Stephen A. Morse, Siddhartha Bajracharya, Landon A. Krone, Farshid Yazdi

School of Medicine Faculty Publications

Cholesterol crystal embolization (CCE) results from the release of cholesterol crystals from ruptured atherosclerotic plaques into circulation, resulting in the occlusion of small arteries and arterioles in various organs. Ischemia triggers a systemic inflammatory response resulting in vascular obstruction and organ dysfunction. Kidneys are often involved because of the proximity to the aorta and CCE in the kidneys can result in acute, sub-acute, or chronic kidney disease. There are many known risk factors for renal involvement of CCE, including iatrogenic and spontaneous causes. The pathophysiology of CCE includes complex pathways that lead to acute and chronic effects that can have …

Gastric Sarcina Ventriculi: A Report On Two Cases, Yaomin Chen, Yu Liu, Zhiyan Fu

School of Medicine Faculty Publications

: Sarcina ventriculi is a rare Gram-positive coccus that thrives in acidic environments such as the human stomach. It has been increasingly identified in individuals with delayed gastric emptying and has been reported in association with various gastric disorders. However, its exact pathogenic role is not fully understood and remains controversial. : We present two cases of patients, one with a small bowel obstruction and the other with epigastric pain, both diagnosed with Sarcina ventriculi infection by histological examination of gastric biopsies. The patients were managed with a combination of antibiotics and a proton pump inhibitor, resulting in symptom resolution …

Lipid Nanoparticle-Mediated Drug Delivery To Cns Targets, Purva Khare

Electronic Theses and Dissertations

Lipid nanoparticles (LNPs) have revolutionized drug delivery, particularly in the delivery of gene silencing siRNA to the liver (Onpattro) and COVID-19 mRNA vaccines (Pfizer-BioNTech, Moderna). It is no exaggeration to state that the LNP delivery technology has protected billions of vaccinated people against a severe COVID-19 infection and subsequent mortality. Despite extensive research on LNPs for hepatic and muscle delivery, their potential for brain drug delivery remains underexplored. Many neurological disorders lack effective treatments, making LNP-based approaches promising for crossing or targeting drug delivery to the blood-brain barrier (BBB). Brain endothelial cells (BECs), a key component of the BBB, play …

Development And Implementation Of An Ob/L&D Sbar Framework To Enhance Communication Between Obstetric Nurses And Anesthesia Providers: A Quality Improvement Initiative, Jenna E. Bigam, Laina J. Uzarski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication between obstetric (OB) nurses and anesthesia providers is critical to ensure patient safety during epidural placements in labor and delivery (L&D) settings. At a large teaching hospital, communication gaps were identified when OB nurses requested anesthesia for epidural placements without consistently providing vital patient information. The lack of structured communication can result in important details being overlooked, which may lead to delays in care and potential patient harm. To address this, the SBAR (Situation, Background, Assessment, Recommendation) communication framework was implemented to standardize and improve information exchange. This Doctorate of Nurse Anesthesia Practice (DNAP) project aimed to enhance …

Honoring Childhood Agency In Developmental Research: Best Practices, Applications, And Insights, Amanda N. Howery, Olivia J. Lashley, Hanna R. Wright, Julia L. Williams, Olivia K. Nomura, Eline Lenne, Elizabeth K. Wood, Hanna C. Gustafsson, Elinor L. Sullivan

School of Social Work Faculty Publications and Presentations

Pediatric research requires caregivers to provide informed consent on behalf of their children. While not a formal requirement for children under the age of seven, it is important to involve child participants in the assent and decision-making processes in developmentally appropriate ways. This is especially important in longitudinal research, where the extent to which a developing child understands study tasks evolves over time. Although there is consensus that assent procedures are important and necessary, limited resources synthesizing strategies for pediatric researchers to encourage positive and respectful research experiences for young children exist. We describe methods used in an ongoing longitudinal …