Digital Commons Network^™

Involved But Not Essential: Cognitive Activity In Periventricular Nodules And Neuropsychological Outcomes Following Their Ablation, Yosefa A Modiano, Oscar Woolnough, Ryan M Mccormack, Kathryn Snyder, Ellery Wheeler, Samden D Lhatoo, Nuria Lacuey, Sandipan Pati, Katherine Harris, Jay Gavvala, Jessica A Johnson, Nitin Tandon

Faculty, Staff and Student Publications

Objective: Periventricular nodular heterotopia (PVNH) is a malformation of cortical development with high rates of epilepsy. The extent to which nodules participate in normal cerebral functions in addition to pathological processes is unclear. The authors assessed the functional utility (i.e., cognitive impacts) of surgically ablated epileptogenic PVNH tissue via comprehensive neuropsychological testing.

Methods: The sample included 32 patients with PVNH who underwent presurgical neuropsychological evaluation and a subsample of 16 patients who underwent MR-guided laser interstitial thermal therapy (MRgLITT) of nodules, with postsurgical neuropsychological testing. In 11 patients in whom intracranial recordings were performed, reading and naming tasks were tested …

Diagnostic Guidance For Chronic Complex Regional Pain Syndrome Type I And Type Ii From The American Society Of Interventional Physicians (Asipp), Christopher Gharibo, Miles Day, Steve M Aydin, Alan D Kaye, Salahadin Abdi, Sudhir Diwan, Lisa V Doan, Danielle Feng, Kris Ferguson, Kirolos Georges, Andrew Kaufman, Nebojsa Nick Knezevic, Sean Li, Franzes A Liongson, Devi Nampiaparampil, Annu Navani, Mahendra Sanapati, Michael E Schatman, Amol Soin, Peter S Staats, Giustino Varrassi, Jing Wang, Laxmaiah Manchikanti

Faculty, Staff and Student Publications

Background: Complex Regional Pain Syndrome (CRPS) is a challenging and often disabling condition marked by persistent pain, most commonly in a limb following injury or surgery. It presents with a wide array of symptoms, including intense pain, swelling, alterations in skin color and temperature, motor dysfunction, and trophic changes such as skin and tissue atrophy. While the precise cause of CRPS is not fully understood, it is thought to stem from abnormal nervous system activity, leading to heightened pain sensitivity and inflammatory responses. A thorough understanding of CRPS is essential for accurate diagnosis, effective treatment, and enhancing patients' quality of …

Targeting Cdk2 And Other Novel Cell Cycle Targets For Breast Cancer Therapy, Mei-Kuang Chen, Linjie Luo, Nicole Massoumi, Khandan Keyomarsi

Faculty, Staff and Student Publications

Introduction: The dysregulation of cyclin-dependent kinases (CDKs) is a key driver of cancer progression, making them attractive therapeutic targets. In CDK4/6 inhibitor (CDK4/6i)-resistant breast cancer, targeting CDK2 offers a promising approach. CDK2 is frequently hyperactivated due to cyclin E1 overexpression or retinoblastoma protein loss, acting as a mechanism that sustains proliferation despite CDK4/6 inhibition. CDK2 inhibitors (CDK2i) show strong anti-tumor activity, particularly in combination with CDK4/6i or immune checkpoint inhibitors.

Areas covered: This review explores the biological roles of CDK2 and its regulatory mechanisms. The review highlights the latest advancements in CDK2i, their mechanisms of action, and their potential in …

Institutional Learning Curve And Factors Of Prolonged Operation Time Of Robotic Distal Pancreatectomy: An Analysis Of An Initial 117 Cases, Yuki Hirata, Laura Prakash, Jess Maxwell, Rebecca Snyder, Michael Kim, Hop Tran Cao, Ching-Wei D Tzeng, Jefferey E Lee, Matthew H G Katz, Naruhiko Ikoma

Faculty, Staff and Student Publications

Background: The granular methods by which centers can safely implement and effectively expand robotic distal pancreatectomy (RDP), including those related to appropriate patient selection during the learning curve period, remain unclear. This study aimed to verify that our strategic robotic surgical oncology program effectively implemented RDP as standard practice and to identify factors associated with prolonged operation time.

Materials and methods: We performed a detailed analysis of the intraoperative and short-term outcomes of consecutive patients (October 2018-September 2023) undergoing RDP at our center, beginning with the first patient in our program. Operation time was analyzed using a cumulative sum chart …

Long-Term Cytoreduction Outcomes With Or Without Heated Intraperitoneal Chemotherapy For Colorectal Peritoneal Metastases, Michael G White, Paula Marincola Smith, Neal Bhutiani, Beth Helmink, Norman Galbraith, Scott Kopetz, Michael Overman, Paul Mansfield, Keith Fournier, Abhineet Uppal

Faculty, Staff and Student Publications

Background: Patients with peritoneal metastases from colorectal adenocarcinoma (CRC) benefit from cytoreductive surgery (CRS). However, the role of heated intraperitoneal chemotherapy (HIPEC) remains unclear. We studied associations between HIPEC, peritoneal disease-free survival (PDFS), and overall survival (OS) in patients with CRC undergoing CRS.

Study design: All patients with CRC undergoing CRS between 2008 and 2023 were retrospectively identified at our center. Patient clinicodemographic factors were determined by chart review. OS and PDFS were evaluated using the Kaplan-Meier method. Associations between clinical factors and survival were determined using Cox proportional hazard models.

Results: A total of 147 patients were identified with …

Author Correction: Autologous T Cell Therapy For Prame+ Advanced Solid Tumors In Hla-A*02+ Patients: A Phase 1 Trial, Martin Wermke, Dejka M Araujo, Manik Chatterjee, Apostolia M Tsimberidou, Tobias A W Holderried, Amir A Jazaeri, Ran Reshef, Carsten Bokemeyer, Winfried Alsdorf, Katrin Wetzko, Peter Brossart, Katrin Aslan, Linus Backert, Sebastian Bunk, Jens Fritsche, Swapna Gulde, Silvana Hengler, Norbert Hilf, Mohammad B Hossain, Jens Hukelmann, Mamta Kalra, Delfi Krishna, M Alper Kursunel, Dominik Maurer, Andrea Mayer-Mokler, Regina Mendrzyk, Ali Mohamed, Karine Pozo, Arun Satelli, Marilena Letizia, Heiko Schuster, Oliver Schoor, Claudia Wagner, Hans-Georg Rammensee, Carsten Reinhardt, Harpreet Singh-Jasuja, Steffen Walter, Toni Weinschenk, Jason J Luke, Cedrik M Britten

Faculty, Staff and Student Publications

No abstract provided.

Wnt-Directed Cxcl12-Expressing Apical Papilla Progenitor Cells Drive Tooth Root Formation, Mizuki Nagata, Gaurav T Gadhvi, Taishi Komori, Yuki Arai, Hiroaki Manabe, Angel Ka Yan Chu, Ramandeep Kaur, Meer Ali, Yuntao Yang, Chiaki Tsutsumi-Arai, Yuta Nakai, Yuki Matsushita, Nicha Tokavanich, W Jim Zheng, Joshua D Welch, Noriaki Ono, Wanida Ono

Faculty, Staff and Student Publications

The tooth root is a critical component of the tooth anchored to surrounding alveolar bones. Tooth root formation is driven by cells in the apical papilla (AP) that generate new dentin-forming odontoblasts at the root-forming front. Mesenchymal stem cells have been isolated from AP for regenerative use; however, how AP cells physiologically coordinate tooth root formation remains undefined. We find that CXCL12+ cells emerge in AP under hypoxic environments at the onset of tooth root formation. Using Cxcl12-creER-based cell-lineage analysis, we further find that CXCL12+ AP cells contribute not only to odontoblasts but also to cementum-forming cementoblasts of the elongating …

Cdemapper: Enhancing National Institutes Of Health Common Data Element Use With Large Language Models, Yan Wang, Jimin Huang, Huan He, Vincent Zhang, Yujia Zhou, Xubing Hao, Pritham Ram, Lingfei Qian, Qianqian Xie, Ruey-Ling Weng, Fongci Lin, Yan Hu, Licong Cui, Xiaoqian Jiang, Hua Xu, Na Hong

Faculty, Staff and Student Publications

Objective: Common Data Elements (CDEs) standardize data collection and sharing across studies, enhancing data interoperability and improving research reproducibility. However, implementing CDEs presents challenges due to the broad range and variety of data elements. This study aims to develop a CDE mapping tool to bridge the gap between local data elements and National Institutes of Health (NIH) CDEs.

Methods: We propose CDEMapper, a large language model (LLM)-powered mapping tool designed to assist in mapping local data elements to NIH CDEs. CDEMapper has 3 core modules: (1) CDE indexing and embeddings. NIH CDEs were indexed and embedded to support semantic search; …

Assessing Health And Academic Disparities In The Deep South: The Enduring Impact Of Segregation And Redlining In Georgia, Bridget Hamilton

Theses and Dissertations

Background: Within the American South, marginalized Black populations continue to suffer from health disparities. A key resource that could aid in the prevention of health disparities such as teen pregnancy is the school nurse. School nurses are well positioned to assist in the development of independent health maintenance among student populations. However, school nurses remain understaffed and underfunded throughout most of the United States, which limits their effectiveness. It is possible that within southern states there are inequities in how school resources are allocated that have ties to segregation and redlining practices that systemically marginalized Black populations throughout the 1900s. …

The Impact Of Consumer Complaints On Corporate Digital Transformation, Yingchao Lu, Hailing Chang, Yadan Zhou

Research Collection Lee Kong Chian School Of Business

This paper examines the impact of consumer complaints on corporate digital transformation and its underlying mechanisms. Using quarterly data from China's Shanghai and Shenzhen A-share listed companies from 2018 to 2023, the empirical results show that an increase in consumer complaints significantly hinders corporate digital transformation. Mechanism analysis reveals that consumer complaints raise legal risks and non-productive costs for firms, leading them to allocate more resources toward short-term crisis management rather than long-term digital development. Heterogeneity analysis indicates that this inhibitory effect is more pronounced in firms with weaker cybersecurity governance, firms whose executives lack a digital background, and firms …

Misinformation Regulations: Early Evidence On Corporate Social Media Strategy, Richard M. Crowley, Yun Lou, Samuel T. Tan, Liandong Zhang

Research Collection School Of Accountancy

Against the backdrop of an increasing threat of misinformation on social media, several countries have enacted regulations to curb the spread of misinformation. This study examines how corporate social media strategy responds to misinformation regulations. Using a large cross-country dataset of corporate tweets and a stacked regression analysis, we show that misinformation regulations lead to less corporate social media disclosure. This result suggests that by deterring misinformation, these regulations reduce firms’ need to use social media to counteract its adverse effects. Additional analyses show that the effect is more pronounced among countries with higher social media usage and countries with …

Extubation Decisions With Predictive Information For Mechanically Ventilated Patients In Icu, Guang Cheng, Jingui Xie, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Weaning patients from mechanical ventilators is a crucial decision in intensive care units (ICUs), significantly affecting patient outcomes and the throughput of ICUs. This study aims to improve the current extubation protocols by incorporating predictive information on patient health conditions. We develop a discrete-time, finite-horizon Markov decision process with predictions of future state to support extubation decisions. We characterize the structure of the optimal policy and provide important insights into how predictive information can lead to different decision protocols. We demonstrate that adding predictive information is always beneficial, even if physicians place excessive trust in the predictions, as long as …

Can Lower(Ed) Expert Opinions Lead To Better Consumer Ratings?: The Case Of Michelin Stars, Xingyi Li, Yiting Deng, Puneet Manchanda, Bert De Reyck

Research Collection Lee Kong Chian School Of Business

Expert opinion exerts tremendous influence on the purchase journey, but its effect on overall consumer experience is ambiguous because it can give rise to both “expectation” and “reputation” effects. This paper explores the effect of expert opinions on consumer experience via the lens of consumer reviews in the restaurant industry, where the expert opinions are conveyed by Michelin stars. The paper uses a unique data set based on the Michelin Guide for Great Britain & Ireland from 2010 to 2020. The data include consumer reviews on TripAdvisor for all restaurants that were awarded Michelin stars during this period and a …

Multi-Period Portfolio Allocation: A One-Shot Stochastic Optimization Approach, Peng Liu, Chyng Wen Tee, Xiaofei Xu

Research Collection Lee Kong Chian School Of Business

Multi-period portfolio optimization is a central problem in finance, yet it is computationally intractable for traditional dynamic programming methods due to the curse of dimensionality. This paper develops a tractable and theoretically grounded 'one-shot' stochastic optimization framework that recasts the sequential decision problem into a single, high-dimensional optimization task. Our approach models the predictive distribution of factor returns using Gaussian Processes (GPs), allowing it to capture complex, non-linear market dynamics. We make three primary contributions. First, for the special case of a linear GP kernel, we derive an analytical solution for the optimal portfolio path, providing a clear economic interpretation …

Hernia Recurrence Risk Matters More Than Mesh Type To Patients Undergoing Ventral Hernia Repair, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Chelsea J Guy-Frank, Dalya M Ferguson, Jonah J Stulberg, Lillian S Kao, Julie L Holihan

Faculty, Staff and Student Publications

Introduction: Patients' perceptions about synthetic mesh for ventral hernia repair (VHR) may stem from a lack of knowledge of risks. We assessed patients' threshold for accepting the risk of hernia recurrence to avoid synthetic mesh.

Methods: Patients ≥18 y old with prior or upcoming VHR viewed a one-time video decision aid describing recurrence risk with biologic versus synthetic mesh. Patients chose between these options using a probability trade-off (PTO) technique, varying hernia recurrence rate with biologic mesh. Based on randomized trials, the recurrence rate using synthetic mesh was 9%. The PTO score was the recurrence rate (0%-100%) at which patients …

Aortopexy With Plication Of Kommerell Diverticulum Is An Effective Alternative To Diverticulum Resection And Reimplantation Of The Aberrant Left Subclavian Artery For Surgical Management Of Vascular Rings In Children, Adegbemisola Aregbe Perkins, Ana-Lucia Tomescu, Christopher J Knott-Craig, Umar Boston, Thomas Spentzas, Karthik Vaidyanathan Ramakrishnan

Faculty, Staff and Student Publications

Background

Right aortic arch with an aberrant left subclavian artery arising from a Kommerell diverticulum is the most common form of vascular ring. We report the outcomes of plication and pexy of the diverticulum in addition to division of the left-sided ligamentum to treat this lesion in children.

Methods

Forty-four patients were included in the study; 22 patients underwent division of the ligamentum arteriosum alone, while the other half underwent plication and/or pexy of the Kommerell diverticulum in addition to division of the ligamentum. The primary outcome of interest was reintervention for persistent symptoms following the initial operation. The other …

A Mystery Caller Study On Pain Management Options For Intrauterine Device Placement, Mitali Sharma

Student Scholarship

Objectives: To understand whether clinics present pain management options for intrauterine device (IUD) placement over the phone and whether these options align with current evidence for effective pain control during placement. Study design: We used a mystery shopper approach and a standardized call script to collect information from a diverse, purposive sample of 100 clinics listed on www.bedsider.org. Results: We reached responsive personnel at 90 of the 100 selected clinics, of whom 32 (36%) would not provide information about pain control for IUD placement by phone or to non-established patients. Of the 58 clinics that provided information, four (6.9%) reported …

Engage & Empower: Foundations Of Social Work Practice, Elhanan Marvit

Open Touro Created

2025

Engage & Empower: Foundations of Social Work Practice is an open educational resource for social work students in “foundations of social work practice” courses. It begins by explaining Open Educational Resources and their benefits. Students then explore social work fundamentals, including the diverse roles of social workers.

With this foundation, students engage with the NASW Code of Ethics’ key terms, and principles. This ethical grounding prepares them for the “growth work” needed to develop cultural competence and cross-cultural awareness. They then learn to apply various Generalist Practice skills across different-sized systems to empower client populations.

Next, the book explores …

Methods For Meaningful Connection: Supporting Teacher-Child Relationships In Early Care And Education, Sheila Smith, Maribel Granja, Cristina Medellin, Mark Nagasawa

Straus Institute for Thriving Children & Families

This report discusses a combined professional development/exploratory research project focused on how to support relationships between early childhood educators and children. The project piloted the Teacher Reflection Tool (TRT), a very brief reflection tool, paired with a community of practice approach with 19 early childhood educators across 10 classrooms. Among the lessons learned were that the participants:

• Viewed positive relationships with children as family-like and individualized
• Observed that their relationships with parents influenced relationships with children
• Found that the TRT helped them to notice and reflect on their interactions with children in new ways

Among the recommendations that emerged were: …

I Belong Here And Am Thriving: Understanding Full-Time Graduate Student Well-Being And Belonging In An Msw Program, Lana Hart Elkins

Theses and Dissertations

Graduate-level social work students face high levels of stress that can impact their academic success and well-being. According to a national college health assessment, fulltime Master of Social Work (MSW) students at a southeastern university report significantly more academic, career-related, and financial stress than peers in other graduate programs. This study addressed the need to better understand full-time MSW student experiences and identify ways the program can mitigate stress, promote wellbeing, and foster a sense of belonging. Using a two-phase qualitative action research design, the study first analyzed responses to 12 open-ended questions from four student feedback surveys. These findings …

Database Development For Reliable Small Object Detection In Maritime Environments, Jacob Matthew Whisenant

Theses and Dissertations

Achieving high reliability in small object detection is critical for advancing maritime and littoral intelligent navigation operations. Computer vision provides an undetectable form of perception that can be easily integrated into existing camera systems, offering a low-profile yet powerful solution for navigation and situational awareness in water-based environments. While deep learning techniques have significantly advanced the field of computer vision, the detection of small objects remains a persistent challenge. Limited pixel representation, the scarcity of large-scale small object datasets, and the reduced detail and indistinct features of small objects complicate detection efforts, especially in complex environments. These factors collectively hinder …

Improving Professional Learning Communities (Plcs) For Singletons, Stephanie Harbulak-Barron

Theses and Dissertations

Participation in professional learning is generally recognized as a required component of the teaching profession. One type of professional learning is professional learning communities (PLCs). However, there are challenges to implementing successful PLCs that result in relevant professional learning. One challenge is non-standard PLC groupings that contain singletons, especially when those PLC groups are primarily all singletons. This action research study examined educators’ and administrators’ expectations of and experiences with PLCs in a special education cooperative in the Midwest. The goal of the mixed methods research design was to gather enough information from participants to facilitate the creation of an …

An Economic Evaluation Of Cook At All Costs, Abigail Green

Theses and Dissertations

Cooking shows have been popular for decades with many variations, prizes, and a collection of talented chefs. The Netflix series Cook at All Costs provides a newer playing field incorporating auctions into the challenging landscape. Home chefs are challenged with creating unique dishes from mystery ingredients boxes acquired through various auction types in hopes of winning a monetary prize. The chefs must balance the trade-off between spending money on higher-quality ingredients to improve their chances of winning and saving money across rounds. This thesis will explore the economic concepts presented in the show by providing an understanding of how the …

Awareness And Practice Methods For Musicians With Invisible Disabilities: Insights Gained From Playing The Flute With Ehlers-Danlos Syndrome, Jessica Pelltier

Theses and Dissertations

Ehlers-Danlos Syndrome (EDS) is a connective tissue disorder that presents significant physical and mental challenges for musicians, particularly in instrumental performance. These challenges may include chronic pain, joint instability, fatigue, anxiety, and depression. While such symptoms are associated with EDS, they are not exclusive to it and are also common among individuals with other invisible disabilities, such as fibromyalgia, postural orthostatic tachycardia syndrome (POTS), celiac disease, attention-deficit/hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic fatigue syndrome (ME/CFS). This study explores the experiences of flutists with EDS and other invisible disabilities, focusing on the coping strategies and adaptations they use …

Aggressive, Adaptive, And Underestimated: From Allergy To Arboviruses, The Rise Of The Lone Star Tick, Emily Ellen Owens Pickle

Theses and Dissertations

Once considered a nuisance with little medical importance, the lone star tick (Amblyomma americanum, Acari:Ixodidae) has emerged as a formidable vector driving a new era of public health threats across the United States of America. This dissertation traces the rise of the lone star tick from obscurity to infamy, exploring its expanding geographic range, unique immunologic impacts on humans, and role in the transmission of emerging tickborne viruses. Through a series of integrated studies, this work characterizes the epidemiology, immunology, and ecological context of tick-borne diseases in the southeastern U.S., with a particular focus on α-Gal syndrome (AGS), …

Self-Efficacy And Mathematical Identities In A Rural Georgia Middle School Classroom, Gavin Wilson

Theses and Dissertations

Even into adulthood, some people have a strong resentment of math. Their beliefs toward their mathematical abilities have created a fear of the subject, resulting in an avoidance of anything math-related. These thoughts and beliefs regarding math and mathematical abilities begin somewhere along an individual’s academic journey in a math classroom. This action research study, using a mixed-methods approach, attempted to uncover the origins and development of self-efficacy and mathematical identities in rural eighth-grade students. Furthermore, this study explored ways that a teacher can influence these sets of beliefs and examined the impact on academic performance. The framework used to …

Multi-Task Deep Learning Approach For Segmenting And Classifying Competitive Swimming Activities Using A Single Imu, Mark Shperkin

Theses and Dissertations

Competitive swimming performance analysis has traditionally relied on manual video review and multi-sensor systems, both of which are resource-intensive and impractical for everyday training use. This study investigates whether a single wrist-worn inertial measurement unit (IMU) can be used to automatically segment and classify swimming activities with high accuracy. We propose a multi-task deep learning pipeline based on the MTHARS (Multi-Task Human Activity Recognition and Segmentation) architecture introduced by Duan et al. to perform stroke classification, lap segmentation, stroke count estimation, and underwater kick count estimation. Data were collected from eleven collegiate-level swimmers wearing left-wrist-mounted IMUs, each performing five 100-yard …

Academic Wellness In Health Professional Students: The Intersection Between Dietary Attitudes And Behaviors, Sleep Quality, And Mental Health, Kenya Shereece Moore

Theses and Dissertations

Academic success is strongly influenced by student well-being, with nutrition, sleep, and mental health emerging as critical and interconnected components. Health profession students often face significant mental and physical demands, as they navigate their educational training, which can challenge their ability to maintain healthy behaviors and access necessary support. Although these students are often trained to recognize, treat, and promote wellness in others, they may struggle to prioritize or seek care for themselves. This work aims to explore the health behaviors and care-seeking patterns of health profession students, with a focus on dietary habits, sleep, and barriers to mental health …

Process-Grounded Knowledge-Infused Learning And Decision Making, Kaushik Roy

Theses and Dissertations

This dissertation introduces process-grounded knowledge-infused learning and reasoning, a novel framework for integrating domain-expertise-based process knowledge into the learning and reasoning mechanisms of artificial intelligence systems. This approach is designed to produce controlled, transparent, and reliable predictions in critical tasks such as medical diagnosis and recommendation. By focusing on the case study of mental illness diagnosis and recommendation—where decision-making must be grounded in processes such as disorder-specific diagnostic criteria—this work demonstrates methods to embed structured decision-making directly into the system architecture during both training and inference. This integration facilitates end-to-end training and reasoning while ensuring that outputs strictly adhere to …

The Impact Of Adverse Childhood Experiences And Living With Hiv On Cardiovascular Health And Cardiometabolic Disorders In An African Population: An Analysis Of The Indepth Community In Rural South Africa, Samuel Gavi

Theses and Dissertations

Background: Adverse Childhood Experiences (ACEs) have been shown to be associated with cardiometabolic disorders (CMDs) and poor CVH; however, in Africa, this has not been well studied. Cardiovascular health (CVH) is an important measure of risk for cardiovascular diseases (CVD) developed by the American Heart Association (AHA). With the increasing prevalence of CVD in Africa, CVH is a potential upstream prevention approach. Africa also has the highest prevalence of HIV, and an increasing prevalence of comorbidities associated with it. Various mechanisms have been investigated to explain the relationship between CVD and chronic HIV infection. This study explores the potential relationship …