Digital Commons Network^™

Case Report: Primed Dendritic Cell Immunotherapy For Multiple Solid Tumors, Jeffrey Jones, Aly Alrabaa, William Decker, Luis Ferbeyre, Gregorio Viramontes, Rafael Gonzalez, Elideth Angulo, Antonio Zamudio, Raul Hernandez, Stephen Noga, Susana Hernandez-Reyes, Paul Zhang, Darryl Smith, Ara Karamanian, Luis Tamara, Dalton Greenwood, Matthew Halpert

Faculty, Staff and Students Publications

Many patients with advanced solid tumors ultimately develop resistance to conventional therapies, with especially limited options for those experiencing rapid progression or poor performance status, highlighting the need for personalized immunotherapies capable of inducing durable responses. In this retrospective case series, we describe the clinical course and outcomes of five adults (4 male, 1 female; median age 51 years [range, 39-62]) with metastatic solid tumors who achieved complete and durable remission following doubly loaded autologous dendritic cell therapy after failure of standard treatments, such as immune checkpoint inhibition, radiation, surgery, or endocrine therapy. Five patients, including prostate adenocarcinoma (n=1), malignant …

A Year In Review On Tuberculosis And Non-Tuberculous Mycobacteria Disease: A 2026 Update For Clinicians And Scientists, Simone Tunesi, Graham Bothamley, Gunar Günther, Yousra Kherabi, Liga Kuksa, Berit Lange, Christoph Lange, Natalie Lorent, Francesca Saluzzo, Martina Sester, Xenia Emilie Sinding Iversen, Marc Tebruegge, Conor Tweed, Anca Vasiliu, Lorenzo Guglielmetti, Tuberculosis Network European Trials Group (Tbnet)

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide, while infections from non-tuberculous mycobacteria (NTM) represent a growing public health threat. In its 20th year of activity, the Tuberculosis Network European Trials group (TBnet; www.tbnet.eu) is one of the leading research networks in Europe. In this review, we summarize the main advances in TB and NTM that occurred in 2025.

Methods: We conducted a non-systematic review of articles published in 2025, with a strong emphasis on research with current or potential impact on clinical practice. We also selected the most impactful papers regarding the management of adult …

A Review Of Current Research And Barriers To Access: Exploring Disparities In Pediatric Epilepsy Surgery, Nikita Das, Ali A Mohamed, Akshat Katyayan, Meena Vessell

Faculty, Staff and Students Publications

Background: Drug-resistant epilepsy (DRE) impacts at least 30% of pediatric epilepsy patients, adversely affecting neurodevelopment and quality of life, as well as risk of sudden unexplained death in epilepsy (SUDEP). While surgical intervention has proven to be an effective treatment for DRE, disparities in access to surgical care persist. Compared to adults, pediatric patients face unique challenges, including delayed recognition of surgical candidacy, limited access to specialized epilepsy centers, complex care coordination, and socioeconomic barriers.

Summary: This review explores the current state of pediatric epilepsy surgery, highlighting its effectiveness in achieving seizure freedom, improving neurocognitive outcomes, and reducing long-term healthcare …

Hypothyroidism Is Associated With Higher Healthcare Utilisation And Higher Need For Blood Transfusion After Primary Total Knee Arthroplasty (Tka) In Patients With Osteoarthritis: A National Inpatient Sample Analysis, Sumanth R Chandrupatla, Kranti C Rumalla, Jasvinder A Singh

Faculty, Staff and Students Publications

Purpose: To examine the association of hypothyroidism with primary total knee arthroplasty (TKA) outcomes in adults with primary underlying diagnosis of osteoarthritis (OA).

Methods: We identified a prospective cohort of patients in the 2016-2020 national inpatient sample (NIS) that received primary TKA with an underlying diagnosis of OA, identified using International Classification of Diseases, Tenth Revision, Common Modification (ICD-10-CM) and Procedure Coding System (ICD-10-PCS) codes in the primary procedure and diagnosis positions, respectively. We performed multivariable-adjusted regression analyses for healthcare utilisation (length of hospital stay, hospital charges and discharge destination) and clinical outcomes (blood transfusion; prosthetic fracture, dislocation or infection; …

The Words Community Dwelling, Spanish-Preferring Mexican/Mexican American Adults Use To Talk About Alzheimer’S Disease And Genetic Testing: Implications For Education And Outreach, Jamie C Fong, Fatima I Chavez, Karla Silos, Mirna L Arroyo-Miranda, Gabriela Castro Castro, Mark E Kunik, Joshua M Shulman, Luis D Medina

Faculty, Staff and Students Publications

Introduction: Hispanic/Latino (H/L) adults are more likely than non-Hispanic White individuals to have Alzheimer's disease (AD), yet fewer than one in five H/L adults has apolipoprotein E (APOE) Ɛ4, underscoring gaps in understanding genetic risk across H/L heritage groups. H/L adults remain underrepresented in AD research that uses genetic data for participant stratification. To inform culturally appropriate educational materials for 16 million U.S. Spanish speakers, we identified culturally salient words Spanish-preferring H/L adults use to describe AD and genetic testing beyond APOE.

Methods: Community-residing, Spanish-preferring Mexican/Mexican American adults (n = 14) completed freelisting interviews, a method eliciting …

Proceedings Of The 13th Annual Deep Brain Stimulation Think Tank: The Evolving Landscape, Chance R Fleeting, Eduardo M Moraud, Kamil Uğurbil, Doris D Wang, Wolf-Julian Neumann, Andrea A Kühn, Valerie Voon, Victor Pikov, Marie-Laure Welter, Michael D Fox, John D Rolston, Mahsa Malekmohammadi, Yagna J Pathak, Lyndahl M Himes, David Greene, Abbey S Holt-Becker, Gabriel Lázaro-Muñoz, Alexander W Charney, Amanda R Merner, Martijn Figee, Katherine W Scangos, Timothy Denison, Kent Leyde, Aysegul Gunduz, Helen M Bronte-Stewart, James C Beck, Nora Vanegas-Arroyave, Marta San Luciano, Norbert Brüggemann, Kelly D Foote, Michael S Okun, Joshua K Wong

Faculty, Staff and Students Publications

The Deep Brain Stimulation (DBS) Think Tank XIII was held September 2-4th, 2025, in Gainesville, Florida, at the Norman Fixel Institute for Neurological Diseases at the University of Florida. The theme was "The Evolving Landscape of DBS: New Indications, New Goals." This theme was a continuation of the DBS Think Tank XI and XII, which were focused on emerging technology and pushing the horizon of indications. Since its founding in 2012, the DBS Think Tank has provided a global forum for leading clinicians, engineers, and researchers in both in industry and academia to present, discuss, and debate the current state …

Cultured Ex Vivo Human Brain Tissue Maintains Cell-Type Transcriptional Identities, J P Mcginnis, Sai Mallannagari, Maria Camila Guevara, Joshua Ortiz-Guzman, Benjamin D W Belfort, Suyang Bao, Snigdha Srivastava, Maria Morkas, Emily Ji, Kalman A Katlowitz, Angela Addison, Evelyne K Tantry, Carrie A Mohila, Melissa M Blessing, Nisha Gadgil, Samuel G Mcclugage, David F Bauer, William E Whitehead, Guillermo Aldave, Omar Tanweer, Naser Jaleel, Ali Jalali, Akash J Patel, Sameer A Sheth, Howard L Weiner, Shankar Gopinath, Ganesh Rao, Akdes Serin Harmanci, Daniel Curry, Benjamin R Arenkiel

Faculty, Staff and Students Publications

There is growing recognition of the need for human-based models of the nervous system and its diseases. Studies have investigated the electrophysiological properties of neurons in ex vivo human brain tissue, but the maintenance of other cell types remains unclear. We therefore used single-nucleus RNA sequencing of six patient samples to determine how well various cell types maintain their transcriptional identities over two weeks in organotypic slice culture (day 0, with 83 501 nuclei, and day 14, with 45 738). For each patient sample (two pediatric temporal lobectomies, one adult frontal cortex, two glioblastomas, and one medulloblastoma), we generated correlations …

Mapping The Structural Connections Between The Anterior Cingulate Cortex And The Insula/Ventrolateral Prefrontal Cortex.Mapping The Structural Connections Between The Anterior Cingulate Cortex And The Insula/Ventrolateral Prefrontal Cortex, Wei Tang, Javier Guaje, Shreyas Fadnavis, Sarah R Heilbronner, Eleftherios Garyfallidis

Faculty, Staff and Students Publications

The anterior cingulate cortex (ACC) is functionally closely related with the insula and the ventral lateral prefrontal cortex (vlPFC). The ACC and insula are the main hubs of the salience network, a set of functionally related brain regions involved in detecting salient stimuli and coordinating inter-network communication, while communication between ACC and vlPFC is closely linked to inhibitory control. However, despite strong indirect evidence from nonhuman primate (NHP) tract tracing, the structural connections between the ACC and the insula/vlPFC remain poorly understood in the human brain, in part because standard approaches fail to capture this projection. In this study, we …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Impact Of Sepsis Order Set Optimization On Sep-1 Compliance And Clinical Outcomes: A Retrospective Data Analysis, Janelle Harding

West Chester University Graduate Theses, Dissertations, and Final Projects

Sepsis remains a leading cause of mortality, morbidity, and healthcare expenditure in the United States, with national SEP-1 compliance rates persistently near 60%. This quality improvement project evaluated whether optimizing sepsis order sets within a large, urban, Magnet-designated hospital improved adherence to the CMS SEP-1 quality measure and associated patient outcomes. Guided by the Donabedian Model, a multidisciplinary sepsis workgroup redesigned emergency department and inpatient sepsis order sets to streamline evidence-based care, enhance workflow alignment, and reduce variation in treatment. A retrospective analysis of 158 adult SEP-1 cases, with 67 cases in the preintervention group and 91 cases in the …

Human Resources Representation Models And Municipal Employee Outcomes: A Quantitative Study Of Small Pennsylvania Municipalities, John W. Crouser

West Chester University Graduate Theses, Dissertations, and Final Projects

Small municipalities operate in resource-constrained environments that shape how human resource management (HRM) is organized and experienced. This study examines whether HR representation models (in-house, delegated, outsourced, and hybrid) differ in association with employee job satisfaction and manager-reported turnover trends (RQ1), and whether delegating HR responsibilities to non-HR managers is associated with outcomes differently than other models (RQ2). Grounded in Strategic Human Capital Management, the Resource-Based View, and contingency theory, the study assesses whether HR information system (HRIS) capability is associated with turnover trends or employee satisfaction (RQ3) and whether Strategic Human Capital Management (SHCM) alignment is associated with manager-reported …

Rooted In Relationships: How Personal And Workplace Social Capital Help Sustain Principal Leadership, Megan Scelfo

West Chester University Graduate Theses, Dissertations, and Final Projects

It takes five or more years to fully realize a vision for change in any organization (Fullan, 2002; Snodgrass Rangel, 2018), yet the average tenure for a public-school principal in their same school is 4.5 years (National Center for Education Statistics [NCES], 2023). This work adds to our understanding of what factors may improve principal longevity to positively impact school effectiveness. This multiple-case study (Yin, 2018) incorporated a survey and interviews to determine how components of social capital (Bourdieu,1986; Coleman, 1988; Tsounis 2022, Wang et al., 2014) may impact the retention of Pennsylvania public school principals. The survey asked about …

A Pull Toward Independence: Improving Pessary Removal Ease And Patient Independence Using Dental Floss, Stephanie Haly

West Chester University Graduate Theses, Dissertations, and Final Projects

Pelvic Organ Prolapse and Stress Urinary Incontinence are the most common medical conditions for prescribing a vaginal pessary. Treating these conditions is vital to improve patient outcomes and quality of life. Treatment options vary from surgical options to less invasive alternatives. Due to various reasons, a patient might opt to avoid surgical management which leaves a vaginal pessary as the next best treatment option. Barriers to pessary self-management are seen frequently and can reduce patient independence and compliance. This quality improvement project sought to answer the following research question: In women using vaginal pessaries for pelvic organ prolapse or stress …

Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin

West Chester University Graduate Theses, Dissertations, and Final Projects

Point-of-care testing (POCT) is used to measure a variety of healthcare data rapidly at the bedside. It can be particularly useful when laboratory data is not available at the time a patient sees their healthcare provider (HCP). Patients living with diabetes frequently do not obtain laboratory data prior to their visit with their HCP. This quality improvement projected aim to assess if use of POCT to measure an Hgb A1c level in patients with diabetes affected patient satisfaction in an endocrinology clinic. Eligible participants were asked to complete an anonymous survey, with three questions asking if having their Hgb A1c …

Factors That Impact K-6th Grade Teachers’ Sense Of Self-Efficacy: A Mixed Methods Study, Becky A. Eckburg

West Chester University Graduate Theses, Dissertations, and Final Projects

Although there have been efforts to narrow the "achievement gap," research shows that the academic achievement levels of students in low socioeconomic school settings are likely to be significantly lower than the academic achievement levels of students in higher socioeconomic school settings (Babayiğit et al., 2021; Rahman et al., 2024). Studies also show that teachers have a significant impact on their students' growth, no matter what their academic setting may be (Petek & Pope, 2023), and that collective teacher self-efficacy is a significant factor in positive student achievement (Hattie, 2008). If targeted professional development could support teachers' self-efficacy, student achievement …

Retrospective Analysis Of Calcium Administration In Patients Undergoing Massive Transfusion Protocol (Mtp), Chrissy Unton

West Chester University Graduate Theses, Dissertations, and Final Projects

Unintentional injuries have remained the third leading cause of death in the United States since 2015, with the exception of 2020. Of those deaths resulting from traumatic injury, 40% result from hemorrhage and uncontrolled blood loss. Current treatment efforts focus on early, balanced transfusion of blood products and aim to correct metabolic derangements/coagulopathies, while minimizing crystalloid administration. As such, the role hypocalcemia plays in the injury process and the importance of calcium administration in resuscitation efforts has gained traction over recent years. The aim of this retrospective analysis was to assess calcium supplementation in relation to current facility protocol for …

Urban Megaregions In The United States: A Gis-Based Approach To Defining A New Regional Geography, Jonas Rugys

West Chester University Graduate Theses, Dissertations, and Final Projects

This study investigates urban megaregions in the United States. The regional concept is examined from its origins in the geographic tradition as well as its transformation in the twentieth century to its current state. A GIS-based methodology for defining urban megaregions is presented and discussed. The results challenge existing assumptions of population and employment growth in the United States.

Improving Scoliosis Screening Protocol And Outcomes, Beverly R. Jordan

West Chester University Graduate Theses, Dissertations, and Final Projects

The purpose of this Quality Improvement (QI) project was to address outdated scoliosis screening protocols and guidelines by identifying barriers and improving outcomes. Current protocols and guidelines are not current with evidence-based practices. School nurses are mandated to conduct scoliosis screening on 6^th & 7^th graders annually using Adam’s forward bend test and a second screener for failed screens. Although this guideline attempts to use a 2^nd screener as another tool to reduce false positives, it does not address the barriers school nurses may have with these older guidelines and protocols. Scoliosis screening has fallen out of …

College Students’ Use Of Cell Phones And Their Level Of Attention To Academics, Social Relationships, And Health, Nicole L. Istvan

West Chester University Graduate Theses, Dissertations, and Final Projects

This research utilized a single case study design to examine how college students, ages 18–24, perceive their attention in relation to cell phone use within academic, social, and health-related contexts. The case was bound by undergraduate students enrolled at a public university in the northeastern United States, referred to as Tapaton University. The study employed multiple sources of data to support triangulation and credibility, while providing an in-depth exploration of a complex, real-world phenomenon.

Following Institutional Review Board approval, participants were recruited through community flyers, social media outreach, and snowball sampling. Data collection included observational field notes, a quantitative survey, …

Assessing The Mentorship Role In Neonatal Outcomes, Patricia Juhline Brunner

West Chester University Graduate Theses, Dissertations, and Final Projects

The complex environment of neonatal intensive care requires a skilled, engaged nursing workforce to maintain high‑quality outcomes. Structured mentorship is an evidence‑based strategy shown to enhance professional engagement and support improved clinical outcomes. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of a structured clinical mentorship program on evidence‑based practice beliefs, nurse engagement, and selected neonatal outcomes in a Level III academic intensive care nursery.

Guided by the Donabedian model, the project evaluated structure through mentorship design and preparation, process through mentor–mentee interactions and workflow integration, and outcomes through nursing and patient metrics. Lewin’s change …

Beyond The Bedtime Story Beginnings: A Qualitative Study Exploring The Phenomenon Of Family Shared Reading With Middle-Grade Children, Kelly Rorvik

West Chester University Graduate Theses, Dissertations, and Final Projects

Literacy can serve as a critical outlet for children to develop empathy and academic success. However, substantial evidence suggests that by middle school, many students develop less positive attitudes and motivations for recreational and academic reading. The purpose of this asset-based phenomenological qualitative study, framed by Attachment and Socio-Critical Literacy theory, is to examine the parental experiences of shared reading with children between the ages of 10 and 15 to understand the perceived purpose and emotional impact it has on families. The 14 participants in this study were selected through a purposive interest survey. This asset-based phenomenological study seeks to …

Real-Time Isolated Asl Recognition: Evaluating Spatial-Temporal Networks And Multimodal Llms, Raga Mouni Batchu

West Chester University Graduate Theses, Dissertations, and Final Projects

This thesis investigates the deployment of high-accuracy Isolated ASL Recognition (ISLR) in resource-constrained edge environments. We train a lightweight Spatio-Temporal Attention Network (SSTAN,∼2.7 M parameters,∼10 MB) on the WLASL-100 benchmark, achieving 75.25% Top-1 and 88.24% Top-5 accuracy with 139 ms CPU-only inference. A systematic comparison against frontier multimodal LLMs (Gemini 3 Flash, Gemini 3.1 Pro, Qwen 3 VL) shows SSTAN outperforms the best LLM baseline by∼1.85×in accuracy while being 22–230×faster and up to 40×cheaper annually. The LLMs’ core limitation is a lack of fine-grained temporal perception; they impose English-language semantic priors rather than learning the articulatory distinctions that define ASL …

Empowerment Vs. Oversight: Student Perspectives On Classroom Genai Policies, Jessica A. Drass

West Chester University Graduate Theses, Dissertations, and Final Projects

The widespread availability of generative artificial intelligence (GenAI) tools and their rapid evolution has prompted faculty and institutions to develop classroom policies in effort to manage use, yet little empirical research exists on how such policies impact students. This qualitative study sought to explore how higher education students define academic integrity and GenAI’s place within it, how they perceive and evaluate classroom GenAI policies, and how such policies shape their academic self-efficacy, motivation, and engagement. Semi-structured interviews were conducted with sixteen undergraduate and graduate students at a mid-sized public university located in the Mid-Atlantic region of the United States. Interview …

Beyond Superpowers And Stereotypes: Female High School Band Directors Navigating Gendered Expectations In Leadership, Rachael L. Urquhart

West Chester University Graduate Theses, Dissertations, and Final Projects

Female high school band directors (FHSBDs) are significantly underrepresented (approx. 25%) in a male-dominated field. This inequity is sustained by societal gender stereotypes that create a double standard for traits like assertiveness and empathy. This mixed-methods study examined the leadership perceptions and career aspirations of female music teachers and highlighted the career obstacles and encouragements of female high school band directors (FHSBDs) by applying feminist theory to gender roles, self-concept, and leadership conceptualization. A survey of female music teachers yielded 89 responses. Then, 10 FSHBDs participated in a narrative-mapping activity and follow-up interview.

Survey data confirmed that leadership is a …

Bridging Vision And Practice: A Case Study Of Educator Perceptions Within The Community School Model, Jessica M. Riedel

West Chester University Graduate Theses, Dissertations, and Final Projects

Guided by a qualitative collective case study employing two focus groups and six individual interviews, this dissertation in practice examined educator and community school specialist perceptions of the community school model and sought to understand how those perceptions inform the district’s approach to teaching and school operations. Findings indicated a genuine desire to make the community school model successful for students within the buildings but also emphasized a lack of role clarity and professional development opportunities, misconceptions around the model, and siloing within different programs in the schools. These results highlight the need for more communication within districts and schools …

The Effect Of Social Buffering And Gender On Cortisol Response In Emerging Adults, Ashley G. Molchany

West Chester University Graduate Theses, Dissertations, and Final Projects

Abstract

Cortisol, the primary stress hormone in the body, is released in times of challenge, including challenges faced throughout the transition to college. The experience of acute stress can be assessed through cortisol measures. The present study involved a 60-minute lab assessment for first-year students to analyze their physiological response to stress. Previous research has illustrated factors which impact cortisol responses, two of which are social support and gender. In the current study, participants (n = 71) were assigned to work either by themselves (Student Alone Condition) or in a peer triad group (Peer Triad Condition). Additionally, participants identified …

Dual Language Learner Status In Relation To Cortisol For Children In Head Start Preschool, Keala Bratsch

West Chester University Graduate Theses, Dissertations, and Final Projects

Early childhood education (ECE) has well documented school readiness benefits, especially for children facing economic hardship. Yet preschool context poses challenges that are associated with elevated stress levels and potential long-term tax on physiological systems that respond to stress. The present study examined dual language learner (DLL) status in relation to levels of the stress hormone cortisol among low-income children attending Head Start Preschool programs. Participants included 207 children ages 3- 5 years who attended preschool in 2021-22 (60.9% attending a dual-language learning school, 39.1% attending an English-instruction-only preschool; all participants meeting the criteria for low-income), and their parents or …

The Evolution Of Ethical Conviction, Tracy Henry

West Chester University Graduate Theses, Dissertations, and Final Projects

There is a steady decline in public opinion polling when it comes to the public’s perspective of public officials. In 2023, the combined unfavourability rating of Congress was at 72%.  There are ongoing unfavorable ratings, by issue, for the judiciary, and by individual for the executive. The researcher went in search of the reasons behind the declining opinions. Semi-structured interviews were conducted to identify those reasons and to answer the research question: To what extent do the ethical philosophies of consequentialism, deontology, and virtue inform the perceptions of the American public when they scrutinize the decision-making and conduct of public …

School-Based Mental And Emotional Support For Urban Students Experiencing Traumatic Loss, Britney Daniel-Harris

West Chester University Graduate Theses, Dissertations, and Final Projects

This study explores the perception of educational staff members on school-based mental and emotional resources for urban students experiencing traumatic loss. With increased levels of research centered on enhancing training protocols to educate teachers on identifying, supporting, and guiding traumatic care through evidence-based resources, there is an opportunity to understand their experiences by hearing their voices through a narrative inquiry qualitative research design. The Substance Abuse and Mental Health Services Administration (SAMHSA) has six principles of a trauma-informed environment, which were utilized to analyze participant stories. Five teachers, one social worker, and one special education leader participated in one-on-one interviews …