Medicine and Health Sciences Commons^™

Stitched With Purpose, Abigail Gooler

OTD 721: Cultural Responsiveness & Occupation

I chose this topic for this zine because fiber arts have become a meaningful part of my life. What began as a hobby during the COVID pandemic has grown into a way for me to manage stress, find purpose through creating, and build a small business.

This project deepened my understanding of occupational justice and the way that occupations are shaped by culture, gender, access, and social determinants of health. It challenged me to view what is an everyday occupation for me as culturally significant and, at times, political.

This project also reminded me of the privilege I have to …

Girl, Just Shut Up & Take An Advil: A Zine About Periods, Participation, And Why We All Became Experts At The Tampon-To-Sleeve Transfer, Alexa Ford

OTD 721: Cultural Responsiveness & Occupation

Like many people, I learned early on that menstruation was something to manage quietly. I learned how to check for stains without making it obvious. I learned how to strategically tie a sweatshirt around my waist. I learned that asking, "Do you have one?" across a public restroom often resullts in an immediate and enthusiastic, "Yes, girl. What do you need?" Over time, I realized these weren't just funny shared experiences. They reflected something bigger. The silence. The stigma. The expectation that people should function through discomfort without complaint.

As I've learned more through occupational therapy, I've started to understand …

How To Be 2slgbtqia+ And Neurodivergent Affirming As An Occupational Therapist, Ellie Shoop

OTD 721: Cultural Responsiveness & Occupation

When we were asked at the beginning of our class, "What is one thing you have experienced that you wish no one would ever have to experience again?", by author and occupational therapist Elizabeth Ching, OTD, M.Ed., BSOT, OTR/L, my mind began to swirl with ideas. I identify as a gay, white, neurodivergent, non-binary person, and I wish that no one would be misgendered or have their sexuality assumed by health professionals ever again. I also wish that people with neurodivergent brains would be given the support they need to thrive in a world that was not built with us …

Seasonal And Geographic Trends In Photodynamic Therapy And Cryosurgery Use In The United States: A Cross-Sectional Study From 2015-2022., Dawn Merritt, Jon Lyons, Mouna Mikati, Christian Geils, Todd Schlesinger

Ambulatory and Primary Care Articles

BACKGROUND: Photodynamic therapy (PDT) is an effective field treatment for actinic keratoses (AKs). It is an ideal option for patients who prefer a minimally invasive procedure conveniently administered in their physician's office. Anecdotal clinician insights suggest that it may not be used at the same rate year-round.

OBJECTIVE: This study investigates whether PDT and cryosurgery usage is affected by season and geographic location in the United States.

METHODS: The data source is an aggregate of closed and open United States medical procedural claims (

RESULTS: PDT utilization is affected by season and geographic location. Procedural claims peak during cooler months …

Revisiting The Life Cycle Of Margalefidinium Polykrikoides Group Iii, Eduardo Pérez-Vega, Kenneth N. Mertens, Pjotr Meyvisch, Margaret R. Mulholland

OES Faculty Publications

Dinoflagellates produce cysts as a strategy to withstand environmental stressors, with nutrient depletion generally considered a key trigger for cyst production. Resting cysts are thick-walled, typically composed of one to several layers, and characterized by a prolonged dormancy period. In contrast, pellicle cysts possess a thin, single wall and exhibit no dormancy or a markedly shorter dormancy than resting cysts of the same species. Margalefidinium polykrikoides produces pellicle and resting cysts, whereas its congener, M. fulvescens, has been shown to produce pumpkin-like structures. Using phase-contrast microscopy, time-lapse microscopy, FlowCam, and attenuated total reflection Fourier transform infrared microspectroscopy (ATR μ-FTIR), …

Influence Of Motion Artifacts On Instantaneous Frequency Based Heart Rate Variability Of Arterial Pulse Signals Measured By A Tactile Sensor: An Analytical Study, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Objective: Heart rate variability (HRV), quantified via the instantaneous frequency (IF) of arterial pulse signals, is a key indicator of cardiovascular (CV) regulation. This study presents a theoretical and experimental investigation of how motion artifacts (MA) influence IF-and thus HRVmeasured with a tactile sensor, emphasizing underlying mechanisms rather than population-level validation. Approach: Building on a previously developed single-degree-of-freedom (SDOF) model of the tissue-contact-sensor (TCS) stack between the sensor and the artery, MA is represented as low-frequency baseline drift and time-varying system parameters (TVSP) of the TCS stack. Analytical expressions quantify the effect of MA on the IF of each harmonic …

Mechanical-Medical Convergence In Heart Failure: Artificial Intelligence, Finite-Element Modeling, And 3d Printing For Diagnosis And Prognosis, Quazi Noor E. Sabrina, Quazi Md Zobaer Shah, Quazi Noor E. Sohela, Md Mahabub Hasan Mousum, Md. Moyeen Uddin Chisty, Quazi Md. Akbar Shah

Mechanical & Aerospace Engineering Faculty Publications

Heart failure remains a leading cause of global morbidity and mortality, yet routine clinical indices often miss the regional biomechanical disturbances that drive progression and shape treatment response. This State-of-the-Art review examines how finite-element (FE) modeling, additive manufacturing, and artificial intelligence (AI) are converging to improve the diagnosis, phenotyping, procedural planning, and prognostic assessment of heart failure (HF). Although these technologies have matured in structural heart disease and transcatheter intervention research, their greatest translational potential may lie in HF, where patient-specific ventricular remodeling, myocardial stress–strain heterogeneity, valve-ventricular coupling, and device-tissue interaction are incompletely captured by conventional clinical indices. We synthesize …

The Untold Art History Of Grillz: An Introduction Exhibition At The Ica, Helena Opuama

MA in Fine and Decorative Art and Design Dissertations

The Untold Art History of Grillz: An Introduction Exhibition at the ICA is a prompt multisensory exhibition scheduled to open 15th April 2028 in celebration of World Art Day, at the Institute of Contemporary Arts, in London, UK. The exhibition critically utilises postcolonial frameworks to explore the dismissed decorative history of dental adornment and its influence on contemporary grill design today.

Through a limited chronological selection of physical objects, holographic projections, archival photographs, oral histories, and social media contributions; the exhibition co-narrates the history of dental adornment across four historical periods. These periods include Precolonial Traditions (14th-15th century); Colonial Evolutions …

Meconium Metal Concentrations And Infant Temperament And Development, Fiona Fogarty

Dissertations and Theses

BACKGROUND: Prenatal exposure to metals poses significant health consequences for early childhood development. Understanding the factors influencing metal concentrations that infants are exposed to in-utero is crucial for developing targeted interventions, particularly when maternal characteristics and environmental factors, may contribute to varying levels. Meconium offers insight into in-utero exposures for the developing infant, and the effect of each individual metal may be mediated or exacerbated by another and therefore should be studied in the context of a mixture. The effect of metal mixture exposure, as measured in meconium, on milestone and temperament outcomes has yet to be determined.

DESIGN: …

Independence Of Spectral Contrast Effects Across Different Frequency Regions In Speech Perception, Christian E. Stilp, Matthew B. Winn

Speech Pathology and Audiology Faculty Research and Publications

Identification of speech sounds is influenced by spectral contrast effects (SCEs), the perceptual magnification of spectral differences between successive sounds. SCEs result in the categorization of a target sound being biased away from spectral properties in the preceding acoustic context. Given remarkable consistency in the magnitudes of these contrast effects within the same frequency region, it was hypothesized that they would also show stable relationships across different frequency regions. In this study, normal-hearing listeners’ phoneme categorization and contrast effects were assessed where phonetic contrasts were driven by changes in low-frequency F₁ (“big”-“beg” continuum), mid-frequency F₃ (“dot”-“got”), or high-frequency …

The Mediating Effect Of Socioeconomic Status And Persistent Poverty On Racial And Ethnic Disparities In Pediatric Cancer Mortality In The United States, Josiane Kabayundo, Apu Das, Cheng Zheng, Emma Hymel, Krishtee Napit, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Socioeconomic (SE) factors have been shown to mediate racial and ethnic disparities in adult cancer mortality. However, evidence in pediatric cancer is limited, especially at finer geographic levels.

OBJECTIVE: Evaluate the mediating effect of socioeconomic status (SES) and persistent poverty in racial and ethnic disparities in childhood cancer mortality using census tract-level data.

METHODS: Data were obtained from the 2006-2020 SEER Incidence Data with Census Tract Attributes Database and included children 0-19 years. Neighborhood-level SES was measured using a composite variable with five categories. Census tracts were classified as persistently poor if 20% or more of the population lived …

Ebola In The Drc: A Different Problem Compounded By Violence, David Brett-Major

Journal Articles: Epidemiology

A Public Health Emergency of International Concern (PHEIC) has been declared in the Democratic Republic of Congo (DRC) due to Ebola disease from Bundibugyo virus. Non-health-focused factors should be fundamental to how DRC and its partners respond to and recover from the current emergency. Filovirus emergencies are violent in every sense-the disease experience of patients and their caregivers, the tumult in impacted communities, sometimes the physical manifestations of frustration against healthcare services, the fits and starts of concerted response, and the milieu of conflict in which this emergency occurred. Yet, interpersonal and organized violence may contribute to frequency of health …

The Treatment Of Obesity In The Context Of The Obesity Paradox In Patients With Heart Failure: A Narrative Review, Pamela L. Alebna, Sarah Martey, Anurag Mehta, Carl J. Lavie, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Purpose of review

While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes.

Recent findings

In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents …

Estimating Short-Term And Long-Term Survival For Patients With Kidney Failure Using A Mixture Survival Model, Nathan Meyer, Maxwell Donelan, Hossein Moradi Rekabdarkolaee, Brandon Varilek, Surachat Ngorsuraches, Patti Brooks, Jerry Schrier, Semhar Michael

Journal Articles: College of Nursing

Rationale & Objective

Study Design

Setting & Participants …

Video Instructions For Pre And Post Procedure Care: Evidence-Based Quality Improvement Project, Lynn V. Wojton

DNP Projects

Background: Patient adherence to pre- and post-procedure instructions is essential to ensuring optimal outcomes and patient satisfaction in cosmetic dermatology. However, patients frequently overlook or misunderstand written instructions, leading to suboptimal preparation and recovery experiences.

Project Purpose: The purpose of this quality improvement initiative was to evaluate whether the implementation of short, accessible video-based instructions could improve patient understanding, adherence, and satisfaction compared to standard written instructions alone.

Methods: The project was conducted in a high-volume cosmetic dermatology practice in the Northeastern United States. A HIPAA-compliant platform using a video-based educational intervention was developed and implemented to supplement or replace …

College Student Perceptions Of A Pilot Cooking And Nutrition Education Workshop Through The Lens Of The Social Cognitive Theory: A Qualitative Study, Emma Watras, Amelia Sullivan, Emalee Harrington, Mona Therrien-Genes, Kathryn Yerxa, Makenzie Barr-Porter, Jade Mcnamara

Dietetics and Human Nutrition Faculty Publications

This study qualitatively examined college students' perceptions of a pilot cooking and nutrition workshop, College Cooking Connection (CCC), through the Social Cognitive Theory (SCT) framework. Undergraduate students who attended at least one CCC workshop (N = 29) were invited to a 30 min virtual focus group. A trained moderator guided the discussion to gather perceptions of the program. Themes were identified using thematic analysis with a directive and deductive approach based on SCT. Focus groups revealed eight major themes across the SCT. Cognitive themes included: (1) improved nutrition literacy, (2) understanding the nutrition-mental health connection, and (3) increased awareness of …

Unlocking The Power Of Cxcr2 Inhibition To Overcome Gemcitabine Resistance In Pancreatic Cancer, Caitlin Molczyk, Reegan Sturgeon, Sugandha Saxena, Esther Johnson, Rakesh Bhatia, Namita Bhyravbhatla, Sushil Kumar, Surinder K. Batra, Rakesh K. Singh

Journal Articles: Biochemistry & Molecular Biology

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related mortality, characterized by intrinsic resistance to conventional therapies and limited effective treatment options. In this study, we investigated the role of the CXCR2 axis in PDAC therapy resistance. CXCR2, a chemokine receptor, is actively involved in inflammation, tumor angiogenesis, and metastasis. Our working hypothesis is that CXCR2 contributes to PDAC chemotherapy resistance. To test this, we generated gemcitabine-resistant (GemR) lines using T3M4 and CD18/HPAF (CD18) cell lines. Baseline expression of CXCL1, CXCL5, and CXCL8 ligands was higher in GemR cells compared to parental cells. Upon gemcitabine treatment, parental cells …

Midkine (Mdk) As A Central Regulator Of The Tumor Microenvironment: From Developmental Cytokine To Therapeutic Target, Hareesh B. Nair, Ajay Nair, Ya-Guang Liu, Dileep K. Vijayan, Ramadevi Subramani, Rajkumar Lakshmanaswamy, Suryavathi Viswanadhapalli, Gangadhara R. Sareddy, Surinder K. Batra, Ratna K. Vadlamudi

Journal Articles: Biochemistry & Molecular Biology

Midkine (MDK) is an oncofetal, heparin-binding cytokine that is re-expressed across diverse cancers and correlates with aggressive disease and treatment resistance. This review synthesizes current evidence on MDK as a coordinator of tumor-intrinsic signaling and microenvironmental remodeling. We summarize MDK structural features, extracellular matrix interactions, and receptor systems that mediate MDK signaling, highlighting LRP1 and PTPRZ1 with context-dependent participation of ALK, nucleolin and integrins. Downstream, MDK engages MAPK, PI3K-AKT, STAT3 and NF-κB pathways to promote tumor cell survival, epithelial-mesenchymal plasticity, and therapeutic stress tolerance. We then focus on tumor microenvironment (TME) programs shaped by MDK, including angiogenesis, fibroblast activation and …

Mucin 5ac Modulates Cancer-Associated Fibroblast Heterogeneity Through Epigenetic Reprogramming Of Precursor Cells, Rachel J. Kehrberg, Namita Bhyravbhatla, Zahraa Wajih Alsafwani, Xiaoqi Li, Gopalakrishnan Natarajan, Imran Khan, Randall E. Brand, Maneesh Jain, Surinder K. Batra, Sushil Kumar

Journal Articles: Biochemistry & Molecular Biology

Pancreatic cancer (PC) is characterized by extensive desmoplasia, with heterogeneous cancer-associated fibroblasts (CAFs) as a major component. However, the contribution of distinct precursor cells to CAF heterogeneity remains poorly defined. This study investigated the role of Muc5ac in modulating CAF heterogeneity by maturing precursor cells, including adipose-derived mesenchymal stem cells (AD-MSCs), bone marrow-derived MSCs (BM-MSCs), and pancreatic stellate cells (PSCs), into different CAF subsets. RNA sequencing of precursor cells treated with conditioned media from Muc5ac-proficient or -deficient cancer cells revealed distinct transcriptional profiles. Muc5ac significantly modulated the expression of Dnmts and Tets in AD-MSCs, promoting the acquisition of extracellular matrix …

Addressing Obesity And Diabetes In Appalachian Kentucky, Hannah E. Orens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Type 2 diabetes and obesity are major public health concerns in Appalachian Kentucky. Populations in this region experience much higher rates of chronic disease than the rest of the state, have limited access to preventive care, and ongoing economic challenges that affect health. Many rural counties face increased poverty, transportation challenges, and shortages of healthcare professionals, all of which contributed to poor health outcomes and reduced access to evidence-based prevention programs. As a result, there is a strong need for focused, feasible, community-based interventions that improve access to evidence-based prevention while addressing the social and economic factors influencing health in …

Purchasing A Healthier Future: A Nutrition-Focused, Community-Centered Approach To Reduce Obesity And Diabetes In Graves County, Kentucky, Marissa Stephens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food …

Challenging Cases In Infection Prevention And Control: Proceedings From Shea Spring 2025., Jessica Seidelman, Tsun Sheng N Ku, Anna Lafountaine, Curtis J Donskey, Edo-Abasi U. Mcgee, Rachel Pryor

PCOM Scholarly Works

Hospital epidemiologists and infection prevention professionals are frequently required to make high-stakes decisions in complex clinical scenarios where evidence-based guidance is limited or absent. These decisions often carry significant implications for patient safety, healthcare worker protection, hospital operations, and legal or financial risk. This article presents three challenging cases originally featured during the "Interesting Cases" session at the Society for Healthcare Epidemiology of America (SHEA) Spring 2025 Conference, with the goal of sharing practical lessons learned and contributing to the evolving literature in healthcare epidemiology. The first case describes the intraoperative contamination of a polyethylene liner during emergency revision total …

Intermittent Androgen Deprivation Therapy For Biochemical Recurrence Or Prostate-Specific Antigen (Psa) Persistence After Radical Prostatectomy: Efficacy And Prognostic Factors, Jian Chen, Qiming Chen, Xuzhi Yan, Ziqian Wang, Yapeng Wang, Yao Zhang, Jun Zhang, Jing Xu, Junying Zhang, Dianzheng Zhang, Qiuli Liu, Wuihua Lan, Jun Jiang

PCOM Scholarly Works

Background: The optimal protocol for intermittent androgen deprivation therapy (IAD) in managing biochemical recurrence (BCR) and persistent prostate-specific antigen (PSA) levels after radical prostatectomy (RP) remains undefined. This study aimed to introduce a novel IAD protocol, conduct an initial assessment of the protocol’s effectiveness in real-world settings, and develop a risk-based model to identify patients most likely to benefit from this approach. Methods: This study included 175 post-RP patients receiving IAD, with a median follow-up of 44.77 months [interquartile range (IQR), 31.87–69.50 months] post-androgen deprivation therapy (ADT). The IAD protocol used a PSA threshold of 0.2 ng/mL to define progression …

Therapeutic Landscape Of Early Symptomatic Alzheimer's Disease Translated Into Everyday Practice For Geriatric Providers., Melissa J Bailey-Taylor, Paula Morrow, James Hendrix, Katherine E. Galluzzi, Golnosh Sharafsaleh

PCOM Scholarly Works

Alzheimer's disease (AD) accounts for 60-80% of all dementia cases. Recent advances in diagnostic biomarkers of early symptomatic AD (ie, mild cognitive impairment and mild dementia due to AD) and amyloid-targeting therapies (ATTs) have the potential to improve outcomes for patients with AD. Two ATTs (donanemab and lecanemab) are currently approved and available for use in the US. Both ATTs can slow disease progression as well as cognitive and functional decline in patients with early symptomatic AD. Treatment with ATTs is associated with specific safety concerns such as amyloid-related imaging abnormalities. Therefore, the benefit versus risk profile needs to be …

Anchoring Roots And Spreading Branches: The Growth And Regulation Of Art Therapy In Singapore, Christine Phang

Art Therapy | Doctoral Dissertations

The development of art therapy in Singapore has advanced rapidly over the last two decades. Yet, to date, there has not been a comprehensive overview of art therapy in Singapore. Additionally, more research is needed to understand how the complex component of regulation can benefit the profession of art therapy. This study therefore set out to paint a picture of art therapy in Singapore, capture the art therapy community’s thoughts and opinions concerning regulation, and identify actionable ways to advance the profession. A mixed method design was employed which utilized a survey and interviews to gather quantitative, qualitative, and arts-informed …

Creativity In A Flash: Exploring The Perceived Therapeutic Effects Of Combining Creative Arts Therapies And Flash Technique, Celia J. Gagnon

Art Therapy | Doctoral Dissertations

Since the onset of the COVID-19 pandemic, research has revealed a significant strain on mental healthcare systems and healthcare professionals. Concurrently, there has been a rapid escalation in the prevalence of anxiety, depression, loneliness, and adolescent suicide rates, all of which have reached critical levels (World Health Organization, 2025; World Health Organization, 2022; Institute for Health Metrics and Evaluation, 2025; American Psychiatric Association, 2024). Post-pandemic, these statistics continue to rise across all nations and socioeconomic groups (WHO, 2025). Consequently, there is an urgent need to intensify research that supports the enhancement of mental health services globally (Institute for Health Metrics …

Enhancing Self-Acceptance And Reducing Anxiety Through Tree Ring Self-Portraits In Art Therapy: A Mixed-Methods Study, Stacey Kamp

Art Therapy | Doctoral Dissertations

This mixed-methods dissertation examined the therapeutic potential of the Tree Ring Self-Portrait, a novel art therapy intervention designed to enhance self-acceptance and reduce anxiety through symbol-based, life-phase self-portraiture grounded in narrative meaning-making and image-based processing (White & Epston, 1990; Moon, 2010; Hinz, 2020). Adults who self-identified with anxiety-related concerns were recruited through community and clinical referral sources and completed a standardized three-session intervention involving reflective mapping of life phases, a watercolor-based concentric-ring self-portrait process, and a guided review of the completed artwork with semi-structured interviews. The final sample (n = 20; ages 22–74) included participants with varied engagement in psychotherapy …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

Reducing Live Discharges In Hospice Care Through A Bundled Intervention, Fiona P. White

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction

 Among Medicare fee-for-service hospice beneficiaries, the national live discharge rate increased from 16.9% in FY2021 to 19.1% in FY2025. At a Medicare-certified hospice agency in a southern state, the pre-intervention live discharge rate of 35.3% substantially exceeded national norms, with 68.7% of events representing patient-initiated revocations.

Methods

 A pre-post quality improvement design guided by the Plan-Do-Study-Act framework was implemented over 8 weeks at a single site with 106 newly admitted hospice patients and 15 clinical staff. The four-component bundled intervention comprised Revocation Risk Assessment administration within 24 hours of admission, structured patient and caregiver education within 72 hours of …

Toolkit To Prevent Venous Thromboembolism Among Surgical Patients, Carine Wawa

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: According to the Centers for Disease Control and Prevention, approximately 900,000 people in the United States are affected annually by venous thromboembolism (VTE) (CDC, 2025). The surgical patient population is vulnerable to VTE due to factors such as immobility, tissue injuries, and inflammatory responses. The lack of standardized protocols for surgical patients causes practice variability among healthcare providers and potentially increases the risk for preventable VTE events.

Methods: A toolkit to prevent VTE was developed utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC). A literature review was conducted, reviewed, and graded using the …