Digital Commons Network^™

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 …

Frailty Is A Predictor Of Inpatient Mortality And Unplanned Icu Admission Following Early Fixation Of Intertrochanteric Fractures., Victor Koltenyuk, Jared Sasaki, Nithin Gupta, Zachary Chanmin, Ruby G Patel, Taylor Manes, Jack W Weick

Surgery Articles

Purpose: This study sought to examine the role of frailty in predicting inpatient mortality following early surgical fixation of intertrochanteric (IT) fractures.

Methods: The ACS-TQIP (2017-21) database was queried for patients with intertrochanteric fractures undergoing surgical fixation within 48 h. Frailty status was determined using the 5-item modified frailty index (mFI-5) (0 = nonfrail, 1 = prefrail, and, 2 = frail, and > 2 = severely frail). The primary end point was inpatient mortality. Secondary end points were unplanned ICU admission and thromboembolic events (DVT or PE). Significance was considered a p-value < 0.05.

Results: Frailty, as determined by the mFI-5, was …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Justin Ruiz, Emma Mowery

Doctor of Nursing Practice Final Project Abstract

Purpose

To investigate the impact of implementing the use of the Smiling Mind app (a free and easily accessible mobile application that teaches mindfulness skills) among inpatient psychiatric nurses. The aims were to see a 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background

Stressors experienced at work by inpatient psychiatric nurses include patient acuity, emotional demands, environmental factors, and policy implementation. Unmanaged stress can disrupt a nurse's work-life and harm the quality of care provided to patients.

Methodology

Using a pre-post implementation design, 7-day shift and 10-night shift nurses used the Smiling Mind app for …

Fall Prevention In A Medical Intermediate Care Unit (Mimu) Through Use Of A Collaborative Fall Bundle, Sara M. Jose

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This DNP project focused on reducing the fall rate in a medical intermediate care unit by half, from 1.81 falls per 1000 patient days to 0.91 falls per 1000 patient days.

BACKGROUND

The number of patient falls poses a significant concern in a medical intermediate care unit. The fall rate goal is zero.

METHODOLOGY

The Collaborative Fall Bundle includes implementing the Fall TIPS Toolkit, an 11 x 17 bedside poster informing patients and staff of their fall risk factors and interventions to counteract; an alarm buddy system pairing two nurses to answer each other's call lights and assist with …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Emma Jade Mowery, Justin D. Ruiz

Doctor of Nursing Practice Final Project Abstract

Purpose: To investigate the impact of implementing use of the Smiling Mind app (a free and easily accessed mobile application that teaches mindfulness skills) in inpatient psychiatric nurses. The aims: A 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background: Workplace stressors experienced by psychiatric nurses include high patient acuity, emotional strain, environmental factors, and new policies. Unmanaged stress can harm nurse's well being and affect quality of care.

Methodology: Using a pre-post implementation design, 7 dayshift and 10 night-shift nurses used the Smiling Mind app for 10 weeks. Perceived stress (PSS-10) and workplace satisfaction (WPS) …

Glp-1 Receptor Agonists And Disordered Eating: Clinical Indicators And Patient Narratives, Samantha E. Schulz

Masters Theses

Introduction: The use of the medication, GLP-1 receptor agonist (GLP-1 RA), for weight loss has increased exponentially in the United States over the past decade. The continuing rise in demand for the use of GLP-1 RAs for weight loss justifies the need to better understand the physical and psychological effects that can occur with significant weight loss. By combining a standardized screening tool for eating disorder (ED) risk with narratives from patients undergoing GLP-1 RA treatment for weight loss, this study examines associations between GLP-1 RA use patterns and risk of ED and explores patient experiences, including the role of …

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. …

Improving Psychopharmacologic Continuity Of Care In Home Health Psychiatric Patients Using The Ideal Protocol, Serah Angela Guilbe

Walden Dissertations and Doctoral Studies

No abstract provided.

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, Michael J. Doherty, Babak Razavi, Tiffany L. Fisher, Christopher T. 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

Department of Neurology Faculty Papers

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 …

Mosunetuzumab Monotherapy Is Active And Tolerable In Patients With Relapsed/Refractory Richter Transformation, Katharine L Lewis, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

Richter transformation (RT) to diffuse large B-cell lymphoma is an aggressive lymphoma that arises from underlying chronic lymphocytic leukemia or small lymphocytic lymphoma. RT is often chemorefractory, resulting in poor clinical outcomes with standard chemoimmunotherapy. Mosunetuzumab, a bispecific CD20/CD3 T-cell-engaging antibody, was investigated in a cohort of 20 patients with relapsed/refractory RT. Cytokine release syndrome occurred in 65% of patients, almost exclusively grade 1 (20%) or grade 2 (40%), and occurring during the first treatment cycle. Other adverse events included infections, neutropenia, thrombocytopenia, tumor flare, and low-grade neurotoxicity, with no adverse events leading to treatment discontinuation. Mosunetuzumab resulted in an …

Exposure To Agent Orange And Association With Myelodysplastic Syndromes, Mikkael A Sekeres, Matthew J Walter, Et Al.

2020-Current year OA Pubs

No abstract provided.

Simultaneous Multielectrode Recordings Along The Human Scala Tympani: Evidence For Level-Dependent Place Coding, Amit Walia, Matthew A Shew, Shannon M Lefler, Amanda J Ortmann, Patrick Ioerger, Jordan Varghese, Jacques A Herzog, Craig A Buchman

2020-Current year OA Pubs

The cochlea systematically encodes sound frequency and intensity via a precisely organized tonotopic map, in which traveling waves peak at specific cochlear locations. A fundamental but incompletely understood aspect of auditory coding involves how stimulus intensity shapes this tonotopic organization. In animal models, increasing intensity shifts the cochlear traveling wave peak basally; however, physiological evidence for such intensity-dependent shifts in human cochlear processing is limited. Here, we performed simultaneous multielectrode electrocochleography recordings along the human scala tympani to characterize how cochlear place coding varies as a function of stimulus intensity. In subjects with preserved cochlear mechanics, including individuals with auditory …

When Healing Becomes Horror: Medical Malpractice And Institutional Fear, Taryn Prater

COD Library Student Research and Award Symposium

I studied medical malpractice through the lens of Monster Theory, examining how systemic failures, institutional silence, and cultural ideals shape harm in healthcare. I learned that malpractice is not only a legal issue, but a structural and ethical one, where fear and lack of transparency erode trust and impact both patients and providers.

Monstrous Medicine website

Faculty Sponsor: Professor Aleisha Balestri

Neuroplasticity And Hippocampal Impacts Associated With Obstructive Sleep Apnea, Rumaysa Aliniazee

COD Library Student Research and Award Symposium

A review on the implications of Obstructive Sleep Apnea (OSA) and Hippocampal Brain Health. It explores the role of sleep medicine, its effect on the hippocampus, its influence on cognitive function, and emphasizes the need for continued research and intervention to preserve cognitive health.

Faculty Sponsor:  Professor Felipe Armas

Boosting Psychological Well-Being In One Session: A Rapid Counseling Approach To Digital Detox And Music Therapy, Aryobimo Oentarto

Buletin Konseling Inovatif

The rapid acceleration of technology has trapped modern youth in a digital connectivity paradox, where constant social media exposure triggers cognitive distortions and maladaptive behaviors that erode psychological well-being. This study evaluates the effectiveness of a Rapid Counseling approach integrated with Single-Session Music Therapy (RC-SSMT) in enhancing the psychological well-being of youth by breaking the cycle of digital addiction. Using a pre-test and post-test experimental design, the study focused on six youths (aged 15–17) at Church "X" in Jakarta who were identified as having low psychological well-being. The intervention combined a mandatory digital detox as a behavioral task with music …

Developing Antibodies Against Galectin-3 And Galectin-9 To Target Endometriosis, Ashleigh Burger, Noah Farnsworth, Jared J. Reisnouer, Cheyenne Vue

2026 Symposium

Endometriosis is a disease characterized by pelvic pain and the formation of endometrial-like tissue on the outside of the uterine lining. This condition affects nearly 10% of women across the globe and confirming whether someone has endometriosis requires visualization in surgery. While the specific causes of this disease remain unclear, the over-expression of the Galectins 3 and 9 in ectopic endometrial tissues suggests a role in the development and maintenance of the condition. Monoclonal antibodies (mAbs) are highly specific proteins with potential as diagnostic or treatment tools. The goal of this study is to generate antibodies against Gal3 and Gal9. …

Parent Attitudes Toward Augmentative And Alternative Communication (Aac) In Children With Speech And Language Disorders, Megan N. Wells, Jane Grothaus

Undergraduate Research Journal

Augmentative and Alternative Communication (AAC) systems support individuals who experience difficulty communicating through spoken language. While research demonstrates that AAC can significantly improve communication outcomes, caregiver perceptions play a critical role in the successful implementation of these systems. The purpose of this study was to examine parent and caregiver attitudes toward AAC use among children with speech and language disorders. A fifteen-question online survey was distributed to caregivers of children currently using AAC systems. Responses from caregivers (n = 17) were analyzed using descriptive statistics and thematic analysis of open-ended responses. Results indicated that most caregivers reported improvements in their …

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 …

Asymmetric Maxillary Molar Distalization And Guided Canine Eruption Using Temporary Anchorage Devices And Super-Elastic Niti Wire, Kah-Ying Yim, Huei-Mei Tsai, Yu-Ling Cheng, Ming-Jeaun Su, Yi-Min Liu

Taiwanese Journal of Orthodontics

An adult female patient presented with a pronounced maxillary dental midline deviation and localized crowding in the upper right quadrant, particularly involving the canine and second molar. The maxillary right canine was buccally erupted and overlapped the lateral incisor and first premolar due to insufficient arch space and unfavorable root proximity. The mandibular arch exhibited mild anterior crowding with a flat curve of Spee. Orthodontic treatment was initiated using preadjusted fixed appliances. Extraction of the maxillary right third molar was performed to allow immediate sequential distalization of the maxillary right molars. A bypassed-canine main archwire in combination with a temporary …

Management Of Lower Incisor Protrusion In An Angle Class Iii Malocclusion Using Improved Super-Elastic Ti-Ni Alloy Wire, Jr-Wei Jian, Yu-Hsiang Chang, Yi-Mien Cheng, Ming-Han Cheng, Jian-Hong Yu

Taiwanese Journal of Orthodontics

A 16-year-old adolescent female presented with the chief complaint of poor dental alignment and protrusion of the lower teeth. Clinical examination revealed Angle Class III malocclusion accompanied by lower anterior crowding and a protrusive lip profile involving both the upper and lower lips. Cephalometric analysis demonstrated a skeletal Class I relationship with a normal mandibular plane angle. To facilitate anterior retraction, four premolars (15, 24, 34, and 45) were extracted. Following extraction, Improved Super-elastic Ti-Ni alloy wire (ISW) was employed to relieve lower anterior crowding. Canine distalization and anterior retraction were subsequently performed. Elastic chains were used to assist midline …

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 …

Correlation Between Maxillary Incisor Inclination And Buccopalatal Alveolar Bone Thickness Assessed By Cbct: A Retrospective Observational Study, Raee Korgaonkar, Nandini Kamat

Taiwanese Journal of Orthodontics

Purpose: This retrospective study aimed to evaluate the correlation between buccal and palatal alveolar bone thickness and the degree of maxillary incisor inclination. The objective was to derive clinically relevant insights for orthodontic treatment planning and controlled tooth movement. Materials and Methods: Sixty-one maxillary central incisors from cone-beam computed tomography (CBCT) scans of thirty-four subjects were retrospectively evaluated and grouped as proclined, upright, and retroclined incisors. Buccal and palatal thicknesses of cortical and cancellous alveolar bone were measured at various levels of the incisor root. The correlation between bone thickness and incisor angulation was investigated using Spearman’s correlation test. Results: …

Evaluation Of Mandibular Buccal Shelf Bone Thickness And Height For Miniscrew Placement Using Cone-Beam Computed Tomography, Roji Shrestha, Rabindra Man Shrestha, Jyoti Dhakal, Sujita Shrestha

Taiwanese Journal of Orthodontics

Introduction: Buccal shelf area (BSA) is a recommended anatomic site for mini-screw insertion. Stability of miniscrew is determined by quantity of bone available in the region.

Objective: To determine bone thickness and height of BSA for optimum placement of miniscrew.

Materials and Methods: This cross-sectional observational study included 40 cone-beam computed tomography (CBCT) scans (23 males, 17 females) of patients aged 19-38 years. Patients were further divided into two age groups 19-28 years and 29-38 years. Measurements were made at 4 different sites: mandibular first molar mesial root (M6) and distal root (D6), second molar mesial root …

Preparing A Qualified Workforce To Support The Disability Community Through The Lend Interprofessional Learning Experience, Megan K. Roberts, Beth W. Degrace, Mark J. Fisher, Sandra H. Arnold

Developmental Disabilities Network Journal

Leadership and workforce preparation are vital roles of the nation’s academic institutions to advance health care services for the members of our communities. Leadership Education in Neurodevelopmental and other Related Disabilities (LEND) programs aim to prepare leaders in health care services and advocacy to improve systems and the quality of care and supports for the disability community, specifically children with developmental disabilities. LEND programs enhance standard health care pre-service training by providing interdisciplinary learning experiences for student trainees from a minimum of ten disciplines in 300 hours of learning activities over one academic year. An innovative feature of LEND programs …

Lungs And Beyond: Seizures As Presenting Symptom In A Patient With Mycobacterium Chimaera Infection, Samar Mehyar, Tripti Adhikari, Shweta Kambali, Harneet K. Ghumman, Avneet K. Ghumman, Parul Sud, Mehrshad Fathian Sabet, Elizabeth Mikhail, Sohrab Singh

Journal of Community Hospital Internal Medicine Perspectives

Mycobacterium chimaera is a slow-growing, non-tuberculous mycobacterium (NTM) that belongs to the Mycobacterium avium complex (MAC). It first emerged as a pathogen after being associated with infections in patients who underwent cardiothoracic surgery when patients were getting exposed to heater cooler units, especially those requiring extracorporeal membrane oxygenation (ECMO) or prosthetic valve placement. We report an atypical presentation of M. chimaera infection in a patient with COPD, but no prior history of cardiac surgery or immunosuppression.

Adrenal Crisis Induced-Seizures: A Case Report And Literature Review, Israel Umoh, Elizabeth Mikhail, Narjis Batool, Nosheen Hajra, Ibrahim Al-Sanouri

Journal of Community Hospital Internal Medicine Perspectives

This case report underscores the critical interplay between adrenal crisis and seizure activity, emphasizing the importance of rapid recognition and management of this life-threatening condition. Adrenal crisis, characterized by severe hypotension and electrolyte disturbances, often manifests with nonspecific symptoms such as fatigue, nausea, and altered consciousness, which can obscure diagnosis, especially in pediatric and young adult populations. The report details a 21-year-old female with a complex endocrinologic background who developed seizures precipitated by an adrenal crisis triggered by gastroenteritis and compounded by medication noncompliance. Clinical findings included profound dehydration, electrolyte abnormalities, refractory hypotension, and low cortisol levels, which responded favorably …

The Hidden Crisis: A Rare Case Of Thyrotoxicosis In A Young Female, Mimicking Neuromuscular Disease, Ali Haider Awan, Seerat Riaz, Hafiz Muhammad Hashim Butt, Sajeela Riaz, Fnu Sameeha, Hilana Soliman Omar, Shafia Naeem, Abida Perveen, Jahanzeb Malik

Journal of Community Hospital Internal Medicine Perspectives

Thyrotoxic periodic paralysis (TPP) is a rare but life-threatening cause of acute flaccid paralysis associated with hypokalemia. Although more common in males and individuals of Asian descent, it may present atypically in young females and be easily misdiagnosed. We report a case of a 30-year-old female who presented with acute quadriparesis. Extensive neuromuscular evaluation initially pointed toward Guillain-Barré syndrome (GBS), but subsequent investigations revealed profound hypokalemia. Further workup confirmed thyrotoxicosis as the underlying cause. Prompt potassium replacement and initiation of antithyroid therapy led to complete clinical recovery. This case highlights the importance of considering both endocrine disorders and electrolyte disturbances, …

Staff Education On Central Line-Associated Bloodstream Infection Prevention Bundle Practices, Ngowari Warmate

Walden Dissertations and Doctoral Studies

No abstract provided.

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.

Pediatric Burns: Severity, First Aid, And When To Refer, Mike Smith, Pablo Aguayo

Pediatrics in Practice: A CME Podcast

This episode explains burn depth, TBSA estimation, and practical first aid that reduces complications—essential for pediatricians and ER providers who triage children with burns. Pablo Aguayo, MD (Children’s Mercy) walks through burn classification (superficial to fourth-degree), scald burns, and American Burn Association referral criteria. Keywords: pediatric burns, burn severity, burn first aid, scald injuries, TBSA, burn center referral. For more resources and show notes, visit the Pediatrics in Practice CME Podcast page and subscribe for updates.

Click here to stream the podcast episode.