Digital Commons Network^™

Fatigue And Circadian Disruption In Long-Haul Ferry Pilots: Human Factors Challenges And Mitigation Strategies, Parneet Makkar

Discovery Day - Daytona Beach

Fatigue and circadian rhythm disruption present significant human factors challenges in long-haul aviation operations, particularly for ferry pilots (pilots responsible for transporting aircraft long distances between locations) who often travel across multiple time zones before beginning flight duties. Circadian rhythms regulate the human sleep-wake cycle and are closely tied to cognitive performance, alertness, and coordination. Rapid travel across time zones can disrupt these rhythms, producing symptoms commonly associated with jet lag such as sleep disturbances, fatigue, and reduced cognitive functioning. For ferry pilots, long travel periods and irregular schedules may increase the likelihood of fatigue before flight operations even begin. …

Mri-Based Estimation Of The Hip Joint Center In Infants Using Two Sphere-Fitting Methods, Victoria Melendez

Discovery Day - Daytona Beach

Accurate estimation of the hip joint center (HJC) is critical for biomechanical modeling and clinical assessment. Common methods include predictive methods (e.g., regression equations) and functional methods such as sphere-fitting. In infants, femoral head-based methods are often limited due to incomplete ossification of the anatomy and poor visualization in computed tomography (CT) images. This study evaluates an alternative approach using MRI-based sphere fitting of the ossified acetabular rim, comparing its accuracy to traditional femoral head-based methods. MRI scans of three male infants (ages 10.7- 12.7 months) were used to manually place landmarks on the ossified acetabulum and the cartilaginous boundary …

Metabolic Regulation And Immunity In The Spaceflight Environment, Graeme Grainger, Riley Dienna, Astrid Senko, Angela Cebula, Arden Rodriguez Arden Rodriguez

Discovery Day - Daytona Beach

Long-duration spaceflight exposes astronauts to chronic ionizing radiation and microgravity that disrupts homeostasis in the immune system and cellular metabolism. While simulated spaceflight models demonstrate altered T-cell polarization and sex-dependent shifts toward regulatory phenotypes, the metabolic mechanisms driving these immune changes remain unclear. Immune cell function is tightly linked to metabolic programming, with effector T cells relying on glycolysis and regulatory T cells favoring oxidative metabolism, making them highly sensitive to shifts in nutrient availability and redox balance. Emerging research further suggests that neutrophils act as metabolic regulators capable of reshaping the immune microenvironment through oxidative stress, cytokine production, and …

Implementation Of Artificial Intelligence In Retinoblastoma Diagnosis, Zana Moldavsky

inSIGHT

The retina is essential for vision. It is composed of 10 distinct layers and contains specialized photoreceptor cells, rods, and cones that are responsible for converting photons of light into electrical signals through a process called phototransduction.¹ These electrical signals are transmitted to the brain via the optic nerve where they are interpreted as a visual picture.¹

Retinoblastoma is a rare but aggressive malignant tumor of the retina and represents the most common intraocular malignancy in the pediatric populabon.² The disease follows Knudson's two-hit hypothesis and occurs due to biallelic inactivation of the RB1 tumor suppressor gene …

Home-Use Oct For Neovascular Age-Related Macular Degeneration: A Rapid Review, Sneh S. Shah

inSIGHT

Neovascular age-related macular degeneration (nAMD) requires frequent monitoring to identify recurrent exudation and guide treatment with anti-vascular endothelial growth factor (VEGF) therapy.1 Clinic-based optical coherence tomography (OCT) plays a central role in management but provides only intermittent assessments of a disease that changes over time. Home-use OCT technologies have recently been developed as a possible solution, allowing patients to perform self-imaging with remote clinician review and artificial intelligence (AI)-assisted analysis. This rapid review summarizes current evidence on home-use OCT for nAMD, including feasibility, diagnostic performance, clinical usefulness, and challenges related to implementation. Findings from feasibility studies, AI validation analyses, observational …

Glp-1 Receptor Agonists And Ocular Risk, Saharsh Satheesh

inSIGHT

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have moved from second-line diabetes medications toward the frontline of type 2 diabetes, obesity, and cardiometabolic care.¹ A meta-analysis of 10 randomized cardiovascular outcomes trials (n = 71,351) demonstrated that longacting GLP-1 RAs reduce major adverse cardiovascular events by 14%, all-cause mortality by 12%, and composite kidney outcomes by 17%.² With GLP-1 RAs usage increasing, ophthalmology is also increasingly encountering patients who have recently started GLP-1 RAs therapy, often alongside substantial improvements in glycemic control.

In the context of GLP-1 RAs ocular complications, two specific topics currently dominate conversations: (1) worsening diabetic …

Dichoptic Therapy Versus Patching – State Of Literature Review, Eve Miller

inSIGHT

Amblyopia is the most common cause of vision loss in children. A meta-analysis performed by Hu et al. 2022 estimated the global prevalence of amblyopia to be 1.36%.¹ Amblyopia is defined as a reduction in best-corrected visual acuity (BCVA) of one or both eyes caused by abnormal neurologic development in the critical period of visual development. Amblyopia may result from unequal refractive error, strabismus or ocular pathology.² Despite treatment of these inciting factors, suppression of one eye remains, resulting in unequal vision. The clinical consequences of untreated amblyopia include permanent reduction in vision in the affected eye and …

Novel Advancements In Glaucoma Surgery, Eshani Ragam

inSIGHT

Glaucoma is a degenerative ocular condition characterized by irreversible vision loss from damage to the optic nerve. This is usually secondary to increased aqueous production or impaired aqueous outflow, resulting in increased intraocular pressure (IOP). Aqueous outflow is managed by the trabecular meshwork and Schlemm’s canal, although secondary pathways may also be involved.¹ Injury to the nerve is permanent, and interventions are primarily aimed at slowing the rate of progression. While eye drops and laser procedures are first-line measures to lower IOP, more persistent or severe etiologies require surgical treatment to preserve sight.² In recent years, advancements in …

Novel Treatments For Keratoconus, Caroline Paik

inSIGHT

Keratoconus is a progressive condition in which the cornea gradually thins and bulges outward, causing it to become steep and irregular. This leads to irregular astigmatism and worsening vision, most often beginning in adolescence or early adulthood.¹ The management of keratoconus has evolved significantly over the past two decades, with novel therapeutic approaches emerging across three critical domains: halting disease progression, improving visual function, and providing surgical alternatives when conservative measures fail. This review examines the latest advances in keratoconus treatment, focusing on innovative approaches that are reshaping clinical practice.

Insight, Volume 6, Issue 1, 2026

inSIGHT

Contents

7 - Novel Treatments for Keratoconus
By Caroline Paik

12 - Novel Advancements in Glaucoma Surgery
By Eshani Ragam

16 - Dichoptic Therapy versus Patching – State of Literature Review
By Eve Miller

24 - GLP-1 Receptor Agonists and Ocular Risk
By Saharsh Satheesh

33 - Home-use OCT for Neovascular Age- Related Macular Degeneration
By Sneh Shah

40 - Implementation of Artificial Intelligence in Retinoblastoma Diagnosis
By Zana Moldavsky

Transfemoral Approach To Patent Ductus Arteriosus Occlusion Using Acdo In A Dog With Complex Surgical History, Nawat Sannamwong, Hataichon Owatdhumma, Kornrawee Tharavanij, Thitinan Tangarsasilp, Nardtiwa Chaivoravitsakul, Kongthit Horoongruang, Patmanachatr Bunnag, Nakkawee Saengklub, Krishaporn Kradangnga, Sirilak Disatian Surachetpong, Anusak Kijtawornrat

The Thai Journal of Veterinary Medicine

A five-year-old spayed female Welsh Corgi weighing 12.4 kg presented with exercise intolerance and was diagnosed with a patent ductus arteriosus (PDA). Due to signs of left-sided volume overload, the dog was initially managed with oral pimobendan and was subsequently referred to the Small Animal Teaching Hospital at Chulalongkorn University for further evaluation and intervention. Upon presentation, the patient was bright, alert, and responsive, with a body condition score of 6 out of 9 and normal muscle condition. The mucous membranes were pink and moist, with a capillary refill time of 1 to 2 seconds. A continuous heart murmur was …

Miconazole As A Repurposed Anticancer Candidate For Prostate Cancer, Eswara Naga Hanuma Kumar Ghali, Lindsey Shim, Rajasekhar Baru, Anupam Dhasmana, Ryan Chang, Sung Yun Jung, Rahul Tiwari, Neeraj Chauhan, Vivek K. Kashyap, Sheema Khan, Diane Nguyen, Subhash C. Chauhan, Murali Mohan Yallapu

School of Medicine Publications

Prostate cancer is one of the major health concerns, with increasing incidence and persistent therapeutic resistance worldwide. Despite various available treatments (radiation therapy, chemotherapy, hormone therapy, cryotherapy, biological therapy, and high-intensity focused ultrasound), patients still show treatment-related side effects over many years. These challenges highlight the urgent need for novel and safe therapeutic strategies. In the present study, we repurposed five FDA-approved antifungal agents, namely natamycin (NM), terbinafine hydrochloride (TH), ketoconazole (KZ), miconazole (MZ), and clotrimazole (CZ), as they can modulate conserved cellular processes, including sterol metabolism and mitochondrial function, which are increasingly recognized as critical determinants of cancer cell …

Improving Patient Preparedness Through Implementation Of A Structured Wound Care Discharge Protocol, Kiran N. Gupta

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was to implement a structured wound care discharge protocol to improve patient preparedness and confidence in wound self-management after hospital discharge.

Background: Patients discharged with active wounds may experience complications, delayed healing, and unplanned health care use when discharge education and follow-up support are inconsistent. Standardized education may strengthen readiness for self-care and improve transitions from hospital to home.

Methodology: A three-month project used the Plan-Do-Study-Act framework in an inpatient medical-surgical setting. Thirty adults discharged with active wounds received standardized wound care education, written instructions, teach-back verification, and a follow-up telephone call …

Runx1+23 Enhancer Marks Erythro-Megakaryocyte Lineages In Early Waves Of Hematopoiesis In Human Esc Differentiation, Chika Nishida, Michihiro Kobayashi, Alina Syed, Philipp Kramer, Haizi Cheng, Pamela L Wenzel, Motomi Osato, Jason David Chobirko, Andrew Grimson, Igor I Slukvin, Brian R Davis, Momoko Yoshimoto

The Brown Foundation: Institute of Molecular Medicine

No abstract provided.

Belonging And Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia Hickman

Papers

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

Improving Pain Reassessment Within One Hour Of Pain Medication Administration, Geraldine B. Macalma

Master's Projects and Capstones

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, …

Implementing A Standardized Counting Process, Paula M. Mbye

Master's Projects and Capstones

Abstract

Background: In a Northern California medical center with 11 operating rooms, two retained foreign object (RFO) events occurred following surgical procedures in 2025.

Problem: Surgical teams rely on manual counting processes to prevent retained foreign objects. Variability in counting practices among registered nurses and surgical technologists, combined with workflow interruptions and environmental distractions, can increase the risk of counting discrepancies and missed items. Standardizing the counting process may improve count accuracy and reduce the risk of RFOs.

Interventions: This quality improvement project implemented a standardized surgical counting process based on Association of periOperative Registered Nurses (AORN) guidelines within …

08-19-26 Bor Hsc Committee Notice Of Meeting Revised, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

08-19-26 BOR HSC Committee Notice of Meeting Revised

What Do Children Think About Bouncy Bands: A Mixed Methods Examination Of Bouncy Bands' Influence On Attention And Physical Activity, Ken Murfay, Sarah Collins

International Journal of Physical Activity and Health

Purpose: To examine how bouncy bands put onto elementary students’ classroom desks influenced students’ physical activity and attention/concentration, in addition to exploring students’/teachers’ opinions of the bands. Methods: Students within both experimental and control groups wore pedometers to assess movement during instruction and completed the d2 test for attention. Results: The group with bouncy bands on the desks had significantly more movement compared to the control group. For d2 scores, there was no significant difference between the two groups, nor was there a significant linear relationship between movement and d2 scores. Interviews were conducted with the students in the experimental …

Dosimetric Comparison Of Hybrid 3d Conformal Radiation Therapy And Volumetric Modulated Arc Therapy Versus Vmat-Only Planning For Accelerated Partial Breast Irradiation, Erjona Jusufi

Masters Projects

Abstract

Purpose: To compare dosimetric outcomes between volumetric modulated arc therapy (VMAT)-only and hybrid VMAT plus three-dimensional conformal radiotherapy (3D-CRT) techniques for accelerated partial breast irradiation (APBI) in patients with early-stage left-sided breast cancer.

Methods and Materials: Thirty patients treated with APBI at a single institution were retrospectively replanned using both VMAT-only and hybrid (VMAT + 3D-CRT) techniques. All plans were prescribed 26 Gy in 5 fractions. Each patient was planned using the same target volumes, optimization objectives, and evaluation criteria for both techniques. Planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), hotspot control, organ-at-risk (OAR) doses, …

Staff Education To Enhance Phq-9 Depression Screening Compliance, Chibugo Chukwu

Walden Dissertations and Doctoral Studies

This staff education quality improvement project at Clinic P targeted the clinical problem of depression under-diagnosis, evidenced by less than 60% of patients completing the patient health questionnaire (PHQ-9) before the initiative. Depression under-diagnosis, significantly caused by provider PHQ-9 screening competency deficits that need to be addressed through staff education, is associated with adverse patient health outcomes, in turn generating negative implications for providers and wider society. The problem compromises the quality of nursing care because it limits nurses' ability to intervene and deliver timely and effective care to patients with depression. Thus, at Clinic P, this initiative asked how …

Staff Education To Address Verbal De-Escalation Skills In Correctional Mental Healthcare, Mary L. Goodman

Walden Dissertations and Doctoral Studies

This staff education project evaluated the effects of a structured verbal de-escalation training program on self-efficacy among staff in a federal correctional mental health unit. Staff at the site often reported uncertainty managing escalating behaviors, leading to frequent use of restrictive interventions like restraints and seclusion—practices that can compromise safety, quality of care, and raise ethical concerns. To address this gap, an evidence-based curriculum was implemented for 41 multidisciplinary staff, including nurses, certified nursing assistants, and correctional officers. The curriculum included a PowerPoint presentation, role play, and group discussion. A pre–post design measured changes in staff confidence using a modified …

A Program Proposal For An Evidence-Based Dietary Program To Support Spanish Speaking Diabetic Patients, Shaquetta Ann Mccloud-Petion

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) executive leadership system improvement project addresses provider-identified gaps in dietary education for Spanish-speaking patients with diabetes, which may contribute to suboptimal glycemic control and diabetes self-management. A comprehensive review of evidence from CINAHL Complete, PubMed/MEDLINE, and Cochrane supports the use of culturally tailored, evidence-based dietary education to improve diabetes knowledge, self-management behaviors, and health outcomes. The project proposes the development and implementation of a standardized dietary education program using culturally appropriate dietary exchange tools within an outpatient clinic. The initiative aims to improve staff confidence, adoption, and consistency in delivering culturally responsive diabetes education …

Staff Education To Improve Knowledge On Accurate Administration Of Medication, Deepu Pudasaini

Walden Dissertations and Doctoral Studies

Medication errors have been a significant problem, primarily due to a lack of continuous monitoring and inadequate training for personnel involved in managing or administering medications in non-healthcare settings. These errors often go undetected or unreported. This Doctor of Nursing Practice (DNP) project was a staff education project to improve staff knowledge of accurate medication administration of medication in a group home. The practice-focused question was: Will a staff education program on the accurate administration of medication improve certified medication technicians’ (CMTs) knowledge about the association between the medication administration process and medication error? The purpose of this DNP staff …

Staff Education To Reduce Foley Catheter Utilization In Patients With Acute Urinary Retention, Dennis Ulep

Walden Dissertations and Doctoral Studies

Acute urinary retention (AUR) is a common inpatient condition associated with complications such as urinary tract infections, prolonged hospitalization, and impaired mobility when not managed appropriately. Despite evidence supporting intermittent catheterization as a preferred first-line intervention for many patients with AUR, indwelling Foley catheters continue to be overused in acute care settings. Purpose: This Doctor of Nursing Practice (DNP) project evaluated whether staff education on a standardized AUR algorithm would improve evidence-based urinary retention management and reduce unnecessary Foley catheter utilization among nurses caring for adult hospitalized patients on a hematology and oncology unit in a Southern California acute care …

Standardizing Interfacility Transfer In And Out Processes Across The Local Va Setting, Petrice Robinson Brown

Walden Dissertations and Doctoral Studies

The quality improvement project focused on the inconsistent documentation and communication of the transfer of veterans in and out of a Veterans Affairs Medical Center. Lack of transparency in handoff knowledge and ineffective documents posed a risk of delayed care and patient injuries. The staff provided an audit tool with staff education to monitor completion of mandatory transfer steps, such as special mode travel approval, equipment needs, nurse-to-nurse handoff, transfer notes, consent, and physician correspondence. This method was based on the evidence found in literature indicating that structured checklists and handoff tools minimize missed information and facilitate safer care transitions …

Early Mobilization In Post Op Care, Jakob Hollenbach, Taylor Grove, Rachael Nembo

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Implementation Of A Structured Safety Planning Intervention In An Outpatient Psychiatric Setting, Ellen Riccio

Walden Dissertations and Doctoral Studies

This organization change process evaluation addressed continued reliance on outdated no-suicide and no-harm contracts in an outpatient psychiatric setting, despite evidence that such contracts do not reduce suicide risk and may create a false sense of security. Adult outpatients with mood or psychotic disorders who express safety concerns represent a population for whom structured, collaborative safety planning is the accepted standard of care. Addressing this gap is central to patient safety and quality nursing care. The practice-focused question asked whether replacing no-suicide contracts with a structured, six-step Safety Planning Intervention would influence safety events, self-harm behaviors, and psychiatric hospitalizations among …

Staff Education To Reduce Stress In Assisted Living Nursing Staff, Cherechi Onyenso

Walden Dissertations and Doctoral Studies

In this staff education doctor of nursing practice (DNP) project, I addressed a practice gap associated with inadequate staff knowledge of workplace stress-management strategies in an assisted living facility. Workplace stress in nursing practice is a contributing factor to burnout, reduced job satisfaction, poor teamwork, and a decline in the quality of resident care. The practice-focused question for this project was about whether staff knowledge would be enhanced over an 8-week period in comparison to baseline knowledge as a result of their participation in a structured staff education program on workplace stress management. The purpose of the project was to …