Digital Commons Network^™

Explaining Variation In Medical Aid In Dying Policy Across U.S. States, Abigail Hopper

Undergraduate Theses, Capstones, and Recitals

This paper asks why Medical Aid in Dying (MAiD) policy in the United States does not follow a simple partisan pattern between states. Existing scholarship on morality policy emphasizes ideological conflict and partisan alignment, but this framework cannot fully explain why states with similar political compositions have adopted different MAiD policy outcomes, indicating that some key mechanisms shaping the variation have been overlooked. To address this, this paper combines a national dataset of MAiD policies across all fifty states with a comparative case study of Montana, Colorado, and West Virginia, focusing on differences in institutional venues, framing strategies, and coalition …

Differential Roles Of Moesin And Vasp In Β-Catenin-Associated Networks During Zebrafish Heart Regeneration, Allen Rutman

Undergraduate Theses, Capstones, and Recitals

With cardiovascular disease remaining as the leading cause of mortality worldwide, it is largely due to the limited regenerative capacity of the human heart. However, zebrafish (Danio rerio) can fully regenerate cardiac tissue following injury, providing a valuable model for studying the mechanisms of heart repair. To investigate these mechanisms, we used proteomics methods in the past. Proximity labeling is a technique that identifies proteins based on their physical proximity to a protein of interest. It can be applied in organisms and in living cells (Roux et al., 2012; Cho et al., 2020). We used proximity labeling to characterize protein …

Healthcare Experiences And Needs Of Patients With Pregnancy Of Unknown Location: A Qualitative Study, Kavita Vinekar, Zahava Shimshi, Amanda Doty, Samantha Kolowrat, Rebecca Mercier, Agatha Berger, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Patients presenting with bleeding or pelvic pain in early pregnancy are commonly found to have pregnancies of unknown location (PUL), with no sonographic findings of intrauterine nor ectopic pregnancy. We aimed to explore healthcare experiences and needs of patients presenting with PUL.

METHODS: This was a qualitative study using semi-structured interviews to explore healthcare experiences among patients with PUL. Patients were eligible if they presented with bleeding or abdominopelvic pain to the OB/GYN office or emergency department and were found to have a PUL followed in an electronic health record tracking list; had an initial human chorionic gonadotropin (hCG) …

Esophageal Innominate Artery Fistula After Delayed Recognition Of Esophageal Foreign Body., Arianne J Abreu, Rahul Sinha, Robert T Sataloff

Otolaryngology (ENT) Resident Research

Esophageal innominate artery fistula (EIF) is a rare cause of life-threatening gastrointestinal hemorrhage. This condition occurs most often secondary to an aneurysm, tumor, or esophageal foreign body. After stabilization of airway and circulation, the management options vary from open to endoscopic and endovascular repair. The initial presentation, diagnosis and management of EIF in the literature focuses on adults primarily. In this case report, the clinical presentation of EIF in a pediatric patient, secondary to delayed recognition of a foreign body, highlights management considerations in this population.

Deciphering Small Sequence Differences In T Cell Receptor-Antigen Pairing, Yi Han, Yuqiu Yang, James Zhu, Farjana J Fattah, Mitchell S Von Itzstein, Minying Zhang, Casey Bermack, Peixin Jiang, Shailbala Singh, Yanhua Tian, Yifei Hu, Yafang Deng, Xiongbin Kang, Donghan M Yang, Jialiang Liu, Yaming Xue, Chaoying Liang, Indu Raman, Chengsong Zhu, Olivia Xiao, Jonathan E Dowell, Jade Homsi, Sawsan Rashdan, Ke Pan, Shengjie Yang, Mary E Gwin, David Hsiehchen, Yvonne Gloria-Mccutchen, Fangjiang Wu, John V Heymach, Don Gibbons, Junzhou Huang, Chao Cheng, Jianjun Zhang, Cassian Yee, Alexandre Reuben, David E Gerber, Tao Wang

Faculty, Staff and Students Publications

T cells have important functions in development and disease processes through T cell receptor (TCR)-dependent activities. Many tools were developed to predict the binding between TCRs and antigens. However, one of the uncertainties is whether such tools can decipher how small changes in the TCRs or antigenic peptides contribute to binding. We develop a deep learning model, pMTnet-omni, which not only predicts the binding vs. non-binding of TCRs towards pMHCs, but also distinguishes the stronger vs. weaker binding of TCRs similar in sequence. We leverage this capability to interpret the biological rules that govern TCR-antigen pairing. This also enables pMTnet-omni …

Bridging Interprofessional Gaps: A Pilot Study On Aac And Asl Training For Allied Health Profession Students, Angela M. Riccelli, Danielle Osmelak, Leslie Guca, Keith Werosh, Valerie Coolman, Rebecca Kvasnicka

Journal of Applied Disciplines

Interprofessional education (IPE) is recognized as a critical component of health professions training, equipping future clinicians with the skills necessary for collaborative practice and patient-centered care. However, students in speech-language pathology, occupational therapy, and physical therapy programs often have limited exposure to individuals who rely on Augmentative and Alternative Communication (AAC) or American Sign Language (ASL). This study evaluated the impact of a grant-funded, AAC- and ASL-focused IPE event at Governors State University on students’ self-reported interprofessional competencies. Using the Interprofessional Collaborative Competencies Attainment Survey (ICCAS-R) developed by Archibald, D., Trumpower, D., and MacDonald, C.J., in 2009 and revised in …

2nd National Research Day Lebanese Medical Schools

MEAMS Middle East Annals of Medical Sciences - Saint Joseph University of Beirut

No abstract provided.

Neuromuscular Responses During Vigorous Intensity Heart Rate-Clamp Cycling Exercise, Clara J. Mitchinson, Pasquale J. Succi, Brian Benitez, Djadmann Gustave, Minyoung Kwak, Erik Snell, Haley C. Bergstrom

Journal for Sports Neuroscience

Introduction: Electromyography (EMG) and mechanomyography (MMG) provide non-invasive assessments of neuromuscular function and fatigue during dynamic exercise. This study examined neuromuscular fatigue and cycling performance through changes in power output (PO), total work (TW), EMG and MMG, amplitude (AMP) and mean power frequency (MPF) during three, heart rate (HR)-Clamp trials in the vigorous range (77-95% HR_max). Methods: Ten men (mean±SD, 25.9±5.0yr, 74.9±15.0kg, HR_max=178±12b×min^-1) performed a cycle ergometer graded exercise test, followed by three separate HR-Clamp trials at 77%HR_max (HR_L, time to exhaustion [T_Lim]=58.5±4.6 min, range=45.3-60.0min), 86%HR_max (HR_{M …}

Impact Of Insurance On In-Hospital Mortality And Other Outcomes Among Patients With Acs And Cardiogenic Shock: A Nationwide Analysis From 2022., Renzo Aller, Aura Calderon

Research Symposium

Introduction: Insurance coverage may significantly affect access to timely and advanced cardiovascular therapeutic interventions within the United States. Among individuals experiencing acute myocardial infarction (AMI) accompanied by cardiogenic shock (CS), variations based on the primary payer may play a role in subsequent in-hospital outcomes. We conducted a retrospective analysis to determine whether insurance status correlates with in-hospital mortality and other outcomes among patients with AMI and CS, utilizing the NIS database.

Methods: ACS patients in the 2022 NIS were categorized as STEMI or NSTE-ACS using appropriate ICD‐10 codes. Patients with both types of ACS and cardiogenic shock were included in …

The Triple Threat: Hiv, Nonadherence, And Substance Use Driving Premature Coronary Events, Jose J. Loayza Pintado, Taiwo Ajani, Angelica Lopez Jesus, Aura Calderon, Jose Pena

Research Symposium

Background: People living with HIV (PLWH) experience nearly double the risk of premature atherosclerotic cardiovascular disease and often present with acute coronary syndromes at younger ages [1]. Chronic inflammation, immune activation, and drug–drug interactions between antiretrovirals and antiplatelet agents further contribute to accelerated atherosclerosis and poor outcomes after percutaneous coronary intervention (PCI) [2,3]. Importantly, in-stent restenosis (ISR) remains disproportionately frequent in PLWH despite modern drug-eluting stents, with medication nonadherence compounding risk [4]. We present a young woman with HIV and recurrent myocardial infarction due to rapid ISR, underscoring the impact of inflammation, adherence, and pharmacologic interactions on secondary prevention.

Case …

Survival Outcomes And Tumor Site Distribution By Molecular Subtype In Breast Cancer Patients Under 40, Muhammad Noorani, Shubhank Goyal, Sierra Viduarri, Aura Calderon, Christine Pham, Shweta Singh, Mutaaz Ahmed, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Shubash Chauhan, Diane Nguyen, Sidketa Fofana, Sheema Khan

Research Symposium

Background: Screening guidelines for breast cancer typically begin at age 40, leaving younger women at risk for delayed detection. The survival outcomes and tumor site patterns by subtype in this younger population remain underexplored. Our analysis leverages comprehensive national data to fill this critical knowledge gap, offering one of the most detailed evaluations to date of molecular subtype distribution, prognostic disparities, and anatomical presentation in women under 40.

Methods: Using the SEER 18 registry, we identified 5,026 female patients diagnosed under age 40 with invasive breast cancer in 2018. This year was selected for the most recent data available on …

Severe Cold Agglutinin Hemolytic Anemia Secondary To Mycoplasma Pneumoniae And Epstein-Barr Virus Co-Infection In An Elderly Patient, Aura Mc Calderon, Jose Loayza, Luis Salcedo, Ivan Mogollon, Asmik Asatrian

Research Symposium

Introduction: Cold autoimmune hemolytic anemia (AIHA) is an uncommon, complement-mediated hemolysis typically driven by IgM autoantibodies; secondary forms are often infection-related. Severe, transfusion-refractory presentations are rare in older adults. We present an elderly patient with Mycoplasma pneumoniae and Epstein–Barr virus co-infection complicated by life-threatening cold agglutinin hemolysis.

Case report: Upon admission, a 79-year-old male patient presented with a one-week history of fatigue, pyrexia, nasal congestion, and dyspnea; examination findings revealed pallor, bibasilar crackles, and mild splenomegaly. Laboratory investigations indicated the presence of severe hemolytic anemia accompanied by compensatory reticulocytosis and thrombocytosis (hemoglobin 5.5 g/dL, hematocrit 17.2%, MCV 100 fL, reticulocytes …

Iptacopan-Responsive Pnh With Pancytopenia: Hematologic Normalization And Dose Adjustment For Transaminitis, Aura Mc Calderon, Jose Loayza, Francisco Arias, Catherine Matos, Bharat Peddinani, Diane Nguyen

Research Symposium

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal hematopoietic stem-cell disorder driven by loss of GPI-anchored complement regulators (CD55, CD59), leading to complement-mediated intravascular hemolysis, cytopenias, and thrombosis. We report a new PNH diagnosis in a young woman with severe pancytopenia who achieved hematologic improvement on oral iptacopan, requiring dose adjustments for mild liver enzyme elevation.

Case Report: On February 27, 2025, a 38-year-old female patient exhibited symptoms of progressive fatigue, dyspnea, and jaundice. Initial laboratory assessments indicated the presence of severe hemolytic anemia accompanied by pancytopenia, hemoglobin level recorded at 4.7 g/dL, white blood cell count at 1.6×10³/µL (absolute …

Expression And Functional Significance Of The G Protein–Coupled Estrogen Receptor (Gper) In Breast Cancer Subtypes, Sierra E. Vidaurri, Shweta Singh, Valerie E. Ledezma, Rajasekhar Baru, Emma Garza, Francisco Flores, Muhammad Noorani, Shubhank Goyal, Aura Calderon, Alexander Lim, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Subhash Chauhan, Diane Nguyen, Sheema Khan

Research Symposium

Background: The G protein–coupled estrogen receptor (GPER) mediates rapid non-genomic estrogen signaling and has been implicated in breast cancer progression and aggressiveness. However, its expression patterns across molecular subtypes and its direct functional contribution to tumor behavior remain incompletely defined. The objective of this study was to comprehensively characterize GPER expression in breast cancer tissues and to functionally validate its role in regulating tumor cell proliferation and migration using genetic modulation approaches.

Methods: GPER expression was evaluated in breast cancer cell lines and patient tumor tissues using immunohistochemistry (IHC), Western blotting, and RT-PCR. Tumors were classified into Luminal A, Luminal …

Clinical Outcomes In Neutropenic Fever At A South Texas Community Hospital In Hispanic Patients., Bharat K. Peddinani, Aura Calderon, Ramon Elizondo-Romo, Elizabeth Mills-Reyes, Everardo Cobos

Research Symposium

Background: Febrile neutropenia (FN) remains a high-acuity complication of myelosuppressive chemotherapy, yet outcomes in Hispanic patients—particularly in South Texas—are underrepresented. We compared outcomes of FN admissions among Hispanic adults with solid tumors versus hematologic malignancies at a community hospital in the Rio Grande Valley.

Methods: We conducted a retrospective cohort study of adult hospital admissions for FN from January 2022 through January 2025. Inclusion criteria were age ≥18 years, FN documented in the emergency department, active chemotherapy for a solid or hematologic malignancy, and Hispanic ethnicity. Of 139 charts screened, 97 met criteria (46 solid tumors; 51 hematologic malignancies). Primary …

From Risk Factor To Cause Of Death: Hypertensive Heart Disease And The Changing Composition Of Heart Disease Mortality In Texas Compared With The United States, 1999–2020, Jose J. Loayza Pintado, Angelica Lopez Jesus, Aura Calderon, Jorge Aboytes Trevino, Daniela Hernandez

Research Symposium

Background: Heart disease mortality has declined nationwide, but Texas continues to experience higher rates than the United States overall. At the same time, hypertensive heart disease (HHD) has become more prominent within cardiovascular mortality statistics. Whether this shift reflects a growing hypertension-driven contribution to the Texas–U.S. gap has not been well quantified. We compared long-term trends in HHD mortality and the presence of HHD on death certificates among heart disease deaths in Texas versus the United States.

Methods: We analyzed CDC WONDER Underlying Cause of Death and Multiple Cause of Death files, 1999–2020, restricted to decedents aged ≥25 years. HHD …

Gper As A Therapeutic Target In Breast Cancer: Pharmacologic Inhibition And Microbiome Associations, Sierra E. Vidaurri, Shweta Singh, Valerie E. Ledezma, Rajesekhar Baru, Emma Garza, Francisco Flores, Muhammad Noorani, Shubhank Goyal, Aura Calderon, Alexander Lim, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Subhash Chauhan, Diane Nguyen, Sheema Khan

Research Symposium

Background: The G protein–coupled estrogen receptor (GPER) mediates rapid estrogen signaling that promotes proliferation, migration, and therapeutic resistance in breast cancer, including in hormone receptor–negative subtypes. Notably, standard endocrine therapies may inadvertently activate GPER, highlighting the need for direct targeting of this pathway. The objectives of this study were to evaluate GPER as a therapeutic target using pharmacologic modulators and to determine how GPER-driven tumor behavior relates to tumor microbiome composition across breast cancer subtypes.

Methods: Breast cancer cell lines representing Luminal A (MCF7), Luminal B (BT474), HER2-enriched (SKBR3), and triple-negative (HCC38, MDA-MB-453, MDA-MB-231) subtypes were treated with Ormeloxifene (ORM). …

When A Pain Crisis Isn’T Only A Crisis: Delayed Hemolytic Transfusion Reaction With Hyperhemolysis In Adult Sickle Cell Disease., Bharat K. Peddinani, Conrad Chouinard, Aura Calderon, Maria I. Lopez, Diane Nguyen

Research Symposium

Introduction: Delayed hemolytic transfusion reaction (DHTR) in adults with sickle cell disease (SCD) is frequently mistaken for vaso-occlusive crisis (VOC) or evolving acute chest syndrome (ACS). New alloantibodies may be absent or delayed, so reflex transfusion can worsen hemolysis. Programs now emphasize routine post-transfusion surveillance and a protocolized, transfusion-sparing response when DHTR is suspected.

Case Presentation: A 35-year-old man with hemoglobin SS SCD, hypertension, chronic kidney disease, and recurrent priapism presented with severe left-leg pain two weeks after receiving two units of packed red blood cells for pre-operative optimization. Baseline hemoglobin (Hb) was ~6 g/dL; he was off disease-modifying therapy. …

Seeing The Pattern: Optic Neuritis, Multifocal Mri Lesions, And The Early Diagnosis Of Multiple Sclerosis, Jose J. Loayza Pintado, William Reckley, Aura Calderon, Luis Gaitan

Research Symposium

Background: Optic neuritis is a common neuro-ophthalmic emergency and may be the first clinical manifestation of inflammatory demyelinating disease. In the acute setting, clinicians must rapidly distinguish multiple sclerosis (MS) from important mimics, particularly when optic nerve involvement is accompanied by spinal cord lesions. A structured approach integrating phenotype, MRI lesion distribution and activity, and cerebrospinal fluid (CSF) markers can support timely diagnosis and guide counseling regarding long-term management. We report a young man presenting with unilateral optic neuritis and prior transient neurologic episodes, highlighting a practical diagnostic framework applicable to emergency and inpatient care.

Case Presentation: A 27-year-old man …

Rural–Urban Disparities In Monkeypox-Related Behaviors And Attitudes Among Men Who Have Sex With Men, Patcharaporn Krainara, Benjamas Klahan, Rungrot Jaiyong, Jitti Hanprasertpong

Journal of Health Research

Background: Monkeypox (Mpox) is a global health threat, particularly among men who have sex with men (MSM). Despite the predominance of urban cases in Thailand, rural–urban disparities in Mpox-related attitudes and behaviors remain underinvestigated. This study aimed to compare Mpox-related attitudes and preventive behaviors among urban (Chonburi) and rural (Nakhon Nayok) MSM and identify their influencing factors.

Method: This cross-sectional study was conducted between March and April 2025. A total of  842 MSM (421 urban; 421 rural) were recruited via convenience sampling. Data were collected using paper-based, self-administered Health Belief Model (HBM) questionnaires and analyzed using descriptive statistics and multivariable …

Staff Education To Improve Knowledge On Delirium Assessment, Prevention, And Treatment, Michelle Lee Coll

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education On Triage For Resource Nurses In The Emergency Department, Michelle Donahue Smeltzer

Walden Dissertations and Doctoral Studies

No abstract provided.

Standardizing Pressure Injury Prevention Documentation Through A Clinical Procedure Flowsheet, Aixa Quijano Palés

Walden Dissertations and Doctoral Studies

No abstract provided.

Integrating Structural Analysis In The Pre-Appe Curriculum: Experiences From Three Institutions, Jennifer Ko, Sharon E. Connor, Emily K. Frederick, Katherine Foley, Emiline Snook, Ava Romah, Katie F. Leslie

Pharmacy Faculty Articles and Research

Background

Educational activity

Evaluation findings

Staff Education To Improve Nurses’ Knowledge Of Standardized Car, Relax, Alone, Forget, Friends, Trouble (Crafft) Screening In Outpatient Psychiatric Care, Linda Edeity

Walden Dissertations and Doctoral Studies

No abstract provided.

Understanding Whole-Brain Dynamics Through Generative Modeling, Ruiqi Chen

Arts & Sciences Graduate Student Theses and Dissertations

A central goal in cognitive neuroscience is to map mental processes onto their physical substrates. Traditionally, this goal is pursued by associating different mental processes with spatially-based anatomic localization. On the contrary, much less is known about the temporal dynamics of neural activity, particularly at the scale of the whole brain. Research into whole-brain dynamics has been challenging primarily due to the lack of an analytic framework that can summarize such dynamics, expose the underlying mechanisms, and associate the mechanisms with cognitive processes. In this dissertation, I describe my doctorate research aimed at building such a framework and deploying it …

School Policy, Health Equity, And Lgbtq+ Youth: Implications Of Mahmoud V. Taylor, Anna Folta

Online/Hybrid MPH Integrative Learning Experience (capstone projects)

School-based policy functions as a critical lever for reducing health disparities among LGBTQ+ youth, who face elevated risks of suicidality, bullying, unsafe school environments, and housing instability. An extensive body of research identifies inclusive school practices—such as affirming curricula, supportive staff, and student organizations—as key protective factors that foster belonging and improve mental health outcomes. However, recent political and legal developments threaten the implementation and consistency of these protections.

Using a structured literature review and comparative policy analysis of federal, state, and district responses, this project integrates public health evidence with legal interpretation to assess how emerging parental opt-out frameworks …

Prevalence And Practice Patterns Of Facial Plastic And Reconstructive Procedures Among Otolaryngologists: A National Medicare Claims Analysis, Justin Z. Heckman, Shizue Mito

MEDI 9331 Scholarly Activities Clinical Years

Facial plastic and reconstructive procedures represent a small but relatively well-reimbursed component of ENT Medicare billing. Of 860 otolaryngologists identified in the 2023 CMS Physician and Other Practitioners Public Use File, 104 (12.1%) billed at least one facial plastic CPT code, with a mean of 16.9 services per participating provider. A total of 1,756 facial plastic services were rendered, representing 0.16% of total ENT Medicare volume, with a cumulative reimbursement of $584,834. Mean reimbursement per facial plastic provider-CPT combination was $435, compared to $104 across all ENT services, a 4.2-fold difference. Facial plastic billing was concentrated in non-rural settings (95.5%) …

Flame Retardant Metabolites In Urine Samples Associated With U.S. Consumer Dietary Behaviors, Heather Marie Holliday

Walden Dissertations and Doctoral Studies

No abstract provided.

Nurses’ Knowledge Regarding Ventilator-Associated Pneumonia Prevention Bundle In Adult Cardiac Care Units, Marwa Abdo

Nursing

Ventilator-associated pneumonia (VAP) is among the most common ICU infections for ventilated patients, associated with increased mortality (20-50%), morbidity, and health care costs. Nurses' knowledge of VAP prevention bundles is vital to reducing its incidence in critical care areas. Aim: To assess Nurses’ knowledge regarding the ventilator-associated pneumonia prevention bundle in Adult Cardiac Care Units. Study design: A cross-sectional study design was used. Setting: This study was conducted in both the adult cardiac intensive care unit and the cardiac care unit at Aswan Heart Centre–Magdy Yacoub Foundation, Egypt. Subject: A convenience sample of 67 nurses was selected. Data collection tool: …