Medicine and Health Sciences Commons^™

Improving Post-Resuscitation Debriefing Completion Rates In An Acute Care Community Hospital: A Quality Improvement Project, Tiffany Tolden

Doctor of Nursing Practice Projects

Background: Post-resuscitation debriefing improves team dynamics and CPR quality and can identify systemic barriers to quality care delivery. However, completion rates remain low in acute care settings. Purpose: This quality improvement project evaluated whether a one-hour training session for rapid response nurses and charge nurses, combined with weekly reminder emails, would increase completion rates of post-resuscitation debriefings and influence nurses’ perceptions of their usefulness in an acute care community hospital. PICOT Questions: Will a one-hour training session (I) with rapid response nurses and unit charge nurses (P), along with a weekly reminder system (I), increase the completion rate (O) of …

Decorin Deficiency Promotes D-Galactose-Induced Skeletal Muscle Atrophy And Fibrosis By Regulating Itgb1/Akt/Mtor Signalling Pathway, Xiaoqin Luo, Mengxue Zhang, Lili Chen, Ruichang Wang, Jiabing Lian, Zhe Yang, Renato V. Iozzo, Jin Wang, Yan Zhang, Xiuli Bi

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Primary sarcopenia is an age-associated disorder with progressive and generalised loss of skeletal muscle strength and mass. Skeletal muscle fibrosis is one of the significant pathological manifestations of age-associated sarcopenia. Decorin, a small dermatan-sulfate proteoglycan, participates in extracellular matrix assembly. In numerous studies, the involvement of decorin is not restricted to matrix structural proteins, and it also affects a diverse variety of biological functions like cell growth, adhesion, migration, proliferation and differentiation. Additionally, it modulates the process of inflammation and fibrillogenesis. Based on these preclinical evidences, we hypothesised that decorin may potentially play an important role in skeletal muscles …

J Mich Dent Assoc December 2025

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons. The December 2025 (Volume 107, No. 11) issue of the Journal is published in a digital-only format to provide updates and insights for Michigan's oral health community and MDA members. Print editions will resume in the new year.

This issue includes feature articles on the Michigan Dental Foundation, A Case for Credentialing Dental Assistants, and a feature …

The Spoon Theory & Autoimmune Diseases, Karen Davis Rdh, Bsdh

Metro Denver Dental Society Articulator Magazine

In this article, Karen Davis, RDH, BSDH, uses the Spoon Theory to illustrate how the hidden challenges of living with an autoimmune disease or chronic illness can impact oral health, treatment tolerance and daily hygiene routines. She offers practical strategies for dental teams to better support “Spoonie” patients with compassionate, customized care.

Oral Health Is Still The World’S #1 Disease. Here’S How We Fix That, Kami Hoss Dds

Metro Denver Dental Society Articulator Magazine

Dr. Kami Hoss explores how outdated products, one-size-fits-all routines and microbiome-disrupting ingredients are failing patients, and why a more personalized, science-driven approach is urgently needed. His message is clear: it’s time to reinvent oral care for the 21st century.

Here’S What’S New — Coming To The 2026 Mda Annual Session, Andrea Sunderman, David Foe

The Journal of the Michigan Dental Association

The 2026 MDA Annual Session, held April 30 – May 2 at DeVos Place in Grand Rapids, will feature significant improvements. The major change eliminates cumbersome a la carte pricing for courses. Instead, attendees can purchase a one-day pass or a full conference package, granting access to any course without advance sign-up. The schedule is shortened to two-and-a-half days. Passes include a hot lunch in the Exhibit Hall on Thursday and Friday, and courses are streamlined to allow more time for vendor visits and socializing. The event will also feature three keynote addresses and a new Friday night social event, …

Do Patient-Important Outcomes Differ By Care Setting? Findings From Semi-Structured Interviews With Individuals With Diabetes, Amy Cunningham, Alexzandra Gentsch, Pouya Arefi, Judd E. Hollander, Marianna D Lanoue, Amanda M. B. Doty, Geoffrey Mills, Brendan Carr, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

Background: Patient-important outcomes (PIOs) reflect patient values and preferences. Prior studies have elicited a variety of PIOs for diabetes. However, no studies have examined whether, or how, PIOs differ across diabetes care settings. The purpose of this study was to compare the frequencies of PIOs derived from patients with diabetes in primary care (PC), acute care (emergency department (ED)), and post-acute care (post-hospital discharge (PHD)) settings within a large delivery system. Methods: This study was an analysis of 89 interviews with patients in PC, ED, and PHD settings. Participants had moderately to poorly controlled diabetes, defined as follows: presented to …

Applying Entrustable Professional Activities Across Emergency Medicine Medical Education Fellowships: A Cross-Institutional Commentary, Carrie Maupin, Ambika Anand, Danielle Nesbit, Casey Morrone, Danielle Sultan

Department of Emergency Medicine Faculty Papers

No abstract provided.

Evaluation Of Heterotopic Ossification Following Two-Level Cervical Disc Arthroplasty With A Peek-On-Ceramic Artificial Disc, Jad Khalil, Hyan Bae, Pierce Nunley, K Brandon Strenge, Ashvin Patel, Armen Khachatryan, Rick Sasso, Andrew Park, Christopher Good, James Yue, Paul Kim, Richard Guyer

Conference Presentation Abstracts

Introduction: While favorable outcomes have consistently been reported following treatment of disc degeneration with cervical total disc replacement (cTDR), the development of heterotopic ossification (HO) at the index level has been reported. This study evaluated baseline characteristics potentially associated with the development of HO, as well as the impact of HO on 5-year clinical outcomes Materials and Methods: Baseline characteristics and 5-year outcomes of two-level polyetheretherketone (PEEK)-on-ceramic cTDR patients were stratified by worst HO grade at either index level through 5 years (defined as grade 1, 2, 3 or 4 on the McAfee/Mehren scale). Baseline index-level radiographic variables were stratified …

Black Women’S Experiences Accessing Health Care And Law Enforcement After Intimate Partner Violence: A Qualitative Pilot Study, Kaylen M. Moore, Linda M. Wesp, Jeneile Luebke, Peninnah M. Kako

College of Nursing Faculty Research and Publications

Background:

Intimate partner violence (IPV) is a global public health issue impacting millions of people each year. Black women constitute 14% of the US population but alarmingly comprise 31% of homicides resulting from IPV. African American women survivors of IPV experience intersecting impacts of racism, sexism, and historical mistrust. This research aimed to raise awareness about their experiences of violence and perceptions of institutional support.

Objective:

This study sought to explore African American women’s experiences with IPV and navigation of health care and law enforcement after experiences of violence.

Method:

Critical ethnography was used as an approach for this qualitative …

Sleep-Disordered Breathing Subtypes And Future Diet Quality In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Cecilia Castro-Diehl, Tianyi Huang, Alexis C Wood, Jerome I Rotter, Stephen S Rich, Tamar Sofer, Susan Redline, Heming Wang

Children’s Nutrition Research Center Staff Publications

Objectives: Sleep-disordered breathing (SDB) and diet quality impact cardiometabolic disease, but few studies have examined if SDB influences diet quality. This study estimated the association between SDB subtypes (with and without sleepiness) and future diet quality in the Multi-Ethnic Study of Atherosclerosis.

Methods: Probable SDB was characterized by self-reported physician-diagnosed sleep apnea (PDSA) or habitual snoring and subtyped by presence or absence of sleepiness. A food frequency questionnaire measured diet 1.6 years before, and 7.8 years after SDB assessment. Diet quality was measured with the Alternate Healthy Eating Index-2010 (AHEI). Mean differences in AHEI at follow-up by SDB subtypes were …

Predicting Five-Year Comorbid Bipolar Disorder After Attention-Deficit/Hyperactivity Disorder Diagnosis: A Population-Based Machine Learning Approach, Yen-Shan Yang, Chih-Wei Hsu, Liang-Jen Wang, Kuo-Chuan Hung, Yang-Chieh Brian Chen, Chih-Sung Liang, Mu-Hong Chen

Children’s Nutrition Research Center Staff Publications

Background

Early detection and accurate prediction of bipolar disorders (BDs) comorbidity in individuals with attention-deficit/hyperactivity disorder (ADHD) are clinically critical. This study used machine-learning methods to identify features predictive of subsequent BD among patients initially diagnosed with ADHD.

Methods

We analyzed claims from the Taiwan National Health Insurance Research Database (2000–2013) and included patients aged ≥ 12 years with at least two diagnoses of ADHD. Predictor features included demographics (sex, age at ADHD onset), healthcare utilization (psychiatric outpatient visit counts), comorbidities (International Classification of Diseases–coded diagnoses), psychiatric medications (Anatomical Therapeutic Chemical–coded prescriptions), and family psychiatric history. All features were extracted …

A Class Of Benzofuranoindoline-Bearing Heptacyclic Fungal Ripps With Anticancer Activities, Qiuyue Nie, Fanglong Zhao, Xuerong Yu, Mithun C Madhusudhanan, Caleb Chang, Siting Li, Sandipan Roy Chowdhury, Bryce Kille, Andy Xu, Rory Sharkey, Chunxiao Sun, Hongzhi Zeng, Shuai Liu, Dishu Zhou, Xin Yu, Kevin Yang, Sandra A C Figueiredo, Maria Zotova, Zichen Hu, Alan Y Du, Dongyin Guan, Rui Tang, Todd Treangen, Jin Wang, Pedro N Leão, Yang Gao, Junjie Chen, Peng Liu, Hans Renata, Xue Gao

Children’s Nutrition Research Center Staff Publications

Ribosomally synthesized and post-translationally modified peptides (RiPPs) are a promising source of new pharmaceuticals, yet the therapeutic potential of fungal RiPPs remains largely underexplored. Here, we report asperigimycins as a distinct class of fungal RiPPs, featuring a unique heptacyclic scaffold consisting of a benzofuranoindoline core and three additional macrocycles, primarily assembled by six distinct fungi-specific DUF3328 oxidases. Inspired by the enhancement of anticancer activity through the N-terminal pyroglutamate in naturally occurring asperigimycins C and D, we chemically modify the inactive asperigimycin B with a series of lipid substitutions at its N-terminus. A derivative with a C-11 linear fatty …

Bypassing Cisplatin Resistance In Nrf2 Hyperactivated Head And Neck Cancer Through Effective Pi3kinase Targeting, Pedram Yadollahi, Kelli A Mccord, Yang Li, Hussam Dayoub, Kalil Saab, Fonma Essien, Sean Hyslop, Emerald Kan, Kazi M Ahmed, Parker R Kirby, Vasanta Putluri, Chandra Shekar R Ambati, Karthik Reddy Kami Reddy, Patricia Castro, Heath D Skinner, Cristian Coarfa, William K Decker, Abdullah A Osman, Rutulkumar Patel, Jeffrey N Myers, Stephen Y Lai, Nagireddy Putluri, Faye M Johnson, Mitchell J Frederick, William H Hudson, Vlad C Sandulache

Faculty, Staff and Students Publications

Background: For patients with head and neck squamous cell carcinoma (HNSCC), failure of definitive radiation combined with cisplatin nearly universally results in death. Although hyperactivation of the Nrf2 pathway can drive radiation and cisplatin resistance along with suppressed anti-tumor immunity, treatment-refractory HNSCC tumors may retain sensitivity to targeted agents secondary to synergistic lethality with other oncogenic drivers (e.g., NOTCH1 mutations).

Methods: Using state of the science mechanistic, metabolomic and spatial transcriptomic approaches combined with preclinical models of HNSCC, we tested whether a novel PI3K inhibitor, gedatolisib, can bypass hyperactivation of the Nrf2 pathway.

Results: The PI3K pathway is activated in …

Intentional Ai: Preserving Skills, Judgment And Humanity

Metro Denver Dental Society Articulator Magazine

Dr. Amisha Singh explores the rapid rise of AI across dentistry, highlighting both its transformative potential and the ethical, cognitive and professional risks that come with overreliance. She emphasizes the need for intentional use, critical thinking and boundaries that preserve core clinical and human skills. Her reflection offers a roadmap for using AI as an amplifier of expertise rather than a replacement for it.

Mda At Your Service: A Deaf Person Wants To Become My Patient, Rachel Sinacola Dds, Ms

The Journal of the Michigan Dental Association

The column clarifies that under the Americans with Disabilities Act (ADA), dental offices must provide auxiliary aids or services for patients with hearing impairments, which may require a professional interpreter paid for by the dentist in complex visits. Members are encouraged to notify the MDA about practice/life changes (e.g., address changes or caseload shifts) to ensure proper benefits and dues discounts. New associates are strongly urged to utilize the MDA resource for contract review, which offers a 10% discount with Kerr Russell Attorneys. Additionally, the MDA Store provides free Labor Poster Packets, fulfilling state and federal employer requirements.

The Case For Credentialing Dental Assistants, Michelle Godofsky

The Journal of the Michigan Dental Association

Credentialing dental assistants is presented as a method to enhance productivity and address workforce shortages; currently, only about 15% of Michigan dental assistants are Registered Dental Assistants (RDAs). A case study at Thunder Bay Community Health Service, an FQHC in Northern Michigan, illustrates success, where RDAs perform expanded functions—like placing restorations and monitoring nitrous oxide—boosting clinic productivity by 16%. The clinic supports its dental assistants by covering education and exam expenses and providing study time during work hours. This investment improves job satisfaction, confidence, morale, and patient communication among staff, strengthening employee retention.

Back Page: 9th District Delegation Attends Ada House Of Delegates, Michelle M. Nichols-Cruz

The Journal of the Michigan Dental Association

The ADA 9th District delegation, representing Michigan and Wisconsin, attended the ADA House of Delegates meeting in Washington, D.C., in October, which coincided with the ADA SmileCon event. During the meeting, Dr. Deb Peters, former MDA president and MDA House Speaker, was elected Speaker of the ADA House. This historic election makes Dr. Peters the first female ADA speaker. Dr. Michele Tulak-Gorecki, outgoing 9th District ADA trustee, was unsuccessful in her bid for ADA president-elect. The next ADA House meeting is scheduled for October 10-13, 2026, in Indianapolis, Indiana.

Staff Education To Implement Phq-9 Depression Screening Among Adults, Sharon C. Nwanne-Temple

Walden Dissertations and Doctoral Studies

Abstract Depression remains one of the most prevalent and underdiagnosed mental health conditions globally, resulting in substantial morbidity, diminished quality of life, and increased healthcare costs. The purpose of this Doctor of Nursing Practice (DNP) project was to improve early detection of depression among adults in a primary care setting through a structured staff education program on the use of the Patient Health Questionnaire-9 (PHQ-9) screening tool. A mixed-methods quality improvement design guided implementation over a six-week period with nine clinical staff participants, including nurses, medical assistants, and providers. The educational intervention comprised a PowerPoint presentation, interactive discussion, and post-training …

Improving Patient Access To Providers By Optimizing Message Center Workflow, Serena Valino

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement initiative that addressed the practice problem of having large volumes of unanswered messages within the patient portal. To increase patient access to the healthcare provider, a literature search was conducted using the practice-focused question: Can standardization of patient portals improve the message turnaround time? In January 2024, a scoping review of nursing message center pools determined 79 pools lacked standardized names and established workflows for 37 ambulatory clinics. Pool names were identified for each clinic and listed using an Excel spreadsheet. Clinic pool members were isolated, and it was determined by …

The Role Of Fast-Food Consumption, Residential Fast-Food Exposures, And Urinary Essential Trace Heavy Metals In Colorectal Cancer (Crc) Outcomes., Jeevan Adhikari

Electronic Theses and Dissertations

Background: Colorectal cancer (CRC) is a public health concern. Within the United States (US), fast-food consumption and environmental exposure to heavy metals have increased. The impact of fast-food consumption frequency from fast-food restaurants, residential fast-food exposures, and urinary essential trace heavy metals in relation to CRC outcomes have not yet been rigorously evaluated in the US. Methods: Within the LEAPS-CRC study, we used geographic information systems (GIS) and logistic regression to study the association of fast-food consumption, residential proximity to a fast-food outlet, and urinary essential trace metals with CRC incidence. Additionally, within Kentucky Cancer Registry (KCR) CRC cases, the …

Residential Segregation And Breast Cancer In Louisville: Impact Of Race And Contextual Factors On Advanced-Stage Diagnosis, Delayed Treatment, And Disease-Specific Mortality., Toheeb Ajani Mustapha

Electronic Theses and Dissertations

Female breast cancer (BC) remains the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among U.S. women. Despite advances in detection and treatment, substantial inequities in BC outcomes persist, driven in part by structural forces such as residential segregation. This dissertation examined the relationship between residential segregation, BC outcomes, and key contextual factors in Louisville, Kentucky. Using data from the Kentucky Cancer Registry, American Community Survey, CDC’s Population-Level Analyses and Community Estimates, and the National Neighborhood Data Archive, the study tested two hypotheses: (1) higher Black/low-income segregation is associated with elevated risks of adverse BC …

Increasing Histidyl Dipeptides In Skeletal Muscle Preserves Muscle Mass And Function In Heart Failure., Mamata Hiraman Chaudhari

Electronic Theses and Dissertations

Introduction: Heart failure is a systemic disease associated with multiple comorbidities, such as skeletal muscle wasting and cardiopulmonary disease. Muscle wasting in heart failure patients is a severe comorbidity associated with decreased exercise capacity and poor quality of life. Previous reports show that oxidative stress is increased in the skeletal muscle of heart failure patients, which can directly lead to muscle wasting. However, antioxidant intervention in these patients was unable to improve cardiac function and consequently had no effect on muscle wasting. Although oxidative stress is the primary driver of skeletal muscle atrophy, no attempt has been made to examine …

A Multilevel Analysis To Evaluate Variability In Sdoh Clusters Within Rurality And Its Effects On Cancer-Specific And All-Cause Mortality In The Us., Stephie Ann Abraham

Electronic Theses and Dissertations

Social determinants of health (SDOH) factors have consistently been shown to impact all-cause and cancer-specific mortality. Area-level SDOH factors that coexist to form “high-risk” clusters are more prevalent in rural than urban areas. However, heterogeneity within rural and urban areas may contribute to variations in SDOH factors that could influence higher mortality rates and is not considered in other studies. The primary objective of this study was to utilize ecological and individual-level data to determine if the composition of SDOH clusters within counties in the rural-urban continuum contributes to differences in all-cause (AC) and cancer-specific mortality rates of lung and …

Understanding Social And Cognitive Influences In Medical Students' Learning Processes For Step 1: An Interpretivist Case Study., Ashley Elaine Triplett

Electronic Theses and Dissertations

This qualitative interpretivist case study explores, at a singular institution, medical students’ perspectives on the social and cognitive factors influencing the learning process as students prepare for the Step 1 examination. While prior research regarding medical students Step 1 preparation have focused primarily on wellness, stress, and career outcomes, limited studies have examined medical students' lived experiences to navigate what occurs during the learning process while they prepare for this critical exam. Utilizing a qualitative case study approach, this dissertation draws on fourteen student interviews, seven that passed Step 1 on their first attempt, and seven that failed. Findings reveal …

Articulator Volume 31, Issue 4

Metro Denver Dental Society Articulator Magazine

The 4^th Quarter 2025 of the MDDS Articulator Magazine offers a preview of the 2026 Rocky Mountain Dental Convention, taking place January 22–24 in Denver. The collection spotlights RMDC speakers and the future of dentistry, from the rise of AI and the shift toward integrated whole-health care to the hidden challenges of chronic illness, and a commitment to preserving natural dentition. The articles challenge dental professionals to rethink assumptions, embrace interdisciplinary collaboration and adopt more personalized and evidence-driven approaches to care.

The Personality Profile Of U.S. Vice President Jd Vance, Aubrey Immelman, Logan Butler

Psychology Faculty Publications

This paper presents the results of an indirect personality assessment of U.S. vice president JD Vance, from the conceptual perspective of personologist Theodore Millon.

Psychodiagnostically relevant data relating to Vance were collected from biographical sources and media reports and synthesized into a personality profile using the Millon Inventory of Diagnostic Criteria (MIDC), which yields 34 normal and maladaptive personality classifications congruent with DSM-III-R, DSM-IV, and DSM-5-TR.

The personality profile yielded by the MIDC was analyzed in accordance with interpretive guidelines provided in the MIDC and Millon Index of Personality Styles manuals. Vance’s primary personality patterns were found …

The Effect Of Shared Decisions On Intertemporal Choice, Rosemarie M. Davidson

Masters Theses

Substance use disorders are a significant public health concern, and improving treatment outcomes requires a better understanding of the behavioral processes that influence drug consumption. Delay discounting, or the tendency to overvalue immediate reinforcers, is reliably more severe among individuals with substance use disorders. Recent work suggests that shared decision-making may increase tolerance for delayed rewards; however, prior studies used procedures that confounded delay to token delivery with delay to token exchange, limiting conclusions. The present study evaluates delay discounting across individual and social decision-making contexts using a traditional delay discounting paradigm.

Ten undergraduate participants completed sessions involving choices between …

Caring For Caregivers: Fostering Empathetic Educational Practices Among Undergraduate Nursing Faculty, Karlee Hedrick

DNP Projects

BACKGROUND: Trauma is highly prevalent among nursing students, and unrecognized responses to that trauma can negatively impact learning, psychological safety, and academic performance (Doughty, 2020). Although trauma-informed care (TIC) principles are described in clinical settings, its use in undergraduate nursing programs remains limited. Faculty often lack formal TIC training, reducing their ability to support students with lived traumatic experiences. TIC education can improve awareness, responsiveness, and educator confidence (Bosse et al., 2021; Doughty, 2020; MacLochlainn et al., 2022). This project aimed to improve faculty knowledge and explore attitudinal shifts following a structured TIC educational intervention.

METHODS: Two Plan-Do-Study-Act (PDSA) cycles …

Evaluating Healthcare Professionals’ Perceptions Of The Ist Algorithm In Maternal-Fetal Health Clinic: Usability And Satisfaction, Terri Taylor

Doctor of Nursing Practice Projects

Background: Standardizing substance-use screening in perinatal care is essential for optimizing clinical decision-making and promoting equitable patient outcomes. To address gaps, the Integrated Screening Tool (IST) algorithm was introduced in a Maternal–Fetal Medicine (MFM) clinic. However, 2023 data revealed inconsistent utilization. Evaluation Question: This Doctor of Nursing Practice (DNP) project evaluated: (1) How do nurse practitioners, medical doctors, and registered nurses perceive the usability of the IST algorithm for standardized drug screening in pregnancy? (2) How do these providers rate their satisfaction with the IST algorithm in managing patients with positive drug screens? Methodology: A cross-sectional survey was conducted with …