Medicine and Health Sciences Commons^™

Titer-First Vaccination Protocol In An Employee Health Clinic, Obehi Dickson

Doctor of Nursing Practice Final Project Abstract

Purpose:

The purpose of this project was to evaluate the clinical and financial outcomes of implementing a titer-first vaccination protocol for new employees at an Employee Health Clinic. This project sought to improve cost-effectiveness and reduce unnecessary vaccinations.

Background:

This project was conducted at a large healthcare organization in Houston, Texas, to address the cost burden of traditional vaccination protocols. Pre-vaccination serologic testing helps identify existing immunity, reducing unnecessary vaccinations and overall clinic costs.

Methodology:

The titer-first vaccination protocol includes serologic testing for measles, mumps, rubella (MMR), varicella, and hepatitis B, followed by vaccine administration for those without immunity. Data …

Mandibular Lingual Concavity Evaluation Using Cone Beam Computed Tomography, Anthony L. Neely Dds, Mdentsc, Phd, Bassam M. Kinaia Dds, Ms, Dicoi, Lidya Jirjis Dds, Ms, Dalia Hasso Dds, Ms, Jonathan Zora Dds, Ms, David Van Winkle Dds, Naiomy Perez-Villanueva, Sharhdad Kazerani Dds, Ms, Samual Korkis Dds, Ms, Omar Masabni Dds, Ms, James R. Geist Dds, Ms

The Journal of the Michigan Dental Association

Dental implant placement in the posterior mandible can be impacted by the presence of the lingual concavity. Perforating the lingual cortical bone could lead to life-threatening hemorrhage/airway obstruction. The aim of this retrospective study is to examine dentate and partially edentulous mandibles to describe anatomical variations related to the lingual concavity by evaluating cone beam computed tomography (CBCT).

Mda Services: Endorsed Programs News

The Journal of the Michigan Dental Association

Throughh MDA Services, the Michigan Dental Association (MDA) has announced several endorsed programs aimed at supporting dental practices across Michigan: Compass Dental Gas Service is now endorsed by the MDA for its expertise in installing, maintaining, and repairing dental gas systems. Members benefit from exclusive discounts and safety compliance support. MEDVA Virtual Staffing offers HIPAA-compliant, human virtual assistants to handle administrative tasks remotely. This service helps reduce labor costs and allows in-office staff to focus on patient care. MDA Health Plan sponsors are reminded to submit overdue eligibility verification documents, which are essential for compliance and 2026 renewal preparations. DBS …

Dean's Research Newsletter, August 2025, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Simulating The Blood Transfusion System In Kenya: Modelling Methods And Exploratory Analyses, Yiqi Tian, Bo Zeng, Jana Macleod, Gatwiri Murithi, Cindy Makanga, Hillary Barmasai, Linda Barnes, Rahul Bidanda, Tecla Chelagat, Carolyne Njoki

Anaesthesiology, East Africa

The process of collecting blood from donors and making it available for transfusion requires a complex series of operations involving multiple actors and different resources at each step. Ensuring hospitals receive adequate and safe blood for transfusion is a common challenge across low- and middle-income countries, but is rarely addressed from a system level. This paper presents the first use of discrete event simulation to study the blood system in Kenya and to explore the effect of variations and perturbations at different steps of the system on meeting blood demand at patient level. A process map of the Kenyan blood …

2024 Eacts/Eactaic Guidelines On Patient Blood Management In Adult Cardiac Surgery In Collaboration With Ebcp, Filip Casselman, Marcus Lance, Aamer Ahmed, Alice Ascari, Juan Blanco-Morillo, Daniel Bolliger, Maroua Eid, Gabor Erdoes, Renard Haumann, Anders Jeppsson

Anaesthesiology, East Africa

No abstract provided.

Digital Pathology In Tau Research: A Comparison Of Qupath And Halo, Angelique D. Gonzalez, Yannick Joel Wadop Ngouongo, Benjamin Danner, Kyra M. Clarke, Matthew B. Dopler, Ali Ghaseminejad-Bandpey, Sahana Babu, Julie Parker-Garza, Cole Corbett, Gladys Maestre

School of Medicine Publications

The application of digital pathology tools has expanded in recent years, but non-neoplastic human brain tissue presents unique challenges due to its complexity. This study evaluated HALO and QuPath tau quantification performance in the hippocampus and mid-frontal gyrus across various tauopathies. Percent positivity emerged as the most reliable measure, showing strong correlations with Braak stages and CERAD scores, outperforming object and optical densities. QuPath demonstrated superior correlations with Braak stages, while HALO excelled in aligning with CERAD scoring. However, HALO’s optical density was less consistent. Paired t-tests revealed significant differences in object and optical densities between platforms, though percent positivity …

Summit Max: A Randomized Trial Of The Super Large Bore Hipoint Reperfusion System Versus Vecta System For Aspiration Thrombectomy, Thanh N. Nguyen, Guilherme Dabus, Ben Mcguinness, James Caldwell, Ryan Priest, Ansaar T. Rai, Osama O. Zaidat, Bradley A. Gross, Ricardo Hanel, Ameer E. Hassan

School of Medicine Publications

Background: Rapid and complete recanalization is a primary goal in the endovascular treatment of large vessel occlusion stroke. The effectiveness and safety of super large bore aspiration catheters (0.088″ inner diameter) for the treatment of large vessel occlusion stroke have not been demonstrated in a randomized trial.

Methods: SUMMIT MAX (A Prospective, Randomized, Controlled, Interventional Clinical Trial to Evaluate the Safety and Effectiveness of the Route 92 Medical MonoPoint Reperfusion System for Aspiration Embolectomy in Acute Ischemic Stroke Patients) was a prospective, randomized, controlled, open-label clinical trial of patients with internal carotid artery and middle cerebral artery M1 occlusions, comparing …

An Evaluation Of Training Strategies Among Healthcare Professionals During The Covid-19 Pandemic: A Cross-Sectional Survey Study, Darshani D. Singh

Theses & Dissertations

Background: During Spring 2020, the COVID-19 pandemic temporarily displaced healthcare workers from suspended clinical work areas to inpatient critical care areas. Nurses were rapidly uptrained for unfamiliar roles in critical care using a variety of instructional formats.

Purpose: The purpose of this survey study was to evaluate the effectiveness of eight training strategies on healthcare workers' perceived competence, confidence, and satisfaction during the first wave of the COVID-19 pandemic.

Methods: This cross-sectional, retrospective, investigator-developed survey study examined the effectiveness of eight training strategies used during the COVID-19 pandemic on three outcomes for professional registered nurses. The three outcomes were self-reports …

Prevalence And Risk Factors Of Cerebral Microhemorrhages And Superficial Siderosis In Cognitively Unimpaired Older Adults: Analysis From The Chariot-Pro Substudy, Sujin Kang, Dimitra Kafetsouli, Jamie Ford, Janice Wong, Luc Bracoud, Joyce Suhy, Parthenia Giannakopoulou, Chinedu Momoh, Tom Russ, Craig Ritchie

Brain and Mind Institute

Introduction: Cerebral microhemorrhages (CMHs) and superficial siderosis (SS) are relatively common side effects of anti-amyloid immunotherapies, termed amyloid-related imaging abnormalities (ARIA-H). They are also observed in treatment-naïve older adults. This study explored relationships with modifiable and non-modifiable risk factors.

Methods: This cross-sectional study included 1414 cognitively unimpaired, treatment-naïve individuals aged 60 to 85 years from the Cognitive Health in Ageing Register: Investigational, Observational and Trial Studies in Dementia Research (CHARIOT): Prospective Readiness cOhort (PRO) SubStudy. Relationships between CMHs/SS and cardiovascular risk factors, amyloid beta (Aβ) load, apolipoprotein E (APOE) ε4 status, educational attainment, and white matter hyperintensities were …

Integrating Art Therapy And Emerging Technologies For Enhanced Neuroplasticity And Ptsd Intervention, Piper Hutson, James Hutson

Faculty Scholarship

Post-traumatic stress disorder (PTSD) remains resistant to many conventional treatments, underscoring the need for integrative approaches that harness neuroplasticity. Art therapy, with its capacity to facilitate nonverbal trauma processing and multisensory engagement, has shown distinctive advantages over verbal and pharmacological interventions. Recent innovations, including virtual reality (VR), artificial intelligence (AI), and biofeedback have amplified the therapeutic efficacy of art-based interventions by enabling adaptive, real-time modulation of emotional and physiological states. This review synthesizes current research on technologically enhanced art therapy, comparing it to established treatments such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Findings indicate …

Culturally Centered, Primary Care Interventions For Effective Weight Management Goals In Hispanic/Latino Children, Remigio Acevedo

Doctor of Nursing Practice Final Project Abstract

PURPOSE To implement and evaluate the effectiveness of a clinic-based childhood obesity intervention program for Hispanic/Latino children.

BACKGROUND From 1975 to 2016, childhood obesity rates have more than quadrupled, affecting Hispanic/Latino families the most. Growing evidence suggests that incorporating the family unit and utilizing culturally centered weight management interventions can be cost-effective and pragmatic compared to a standard, generic approach.

METHODOOLOGY A quality improvement project was initiated to provide information on the degree of success of a clinic-based childhood obesity program for Hispanic/Latino children and their parents. The intervention focused on delivering a culturally centered health promotion message based on …

Ambulatory Blood Pressure Monitoring, European Guideline Targets, And Cardiovascular Outcomes: An Individual Patient Data Meta-Analysis, Dong-Yan Zhang, De-Wei An, Yu-Ling Yu, Jesus D. Melgarejo, José Boggia, Dries S. Martens, Tine W. Hansen, Kei Asayama, Takayoshi Ohkubo, Gladys E. Maestre

School of Medicine Publications

Background and aims: Hypertension is the predominant modifiable cardiovascular risk factor. This cohort study assessed the association of risk with the percentage of time that the ambulatory blood pressure (ABP) is within the target range (PTTR) proposed by the 2024 European Society of Cardiology (ESC) guidelines for blood pressure (BP) management.

Methods: In a person-level meta-analysis of 14 230 individuals enrolled in 14 population cohorts, systolic and diastolic ABPs were combined to assess 24-h, daytime, and nighttime PTTR with thresholds for non-elevated ABP set at < 115/65, < 120/70, and < 110/60 mmHg, respectively.

Results: Median 24-h PTTR was 18% (interquartile range 5-33) corresponding to 4.3 h (1.2-7.9). Over …

Cultural And Socioeconomic Determinants Of Hip And Knee Arthroplasty In The Medically Underserved Rio Grande Valley Community, Blake C. Martin, Juan C. Lopez Alvarenga, John M. Gaddis

School of Medicine Publications

Introduction: Joint arthroplasty is a common procedure that is increasing worldwide. In this study, we aimed to discover if there were differences in demographics and social factors associated with individuals undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the Rio Grande Valley (RGV). We hypothesized that older individuals and those with higher body mass index (BMI) would have an increased risk of TKA.

Methods: We conducted a retrospective chart review using the University of Texas Rio Grande Valley UTHealth electronic database from January 1, 2018, to July 1, 2024. Individuals were selected using Current Procedural Terminology codes …

Vascular Risk Factors And 1-Year Cognitive Change Among Individuals With Traumatic Brain Injury, Andrea L. C. Schneider, Katherine Hunzinger, Benjamin L. Brett, Danielle K Sandsmark, Sonia Jain, Xiaoying Sun, Raquel C. Gardner, Geoffrey T. Manley, Ramon Diaz-Arrastia, Lindsay D. Nelson, Patrick Belton, Shawn Eagle, Shankar Gopinath, Ramesh Grandhi, C. Dirk Keene, Vijay Krishnamoorthy, Christine Mac Donald, Michael Mccrea, Randall Merchant, Pratik Mukherjee, Laura B. Ngwenya, David Okonkwo, Claudia Robertson, David Schnyer, Sabrina R. Taylor, John K. Yue, Ross Zafonte

Department of Exercise Science Faculty Papers

IMPORTANCE: Traumatic brain injury (TBI) and vascular risk factors are associated with cognitive impairment, but it is unknown if individuals with vascular risk factors experience worse cognitive outcomes after TBI.

OBJECTIVE: To evaluate cognitive function among patients with TBI with vs without comorbid preinjury vascular risk factors.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study examined individuals with TBI enrolled in the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Study between February 26, 2014, and August 8, 2018, with a 1-year follow-up. Analyses were conducted February 26, 2024, to May 29, 2025.

EXPOSURES: Vascular risk factors (ie, hypertension, diabetes, …

A Tale Of Two Toxicants: Investigating The Interaction Between Hexavalent Chromium And Perfluorooctane Sulfonic Acid., Morgan Elizabeth Delnicki

Electronic Theses and Dissertations

Hexavalent chromium [Cr(VI)] and per- and polyfluoroalkyl substances (PFAS) are environmental contaminants of major public health concern. Despite commonly being found together in contaminated drinking water, no studies have considered the concomitant health effects of Cr(VI) and PFAS, specifically perfluorooctane sulfonic acid (PFOS). In vitro studies using CHO cells assessed the cytotoxicity and genotoxicity of Cr(VI) and PFAS both individually and in combination. Intracellular and extracellular Cr levels were measured with Atomic Absorption Spectrometry. PFOS was found to exacerbate Cr(VI) induced cytotoxicity and genotoxicity. Additionally, a novel in vivo model of studying the hepatotoxicity of Cr(VI) was established. Adult Hartley …

Exploring Hexavalent Chromium Exposure And Lipid Accumulation In Liver Disease., Gabrielle Celine Griffin

Electronic Theses and Dissertations

The prevalence of MASLD has doubled over the past 20 years and continues to rise. Hexavalent chromium [Cr(VI)], a top chemical hazard in U.S. drinking water, is emerging as potential risk factor for liver disease. To study the impact of Cr(VI) and high-fat diet on MASLD, we developed an in vivo model using Sprague-Dawley rats exposed to Cr(VI) in drinking water (0, 0.05, or 0.1 mg/L) and fed normal or high-fat diet for 90 days. High-fat diet significantly increased body mass, plasma lipoproteins, cholesterol, liver injury, and hepatic triglycerides, which were exacerbated by Cr(VI) exposure. Cr(VI) alone increased hepatic chromium …

Integrating Bulk And Single-Cell Transcriptomics To Investigate Intratumor Heterogeneity, Shuai Guo

Dissertations and Theses (Open Access)

Cancers are heterogeneous mixtures of tumor and surrounding cells, where each component comprises multiple distinct sub-types and/or states. Understanding the cell-type-specific contributions is critical for advancing cancer biology, yet high-throughput expression profiles from tumor tissues only represent combined signals from all diverse cellular sources. Bulk deconvolution with single-cell/nucleus (sc/sn) RNA-seq data has emerged as a powerful approach to dissect both cellular composition and cell-type-specific expression patterns, yet the technological discrepancy across sequencing platforms limits accuracy.

To systematically evaluate the impact of platform discrepancies on bulk deconvolution, we first generated a benchmark dataset of 24 healthy retinas with paired bulk and …

Chronic Cluster Headache Is A Rare Disease: Implications For Diagnosis, Treatment And Public Health, Hsiangkuo Yuan, Jan Hoffmann, Elena Ruiz De La Torre, Michael J. Marmura, Mario F. P. Peres

Department of Jefferson Headache Center Papers and Presentations

Cluster headache (CH) is a rare and painful primary headache disorder characterized by severe unilateral pain and cranial autonomic symptoms. This perspective examines the epidemiological evidence supporting the classification of chronic cluster headache (CCH) as a rare disease, noting a prevalence of CH of approximately 124 per 100,000 individuals, with only 3.5-13.7% manifesting CCH. This prevalence meets criteria established by both the US Food and Drug Administration and European Medicines Agency for rare disease designation. The rarity of CCH creates substantial clinical and research challenges, including prolonged diagnostic delays, limited research funding and a dearth of approved treatments. The economic …

College Students And Wearable Health Technology: A Study On Digital Health Literacy, Gavin Wright

Undergraduate Honors Thesis Collection

The market for wearable devices has seen significant growth in the last decade and is only expected to increase as the world enters a new age of health literacy known as digital health literacy. Digital health literacy, or eHealth literacy, is defined as “the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem.” The issue with this new age is that most consumers have access, but lack the ability to apply the knowledge that they must improve their health. The goal of this study is …

Therapeutic Potential Of Sglt2 Inhibitors In A Repeated Love Dose Cisplatin Model., Dianet C. Sanchez

Electronic Theses and Dissertations

Cisplatin is a potent chemotherapeutic, thirty percent of patients develop Acute Kidney Injury (AKI). These patients are ten times more likely to develop chronic kidney disease (CKD). Sodium-glucose-cotransporter-2-inhibitors (SGLT2i), FDA approved for diabetes, has shown protection in multiple mouse models of AKI-CKD. We hypothesize SGLT2i can protect the kidney in a model of repeated low dose cisplatin with/without cancer. B6:129 mice with/without lung adenocarcinoma (Lung-adeno) were treated daily with SGLT2i dapagliflozin (10mg/kg)/vehicle control. After seven days, weekly cisplatin (7mg/kg)/vehicle control was initiated for 3-4 weeks. Following final cisplatin dose, kidney function, injury, fibrosis, inflammation was assessed. SGLT2i treatment attenuated alterations …

Measuring The Impact Of The Australian National Placement Evaluation Centre To Enhance Nursing And Midwifery Student Clinical Placements: A Multimodal Evaluation, Colleen Ryan, Robyn Cant, Areum Hyun, Debbie Procter, Louise Alexander, Dianne Bloxsome, Lynda Hughes, Fiona Bogossian, Simon Cooper

Research outputs 2022 to 2026

Aim: To evaluate the early impact of the Centre. Background: The educational quality of nursing and midwifery student clinical placement learning varies. The National Placement Evaluation Centre has a pivotal role in quality improvement by systematically collecting student and supervisor feedback on placement experiences. Design: Multimodal impact evaluation. Methods: Data were collected from website analytics and a survey shared via stakeholder registration emails and social media. The Impact Management Planning and Evaluation Ladder model was used to understand impact. Data were analysed using a sequential, hybrid inductive/deductive approach. Descriptive statistics summarised participant characteristics and qualitative data were themed. Results: Website …

Cross-Cultural Comparison Of Nomophobia, Netlessphobia And Anxiety Among Nursing Students In Iran And Türkiye: A Mediation Analysis, Mohsen S. Ardakani, Abdolrahim Asadollahi, Sevil Ç. Özbay, Yalçın Kanbay, Maryam Bakhtiar

Sultan Qaboos University Medical Journal

Objectives: In the digital era, excessive reliance on smartphones and internet access has led to emerging psychological concerns, including nomophobia (fear of being without a mobile phone) and netlessphobia (fear of being without internet), which are increasingly linked to anxiety among students. This study aimed to compare the prevalence and psychological impact of these phobias among nursing students in Iran and Türkiye. Methods: This cross-sectional study was included nursing students; participants completed validated questionnaires assessing nomophobia, netlessphobia and anxiety. Data were collected from June to July 2024 via paper-based and electronic surveys. Statistical analyses included independent t-tests, multiple regression and …

Does Change In Faith Maturity Reflect Maturation? Establishing Strict Measurement Invariance For The Faith Maturity Scale Across Time, Hiroki Matsuo, Tyler Greenway, Grant B. Morgan, Sarah A. Schnitker

University Faculty Publications and Creative Works

Despite its early focus on religious development and faith maturation, the psychology of religion and spirituality field underutilizes longitudinal designs; work is needed to reduce barriers to the longitudinal study of the processes by which faith matures. As a first step, the present study examines the invariance structure of the Faith Maturity Scale across three time points to assess the reliability and structure of the scale over time. The confirmatory factor analytic method was used to examine data from 572 college students. Configural, metric, scalar, and residual/strict models were tested. Findings support the full strict residual longitudinal invariance model, providing …

Detection Of Activity Cliffs Produced By Anti-Cancer Drugs And An Algorithm For Reliable Predictions In Affected Areas, Sarah Josephine Aurit

Department of Statistics: Dissertations, Theses, and Student Research

An activity cliff (AC) occurs when drugs close in chemical space produce dissimilar biological results. We focus on developing an inferential procedure to detect the presence of ACs in a chemical landscape. If detected, we provide a distance-based procedure that can be used to identify regions of stability in the chemical landscape of interest and generate prediction with higher precision in those areas of stability. We conceptualize the chemical landscape as a spatial random field and use spatial models for prediction of efficacy for new drugs based on “distance” in chemical space. We argue that an AC manifests itself by …

Applications Of Preclinical Magnetic Resonance Imaging In The Treatment Of Traumatic Brain Injury And Understanding Carotid Artery Atherosclerosis, Evan Timothy Curtis

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Advances in magnetic resonance imaging (MRI) provide the opportunity to investigate research questions that have been left unanswered. In the cases of traumatic brain injury (TBI) and carotid artery atherosclerosis, MRI is a resource for non-invasively viewing the phenomena taking place. Additionally, potential interventions and treatments can be observed without harm to the subject. This dissertation expands the understanding of two preclinical applications of MRI: traumatic brain injury and carotid artery atherosclerosis in mouse models.

TBI is a leading cause of death and disability for individuals between 15–45 years of age and effective pharmaceutical interventions for treating the secondary damage …

Intergenerational Family Dynamics Among Caregivers And Children’S Social-Emotional Development In China, Weiman Xu

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The early years of a child’s life are pivotal for social-emotional development. While extensive research has explored the role of family settings in fostering children's social-emotional development (Bornstein, 2005), the impact of grandparental involvement, particularly the caregiving dynamics between generations, remains less well understood. This study aims to fill this gap by examining two critical aspects of intergenerational dynamics among caregivers (i.e. parent-grandparent coparenting and parent-grandparent relationship quality) and their associations with children’s social-emotional development (i.e. social skills and problem behaviors). Two specific aims were delineated: 1) examine the unique contribution of parent-grandparent coparenting, especially the power and authority domain …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

Outcomes And Resource Utilization In Hyperkalemic Emergency Department Patients Treated With Patiromer Or Sodium Zirconium Cyclosilicate., William Frank Peacock, Zubaid Rafique, Julie Gayle, James Neuenschwander, Harold Brown, Jennifer Kammerer, Jeffrey Budden, Ning Rosenthal

Ambulatory and Primary Care Articles

OBJECTIVES: Hyperkalemia (HK) is a life-threatening condition commonly treated in emergency department (ED). Real-world outcomes associated with ED administration of potassium binders are limited. This study assessed ED discharge disposition and resource utilization in hyperkalemic ED patients treated with patiromer or sodium zirconium cyclosilicate (SZC).

METHODS: We performed a retrospective cohort study using discharge data from 230 hospitals in the Premier PINC AI Healthcare Database. ED patients were included if they were ≥18 years old, had potassium ≥5 mEq/L, and received patiromer/SZC during January 1, 2019 to December 31, 2021. Descriptive statistics and multivariable logistic regression analysis were used to …

Enhancing Severely Compromised Premolar Strength: Role Of Cusp Reduction Design In Cad/Cam Composite Restorations, Hend Sayed Ahmed, Mohamed Fouad Haridy, Ahmed Refaat Mohamed, Shehabeldin Saber, Edgar Schafer, Samar Swelam, Youssef Mohamed Haridy

Dentistry

No abstract provided.