Digital Commons Network^™

A Joint Endeavor: Methotrexate Vs. Jak Inhibitors For Joint Inflammation Reduction In Rheumatoid Arthritis, Madeleine Kennedy

Physician Assistant Scholarly Project Posters

This paper investigates the comparative efficacy of Janus kinase (JAK) inhibitors versus methotrexate (MTX) in reducing joint inflammation in adult patients with rheumatoid arthritis (RA). The study addresses the critical research question: In adult patients with RA, does treatment with JAK inhibitors or methotrexate demonstrate superior efficacy in reducing joint inflammation? A literature review was conducted analyzing various clinical trials, including phase II and III studies, that evaluated the effectiveness of JAK inhibitors, both as monotherapy and in combination with MTX. The findings indicate that JAK inhibitors, particularly tofacitinib and baricitinib, consistently show superior or equivalent efficacy in achieving American …

The Promise Of Psilocybin-Assisted Therapy For Opioid Use Disorder, Craig Kimble, Alberto Coustasse

Management Faculty Research

The opioid epidemic presents a profound and escalating public health and economic crisis in the United States. According to the CDC, the economic burden of opioid use disorder and fatal opioid overdose in the U.S. reached an estimated $1.02 trillion in 2017 alone, encompassing healthcare costs, lost productivity, criminal justice expenditures, and premature mortality. While current pharmacologic treatments—such as methadone, buprenorphine, and naltrexone—have proven efficacy, they are not without limitations, including high relapse rates, issues with compliance, stigma, and insufficient engagement in long-term recovery. These shortcomings necessitate an exploration of innovative, cost-effective interventions. One such promising alternative is psilocybin-assisted therapy. …

Exploration Of Advanced Practice Registered Nurses’ Perception Of Barriers To Promoting And Supporting Breastfeeding In Primary Care, Devon L. Stubblefield, Allison L. Scott, Carmel Kruse, Marilou D. Shreve, Hope A. Ballentine

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Breastfeeding is the biological way to provide active and passive immunity, as well as necessary nutrients, to infants while concurrently providing multiple health benefits for mothers. Even though evidence is readily available to support the argument to breastfeed, United States’ breastfeeding rates fall below Healthy People 2030 goals. Advanced practice registered nurses (APRNs) in primary care settings are in a prime position to give education and create care plans to support breastfeeding mothers to improve breastfeeding rates but literature supports APRNs lack confidence to do so. An APRN is likely to defer care to another provider to address …

Functional Characterization Of The C-Terminal Cholinesterase-Like (Chel) Domain Of The Thyroid Hormone Precursor Protein, Berenice Morales-Rodriguez

Pharmaceutical Sciences (MS) Theses

Vertebrate life is unsustainable without thyroid hormones. The only known precursor for thyroid hormone synthesis is thyroglobulin (Tg), composed of upstream regions I-II-III and a C-terminal cholinesterase-like (ChEL) domain, which bears 47% similarity to acetylcholinesterase (AChE). Mutations in Tg cause congenital hypothyroidism, the most common congenital endocrinopathy affecting 1 in 2,000-4,000 newborns, with a varying degree of phenotypic manifestations. Tg protein, regulated by TSH, is secreted to the lumen of thyroid follicles, where thyroxine (T₄) is formed primarily at the N-terminus, and triiodothyronine (T₃) is formed primarily in the ChEL domain. Previous in vitro studies indicated …

Pseudomonas Aeruginosa Exoy Enzymatic Activity Inhibits Exos-Induced Caspase-3/7 Activation But Not Cytotoxicity In Pmvecs, Connor Holm

Poster Presentations

Pseudomonas aeruginosa (P. aer.) is the most common cause of ventilator associated pneumonia (VAP) in ICU patients. Different combinations of exoenzymes (S, T, Y, and U) are found in P. aer. strains. ExoY is most often associated with VAP in ICU patients. ExoY infection of pulmonary microvascular endothelial cells (PMVECs) induces cell rounding but does not activate intracellular caspase-3/7 or cause cell death. ExoS and ExoT infection of epithelial cells leads to caspase-3/7 dependent cell death. Previous studies using epithelial cells show that ExoY alleviates the cytotoxic effects of ExoS and ExoT. Here, we sought to determine whether ExoY inhibits …

Education For Healthcare Providers: Psilocybin-Assisted Psychotherapy, Chelsi Carlson

Theses and Graduate Projects

Psilocybin-assisted psychotherapy is emerging as a promising therapeutic modality for addressing psychological distress in psychiatric and palliative care settings. This scholarly project explores the current literature on psilocybin-assisted therapy, providing an educational framework for healthcare providers regarding its clinical applications, potential benefits, and safety considerations. With the rise in treatment-resistant mental health disorders, there is an increasing need for innovative and holistic approaches to care. This project evaluates healthcare providers’ existing knowledge and attitudes toward psilocybin therapy and delivers an educational intervention aimed at reducing stigma and fostering informed clinical perspectives. Grounded in Margaret Newman’s Theory of Health as Expanding …

Analysis Of The Mechanical, Microstructural, And Biocompatibility Properties Of Novel Magnesium-Based Hybrid Nanocomposite Materials For Orthopedic Applications, Thomas H. Mcgehee

Biomedical Engineering Undergraduate Honors Theses

Bone fractures and complete joint replacements are becoming more common, primarily because of accidents and age-related issues. Conventional solutions to treat these orthopedic injuries involve inert metal alloys to correct bone fractures until the healing process is complete, where a secondary revision surgery is then required to remove the implant. Issues regularly associated with these solutions include stress shielding, bone resorption, infection, inflammation, and implant loosening. Magnesium (Mg)-based nanocomposites offer promising potential as an alternative to commonly used metal alloys because of their favorable mechanical properties and biocompatibility. A particularly advantageous property of Mg is its natural biodegradation in vivo, …

Frontier Healthscapes: Competing Narratives Of Disease, Environment, And Wellbeing In Early Minnesota, Aidan Reynolds

Geography Honors Projects

Across settler societies, health narratives were shaped by evolving tensions between lay and expert knowledge, frameworks of disease causation, and perceptions of the environment as both a source of health and a threat. In the decades following Euro-American settlement (1860-1900), Minnesota became a focal point for these debates, with its landscape fostering complex and competing narratives on health, wellbeing, and disease. This paper explores how public health discourse developed in Minnesota through the perspectives of institutions, the public, and economic interests. Combining environmental history with critical discourse analysis of archival materials, this study examines shifts within the Minnesota State Board …

Assessing Language Skills Of Children Within The Head Start Program Using Language Sampling Analysis, Lynley Bowen

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Fluency disorders, including stuttering and cluttering, disrupt one’s natural rate of speech and can cause implications for one’s emotional well-being. This study explores the relationship between language factors and stuttered events in preschool-age children by analyzing a spontaneous language sample using two transcription software programs, CLAN and SALT. A language sample was collected from a child enrolled in a local Head Start program and was transcribed and analyzed using the software programs. Results from CLAN’s KIDEVAL and FLUCALC features offered analysis of the child’s language profile, as well as SALT’s standards measure report feature. This study highlights the importance of …

Over-Imitation In Adolescents With Autism Compared With Typically Developing Peers: An Expanded Literature Review, Elizabeth Floeck

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Abstract

Background:

Over-imitation, the act of imitating both relevant and irrelevant actions, is a behavior commonly found in human learning and social development. It is often observed in typically developing (TD) children and is believed to play a role in both social and learning development. While the exact motivations behind over-imitation remain a mystery, over-imitation appears to be a socially motivated behavior. Children may over-imitate when they know certain actions are unnecessary, suggesting this behavior stems from social acceptance and norms. In individuals with autism spectrum disorder (ASD), social and communicative behaviors are drastically different from TD individuals. In individuals …

Empowering Through Technology: An Internship Report On Augmentative And Alternative Communication Devices, Olivia G. Macdonald

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Augmentative and Alternative Communication (AAC) devices play a crucial role in supporting individuals with communication challenges, particularly children with developmental disabilities such as Autism Spectrum Disorder (ASD). This paper provides a comprehensive review of the literature on AAC and offers a detailed report of an internship experience at the University of Arkansas WE CARE Summer Camp. During the internship, firsthand experiences provided valuable insights into how AAC technologies can be applied to enhance communication, foster social connections, and support behavioral regulation.

The literature review explores the different types of AAC systems, including both aided and unaided options, and discusses the …

Improving Breast Cancer Modifiable Risk Factor Knowledge Among Patients In A High Risk Breast Cancer Prevention Clinic In The Midwest, Bailee Torneden

Doctor of Nursing Practice Scholarly Project

Preventative health care is the best choice in moving forward to reduce disease incidence. In the case of breast cancer, prevention clinics have been set up for those who have been determined as a high risk status for developing breast cancer over the course of their lifetime. There are many risk factors for breast cancer that are out of the patient’s control, but there are lifestyle health behaviors that could be implemented to lower the patient’s risk. The potential impact of these can not only lower the incidence of breast cancer, but can be linked with reduction of other disease …

Computationally Assessing The Specificity Of Receptor Tyrosine Kinase Inhibitors, Htoo Say

Theses/Capstones/Creative Projects

Receptor tyrosine kinases (RTKs) are vital to cell signaling processes such as growth, survival, and differentiation. Dysregulation through mutation or overexpression often contributes to cancer, making RTKs key therapeutic targets for tyrosine kinase inhibitors (TKIs). However, the low specificity of many TKIs leads to off-target effects. This project uses molecular docking to evaluate the binding affinities and selectivity of FDA-approved TKIs across 18 RTK subtypes. The dockings conducted revealed significant variability in binding affinities, with Sorafenib exhibiting strong specificity for EphB2 (-7.6 kcal/mol) and poor compatibility with EphA7 and ErbB4 (-3.0 kcal/mol). These findings underscore the role of specific molecular …

Justification For The Biological Foundation Of Methane On Mars: Methanogens’ Capacity To Metabolize On Montmorillonite Clay And Basalt, Ashley Ezeldin

Biological Sciences Undergraduate Honors Theses

The possibility of extraterrestrial life, particularly on Mars, remains a compelling question in astrobiology. Mars' harsh atmospheric conditions, dominated by carbon dioxide and extreme cold, prevent the survival of aerobic species. However, it still leaves the possibility of methanogens, an anaerobic species that can survive in extreme conditions, to inhabit this planet. Due to the discovery of methane on Mars, it is possible that methanogens may live and grow in the subsurface of this planet.

For this experiment, basalt and montmorillonite clay were chosen as substrates because they are believed to be found in the composition of Mars's subsurface. Methane, …

Postpartum Depression And Anxiety Between First-Time And Multiparous Mothers Of Infants In The Nicu, Jennifer L. Diaz-Miranda

2025 Spring Honors Capstone Projects - Archive

Postpartum depression (PPD) and anxiety are significant concerns for mothers with infants in neonatal intensive care units (NICUs); yet the role of parity in shaping these experiences remains underexplored. This cross-sectional secondary analysis examined data from 82 NICU mothers (62 adults, 20 adolescents) using the Edinburgh Postnatal Depression Scale and anxiety subscale. Findings revealed that primiparas and adolescents exhibited higher depression scores and multiparas and adolescents were more likely to experience anxiety symptoms. Parity, however, was not found to be a significant factor capable of predicting PPD or anxiety but results highlight the importance of early screening, personalized mental health …

Health Care Delivery Of Asthma In Health Care Systems Across The World: A Comparison Of Three Health Systems, Megan T. Hui

2025 Spring Honors Capstone Projects - Archive

Asthma remains a significant health concern globally, with healthcare delivery varying across different systems. This study aims to compare asthma care within three healthcare system: the Beveridge model (United Kingdom), the Bismarck model (Switzerland), and the National Health Insurance model (Canada) focusing on cost, quality, and accessibility. This study used a systemic review, gathering published evidence from the Organization for Economic Cooperation and Development (OECD) Data Explorers that explicitly met eligibility criteria for asthma treatment and outcomes. Evidence from government reports, public health databases, and peer-reviewed literature were analyzed. Kissick’s Iron Triangle framework was applied to assess the inherent trade-offs …

The Dynamic Role Of Hyaluronan In Acute Cardiac Wound Healing., Danielle T. Little

Electronic Theses and Dissertations

During acute myocardial infarction (MI), the composition of the extracellular matrix (ECM) undergoes significant changes. While collagen accumulation is one of the most well-documented ECM alterations, hyaluronan (HA) is equally abundant. However, the cellular sources, enzymatic regulation, and functional significance of HA accumulation remain largely unexplored. Here, we hypothesized that activated cardiac fibroblasts produce HA via hyaluronan synthase 2 (HAS2), facilitating scar formation and stability. Our findings demonstrate that HA accumulates post-MI and persists for at least four weeks. Through HA sizing techniques, we determined the molecular weight of this persistent HA. Additionally, RNA sequencing analysis of failing human hearts …

The Role Of Tgfβ-Activated Kinase 1 In Fibroblast Differentiation And Cardiac Remodeling After Injury., Daniel Chien Nguyen

Electronic Theses and Dissertations

Immediately following myocardial injury, a robust reparative response is orchestrated through intercellular communication. While various cell populations play critical roles in this process, cardiac fibroblasts have long been recognized as essential mediators of collagen synthesis and scar maturation; however, recent investigations have uncovered significant heterogeneity within the cardiac fibroblast population, revealing distinct subpopulations with roles that extend beyond their traditional functions. Notably, after tissue injury, fibroblasts exposed to damage signals can transition to an inflammatory phenotype, utilizing paracrine and autocrine signaling to coordinate immune cell recruitment and activation. Yet, the mechanisms underlying inflammatory cardiac fibroblast differentiation and their influence on …

Investigating Mental Health Outcomes Of National Collegiate Athletic Association (Ncaa) Division I Student-Athletes At The University Of Louisville, 2019-2023., Paul Harvey

Electronic Theses and Dissertations

Mental health outcomes among collegiate student-athletes, has become a broader concern in the 21^st century. This study examines prevalence and incidence of anxiety and depression amongst student-athletes at the University of Louisville from 2019-2023 across different Sports Groups. The prevalence of anxiety was found to be 20.22% and risk of anxiety was 15.65%. The prevalence of depression was found to be 13.11% and risk of depression was 18.75%. Logistic regression was used to estimate the association between sports groups and anxiety/depression. There was a borderline association between sports groups and prevalence of anxiety after confounder adjustment (OR=1.86, 95% CI: …

Cns-Specific Hiv Reservoir Characterization In Humans: Advancing Our Understanding Through Novel Genomics Methods., Ghazal Sadri

Electronic Theses and Dissertations

The persistence of the human immunodeficiency virus (HIV) reservoir despite years of suppressive antiretroviral therapy (ART) represents the principal obstacle to achieving a functional cure. Because the intact, replication-competent portion of the reservoir drives viral rebound after treatment interruption, HIV cure strategies must specifically identify and target cells harboring these proviruses. Conventional reservoir‐characterization techniques typically require separate assays to capture integration sites, assess proviral integrity, and quantify clonal proliferation and they rely on short‐read sequencing. These limitations hinder our ability to understand how integration landscapes, the integrity of the HIV genome, and cell‐division dynamics intersect to maintain viral persistence in …

Differences In Prostate Cancer (Pca) Stage At Primary Diagnosis And Pca-Specific Mortality Among Rural Versus Urban Populations In Kentucky., Chase Herrmann

Electronic Theses and Dissertations

Kentucky Cancer Registry (KCR) prostate cancer (PCa) cases between the years of 1994 and 2021 were analyzed to examine differences between rural and urban populations’ primary stage at diagnosis and PCa-specific mortality. After adjusting for covariates, rural populations did not experience significantly higher odds of stage 3 diagnosis when compared to urban populations (OR = 1.02, 95% CI = 0.95 – 1.06). Rural populations had 16% increased odds of stage 4 diagnosis when compared to urban populations (OR = 1.16, 95% CI = 1.10 – 1.23). Rural populations had a 17% increased rate of PCa-specific death when compared to urban …

The Association Of Discrimination, Inflammation, And Coping Style On Self-Rated Health Among South Asian Individuals In The Masala Study, Raji Pillai, Sahiti Myneni, Constance M Johnson, Nilay S Shah, Alka M Kanaya, Jennifer E S Beauchamp

Faculty, Staff and Student Publications

Objectives: South Asian individuals (SAs) may have heightened levels of inflammatory markers, such as C reactive protein (CRP), Tumor Necrosis Factor-α (TNF-α), leptin, and resistin, and decreased levels of anti-inflammatory adiponectin, contributing to higher cardiovascular disease (CVD) incidence. Social determinants of health, like discrimination, are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether coping styles moderated the association between discrimination and self-rated health (SRH) among SAs in the United States.

Design: Secondary analysis of data obtained from 1164 SAs (mean age = 57 years, SD = 9.4, 48% women) …

Depression, Anxiety, And Suicide Among Adolescents: Sex Differences And Future Perspectives, Giovana V.R. Toro, Paula Arias, Alejandro De La Torre-Luque, Jonathan B. Singer, Natalia Lagunas

Social Work: School of Social Work Faculty Publications and Other Works

Depression and anxiety are two disorders that significantly increase the risk of suicidal behavior. The disparity between females and males in the prevalence of these disorders becomes more pronounced from adolescence onwards. Specifically, risk factors associated with suicidal behavior in adolescent females are often linked to anxiety and depression, whereas in males, these behaviors are more frequently associated with other types of disorders, such as disruptive behavior. Furthermore, there are notable sex differences in the efficacy and acceptance of treatments aimed at preventing suicidal behavior. This review examines the sex differences in the relationship between depression, anxiety disorders, and suicidal …

Pd-L1 Testing, Treatment Patterns, And Clinical Outcomes Among Patients With Metastatic Nsclc At An Academic Medical Center, 2017-2021., Mehmet Altan, Dawen Sui, Cai Xu, George R Simon, Saliha T Sulihem, Donna Malveaux, Darcy Ponce, Waree Rinsurongkawong, Vadeerat Rinsurongkawong, J Jack Lee, Jianjun Zhang, Don L Gibbons, Ara A Vaporciyan, John V Heymach, Melissa L Santorelli, Thomas Burke, Loretta A Williams

Oncology Articles

INTRODUCTION: Targeted therapies and immune checkpoint inhibitors (ICIs) have revolutionized the management of metastatic non-small cell lung cancer (NSCLC) over the past decade.

METHODS: This single-center observational study was conducted to describe programmed death-ligand 1 (PD-L1) testing, choice of therapy, and outcomes for adult patients with stage IV NSCLC initiating first-line therapy from 2017 through 2020, with follow-up through June 2021. Patient characteristics and study assessments were described according to four histomolecular subtypes, defined by histologic characteristics and availability of standard-of-care therapies for molecular subgroups at the time of study conduct.

RESULTS: Of 507 eligible patients with metastatic NSCLC, 85 …

A Review On Treatment, Prevention, And Research Of Worldwide Parasitic Disease: Toxoplasmosis, Hannah Skinner

All Theses

Toxoplasmosis is a worldwide, yet often overlooked, parasitic disease caused by the protozoan parasite, Toxoplasma gondii. The parasite is capable of infecting humans and almost all warm-blooded vertebrates. Over a million people are infected in the United States with toxoplasmosis each year. Most infections are asymptomatic but severe cases can lead to vision impairment, neurological disorders, and congenital birth defects. T. gondii is transmitted through undercooked meat, infected feline feces, or contaminated water and soil. The burden of T. gondii infection is most notable in livestock, felines, and immunocompromised humans. Despite being a widespread disease, toxoplasmosis is neglected in …

Personalizing Intermittent Fasting: The Role Of Microbiome Diversity And Fiber Intake In Shaping Health Outcomes, Jana Gjini, Robin Moore, Venkateswar Venkataraman

Rowan-Virtua Research Day

BACKGROUND: Intermittent fasting (IF) has been linked to improved metabolic health, reduced inflammation, and increased longevity in animal models. These effects are thought to be mediated through changes in the gut microbiome. Murine studies consistently show that IF enhances microbial diversity and promotes beneficial species like Lactobacillus and Bifidobacterium, improving metabolic profiles and gut barrier function. However, human studies reveal inconsistent results, suggesting that individual-level factors such as baseline microbiome composition and fiber intake may influence response to IF.

HYPOTHESIS: Baseline gut microbiome diversity and habitual dietary fiber intake modulate the metabolic and inflammatory benefits of intermittent fasting in humans. …

Ks151 Synergizes With Venetoclax And Abt-737 In Aml: Efficacy In Both Flt3-Wildtype And Flt3-Mutant Models, Sahil Jethi, Arnold Rojas, Omar S. Al-Odat, Krishne Gowda, Subash C. Jonnalagadda, Manoj Pandey

Rowan-Virtua Research Day

Acute myeloid leukemia (AML) is the most common leukemia in adult patients, with a 5-year survival rate of less than 30 percent. Therefore, more effective therapeutic strategies are required to prolong the survival of AML patients. Importantly, anti-apoptotic proteins, especially B-cell lymphoma 2 (Bcl-2), overexpression in AML is associated with uncontrolled growth as well as chemoresistance. Unsurprisingly, Bruton’s tyrosine kinase (BTK) overexpresses in AML and associated with poor prognosis and chemoresistance. The FDA-approved BTK inhibitor, ibrutinib, has been successful in treating other hematologic malignancies, but a proportion of patients relapse mainly because of acquired mutations at Cys481Ser (C481S) in the …

Modeling Buprenorphine Treatment Discontinuation In Opioid Use Disorder – Predictors And Disparities Using Statistical And Machine Learning Approaches, Wanru Guo

Dissertations and Theses (Open Access)

Background: Opioid Use Disorder (OUD) remains a major public health crisis in the U.S., and while buprenorphine is an effective treatment, early discontinuation undermines its impact. Existing statistical and machine learning (ML) models often overlook key social and healthcare-related predictors and fail to capture subgroup disparities, limiting their utility for equitable intervention design. This study addresses these gaps using a nationwide, longitudinal dataset and a two-stage modeling approach focused on disparity identification. Methods: We analyzed buprenorphine treatment episodes for OUD from the IQVIA Pharmetrics Plus database (2006–2023), defining discontinuation as episodes lasting under 180 days. A Cox proportional hazards model …

Investigating Fatty Acid Influence On West Nile Virus In Mosquitoes And Birds, Hayley Moree

Honors Program: Senior Projects (Public)

Vector-borne diseases, including Zika virus (ZIKV), Dengue virus (DENV), and West Nile virus (WNV), pose considerable global health threats, accounting for over 400 million infections and more than 700,000 deaths annually. Many vector-borne diseases are within the Flaviviridae family. Despite this, effective treatments have not been found for some flaviviruses. Flaviviruses exploit host cellular machinery to facilitate their replication and survival, reprogramming metabolic pathways, including lipid metabolism. Lipids play essential roles in the viral life cycle, providing structural components for the viral envelope, enabling membrane rearrangements for replication complexes, and supplying energy resources necessary for particle assembly.

Targeting lipid metabolism …

The Perceived Effect Of The Menstrual Cycle On Sleep, Mood, And Training In Ncaa Di Collegiate Athletes, Rachel Conhoff

All-Inclusive List of Electronic Theses and Dissertations

Purpose: This study aimed to understand whether collegiate female athletes perceived that their menstrual cycle influenced sleep, mood, and training. Additionally, it looked to identify which phases of the menstrual cycle (pre-menstruation, menstruation, and post-menstruation) were associated with a positive perception of these three variables. Methods: An online questionnaire was designed and sent out to all NCAA Division I (DI) female athletes whose schools had permitted them to participate in the study. The questionnaire was a novel instrument that assessed the perception of the menstrual cycle on the three variables across the three phases. Inclusion criteria included NCAA DI female …