Digital Commons Network^™

Antitrust Law And Healthcare Consolidation: Case Analyses Of U.S. Hospital And Insurance Mergers, Francesca Meek

Honors Projects

Rising healthcare costs in the United States have intensified concerns about hospital consolidation and its effects on market competition. This paper examines the application of antitrust law to horizontal mergers involving hospitals and health insurers, focusing on how courts evaluate proposed mergers under Section 7 of the Clayton Act. Using a qualitative case study approach, the study analyzes eight major federal antitrust cases from the past two decades to determine how courts assess market concentration, competitive effects, and merger defenses.

The findings show that the Federal Trade Commission (FTC) and Department of Justice (DOJ) were successful in six of the …

Supporting Nurse Practitioner Autonomy: A Policy Proposal To Advance Hospice Np Scope, Lauren Hochart

Doctor of Nursing Practice Final Manuscripts

The Nurse Practitioner (NP) profession has achieved many advancements in its autonomy and scope of practice in the last 61 years since becoming a recognized advanced practice registered nursing role. However, some areas of healthcare still limit the NPs ability to practice autonomously even though it is within their scope of practice. This is notable in the subspecialty of hospice care with regards to certifying a terminal diagnosis as part of eligibility determination for a Medicare beneficiary to be able to receive covered hospice services. This health policy paper reviews current hospice regulations and provides evidence to support the benefits …

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …

Evaluating The Role Of Ultrasound As A Tool For Airway Assessment And Management For Anesthesia Providers, Alexyss Capestany

Doctor of Nursing Practice Final Manuscripts

Introduction: The ability to predict and manage difficult intubations is a critical component of airway management in clinical practice.

Background: Ultrasound airway assessment has emerged as a valuable tool in predicting difficult intubation, yet its integration into routine clinical practice remains limited. This Doctor of Nursing Practice (DNP) project aimed to educate healthcare providers, specifically nurse anesthetists, on the use of ultrasound to assess airway anatomy and enhance prediction of difficult airways.

Methods: An evidence-based airway assessment, the Difficult Airway Evaluation with Sonography (DARES), was implemented during a single-day skills fair. Participants received both didactic instruction and hands-on training focused …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Innovating Adhd Care: A Doctoral Capstone On A Pilot Adult Adhd Diagnostic Clinic Implementation, Fozia Aman

Doctor of Nursing Practice Final Manuscripts

Objective: To evaluate whether an APRN-led pilot Adult ADHD Diagnostic Clinic within a large academic healthcare system in the San Diego area improves timely access to diagnostic evaluation and optimizes care disposition for adults with suspected ADHD.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that interferes with functioning in daily life. It often emerges in childhood and persists into adulthood, affecting approximately 360 million adults globally. Despite its prevalence and associated functional and psychiatric burden, adult ADHD remains underdiagnosed and undertreated due to limited primary care training, stigma, and reduced access to psychiatric services, resulting in delayed …

Sleep Tight: A Sleep Hygiene Bundle For Adults To Improve Sleep Quality In A Skilled Nursing Facility, Meaghan Corbin

Doctor of Nursing Practice Final Manuscripts

Abstract

Nearly two thirds of skilled nursing facility (SNF) residents report poor sleep. Negative consequences of poor sleep are depressed mood, anxiety, pain, cognitive impairment, increased risk for dementia, fatigue, decreased concentration, and lower activity participation. A review of literature has shown that implementation of non-pharmacological sleep interventions can significantly improve sleep quality. The aim to screen SNF residents on current self-reported sleep quality and provide non-pharmacological sleep interventions. The evidence-based project utilized the 8 A’s Model. Using the Pittsburg Sleep Quality Index (PSQI), a resident with a score above 0, received the non-pharmacological sleep hygiene bundle: eye mask, earplugs, …

Improving Transition To Adult Care: Assessing Health Insurance Literacy In Adolescent Patients With Congenital Heart Disease, Kaitlyn V. Mudge

Doctor of Nursing Practice Final Manuscripts

Background: With advances in surgery and medical management, 95% of children with congenital heart disease (CHD) survive into adulthood. Transition to adult care is an intricate process. Up to 60% of adolescents fail to follow through with cardiology care, facing three times the risk of needing emergency services. Only 25% of young adults with CHD knew of the need to change their care to an adult provider and to acquire health insurance as an adult. One barrier to successful transition is a lack of insurance coverage and limited insurance health literacy. Higher insurance literacy is associated with increased utilization …

Petals And Pride: A Botanical History Of Queer Expression, Sarah O. Kowal

Graduate Masters Theses

“Petals and Pride” examines the historical use of flowers as enduring symbols of queer expression and persecution across diverse cultures and time periods, paying particular attention to violets, green carnations, roses, lilies, pansies, and lavender. This study begins with the appearance of violets in the works of the Ancient Greek poet Sappho and traces their adoption by the lesbian community of Paris at the turn of the twentieth century. Around this same time, another floral symbol emerged across the English Channel: the green carnation. Popularized by Oscar Wilde, the green carnation functioned in Victorian Britain as an emblem of sexuality …

Reliable Offline Evaluation Under Exposure Bias: A Cross-Scale Study Of Counterfactual Estimators In Recommender Systems, Lakshmi Pranathi Vutla

Graduate Masters Theses

Offline evaluation underpins model selection in recommender systems, yet historical interaction logs are shaped by prior recommendation policies. Because users only provide feedback on exposed items, logged data entangles user preferences with exposure mechanisms, leading to exposure bias and potentially misleading model comparisons. Counterfactual estimators such as IPS, SNIPS, CRM, and DR offer principled corrections, but their empirical reliability across datasets and exposure regimes remains insufficiently under- stood. We present a systematic, cross-scale study of counterfactual evaluation in recommender systems. Comparing IPS, SNIPS, CRM, and DR on datasets with randomized exposure (Yahoo! R3, Coat, and KuaiRec), we analyze estimator behavior …

Anti-Mattering And Negative Core Beliefs In The Association Between Internalized Racism And Social Anxiety, Alicia K. López

Graduate Masters Theses

Internalized racism is associated with adverse mental health conditions, including anxiety. However, research examining the relation between internalized racism and social anxiety remains limited. The primary purpose of this current study was to explore the relation between internalized racism and social anxiety and whether cognitive processes, such as negative core beliefs about the self or interpersonal factors, such as anti-mattering help explain this relation.  Specifically, this study examined anti-mattering as a potential mediator linking internalized racism and social anxiety and whether negative core beliefs about the self, mediate the relation between internalized racism and anti-mattering. Lastly, the study examined a …

Identity And Distress: The Role Of Misracialization And Membership Esteem In Multiracial Mental Health, Jordan Cherry

Graduate Masters Theses

The population of Multiracial individuals in the US is growing (Jones et al., 2021). Multiracial people face a higher likelihood of adverse consequences, including reconciling the significance of holding multiple racial identities in a society that predominantly categorizes race in single categorical terms (Gabriel et al., 2023). The inaccurate perception of Multiracial individuals by others, or misracialization, is a result of this dynamic. Research indicates that inaccurate racial representation relates to worse mental health outcomes for Multiracial individuals (Campbell & Troyer, 2007; Does et al., 2023; Franco, Toomey, et al., 2021; Lusk et al., 2010). Further, one’s racialized experiences have …

The Cultivation Of Public Perception: Cultivated Meat Narratives And Misinformation On Tiktok, Anna M. Balkus

Graduate Masters Theses

Cultivated meat is an emerging tissue engineering technology that has the potential to address major issues threatening food systems, including climate change, rapid population growth, and the spread of disease. Among technical challenges, public perception remains a significant barrier for the widespread adoption of cultivated meat. While social media has transformed communication globally, it has simultaneously contributed to corrupt online environments infected with misinformation—unintentional inaccuracies that differ from disinformation, which is spread with the intent to mislead. The way the public receives and digests information regarding new food technologies, like cultivated meat, will be shaped by their social media environment. …

Mandates, Markets, And Megawatts: An Empirical Analysis Of The Causal Effects Of State-Level Energy Storage Mandates On Utility-Scale Battery Storage Deployment In The United States, Bill Zheng

Quantitative Social Science Undergraduate Senior Theses

Utility-scale battery storage is accelerating at an unprecedented pace as the world increasingly relies on renewable energies to power grids. Demand for data centers has produced record-high electricity demand, and utility-scale batteries are becoming crucial in supporting the grid and the variability of renewables. As a result, analysis on the efficacy of policy drivers of battery storage will provide the field with a roadmap for the most impactful policy solutions to spur battery storage deployment. This paper estimates the effect of state battery storage mandates on cumulative installed battery capacity using a staggered difference-in-differences (DiD) design following Callaway and Sant’Anna …

Rewarding Risk: How Political Health Messaging Drives Virality And Controversy On X, Hiba Ali

Quantitative Social Science Undergraduate Senior Theses

No abstract provided.

Perceptual And Geometric Advances In Crowd Simulation, Bilas Talukdar

Dissertations

Simulating realistic crowd motion remains a fundamental challenge in computer graphics and multi-agent systems, as it requires modeling both physically plausible interactions and perceptually natural behaviors. Existing crowd simulation methods typically employ simplified geometric abstractions, most commonly circular agent representations, and model navigation using either analytical interaction formulations (e.g., force, velocity, or constraint-based methods) or learned policies derived through reinforcement learning. Despite their effectiveness, these approaches often overlook detailed geometric structure and do not explicitly account for perceptual realism. This dissertation addresses these challenges by improving the realism of virtual crowd simulation through two key advancements: perceptual preference learning and …

Principles Of Privacy And Security In Artificial Intelligence And Applications, Khang Tran

Dissertations

Modern artificial intelligence (AI) systems have transformed critical domains such as healthcare, software engineering, finance, and the legal system. Despite their broad impact, concerns about trustworthiness, especially regarding privacy and security, remain major obstacles to wider adoption. Addressing these concerns requires both a systematic understanding of the privacy and security risks inherent in AI systems and the development of principled foundations for trustworthy AI that safeguard client privacy and security. This goal is particularly challenging because of the complexity of modern large-scale AI systems, the trade-offs between privacy and model utility, and the need to simultaneously ensure other important properties …

Mechanics And Physical Attributes Of Nature-Based Alterations: Rock Reinforcement And Urban Heat Island Assessment, Mary Chikondi Ngoma

Dissertations

Ground improvement is critical to geotechnical and geo-engineering systems, where modification of the properties of geomaterials (rocks and soils) is required to maintain stability and prevent failure of infrastructure installed within and around them. This need has become increasingly important with rapid urbanization and population growth, which intensify demands on surface and subsurface systems and further challenge the performance of supporting geomaterials. As a result, there is growing interest in nature-based solutions, particularly biologically mediated processes such as biocementation, which can enhance the physical, hydraulic, and mechanical properties of geomaterials while offering environmentally sustainable alternatives to conventional ground improvement techniques. …

Enabling Ml/Ai In 6g And Future Wireless Communication With Privacy Preservation, Mec Offloading And Quantum Computing, Changshi Zhou

Dissertations

The forthcoming sixth-generation (6G) and future wireless networks are envisioned to support an unprecedented range of services, delivering ultra-low latency, massive connectivity, and intelligent real-time responsiveness. These capabilities will enable emerging applications such as extended reality (XR), autonomous vehicles (AVs), industrial robotics, and the Internet of Things (IoT) to reach their full potential. Achieving this vision requires the integration of enabling technologies such as artificial intelligence and machine learning (AI/ML) and quantum computing, which are poised to play central roles in shaping the landscape of wireless communication systems.

In AI-native, data-driven, and computing-centric 6G networks, ML models will be deeply …

Differential-Geometric Methods For Neural Signed Distance Fields: Parameterized Surface Extraction And Curvature Regularization For Cad Models, Haotian Yin

Dissertations

Neural signed distance fields have emerged as a powerful framework for representing three-dimensional geometry through continuous and differentiable neural functions. Their flexibility, resolution independence, and compatibility with gradient-based optimization make them especially attractive for surface reconstruction and geometric learning. However, despite these advantages, two fundamental challenges remain for engineering-grade applications. First, higher-order geometric properties such as curvature are difficult to model reliably during training and often require computationally expensive second-order differentiation. Second, while neural signed distance fields provide implicit surface representations, they do not directly yield a globally consistent forward map or parameterization for downstream geometric processing.

This dissertation addresses …

Holistic Dram Enhancements: From Intrinsic In-Memory Operations To Robust Security Mechanisms, Ranyang Zhou

Dissertations

Dynamic Random-Access Memory (DRAM) is both the performance bottleneck and a critical security boundary of modern computing systems. Its physical properties make it an attractive substrate for near-data computation—yet those same properties expose it to disturbance-based hardware attacks. This dissertation argues that these two dimensions are not independent: the architectural choices that make DRAM efficient also reshape its threat landscape. Addressing both requires a unified approach to memory architecture and security co-design.

The first part of this dissertation attacks the memory wall through four processing-in-DRAM (PIM) frameworks. ReD-LUT and LT-PIM unify lookup-table arithmetic with charge-sharing logic, achieving up to 37.8x …

Vergence Task-Based Neural Pathways With Binocularly Normal Vision And Comorbid Persistent Post-Concussive Symptoms -Convergence Insufficiency, Ayushi Sangoi

Dissertations

Binocular dysfunctions are more prevalent in the persistent post-concussive symptoms (PPCS) population than in the general population. The most prevalent binocular disorder is convergence insufficiency (CI), affecting 3-17% of the general population and up to 10 times as many people with PPCS. CI makes it difficult to fuse or maintain fusion on targets at near, and its symptoms include double or blurry vision and headaches when performing close-range tasks such as reading, which can exacerbate PPCS symptoms. Given controversy over the subjectivity and effectiveness of diagnostic tools and symptom surveys for both PPCS and CI, understanding why CI has high …

Disentangling Non-Thermal Electron Injection And Decay In Solar Flares Using Multi-Wavelength Radio Observations, Brian Eugene O’Donnell

Dissertations

The broadband microwave imaging spectroscopy capability provided by the Expanded Owens Valley Solar Array (EOVSA) allows new diagnostics of high-energy processes in solar flares, providing spatially and temporally resolved spectra rich in information about the acceleration and transport of energetic electrons.

In this work, injections and transport of energy and particles into the solar corona during flares are studied. This is accomplished through the development and use of the PIP_Decomp Fitter, an automated fitting tool made by the author to fit injection and precipitation/decay parameters using the spatially resolved radio spectra obtained by EOVSA. These tools are used to study …

A Generative Ai-Driven Computational Framework For Industry-Scale Discovery Of Novel Battery Materials, Joy Datta

Dissertations

The growing demand for sustainable, high-energy-density electrochemical storage has motivated the exploration of multivalent-ion batteries based on earth-abundant elements such as aluminum, calcium, magnesium, and zinc. While multivalent charge carriers offer higher theoretical energy density than lithium, their practical deployment is hindered by sluggish ion transport, strong ion-host interactions, and structural degradation of electrode materials. Identifying host materials that can reversibly accommodate multivalent ions while maintaining structural integrity remains a fundamental challenge. The dissertation develops a scalable, end-to-end computational framework that integrates density functional theory (DFT), machine learning (ML), and generative artificial intelligence (GenAI) to accelerate the discovery of next-generation …

Toward Learning-Based Reconstruction And Part Decomposition Of Man-Made 3d Geometry: Neural Implicit Representations And Scalable Supervision, Shen Fan

Dissertations

Digital three-dimensional (3D) models are central to engineering design, analysis, and manufacturing, but learning pipelines for man-made geometry often operate on sampled carriers that do not preserve all of the structure present in exact CAD representations. This dissertation studies learning-based reconstruction and part decomposition for structured man-made 3D geometry, from general object benchmarks to CAD-derived datasets, with a focus on neural implicit representations trained from signed-distance samples, point clouds, and tessellated meshes. The goal is to make these models more accurate, more part-aware, and more consistently supervised.

First, signed distance function (SDF) reconstruction with implicit neural representations is improved through …

Significant Crash Characteristics Associated With E-Scooter And E-Bike Crashes, Aimee Jefferson

Dissertations

Micromobility devices—namely e-scooters and e-bikes—have rapidly gained popularity in the United Sates, rising from 35 million annual shared rides in 2017 to over 133 million in 2023 (NACTO 2024). But also increasing is the number of injuries associated with these devices; however, most research emphasizes injury and demographic patterns rather than crash characteristics that would inform prevention strategies. Most existing crash research also relies on small sample sizes, lacks nuance distinguishing between involved parties (motorists, pedestrians, single device), and fails to distinguish between bicycle and micromobility crash patterns despite micromobility devices often being instructed to use conventional bicycle facilities. These …

Anonymity And Accountability In Secure Messaging, Erin Kenney

Dissertations

Encypted messaging has become more and more prevalent as time moves on, and its benefits in assuring privacy cannot be overstated, but it also brings along with it concerns on how to moderate platforms where all messages are hidden. Message Franking, followed by Traceback systems, addressed these concerns by allowing the sender of a message to be proven when reported, even for forwarded messages in the case of Traceback, however these systems damage the privacy guarantees that originally motivated encrypted messaging to begin with.

In practice, even without those concerns encrypted messaging alone is not enough to prevent the most …

Glass Transition Temperature Of Plga Nanoparticles And The Application In Drug Delivery, Guangliang Liu

Dissertations

The glass transition temperature (T_g) of poly(D,L-lactic-co-glycolic acid) (PLGA) nanoparticles plays a crucial role in governing molecular mobility, diffusion, and consequently, drug release kinetics. However, the interaction among residual surfactant, drug effect, nanoscale confinement, and release medium on T_g remains insufficiently characterized. This study aims to bridge this gap by correlating the thermal behavior of PLGA nanoparticles with their drug release behavior under physiologically relevant conditions.

In the present study, PLGA nanoparticles were synthesized using both nano-emulsion and surfactant-free nano-precipitation approaches. The influence of residual surfactants - poly(vinyl alcohol) (PVA) and didodecyldimethylammonium bromide (DMAB) - was systematically …

Membrane-Engineered Nanotherapeutic Platforms For Drug Delivery: Hollow Fiber Membrane Synthesis Of Lipid Nanoparticles, Biomimetic Nanocarriers, And Nanobubbles, Zhixiang Liu

Dissertations

Lipid-based nanocarriers have emerged as a cornerstone technology for RNA therapeutics, enabling effective intracellular delivery for applications ranging from vaccination to gene regulation. However, current manufacturing approaches, particularly microfluidic-based platforms, face inherent limitations in scalability, throughput, and structural tunability due to their reliance on confined channel geometries and restricted mixing architectures. Addressing these challenges requires fundamentally new strategies that decouple nanoparticle formation from traditional microscale flow constraints while maintaining precise control over physicochemical properties.

This dissertation presents a comprehensive framework for the design, engineering, and application of advanced lipid-based nanocarriers, centered on a hollow fiber membrane (HFM)—assisted nanopore-mediated assembly platform. …

Parameter Density Estimation For Cardiac Electrophysiology Models Using Data Consistent Deep Learning, Michael Luo

Dissertations

Mathematical models of biological rhythms and excitable systems can provide insights into mechanisms underlying cardiac electrical dynamics. However, estimating the parameters of these models from experimental observations is often difficult due to noise, heterogeneity, and unobserved variables. For example, in an electrocardiogram (ECG) recording, information about the electrical properties of different regions of the heart is compressed into a single voltage trace. Additionally, variability within these signals may contain important information about population heterogeneity, regional differences in electrophysiology, and time-dependent modulation.

This dissertation develops, explores, and evaluates methods that perform feature-based distributional inference for complex nonlinear dynamical systems. The objective …