Medicine and Health Sciences Commons^™

Rural-Urban Differences In Dental Care Utilization After A Public Health Emergency, Quazi Minhaz Tabassum, Redwan Bin Abdul Baten, Ahmed A. Arif

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Past year dental clinic visits declined among both rural and urban populations after the COVID-19 pandemic. However, rural patients are more likely to report delayed dental service utilization than their urban counterparts.

• Participants residing in Medicaid expansion states or with health insurance coverage were 16% less likely to delay dental visits overall.

• The COVID-19 pandemic further worsened the existing challenges in dental healthcare access for urban and rural communities.

Review Of Current Research Describing The Influence Of Non-Health Care Drivers Of Health In Rural And Urban Populations, Katie Youngen, Julia Cecil, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Social determinants of health (SDOH) (also called social drivers of health) are the conditions of the environment where people live, learn, work, and play that are known to affect health outcomes.¹ The primary objective of this literature review is to summarize the most recent literature related to the Healthy People 2030 domains of a) economic stability, b) education access and quality, c) neighborhood and built environment, and d) social and community context.² Our particular focus is on non-health care drivers of health. The secondary objective is to identify gaps in literature applied to rural populations.

The Performance Of Machine Learning Algorithms In Predicting Under-Five Anaemia In Tanzania, Henry Ofori Duah, Derrick Nyantakyi Owusu, Godwin G. Duah, Paul Shidende

College of Nursing Faculty Research and Publications

Aim

Anaemia in children under five remains a major public health concern, contributing significantly to global child morbidity and mortality. With the rise of machine learning (ML), novel opportunities exist to model and predict anaemia more effectively. This study aimed to evaluate and compare the performance of five ML algorithms in predicting anaemia among under-five children in Tanzania.

Methods

We conducted a secondary data analysis using the 2017 Tanzania Malaria Indicator Survey (TMICS). The dataset (n = 5906) was randomly split into training (70%) and test (30%) sets. Five ML algorithms, Linear Discriminant Analysis (LDA), Logistic Regression, Random Forest (RF), …

Comparing Us Medicare Coverage Options As A Contributing Mechanism To Sticking Or Switching To An Insurance Plan, Lisa M. Grabert, Brian J. Miller, Kathryn L. Wagner

College of Nursing Faculty Research and Publications

Background

In 2025, the US Medicare program is expected to spend over $1.1 trillion taxpayer dollars. A growing trend in the US Medicare program is more beneficiaries electing a private insurer, referred to as Medicare Advantage (MA), to manage their care. Since 2023, a slight majority of Medicare beneficiaries have elected to enroll in MA, yet little is understood about the mechanisms that drive beneficiaries toward their choices.

Methods

Our objective was to examine the association between comparing coverage options and ‘switching’ or ‘sticking’ with Fee-for-Service (FFS) Medicare or Medicare Advantage (MA). We conducted a panel study, using data from …

From The Goodness Of Our Hearts: A Scoping Review Of Qualitative Literature On Altruism As A Reward Mechanism For Nursing, Jacqueline Christianson, Madaline Mccarthy, Bonnie Sommers-Olson, Emily Horner, Norah L. Johnson

College of Nursing Faculty Research and Publications

Introduction

Altruism, the desire to help others, is a common motivation for choosing a career in nursing. Improved understanding of the role of altruism as a reward or motivation for currently-practicing nurses may inform future interventions to improve effort-reward balance among practicing nurses. Therefore, the purpose of this study was to collect, examine, and present literature on how altruism has been described as a reward mechanism or motivation for engaging in professional nursing.

Methods

This scoping review of literature used the Arksey & O’Malley method, PRISMA-ScR reporting checklist, and Rayyan review management platform. PubMed, Web of Science, and CINAHL were …

An Educational Intervention On Mutual Goal Setting For Hospital Nurses: A Mixed-Methods Study, Teresa Jerofke-Owen, Kristi Opper, Joseph Beiler, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Including patients in mutual goal setting is one mechanism to personalize care delivery and improve patient outcomes.

Objective:

The purpose of this study was to examine the impact of a nurse educational intervention about mutual goal setting on nurse engagement and self-efficacy for goal setting and the nurse/patient experience of goal setting.

Methods:

During this explanatory, sequential mixed-methods study, nurse engagement in goal setting and goal quality was assessed through chart audits 1-month pre-intervention (n = 173) and 1 and 3-months (n = 144, n = 137) post-intervention. Nurse self-efficacy was measured with the Appraisal Inventory Tool. Patient experience …

Politics Of A Silent Pandemic: Antimicrobial Resistance And State Capacity In India And Nigeria, Mia Kelly

CMC Senior Theses

Antimicrobial Resistance (AMR) has emerged as one of the most pressing yet widely underestimated health threats of the 21st century; this thesis explores the potentially devastating global impact of this “silent pandemic”, exposing how deeply health outcomes depend on political choices, regulatory capacity, and economic constraints. Although the danger of spreading drug-resistant pathogens is now widely acknowledged in both the scientific and political communities, states differ in their abilities to contain the issue, with low- and middle-income countries facing the greatest obstacles to national action plan implementation. This thesis investigates these disparities through a comparison of India and Nigeria, two …

Bioinformatic Identification And Analysis Of Shared Splicing Errors In Myotonic Dystrophy Type (Dm1) And Fuchs' Endothelial Corneal Dystrophy (Fecd), Carter I. Wilkins

Electronic Theses & Dissertations (2024 - present)

Myotonic dystrophy type 1 (DM1) is an autosomal dominant form of muscular dystrophy, and it is the most common form of adult-onset muscular dystrophy. The disease is the result of CTG trinucleotide repeats (TNR) in the 3’UTR of the dystrophia myotonica protein kinase (DMPK) gene. This produces toxic RNA hairpin structures by CUG repeat expansions that sequester proteins–most relevantly muscleblind-like 1 (MBNL)–that regulate alternative RNA splicing. The missplicing of a wide variety of genes results in the symptoms such as myotonia (rigidity of the muscles), atrophy, and cardiac failure.

Fuchs’ Endothelial Corneal Dystrophy (FECD) is characterized by progressive loss and …

Specification Of Validated Groundwater Flow And Transport Models For Historical Perfluorinated Compound Dose Reconstruction, Cindy A. Arthur

Electronic Theses & Dissertations (2024 - present)

Per- and polyfluoroalkyl substance (PFAS) contamination in Hoosick Falls, New York, resulted from historical industrial activities, with groundwater transport identified as the primary pathway impacting the municipal wellfield within the Village of Hoosick Falls, whereas atmospheric deposition remains a potential source of private well contamination. This study employed two complementary methodologies to evaluate historical municipal and private well contamination: (i) groundwater flow and transport modeling of PFOA, PFOS, PFHxS, and PFNA within the village, and (ii) Geographic Information Systems (GIS)–based inverse distance weighting (IDW) interpolation of PFOA concentrations in private wells across the broader Town of Hoosick.

Groundwater modeling results …

Racial Bias In Collateral Report Of Adhd Symptom Endorsement, Teresa Mejia

Electronic Theses & Dissertations (2024 - present)

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed mental health condition among children in the United States. However, prevalence rates in the diagnosis and treatment of ADHD are unequal across populations. Specifically, the literature has demonstrated consistent variability in symptom endorsements and diagnosis dependent on a child’s demographic factors (i.e., race, gender, age). A diagnosis of ADHD requires that the diagnostic criteria be met in at least two aspects of a child's life, usually the school and home environments. As such, teacher reports are commonly used in the assessment of ADHD for children and adolescents. Given the challenges in obtaining …

Development And Applications Of Fluorescence Microscopy Protocol To Investigate Borrelia Burgdorferi Immune Interactions In The Skin, Rebecca V. Landry

Electronic Theses & Dissertations (2024 - present)

The skin is an immunological organ that acts as the hosts’ first line of defense against infectious agents. Infectious disease vectors like ticks breach this barrier by feeding on hosts, transmitting pathogens like Borrelia burgdorferi in the process. Uncleared infection with B. burgdorferi causes Lyme disease, the most prevalent vector-borne disease in the United States. Previous research has explained many elements of Lyme disease pathogenesis and immunity including the dissemination of the spirochete, innate immune cells performing phagocytosis, the production of antibodies by the humoral response, and the impact of prophylactic treatment with monoclonal antibodies. A remaining gap in the …

Combating Antibiotic Resistance With Plasmid-Dependent Phages, Rhiannon T. Mariano

Electronic Theses & Dissertations (2024 - present)

The alarming rise of carbapenem-resistant bacteria poses an urgent global health threat, driven in large part by the horizontal spread of carbapenemase-encoding plasmids (Ma et al., 2023). These plasmids are often highly mobile and transmissible, enabling rapid dissemination of resistance genes across diverse bacterial populations. Their mobility is largely mediated by conjugation, a process dependent on the formation of pili, which serve as physical bridges for plasmid transfer between cells (Murray et al. 2022; San Millan and MacLean 2017; Virolle et al. 2020). Beyond their role in gene exchange, these pili also act as entry points for a unique class …

Pillpetz: A Smarter Way To Encourage Medication Adherence In Children, John H. Begley

CMC Senior Theses

Medication adherence is usually framed as a problem of patient behavior, but this thesis argues that it is equally a problem of design. Children who take daily medication face barriers that adults often do not: developing executive function, dependence on caregivers, shifting school and home routines, privacy concerns, and stigma around being perceived as different. The standard prescription bottle, by contrast, was designed primarily for dispensing efficiency, safety, and accidental ingestion prevention—not for sustained daily use by a developing child.

This thesis proposes PillPetz, a smart pill case and digital companion that uses routine, play, dose confirmation, and caregiver-connected support …

Modulating Oran Nitrate-Reducing Bacteria To Enhance Nitric Oxide Bioavailability As A Therapeutic Target For Atherosclerosis, Donovan C. Davidson

CMC Senior Theses

Atherosclerosis remains the primary driver of global cardiovascular disease, yet clinical interventions are largely restricted to high-cost, invasive procedures only after it has reached a critical stage. Recent research has identified a connection between the oral microbiome and vascular health via the enterosalivary nitrate-nitrite-nitic oxide (NO) pathway. Oral nitrate-reducing bacteria (ONRB) drive the synthesization of NO by reducing dietary nitrate into nitrite, which is then converted into bioavailable NO. NO is a potent vasodilator that maintains endothelial health by suppressing inflammation through inhibiting the expression of adhesion molecules VCAM-1 and ICAM-1. However, this pathway is easily compromised by dysbiotic oral …

Not Biological, But Built: Structural And Metabolic Pathways Driving Black Maternal Health Disparities In The United States, Alexandra I. Umegboh

CMC Senior Theses

Black infants in the United States are more than twice as likely to die before their first birthday than white infants, a disparity often attributed to genetics, behavior, or individual health choices. However, this idea is challenged by a key contradiction: African immigrant women consistently experience better birth outcomes than U.S.-born Black women despite being similarly racialized. This thesis investigates the origins of this reproductive advantage and the factors contributing to its decline over time. By drawing on epidemiological data, metabolic health research, and literature on African diasporic healing traditions, it argues that the “healthy immigrant effect” is not biological, …

Intermittent High-Fat, High-Sugar Access During Adolescence Drives Binge-Restriction Feeding And Reduced Weight Gain In A Food Unpredictability Model, Calvin G. Miller

CMC Senior Theses

Food insecurity affects nearly 48 million Americans and 318 million people worldwide, with very low food security disrupting normal eating habits through “feast-or-famine” episodes characterized by cycles of food overconsumption followed by restriction. This dietary pattern alters dopamine signaling within the mesocorticolimbic system — brain circuitry intimately linked to reward processing. This system includes the ventral tegmental area (VTA) and prefrontal cortex (PFC). Overstimulation can be promoted through sporadic high-fat, high-sugar diet (HFHSD) exposure, promoting dopamine neuron architecture alterations and binge-eating behavior. Adolescence represents a vulnerable window, as mesocorticolimbic dopamine projections undergo maturation during this period. Though evidence links food …

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …

The Effects Of Vitamin K On Neuronal Ferroptosis, Chelsey P. Eighmey

Electronic Theses & Dissertations (2024 - present)

Dementia is a crippling illness affecting millions worldwide causing significant public health burdens with long-term care. The lack of treatment options results in many years of suffering for affected individuals and their loved ones who often become primary caretakers. Decades of study have focused on treating dementia with little-to-no success, so an emphasis is needed on attempting to prevent disease progression altogether. This research explored vitamin K as a potential strategy for prevention of dementia onset or progression through the mechanism of suppressing ferroptosis. Ferroptosis is a type of cell death suggested to contribute to the hallmark traits of Alzheimer’s …

Beyond Numbers: Bridging Statistical Significance And Clinical Relevance In Healthcare Research, Maharaj Singh, Waheeda Khan, Mehreen Fatima

College of Nursing Faculty Research and Publications

Objective: This study aims to bridge the gap between statistical significance and clinical relevance using rigorous statistical methodologies applied to simulated healthcare data, thereby enhancing the translational value of research outcomes for patient‑centered care. Methods: A synthetic dataset representing 10,000 patients was generated, and descriptive statistics were applied to compare two treatment groups. Binary outcomes were predicted using both a logistic regression model and a neural network. Two‑tailed tests with a significant level of 0.05 were employed, utilizing SAS version 9.4 and IBM SPSS Statistics, Version 29.0 (IBM Corp., Armonk, New York, United States of America). Results: The simulated dataset …

Structural Inequities, Environmental Toxicants, And Cardiometabolic Pathways In Cardiovascular Disease: Evidence From A Nationally Representative U.S. Population, Ese F. Oghaghare

Electronic Theses & Dissertations (2024 - present)

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States and continues to disproportionately burden racial/ethnic minorities and socioeconomically disadvantaged populations. Traditional risk factors and behavioral explanations fail to fully account for these persistent disparities, motivating increased attention to intermediate biological pathways and environmental toxicant exposures through which structural inequities may become biologically embedded. This dissertation investigates how cardiometabolic biomarkers, diet quality, and exposure to persistent organic pollutants jointly contribute to cardiovascular disease risk in a nationally representative U.S. population.

Using data from the National Health and Nutrition Examination Survey (NHANES), three complementary studies were …

Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti

Electronic Theses & Dissertations (2024 - present)

Syphilis is caused by Treponema pallidum and transmitted through direct contact with infected mucosal lesions and via vertical transmission during pregnancy (i.e., congenital). Transmission of syphilis to an infant during pregnancy (i.e., congenital syphilis [CS]) can lead to early fetal death, stillbirth, neonatal death, preterm birth, low birthweight, and congenital infection in infants. The United States (U.S.) is experiencing epidemic increases in both females of reproductive age with syphilis and infants with CS. In New York State (NYS), these trends have also occurred, especially after COVID-19 emergence, and increases in reported cases and incidence rates are comparable to national statistics. …

From Imbalance To Phenotype: Neurodevelopmental Alterations In Trisomy 21, Andrew Yuan

CMC Senior Theses

Down syndrome (DS), caused by Trisomy 21, is the most common genetic cause of intellectual disability. Individuals with DS consistently show reduced brain volume, decreased cortical thickness, and lasting impairments in learning, memory, and executive functioning. These neuroanatomical changes emerge during fetal development and are accompanied by chronic immune dysregulation due to the triplication of four interferon receptor genes on chromosome 21. Although decreased neuron progenitor proliferation has been known to contribute to these phenotypes, the precise timing and cellular mechanisms underlying disruptions in neurogenesis remain not fully understood. This study used immunohistochemistry to examine human fetal cortical tissue from …

Associations Between Neighborhood Physical And Social Stressors During Sensitive Developmental Periods And Substance Use In Early Adulthood, Abigail M. Ulofoshio

Electronic Theses & Dissertations (2024 - present)

Background

Substance use is a major public health problem. Neighborhood disadvantage and related stressors have been linked to increased substance use in adolescence and early adulthood, although findings are mixed. No studies have explored whether the timing or accumulation of neighborhood stressors in childhood and adolescence impact substance use in early adulthood. This study aims to investigate to what extent physical and social neighborhood stress during sensitive developmental periods influence substance use dependency and illicit substance use in early adulthood.

Methods

We analyzed an imputed sample (n = 7,494) from the Avon Longitudinal Study of Parents and Children (ALSPAC), a …

Access To Appropriate Care, Mortality, And Cost Of Inpatient Hospitalization In Infants With Omphalocele And Gastroschisis In The United States, Treeva A. Jaff

Electronic Theses & Dissertations (2024 - present)

Congenital abdominal wall defects (AWDs), including omphalocele (OM) and gastroschisis (GS), are rare but clinically significant conditions that require immediate surgical intervention and prolonged neonatal intensive care. OM is a midline defect in which abdominal organs protrude into the umbilical cord covered by a membranous sac, while GS is a full-thickness defect typically located to the right of the umbilicus through which organs protrude without protective coverage. OM is frequently associated with major co-occurring congenital anomalies and chromosomal abnormalities, while GS more commonly occurs as an isolated defect but requires more intensive surgical management. As survival rates have improved, research …

Genetic Diversity Of Cryptosporidium Species In New York State, Kimberly A. Mergen

Electronic Theses & Dissertations (2024 - present)

The knowledge regarding Cryptosporidium infections in New York State (NYS) is severely lacking in two ways: 1) there are currently no NYS-based data regarding the subtypes of Cryptosporidium parvum and Cryptosporidium hominis, which are the two most prevalent species that infect humans and 2) information regarding uncommon Cryptosporidium species that infect the New York population is also unavailable. Filling these gaps concerning this pathogenic parasite would provide a substantial amount of information when considering public health, outbreak investigations, and prevention measures. Therefore, improving Cryptosporidium subtype and species surveillance in NYS will aid in prevention and control efforts as well …

Studies Towards Chemical Synthesis Of Homogeneous Prion Glycoprotein, Baotong Tian

Electronic Theses & Dissertations (2024 - present)

Prion diseases are fatal neurodegenerative disorders initiated by conformational misfolding of the prion protein (PrP), which generates pathogenic conformers that propagate via templated conversion and accumulate as aggregates. Glycosylation can modulate the PrP folding energy landscape, thereby biasing folding trajectories and the distribution of resulting conformational states. Bank vole PrP contains two N-linked glycosylation sites, and disentangling the contributions of site occupancy versus glycan structure requires homogeneous, site-defined glycoforms. In contrast, biosynthetic expression typically produces heterogeneous glycoform ensembles due to multistep Golgi processing, precluding independent control of glycan identity at each site. Here we report a chemical synthesis strategy of …

Photo And Spatial Control Of Rna Structures And Functions: Exploring Positional Effects And Photo-Responsiveness Of Azobenzene Modified Nucleotides, Jinxi Du

Electronic Theses & Dissertations (2024 - present)

RNA molecules perform many important biological functions by forming complex three-dimensional structures stabilized by base pairing, tertiary interactions, and metal ion coordination. Because RNA function depends strongly on its structure, methods that allow reversible control of RNA conformation and activity are important for understanding RNA behavior and for potential therapeutic applications. However, achieving reversible and site-specific control of RNA structure, especially at the single-nucleotide level, remains challenging. In this dissertation, I developed and applied azobenzene-modified nucleotides as a chemical tool to enable optical and spatial control of RNA structure and function.

The first part of this dissertation focuses on establishing …

Geovig And Purevig: Geometry-Aware Architectures For Efficient Computer Vision, Omar Ismail

Theses and Dissertations (Comprehensive)

Deploying deep learning models for medical image analysis on mobile devices requires a balance between inference latency, memory footprint, and delineating anatomical boundaries with high accuracy. While Convolutional Neural Networks (CNNs) and mobile Vision Transformers (ViTs) offer efficiency, they often struggle to model the irregular, non-local geometric structures inherent in biological tissues without incurring prohibitive computational costs. In this thesis, we introduce GeoViG (Geometric Vision Graph), an architecture that bridges the gap between efficient grid-based processing and explicit Geometric Deep Learning. GeoViG introduces a novel transition from high-resolution pixel grids to low-resolution dynamic graphs via a SpreadEdgePool operator, a geometry-aware …

Investigating The Immunostimulatory Potential Of Dsrna-Silk Nanoparticle Complexes In Melanoma, Samuel J. Peters

Theses and Dissertations (Comprehensive)

The rate of resistance to immune checkpoint inhibitor treatment in metastatic melanoma is quite high, with an overall rate of 70%. Melanoma achieves these high rates of resistance by suppressing the immune response in the tumour microenvironment (TME), making them immunologically “cold”. The type 1 interferon response could be leveraged to initiate immune responses in melanoma, making their “cold” TMEs “warm” again. Double-stranded ribonucleic acids (dsRNAs) are potent activators of an innate immune response; however, they are susceptible to degradation by nucleases present in the body and need a carrier. Silk nanoparticles (SNPs) are an ideal drug-delivery platform as they …

“Shaking The Ladder” Reveals How Analytic Choices Can Influence Associations In Nutrition Epidemiology: Beef Intake And Coronary Heart Disease As A Case Study, Colby J Vorland, Lauren E O'Connor, Beate Henschel, Cuiqiong Huo, James M Shikany, Carlos A Serrano, Robert Henschel, Stephanie L Dickinson, Keisuke Ejima, Aurelian Bidulescu, David B Allison, Andrew W Brown

Children’s Nutrition Research Center Staff Publications

Nutrition epidemiological models involve many analytic decisions, such as defining exposures, selecting which covariates to include, or configuring variables in different ways. We explored the impact of analytical decisions on conclusions in nutrition epidemiology using self-reported beef intake and incident coronary heart disease as a case study. We used REasons for Geographic and Racial Differences in Stroke (REGARDS) data, and selected covariates and their configurations from published literature to recapitulate common models used to assess associations between meat intake and health outcomes. Three model sets were designed: sets one and two used continuous and quintile-defined beef intakes, respectively, each with …