Digital Commons Network^™

Two-Year Retrospective Evaluation Of Frailty To Optimize Postoperative Spinal Fusion Outcomes In Adults Aged 65 And Older, Sheri Loo

Doctoral Projects

Many older adults over the age of 65 have both spinal stenosis requiring spinal fusion surgery and frailty. As life expectancy has increased, many older individuals will undergo elective spinal fusion surgery to decrease their chronic pain in pursuit of improved quality of life. There is currently an underutilization of frailty screening for risk stratification of postoperative complications. A retrospective chart review over a two-year period from July 2023 to June 2025of adults aged 65 and older who underwent posterior spinal fusion surgery, involving 126 participants, was completed. We assessed the correlation between frailty and postoperative outcomes, discharge disposition, and …

Leveraging Mobile Health To Prevent Coronary Artery Disease Through Physical Activity Promotion Among Underserved Youth, Alina Yang, Jessh M. Mavoungou, Matthew C. Miller, Zarmina Amin, Zan Gao

International Journal of Physical Activity and Health

Coronary artery disease (CAD) develops earlier than often recognized, with underserved youth facing disproportionate cardiometabolic risk. Low participation in moderate-to-vigorous physical activity (PA) is a key driver. This viewpoint explores how mobile health (mHealth) technologies can serve as tools to increase PA engagement among underserved youth, guided by a combined Self-Determination Theory and RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. It highlights current barriers to mHealth adoption, limited cultural relevance, engagement challenges, and accessibility gaps, and presents key considerations for designing culturally informed, age-tailored, and youth-centered mHealth interventions. Overall, the paper calls for a more inclusive and targeted approach …

The Mediating Effect Of Physical Activity On Mental Health Among Sexual Minority Adolescents During Covid-19, You Fu, Ryan D. Burns, Hayley Almes, Xiangren Yi, Nora Constantino

International Journal of Physical Activity and Health

Purpose: Adolescents identifying as a sexual minority frequently experience mental health issues exacerbated by the COVID-19 pandemic. Physical activity (PA) has numerous benefits for mental health and emotional development. The purpose of this study was to examine the mediating effect of PA on the association between sexual minority status and mental health among adolescents during COVID-19. Methods: A sample of adolescents (grades 9-12) completed the online Adolescent Behaviors and Experiences Survey (ABES; N = 7677; 49.6% male) in 2021. The independent variable in this study was a recorded binary response item asking about sexual orientation. The dependent variable was a …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Redefining Skincare For Sensitive Lives, Ashlyn G. Sierra Ms

Honors College Theses

This study outlines how a skincare company that is both ethically and effectively developed for people suffering from eczema could create accessible, affordable products as well as maintain its commitment to being inclusive. The study uses scientific data regarding eczema in order to examine why certain aspects of skin care are helpful or dangerous when it comes to individuals who suffer from eczema, in addition, it provides an assessment of current skin care product offerings that are designed for people with eczema. Using the Wise Leadership Framework, the study presents a hypothetical business plan for a new, eczema-based skin care …

Development And Psychometric Analysis Of An Instrument To Assess Social Stigma Associated With Parkinson's Disease, Ana Lourdes Guerra-Anzaldo, Arturo Emmanuel Espinosa-Picos, Karen Itzel Sánchez-Ramírez, Ana Jimena Hernández-Medrano, Amin Cervantes-Arriaga, Ariadna Domínguez-García, Mayela Rodríguez-Violante

Journal of Patient-Centered Research and Reviews

Purpose: To develop and report the psychometric properties of a comprehensive scale designed to measure stereotypes and attitudes of the general population towards people with Parkinson’s disease (PwP).

Methods: The development and analysis of the Parkinson's Disease Stigma Perception scale (PDSP) included four phases: 1) literature review, 2) item development, 3) tests of validity and reliability, and 4) dissemination of a preliminary version. Internal consistency was assessed using Cronbach's alpha, exploratory factor analysis (EFA) to explore underlying structures, and confirmatory factor analysis to test the model's fit.

Results: Six (2%) of the 294 survey respondents were disqualified because of incomplete …

The Compassionate Heart Patient Questionnaire: Validation And Reliability Of A Novel Measure Of Relationship-Centered Care, Dustin Willis, Everett Lohman, Lida Gharibvand, Andrew Sullivan, Lee Berk

Journal of Patient-Centered Research and Reviews

Purpose: To establish the validity and reliability of the Compassionate HEART Patient Questionnaire (CHPQ) for measuring relationship-centered care and exploring associations between patient ratings and mood state changes in patients with persistent pain.

Methods: Thirty-nine adults with persistent pain (> 3 months) completed pre-/post-interaction Profile of Mood States assessments and rated providers using the Consultation and Relational Empathy (CARE) measure and the novel CHPQ following physical therapy evaluations. Psychometric properties were assessed through factor analysis, concurrent validity (correlation with CARE), and internal reliability (Cronbach's alpha). Pre-post mood changes were analyzed using Wilcoxon signed-rank test.

Results: The CHPQ demonstrated good internal …

Restless Legs Syndrome And Neurological Comorbidities: A Narrative Review, Kyrillos Ghattas, Helen Hernandez, Yongwoon Huh, Zhanna Fast, Zhikui Wei

Department of Sleep Medicine Faculty Papers

Restless legs syndrome (RLS) is a common yet underrecognized neurological disorder characterized by uncomfortable sensations and an irresistible urge to move he legs, typically following a circadian pattern. RLS frequently co-occurs with various other neurological diseases, raising questions about shared mechanisms and clinical consequences. This review synthesizes evidence on the prevalence, outcomes, and pathophysiology of RLS in various neurological disorders, including Parkinson's disease, multiple sclerosis, migraine, dementia, stroke, epilepsy, and peripheral neuropathy. In Parkinson's disease, RLS is linked to disease progression and dopaminergic therapy. In stroke and multiple sclerosis, RLS is associated with structural lesions at specific locations, such as …

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 …

The Impact Of Trump Administration Immigration Policies On Connecticut Educators And Families, Elena C. Bielesz

Honors Scholar Theses

Anti-immigrant rhetoric, policies, and practices, which have grown increasingly prevalent due to the current national political climate, have adverse effects on the mental health of immigrant families and the teachers that support them in Connecticut. This study seeks to represent the opinions of Connecticut K-12 MLL (Multilingual Learners) Education Teachers and Administrators whose daily lives are impacted by the anti-immigrant and anti-refugee policies and procedures. The study employed a human subjects-based approach supported by a review of related literature. MLL Educators from around the state of Connecticut were interviewed. These interviews found that while immigration-based trauma and stressors are common …

Comparing The Use Of Measured And Smoothed Data In Forecasting Visual Field Tests Using Deep Learning, Ashkan Abbasi, Sowjanya Gowrisankaran, Wei-Chun Lin, Xubo Song, Bhavna Josephine Antony, Gadi Wollstein, Joel Schuman, Hiroshi Ishikawa

Wills Eye Hospital Papers

OBJECTIVE: To evaluate the impact of training and testing deep learning (DL) models for visual field (VF) forecasting using input-target pairs in which the target is either the measured VF test result, or its smoothed counterpart constructed via linear regression.

DESIGN: A retrospective data analysis study evaluating DL models for VF forecasting under multiple training and testing configurations.

SUBJECTS AND CONTROLS: A total of 1400 subjects (healthy and glaucoma patients) with 19 437 reliable Humphrey VF (24-2 Swedish Interactive Threshold Algorithm) tests collected from longitudinal cohorts at the University of Pittsburgh and New York University.

METHODS: Three DL-based pointwise VF …

Multi-Grader Validation Of The Telemedicine Retinopathy Of Prematurity Severity Score, Harrison W. Pratt, Sarthak V. Shah, Cindy S. Zhao, Arthur R. Brant, Caroline R. Baumal, Cagri G. Besirli, Audina M. Berrocal, Kimberley A. Drenser, Anna L. Ells, Clio Armitage Harper, G. Baker Hubbard, Eric D. Nudleman, Polly Quiram, Irena Tsui, Edward Wood, Yoshihiro Yonekawa, Tatiana Rosenblatt, Jochen Kumm, Darius M. Moshfeghi

Wills Eye Hospital Papers

We aimed to statefully validate Retinopathy of Prematurity (ROP) grading by evaluating intergrader variability over age-matched simulated exams. In a prospective retinal photographic grading cohort study, both eyes of twenty patients with five images per eye per visit were graded by twelve expert graders across six weekly visits. For each eye visit, ROP experts graded the Zone, Stage, and Plus, from which the Telemedicine ROP Severity Score (tROP-SS) was calculated. Graders retained knowledge of prior assessments for a given eye and followed International Classification of ROP rules. Intergrader coefficient of variation (CoV) for Zone, Stage, Plus, and tROP-SS remained below …

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 …

Comparison Of Early-, Average-, And Late-Onset Pancreatic Cancer In A Multi-Site Cancer Center: Treatment Patterns And Outcomes, Chirag K. Patel, Jimmy J. Hwang, Mohamed E. Salem, Kunal C. Kadakia

Journal of Patient-Centered Research and Reviews

Purpose: The aim of this study was to investigate treatment and outcomes differences, as well as predictors of early mortality, among early-onset pancreatic adenocarcinoma (EOPC, ≤ 50 years), average-onset pancreatic adenocarcinoma (AOPC, 51-69 years), and late-onset pancreatic adenocarcinoma (LOPC, ≥ 70 years).

Methods: We retrospectively analyzed 333 patients with pancreatic adenocarcinoma at a multi-site center between 2011-2018. Clinical, demographic, and treatment variables were compared by age group. Predictors of early mortality (death ≤ 6 months from diagnosis) were assessed using multivariable logistic regression. Survival outcomes were evaluated using Kaplan-Meier analyses.

Results: Among the 333 patients, 56% were male, and the …

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 …

Improving Provider Awareness Of Digital Asthma Applications Through Staff Education, Sade Turner

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Veteran Mental Health Screening In Primary Care, Denise Williams

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, 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 …

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 …

Implementation Of An Interprofessional Practice Model, Jessica K. Mcguire-Wasylowich

Walden Dissertations and Doctoral Studies

No abstract provided.

Reducing Burnout Among Psychiatric Practitioners And Therapists, Sarah Lemaine

Walden Dissertations and Doctoral Studies

No abstract provided.

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 …

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