Digital Commons Network^™

Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis

Walden Dissertations and Doctoral Studies

Shingles (herpes zoster) causes substantial morbidity, especially among adults over age 50 in the United States. There is a need to better understand the reasons behind low vaccination rates among adults over age 50 given the associated risks for infection and adverse health outcomes that can reduce their quality of life. This qualitative interpretative phenomenological study explored how individuals’ perceptions of the benefits, barriers, susceptibility, and severity of shingles influence vaccine intentions and identified what factors influence vaccine uptake. The health belief model was used to guide the study. Data were collected from one-on-one semistructured virtual interviews with eight adults …

The Right To Rock The Cradle: Parental Leave And Flexible Work Arrangements As Social And National Capacity Priorities For 21st-Century U.S. Public Policy, Georgiana Constantin-Parke

Helms School of Government Spring Public Policy Conference

No abstract provided.

Innovator - Summer 2024

Innovator

06 - A Message from the President

10 - Time Machine

16 - The Nexus

32 - Our History

38 - Weaving a Legacy of Excellence

40 - Bridging the Gaps

44 - Harnessing the Qualities That Create Healthcare Heroes

48 - Question & Innovate

52 - Alumni Impact

54 - Ram Roundup

58 - Be Kind

62 - Class Notes

68 - In Memory

70 - Trivia

Cleveland Checkers, Christopher Batarseh, Andrea Wang, William Zhu

The International Journal of Ethical Leadership Special Volumes

No abstract provided.

Cell-Free Mitochondrial Dna (Mtdna) Triggers Vascular Dysfunction Via Toll-Like Receptor 9 (Tlr9)-Dependent Activation Of Inflammasomes, Mohin Amin

Senior Theses

Hypertension is the leading global risk factor for mortality and is closely associated with vascular inflammation and dysfunction. Damaged mitochondria release cell-free mitochondrial DNA (cf-mtDNA), which activates toll-like receptor 9 (TLR9). The binding of TLR9 to mtDNA activates the NLRP3 inflammasome pathway, promoting the release of pro-inflammatory cytokines via gasdermin D (GSDMD), therefore worsening inflammation. However, the mechanisms linking mitochondrial injury to inflammation-induced vascular dysfunction remain unclear. We hypothesize that cf-mtDNA triggers TLR9-dependent NLRP3 inflammasome activation contributing to vascular and endothelial dysfunction. To assess that, adult male C57BL/6 were exposed to 28 consecutive days of chronic unpredictable stress (CUS) or …

Health Disparities For Pneumonia And Sinusitis Antibiotic Treatment In The Emergency Department, Joshua Saucedo, Leslie Hueschen, Amanda Nedved, Rana El Feghaly Md

Posters

Optimal antibiotic selection and duration are pillars of antimicrobial stewardship efforts. In our emergency department (ED), >80% of community acquired pneumonia (CAP) and acute bacterial rhinosinusitis (ABRS) are treated with first-line (FL) guideline-concordant antibiotics. Differences in care based on socioeconomic factors (race, ethnicity, language, and insurance status) have not been characterized. We sought to compare differences in antibiotic choice and duration for different socioeconomic factors, and analyze changes after quality improvement (QI) efforts. Multidisciplinary QI team used multiple Plan- Do-Study-Act cycles and was successful in improving antibiotic duration for CAP and ABRS from a baseline of 13% to 61% (January …

The Significance Of Vaccine Education In Vaccination Status, Emma Webb

Honors College Theses

In recent years, more of the general population of the United States has become skeptical about vaccines and overall vaccination numbers have declined. Since the Covid-19 pandemic, vaccines have become somewhat of a controversial topic due to varying opinions about the adverse reactions and effectiveness of vaccines. The purpose of this study was to determine if there is a correlation between a person’s overall knowledge of vaccinations and a person’s vaccination status by asking a series of questions about the science used in vaccines and identifying the participant’s vaccination status in regards to influenza and Covid-19. This study also asked …

Dipl 6277 Global Health Security In A Changing World, Matthew Brown Phd, Mps

Diplomacy Syllabi

This course provides an interdisciplinary survey of global health security at a critical juncture in international health governance. The Spring 2026 semester unfolds against the backdrop of dramatic shifts in U.S. global health policy, including the withdrawal from the World Health Organization, the dismantling of USAID, and the introduction of the "America First Global Health Strategy." These changes, coupled with ongoing threats such as the H5N1 avian influenza outbreak and climate-driven health challenges, create an unprecedented moment for examining the intersection of health and security.

Students will analyze how the reconfiguration of global health architecture affects disease surveillance, pandemic preparedness, …

Legalizing Sex Work: Transforming Hidden Jobs Into Professions, Sakura L. Wilder-Hamilton

Honors Theses

Prostitution, also known as the “world’s oldest profession,” has long been tried and remembered as a tolerated vice. However, sex work is still a stigmatized and criminalized profession around the globe that has yet to become a real profession. Because of this stigma and criminal label, sex workers have become a hidden population within society. Meaning, although there is a lot of stigma attached to sex work and sex workers, there is relatively little known about the realities of sex work, as sex workers are often excluded from scholarly research and discussions regarding their work. This research, through a thematic-chronological …

Cleantide, Ryan Agozo, Valeria Jimenez, Danny Blanchard, Adam Sandoval, Daylin Diaz, Hernan Garcia

Business Core Student Work

CLEANTIDE is a water sanitation and filtration initiative created to improve access to clean water in remote island communities across the Polynesian region. The project responds to challenges such as contaminated water sources, waterborne disease, and the lack of reliable infrastructure in underserved coastal and rural areas. By providing affordable, durable, and environmentally friendly filtration systems, CLEANTIDE helps households and communities gain consistent access to safe water for drinking and daily use. The project also emphasizes local training, trust-building, and sustainable implementation to support long-term impact.

Development Of A Dendritic Cell Model To Unravel The Secrets Of Cards Toxin, Lizbeth Gomez

Posters - 2026

Dendritic cells (DCs) are derived from hematopoietic stem cells of the bone marrow. They are the most efficient antigen presenting cell, presenting antigens to T cells to initiate clonal expansion and differentiation of the T cells into memory and effector cells. Thus, activating the effector functions of T cells in cell-mediated and humoral immune responses (2). Community-acquired respiratory distress syndrome (CARDS) toxin is produced by Mycoplasma pneumoniae that causes acute and chronic lung infections (4). Dendritic cells play a key role in the immune response to respiratory mycoplasmas (3). However, the mechanism underlying in DC and CARDS toxin interactions are …

Effects Of Mycoplasma Pneumoniae Cards Toxin On Lung Fibroblast Function, Shuri Magdalene

Posters - 2026

Mycoplasma pneumoniae is a common respiratory pathogen whose virulence depends largely on the community-acquired respiratory distress syndrome (CARDS) toxin, a 591-amino-acid ADP-ribosylating protein¹. CARDS toxin induces immune responses²˒³, causes vacuolation in lung epithelial cells, and contributes to the inflammatory and pathological features of pneumonia. IMR-90 fibroblasts. IMR-90 cells are human fetal lung fibroblasts widely used to study responses to inflammatory signals, extracellular matrix production, and lung injury or repair. Rationale. Fibroblasts are key drivers of tissue remodeling and fibrosis during lung injury. Defining how CARDS toxin influences fibroblast programs in inflammation, cell-cycle control, and matrix remodeling²˒³ will clarify how M. …

Impact Of Ashwagandha Treatment On Cytokine Production And Macrophage Differentiation Into Thp-1 Cells, Betsi Diaz Chavarin, Aditi Kumar

Posters - 2026

Inflammation is a critical biological response that enables the immune system to react to infections, injuries, or stressful situations. However, chronic or excessive inflammation can lead to tissue damage and contribute to a wide range of diseases, including neurodegenerative disorders, metabolic syndromes, and immune dysregulation. 3,4 Interleukin-1 beta (IL-1β) is a key pro-inflammatory cytokine that plays a central role in initiating and amplifying the immune response. 1,2 It is primarily produced by activated monocytes and macrophages in response to stimuli such as pathogens or stress signals. In addition, IL-1β acts on the hypothalamus to induce fever, which creates an environment …

Prevalence Of Plasmodium Ovale And Plasmodium Malariae Mixed Infections And Associated Mortality In Children With Severe Falciparum Malaria, Giselle Lima-Cooper, Dibyadyuti Datta, Caitlin Bond, Kagan Mellencamp, Ruth Namazzi, Mahesh Gupta, Andrea Conroy, Robert Opoka, Chandy John

Paediatrics and Child Health, East Africa

The prevalence and clinical significance of mixed Plasmodium infections in children with severe Plasmodium falciparum (P. falciparum) malaria are not well characterized. In a cohort of 440 Ugandan children hospitalized with severe malaria who were diagnosed with Plasmodium species via microscopy, nested polymerase chain reaction (nPCR) testing was used to detect P. falciparum, Plasmodium ovale (P. ovale), Plasmodium malariae (P. malariae), and Plasmodium vivax (P. vivax) infections and assess their association with adverse clinical outcomes during hospitalization. Using nPCR testing, the Plasmodium 18S small-subunit ribosomal RNA gene was detected in 440 children. Plasmodium falciparum mono-infection was identified in 329 (74.8%) …

Generative Adversarial Discrimination, Josh Fairfield

Washington and Lee Journal of Civil Rights and Social Justice

Anti-discrimination law assumes that discrimination can be detected and rectified, that the evidentiary burden of the plaintiff can in fact be met. But the evolutionary logic of AI training causes it to target vulnerable groups, lie about reasoning, and above all resist detection. Because of hidden core prompts in generative AI systems, and how those prompts interact with the nature of AI training and deployment, AI will often actively hide discrimination rather than surface and address it. Stopping this will be difficult. At present, neither humans or AI can detect this emergent dark-pattern behavior. Without legal intervention, the broad use …

Efficacy Analysis In Clinical Trials: A Comprehensive Review Of Statistical And Machine Learning Approaches, Dhrubajyoti Ghosh, Samhita Pal

Faculty Articles

Efficacy testing is a cornerstone of clinical trials, ensuring that medical interventions achieve their intended therapeutic effects. Over the decades, a wide range of statistical methodologies have been developed to address the complexities of clinical trial data, including parametric, nonparametric, Bayesian, and machine learning approaches. Parametric methods, such as t-tests, ANOVA, and LMMs, have traditionally been the foundation of efficacy testing due to their efficiency under well-defined assumptions. Nonparametric techniques, including the Friedman test, Brunner-Munzel test, and modern extensions like nparLD, have emerged as robust alternatives, particularly for skewed, ordinal, or non-normal data. Bayesian methodologies have enabled the incorporation of …

Policy Brief For Integrated Perspectives: Florida Ems Workforce And Agency Synthesis 2025, Florida Center For Emergency Medical Services

Florida Center for Emergency Medical Services Research Reports

Executive Summary

Workforce shortages persist. Paramedic vacancies remain widespread across Florida, with a median of two open positions per agency. Clinicians cite dissatisfaction with pay as the most significant retention concern, with compensation receiving the lowest satisfaction rating among all employment domains.

Recruitment pipelines are growing. Agencies report active investment in cadet programs (42 agencies), explorer programs (31 agencies), and high school EMS academy partnerships (24 agencies). However, clinicians emphasize that systemic barriers including low entry-level pay and limited advancement opportunities constrain the long-term effectiveness of these efforts.

Wellness programs are underutilized. A significant gap exists between …

Analyzing Antibody Immune Response In Α1,3galt-Ko Mice After Intranasal Vaccination Of Α-Gal Virus-Like Particle, Faith Brown

Honors Theses

In this study, we evaluated the immunogenicity of intranasal immunization with α-Gal-conjugated virus-like particles (VLPs) in an α1,3-galactosyltransferase-knockout (α1,3GalT-KO) mouse model that mimics the human immune response to the α-Gal epitope. The carbohydrate epitope galactose-α-1,3-galactose (α-Gal) is expressed on the cell surface of several pathogens, including Leishmania species. This molecule is absent in humans and has emerged as a promising immunogenic vaccine target. α1,3GalT-KO mice were intranasally immunized with 10 μg either Qβ-α-Gal or Qβ per nostril and boosted twice prior to sample collection. Blood and lung lavage samples were used to evaluate the antibody response. The Qβ-α-Gal group developed …

Quantifying The Antifungal Properties Of Bacteria Using Cotton Strips, Lily Lofton

Honors Theses

Many bacteria have been known to have antifungal properties. Research has begun to determine how these bacteria can be used to protect cotton and other cellulose-rich textiles. In the present study, standardized cotton strips were inoculated with two different bacterial consortia that have exhibited anti-fungal properties. These strips were then inoculated with the melanized cellulolytic fungi, Chaetomium globosum and Rhinocladiella similis. Similarly, some cotton strips were also inoculated with a non-melanized fungus, Rhodotorula toruloides, which is also thought to be cellulolytic. The tensile strength of cotton strips was measured along with the ergosterol concentrations (fungal biomass) for each cotton strip …

Deep Learning-Based Automated Pneumonia Detection From Chest X-Rays: A Comparative Study Of Custom Cnn And Transfer Learning Architectures, Ahmed Sajim

Honors Theses

Pneumonia is a leading global cause of mortality, claiming approximately 2.5 million lives an-nually and placing exceptional diagnostic pressure on radiologists in resource-limited settings. Manual interpretation of chest X-ray (CXR) images is time-consuming, subject to inter-observer variability, and limited by radiologist availability. This thesis presents a systematic investiga-tion into deep learning-based automated pneumonia detection comparing five convolutional neural network (CNN) architectures: a custom-designed 2D CNN and four pretrained transfer learning models—ResNet, DenseNet, MobileNet, and VGG19.

A targeted data augmentation pipeline addresses the severe class imbalance in the Kag-gle Chest X-Ray Pneumonia dataset, expanding the Normal class from 1,583 to 9,495 …

Modeling Of Aggregate Losses Of Metastatic Cancer Using Katz Family (A, B, 0) Distributions, Cynthia M. Mwau, Howard Omukami

Institute for Educational Development, East Africa

The incidence of metastatic cancer over the years has gradually increased. This can be due to delayed quality treatment, attributed to insufficient funds. Models that can more accurately price cancer insurance policies incorporating its metastatic nature would enable insurance firms to develop affordable and profitable cancer insurance policies. Effectively marketed and reasonably priced insurance policies can enhance the uptake of cancer specific insurance, thereby alleviating the financial strain linked to cancer treatment. To capture the impact of metastatic cancer on overall cancerrelated losses, we construct Katz recursive models grounded in the Katz family of distributions, specifically the (a, b, 0) …

A Test Case For Raccoon Roundworm Anthelmintic Baiting In Western Virginia, Karen Powers, W. Jayme Viers, Carolyn K. Rossmeisl, L Kristen Page

Virginia Journal of Science

As a test case to determine the efficacy of anthelmintic baiting to reduce raccoon roundworm (Baylisascaris procyonis) prevalence in western Virginia, we deployed baits in a mountainous area of Roanoke Co., Virginia that historically was occupied by Allegheny woodrats (Neotoma magister). We deployed anthelmintic baits at 6-wk intervals from August to December 2024 at a density of 100/km². We opportunistically collected raccoon (Procyon lotor) scat in the drop area from August 2024 to May 2025 and found a marked decline in prevalence of raccoon roundworm in the samples. Deeming this a measured …

Argument For Statewide Vaccine Mandates—An Ethical And Legal Analysis, Liv Hymowitz

Colorado Law Student Scholars

No abstract provided.

Increased Backbone Rigidity Of Artificial Transcription Factors, Jasmine Glover, Emma Otey, Joanna K. Kwao, Nicholas Truex

Senior Theses

Programming DNA-binding proteins is an effective strategy for developing therapeutics that regulate gene expression. These proteins can directly bind to DNA to activate or repress transcription of specific genes. Zinc finger proteins are a class of DNA-binding proteins commonly found in eukaryotic organisms. Their DNA-binding function is derived from unique amino acid sequences within each domain that recognizes specific nucleotides, allowing each finger to selectively recognize three DNA base pairs. Adjoining of multiple domains in tandem allows recognition of a specific DNA sequence. Artificial transcription factors can be made of multiple zinc finger domains arranged in tandem and engineered to …

Strategic Resource Management In Pandemics: Integrating Capacity Planning With Non-Pharmaceutical Interventions For Covid-19, Ozlem Cosgun, Eyyub Kibis, Ali Dag, Burak Cankaya

Department of Information Management and Business Analytics Faculty Scholarship and Creative Works

The COVID-19 pandemic underscored the urgent need for integrated healthcare resource planning to manage patient surges and reduce mortality. This study presents a novel optimization-based framework that jointly considers healthcare capacity planning and non-pharmaceutical interventions (NPIs), including mask mandates, social distancing, and quarantining. The framework extends traditional compartmental models by distinguishing patient categories—such as hospitalized non-ventilator patients, ventilated patients, and ICU admissions—within a mixed-integer programming (MIP) structure that remains computationally tractable. Applied to the COVID-19 outbreak in New York City, the model optimizes the allocation of hospital beds and ventilators while minimizing deaths. Results show that combining high-effectiveness NPIs with …

Why Complex Risks Demand Multidisciplinary Action, Lisa Ng, Benny Chew, Julian Lai, Siti Naqiah Amrun

Asian Management Insights

The A*STAR Infectious Diseases Labs offers a model for how organisations can move from ad-hoc crisis response to sustained, shared preparedness.

Analyzing The Effect Of Melatonin On B Cells' Expression Of Cd36, Caitlyn Pinaga, Gabriella Galdeano, Nayi Gonzalez, Emma Welsch

Posters - 2026

• B cells specifically target pathogens and proliferate to make a plasma cell and secrete antibodies when stimulated. They use glucose as a main energy source but can also use fatty acids. • CD36 is a glycoprotein involved in the transportation and metabolism of fatty acids. • B cells express CD36 in unusually high levels in autoimmune patients. It is unknown as to how this occurs. • Melatonin is a hormone produced in the pineal gland, commonly known for its function in regulating the circadian rhythm. • Melatonin is also known as a master cell regulator and is believed to …

"I Need Help!": Can Ashwagandha Reduce Inflammation-Driven Oxidative Stress Without Inducing Cytotoxicity In Macrophages?, Caitlyn Pinaga

Posters - 2026

Ashwagandha has been shown to reduce inflammation in humans by lowering pro-inflammatory cytokines and oxidative stress markers, helping regulate immune responses. It is commonly used to support conditions linked to chronic inflammation, such as stress-related disorders, arthritis, and metabolic imbalance. THP-1 macrophages are a part of the body's immune response to inflammation. While they produce a lot of different responses to inflammation, one of them is the production of Reactive Oxygen Species (ROS). N-acetylcysteine (NAC) is established to be a powerful antioxidant and is used as a positive control. My study aims to understand how ashwagandha, a popular supplement, affects …

Characterization Of A Core Fungal Community And Captivity-Induced Gut “Mycobiome” Change In Fowler's Toad (Anaxyrus Fowleri), Alexander J. Bradshaw, Sinlan Poo, Tracey E. Malter, Rylie M. Strasbaugh, Brianna Bodner, Madison R. Hincher, Anne Devan-Song, Javier F. Tabima

Biology

Amphibious animals, such as frogs, are found at the intersection of aquatic and terrestrial ecosystems. They may serve as keystone and sentinel species and play key roles in nutrient cycling and food webs. In recent decades, amphibians have experienced drastic population declines due to habitat loss, climate change, and disease. These declines have prompted investments in ex situ conservation and captive breeding programs, which aim to reduce extinction risk by creating assurance colonies and reintroducing individuals once threats are mitigated. A critical component of these programs is proper husbandry, which ensures the health and longevity of captive populations and their …

Hlt 101 Introduction To Public Health, Elyse Gruttadauria

Open Educational Resources

The syllabus, created by Professor Elyse Gruttadauria as part of the CUNY OER Initiatives for HLT 101 contains a course description, course objectives, course readings divided by week and a link to four OER textbooks.