Medicine and Health Sciences Commons^™

Enhancing Medication Adherence In Home-Based Hypertension Care Through Targeted Staff Education, Marie Lunie Bazile

Walden Dissertations and Doctoral Studies

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education …

Oncofetal Reprogramming: A New Frontier In Cancer Therapy Resistance, Anh Nguyen, Molly Lausten, Bruce M. Boman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Oncofetal reprogramming has recently emerged as a critical concept in translational cancer research, particularly for its role in driving therapeutic resistance across a variety of malignancies. This biological process refers to a pattern of gene expression that is restricted to embryogenesis, but becomes expressed again in a subpopulation of cancer cells. These genes are typically suppressed after embryogenesis, and their aberrant re-expression in tumors endows cancer cells with stem-like properties and enhanced adaptability. The goal of this review is the following: (i) comprehensively examine the multifaceted nature of oncofetal reprogramming; (ii) elucidate its underlying molecular mechanisms, including its regulators and …

Connecting Through Creativity: Enhancing Pediatric Care With Playful Ppe, Betty Abraha, Lauren Burns, Alayna Smith

2025

No abstract provided.

Nilotinib-Mediated Reprogramming Of Bone Marrow Macrophages Alters Hematopoietic Stem Cell Fate In Chronic Myeloid Leukemia, Tiffany Davia Ricketts

ETDs from 2020-2029

Tyrosine kinase inhibition (TKI) is highly effective and promotes favorable long-term outcomes for many patients with chronic myeloid leukemia (CML). However, many patients experience treatment resistance or recurrence after TKI cessation due to leukemic stem cell (LSC) persistence within the hematopoietic stem cell (HSC) niche. Within the niche, macrophages adopt different activation states to alter HSC function, however, CML disrupts niche signals to selectively support LSCs and macrophages may contribute to this process. We hypothesize that macrophages contribute to pro-inflammatory activation within the niche to promote LSC development and nilotinib will reprogram macrophages to selectively support non-leukemic stem cells. To …

Conserved Chromatin Programs Orchestrate Cardiac Cell States In Health And Disease And Drive Cardiomyocyte Proliferation After Injury, Xiaoxiao Geng

ETDs from 2020-2029

Chromatin structure is a central regulator of gene expression and cellular identity, yet the chromatin structural factors driving cardiac disease and regeneration remain incompletely defined. This dissertation investigates how modulation of chromatin architecture shapes pathological and regenerative cardiac phenotypes through integrated single-cell transcriptomic, epigenomic, and functional analyses. To determine whether chromatin structural regulators distinguish healthy from diseased cardiac states, we curated a comprehensive list of chromatin structural genes and applied it to single-nuclei RNA sequencing datasets from human hearts with and without dilated cardiomyopathy (DCM). Chromatin structural gene expression effectively stratified cardiomyocyte and fibroblast populations by disease status. Diseased cardiomyocytes …

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Comparative Outcomes Of Abdominal, Laparoscopic, And Vaginal Sacral Colpopexy: A National Analysis Of Apical Suspension Procedures (2014–2022), Smit Bharat Solanki, Apurva B Pancholy, Vishal Pancholy

Faculty, Staff and Student Publications

Objective: Sacral colpopexy is a well-established procedure for apical suspension, but the relative outcomes of abdominal, laparoscopic, and vaginal approaches remain debated. This study compared perioperative outcomes across these surgical routes using a national database and evaluated trends in robotic assistance.

Materials and methods: We analyzed sacral colpopexy cases from the American College of Surgeons National Surgical Quality Improvement Program between 2014 and 2022. Patient demographics, complication rates, and surgical outcomes were compared among abdominal, laparoscopic, and vaginal procedures. Relative risks (RR) were adjusted for confounders. The utilization of robotic systems in laparoscopic procedures was examined.

Results: Among 61,524 cases, …

Seipin Expression In Hepatocytes Impairs The Assembly Of Vldls And Exacerbates Steatohepatitis, Qianqian Dong, Yidan Ma, Xin Chen, Xiaowei Wang, Ziwei Liu, Chenxi Liang, Liwen Qiu, Jinye Tang, Jin Wu, Yang Liu, Xiaoqin Wu, Yaru Zhou, Mingming Gao, Hongyuan Yang

Faculty, Staff and Student Publications

VLDLs are crucial for maintaining liver and whole-body lipid homeostasis. Limited knowledge exists regarding the lipidation process of VLDL. Endoplasmic reticulum (ER) luminal lipid droplets (LLDs) have been suggested to provide lipids for VLDL lipidation and maturation. Seipin, an integral membrane protein of the ER, plays key roles in the formation of cytoplasmic LDs (CLDs) and adipocyte differentiation. Surprisingly, seipin is hardly detectable in hepatocytes. Given the critical contribution of seipin in forming CLDs, we hypothesize that the absence of seipin in hepatocytes might ensure the proper formation of LLDs and the lipidation and assembly of VLDLs. To explore the …

Downregulation Of Slc40a1 Leads To Iron Accumulation In Fibrotic Lung Fibroblasts, Quanjin Dang, Chaoqun Huang, Yurong Liang, Akshaya Surendran, Dharanya Muthiah, Kishore Vaddadi, Sankha Hewawasam, Tingting W Mills, Lin Liu

Faculty, Staff and Student Publications

Iron is an essential nutrient for almost all organisms. However, excess iron generates reactive oxygen species and causes tissue injuries. Iron is implicated in idiopathic pulmonary fibrosis (IPF). In this study, we examined iron accumulation in fibrotic lung fibroblasts and the underlying mechanisms. We hypothesize that the downregulation of Solute Carrier Family 40 Member 1 (SLC40A1) results in iron accumulation in lung fibroblasts of IPF patients. Using a Prussian Blue iron staining, we found that iron accumulated in the fibrotic region of the lungs from IPF patients and bleomycin- and asbestos-induced lung fibrosis mice. Iron was partially co-localized with the …

An Application-Based Ontological Knowledge Base Of Medications To Support Health Literacy And Adherence For The Consumer Population: An Aging Population Use Case, Clifford Chen, Muhammad Amith, Kirk Roberts, Rebecca Mauldin, Renata Komalasari, Cui Tao

Faculty, Staff and Student Publications

No abstract provided.

The Origin Of Hepatocellular Carcinoma Depends On Metabolic Zonation, Jason Guo, Roger Liang, Andrew Chung, Zhijie Li, Boyuan Li, Eric Chen, Lin Li, Jingjing Wang, Meng-Hsiung Hsieh, Ivy Xiangyi Fang, Benjamin Kroger, Yunguan Wang, Min Zhu, Xiongzhao Ren, Greg Mannino, Yuemeng Jia, Yonglong Wei, Stephen Moore, Daniel J Siegwart, Stephen S Chung, Zixi Wang, Tripti Sharma, Suman Komjeti, Yi Han, Purva Gopal, Guanghua Xiao, Tao Wang, Hao Zhu

Faculty, Staff and Student Publications

The origin of cancer is poorly understood because premalignant cells are rarely followed in their native environments. Although the spatial compartmentalization of metabolic functions is critical for proper liver function, it is unknown whether cancers arise from some zones but not others and whether there are metabolic determinants of cancer risk. Zone-specific, mosaic introduction of Ctnnb1 (catenin beta 1) and Arid2 (AT-rich interaction domain 2) mutations, commonly co-mutated genes in hepatocellular carcinoma (HCC), in mouse models showed that position and metabolic context determine clone fates. Ctnnb1/Arid2-driven cancers were much more likely to arise in zone 3. The …

Dhodh Links Mitochondrial Bioenergetics, One-Carbon Metabolism, And Dna Repair To Sustain Aggressive Prostate Adenocarcinoma, Saiswaroop Rajaratnam, Danthasinghe Waduge Badrajee Piyarathna, Ranjit K Mehta, Venugopalareddy Mekala, Jun Hyoung Park, Uttam Rasaily, Vani Venkatappa, Karthik Reddy Kami Reddy, Vasanta Putluri, Kaveri Goel, Sandra L Grimm, Sai Manohar Thota, Taylor Morrison, Cristian Coarfa, Benny Abraham Kaipparettu, Chao Cheng, Nagireddy Putluri, Jeffrey A Jones, Mukesh K Nyati, Michael Ittmann, Natalie R Gassman, Arun Sreekumar

Faculty, Staff and Students Publications

Background

Dihydroorotate dehydrogenase (DHODH) is a mitochondrial enzyme that connects de novo pyrimidine biosynthesis with the electron transport chain (ETC) function. However, its broader role in prostate cancer (PCa) signaling and response to therapy remains unclear.

Methods

We combined transcriptomic, metabolomic, epigenomic, and functional analyses with clinical outcome data to explore the effects of DHODH depletion in ancestry-annotated European American (EA) and African American (AA) prostate cancer cell line models.

Results

DHODH was markedly overexpressed in malignant prostate epithelial cells and was abundant in tumors. Its knockdown hindered cell proliferation by causing pyrimidine depletion, while unexpectedly increasing oxidative phosphorylation, ETC …

Use Of Electrocardiograms To Identify Coronary Artery Disease: Cross-Validation Of An Artificial Intelligence Model, Michael Leasure, Indu Poornima, Adam Butchy, Utkars Jain, Devin Vasoya, Michael Warnick, Brent Williams, John Rehder, Prahlad Menon, Veronica A. Covalesky, Gary S. Mintz

Department of Medicine Faculty Papers

BACKGROUND: The current gold standard for the diagnosis of coronary artery disease (CAD) is invasive angiography; however, it is an invasive procedure. Therefore, we developed an artificial intelligence model designed to predict significant CAD from a resting digital 12-lead electrocardiogram (ECG).

OBJECTIVES: This retrospective study assessed the model's ability to predict clinically significant CAD in a patient population presenting for coronary angiography.

METHODS: From 2019 to 2021, 16,476 patients had a resting 12-lead digital ECG recorded within 90 days prior to coronary angiography. The artificial intelligence model was developed using 10-fold cross-validation methodology. Clinically significant disease was defined as angiographic …

Shingles: A Case Report, Michele White Dds, Ryan Vahdani Dds, Mha, Gary Frey Dds, Ben Warner Ms, Dds, Md

The Journal of the Michigan Dental Association

This case report details a 58-year-old male who presented at a dental urgent care clinic with oral pain and a facial rash. The report identifies the condition as shingles (herpes zoster), caused by the reactivation of the varicella-zoster virus. It explores the clinical presentation, differential diagnosis—distinguishing it from Ramsay Hunt Syndrome and Bell’s palsy—and emphasizes the importance of early antiviral treatment. Furthermore, the source highlights the role of dental practitioners in identifying infectious diseases and promoting vaccination. It serves as an educational tool for medical and dental clinicians to enhance collaborative care and expedite treatment through better recognition of shingles …

Comparative Analysis Of Mmpi-2-Rf Scale Differences Based On History Of Mild Traumatic Brain Injury, Arielle Mousseau, Linda Baum, Nikolaus Greven, Anna S. Ord

Archives of Assessment Psychology

The present study investigated differences in MMPI-2-RF scale scores between individuals with and without a history of mild traumatic brain injury (mTBI). The goal was to identify distinct psychosocial functioning patterns in individuals with mTBI. Archival outpatient sample of 147 adults aged 18 to 70 (M = 43.28, SD = 11.13) was utilized, comprising 65 participants with mTBI and 82 without TBI. Significant differences were observed across multiple MMPI-2-RF scales. The group with mTBI history exhibited higher levels of symptom overreporting, symptom validity concerns, emotional and internalizing dysfunction, somatic and cognitive complaints, and negative emotionality, as compared to the …

Mental Health First Aid Training In K-12 Schools, Jenna L. Workman, Brianna L. Schierberg, Grace H. Sullivan, Erin Robinson

Posters-at-the-Capitol

The increasing prevalence of mental health challenges among school-aged children has become a rising public health concern. Recent data indicates that nearly 70% of schools report heightened mental health problems among students, with anxiety and depression being most common (National Center for Education Statistics, 2024). The purpose of this capstone project is to raise awareness of mental health issues in K–12 public schools and to increase faculty and staff confidence in recognizing and assisting students experiencing mental health difficulties through nurse-led Mental Health First Aid (MHFA) training. Using Peplau’s Interpersonal Relations Theory as a guiding framework, this project emphasizes the …

The 24 Hour Rule: Science Over Subds Improving Newborn Physiological Stability, Paige Orth, Grace Brown, Jena Rhoads, Erin Robinson

Posters-at-the-Capitol

The first few hours after birth are the most crucial period in a newborn’s life. Adapting to a world outside of the womb can be both challenging and stressful, leaving the neonate susceptible to many health complications. The purpose of this project is to explore if delaying the first bath for 24 hours improves the physiological stability of the newborn. Bathing time policies vary among hospitals, and there is no clear set time to follow. The importance of this project is to address the inconsistencies throughout hospital bathing policies and implement a specific 24-hour policy. Multiple databases were used to …

The Effects Of Antihistamines On Drowsiness, Symptom Relief, And Restless Leg Syndrome, Suki Kaur

Posters-at-the-Capitol

“Antihistamine” categorizes a large selection of drugs, all with different side effects and user experiences. This study explores the relationships between allergy medicine usage, side effects, symptom relief, and Restless Leg Syndrome (RLS) using data collected from 113 participants of an anonymous online survey. Five hypotheses were tested using chi-square analyses of independence at a significance level of 0.05. The data revealed a strong statistical association between first-generation antihistamine (Benadryl) use and drowsiness, misuse of allergy medicine and RLS, drowsiness and RLS, and duration of use and routine disruption. The data did not find a statistically significant relationship between relief …

Digital Morality And National Values: Pancasila As An Ethical Compass For Technology-Enhanced Counseling In Indonesia, Dominikus David Biondi Situmorang, Hendrik Tuaputimain, Muqaffi Muqaffi, M. Solehuddin

Buletin Konseling Inovatif

The very fast development of Artificial Intelligence (AI), Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) in the last decade have changed the way of mental health practice internationally, including Indonesia. Although these technologies extend reach, deepen therapeutic engagement, and facilitate clinical analysis, they also present serious ethical challenges with respect to privacy, algorithmic bias, depersonalization, and disparity. This integrative review draws on literature from counseling, digital ethics, immersive technologies, and Indonesian philosophical studies to consider how Pancasila can serve as a culturally situated ethical guide for technology-mediated counseling. The results disclose four overarching themes: shifting role of …

Interpretable Linear Models For Heart Disease Prediction: A Comparative Study, Dipok Deb, Emran Hossain

Data Science and Data Mining

Heart disease remains a leading cause of mortality worldwide, underscoring the importance of accurate and transparent methods for early diagnosis. While many machine learning and artificial intelligence models have demonstrated strong predictive performance, their limited interpretability poses challenges for clinical adoption. In this study, we evaluate three interpretable linear classification models—Generalized Linear Model (GLM) logistic regression, L1-regularized (Lasso) logistic regression, and Linear Discriminant Analysis (LDA)—for heart disease prediction using the Cleveland Heart Disease dataset. Following comprehensive data preprocessing, the models are assessed on a held-out test set using standard evaluation metrics, including accuracy, precision, recall, F1-score, and the area under …

Executive Leadership System Improvement Mobile Lung Cancer Screening, Tracy Holladay

Walden Dissertations and Doctoral Studies

This doctoral project is an evidence‑based practice initiative to develop a mobile lung cancer screening program that expands early detection services in rural Arkansas. The practice problem involves low screening rates, high mortality, and access barriers that delay diagnosis for high‑risk individuals, making this work essential to nursing roles in prevention, coordination, education, and population health. The practice focused question examined whether creating a Mobile Lung Cancer Screening Unit proposal will support timely referrals and treatment. The purpose of the project was to design a feasible, evidence informed model aligned with organizational capacity and equitable access goals. Analytical strategies included …

Pemodelan Regresi Logistik Spasial Pada Kejadian Demam Berdarah Dengue (Dbd) Di Provinsi Jawa Barat Tahun 2023, Valida Ulfa Septiana, Sutanto Priyo Hastono

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Demam Berdarah Dengue (DBD) merupakan salah satu penyakit menular yang masih menjadi masalah kesehatan masyarakat di Indonesia, termasuk Provinsi Jawa Barat, dengan rata-rata kejadian yang lebih tinggi dari rata-rata nasional. Analisis spasial diperlukan untuk memahami pola penyebaran DBD, mengingat adanya kemungkinan pengaruh antar wilayah. Penelitian ini bertujuan untuk menganalisis pengaruh faktor sosio-demografi, faktor perilaku, serta efek spasial kedekatan geografis antar wilayah terhadap kejadian DBD di Provinsi Jawa Barat tahun 2023. Penelitian ini menggunakan desain potong lintang dengan unit analisis 27 kabupaten/kota di Jawa Barat tahun 2023. Data sekunder diperoleh dari Survei Kesehatan Indonesia 2023 dan Jawa Barat dalam Angka 2024. …

Psychological Resilience In The Covid-19 Response: A Systematic Review For Future Public Health Preparedness, Atena Pasha, Abdul-Hanan Saani Inusah, Jannatun Nayem, Xiaoming Li, Shan Qiao

Faculty Publications

Objective: The COVID-19 pandemic has highlighted the importance of psychological resilience for well-being. While several reviews have addressed resilience in specific populations or contexts, few have synthesized global literature across diverse populations. This review examines psychological resilience across diverse populations, focusing on measurement, associated factors, and future public health preparedness strategies. Method: Guided by the PRISMA, a thorough search of PsycINFO, PubMed, ScienceDirect, and Web of Science was conducted in February 2024, including quantitative studies considering psychological resilience during the COVID-19 pandemic published in peer-reviewed English journals from 2020 to 2024, using search terms relevant to psychological resilience and COVID-19. …

Assessment Of Knowledge, Attitude And Behaviors Towards Invasive Meningococcal Disease And Its Vaccination Among Young Adults In Saudi Arabia: A Cross-Sectional Study, Wesam Osama Mandoura, Anmar Abdullah Bijar, Anmar Aiman Rehbini, Ghali Ghalib Alhindi

Saudi Toxicology Journal

Background: Invasive meningococcal disease (IMD) remains a life-threatening infection associated with high mortality and long-term morbidity. Effective vaccines are available but meningococcal vaccination in Saudi Arabia is not mandatory outside specific high-risk groups. Public knowledge, attitudes and behaviors (KAB) toward IMD and its vaccination play a pivotal role in disease prevention and vaccine uptake. Methods: A cross-sectional survey was conducted among 382 residents of Saudi Arabia between July and August 2024 using a validated, Arabictranslated questionnaire distributed via social media. The survey assessed socio-demographic characteristics, knowledge of IMD, attitudes toward vaccination, vaccination behaviors and sources of information. Knowledge scores were …

Staff Education To Enhance Psychiatric Medication Adherence In Psychiatric Care, Emmanuel Nusta

Walden Dissertations and Doctoral Studies

Medication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play …

From Latent Manifolds To Targeted Molecular Probes: An Interpretable, Kinome-Scale Generative Machine Learning Framework For Family-Based Kinase Ligand Design, Gennady M. Verkhivker, Ryan Kassab, Keerthi Krishnan

Mathematics, Physics, and Computer Science Faculty Articles and Research

Scaffold-aware artificial intelligence (AI) models enable systematic exploration of chemical space conditioned on protein-interacting ligands, yet the representational principles governing their behavior remain poorly understood. The computational representation of structurally complex kinase small molecules remains a formidable challenge due to the high conservation of ATP active site architecture across the kinome and the topological complexity of structural scaffolds in current generative AI frameworks. In this study, we present a diagnostic, modular and chemistry-first generative framework for design of targeted SRC kinase ligands by integrating ChemVAE-based latent space modeling, a chemically interpretable structural similarity metric (Kinase Likelihood Score), Bayesian optimization, and …

The Effects Of Ovine-Derived Reinforced Tissue Matrix Surrounding Silicone-Based Implants In A Rat Prepectoral Reconstruction Model, Sai L Pinni, Cameron Martin, Nicholas Fadell, Xiaochao Xia, Evan Marsh, Lauren Schellhardt, Xiaowei Li, Matthew D Wood, Justin M Sacks

2020-Current year OA Pubs

Silicone-based implants have been widely used in breast reconstruction but have also been associated with poorly understood complications, including pathologic foreign body responses such as capsular contracture. In this study, we leveraged 3D-printing technology to generate silicone-based implants in a novel, anatomically relevant, prepectoral rat model. We used this model to evaluate the response to an extracellular matrix-based product: ovine-derived reinforced tissue matrix (RTM). Two-piece negative molds were developed through computer-aided design and 3D-printed. The molds were filled with various polydimethylsiloxane mixtures and dip-coated to fabricate implants. Implant material characterization revealed that the implants retained the original 3D-printed mold shape …

Mast Cells Promote Pathology And Susceptibility In Tuberculosis, Ananya Gupta, Vibha Taneja, Javier Rangel-Moreno, Nilofer Naqvi, Abhimanyu, Yun Tao, Mushtaq Ahmed, Kuldeep Singh Chauhan, Daniela Trejo-Ponce De Leon, Gustavo Ramírez-Martínez, Luis Jiménez-Alvarez, Cesar Luna-Rivero, Joaquin Zuniga, Deepak Kaushal, Shabaana A Khader

2020-Current year OA Pubs

Tuberculosis (TB), caused by the bacterium

Assessment Of Parental Knowledge And Anxiety Surrounding The Informed Consent Discussion For Neonatal Cardiac Interventions, Kristal Mancuso Hock

ETDs from 2020-2029

The purpose of this dissertation was to explore the complexities of the informed consent (IC) process in the context of neonatal cardiac interventions, with a focus on parental knowledge and anxiety during decision-making. Across three manuscripts, this work examined conceptual dimensions, feasibility, and acceptability of a new prenatal treatment (palliative care (PC) support sessions), and the effect sizes of this new treatment on parental knowledge and anxiety levels surrounding the IC discussion for neonatal cardiac palliations. The first manuscript employed dimensional analysis to conduct a concept analysis of IC in surgical care. The review of 27 publications revealed three distinct …

Staff Education To Emergency Nurses On Improving Handoff Communication Using The I-Pass Tool, Lekeyna Gleason

Walden Dissertations and Doctoral Studies

Effective communication during nurse-to-nurse handoff remains a critical determinant of patient safety in high-acuity emergency settings, where rapid decisions and fluctuating clinical demands can lead to inconsistent structure, omission of critical information, and inefficient transitions of care. The practice gap identified was a lack of standardized knowledge and consistent use of a structured bedside handoff tool among emergency department (ED) nurses. The practice-focused question guiding this project was, Does educating ED nurses on using the I-PASS bedside handoff tool improve knowledge of structured bedside reporting as measured by pre- and post-implementation surveys? The ADDIE framework and the Johns Hopkins evidence-based …