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2026

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Full-Text Articles in Medicine and Health Sciences

Association Between Children’S Secondhand Co-Exposure To Tobacco And Cannabis Smoke And Elevated Urinary Cotinine Levels: A Cross-Sectional Analysis, Bradley N. Collins, Stephen J. Lepore, Vincent Berardi, Renee D. Goodwin, Karen Wilson, Mona Baishya Feb 2026

Association Between Children’S Secondhand Co-Exposure To Tobacco And Cannabis Smoke And Elevated Urinary Cotinine Levels: A Cross-Sectional Analysis, Bradley N. Collins, Stephen J. Lepore, Vincent Berardi, Renee D. Goodwin, Karen Wilson, Mona Baishya

Psychology Faculty Articles and Research

Background Cannabis use is far more common among adults who smoke tobacco than adults who do not, and its use is increasing among people who smoke tobacco with children living in the home. Given the well-established evidence that caregiver smoking is the primary source of children’s secondhand exposures to these products, the increasing trend in caregiver co-use is raising public health concerns about children’s co-exposure. Emerging data indicates that adult co-use is linked to additive health consequences, such as elevated nicotine and other tobacco-related toxicant blood levels, relative to use of only tobacco. It is unknown whether children’s co-exposure leads …


From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe Feb 2026

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …


Improving Stakeholder Communications Practices: A Quantitative Study On The Relational Communication Between Clinical Research Coordinators And Research, Oreofeoluwa F. Adeniji Feb 2026

Improving Stakeholder Communications Practices: A Quantitative Study On The Relational Communication Between Clinical Research Coordinators And Research, Oreofeoluwa F. Adeniji

Harrisburg University Dissertations and Theses

Communication plays an essential part in the responsibilities of the clinical research coordinator’s position. Challenges in communicating with stakeholders during clinical trials can disrupt the study timeline, its outcomes, and the success of the trial. Clinical research coordinators often experience these challenges when interacting with internal stakeholders, such as principal investigators, and external stakeholders, including sponsors. This quantitative correlational study will examine whether clinical research coordinators can utilize project management communication practices to improve their stakeholder interactions. Data from 32 clinical research coordinators will be collected using SurveyMonkey and analyzed. The study results will fill gaps in the literature on …


Perinatal And Maternal Outcomes By Indication For Delivery In The Second Trimester, Kristen A Cagino, Paula L Mcgee, Maged M Costantine, Michael W Varner, Alan T N Tita, Monica Longo, Barbara J Stoll, John M Thorp, Uma M Reddy, William A Grobman, Dwight J Rouse, Hyagriv N Simhan, Jennifer L Bailit, Lorraine Dugoff, George R Saade, Baha M Sibai Feb 2026

Perinatal And Maternal Outcomes By Indication For Delivery In The Second Trimester, Kristen A Cagino, Paula L Mcgee, Maged M Costantine, Michael W Varner, Alan T N Tita, Monica Longo, Barbara J Stoll, John M Thorp, Uma M Reddy, William A Grobman, Dwight J Rouse, Hyagriv N Simhan, Jennifer L Bailit, Lorraine Dugoff, George R Saade, Baha M Sibai

Faculty, Staff and Student Publications

Perinatal and maternal morbidity in the setting of preterm birth may differ by delivery indication. We compared perinatal and maternal outcomes of second-trimester (240/7-276/7 weeks of gestation) deliveries indicated for preeclampsia with severe features (PE-SF), with those following preterm premature rupture of membranes (PPROM).Secondary analysis of an observational cohort study of singleton and twin preterm deliveries before 35 weeks' gestation at 33 hospitals across the United States. Singletons without congenital anomalies who were delivered due to PE-SF or PPROM from 240/7 to 276/7 weeks of gestation were included. The primary outcome was a composite of perinatal morbidity or death, defined …


Dasatinib Resensitizes Braf/Mek Inhibitor Efficacy In Patient-Derived Xenografts From Patients With Progression On Braf/Mek Inhibitor Treatment, Vito W Rebecca, Min Xiao, Andrew Kossenkov, Tetiana Godok, Gregory Schuyler Brown, Dylan Fingerman, Gretchen M Alicea, Meihan Wei, Hongkai Ji, Marie Portuallo, Jeremy Bravo, Vissy Elad, Yeqing Chen, Eneda Toska, Mitchell E Fane, Kasey L Couts, Jessie Villanueva, Katherine Nathanson, Keerthana M Arun, Govind Warrier, Xiangfan Yin, Jianyi Ding, Qin Liu, Yogesh Goyal, Y N Vashisht Gopal, Michael A Davies, Meenhard Herlyn Feb 2026

Dasatinib Resensitizes Braf/Mek Inhibitor Efficacy In Patient-Derived Xenografts From Patients With Progression On Braf/Mek Inhibitor Treatment, Vito W Rebecca, Min Xiao, Andrew Kossenkov, Tetiana Godok, Gregory Schuyler Brown, Dylan Fingerman, Gretchen M Alicea, Meihan Wei, Hongkai Ji, Marie Portuallo, Jeremy Bravo, Vissy Elad, Yeqing Chen, Eneda Toska, Mitchell E Fane, Kasey L Couts, Jessie Villanueva, Katherine Nathanson, Keerthana M Arun, Govind Warrier, Xiangfan Yin, Jianyi Ding, Qin Liu, Yogesh Goyal, Y N Vashisht Gopal, Michael A Davies, Meenhard Herlyn

Faculty, Staff and Student Publications

Although BRAF/MEK inhibitor (BRAFi/MEKi) therapy initially shows high efficacy in patients with BRAFV600 E/K cutaneous melanoma, resistance develops in over 75% of cases. We tested robustness of the umbrella trial strategy in this population by analyzing relationships between genomic status of a gene and associated downstream consequences at the protein level. The results revealed weak relationships among mutations, copy-number amplification, and protein expression and activation. An in vivo compound repurposing screen using 11 clinically relevant agents from an NCI-portfolio with pan-RTK, non-RTK, and/or PI3K-mTOR specificity identified dasatinib as most capable of restoring sensitivity to BRAFi/MEKi in patient-derived xenograft (PDX) …


External Validation Of The Proliferation Saturation Index Model In Predicting Tumour Volume Regression In Patients With Non-Small Cell Lung Cancer Undergoing Radiation Therapy, Sarah Barrett, Mohammad Zahid, Conor K Mcgarry, Heiko Enderling, Gerard M Walls, Laure Marignol Feb 2026

External Validation Of The Proliferation Saturation Index Model In Predicting Tumour Volume Regression In Patients With Non-Small Cell Lung Cancer Undergoing Radiation Therapy, Sarah Barrett, Mohammad Zahid, Conor K Mcgarry, Heiko Enderling, Gerard M Walls, Laure Marignol

Faculty, Staff and Student Publications

Background: The Proliferation Saturation Index (PSI) model is a patient-specific mathematical model designed to simulate and predict tumour volume regression (TVR) during radiation therapy (RT) using early treatment response dynamics. This study validates the PSI model in an independent external cohort of patients with non-small cell lung cancer (NSCLC) using previously derived model parameters.

Methods: In a cohort of 71 patients, treated with definitive RT alone (55Gy/20#) tumour volume measurements extracted from 6 Cone Beam CT (CBCT) scans acquired on days 1, 2 and 3 and weekly thereafter. Model predictions of TVR at final CBCT (CBCT6) were made using tumour …


Hp1Β Recruits Ring1a To Ubiquitinate Histone H2a For Brca1-Mediated Resection Of Double-Stand Breaks, Vijaya Charaka, Raj K Pandita, Chi-Lin Tsai, Xiaoyan Wang, Sharmista Chakraborty, Kenneth S Ramos, Sandhik Nandi, Fransisca Leonard, Vipin Singh, Partha S Sarkar, Clayton R Hunt, John A Tainer, Chandrima Das, Tej K Pandita Feb 2026

Hp1Β Recruits Ring1a To Ubiquitinate Histone H2a For Brca1-Mediated Resection Of Double-Stand Breaks, Vijaya Charaka, Raj K Pandita, Chi-Lin Tsai, Xiaoyan Wang, Sharmista Chakraborty, Kenneth S Ramos, Sandhik Nandi, Fransisca Leonard, Vipin Singh, Partha S Sarkar, Clayton R Hunt, John A Tainer, Chandrima Das, Tej K Pandita

Faculty, Staff and Student Publications

Efficient DNA double-strand break (DSB) repair by homologous recombination (HR), as initiated by BRCA1 recruitment orchestrated by histone and non-histone proteins, is critical to genome stability, replication, transcription, and cancer avoidance. Here we reveal Heterochromatin Protein1 beta (HP1β) promotes BRCA1 enrichment at DNA DSB sites in gene-rich regions, and this is impaired by HP1β depletion. We find that HP1β is specifically enriched at DSBs within gene-rich regions via its Chromo Shadow Domain (CSD) that interacts with both Chromatin Assembly Factor 1 and the RING1A ubiquitinase component of Polycomb Repressor Complex 1. The resulting protein complex facilitates BRCA1 recruitment by promoting …


Nci9673 (Part B): Etctn Randomized Phase Ii Study Of Nivolumab With Or Without Ipilimumab In Refractory, Metastatic Squamous Cell Carcinoma Of The Anal Canal, Van K Morris, Kristen K Ciombor, Lianchun Xiao, Joshua K Ochieng, Enrica Marmonti, Blase Polite, Benjamin A Weinberg, John C Krauss, John Hays, Sarbajit Mukherjee, Olivia Aranha, Syma Iqbal, Tony Shields, Al B Benson, Syed Kazmi, Christopher Lieu, Howard Hochster, Jennifer Whisenant, Cara Haymaker, Cathy Eng Feb 2026

Nci9673 (Part B): Etctn Randomized Phase Ii Study Of Nivolumab With Or Without Ipilimumab In Refractory, Metastatic Squamous Cell Carcinoma Of The Anal Canal, Van K Morris, Kristen K Ciombor, Lianchun Xiao, Joshua K Ochieng, Enrica Marmonti, Blase Polite, Benjamin A Weinberg, John C Krauss, John Hays, Sarbajit Mukherjee, Olivia Aranha, Syma Iqbal, Tony Shields, Al B Benson, Syed Kazmi, Christopher Lieu, Howard Hochster, Jennifer Whisenant, Cara Haymaker, Cathy Eng

Faculty, Staff and Student Publications

Purpose: In the previously completed NCI9673 (part A) single-arm study, the antiprogrammed death (PD)-ligand-1 antibody nivolumab demonstrated efficacy for patients with metastatic anal cancer. In NCI9673 (Part B), we evaluated the anticytotoxic T-cell lymphocyte antigen-4 (CTLA-4) antibody ipilimumab in combination with nivolumab for patients with incurable anal cancer.

Methods: In this phase II NCI ETCTN trial, 100 patients with refractory, incurable anal cancer were randomly assigned to receive nivolumab (480 mg IV once every 4 weeks) alone or with ipilimumab (1 mg/kg IV once every 8 weeks). The primary end point was progression-free survival (PFS). Secondary endpoints included radiographic response, …


Improving Structured Handoff Documentation In A Pediatric Emergency Department, Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson Feb 2026

Improving Structured Handoff Documentation In A Pediatric Emergency Department, Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson

Department of Pediatrics Faculty Papers

INTRODUCTION: The I-PASS handoff tool guides provider handoffs and reduces adverse events in the inpatient setting. Transitions of care occur frequently in the emergency department (ED), and the unpredictable environment can lead to less structured handoffs. Our goal was to increase the percentage of handoff notes that include all 4 I-PASS components by 20% within 6 months.

METHODS: We developed a handoff note template for the pediatric ED that included 4 key I-PASS elements: illness severity, patient care summary, action list, and situational awareness/contingency planning. Our primary outcome measure was the percentage of handoff notes that contained all 4 I-PASS …


Steroid Receptor Coactivators - From Basic Research To Translational Opportunities, Yosef Gilad, Sang Jun Han, David M Lonard Feb 2026

Steroid Receptor Coactivators - From Basic Research To Translational Opportunities, Yosef Gilad, Sang Jun Han, David M Lonard

Faculty, Staff and Students Publications

The concept of nuclear receptor (NR) coregulation was proposed nearly two decades before it was experimentally validated. According to this model, NRs - executors of a vast array of transcriptional programs - do not act independently but are governed by a network of regulatory proteins that either activate or repress their biological function. NRs identify the genes to be regulated. However, coregulators ultimately serve as the true controllers of transcriptional outcomes. They recruit cofactors and coordinate the activity of transcriptional complexes, thereby shaping NR-mediated gene expression beyond NRs' intrinsic functionality. The Steroid Receptor Coactivator (SRC) family is the most extensively …


Disruption Of Proteoglycan 4 (Prg4)-Cd44 Signaling Modulates Chronic Synovitis In Conditionally Inactivated Mice, Khaled A. Elsaid, Ling Zhang, Thomas Zhao, Ava Marks, Derek Jenkins, Gregory D. Jay Feb 2026

Disruption Of Proteoglycan 4 (Prg4)-Cd44 Signaling Modulates Chronic Synovitis In Conditionally Inactivated Mice, Khaled A. Elsaid, Ling Zhang, Thomas Zhao, Ava Marks, Derek Jenkins, Gregory D. Jay

Pharmacy Faculty Articles and Research

Background

Proteoglycan-4 (PRG4) is a mucinous glycoprotein secreted by synovial fibroblasts and superficial zone chondrocytes. PRG4 inhibits synovial macrophage (SM) activation via xanthine oxidase (XO) and hypoxia inducible factor alpha (HIF-1α) suppression. We aimed to evaluate the contribution of PRG4-CD44 interaction to synovial homeostasis and investigate PRG4’s signaling dysfunction in synovial tissues from patients with osteoarthritis (OA). We hypothesized that CD44 mediates synovitis due to PRG4 loss and that PRG4 signaling dysfunction is associated with high-grade synovitis in OA.

Methods

Prg4FrtloxP/FrtloxP are transgenic mice wherein tamoxifen (TAM) inactivates the Frt allele and creates a knockout state (Prg4FrtKO/FrtKO …


A Phenomenological Approach To Spastic Movement Disorders: An International Expert Panel Consensus, Bo Biering-Sørensen, Jörg Wissel, Raymond Rosales, Rajiv Reebye, Jorge Jacinto, Gerard E Francisco, Peter Sanderson, Per Ertzgaard Feb 2026

A Phenomenological Approach To Spastic Movement Disorders: An International Expert Panel Consensus, Bo Biering-Sørensen, Jörg Wissel, Raymond Rosales, Rajiv Reebye, Jorge Jacinto, Gerard E Francisco, Peter Sanderson, Per Ertzgaard

Faculty, Staff and Student Publications

Background and objectives: Hyperkinetic movement disorders, characterized by complex and overlapping motor patterns, present significant challenges in classification and treatment. The inconsistency in definitions and descriptors complicates both research and clinical communication. This study aims to provide an overview of current terminology and definitions related to spasticity and other hyperkinetic movement disorders associated with central nervous system lesions. We propose a unified terminology and classification system for spastic movement disorders (SMD).

Methods: In this scoping review, definitions of spasticity, dystonia, tremor, chorea, hemiballismus, athetosis, myoclonus, and dyssynergia were reviewed, with emphasis on overlaps and diagnostic challenges among these disorders. The …


Management Of Alcohol Withdrawal Syndrome In The Emergency Department, Janet Fuller Feb 2026

Management Of Alcohol Withdrawal Syndrome In The Emergency Department, Janet Fuller

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project involved development and approval of a clinical practice guideline (CPG) for management of alcohol withdrawal syndrome (AWS) in the emergency department (ED) of a large community trauma center in the southeastern United States. AWS is a common, potentially life-threatening condition requiring timely assessment and intervention to prevent. Variability in ED screening and treatment contributes to delayed intervention, increased rapid response activations, and intensive care transfers. The project purpose was to develop and obtain expert approval of an evidence-based CPG using the Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) tool to support standardized screening, symptom-triggered …


Renin-Angiotensin-Aldosterone System In Preeclampsia: Pathophysiological Insights And Links To Vascular Dementia, Robin C. Finch, Jenny Lutshumba, Elizabeth Mirsky, Esther Ndashaala, Kelsey Bullens, Emma Smith Feb 2026

Renin-Angiotensin-Aldosterone System In Preeclampsia: Pathophysiological Insights And Links To Vascular Dementia, Robin C. Finch, Jenny Lutshumba, Elizabeth Mirsky, Esther Ndashaala, Kelsey Bullens, Emma Smith

Pediatrics Faculty Publications

Pre-eclampsia, a condition characterized by new-onset hypertension during pregnancy and one or more indices of organ damage, is a major driver of both short and long-term maternal health outcomes. Individuals with a history of pre-eclampsia are at increased risk for cardiovascular, renal, and other chronic diseases. Recent studies have linked pre-eclampsia history with increased risk of dementia later in life, underscoring the importance of new guidelines emphasizing blood pressure control to reduce the risk of cognitive decline. Unfortunately, neither mechanisms underlying causes of pre-eclampsia nor their links with cognitive function are well understood. Vascular contributions to cognitive impairment and dementia …


Quality Improvement Project: Reducing Test Anxiety: Faculty Training For Supporting Students, Chichi Markham Feb 2026

Quality Improvement Project: Reducing Test Anxiety: Faculty Training For Supporting Students, Chichi Markham

Doctor of Nursing Practice Projects

Test anxiety significantly affects nursing students’ academic performance and well-being. Emotional Freedom Techniques (EFT) offer a non-pharmacological method for alleviating anxiety; however, research on faculty-centered approaches in nursing education is limited. The purpose of this quality improvement project is to evaluate the impact of EFT training on nursing faculty’s knowledge, attitudes, and confidence regarding test anxiety, as well as on student exam performance. Guided by Lewin’s Change Theory, Stetler’s Model, and the Plan-Do-Study-Act (PDSA) cycle, the initiative aimed to enhance faculty capacity to identify and address test anxiety within a prelicensure nursing program. A pre-post quality improvement design involved faculty …


Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish Feb 2026

Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish

Doctor of Nursing Practice Projects

Medication administration errors remain a persistent threat to patient safety in emergency department settings, where high acuity, rapid throughput, and workflow interruptions increase vulnerability to preventable adverse events. The purpose of this Doctor of Nursing Practice quality improvement project was to increase medication-safety knowledge scores by at least 10% and reduce medication administration error rates by 20% within eight weeks among registered nurses in a freestanding emergency department in South Texas. The project was grounded in Lewin’s Change Theory as the theoretical framework and implemented using the Plan–Do–Study–Act quality improvement model. A quasi-experimental, single-group pretest–posttest design was used with a …


The Neuroprotective Effects Of Alpha-Tocopherol As An Anti-Inflammatory Agent: Mechanistic Insights And Therapeutic Challenges, Megumi H Seese, Yuanzhong Xu Feb 2026

The Neuroprotective Effects Of Alpha-Tocopherol As An Anti-Inflammatory Agent: Mechanistic Insights And Therapeutic Challenges, Megumi H Seese, Yuanzhong Xu

The Brown Foundation: Institute of Molecular Medicine

Vitamin E (alpha-tocopherol, αToc), an antioxidant fat-soluble vitamin that prevents lipid peroxidation and modulates pro-inflammatory cytokine production, is well-known to be critical for neuroprotection. However, the underlying mechanism remains poorly understood. Accumulating evidence demonstrates that αToc influences neuroinflammatory processes. Here, we review recent research progress on the effects of αToc on neuroinflammation. Preclinical studies included in this narrative review were identified through PubMed searches using the keywords "alpha-tocopherol AND neuroinflammation or alpha-tocopherol AND brain AND inflammation". While many studies support a neuroprotective role of αToc, the magnitude and direction of its effects vary substantially depending on dosage, route of administration, …


A Transcriptional Program Associated With Neurotransmission In The Living Human Brain, Alexander W. Charney, Lora E. Liharska, Eric Vornholt, Alissa Valentine, Anina Lund, Alice Hashemi, Ryan C. Thompson, Terry Lohrenz, Jessica S. Johnson, Nicole Bussola, Esther Cheng, You Jeong Park, Salman Qasim, Alisha Aristel, Lillian Wilkins, Kimia Ziafat, Hannah Silk, Lisa M. Linares, Brendan Sullivan, Claudia Feng, Beniamino Hadj-Amar Ph.D. Feb 2026

A Transcriptional Program Associated With Neurotransmission In The Living Human Brain, Alexander W. Charney, Lora E. Liharska, Eric Vornholt, Alissa Valentine, Anina Lund, Alice Hashemi, Ryan C. Thompson, Terry Lohrenz, Jessica S. Johnson, Nicole Bussola, Esther Cheng, You Jeong Park, Salman Qasim, Alisha Aristel, Lillian Wilkins, Kimia Ziafat, Hannah Silk, Lisa M. Linares, Brendan Sullivan, Claudia Feng, Beniamino Hadj-Amar Ph.D.

Faculty Publications

At the foundation of neurotransmission, and by extension at the foundation of brain function, are coordinated programs of gene expression involving many thousands of genes. These programs are poorly defined in humans because most modern studies that characterize human brain gene expression use tissue obtained in the postmortem state when neurotransmission and brain function have ceased. Here, to advance knowledge of the gene expression programs at the foundation of neurotransmission in the human brain, gene expression was characterized in 130 prefrontal cortex (PFC) samples obtained from participants of the Living Brain Project (LBP) during neurosurgical procedures in conjunction with intracranial …


Adipocyte-Specific Deletion Of Sine Oculis Homeobox Homolog 1 Inhibits Lipolysis And Reduces Skin Fibrosis, Nancy Wareing, Tingting W Mills, Scott Collum, Minghua Wu, Lucy Revercomb, René Girard, Hui Liu, Alexes Daquinag, Mikhail Kolonin, Marka Lyons, Brian Skaug, Weizhen Bi, Meer A Ali, Haniyeh Koochak, Anthony R Flores, Yuntao Yang, W Jim Zheng, William R Swindell, Shervin Assassi, Harry Karmouty-Quintana Feb 2026

Adipocyte-Specific Deletion Of Sine Oculis Homeobox Homolog 1 Inhibits Lipolysis And Reduces Skin Fibrosis, Nancy Wareing, Tingting W Mills, Scott Collum, Minghua Wu, Lucy Revercomb, René Girard, Hui Liu, Alexes Daquinag, Mikhail Kolonin, Marka Lyons, Brian Skaug, Weizhen Bi, Meer A Ali, Haniyeh Koochak, Anthony R Flores, Yuntao Yang, W Jim Zheng, William R Swindell, Shervin Assassi, Harry Karmouty-Quintana

Faculty, Staff and Student Publications

Dermal fibrosis is a cardinal feature of systemic sclerosis (SSc) for which there are limited Systemic sclerosis (SSc) is characterized by dermal fibrosis accompanied by loss of dermal white adipose tissue (DWAT), yet the mechanisms linking adipocyte depletion to fibroblast activation remain unclear. Here we identify the transcription factor SIX1 as a central regulator coupling adipogenic repression with profibrotic signaling. SIX1 expression was increased in skin biopsies from two independent SSc cohorts and localized to fibroblast and perivascular stromal cells. In mice, ubiquitous or adipocyte-specific deletion of Six1 preserved DWAT, reduced collagen accumulation, and selectively decreased pro-fibrotic mediators. In cultured …


Staff Education On Evidence-Based Interventions To Improve Patient Engagement In An Outpatient Mental Health Clinic, Gloria Egeh Feb 2026

Staff Education On Evidence-Based Interventions To Improve Patient Engagement In An Outpatient Mental Health Clinic, Gloria Egeh

Walden Dissertations and Doctoral Studies

In this project, I implemented a staff education initiative at an outpatient psychiatric facility in Michigan to address gaps in clinicians’ and office managers’ knowledge of evidence-based patient engagement strategies. Limited understanding had hindered patient participation in treatment planning, symptom self-management, and shared decision-making, key components of recovery-oriented care. The education initiative was aimed at enhancing staff competencies to strengthen therapeutic alliances, improve treatment adherence, and support positive mental health outcomes. Guided by a practice-focused question, in the project I examined whether an evidence-based staff education program would improve patient engagement among adults receiving outpatient mental health services. A pre-/postintervention …


Survival On Image Regression With Application To Partially Functional Distributional Representation Of Physical Activity, Rahul Ghosal, Sunwoo Emma Cho, Marcos Matabuena Feb 2026

Survival On Image Regression With Application To Partially Functional Distributional Representation Of Physical Activity, Rahul Ghosal, Sunwoo Emma Cho, Marcos Matabuena

Faculty Publications

Technological advancements in wearable devices and medical imaging often lead to high-dimensional physiological signals in the form of images or surfaces. To address these data structures, we develop a novel survival on image regression model with a specific focus on partially functional distributional representation of wearable data. The existing approaches for functional data and survival outcomes have been primarily developed for uni-dimensional functional predictors. Drawing on recent developments in distributional data analysis, we model temporally varying distributional patterns of physical activity (PA) as a partially functional distributional predictor within a semiparametric Cox model framework. We use tensor product splines to …


Environmental Chemicals And Maternal Depression During And After Pregnancy: A Scoping Review, Pengfei Guo, Yunyue Shi, Cindy Nguyen, Haoran Zhuo, Tormod Rogne, Zeyan Liew Feb 2026

Environmental Chemicals And Maternal Depression During And After Pregnancy: A Scoping Review, Pengfei Guo, Yunyue Shi, Cindy Nguyen, Haoran Zhuo, Tormod Rogne, Zeyan Liew

Faculty Publications

Purpose of Review

There is increasing evidence that several environmental exposures may pose a risk for depression, including maternal depression. We conducted a scoping review of epidemiological evidence regarding maternal exposure to environmental chemicals and perinatal depression.

Recent Findings

We searched PubMed, Embase, Web of Science, Dimensions, and Scopus, and summarized the findings from 27 articles that examined environmental chemical exposures and maternal depression. Studies of ambient air pollutants (N = 11) showed exposure to NO2 and PM10 to be most consistently associated with antenatal or postnatal depression. Studies of endocrine-disrupting chemicals, including phthalates (n = 6), …


Cardiac Output-Guided Vs. Mean Arterial Pressure-Guided Hemodynamic Management In Craniotomy Patients With Cardiovascular Disease: A Randomized Trial, Na Chen, Minjing Yang, Renhua Li, Chunyan Ye, Lu Wang, Xingyang Liu, Jinghan Wu, Daniel I Sessler, E Wang Feb 2026

Cardiac Output-Guided Vs. Mean Arterial Pressure-Guided Hemodynamic Management In Craniotomy Patients With Cardiovascular Disease: A Randomized Trial, Na Chen, Minjing Yang, Renhua Li, Chunyan Ye, Lu Wang, Xingyang Liu, Jinghan Wu, Daniel I Sessler, E Wang

Faculty, Staff and Student Publications

We tested the primary hypothesis that cardiac output (CO)-guided versus mean arterial pressure (MAP)-guided hemodynamic management reduces the fraction of patients with 90-day Glasgow Outcome scores ≤ 4 (on a 1–5 scale, 5 better) after supratentorial brain tumor resections in adults with cardiovascular disease. 202 adults were randomized to intraoperative hemodynamic management guided by either CO or MAP. In patients assigned to CO guidance, clinicians targeted CO > 4 L/min and > 90% of baseline values using a combination of fluids and vasoactive agents. In patients assigned to MAP guidance, clinicians targeted MAP within ± 20% of baseline and ≥ 65 mmHg. …


Applications Of Chatbots In Improving Patient Care Outcomes: A Scoping Review, Mohammadhiwa Abdekhoda, Afsaneh Dehnad Feb 2026

Applications Of Chatbots In Improving Patient Care Outcomes: A Scoping Review, Mohammadhiwa Abdekhoda, Afsaneh Dehnad

Sultan Qaboos University Medical Journal

This review explored the application of chatbots in healthcare, focusing on patient monitoring, personalised care and medical services. It examined the potential of chatbots to improve patient outcomes through artificial intelligence-driven technologies, addressing challenges such as data security and system integration. This scoping review, conducted from January to March 2025, adhered to the PRISMA-ScR guidelines. A thorough literature search was performed across Web of Science, Scopus and PubMed, using keywords such as "patient care", "outcome", and "chatbot*". After screening for relevance and applying inclusion criteria, a total of 70 articles were analysed, focusing on chatbots' roles in improving patient care …


Cml-Like Biology Is A Unifying Feature Of Myeloid/Lymphoid Neoplasms With Tyrosine Kinase Fusions In Lymphoid Blast Phase Comment On: Multilineage Involvement In Abl-Class Fusion-Positive Pediatric B-Cell Acute Lymphoblastic Leukemia: Cml-Like Biology, Wei J Wang, Shimin Hu Feb 2026

Cml-Like Biology Is A Unifying Feature Of Myeloid/Lymphoid Neoplasms With Tyrosine Kinase Fusions In Lymphoid Blast Phase Comment On: Multilineage Involvement In Abl-Class Fusion-Positive Pediatric B-Cell Acute Lymphoblastic Leukemia: Cml-Like Biology, Wei J Wang, Shimin Hu

Faculty, Staff and Student Publications

No abstract provided.


The Cost Of A Healthy Diet And Its Association With Bmi In Crisis-Stricken Lebanon, Maha Hoteit, Myriam Abboud, Maroun Khattar, Rana Rizk Feb 2026

The Cost Of A Healthy Diet And Its Association With Bmi In Crisis-Stricken Lebanon, Maha Hoteit, Myriam Abboud, Maroun Khattar, Rana Rizk

All Works

Objectives: This study aimed to determine the prevalence of Lebanese adults living with underweight, overweight or obesity, assess and compare the cost of the Mediterranean Diet (MD) with that of the current dietary consumption pattern and explore diet cost as a determinant of living with underweight, overweight or obesity. Design: Data for this nationally representative cross-sectional study were collected through sociodemographic questionnaires, anthropometric measurements, the Arab Family Food Security Scale and dietary assessments using a validated FFQ and 24-h recalls. Diet costs were calculated based on 2023 market prices using purchasing power parity. Logistic regression was used to assess associations …


Sex-Specific Differences In Mediobasal Hypothalamus In Response To Nutritional States, Jonathan C Bean, Jinjing Jian, Tzu-Chiao Lu, Hailan Liu, Kristine Conde, Darah A Threat, Sanika V Jossy, Megan E Burt, Jingjing Cheng, Yue Deng, Xing Fang, Xiaoyu Geng, Junying Han, Yongxiang Li, Hesong Liu, Qingzhuo Liu, Yutian Liu, Yuhan Shi, Longlong Tu, Mengjie Wang, Xu Xu, Yuxue Yang, Meng Yu, Xinming Liu, Meixin Sun, Fuhui Wang, Olivia Z Ginnard, Yongjie Yang, Yang He, Chunmei Wang, Yanyan Qi, Hongjie Li, Yong Xu Feb 2026

Sex-Specific Differences In Mediobasal Hypothalamus In Response To Nutritional States, Jonathan C Bean, Jinjing Jian, Tzu-Chiao Lu, Hailan Liu, Kristine Conde, Darah A Threat, Sanika V Jossy, Megan E Burt, Jingjing Cheng, Yue Deng, Xing Fang, Xiaoyu Geng, Junying Han, Yongxiang Li, Hesong Liu, Qingzhuo Liu, Yutian Liu, Yuhan Shi, Longlong Tu, Mengjie Wang, Xu Xu, Yuxue Yang, Meng Yu, Xinming Liu, Meixin Sun, Fuhui Wang, Olivia Z Ginnard, Yongjie Yang, Yang He, Chunmei Wang, Yanyan Qi, Hongjie Li, Yong Xu

Children’s Nutrition Research Center Staff Publications

The arcuate nucleus of the hypothalamus plays a central role in sensing and integrating nutritional, hormonal, and neural signals that regulate feeding, energy homeostasis, growth, and reproduction, all of which show pronounced sex differences. However, the cellular mechanisms underlying these responses remain poorly understood. We performed snRNA-seq of the mediobasal hypothalamus, focusing on the arcuate nucleus, in female and male mice under different nutritional states. Analysis of 42 cell types revealed that Agrp neurons were most sensitive to nutritional changes, dopaminergic neurons showed strong sex-specific differences, and KNDy neurons were highly responsive to both sex and nutrition. Pomc neurons displayed …


Unbalanced Chromatin Binding Of Polycomb Complexes Drives Neurodevelopmental Disorders, Rodrigo L Borges, Gretter González-Blanco, Harikumar Arigela, Yingyu Huang, Lucas D Caeiro, Nikolai Fattakhov, Stefano Lepore, Liliana Garcia-Martinez, Matea Maurice, Pushti D Mehta, Emily J Park, Kailynn Macgillivray, Jevithen Nehru, Matthew Chau, Maria C Robayo, Clemer Abad, Alicia Bilbao-Martinez, Fabiola Monteiro, Xi Luo, Song Tan, Daniel Bilbao, Simone Sidoli, Bruno Di Stefano, Katherina Walz, Arneet L Saltzman, Ramiro E Verdun, Ramin Shiekhattar, Lluis Morey Feb 2026

Unbalanced Chromatin Binding Of Polycomb Complexes Drives Neurodevelopmental Disorders, Rodrigo L Borges, Gretter González-Blanco, Harikumar Arigela, Yingyu Huang, Lucas D Caeiro, Nikolai Fattakhov, Stefano Lepore, Liliana Garcia-Martinez, Matea Maurice, Pushti D Mehta, Emily J Park, Kailynn Macgillivray, Jevithen Nehru, Matthew Chau, Maria C Robayo, Clemer Abad, Alicia Bilbao-Martinez, Fabiola Monteiro, Xi Luo, Song Tan, Daniel Bilbao, Simone Sidoli, Bruno Di Stefano, Katherina Walz, Arneet L Saltzman, Ramiro E Verdun, Ramin Shiekhattar, Lluis Morey

Faculty, Staff and Students Publications

The prevalence of neurodevelopmental disorders (NDDs) in children is increasing, yet their underlying causes remain largely unknown. We identified heterozygous mutations in the Polycomb repressive complex 1 (PRC1) E3 ligases RING1 and RNF2 in individuals with NDDs and revealed distinct mechanisms by which they compromise PRC1 activity. We developed cellular and mouse models carrying the Ring1b


“From Compression To Closure: Efficacy And Safety Of Vascular Closure Devices (Vcd) Versus Manual Compression: A Comparative Analysis Of Hemostatic Strategies Of Obtura, Angioseal, And Proglide Vcd“, Praveen Shukla, Kumar Himanshu, Ali Mohammed, Mukesh Jitendra Jha, Santosh Kumar Sinha, Puneet Aggarwal, Mohammad Mahmodullah Razi, Mohit Sachan, Awadhesh Kumar Sharma, Umeshwar Pandey, Neeraj Prakash, Rakesh Kumar Verma Feb 2026

“From Compression To Closure: Efficacy And Safety Of Vascular Closure Devices (Vcd) Versus Manual Compression: A Comparative Analysis Of Hemostatic Strategies Of Obtura, Angioseal, And Proglide Vcd“, Praveen Shukla, Kumar Himanshu, Ali Mohammed, Mukesh Jitendra Jha, Santosh Kumar Sinha, Puneet Aggarwal, Mohammad Mahmodullah Razi, Mohit Sachan, Awadhesh Kumar Sharma, Umeshwar Pandey, Neeraj Prakash, Rakesh Kumar Verma

Journal of the Saudi Heart Association

Objective: Use of vascular closure devices (VCDs) for femoral artery puncture site hemostasis has increased but their safety and efficacy have remained unclear. This study was designed to compare safety and efficacy of Obtura, Angioseal, and Proglide VCD to manual compression (MC) and also between for femoral artery haemostasis.

Methods:This was prospective, randomized controlled study where patients were randomly assigned on 1:1:1:1 basis. Primary endpoints were time to hemostasis (TTH) and ambulation time (AT) while secondary endpoints were deployment success, device related adverse events and technical success rate. ANOVA and Tukey HSD was conducted to draw significant difference between …


Differences And Changes In Cross-Cultural Sensitivity Of German And Japanese Students Before And After Short-Term Exchange Programs, Kazumasa Nakagawa, Yuko Takahashi, Melanie Zwiorek Feb 2026

Differences And Changes In Cross-Cultural Sensitivity Of German And Japanese Students Before And After Short-Term Exchange Programs, Kazumasa Nakagawa, Yuko Takahashi, Melanie Zwiorek

Journal of Educational Research and Practice

Since 2012, a Japanese and a German university have conducted exchange programs. This study examined the effects of a short-term exchange program in 2023, focusing on intercultural sensitivity. Nine Japanese students and nine German students completed a 24-item Intercultural Sensitivity Scale before and after the program using a 5-point Likert scale. We performed cross-tabulations and analyzed differences between countries and pre- and post-program changes using chi-square or Fisher’s exact tests. The results suggest that even a short-term exchange enhanced Japanese students’ confidence in intercultural interactions and encouraged German students to reflect on their own culture. However, Japanese students showed lower …