Medicine and Health Sciences Commons^™

Graduate School Blog - June 2025, Cynthia Haynes

UofM Grad School Blog

The June 2025 edition of the UofM Graduate School Blog helps prospective and current students make informed financial decisions with Part 1 of the Graduate School Cost Guide, breaking down tuition structures such as per-credit hour versus flat-rate models, highlighting UofM’s tuition cap for in-state students, and explaining key university fees and cost differences between online and on-campus formats. The blog also features Brianna Reilly, a Doctor of Musical Arts graduate from New York, who shares how a graduate assistantship and her passion for music education led her to continue at UofM through the pandemic. Additional resources include an …

How Do Health Insurer Practices Affect Health Equity For Gay And Bisexual Men And Transmasculine Individuals? A Qualitative And Health Policy Assessment, Alexa D'Angelo

Dissertations and Theses

In the U.S. there continue to be stark disparities in health that affect LGBTQ+ communities. These disparities include those related to mental health, sexually transmitted infections, along with chronic illnesses and some cancers. Higher health needs across diagnostic categories mean that LGBTQ+ individuals require access to the healthcare system both to prevent conditions disproportionately affecting the community, and to treat conditions as they arise. In the U.S., access to healthcare often requires either reliable insurance coverage or another payer to cover costs associated with care. Thus, health insurance status and coverage of care, along with coverage regulations and health policies …

Stress And Burnout: Is There A ‘Happily Ever After’?, Margaret S. Gingrich D.D.S.

The Journal of the Michigan Dental Association

Executive Summary Dental professionals experience significant stress and burnout due to high patient expectations, challenging patients, employee management issues, and insurance complexities. Dr. Margaret Gingrich outlines Christina Maslach's six stages of burnout, from the honeymoon phase to reduced personal accomplishment. Recovery requires intentional rest following the "rule of 42" - dedicating 42% of daily time to various forms of rest, including physical, emotional, sensory, mental, spiritual, social, and creative restoration. Key strategies involve setting boundaries, saying no, taking breaks, seeking social support, and, when necessary, terminating problematic patient relationships. The Michigan Dental Association and American Dental Association provide wellness resources, …

Topodino: Self-Supervised Topological Representation Learning For Neuronal Morphologies, Yasser Binbisher

Master's Theses

Neuronal cell types are categorized by transcriptomic identity, yet their morphological heterogeneity defies this classification. In response, researchers have adopted unsupervised graph representation learning as a tool to reveal morphological variation within single-class transcriptomic types. However, the complex geometry of neuronal morphology—especially long axons and dense dendrites—challenges graph neural networks, which struggle with message propagation across extended structures. To mitigate this, current approaches enforce sub-sampling on neuronal graphs and omit axons entirely, sacrificing critical biological features for computational efficiency. To overcome this trade-off, this thesis introduces TopoDINO, a self-supervised, topology-aware representation learning model designed to preserve the full hierarchical organization …

J Mich Dent Assoc June 2025

The Journal of the Michigan Dental Association

The Journal of the Michigan Dental Association is the leading monthly digital publication serving Michigan’s oral health community and the MDA’s 6,200+ members. Distributed globally through the searchable ADA Commons publishing platform, it is the primary channel for news, clinical insights, and professional resources for Michigan dentists.

June Issue Highlights:

• Cover Feature: An in-depth report on the MDA’s advocacy efforts beyond insurance reimbursement, highlighting recent legislative wins and member services that support practice profitability and success.
• Workforce Well-being: A special feature on the stages of stress and burnout, with strategies and resources to support mental health and resilience.
• Compliance Update: …

The New Professional: Demystifying Dental Insurance For The New Professional, Amrita Patel D.D.S.

The Journal of the Michigan Dental Association

This comprehensive guide explains dental insurance complexities for new associates and practice owners. The author distinguishes dental insurance from medical insurance, noting annual benefit caps of $1,000-$2,000 versus unlimited medical coverage. Four main plan types are detailed: PPO plans (most common, flexible), HMO plans (lower costs, network restrictions), Indemnity plans (no network limits, higher costs), and Discount plans (membership programs, not insurance). Key business considerations include in-network versus out-of-network decisions, with in-network providing patient attraction but reduced reimbursements, while out-of-network allows fee control but limits patient base. The article addresses practical challenges including write-offs (difference between standard fees and insurance …

Mda At Your Service: One Way To Free Your Practice From Insurance Plan Restrictions, Rachel Sinacola D.D.S.

The Journal of the Michigan Dental Association

This Q&A-style article provides practical answers to common member questions. Topics include managing in-office dental plans (via Quality Dental Plan), evaluating associate contracts, showcasing MDA membership, handling radiography training course transfers, and understanding patient record retention requirements. The article encourages using MDA-endorsed resources and legal guidance to enhance practice efficiency and compliance.

Down Syndrome In Africa: Challenges, Opportunities, And Future Directions, Eimear Mcglinchey, Salina Tewolde, Amanda He, Juan Fortea, Lingani Mbakile-Mahlanza, Ayda Tefera, Emmanuel Epenge, Jason Hassenstab, Rachel Maina, Zul Merali

Brain and Mind Institute

INTRODUCTION: As life expectancy improves for people with Down syndrome (DS) in Africa, the risk of developing DS-associated Alzheimer’s disease (DSAD) will rise. There is a pressing need to plan for this emerging challenge, particularly in the context of existing health and social disparities.

METHODS: This work emerged from a pan-African collaboration, including discussions at the Brain Ageing and Dementia in Low- and Middle-Income Countries conference held in Nairobi in 2024, where stakeholders identified regional priorities for DS and dementia care.

RESULTS: Limited epidemiological, cognitive, biomarker data, delayed diagnoses, and gaps in specialized services may impact access …

Ecological Grief Among Farmers And Pastoralists In Ethiopia And Kenya, Syed Shabab Wahid, Christine Musyimi, Benjamin Oestericher, Linda Khakali, Lauren Carruth, Emily Mendenhall, Edna Bosire

Brain and Mind Institute

Climate change is a major cause of mental distress worldwide. In many ways, climate change has become a chronic disaster, while in other ways each acute event can accumulate and present challenges within and between communities. A growing body of evidence indicates that a changing climate can precipitate a cluster of negative affective states scholars call “ecological grief.” Ecological grief reflects psychological responses to climate changes and destruction of nature, species, culturally significant or sacred spaces. Until now, ecological grief has been conceptualized as a psychological response connected primarily to the destruction of the natural environment, and has not fully …

Statewide Universal School Meal Policies And Food Insecurity In Households With Children, Dania Orta-Aleman, Marlene B. Schwartz, Anisha I. Patel, Michele Polacsek, Christina A. Hecht, Kenneth Hecht, Monica D. Zuercher, Lorrene D. Ritchie, Juliana F W Cohen, Wendi Gosliner

Health Sciences Faculty Publications

No abstract provided.

Flexible Pathways In Medical Science - Evaluating The Impact Of Hyflex Teaching Modes, Aine Balfe

Case studies: Digital Education

The HyFlex teaching model has been implemented in the part-time TU088 Higher Diploma in Medical Science programme to support students who work as hospital laboratory aides. This flexible approach reduces on-site attendance requirements while maintaining academic standards. TU088 runs concurrently with two full-time programs - TU867 BSc in Medical Science and TU888 HDip in Medical Science—and shares key modules delivered in HyFlex mode in stage 2 and stage 4. Additionally, HyFlex is employed in a final-year research module co-taught across TU867, TU866 BSc in Biomedical and Molecular Diagnostics, and TU886 BSc in Biomolecular Science. This supports students completing research projects …

The Glim Consensus Approach To Diagnosis Of Malnutrition: A 5-Year Update., Tommy Cederholm, Gordon L Jensen, M Isabel T D Correia, M Cristina Gonzalez, Ryoji Fukushima, Veeradej Pisprasert, Renee Blaauw, Diana Cardenas Braz, Fernando Carrasco, Alfonso J Cruz Jentoft, Cristina Cuerda, David C Evans, Vanessa Fuchs-Tarlovsky, Leah Gramlich, Han Ping Shi, Jeanette M Hasse, Michael Hiesmayr, Naoki Hiki, Harriët Jager-Wittenaar, Shukri Jahit, Anayanet Jáquez, Heather Keller, Stanislaw Klek, Ainsley Malone, Kris M Mogensen, Naoharu Mori, Manpreet Mundi, Maurizio Muscaritoli, Doris Ng, Ibolya Nyulasi, Matthias Pirlich, Stephane Schneider, Marian De Van Der Schueren, Soranit Siltharm, Pierre Singer, Alison Steiber, Kelly A Tappenden, Jianchun Yu, André Van Gossum, Jaw-Yuan Wang, Marion F Winkler, Rocco Barazzoni, Charlene Compher

Ambulatory and Primary Care Articles

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 comprised of screening followed by assessment of three phenotypic criteria: weight loss, low BMI, and low muscle mass, and two etiologic criteria: reduced food intake/assimilation, and inflammation/disease burden. This planned update reconsiders the GLIM framework based on published knowledge and experience over the past five years.

METHODS: A GLIM working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM". Prior GLIM activities providing guidance for use of the criteria on muscle mass …

Demographic And Clinical Characteristics Of Patients With Benign Bone Tumors: Evidence Of Bimodal Age Distribution In A Hispanic Population, Blake Martin, Mohammad Khalil, Juan Lopez-Alvarenga, Michael Sander

School of Medicine Publications

Background

As far as researchers know, there's no way to prevent BBTs from forming. Although these tumors generally do not metastasize, they can still be dangerous as they may grow and compress healthy tissues and lead to poor outcomes. The principal objective was to evaluate the demographic and clinical characteristics linked to BBTs in individuals from the Rio Grande Valley. We hypothesized that older age and males would have greater frequency of BBTs.

Methods

This was a retrospective chart review and IRB approval was obtained prior to starting this study. We obtained medical charts for individuals who had been diagnosed …

Impact Of Metabolically Healthy Obesity On Post Percutaneous Coronary Intervention Outcomes In Patients With Acute Myocardial Infarction: A Nationwide Propensity Matched Analysis, Rupak Desai, Adhvithi Pingili, Arankesh Mahadevan, Vishal Reddy Bejugam, Hafeezuddin Ahmed, Vamsikalayan Borra, Adil Sarvar Mohammed, Gayatri Bondi, Shobana Krishnamurthy, Nithya Borra

School of Medicine Publications

Background

Obesity paradox in post-percutaneous coronary intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a known controversy. However, these studies included patients who had diabetes, hypertension, or hyperlipidemia. We studied relationship between metabolically healthy obesity (MHO—without diabetes, hypertension, or hyperlipidemia) and in-hospital post-PCI outcomes among AMI patients.

Methods

We extracted data from National Inpatient Sample 2020 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for admissions of AMI patients who underwent PCI. We then identified patients with diabetes, hypertension, and hyperlipidemia using Elixhauser comorbidity index and Clinical Classifications Software and excluded them. Then, using Elixhauser …

Acute Dentate Nucleus Deep Brain Stimulation Modulates Corticomotor Excitability In Chronic Stroke Survivors, Xin Li, Kenneth B. Baker, Kyle O'Laughlin, Yin-Liang Lin, Kelsey Baker, Robert Chen, Jacqueline Chen, Andre G. Machado, Ela B. Plow

School of Medicine Publications

Background

Deep brain stimulation of the dentate nucleus (DN-DBS) is an emerging therapy to improve upper extremity (UE) motor function after stroke. This study sought to investigate the physiologic mechanisms of acuteDN-DBS in chronic stroke survivors enrolled in a phase I trial for DN-DBS.

Methods

Twelve chronic stroke participants with moderate-to-severe UE impairment received (acute) single sessions (≥45 min) of active DBS and sham DBS in a sham-controlled, double-blind, cross-over experiment (order randomized). Transcranial magnetic stimulation (TMS) was used to evaluate corticomotor physiology. We also characterized the relationship between acute DBS effects on physiology and baseline clinical …

A Scan Of Pleiotropic Immune Mediated Disease Genes Identifies Novel Determinants Of Baseline Fviii Inhibitor Status In Hemophilia A, Marcio Almeida, Vincent P. Diego, Kevin R. Viel, Bernadette W. Luu, Eron G. Manusov, Juan M. Peralta, Satish Kumar, Sarah Williams-Blangero, John Blangero, Tom Howard

School of Medicine Publications

Hemophilia-A (HA) is the X-linked bleeding disorder caused by heterogeneous factor (F)VIII gene (F8)-mutations and deficiencies in plasma-FVIII-activity that prevent intrinsic-pathway mediated coagulation-amplification. Severe-HA patients (HAPs) require life-long infusions of therapeutic-FVIII-proteins (tFVIIIs) but ~30% develop neutralizing-tFVIII-antibodies called “FVIII-inhibitors (FEIs)”. We investigated the genetics underlying the variable risk of FEI-development in 450 North American HAPs (206 and 244 respectively self-reporting black-African- or white-European-ancestry) by analyzing the genotypes of single-nucleotide-variations (SNVs) in candidate immune-mediated-disease (IMD)-genes using a binary linear-mixed model of genetic association with baseline-FEI-status, the dependent variable, while simultaneously accounting for their genetic relationships and heterogeneous-F8-mutations to …

Genetic Analysis Of Psychosis Biotypes: Shared Ancestry-Adjusted Polygenic Risk And Unique Genomic Associations, Cuihua Xia, Ney Alliey Rodriguez, Carol A. Tamminga, Matcheri S. Keshavan, Godfrey Pearlson

School of Medicine Publications

The Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) created psychosis Biotypes based on neurobiological measurements in a multi-ancestry sample. These Biotypes cut across DSM diagnoses of schizophrenia, schizoaffective disorder, and bipolar disorder with psychosis. Two recently developed post hoc ancestry adjustment methods of Polygenic Risk Scores (PRSs) generate Ancestry-Adjusted PRSs (AAPRSs), which allow for PRS analysis of multi-ancestry samples. Applied to schizophrenia PRS, we found the Khera AAPRS method to show superior portability and comparable prediction accuracy as compared with the Ge method. The three Biotypes of psychosis disorders had similar AAPRSs across ancestries. In genomic analysis of Biotypes, 12 genes, …

Differential Gene Expression Study In Whole Blood Identifies Candidate Genes For Psychosis In African American Individuals, Emma M. Knowles, Juan M. Peralta, A. L. Rodrigue, Samuel R. Mathias, Josephine Mollon, Ana C. Leandro, Joanne E. Curran, John Blangero, David C. Glahn

School of Medicine Publications

Genome-wide association has identified regions of the genome that mediate risk for psychosis. It is possible that variants in these regions confer risk by altering gene expression. This work has predominantly been conducted in individuals of European descent and has focused narrowly on schizophrenia rather than psychosis as a syndrome. In the present study we investigated alterations in gene expression in African American individuals with a range of psychotic diagnoses to increase understanding of the etiology in an underserved population. We performed RNA-seq in whole bloody to survey the transcriptome in 126 patients with a psychosis-spectrum disorder and 217 healthy …

Scoring Large Muscle Movements In Pediatric Sleep Studies: An Educational Module For Sleep Technologists, Shauna Michelle Vandoren, David G. Ingram

Posters

Introduction Restless Sleep Disorder (RSD) has recently been recognized as a distinct sleep disorder, with Large Muscle Movement (LMM) scoring being a crucial component of its diagnostic criteria. This project aimed to develop and implement an online educational module to enhance the knowledge and skills of sleep technologists to accurately score LMMs. Methods We constructed an online learning module that included training on the identification and scoring of LMMs in pediatric sleep studies. The module consisted of a 10-question pre-assessment, the educational content (which explained the background of RSD diagnosis, the role of LMMs in diagnostic criteria, and current scoring …

Correlation Of Magnetic Resonance Imaging Findings With Clinical Outcomes In Acute Transverse Myelitis: A Comprehensive Retrospective Study, Anjlee Shankar, Faheem Soomro, Dipanty Khastoori, Tahira Maqsood, Sajjad Jalbani, Alam Ibrahim Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective: Acute transverse myelitis (ATM) is an inflammatory spinal cord disorder presenting with motor, sensory, and autonomic dysfunction. The objective of this study was to assess the prognostic value of spinal MRI findings and treatment timing in predicting neurological outcomes in patients with acute transverse myelitis.

Methods: A retrospective analysis was conducted on 90 patients diagnosed with ATM at Chandka Medical College Hospital, Larkana, between January 2021 and December 2023. All patients underwent spinal MRI at presentation, and imaging characteristics—including lesion location, longitudinal extent, and enhancement pattern—were recorded. Clinical outcomes were assessed at one month, three months, and …

Impact Of Physical Exercise On Reducing The Frequency And Severity Of Migraine Without Aura: A Multi-Center Cross-Sectional Study, Amir Hamza, Abdul Wahid, Abdul Bari, Mohammad Azam, Riaz Ahmed, Ikram Ullah

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective: Migraine without aura is the most common subtype of migraine and causes significant distress to its sufferers. The objective of this study was to evaluate the role of physical exercise in reducing the frequency and severity of attacks in patients with migraine without aura.

Methods: This multicenter cross-sectional study was conducted from March 2024 to February 2025 in departments of neurology and medicine in two tertiary care hospitals in Quetta and Khuzdar. A total of 384 adults age 18–60 years with migraine without aura, diagnosed using ICHD-3 criteria, were selected through consecutive sampling. Patients with other headache …

Raising Awareness In South Punjab: The Importance Of Consulting Neurologists For Neurological Disorders, Muhammad Fahad Saleem, Mohammad Wasay, Sohaib Hassan, Muhammad Wahab Qureshi, Muhammad Hamza Khan, Muhammad Wazir

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

The Compassionate H.E.A.R.T. Of Relationship-Centered Care, Dustin Willis

Loma Linda University Electronic Theses, Dissertations & Projects

The patient-provider interaction (PPI) represents a critical dimension of healthcare delivery that significantly influences clinical outcomes, yet the nuanced dynamics of compassionate care remain operationally elusive. This dissertation presents the Compassionate H.E.A.R.T. (Helping Ease, Alleviate, & Relieve Therapeutically) framework—a novel theoretical model for understanding and enhancing relationship-centered care—and examines its validity, reliability, and therapeutic impact.

Through four interconnected studies, this research explores the multifaceted nature of compassionate care. First, a comprehensive literature review excavates the landscape of patient-provider interactions, highlighting terminological inconsistencies, incomplete theoretical frameworks, and methodological challenges in measuring these ethereal qualities. Second, the Compassionate H.E.A.R.T. model is introduced, …

Sunlight Exposure And The Risk Of Mortality And Breast Cancer Incidence, Noor Nadhim

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Prolonged sun exposure increases the risk of skin cancer. However, multiple sunlight-related health benefits have been identified. The overall impact of sun exposure on mortality is not clear. Sunlight could be associated with breast cancer risk via stimulating vitamin D photosynthesis; however, evidence has been mixed. Objectives: To investigate the association of time spent outdoors in daylight (in warmer and cooler months, and the total [annual]) and UV irradiance using the residential locations of participants with the risks of mortality (all-cause and cause-specific: cancer, cardiovascular [CVD], and non-cancer non-CVD) and primary invasive breast cancer.

Methods: This research …

Nursing Advocacy In Maternal Health For Women With Sickle Cell Disease, Jodian Lyn

Loma Linda University Electronic Theses, Dissertations & Projects

Over 80% of pregnancy-related deaths among Black women in the U.S. are preventable. Racial disparities, biases, and discrimination negatively impact maternal health, by contributing to higher stress levels, affecting pregnancy outcomes. The maternal death rate for Black women with sickle cell (SCD) is 629, Black women without SCD is 12, and the general population 6 per 100,000. The voices of these women are often missing in research.

This qualitative study, using Hermeneutic Phenomenological approach, explores the lived experiences of Black women with SCD during pregnancy. Data analysis was completed using an interpretive framework to elucidate the essence of the lived …

Tobacco, Alcohol, And Poverty In Lao Pdr Based On National Survey Analysis, Robert M. Semakula

Loma Linda University Electronic Theses, Dissertations & Projects

Tobacco and alcohol use are among the most prevalent and harmful addictive behaviors globally, including in the Lao People’s Democratic Republic (Lao PDR). In Southeast Asia and the Western Pacific, substance use patterns are shaped by cultural, social, economic, policyrelated, and environmental factors. This study aimed to: (1) explore associations between different patterns of alcohol and tobacco use among men and women in Lao PDR, and (2) investigate the effect of poverty on the relationship between alcohol and tobacco use. We conducted a secondary analysis of the 2013 Lao National Adult Tobacco Survey (N = 9,706), a nationally representative sample …

Best Practices For A Competency-Based Curriculum In Critical Care Ultrasonography For Fellows, Paru Patrawalla, Frances West, Navitha Ramesh, Paul Mayo, Amik Sodhi

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

New guidelines from the Accreditation Council on Graduate Medical Education for critical care ultrasound (CCUS) training went into effect on July 1, 2024, for critical care medicine and combined pulmonary and critical care medicine fellows. Fellowship programs will need to ensure that their fellows demonstrate competence in skills that are essential to CCUS, which currently encompasses applications in basic cardiac, lung/pleural, abdominal, and vascular ultrasonography (US). This may be a challenge for fellowship programs that have nascent CCUS curricula and limited faculty expertise. In this Perspective, we share expert and evidence-based recommendations on how to implement a competency-based curriculum in …

Perioperative Fluid Therapy Impairs Lymphatic Pump Function In Male Rats, Rebecca C Harlow-Adamek, Reetu Singh, Randolph H Stewart, Cristine L Heaps, Glen A Laine, Charles S Cox, Ranjeet M Dongaonkar

The Brown Foundation: Institute of Molecular Medicine

Because of its life-saving benefits, perioperative IV fluid therapy remains a cornerstone of medical treatment. However, it also induces sustained edemagenic stress. The resulting persistent interstitial edema-excessive fluid accumulation in the interstitium-significantly delays recovery and worsens patient outcomes. Therefore, to gain a detailed understanding of the lymphatic functional consequences of perioperative fluid therapy, this study aimed to test the hypothesis that perioperative IV fluid therapy compromises lymphatic pump function within 3 days after major surgery. Following a midline laparotomy, animals received IV fluid therapy over 48 h during recovery (FLTP). Three days post-surgery, mesenteric lymphatic vessels from FLTP and sham …

Perceptions Of Smoking Stigma Among African Americans: A Qualitative Study, Denine R. Crittendon, Alison C. Brecher, Samantha Okere, Richard Hass, Rosemary Frasso, Rickie Brawer, Mph, Phd, Charnita Zeigler-Johnson

College of Population Health Faculty Papers

INTRODUCTION: African Americans/Blacks (AAB) are at increased risk for morbidity and mortality from smoking-related diseases including lung cancer (LC). Smoking stigma is believed to be a primary barrier to health care-seeking for people who smoke. Previous studies illustrate that perceptions of smoking vary across populations. However, little is known about the prevalence of smoking stigmas among AAB. The purpose of this study was to increase understanding of the perception of cigarette smoking by AAB.

AIMS AND METHODS: We conducted free-listing interviews in which individuals listed all-thoughts and feelings regarding smoking and health-related questions with a convenience sample of eligible AAB …

Neurosurgery Research In Pakistan: An Analysis Of Publications, Citations, And Gender Disparities, Waseem Hassan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.