Digital Commons Network^™

Ai-Driven Detection Of Neurodevelopmental Disorder From Emotional Speech Using A Hybrid Cnn–Bilstm–Attention Framework, Nayarah Shabir, Parveen Lehana, Sheema Khan

School of Medicine Publications

Neurodevelopmental disorders (NDDs) are associated with impairments in communication, behavior, and social interaction, making accurate diagnosis clinically challenging. Autism Spectrum Disorder (ASD), a major NDD, often exhibits atypical speech patterns characterized by altered prosody and reduced emotional expressiveness. The study proposes a hybrid dual-path framework for ASD detection from emotional speech using two strategies: PCA–GMM-based acoustic modeling and a CNN–BiLSTM–Attention architecture for spectral–temporal feature learning. The proposed framework captures probabilistic, spectral, and temporal speech characteristics for robust ASD classification. Acoustic analysis demonstrated clear separability between ASD and non-ASD speech, while the deep learning framework achieved stable and reliable performance across …

Benefits Of Pet Friendly Work Environments On Physical, Mental, And Social Health Of Office Workers: A Systematic Review, Ahmed Radwan, Jenna Keeman, Tristan Hunzinger, Owen Wilson, Shayla Seymour

People and Animals: The International Journal of Research and Practice

Background: Pet-friendly workplace initiatives are increasingly common, yet the empirical evidence for benefits to office workers’ physical, mental, and social health is scattered and heterogeneous.

Objective: To synthesize evidence on health-related outcomes associated with pet-friendly work environments for office and desk-based workers, and to appraise the current level of evidence.

Methods: A PRISMA-guided systematic search (2014–2024) was conducted in PubMed, PsycINFO, MEDLINE, OVID, CINAHL, and Google Scholar. Two reviewers independently screened titles/abstracts and full texts, extracted data, and appraised study quality using the Critical Appraisal Skills Program (CASP) checklists. Outcomes were coded and synthesized narratively within three domains: physical, mental, …

Holding Hands, Alexis Notarianni, Md

The Medicine Forum

My patient had already received the medications we reach for when patients are in pain and afraid — antiemetics, analgesics, and anxiolytics. The nasogastric tube was in place. What remained was not another intervention, but the simple act of being there.

My patient had been healthy until just months earlier, when his life changed abruptly. In the two hundred days since, illness had altered nearly every part of his body. Now he lay in bed in pain, breathing through a tracheostomy, receiving nutrition from a feeding tube. Tears streamed down his cheeks as he reached out and took my hand. …

An Examination Of Generative Ai In Medicine, J. Marco Cipriaso, Md, Trishya Srinivasan, Md

The Medicine Forum

The age of artificial intelligence (AI) is upon us. Specifically, generative AI has been transforming how we interface with the world by directly generating its own novel output.¹ Medicine is not immune to this change. AI search tools such as OpenEvidence have shown promise by providing evidence-based recommendations, already proven to perform well in primary care settings, with additional promise for future applications.² AI tools have taken over the note-writing process through ambient software, allowing physicians to dedicate more time to face-to-face interaction with their patients.³ These and other developments show clear reason to be excited about …

The Emotional Labor Of Clinicians And The Need For Reflective Support, Benedicta Olonilua, Bs, Evan Nardone, Md

The Medicine Forum

Physicians who work in Palliative Care or adjacent fields like Oncology often bear a unique emotional weight in addition to the typical responsibilities that come with the job. The nature of their work puts them in frequent contact with serious illness, dying, and grief. Additionally, they are often required to engage in conversations that are not only medically complex but also deeply personal and, at times, emotionally charged. While this emotional labor is an inherent part of the job, it can become especially heavy when there is no space to process it. Over time, this can build up and eventually …

The Intersection Of Ventilator Support And Hospice In Late Als Diagnosis, J. Marco Cipriaso, Md, Kenna Hawes, Md, Margot Noyelle, Md, Megan Cecchine, Md

The Medicine Forum

Amyotrophic lateral sclerosis (ALS) often leads to respiratory failure that can be treated with respiratory support in the form of tracheostomy plus invasive mechanical ventilation. It typically occurs late in the disease course, often allowing patients to adequately prepare by discussing their goals of care. We describe a case of a patient whose ALS was diagnosed after he had TMV initiated. As a result, the patient and family faced a daily decision on when to withdraw ventilator support, and he was unable to achieve his ultimate wish to die at home. We highlight this to recognize that serious illnesses with …

Radiographic Imaging Of Power Injectable Medical Access Ports As A Supplemental Identification Tool, Nikhil Goyal, Md, Huy M. Do, Md, Alexandra P. Toscano, Bs, Lillian G. Spear, Bs Georgetown University, Lindsey A. Hazen, Rn, Les R. Folio, Do

The Medicine Forum

Medical access ports (MAPs) are implanted devices often used for intravenous administration of chemotherapeutic agents or contrast agents for CT or MR imaging. Improper MAP usage poses risk of catheter rupture; hence, proper identification and usage are essential. We demonstrate an approach for MAP identification based on their unique radiographic imaging features.

Radiation-Induced Biliary Strictures Leading To Recurrent Pyogenic Liver Abscesses: A Case Report, Rhea Ratan, Md, Beatriz Torre, Md, Rishi Pawa, Md

The Medicine Forum

Introduction

Radiation-induced biliary damage, including strictures, stenosis, cholangitis, and posthepatic cholestasis, is a rare complication of radiation therapy reported most frequently in the context of hepatobiliary cancers and other upper abdominal mal ignancies.^1-3 This complication often occurs with a delayed presentation, with a variable latency period ranging from months to as late as decades after treatment.^1-4 Histologic examination demonstrates segmental bile duct wall thickening, cholestasis, fibrosis, and features consistent with radiation injury.^1,5 Most reported cases involve the common bile duct and major hepatic ducts, where endoscopic and percutaneous interventions remain feasible. These are identified during surveillance imaging, …

A Clinical Assessment: Counseling Families On Timing Of Colorectal Cancer Screening, Bertilia Tavarez, Md, Hamzah Shariff, Md, Breanne Mcdermott, Bs, Sanjna Shelukar, Md, Limi Jamma, Md, Sonali Shah, Md, Akash Patel, Do, Christopher Henry, Md, Aaron Martin, Md

The Medicine Forum

Colorectal cancer (CRC) remains the second most common cause of cancer mortality in the United States. Current recommendations advise initiating colonoscopy at age 40, or 10 years earlier than the youngest affected first-degree relative (FDR), in individuals with a family history of CRC or advanced polyps (AP). Despite these guidelines, their translation into routine clinical counseling is not well defined. This study examines how often patients with CRC or AP receive guidance about early screening for FDRs.

A retrospective review was performed using electronic health records from an urban academic center. Patients diagnosed with CRC or AP between January 2019 …

Lvad Patient With Delayed Family Involvement Due To Incarceration, J. Marco Cipriaso, Md, Kathleen Mechler, Md

The Medicine Forum

Left ventricular assist device (LVAD) placement requires an extensive support system for success. Patients who are incarcerated face unique challenges in achieving this due to prison rules. We describe a case in which an LVAD patient suffered a massive intracranial hemorrhage, leaving him unable to make his own decisions. Medical teams did not involve his family in admissions for his slow chronic decline, but family were asked to make decisions for him at this acute change causing them significant distress. We advocate that families of incarcerated patients be more routinely involved in provider communications and education related to their chronic …

The Medicine Forum: Volume 27

The Medicine Forum

The Journal of Thomas Jefferson University Hospital - Department of Internal Medicine, Volume 27, 2025-2026

TABLE OF CONTENTS

• Case Reports
• Letter to the Editor
• Research Studies
• Humanities & Reflections

First Photographic Record Of A Pale-Colored Wild Boar (Sus Scrofa) Consistent With Leucism In The Zagros Mountains, Iraqi Kurdistan, Bahez F. Ali, Hana A. Raza, Nabaz Horeni

AUIQ Complementary Biological System

Pigmentation anomalies in wild mammals are rare and poorly documented in wild boar (Sus scrofa) populations. Leucism, characterized by partial loss of melanin while retaining normal eye pigmentation, represents one of the least frequently reported coloration anomalies in the species. During a camera-trap survey in Bamo Mountain, Zagros Mountains of Iraqi Kurdistan, an unusually pale-colored wild boar consistent with leucism was recorded. The individual exhibited cream to light-blond pelage with retained darker pigmentation on the snout and distal limbs, while the eyes remained normally pigmented. Its morphology and behavior were otherwise consistent with those of a typical wild …

Effects Of Targeted Interventions On Hiv Testing, Knowledge And Sexual Risk Behaviours Among Long-Distance Truck Drivers: A Systematic Review And Meta-Analysis, Cyrus Mutie, Berrick Otieno, Kawira Kithuci, John Gachohi, Grace Mbuthia

School of Nursing & Midwifery, East Africa

Objectives We aimed to systematically summarise and quantify the empirical evidence on targeted interventions and their effects on various HIV prevention outcomes for long-distance truck drivers (LDTDs) globally.

Design A systematic review and meta-analysis.

Data sources We searched PubMed, PubMed Central (PMC), Cumulated Index to Nursing and Allied Health Literature (CINAHL), ProQuest Central, EBSCOhost, ScienceDirect, World Health Organisation (Global Index Medicus), Cochrane Library, Scientific Electronic Library Online (SCiELO), Japan Science and Technology Information Aggregator, Electronic (J-STAGE) and China National Knowledge Infrastructure (CNKI) up to 15th May 2026.

Eligibility criteria We included original peer-reviewed interventional studies involving LDTDs of either gender …

Hiding In Plain Sight: A Case Of Intestinal Tuberculosis Masquerading As Benign Lower Gi Bleeding, Lavender Otom, Priyanka Panwar, Gerald Odong, Fatma Kassim, Patricia Okiro, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

Background Intestinal tuberculosis (TB) represents the most common form of abdominal TB, often affecting the ileocaecal region. Lower gastrointestinal bleeding is an uncommon presentation and may create significant diagnostic uncertainty, particularly in immunocompromised patients and in settings where inflammatory bowel disease is also encountered.

Case Presentation A woman in her sixties from Africa presented with recurrent diarrhoea and intermittent haematochezia over a 6-month period. Initial endoscopic evaluation was nondiagnostic. Cross-sectional imaging later demonstrated multifocal bowel involvement affecting both the small and large bowel, including ileocaecal and rectoanal disease, with associated abdominopelvic lymphadenopathy. Histopathology from repeat colonoscopy biopsy showed caseating granulomas …

Pharmed. System Manual: Hololens Application, Eden Woldeselassie

Systems Manuals - 2026

This document provides the full life cycle of PharmEd HoloLens. PharmEd stands for Pharmacy Education. The overall document will go through the complete system manual by going over requirements, followed by design, how to install the application, how to upload the application to Microsoft store, troubleshooting and source code. The first section will explain the background, the existing problems and why the need to develop PharmEd.  Here techniques of requirement gathering and some statistics will elaborated. The following section discusses about functional requirements. The requirement section includes subtopics: functional and nonfunctional requirements for both -programmer and end user- and the …

Enhancing Colonoscopy Effectiveness: The Impact Of Split Dose Bowel Preparation, Samantha Balestrieri Bsn, Rn

Nurse Residency

In patients undergoing screening colonoscopies, does a split-dose bowel preparation regimen, compared with a standard single-dose regimen, result in improved colonic visualization and adenoma detection?

Improving Patient Outcomes Through Nurse-Led Care Coordination, Anna Berry Rn

Nurse Residency

In patients admitted to the hospital, how does nurse-led care coordination compared to none, or patient reliance alone, impact better patient outcomes, better medication management and reduce hospital readmissions?

Reducing Caregiver Burden In Hospice Care, Aubrey Martin Bsn, Rn

Nurse Residency

In family caregivers of adult hospice patient’s, does a nurse-led support program, compared with usual hospice education, reduce caregiver burden?

Geomapping With Python: An Innovative Data Visualization Technique, Tirna Purkait, Dipti Dev

Journal of Human Sciences and Extension

No abstract provided.

Perspectives Of Scholars, Families, And Advisors On 360-Degree Video Technology In Graduate Education, Oluwatobi A. Mogbojuri, Bridget A. Walsh, Matthew Aguirre

Journal of Human Sciences and Extension

This study explored the experiences of scholars in creating and sharing 360-degree videos, as well as the perspectives of families and advisors who viewed the videos. Focus groups and individual interviews were conducted online using a videoconferencing platform. Perspectives from 20 participants (15 scholars, three advisors, and two family members) were analyzed using thematic analysis. Three primary themes were identified: (1) barriers to 360-degree video use, (2) perspective shifts and limited change, and (3) storytelling and scholar visibility. Findings suggest that 360-degree video technology may be an innovative tool for enhancing recruitment and retention, especially for historically marginalized groups, through …

Covid-19 Case Study, Armando Olmeda

Distinguished Student Scholarship Collection

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, continues to affect healthcare systems and public health worldwide. This case study examines COVID-19 from an epidemiological perspective by looking at how the disease spreads, the populations most affected, the major risk factors, and the impact on healthcare systems. It also analyzes key epidemiological measures, including incidence, prevalence, hospitalization, and mortality trends, to better understand how the pandemic has changed over time. The findings show that older adults, individuals with chronic medical conditions, and socially disadvantaged populations continue to experience the greatest burden of disease, with social determinants of health playing an important …

Use Of The Bethesda System For Reporting Thyroid Cytopathology In Thyroid Nodules Incoordination To The Appropriate Surgical Intervention, Rusul Abid Kareem, Basim Rassam Ghadhban

Iraqi Postgraduate Medical Journal

Background: The thyroid nodule refers to an abnormal growth of thyroid cells. Although the vast majority of thyroid nodules are benign, a small proportion of thyroid nodules are malignant. In order to diagnose and treat malignant thyroid nodules at the earliest stage, most of them need radiological and cytological evaluation. Fine-needle aspiration (FNA) using The Bethesda System for reporting thyroid cytopathology.Aim of study: To evaluate the significance of the Bethesda classification in detecting malignant thyroid nodule and relate the appropriate surgical intervention accordingly.Methods: prospective, case control study was conducted in Baghdad teaching hospital, 2nd floor. from 1st of December 2021 …

A Word From The Writing Team (July 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

Fostering Inclusion: Supporting Children With Hearing Loss In Social Interactions, Danielle Kaletta, Mary Jan Greer

Summer 2026 OTD Capstone Symposium

This project provided an open-access online program for caregivers of children with hearing loss to facilitate social engagement. Qualitative methods were used to conduct a needs assessment and identify areas of concern, barriers, and limited resources that affect participation in social activities. Based on the needs assessment, a 6-module website was created and published. Occupational therapy-based evidence, research, interventions, and best practices were compiled and adapted to target identified areas. Participants reported overall favorable feedback, stating an increase in knowledge, confidence, and participation.

Pragmatic Measures In Aided Language Measurement: Aac Clinical Expert Perspectives, Makayla Hydiea Smith

Speech and Hearing Sciences ETDs

Purpose: The augmentative and alternative communication (AAC) discipline currently lacks psychometrically sound aided language measures. This thesis is designed to address one step in developing such measures: to begin to establish the clinical feasibility of three pragmatic measures – communicative intent, independence/co-construction, and imitation/non-imitation. Therefore, the objective of this thesis is to identify the useability of these pragmatic measures.

Method: A qualitative approach in the form of a focus group was used to examine the perceptions of SLP practitioners who are experts in AAC. Rapid qualitative analysis (RQA) was used to identify relevant themes and subthemes.

Results: Overall, the themes …

Implementing A Sensory-Informed Protocol For Fall Prevention In A Skilled Nursing Facility, Riley R. Scholberg, Amy Lyons-Brown, Elizabeth Force

Summer 2026 OTD Capstone Symposium

This capstone project developed and implemented a sensory-informed admission protocol to support fall prevention at a skilled nursing facility. The development of this protocol aimed to improve the early identification of vision and hearing impairments and integrate sensory considerations into resident care planning and fall prevention. Participants included newly admitted residents and interdisciplinary staff members from rehabilitation, nursing, and administration. Methods included administering the Screening for Severe Dual Sensory Loss (SDSL), reviewing resident characteristics and fall-related indicators, educating staff on sensory-informed care, and developing practical resources to support consistent screening, documentation, and intervention. Expected outcomes included increased staff knowledge, improved …

A Program To Address Anxiety And/Or Add/Adhd In Children With Cerebral Palsy To Improve Social Participation, Victoria Shaw, Mary Jan Greer

Summer 2026 OTD Capstone Symposium

The purpose of this project was to develop a program for children with cerebral palsy, who experience anxiety and/or ADD/ADHD, that will promote their social participation during play activities. The program lasted for 14 weeks and had two participants, within those 14 weeks, several objectives were accomplished. These objectives include the administration of the needs assessment, implementation of the program modules, pre- and post-interviews with the caregivers and staff, and the finalization of the program. The expected outcome from the program was to determine the effectiveness of the different program modules increasing interactions with peers by decreasing anxiety and improving …

Inactive Nurses In New Mexico: Insights Into License Lapse And Inactive Reserve Status, Kiyoko Dell Davis

Doctor of Nursing Practice Scholarly Projects

Nursing shortages have varied over the decades, yet persist at local, national, and global levels. Nurses report leaving the workforce for many reasons, including professional environment factors resulting from these shortages, further exacerbating a shrinking workforce and population growth. Recent efforts include recruitment and education incentives and implementation of the New Mexico Board of Nursing (NMBON) Inactive Reserve Licensure option, which allows retiring nurses to maintain a reduced-scope nursing license with fewer barriers. Despite these efforts, questions remain: why are nurses in New Mexico leaving the profession and would this licensure category have impacted retention? The purpose of this project …

Improving Continuity Of Care: Evaluating Universal Nursing Handoff Sheets, Elizabeth Ifeloluwa Sanya

Doctor of Nursing Practice Scholarly Projects

Effective communication during nursing handoffs is essential for safe, patient-centered care, as breakdowns in communication are a leading cause of adverse patient outcomes. At a large academic level I trauma center, inconsistent nursing handoff practices were identified across progressive care units following the COVID-19 pandemic. This variability contributed to incomplete transfer of patient information and was associated with increased patient safety incidents, including delayed wound care, central line dressing lapses, and medication errors involving high-alert therapies. The purpose of this DNP project was to plan, implement, and evaluate the use of  standardized nursing handoff sheet and its impact on continuity …

How To Tell A True Food Allergy From An Intolerance, Sarah Gubara, Aarti Pandya

Pediatrics in Practice: A CME Podcast

This episode explains the key history elements and symptom timeline that differentiate an IgE-mediated food allergy from an intolerance or sensitivity, so clinicians and parents can make safer, evidence-based decisions. Aarti Pandya, MD, Medical Director of the Food Allergy Center at Children’s Mercy, reviews symptom patterns, timing and red flags for anaphylaxis. Learn about food allergy testing, IgE-mediated food allergy, anaphylaxis action plan, epinephrine auto-injector, food intolerance and when testing is truly warranted.

Click here to stream the podcast episode.