Medicine and Health Sciences Commons^™

Quantifying Multidimensional Effects Of Physicochemical Parameters On Pfas Adsorption Using A Hybrid Response Surface Methodology-Machine Learning Approach, Harsh V. Patel, Jazmin Green, John Park, Stephanie Luster-Teasley Pass, Renzun Zhao

Engineering Management & Systems Engineering Faculty Publications

Per- and polyfluoroalkyl substances (PFAS) contamination has posed a significant environmental and public health challenge due to their ubiquitous nature. Adsorption has emerged as a promising remediation technique, yet optimizing adsorption efficiency remains complex due to the diverse physicochemical properties of PFAS and the wide range of adsorbent materials. Traditional modeling approaches, such as response surface methodology (RSM), struggled to capture nonlinear interactions, while standalone machine learning (ML) models required extensive datasets. This study addressed these limitations by developing hybrid RSM-ML models to improve the prediction and optimization of PFAS adsorption. A comprehensive dataset was constructed using experimental adsorption data, …

Exploring Factors Associated With Adverse Childhood Experiences And The Development Of Posttraumatic Stress Symptoms Among Children And Adolescents, Ayesha Qureshi, Sarah Delahanty Phd, Sima Sharghi Phd, Lisa Shauver Ms, Ayla Mapes Phd

Williams Honors College, Honors Research Projects

Adverse Childhood Experiences (ACEs) have a significant influence on long term mental and physical health risks, including the development of Posttraumatic Stress Symptoms (PTSS). The current study examined the association between demographic and geo-coded environmental factors and ACE exposure and PTSS development among pediatric patients seen in a behavioral health department at a children’s hospital. Geo-coded factors included Child Opportunity Index (COI scores) and Rural Urban Area Commuting Codes (RUCA). ACE-related factors (type of ACE, ACE overall score) were also included when examining PTSS. Machine learning results indicated that models incorporating environmental data and ACE-related factors performed better than models …

Removal Of Fluoridation Caused 700% Increase In Serious Dental Infections

Bulletin of the Ninth District Dental Association

Yorktown Totwn Supervisor Lachterman is waiting for a decision by the EPA per court order to act concerning possibility of IQ loss at current fluoridation levels before making a final decision on town fluoridation. The court decision was based on a report by the National Toxicology Program of foreign studies of high dose exposure that the public health community deemed as having “high bias,” i.e., questionable studies and results. The EPA has decided to appeal the decision. Evidence-based studies deemed as having low bias have consistently shown no harm to IQ at fluoridation levels of 1.5mg/L, twice the amount of …

Paul Revere-Founding Father And America’S First Forensic Dentist, William J. Maloney

Bulletin of the Ninth District Dental Association

Paul Revere is remembered today for his many contributions to the independence efforts of the American colonies. It is also well-known that he was a skilled goldsmith and silversmith. Revere put these skills to use in providing dental care to the people of Boston. Revere had acquired his dental knowledge from John Baker- a dentist who emigrated from Europe to America in 1760 and is considered to be the first dentist to practice in North America. In his dental practice, Revere cleaned teeth and replaced missing teeth by wiring in replacement teeth usually utilizing various metals and animal bone.

Working With Foster Families: What Providers Should Know, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Foster parents play a vital, yet often challenging role in the lives of children who have experienced trauma and instability. Navigating the healthcare system for children in foster care can be particularly complex and overwhelming, requiring understanding, collaboration, and a unique approach from healthcare professionals. This page offers insights and practical ideas for healthcare professionals to effectively support foster parents, ultimately contributing to the well-being of the children in their care.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Ensuring The Health And Well-Being Of Children After Adoption, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children in foster care have higher rates of health concerns and healthcare utilization than their peers who have not experienced foster care. For example, one study found that children in foster care had 2.5- and 2.3-times higher odds of having a mental health diagnosis and developmental disability diagnosis, respectively. Data on our patient population supports these findings, revealing that 70.4% of our patients had chronic or complex chronic health conditions.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison

Theses, Dissertations and Capstones

Problem Statement: Cesarean delivery is associated with significant postoperative pain, typically managed with spinal anesthesia using a local anesthetic. While opioids are often added as adjuncts, the addition of dexmedetomidine, an alpha-2 agonist, has emerged as a potential alternative that may enhance the efficacy of the spinal block in terms of pain management, potentially improving block duration and quality compared to local anesthetic alone.

Methodology: A literature review was conducted on the use of dexmedetomidine as an adjunct to spinal anesthesia for patients undergoing cesarean sections. Databases used for the search included PubMed, CINAHL Complete, and MEDLINE. The keywords used …

Improving The Emotional Wellbeing Of Healthcare Workers In A Homecare Agency, Crystal U. Okafor

Doctor of Nursing Practice Projects

Healthcare workers (HCWs) often have traumatic experiences in the course of care delivery, and these experiences negatively impact their well-being, affecting them emotionally, psychologically, and physically. With the COVID-19 pandemic, healthcare workers have had indelible experiences questioning their choice of profession. This project aimed to teach the factors affecting the emotional well-being of healthcare workers and develop strategies to improve emotional distress in a home care agency. The implementation site was Carolina Homecare Solutions, with 21 participants, including nursing assistants and registered nurses. Sample selection was via a convenient strategy, selecting the most conveniently available participants. The project leader used …

The Use Of Therapeutic Communication To De-Escalate Aggression And Violence In Clients Living In A Homeless Shelter, Tionna S. Felder

Doctor of Nursing Practice Projects

Individuals working at homeless shelters have the daunting task of managing violent/aggressive behaviors with the population they serve. This project focused on educating homeless shelter staff on the use of therapeutic communication to decrease the escalation of aggression and violence when caring for their guests. The DNP Project Leader taught 23 homeless shelter staff members, and the project included three 2-hour educational sessions. The first class focused on understanding what regions in the brain are responsible for aggressive, violent, and emotional behaviors; the second class focused on what the literature says about aggressive behavior in homelessness; and the last class …

Increasing Awareness And Support For Women With Anxiety Disorders In Rural Communities, Candice C. Jones

Doctor of Nursing Practice Projects

Anxiety disorders are among the most common mental health conditions, disproportionately affecting women, particularly those in rural communities with limited access to care. Many women experience perinatal, postpartum, or generalized anxiety, often suffering in silence due to stigma, lack of awareness, and inadequate mental health education. This project focused on increasing awareness and understanding of anxiety disorders among women in rural Randolph County, North Carolina. A comprehensive literature review was conducted to assess the scope of anxiety disorders in women, identify community education needs, and explore evidence-based interventions. Ten relevant studies were analyzed, including randomized controlled trials, cross-sectional studies, and …

Early Recognition In Patient Deterioration: A Quality Improvement Project, Abigail Bell

Doctor of Nursing Practice Projects

This quality improvement project focused on enhancing early recognition of patient clinical deterioration by leveraging a rapid response team to implement targeted strategies that reduce failures in identifying early and subtle signs of physiologic decline. Rapid response teams have been widely adopted across the healthcare system to facilitate efficient interventions and prevent further deterioration in acutely ill patients. Despite their intended purpose, delays in recognizing clinical deterioration continue to exist. Failure to recognize early signs of deterioration contributes to an increased risk of irreversible organ damage, unplanned transfers to the intensive care unit, prolonged hospital stays, and, in severe cases, …

Overdose Response Training For Volunteers In A Homeless Shelter, Heather Lynne Smallwood

Doctor of Nursing Practice Projects

The opioid overdose epidemic is a critical health crisis across the country. The homeless population is substantially more at risk of overdose death compared to the general public. Naloxone is a life-saving medication for reversing opioid overdose and is available to ambulance and emergency care services, but support persons are also in regular contact with opioid users and training (Fine et al., 2022). This DNP Project was created to educate volunteers at a homeless shelter in the event of an opioid overdose. The objective of the project was to increase the knowledge of opioid overdose signs and symptoms and naloxone …

Pantry To Plate: Using Local Food Pantries To Improve Diabetes Self-Care Deficits, Rachelle Zielazienski

Doctor of Nursing Practice Projects

This project aimed to improve food pantry participants’ diabetes self-management and understanding of diabetes nutrition education through a collaborative approach. Over the course of 2 months, the project provided educational resources on diabetes nutrition at a food pantry. The target population included individuals with diabetes, pre-diabetes, and those responsible for preparing meals for diabetic individuals. A certified diabetes specialist was enlisted to ensure the delivery of culturally sensitive, evidence-based educational support tailored to participants’ diabetes health goals. Orem’s Self-Care Deficit Theory served as a framework for this project. A mixed-methods approach was utilized through pre-and post-test design to gather qualitative …

Addressing Physical Inactivity In Cabarrus County, Amy S. Hicks

Doctor of Nursing Practice Projects

Background: 21% of Cabarrus County, North Carolina, residents report complete physical inactivity during their leisure time, contributing to various health problems affecting 29% to 33% of Cabarrus County residents aged 40 to 84.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate a 3-week community walking challenge (Trim Before the Turkey Walking Challenge) to increase physical activity and social connectedness among Cabarrus County residents aged 50 and older.

Methods: A pre- and post-program survey design was used to evaluate participant-reported physical activity levels and sense of social engagement. Participants were recruited through the …

Hand Hygiene Education For Personal Care Staff In Congregated Care Settings: A Quality Improvement Initiative, Saunders Noel

Doctor of Nursing Practice Projects

For many years, proper hand hygiene has been emphasized as one of the most important defenses in helping to prevent illnesses. The World Health Organization (WHO) is a major organization that stresses the importance of proper hand hygiene and disease prevention. However, hand hygiene education and knowledge must be acquired to successfully utilize the correct steps in combating illnesses and diseases. Hand hygiene is a learned behavior and emphasizing education and awareness is important to successful adoption. This DNP project was implemented to personal care staff in a congregated care setting located in the southeastern part of Virginia. The project …

Practice Patterns In Pediatric And Adult Dysphagia: Implications For Clinical Training, Jane Grothaus, Kaitlyn Hill, Marlee Nebesniak, Anastasia Raymer

Speech-Language Pathology Faculty Publications

Objective: Most speech language pathologists (SLPs) receive training to work with patients with swallowing disorders in graduate school, focusing primarily on adult dysphagia. Although SLPs share common foundational knowledge and skills for adult and pediatric dysphagia populations, there are considerable differences in these two specialized areas of practice. We aimed to query SLPs’ practice patterns for dysphagia assessment and management for adults and pediatric populations to consider differences and guide training efforts.

Methods: We distributed two comprehensive anonymous surveys to explore practice patterns of SLPs who provide assessment and management of dysphagia for adult or pediatric populations. The 118 respondents, …

An Observational Study Of Discourse Tasks And Running Speech Sampling In The Assessment Of Paediatric Voice Quality, Victoria Reynolds, Kristin Scavo-Smith, Kate Oteng-Bediako, Sophie Scanlon

Speech-Language Pathology Faculty Publications

Introduction

Running speech sampling is an essential component of a paediatric voice evaluation, in that it should provide the examiner with a representative vocal sample of the child's everyday voice use outside of the clinic setting. Current speech sampling practices, consisting of reading tasks, informal conversation sampling and the voice question ('Tell me about your voice problem'), may not elicit consistent samples or samples of sufficient length to allow the examiner to make a reliable and valid judgement about vocal quality. The aim of this study is to compare the voice quality of children produced in response to existing running …

On The Frontline: Stop The Bleed© Training For School Staff, Mary Michaela Hinson

Doctor of Nursing Practice Projects

The American College of Surgeons’ Stop the Bleed© course was introduced in 2015 following an outcry from the community surrounding the Sandy Hook Elementary School shooting. The Stop the Bleed© course was developed as a tool for training that any person could participate in, despite their medical background or knowledge. The course is comprised of a 30-minute didactic portion followed by a 30-minute hands-on portion where participants can practice applying tourniquets, packing a wound, and applying manual pressure. This DNP project aimed to educate school staff in a high school located in North Carolina on Stop the Bleed© in an …

Antibiotic Resistance: The Growing Threats And Potential Solutions, Olisaemeka Zikora Akunne, Blessing Nkechi Emmanuel, Umar Faruk Saidu, Ayobami Sunday Akinnawo, Nasiru Ademola Adeyemi, Livia Chinaza Egoh, Malami Aishatu Muhammad, Olusegun Ayo Ade-Adekunle, Deborah Ahuoyiza Peter, Anne Amina Freitas

Department of Biomedical and Translational Sciences Faculty Publications

Antibiotic resistance (AR) has become a critical global health crisis, threatening the efficacy of antibiotics and increasing healthcare costs, morbidity, and mortality. The One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health, is increasingly recognized as an essential framework for addressing the complex drivers of AR. This review explores the mechanisms of resistance, such as genetic mutations, horizontal gene transfer, and biofilm formation, along with contributing factors such as the overuse of antibiotics in healthcare and agriculture. We assess both traditional and emerging strategies to combat AR, including antimicrobial stewardship, the development of new antibiotics, and …

Epigenetic Regulation In Fibrosis, Qingping Wei, Xiaoru Hu, Yan Sanders

Department of Biomedical and Translational Sciences Faculty Publications

[Introduction] Fibrosis is one of the pathological conditions underlying the progression of numerous chronic diseases, and it contributes substantially to morbidity and mortality worldwide. Increasing amounts of evidence indicate that epigenetic mechanisms—including DNA methylation, histone modifications, RNA modifications, and non-coding RNAs—play pivotal roles in epithelial cell injury and maladaptive tissue repair, inflammatory cell and fibroblast activation, and extracellular matrix remodeling and accumulation. Compared to genetic alterations, epigenetic changes are relatively reversible, positioning them as promising therapeutic targets. The articles collected in this Research Topic highlight recent advances in understanding how epigenetic regulation shapes fibrotic processes across multiple organ systems and …

Exploring The Clinical Profiles And Management Of Juvenile Dermatomyositis In Africa: A Survey Of African Rheumatology Care Providers, Jessica Perfetto, Laura B. Lewandowski, Dawn M. Wahezi, Vanessa Ogega, Joan Ahimbisibwe, Kate Webb, Christiaan Scott, Angela Migowa

Paediatrics and Child Health, East Africa

Background: There are limited studies of juvenile dermatomyositis (JDM) in low and middle-income countries (LMIC). Many demonstrate delays to care, high prevalence of severe manifestations, and high mortality. Given the disease-associated damage with JDM, understanding JDM in Africa further is critical. Our objectives are to understand the burden of JDM in Africa and provider access to diagnostic tools and therapy through survey methodology.

Methods: A survey (available in English and French) was distributed via WhatsApp to 363 total members of the African League of Associations for Rheumatology (AFLAR; n = 233) and Paediatric Society of the African League Against Rheumatism …

Facility-Based Uptake Of Colorectal Cancer Screening In 45-49-Year-Olds After U.S. Guideline Changes, Alyssa H. Harris, Hannah Murphy, Madeleine Mcdowell, Margaret E. Wright, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

No abstract provided.

Understanding Food Insecurity Among International Students At Ohio University, Kyle Butler, Joshua Osondu

Sustainable Living Hub Reports and Publications

Recently, food insecurity has emerged as a concern among the student body of Ohio University (OHIO), particularly among its international graduate students. This survey study was undertaken to provide data to inform OHIO’s response to food insecurity among its international graduate students.

Exploring Approaches To Address Racial Discrimination, Stigma, And Provider Communication In Sickle Cell Disease Pain Management Through Interprofessional Education And Collaboration, Ronisha Edwards-Elliott

Graduate Research Theses & Dissertations

This dissertation presents research across three publishable manuscripts that investigate why structural and systemic racism persist among patients with sickle cell disease (SCD) seeking pain management, and how interprofessional collaboration and education can help reduce disparities through shared learning, accountability, and standardized care (Chapters Two through Four). A scoping review identifies current interventions and strategies aimed at sharing the pain experiences and feelings of being unheard by SCD patients (Chapter Two). Findings of the scoping review revealed that although interventions and strategies exist and have been tested, the lack of implementation or buy-in from healthcare professionals has allowed racial discrimination …

Benefit-Risk Assessment Of Rivaroxaban In Older Patients With Nonvalvular Atrial Fibrillation Or Venous Thromboembolism, Paul P. Dobesh, Albert A. Volkl, Ákos Ferenc Pap, C V Damaraju, Bennett Levitan, Zhong Yuan, Alpesh N. Amin

Journal Articles: Pharmacy Practice

BACKGROUND: Both bleeding and adverse ischemic events increase with age, compounding the benefit-risk balance of anticoagulants in older patients. We present analyses using benefit-risk methods to better understand the age-dependence of the benefit-risk profile of rivaroxaban in patients with nonvalvular atrial fibrillation (NVAF) or venous thromboembolism (VTE).

METHODS: Randomized controlled trial data from the ROCKET-AF (NVAF) and EINSTEIN DVT, EINSTEIN PE, EINSTEIN-Extension, and EINSTEIN CHOICE in (VTE) were used. For ROCKET-AF, benefits and risks were assessed with incidence rates for key thrombotic and bleeding endpoints and a net clinical benefit (NCB) measure. Cumulative incidences (estimated by the Kaplan-Meier method) were …

Contract To Kill: Gnas Mutation, Pratima Raut, Poompozhil Mathivanan, Surinder K. Batra, Moorthy P. Ponnusamy

Journal Articles: Biochemistry & Molecular Biology

The mutation in Gsα-coding GNAS exons, popular as gsp oncogene, is the most frequent mutation across all heterotrimeric G proteins involved in oncogenesis. GNAS R201, the most frequently mutated, followed by Q227, are found predominantly across various neoplasms and cancers such as IPMN, pituitary, thyroid, appendiceal, colorectal, etc. This review emphasizes the pivotal significance of the gsp oncogene and its ramifications underpinning the sustained addiction to GNAS mutation. Recent studies delineating the mechanistic intricacies that provide solid evidence of the profound impact of oncogenic GNAS on tumor formation, progression, and maintenance are highlighted. We have leveraged the discoveries of Gsα …

Staphylococcus Aureus Encodes Four Differentially Regulated Pyruvate Transporters, Jennifer L. Endres, Cleofes Sarmiento, William Xiao, Marat R. Sadykov, Kenneth W. Bayles, Mckenzie K. Lehman

Journal Articles: Pathology and Microbiology

The success of Staphylococcus aureus as a pathogen is attributable, in part, to its ability to exploit the diverse nutrient sources available during infection. Critical to this success are the pathways involving pyruvate that serve as a nexus for energy production, oxidative metabolism, and biosynthetic processes. When available, bacteria acquire pyruvate from the environment to fuel growth. Recently, LrgAB was identified as a pyruvate transporter under microaerobic conditions, leading us to speculate that S. aureus encodes other pyruvate transporters that are active during aerobic growth. In this study, we used the toxic pyruvate analog, 3-fluoropyruvic acid (3-FP), to isolate mutants …

A Comprehensive Review On Utilizing Human Brain Organoids To Study Neuroinflammation In Neurological Disorders, Adrian Domene Rubio, Luke Hamilton, Mark Bausch, Mengmeng Jin, Ava Papetti, Peng Jiang, Sowmya V. Yelamanchili

Journal Articles: Anesthesiology

Most current information about neurological disorders and diseases is derived from direct patient and animal studies. However, patient studies in many cases do not allow replication of the early stages of the disease and, therefore, offer limited opportunities to understand disease progression. On the other hand, although the use of animal models allows us to study the mechanisms of the disease, they present significant limitations in developing drugs for humans. Recently, 3D-cultured in vitro models derived from human pluripotent stem cells have surfaced as a promising system. They offer the potential to connect findings from patient studies with those from …

Comprehensive Characterization Of Chronic Midazolam Exposure On Neonates And Long-Term Neurodevelopment, Nghi M. Nguyen, Pranavi Athota, Adrian Flores, Andrew Trease, Daniel Meyer, Vamsi K. Singu, Chandan Krishnamoorthy, Victoria L. Schaal, Reeyan Bhakat, Kunal Sualy, Sathish Kumar Natarajan, Kelly L. Stauch, Sowmya V. Yelamanchili, Gurudutt Pendyala

Journal Articles: Anesthesiology

Approximately 1 in 10 U.S. newborns are born preterm (< 37 weeks of gestation), facing risks of low birth weight, respiratory and birth deficits often requiring surgery, mechanical ventilation, and prolonged sedation. Such long-term exposure to sedatives in these babies can potentially pose neurodevelopmental risks and can further impact changes later in life. The present study focused on midazolam (MDZ), a benzodiazepine class drug commonly used as sedative in the neonatal intensive care unit (NICU). Using a robust preclinical rodent model mimicking chronic MDZ exposure, we did a comprehensive characterization on the phenotypic, molecular, biochemical, and behavioral outcomes in these exposed neonates across key developmental milestones. Our findings indicate that long-term MDZ exposure during the neonatal period negatively affects physical attributes in early childhood. While adult bodyweights between control and MDZ-exposed rats remain comparable, the MDZ rats exhibit accelerated and robust weight gain, potentially indicating a predisposition for binge eating behavior. Additionally, dopamine release in MDZ-exposed rats is markedly reduced in adulthood. Elevated levels of pro-inflammatory cytokines and growth factors in the brain during adulthood suggest a shift in development due to early MDZ exposure. Further, trends of heightened anxiety-like behavior and reduced social interaction during early adolescence compared to other stages were observed. Collectively, our study provides a comprehensive assessment of how long-term MDZ exposure during neonatal stages impacts outcomes throughout life, laying the foundation for understanding mechanisms that contribute to neurodevelopmental complications associated with long-term MDZ use in neonates.

Performance Of Urine Reagent Test Strips In Detecting Schistosoma Haematobium Infection In Individual And Pooled Urine Samples, Abraham Degarege, Berhanu Erko, David Brett-Major, Bruno Levecke, Abebe Animut, Yohannes Negash, M. Jana Broadhurst, Tzeyu L. Michaud, Christopher R. Bilder

Journal Articles: Epidemiology

This study evaluated the performance of urine reagent strips (URSs) in detecting Schistosoma haematobium infection in individual and pooled urine samples. Between June 2022 and April 2023, 2634 urine samples (10 mL each) from school-age children (5-15 years) in 15 villages across Ethiopia's Afar, Benishangul-Gumuz, and Gambella regions were tested using urine filtration microscopy (UFM) and URSs for blood, a marker of S. haematobium eggs. Pooled samples from 5, 10, 20, and 40 individuals (one positive, others negative) were examined with both methods. UFM results were used to calculate URSs' sensitivity, specificity, and predictive values for detecting infection. A total …