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Healthcare Decision-Making Antecedents in Young Adults: A Mixed Methods Study
No full textBackground: In the U.S., healthcare rights and responsibilities are conferred at age 18. Once dependent on parental decisions, young adults are suddenly expected to navigate healthcare independently. The foundation for this transition is health literacy (HL), defined by the Institute of Medicine (IOM) as the "capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” HL development occurs through interactions with education, healthcare, and societal systems. Purpose: The research objective was to identify antecedents to young adults’ healthcare decision-making within the HL framework to create opportunities to educate and prepare for healthcare independence. Methods: This study used narrative inquiry methodology to collect stories (narratives) from adults 18 to 28 years old. The stories were lived experiences related to healthcare decisions, which were analyzed within the HL framework using open coding to identify antecedents to healthcare decision-making. Results: Thirty-three participants, average age 22 years, responded to an initial health interest survey. Four survey respondents progressed to narrative sessions, resulting in 20 total stories. The narrative participants were three white males, one Hispanic female, and all college experienced. The stories were triangulated with validated surveys on HL, locus of control, and self-efficacy. Participant scores were uniformly high, indicating a homogenous population of health-literate adults with a strong sense of control and self-efficacy related to healthcare. Three main antecedents were identified within the HL framework: organized sports participation (education and society), healthcare visits, and family advisors (society). Conclusion: Organized sports, whether school or community-based, played a significant role in healthcare decision-making among these young adults, including determination of severity or when to seek care. Physician visits for injury or illness also emerged as important in shaping approaches to care based on physician behavior, parent role, or both. Family members consulted about health issues were the third source of influence in decision-making. While limited by sample size and demographic homogeneity, the findings suggest valuable opportunities for targeted education and interventions. Further research on HL, particularly within structured activities such as sports, physician engagement, and family influence, could enhance young adults’ preparedness for independent healthcare decision-making
Evaluating the Impact of a Pharmacy Oncology Stewardship Program in an Academic medical Center
No full textPURPOSE: This study evaluates the impact of implementing a pharmacy-managed oncology stewardship program at an academic medical center. METHODS: A retrospective, quasi-experimental, single-center study was conducted from February 2022 to February 2025 to evaluate the impact pharmacists had to transition R-EPOCH and AIM treatment plans to outpatient encounter settings. This intervention was driven by policy that went into effect in September 2023, marking the pre-implementation (February 2022 to August 2023) and post-implementation (September 2023 to February 2025). The primary outcome was the number of patients who avoided inpatient admissions after the implementation of the chemotherapy protocol for R-EPOCH and AIM treatment plans. RESULTS: The study included 99 unique patients, with 12 patients having episodes of care both before and after the intervention. In the post-intervention period, 15.6% (n=10) of patients avoided inpatient admission altogether, compared to only 1 patient (2%) in the pre-intervention period. Black patients had a length of stay approximately 3.3 days longer per episode than white patients (p = 0.0023). CONCLUSION: Implementation of an oncology stewardship program showed a significant reduction in inpatient admissions and median length of stay for chemotherapy-related episodes of care. Further research should include a comprehensive evaluation of the financial and clinical outcomes of an oncology stewardship program as well as investigating potential racial disparities in care
The IRE1α/XBP1 Signaling in Regenerative Myogenesis and Cachexia
No full textSkeletal muscle regeneration and maintenance of muscle mass are regulated through systematic orchestration of multiple signaling mechanisms and reprogramming of genetic transcription. The Endoplasmic Reticulum (ER) is a major organelle that is involved in the synthesis, folding and secretion of various cellular proteins. Accumulation of unfolded or misfolded proteins challenges the folding capacity of the ER and leads to ER stress, which is countered by the stimulation of Unfolded Protein Response (UPR). The physiological activation of UPR is crucial for maintaining cellular homeostasis; however, chronic activation of UPR can lead to maladaptive effects. This dissertation demonstrates that the IRE1α/XBP1 arm of the UPR plays a dual role in skeletal muscle, with both beneficial and detrimental effects depending on the underlying condition. Our results show that IRE1α/XBP1 signaling in myofibers and in muscle stem cells, also called satellite cells, is required for efficient muscle regeneration following injury in adult mice. Myofiber-specific ablation of XBP1 impairs regenerative myogenesis by inhibiting proper satellite cell function, formation of new myofibers, and by modulating the abundance of non-muscle cells in the injured muscle microenvironment. Moreover, inducible inactivation of IRE1α in satellite cells does not affect their proliferation or differentiation but impairs myoblast fusion step during muscle regeneration. IRE1α, through sXBP1, activates the transcription of multiple pro-fusion molecules, including Myomaker. Finally, our study also demonstrates that chronic activation of IRE1α/XBP1 signaling leads to the loss of muscle mass and strength in KPC tumor-bearing mice. Targeted ablation of XBP1 inhibits the activation of proteolytic systems, IL6-JAK-STAT3 signaling, and fatty acid oxidation in skeletal muscle of KPC tumor-bearing mice. Moreover, our results suggest that the sXBP1 transcription factor can bind to the promoter region of various target genes involved in proteolysis, glucose metabolism, and fatty acid metabolism. Lastly, pharmacological targeting of IRE1α/XBP1 signaling restricts cachectic muscle loss in the KPC mouse model of pancreatic cancer. Collectively, this dissertation provides initial evidence that the physiological activation of the IRE1α/XBP1 arm of the UPR is required for efficient adult skeletal muscle regeneration; however, spurious activation of the IRE1α/XBP1 arm leads to skeletal muscle wasting during cancer cachexia
Information Warranties: A Game Theoretic Approach to Address Business Fake News
No full textMotivated by the consequential nature of “fake (business) news” and the structural and civic limitations of existing intervention mechanisms, this dissertation investigates news warranties as a novel, bottom-up intervention designed to improve the digital news ecosystem for business news. In keeping with themes from the Information Systems, Economics, and broader social science literatures, we study this warranty mechanism as a technological artifact and explore implications for its use analytically and experimentally. The first two chapters present distinct Stackelberg games and model the important roles that consumer motivation, warranty adjudication, evidentiary cost structure, information asymmetry, and structural constraints on signals play in determining the equilibria characteristics of these “games”. Building on these insights, the third chapter examines the impact of warranty provision on users’ perceptions of believability of business news and their sharing intentions. Further, the study explores different modalities for tasks of truth estimation and warranty adjudication. In sum, these works provide important policy and design insights related to the proposed mechanism and, perhaps most notably, demonstrate that news warranties can provide business news producers a way by which their low (rather than high) veracity information is spread. We close each chapter with commentary for practitioners, policy makers, and researchers in this space
Investigating the Epigenetic Regulation of Innate Immune Memory
No full textInnate immune memory allows innate immune cells, like monocytes and macrophages, to respond more efficiently upon re-exposure to a stimulus. This process is driven by epigenetic changes, such as histone methylation (H3K4me3) and acetylation (H3K27ac), which enhance gene transcription at inflammatory loci. While macrophages treated with palmitate show increased cytokine production and metabolism, the exact epigenetic mechanisms remain unclear. PURPOSE: This study investigates how palmitate and weight loss influence epigenetic modifications, specifically H3K27ac and H3K4me3, to determine if innate immune memory can be minimized. METHODS: Bone marrow-derived macrophages were cultured from mouse femurs for 5-8 days at 37°C. Cells were treated with palmitate or a DMSO control for 24 hours, followed by a 5-day washout. Histone modifications were analyzed via flow cytometry, while cytokine production was assessed using ELISA after LPS stimulation. RESULTS: Palmitate exposure enhanced histone modifications and cytokine production. Flow cytometry revealed increased H3K27ac expression in macrophages treated with palmitate. ELISA confirmed elevated H3K27ac levels, and TNF-α production was higher in palmitate- and LPS-treated macrophages compared to controls.CONCLUSION: Palmitate induces innate immune memory through increased TNF-α production and histone modifications. These findings highlight measurable epigenetic adaptations and suggest that interventions like exercise, metformin, or weight loss may reverse innate immune memory, offering potential strategies to modulate immune responses.Health and Human Performance, Department ofHonors Colleg
Decomposition of Anomalous Diffusion and Ergodicity Breaking in Variable Speed Generalized L´evy Walks and Related Models
No full textDiffusion is a transport phenomena that typically drives non-equilibrium systems toward equilibrium by moving particles from regions of high concentration to low concentration, attaining uniform dispersion in long time limit. Diffusive behavior is normally governed by the Central Limit Theorem (CLT), which states that the displacement in the limit of large time has a Gaussian distribution with a width that increases as square root of time. However, diffusive behavior that differs from the CLT is found in a wide array of experimental systems. The root causes of anomalous diffusive behavior can be identified by decomposing the behavior into three fundamental constitutive effects, each of which are associated with the violation of an assumption of the CLT and are known as the Joseph, Noah, and Moses effects. This decomposition helps us to know the key reasons of anomalous diffusion without knowing the underlying dynamics of the process. The dynamics of systems with anomalous diffusive behavior are often modeled with Generalized L´evy Walks (GLWs) that have steps of random duration chosen from a power law probability distribution and a velocity in each step of magnitude deterministically nonlinearly coupled to the duration. Here, in the first project, we figured out the decomposition to GLWs that have steps of duration with finite mean, finding that the anomalous diffusive behavior is generally a complex combination of the three constitutive effects. We further extend the decomposition to analyze Variable speed Generalized L´evy Walks (VGLW), which can emulate different previously studied anomalous diffusion models under suitable parametrization. We show that the Latent exponent L that characterizes the Noah effect has no upper bound in VGLW. With the advancement in experimental technique like single particle tracking, it is observed that single model often cannot capture the entire dynamics of a system, which often requires the use of combined models. In our next project, we investigated anomalous diffusion generated by Two-Step Random Walks (TSRW), which have the characteristic of both Continuous Time Random Walks (CTRW) and standard L´evy Walks. We further extend our study of decomposition to a more refined model: the Generalized Two-State Random Walk model (GTSRW), which essentially combines the Drude model with the CTRW framework. In our final project, we explored ergodicity breaking in variable speed generalized L´evy walks. We figured out the phase diagram of the ergodicity breaking parameter of VGLW, which displays the emergence of strong ergodicity breaking or the divergence of ergodicity breaking parameter even where the mean square displacement exhibits normal diffusion. This interdisciplinary research integrates concepts from both equilibrium and non-equilibrium statistical mechanics, as well as mathematical modeling, to analyze displacement and velocity states in various semi-Markov processes. It provides a framework for understanding diverse real-world diffusion phenomena across multiple scales: from the movement of marine predators to intracellular transport within the cytoplasm of human cells
M18K: A Multi-Purpose Real-World Dataset for Mushroom Detection, 3D Pose Estimation, and Growth Monitoring
No full textAutomating agricultural processes holds significant promise for enhancing efficiency and sustainability in various farming practices. This paper contributes to the automation of agricultural processes by providing a dedicated mushroom detection dataset related to automated harvesting, 3D pose estimation, and growth monitoring of the button mushroom produced using Agaricus Bisporus fungi. With a total of 2000 images for object detection, instance segmentation, and 3D pose estimation—containing over 100,000 mushroom instances—and an additional 3838 images for yield estimation featuring eight mushroom scenes covering the complete growth period, it fills the gap in mushroom-specific datasets and serves as a benchmark for detection and instance segmentation as well as 3D pose estimation algorithms in smart mushroom agriculture. The dataset, featuring realistic growth environment scenarios with comprehensive 2D and 3D annotations, is assessed using advanced detection and instance segmentation algorithms. This paper details the dataset’s characteristics, presents detailed statistics on mushroom growth and yield, evaluates algorithmic performance, and, for broader applicability, makes all resources publicly available, including images, code, and trained models, via our GitHub repository. (accessed on 22 March 2025)
Computerized Maintenance Management Software Adoption Evaluation
No full textThe Computerized Maintenance Management Software (CMMS) Adoption Evaluation project aims to evaluate the effectiveness of the adoption from the technicians and facilities. Cintas Corporation recently switched from a desktop-based to an app-centric and cell phone-based platform, which is called MaintainX. This evaluation will help determine how efficiently the technicians and facilities are using the available features within the app to its full capabilities and help identify areas for improvement. To help with the evaluation process, the team will conduct surveys among Cintas employees who use MaintainX to assess user experience, feature utilization, and overall challenges. The data from the surveys will help identify common trends and areas where training or process improvements can be implemented to improve app usage. The effectiveness of MaintainX features will be analyzed to conduct improvements in preventive and reactive maintenance within the facilities.Industrial and Systems Engineering, Department ofHonors Colleg
Effects of Exercise Program on Mental, Pulmonary, and Cardiovascular Health of Elderly Men with Acquired Severe Physical Disabilities: A Retrospective Study
No full text<b>Background/Objectives:</b> Physical activity is recommended for people with physical disabilities and is beneficial not only for physical health but also for mental health. This study aimed to evaluate the quality of life (QoL), pulmonary health, and cardiovascular health among a group of older men with physical disabilities who participated in an exercise program. <b>Methods:</b> This study included 23 participants in the exercise group (EG) as an experimental group and 23 in the culture group (CG) as a control group. All participants were &ge;65 years, with one or more physical disabilities, and used wheelchairs or crutches for mobility. The participants were each provided with the exercise program for 8 weeks. Assessments included a QoL, pulmonary function test, brachial&ndash;ankle pulse wave velocity (baPWV), and factors of metabolic syndrome. The exercise program consisted of aerobics, strength training using dumbbells and tubes, and mat exercises for three days a week for 8 weeks. The culture program included singing, drawing, and writing. <b>Results:</b> The interaction effects by time and group showed that EG had a superior change compared to CG in QoL (physical function, pain, fatigue, social), forced vital capacity, baPWV, triglycerides, and high-density lipoprotein cholesterol (<i>p</i> &lt; 0.05). <b>Conclusions:</b> Participation in the exercise program positively influenced mental, pulmonary, and cardiovascular health in older men with physical disabilities. Our research results will provide useful information for rehabilitation and social security research to improve the health of elderly people with physical disabilities
Rethinking suburban development: Plan it, a participatory and data-driven approach
No full textExpanding on Ray Oldenburg's concept of the "Third Place", the informal space beyond home (first place) and work (second place). This thesis introduces the "Fourth Space," a new typology rooted in ecological and bodily connection rather than purely social gathering. The Fourth Space reimagines how architecture can dissolve boundaries between built environment and nature, fostering a deeper environmental and human entanglement. The program is intentionally minimal, consisting of three elements: a bathing area, a sitting space, and a flexible open zone. These spaces form a spectrum between micro-private experiences and macro-public interactions, challenging traditional separations of public and private life. The structure uses non-invasive, natural materials, such as wood, plants, and linen: which breathe, shade, and adapt to environmental conditions like a living organism. Rather than dominating the landscape, the Fourth Space enhances it, encouraging visitors to experience architecture as a responsive, porous medium. Open to all users regardless of race, ethnicity, or social class, the Fourth Space offers a democratic and ecological sanctuary. It proposes a model for future architecture, one where human presence strengthens, rather than disrupts, the living systems around it.Honors CollegeArchitecture and Design, Gerald D. Hines College o