Digital Commons Network^™

Multidomain Expert Evaluation Of Leading Large Language Models As Providers Of Vaccination And Preventive Medicine Information, Marcello Di Pumpo, Leonardo Villani, Vittorio Maio, Maria Rosaria Gualano, Eleonora Marziali, Lucia De Maio, Rossella Mancini, Stefania Boccia, Walter Ricciardi, Patrizia Laurenti

College of Population Health Faculty Papers

OBJECTIVES: Vaccination is one of the most effective public health interventions. Large language models (LLMs) show great capability for providing health information. This study compared the performance of ChatGPT 3.5 (G3E), ChatGPT 4o in English (G4E), Claude 3.0 (CDE), Gemini 1.5 (GME), and ChatGPT 4o in Italian (G4I) in delivering information on vaccination and preventive medicine.

STUDY DESIGN: Mixed-method analysis evaluating large language models.

METHODS: Twenty-six expert-designed healthcare scenarios were used to evaluate each model through an adapted DISCERN-based instrument. Four experts independently rated outputs across six domains: Information Reliability, Information Quality, Medical Appropriateness, Impact on Vaccine Hesitancy, Potential for …

Evaluating Chest-Worn Light Logger Adherence: Development And Application Of A Wear/Non-Wear Model, Carlyn Patterson Gentile, Adah Thomas, Ryan Shah, Blanca Marquez De Prado, Nichelle Raj, Christina Szperka, Geoffrey Aguirre

Student Papers, Posters & Projects

Light exposure plays an important role in overall health because it entrains circadian rhythms. Recent technological advances in wearable light loggers allow measurement daily light exposure habits. Using a chest-worn light logger, our goal was to (1) develop methodology for differentiating adherent versus non-adherent use, and (2) define differences in lighting intensity in indoor and outdoor environments, to improve data reliability in future clinical studies using this technology. Four testers used a 10-channel chest worn light logging device under different conditions of wear and non-wear (experiment 1), and another tester made measurements with the light logger across a variety of …

Growth In Early Infancy Drives Optimal Brain Functional Connectivity Which Predicts Cognitive Flexibility In Later Childhood, Chiara Bulgarelli, Anna Blasi, Samantha Mccann, Bosiljka Milosavljevic, Giulia Ghillia, Ebrima Mbye, Ebou Touray, Tijan Fadera, Lena Acolatse, Sophie E Moore, Sarah Lloyd-Fox, Clare E Elwell, Adam T Eggebrecht, Bright Study Team

2020-Current year OA Pubs

Functional brain network organisation, measured by functional connectivity (FC), reflects key neurodevelopmental processes for healthy development. Early exposure to adversity, for example undernutrition, affects neurodevelopment, observable via disrupted FC, and leads to poorer outcomes from preschool age onwards. We assessed longitudinally the impact of early growth trajectories on developmental FC in a rural Gambian population from age 5-24 months. To investigate how these early trajectories relate to later childhood outcomes, we assessed cognitive flexibility at 3-5 years. We observed that early physical growth before the fifth month of life drove optimal developmental trajectories of FC that in turn predicted cognitive …

Rehabvr: A Virtual Reality System For Upper-Body Orthopaedic Physical Therapy Rehabilitation, Winnie Brenda Wanjiru Waiya

Computer Science Senior Theses

Physical therapy is a central component of rehabilitation for musculoskeletal conditions, yet adherence to prescribed treatment remains persistently poor. Jack et al. identified pain, boredom, and insufficient feedback as key barriers to treatment adherence in physiotherapy outpatient settings,¹ and Rucinski et al. confirmed that non-adherence rates in orthopaedic populations remain between 50 and 70%, with patients who disengage facing elevated risk of reoperation, progressive functional decline, and poor clinical outcomes.² According to the World Health Organization, approximately 1.71 billion people globally live with musculoskeletal conditions,³ with shoulder pain specifically carrying a community prevalence ranging from 0.67 to 55.2% worldwide and …

Monoclonal Antibodies Targeting Pcdh7 Inhibit Tumor Growth And Enhance Immune Responses In Kras-Mutant Non-Small Cell Lung Cancer, Nicole Novaresi, Poorva Ghosh, Shayna Thomas-Jardin, Hui Deng, Xuejun Fan, Zhiqiang Ku, Wei Xiong, Xiaorong Zhou, Jingfei Zhu, Huiyu Li, Mahesh S Padanad, Bethany Smith, Chul Ahn, John D Minna, Zhiqiang An, Ningyan Zhang, Kathryn A O'Donnell

The Brown Foundation: Institute of Molecular Medicine

We identified an important oncogenic role for protocadherin 7 (PCDH7), a cell surface protein frequently overexpressed in lung adenocarcinoma and associated with poor clinical outcome. Pcdh7 depletion reduces tumor burden and prolongs survival in KrasLSL-G12D; Tp53fl/fl mice. These findings nominate this cell surface protein as an actionable therapeutic target and highlight the therapeutic potential of PCDH7 inhibition for non–small cell lung cancer. We report the development and characterization of high-affinity anti-PCDH7 monoclonal antibodies (mAbs) that inhibit downstream mitogen-activated protein kinase (MAPK) pathway activation and suppress tumor growth in multiple mutant KRAS–driven models. A lead mAb (mAb7) sensitized tumors …

The Impact Of The Covid-19 Pandemic On Obstetric Access In Rural And Urban Areas In The United States, Sandali Chandradasa

Walden Dissertations and Doctoral Studies

No abstract provided.

Does The Availability Of An Additional Set Of Bunker Gear Impact Firefighter Health, Safety, And Operational Readiness?, Ryan Riley

Certified Public Manager® Applied Research

Firefighting is a complex and inherently dangerous profession. Firefighters today face a growing array of occupational hazards, not just from the effects of being exposed to fire and smoke, but also from the personal protective gear they wear, commonly referred to as “bunker” or “turnout” gear. While this gear is designed to protect firefighters in dangerous environments, prolonged use and repeated exposure to smoke, chemicals, and products of combustion can compromise the gear. Research has shown that bunker gear contains and can also retain cancer-causing chemicals. To this end, this paper examines whether the availability of an additional set of …

Transgenic Hookworm Secretes Anti-Tetrodotoxin Human Single Chain Antibody, Kumar Sachin Singh, Suman Bharti, Bruce A Rosa, Mahdiyeh Bigham, Samuel C Uzoechi, Young-Jun Choi, John C Martin, Danielle Kemper, Slavica Pavlovic Djuranovic, Sergej Djuranovic, Makedonka Mitreva, Et Al.

2020-Current year OA Pubs

Biologics, protein- and peptide-based drugs derived from living organisms or cell lines have emerged as effective therapies across a broad range of indications. However, parenteral administration and the need for frequent dosing increase costs and limit compliance, creating an urgent need for innovative platforms capable of continuously, safely, and efficiently delivering sustained biologics in situ within the host. Here, we describe a bioengineered hookworm platform to manufacture and deliver biologic therapeutics in vivo. As proof of concept, we engineer the Ancylostoma ceylanicum secretome by inserting a human single-chain variable fragment antibody (s16-HuScFv) into its genome. Transgene expression does not perturb …

Transgenic Hookworm Secretes Anti-Tetrodotoxin Human Single Chain Antibody, Kumar Sachin Singh, Suman Bharti, Bruce A Rosa, Mahdiyeh Bigham, Samuel C Uzoechi, Young-Jun Choi, John C Martin, Danielle Kemper, Slavica Pavlovic Djuranovic, Darren A Pickering, Rachael Ryan, Bethany K Bracken, Maria Elena Bottazzi, Eric C Carnes, Wannaporn Ittiprasert, Matthew Moyle, Paul J Brindley, Alex Loukas, Sergej Djuranovic, Makedonka Mitreva

Faculty, Staff and Students Publications

Biologics, protein- and peptide-based drugs derived from living organisms or cell lines have emerged as effective therapies across a broad range of indications. However, parenteral administration and the need for frequent dosing increase costs and limit compliance, creating an urgent need for innovative platforms capable of continuously, safely, and efficiently delivering sustained biologics in situ within the host. Here, we describe a bioengineered hookworm platform to manufacture and deliver biologic therapeutics in vivo. As proof of concept, we engineer the Ancylostoma ceylanicum secretome by inserting a human single-chain variable fragment antibody (s16-HuScFv) into its genome. Transgene expression does not perturb …

Vitamin D–Amp Axis In Host Defense Against Fungal Infections, Nuraly S. Akimbekov, Ilya Digel, Svetlana K. Sakhanova, Kuanysh Tastambek, Dinara K. Sherelkhan, Mohammed S. Razzaque

School of Medicine Publications

Vitamin D–mediated regulation of antimicrobial peptides (AMPs) is an important focus in innate immunology and is aimed at elucidating the role of vitamin D in enhancing antimicrobial defense. AMPs are short protein chains that serve as a first line of defense against invading pathogens, including fungi, bacteria and viruses. Unlike conventional antibiotics, AMPs are produced endogenously and are less likely to induce antimicrobial resistance, making them promising candidates for treating infections caused by drug-resistant pathogens. Studies indicate that optimal vitamin D levels are essential for activating antimicrobial pathways and regulating AMPs that target multiple fungal pathogens. This article summarizes recent …

Cytosine Base Editing Of Lpa In Transgenic Mice Averts Large Deletions, Marcel A Chuecos, So Hyun Park, Madhvi M Bhakta, Usosa Too-Chiobi, Daniel Betancourth, Mingming Cao, Marco De Giorgi, Christopher J Walkey, Anjana Tiwari, Biana Godin, Julia M Assini, Donna J Palmer, Philip Ng, Michael B Boffa, Marlys L Koschinsky, Gang Bao, William R Lagor

Faculty, Staff and Students Publications

Lipoprotein(a) (Lp(a)) is a genetically determined causal risk factor for cardiovascular disease, with approximately 20% of the population exhibiting elevated levels. While there are promising drugs in development, there are currently no approved therapies specifically designed to lower Lp(a) levels. For high-risk individuals with extreme levels of Lp(a), liver-directed genome editing could be an effective one-time solution. Genome editing approaches such as CRISPR and TALENs can reduce Lp(a) in LPA-transgenic mouse models, but they frequently induce large and potentially harmful genomic deletions. Here, we report the first application of TadA-derived cytosine base editing (CBE), delivered via helper-dependent adenovirus (HDAdV) and …

From Performance To Practice: Knowledge-Distilled Segmentator For On-Premises Clinical Workflows, Qizhen Lan, Aaron Choi, Jun Ma, Bo Wang, Zhongming Zhao, Xiaoqian Jiang, Yu-Chun Hsu

Faculty, Staff and Student Publications

Deploying medical image segmentation models in routine clinical workflows is often constrained by on-premises infrastructure, where computational resources are fixed and cloud-based inference may be restricted by governance and security policies. While high-capacity models achieve strong segmentation accuracy, their computational demands hinder practical deployment and long-term maintainability in hospital environments. We present a deployment-oriented framework that leverages knowledge distillation to translate a high-performing segmentation model into a scalable family of compact student models without modifying the inference pipeline. The framework is primarily evaluated on nnU-Net, with additional validation across transformer and heterogeneous teacher–student architectures. The proposed approach preserves architectural compatibility …

Student Perceptions Of Artificial Intelligence: A Freelisting Study, Gary Kaplan, Mslis, Ahip, Jessica G. Hamilton, Mls, Rebecca Miller, Mlis, Rosemary Frasso, Phd, Cph

Thomas Jefferson University Faculty Days

Background

Librarians typically provide guest lectures on topics in information literacy, connecting students to the scholarly literature. Hervieux & Wheatley’s Six Frames for AI Literacy emphasize the need to engage in AI discourse. As artificial intelligence changes the way students often interact with information, librarians must adjust their approach, whether changing the framing while retaining the traditional content, or changing the content. In the 2025-26 academic year, we experimented with various approaches. Here we describe a brief freelisting exercise we conducted before the lessons to surface students’ perceptions of artificial intelligence.

Nursing Students Applying Active Teaching And Learning To Develop Clinical Judgment Skills, Charlene Lindsay Jones

Walden Dissertations and Doctoral Studies

No abstract provided.

Activated Dorsomedial Hypothalamic Astrocytes Regulate Feeding Behavior, Bella M. Lisenby

Honors Projects

The dorsomedial hypothalamus (DMH) region of the brain has been shown to be important for anticipatory feeding activity and play a role in restricting excessive food intake. In obese animals that overconsume calories, astrocytes within the DMH exhibit intracellular signaling changes indicative of cellular activation. Because astrocytes are known to influence neuronal function, we hypothesize that activated astrocytes regulate behavior. In the current study, we use chemogenetics combined with stereotaxic surgery to assess the contribution of astrocyte activity in the DMH towards metabolic behaviors.

Secondary Cutaneous Involvement In Peripheral T-Cell Lymphoma: Diagnostic Frameworks, Staging Integration, And Therapeutic Implications, Aura Calderon, Jose Loayza Pintado, Cristina Kochi, Jared Hensley, Andres Suarez Parraga, Everardo Cobos

School of Medicine Publications

The occurrence of secondary cutaneous manifestations in peripheral T-cell lymphoma (PTCL) is relatively infrequent and can resemble benign dermatoses, leading to diagnosis delays. We present the case of a 78-year-old female patient with a diagnosis of PTCL affecting the left parotid gland, who experienced a 2-day sudden and intensely pruritic skin eruption, which progressed from both forearms to the trunk, involving more than 50% of the total body surface area. Initially, the eruption was managed as a hypersensitivity reaction with antihistamines and corticosteroids, with temporary symptomatic relief; however, the rapid clinical progression in the context of an established diagnosis of …

Nmda Receptor Subunit Nmr-2 Regulates Pathogen-Induced Immune Responses Via The Nervous System In C. Elegans, Benson Otarigho, Jonathan Lalsiamthara, Alejandro Aballay

Faculty, Staff and Student Publications

Neural control of innate immunity must balance restraint of basal immune activity with rapid activation upon pathogen encounter. Glutamate, the primary excitatory neurotransmitter in the nervous system, has been implicated in several neurological disorders associated with inflammation, suggesting a potential link to immune regulation. However, how glutamatergic signaling contributes to immune balance remains unknown. Here, we demonstrated that the NMDA-type ionotropic glutamate receptor subunit NMR-2, a component of the NMDA receptor complex, acts in the

An Exploration Of The Intersection Of Artificial Intelligence And Speech-Language Pathology -- Potential Impacts, Manish K. Rami

Internet Journal of Allied Health Sciences and Practice

Purpose: This paper explores the potential impact of Artificial Intelligence (AI) on the profession of Speech-Language Pathology (SLP). AI is widely recognized as a transformative force, presenting opportunities across both service delivery and professional practice in SLP. Method: The analysis employs the American Speech-Language-Hearing Association's  Scope of Practice in Speech-Language Pathology as an organizing framework to systematically evaluate AI applications across professional and service delivery domains. Within each domain, the study identifies emerging use cases, evaluates the capacity for AI technologies to automate or augment clinical processes, and examines broader implications for the profession, with particular attention to anticipated changes …

Perceptions Of Shared Decision-Making And Interprofessional Education At National Collegiate Athletic Association Institutions, Shelene Thomas, Rebecca Downey, Kaylyn Mcanally Star, Erin Choice, Anthony P. Breitbach

Internet Journal of Allied Health Sciences and Practice

Purpose: When a shared decision-making design is employed in the return to sport (RTS) Continuum, the athletes’ outcome improves. Yet, many professional programs (i.e., athletic training and medicine) integrate interprofessional education into curricula differently or not at all. Therefore, there may be a mismatch between theory, curricula, and practice implementation. This discrepancy could impact care team operations and RTS outcomes. The purpose of this study was to assess perceptions of shared decision-making practices, communication strategies, and perceived barriers among interprofessional RTS care team members in NCAA intercollegiate athletics.

Methods: A mixed-methods, cross-sectional study including anonymous, web-based survey responses from 253 …

Defining Success Differently: The Clear Model For Allied Health Admissions, Ladarius Woods

Internet Journal of Allied Health Sciences and Practice

This opinion paper argues that threshold-based lottery admissions offer a strategically necessary response to equity challenges, enrollment pressures, and evolving definitions of merit in allied health education. Current admissions models, whether traditional or holistic, often reflect underlying tensions between academic metrics and institutional missions and may unintentionally privilege certain applicant groups. As demographic shifts and the looming enrollment cliff intensify these pressures, allied health programs must reconsider how they define and identify admissions excellence. Drawing on examples from other sectors and recent literature, this opinion piece argues that a threshold-based lottery system, applied to applicants who meet baseline academic criteria, …

Standardizing Tms Intensity Across Different Coils Using Individualized Electric Field Modeling, Evgenii Kim, Mohammad Daneshzand, Keren Zhu, Danyal Fareed Bhutto, Teresa Jacobson Kimberley, Dylan J. Edwards, Netri Pajankar, Parker Kotlarz, Tommi Raij, Sergey N. Makaroff, Aapo Nummenmaa

Moss-Magee Rehabilitation Papers

Quantitative measures for Transcranial Magnetic Stimulation (TMS) intensity are needed to ensure safe and consistent application in therapeutic and research settings. However, resting motor thresholds (rMTs), commonly used to determine stimulation intensity, depend on the coil used. Unless motor mapping and treatment coils are identical, re-thresholding is necessary, increasing patient discomfort and potentially introducing variability across studies. These considerations raise an unresolved fundamental question: does individual rMT reflect a consistent cortical electric field (E-field) magnitude independent of coil geometry? We tested the hypothesis that rMT corresponds to a coil-invariant cortical E-field magnitude and evaluated a computational method for predicting stimulator …

A Systematic Review Of Intrusion Detection Systems For Internet Of Medical Things: Performance, Efficiency, Explainability, And Generalization, Oswald Adohinzin, Youssef Harrath

Research & Publications

The Internet of Medical Things (IoMT) has transformed health care delivery through medical devices, remote patient monitoring, and real-time clinical decision support. However, the proliferation of IoMT devices introduces security vulnerabilities that put patient safety and data privacy at risk. Intrusion Detection Systems (IDS) have emerged as essential components for protecting IoMT networks from cyberattacks. This article presents a systematic review of IoMT-IDS research, analyzing 53 high-quality papers published between 2020 and 2025, identified through database searches spanning 2016–2025 across IEEE Xplore, Springer, ScienceDirect, and ACM Digital Library. We organize the literature through a comprehensive taxonomy spanning classical machine learning …

Operation Bite Block, Jennifer Aline Robles, Laura Marie Strobbe, William Pearce Graham, Annabelle Katherine Thalken

Mechanical Engineering

Current dental bite blocks, or mouth props, are typically manufactured in fixed sizes, and often result in patient discomfort, reduced procedural efficiency, and the need for dental offices to maintain multiple product sizes. This project sought to design, prototype, and validate an adjustable dental bite block capable of accommodating a wide range of patient mouth openings while maintaining comfort, structural integrity, sterilizability, and operator usability. Working in collaboration with Dr. Alan Latta, a practicing dentist in San Luis Obispo, the design process incorporated stakeholder feedback, patent and market research, engineering analysis, and iterative prototyping to develop a solution that addresses …

Social Media Is A Juggernaut: Lagged Correlation Analysis Using Ngram Data On “Internet” And “Social Media” With Amplification By The Advent Of The “Iphone”, William Zywiak, Gao Niu, Nicolas Petrell, Victoria Nichele, Kirsten Hokeness

Mathematics and Economics Faculty Journal Articles

The amount of new information transmitted per day can be overwhelming. The data available through Ngram Viewer allows statistical examination to determine the most salient topics, as well as lagged correlation and lagged variance to support possible causal connections between concepts. Using this database, we determined that COVID, crypto, microplastics, and especially social media are important topics of the last few years. We also present results that suggest the development of the internet and the iPhone fueled the prominence of social media, and the access of the iPhone also increased access to the internet.

2026 Cyber-Resilient Health Care Workshop Report, Malcolm Schongalla, Sergey Bratus

Computer Science Technical Reports

The ISTS and the Dartmouth College Cybersecurity Cluster hosted the successful, inaugural Cyber-Resilient Health Care (CRHC) Workshop, March 5th & 6th, 2026. The event theme was "Innovation and Implementation," in response to the need to shift from reactive to proactive resiliency measures in the healthcare sector. Approximately 30 experts in clinical health care, cybersecurity, medical technology, policy, and innovation met to discuss solution-focused innovations addressing hard, cyber-related problems in health care. The agenda featured keynotes, an expert panel, innovation pitches, small group discussions, and a tabletop infrastructure disaster exercise. Participants gained insights into the obstacles and solutions involved in supporting …

Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal

Center for Medical Ethics and Health Policy Staff Publications

Introduction: After a patient receives genetic test results that indicate an actionable health condition, cascade genetic screening (CGS) is the process of evaluating the patient's relatives for a potentially elevated genetic risk of disease. The United States primarily relies on patients to communicate with their relatives, resulting in suboptimal rates of risk communication, familial genetic testing uptake, and risk-reducing interventions. There is ongoing debate about whether and how best to inform relatives of a potentially increased genetic risk.

Methods: We conducted a nationally representative survey of US adults to assess attitudes toward informing at-risk relatives, acceptability of system-mediated communication, and …

Exploring The Association Between Social Media Use Frequency And Violence-Related Behaviors Among U.S. High School Students: A Cross-Sectional Analysis Of The 2023 Youth Risk Behavior Survey, Luma Hammoudi

ETDs from 2020-2029

Youth violence remains a major public health concern in the United States (U.S.), with firearm injuries now the leading cause of death among children and adolescents. At the same time, social media use has become nearly universal among youth, raising concerns about how online interactions may influence violence-related behaviors. Social media platforms can facilitate peer conflict, electronic bullying, and public exposure to aggressive behaviors, which may extend into offline environments such as schools and communities. However, the relationship between social media use frequency and youth violence remains understudied. This study examined the relationship between frequency of social media use and …

Electrophysiological Retinal Changes In Aging And Its Implication In Alzheimer’S Disease, Samuel Jacob Haskins

ETDs from 2020-2029

Alzheimer’s disease remains one of the most expensive and fatal diseases facing medical practitioners to this day. According to the CDC, statistics show that it is the seventh leading cause of death worldwide. In addition to fatalities, there is a tremendous financial and emotional cost of dementia to the patient and surrounding caregivers. Improved screening techniques and new treatments for this disease are a priority of several institutes within the NIH. Early detection and early intervention are critical to improve the outcomes of patients worldwide. Amyloid beta plaques and neurofibrillary tangles (NFT) are two of the most important protein aggregates …

Effects Of Mitoquinone On Doxorubicin-Induced Cytotoxicity In H9c2 Cardiac Myoblasts And 22rv1 Prostate Cancer Cells, Tia Patrick

PCOM Biomedical Studies Student Scholarship

Introduction:

Although Doxorubicin (DOX) is a widely prescribed chemotherapeutic agent, its clinical use is limited by cardiotoxicity (DIC) caused by oxidative stress, mitochondrial dysfunction, and cardiac apoptosis. Dexrazoxane (DEX) is the only FDA-approved cardioprotective agent to prevent DIC. However, DEX may induce secondary malignancy. Mitochondria-targeted antioxidants (MTAs), such as mitoquinone (MitoQ) and 10-(6′-plastoquinonyl) decyltriphenylphosphonium (SKQ1), selectively accumulate within mitochondria to scavenge reactive oxygen species (ROS) at their primary site of production. Our previous findings demonstrated that MitoQ and SKQ1 prevented the reduction in cell viability caused by DOX treatment in H9c2 myoblasts. However, it remains unclear whether MitoQ can selectively …

Adjunctive Psychosocial Interventions And Opioid Abstinence Among Patients Receiving Buprenorphine: A Randomized Clinical Trial., Michelle R. Lent, Emily E Hurstak, Kevin G Lynch, Emily Loscalzo, Kimberly Mazur, Helen L Lugo, Karen L Dugosh

PCOM Scholarly Works

IMPORTANCE: Adjunctive psychosocial treatments are recommended for many using medications for opioid use disorder (MOUD), but it is unclear which approaches can best enhance treatment outcomes.

OBJECTIVES: To evaluate the comparative effectiveness of 2 psychosocial treatments, peer recovery support (PRS) and cognitive-behavioral therapy (CBT), on opioid abstinence when used as adjunctive therapies to office-based buprenorphine treatment in adults with opioid use disorder (OUD).

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial included US adults diagnosed with OUD referred for care at 5 federally qualified health centers with office-based addiction treatment programs by their clinicians from 2020 to 2024. Participants were …