Medicine and Health Sciences Commons^™

Improving Graft-Versus-Host Disease Documentation Through Provider Education On An Epic-Based Gvhd Documentation Flowsheet, Emily Shearon

Doctoral Projects

Graft-versus-host disease (GvHD) is a common and serious complication following allogeneic hematopoietic stem cell transplantation (HSCT). Accurate documentation of GvHD severity and management is essential for clinical decision-making, interdisciplinary communication, and regulatory reporting to organizations such as the Foundation for the Accreditation of Cellular Therapy (FACT) and the Center for International Blood and Marrow Transplant Research (CIBMTR). Despite the availability of structured documentation tools within the electronic health record (EHR), their utilization is often inconsistent. The purpose of this quality improvement project was to evaluate whether a targeted provider-focused intervention could improve completion rates of a standardized GvHD documentation flowsheet …

Evaluating The Effect Of Implicit Bias Training On Healthcare Staff In An Outpatient Mental Health Clinic, Mah Awoh

Walden Dissertations and Doctoral Studies

No abstract provided.

Axitinib-Pembrolizumab And Adverse Event Management In Patients With Advanced Renal Cell Carcinoma, Neil Shah, Yaa Ababio, Anthony Eccleston, Dharanija Rao, Scott Kelly, Jane Chang, Sarah Lucht, Caleb Paydar, Bryce Van Doren, Emily Bland, William John, Sarah Giegerich, Jalyna Laney, Bruce Feinberg, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Understanding approaches to managing treatment-related adverse events (AEs) in immunotherapy and tyrosine kinase inhibitor-based treatments in a clinical setting is critical for reaching optimal patient outcomes.

OBJECTIVE: To investigate the management of AEs in community practices during first-line axitinib plus pembrolizumab therapy for advanced renal cell carcinoma (aRCC).

DESIGN, SETTING, AND PARTICIPANTS: This study comprised a cross-sectional electronic physician survey and a multisite, retrospective cohort study of the medical records of US patients with aRCC who initiated first-line axitinib-pembrolizumab between April 22, 2019, and January 31, 2024. Data were analyzed from September 18 to December 20, 2024.

EXPOSURE: First-line …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

Vol 6. May '26 Cover, Publishing, And Table Of Contents, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Community Engagement To Rebuild Confidence In Public Health, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Bayou Blueprint: Louisiana's Path To Ending Cervical Cancer, Cara Mccarthy

Journal of the Louisiana Public Health Association

No abstract provided.

Identifying Barriers To Pursuing Allied Health Careers- Findings From The Lsuhs Ahead Program, Adrienne Brecheen Davis, Laura E. Gray, Madeline F. Barclay, Hilary K. Bates

Journal of the Louisiana Public Health Association

Background: In Louisiana, underrepresented minorities (URMs) compared to the general population face significant disparities in representation within allied health professions.¹ Although Blacks/African Americans represent 31.4% of the state’s population, they comprise only 1.5% of physical therapists, 4.5% of occupational therapists, 2.7% of physician assistants, and 12.7% of speech-language pathologists. Similarly, while the Latinx population makes up 4.8% of Louisiana’s population, they represent only 0.5% of physical therapists and 2.7% of physician assistants. These persistent disparities point to systemic educational barriers and structural inequities that limit access to health profession programs. This study investigated the perceived barriers underrepresented students face when …

Mapping Youth Sexual And Reproductive Health Services In Orleans Parish, Louisiana: A Field-Tested Survey Methodology, Isabelle Jouve, Ryann Martinek, Zoey Ponder, Isabel Arce, Ryley White

Journal of the Louisiana Public Health Association

Background: Fragmented access to sexual and reproductive health (SRH) services is driving a sexual health crisis among the youth population in Orleans Parish, Louisiana. Rates of sexually transmitted infections, HIV, and teen pregnancy continue to rise while SRH education offerings decline. In response to these outcomes, a Sexual Health, Education, and Rights (SHER) Lab team presents a field-tested survey methodology to characterize the landscape of youth-accessible SRH service providers. Methods: In May 2025, the SHER Lab launched an SRH landscape assessment project to survey youth-serving organizations in Orleans Parish, Louisiana. The project team collected comprehensive feedback from community stakeholders to …

Geauxhealth.Org: A Technological Approach To Community Resources In New Orleans, Madelin Mlynczak

Journal of the Louisiana Public Health Association

Background: Connecting patients to appropriate community resources remains a significant challenge for healthcare providers in New Orleans. Existing resource guides have limitations in clinical workflows, highlighting the need for a tool tailored to healthcare professionals. The primary objective of this study was to evaluate the effectiveness of the GeauxHealth.org website in improving medical residents’ and fellows’ knowledge of community resources and decreasing perceived struggle in referring patients to community resources. Methods: We conducted a pre- and post-intervention survey among residents and fellows at two academic institutions in New Orleans. Participants were introduced to GeauxHealth.org, a locally developed and searchable online …

Vol 6. May '26 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Aubrey K Hubbard, Irenaeus C C Chan, Weiyin Zhou, Yasminka A Jakubek, Giulio Genovese, Wendy S W Wong, Rebecca L Kelly, Corey D Young, Derek W Brown, Wen-Yi Huang, Neal D Freedman, Kristine Jones, Amy Hutchinson, Belynda Hicks, Duc Tran, Donna Arnett, Kathleen C Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Michael H Cho, Pinkal Desai, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Nancy Heard-Costa, Marguerite Ryan Irvin, Andrew D Johnson, Sharon L R Kardia, Charles Kooperberg, Daniel Levy, Joshua P Lewis, Yun Li, Ruth J F Loos, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Kari E North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Albert V Smith, Jennifer A Smith, Adrienne Stilp, Yin Cao, Paul Scheet, Alexander P Reiner, Alexander G Bick, Stephen J Chanock, Paul L Auer, Kelly L Bolton, Mitchell J Machiela

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

Staff Education To Standardize Suicide Risk Assessment Across All Patients, Ebiere Erukanure

Walden Dissertations and Doctoral Studies

No abstract provided.

Standardized Pediatric Obesity Screening Guideline For Children Ages 5–17 Years, Jennifer Nacius

Walden Dissertations and Doctoral Studies

No abstract provided.

In-Use Stability And Device Compatibility Define Clinically Actionable Handling Limits For A Gmp-Produced Attenuated Listeria Monocytogenes Vaccine Expressing Gucy2c, Jagmohan Singh, Taranjot Johar, Vannessa Scully, Scott A. Waldman, Babar Bashir, Adam E. Snook

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Background: Live-attenuated Listeria monocytogenes (Lm) vectors are a clinically validated cancer immunotherapy platform, but translation requires reproducible, clinically realistic workflows for dose preparation and infusion. For live bacterial products, in-use stability and device compatibility can drive dose variability through adsorption, settling, and device losses. Methods: We developed and GMP-manufactured an attenuated Lm vaccine expressing human GUCY2C (Lm-GUCY2C) and performed translational characterization, including construct verification and immunogenicity readouts, and defined the administration-focused in-use stability and device compatibility. Post-thaw stability was assessed in primary cryovials and during preparation and delivery from 250 mL saline infusion bags using standard clinical devices (syringes/needles, filter-free …

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

A Soft Diet Attenuates Exercise-Induced Increases In Cortical Bone Density And Formation In Long Bones In Growing Mice, Yasuhiro Shimizu, Fatma Rashed, Huan Cao, Yuki Arai, Takashi Ono, Kazuhiro Aoki

Faculty, Staff and Student Publications

Bone and muscle are closely linked through functional interdependence. Training and regular exercise can improve and maintain optimal bone mass and strength. Here, we investigated the effects of exercise combined with soft versus hard diet (pellet) on long bones in mice. Four groups of male C57BL/6J mice (n = 5 per group) were studied: hard diet (pellet) with exercise, soft diet (powdered) with exercise, hard diet (pellet) without exercise, and soft diet (powdered) without exercise. Femur and tibia were analyzed using radiographic, micro-CT, and histomorphometric techniques. Exercise combined with a hard diet significantly increased cortical bone density, mineral apposition rate, …

In Silico Molecular Docking Study Of Antidiabetic Bioactive Compounds From Brotowali (Tinospora Cordifolia) Targeting Glut4 In Type Ii Diabetes Mellitus, Gita Euaggelion Tarigan, Surya Dwira

Indonesian Journal of Medical Chemistry and Bioinformatics

Type 2 diabetes mellitus (T2DM) is a global metabolic disorder characterized by insulin resistance and impaired glucose uptake. Despite the availability of pharmacological therapies, limitations such as adverse effects and high costs highlight the need for alternative therapeutic candidates. Tinospora cordifolia has been widely reported to contain bioactive compounds with antidiabetic potential; however, comparative evaluation of their interaction with glucose transporter type 4 (GLUT4) remains limited.

This study aimed to identify the most promising bioactive compounds from Tinospora cordifolia targeting GLUT4 using an in silico molecular docking approach, followed by pharmacokinetic and toxicity (ADMET) prediction. Molecular docking was performed using …

Hiv/Aids-Related Awareness And Misconceptions Among Grade 10 Students In Muttrah Wilayat, Muscat, Oman: A Descriptive, Cross-Sectional Study, Rahma Abdullah Al Riyami, Balqees Ahmed Al -Maawali, Nabila Hamood Al Wahaibi, Mariam Rashid Al Rashdi, Fatma Ahmed Al Hinai

Sultan Qaboos University Medical Journal

Objectives: Despite Oman having a low HIV prevalence, stigma and lack of knowledge among young people may hinder prevention efforts. This study aimed to assess HIV/AIDS-related knowledge and misconceptions among Grade 10 students in Muttrah wilayat in Oman. Methods: This cross-sectional study was conducted in February 2025 and included Grade 10 students from 4 governmental schools in Muttrah selected via proportional stratified sampling. The sample size was calculated depending on the number of students in Grade 10. Data collection was performed during face-to-face interviews using a validated Arabic-language questionnaire. Results: A total of 271 Grade 10 students were included in …

The Perijunctional Zone Is A Molecularly Distinct Muscle Subdomain Altered In Duchenne Muscular Dystrophy, Seth G Haddix, Chuansheng Zhang, Yanhong Liu, Juan Oses-Prieto, Alma L Burlingame, Matthew N Rasband

Faculty, Staff and Students Publications

The neuromuscular junction (NMJ) is a well-established model for synapse development, structure, and function. Surrounding the NMJ is a narrow perijunctional zone (PJZ), enriched in muscle-specific voltage-gated sodium channels that prevent synaptic fatigue. Despite this role, the PJZ remains poorly characterized. To determine its molecular composition, we engineered mice to express the biotin ligase TurboID fused to the cell adhesion molecule neurofascin (Nfasc), and that localizes to the PJZ through ankyrin scaffolding proteins. Using proximity proteomics, we identify numerous PJZ-associated proteins, including Perilipin 4 (Plin4), that are highly enriched and clustered at the PJZ. We also perform proximity proteomics on …

Circulating Metabolites Associated With Protection Against Mycobacterium Tuberculosis Infection And Inhibition Of Mycobacterial Growth, Todia P Setiabudiawan, Lika Apriani, Julian Avila-Pacheco, Edwin Ardiansyah, Vinod Kumar, Bachti Alisjahbana, Ayesha J Verrall, Andrew R Dinardo, Agnes R Indrati, Vera P Mourits, L Charlotte J De Bree, Simone J C F M Moorlag, Clary B Clish, Leo A B Joosten, Arjan Van Laarhoven, Krista E Van Meijgaarden, Mihai G Netea, Simone A Joosten, Valerie A C M Koeken, Philip C Hill, Reinout Van Crevel

Faculty, Staff and Students Publications

A significant proportion of individuals who are heavily exposed to infectious tuberculosis patients do not acquire Mycobacterium tuberculosis (Mtb) infection, as detected by an interferon gamma release assay (IGRA). We examined circulating metabolite profiles and metabolic genotypes in 199 heavily exposed IGRA-negative tuberculosis household contacts in Indonesia. Based on differentially abundant metabolites, activity of several pathways including arachidonic acid, arginine and proline, glutathione, and tryptophan metabolism, correlated with a negative IGRA at three months. SNPs near PRODH (involved in arginine and proline metabolism) were associated with circulating proline concentrations and persistently negative IGRA results, while SNPstudys near AFMID (involved in …

Childcare Challenges Among Surgical Trainees And Faculty: A Single-Institution Study, Emma G Burke, Sarah Peiffer, Melissa Koci, Lindsay Dean, Kristy L Rialon, Michele Loor, Alice King

Faculty, Staff and Students Publications

Background: Previous studies have demonstrated the challenges of parenthood in surgical training and careers. However, certain aspects of childrearing for surgeons remain understudied. We aim to leftacterize the complexity and costs of childcare amongst surgical trainees and faculty.

Methods: An anonymous, self-administered survey was conducted within the Department of Surgery at a large academic medical center. Both male and female trainees and faculty were included in the analysis. Chi-square or Fisher's Exact test was performed.

Results: Forty-six respondents provided information about childcare costs, with 37% of respondents being residents or fellows. Trainees worked longer workhours (p = 0.003) than their …

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Irenaeus C C Chan, Duc Tran, Yin Cao, Kelly L Bolton, Et Al.

2020-Current year OA Pubs

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

Clinical Practice Guideline Emergency Department Discharge Acuity Scale To Improve Care Transitions, Charlisa Hedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education On Nonpharmacological Sleep Hygiene Strategies, Miranda Akateh Morfaw

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Staff Competence In Phq-9 Administration, Obinna C. Okonkwo

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Early Identification And Management Of Clinical Deterioration In Pediatric Patients Using A Standardized Assessment Protocol, Sarabjit Chahal

Walden Dissertations and Doctoral Studies

No abstract provided.

An Evidence-Based Practice Trauma-Informed Care And Pediatric Crisis Management Training Initiative, Annette Renea Porter

Walden Dissertations and Doctoral Studies

No abstract provided.

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

Improving A1c Levels Through An Individualized Diabetes Education Among Patients Living With Type 2 Diabetes, David W. Cardona Jr.

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) represents an increasing global health, social, and financial burdens. Nutrition, among other diabetes self-management topics, is a foundational aspect in managing T2DM. Significant knowledge gaps persist among patients regarding the impact of mindful eating habits in relation to euglycemia. Individualized diabetes education focused on healthy eating habits offers a promising strategy to address this gap. The quality improvement (QI) project aimed to evaluate the impact of diabetes education, focused on nutritional awareness, and mindful eating habits on hemoglobin (A1c) levels, weight, and diabetes self-management questionnaire scores (DSMQ-R) were assessed among adults living with T2DM. The …