Digital Commons Network^™

Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.

Objective: The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of …

The Effectiveness Of A Chronic Care Management Program On Hospitalization Rates And Quality Of Life In Chronic Kidney Disease Patients, Sophie Burris

Doctoral Projects

Chronic Kidney Disease (CKD) is a progressive condition that distinctively affects underserved rural communities due to limited access to healthcare, provider shortages, and transportation barriers. Chronic Care Management (CCM) has emerged as a patient-centered, initiative-taking approach that emphasizes care coordination and self-management support. The purpose of this doctoral project was to evaluate the impact of implementing a CCM program in Caucasian females over the age of 40 with CKD residing in an underserved rural community post hospitalization. The Chronic Care Model (CCM) is the framework that guides the doctoral project which compared outcomes in patients enrolled in a CCM program …

Point-Of-Care Gastric Ultrasound For Preoperative Assessment Of Gastric Contents: An Objective Structured Clinical Examination, Joshua Mann, Michael Sykes

Doctoral Projects

Pulmonary aspiration remains a leading cause of anesthesia-related mortality. The current nil per os (NPO) guidelines are proving unreliable in the presence of delayed gastric emptying due to comorbidities and the increasing use of glucagon-like peptide-1 (GLP-1) agonists. Gastric point-of-care ultrasound (POCUS) use provides a non-invasive, evidence-based, and cost-effective approach to assess gastric content and volume directly. However, limited formal training exists for advanced practice registered nurses (APRNs), and this lack of training contributes to the lack of its utilization. This doctoral project evaluated the effectiveness of an educational intervention that incorporated a didactic lecture as well as a hands-on …

Molecular Pathway Dysregulation In Chronic Liver Disease: Metabolic And Mechanotransductive Drivers Of Hepatic Pathophysiology, Samantha Harvat

Department of Chemical and Biomolecular Engineering: Dissertations, Theses, and Student Research

Metabolic dysfunction–associated steatotic liver disease (MASLD) represents a rapidly growing cause of chronic liver injury, yet the molecular interactions linking metabolic stress, inflammation, fibrosis, and hepatocellular carcinoma (HCC) remain incompletely defined. This thesis integrates transcriptomic analyses across multiple GEO datasets to identify coordinated metabolic, inflammatory, and mechanotransductive pathways that collectively drive disease progression.

Analysis of human liver biopsy datasets (GSE126848 and GSE89632) revealed consistent suppression of glycolysis, β-oxidation, and oxidative phosphorylation across MASLD and MASH samples, accompanied by modest compensatory TCA cycle activation. These alterations reflect impaired metabolic flexibility, mitochondrial stress, and increased ROS susceptibility. Concurrently, cytokine-network enrichment demonstrated activation …

An Evaluation Of Virtual Supervision Effectiveness Within Department Of Veterans Affairs (Va) Health Professionals Training Programs, Linda M. Kawentel, John P. Donnelly, Kaylee W. Burgan, Gezan M. Yahya, Joanna S. Doredla, Jessica L. Johnson, Kimberly Falco, Marjorie A. Bowman, John Byrne, Nicholas W. Bowersox

Population and Public Health Sciences Faculty Publications

Background Limited information exists on whether virtual training is equivalent to traditional in-person training in supporting the development of clinical providers. Methods A multi-site evaluation using survey methods was conducted with a multidisciplinary group of health professions trainees and supervisors within the Veterans Health Administration to assess the equivalence of two supervision modalities – exclusively in-person supervision and supervision incorporating at least some virtual supervision – on trainee clinical competency development, trainee preparedness to respond to patient emergencies, and effective trainee/supervisor working relationships. Results Trainees who experienced some virtual supervision rated their clinical competency levels as higher than trainees with …

Spectrum Of Headache Disorders In Pakistan: A Multicenter Study, Amina Javed, Shafaq Saleem, Safia Awan, Saba Zaidi, Manzoor Lakhair, Fahad Saleem, Waleed Shahzad, Ahmed Wali

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Headache disorders represent some of the most prevalent neurological conditions worldwide. While community-based

studies provide general prevalence, data on their diagnostic spectrum in specialized clinical settings in Pakistan remain

limited. The objective of this multicenter study was to evaluate the demographic distribution and spectrum of headache

disorders among patients presenting to neurological services across Pakistan.

Methods:

This cross-sectional observational study was carried out at 39 neurology centers across Pakistan, from August 2017

to December 2019. Diagnosis was made using International Classification of Headache Disorders, 3rd edition

(ICHD-3). Demographic details, and headache subtypes were compared across gender and …

Electrophysiological Localization And Prognostic Indicators In Radial Neuropathy Presenting As Wrist Drop: A Three-Year Retrospective Observational Study, Assad Ullah Khan, Muhammad Farooq, Saad Ali, Sadiq Ali Shah

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Radial neuropathy is a common cause of wrist drop, and accurate lesion localization is essential for appropriate

management and prognostication. The objective of this study was to analyze electrophysiological localization patterns

of radial nerve lesions presenting as wrist drop and to assess whether earlier referral for electrophysiological evaluation

was associated with recovery outcomes.

Methods:

This retrospective observational study was conducted at Lady Reading Hospital Peshawar, a tertiary care setting, over

a three-year period (January 2022–December 2024). Adult patients with wrist drop and electrophysiological confirmed

radial neuropathy were included. Nerve conduction studies and needle electromyography were used to …

Visual And Brainstem Evoked Potentials: A Retrospective Cross-Sectional Audit From A Tertiary Care Hospital In Pakistan, Zuha Amin Alvi, Sundus Mehtab Shafee, Zahra Talib Shah, Dureshahwar Kanwar, Sajid Hameed

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Visual and brainstem auditory evoked potentials (VEPs and BAEPs) are standard techniques for evaluating the integrity of visual and auditory pathways respectively. The objective of our audit study was to assess demographic trends,referral indications, and electrophysiological outcomes of patients undergoing VEP and BAEP testing in a tertiary care neurophysiology laboratory in Pakistan.

Methods:

A retrospective, cross-sectional audit was conducted of 952 patient records (VEP, n=219; BAEP, n=733) over a three-year period from neurophysiology laboratory of Aga Khan University Hospital. Demographic characteristics,clinical referral indications, and electrophysiological findings were collected. Standard ACNS guidelines were used for all recordings. Statistical …

Subacute Sclerosing Panencephalitis In A 24-Month-Old Child: A Rare Early Onset And Alarming Presentation, Arshad Mehmood, Javeria Raza Alvi, Sameen Qureshi, Ahmed Bilal, Shaila Ali, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal neurodegenerative disorder caused by persistent measles virus infection. Early-onset SSPE in children under five years is uncommon but often rapidly progressive. We report a 24-month-old unvaccinated male who presented with progressive myoclonic seizures, gait difficulty, and rapid neurodevelopmental regression. Electroencephalography (EEG) showed periodic generalized discharges, and CSF measles antibody titers were elevated, fulfilling modified Dyken criteria. The child was classified as stage III SSPE. Symptomatic therapy including anti-seizure medications and supportive care, along with a planned ketogenic diet, was initiated but neurological outcome remained poor. This case emphasizes the aggressive …

Challenges Of Neurological Care In A Public Sector Hospital In Pakistan, Anila Umer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Lack Of Multidisciplinary Collaboration In Stroke Rehabilitation In Pakistan: A Call For Integrated Care Models, Etisam Wahid, Shahzad Ahmad, Nimrah Humayoon

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Corrigendum: Correction Of Second Author’S Name And Affiliation In “Chorea As A Rare Manifestation Of Neuropsychiatric Systemic Lupus Erythematosus: A Case Report”, Editor Pjns

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Blood- Borne Biomarkers: Exploring The Frontiers Of Minimally-Invasive Diagnosis Of Alzheimer’S Disease, Sidra Afzal, Minahil Fatima, Nimra Afzal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Optimal Anthropometric Discharge Criteria From Treatment Of Wasting: Meta-Analysis Of Individual Patient Data From 34 Studies, Lilia Bliznashka, Sandhya Chaudhary, Susan Rattigan, Sheila Isanaka, Ruth Adah, Tahmeed Ahmed, Nur Alam, Rodrigue Alitanou, Paluku Bahwere, Helen Nabwera

Paediatrics and Child Health, East Africa

Background: Community-based treatment of acute malnutrition saves lives, but recovered children remain at risk of relapse post-discharge. Strategies to reduce this risk may include modification of anthropometric discharge criteria.

Objectives: This study aims to compare the diagnostic accuracy of anthropometric indices to reduce post-discharge relapse risk.

Methods: We searched PubMed from inception to June 2022. We included studies that enrolled children aged 0–59 mo successfully treated for severe or moderate acute malnutrition (SAM or MAM), assessed anthropometry at discharge, and had ≥1 follow-up assessment ≤6 mo post-discharge. Pooled sensitivity and specificity for anthropometric indices at discharge over multiple cutoffs were …

Implementation Of The Modified Severity Assessment Scale (Msas) For Alcohol Withdrawal In An Inpatient Psychiatric Unit, Grace R. Lindsey

Doctor of Nursing Practice

Background: Alcohol withdrawal is a potentially life-threatening condition frequently seen in psychiatric inpatient settings, especially among individuals with co-occurring alcohol use disorder and mental illness. The Clinical Institute Withdrawal Assessment for Alcohol Scale-revised, while widely used, depends on patient self-report, making it less effective for individuals with altered mental status or psychosis.

Purpose: This quality improvement project implemented the Modified Severity Assessment Scale, an objective, observation-based alcohol withdrawal protocol, in an inpatient psychiatric setting to improve safety, treatment accuracy, and care standardization.

Objectives: The project focused on ensuring full staff adoption of the protocol, reducing intensive care unit transfers …

Implementing A Cardiac Catheterization Pre-Procedure Protocol To Decrease Avoidable Same-Day Cancellations, Christina C. Perry

Doctor of Nursing Practice

Background and significance of the problem: Pediatric congenital heart defect patients are amongst the sickest hospital population. These patients require planned palliation in the cardiac catheterization lab (cath lab), which has a limited number of providers and appointments available. In the cath lab, the percentage of avoidable same-day cancellations for interventional procedures was found to be greater than 30%, representing significant resource utilization opportunities.

Purpose: The purpose of this project was to develop and implement a standardized, evidence-based pre-procedure protocol to decrease avoidable same-day cath lab cancellations.

Goals and objectives: The goals of this project were a 10% decrease in …

Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring

All-Inclusive List of Electronic Theses and Dissertations

Enhancing quality of life and well-being is a universal phenomenon across the lifespan. As the population ages, older adults are in great need of supportive services to enhance quality of life and their ability to manage their mental health. The purpose of this study is to examine the quality of life (QoL) of older adults. This study aimed to provide valuable research in the area of QoL through the exploration of perceived factors that impact the older adult population. This exploratory qualitative research study consisted of 10 older adult participants between the ages of 65 and 95. Research recruitment prioritized …

A Novel Maturation Equation For Hepatic Clearance Across Preterm, Term Neonates, Children, And Adults: Application To Paracetamol And Its Metabolite, Yunjiao Wu, Swantje Völler, Sebastiaan C. Goulooze, Karel Allegaert, Catherine M.T. Sherwin, Anne Van Rongen, Daniëlla W. E. Roofthooft, Sinno H.P. Simons, Dick Tibboel, Robert B. Flint, John N. Van Den Anker, Catherijne A.J. Knibbe

Pediatrics Faculty Publications

A preterm and term neonate to adult (PTNA) maturation equation was introduced recently to describe the glomerular filtration rate maturation from birth to adulthood for neonates of varying gestational age. This study aims to evaluate the newly developed PTNA equation against common maturation approaches like allometric scaling (AS0.75), the AS0.75 plus postmenstrual age (PMA)-based Emax (AS0.75 + PMA) equation, and the bodyweight dependent exponent equation (BDE) for the maturation of three hepatic pathways of paracetamol (PCM) from preterm and term neonates up to adults. A population pharmacokinetic analysis was conducted with pooled plasma and urine data of PCM, PCM-glucuronide (PCM-GLU), …

Issue 16: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 16

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics:

EVERDAC Trial: Do All Shock Patients Need Arterial Lines?

Beyond MAP: Redefining Perfusion Pressure in Septic Shock

ECG Findings You Cannot Miss in Acute Pulmonary Embolism

Food for Thought: When Private Equity Buys Hospitals, Who Pays …

Integrating Evidence Synthesis Into Doctoral Research: A Guide For Family Medicine And Primary Care, Klaus B. Von Pressentin, Jacob Shabani, Taryn Young

Family Medicine, East Africa

Given the increased complexity of healthcare needs, evidence-informed practices are needed, now more than ever. Combining the best available research evidence, the perspectives of patients and communities, and the voices of healthcare workers in guiding policy and practice is essential. All of us involved in providing and strengthening family medicine and primary care need to be good consumers (users) of research, and some will be good producers (doers) of research. In both using and doing research, a helpful starting point is evidence synthesis – a form of secondary research that collates primary research on the same research question. This short …

Telehealth And Virtual Supervision Practices For Health Professions Education In The Department Of Veterans Affairs, Nancy D. Harada, Kimberly Falco, Marjorie Bowman, John M. Byrne

Population and Public Health Sciences Faculty Publications

Background Telehealth and virtual supervision practices in health professions clinical education has grown rapidly, including in the Department of Veterans Affairs (VA) which oversees the largest interprofessional training effort in the United States. Telehealth is the provision of healthcare that is provided remotely through telecommunication technology, and virtual supervision is clinical supervision of health professions trainees (HPTs) that occurs through telecommunication technology. In this study we evaluate participation in telehealth and virtual supervision for physician, nursing, and associated health HPTs, and describe prevalent themes concerning HPT perceptions of telehealth and virtual supervision. Methods The survey study cohort included 10,865 HPTs …

The Frontal Assessment Battery In Older Multilingual Kenyan Adults, Anne Njoki Gitere, Anne Nyambura, Karen Blackmon, Levi Muyela, Rachel Maina, Olivera Nesic Taylor,, Jasmit Shah, Dilraj Sokhi, Sylvia Mbugua, Samuel Gitau, Sheila Waa, Juzar Hooker, Zul Merali, Chinedu Momoh, Karen Blackmon

Brain and Mind Institute

Background: The Frontal Assessment Battery (FAB) was developed as a short (6-item) bedside assessment of executive dysfunction in older adults with suspected neurodegeneration. This study describes psychometric features of the FAB in multilingual Kenyan adults with and without clinical diagnosis of dementia.

Method: The FAB consists of six items assessing verbal abstract reasoning, lexical fluency, motor learning, and inhibitory control. The score on each item ranges from 0-3, with higher scores indicating better performance. Bilingual English-Swahili study personnel translated, blind back-translated, and applied consensus-driven cultural adaptations. FAB was then administered to 95 participants [71 cognitively unimpaired (CU) controls; 24 people …

Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Importance: Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability contribute to one-tenth of the global burden of mental and neurologic disorders. The burden of NDDs is not well documented in Africa.

Objective:To assess the prevalence, risk factors, and comorbidities of NDDs in young Kenyan children.

Design, setting and participants: This cross-sectional study was conducted among children aged 6 to 9 years residing in the Kilifi Health and Demographic Surveillance System in Kenya. In stage I of the study, children were screened for NDDs from March 16, 2015, to September 14, 2016; those …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

The Nature Of Nasal Discharge In Chronic Rhinosinusitis: A Systematic Review And Meta-Analysis Using Patient-Reported Outcomes, Ethan M. Kallenberger, Asher T. Ripp, Shaun A. Nguyen, Erin Briggs, Alexander N. Duffy, Isabella V. Schafer, Jess C. Mace, Timothy L. Smith, Zachary M. Soler, Rodney J. Schlosser

SKMC Student Presentations and Publications

OBJECTIVE: The objective of this study is to answer the question "What is the most common and severe type of nasal discharge in patients with chronic rhinosinusitis (CRS) at baseline as measured by patient-reported outcomes?".

METHODOLOGY: Two independent reviewers evaluated studies for inclusion, extracted data from included studies, and performed critical appraisal of studies. Data on the four Sino-Nasal Outcome Test 22 (SNOT22) discharge questions, demographic, and comorbidity data was collected. Meta-analysis of single means and proportions was performed for demographic, comorbidity, severity, and prevalence data.

RESULTS: A total of 53 studies (n = 6584) were included for analysis. Postnasal …

Neurology Residency Training In Pakistan: Current Status And Future, Bashir Soomro

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Alarming Rate Of Hemorrhagic Stroke Showing An Urgent Need For Hypertension Control: A Retrospective Study From A Major Stroke Center In Sindh, Sana Ghous, Muhammad Hashim Kalwar, Muhammad Hassan Butt, Irfan Ali Vighio, Mehfooz Ali Shah, Javed Khurshed Shaikh, Mansoor Hassan

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Hemorrhagic stroke accounts for approximately 18–20% of the global stroke burden and is associated with high mortality and disability. It poses a significant challenge in low- and middle-income countries, where delayed presentation and inadequate risk factor control worsen outcomes. Hypertension remains the most important modifiable risk factor, particularly when poorly controlled. The objective of this study was to investigate the incidence of hemorrhagic stroke at a major stroke center and its association with uncontrolled hypertension.

Methods:

This retrospective study was conducted at Sindh institute of cardiovascular diseases (SICVD) Sukkur over three months, from May to July 2024. …

Integrating Spot-Scanning Proton Arc Therapy With Functional Avoidance Strategies To Reduce Pulmonary Toxicity, Yingxuan Chen, Peilin Liu, Xiaoda Cong, Edward Castillo, Richard Castillo, Inga Grills, Craig Stevens, Xiangkun Xu, Xiaoqiang Li, Yevgeniy Vinogradskiy, Xuanfeng Ding

Department of Radiation Oncology Faculty Papers

Background and purpose: Functional avoidance radiotherapy has emerged as a promising technique using functional imaging to minimize pulmonary toxicity by reducing doses to functional lung. This study aims to investigate the potential dose-volume advantages of a novel spot-scanning proton arc (SPArc) therapy for functional avoidance radiotherapy with four-dimensional computed tomography (4DCT)-based ventilation imaging.

Material and methods: Twenty-five patients from a prospective functional avoidance clinical trial treated with intensity-modulated photon radiotherapy were included. Robustly optimized intensity modulated proton therapy (IMPT) and SPArc plans were generated in RayStation. Functional lung contour was derived from the 4DCT-based ventilation imaging and utilized as an …

Hypercalcemia Of Down Syndrome., Seth Lmb, Melissa Litao, Nasreen Talib, Jacob M. Redel

Manuscripts, Articles, Book Chapters and Other Papers

We present a case of hypercalcemia in a 12-month-old female with Down syndrome. The patient presented with significant weight loss (810 g since her 6-month visit) and severe growth failure (weight 5.8 kg, -4.5 SDs). Laboratory evaluation revealed severe hypercalcemia with appropriately suppressed PTH and 1,25-hydroxyvitamin D levels. Renal ultrasound confirmed medullary nephrocalcinosis. After excluding common etiologies, the patient was diagnosed with hypercalcemia of Down syndrome, also termed Abnormal Calcium, Calcinosis, Creatinine in Down syndrome. Treatment with intravenous fluids, calcitonin, and transition to a low-calcium formula (Calcilo XD) normalized serum calcium levels. The patient maintained normal calcium levels on restricted …