Digital Commons Network^™

Implementation And Effectiveness Of An Enhanced Recovery Protocol For Children Undergoing Surgery: The Enrich-Us Stepped-Wedge Cluster-Randomized Trial, Mehul V Raval, Yao Tian, Willemijn Schäfer, Salva N Balbale, Mallory N Perez, Martha-Conley E Ingram, Alison Lehane, Charesa J Smith, Gwyneth A Sullivan, Audra J Reiter, Andrew Hu, Johanna M Borst, Sarah C Blake, Sharron Close, Teaniese L Davis, Bonnie S Essner, Kurt F Heiss, Lynn W Huang, Erin Wymore, Deysi Paniagua-Perez, Kirsty M Engelhardt, Peter M Graffy, Julie K Johnson, Craig W Lillehei, Brian W Gray, Seth D Goldstein, Scott S Short, Samir R Pandya, Janice A Taylor, Christopher Gayer, Adam B Goldin, Matthew M Boelig, Kristy L Rialon, Tim Jancelewicz, Aaron M Lipskar, Mubeen Jafri, Elisabeth T Tracy, Matthew T Harting, Jason P Sulkowski, P Benson Ham, Kaveh Vali, Robert A Cina, David T Schindel, Saleem Islam, Erin A Teeple, Sohail R Shah, Ankush Gosain, David H Rothstein, Megan A Brockel, Jillian Chown, Jane L Holl

Faculty, Staff and Student Publications

Importance: Despite evidence that enhanced recovery protocols (ERPs) improve outcomes in adults undergoing surgery, adoption for pediatric populations has lagged.

Objective: To assess the implementation and clinical effectiveness of a consensus-based ERP for pediatric patients undergoing elective gastrointestinal (GI) surgery.

Design, setting, and participants: A prospective type 2 hybrid implementation-effectiveness, stepped-wedge, cluster-randomized by entry date into implementation phase, trial of pediatrics patients, 10 to 18 years of age, undergoing elective GI surgery at 18 US sites from September 2019 to June 2024.

Interventions: Sites were randomized into 3 groups, each spending at least 9 months in a control phase, with …

A Lifecycle Governance And Learning Health System Framework For Trustworthy, Generalizable, And Sustainable Human-Ai Partnership In Clinical Practice: Lessons From The Asthma-Guidance And Prediction System (A-Gps), Chung-Il Wi, Shauna Overgaard, Momin Malik, Dave Watson, Deepak Sharma, Jennifer Le-Rademacher, Dan Kelleher, Lu Zheng, Joshua Ohde, Brian Lynch, Ashwani Khurana, Sunghwan Sohn, Mahmoud M Aljuhani, Chris Carpenter, Manuel Arteta, Jason Greenwood, Martha Hartz, Randy Foss, Elif Polat, Imad Absah, Carla Davis, Meera Gupta, Lynnea Myers, Björn Nordlund, Cui Tao, Mark L Wieland, Christi Patten, Amie Jones, Prathibha Varkey, Brenna T Loufek, David E Vidal, Nari Gopala, Eric Klee, Vijay H Shah, John D Halamka, Matthew R Callstrom, Nicholas L Rider, Hongfang Liu, Constantin Aliferis, Vesna D Garovic, Young J Juhn

Faculty, Staff and Students Publications

The integration of artificial intelligence (AI) into clinical decision support (CDS) holds promise for proactive, personalized, and precision care. However, current understanding of how to establish trustworthy human-AI partnerships is in its infancy, despite its critical importance for implementing AI in healthcare. We present the Asthma-Guidance and Prediction System (A-GPS) as a case study of a practice-integrated AI platform that demonstrates how trustworthy, generalizable and sustainable AI can be developed, evaluated, and implemented in real-world asthma care. We describe major challenges and solutions based on our real-world experience during the process and offer the practical framework, approaches, tools and workflow …

A Study Of Descriptive Values Of Echocardiography In Unanesthetized Syrian Hamsters, Kasidit Ladkhoksung, Nattapart Lerdkarnvijai, Thanakorn Ngamsawat, Napassorn Napassorn, Suphisara Chantharadech, Pattharat Asvaesoontorn, Thawat Lekdumrongsak, Sirilak Surachetpong

The Thai Journal of Veterinary Medicine

The Syrian hamster (Mesocricetus auratus) is the most commonly presented hamster species in veterinary practice, yet descriptive echocardiographic values remain limited, particularly under conscious conditions. This study aimed to establish normal two-dimensional, M-mode, and Doppler echocardiographic values in healthy conscious Syrian hamsters and to evaluate the influence of age, body weight, and sex on cardiac parameters. Forty Syrian hamsters (27 males and 12 females; one excluded) underwent physical examination, thoracic radiography, and echocardiography. Age and body weight were recorded. Echocardiographic parameters were analyzed for their distribution and correlation with age and body weight. All echocardiographic parameters demonstrated a …

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

Walden Dissertations and Doctoral Studies

No abstract provided.

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 …

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 …

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 …

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 …

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 …

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. …

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 …

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: …

Accesstem: How Small Colleges Can Open Stem Pathways For Local High School Students, Dina D. Isakov

Program in Community Action (PICA)

This paper reflects my experience developing ACCESStem as part of the Program in Community Action (PICA) center at Connecticut College. ACCESStem is a community-engaged research project designed to create hands-on, lab-based STEM workshops for local high school students in New London. ACCESStem was built on the premise that even small liberal arts colleges can hold a meaningful impact on helping diversify the science workforce. Over the course of three years, this project took shape through my relationships with STEM faculty on campus and relationships with staff at the Holleran Center for Community Action. This paper works to begin contextualizing the …

Establishing The Division Interprofessional Council By Using Magnet Principles, Warisara Manuel

Walden Dissertations and Doctoral Studies

No abstract provided.

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

Faculty, Staff and Student Publications

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

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

Faculty, Staff and Students Publications

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

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

Faculty, Staff and Students Publications

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

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

2026 Spring Honors Capstones Projects

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

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

Oral Health

Abstract

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

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

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

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

Honors Capstones

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

From Exploitation To Healing: Mental Health And Resilience Among Native American Survivors Of Sex Trafficking, Katelin A. Stoebner

Honors Thesis

The mental health impacts of sex trafficking on Native American survivors and pathways to resilience are important to understanding healing. Native Americans are disproportionately affected by sex trafficking due to systemic inequities, historical trauma, and socioeconomic vulnerability. Using interviews with 47 Native survivors conducted as part of a larger Office on Violence Against Women project, this study analyzes the mental health challenges and recovery strategies identified by participants. Findings reveal that survivors commonly experience significant psychological effects, including post-traumatic stress disorder (PTSD), depression, and anxiety. Among participants, PTSD emerged as the most frequently reported condition, followed by depression and anxiety, …

Care, Control, And The Racial Regulation Of Black Women’S Reproduction In American Medicine, Rheya K. Wilk

Honors Thesis

Black women in the United States continue to experience disproportionately high rates of maternal mortality, negative reproductive healthcare experiences, and documented disparities in medical treatment. From slavery through the twenty-first century, American medicine has repeatedly positioned Black women’s reproduction as a site of regulation, rather than care, making medical mistrust among Black women a rational response to a long history of institutional conflict embedded in American medicine. Drawing on medical history and bioethical analysis, this thesis traces reproductive abuse across distinct, yet connected, eras. Beginning with antebellum gynecological experimentation on enslaved women, it demonstrates how racialized assumptions about pain and …

Reframing Intimacy: An Occupation-Based Approach To Pelvic Floor & Sexual Health, Emma Stone

Occupational Therapy Capstone Presentations

Pelvic floor dysfunction is highly prevalent among women in the United States, and sexual health is often underaddressed in healthcare. This capstone project aimed to define the role of occupational therapists (OTs) in pelvic floor therapy and promote integration of sexual health into practice. Completed in an outpatient pelvic floor setting, the project included clinical skill development, program development, and advocacy. Interventions involved continuing education, creation of educational handouts, implementation of home exercise programs, and tracking outcomes using the PFDI-20. Additional initiatives included staff education and student training on OT’s role in pelvic health. All 12 tracked clients progressed toward …

Exploring The Neural Correlates Of Motor Learning, Brooklyn R. Thomas

Honors Thesis

The left anterior supramarginal gyrus (aSMG) is recognized as a fundamental cortical region involved in the mastery of skilled tool-use. Although various research studies have revealed that anodal transcranial Direct Current Stimulation (atDCS) over the cortex has the potential to boost manual dexterity, the impact of stimulating the aSMG is less understood in relation to the learning process. Within this study, there was a chopstick-based marble task to discover if atDCS applied to the left aSMG was capable of facilitating the acquisition of a novel motor skill. Concurrent electroencephalography (EEG) was used to measure the changes in neural synchrony within …

The Effects Of Acute Exercise And Observation On Procedural Learning: Considerations Of Biological Sex, Madeline R. Gossett

Honors Theses

As memories are formed or learning progresses, neurons within the brain establish a strong connection in what is referred to as a “neural engram.” This neural engram can be strengthened or weakened by certain physiological factors. Dopamine, for example, is released during physical exercise or when positive reinforcement is incorporated (Greenwood, 2019). This is a neurotransmitter that leads to a stronger connection between neurons, which in turn leads to a stronger memory formed in the brain. These physiological relationships that contribute to cognition are still being discovered, so research in this area is ongoing (Guskjolen and Cembrowski, 2023).

Memory is …

Menstruation Behind Bars: A Mixed-Methods Study On Menstrual Product Access And Distribution Practices In Mississippi County Jails, Eron Hendrix

Honors Theses

This study examines menstrual product access and distribution practices in Mississippi county jails. It highlights the impact of period poverty as a critical yet underexplored public health and human rights issue within the corrections system. While existing research documents widespread inequities in access to menstrual products women’s healthcare in the correctional system, limited attention has been given to menstrual health at the local jail level. Using a mixed-methods approach, this study combines qualitative interviews with jail correctional staff and quantitative survey data from formerly incarcerated women to better understand institutional practices and lived experiences.

Interviews were conducted with sheriffs, jail …

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

Electronic Theses and Dissertations

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

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

Periodontal Disease In A Classic Maya Population From Ambergris Caye, Belize: A Cej-Ac Analysis, Avery R. Mcneil

Honors Theses

Dental remains provide a durable and information-rich record of biological, dietary, and health-related processes in past populations. This study examines periodontal disease, dental wear, and morphometric variation in a Classic period Maya population from coastal Belize (ca. A.D. 700-900) using cementoenamel junction-alveolar crest (CEJ-AC) distance as one measure of periodontal health. Dental remains were assessed using standardized bioarchaeological methods, including tooth identification, crown measurements, and periodontal scoring based on mean CEJ-AC distances recorded at preserved surfaces. The results indicate widespread mild to moderate periodontal disease across the sample, with posterior teeth exhibiting greater alveolar bone loss than anterior dentition. These …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

What Is Screen Apnea And How Does It Affect You?, Kristi M. Soileau

New Orleans Dental Association News

Screen apnea is a modern epidemic of significant proportions. Research suggests that nearly 80% of people unconsciously alter their breathing, often holding their breath or breathing shallowly, while working on digital devices. This subtle shift in respiration, sometimes called “email apnea,” can place the body into a low-grade stress response without being noticed by the individual at the screen. When breathing becomes restricted from poor posting or content anxiety, the nervous system enters into a sympathetic response, much as it interprets signs of threats to that person. The resultant physiological response may be exhibited by muscle tension, mental fog, increased …