Digital Commons Network^™

Targeting Oxidative Stress In Cadasil: Case Insights And Therapeutic Approaches, Maria Meshreky, Richard Weinberger, Giana Johnson, Andrew Abraham, Jacob Rosendale

The Journal of Integrated Primary Care

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare hereditary small-vessel disease caused by NOTCH3 mutations, leading to recurrent ischemic strokes, cognitive decline, and early-onset dementia. Oxidative stress has been implicated in the pathophysiology of small-vessel cerebrovascular disease, but therapeutic strategies targeting oxidative injury remain limited. We present a 40-year-old female with recurrent ischemic strokes involving the right and left middle cerebral arteries, persistent hypercoagulability of unknown etiology, and no identifiable inherited or acquired thrombophilia. Despite well-controlled blood pressure and standard medical management, the patient remains at high risk for cerebrovascular injury. An extensive review of …

Implementing An Integrated Primary Care Model In Outpatient Specialty Medicine: Lessons Learned And Future Directions, Kristen Perry, Rachel Allen, Katherine Dollar, Christina B. Shook, Alexandra Alvarez, April Eaker, Molly Goodrich, Jennifer Patterson

The Journal of Integrated Primary Care

The Veterans Health Administration (VHA) has a successful history of integrating behavioral health into primary care through its Primary Care Mental Health Integration (PCMHI) program, utilizing the Colocated Collaborative Care (CCC) model to improve access, early intervention, and team-based care. Recognizing this model’s utility, coupled with the high prevalence of psychological concerns among patients with chronic medical conditions—such as cancer and pain—and their associated elevated suicide risk, VHA launched the Mental and Behavioral Health Integration (MBHI) into Specialty Medicine Demonstration Projects in 2022. These projects expand CCC services into outpatient Oncology and Pain Management clinics, supported by implementation facilitation strategies …

Innovations In Developing Behavioral Health Care Managers Within Collaborative Care Programs, Jesse K. Allen-Dicker, Virginia Kelly Arlt Mutch, Derek M. Tate

The Journal of Integrated Primary Care

The collaborative care model is an effective method to treat adults with depression and other psychiatric symptom presentations within primary care settings. Research suggests that patients treated by more experienced behavioral health care managers receiving consistent supervision experience greater symptom relief. Supervision is an essential and widely accepted component of the collaborative care model, though minimal guidance has been offered on how to best implement supervision and foster behavioral health care manager development within these programs. The present paper highlights the approach developed by a collaborative care program with an emphasis placed on consistent and frequent consultation and supervision and …

A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long

Walden Dissertations and Doctoral Studies

The emergence of illicitly manufactured fentanyl has increased clinical uncertainty during buprenorphine induction in medication-assisted treatment for opioid use disorder. The purpose of this quantitative, retrospective cohort study, guided by the Transtheoretical Model (TTM), was to examine whether prescriber-level buprenorphine induction practices and experiences with precipitated withdrawal were associated with reported buprenorphine induction challenges, and whether county-level fentanyl prevalence contributed to these challenges after accounting for geographic clustering. Secondary, de-identified archival data were obtained from the National Institute on Drug Abuse Clinical Trials Network study CTN-0134 and included 64 prescribers practicing in fentanyl-endemic settings. Buprenorphine induction challenges were operationalized as …

G1p3 Dysregulates Interferon-Stimulated Gene Expression In Er (+) Breast Cancer Cells, Karina Santana

Honors Theses

Even with advances in diagnosis and treatment, breast cancer remains the second leading cause of cancer-related death in women, with nearly 90% of fatalities linked to drug resistance driven by metastasis and recurrence. G1P3, an anti-apoptotic mitochondrial protein, is upregulated in breast cancer and has been associated with increased metastatic potential and poor prognosis. Recent findings show that G1P3 enhances interactions between Rab5-containing endosomes (RCEs) and mitochondria, and emerging evidence suggests that mitochondria play a critical role in initiating interferon (IFN) responses. Based on this, we hypothesized that G1P3-mediated interactions between RCEs and mitochondria promote interferon-stimulated gene (ISG) expression in …

Building Connections For Care: A Practical Guide For Novice Nursing Professional Development Practitioners, Debra Hunt

Student Dissertations

Building Connections for Care is a practical textbook designed to support novice Nursing Professional Development Practitioners (NPDPs) as they transition from expert bedside clinicians to educational leaders within complex healthcare systems. Grounded in the Association for Nursing Professional Development (ANPD) practice model, the book integrates ethical foundations, communication strategies, leadership frameworks, and inquiry methods to build confidence and competence in the NPDP role. Chapters trace a developmental pathway from role transition and Benner’s novice-to-expert model through ethics and just culture, incivility and workplace culture, and communication skills including feedback, SMART goals, SBAR, and professional digital conduct. Subsequent chapters expand NPDP …

Prmt5 Inhibition Impairs Fanconi Anemia Pathway-Mediated Homologous Recombination And Enhances The Antitumor Efficacy Of Temozolomide In Glioblastoma, Shumpei Onishi, Sridharan Jayamohan, Ashis Chowdhury, Sarah Rivas, Yoshihiro Otani, Celine Ertekin, Jean-Paul Bryant, Sara A Murphy, Kimberly A Rivera-Caraballo, Stuart Walbridge, Bayu Sisay, Dragan Maric, Abdel Elkahloun, Kory Johnson, Desmond A Brown, John D Heiss, Ashish H Shah, Tae Jin Lee, Sangamesh G Kumbar, Ji Young Yoo, Andrew J Brenner, Balveen Kaur, Gangadhara R Sareddy, Yeshavanth Kumar Banasavadi-Siddegowda

Faculty, Staff and Student Publications

Despite multimodal therapy of surgical resection, radiation, and chemotherapy, glioblastoma patients show a dismal prognosis. Protein Arginine Methyltransferase 5 (PRMT5) is overexpressed in glioblastoma, and its inhibition imparts an anti-tumor effect. Tumor cells invariably develop resistance to Temozolomide (TMZ), the standard chemotherapeutic agent for glioblastoma. However, the mechanistic role of PRMT5 in treatment-resistant glioblastoma is unknown. Patient-derived glioma stem-like cells (GSCs), treated with PRMT5 inhibitor (LLY-283) or transfected with PRMT5-target-specific siRNA, were treated with TMZ and subjected to in vitro functional and mechanistic studies. The intracranial mouse xenograft model was used to test the in vivo antitumor efficacy of combination …

Subchronic Oral Exposure To Propylparaben Induces Endocrine Disruption And Genotoxicity In Male Rats, Sarah M. Moud, Najiah M. Alyamani

Saudi Toxicology Journal

ropylparaben (PP) is widely employed as a preservative in consumer products such as cosmetics, pharmaceuticals, and food items, prompting increasing safety apprehensions due to its possible endocrine-disrupting properties. A controlled experimental investigation was conducted to assess the toxicological effects of sub-chronic propylparaben exposure on the testes of adult male rats. Twenty adult male rats (n = 20) were randomly assigned to two groups (10 rats per group): a control group receiving distilled water and a treated group receiving PP orally at a dosage of 100 mg/kg body weight once daily for four consecutive weeks. This dosage was selected based on …

Convergent Rna Pathophysiology In Amyotrophic Lateral Sclerosis, Hunter Lee Patterson

Arts & Sciences Graduate Student Theses and Dissertations

This dissertation explores the connection between amyotrophic lateral sclerosis pathogenesis and RNA biology via two mechanisms: microRNA regulation of gene expression in the spinal cord and modulation of TDP-43 pathology through synthetic oligonucleotides. Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by selective loss of motor neurons in the brain and spinal cord that leads to progressive weakness. However, despite this shared clinical pattern the known causes of ALS are extremely varied. Only about 10% of ALS cases are familial while the other 90% occur sporadically. Even among that small fraction of familial cases, researchers have identified dozens …

A Scoping Review Of The Objective Structured Assessment Of Technical Surgical Skills (Osats), David J. O'Regan, Christopher Caddy, Retnagowri Rajandram, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Objective structured assessment of technical skills (OSATS) offers an objective tool for assessing bowel anastomosis on a benchtop. It was developed in 1997 to set appropriate standards and expectations for the surgical trainee. OSATS have become the gold standard of assessment across many disciplines. A global Likert rating scale, including respect for tissues, instrument handling, economy of movement, and flow of the operation predominates the literature. This has led to many questioning OSATS objectivity, claiming the process to be time-consuming, subjective, demanding human resources, and requiring extensive training of the trainer. We believe OSATS scoring has omitted the 22-point …

Spontaneous Blood Oxygen Level Dependent Signals In Glioblastoma-Bearing And Aging Brains, Ki Yun Park

Arts & Sciences Graduate Student Theses and Dissertations

Brain activity fluctuates across timescales from microseconds to decades, reflecting processes ranging from rapid synaptic transmission to slow neuromodulatory and homeostatic changes. Resting-state functional magnetic resonance imaging (rs-fMRI) captures the slow end of this spectrum (spontaneous blood oxygen level-dependent (BOLD) fluctuations over tens to hundreds of seconds), which reflect the integrated output of these underlying processes and are increasingly recognized as sensitive to both pathological and physiological brain states. The core of this thesis examines rs-fMRI as a biomarker for two clinical entities: glioblastoma and aging. Reliable biomarker development requires both methodological rigor and analytic breadth, knowing what the method …

Process Evaluation Of The Cheers Automated A1c Follow-Up Reminder System In Primary Care, Heather E. Lewis

Doctoral Dissertations & Projects

Background: Missed diabetes follow-up contributes to suboptimal glycemic control in primary care. Health record embedded reminder systems may improve continuity of care, but process evaluation is needed to understand real-world implementation (Bugge, 2024; Rathod et al., 2024).

Objective: To evaluate fidelity, workflow processes, and reach of the Cheers automated A1c reminder program among adults with type 2 diabetes in primary care.

Methods: This retrospective process evaluation used EHR data guided by the CDC Program Evaluation Framework (CDC, 2024). Measures included reminder delivery, follow-up completion, fidelity, and contextual factors.

Results: Of 72 eligible patients, 26 met success criteria (36.1%); 92.0% completed …

Acute Musculoskeletal Injuries In Kids—Assessment, Imaging & Return-To-Play, Mike Smith, Kevin Latz Md

Pediatrics in Practice: A CME Podcast

How should pediatricians triage an acute sports injury—what to check first, what imaging to order, and when to escalate urgently? In this Pediatrics in Practice CME episode, Kevin Latz, MD, MBA shares a practical framework for assessment, red flags, return-to-play counseling, and prevention strategies for active kids.

Click here to stream the podcast episode.

Growing Healthy Habits: Impacts Of A Youth Community Garden For Children In Rural Mississippi, Olivia G. Degravelle

Honors Theses

This study examines the implementation and outcomes of a Youth Garden Program conducted in Pontotoc, Mississippi. Funded by the Allstate Community Service Project Grant, the Youth Garden was constructed within the previously established Pontotoc Community Garden. The initiative comprised four weekly workshops designed for participants ranging from preschool to adolescence. Each session incorporated hands-on fruit and vegetable (FV) planting or harvesting, an educational lesson, and a complementary craft activity. Children’s FV consumption patterns, nutritional knowledge, and attitudes toward FV were assessed through pre- and post-program surveys. In addition, the photo-elicitation interview method invited participants to take digital photographs of garden …

The Influence Of The Timing Of Definitive Restoration Placement After Root Canal Completion: A 22-Year Retrospective Study, Shikha Gupta

Master's Theses (2009 -)

Objective: To evaluate how the time interval between root canal obturation and the placement of a definitive restoration impacts the incidence of tooth failure, defined as non-surgical retreatment, apical surgery, or extraction. Methods: This 22-year-retrospective cohort study utilized electronic health records from the Marquette University School of Dentistry (MUSoD) axiUm database, analyzing 11,002 teeth treated between 2004 and 2026. Inclusion criteria required patients to be at least 18 years of age, categorized as established patients of record, with all non-surgical root canal treatments (NSRCT) meeting the 2020 AAE quality standards. The interval between obturation and restoration was categorized into seven …

Ellagic Acid Reduces Inulin's Adverse Effects: A Combined Approach To Enhance Therapeutic Potential In Nonalcoholic Steatohepatitis, Tharani Senavirathna, Shafaei, Ricky Lareu, Lois Balmer

Research outputs 2022 to 2026

This mouse study investigates the efficacy of ellagic acid (EA), a potent antioxidant in fruits and nuts, and inulin, a prebiotic known for gut microbiota benefits, in nonalcoholic steatohepatitis (NASH). A Western-style diet (WD) was used to induce NASH in C57BL/6J male mice for 16 weeks. Mice then received EA (100 mg/kg/day, oral gavage, 5 days/week) and/or 5% inulin (w/w in diet) for 12 weeks while continuing WD. Inulin increased energy intake and trended toward higher body weight and fasting glucose. EA reduced liver weights and restored the liver-to-body weight ratio. EA and inulin combined significantly reduced steatosis and hepatocyte …

Lateral Minimally Invasive Si Joint Fusion Following Adult Spinal Deformity: A Case-Report And Literature Review, Basel Musmar, Hassan Saad, Joshua Pelta-Heller

Department of Neurosurgery Faculty Papers

This case report describes lateral minimally invasive sacroiliac (SI) joint fusion for SI joint–mediated pain in a patient with a history of adult spinal deformity surgery. A 48-year-old woman with multiple medical comorbidities previously underwent long thoracolumbar fusion. She subsequently had L4-S1 anterior lumbar interbody fusion and posterior L4-pelvis instrumentation in 2010. Following a ground-level fall in 05/2021, she developed new left-sided hip and sacroiliac pain with intermittent left lower-extremity numbness. Radiographs demonstrated mild hip osteoarthritis and sacroiliac joint sclerosis; spine imaging revealed discontinuity of the right iliac fixation rod without acute fracture. MRI of the hip showed bilateral sacroiliitis …

To Seize Or Not To Seize? That Is The (Epigenetic) Question, Corey St Romain, Jeannie Chin

Faculty, Staff and Students Publications

No abstract provided.

Horseshoe Kidneys In Transplantation: Underutilization Despite Comparable Quality And Favorable Outcomes: Unos Registry Analysis (2007-2023), Abigail W. Cheng, Samrawi Misiker, Roberto Sagaribay, Kavita Batra

School of Medicine Research Poster Showcase

Introduction: Horseshoe kidneys (HSKs) are the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals and often discovered incidentally. Historically excluded from transplantation due to complex anatomy, advances in surgical techniques have made HSK transplantation increasingly feasible. Although successful procurement and transplantation have been described in case reports, national-level data comparing donor characteristics and organ utilization between HSK and non-HSK donors remain limited. This study characterizes donor demographics, clinical profiles, and organ utilization of HSK donors using the United Network for Organ Sharing (UNOS) database.

Methods: A retrospective analysis of the UNOS kidney transplant registry was performed, …

Anesthetic Management In Patients With Impella Devices: A Retrospective Review And Clinical Guide, Harrison Yang, Divakara Gouda, Kent B. Berg, Katherine Green, Suvan Sundaresh, Basavana Goudra

Department of Anesthesiology Faculty Papers

Background: The Impella family of percutaneous a left ventricular assist devices are increasingly used for hemodynamic support in patients with cardiogenic shock or advanced heart failure. However, guidance on anesthetic management for patients with Impella support undergoing noncardiac procedures remains sparse. This study reviews perioperative practices and outcomes to inform clinical management.

Methods: Following institutional review board approval, a retrospective analysis was performed of adult patients receiving an Impella device (2.5, CP, 5.0, or 5.5) at Thomas Jefferson University Hospital, Philadelphia, USA, between December 2017 and October 2024. Patients, who subsequently underwent procedures involving anesthesia care were included. Demographics, procedure …

Decoding Immunotherapy Response Through Computational Modeling, Bingrui Li, Ruihan Luo, Kexin Huang, Jiajia Liu, Weiling Zhao, Xiaobo Zhou

Faculty, Staff and Student Publications

Immunotherapy has seen success in treating patients with cancer, but variable responses underscore the need for effective patient stratification and therapy planning. Computational tools integrating multi-omics, imaging and machine learning have advanced, yet reliable personalized predictions remain challenging. This review analyzes the field through four converging paradigms: classical machine learning, deep learning, graph and network modeling, and mechanistic systems biology. We examine the evolution from correlational features to representation learning, relational inference, and causal simulation of tumor-immune dynamics, highlighting the shift towards multi-modal fusion and interpretable, clinically deployable models. By providing an integrated review of these computational tools, we hope …

Promoting Mental Wellness And A Calm Learning Environment In A 2nd Grade Classroom, Grace Tone

Capstone Projects

Promoting mental wellness and implementing cognitive behavioral strategies brings awareness to staff and students and helps to promote a calm learning environment. School-based occupational therapists support students to participate in school occupations that they may be struggling with and provide them with cognitive behavioral strategies to regulate their emotions. The ACOTE concentration area for this capstone included education to staff members on the impact of mental wellness on student participation in school occupations and education on the Calm Moment Cards program from Every Moment Counts. The second ACOTE concentration area for this capstone was program development for sustainability of the …

Perioperative Outcomes And Challenges In Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy: A Single-Institution Case Series, Parli Raghavan Ravi, Maha Abdullah Naseer Alshaibi, Raj Sahajanandan, Mohammed Abdullah Saif Alhosni, Srinivas Shyam Mantha

Sultan Qaboos University Medical Journal

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a high-risk, but potentially curative, treatment for peritoneal surface malignancies. This retrospective analysis was conducted between March 2023 and September 2025 at Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman, with the objective of analysing perioperative outcomes and challenges in patients undergoing CRS with HIPEC. Data on demographics, intraoperative variables and postoperative outcomes were collected and statistically analysed. A total of 25 consecutive patients were included. The cohort had significant comorbidities (American Society of Anesthesiologists II/III = 84%). Significant metabolic stress was evidenced by increased lactate (P <0.001) and base deficit (P …