Medicine and Health Sciences Commons^™

The Art Of Resiliency: Patient Stories Of Maternal Mental Health Experiences, Sara Santarossa, Becca Austin, Molly A. Bell, Samantha C. Henry, Ashley Inclima, Hailey Maddox, Tara G. Smith, Leah Copeland, Dana Murphy, Ashley Redding, Amy Loree

Journal of Patient-Centered Research and Reviews

As part of a Patient-Centered Outcomes Research Institute Eugene Washington Engagement Award aimed at improving capacity to address maternal mental health in research, this collection of stories describes experiences from six unique patient perspectives. Using motherhood as a common thread, these six stories weave together the patients’ challenges and barriers juxtaposed with their hopes and dreams. Exploring such topics as infant loss, expectations versus the reality of the postpartum experience, grief, loss of identity, loss of physical or emotional safety, advocacy, and perseverance through challenging maternal mental health experiences, these tales of resiliency leverage the voices and lived experiences of …

New Insights Into Epileptic Spasm Generation And Treatment From The Ttx Animal Model, John W Swann, Carlos J Ballester-Rosado, Chih-Hong Lee

Duncan NRI Faculty and Staff Publications

Currently, we have an incomplete understanding of the mechanisms underlying infantile epileptic spasms syndrome (IESS). However, over the past decade, significant efforts have been made to develop IESS animal models to provide much-needed mechanistic information for therapy development. Our laboratory has focused on the TTX model and in this paper, we review some of our findings. To induce spasms, tetrodotoxin (TTX) is infused into the neocortex of infant rats. TTX produces a lesion at its infusion site and thus mimics IESS resulting from acquired structural brain abnormalities. Subsequent electrophysiological studies showed that the epileptic spasms originate from neocortical layer V …

Vaccination Schedules Recommended By The Centers For Disease Control And Prevention: From Human-Readable To Machine-Processable, Xia Jing, Hua Min, Yang Gong, Mytchell A Ernst, Aneesa Weaver, Chloe Crozier, David Robinson, Dean F Sittig, Paul G Biondich, Samuil Orlioglu, Akash Shanmugan Boobalan, Kojo Abanyie, Richard D Boyce, Adam Wright, Christian Nøhr, Timothy D Law, Arild Faxvaag, Lior Rennert, Ronald W Gimbel

Faculty, Staff and Student Publications

Background: Reusable, machine-processable clinical decision support system (CDSS) rules have not been widely achieved in the medical informatics field. This study introduces the process, results, challenges faced, and lessons learned while converting the United States of America Centers for Disease Control and Prevention (CDC)-recommended immunization schedules (2022) to machine-processable CDSS rules.

Methods: We converted the vaccination schedules into tabular, charts, MS Excel, and clinical quality language (CQL) formats. The CQL format can be automatically converted to a machine-processable format using existing tools. Therefore, it was regarded as a machine-processable format. The results were reviewed, verified, and tested.

Results: We have …

Tobacco Smoking Functional Networks: A Whole-Brain Connectome Analysis In 24 539 Individuals, Yezhi Pan, Chuan Bi, Zhenyao Ye, Hwiyoung Lee, Jiaao Yu, Luba Yammine, Tianzhou Ma, Peter Kochunov, L Elliot Hong, Shuo Chen

Faculty, Staff and Student Publications

Introduction: Nicotine addiction, a multifaceted neuropsychiatric disorder, profoundly impacts brain functions through interactions with neural pathways. Despite its significance, the impact of tobacco smoking on the whole-brain functional connectome remains largely unexplored.

Aims and methods: We conducted a whole-brain analysis on 24 539 adults aged 40 and above from the United Kingdom Biobank cohort. Subjects were categorized into individuals who use nicotine and those who do not use nicotine based on current and chronic tobacco smoking information. Functional connectivity was assessed using resting-state functional magnetic resonance imaging. We employed a network analysis method to assess the systematic effects of tobacco …

Can The Discovery Of High-Impact Diagnostics Be Improved By Matching The Sampling Rate Of Clinical Diagnostics To The Frequency Domain Of Diagnostic Information?, Steven W Millward, Peng Wei, David Piwnica-Worms, Seth T Gammon

Faculty, Staff and Student Publications

Over the past 30 years, academic and industrial research investigators have developed molecular reporters to visualize cell death in complex biological systems. In parallel, clinical researchers, chemists, biochemists, and molecular biologists have endeavored to translate these molecular tools into clinical imaging agents. Despite these efforts, there are no clinically approved imaging methodologies with which to image cell death consistently and quantitatively. One reason may reside in the intrinsic mismatch between the sampling frequency of translational molecular imaging and the biochemical kinetics that define cell death. Beyond cell death imaging, many active research programs are now attempting to create translational diagnostic …

Swi/Snf Complex-Mediated Znf410 Cooperative Binding Maintains Chromatin Accessibility And Enhancer Activity, Siyuan Xu, Chuxuan Peng, Ren Ren, Haowen Lu, Han Zhao, Sijian Xia, Yijie Shen, Bin Xu, Haoyue Zhang, Xiaodong Cheng, Gerd A Blobel, Xianjiang Lan

Faculty, Staff and Student Publications

The clustering of multiple transcription factor binding sites (TFBSs) for the same TF has proved to be a pervasive feature of cis-regulatory elements in the eukaryotic genome. However, the contribution of binding sites within the homotypic clusters of TFBSs (HCTs) to TF binding and target gene expression remains to be understood. Here, we characterize the CHD4 enhancers that harbor unique functional ZNF410 HCTs genome wide. We uncover that ZNF410 controls chromatin accessibility and activity of the CHD4 enhancer regions. We demonstrate that ZNF410 binds to the HCTs in a collaborative fashion, further conferring transcriptional activation. In particular, three ZNF410 motifs …

Evidence-Based Alternative Pain Management Techniques For Chronic Pain, Alise Williams Condie, Ashley Yaugher, Kira Swensen, Maren Wright Voss

All Current Publications

Chronic pain and opioid use have become topics of importance as opioid overdose deaths have risen to epidemic proportions throughout the nation. Chronic pain lasts for long periods of time and can be caused by a past injury or have no known cause. Opioids have been utilized to treat pain in the past, but it has been discovered that opioids are better used to treat acute pain and not chronic pain. Opioids can have negative consequences including changes to the brain, depression, increased pain, constipation, sedation, and even death. This fact sheet reviews and explains some of the most successful …

5-Year Outcomes After Transcatheter Or Surgical Aortic Valve Replacement In Low-Risk Patients With Aortic Stenosis., John K Forrest, Steven J Yakubov, G Michael Deeb, Hemal Gada, Mubashir A Mumtaz, Basel Ramlawi, Tanvir Bajwa, John Crouch, William Merhi, Stephane Leung Wai Sang, Neal S Kleiman, George Petrossian, Newell B Robinson, Paul Sorajja, Ayman Iskander, Pierre Berthoumieu, Didier Tchétché, Christopher Feindel, Eric M Horlick, Shigeru Saito, Jae K Oh, Yoojin Jung, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: The Evolut Low Risk trial demonstrated that transcatheter aortic valve replacement (TAVR) was noninferior to surgery for the primary endpoint of all-cause mortality or disabling stroke at 2 years. Outcomes at 5 years have not been reported.

OBJECTIVES: This study sought to evaluate 5-year clinical and hemodynamic outcomes with TAVR vs surgery in patients from the Evolut Low Risk trial.

METHODS: We randomly assigned low-risk patients with severe aortic stenosis to TAVR or surgery. The primary endpoint was a composite of all-cause mortality or disabling stroke. Secondary endpoints included clinical, echocardiographic, and quality-of-life outcomes through 5 years.

RESULTS: A …

The Impact Of Marijuana Edibles On Fetal Development In Pregnant Adolescents And Young Mothers, Rachel Doyle

Honors Theses

With the growing prevalence of marijuana use for both recreational and medicinal purposes, this study explores the impact of edible cannabis consumption on fetal development in pregnant adolescents and young mothers. While most existing research focuses on smoked cannabis in adult populations, this review highlights a significant gap regarding the unique risks of edibles among younger, vulnerable users who may perceive them as safer. Through a comprehensive literature review, the study examines the physiological effects of THC in edible form, as well as the social, economic, and healthcare factors influencing its use. Key areas of focus include maternal health, placental …

Liposomes As Imaging Agents Of Inflammation And Oxidative Stress In Bone Implants, Delia Danila, Patricia S Pardo, R Devesh Kumar Misra, Aladin M Boriek

Faculty, Staff and Students Publications

Liposomes are tiny, spherical vesicles made from cholesterol and natural phospholipids that are promising imaging agents for detecting medical complications. They can carry fluorescent markers or other imaging agents, making them effective for medical imaging. Furthermore, liposomes can target specific cells involved in inflammation, such as macrophages, and accumulate at inflammation sites when injected. Additionally, liposomes can be designed to respond to oxidative stress, which is often associated with bone implant complications. By detecting areas of stress, liposomes provide valuable information about implant health. However, challenges such as rapid clearance from the body, precise targeting, immune reactions, and high production …

Dna Methylation Signature Of A Lifestyle-Based Resilience Index For Cognitive Health, Wei Zhang, David Lukacsovich, Juan I Young, Lissette Gomez, Michael A Schmidt, Eden R Martin, Brian W Kunkle, X Steven Chen, Deirdre M O'Shea, James E Galvin, Lily Wang

Faculty, Staff and Students Publications

Cognitive resilience (CR) contributes to the variability in risk for developing and progressing in Alzheimer's disease (AD) among individuals. Beyond genetics, recent studies highlight the critical role of lifestyle factors in enhancing CR and delaying cognitive decline. DNA methylation (DNAm), an epigenetic mechanism influenced by both genetic and environmental factors, including CR-related lifestyle factors, offers a promising pathway for understanding the biology of CR. We studied DNAm changes associated with the Resilience Index (RI), a composite measure of lifestyle factors, using blood samples from the Healthy Brain Initiative (HBI) cohort. After corrections for multiple comparisons, our analysis identified 19 CpGs …

Epidemiology Of Tourette Syndrome, Abdullah Yasir Yilmaz, Joseph Jankovic

Faculty, Staff and Students Publications

Background/Objectives: Tourette syndrome (TS) is a neurodevelopmental disorder, manifested by tics and a variety of behavioral comorbidities that cluster strongly within families, suggesting a combination of genetic and environmental risk factors. The underlying pathophysiology of TS remains to be elucidated. Understanding the incidence and prevalence across different populations provides valuable insights into the etiology and pathogenesis of the condition and aids in the development of effective treatment strategies.

Methods: A comprehensive literature search was conducted on PubMed covering the period from 1 January 2000 to 1 January 2025. The search used the terms "Tourette syndrome", "tics", "tic disorders", "epidemiology", "prevalence", …

Samd9 Senses Cytosolic Double-Stranded Nucleic Acids In Epithelial And Mesenchymal Cells To Induce Antiviral Immunity, Gaopeng Hou, Wandy Beatty, Juhee Son, Yinxing Zhu, Qingyu Sheng, Wanyi Huang, Dian Li, Constin Liu, Chen Shen, L David Sibley, Siyuan Ding, Et Al.

2020-Current year OA Pubs

Sensing of cytosolic, double-stranded (ds) DNA or dsRNA molecules derived from microbial or endogenous sources triggers cell-intrinsic innate immunity, but sensors recognizing both cytosolic dsDNA and dsRNA are sparsely reported. Here we find that full-length human SAMD9 protein directly binds to synthetic or viral dsDNA or dsRNA. Overexpression of SAMD9 from various vertebrate species leads to robust production of interferons and pro-inflammatory cytokines. By contrast, loss of endogenous SAMD9 impairs the interferon responses to cytosolic dsDNA and dsRNA stimulation in multiple cell types and enhances the infectivity of pathogenic dsDNA and dsRNA viruses. Mice lacking Samd9l, the human SAMD9 homolog, …

The Combined Effect Of High-Intensity Interval Training And Time-Restricted Feeding On The Akt-Igf-1-Mtor Signaling Pathway In The Muscle Tissue Of Type 2 Diabetic Rats, Motahareh Mohebinejad, Fatemeh Kazeminasab, Mahtab Ghanbari Rad, Reza Bagheri, Mazdak Razi, Darryn Willoughby, Fred Dutheil

Faculty, Staff and Students Publications

Background/Objectives: High-intensity interval training (HIIT) and time-restricted feeding (TRF) have shown potential in enhancing glucose metabolism, increasing insulin sensitivity, and promoting muscle health. This study investigates the combined effects of HIIT and TRF on the AKT-IGF-1-mTOR signaling pathway in the muscle tissue of type 2 diabetic (T2D) rats.

Methods: 42 male Wistar rats (4-5 weeks of age) were included in the study. The animals were randomly divided into two groups: 1. Standard diet (SD) non-diabetic (n = 7) and 2. High-fat diet (HFD n = 35) for 4 weeks. T2D was induced by intraperitoneal injection (IP) of streptozotocin (STZ) …

Disuse-Driven Plasticity In The Human Thalamus And Putamen, Roselyne J Chauvin, Dillan J Newbold, Ashley N Nielsen, Ryland L Miller, Samuel R Krimmel, Athanasia Metoki, Anxu Wang, Andrew N Van, David F Montez, Scott Marek, Vahdeta Suljic, Noah J Baden, Nadeshka Ramirez-Perez, Kristen M Scheidter, Julia S Monk, Forrest I Whiting, Babatunde Adeyemo, Jarod L Roland, Abraham Z Snyder, Benjamin P Kay, Marcus E Raichle, Timothy O Laumann, Evan M Gordon, Nico U F Dosenbach

2020-Current year OA Pubs

Subcortical plasticity has mainly been studied using invasive electrophysiology in animals. Here, we leverage precision functional mapping (PFM) to study motor plasticity in the human subcortex during 2 weeks of upper-extremity immobilization with daily resting-state and motor task fMRI. We found previously that, in the cortex, limb disuse drastically impacts disused primary motor cortex functional connectivity (FC) and is associated with spontaneous fMRI pulses. It remains unknown whether disuse-driven plasticity pulses and FC changes are cortex specific or whether they could also affect movement-critical nodes in the thalamus and striatum. Tailored analysis methods now show spontaneous disuse pulses and FC …

Sars-Cov-2 N Protein And Anti-Spike Serologies: Insights Into Covid-19 Disease Severity And Mortality-A Secondary Analysis Of The Activ-1 Trial, Alfredo J Mena Lora, Kimi Enders, Huimin Wu, Luis Parra-Rodriguez, Christopher Palma, Katy Saliba, Sylvain Laverdurre, P Brian Smith, Kevin J Anstrom, Samuel A Bozzette, William G Powderly

2020-Current year OA Pubs

BACKGROUND: Understanding factors that predict progression to severe COVID-19 is critical. Antibodies targeting SARS-CoV-2 spike protein confer protection, while the N protein of SARS-CoV-2 plays roles in viral replication and immune dysfunction. This study explores the significance of N protein and anti-spike antibodies on disease severity, progression, and mortality.

OBJECTIVES: To evaluate the relationship between SARS-CoV-2 N protein and anti-spike antibody levels with disease severity, clinical outcomes, and mortality in hospitalized patients with COVID-19.

DESIGN: A secondary analysis of serologic data from participants in the ACTIV-1 randomized clinical trial, which evaluated immunomodulators for the treatment of hospitalized patients with COVID-19. …

Is Love A “Pathological Condition Of The Soul”? Joyce Carol Oates's Beasts And Rape: A Love Story, Nicolas P. Boileau

Bearing Witness: Joyce Carol Oates Studies

This paper seeks to address the question of Oates’s relation to feminist and gender theories by looking at two novellas published consecutively, Beasts and Rape: A Love Story in the beginning of the 2000s. The short texts share a common storyline based on rape, which is far from uncommon in Oates’s fiction. However, I argue that there is something very specific in these two novellas in the way Oates chooses to handle the testimony of the rape, both overtly and covertly, both in graphic details and in repressed forms of expression, giving way to a reflection on women’s vulnerable position …

Millennial And Gen-Z Experiences In Healthcare And Education In The Us, Zabia Evans, Anastasia Raymer, Beverly Khabo

Graduate Student Government Association Research Conference

In the United States, healthcare and educational institutions have a deep-rooted history of discrimination based on race, ethnicity, and other demographic factors, resulting in unequal access to services and mistreatment of minority populations. This history extends to the field of speech-language pathology, with disparities in service being cited in the literature due to lack of clinician knowledge, non-diverse standardized testing measures, lack of resources and support, among other factors. Policies and legislation in recent decades have attempted to address these serious issues. This survey research investigates the childhood healthcare and educational experiences of individuals born during or after 1981, focusing …

Guideline Development And Implementation For Non-Intubated Video-Assisted Thoracoscopic Surgery, Lauren Moad

Doctor of Nursing Practice Scholarly Projects

Since the 1990s, video-assisted thoracoscopic surgery (VATS) has become the standard for many thoracic operations, providing a minimally invasive approach. Traditional VATS management with general anesthesia (GA), muscle relaxation, and one-lung ventilation (OLV) poses risks of postoperative pulmonary complications (PPCs) that can lead to a prolonged length of hospital stay (LOS). Recently, non-intubated VATS (NI-VATS) has become popular due to fewer anesthesia-related complications and faster recovery, especially for patients with compromised respiratory function who may not tolerate GA or intubation. NI-VATS combines regional anesthesia with spontaneous non-invasive ventilation mechanisms, avoiding GA, intubation, and OLV complications. Studies show NI-VATS leads to …

Evolving Move Inclusive Dance's Evaluation System, Taylor L. Nock

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with MOVE Inclusive Dance in Nashville, Tennessee. MOVE Inclusive Dance is a nonprofit organization that empowers individuals of all ability levels to learn life skills through dance. The aim of this project was to promote goal setting for each dancer, and to develop manageable systems for evaluation data and progress monitoring. Goals promoted occupational therapy-based skills such as independent sensory regulation, social participation, memory, and sustained attention. The project involved creating a web-accessible platform to easily input dancer progress and implementing suggestions from staff as they utilized the platform. Efficient data …

Elopement: Developing An Improved Plan Of Care For Vanderbilt Pediatric Seating And Mobility Clinic, Chloe Nease

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Monroe Carell Jr. Children’s Hospital at Vanderbilt within the Pediatric Seating and Mobility clinic. There has been an increased number of referrals to the clinic for equipment aimed at preventing elopement behaviors, primarily for children diagnosed with Autism Spectrum Disorder. The goal of this capstone project was to improve the current plan of care regarding elopement evaluations to decrease strain on therapists and families. The objectives for this project were based on information from various stakeholders, including therapist and caregiver feedback, equipment vendors, and insurance providers. Outcomes included the creation of …

Road To Recovery: Reboot Recovery, Brooke Gephart

OTD Capstone Projects

This doctoral capstone project was completed in partnership with REBOOT Recovery, a non-profit organization dedicated to providing trauma healing through faith-based, peer-led courses. The purpose of this project was to create content to aid the participants and the leaders of REBOOT to overcome trauma and improve their well-being. Life guides were created to address feelings of anxiety and depression, substance use disorder, and provided education on implementing coping skills to help improve their daily functioning. Educational content was developed for leaders regarding the complexities of overcoming trauma for autistic people and highly sensitive people, to best equip leaders to assist …

The Role Of Occupational Therapy In The Care Of Informal Caregivers Of People With Dementia: A Concept Analysis, Ashley M. Taylor

Student Capstone Papers

Informal caregivers (care partners) are people, such as family members, who provide care to those who cannot care for themselves, including people with dementia (PwD). Care partners assist PwD in their daily occupations, often without training. Caring for PwD can lead to emotional, physical, financial, and occupational challenges for care partners. Occupational therapy (OT) has a role to play in the care of PwD. However, if clinicians do not operate from a dyadic model, care partners’ needs may be overlooked. Problem: Although addressing the care partner dyad is important to the delivery of OT, the role of OT in the …

Desmoplastic Small Round Cell Tumor: An Update Of Current Management Practices, Ahmed Gawash, Alexa Simonetti, Brandon J Goodwin, Alissa Brotman O'Neill

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Desmoplastic small round cell tumor (DSRCT) poses a diagnostic challenge, initiating with imaging techniques like ultrasound, CT, MRI, and PET scans, with CT being the primary choice for abdominal tumor visualization. Despite advances, the absence of a standardized staging system complicates the diagnostic process.

METHODS: A comprehensive literature review and search strategy, encompassing databases like PubMed and Cochrane was performed.

RESULTS: Systemic chemotherapy, notably the P6 regimen, is the cornerstone of DSRCT treatment, while other options, including CDK4/6 inhibitors, antibody-drug conjugates, and anlotinib present varying efficacy. A novel chemotherapeutic agent, ONC-201, exhibits promise, inhibiting tumor growth in preclinical models. …

Air Travel Experiences Of Families With Autistic Children, Tiffany Pham, Karen Park

Spring 2025 OTD Capstone Symposium

This mixed-methods research design aimed to understand families' experiences traveling by plane with autistic children to identify supports, needs, challenges, and barriers that influence participation and well-being. Although air travel offers significant benefits for families and their children, including promoting personal growth, strengthening communication and bonding, reducing stress, and improving the overall quality of life and life satisfaction across many domains, families with autistic children face significant challenges due to sensory and environmental barriers that make the experience stressful and unpredictable. Findings highlight a need for autism-informed policies, training among airport and airline staff, sensory-friendly spaces, and extended support to …

Training And Thickening Skills Among Food Service Professionals In Early Intervention Day Treatment Facilities, Keelin G. Fullen

Student Theses and Dissertations

Dysphagia, defined as impaired swallowing, affects children and is often treated by modifying food textures and thickening liquids before consumption. Early intervention day treatment (EIDT) facilities serve children with developmental delays and medical conditions that may require food modification such as thickened liquids. Inaccuracies in thickened liquid consistency have been documented in multiple professions, leading to potential negative health implications for the consumer. This study aimed to evaluate food service providers in EIDT facilities and the implementation of thickened liquids plans, training factors, and the accuracy of liquid thickening. Using interviews with five administrators (n=5) and observation of thickened liquid …

Enhancing Provider Knowledge With Phq-9 Education, Laurette Abunaw

Walden Dissertations and Doctoral Studies

Depression represents a significant public health concern that often remains undiagnosed or untreated, primarily due to insufficient systematic screening in primary care settings. The lack of standardized screening tools such as the Patient Health Questionnaire-9 (PHQ-9) elevates patient risks, increasing symptom severity, increasing suicide rates, and delaying interventions. Research studies show that a significant number of individuals with depression go untreated for long durations, with primary care settings recognizing only a small percentage of cases. The PHQ-9 is an effective tool for assessing and monitoring depression in a primary care setting, leading to early detection of symptom severity. Clinical practice …

Nourishing Movement: Nutrition For Parkinson's Wellness, Alexa E. Shever

OTD Capstone Projects

This doctoral capstone project was conducted in collaboration with Bridges for Parkinson's, an organization designed to connect people living with Parkinson's Disease to a community that engages them in a specialized fitness program that helps them rediscover hope and joy and connect them to other resources to improve overall quality of life. The primary objective was to understand the lived experience of individuals with PD and develop PD specific nutrition education and programming for PD fighters and their care partners to use in fighting back against PD. The specific nutrition topics in the education and programming include Whole Foods, Hydration, …

Supporting Occupational Identity In Senior Collegiate Athletes, Kara Montilla, Amy Lyons-Brown

Spring 2025 OTD Capstone Symposium

Capstone project designed to support the transition of retired collegiate athletes by promoting occupational identity and mental well-being. Built upon occupational therapy theories, the program addresses key challenges such as loss of routine, social reintegration, and identity development post-sport. It incorporates goal setting, time management strategies, and group discussions to foster self-exploration and resilience. The project aims to build a supportive environment that empowers athletes to thrive beyond their athletic careers.

Influence Of Collectivist Cultural Values On Occupational Roles And Mental Health Of First-Generation College Students, Guenne Sarmiento, Jazminne Orozco Arteaga

Spring 2025 OTD Capstone Symposium

First-generation college students (FGCS) from collectivist backgrounds often encounter unique challenges as they navigate academic duties alongside familial responsibilities. These challenges are influenced by collectivist cultural values (CCV), which prioritize family ties, community cohesion, and collective well-being. This capstone project utilizes the Kawa Model to illustrate the supportive and unsupportive factors in the lives of these students, examining how cultural expectations, occupational roles, and mental health intersect. It emphasizes the critical role of occupational therapy in unraveling and addressing these complexities.