Digital Commons Network^™

Eeg Signatures Of Motor Development In Early Childhood: A Systematic Review, Sonia Khurana, Ashwini Kulkarni, Thomas C. Bulea, Hunter J. Bennett

Rehabilitation Sciences Faculty Publications

Background

Early identification of motor developmental disorders is limited due to lack of objective neural markers that characterize typical neurodevelopmental patterns. This systematic review interprets and synthesizes existing evidence to propose a framework of EEG signatures associated with motor development in children aged 0-5 years, which may help inform future benchmarks for early assessment and intervention.

Methods

Following PRISMA guidelines, we searched published and gray literature across five databases between 2000 and 2025 (registered protocol). Included studies examined EEG during task-based, resting-state, or sleep studies linked to motor milestones, task performance, or standardized motor assessments. Study quality was assessed using …

Improving Early Detection And Response To Clinical Deterioration Among Nurses Through Competency-Based Interventions, Courtney E. Miller

Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Clinical deterioration among hospitalized patients remained a significant contributor to preventable morbidity and mortality, often due to delayed recognition and response in general care settings (Choi et al., 2025; Chung & Jung, 2024).

PICOTS: For registered nurses working on a general level of care inpatient hospital unit (P), how did a competency-based training program bundle incorporating didactic educational intervention of learning how to use technology, machine learning (ML) based early warning system (EWS) of trends and patterns to identify at risk patients, and low-fidelity simulation-based education (SBE) (clinical readiness to improve confidence with education and coaching) (I), …

Multisystem Predictors Of Dynamic Gait Stability Across Fall Risk In Older Adults, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea, Brittany Samulski

Rehabilitation Sciences Faculty Publications

Gait stability arises from interactions between physiological, cognitive, and psychological systems, yet these domains are often assessed in isolation. This study examined multisystem predictors of anteroposterior margin of stability during walking (MoSAP) in community-dwelling older adults. Of 340 participants, 143 were retained after data quality screening (105 females; age: 70.8 ± 7.8 years). Participants completed the Physiological Profile Assessment (PPA), cognitive testing using Montreal Cognitive Assessment (MoCA), fear-of-falling evaluations using Modified Falls Efficacy Scale (MFES) and a biomechanical gait assessment during preferred and fast speeds. Participants were stratified into four PPA-based fall-risk groups: low, mild, moderate, and high risk. MoSAP …

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design:

Prospective observational pilot study of adult spinal deformity surgery patients.

Objective:

To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data:

Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods:

We prospectively enrolled 18 patients undergoing adult …

Sexual Dysfunction In Women With Endometriosis In A Low-Middle-Income Country, Edna Chacha, Charles Muteshi, Felix Oindi, Elsie Wandera

Obstetrics and Gynaecology, East Africa

Background Endometriosis affects up to 10% of reproductive-age women and significantly impairs quality of life including sexual function, intimate relationships, fertility, and psychological wellbeing. While its impact has been extensively studied in Western populations, there is limited Sub-Saharan African data exploring how the disease affects female sexual health and distress. This study aimed to assess sexual function and sexual distress among women with endometriosis at a tertiary hospital in Kenya.

Methods A cross-sectional study was conducted involving 108 women aged 18 to 49 with confirmed endometriosis from January to June 2022. The study used validated self-administered questionnaires: Female Sexual Function …

“Medical Cannabis”: Advising Patients While Navigating Medical Ethics And Limited Evidence, Anna-Maria South, Shanna L. Babalonis, Laura C. Fanucchi, Michelle R. Lofwall

Internal Medicine Faculty Publications

Cannabis is increasingly legalized in more areas of the USA and marketed under the misnomer “medical cannabis.” Yet, there are no official dosing guidelines or approved medical uses for plant cannabis by the Food and Drug Administration. Due to significant federal barriers, research on efficacy, safety, and adverse effects of cannabis is limited. Patients are interested in cannabis as potential treatment of medical issues and/or symptoms and clinicians should include a discussion of the risks of cannabis consumption. However, many risks are not yet known, and clinicians might be unaware of the emerging literature. This perspective summarizes the potential harms …

Prevalence And Characteristics For Mental Health Disorder Before And After Childhood Cancer Diagnosis—A Statewide Population-Based Study Among Medicaid Beneficiaries, Feitong Lei, Laurie E. Mclouth, Eric B. Durbin, Thomas T. Tucker, John L. Villano, Bin Huang

Internal Medicine Faculty Publications

Introduction: Pediatric cancer patients suffer mental health deficits. Patients who are vulnerable with respect to socioeconomic or other sociodemographic factors may be at heightened risk for worse mental health outcomes during cancer for many reasons including entering treatment with an existing mental health disorder. The purpose of this study was to describe the prevalence and trajectory of mental health before and after a childhood cancer diagnosis in a socio-demographically at-risk sample.

Methods: Data from the Kentucky Cancer Registry was utilized to identify patients aged 19 or under with a first primary childhood cancer diagnosis during 2001–2017. Linking KCR data with …

Discrimination Distress And Current Combustible And Non-Combustible Tobacco Product Use Among Us Youth, 2023, Meman Diaby, Osayande Agbonlahor, Maggie K. Richardson, Joy L. Hart, Shyanika W. Rose, Delvon T. Mattingly

Markey Cancer Center Faculty Publications

Introduction: Discrimination is the unfair treatment of people based on their identity. Youth who experience discrimination may cope with associated distress by using tobacco products, with amplified health consequences depending on the type of product.

Methods: We used data from the 2023 National Youth Tobacco Survey (n = 22 069) and derived an overall continuous measure from the 15-item Adolescent Discrimination Distress Index, as well as three continuous discrimination distress sub-indices: educational, institutional, and peer (range for each: 0–5). We defined current tobacco use as two outcomes: any past 30-day use of combustible (cigarettes, cigars, hookah, roll- your-own, pipe, bidis) …

Cost Effectiveness Of Lifestyle Program For Diabetes Remission In The Era Of Glp-1, Prasanthi Tondapu, Haasini Sunkavalli, Micaela C. Karlsen, Kara L. Staffier, Kathryn J. Pollard, Surabhi Naik

North Texas GME Research Forum 2026

BACKGROUND: GLP-1 receptor agonists are popular for managing type 2 diabetes (T2D) and obesity but are costly and can result in side effects including weight rebound. Intensive therapeutic lifestyle change (ITLC) programs present an effective alternative, facilitating an HbA1C (A1C) less than 6.5% for 3 months without medication and long-term weight control.

CASE PRESENTATION: We present a 69-year-old Black man with T2D, hypertension, chronic kidney disease, obesity, and sleep apnea. In 2023, he was hospitalized with a blood glucose of 800 mg/dL and A1C 10.8% and discharged on insulin. And, with a BMI of 32 kg/m2 and weight of 238.6 …

Pulse Check: Im Resident Wellness Initiative -- A Continuous Qi Project, Jacqueline Bekhit, Ngoc Vu, Yasasvi Sabbineni, Nihar Raju, Parth Patel, Teena Mathew

North Texas GME Research Forum 2026

Background Burnout is a psychological syndrome that arises from chronic workplace stress that has not been effectively managed. It is characterized by emotional exhaustion, increased mental distance or cynicism toward one’s work, and a sense of reduced professional efficacy (WHO, 2019). Due to the long work hours, high workload, and extensive training demands, medical residents are particularly vulnerable to experiencing burnout, contributing to higher rates of anxiety and depression. Burnout typically emerges mid-intern year and progresses through the remainder of residency. Burnout can contribute to higher medical errors, decreased work efficiency, and poor patient-physician interactions.

Methods This QI is a …

Too Young For A Broken Heart: Stemi At Twenty, Shana-Kay Lambert-Johnson, Jason Thompson

North Texas GME Research Forum 2026

Background: ST-elevation myocardial infarction (STEMI) is exceptionally rare in young adults, accounting for less than 1% of acute coronary syndromes in individuals younger than 35 years. When it occurs in early adulthood, particularly among women, it introduces diagnostic uncertainty and exposes gaps in post-discharge continuity of care. This case of a 20-year-old female with STEMI highlights the role of primary care in preserving evidence-based therapy while addressing psychosocial determinants of recovery.

Case Presentation: A 20-year-old female presented to her primary care clinic for post-discharge follow-up after hospitalization for an anterior STEMI that began with sudden-onset substernal chest pain radiating to …

Ultrasound-Derived Liver Composition And Metabolic Flexibility Under Exercise Stress, Rhodes Van Houten

All Master's Theses

Metabolic Associated Fatty Liver Disease (MAFLD) is characterized by abnormal liver fat accumulation in conjunction with metabolic syndromes. MAFLD affects 33% of individuals worldwide, though little is known about how increased liver fat impacts physiological responses to exercise. This study aimed to analyze the relationship between liver composition and metabolic flexibility during a graded exercise test.  Body composition was analyzed via dual-energy X-ray absorptiometry. Liver ultrasound was evaluated for echogenicity, where elevated mean gray volume (MGV) indicates abnormal liver tissue. Rates of fat (FATox) and carbohydrate (CHOox) oxidation (g/min), respiratory exchange ratio (RER), and blood lactate concentrations ([LA^-], …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Developing A Multidisciplinary Pediatric Cancer Predisposition Service At A Mid-Sized Children’S Hospital, Amanda M. Harrington, John August D'Orazio

Markey Cancer Center Faculty Publications

Roughly one in ten children and young adults diagnosed with cancer has an underlying genetic variant that may explain his/her malignancy. It is critical to identify patients with cancer predisposition syndromes (CPSs) to provide personalized cancer treatment, surveillance, counseling, psychosocial support, and in some cases, risk-reducing interventions to maximize long-term outcomes. Over the past five years, we developed a comprehensive pediatric CPS program at our institution. We engaged our institutional adult cancer center for clinical cancer genetic counseling services and needed research shared resource facilities. We also initiated a clinical study called “Project Inherited Cancer Risk” (PICR) to identify pediatric …

Microgravity-Induced Alterations In Left Atrial Hemodynamics And Thrombogenic Risk: Insights From Healthy And Atrial Fibrillation Models, Grace M. Hoeppner

Dissertations, Master's Theses and Master's Reports

Background: Microgravity exposure alters cardiovascular loading, yet its impact on left atrial flow dynamics and thrombotic risk remains poorly understood. This study investigates how spaceflight-relevant microgravity-induced changes in cardiac outflow affect left atrial hemodynamics in healthy individuals and patients with atrial fibrillation.

Methods: Patient-specific left atrial models were generated for three healthy individuals and three AF patients. Computational fluid dynamics (CFD) simulations were performed using each patient’s baseline mitral outflow waveform and two modified waveforms representing short- and long-duration post-flight cardiac loading changes derived from echocardiographic observations. Hemodynamic metrics included left atrial velocity, time averaged wall shear stress, oscillatory shear …

Evolution Of A Client‐Level Dataset: 20 Years Of National Child Traumatic Stress Network Data Collection, C. A. Purbeck, A. N. Cooke, L. J. Liang, C. Smith, J. Staten, J. Epstein, H. B. Hodgdon, Jessica Eslinger, A. Wells, J. Goodrich, T. H. Bethel, K. Willett, Y. C. Fu, J. A. Fairbank, E. C. Briggs

Center on Trauma and Children Faculty Publications

Objectives: For 20 years, the National Child Traumatic Stress Network's (NCTSN) data collection efforts have been a central mechanism for Clinical Quality Improvement (ClQI). The NCTSN is a federally funded initiative in the United States composed of programs dedicated to raising the standard of care and increasing access to services for children and families who have experienced traumatic events.

Methods: These efforts span three initiatives: the Core Data Set (CDS), the Clinical Improvement through Measurement Initiative (CIMI) Measurement Based Care (MBC), and CIMI Data Sharing (CIMI-DS) that collected and analyzed client-level data to improve care for children and families served …

Effectiveness Of Interferential Stimulation And Anorectal Neuromuscular Electrical Stimulation On Secondary Encopresis In Children: A Comparative Randomized Controlled Clinical Trial, Seham M. Abd El-Moghny, Mohamed I. Elsepaee, Abdelaty Alghonimy, Rabab S. Mohamed

Journal of Medicine in Scientific Research

Background Encopresis, fecal soiling is often secondary to functional constipation and retention. It is significantly impact a child's psychological health as it can result in feelings of shame, social isolation, and low self-esteem and negatively affect their quality of life and their families. Objective To evaluate and compare the efficacy and safety of interferential stimulation (IF) applied on sigmoid colon and anorectal neuromuscular electrical stimulation (NMES), in combination with behavioral therapy and pelvic floor muscle training (PFMT), in improving continence outcomes in children with secondary encopresis refractory to laxatives. Methods In this comparative randomized controlled clinical trial, 30 children (5–10 …

A Comparison Of Haemodialysis And Renal Transplantation On Male Sexual Function And Hormonal Abnormalities, Hala Ibrahim Mohamed, Ahmad Mohamad Abbas Elseasi

Journal of Medicine in Scientific Research

Background Sexual dysfunction and hormonal imbalance are common in males with end-stage renal disease (ESRD), particularly among those on chronic hemodialysis. Kidney transplantation may restore endocrine homeostasis and improve sexual function. This study aimed to compare the effects of hemodialysis and renal transplantation on male sexual function and related hormonal profiles. Methods This cross-sectional study was conducted on 40 married men (≥18 years) with ESRD at National Institute of Urology and Nephrology from October 2024 to October 2025. Participants were divided into two groups: Group I (hemodialysis) and Group II (renal transplantation). Clinical evaluation, laboratory tests, and hormonal assays (Folliclestimulating …

The Impact And Prevalence Of Pain In Adolescents And Children Living With Type-One Diabetes Mellitus, Randa Mohamed Darwish, Ayat Ibrahim Ghanem, Lamis Safwat Mubarak

Journal of Medicine in Scientific Research

Background: Pain is frequent but often underrated and even overlooked in adolescents and children living with type-one diabetes mellitus and can negatively impact their quality of life(QoL) and their cooperation within the management plan. Objective: To discern the common types , severity and prevalence of pain in pediatrics living with type-one-diabetes;compared to the group of diabetes-free control, and to probe associations with glycemic control, fatigue, and (QoL). Methods: This cross-sectional study incorporated 102 adolescents and children withtype -one- diabetesmellitus; and 99 age- and sex-matched healthy peers aged 8- 16 years. Pain intensity was evaluated using the (body-pain) domain in the …

A Narrative Review Of Bertolotti's Syndrome: Etiology, Classification, Diagnosis, And Treatment, Matyas Abel Tsegaye, Andrea Muffly

Rehabilitation Sciences Faculty Publications

Bertolotti's syndrome is a congenital condition characterized by chronic low back pain stemming from a lumbosacral transitional vertebra (LSTV). Because the condition is frequently overlooked, patients often face years of delayed diagnosis before the true source of their pain is identified. Furthermore, current information regarding the biological origins and clinical management of the condition remain scattered. To address this knowledge gap, this narrative review aims to provide a comprehensive overview of Bertolotti’s syndrome by consolidating these disparate sources and suggesting new connections. We synthesize the latest understanding of this condition, ranging from its genetic origins to modern clinical management. We …

Introducing Education For Sensory Approaches In Mental Health-Related Emergency Department Visits: A Quality Improvement Project To Enhance Patient-Centered Care, Jesse O'Neill

Master's Theses and Capstones

Background: Barriers to specialty care access have resulted in emergency departments (ED) operating as temporary psychiatric hold facilities for their communities. Patients boarding in the ED are demonstrated to use a disproportionate percentage of facility resources with minimal benefit to the patient. The Institute for Healthcare Improvement identifies the impact of the healthcare environment on patient outcomes and suggests staff training to foster trauma-informed practice culture (Schall et al., 2020).

Local Problem: High-stress healthcare environments can escalate maladaptive patient behaviors and the use of restrictive interventions. Traditional use of restrictive interventions lacks supportive evidence and contradicts person-centered care goals (Molloy …

Associations Between Oral Hormonal Contraceptive Use, Digestive And Other Health Symptoms In Young Women, Silviana E. Buzatu

Honors Undergraduate Theses

Oral hormonal contraceptives (OHCs) are widely used among reproductive-age women; however, their gastrointestinal (GI) side effects remain understudied. The present study examined associations between OHC use, GI, physical, and psychological symptom burden in a large sample of undergraduate women. Participants (N = 669) aged 18 to 25 years were recruited from UCF’s SONA system and classified into three groups based on self-reported contraceptive status: no birth control, combined estrogen–progestin OHC, and progestin-only OHC. Participants completed GI questionnaires, as well as physical and mental health symptoms ones.

Multivariate analyses indicated that overall GI symptom profiles did not differ significantly by birth …

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Publications 2026-present

No abstract provided.

Gender Differences In The Association Between Adverse Childhood Experiences And Drug Use: Findings From A Community-Based Survey In China, Hongyun Fu, Elizabeth Monk-Turner, Xiushi Yang

Department of Pediatrics Faculty Publications

Background

While adverse childhood experiences (ACEs) are widely recognized risk factors for behavioral health problems, including drug use, prior research has largely been conducted in Western countries, focused primarily on males, and relied on convenience samples without comparison groups of nonusers. Limited work has examined the impact of ACEs on drug use in non-Western contexts. This study examines gender differences in the relationship between ACEs and drug use in China, using data from a population-based probability sample survey.

Methods:

Cross-sectional data were collected in 2019 from one city in Yunnan Province in Southwest China and one city in Guangdong Province …

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch, Christopher Ames

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design: Prospective observational pilot study of adult spinal deformity surgery patients.

Objective: To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data: Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods: We prospectively enrolled 18 patients undergoing adult …

From Screens To Stress: Public Health Implications Of Cancer Worry In A Digitally Connected World, Shreya Mathur, Ethan Burns, Michael Pokojovy, Tzu-Liang Bill Tseng, Sunil Mathur

Mathematics & Statistics Faculty Publications

Aims:

This study examines how digital information environments, genetic testing experiences, health behaviors, and psychological distress influence cancer-related worry among adults in the United States. It further considers the public health implications of elevated or reduced cancer worry for prevention and risk communication.

Methods:

Data were drawn from a nationally representative survey of 6,252 U.S. adults. Measures included reliance on social media for health decision-making, smoking status, history of genetic testing, and psychological distress. Multivariable analyses assessed associations between these factors and levels of cancer worry.

Results/Findings:

Reliance on social media for health decisions was associated with greater cancer worry, …

Socialization Interventions For Older Adults In Assisted Living Facilities: A Systematic Review, Anoop S. Muvva

Honors Undergraduate Theses

Older adults, defined as individuals over the age of 65, are a growing population in the United States, with projections estimating this group will reach approximately 80 million persons by 2050. Over 90% of older adults are diagnosed with a chronic condition, which can make it difficult to carry out the activities of daily living. As a result, some older adults reside in assisted living facilities, where dedicated staff provide daily support. However, issues in the delivery of care within these settings, including unmet socialization needs and complications among care staff, may contribute to social isolation. Programs designed to address …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …