Digital Commons Network^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

Avian Influenza And The Approach To Designing An H5n1 Vaccine, Lauren N. Hickey

Honors Program: Senior Projects (Public)

The Avian influenza virus (AIV) H5N1 has been responsible for the culling and deaths of millions of birds since 2022 with concern for wildlife, livestock, and human infections occurring as well. With eggs flying off the shelves in grocery stores, even individuals not involved in the agricultural industry have seen the drastic effects of this disease first-hand. For chickens, this virus works quickly and overpowers the innate immune system before the adaptive immune system has time to properly respond. Therefore, a safe and effective vaccine could reduce the number of poultry deaths and prevent the continuous spread of the infection. …

Reflecting On Psychotherapy In Adolescence: A Qualitative Analysis Of Processes Of Change, John Parigger

Electronic Theses and Dissertations

There is a sharp increase in anxiety and depression symptoms in adolescence, and many forms of psychotherapy are shown to be effective. However, most research has examined average effects for manualized treatments that address multiple areas of functioning, which makes it difficult to determine how psychotherapy causes positive change. Process-based therapy postulates that all psychotherapies work through promoting adaptive biopsychosocial patterns of behavior (i.e., processes of change). Research has increasingly focused on the process-based therapy model, and there is a need for qualitative studies to incorporate lived experience into our understanding of change processes. The current study utilized the process-based …

Sanctuary: Counter-Oppressive Relationships With Farmed Animals As An Ecopsychological Imperative, Kelsey Bomboy

The International Journal of Ecopsychology (IJE)

Consumers are intentionally shielded from and often misled about the process of breeding, raising, and slaughtering animals for consumption. By confining most farmed animals to warehouses in rural areas while the majority of humans are sequestered in urban areas, we have effectively created a world where humans do not have to contend with the sense of interconnectedness that arises when witnessing and being witnessed by a farmed animal. Within industrial slaughterhouses, the physical act of killing is minimized to just a fraction of the workers, so that even those who are responsible for rendering a once living being will never …

Loneliness And Social Isolation: Finding Connection Through Art, Elijah K. Wong

Art Therapy | Master's Theses

This study explored whether creativity might help alleviate feelings of loneliness and social isolation. The COVID-19 pandemic was an extraordinary event that significantly impacted people's emotional, physical, psychological, and social health globally. To gain insight into these impacts, the research focused on participants’ creative activities and their experiences of loneliness during and after the pandemic. The aim was to find possible links between making and viewing art and reducing feelings of loneliness and loneliness-related experiences. Ten participants were surveyed and asked about their artistry, their time during the COVID-19 pandemic, and their sense of belonging to a community. This investigation …

Shadow Garments: Costume Creation For Integrating Alienated Parts Of The Self, Mega M. Galvin

Art Therapy | Master's Theses

This study explores costume creation as a narrative-based intervention for integrating "shadow" parts, or aspects of the self that are repressed or alienated due to shame, trauma, or social pressure. Grounded in Jungian analytic psychology, narrative therapy, and expressive arts theory, the research addresses the limitations of traditional talk therapy in accessing somatic memory and proposes costume making as a pathway for externalization and re-authorship. Using a qualitative, participatory study inspired by Pat B. Allen’s Open Studio Process, four adult participants engaged in a three-session workshop to design, construct, and wear costumes representing their identified shadow aspects. Data was collected …

Restorative Environments And Therapeutic Artmaking: A Strengths-Based Art Gallery Workshop To Enhance Well-Being In Emerging Adults, Jeannine Case

Art Therapy | Master's Theses

Emerging adults aged 18 to 29 face increased mental health risks yet encounter considerable barriers to traditional care, which highlights the need for accessible, preventive alternatives. This mixed-methods pilot study investigated whether an art gallery environment could serve as a supportive setting for a strengths-based, positive art therapy-informed wellness workshop aimed at promoting well-being for this population. Six participants between the ages of 20 and 27, all enrolled in post-secondary education, took part in this study. Five identified as female and one as male. Three participants (50%) identified as Hispanic/Latino, one as Asian, one as White, and one as Hispanic/Latino …

Comparing Monoclonal Antibodies Targeted At Amyloid-Beta Plaques’ Efficacy To Acetylcholinesterase Inhibitors In Alzheimer’S Disease Management, Megan B. Hardy

The PA Department Journal of Medical Science

Alzheimer’s disease is a detrimental neurodegenerative disorder that is the leading cause of dementia worldwide. Without a cure, this disease slowly robs patients of their dignity and livelihoods. Traditionally, pharmacologic management has relied on symptomatic relief with acetylcholinesterase inhibitors (AChEIs). However, new monoclonal antibodies (mAbs) targeting amyloid-beta plaques may be the first disease modifying therapy. The purpose of this clinical review was to compare the efficacy, safety, and clinical utility of mAbs and AChEIs in the management of Alzheimer’s disease.

A comprehensive PubMed search was conducted through June 2026 using terms related to monoclonal antibodies, acetylcholinesterase inhibitors, and Alzheimer’s disease. …

Biologic Therapies Versus Methotrexate In Psoriatic Arthritis Management: A Literature Review, Yisel Ramos

The PA Department Journal of Medical Science

Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease that can cause progressive joint damage, functional impairment, and reduced quality of life. Methotrexate (MTX) is commonly used as a systemic therapy, while biologic therapies target specific inflammatory pathways. This review evaluated the efficacy and safety of biologic therapies compared with MTX in adults with PsA.

Methods: A PubMed/MEDLINE search identified studies evaluating biologic therapies and MTX in adults with PsA. Four publications were included based on methodological quality, clinical relevance, and applicability to the PICO question. Outcomes included joint symptoms, disease activity, physical function, radiographic progression, and adverse …

Efficacy Of Sglt2 Inhibitors In The Management Of Polycystic Ovarian Syndrome, Paige N. Curtis-Campbell

The PA Department Journal of Medical Science

Introduction: Polycystic ovarian syndrome (PCOS), recently proposed to be termed polyendocrine metabolic syndrome (PMOS), is a complex multifactorial disorder commonly associated with obesity, hyperandrogenism, infertility, and insulin resistance. First-line treatments for metabolic characteristics include lifestyle modifications and metformin; however, metabolic abnormalities may persist. Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent a potential therapeutic agent due to their effects on insulin resistance, glucose metabolism, and body weight.

Methods: A literature search of PubMed identified studies examining SGLT2 inhibitors in women with PCOS compared to metformin, standard therapies, or placebo. The search was restricted to randomized controlled trials (RCTs), systematic reviews, and meta-analyses available …

Effect Of Intramedullary Nailing Vs Plate Fixation On Bone Union Time In Distal Tibial Fractures, Madeline Wasmund

The PA Department Journal of Medical Science

Distal tibia fractures are complex fractures due to the intricate anatomy and minimal soft-tissue protection. There are currently two techniques that are mainstays for repairing a distal tibia fracture: intramedullary nailing and plate fixation. This study explores the bone union time between these two different techniques. PubMed was searched with a specific search strategy using the terms “intramedullary rod”, “plate/screw fixation”, “tibial fractures”, and “time to bone union.” Filters were applied to find articles that were most relevant, which resulted in 4 articles, each of which was appraised. Three articles were systematic reviews/meta-analyses comparing intramedullary nail fixation and plate fixation …

Vitamin D And The Expression Of Systemic Lupus Erythematosus (Sle), Sonephet S. Phoumsavath

The PA Department Journal of Medical Science

Introduction: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that disproportionately affects women and minority populations, carrying significant morbidity. The purpose of this literature review is to analyze the effectiveness of vitamin D supplementation in reducing disease activity in SLE patients, compared with none.

Methods: PubMed was searched using a specific strategy with key terms including "vitamin D," "systemic lupus erythematosus," and "disease activity." Boolean operators and filters included a five-year publication limit and restriction to randomized controlled trials (RCTs), systematic reviews, and meta-analyses. This narrowed the results to five quality articles for review.

Results: Two meta-analyses and …

The Role Of Probiotics As Adjunctive Therapy In The Treatment Of Depressive Disorders, Maritza Lopez

The PA Department Journal of Medical Science

Major depressive disorder (MDD) is a common psychiatric disorder that remains difficult to treat for many patients despite available therapies. The purpose of this clinical review was to evaluate the effectiveness of adjunctive probiotic supplementation for adults with major depressive disorder. PubMed was searched using key terms including major depressive disorder, probiotics, Lactobacillus, Bifidobacterium, and gut-brain axis. Search filters and eligibility criteria narrowed the results to six relevant articles for review, including one randomized clinical trial, four systematic reviews, and one clinical practice guideline. Overall, the included studies generally reported reductions in depressive symptom severity and favorable safety …

Prevention Of Chronic Migraine With Injection Medications: Onabotulinumtoxina Vs Monoclonal Antibodies, Jillian Jesser

The PA Department Journal of Medical Science

Introduction: Adults diagnosed with chronic migraine (CM) frequently experience severe pain, nausea, vomiting, sensitivity to light or sound, and blurred vision. All of which are not conducive to routine daily functioning. The purpose of this review article is to explore the efficacy of preventative medications for CM such as OnabotulinumtoxinA injections (onabotA) and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs).

Methods: PubMed was searched using “OnabotulinumtoxinA,” “chronic migraines,” and “monoclonal antibodies”, and related branch terms. The 263 results of this search were reduced to 20 with the following filters: published date 2020-2025, randomized controlled trials (RTCs), systematic review, meta-analysis, free …

Restrictive Fluid Resuscitation With Early Vasopressor Initiation Vs Liberal Fluid Resuscitation In Adults With Septic Shock: A Review Of Mortality And Clinical Outcomes, Gabriel Locke

The PA Department Journal of Medical Science

Introduction

Septic shock is a life-threatening medical emergency characterized by profound hypotension, impaired organ perfusion, and significant risk of mortality. While large fluid resuscitation has been considered the commonplace, emerging evidence of increased adverse outcomes has prompted further investigation into restrictive fluid strategies in combination with early vasopressor use.

Methods

PubMed was searched with key terms “septic shock”, “vasopressors”, “norepinephrine”, “restrictive fluid resuscitation”, “liberal fluid resuscitation”, and “mortality”. Operators and filters were implemented such as randomized control trial, systematic reviews, meta-analyses published between 2021 and 2026. After applying these filters. Of the 39 results, 4 articles were selected based on …

The Bidirectional Effects Of Traumatic Brain Injury And Caudal Fin Amputation On Regeneration In Zebrafish (Danio Rerio), Makenna Wiebe

Theses and Dissertations (Comprehensive)

Traumatic brain injury (TBI) and caudal fin amputation initiate robust regenerative responses in adult zebrafish (Danio rerio), yet whether regenerative activity in one tissue influences repair at a distant site remains unclear. This study investigated the bidirectional effects of concurrent brain and peripheral injury on regeneration and functional recovery. Specifically, we assessed the effects of TBI on caudal fin regeneration, caudal fin amputation on neural stem cell-associated cellular responses, and combined injury on behaviour. Adult zebrafish received no injury, TBI, caudal fin amputation, abdominal puncture, or combined TBI and caudal fin amputation. I assessed caudal fin regeneration morphometrically and evaluated …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

Mucin-Derived Sugars Act As Metabolic Brakes Controlling Growth Initiation In Akkermansia Muciniphila, Bryan D Lakey, Katherine J Wozniak, Robert A Britton, Jeffrey J Tabor

Faculty, Staff and Students Publications

Akkermansia muciniphila is a key member of the gut microbiota and plays important roles in host metabolism and health. In the colon, A. muciniphila extracts nutrients from oligosaccharide-rich mucin glycans that comprise the mucosa. However, this environment is complex and shaped by dietary inputs, microbiome metabolism, and mucin glycan composition varying across hosts, gastrointestinal regions, and physiological states. How strains of A. muciniphila integrate these nutrient signals into growth initiation and niche colonization remains unclear. Here, we compare physiological responses of a human- and mouse-derived strain of A. muciniphila, finding that dietary sugars differentially affect these isolates, suggesting host-associated …

Gut-Derived Bacterial Extracellular Vesicles: The Microbial Dark Matter Contributing To Host Inflammation And Cardiometabolic Disease, Blayne Oliver, Michael Sun, Young Seo Lee, Ssanggoo Cho, Tianyi Zhu, David Durgan, Gary Sweeney

Faculty, Staff and Students Publications

Cardiometabolic diseases (CMDs) represent a growing global health burden, with chronic inflammation and gut microbiota dysbiosis emerging as central contributors to their pathogenesis. Among the diverse microbial products influencing host physiology, bacterial extracellular vesicles (BEVs) have gained attention as potent mediators of interkingdom communication. These nanoscale vesicles, secreted by both gram-positive and gram-negative bacteria, carry a complex cargo of proteins, lipids, nucleic acids, and pathogen-associated molecular patterns (PAMPs) that interact with host pattern recognition receptors (PRRs) to modulate immune and metabolic responses. BEVs can traverse intestinal barriers, disseminate systemically, and accumulate in cardiometabolic tissues, where they influence inflammation, insulin sensitivity, …

When Probiotics Guidelines Differ: A Practical Guide For Clinicians And Researchers, Howard Bauchner, Daniel J Merenstein

Faculty, Staff and Students Publications

Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations …

Steroid Receptor Coactivator 3-Deficient Regulatory T Cells Eradicate Multiple Solid Tumors In Syngeneic Mouse Models, Yuri Park, Adam M Dean, Yan Xia, Jianming Xu, Clifford C Dacso, David M Lonard, Sang Jun Han

Faculty, Staff and Students Publications

Steroid receptor coactivator 3 (SRC-3) is highly expressed in regulatory T cells (Tregs) and is important for their immunosuppressive activity. Recently, we demonstrated that disrupting SRC-3 expression in Tregs eliminates triple-negative breast cancer (TNBC) and prostate cancer in syngeneic animal models by generating an anti-tumor immune microenvironment without inducing immune-related adverse events (irAEs). Further analysis of these mice revealed that SRC-3 knockout (KO) Tregs infiltrated breast tumors and facilitated the infiltration of CD8

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Is Your Cyst Really A Ganglion Cyst? A Case Report Of Angioleiomyoma Mimicking A Plantar Fascia Cystic Lesion, Christopher Anjorin Ms Dpmc, Joseph Bender Dpm

School of Podiatric Medicine - Student Research

Ganglion cysts are among the most common benign soft tissue masses encountered in podiatric clinical practice, and their diagnosis is often presumed based on location, clinical observation, and transillumination. However, this case highlights a diagnostic idiosyncrasy: a lesion clinically presumed to be a ganglion cyst within the plantar fascia was ultimately identified as an angioleiomyoma following surgical excision and histopathological evaluation. This finding underscores the importance of maintaining a broad differential diagnosis when assessing cystic lesions, particularly those that transilluminate, as benign vascular tumors may closely mimic more common entities in both clinical presentation and imaging. More importantly, what if …

Deep Brain Stimulation In Early-Stage Alzheimer's Disease: A Systematic Review Of Neuropsychological Outcomes, Nora Huey

Doctoral Dissertations

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory impairment, and disruption of neural networks involved in cognitive functioning. Although existing treatments may provide symptomatic benefit, there remains a need for interventions capable of slowing or stabilizing disease progression. Deep brain stimulation (DBS) has emerged as a potential neuromodulatory intervention for early-stage AD through stimulation of memory- and cognition-related neural circuitry. This dissertation employed a systematic review research methodology to examine teh neuropsychological and neurobiological outcomes associated with DBS targeting the fornix (DBS-f) and nucleus basalis of Meynert (DBS-NBM) in individuals with early-stage AD over 12–24 …

Interplay Of Autophagy And Mtor Signaling On Amyloid-Beta, Samuel Wycoff

WUSM Theses and Dissertations – All Programs

Alzheimer's disease (AD) is characterized by the accumulation of amyloid-β (Aβ), a process thought to result from an imbalance between Aβ production and clearance. Autophagy, a major intracellular degradation pathway regulated by the mechanistic target of rapamycin (mTOR), has emerged as a potential therapeutic target for restoring Aβ homeostasis, although its precise role in Aβ metabolism remains unclear. This study investigated how pharmacological modulation of autophagy and mTOR signaling influences Aβ levels in both in vitro and in vivo models.

Wild-type SH-SY5Y neuroblastoma cells were treated with a panel of autophagy-modulating compounds, and extracellular Aβ secretion was quantified alongside the …

Surveillance And Comparative Genomics Of Bacteria From Hospital And Human Reservoirs, Emily E. Benedict

WUSM Theses and Dissertations – All Programs

Bacteria are diverse and adaptable and, consequently, present in a wide variety of environments. They are capable of growing under intense pressures, including those brought on by the human immune system and disinfection strategies. To survive these pressures, bacteria develop resistances. Antimicrobial resistance, which occurs when a microbe is no longer responsive to the antibiotic intended to control it, is one such adaptation that presents an especially serious threat, as it limits treatment options for infections caused by antimicrobial resistant microbes. Similarly, the ability of bacteria to survive in environments subjected to heavy disinfection efforts, such as intensive care units …

Multiomic And Single-Cell Analysis Of Tumors And Their Immune Microenvironment For Personalized Cancer Therapy, Kartik Singhal

WUSM Theses and Dissertations – All Programs

Precision oncology aims to match cancer treatment to the biology of an individual patient’s tumor. However, tumors that share a diagnosis can differ in their molecular features, cellular composition, clinical course, and response to therapy, making it difficult to determine which treatment will benefit an individual patient. This dissertation integrates genomic, transcriptomic, and single-cell multiomic computational analysis to characterize tumors across their somatic alterations, transcriptional cell states, microenvironment, and the immune response they elicit.

The first study describes a rare case of donor-derived follicular lymphoma following kidney transplantation. Genomic profiling showed that the donor and recipient tumors shared 31 somatic …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Associations Between Trpm4 Gene Variants And Intracranial Pressure Dynamics Following Traumatic Brain Injury, Emily H. Saweris

Summer Research Program Abstracts

No abstract provided.

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …