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ARTIFICIAL INTELLIGENCE FOR CLINICAL DECISION SUPPORT, DIAGNOSIS OF NEUROLOGICAL DISORDERS, INFECTIOUS DISEASE SURVEILLANCE, AND EARLY INTERVENTION
Get PDFThis dissertation explores innovative artificial intelligence approaches to detect and diagnose neurological disorders earlier and more effectively than current methods. The research addresses critical diagnostic delays in stroke, autism, COVID-19, brain cancer, and hypoxic-ischemic injury—conditions where early intervention significantly improves outcomes.
For stroke detection, a deep learning pipeline analyzes facial expressions in smartphone videos, achieving 76.1% accuracy using transformer networks with adversarial training. A complementary approach leverages large language models to identify interpretable linguistic markers in neurological disorders by analyzing transcripts of picture descriptions, revealing distinct patterns in patients with dementia and stroke.
For brain cancer detection during surgery, vision transformers analyze optical coherence tomography images with 98.6% accuracy, while minimizing patient-specific bias through adversarial training to improve generalizability. For autism detection, a computer vision pipeline analyzes naturalistic videos of 14-month-old infants, revealing significant differences in emotional state transitions between children later diagnosed with autism and neurotypical children, identifying markers 22 months before standard diagnosis.
In pandemic surveillance, a mobile application collecting self-reported symptoms enables early detection of COVID-19 outbreaks through space-time cluster analysis, providing a 5-day advance warning before confirmed cases surge. Finally, ultrasound neuromodulation combined with voltage-sensitive dye imaging demonstrates differential responses between normoxic and hypoxic neurons, establishing a foundation for early detection of hypoxic-ischemic neural injury.
The integration of advanced computational methods—deep learning, transformers, adversarial training, and spatio-temporal analysis—with novel sensing modalities creates powerful tools for earlier disease detection. These approaches demonstrate substantial improvements over conventional methods in accuracy, timeliness, and clinical utility, with the potential to transform neurological care through earlier intervention and improved patient outcomes
Evaluation of Peer Power Initiative in Memphis Charter Schools
Get PDFThe Center for Research and Reform in Education (CRRE) at Johns Hopkins University contracted with the Memphis Education Fund to obtain and disseminate evidence regarding Peer Power’s (PP) implementation and impact of their program in six Memphis area charter middle and high schools. This preliminary report synthesizes comprehensive descriptive data gathered from multiple participant groups to address research questions concerning classroom teacher experiences and perceptions, program coherence with course instruction and curricula, identified “best practices,” and recommendations for program improvement and future research.
• Measures employed with the six schools included a teacher survey, 35 classroom observations staffed by 54 Success Coaches (SCs), interviews with four Program Directors (PDs), and focus groups conducted with 26 SCs and 45 students.
• Participants expressed strong appreciation for Peer Power’s support of students and teachers and highlighted the SCs’ unique role as tutor, mentor, and coach.
• Teachers highlighted the program’s positive effects on student engagement and motivation. Many noted that Peer Power not only improved students’ academic skills but also promoted greater confidence in learning and interest in attending school. Notably, every teacher respondent to the survey (n = 25) indicated the desire to have an SC next year.
• Students universally praised the SCs and noted numerous benefits they received from their academic and social-emotional support.
• Across all data sources, the PDs emerged as the main drivers of the program through their roles of communicating, scheduling, monitoring, and overall quality control of activities.
• Salient best practices included the preparation and engagement of effective and caring SCs; the pairing and teaming of the SCs and classroom teachers; the fluidity and timeliness with which SCs provided individualized support to students through coaching and mentoring; the effective selection and training of SCs; and the data-intensive orientation of the Peer Power model.
• Recommendations for improvement suggested increasing adaptation of program goals to schools’ needs for broader classroom-centered student support versus personalized tutoring; refining the Daily Checks process; formalizing expectations for teachers and school leaders through MOUs; optimizing SC-teacher matches; and holding more meetings within and across participant groups to share experiences and develop stronger community.
• Continued research and evaluation is recommended to increase the program’s evidence base and inform future practices.
Peer Power has demonstrated substantial promise as a provision for academic achievement through coaching and mentoring students. The program’s flexible implementation model aligns with best practices, particularly for high needs groups, making it a valuable option for schools seeking impactful interventions and student support
ADVANCED IMAGE ANALYSIS FOR LOCALIZATION AND GUIDANCE OF IMAGE-GUIDED SPINE SURGERY
No full textImage-guided spine surgery (IGSS) has become a new standard of care in recent years, transforming spine interventions to enhance precision and patient safety. Despite significant advancements, existing IGSS workflows still present challenges and opportunities for innovation, particularly in robust anatomical identification and accurate, efficient integration of multi-modality images. During the planning stage, manual vertebral labeling remains prone to human errors, risking incorrect surgical site localization. During the intraoperative phase, while magnetic resonance (MR) imaging offers superior soft tissue contrast without radiation exposure, its integration into the IGSS workflow has been limited by difficulties in accurately registering preoperative MR with intraoperative x-ray images. The research in this dissertation aims to address these gaps by developing data-driven image analysis and image registration algorithms to enhance safety and expand the utility of IGSS.
A memory-efficient deep learning framework was developed to automate vertebrae labeling in preoperative 3D imaging. By leveraging orthogonal 2D slices to predict accurate 3D vertebral localization, the method reduced computational load compared to traditional 3D approaches. In addition, a novel imaging geometry-aware network was introduced for vertebrae labeling in intraoperative long-length x-ray imaging, utilizing multi-perspective aggregation and spine order incorporation to enhance labeling performance.
A 3D-2D registration framework for preoperative MR and intraoperative long-length x-ray imaging was developed to integrate MR into the intraoperative workflow. Combining deep image synthesis and multi-scale local registration, the proposed framework addressed the modality and patient pose mismatch between images, demonstrated robust performance in cadaver and clinical studies. To facilitate clinical translation and address the critical runtime limitation of 3D-2D registration, a real-time multi-modality 3D-2D pose regression network was developed and experimentally validated. The network achieved comparable registration accuracy with traditional approach with substantial speedup, enabling a pre-clinical MR-based surgical navigation prototype.
The dissertation presents innovations for bridging 3D and 2D imaging modalities in IGSS, with emphasis on robust anatomical localization and efficient multi-modality registration, ultimately enhancing surgical precision, workflow efficiency, and patient outcomes
Dietary factors associated with blood pressure and glycemia among adults with hypertension living in a high-altitude area of the Peruvian Andes
No full textHypertension and type 2 diabetes mellitus (T2DM) are highly prevalent non-communicable diseases that contribute significantly to global morbidity and mortality, particularly in low- and middle-income countries (LMICs) and nutritional factors play an important role on blood pressure and glycemic control. However, limited evidence exists on the effectiveness of nutritional interventions in LMIC settings, and the association between dietary patterns and disease management among high-altitude populations.
First, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of nutrition education interventions on blood pressure and glycemia in adults with hypertension and T2DM in LMICs.
From the meta-analysis of 65 RCTs, nutrition education interventions significantly reduced systolic blood pressure (mean difference: –5.99 mmHg), diastolic blood pressure (–4.07 mmHg), and hemoglobin A1c (–0.65%) compared to control groups from baseline to endline.
Further, we implemented a cross-sectional study of adults with hypertension participating in a community health worker–led intervention in high-altitude Peru at baseline, ANDES trial. First, we evaluated diet quality using the Global Diet Quality Score (GDQS). We enrolled 154 participants (mean age 66.5 years; 51.9% female), overall diet quality score was 15.7 points. Higher GDQS quartiles were inversely associated with systolic blood pressure among those who were aware of and receiving treatment for hypertension.
Second, polyphenol intake was estimated using three non-consecutive 24-hour recalls and linked to the Phenol Explorer database. Potatoes, red onions, and apples being primary sources of polyphenol intake in the study participants. Using multivariable linear regression, no statistically significant association was found between total polyphenol intake and blood pressure, adjusting for relevant sociodemographic and clinical variables.
Nutrition education interventions are effective in improving blood pressure and glycemic control among adults with hypertension and T2DM in LMICs. In high-altitude settings, better overall diet quality is associated with improved blood pressure outcomes among those with hypertension awareness and treatment, though polyphenol intake alone was not associated with blood pressure changes. These findings highlight the importance of comprehensive dietary strategies in chronic disease management, and the need for further research on nutrition strategies in diverse populations
PLASMA MEMBRANE DYNAMICS: INVESTIGATING MEMBRANE PROTEIN OLIGOMERIZATION AND PEPTIDE-MEDIATED MACROMOLECULE DELIVERY
No full textIn this dissertation, we explore the organization and function of the plasma membrane, with a focus on receptor tyrosine kinases (RTKs) and peptides. The plasma membrane is a dynamic and essential structure composed of a lipid bilayer and embedded proteins that mediate transport, communication, and signal transduction. We discuss how RTKs and their associated proteins interact within the plasma membrane.
As a central focus of this work, we also discuss the behavior of RTKs and their associated proteins that regulate processes such as angiogenesis, cell growth, and motility. Traditionally, RTKs were thought to exist as monomers in the absence of ligand, forming dimers only upon ligand binding. However, recent evidence suggests that some RTKs can form higher-order oligomers without ligand stimulation. In this dissertation, we examine how membrane protein oligomerization is influenced by receptor concentration and membrane context, and investigate the implications of unliganded RTK organization.
We conduct live-cell experiments using confocal microscopy to quantitatively assess RTK organization at the plasma membrane. Confocal microscopy provides high-resolution, noninvasive imaging suitable for tracking protein clustering and dynamics.
Additionally, we explore the use of peptide-based delivery systems, including cell-penetrating and pore-forming peptides, to facilitate intracellular delivery of fluorescent proteins and antibodies. These tools allow us to manipulate and visualize protein localization in live cells, enhancing our ability to probe membrane-associated processes.
Collectively, this work contributes to our understanding of membrane protein organization, RTK signaling behavior, and the development of new methods for delivering biomolecules into cells—advancing both basic biology and therapeutic strategy development
Oral history of Dr. Malcolm Franklin
No full textDr. Malcom Franklin graduated from Dunbar in 1990. He went on to attend Clark Atlanta University and Boston University School of Medicine where he earned his MD. He joined the Navy, serving as a physician. He currently serves as an internal medicine physician with Duly Health and Care in Plainfield, Illinois. Malcom speaks about the pre-academy summer program where he took courses on the JHU campus. He elaborates on visits to local science and medical facilities where students could shadow physicians. He notes that the program prepared him for the pursuit of an undergraduate degree, especially in biology. Malcom reflects that he’d wanted to be a physician since middle school and gives advice to current Dunbar students. He mentions the similarity in his background, being from Baltimore, but the importance of pursuing one’s dreams and finding people who can guide you. Malcom notes he was a part of a partnership between Clark Atlanta and Boston University, which allowed early acceptance to medical school and was geared towards recruiting minority applicants. Dr. Franklin discusses some of the prominent health conditions facing African Americans and explains his role is to promote wellness. Lastly, Malcom reflects on personal relationships built with other Hopkins Dunbar alumni
THEY SEE OUR MAGIC BUT NOT OUR STRESS: EXAMINING SUSTAINABILITY IN BLACK WOMEN PRINCIPALS
Get PDFAlthough an essential presence in K-12 education, Black women are woefully underrepresented in the scholarship on educational leadership. The existing research shows that Black women’s unique leadership style positively impacts the well-being of the students, staff, and schools they serve. The current literature on Black women principals reveals common themes amongst the experiences of Black women that highlight a unique standpoint. This standpoint provides insight into the needs of Black women in school leadership. To ensure that Black women principals remain in their seats, there must be more insight into how intersectionality affects their ability to achieve work-life balance, build productive relationships, receive stakeholder support, and feel
accomplished. Examining how these factors present in the ecological systems of Black women
principals provides further insight into their ability to sustain as leaders. Using Black feminist
thought theory as a theoretical framework, this study aims to build on the limited body of work
focused on the experiences of Black female principals by centering their leadership experiences,
surfacing their collective knowledge, and identifying and examining the organizational structures
and support that contribute to their sustainability. A secondary purpose of this research is to
investigate how the constructs associated with burnout present in Black women. Creating more
transparency around the leadership experience of Black women by surfacing the factors that lead
to their thriving or not thriving in principalships can positively impact schools and districts
across the nation
The Organic and the Synthetic: Creativity and Rome
No full textModern Western ideas of creativity were shaped in part through a dismissive view of Roman culture. Long seen as derivative and unoriginal, Rome was cast as the antithesis of a supposedly authentic Greek creativity—a perception reinforced by Romanticism and inherited by later literary theory. This dissertation reexamines that narrative by exploring how Roman thinkers themselves conceptualized the creative act.
At the heart of the study is a historical tension between two dominant models of creativity: one to be called “synthetic,” emphasizing the recombination of existing elements; the other “organic,” drawing on metaphors of birth, growth, and embodied development. While Roman literature has often been reduced to a paradigm of the synthetic model, this dissertation advances a different perspective, one bridging these opposing models into a cohesive understanding of creativity. It does so through close readings of the Roman poets Vergil, Ovid, and Manilius, the Epicurean philosopher and poet Philodemus, as well as surrounding ancient literary and rhetorical theory, materialist philosophy, biology and medicine.
The thesis proceeds through three interconnected steps. The first part presents a phenomenology of poetic practice: how Roman poets describe what they do, from gathering material to composing verse. The second part explores creativity from an ontological perspective, focusing on what kind of process the creative act is. It examines how Roman writers reflect on how things come into being in a tension of physical and biological frameworks, and how these reflections shape their understanding of poetic creation. The final part offers a sociology of creativity, examining how poetic activity and its associated metaphors interact and clash with Roman values, social structures, and anxieties.
In doing so, this dissertation positions Rome not simply as a formative influence on Western conceptions of creativity but as a distinct intellectual framework that challenges those very notions
STAPHYLOCOCCUS AUREUS IN INDIGENOUS COMMUNITIES IN THE SOUTHWEST UNITED STATES: ESTIMATING INVASIVE DISEASE BURDEN, MEASURING CARRIAGE PREVALENCE, AND EXPLORING KNOWLEDGE AND ATTITUDES RELATED TO DISEASE PREVENTION
No full textBackground:
Staphylococcus aureus (Staph) is a common bacterial pathogen that disproportionately affects Indigenous communities in the United States. Despite its public health importance, few studies have examined the burden of invasive Staph disease or carriage prevalence in these communities using population-based approaches. This dissertation sought to quantify the burden of invasive disease, describe carriage prevalence and risk factors, and assess community knowledge and attitudes to inform culturally grounded prevention strategies.
Methods:
Three studies were conducted in partnership with the White Mountain Apache Tribe and Navajo Nation. Paper 1 used data from the Johns Hopkins University Center for Indigenous Health’s Active Bacterial Surveillance (ABS) system to estimate incidence rates of invasive Staph infections from 2019–2023. Paper 2 used cross-sectional data from the PNEU-CARE study to estimate Staph carriage prevalence among children under five years and analyze associated risk factors. Paper 3 employed qualitative methods, including 39 in-depth interviews and 3 focus group discussions, to explore community awareness and acceptability of Staph prevention strategies.
Results:
From 2019–2023, 138 invasive Staph cases were recorded in the White Mountain Apache Tribal lands and 1,104 cases in the Navajo Nation. Age-standardized MRSA incidence in 2023 was 126.8 per 100,000 in the White Mountain Apache community—over 6 times the U.S. average—and 26.2 per 100,000 in the Navajo Nation. Staph carriage was detected in 42.8% of children <24 months and 47.6% in those aged 24–59 months, with highest positivity from oropharyngeal swabs. Key risk factors included livestock exposure, and skin burns. Community members demonstrated strong awareness of Staph symptoms and prevention and emphasized the need for culturally tailored education and greater access to supplies like antiseptics.
Conclusions:
Indigenous communities in the Southwest U.S. face a high burden of invasive Staph disease and notable carriage prevalence among young children. These findings underscore the importance of sustained surveillance, community engagement, and culturally adapted interventions. Future efforts should prioritize health equity through co-developed prevention strategies that respect Indigenous knowledge, reduce structural barriers, and support holistic community health
Exposed Bodies: Dressing and Undressing Women in Italian Chivalric Literature
Get PDF“Exposed Bodies: Dressing and Undressing Women in Italian Chivalric Literature” offers a comparative analysis of Matteo Maria Boiardo’s Orlando innamorato, Ludovico Ariosto’s Orlando furioso, and Torquato Tasso’s Gerusalemme liberata, the three most influential chivalric poems of the Italian Renaissance, by focusing on the relationship between clothing and the gendered bodies they interact with in the
narrative. Specifically, I argue that garments, armor, masks, and even the absence of clothing are not mere descriptive details, but rather powerful and active semiotic signs whose narrative implications evolve as Italian chivalric romance progresses from the fifteenth to the sixteenth century. By analyzing Boiardo, Ariosto, and Tasso’s poems, I demonstrate how the use of these signs enables women to subvert the gendered dynamics of the literary tradition, by manipulating the male gaze that would otherwise constrain their agency within the conventions of the genre. However, these signs are usually wearable and, therefore, impermanent; they can be removed, either deliberately or by force, and this dynamic highlights a fundamental distinction between characters depicted as men from those depicted as women. Men can lose the wearable signs that signify them, but this loss never constitutes a
permanent condition. Conversely, women’s power to shape and control the gaze of others is fleeting, only temporarily granted by clothing, and it shifts to a state of passive nakedness when stripped away. In other words, I argue that while knights are dressed and armored, women are naked and defined by the gaze of others. At the same time, nudity itself can be read not only as an empty medium on which signs are inscribed, but also as an active element of the semiotic dynamics described so far. Therefore, the last section of this dissertation explores instances where nakedness itself functions as a costume for female characters. A tool for seduction or a signifier of vulnerability; either way, a signal that elicits male reactions, both within the narrative worlds of the poems and among their contemporary audience