Digital Commons Network^™

Mechanism Of Injury And Fracture Status Influence Outcomes After Central Cord Injury, Karlo M. Pedro, Mohammed Ali Alvi, Kathleen Zang, Christopher Lozano, Jetan H. Badhiwala, Jefferson R. Wilson, James Harrop, James D. Guest, Bizhan Aarabi, Christopher I. Shaffrey, Michael G. Fehlings

Department of Neurosurgery Faculty Papers

Central cord syndrome (CCS) is the most common form of incomplete cervical spinal cord injury (SCI), yet its optimal management remains controversial. We examined whether stratifying CCS by injury stability improves treatment assessment. CCS was defined as an American Spinal Injury Association Impairment Scale (AIS) C/D cervical SCI with a ≥5-point lower-upper extremity motor score difference and classified as CCS-stable (CCS-S) or -unstable (CCS-U) based on the absence or presence of fracture/dislocation. Functional recovery at 1 year was assessed using the functional independence measure (FIM) motor score. Among 291 patients, 131 (45%) had CCS-S. These patients were older and more …

Panitumumab-Based Egfr Blockade In Smarcb1-Deficient Renal Medullary Carcinoma: Preclinical Basis And Prospective Clinical Activity, Niki M Zacharias, Eric S Rupe, Xinyue Chen, Ritesh R Kotecha, Damian T Rieke, Bradley A Mcgregor, Pedro Pesquera, Zhiyuan Yu, Abha Grover, Najat C Daw, Emily Wang, Sze Wah Samuel Chan, Dorothea Douglas-Lindsay, Alice C Fan, Eric M Knoche, Christos E Kyriakopoulos, Aly-Khan A Lalani, Charlene M Mantia, Amartej Merla, Martin H Voss, Nicklas Pfanzelter, Sneha Ramakrishna, Neil M Reaume, Tianyi Tang, Davis R Ingram, Diana Shamsutdinova, Khalida M Wani, Wei-Lien Wang, Alexander J Lazar, Rahul A Sheth, Priya Rao, Sandra L Grimm, Cristian Coarfa, Rong He, Jing Qian, Fei Duan, Deepa Bisht, Pankaj K Chauhan, Luigi Perelli, Giannicola Genovese, Liuqing Yang, Chunru Lin, Jose A Karam, Ludovica La Posta, Eleonora Dondossola, Rafet Basar, Nadima Uprety, Katayoun Rezvani, Jianjun Gao, Linghua Wang, Luisa M Solis Soto, Bora Lim, Nizar M Tannir, Menuka Karki, Pavlos Msaouel

Faculty, Staff and Students Publications

Purpose: SMARCB1-deficient renal medullary carcinoma (RMC) is an ultra-rare, lethal malignancy refractory to therapies approved for other renal cell carcinomas, and its rarity makes randomized trials logistically unfeasible. We investigated whether wild-type epidermal growth factor receptor (EGFR) is a therapeutically actionable dependency in RMC and translated this insight into a deployable clinical regimen.

Experimental design: EGFR expression was assessed by CLIA-certified immunohistochemistry in RMC tumors and by integrated RNA- and chromatin immunoprecipitation-sequencing of primary tumors and adjacent kidney. Panitumumab was compared with erlotinib in patient- and cell line-derived xenografts, and its mechanism defined by immunoblotting, confocal colocalization, cell-cycle and apoptosis …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

From “Fixer” To “Facilitator”: A Clinical Review Of Shared Medical Appointments As A Strategy For Workforce Sustainability, Barbara A. Slusher

Lynchburg Journal of Medical Science

Clinician burnout remains a significant threat to workforce sustainability, particularly in resource-constrained settings managing complex chronic diseases. While shared medical appointments (SMAs) have demonstrated clear benefits in patient satisfaction and access, their impact on clinician well-being and professional fulfillment is less clearly defined. This review evaluates whether participation in SMAs improves clinician satisfaction and mitigates burnout by facilitating a conceptual transition from isolated “Fixer” to collaborative “Facilitator.”

A targeted literature search of PubMed, the Cochrane Library, and Google Scholar identified peer-reviewed publications examining shared medical appointments and clinician-centered outcomes, including burnout, clinician satisfaction, and workforce sustainability. …

Hidden Infarctions: Understanding And Managing Myocardial Infarction With Non-Obstructive Coronary Arteries Through A Multimodal Lens, Catalina Esquivel

Lynchburg Journal of Medical Science

Myocardial infarction with non-obstructive coronary arteries (MINOCA) accounts for 5–15% of myocardial infarctions and disproportionately affects women and minority populations. It is defined by clinical evidence of myocardial ischemia with

Countering Hpv Vaccine Misinformation On Social Media: Practical Strategies For Healthcare Providers, David Baldwin

Lynchburg Journal of Medical Science

Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical and other HPV-related cancers; however, vaccine hesitancy remains a significant barrier to optimal vaccination rates. Social media has become a major source of health information while simultaneously amplifying misinformation that influences parental attitudes toward HPV vaccination. This narrative literature review examined the relationship between social media misinformation and HPV vaccine hesitancy and identified evidence-based strategies healthcare providers can use to improve vaccine confidence.

A literature search of PubMed and Google Scholar identified 31 articles published between 2016 and 2025, of which 19 met inclusion criteria. The literature demonstrates …

Artificial Intelligence-Assisted Retinal Imaging For Chronic Disease Detection, Prediction, And Screening, Shivani Gandhi

Master's Projects and Capstones

A retinal image may reveal more than eye disease; it may also show early signs of chronic illness elsewhere in the body. Diabetes, hypertension, cardiovascular disease, and chronic kidney disease can develop before symptoms become noticeable, making earlier detection an important public health goal. Advances in artificial intelligence have created new possibilities for using retinal images to identify patterns linked to these conditions. This scoping review examined how Artificial Intelligence -assisted retinal imaging has been used for chronic disease detection, prediction, and screening, along with the practical and health-equity factors that may influence its use.

To map the current evidence, …

Predictors Of Adalimumab Durability In Hidradenitis Suppurativa: A Multicenter Cohort Study, Albert T. Young, Arashleen Pannu, Alexander Velaoras, Roland Leyson, Rayad B. Shams, Alexandra Turfe, Andrea Dai, Mohsen Mokhtari, Sarah Bassett, Joshua Vazhappilly, Richard W. Hass, Iltefat Hamzavi, Christopher J. Sayed, Qing-Sheng Mi, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Adalimumab is widely used for hidradenitis suppurativa (HS), but treatment durability varies and predictors of sustained benefit remain uncertain.

OBJECTIVE: To identify clinical and laboratory factors associated with adalimumab treatment durability in HS.

METHODS: We retrospectively studied 135 adults with HS who initiated adalimumab as first biologic therapy across three academic centers from 2013 to 2023. Outcomes were categorized as primary failure (12-24 weeks), secondary failure (24 weeks-2 years), or sustained response (>2 years) based on discontinuation for inefficacy. Predictors of treatment durability were evaluated using ordinal logistic regression.

RESULTS: In univariable analyses, Hurley stage 3, higher body …

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu

Walden Dissertations and Doctoral Studies

The utilization of substance use disorder (SUD) screening tools at the practice site was inconsistent, contributing to limited identification and diagnosis of SUDs. The project was conducted at a psychiatric outpatient clinic in an urban region of Maryland that serves many patients with co-occurring mental health and substance use disorders. The purpose of the project was to develop, implement, and evaluate a staff education program focused on the Drug Abuse Screening Test (DAST-10). The primary goal was to improve staff knowledge and understanding of the DAST-10 screening tool. A 14-item multiple-choice questionnaire was administered before and after the educational intervention …

Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams

Walden Dissertations and Doctoral Studies

Pulmonary hypertension (PH) is a progressive, life-limiting disease that significantly affects quality-of-life (QoL). Limited research has explored lived experiences of individuals with PH. Guided by Parse’s human becoming theory, this qualitative descriptive phenomenological study explored the lived experiences of individuals affected by PH and examined how activity-induced respiratory distress affected QoL. The research Question was: How do individuals with PH describe the impact of activity-induced respiratory distress on their QoL. I conducted interviews with nine participants, including eight adults diagnosed with PH and one caregiver of an individual with PH. Data were analyzed using Saldaña's comparative coding framework to identify …

Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening condition that can rapidly lead to organ dysfunction, septic shock, and death if not recognized and treated early. Older adults in skilled nursing facilities (SNFs) are especially vulnerable because of age-related physiological changes, chronic conditions, weakened immunity, and increased exposure to infections. Consequently, sepsis remains a major cause of hospital readmissions, mortality, and healthcare utilization among SNF residents. The SNF serving as the site for this Doctor of Nursing Practice (DNP) project experienced increased hospital readmissions associated with recurrent sepsis, highlighting the need for a standardized, evidence-based approach to sepsis recognition and management. The practice-focused question …

Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey

Walden Dissertations and Doctoral Studies

Many nurses receive little formal instruction about trauma-informed principles and their practical application in behavioral health settings. To address this practice gap, the project implemented a staff education program for staff at an intensive outpatient program (IOP) and a partial hospitalization program (PHP) located in a northeastern state. The aim was to increase staff knowledge and confidence in trauma-informed principles within clinical practice. The education program emphasized the relevance of trauma-informed care (TIC) in outpatient behavioral health settings, its principles, and its application in nursing assessments, therapeutic communication, and patient interactions. A pretest and posttest questionnaire consisted of 12 multiple-choice …

Exploring The Impact Of Spiritual Fitness On Combat Veterans In Their Recovery From Ptsd, Chronic Pain, And Sleep-Related Impairments, Minnette Danielle Sandoval Cornish

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore how combat veterans utilize and perceive spiritual practices in their recovery from PTSD chronic pain, and sleep-related impairments (SRIs). Guided by Self-Determination Theory (Deci & Ryan, 2017) the study sought to understand which spiritual practices combat veterans used, how they incorporated the practice into recovery, and how they perceived the impact of those practices in managing their symptoms. Participants included 13 combat veterans who self-identified as using spiritual practices in their recovery from PTSD, chronic pain, and SRIs. Data was collected through semi-structured interviews and a focus group. Interview and focus …

Osteoarthritis In Saudi Arabia: Current Evidence, Public Perceptions, And Future Research: A Narrative Review, Khalid Yaseen

Journal of Medical Rehabilitation Science

Background and Purpose: Osteoarthritis (OA) is a leading cause of pain and disability worldwide and represents a growing public health concern in Saudi Arabia. This narrative review synthesises current evidence on OA in the Saudi context, with particular emphasis on epidemiology, risk factors, public perceptions, clinical management patterns, and the utilisation of physiotherapy and other conservative interventions. The aim is to inform clinical practice, public health strategies, and health system planning in alignment with Saudi Vision 2030.
Methods: A narrative review was undertaken, drawing on evidence from PubMed/MEDLINE, Scopus, Web of Science, Saudi Digital Library, Ministry of Health (Saudi Arabia) …

Cells And Networks In Flux: Rethinking Ontogenesis And Pathogenesis, Mark L. Tykocinski

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Organ and tissue functions emerge from the coordinated activity of cell networks. Therapeutics that act on pathogenic cell networks, modulating their cellular interplay, follow naturally. Over several decades, our laboratory has developed a series of approaches for rewiring cell networks, culminating in a class of cell surface-directed signal converter proteins (SCPs) that do so by modulating juxtacrine and autocrine signaling in and among their nodal cells. A first such SCP has now produced encouraging clinical data for cancer immunotherapy. Yet, these early network-directed fusion proteins rest on a deliberately simplified picture: discrete end-cell types plugged into graphically tractable networks. That …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Predictors Of Academic Performance In First-Year Bsn Students: The Role Of Emotional Exhaustion, Alcohol Use, And Resilience, Jennifer Nerius

Doctoral Dissertations and Projects

The first year of nursing school can be academically demanding and emotionally challenging as students adjust to rigorous coursework, clinical expectations, and professional responsibilities. Understanding factors that influence student well-being and academic success is important for supporting students during this transition. The purpose of this quantitative longitudinal correlational study was to examine the relationships among emotional exhaustion, alcohol use, resilience, and academic performance in first-year Bachelor of Science in Nursing (BSN) students. Guided by Resilience Theory, the study explored whether resilience was associated with emotional exhaustion and alcohol use and whether emotional exhaustion, resilience, and alcohol use predicted academic performance. …

Implementation Of Staff Education To Reduce Or Prevent Pressure Injury, Beverley A. Moses

Doctoral Dissertations and Projects

Pressure injuries (PIs) present a significant clinical challenge in healthcare settings, particularly among patients with limited mobility, comorbidities, and complex musculoskeletal injuries. These injuries lead to adverse patient outcomes, such as increased morbidity, prolonged hospital stays, and an increase in healthcare costs. Despite advancements in clinical practice, PI prevention remains a critical area for quality improvement, necessitating a standardized, patient-centered approach to care. This Doctor of Nursing Practice (DNP) project aimed to improve patient outcomes by implementing a standardized educational initiative for nursing staff in a bone and joint unit at a private hospital in Upstate New York. The project …

Navigating The Maternal Health Crisis: Enhancing Maternal Health Outcomes In New Jersey, Nyrobi Barnes

Doctoral Dissertations and Projects

The purpose of the study was to better understand the implications of race and ethnicity on perinatal health experiences and maternal health outcomes in non-Hispanic Black women (nHBw) in New Jersey and mitigate the maternal health crisis. A secondary outcome was to propose an evidence-based initiative to elicit equitable care in New Jersey via grant-funded programs at the New Jersey Department of Health. Although New Jersey has made progress in improving maternal and infant health outcomes, racial disparities continue to persist. The research aims to further understand implications of race and ethnicity on adverse perinatal health experiences and maternal health …

Staff Education To Primary Care Staff About The Standardized Asthma Control Test, Paulina Asiedu

Walden Dissertations and Doctoral Studies

Staff Education to Primary Care Staff About the Standardized Asthma Control Test by Paulina Asiedu Walden University, 2026. Background Inconsistent primary care asthma tracking leads to reactive management and avoidable emergency utilization. At a Minnesota community clinic, baseline electronic health record (EHR) audits revealed validated Asthma Control Test (ACT) scores were documented in only 5% of eligible encounters, driving a 12% emergency department utilization rate. Purpose & Methods This Doctor of Nursing Practice quality improvement project evaluated whether educating primary care staff on a standardized ACT protocol improved clinical knowledge, behavioral intent, and documentation compliance. Using ADDIE and ADKAR change …

Promoting Scientific Impact At The Nih, Fred D. Ledley M.D.

CISI Publication

We are honored to offer our comments on Promoting Scientific Impact at the NIH in response to NOT-OD-26-087: Request for Information on Measuring and Rewarding Scientific Impact.

These comments are informed by my professional experience as the founding director of the Center for Integration of Science and Industry at Bentley University, which has a mission to “advance the translation of scientific discoveries for public value by engaging science, business, and policy in transdisciplinary dialogue, scholarship, and education.” Our approach is to bring together the perspectives of natural science, business, analytics, economics, law, and policy to better understand, and advance, the …

Can The Safety Net Support Families Through Childbirth?, Hyojeong Kim, Colleen Heflin, Taryn Morrissey

Center for Policy Research

Childbirth is a life event that often disrupts maternal employment and household earnings just as family expenses increase. In the United States, families do not have access to a national paid parental leave program and must rely on a patchwork of safety net programs that were not designed specifically to support households during pregnancy and the immediate postpartum period. This brief uses linked administrative data from the Virginia Longitudinal Data System (2016–2021) to describe changes in household earnings and social welfare benefits before and after childbirth among low-income mothers receiving the Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for …

Implementation Readiness For National Cancer Survivorship Care Standards, Christiane J. El Khoury, Meera Gupta, Maryem Shirzadi, Heidi Dowst, Martha Mims, Maysa Abu-Khalaf, Hoda Badr

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Cancer survivorship care is a growing public health priority, yet delivery remains variable across health systems. The National Standards for Cancer Survivorship Care provide a framework for high-quality care, but little empirical evidence exists regarding health system readiness to implement these standards in routine practice.

OBJECTIVE: To assess implementation readiness for the National Standards for Cancer Survivorship Care and identify perceived barriers to implementation.

DESIGN, SETTING, AND PARTICIPANTS: This real-time Delphi survey study was conducted from January to March 2025 at a National Cancer Institute-designated comprehensive cancer center. Participants were multidisciplinary experts involved in cancer survivorship care delivery, care …

Nascent Adam17 Synthesis Potentiates Gpibα Cleavage In Resting And Stimulated Stored Platelets, Shayan Askari, Harriet Ghansah, Christopher D. Mansi, Timothy J. Stalker, Lawrence E. Goldfinger

Cardeza Foundation for Hematologic Research

Platelet concentrates stored at room temperature have a shelf life of 5 to 7 days. During storage, platelets undergo glycoprotein cleavage by metalloproteases, notably cleavage of glycoprotein Ibα (GPIbα) by a disintegrin and metalloprotease 17 (ADAM17), which leads to decreased posttransfusion reactivity and recovery. To investigate the putative roles of nascent synthesis of ADAM17 in GPIbα shedding and platelet function during room temperature platelet storage. Human platelets maintained in autologous plasma were treated with naked endonuclease-resistant ADAM17 or control short inhibitory RNA (siRNA) and monitored for molecular and cellular effects during storage. Platelet-specific Adam17-deleted mice were generated, and the dynamics …

Guideline For Early Identification Of Chronic Kidney Disease In At-Risk Adults In Primary Care, Catherine Ugo

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on developing and validating a clinical practice guideline (CPG) to improve the early identification of chronic kidney disease (CKD) among at-risk adults in a primary care practice. The project addressed a site-specific practice gap involving the inconsistent use of evidence-based CKD screening, particularly estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) testing, which may delay diagnosis and treatment (Kidney Disease: Improving Global Outcomes [KDIGO] CKD Work Group, 2024). The purpose of this project was to develop an evidence-based CPG and evaluate its quality using the Appraisal of Guidelines for Research and …

Implementing A Structured Lifestyle Counseling Program To Improve Weight Management In Obese Adults Ages 18–65 Within The Private Primary Care Setting, Ntoge Sone Penda

Walden Dissertations and Doctoral Studies

Obesity is a major public health concern that affects millions of adults. As a chronic, progressive disease, obesity increases the risk of developing several medical conditions. Although evidence-based clinical practice guidelines recommend comprehensive lifestyle modification as a first-line treatment, implementation of structured lifestyle counseling in primary care remains inconsistent. The practice-focused question guiding this Doctor of Nursing Practice (DNP) quality improvement project was: Among obese adults aged 18–65 years in a private primary care setting, does implementing a structured lifestyle counseling program improve body weight and body mass index (BMI) outcomes over an 11-week period? An organizational change process guided …

Improving Interdisciplinary Healthcare Staff Confidence And Competence In Screening, Brief Intervention, And Referral To Treatment Through Standardized Sbirt Training In A Behavioral Health Facility, Grace Kakie Awo Aidoo

Walden Dissertations and Doctoral Studies

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach for the early identification and management of substance use concerns. However, inconsistent implementation may occur when healthcare staff lack confidence and competence in applying SBIRT in clinical practice. This Doctor of Nursing Practice staff education project addressed a practice gap related to low confidence and competence among interdisciplinary healthcare staff implementing SBIRT in a behavioral health facility. The purpose of the project was to implement and evaluate a standardized SBIRT education and competency-based training program. Guided by the Johns Hopkins evidence-based practice model, the educational intervention incorporated evidence-based …

International Federation Of Clinical Neurophysiology Standardized Stereo-Electroencephalography Terminology, Birgit Frauscher, Guoping Ren, Chifaou Abdallah, Fabrice Bartolomei, Milan Brazdil, Francine Chassoux, Patrick Chauvel, Mark Cook, Beate Diehl, Guada Fernandez Baca Vaca, Stefano Francione, Vadym Gnatkovsky, Walter Gonzalez, Akio Ikeda, Jean Gotman, Julia Jacobs, Lara Jehi, Philippe Kahane, Hui Ming Khoo, Sam Lhatoo, Louis Maillard, Daniel Mansilla, Aileen Mcgonigal, Ioana Mindruta, Dang Khoa Nguyen, Piero Perucca, Ivan Rektor, Sylvain Rheims, Philippe Ryvlin, Stephan Schuele, Andreas Schulze-Bonhage, Margitta Seeck, Jaysingh Singh, Michael Sperling, Rainer Surges, Laura Tassi, Eugen Trinka, Manjari Tripathi, Shuang Wang, Samuel Wiebe, Gregory Worrell, Sandor Beniczky

Department of Neurology Faculty Papers

OBJECTIVE: Stereo-electroencephalography (SEEG) is an intracranial EEG methodology used in presurgical epilepsy evaluation to precisely delineate the epileptogenic zone and associated networks. Although established for decades, its global adoption has accelerated due to a favorable safety profile and clinical effectiveness. However, inconsistent terminology limits comparability of findings and multicenter collaboration. This guideline addresses this gap by providing standardized SEEG terminology based on international consensus.

METHODS: A working group of 41 experts appointed by the International Federation of Clinical Neurophysiology (IFCN) Executive Committee used a modified Delphi process to develop standardized terminology. The process included two meetings and four Delphi rounds, …

08-19-26 Bor Hsc Committee Meeting Agenda, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

08-19-26 BOR HSC Committee Meeting Agenda