Medicine and Health Sciences Commons^™

Racial Differences In Adverse Pregnancy Outcomes And Incident Hypertension: A Mediation Analysis, Lucia C. Petito, Xiaoning Huang, C. Noel Bairey, Natalie Bello, Janet Catov, Ernesto Licon, Abbi Lane, David M. Haas, Lisa D. Levine, Rebecca B. Mcneil, Eliza Miller, Uma M. Reddy, Bethany Barone Gibbs, George Saade, Lauren Theilen, Laura E. Wiener, Brian M. Mercer, Hyagriv N. Simhan, Lynn M. Yee, Philip Greenland, William A. Grobman, Sadiya S. Khan

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) are associated with increased hypertension risk. Black women experience higher rates of APOs and hypertension compared with White women, but whether APOs contribute to Black-White hypertension disparities remains unknown.

Methods

The nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be-Heart Health Study) prospectively recruited nulliparous pregnant people at 8 US centers (2010-2013) with follow-up 2 to 7 years postpartum (2014-2017). Race, which represents a social construct, was self-identified. The primary outcome was incident hypertension at follow-up. APOs included hypertensive disorders of pregnancy, preterm birth, and small-for-gestational age birth. Potential confounders (psychological health, social factors, and health behaviors) …

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …

Trends In Glp-1 Based Therapy Use Before And After Pregnancy, Nansi S. Boghossain, Lauren Mcabee, Antonio F. Saad, Maged M. Costantine, Marwan Ma'ayeh, Joseph A. Ewing

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] Glucagon-like peptide-1 (GLP-1)-based therapies are increasingly prescribed for the treatment of type 2 diabetes and obesity, with rapid uptake of newer agents such as semaglutide and tirzepatide [1, 2]. These medications improve glycemic control and promote weight loss and are now widely used among reproductive-aged individuals [2, 3]. However, GLP-1-based therapies are typically discontinued prior to pregnancy because of limited safety data and potential fetal risks, and current guidance recommends avoiding use during pregnancy [3]. As prescribing expands, a growing number of individuals entering pregnancy may have recent exposure to GLP-1-based …

Histotripsy Process Improvement, Jordan Van Durme

Publications 2026-present

No abstract provided.

Npd Winner's Circle: Overcoming Imposter Syndrome In New Clinical Specialties, Leanna Ross

Publications 2026-present

No abstract provided.

Limits Of Machine Learning For Predicting Stillbirth At Term: A Population-Based Cohort Of 302,192 Pregnancies In Northern Italy, M. Benuzzi, T. Kawakita, F. Monari, B. Melis, G. Guariglia, A. La Marca, I. Neri, G. Saade, F. Facchinetti, I. El Moudden

Department of Obstetrics & Gynecology Faculty Publications

Background

Objective

Study Design

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

Paneugenesis: A Regenerative Systems Hypothesis For Advancing Health Promotion, Craig M. Becker, Leslie Hoglund, Beth Chaney, Joseph G. L. Lee, Michael Stellefson, Alex Davis

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-positive outcomes, thereby extending health promotion beyond its traditional pathogenic emphasis. Paneugenesis integrates systems science, salutogenesis, behavioral science, complexity theory, and quality management principles into a unified four-function process: operationalizing idealized outcomes, identifying key precursors, optimizing processes, and continually plotting progress through feedback mechanisms. The central hypothesis …

The Moderating Role Of Social And Emotional Support In The Association Between Adverse Childhood Experiences And Adult Mental Health Across Racial Groups: The Need For Investing In Social Capital, Syeda S. Jesmin, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

The sustained impact of Adverse Childhood Experiences (ACE) on mental health outcomes in adulthood is well documented in the literature. ACE survivors may be especially vulnerable to poor mental health outcomes if they have limited or no social support. This study examined the moderating role of social support on the association of ACEs and mental health across different racial groups.

Methods

Data were obtained from the 2022 Behavioral Risk Factor Surveillance System (n = 14,327). The nine ACE questions about traumatic events in childhood were used to create ACE scores. Chi-square tests were used for bivariate comparisons. Both stratified …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …

Modeling Healthcare Data With Logistic Quantile And Uniform-Based Mixture Polynomial Distributions, Mohan D. Pant, Aditya Chakraborty, Jovanna A. Tracz

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Continuous healthcare data often deviate from normality, which can substantially increase the risk of making invalid inferences, given that many inferential statistical procedures rely on normality assumption. To obviate this issue, we propose a new family of non-normal distributions based on a linear combination of the quantile functions of standard logistic and uniform (0, 1) distributions. This new family of non-normal distributions is studied within three different methods: L-moments, conventional moments, and percentiles. Its performance is compared among the three methods in the context of parameter estimation and data modeling. The results of Monte Carlo simulation and bootstrapping techniques indicate …

Understanding Cancer Information Burden And Quality Concerns: The Roles Of Medical Statistics Literacy, Online Health Information Confidence, And Social Media, Aditya Chakraborty, Sikta Das, Amy Myat Phyo

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Understanding factors shaping perceptions of cancer-related information is important for public health communication. This study examined associations of three information-related predictors, understanding medical statistics, confidence in online health information, and difficulty interpreting social media information, with two outcomes: cancer information was too hard to understand (CTU) and concern about cancer information quality (CCQ). Data came from the 2022 Health Information National Trends Survey. The cross-sectional study included 1972 participants. Survey-weighted univariable and multivariable logistic regression models assessed associations between the three predictors and CTU and CCQ, adjusting for sociodemographic characteristics, health insurance, and cancer history. LASSO logistic regression, random forest, …

Novel Socially Assistive Robot For Alzheimer's And Dementia Home Care; Lived Experiences Of Families, Audrey V. Downs

Honors Theses and Capstones

Informal caregivers for individuals with Alzheimer’s disease and related dementias (ADRD) typically experience high levels of subjective caregiver burden due to strenuous role demands, notably the need to provide frequent reminders and 24/7 monitoring to address care recipient cognitive decline. The purpose of this study was to understand the lived experiences of informal caregivers using a novel Socially Assistive Robot (SAR) to care for individuals with ADRD in a home setting and evaluate SAR impact on caregiver subjective burden. SARs are autonomous, interactive devices that can provide timed reminders and monitor home environments, potentially alleviating some caregiver role demands and …

The Effects Of Micro- And Nanoplastics On Human Monocytes, Caitlin G. Valerian

Honors Theses and Capstones

No abstract provided.

Surveillance Of A Novel Vesivirus Discovered In An Urban Mephitis Mephitis Population, Amanda E. Diggins

Honors Theses and Capstones

Caliciviridae is a family of non-enveloped, positive-sense, single stranded RNA viruses, including eleven defined genera that contain important pathogens of humans and animals. Within the Caliciviridae family, the genus Vesiviridae includes feline calicivirus, a leading cause of upper respiratory disease in cats, and vesicular exanthema of swine virus, a historical disease of domestic swine that has now been implicated in several marine mammal vesicular diseases, one of which has been confirmed zoonotic. Urban landscapes create a unique environment for rapid intra- and interspecies transmission of viruses. Clustered resources attract high-density populations of synanthropic wildlife species, increasing spatial overlap and heightening …

Exploring Biopsychosocial Influences On Hookup Culture And Disrupting Compulsory Behaviors In Emerging Adults: A Multidisciplinary Analysis Of A Contemporary Public Health Concern, Catherine Benjamin

Honors Theses and Capstones

Multidisciplinary analysis, including biology, psychology, and sociology, to better understand the compulsory Hookup Culture that exists as a contemporary public health concern among the age group defined as emerging adults. Sexually Transmitted Infections (STIs) diagnoses are steadily rising in the United States and disproportionately affecting college students. Early socialization and current educational resources that contribute to shame and stigma are discussed to explain how lifestyle and social conditions can act as risk factors for individual health outcomes.

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

Honors Theses and Capstones

Introduction: Nursing education prepares students to care for patient populations by enhancing knowledge of clinical pathophysiology and applying foundational nursing skills to tailor to the unique care requirements of each patient. When analyzing the nursing course curriculums as guides for what is included in nursing education, it is essential to consider relevant patient populations to ensure adequate representation in lectures. Inclusivity of relevant patient populations within curriculums equips students to encounter a variety of patients in a clinical setting. Perinatal substance use has prevalence in the local community of this university, with 6% of all births in New Hampshire in …

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Preserved Artificial Grammar Learning In Individuals With Parkinson’S Disease: A Systematic Review, Sarah I. Cranna

Honors Theses and Capstones

Abstract

            Implicit statistical learning is a crucial cognitive function that is highly involved in the learning and processing of language. Since both language and implicit statistical learning are supported by the basal ganglia through cortico-striatal networks, disruptions to this network could result in their impairment. Parkinson’s Disease (PD) can therefore be used to model disruptions to this system as it is primarily characterized by dysfunction in the basal ganglia. Thus, this review aims to examine the current literature studying the performance of individuals with PD on artificial grammar tasks in order to investigate the impact of impaired basal ganglia function …

Stress And Reward Interactions In Substance Use Disorder: An Evolutionary Mismatch Framework, Nicholas L. Castrucci

Honors Theses and Capstones

Substance use disorder (SUD) is a major public health concern characterized by compulsive substance use despite adverse consequences. While contemporary models emphasize biological, psychological, and environmental contributors, stress- and reward-related systems are often examined in isolation. This review integrates these systems within an evolutionary mismatch framework to examine how chronic stress exposure and repeated substance use increase vulnerability to addiction. Stress and reward systems are evolutionarily conserved but may become chronically dysregulated under modern conditions characterized by persistent psychosocial stressors and highly potent rewarding stimuli. This is associated with converging neuroadaptations across stress and reward circuitry, resulting in altered affective …

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design:

Prospective observational pilot study of adult spinal deformity surgery patients.

Objective:

To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data:

Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods:

We prospectively enrolled 18 patients undergoing adult …

Multisystem Predictors Of Dynamic Gait Stability Across Fall Risk In Older Adults, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea, Brittany Samulski

Rehabilitation Sciences Faculty Publications

Gait stability arises from interactions between physiological, cognitive, and psychological systems, yet these domains are often assessed in isolation. This study examined multisystem predictors of anteroposterior margin of stability during walking (MoSAP) in community-dwelling older adults. Of 340 participants, 143 were retained after data quality screening (105 females; age: 70.8 ± 7.8 years). Participants completed the Physiological Profile Assessment (PPA), cognitive testing using Montreal Cognitive Assessment (MoCA), fear-of-falling evaluations using Modified Falls Efficacy Scale (MFES) and a biomechanical gait assessment during preferred and fast speeds. Participants were stratified into four PPA-based fall-risk groups: low, mild, moderate, and high risk. MoSAP …

Infection Control Across Clinical And Laboratory Dental Settings Protocols, Risks, And The Role Of Emerging Technologies, Khrystyna Vyprynyuk, Laura Andreesku

Publications and Research

This article explores infection prevention strategies and disease transmission pathways in dental settings, emphasizing the critical connection between clinical practice and dental laboratories. It highlights the risks of cross-contamination, disinfection and sterilization challenges, and the growing role of technology in enhancing infection control.

Dosimetric Effect Of Abdominal Compression In Online Adaptive Planning For Abdominal Cancers Treated With A 15 Tesla Magnetic Resonance-Guided Linear Accelerator, Moghadaseh Khaleghibizaki, Angela Sobremonte, Luis Perles, Surendra Prajapati, Ergys Subashi, Yao Ding, Kristy Brock, Roya Barati, Eugene Koay, Chad Tang, Jinzhong Yang

Faculty, Staff and Student Publications

Compression belts (CBs) are sometimes used to reduce respiratory motion during stereotactic body radiotherapy of abdominal cancers with magnetic resonance (MR)-guided online adaptive planning. This study evaluated the dosimetric effects of overriding the relative electron density (ED) value of CBs in creating synthetic computed tomography (CT) scans for MR-guided adaptive planning. We evaluated plans for 12 patients with abdominal cancer and identified that ED values between 0.2 and 0.3 achieved the best approximation of CB ED in dose calculation. Our study presented an approach to estimate appropriate ED overrides for CBs in MR-guided online adaptive planning.

Reduced Threat-Related Neural Efficiency: A Possible Biomarker For Pediatric Anxiety Disorders, Julia O. Linke, Reut Naim, Simona P. Haller, Parmis Khosravi, Beck Scheinberg, Meghan E. Byrne, Anita Harrewijn, Ellen Leibenluft, Melissa A. Brotman, Anderson M. Winkler, Daniel Samuel Pine

School of Medicine Publications

Objective: Pediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as cognitive-behavioral therapy (CBT), produce lasting remission in less than 50% of affected youths. To support the search for improved, mechanistically grounded interventions, this study evaluated neural efficiency, defined as similarity in functional connectivity between a threat task and rest, as a potential biomarker. The study evaluated neural efficiency in relation to anxiety diagnosis and treatment response.

Methods: The authors compared 103 youths with an anxiety disorder diagnosis (mean age, 12.5 years [SD=2.91], 62% female) to 103 youths with no psychiatric diagnosis (mean age, 13.4 years …

Accuracy Of The Phenotypic 1g Test To Detect Mycobacterium Tuberculosis And Drug Resistance From Sputa In The Us-Mexico Border, Mia Aguirre, Doris Ayala, Juan Ignacio Garcia, Yoscelina Estrella Martinez-Lopez, Amberlee Hicks, Nadine M. Chacon, Ashley Gay-Cobb, Alyssa Schami, Selena Zavala-Perez, Blanca I. Restrepo

School of Medicine Publications

Background: With >10 million new tuberculosis (TB) cases/year, a limitation to TB control is the lack of simple and accurate tests for TB diagnosis and drug-susceptibility testing (DST) in endemic regions. We evaluated the accuracy of the first-generation, low-complexity phenotypic TB test (1G test), designed for simultaneous Mtb detection and resistance to isoniazid, rifampicin and moxifloxacin, suitable for resource-limited settings.

Methods: A cross-sectional study was conducted using sputa from 426 possible pulmonary TB subjects from two small Mexican cities bordering Texas. The 1G test was compared against phenotypic TB detection tests in the region [acid fast bacilli smear microscopy and …

Prevalence And Correlates Of Anxiety And Depression Symptoms Among Medical Students: The Role Of Student Debt Burden, Foroozan Afsharchi, Joshua F. Edwards, Kailash S. Ram, Jingru Huang, Valicia Hale, Ismail El Moudden

Department of Family and Community Medicine Faculty Publications

Background

This cross-sectional study examined whether anxiety and depression symptoms decrease as medical students progress through training (suggesting adjustment disorder) or persist (suggesting chronic conditions), while identifying associated risk factors, including student debt burden and treatment effectiveness.

Methods

We surveyed medical students (years 1-4) at VHS-ODU using a sociodemographic questionnaire and validated screening instruments (GAD-7 for anxiety and PHQ-9 for depression) via RedCap from September to November 2024.

Results

Among 126 students, Scores were higher in Years 2-3 than in Years 1 and 4, but differences by year were not significant (GAD-7 p=0.055; PHQ-9 p=0.352). Students with a prior mental-health …

Healthcare Provider Perspectives On A Clinical Decision Tool To Support Individualized Exercise Prescriptions And Discussions For Breast Cancer Survivors, Jinani Jayasekera, Oliver W. A. Wilson, Kaitlyn M. Wojcik, Eleanor M. Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K. Parson, Padma Sheila Rajagopal, Richard L. Street Jr.

Department of Medicine Faculty Publications

Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.

Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged >= 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.

Results: The sample consisted of …

Assessment Of Skin In Patients With Systematic Sclerosis Using High-Frequency Ultrasound And Shear Wave Elastography: A Comparative Study With Histology, Molecular, And Clinical Parameters, Ruhani Desai, Filemon Tan, Minghua Wu, Jeffery L. Browning, Samuel Theodore, Meng Zhang, Brian Skaug, Harshdeep Singh Chawla, Manmohan Singh, Salavat Aglyamov, Kirill V. Larin, Maureen Mayes, Shervin Assassi

Department of Medicine Faculty Publications

Objective: Ultrasound (US) has been proposed as a potential tool for assessing skin fibrosis in systemic sclerosis (SSc). However, a large-scale comparison of US-based assessment with histologic markers of skin fibrosis has not been reported. We evaluated US-based skin assessments for their face validity (differentiation between involved SSc and healthy control [HC] skin), construct validity (comparison to modified Rodnan skin score [mRSS]), and criterion validity (comparison to histologic and gene expression fibrosis markers).

Methods: Twenty HCs and 52 patients with SSc underwent clinical and US assessment followed by a forearm skin biopsy. Predefined areas were assessed on the finger, hand, …