Digital Commons Network^™

The Healthcare Transition Experiences Of Emerging Adults With Congenital Adrenal Hyperplasia, Leslie Noojin Pitts

ETDs from 2020-2029

Congenital adrenal hyperplasia (CAH) is a group of disorders characterized by enzyme deficiencies impairing adrenal hormone production and requiring lifelong management. Individuals with CAH experience increased morbidity and mortality due to the underlying condition, steroid exposure, and inadequate preventative care. Despite clinical guidelines recommending a structured healthcare transition (HCT), little is known about the HCT experiences of emerging adults with CAH. Understanding these experiences is critical for identifying practice gaps and developing interventions to improve health outcomes. This qualitative descriptive study explored the HCT experiences, challenges, and outcomes of emerging adults with CAH, as guided by the refined Social Ecological …

Robotic-Assisted Pedicle Screw Placement Achieves High Accuracy And Narrows The Experience Gap: A Preclinical Evaluation, Anna T. Reza, Matthias Walper, Mitchell K. Ng, Paul G. Mastrokostas, Andrew S. Lee, Rafael G. Rafael, Kornelis A. Poelstra, Ratliff K. John, Rajiv K. Sethi, Michael A. Mont

Rothman Institute Papers

To assess a robotic-assisted system versus open manual techniques to: (1) compare pedicle screw accuracy between fellows and attendings with and without robotic assistance, and (2) evaluate executed versus planned trajectory fidelity relative to prior reports. Robotic-assisted spine systems aim to improve the accuracy, reproducibility, and safety of pedicle screw placement. Limited evidence compares outcomes across differing surgeon experience levels. A total of 255 thoracolumbar pedicle screws were placed in synthetic torsos simulating adult degenerative anatomy. Four surgeons (two fellows, two attendings) each placed half their screws using open fluoroscopy-guided techniques and half using a minimally invasive percutaneous approach with …

The Dermatologic Effects Of Climate Change On Skin Of Color Populations: A Comprehensive Review, Grace Ugwueke, Simona A. Alomary, Nicole J. Baker, Susan C. Taylor Md, Nada Elbuluk Md

Student Papers, Posters & Projects

Background: Climate change contributes to rising temperatures, worsening air pollution, increasing UV exposure, and more frequent extreme weather events with downstream consequences for dermatologic conditions. However, limited research has examined how these climate-related effects can impact skin of color (SOC) populations, who often face disproportionate environmental exposures and structural inequities. Objective: To summarize the dermatologic implications of climate and environmental stressors on SOC populations. Methods: A literature search of PubMed and Embase (2000-2025) identified studies assessing dermatologic outcomes related to climate change or environmental exposures. Of 1254 records screened, 133 duplicates were removed, leaving 1121 studies for evaluation. Twenty-three studies …

A Word From The Writing Team (June 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

The Effects Of Bone Health And Variation On Saw Mark Signatures, Lily Ambrose

PCOM Biomedical Studies Student Scholarship

Bone health and structural variation are multifactorial. Population, environment, age, diet, and health influence the overall functional morphology of bone and its response to stressors. Reduced cortical porosity, trabecular thinning, and low bone mass are common indicators of age-related and pathological changes, affecting a significant portion of the population. Because of this, bones encountered in medicolegal investigations often differ from what is considered “normal.” The structural integrity of bone needs to be considered because density influences mechanical strength and response to external forces. In criminal dismemberment cases, forensic scientists analyze saw marks to identify tool class and reconstruct events. While …

The Effect Of Bai1 Deficiency On Cell Survival During The Critical Period Of Retinal Development, Nicholas Mirmanesh

PCOM Biomedical Studies Student Scholarship

The postnatal retina undergoes further development during the critical period, during which excess neurons are culled, and synapses are refined to shape the mature retinal circuitry. Brain-specific angiogenesis inhibitor-1 (BAI1) has been implicated in synaptic development, phagocytosis, the regulation of angiogenesis, and inflammatory signaling, suggesting it may play an important role in retinal maturation. The goal of this project was to determine how BAI1 deficiency affects retinal cell survival and layer morphology during the critical period. Mice were divided into three genotype groups: BAI1 +/+ Wild Type (WT), +/- (Het), and -/- (KO). Apoptotic cells were quantified using TUNEL staining …

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 …

Personal And High-Intensity Gait Factors Associated With Balance And Walking Improvement With Outpatient Stroke Rehabilitation: A Retrospective Study, Heather Staal

Dissertations

Objective: The purpose of this study is to examine the relationships between personal factors and High-Intensity Gait variables and balance and walking improvement in an outpatient stroke population.

Background: Stroke is a leading cause of long-term disability, with persistent gait and balance impairments commonly limiting independence and participation. High-intensity gait training (HIGT) is an evidence-based rehabilitation approach that improves walking outcomes following stroke; however, guidance on how specific training variables are applied in outpatient physical therapy settings remains broad.

Methods: This retrospective observational study analyzes clinical data from outpatient physical therapy episodes in which HIGT is a …

Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar

Dissertations

Client self-disclosure is a core component of the psychotherapy process and increased levels of client self-disclosure have been shown to predict more positive therapeutic outcomes (Pattee & Farber, 2008; Sloan & Kahn, 2005). Similarly, the working alliance and attachment are constructs that have been studied in psychotherapy research and are consistently associated with therapeutic outcomes. Specifically, stronger working alliance ratings and higher levels of secure attachment have been found to predict more positive therapy outcomes (e.g., Flückiger et al., 2018; Mallinckrodt et al., 2005; Sauer et al., 2010). As these three constructs have been found to influence psychotherapy outcomes, the …

Predicting Clinical Outcomes Of Non-Specific Low Back Pain By Studying The Interaction Of Clinical And Demographic Factors Of A Retrospective Data Set, Erica Michelle Fernandes

Dissertations

The purpose of this research is to investigate demographic factors, including age, gender, body mass index (BMI), race, marital status, insurance type, severity of disease (initial pain level), and clinical factors such as number of visits (no. of visits) at physical therapy (PT), length of time at PT and the type of clinician either physical therapist versus physical therapy assistant (PTA), that most predict PT clinical outcomes in patients with nonspecific low back pain (NSLBP) and see if there is an interaction between demographic and clinical variables.

Methods

The current study is a retrospective, cross-sectional, observational study using secondary electronic …

Exploring How Therapist Trainees’ Mentalization, Attachment Styles, And The Working Alliance Impact Treatment Outcomes In Psychotherapy, Hanali Gilbert

Dissertations

A burgeoning area of research within the past 30 years has sought to identify which specific therapist factors contribute to differential treatment outcomes (Barkham et al., 2017). The purpose of the current naturalistic study was to explore how two personal characteristics of therapist trainees, mentalization capacity and attachment styles, impact early treatment outcomes at two Midwestern psychology training clinics. This study also examined whether therapist mentalization and the working alliance interacted to influence client outcomes. Therapists completed the Mentalization Scale (MentS; Dimitrijević et al., 2018) and the Experiences in Close Relationships scale (ECR; Brennan et al., 1998), while the Working …

An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux

Dissertations

Child sexual abuse (CSA) is an adverse childhood experience and a global health issue. Approximately one in four girls encounter CSA per year. Research evidence suggests approximately 50% of CSA survivors encounter sexual revictimization during adulthood (Walker & Wamser-Nanney, 2023), but formal help and intervention can mitigate further psychosocial harm experienced by CSA survivors (Widom et al., 2008). Attachment theory has provided a theoretical framework for identifying individuals at risk for revictimization and help-seeking patterns, such that individuals who have insecure attachment styles report more revictimization frequency, but the literature is mixed about attachment styles and help-seeking (Brenner et al., …

Defining Varus Thrust Assessment And Measurement: A Scoping Review, Haonan Shen, Nicole D'Souza, Claire E. Hiller, Marnee J. Mckay, Kun Hu, Zhiyong Wang, Milena Simic

Research outputs 2022 to 2026

Objective: The primary aim of this scoping review was to identify and evaluate the methodologies used for classifying and quantifying varus thrust of the knee during walking. The secondary aim was to report outcomes of reliability, validity, prevalence, and quantitative cutoffs of varus thrust in existing studies. Methods: A systematic literature search was conducted across five electronic databases from inception to April 2024. Studies that reported varus thrust during gait in adults were included. Two independent reviewers extracted data, and data were synthesized based on thrust classification methods, prevalence, reliability, and validity results. Results: A total of 59 studies were …

Exploring Occupational Exposures And Health Risks Among Long-Haul Truck Drivers: Tobacco Smoke, Cara Harris

ETDs from 2020-2029

Long-haul truck drivers (LHTDs) are exposed to a range of occupational hazards and stressors that threaten their health and well-being. These include, but are not limited to, irregular sleep patterns, fatigue, and chronic exposure to diesel engine exhaust (DEE) and tobacco smoke in the confined spaces of truck cabins. Smoking tobacco cigarettes is often used as a coping mechanism for occupational stressors and nicotine dependence, contributing to a high smoking rate among LHTDs (51%) compared to the general population (19%). Collectively, exposure to DEE and tobacco smoke may have a synergistic effect, increasing LHTD’s risk for lung cancer and other …

Decentralizing Dementia Research To The Us–Mexico Border: The Rio Grande Valley Ad-Rcmar As A Model For Translational Equity, Gladys E. Maestre, John Blangero, Eron Manusov, Gabriel A. De Erausquin, Francisco Fernandez, Silvia Mejia-Arango, Vincent P. Diego, Juan C. Lopez-Alvarenga, Claudia Alaniz, Neyra García, Rosa V. Pirela, Andrew Tsin, Michael Mahaney

School of Medicine Publications

Translational equity means ensuring that diagnostics, treatments, care models, and prevention strategies are developed and implemented so they work for populations with the greatest burden and least access to care. In Alzheimer's disease and related dementias (ADRD), where most evidence derives from highly educated, non-Hispanic White participants at large academic centers, translational equity is critical to prevent misclassification, limited access, and widening disparities and to ensure that underrepresented communities shape how new knowledge moves into practice. Hispanic and other populations in the United States are disproportionately affected by ADRD yet remain underrepresented in research, with gaps especially pronounced in high-poverty …

Understanding And Overcoming Innate And Acquired Mapk Inhibition Resistance In Anaplastic Thyroid Cancer, Peter Y F Zeng, Jalna Meens, Amir Hossein Karimi, Harrison Pan, Matthew J. Cecchini, Laura Jarycki, Sarah B. Ryan, Alice E. Dawson, Mushfiq H. Shaikh, David A. Palma

School of Medicine Publications

Anaplastic thyroid cancer (ATC) is highly lethal. Although patients with the BRAFV600E alteration respond to the type I RAF inhibitor (RAFi) dabrafenib with trametinib, most rapidly develop adaptive or acquired resistance. Here, multi-region whole-genome, high-coverage whole-exome, and single-nuclei RNA sequencing of tumors from ATC patients undergoing type I RAFi and MEKi therapy reveals that reactivation of the mitogen-activated protein kinase (MAPK) pathway, along with immunosuppressive macrophage proliferation, may underlie the development of acquired resistance. Screening of several RAFi reveals that ATC cell lines are exquisitely sensitive to the type II RAFi naporafenib, which inhibits EphA2-mediated MAPK signaling. Further, naporafenib and …

Roots And Greens: Discovering The Power Of Indigenous Produce, Abiodun T. Atoloye, Sherif O. Olasoji, Ebunoluwa G. Ibidapo

Nutrition, Dietetics, and Food Sciences Courseware

The curriculum was designed in alignment with the Cognitive Theory of Multimedia Learning (CTML), Empowerment Theory (ET), and Social Cognitive Theory (SCT) frameworks. These frameworks were used to determine the selection and sequencing of learning activities. As reflected in CTML principles, the use of texts, images, infographics, and videos enhances knowledge retention and information comprehension and helps prevent cognitive overload. Through activities, homework, and family engagement, the principles of ET were incorporated into the curriculum to facilitate participants’ perceived control over food-related decisions. Additionally, by applying the principles of SCT, the curriculum incorporates scenario-based questions, opportunities to engage with peers, …

Standardizing Nutrition Protocols For Brain Tumor Patients, Wendy Aldrich, Clifford A Pierre, Jun Ma, Mariam Ishaque, Christa Seyler, Miri Kim

All Poster Presentations

No abstract provided.

Evaluation Of The Impact Of Pharmacist-Led Toc On Patient Care Outcomes, Taabris Jaamal, Hana Breeland, Thanh Nguyen, Barbara Branneman, Jack Huber, Hung Phan

All Poster Presentations

No abstract provided.

Development Of An Oncology Clinical Research Complexity And Acuity Score For Outpatient Treatment By Visit, Shannon Hoffman

All Poster Presentations

No abstract provided.

The Impact On Nurses' Knowledge And Confidence Of Simulation With Chimeric Antigen Receptor T-Cell Infusion, Rachael Crickman, Shannon Williams, Heather Bissmeyer, Frances Chu, Cara Gallegos

All Poster Presentations

No abstract provided.

Evaluating Low Molecular Weight Heparin For Venous Thromboembolism Treatment In Extreme Body Weights, Natalie Tran, Brittanii Prahl, Jordan Amaro, Barbara Branneman, Jack Huber

All Poster Presentations

No abstract provided.

Euglycemic Diabetic Ketoacidosis: Institutional Review And Protocol Development, Lim Kang, Jordan Amaro, Brittanii Prahl, Jack Huber

All Poster Presentations

No abstract provided.

A Qualitative Exploration Of Spirituality In People Living With Dyspnea And Serious Illness, Leah Mccann Klug

All Poster Presentations

No abstract provided.

Comparable Endogenous Immune Reconstitution, Car-T Expansion, And Cytokine Profiles With Bendamustine Versus Fludarabine/Cyclophosphamide Lymphodepletion, Matthew Schwede, Sarah Hawley, Zachary Reitz, Faith Kierney, Neil Bailey, Tenzin Tsomo, Laiken Lopez, Terry Gilbertson, Christopher A Carney, Doug Kieper, Kelly Paulson, Krish Patel

All Poster Presentations

No abstract provided.

Beyond Ce Credit: A Retrospective Analysis Of Cme And Cpe Impact In A Health System, Diem Pham, Michelle Eng, Brandon Wu

All Poster Presentations

No abstract provided.

Where Housing And Healthcare Meet: Ed Utilization Through On-Site Nursing And Fmr Collaboration, Bennett Gosiker, Tara Ahmadi, Bessie Liu, Naeemah Munir, Viet Nguyen, Carrie B Rubenstein

All Poster Presentations

No abstract provided.

Enhancing Lactation Support In The Icu Via Interdisciplinary Collaboration, Lexxi Ellis, Aretha Miller

All Poster Presentations

No abstract provided.

Assessment Of Patients With Newly Scheduled Opioids And Inappropriate Bowel Regimen, Melody Kazemini, Ryan Dow, Brittanii Prahl, Barbara Branneman, Jack Huber

All Poster Presentations

No abstract provided.

Standardizing Interprofessional Serious Illness Conversations In Inpatient Specialty Palliative Care, Leah Mccann Klug, Catherine Patterson

All Poster Presentations

No abstract provided.