Digital Commons Network^™

Two-Year Retrospective Evaluation Of Frailty To Optimize Postoperative Spinal Fusion Outcomes In Adults Aged 65 And Older, Sheri Loo

Doctoral Projects

Many older adults over the age of 65 have both spinal stenosis requiring spinal fusion surgery and frailty. As life expectancy has increased, many older individuals will undergo elective spinal fusion surgery to decrease their chronic pain in pursuit of improved quality of life. There is currently an underutilization of frailty screening for risk stratification of postoperative complications. A retrospective chart review over a two-year period from July 2023 to June 2025of adults aged 65 and older who underwent posterior spinal fusion surgery, involving 126 participants, was completed. We assessed the correlation between frailty and postoperative outcomes, discharge disposition, and …

Leveraging Mobile Health To Prevent Coronary Artery Disease Through Physical Activity Promotion Among Underserved Youth, Alina Yang, Jessh M. Mavoungou, Matthew C. Miller, Zarmina Amin, Zan Gao

International Journal of Physical Activity and Health

Coronary artery disease (CAD) develops earlier than often recognized, with underserved youth facing disproportionate cardiometabolic risk. Low participation in moderate-to-vigorous physical activity (PA) is a key driver. This viewpoint explores how mobile health (mHealth) technologies can serve as tools to increase PA engagement among underserved youth, guided by a combined Self-Determination Theory and RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. It highlights current barriers to mHealth adoption, limited cultural relevance, engagement challenges, and accessibility gaps, and presents key considerations for designing culturally informed, age-tailored, and youth-centered mHealth interventions. Overall, the paper calls for a more inclusive and targeted approach …

The Mediating Effect Of Physical Activity On Mental Health Among Sexual Minority Adolescents During Covid-19, You Fu, Ryan D. Burns, Hayley Almes, Xiangren Yi, Nora Constantino

International Journal of Physical Activity and Health

Purpose: Adolescents identifying as a sexual minority frequently experience mental health issues exacerbated by the COVID-19 pandemic. Physical activity (PA) has numerous benefits for mental health and emotional development. The purpose of this study was to examine the mediating effect of PA on the association between sexual minority status and mental health among adolescents during COVID-19. Methods: A sample of adolescents (grades 9-12) completed the online Adolescent Behaviors and Experiences Survey (ABES; N = 7677; 49.6% male) in 2021. The independent variable in this study was a recorded binary response item asking about sexual orientation. The dependent variable was a …

Mosunetuzumab Monotherapy Is Active And Tolerable In Patients With Relapsed/Refractory Richter Transformation, Katharine L Lewis, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

Richter transformation (RT) to diffuse large B-cell lymphoma is an aggressive lymphoma that arises from underlying chronic lymphocytic leukemia or small lymphocytic lymphoma. RT is often chemorefractory, resulting in poor clinical outcomes with standard chemoimmunotherapy. Mosunetuzumab, a bispecific CD20/CD3 T-cell-engaging antibody, was investigated in a cohort of 20 patients with relapsed/refractory RT. Cytokine release syndrome occurred in 65% of patients, almost exclusively grade 1 (20%) or grade 2 (40%), and occurring during the first treatment cycle. Other adverse events included infections, neutropenia, thrombocytopenia, tumor flare, and low-grade neurotoxicity, with no adverse events leading to treatment discontinuation. Mosunetuzumab resulted in an …

Simultaneous Multielectrode Recordings Along The Human Scala Tympani: Evidence For Level-Dependent Place Coding, Amit Walia, Matthew A Shew, Shannon M Lefler, Amanda J Ortmann, Patrick Ioerger, Jordan Varghese, Jacques A Herzog, Craig A Buchman

2020-Current year OA Pubs

The cochlea systematically encodes sound frequency and intensity via a precisely organized tonotopic map, in which traveling waves peak at specific cochlear locations. A fundamental but incompletely understood aspect of auditory coding involves how stimulus intensity shapes this tonotopic organization. In animal models, increasing intensity shifts the cochlear traveling wave peak basally; however, physiological evidence for such intensity-dependent shifts in human cochlear processing is limited. Here, we performed simultaneous multielectrode electrocochleography recordings along the human scala tympani to characterize how cochlear place coding varies as a function of stimulus intensity. In subjects with preserved cochlear mechanics, including individuals with auditory …

Making Process Evaluations More Explanatory - Key Opportunities To Advance Implementation Research, Michel Wensing, Elvin H Geng

2020-Current year OA Pubs

Process evaluation of implementation strategies is increasingly common, but a review by Bracci et al. showed that room for improvement exists. In this contribution, we complement their recommendations by ideas on the design of process evaluations. Process evaluations are meant to provide explanations for why implementation strategies were effective, or not effective. Therefore, they are best guided by theory or frameworks, but the frequent focus on intervention acceptability reflects a lack of imagination on moderators and mediators that influence outcomes. Intervention fidelity is relevant in all process evaluations. Meaningful synthesis of process evaluation studies requires a homogeneous outcome, such as …

Exposure To Agent Orange And Association With Myelodysplastic Syndromes, Mikkael A Sekeres, Matthew J Walter, Et Al.

2020-Current year OA Pubs

No abstract provided.

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Redefining Skincare For Sensitive Lives, Ashlyn G. Sierra Ms

Honors College Theses

This study outlines how a skincare company that is both ethically and effectively developed for people suffering from eczema could create accessible, affordable products as well as maintain its commitment to being inclusive. The study uses scientific data regarding eczema in order to examine why certain aspects of skin care are helpful or dangerous when it comes to individuals who suffer from eczema, in addition, it provides an assessment of current skin care product offerings that are designed for people with eczema. Using the Wise Leadership Framework, the study presents a hypothetical business plan for a new, eczema-based skin care …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Emma Jade Mowery, Justin D. Ruiz

Doctor of Nursing Practice Final Project Abstract

Purpose: To investigate the impact of implementing use of the Smiling Mind app (a free and easily accessed mobile application that teaches mindfulness skills) in inpatient psychiatric nurses. The aims: A 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background: Workplace stressors experienced by psychiatric nurses include high patient acuity, emotional strain, environmental factors, and new policies. Unmanaged stress can harm nurse's well being and affect quality of care.

Methodology: Using a pre-post implementation design, 7 dayshift and 10 night-shift nurses used the Smiling Mind app for 10 weeks. Perceived stress (PSS-10) and workplace satisfaction (WPS) …

Left Behind: How The Ssi Program Fails To Support Young People With Disabilities, Caitlyn B. Acosta

The Scholar: St. Mary's Law Review on Race and Social Justice

The Supplemental Security Income (SSI) Program was created to protect people with disabilities from extreme poverty. However, its outdated rules and punitive structures trap millions in cycles of poverty and exclusion. For young adults with disabilities, the SSI system worsens existing barriers by limiting income and savings, discouraging work, and fostering dependence instead of independence. Drawing on personal narratives, historical context, and current policies, this Comment highlights how SSI reflects a long legacy of ableism and systemic neglect. The stories of individuals who have been denied dignity, family stability, and community belonging illustrate that reform is not just about policy, …

Statutes Of Unjust Limitations: An Argument In Favor Of Increasing The Statute Of Limitations For Civil Cases Of Adult Sex Crimes In Texas, Athina E. Castañon

The Scholar: St. Mary's Law Review on Race and Social Justice

This Comment argues that Texas’s current five-year statute of limitations for civil claims arising from adult sex crimes is unjust and misaligned with modern trauma research. While Texas has enacted meaningful legislation for child survivors, adult survivors who experience sexual violence after the age of eighteen remain subjected to an arbitrarily short filing window that fails to account for the psychological, social, and economic barriers to reporting and litigation. Drawing on historical context, trauma-informed research, and a comparative analysis of reform efforts, this Comment demonstrates how rigid statutes of limitations disproportionately harm survivors and undermine access to civil justice.

Development And Psychometric Analysis Of An Instrument To Assess Social Stigma Associated With Parkinson's Disease, Ana Lourdes Guerra-Anzaldo, Arturo Emmanuel Espinosa-Picos, Karen Itzel Sánchez-Ramírez, Ana Jimena Hernández-Medrano, Amin Cervantes-Arriaga, Ariadna Domínguez-García, Mayela Rodríguez-Violante

Journal of Patient-Centered Research and Reviews

Purpose: To develop and report the psychometric properties of a comprehensive scale designed to measure stereotypes and attitudes of the general population towards people with Parkinson’s disease (PwP).

Methods: The development and analysis of the Parkinson's Disease Stigma Perception scale (PDSP) included four phases: 1) literature review, 2) item development, 3) tests of validity and reliability, and 4) dissemination of a preliminary version. Internal consistency was assessed using Cronbach's alpha, exploratory factor analysis (EFA) to explore underlying structures, and confirmatory factor analysis to test the model's fit.

Results: Six (2%) of the 294 survey respondents were disqualified because of incomplete …

The Compassionate Heart Patient Questionnaire: Validation And Reliability Of A Novel Measure Of Relationship-Centered Care, Dustin Willis, Everett Lohman, Lida Gharibvand, Andrew Sullivan, Lee Berk

Journal of Patient-Centered Research and Reviews

Purpose: To establish the validity and reliability of the Compassionate HEART Patient Questionnaire (CHPQ) for measuring relationship-centered care and exploring associations between patient ratings and mood state changes in patients with persistent pain.

Methods: Thirty-nine adults with persistent pain (> 3 months) completed pre-/post-interaction Profile of Mood States assessments and rated providers using the Consultation and Relational Empathy (CARE) measure and the novel CHPQ following physical therapy evaluations. Psychometric properties were assessed through factor analysis, concurrent validity (correlation with CARE), and internal reliability (Cronbach's alpha). Pre-post mood changes were analyzed using Wilcoxon signed-rank test.

Results: The CHPQ demonstrated good internal …

Universal Free Lunch: Why Not New Hampshire?, Delaney Hesler

Carsey Publications

School lunch is an essential component of students’ lives. Spending an average of 6.8 hours a day at school, students need food to fuel their learning. Along with many other states across the nation, most New Hampshire schools participate in the National School Lunch Program. This program provides federal reimbursements to schools for students who qualify for free or reduced-price lunch. Across all New Hampshire districts, an average of 23 percent of kids were eligible for free or reduced-price meals during the 2025–26 school year. However, in pockets of both rural and urban New Hampshire, rates far exceed the average. …

Restless Legs Syndrome And Neurological Comorbidities: A Narrative Review, Kyrillos Ghattas, Helen Hernandez, Yongwoon Huh, Zhanna Fast, Zhikui Wei

Department of Sleep Medicine Faculty Papers

Restless legs syndrome (RLS) is a common yet underrecognized neurological disorder characterized by uncomfortable sensations and an irresistible urge to move he legs, typically following a circadian pattern. RLS frequently co-occurs with various other neurological diseases, raising questions about shared mechanisms and clinical consequences. This review synthesizes evidence on the prevalence, outcomes, and pathophysiology of RLS in various neurological disorders, including Parkinson's disease, multiple sclerosis, migraine, dementia, stroke, epilepsy, and peripheral neuropathy. In Parkinson's disease, RLS is linked to disease progression and dopaminergic therapy. In stroke and multiple sclerosis, RLS is associated with structural lesions at specific locations, such as …

Assessing Estimated Premorbid Iq In Dementia In The Uae: A Way Forward For The Gulf Cooperation Council Countries, Sophie Price

Sultan Qaboos University Medical Journal

No abstract provided.

Reducing Nurse Burnout In Medical/Surgical Units In South Carolina Acute Care Hospitals, Jessica D. Robinson

Walden Dissertations and Doctoral Studies

No abstract provided.

Barriers Inhibiting African American Male Nurses’ Promotion To Leadership Positions, Amaziah Ali Dominic

Walden Dissertations and Doctoral Studies

No abstract provided.

Climate Anxiety Shapes Career And Parenthood Decisions In College Students, Minha Hossain, Patrycja Sleboda-Sobolev

Publications and Research

This study examined how climate anxiety influences future-oriented decision-making among college students, with particular attention to four decision-making domains: career planning, parenthood decisions, sustainability behaviors, and geographic mobility. Although climate anxiety has become increasingly common among young adults, less research has explored how it shapes long-term life decisions within diverse U.S. college populations or how psychological and contextual factors influence these relationships. A sample of 257 undergraduate students from Baruch College completed a Qualtrics survey measuring climate anxiety, climate-related emotions, hope, self-efficacy, migration background, and future-oriented decision-making domains. Results indicated that climate anxiety significantly predicted career and parenthood decision-making, but …

The Impact Of Nurse-Led Universal Depression And Suicide Risk Screening On Adolescent Mental Health Outcomes In Pediatric Primary Care, Malu-Kanoa Hewitt, Briana Morris, Dolly Ukpong, Lula Teklehaimanot, Preet Kamal Singh, Latasha Scott, Charity Msamalia Chimwala-Selico

General Submissions: Clinical Settings Materials

Background: Adolescent depression and suicide are critical public health concerns in the United States. Approximately 20% of youth aged 12–17 experience a major depressive episode annually, yet fewer than half receive treatment (NIMH, 2023). Suicide is a leading cause of death among adolescents and young adults (CDC, 2023). The U.S. Preventive Services Task Force (USPSTF) recommends screening for major depressive disorder (MDD) in adolescents aged 12–18 when adequate systems are in place for diagnosis, treatment, and follow-up, but concludes that evidence is insufficient to recommend routine suicide risk screening in children and adolescents (USPSTF, 2022).

Purpose: This literature review evaluates …

Redefining Capital Cities: A Smart Growth Evaluation Of Capital Cities And How Albany Can Learn From Them, Richard Turoski Iii

Theses

Mid-sized American capital cities face distinct development challenges determined by historical growth patterns, economic restructuring, and evolving urban priorities. This study examines Albany, New York, through the lens of Smart Growth, a planning framework that emphasizes compact development, mixed land use, multimodal transportation, and reinvestment in existing urban areas. Using comparative policy analysis, Albany is evaluated alongside Columbus, Ohio; Hartford, Connecticut; and Harrisburg, Pennsylvania, enabling consistent cross-case comparison based on similar roles as state capitals and overlapping comprehensive planning timelines. The research studies Smart Growth principles by structured policy analysis centered on downtown revitalization, mixed-use development, transportation connectivity, waterfront redevelopment, …

Type-1 Ryanodine Receptor Plays An Important Role In Cardiac Hypertrophy And Heart Failure By Increasing Type-2 Ryanodine Receptor-Mediated Calcium Release, Yong-Xiao Wang, Ed Wilson Santos, Sarahann Mistretta, Yuexing Yuan, Harold A. Singer, Shey-Shing Sheu, Yun-Min Zheng

Center for Translational Medicine Faculty Papers

Type-1 ryanodine receptor (RyR1) is essential for skeletal muscle contraction. This Ca²⁺ release channel is expressed in cardiac myocytes; however, its function remains elusive. Cardiac-specific RyR1 overexpression (OE) mice were generated under the cardiac-specific Myh6 promoter. Cardiac hypertrophy (CH), cardiac functions, and mechanistic changes in RyR1 OE and control (wildtype, WT) mice were assessed using hematoxylin and eosin staining, echocardiography, electrocardiogram, quantitative RT-PCR, Western blotting, [³H]-ryanodine binding assay, confocal microscope, ROS dye Amplex Red and 2′,7′-dichlorofluorescein diacetate. RyR1 OE mice had increased whole heart, left ventricular weight, and left ventricular wall thickness, but decreased cardiac output and …

Choosing A Primary Care Provider: A Formative Qualitative Study To Identify Patient Preferences, Chris Gillette, Jan Ostermann, Sarah O'Neal, Aylin A. Aguilar, Kandice Lacci-Reilly, Jessica Valente, Chris Everett, Robin Gibson, Sonia Crandall, Laiton Steele

Journal of Patient-Centered Research and Reviews

Purpose: (1) Identify what characteristics patients evaluate when choosing their primary care provider (PCP), (2) characterize how provider characteristics factor into patients’ choice of PCP, and (3) develop a list of features for a quantitative preference study in the form of a discrete choice experiment (DCE).

Methods: We used a cross-sectional, qualitative study to accomplish the objectives. We recruited participants from an internal medicine clinic and the general public in North Carolina. We used convenience and purposive sampling to recruit participants as a single sample. All participants completed a semistructured interview. We then used a reflexive thematic analysis to analyze …

Postapproval Study For Brain-Responsive Neurostimulation For Drug-Resistant Focal Epilepsy, Dawn Eliashiv, Vikram R. Rao, Barbara C. Jobst, Jerzy P. Szaflarski, John D. Rolston, Lesley C. Kaye, Taneeta Mindy Ganguly, Katie Bullinger, Patricia C. Dugan, David E. Burdette, Angela Y. Peters, Atif Sheikh, Kevin F. Haas, Dileep R. Nair, Lilit Mnatsakanyan, Imran H. Quraishi, Meriem K. Bensalem-Owen, Michael J. Doherty, Babak Razavi, Tiffany L. Fisher, Christopher Skidmore, Pradeep N. Modur, Tawnya M. Constantino, Vicenta Salanova, Andrew J. Cole, Olga Taraschenko, Angelica Rivera-Cruz, James W. Wheless, Nitin Tandon, Antoaneta Balabanov, Sami Aboumatar

Neurology Faculty Publications

BACKGROUND AND OBJECTIVES: Neuromodulation therapies are approved for the treatment of focal epilepsy based on data from randomized controlled trials (RCTs). After approval of a responsive direct brain stimulation device (The RNS System for focal epilepsy), the Food and Drug Administration required a prospective study to evaluate whether real-world safety and effectiveness differed from outcomes in the RCT. METHODS: This open-labeled study enrolled adult participants who met the RNS System-approved indication for use. The primary effectiveness end point was median percent change in seizure frequency at 3 years of treatment. Interim safety is presented; the primary safety endpoint analysis will …

A Hedonic Analysis Of Farm Tractor Auction Prices, Madison Pearson, Chad Fiechter, Andy Campbell

Department of Agricultural Economics Faculty Publications

Used farm machinery values play a critical role in farm management and in assessing the financial health of the agricultural sector. However, the heterogeneity of machines, particularly regarding embedded technology and usage, complicates efforts to isolate the factors that influence prices. This study leverages a detailed dataset from Tractor Zoom to estimate the effects of machine characteristics and market conditions on auction prices of used 300 to 450 horsepower tractors. We find a nonlinear relationship between machine usage and price: tractors with fewer than 500 hours of use lose approximately 118⁢𝑝⁢𝑒⁢𝑟⁢𝑎⁢𝑑⁢𝑑⁢𝑖⁢𝑡⁢𝑖⁢𝑜⁢𝑛⁢𝑎⁢𝑙⁢ℎ⁡𝑜⁢𝑢⁢𝑟,𝑤⁢ℎ⁡𝑖⁢𝑙⁢𝑒⁢𝑡⁢𝑟⁢𝑎⁢𝑐⁢𝑡⁢𝑜⁢𝑟⁢𝑠⁢𝑤⁢𝑖⁢𝑡⁢ℎ⁡𝑚⁢𝑜⁢𝑟⁢𝑒⁢𝑡⁢ℎ⁡𝑎⁢𝑛⁢10,000⁢ℎ⁡𝑜⁢𝑢⁢𝑟⁢𝑠⁢𝑠⁢ℎ⁡𝑜⁢𝑤⁢𝑜⁢𝑛⁢𝑙⁢𝑦⁢𝑎⁢𝑤⁢𝑒⁢𝑎⁢𝑘⁢𝑙⁢𝑦⁢𝑠⁢𝑖⁢𝑔⁡𝑛⁢𝑖⁢𝑓⁡𝑖⁢𝑐⁢𝑎⁢𝑛⁢𝑡⁢𝑑⁢𝑒⁢𝑐⁢𝑙⁢𝑖⁢𝑛⁢𝑒⁢𝑜⁢𝑓⁡𝑎⁢𝑏⁢𝑜⁢𝑢⁢𝑡2 per hour. We also document pronounced seasonal patterns, with …

The Impact Of Trump Administration Immigration Policies On Connecticut Educators And Families, Elena C. Bielesz

Honors Scholar Theses

Anti-immigrant rhetoric, policies, and practices, which have grown increasingly prevalent due to the current national political climate, have adverse effects on the mental health of immigrant families and the teachers that support them in Connecticut. This study seeks to represent the opinions of Connecticut K-12 MLL (Multilingual Learners) Education Teachers and Administrators whose daily lives are impacted by the anti-immigrant and anti-refugee policies and procedures. The study employed a human subjects-based approach supported by a review of related literature. MLL Educators from around the state of Connecticut were interviewed. These interviews found that while immigration-based trauma and stressors are common …

Christine Mcgoveran V. Amazon Web Services Inc

2026 Decisions

USDC for the District of Delaware

Optimal Timing Of Ventriculoperitoneal Shunt Insertion Relative To Cranioplasty Post-Decompressive Craniectomy: A Frequentist Network Meta-Analysis, Shaan Patel, Shiva A. Nischal, Kush M. Kale, Pious D. Patel, James S. Harrop, Jack Jallo, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

OBJECTIVE: Optimal timing of ventriculoperitoneal shunting (VPS) relative to cranioplasty (CP) after decompressive craniectomy remains controversial. VPS may be performed before, during, or after CP, but no consensus exists on which sequence minimizes complications. We performed a systematic review and network meta-analysis to compare the safety profiles of pre-, simultaneous, and post-CP shunting.

METHODS: We searched PubMed/MEDLINE, Embase, and CENTRAL from inception to October 2025. Eligible studies directly compared at least two timing strategies in patients undergoing both CP and VPS. Primary outcomes included overall complications, reoperation, infection, and intradural bleeding. Secondary outcomes included shunt-related and other procedure-specific adverse events. …

Comparing The Use Of Measured And Smoothed Data In Forecasting Visual Field Tests Using Deep Learning, Ashkan Abbasi, Sowjanya Gowrisankaran, Wei-Chun Lin, Xubo Song, Bhavna Josephine Antony, Gadi Wollstein, Joel Schuman, Hiroshi Ishikawa

Wills Eye Hospital Papers

OBJECTIVE: To evaluate the impact of training and testing deep learning (DL) models for visual field (VF) forecasting using input-target pairs in which the target is either the measured VF test result, or its smoothed counterpart constructed via linear regression.

DESIGN: A retrospective data analysis study evaluating DL models for VF forecasting under multiple training and testing configurations.

SUBJECTS AND CONTROLS: A total of 1400 subjects (healthy and glaucoma patients) with 19 437 reliable Humphrey VF (24-2 Swedish Interactive Threshold Algorithm) tests collected from longitudinal cohorts at the University of Pittsburgh and New York University.

METHODS: Three DL-based pointwise VF …