Digital Commons Network^™

Effective Measurement-Based Care For Depression Within Va Health Systems: A Quality Improvement Initiative, Amie L. Doyle

DNP Scholarly Projects

Background: Depression is highly common among U.S. veterans, surpassing civilian rates. Measurement-Based Care (MBC), including the Patient Health Questionnaire-9 (PHQ-9), facilitates systematic symptom monitoring and treatment enhancement. At Manchester VA Medical Center (VAMC), PHQ-9 completion in primary care was low (18.93% in May 2025) due to workflow inefficiencies, provider workload, and dependence on Mental Health Service Line (MHSL) referrals.

Local Problem: Underutilization of the PHQ-9 in primary care hampers early detection and effective treatment of depression among veterans.

Methods: Four primary care teams received training on using the Behavioral Health Laboratory (BHL) software, which facilitates pre-visit electronic completion of the …

Implementation Of A Standardized Educational Training Series For Anaphylaxis Recognition And Epi-Pen Administration To Non-Licensed Personnel In A School Setting, Katherine T. Darak

DNP Scholarly Projects

Background: Anaphylaxis is a life-threatening allergic reaction that requires early recognition and administration of intramuscular epinephrine. In the elementary school setting, non-licensed personnel are often the first staff to identify this, making training and preparedness essential. This quality improvement project aims to enhance school personnel knowledge, confidence, and competence in recognizing and managing anaphylaxis through a standardized educational training series.

Purpose: The purpose of this quality improvement project aimed to increase the knowledge, confidence, and competence of non-licensed personnel in managing and responding to anaphylaxis in the school setting. Participants accessed the educational module and hands-on training interventions …

Implementation Of Outpatient Cervical Ripening In The Community Hospital Setting: A Quality Improvement Process, April St Hilaire

DNP Scholarly Projects

Background: Cervical ripening is a critical component of labor induction. Outpatient cervical ripening using mechanical dilators offers a safe patient- centered alternative to inpatient management, with potential benefits in efficiency and patient satisfaction and cost savings.

Local Problem: At a community hospital setting with increasing induction rates, prolonged admission-to-delivery times and prolonged patient stays were observed in patients undergoing inpatient cervical ripening, prompting a need for more efficient, patient centered approaches.

Methods: Using the Plan-Do-Study-Act (PDSA) framework, an outpatient cervical ripening protocol was implemented over a 15-week period to compare inpatient versus outpatient cervical ripening using mechanical …

Improving The Process Of Performing Stroke Assessments Within The Emergency Department: A Quality Improvement Initiative, Michael Ferrone

DNP Scholarly Projects

Background: An acute stroke is a potentially life-threatening medical condition that may lead to significant morbidity and mortality. It is imperative that patients seek emergent medical attention as several of the known interventions are time-limited based upon the time of symptom onset. Once patients present for evaluation, it is of equal importance for medical professionals to recognize that someone may be experiencing an acute stroke and to escalate their care appropriately. Among the various evidence-based stroke assessments, the National Institute of Health Stroke Scale (NIHSS) is often implemented given its ability to detect acute neurological abnormalities and estimate stroke severity. …

Pathways To Nursing And Midwifery Education In Tanzania With Reflection To The Global Perspectives: A Narrative Review, Tumbwene Mwansisya, Mary Lyimo, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background/Objectives:

This review aimed to explore the pathways of nursing and midwifery education in Tanzania and compare them with global perspectives. The goal was to identify similarities, differences, and areas for potential improvement to align with international standards.

Methods:

A narrative literature review was carried out through databases with published studies in nursing and gray literature. The database search included Medline, PubMed, Google Scholar, EBSCO, PsycINFO, clinical nursing, and gray literature from January 2014 up to December 2024. The search process was carried out by the authors with the following key words: admission, pathway to nursing profession, delivery mode, …

Co-Designing An International Nursing Course On Workplace Violence In Ethiopia, Sweden, And Tanzania: A Collective Autoethnography, Martin Salzmann-Erikson, Elisabet Eriksson, Tilahun Saol Tura, Tumbwene Mwansisya, Loveluck Mwasha, Malin Jordal

School of Nursing & Midwifery, East Africa

This study explores whether and how the co-creation of an international university course on workplace violence served as a site of transformative learning for us as nursing educators across Sweden, Ethiopia, and Tanzania. Using collaborative autoethnography, our team of six faculty members critically reflected on pedagogical assumptions, educator identities, and experiences of cross-cultural collaboration. The data comprised written reflections, meeting transcripts, and observational notes. Through this process, our pedagogical approaches and professional identities were reshaped, shifting from content deliverers to reflective co-learners within the cross-cultural partnership. Our analysis highlights the interplay of cultural negotiation, logistical frictions, and unspoken yet influential …

Using Shared Governance To Improve Oral Care Documentation In The Inpatient Setting, Angela G. Arseneau

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The concept of shared governance in nursing encompasses shared decision-making between leaders and bedside nurses, which includes areas of evidencebased practice projects and nursing research. Using shared governance as a way of implementing desired change can positively impact patient outcomes.
Local Problem: The inpatient med-surg unit at a small rural hospital was below the facility’s threshold for the documentation of oral care. Current standards require oral care to be performed and documented two times during a 24-hour period for each admitted patient 90% of the time. The unit currently documents oral care at a rate of 35%.
Methods: …

Microwave Photonics-Assisted Interrogation Of Fiber-Optic Interferometric Sensors With Joint Frequency-Time Domain Analysis, Ruimin Jie, Jie Huang, Chen Zhu

Electrical and Computer Engineering Faculty Research & Creative Works

Fiber-optic interferometers are widely used in localized sensing applications due to their compact size, high sensitivity, and immunity to electromagnetic interference. In this paper, we propose and experimentally demonstrate a novel interrogation scheme for fiber-optic interferometric sensors, utilizing microwave photonics (MWP) and joint frequency-time domain analysis. As a proof of concept, a miniature fiber in-line Fabry-Perot interferometer (FPI) is integrated with a microwave photonic single-passband filter, enhanced by a dispersion compensation module to improve sensing performance. By applying an inverse Fourier transform to the system's complex frequency response, the time-domain representation of the signal is obtained, translating spectral shifts of …

Fast Demodulation Of Ofdr-Based Distributed Sensing Based On Enhanced Buneman Frequency Estimation, Zhaopeng Zhang, Bo Liu, Xiao Liu, Caiyun Li, Osamah Alsalman, Chen Zhu

Electrical and Computer Engineering Faculty Research & Creative Works

Aiming at realizing high-efficiency distributed strain sensing through optical frequency domain reflectometry (OFDR), this paper introduces a fast demodulation algorithm to determine strain-induced spectral shifts from coarse Rayleigh backscattering (RBS) cross-correlation spectra. The proposed approach employs an enhanced Buneman frequency estimation (BFE) algorithm, enabling direct spectral shift analysis across coarse signals. By applying this algorithm, the need for dense interpolation in the conventional cross-correlation demodulation process - typically required for a finer spectral sampling interval but at the cost of demodulation efficiency - can be eliminated. Both theoretical analysis and experimental investigation reveal the equivalence of the BFE and conventional …

Advancing Temperature Monitoring Of The Bottom Anode In A Direct Current Electric Arc Furnace Operations With Distributed Optical Fiber Sensors., Ogbole Collins Inalegwu, Rony Kumer Saha, Yeshwanth Reddy Mekala, Farhan Mumtaz, Nicholas Dionise, Zane Voss, Jeffrey D. Smith, Ronald J. O'Malley, Rex E. Gerald, Jie Huang

Electrical and Computer Engineering Faculty Research & Creative Works

The bottom anode in the Direct Current Electric Arc Furnace (DC EAF) is critical for completing the electrical circuit necessary for sustaining the arc within the furnace. For pin-type bottom anodes, monitoring of the temperature of select pins instrumented with thermocouples is performed to track bottom wear in the EAF and inform the operator when the furnace should be removed from service. This work presents the results from a plant trial using distributed temperature monitoring of bottom anode pins in a 165-ton DC EAF over a two-month service period utilizing two optical fiber sensing techniques: fiber Bragg grating (FBG) and …

Microwave Photonic Fiber Ring Resonator For Optical Sensing Based On In-Ring And Out-Of-Ring Modulation, Shiyu Li, Chen Zhu

Electrical and Computer Engineering Faculty Research & Creative Works

Intensity-modulated optical fiber sensors (IM-OFSs) have garnered significant research interest due to their advantageous characteristics, including simplified fabrication procedures, cost-efficient systems, and straightforward signal demodulation, leading to their widespread application across diverse fields. Nevertheless, the multiplexing technique for IM-OFSs remains underexplored, primarily because isolating the contributions of individual sensors within the system using traditional power measurements poses a significant challenge. In this study, we introduce and experimentally validate a novel approach leveraging a simple microwave-photonic fiber ring resonator (MWP-FRR). This approach enables the concurrent interrogation of two IM-OFSs based on an in-and-out-of-ring-modulation (IORM) strategy. The transmission losses of both IM-OFSs …

It’S Time To Stop Calling People "Stakeholders", Bethann Garramon Merkle, Evelyn Valdez-Ward, Priya Shukla, Skylar R. Bayer

Human–Wildlife Interactions

Although the term “stakeholder” has been widely used in science communication, recent expansion in the discourse around the negative connotations of the term necessitate that scientists and practitioners cease using the term. We discuss why this shift is necessary, how it affects our own praxis, and suggest resources for working through more respectful and just language. Looking to the science communication literature can help recalibrate terminology in positive ways.

Mitigating And Preparing For Disasters At The Organizational Level: A Global Systematic Literature Review, Abdul-Akeem Sadiq, Ratna B. Dougherty, Rebecca Entress, Bikash Adhikari, Katherine Wilson Mccoy, Emilie Rott, Grace L. Chikoto-Schultz, Shannon Maharajh

Faculty Scholarship and Creative Works

Organizations play significant roles in society by providing goods and services and contributing to the economies of communities, globally. Amid the predicted increase in the frequency and impact of disasters, which will invariably lead to higher disaster costs, there is an urgent need to ameliorate disaster impact on society and organizations. Disaster mitigation and preparedness are strategies for stemming disaster impact and losses within organizations. Cognizant of the importance of disaster mitigation and preparedness, researchers have conducted a myriad of studies on both concepts at the organizational level. To advance knowledge on this topic, this study conducted a comprehensive systematic …

Multi-Source Remote Sensing–Based Soil Moisture Prediction Using Machine Learning, Niraj Neupane

Electronic Theses and Dissertations

Soil moisture (SM) plays a central role in climatic and environmental processes, influencing shear strength of soil, agricultural productivity, land–atmosphere interactions, and hydrologic functioning. However, accurately estimating SM across diverse climatic regions remains challenging due to spatial heterogeneity, limited in situ measurements, and inconsistencies in sensor resolution. Machine learning (ML) and remote sensing offer promising avenues for improving SM prediction, yet many existing approaches struggle with generalization across climatic gradients and often fail to capture temporal variability. This study integrates multi-source satellite and climate datasets, including SMAP L4_SM, MODIS land surface temperature, Daymet meteorological variables, and in situ observations from …

Spatiotemporal Habitat Use, Sex-Specific Movement, And Site Fidelity Of Walleye In Lake Sharpe, Sd, Carter S. Dollen

Electronic Theses and Dissertations

Walleye Sander vitreus are a popular sportfish among anglers in South Dakota with large economic impacts to local communities. A popular destination for Walleye anglers is Lake Sharpe, a 25,000-ha reservoir on the Missouri River, in central South Dakota. Gill net catches in Lake Sharpe show high annual variation, prompting concern that gill net catch rates may be poorly related to population abundance. A better understanding of Walleye movement and distribution could lead to increased precision in annual abundance estimates and improved active management that increases angler success. The goals of this study were: 1) determine spatiotemporal movement patterns of …

Quantifying Avian And Vegetation Communities On Agricultural Conservation Easement Wetlands In Eastern South Dakota, Katherine Millman

Electronic Theses and Dissertations

The Prairie Pothole Region of eastern South Dakota contains numerous small depressional wetlands, colloquially known as potholes, that provide important ecosystem services, including water storage, water quality improvement, and wildlife habitat. The Agricultural Conservation Easement Program (ACEP) was established by the U.S. Department of Agriculture to protect and restore wetlands and grasslands on private land through easements such as Wetland Reserve Easements. Although ACEP requires management practices intended to maintain or improve habitat quality, few studies have evaluated their effectiveness at supporting wildlife communities and vegetation integrity. To address this gap, we evaluated wetlands at 30 ACEP sites and 20 …

Enhancing Alfalfa Persistence In Rangelands: Evaluating Morphological Traits Of Medicago Sativa Subsp. Falcata Germplasm, Abdulallah Mohammed Alomair

Electronic Theses and Dissertations

Rangelands cover nearly half of the Earth’s surface, representing about 54% (79 million km2), and occur in different types and climates worldwide. Alfalfa (Medicago sativa L.) is a major component in rangelands and covers about (320 thousand km2), representing about 0.4% of total global rangeland area. As a critical perennial legume crop, alfalfa can improve soil health by fixing approximately 336 kg/ha/year of nitrogen and sequestering up to 614 kg/ha/year of carbon, while enhancing livestock production due to its high content level of vitamins, magnesium, minerals, fiber, and protein. However, environmental stresses such as drought, freezing, and grazing limit alfalfa …

Formulation And Immunogenicity Of L1 Orf1 Mrna Vaccine In Mice, Raj Nandani

Electronic Theses and Dissertations

This dissertation presents the design, formulation, and immunogenicity evaluation of a novel mRNA vaccine targeting the L1 ORF1p protein, a tumor-associated antigen. The vaccine was synthesized using in vitro transcription and encapsulated in lipid nanoparticles (LNPs), with both unmodified uridine and N1-methylpseudouridine variants tested. Physicochemical characterization confirmed optimal particle size (160–220 nm), acceptable zeta potential, and encapsulation efficiency ranging from 74% to 92%, with preserved RNA integrity post-formulation. These results validate the robustness of the formulation workflow and its suitability for antigen delivery. Immunogenicity studies in C57BL/6 mice revealed modest but promising immune responses. While early activation markers (CD69) and …

Epidemiological And Diagnostic Approaches For Soybean Cyst Nematode In South Dakota, Nabina Karki

Electronic Theses and Dissertations

Soybean cyst nematode (SCN), Heterodera glycines (HG) Ichinohe, is an endoparasitic nematode and one of the major yield-limiting pathogens of soybean (Glycine max L.) in the United States. Soybean cyst nematode alone accounts for more than $1.5 billion economic loss annually in North America. First reported in the U.S.A. in 1954 in New Hanover County, North Carolina and later in 1995 in Union County, South Dakota. Prior to this study, SCN has spread in 34 counties in the state. As a soil pathogen, which can adapt to most soil conditions under soybean production and beside soybean, it is hosted on …

Artificial Intelligence System Accurately Detects Fetal Ultrasound Findings Suspicious For Major Congenital Heart Defects, Carolyn M. Zelop, Jennifer Lam-Rachlin, Alisa Arunamata, Rajesh Punn, Sarina K. Behera, Matthias Lachaud, Nadine David, Greggory R. Devore, Andrei Rebarber, Sara Garmel

Conference Presentation Abstracts

Objective: Prenatal detection of congenital heart defects (CHD) improves patient outcomes. Despite advances in imaging techniques and equipment, prenatal diagnosis remains low. We evaluated the accuracy of an artificial intelligence (AI) system to detect 2nd trimester (2T) ultrasound studies suspicious for CHD. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of a study and detects 8 morphological findings suspicious for CHD. The findings were selected such that most major forms of CHD would feature at least one such finding, and the presence of any of these would flag the study for referral for further examination. We retrospectively …

Ai Significantly Improves Detection Of Prenatal Ultrasounds Suspicious For Major Congenital Heart Defects By Obgyn/Mfms, Jennifer Lam-Rachlin, Rajesh Punn, Sarina K. Behera, Miwa Geiger, Matthias Lachaoud, Nadine David, Sara Garmel, Matthew K. Janssen, Kendra Sylvestser, John Kennedy

Conference Presentation Abstracts

Objective: Congenital heart defects (CHDs) are a leading cause of infant morbidity and mortality partly due to low prenatal detection rates. We evaluated whether an artificial intelligence (AI) system can improve the detection of CHDs on fetal ultrasound exams among both general OBGYNs and MFM specialists. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of an exam and detects 8 morphological findings associated with severe CHDs. The presence of any such finding should justify patient referral for further examination. The AI system identifies each finding as present, absent or inconclusive, and highlights frames where findings can be …

Evaluation Of Two Stem Boring Insects In South Dakota: A Survey Of Wheat Stem Sawfly And Determining The Impact Of Planting Date On Dectes Stem Borer Infestations In Sunflowers, Khuma Kumari Bhusal

Electronic Theses and Dissertations

Wheat, Triticum aestivum L., and sunflower, Helianthus annuus L., are major crops in South Dakota that are threatened by stem-boring insect pests capable of reducing yield and harvestability. In wheat, the wheat stem sawfly, Cephus cinctus Norton, has long been recognized as a destructive pest in the Northern Great Plains, yet its actual distribution within South Dakota remained uncertain. To determine its presence, a two-year survey was conducted across the state from 2023–2024, during which one to four wheat fields per county were sampled using standardized sweep net transects. Wheat stem sawflies were collected only from Harding and Perkins Counties …

Mind The Gap(S): Mitigating Harassment In A Post-#Metoo Workplace, Jamillah Bowman Williams, Elizabeth C. Tippett, Anu Ramdin

Georgetown Law Faculty Publications and Other Works

In a post-#MeToo workplace, harassment remains pervasive, and harassment law still fails to provide protection for the harms experienced by many workers—particularly those in the most vulnerable jobs. Even when reform efforts are introduced through legislation, courts, and agency guidance, it often does not provide greater power, autonomy, and dignity to women in ways that would more meaningfully protect them from workplace abuse. We are the first to create a database of state legislation, including over three thousand bills, that allows us to empirically analyze the extent to which lawmakers comprehensively address harassment following the rise of the #MeToo movement. …

Pozen And The Puzzle Of Counterfactuals, Louis Michael Seidman

Georgetown Law Faculty Publications and Other Works

The Constitution and the War on Drugs, David Pozen’s carefully researched and brilliantly argued book, is both illuminating and disturbing: illuminating because it unearths forgotten moments when judicially formulated constitutional doctrine that could have ended or sharply restricted the War on Drugs were well within the Overton Window, and disturbing because it surfaces hard questions about historical contingency and the scope of the change that might have occurred in a counterfactual world. In this review, the author argues that the failure to specify both the nature of the counterfactual and the breadth of the alternative possibility have confused discussions …

The Administrative State's Second Face, Emily R. Chertoff, Jessica Bulman-Pozen

Georgetown Law Faculty Publications and Other Works

We often assume that there is one administrative state, with one body of administrative law that governs it. In fact, the administrative state has two distinct faces: one turned toward regulation and benefits distribution, and one turned toward physical force and surveillance. The two faces are growing further apart under the Roberts Court, which has hemmed in the first face with decisions like Loper Bright while showing solicitude for national security and law enforcement agencies.

This Article delineates the two faces of the administrative state. It provides a descriptive account of the second face and the distinctive administrative law that …

Patent Infringement In Time, John R. Thomas

Georgetown Law Faculty Publications and Other Works

No patent lasts forever. When intellectual property rights expire, a canonical principle states, all benefits of their ownership cease. But patents may cast a long shadow after they are gone, hindering the advent of immediate competition upon their expiration. The law acts unevenly in these circumstances, leading to questionable intellectual property and public health policies. Ordinarily competitors cannot make and use a patented invention until the patent's term has concluded. This delay ordinarily extends the effective period of exclusivity that the patentee enjoys. However, a statutory safe harbor shields from infringement acts undertaken "solely for uses reasonably related" to Food …

Does The Original Meaning Of The Fourteenth Amendment Protect Economic Liberty?, Randy E. Barnett

Georgetown Law Faculty Publications and Other Works

In my remarks today, I will defend the proposition that the original meaning of the Fourteenth Amendment protects "economic liberty." To clarify the issue, let me being by defining economic liberty. I define economic liberty as the right to acquire, use and possess private property and the right to enter into private contracts of one's choosing. If these rights are protected by the original meaning of the Fourteenth Amendment, then we can conclude that the Amendment does protect economic liberty.

In my view, the evidence that the original meaning Fourteenth Amendment protects rights of private property and contract is overwhelming. …

Just Research And Citation, Amanda Levendowski

Georgetown Law Faculty Publications and Other Works

Contemporary research and citation practices are often unjust. Data cartels like Westlaw and Lexis have parent companies that prioritize profits in ways that threaten immigrants. Even before the Dobbs decision, search engines could be deployed to weaponize data against pregnant people seeking reproductive care. Women and people of color have been legal scholars for more than a century but, as many scholars have observed, colleagues consistently under-cite, mis-cite or appropriate those scholars’ work with minimal recourse. Citation materials are often inaccessible to disabled people, poor people, or the public due to poor design, paywalls, or unpreserved content that falls prey …

Promoting Public Health And Public Safety By Ending The Exclusion Of Incarcerated Children From Access To Medicaid, Eduardo R. Ferrer

Georgetown Law Faculty Publications and Other Works

This essay is a response to Professor Den Houter's article entitled Children are Not Inmates in which she effectively calls eliminating the exclusion of indigent incarcerated children from Medicaid coverage pursuant to the Medicaid Inmate Exclusion Policy (MIEP). This essay affirms and builds upon Professor Den Houter's recommendation. Part I of this response provides additional support for why ensuring system-involved youth receive timely, uninterrupted, high-quality behavioral health services is critical to improving both public health and public safety. Part II analyzes the benefits and risks attendant to excluding indigent incarcerated children from the MIEP. Part III proposes the implementation of …

De/Reconstructing Delinquency, Eduardo R. Ferrer

Georgetown Law Faculty Publications and Other Works

Hundreds of thousands of children are brought under the jurisdiction of delinquency courts every year in the United States. Despite the reality that most children engage in delinquent behavior during their adolescence, poor children, children of color, children with disabilities, and children who identify as LGBTQIA+ comprise a disproportionate number of those who become delinquency system-involved. These disparities exist by design. Their origins can be traced back to the flawed first principles upon which the juvenile court was built and, specifically, to the unduly expansive legal definition of delinquency that has undergirded the jurisdiction and power of the juvenile court …