Digital Commons Network^™

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 …

Identity: Inpatient Dialogue & Engagement With Nurses To Improve Team Dynamics Final Results, Anna Maria Abi Nehme, Ashley Becker, Raheeq Mohamedsaleh, Shin Zaw, Vigneshwar K. Ramasamy, Richard Henriquez, Jorge Restrepo, Ashwini Komarla

North Florida Division GME Research Day 2025

No abstract provided.

Duodenorenal Fistula Post-Lithotripsy: A Rare Complication, Anam Zara, Aarohi Parikh, Duyen Quach, Ismail Hader, Georg Elias

Gulf Coast Division GME Research Day 2025

No abstract provided.

Postpartum Glucose Testing And Primary Care Follow-Up For Women With Gestational Diabetes Mellitus: A Quality Improvement Project, Madeline Bartram, Anusha Hussain, Timothy Kremer

North Texas Research Forum 2025

BACKGROUND: Patients with gestational diabetes mellitus (GDM) have a 40-70% lifetime risk for developing type 2 diabetes mellitus, which is 9 times the risk of patients without a history of GDM. Joint association guidelines recommend a 75-gram, 2-hour oral glucose tolerance test (GTT) at 4 to 12 weeks postpartum for all patients with GDM, and to follow-up with a primary care physician. Currently, less than half of these patients do not receive the recommended postpartum glucose testing and/or follow-up. METHODS: For each GDM-affected pregnancy, two primary outcome measures were retrospectively collected from the clinic EHR: completion of the 75-gram GTT …

Reconciliaction Ensuring Accurate Home Medication List, Juan Pablo Meruvia Garron, Saud Khan, Akash Patel, Anna Maria Abi Nehme, Jomaris Centeno Girona, Olga Karasik

North Florida Division GME Research Day 2025

No abstract provided.

There’S A Qr Code For That: Trauma Performance Improvement, Patient Safety, And Peer Review, April Miller, Luis Taveras, Elizabeth Kim, Kathy Galt

North Texas Research Forum 2025

In preparation for our facility’s initial ACS verification visit, a Trauma Consultative Site visit in 2021 identified the need for a streamlined process to communicate issues to the Trauma Program that were recognized during patient care. This was especially true on weekends and nights when issues were most likely to occur. A recent literature review revealed implementation of electronic communication tools increased reporting of performance improvement and patient safety (PIPS) events and improved tracking and resolution of events. The authors of that study used a virtual chatroom accessible from cell phone to post PIPS events. One perceived drawback to this …

Designing A Narrative-Based Video Game For Adolescents Coping With A Parent's Cancer, Sophia Hamilton, Xubing Hao, Sharon Andrews, Eveyln Roldan, Carlos Martinez, Jane Hamilton, Muhammad Tuan Amith, Licong Cui

Faculty, Staff and Student Publications

We developed the narrative video game Sophia that immerses users in the story of a 13-year-old girl during her father's 18-month battle with glioblastoma and her journey toward resilience during her high school years following his passing. The game is designed to engage adolescents coping with parental cancer in multiple gameplay modes and levels, the character, and the outcome of the story as a way to build connections and explore the themes of illness, dying, bereavement, and resilience. The scenes at each level correspond to the stages of glioblastoma illness as well as the teenage milestones she passes through without …

Enhancing The Accuracy Of Image Classification For Degenerative Brain Diseases With Cnn Ensemble Models Using Mel-Spectrograms, Sang-Ha Sung, Michael Pokojovy, Do-Young Kang, Woo-Yong Bae, Yeon-Jae Hong, Sangjin Kim

Mathematics & Statistics Faculty Publications

Alzheimer’s disease (AD) and Parkinson’s disease (PD) are prevalent neurodegenerative disorders among the elderly, leading to cognitive decline and motor impairments. As the population ages, the prevalence of these neurodegenerative disorders is increasing, providing motivation for active research in this area. However, most studies are conducted using brain imaging, with relatively few studies utilizing voice data. Using voice data offers advantages in accessibility compared to brain imaging analysis. This study introduces a novel ensemble-based classification model that utilizes Mel spectrograms and Convolutional Neural Networks (CNNs) to distinguish between healthy individuals (NM), AD, and PD patients. A total of 700 voice …

Felt Need For Psychiatry Clubs In Medical Colleges To Enhance Teaching-Learning, Aditya Rao, Sheryl Agarwal, Sharanya Bose, M Kishor

Digital Journal of Clinical Medicine

Mental health competence is critical for medical graduates, yet in India the treatment gap for common mental disorders remains substantial, with prevalence estimates indicating up to 80.4% of unmet need. Recent reforms under the Competency-based Medical Education (CBME) curriculum have expanded psychiatry training; however, deficiencies in applied skills, preventive psychiatry, and communication remain. Psychiatry clubs have been proposed as supplementary, student-led platforms to address these limitations. This cross-sectional study assessed the perceived need for psychiatry clubs among undergraduate medical students and explored their potential role in enhancing teaching–learning. A structured online survey was administered to 94 students across different phases …

The History Of Cardiopulmonary Resuscitation And Where We Are Today, Maren Downing, Eren Sakarcan, Kristen Quinn

General Surgery Resident Research

Cardiac arrest remains a leading cause of death worldwide and is a global health crisis. First described in the medical literature in the 18th century, modern cardiopulmonary resuscitation (CPR) with closed chest compressions has remained the standard of care since 1960. Despite exponential advances in basic science research and technological innovations, cardiac arrest survival remains a dismal 10%. The standard of care closed chest compressions provide only 20–30% of baseline cardiac output to the body. Have modern therapies plateaued in effectiveness? This article reviews the history of cardiac arrest, its therapies, and opportunities for future treatments. Through an exploration into …

Analysis Of Errors In The Management Of Cutaneous Disorders, Robert J. Pariser, Sarah Alnaif

Department Dermatology Faculty Publications

In this study, we prospectively and retrospectively evaluated the occurrence of errors in the management of cutaneous disorders from patient visits and medical records in a single dermatology practice in southeast Virginia over a 3-year period (June 2020-July 2023). Providers should be able to improve diagnostic accuracy by utilizing established rapid bedside diagnostic techniques.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Reducing Colonoscopy Cancellations Saves Lives, A Quality Improvement Project, Jennifer L. Brosnan

West Chester University Doctoral Projects

One of Healthy People 2030’s objectives is to increase the proportion of adults screened for colorectal cancer. To address this objective, a quality improvement project was completed within an Ambulatory Surgical Center (ASC). An evidenced-based committee was formed with the primary goal to decrease the number of cancelled colonoscopies. The committee aimed to answer the PICOT question: For patients who cancel their colonoscopy, how does the development and implementation of an evidence-based practice (EBP) committee’s nursing interventions reduce cancelled colonoscopy rates and increase reschedule rates, compared to no implementation of an EBP committee’s nursing interventions, over three months?

Nursing interventions …

Time To Measure: A Proposed Theoretical Model For Head And Neck Cancer Intervals Of Care, Mary Jue Xu, Hannah Decker, Arianne Abreu, Rolvix H. Patterson, Hirwa Nteyumwete, Pier-Luc Beaudoin, David W. Hamilton, Aslam Nkya, Willybroad Massawe, Nicholas Correia, Furahini Yoram Paulo, Katherine Van Loon, Susan D. Emmett, Christina Reaves, Samuel Okerosi

Otolaryngology (ENT) Resident Research

Head and neck cancer care delays are challenging, given the complexity of cancer care pathways, which leads to delays throughout the patient journey, from the symptom onset to treatment completion. Current models and literature addressing cancer care are limited by heterogeneous definitions of care intervals, a focus on specific aspects of the patient journey instead of the whole care continuum, and limited use of implementation science to target gaps in implementing evidence-based interventions. Here, we propose the Head and Neck Cancer TImely aCess TO Care Model as an approach to conceptualize, measure, and address delays in diverse health systems.

Platypnea-Orthodeoxia Syndrome In A Case Of Septal Occlusion Device Migration, Bike Ozkan, Richard Shalmiyev, Adam Devine, Michael Pelekhach, Siddarth Kathuria, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction

Platypnea-orthodeoxia syndrome (POS) is defined by dyspnea and hypoxemia in the upright position, which improves upon recumbency. While often linked with hepatopulmonary syndrome, intracardiac etiologies, particularly a patent foramen ovale (PFO), may also be responsible. PFOs are typically managed with device closure, and while rare, device migration can occur unbeknownst to the patient with resultant critical sequelae.

Methods

Here, we present the case of an 89-year-old female with a medical history of hypertension, diabetes, and coronary artery disease status post PCI, who arrived with severe dyspnea and was subsequently intubated for profound hypoxia. A chest CT angiogram ruled out …

Closing The Communication Gap: A Quality Improvement Approach To Safer Shift Changes And Transfers, Stephanie O'Kresik Jewette, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Size Of Pediatric Tracheostomy Tube And Predictors Of Postoperative Complications, Soukaina Eljamri, Jordyn Lucas, Amber Shaffer, Basil Hashimi, Marina Rushchak, Reema Padia

Department of Otolaryngology (ENT) Faculty Publications

Objective

(1) To investigate weight as an alternative guide for trach tube choice. (2) Evaluate complications 3-month posttracheostomy and associations with patient and trach tube factors.

Study design

Retrospective cohort study.

Setting

Single academic medical center.

Methods

Patients < 2 years old who underwent tracheostomy placement from 2017 to 2022 were identified. Associations between trach characteristics, trach size/length, chest x-ray (CXR) and intraoperative endoscopy measurements, and complications within 3 months posttracheostomy placement were evaluated.

Results

In total, 68 patients were included in the study, with a median age of 4 months (range: 1 day to 1.74 years) and weight of 4.1 kg (range: 1.8-11.6 kg) at the time of the procedure. The length of the trachea measured on CXR was more closely associated with weight (ρ = 0.403, P = .0007) than with age (ρ = …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Comparison Of Apixaban And Left Atrial Appendage Exclusion Device (Watchman) In Preventing Stroke And Systemic Embolism In Atrial Fibrillation Patients, Sreeja Konatham

Master's Theses and Doctoral Dissertations

Atrial fibrillation is a cardiac arrhythmia associated with increased risk of stroke and systemic embolism. Apixaban, an oral anticoagulant, and the Watchman, a left atrial appendage closure device, are the currently used therapeutic treatments for the prevention of stroke and systemic embolism in atrial fibrillation patients. However, a direct comparison of these two treatments with respect to safety and effectiveness remains limited. This research evaluates Apixaban and the Watchman device by analysing the clinical trial data and full regulatory approval pathways. Apixaban has been approved through New Drug Application process, and the Watchman device is approved via the premarket approval …

Nurse Education For Perinatal Substance Use Disorder And Mental Health, Michelle Simpson

Articles, Abstracts, and Reports

No abstract provided.

Healthcare Utilization Unchanged In The Control Arm Of A Randomized Clinical Trial, Pratik Gongloor, Saad Nadeem, Xiaoying Yu, Mukaila Raji, Kristina D Mena, Elizabeth M Vaughan

Faculty, Staff and Students Publications

including among control groups. Increased access to care and heightened health awareness during trial enrollment could lead to altered behaviors, a phenomenon known as the Hawthorne effect, which may obscure true intervention impacts; however, this effect remains poorly studied in low-income environments.

Aim: To conduct a secondary exploratory analysis of healthcare utilization among control participants of a randomized clinical trial (RCT).

Methods: We retrospectively analyzed electronic medical records from the control arm (n = 26) of an RCT involving low-income Hispanic adults with type 2 diabetes receiving care at a community clinic. Before randomization to a 12-month diabetes education intervention …

Revealing Spatiotemporal Neural Activation Patterns In Electrocorticography Recordings Of Human Speech Production By Mutual Information, Julio Kovacs, Dean Krusienski, Minu Maninder, Willy Wriggers

Mechanical & Aerospace Engineering Faculty Publications

Background

Spatiotemporal mapping of neural activity during continuous speech production has been traditionally approached using correlation coefficient (CC) analysis between cortical signals and speech recordings. A prior study employed this approach using electrocorticography (ECoG) data from participants who underwent invasive intracranial monitoring for epilepsy. However, CC cannot detect nonlinear relationships and is dominated by the correspondence between periods of silence and of non-silence.

New Method

We introduce the mutual information (MI) measure, which can capture both linear and nonlinear dependencies. We validated CC and MI on the sub-second spatiotemporal brain activity recorded during continuous speech tasks. To refine the results, …

Caregiver Policies In The United States: A Systematic Review, Makenna R. Green, M. Courtney Hughes, Sadia Afrin, Erin Vernon

Faculty Articles, Papers, and Other Scholarship

In the United States, there are nearly 53 million informal or unpaid caregivers, many of whom experience mental and physical stress related to their caregiving duties and increased financial responsibility. We identified federal and state informal caregiver support policies authorized by specific legislation along with their key provisions and conducted a systematic review of the academic literature related to quantitative evaluations of these policies. Twenty policies, eight academic studies, and four gray literature reports were included in the study, with half of the policies introduced since 2000. Our study criteria yielded few academic valuations tied to caregiver policies and few …

Academic Proficiency In Ugandan Children With Sickle Cell Anemia: A Cross-Sectional Study, Robert Opoka, Shubaya Kasule Naggayi, Paul Bangirana, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Ann Jacqueline Nakitende, Dennis Kalibbala

Paediatrics and Child Health, East Africa

Introduction: Academic proficiency is crucial for advancing learning goals, school advancement, and future economic security. Children with sickle cell anemia (SCA) in sub-Saharan Africa (SSA) may be at risk of disease-associated learning difficulties. Limited data exist on this topic among school-age children in the region. We aimed to assess academic proficiency in a sample of children with SCA in Uganda compared with unaffected controls.

Methods: This cross-sectional study was conducted in Kampala, Uganda. Participants were school-going children with SCA, aged 6–12 years, attending Mulago Hospital SCA Clinic, and age-matched sibling controls without SCA. Academic proficiency was assessed by the Wide …

Improving Communication And Follow Up For Incidental Findings From Panscan Imaging, Makenzie Morrissey, Kristen Payne, Randall Rittmann, Chris Robert, Joseph Lim, Danielle Pigneri

North Texas Research Forum 2025

OBJECTIVE: Incidental findings in medical imaging pose a significant challenge in healthcare due to the potential for missed follow-ups, which can lead to adverse outcomes for patients. These findings, which are unrelated to the primary purpose of the imaging study, are increasingly common due to advances in imaging technology and its widespread use. The consequences of missed follow-ups can be severe. For instance, the rate of malignancy in incidental pulmonary nodule id about 5% and follow up fails in 30-70% of cases. This means for every 120 CT chest scans ordered, 1 lung cancer is missed (McWilliams et al., 2013). …

Assessment Of Patient Satisfaction Through The Introduction Of A Post-Procedure Pamphlet In An Outpatient Clinic, Mohammad Rashik, James Aston, Sajid Surve

North Texas Research Forum 2025

This quality improvement project aimed to create a patient pamphlet for the Osteopathic Manipulative Medicine (OMM) clinic at the University of North Texas Health Science Center. The pamphlet provides important post-procedure information for patients who undergo treatments like joint injections, platelet-rich plasma therapy, prolotherapy, hydrodissection, botulinum toxin injection, and nerve blocks. These procedures can lead to potential side effects, some of which patients may not be aware of. To address this, the pamphlet includes information on common symptoms, their causes, recommended next steps, and guidance on when to contact the OMM clinic or visit the Emergency Department. The pamphlet was …

Medical Students And Program Directors Attitudes And Opinions On The Use Of Artificial Intelligence In Medical Education, Kayla Nguyen, Vishal Patel, Shehroze Akhter, Alexander T. Gibson, Ryan K. Wong, Mike Liang

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Unique Case Of Small Bowel Arteriovenous Malformations In The Setting Of Immune Thrombocytopenic Purpura, Austin Moore, Evan Chen, Hassan Ahmed

North Texas Research Forum 2025

Arteriovenous malformations (AVM) are a common cause of gastrointestinal (GI) bleeding and often require intervention for definitive treatment. The diagnosis and management of this disease process becomes complicated when combined with an immunologic coagulation disorder. There is very limited literature describing management techniques for patients with these coinciding diseases. This unique case describes a 65-year-old male with a history of AVMs of the small bowel as well as immune thrombocytopenic purpura (ITP). Previously he had undergone multiple medical interventions for management of his ITP, including steroids and intravenous immunoglobulin therapy. He had also undergone multiple imaging and endoscopic interventions to …

Development Of A Continous Renal Replacement Therapy Protocol For A Midsize Community Hospital, Srinidhi Shyamkumar, Eric Riha, Crystal Ike, Rachel Wright, D Villareal, Justin Shanks, Damon Cao

Gulf Coast Division GME Research Day 2025

No abstract provided.

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …