Digital Commons Network^™

Volume Electron Microscopy Reveals Heterogeneity Of The Hemostatic Response In Veins And Arteries, Maurizio Tomaiuolo, Meghan E. Roberts, Jenna R. Severa, Christopher D. Mansi, Brenna B. Y. Mathers, Anna Mannix, Trace A Christensen, Lawrence F Brass, Talid Sinno, Timothy J. Stalker

Cardeza Foundation for Hematologic Research

Intravital imaging studies have provided insights into the spatial and temporal variations of platelet activation and thrombin generation that occur during hemostasis; however, these studies are generally limited to small vessels due to the practical limitations of imaging in thicker tissues. Recent advances in cleared tissue fluorescence imaging as well as volume electron microscopy (vEM) coupled with machine learning-based image segmentation provide an opportunity for analysis of the 3-dimensional structure of complex tissues. We utilized these technologies to examine hemostatic plugs from murine jugular veins and carotid arteries to investigate the spatial distribution of platelet activation and biochemical responses in …

Smart Pediatric Oncology Tracker Of Symptoms (Spots), A Web-Based Interface For The Pediatric Pro-Ctcae: Development And Usability Study, Stacey Crane, Deevakar Rogith, Melody Hellsten, Andrew D Miller, Jacqueline Castillo, Brandy Boeger, Susan Vidaurre, Stefanie Pieper, Cecile Nguyen, Duc Anh Thanh Huynh, Jessica Wooden, Amy Franklin, Karen Moody, Wenyaw Chan, Pamela S Hinds, Constance Johnson

Faculty, Staff and Student Publications

Background: Children undergoing cancer treatment experience a range of treatment-related toxicities that significantly affect quality of life and adherence to therapy. Current methods for symptom reporting rely heavily on clinician interpretation of caregiver or child verbal reports, which can result in incomplete or inaccurate records. The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Pediatric PRO-CTCAE; National Cancer Institute) provides a validated mechanism for direct symptom reporting by children and caregivers, yet its traditional administration and preselection of questions limit the breadth of symptom capture.

Objective: This research aimed to co-design and conduct formative usability testing …

Postapproval Study For Brain-Responsive Neurostimulation For Drug-Resistant Focal Epilepsy: Three-Year Efficacy And Interim Safety Results, Dawn Eliashiv, Vikram R Rao, Barbara C Jobst, Jerzy P Szaflarski, John D Rolston, Lesley C Kaye, Taneeta Mindy Ganguly, Katie Bullinger, Patricia C Dugan, David E Burdette, Angela Y Peters, Atif Sheikh, Kevin F Haas, Dileep R Nair, Lilit Mnatsakanyan, Imran H Quraishi, Meriem K Bensalem-Owen, Rns System Pas Study, Michael J Doherty, Babak Razavi, Tiffany L Fisher, Christopher Skidmore, Pradeep N Modur, Tawnya M Constantino, Vicenta Salanova, Andrew J Cole, Olga Taraschenko, Angelica Rivera-Cruz, James W Wheless, Nitin Tandon, Antoaneta Balabanov, Sami Aboumatar, Itzhak Fried, Cornelia Drees, Hae Won Shin, Zeenat Jaisani, Stephanie E Maciver, Sanjay E Patra, Edward F Chang, Jon T Willie, Ryder Gwinn, Travis Stoub, John M Stern, Tami Crabtree, Cairn G Seale, Sharon C Mcfadden, Jacob F Norman, Lise Johnson, Martha J Morrell

Faculty, Staff and Student Publications

Background and objectives: Neuromodulation therapies are approved for the treatment of focal epilepsy based on data from randomized controlled trials (RCTs). After approval of a responsive direct brain stimulation device (The RNS System for focal epilepsy), the Food and Drug Administration required a prospective study to evaluate whether real-world safety and effectiveness differed from outcomes in the RCT.

Methods: This open-labeled study enrolled adult participants who met the RNS System-approved indication for use. The primary effectiveness end point was median percent change in seizure frequency at 3 years of treatment. Interim safety is presented; the primary safety endpoint analysis will …

Assessing Estimated Premorbid Iq In Dementia In The Uae: A Way Forward For The Gulf Cooperation Council Countries, Sophie Price

Sultan Qaboos University Medical Journal

No abstract provided.

Optimal Timing Of Ventriculoperitoneal Shunt Insertion Relative To Cranioplasty Post-Decompressive Craniectomy: A Frequentist Network Meta-Analysis, Shaan Patel, Shiva A. Nischal, Kush M. Kale, Pious D. Patel, James S. Harrop, Jack Jallo, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

OBJECTIVE: Optimal timing of ventriculoperitoneal shunting (VPS) relative to cranioplasty (CP) after decompressive craniectomy remains controversial. VPS may be performed before, during, or after CP, but no consensus exists on which sequence minimizes complications. We performed a systematic review and network meta-analysis to compare the safety profiles of pre-, simultaneous, and post-CP shunting.

METHODS: We searched PubMed/MEDLINE, Embase, and CENTRAL from inception to October 2025. Eligible studies directly compared at least two timing strategies in patients undergoing both CP and VPS. Primary outcomes included overall complications, reoperation, infection, and intradural bleeding. Secondary outcomes included shunt-related and other procedure-specific adverse events. …

Evaluating Lingualai: A Prospective Validation Of Ai-Based Real-Time Translation Against Certified Human Interpreters, Uday P Singh, Carlos A Jaimes Garcia, Gabriel M Aisenberg, Javier Barreda Garcia, Jessica A Hernandez-Chilatra, Cecilia Wang, Dalilah Reyes De Jesus, Eileen Whalen, Veronica Santos Canellas, Amanda R Falk Vargas, Brian O Rodriguez Echevarria, Martin J Citardi, Babatope O Fatuyi, Xiaoqian Jiang

Faculty, Staff and Student Publications

Limited English proficiency affects over 25 million people in the United States and is associated with disparities in healthcare access, safety, and outcomes. We conducted a prospective, within-subject, simulation-based comparison to evaluate whether an in-house AI application (LingualAI) achieves non-inferior translation quality versus certified medical interpreters in English-Spanish otorhinolaryngology encounters. Standardized clinician-patient scripts were translated by LingualAI and by certified interpreters, and bilingual clinicians rated anonymized audio across multidomain quality measures. Using a prespecified non-inferiority margin of 0.30 points (Human - AI) on 5-point scales, LingualAI met non-inferiority for 2 of 3 primary factors (terminology accuracy Δ = 0.07; adequacy …

Investigating The Clinical Relevance Of A Modified 10 Meter Walk Test For Physical Therapists In The Treatment Of Acute Stroke Populations: Insights From A Case Series, Sarah Rowe, Gwen Juha, Todd E. Davenport, Joy Williams

Pacific Journal of Health

The purpose of this case series is to examine the utility of a modified 10 Meter Walk Test (10MWT) for physical therapists treating acute stroke populations including discharge planning, equipment needs and clinical reasoning. Seven patients admitted within five days of various cerebrovascular accidents completed the 10MWT during inpatient treatment sessions with modifications such as assistive device use, modified instructions and physical assistance. Of these, two patients also completed a standardized 10MWT in the outpatient setting following discharge from inpatient services. Patients recommended versus actual discharge settings were recorded. Ultimately, those who were recommended for acute rehabilitation had the slowest …

Comparative Effectiveness Of Single Versus Two Miniscrews For Maxillary Incisor Intrusion In Gummy Smile: A Systematic Review And Meta-Analysis, Vaibhav Sunil Zanwar, Santosh Jetu Chavan, Jyoti Sunny Manchanda, Sakshi Santoshkumar Jain, Vedant S, Rishika Arya

Taiwanese Journal of Orthodontics

Background: Orthodontic intrusion of maxillary incisors is commonly used to treat gummy smiles in deep bite patients. The effectiveness of using one versus two miniscrews for this purpose remains debated. This systematic review and meta-analysis aimed to compare the dental effects of one versus two miniscrews for maxillary incisor intrusion.

Materials and Methods: A literature search was conducted across multiple databases for studies published up to December 31, 2024. Five studies (four randomized controlled trials and one non-randomized study) met the inclusion criteria. Risk of bias was assessed using the RoB 2 and ROBINS-I tools.

Results: Intrusion was greater in …

Clinical Practice Guideline To Reduce Lgbtq+ Disparities In Health Care, Angel Lb Ambrose

Walden Dissertations and Doctoral Studies

No abstract provided.

Educating Staff On The Use Of Generalized Anxiety Disorder-7 Screening Tool, Adetayo Adebayo

Walden Dissertations and Doctoral Studies

No abstract provided.

Vaccines And Guns Data File, Alice Ann Crandall

ScholarsArchive Data

Three generation study of family health. The data sets associated with this submission examine attitudes about vaccines and guns across generations.

Water-Soluble Fullerene Derivatives Mitigate Cranial Radiation-Induced Neuroinflammation And Cognitive Dysfunction, Naren Gundapaneni, Iona Hill, Lydia W T Cheung, Khadijeh Koushki, Alyssa Fausnaught, Phuoc Minh Quan Mai, Arjun Vasan, Prapannajeet Biswal, Ashutosh Tripathi, Anilkumar Pillai, Vijayasree V Giridharan, Tatiana Barichello, Yuri Mackeyev, Sunil Krishnan

Faculty, Staff and Student Publications

Radiotherapy is widely used to treat malignant and benign brain tumors. A major constraint, however, is the low tolerance of normal brain tissue to radiation. Cranial irradiation-induced injury manifests as inflammatory responses and neurodegeneration, which jointly contribute to progressive cognitive decline. These complications can restrict the delivery of optimal therapeutic doses, cause persistent neurological symptoms, and ultimately compromise quality of life. Thus, neuroprotective agents have emerged as a strategy to safeguard normal tissues from radiation-induced neurotoxicity. This study investigated the efficacy of a highly soluble [60]fullerene (C60) derivative, C60-ser, a carbon-based nanomaterial, to mitigate radiation-induced brain injury. Oral administration of …

Correction: Berezowski Et Al. Biomarkers In Renal Cell Carcinoma: A Systematic Review And Immunohistochemical Validation Study, Brett Berezowski, Robert Boothe, Billy Chaplin, Sharon J Del Vecchio, Zakariya Fares, Tyrone L R Humphries, Keng Lim Ng, Taylor Noonan, Hemamali Samaratunga, Aaron Urquhart, David A Vesey, Simon T Wood, Glenda C Gobe, Robert J Ellis

Faculty, Staff and Student Publications

This corrects the article "Biomarkers in Renal Cell Carcinoma: A Systematic Review and Immunohistochemical Validation Study" in volume 17, 2588.

Animal Models Of Delirium: A Narrative Review, Tatiana Barichello, Carla Sasso Simon, Diogo Dominguini, Cristiane Ritter, Tsuyoshi Nishiguchi, Gen Shinozaki, Felipe Dal-Pizzol

Faculty, Staff and Student Publications

Delirium is an acute cognitive failure characterized by an acute onset and psychomotor disturbances. It is associated with poor outcomes in hospitalized patients, resulting in prolonged hospital stays, elevated rates of mortality, and cognitive dysfunctions after hospital discharge. The pathophysiology of delirium remains poorly understood, making the development of animal models a promising avenue for researchers to elucidate the mechanisms underlying human delirium. These models not only aid in understanding the pathophysiology and etiology of the disease but also enhance the efficacy of nonpharmacological interventions and identify pharmacological therapies. This review aims to present the most relevant and translational animal …

Aligning Nutrition Screening Workflows To Improve Early Identification Of Pressure Injury Risk In Hospitalized Adults, Stephanie M. Vigil

Walden Dissertations and Doctoral Studies

No abstract provided.

Is2c2: A Cointelligent Platform For Mechanistic Discovery Of Disease Cellular Crosstalk, Jianting Sheng, Ju Young Ahn, Li Yang, Zhihao Wan, Shaohua Qi, Xiaohui Yu, Zhan Xu, Yuliang Cao, Matthew Vasquez, Amna Irfan, Yuanyuan Zhu, Hong Zhao, Zheng Yin, Ying Zhu, Yunfeng Ding, Alireza Faridar, Lin Wang, Fengshuo Liu, Hongxia Wang, Zhigang Ji, Dongxue Mao, Michael Chan, Daniel Kermany, Wenjuan Dong, Doo Yeon Kim, Xiang H-F Zhang, Stephen T C Wong

Faculty, Staff and Students Publications

Large language models (LLMs) have demonstrated impressive capabilities in summarization, reasoning, and content generation, yet their inability to directly interpret large-scale omics data has limited their utility in data-driven hypothesis generation-particularly in mechanism discovery that demands the integration and interpretation of multimodal datasets, heterogeneous models, and deep domain expertise. Conversely, traditional computational algorithms excel at quantitative analysis of omics data but often rely heavily on labor-intensive, expert-driven interpretation to extract biologically meaningful insights. Here, we introduce (cointelligent single-cell spatial cell‒cell communication: iS2C2), a novel cointelligent platform that synergizes mathematically rigorous computational algorithms with the contextual reasoning capabilities of LLMs to …

H2ax C-Terminal Dipeptide Truncation: A Master Switch Of The Dna Damage Response, Faith M Joseph, Matthew V Holt, John M Jerome, Linda Zhang, Ashley G Boice, Patricia D Castro, Sofía I Aramburu, Ruhee Dere, Susan M Rosenberg, David R Rowley, Nicolas L Young

Faculty, Staff and Students Publications

Phosphorylation of histone H2AX at serine 139 (γH2AX) by ATM/ATR kinases is a central marker of the DNA damage response (DDR), widely used to detect DNA double-strand breaks. However, the molecular basis for tissue- and context-specific variation in γH2AX signaling remains poorly defined. Here we discover a post-translational truncation of H2AX, catalyzed by lysine demethylase 4A (KDM4A), which removes two C-terminal amino acids critical for ATM/ATR-dependent phosphorylation. This truncation renders H2AX refractory to γH2AX formation, effectively bypassing canonical DDR signaling. Truncated H2AX accumulates in select cell lines, primary cells, solid tumors, and normal tissues. Genetic knockdown or pharmacologic inhibition of …

Natural History Of Ngly1 Deficiency: Motor Function & Clinical Features, Grace Morrison, Selina Dwight, Hal Landy, William F Mueller, Pam Ventola, Regina Deck, Becky Schweighardt, Matt Wilsey, Kevin J Lee, Bernhard Suter

Faculty, Staff and Students Publications

N-glycanase 1 (NGLY1) Deficiency is an ultra-rare neurodevelopmental disorder caused by biallelic loss-of-function mutations in the NGLY1 gene, leading to severe impairments in neurocognitive and motor function abilities in the affected patient population. Its core clinical features include global developmental delay, hyperkinetic movement disorders, elevation of liver transaminases, (hypo)alacrima, and progressive sensorimotor neuropathy. Due to the range of phenotypes and severity within the confirmed patient population, ongoing characterization of the disease is critical. A prospective natural history study (NHS) was conducted to further elucidate disease phenotypes and examine any changes in neurocognitive or motor function over a one-year period. Fifteen …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Implementing A Buddy System To Enhance Float Pool Nurses’ Experience And Unit Integration, Nancy Kairia

Doctoral Projects

Float pool nurses play a vital role in maintaining hospital operations; however, they often experience role ambiguity, inconsistent integration, and reduced psychosocial empowerment, which may negatively influence engagement and retention. This Doctor of Nursing Practice project implemented and evaluated a structured buddy program designed to enhance psychological empowerment among float pool nurses in a large academic medical center. Guided by Gretchen Spreitzer’s Psychological Empowerment Framework, the project examined changes across four domains: meaning, competence, self-determination, and impact. A pre-post design was used to assess outcomes before and after implementation. Five nurses completed the preintervention survey; of these, four completed the …

Nanoparticle-Based Therapy For Peripheral Artery Disease: Evaluation Of Collagen Reduction And Fibrosis Mitigation In Ischemic Tissue, Tresha Nguyen

2026 Spring Honors Capstones Projects

Peripheral Artery Disease (PAD) is characterized by reduced blood flow, ischemic injury, and fibrosis, which collectively impair tissue function. Current treatment strategies are limited in their ability to target fibrotic tissue and restore normal function effectively. This study evaluates the therapeutic potential of drug-loaded nanoparticles to reduce fibrosis in ischemic tissue. Nanoparticles were synthesized and characterized for in vivo application. Tissue samples from experimental groups, including saline control, blank nanoparticles, free drug, and drug-loaded nanoparticles, were analyzed using Masson’s Trichrome staining to quantify collagen deposition. Histological images were processed using image analysis software to determine the percentage of collagen area. …

The Influence Of Prosthetic Obturators On Quality Of Life In Individuals With Maxillectomy Defects, Minseok Kim

Oral Health

Abstract

Introduction: In recent years, there has been a growing focus on understanding the impact of oral cancer on patients' quality of life. Prosthetic rehabilitation techniques, such as maxillary obturators, often in conjunction with reconstructive surgery, have emerged as interventions to address the challenges posed by post-maxillectomy abnormalities.

Objective: This study aims to systematically review and evaluate the effectiveness of maxillofacial prosthetic rehabilitation using obturators in enhancing the quality of life of patients following maxillectomy.

Methodology: Systematic review of identified literature spanning the timeframe from 2000 to 2020 was used. The comprehensive search encompassed widely recognized databases including PubMed, …

Blue Light Exposure, Eye Strain, And Sleep Quality: Evaluating The Effectiveness Of Blue-Light Filtering Lenses, Sara Rozalowski

Honors Capstones

This study employs a literature review to critically evaluate the benefits of blue light–filtering lenses and to determine whether their use against eye strain and toward sleep quality is supported by empirical evidence. The aim of this research is to provide evidence-based information to better inform patients regarding the clinical utility and practical applications of blue light filtration in corrective lenses.

Beyond Cough Drops And Band-Aids: An Interpretive Phenomenological Study Of Certified School Nurses’ Professional Scope And Enacted Roles In Pk–12 Settings, Brandy Gershon

Electronic Theses and Dissertations

This qualitative dissertation explored the underutilization of certified school nurses (CSNs) in PK–12 educational settings across urban, suburban, and rural school districts in western Pennsylvania. Despite their advanced preparation and wide-ranging scope of practice, school nurses are often limited to providing episodic care, including first aid, medication administration, and treatment of minor injuries. This limited use reflects a significant misalignment with their professional scope of practice, which encompasses chronic disease management, health education, mental health support, care coordination, and leadership in public health. Guided by role theory (Biddle, 1986), this study examined how school nurses perceived and interpreted their professional …

Risk Of Late Recurrence Of Colorectal And Breast Cancer Among Older Long-Term Cancer Survivors., Faiza Yasin, Sarah J. Westvold, Jessica B. Long, Terry Hyslop, Michael Cecchini, Ira Leeds, Andrea Silber, Shi-Yi Wang, Lisa Spees, Rebecca Forman, Tendai Kwaramba, Melissa Taylor, Cary P. Gross, Michaela A. Dinan

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

BACKGROUND: A growing population of older adult cancer survivors faces competing cancer and noncancer health risks. There are limited real-world data on recurrence patterns beyond 5 years post-treatment.

METHODS: This was a SEER-Medicare retrospective cohort study of patients aged ≥66 with stage I-III breast, colon, or rectal cancer who received definitive surgery and survived ≥5 years from diagnosis without recurrence or second primary malignancy. Late recurrence (5-10 years postdiagnosis) was identified using a validated algorithm to detect treated recurrence in Medicare claims. Demographic and clinical characteristics collected at cancer diagnosis were assessed as predictors of late treated recurrence using restricted …

Care Without Barriers: Dei And Cultural Competency In Athletic Training Education Programs, Sydney Hotz

Graduate Theses, Dissertations, and Capstones

In the field of athletic training, cultural competency is a topic that is highly under-researched. Athletic trainers (ATs) are healthcare professionals who provide care in a variety of settings, including secondary schools, where their patient population often includes student-athletes experiencing adverse social determinants of health and barriers to healthcare access. Only since 2022 has the governing body of athletic training education mandated that programs include cultural competency and DEI education in their programs, and to this day does not require programs to report adherence and methods of implementation. A quantitative, cross-sectional analysis was conducted to assess the relationship between cultural …

More Than A Rod: Reconceptualizing Medical Student Development Through The Lens Of Social Determinants Of Learning, Dejour Young

Electronic Theses and Dissertations

Medical education traditionally follows a biomedical paradigm that emphasizes academic rigor but often overlooks non-academic factors that fundamentally influence student success. The aim of this study was to reconceptualize medical student development by shifting focus from traditional academic metrics to the systemic, non-academic factors that affect learning and well-being.

This study employs a systemic analysis of structural barriers, defined as institutional policies, practices, and environments that create and perpetuate inequity in medical education. This investigation was grounded in the Integrated Social-Ecological Framework for Learning (ISEF-L), a three-tiered conceptual framework developed for this study. The ISEF-L includes Social Determinants of Learning …

Standardized Elearning Debriefing Module Effects On Undergraduate Nursing Student Resilience And Coping: A Feasibility Study, Kelsey D. Miller

Doctor of Nursing Practice Projects: College of Nursing

Background: Undergraduate nursing students experience stressful clinical situations that may influence learning, emotional well-being, and practice readiness. Structured debriefing provides an avenue for reflective processing; however, variations in debriefing practices can reduce effectiveness. This program evaluation examined the effect of a faculty-developed, standardized eLearning debriefing module on resiliency and coping among BSN students.

Method: A quasi-experimental, one-group pre-test/post-test design was implemented with junior and senior students during clinical rotations. Faculty completed the module and facilitated standardized debriefings. Student resilience and coping were measured using the Connor‑Davidson Resilience Scale and the Brief Resilient Coping Scale.

Results: Twenty-one students completed baseline surveys, …

What You Don't Hear About Barriers To Healthcare In The Deaf Community: Analyzing Interpreter Experiences In The Deep South, Ryan Augustine

Honors Theses

Deaf and hard-of-hearing individuals experience significant health disparities in the United States, yet the perspective of the ASL interpreter has remained largely absent regarding the barriers documented in existing literature. This pilot case study examined the barriers Deaf individuals face when seeking healthcare through the unique vantage point of eight ASL interpreters across the Deep South: Alabama, Georgia, Louisiana, and Mississippi. Guided by grounded theory methodology, eight semi-structured interviews were conducted and analyzed to find recurring themes. Findings confirmed and revealed barriers that would not have surfaced without the perspective of the interpreter. Four themes emerged from this study: healthcare …

Making Sense Of Hospitalization: An Interpretative Phenomenological Analysis Of Covid-19 Patients’ Psychological Experiences In Indonesia, Mira Wahyu Kusumawati, Heni Dwi Windarwati, Setyawati Soeharto

The Qualitative Report

While previous research has probed into the experiences of COVID-19 patients during isolation in hospitals, little is known about their psychological experiences and the meaning of such experiences. To address the gap,this study was designed to explore the psychological experiences of patients who were confirmed positive for COVID-19 while undergoing isolation in hospitals. Using a phenomenological approach, we recruited 19 COVID-19 survivors who were confirmed positive for COVID-19 in the first six months of the pandemic entering Indonesia, located in Madiun Regency, East Java Province, Indonesia. We conducted face-to-face semi-structured interviews with health protocols and analysed the data using the …