Medicine and Health Sciences Commons^™

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 …

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 …

Primary Breast Sarcoma In Pediatric, Adolescent, And Young Adult Patients: A Single-Institution Retrospective Review, Amelie D. Perrier

Summer Research Program Abstracts

No abstract provided.

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 …

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. …

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 …

Mtorc2-Nav1.2 Signaling Drives Early Hyperexcitability In Alzheimer’S Disease Mouse Model, Nolan M Dvorak, Jeffrey L Noebels

Faculty, Staff and Students Publications

Hyperexcitability is a biomarker of early-stage Alzheimer’s Disease (AD) and hastens cognitive decline later in its course. Mechanistic target of rapamycin (mTOR) signaling contributes to the slope of this trajectory, as evidenced by early increased brain expression and the rescue of hyperexcitability by genetic deletion of mTOR complex 2 (mTORC2); however, a molecular mechanism directly linking mTOR signaling to membrane hyperexcitability in early-stage AD remains elusive. Here, we show that hyperactive mTOR signaling stimulates the voltage-gated Na+ channel 1.2 (Nav1.2), a previously identified downstream phosphorylation target of mTORC2 and a key regulator of membrane electrogenesis. Augmented Nav1.2 channel function induced …

Perspective: Improving Social Connection And Inclusion Through Equitable Digital Health Solutions, Dominika Kwasnicka, Jaimon Kelly, Eleanor Quested, Loretta Baldassar, Suzanne Robinson, Richard Sinnott, Paul O’Halloran, Anne Tiedemann, Paul Flatau, Rajna Ogrin, Jane Farmer, Abby C. King

Research outputs 2022 to 2026

In this Perspective, we address the critical intersection of digital health, social connection, and health equity. Taking an interdisciplinary and complex adaptive systems perspective, we highlight evidence-based digital solutions to improve social connection and inclusion and, consequently, health outcomes. We describe actionable strategies for ensuring that digital health innovations benefit all, highlighting how user-centered design can address diverse needs, particularly for structurally disadvantaged populations.

Application Of The Paediatric Medical Traumatic Stress Model To The Mental Health Experience Of Young People Living With Type 1 Diabetes: A Qualitative Study, Rigel Paciente, Sara Coombs, Karen Lombardi, Helen Milroy, Keely Bebbington, Heather Roby, Craig E. Taplin, Nicole Wickens, Stella Rose, Alix Woolard

Research outputs 2022 to 2026

Despite the various traumatic events that a young person living with type 1 diabetes (T1D) may experience, little is known about the burden and manifestation of traumatic stress in this population. Though mental health outcomes have been explored generally, medical trauma-sensitive approaches to understanding these experiences remain limited. We utilised a qualitative descriptive approach to explore the impact of T1D on young people’s mental health through the paediatric medical traumatic stress model (PMTS). Young people aged 13–30 living with T1D were interviewed. These interviews were recorded, transcribed, and analysed using Reflexive Thematic Analysis. Three main themes were generated: (1) perceived …

Acute Effects Of Accentuated Eccentric Loading On Mean Concentric Velocity During Resistance Training: A Systematic Review And Meta-Analysis, Jiahao Yang, Tsuyoshi Nagatani, Paul Comfort, Kristina L. Kendall, G. Gregory Haff

Research outputs 2022 to 2026

Background: Accentuated eccentric loading (AEL) may acutely enhance the concentric (CON) barbell velocity after the additional eccentric (ECC) load is removed, however there are inconsistent results regarding the effectiveness of this practice within the scientific literature. Objective: The aims of the present study were to: (1) examine the acute effects of applying AEL, only on the first repetition of a set, on mean barbell velocity during the CON phase of the first 3 repetitions of the set and (2) investigate the influence of the magnitude of ECC load, loading differential and exercise selection on the acute effects of AEL. Methods: …

Implementation And Effectiveness Of A Food Education Intervention To Promote Plant-Based Foods: A Partially Cluster-Randomized Controlled Trial, Henna Vepsäläinen, Satu Kinnunen, Sari Niinistö, Leena Forma, Suvi T. Itkonen, Tuuli E. Korhonen, Liisa Korkalo, Heli Kuusipalo, Jelena Meinilä, Kaija Nissinen, Susanna Raulio, Ros Sambell, Mari Åkerlund, Suvi M. Virtanen, Maijaliisa Erkkola

Research outputs 2022 to 2026

Background: Legumes can substitute for meat and are thus a particularly important food group for environmental sustainability. As the use of legumes among Finnish children is marginal, there is potential for a substantial increase in their consumption. However, food education delivered through early childhood education and care (ECEC) settings has rarely focused specifically on environmentally sustainable foods, such as legumes. This study describes the implementation and effectiveness of an ECEC-delivered food education intervention within the FoodStep study. Methods: The partially cluster-randomized FoodStep intervention aimed to increase the supply of vegetables, legumes, fruits, berries, and sustainable fish while reducing the provision …

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 …

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, …

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 …

Cxcr3 Is Associated With T-Cell-Induced Heart Damage In Acute Rheumatic Fever, Francis M. Middleton, Reuben Mcgregor, Natalie Lorenz, Sarah Kilian, Anna E.S. Brooks, Saem Mul Park, Ciara Ramiah, Judith Tresidder, Timothy C. Barnett, Michael Serralha, William J. Martin, Florina Chan Mow, Glenn Pearson, Mark Mayo, David I. Broadhurst, Julie Bennett, Johann Brink, Nigel J. Wilson, Anna P. Ralph, Rachel H. Webb, P. Rod Dunbar, Jonathan Carapetis, Nicole J. Moreland

Research outputs 2022 to 2026

The pathogenesis of acute rheumatic fever (ARF) is poorly understood, limiting the development of immune-modulating therapies to treat disease and prevent progressive heart damage. Here, participants with definite ARF were compared to other severe acute paediatric conditions and matched healthy controls by profiling circulating immune molecules and cells to inform disease mechanisms and potential druggable pathways. ARF shared immunological similarities with other inflammatory conditions, including elevated serum IL-6 and an increased frequency of circulating CD4⁺ T cells. However, elevation of the chemokine CCL5 and immunoglobulin IgG3, along with reduced expression of the chemokine receptor CXCR3 in the T cell …

Local Government Policies Restricting Unhealthy Outdoor Food Advertising In Australia: Stakeholder Perspectives Identify Political Willingness Is Key To Overcoming Barriers, Alexia Bivoltsis, Frith Klug, Jacinta Francis, Clare Whitton, Gina S.A. Trapp, Claire E. Pulker

Research outputs 2022 to 2026

Background: Unhealthy outdoor food advertising is strongly linked to poor diet, highlighting the need for policies. Western Australian (WA) local governments (LGs) can restrict advertising on their owned infrastructure through their Public Health Plans, but limited policy action has occurred. This study aimed to explore the perspectives of WA LGs and public health organizations (PHOs) on current and potential policies restricting unhealthy outdoor food advertising on LG owned infrastructure to (1) identify barriers and enablers to the policy making process, (2) assess the current level of political willingness (i.e. political want, political can and political must) and (3) inform development …

Temptation At The School Fence: A Qualitative Exploration Of The Impact Of External Food Outlets On The School Community, Sharonna Mossenson, Klug, Jacinta Francis, Siobhan Hickling, Lukar Thornton, Gina Trapp

Research outputs 2022 to 2026

Retail food outlets are commonly located in close proximity to schools, providing students with opportunities to purchase and consume food enroute to or from school. These outlets are typically unhealthy and disproportionately clustered near schools, and this trend has been increasing over time. While quantitative studies have established associations between school food environments and adolescent dietary behaviours, little is known about how school personnel perceive and experience their impacts. This qualitative study explored perspectives of school personnel (n = 9) from a secondary school in Perth, Western Australia, located 150 m from two retail food precincts (areas with a high …