Medicine and Health Sciences Commons^™

Perioperative Pressure Injury Prevention Education Program, Stephanie M. Reed

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) are localized injury to the skin and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure including pressure associated from shear. Surgical patients are estimated to represent 42% of hospital acquired PIs. PIs result in poor patient outcomes, increase length of stay, add billions to heath care costs are no longer reimbursed by Centers for Medicare/Medicaid Services. Prevention of PI is different in the perioperative setting due to the complexities of surgery. This project focused on developing, delivering, and evaluating a robust education program for perioperative staff on PI prevention in the perioperative setting. The …

Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have been associated with adverse health outcomes in adulthood; however, less is known about their relationship with preventive health behaviors such as cervical cancer screening. The purpose of this quantitative, correlational study was to examine associations between selected ACEs and cervical cancer screening among women aged 18–65 in South Carolina. Data were drawn from the 2020 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and included 1,323 women. Binary logistic regression analyses were used to examine unadjusted and adjusted associations between ACE exposures and being up to date with Pap testing, controlling for age, race/ethnicity, income, …

Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher

Walden Dissertations and Doctoral Studies

Adolescent dating violence (ADV) is a significant public health issue that disproportionately affects youths in southern rural communities, yet these populations remain underrepresented in research. The purpose of this quantitative cross-sectional study was to examine the association between ADV and sociodemographic factors (gender, race, age, and education level), alcohol consumption, and bullying among adolescents in Alabama, Arkansas, and Mississippi using data from the 2021 Youth Risk Behavior Surveillance System. Guided by the social-ecological model, binary logistic regression analyses were conducted to assess relationships between ADV victimization and the selected predictors. Results indicated that females had significantly higher odds of reporting …

Diabetes Mellitus And Its Association With Tuberculosis Clinical Presentation And Treatment Outcomes: Results From A Prospective Cohort Study In Ghana, Monica Baaba Jones, Kwadwo Ansah Koram, Francis Anto, Michael Lauzardo, Blanca I. Restrepo, Margaret Lartey, Hafisatu Gbadamosi, Awewura Kwara

School of Medicine Publications

Background: Tuberculosis (TB)-diabetes is a growing public health threat in TB-endemic settings. We aimed to determine diabetes prevalence among TB patients in Greater Accra and its association with TB clinical presentation and treatment outcomes.

Methods: We enrolled 204 adults (≥20 years) with bacteriologically confirmed pulmonary TB across 14 health facilities. At treatment initiation, participants were screened for diabetes using self-report, fasting plasma glucose, and glycated hemoglobin, following standard diagnostic criteria. Baseline characteristics were recorded, and participants were followed to determine TB treatment outcomes. Associations between diabetes, baseline characteristics and treatment outcomes were assessed using bivariate and multivariate analysis in STATA. …

From Competition To Complementarity: Narrative Review Of Laser Interstitial Thermal Therapy, Focused Ultrasound, And Radiofrequency Ablation In Minimally Invasive Neurosurgery, Tirath Patel, Hamza Yousuf Ibrahim, Tanzeela Khan, Tehreem Tabrez, Sara Hussain, Alishba Fatima, Aaliya Junaid Siddiqui, Nikhilesh Anand

School of Medicine Publications

Minimally invasive neurosurgical techniques have emerged as a transformative paradigm, offering alternatives to conventional open approaches. The demand for safer, less invasive procedures accelerated the development of laser interstitial thermal therapy (LITT), focused ultrasound (FUS), and radiofrequency ablation (RFA), each employing a distinct mechanism with unique clinical implications. The objective was to critically evaluate and contextualize LITT, FUS, and RFA with emphasis on their comparative efficacy, safety, and roles as competing or complementary technologies in minimally invasive neurosurgery. Literature published between 2005 and 2025 was identified through PubMed, Scopus, and Web of Science, using keywords “LITT,” “FUS,” “RFA,” “minimally invasive …

Multi-Trait Polygenic Scores For Copd And Copd Exacerbations Implicate Druggable Proteins, Chengyue Zhang, Iain R Konigsberg, Yixuan He, Jingzhou Zhang, Tinashe Chikowore, William B Feldman, Xiaowei Hu, Yi Ding, Bogdan Pasaniuc, Diana Chang, Qingwen Chen, Jessica A Lasky-Su, Julian Hecker, Martin D Tobin, Jing Chen, Sean Kalra, Katherine A Pratte, Hae Kyung Im, Emily S Wan, Ani Manichaikul, Edwin K Silverman, Russell P Bowler, Leslie A Lange, Victor E Ortega, Alicia R Martin, Michael H Cho, Matthew R Moll

Faculty, Staff and Student Publications

BACKGROUND

We constructed multi-trait polygenic risk scores (PRSs) predicting chronic obstructive pulmonary disease (COPD) and exacerbations, validated their performance in diverse cohorts, and identified PRS-related proteins for potential therapeutic targeting.

METHODS

PRSmix+, a multi-trait PRS framework, is used to train a composite PRS (PRSmulti) in COPDGene non-Hispanic White participants (n = 6,647). Associations of PRSmulti with COPD status (GOLD 2–4 vs. GOLD 0 or ICD) and exacerbation frequency were tested in COPDGene African American (n = 2,466), ECLIPSE (n = 1,858), Mass General Brigham Biobank (n = 15,152), and All of Us (n = 118,566). …

Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray

Walden Dissertations and Doctoral Studies

Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological …

The Association Between Advanced Technology Use And Quality Of Life Among Those With A Disability, Sarah Antus

Walden Dissertations and Doctoral Studies

Advanced medical technology use among individuals with physical disabilities remains understudied, creating a significant gap in understanding its impact on quality-of-life (QoL) outcomes across demographic and age groups. Guided by the social ecological model, the purpose of this quantitative study was to examine associations between advanced medical technology use, disability status, demographic factors (age, gender, and race/ethnicity), and QoL outcomes using 2017–2018 National Health and Nutrition Examination Survey data. The sample included 9,254 individuals age 6 years and older with physical functional limitations and complete technology-use and QoL data. Advanced medical technology use was significantly associated with improved QoL (p < .001). Disability status demonstrated a statistically significant but modest association with technology use, OR = 0.84, 95% CI [0.83, 0.85], p < .001. Age-stratified analyses indicated that advanced technology use significantly predicted improved QoL among adults aged 20 years and older, OR = 6.90, 95% CI [6.89, 6.91], p < .001, but not among youths aged 6–19 years (p = .929). Gender was a significant predictor of technology use, with females having higher odds than males, OR = 1.07, 95% CI [1.06, 1.08], p < .001. Race/ethnicity was also significantly associated with technology use; compared with non-Hispanic White adults, Mexican American (OR = 0.43, 95% CI [0.42, 0.44], p < .001), other Hispanic (OR = 0.58, 95% CI [0.57, 0.59], p < .001), and non-Hispanic Black adults (OR = 0.79, 95% CI [0.78, 0.80], p < .001) had lower odds of advanced medical technology use. The study may inform health care stakeholders about strategies to promote equitable access to advanced medical assistive technologies for social change

Synthesis And Evaluation Of Novel Mt5-Mmp Inhibitors For Treatment Of Alzheimer’S Disease, Nicholas Borges

Electronic Theses and Dissertations 2020 - Present

Alzheimer’s Disease (AD) is a common neurodegenerative disease that is characterized by the accumulation of amyloid beta (Aβ) plaques and presence of neurofibrillary tangles (NFT) in the brain. Aβ oligomers are directly toxic to CNS synapses and can induce tau protein hyperphosphorylation, that causes NFT buildup. For these reasons, Aβ has been investigated as a therapeutic target, yet very few clinical trials have yielded effective drugs for AD treatment until now. Recently, the MT5-MMPmediated η-secretase pathway, which generates synaptotoxic Aη from amyloid precursor protein, has been reported (Wang et al 2024, Wilem et al 2015). Thus, pharmacologic inhibition of MT5-MMP …

Correction: Exploiting Prmt5 As A Target For Combination Therapy In Mantle Cell Lymphoma Characterized By Frequent Atm And Tp53 Mutations, Yuxuan Che, Yang Liu, Yixin Yao, Holly A Hill, Yijing Li, Qingsong Cai, Fangfang Yan, Preetesh Jain, Wei Wang, Lixin Rui, Michael Wang

Faculty, Staff and Student Publications

No abstract provided.

An Artificial Intelligence Optimized Hepatic Differentiation Unveils Nr5a2 And Ap-1 Transcriptional Regulation In Hepatic Maturation, Zijun Huo, Jian Tu, Wei-Lei Yang, Mo-Fan Huang, Ruoyu Wang, Chih-Wei Chu, An Xu, Yao Yu, Tara N Tavakol, Mikal Kizilbash, Megan E Fisher, Yu-Wen Huang, Dandan Zhu, Trinh T T Phan, Rachel Shoemaker, Ya-Wen Chen, Yang Zhang, Chad D Huff, Shih-Yu Chen, Tien-Jen Liu, Haipeng Xiao, Dung-Fang Lee, Ruiying Zhao

Faculty, Staff and Student Publications

The generation of hepatocyte-like cells (HLCs) from human pluripotent stem cells (hPSCs) holds great promise for drug discovery and cell-based therapy for liver disease. However, current differentiation protocols are complicated and unstable, and the underlying gene regulatory mechanisms of hepatic differentiation remain incompletely defined. Here, we developed a machine learning-based artificial intelligence (AI) tool using phase-contrast images of hepatic progenitor cells (HPCs), which are essential for generating HLCs. The AI tool significantly improves the success rate of hepatic differentiation without the need for immunostaining or lineage tracing. By optimizing the methodology, we achieved an impressive purity of 90-95% for HLCs …

The Effects Of Orexin Receptor Antagonism During Early Withdrawal In Stimulant Use Disorder: Protocol For A Proof-Of-Concept Study, Heather Webber, Nikky Tran, Rita Blake, Sarah Goldman, Trevor George, Bill Bailey, Robert Suchting, Jin Yoon, Jessica Vincent, Michael Weaver, Joy Schmitz, Scott Lane

Faculty, Staff and Student Publications

Background: Stimulant use disorders (StimUDs), including cocaine and methamphetamine use disorders, remain a major public health concern in the United States with no US Food and Drug Administration (FDA)-approved pharmacological treatments. The early recovery period following stimulant use is marked by sleep disturbances, heightened stress reactivity, and dysregulated reward processing, contributing to high rates of resumption of use. Evidence from animal and human studies supports the orexin neuropeptide system as a promising therapeutic target for minimizing these disruptive mechanisms. Suvorexant, an FDA-approved dual orexin receptor antagonist for insomnia, has previously been shown to improve sleep, reduce stress, and attenuate craving …

Analysis Of The Effects Of Magnetic Field, Heat Transfer, And Thermal Radiation On Blood Flow Through Bifurcated Artery To Enhance Tumor Treatments, Abdullahi Isah, Dauda Gulibur Yakubu, Ali Musa

Tanzania Journal of Science

The work presents the effects of some pertinent parameters on blood flow through bifurcated artery to enhance tumor treatments. Combining appropriately the basic equations, together with the fractionalized Maxwell fluid model allow us to determine the velocity, temperature and concentration of blood flow through bifurcated artery. The study adopted the Atangana-Baleanu fractional time derivative on fluid model to describe the non-Newtonian behavior of blood flow. The numerical simulations were performed using the combined Laplace transform and the method of undetermined coefficients and the results obtained with the aid of Mathcad software were simulated and presented graphically. From the graphical results, …

Overlapping Mhc Class I/Ii Epitopes Program Cdc1-Like Differentiation Of Monocyte-Derived Dendritic Cells Via Mtorc1 Signaling Inhibition, S B Amanya, A Murthy, N Bisht, Z N Bullock, K J Ernste, J Vasquez-Perez, W Liu, A Trivedi, D Oyewole-Said, A Paul, L Umokoro, V Akhanov, M Samuel, Z Shi, M H Nguyen, S Huang, M Jeong, P Iakova, K A Jain, K Pham, D C Kraushaar, V Konduri, W K Decker

Faculty, Staff and Students Publications

Viral infection polarizes monocyte-derived dendritic cells (moDC) to initiate type 1 immunity. The availability of overlapping (homologous) MHC class I and II epitopes, an occurrence frequently and primarily associated with intracellular infection, significantly enhances this process; however, the underlying mechanism(s) are unclear. We demonstrate that moDC loaded with homologous MHC epitopes acquire a cDC1-like phenotype in a process governed by mTORC1. mTORC1 pathway inhibition leads to NF-κB-mediated expression of IL-12 and other type I immune polarizing genes. The observed cDC1-like gene signature was also significantly enhanced in clinical moDC vaccine products made through methodologies that enforced class I and II …

What Are The Top 10 Global Research Priorities For Perianal Crohn's Disease? The Global Perianal Crohn's Disease Priority Setting Partnership, Theo Pelly, Parakkal Deepak, Et Al.

2020-Current year OA Pubs

BACKGROUND AND AIMS: Perianal Crohn's disease (pCD) is a debilitating condition with a prevalence of approximately 20% in patients within 10 years of diagnosis of CD. The condition significantly impacts patient quality of life, and there remain a number of unmet needs relating to its optimal management. A global Priority Setting Partnership (PSP) was established to identify the top 10 research priorities for pCD.

METHODS: The PSP followed standard James Lind Alliance (JLA) methodology. An initial survey was circulated to gather unanswered research questions from key stakeholders. From these responses, a longlist of summary questions was formed. These questions were …

Clingen Api Platform For Classification Of Human Genetic Variants, Neethu Shah, Tierra Farris, Arturo Alejandro Zuniga, Andrew R Jackson, Jessie Arce, Kevin Riehle, Christine G Preston, Mark E Mandell, Bryan Wulf, Gloria Cheung, Keyang Yu, Deborah I Ritter, Dubravka Jevtic, Miroslav Milinkov, Novak Martinovic, Nevena Vucinic, Aleksandar Mihajlovic, Alan F Rubin, Melissa S Cline, Marina Distefano, Malachi Griffith, Obi L Griffith, Matt W Wright, Teri E Klein, Sharon E Plon, Aleksandar Milosavljevic

Faculty, Staff and Students Publications

In this commentary, we describe how the Clinical Genome Resource's (ClinGen's) application programming interface-based microservices accelerate growth and dissemination of knowledge about human genetic variation. By exposing findable, accessible, interoperable, reusable, and AI-ready variant data, ClinGen lays a foundation for next-generation software applications, AI systems, and variant classification workflows.

Bridging The Gap: At For Those With Physical Or Intellectual Disability, Rebekah Nesbitt

The 2026 Assistive Technology for Persons with Intellectual and Physical Disabilities Conference

No abstract provided.

Challenges And Opportunities To Access Assistive Technology In The Americas Region, Yasmin Garcia Mendez

The 2026 Assistive Technology for Persons with Intellectual and Physical Disabilities Conference

No abstract provided.

2026 Abstract Book (Pdf), School Of Public Health

School of Public Health Delta Omega Honors Day Poster Sessions

The collection of abstracts for the 2026 Delta Omega Honors Day Poster Session.

Protocol For Inducing Focal Striatal Stroke In Mice Using Photothrombosis, Bridget R. Boyle, Eileen Collyer, Andrea P. Berghella, Elena Blanco-Suarez

Department of Neuroscience Faculty Papers

Here, we present a protocol for inducing focal striatal stroke in mice using photothrombosis. We describe steps for photothrombotic striatal surgery, magnetic resonance imaging, open field behavioral assessment of stroke-induced motor deficits, and post-stroke monitoring. We then detail procedures for tissue collection and immunofluorescence. This protocol provides a standardized approach for consistently modeling striatal stroke in mice, enabling mechanistic studies and preclinical therapeutic testing.

Noise-Induced Gains: Are You Damaging Your Hearing While You Train?, Taylor Hitschmann, Lillian Beauvais, Blake Roth, Andrew Gannon

SACAD: Scholarly Activities

This study investigated the potential risk of noise-induced hearing loss (NIHL) among individuals who listen to music during exercise. Survey data were collected alongside sound intensity measurements to better understand listening behaviors in fitness settings. Results indicated that although most participants reported listening at recommended safe levels, a notable proportion exceeded these thresholds, potentially increasing their risk of NIHL. These findings highlight the importance of monitoring listening habits during workouts. Hearing health professionals are encouraged to enhance public awareness and promote safe listening practices to help reduce the likelihood of long-term auditory damage.

Developing A Community Partnership Toolkit To Expand Vocational Opportunitiesfor Adults With Disabilities In A Day Program Setting, Bonnie Chapman

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

This capstone project aimed to address the gap in community-based vocational opportunities for adults with disabilities within a day program setting. It was identified that participants lacked consistent opportunities to engage in real-world work experiences, which limited their ability to develop vocational skills and explore meaningful roles within the community. This gap was further compounded by a limited number of local businesses willing or prepared to establish partnerships with the program. Additionally, staff reported having insufficient resources and tools to effectively develop and sustain these partnerships, creating a significant barrier to expanding vocational opportunities.

The purpose of this project was …

Examining Moderators In The Relationship Between Injury/Injury Anxiety And Eating Disturbances In College Women Athletes, Lydia M. Reichley

Undergraduate Theses

Introduction: Injury and injury-related anxiety are common in collegiate athletes and may contribute to maladaptive psychological and behavioral outcomes, including eating disturbances. This study examined the relationship between injury/injury anxiety and eating disturbances, and whether athletic identity, injury self-efficacy, and body shame moderated this relationship. Methods: A cross-sectional design was used with 57 female collegiate and club athletes from Bellarmine University (M age = 19.98 + 1.37). Participants completed an online survey including the Sport Injury Anxiety Scale (SIAS), Athletic Identity Measurement Scale (AIMS), Athletic Injury Self-Efficacy Questionnaire (AISEQ), Eating Attitudes Test (EAT-26), and the Objectified Body Consciousness Scale (OBC; …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Is Home Birth A Choice? Racial And Geographic Differences In Unintended Home Births In The U.S., Anna De La Paz

Population Health Research Brief Series

Home births that happen without planning or medical support (i.e., unintended home births) carry a higher likelihood of adverse outcomes, such as low birth weight, preterm birth, and hypothermia. This data slice summarizes findings using data from CDC WONDER (2017–2023) on racial, regional, and metropolitan status differences in home births among women ages 15–44 in the U.S. Findings show that unintended home births are disproportionately concentrated among non-Hispanic Black women, with rates varying substantially by region and metropolitan status.

Progesterone Receptors Drive Advanced Breast Cancer Phenotypes Including Circulating Tumor- And Stem-Like Cell Expansion In The Context Of Esr1 Mutation, Thu H. Truong, Noelle E. Gillis, Amy R. Dwyer, Rosemary J. Huggins, Kyla M. Hagen, Sai Harshita Posani, Nuri A. Temiz, Carlos Perez Kerkvliet, Ellie M. Piepgras, Julie H. Ostrander, Geoffrey L. Greene, Carol A. Lange

Department of Urology Faculty Papers

Endocrine therapy resistance remains a major challenge in the treatment of advanced estrogen receptor positive (ER+) breast cancer. This can be driven by acquired mutations in the estrogen receptor gene (ESR1), such as Y537S or D538G, that results in constitutive estrogen-independent ER activity. Progesterone receptors (PR) are important modifiers of ER activity, in part via direct binding. We previously showed that PR mediates expansion of cancer stem-like cell (CSC) populations. In this study, we sought to define whether PR function changes in the context of ESR1 mutations. PR readily interacted with wild type (WT), but not Y537S or D538G ERs. …

The Mommy Wine Culture: A Scoping Review Using The Person-Environment-Occupational Model., Sabina Khan

Student Dissertations

Maternal alcohol use as a coping response to parenting-related stress has received growing attention in public health and psychology but remains underexplored within occupational therapy. This gap limits understanding of how daily role demands, environmental pressures, and individual vulnerabilities combine to shape drinking as a functional coping behavior. This dissertation aimed to identify and synthesize factors associated with maternal alcohol use in the context of parenting stress and interpret these determinants using the person–environment–occupation model. A scoping review was conducted following the Arksey and O’Malley framework and reported according to PRISMA-ScR guidelines. Five databases were systematically searched without date or …

Mastering The Ppco Framework: A Guide For Evidence-Based Nursing, Mayra Garcia

PPCO Resources & Education

No abstract provided.

Staff Education To Improve Nursing Knowledge Of Follow-Up Adherence Support Strategies In A Large Outpatient Urology Clinic, Ivette Dieguez

Walden Dissertations and Doctoral Studies

Site monitoring identified inconsistent adherence to scheduled follow-up care as an operational concern, underscoring the need for standardized nursing strategies to enhance follow-up communication. This staff education project aimed to determine whether a focused educational intervention could improve nursing knowledge of adherence support strategies, with confidence measured as a secondary outcome. Guided by the ADDIE instructional design model and the Johns Hopkins evidence-based practice model, the project was implemented in a large outpatient urology clinic with 18 participating registered nurses. Participants completed anonymous paper-based pretests and posttests surrounding a single 45-minute, live group education session. Educational content covered common barriers …

Multi-Organ Physiologic Deficits During Exercise Identify Clinical And Molecular Predisposition To Heart Failure With Preserved Ejection Fraction, Isabela Landsteiner, Lindsey K Stolze, Tess E Peterson, Andrew Perry, Phillip Lin, Quanhu Sheng, Shilin Zhao, Kaushik Amancherla, Michael Y Mi, Takenori Ikoma, Laura P Cohen, Ilya Giverts, Joseph Campain, Joao A C Lima, Wendy S Post, Kent D Taylor, Robert Gerszten, Stephen S Rich, Russell Tracy, Peter Durda, Alexis C Wood, Rajeev Malhotra, Jerome I Rotter, Clary Clish, Matthew Nayor, Eric R Gamazon, Ravi V Shah, Gregory D Lewis

Faculty, Staff and Students Publications

Background: Exercise unmasks limitations in multi-organ system reserve capacity characteristic of heart failure with preserved ejection fraction (HFpEF). However, the metabolic and genetic underpinnings of exercise deficits, and their cumulative contribution to HFpEF severity and prognosis, remain incompletely understood.

Methods: We used invasive cardiopulmonary exercise testing (iCPET), metabolite profiling, and genomics to simultaneously characterize seven exercise physiologic deficits in HFpEF patients: reduced exercise stroke volume and heart rate, steep pulmonary capillary wedge pressure/cardiac output (PCWP/CO) slope, elevated pulmonary vascular resistance, pulmonary mechanical limitation to exercise, impaired peripheral oxygen extraction, and obesity-related exaggerated metabolic cost of initiating exercise. We first mapped …