Medicine and Health Sciences Commons^™

Non-Medical Determinants Of Health In Thoracic Aortic Disease: A Montalcino Aortic Consortium Study, Alberta S. Simmons

Summer Research Program Abstracts

No abstract provided.

Centering Community Voices: Protocol For Qualitative Inquiry In A Produce Prescription And Chatbot Intervention, Yesmeena Mahmoud Shmaitelly

Summer Research Program Abstracts

No abstract provided.

Understanding Patient Reported Outcome Measures And Perceptions In Trauma, Jerome D. Scott

Summer Research Program Abstracts

No abstract provided.

Associations Between Trpm4 Gene Variants And Intracranial Pressure Dynamics Following Traumatic Brain Injury, Emily H. Saweris

Summer Research Program Abstracts

No abstract provided.

Assessing The Potential Risk Factors For Major Surgical Complications In Operative Fixation Of Patients With Pelvic Ring Disruptions, Benjamin Roberts

Summer Research Program Abstracts

No abstract provided.

Concurrent Gastroschisis And Biliary Atresia: Surgical And Supportive Management, Joseph M. Pydyn

Summer Research Program Abstracts

No abstract provided.

Assessing The Effects Of Tunicamycin In Trophoblast Stem Cell Differentiation, Kay Chi Pua

Summer Research Program Abstracts

No abstract provided.

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

Smart Medical System Integrating Clinical Workflows For Robust Skin Cancer Detection Across Heterogeneous Pathologies, Ahed Abugabah, Prashant Kumar Shukla, Suchi Mishra, Abhishek Dwivedi

All Works

Skin cancer is among the most prevalent and life-threatening dermatological diseases worldwide, with melanoma responsible for a substantial proportion of skin cancer–related deaths due to delayed and unreliable diagnosis. Conventional clinical screening based on visual inspection and expert interpretation is inherently subjective and often affected by inter-observer variability, lesion heterogeneity, and imaging artifacts, highlighting the need for accurate and generalizable automated diagnostic systems. This study proposes a novel hybrid deep learning architecture for skin cancer classification that integrates an attention-guided autoencoder with a transformer-inspired global context modeling module, forming a unified and robust representation learning framework. The encoder–decoder structure is …

Evaluation Of A No-Code Ai Model For Detecting Periapical Radiolucencies: Impact Of Anatomical Region On Diagnostic Performance, Manal Hamdan, Kevin W. Yu, Marguerite Miller, Stephanie J. Sidow, Zaid Badr, Sergio E. Uribe

School of Dentistry Faculty Research and Publications

Background

To develop a no-code artificial intelligence (AI) model for the detection of apical radiolucent lesions and to assess how lesion location influences the model’s diagnostic performance.

Methods

312 periapical radiographs were retrospectively collected, each accompanied by a corresponding cone-beam computed tomography (CBCT) scan obtained within six months and a radiology report authored by board-certified oral and maxillofacial radiologists. These reports served as the reference standard, and all findings were cross-verified by the primary investigator through CBCT review. The dataset included 181 images with at least one apical radiolucent lesion and 131 lesion-free controls. Using the no-code AI platform LandingLens …

Lessons Learned From A Randomised Controlled Trial Of A Digital Intervention Targeting Eating Disorder Symptoms In Cisgender Sexual Minoritized Men, Emma Austen, Matthew Fuller-Tyszkiewicz, Siân A. Mclean, Beth O’Gorman, Katie Bishop, Hannah K. Jarman, Susan J. Paxton, Rachel F. Rodgers, An Dang, Emily A. Harris, Felicity Angelopoulos, Wesley Grey, Suku Sukunesan, Alexandra Parker, Adrian Shatte, Long Khanh-Dao Le, Scott Griffiths

Research outputs 2022 to 2026

Background: There is an unmet need for evidence-based and accessible interventions designed to treat eating disorders in sexual minoritized men, given their heightened vulnerability to developing disordered eating. Digital interventions are a promising avenue for eating disorder treatment because of their accessibility and flexibility in delivery. Here, we present a randomised controlled trial of Seed, a 10-week treatment-focussed digital intervention for eating disorders, among sexual minoritized men.

Methods: Participants (N = 126 sexual minoritized men) with a binge-spectrum eating disorder diagnosis (e.g., bulimia nervosa, binge-eating disorder) were randomly allocated to one of three conditions: (1) a waitlist control (2) a …

Bone, Muscle, And Physical Function Measures In Older Adults According To Levels Of Social Disadvantage: A Cross-Sectional Study, Jason Talevski, Sharon Brennan-Olsen, Stefanie Bird, Sara Vogrin, Alison Beauchamp, Mizhgan Fatima, Cassandra Smith, Gustavo Duque

Research outputs 2022 to 2026

Summary: This cross-sectional study of 300 older adults (aged ≥ 50 years) found that less education, lower income, and health care card ownership are associated with reduced bone, muscle, and physical function measures. This underscores the need for targeted preventive strategies for osteoporosis and sarcopenia that address socioeconomic-related disparities. Purpose: The prevalence of chronic diseases follows a social gradient, although this is unclear in musculoskeletal conditions. This study aims to examine the association between social disadvantage and diagnostic measures of osteoporosis and sarcopenia in community-dwelling older adults. Methods: A single-centre, cross-sectional study was conducted in adults (≥ 50 years) residing …

Artificial Intelligence (Ai) For Social Innovation In Health Education: Promoting Health Literacy Through Personalized Ai-Driven Learning Tools – A Systematic Review, Dina Mansour Tbaishat, Maha Waleed Elfadel

All Works

Background: Artificial Intelligence (AI) is transforming health education by enabling personalized, adaptive, and scalable approaches that may enhance aspects of health literacy. Despite rapid adoption, comprehensive synthesis of AI tools’ impact on health literacy as social innovation is limited. Understanding these effects guides educators, developers, and policymakers in designing potentially effective, inclusive, and ethical AI interventions. This review examines generative AI models, chatbots, and adaptive learning systems in supporting health literacy globally. Methods: A systematic review was conducted following PRISMA guidelines. Literature was identified primarily through PubMed/Medline, Scopus, and ScienceDirect. Connectedpapers.com was used exclusively as a citation chasing tool, performing …

An Advanced Healthcare System With An Automated Vit Model For Dermoscopic Skin Cancer Identification, Ahed Abugabah, Prashant Kumar Shukla, Suchi Mishra, Abhishek Dwivedi

All Works

Early and reliable diagnosis of skin cancer from dermoscopic images remains challenging due to class imbalance, subtle inter-class variations, lesion boundary ambiguity, and illumination inconsistency, which can degrade the robustness of conventional convolutional neural networks (CNNs). To address these limitations, this study proposes an automated smart healthcare framework for dermoscopic skin cancer diagnosis using an Enhanced Vision Transformer (E-ViT) that improves global-context modeling through self-attention while strengthening fine-grained lesion representation learning. Unlike standard ViT configurations, the proposed architecture integrates multi-scale patch embedding and attention refinement to better capture border irregularities and color–texture heterogeneity that are critical for melanoma discrimination. Furthermore, …

Comparative Performance Of Physiological Vital-Sign Forecasting Under Random And Patient-Wise Splitting Using Deep Learning, Lavanya Vasavi Chittem Reddy

Theses and Dissertations

Physiological vital-sign forecasting estimates future measurements based on recent temporal patterns and can support analysis of continuously recorded monitoring data. This study comparatively evaluated deep feedforward, recurrent, bidirectional recurrent, long short-term memory, and bidirectional long short-term memory architectures for one-step-ahead forecasting of peripheral oxygen saturation, heart rate, and pulse rate. Each model received consecutive observations of peripheral oxygen saturation, heart rate, pulse rate, respiratory rate, and age, while separate single-output models predicted the next value of the selected target.

Random and patient-wise data splitting were compared using identical input definitions, preprocessing procedures, model architectures, and training hyperparameters. The strongest architecture …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Phytochemical And In-Vitro Cytotoxic Analyses Of Flavonoid Species Isolated From Chromolaena Leivensis, Luke A. Bryant

Electronic Theses and Dissertations

As a leading cause of death worldwide, cancer and its treatments remain a primary source of interest among researchers. Modern studies are looking into bioselective cytotoxicity to create new chemotherapies that do not have the same harsh side effects as those we use today. Natural product research has a promising future for the development of such treatments. Specifically, polar flavonoids may be the key to a bioselective treatment. Such flavonoid species are native to plants, often within flower petals or within the body. A natural antioxidant, they are designed not to harm healthy cells. This study focuses on the plant …

Impact Of School Nurse Education On Factors Influencing Hpv Vaccine Communication With Parents, Jihye Choi, Efrat K Gabay, Jeanette Deason, Elizabeth Baumler, Diane Santa Maria, Daisy Mullassery, Lara S Savas, Erika Thompson, Sanghamitra M Misra, Paula M Cuccaro

Faculty, Staff and Student Publications

Human papillomavirus (HPV) can cause six cancer types but can be prevented with timely vaccination in early adolescence. However, despite the wide availability of the HPV vaccine, uptake remains suboptimal among US adolescents. School nurses are invaluable resources to students and their families regarding adolescent immunization needs. As part of the All for Them vaccination program, we assessed the impact of the continued nurse education (CNE) intervention on school nurses’ HPV vaccine communication with parents. Seventy-two school nurses and nurse administrators in Texas participated in the study. Using a single-arm study design, we measured participants’ potential barriers to and self-efficacy …

In-Hospital Mortality Patterns And Readmissions In Patients With Chronic Obstructive Pulmonary Disease: An Analysis Of The Role Of Pulmonary Hypertension, Saad Afzal Khan, Trishna Parikh, Adishwar Rao, Akriti Agrawal, Aarohi Parikh, Farah Kazzaz, Sarah Shin, Harry Karmouty-Quintana, Maulin Patel, Kha Dinh, Bela Patel, Bindu Akkanti

Faculty, Staff and Student Publications

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline …

Individual And Household Factors Associated With Tungiasis In A Marginalized Population In Karamoja, Northeastern Uganda, Lynne Elson, Abneel K. Matharu, Berrick Otieno, Hermann Feldmeier, Charles Waiswa, Amina Abubakar, Jürgen Krücken, Ulrike Fillinger, Francis Mutebi

All Peer-Reviewed Publications

Background: Tungiasis is a neglected tropical skin disease caused by adult female fleas which burrow into the skin of people and animals, causing considerable pain and itching. The distribution of the disease is heterogeneous, with Napak district, Karamoja sub-region of northeastern Uganda having the highest disease burden recorded globally. We aimed to determine the factors associated with this high prevalence to inform future intervention strategies. Methods: We conducted a cross-sectional study to identify factors associated with infection of individual children and adults, and a nested case–control study to identify factors for whole households (families). Infected children were identified through mass-screening …

Evaluating The Pulse Of Exercise Programs: Developing And Validating The Intervention Usability Scale For Exercise (Iuse) To Enhance Implementation And Adherence, Anne Inger Mørtvedt, Eva Ageberg, Steven Elmer, Kevin Trewartha, Erich Petushek

Michigan Tech Publications

Background: Adherence to exercise interventions is often suboptimal, despite numerous studies documenting barriers and facilitators. Usability may be a critical yet underexplored determinant of adherence. This study aimed to develop and assess the psychometric properties of the Intervention Usability Scale for Exercise (IUSE). Methods: Item generation and content validation involved cognitive interviews and feedback from eight exercise intervention stakeholders and ten target users from the general public. Subsequently, 526 target users from University, Qualtrics and Prolific participant panels assessed exercise programs through an online survey. Dimensionality was assessed using Principal Component Analysis (PCA), Exploratory Factor Analysis (EFA), and bifactor models. …

Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina

Faculty, Staff and Student Publications

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known.

Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e'/a'), and …

Association Of Glycd147 With Carotid Atherosclerosis: Evidence From Integrative Analyses, Cuihong Tian, Yang, Xingang Li, Hongxia Zhang, Jieyi He, Jinxiu Zhu, Yequn Chen, Xuerui Tan

Research outputs 2022 to 2026

Background: Atherosclerosis is an inflammatory cardiovascular disease that progresses with ageing. Glycosylation plays a significant role in inflammation and contributes to the pathogenesis of ageing-related diseases, including atherosclerosis. Cluster of differentiation 147 (CD147), a glycosylated agonist of matrix metallopeptidase 9 (MMP9), serves as an inducer of atherosclerosis and atherothrombosis. However, the effect of glycosylated CD147 (GlyCD147) on atherosclerosis remains unclear. This research aims to identify whether GlyCD147 is associated with atherosclerosis. Methods: To begin with, a clinical case-control study was designed to assess the differences of CD147 and GlyCD147 between 69 carotid atherosclerosis (CAS) cases and 69 controls. Traditional atherosclerotic …

Slushies Before School: Exploring How Nearby Food Outlets Impact The Eating Behaviours Of Secondary Students In Perth, Western Australia, Sharonna Mossenson, Klug, Joelie Mandzufas, Jacinta Francis, Siobhan Hickling, Lukar Thornton, Gina Trapp

Research outputs 2022 to 2026

The external school food environment, comprising food outlets and marketing near schools, shapes what young people eat. Yet little is known about how Australian adolescents perceive and navigate these environments. Focus groups were conducted with 31 school students (Years 7–12) from Perth, Western Australia, to explore their experiences of the external school food environment and its influence on their food-related behaviours. Transcripts were thematically analysed and six themes were identified. Accessibility emphasised proximity, transport links, opening hours and speed of service, with older students using outlets as social spaces. Availability of slushies, energy drinks, snacks and fast-food meal deals influenced …

The Effect Of School-Based Educational Session On Knowledge, Attitudes, And Beliefs Of Cervical Cancer Among Adolescents In Mixed Day High Schools In Embu County: A Quasi-Experimental Study, Lucy W. Kivuti-Bitok, Mugo, Dorothy Mituki, Christine Marete, Irene Ngune, Jessica Wells

Research outputs 2022 to 2026

Background: School-based interventions have proven effective in enhancing knowledge and altering attitudes toward cervical cancer among adolescents. This study aimed to evaluate the effect of a school-based educational intervention on the attitudes, beliefs, and knowledge of cervical cancer among adolescents in mixed-day high schools in Embu County. Methods: This study used a single-group, repeated cross-sectional design to assess the effect of a structured health education session on cervical cancer among adolescent boys and girls in mixed-gender secondary schools. A self-administered anonymous questionnaire was administered before and immediately after the post-intervention. The education session lasted 30–45 min, and the study population …

The Impact Of Virtual Reality Simulation On Developing Competence And Confidence In Non-Technical Skills In Nursing. A Scoping Review, Katie Janz, Karen Clark-Burg, Khaya Morris-Binelli, Brennen Mills, Amanda Graf

Research outputs 2022 to 2026

Background: Medical errors are a global concern and can compromise patient safety, with up to 80% of these errors directly linked to non-technical skills (NTS) failures. Traditional simulation using mannikins is resource-intensive, and virtual reality simulation (VR) has the potential to offer comparable outcomes with enhanced consistency and lowered resource requirements, but the effectiveness of VR to teach and enhance NTS has been underexplored.

Aim: This scoping review explores the existing literature on VR simulation as a method for teaching NTS in nursing to evaluate whether VR simulation yields positive learning outcomes, particularly in comparison to traditional training methods such …

Transcutaneous Auricular Vagus Nerve Stimulation Paired With Task-Specific Training For Improving Walking And Balance In Chronic Stroke: A Double-Blind, Randomised Controlled Feasibility Trial, Ashraf N.H. Gerges, Jeric Uy, Lewis Ingram, Susan Hillier, Joanne Bouckley, Ellana Welsby, Ines Serrada, Taya Hamilton, Saran Chamberlain, Brenton Hordacre

Research outputs 2022 to 2026

Background: Transcutaneous auricular vagus nerve stimulation (taVNS) paired with task-specific training has shown promise for improving upper-limb motor recovery after stroke but its effects on gait and balance remain unclear. This study evaluated the feasibility and safety of taVNS paired with task-specific training and explored preliminary effects on walking and balance outcomes in adults with chronic stroke.

Methods: A double-blinded, sham-controlled trial was conducted to evaluate active versus sham taVNS paired with task-specific training (15 one-hour sessions over six weeks). Feasibility metrics included recruitment, participant experience, adverse events (AEs), and blinding effectiveness. Clinical outcomes (walking speed, endurance, gait parameters, and …