Digital Commons Network^™

Tractor Workflow: A Scalable Nextflow Framework For Local Ancestry-Aware Genome-Wide Association Studies, Nirav N Shah, Taotao Tan, Jessica Honorato-Mauer, Yi-Sian Lin, Adam X Maihofer, Clement C Zai, Pgc-Ptsd Ancestry Working Group, Marcos Santoro, Caroline M Nievergelt, Elizabeth G Atkinson

Faculty, Staff and Students Publications

Motivation: The routine exclusion of admixed individuals from traditional genome-wide association studies (GWAS) due to concerns about spurious associations has limited multi-ancestry genetic discovery. Tractor addresses this issue by incorporating local ancestry into association testing, enabling the identification of ancestry-enriched signals and generating ancestry-specific summary statistics. However, adoption has been constrained by the complexity of prerequisite steps, including phasing and local ancestry inference, which require substantial bioinformatics expertise and introduce key analytical decision points.

Results: We developed a scalable, automated Nextflow workflow that integrates phasing, local ancestry inference, and Tractor association testing into a reproducible end-to-end pipeline. To demonstrate its …

Examining The Influences Of Citizen Factors On The Co-Creation Behaviors Of Online Public Services In A Smart City, Ratih Dyah Kusumastuti, Nurmala Nurmala, Juliana Rouli

Journal of Environmental Science and Sustainable Development

As smart cities increasingly rely on digital platforms to deliver public services, citizen participation becomes essential for ensuring effective and sustainable service delivery. However, limited research has examined which citizen-related factors drive co-creation behaviors in smart city contexts, particularly in emerging economies. This study aims to investigate the factors that influence the co-creation behaviors of online public services in five smart cities in Indonesia through the city’s digital platform and online social network (OSN). This study analyzes whether citizen factors, namely, perceived benefits over the city and OSN friends, trust in the city and OSN friends, and self-efficacy, affect co-creation …

Frailty As A Surgical Vital Sign: A Narrative Review Of Risk Stratification And Outcomes In General Surgery, Ambrose Loc T. Ngo, Matthew Tiojanco, Ian Miller, Linda Nguyen, Uyen Tam Nguyen, Carolyn Duong

Student Publications

Frailty has emerged as a critical determinant of perioperative risk, yet it remains underutilized in routine surgical assessment. As the global population ages, an increasing proportion of patients undergoing general surgery present with diminished physiologic reserve that is not adequately captured by traditional risk stratification tools. This narrative review examines frailty as a multidimensional construct and its role as a prognostic marker in general surgery, with the aim of synthesizing current evidence on its biological basis, evaluating commonly used frailty assessment tools, and examining its impact on postoperative outcomes, including morbidity, mortality, length of stay, and discharge disposition. A comprehensive …

Annona Muricata (Soursop) And Hematopoiesis: Ethnomedicinal Insights, Immunomodulatory Mechanisms, And Translational Challenges, Fatma Matano, Amiya Patra

Peninsula Medical School

Annona muricata (soursop) is a tropical medicinal plant widely used in traditional medicine across Africa, the Caribbean, and parts of South America. While its ethnomedicinal applications span a range of conditions, including infections, inflammation, and anemia-related symptoms, its potential relevance to hematopoiesis has not been systematically examined. This narrative review synthesizes ethnomedicinal knowledge, phytochemical composition, and experimental evidence to explore the biological plausibility by which A. muricata may indirectly influence hematopoietic processes. Bioactive constituents of A. muricata, including flavonoids, polyphenols, and acetogenins, have demonstrated antioxidant, anti-inflammatory, and immunomodulatory properties in preclinical models. These effects are particularly relevant given the established …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Extra Of Extracorporeal: Use Of Vv-Ecmo In Complex Tracheal Ring Resection Surgery, Saurabh Ashok Holamb Mr, Ravinath Swami Mr

Journal Of Indian Physician Associates

 Abstract

Background:

Tracheal stenosis may arise from congenital malformation, trauma, prolonged intubation, or malignancy. Surgical correction of such lesions poses a major challenge, especially when airway management becomes difficult due to the location and extent of narrowing.

Case Summary:

We report a case of a 64-year-old male with circumferential thickening of the trachea at the D2–D3 level, exhibiting a 1.3cm long segmental narrowing. The patient underwent tracheal ring resection with veno-venous extracorporeal membrane oxygenation (VV-ECMO) support. Two apnea periods were maintained intraoperatively, totaling 3.5 hours, with stable hemodynamics and 100% oxygen saturation throughout. ECMO support was continued overnight as a …

Stereotactic Radiosurgery For Unruptured Arteriovenous Malformation Of The Left Medial Temporal Lobe In A Young Female, Muhammed Suhail S, Gajalakshmi M Bpa, Danish Ansari Brt

Journal Of Indian Physician Associates

Background

Arteriovenous malformations (AVMs) are congenital vascular anomalies that can be present with seizures or hemorrhage. Management strategies vary based on Spetzler-Martin (SM) grading.

Case Presentation

I report a case of a 22-year-old female presenting with recurrent seizures due to an unruptured AVM (SM Grade 3) located in the left medial temporal lobe. Diagnosis was established using MRI and Digital Subtraction Angiography (DSA).

Intervention

The patient underwent single-fraction stereotactic radio-surgery (SRS) with curative intent using a TrueBeam linear accelerator.

Outcome

Post-treatment course was uneventful, and the patient was discharged in stable condition with excellent seizure control and progressive nidus reduction …

Endo-Epicardial Ventricular Tachycardia Ablation In Arrhythmogenic Right Ventricular Cardiomyopathy- A Case Report, Selva Maheswari M Dr, Sharon Jabamalar Dr, Usnish Adhikari Dr, Deep Chandh Raja S Dr

Journal Of Indian Physician Associates

ABSTRACT:

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic disorder marked by progressive fibrofatty replacement of the right ventricle, causing life-threatening ventricular arrhythmias and sudden cardiac death (SCD). It is predominantly seen in young adults. As the substrate often involves both RV endocardium & epicardium, conventional ablation is often not successful. One of the effective therapies is combined endo- epicardial ablation, which gives good arrhythmia control and reduction of AICD (Automated Implantable Cardioverter Defibrillator) shock. Here we present two such cases.

Methods

Two patients presented with history of recurrent ventricular tachycardia (VT) which were reverted with DC (Direct …

Reimagining Maternal Health: The Crucial Role Of Social And Behavioural Change Communication In Lmics, Sneha Chetri Ms, Monica Koachar

Journal Of Indian Physician Associates

Preventable maternal mortality is still remarkably high in low and middle-income nations, despite growing investments in maternal health systems. Conventional methods have mostly concentrated on expanding access to services, ignoring important social and behavioural factors that affect how people seek health care. In order to bridge the gap between the availability and actual consumption of maternal health treatments, this opinion piece makes the case for the critical role that social and behavioural change communication plays. The article uses real-world examples from Bangladesh, Nepal, India, Ethiopia, Nigeria, Ghana, and Uganda to show how SBCC can empower women, change the dynamics of …

From Confidence To Competence: Embedding Critical Genai Literacy In Physician Associate Education, Chanceeth Chandrakanthan, Amy H. Donaldson-Perrott Mrs, Jane Secker, Julie Voce, Tamara S. Ritsema

Journal Of Indian Physician Associates

Background: Generative artificial intelligence is now embedded in how many healthcare students learn. Tools provide rapid explanations, summaries and practice questions, but use does not equal AI literacy, particularly where accuracy, medicines safety and guideline alignment matter.

Objective: To describe current use of generative AI by Physician Associate students and outline a practical approach to teaching critical AI literacy.

Methods: Educational evaluation using three activities: (1) baseline survey of students about use and attitudes, (2) an embedded compare and critique session in applied pharmacology where small groups assessed AI answers against trusted UK sources, including BNF and NICE guidance, followed …

Navigating The Genetic Frontier: Clinical And Ethical Implications Of Free Genetic Testing In India, Preetha Vijayalakshmi

Journal Of Indian Physician Associates

The expansion of free genetic testing services in India, resulting from government policies like the Ayushman Bharat Digital Mission, corporate-sponsored initiatives, and international collaborations, makes it easier to access genomic services for early identification of inherited disorders such as thalassemia, sickle cell anemia, and certain genetic kidney diseases, particularly in tribal populations. However, this review reveals significant clinical and ethical challenges. Clinically, Western-based genotyping platforms, not tailored to India’s genetic diversity, risk inaccurate results, including false positives and negatives, complicating clinical decision-making. A shortage of genetic counsellors and inadequate post-test care leaves patients, especially in rural areas, struggling within fragmented …

Evaluating The Suitability Of The Berg Balance Scale For Assessing Balance In Diabetes With And Without Prior Covid-19: A Methods-Validation Study, Garima Kaushik Dr, Sheetal Malhan Dr., Apoorva Tiwari Dr, Vishakha Daga Dr

Journal Of Indian Physician Associates

ABSTRACT

Background: Balance impairment in diabetes mellitus is predominantly driven by somatosensory loss secondary to peripheral neuropathy. The Berg Balance Scale (BBS) is widely used to evaluate functional balance, yet it mainly reflects motor performance and may not adequately represent sensory mechanisms. Following COVID-19, additional concerns regarding deconditioning have emerged, but interpretation depends on the measurement tool employed.

Objective: To examine the construct behavior and suitability of the BBS for assessing balance in individuals with diabetes with and without prior COVID-19 infection, and to determine whether the scale reflects known determinants of diabetic imbalance.

Methods: A cross-sectional analysis was conducted …

Exploring Identity Through Clay: A Humanistic Art Therapy Case Study With A Blind Chinese Adoptee, Virginia Jade Leicht

Expressive Therapies Theses

This qualitative case study explored how working with clay in art therapy can help support a blind man’s identity exploration. This paper addresses the problem of many traditional therapeutic approaches within the art therapy realm: They rely too heavily on visual engagement, which can limit the accessibility and opportunities for self-exploration and identity development for those who are blind. The study was grounded in current research and foundational theories based on the humanistic art therapy approach. Clay is considered an accessible medium that engages multiple senses and allows for emotional exploration and meaning making, specifically through tactile and sensory-based engagement …

Youth-Based Mentorship Programs And The Development Of Social Capital, Toby C. Lumley

Honors Projects

Diverse communities often face complex challenges related to integration and collective action across different social, economic, and ethnic groups. Formal youth mentorship programs can be important institutions for addressing these challenges. This research examines how these programs act as intentional sites for cultivating social networks and relational trust necessary for successful civic engagement. Research for this project heavily relies on social capital theory explained through the lens of Robert Putnam. There will be special emphasis on the immediate community of Harrisonburg-Rockingham County, Virginia, due to its diverse population and rural-urban intersections. Through interviews with various directors of local youth-based mentorship …

Aacn Hwe Standards: Bridging Clinical Excellence And Academic Resilience, Michelle Kidd

Creating Healthy Work Environments (CHWE)

For over 20 years, the American Association of Critical-Care Nurses (AACN) has championed Healthy Work Environment (HWE) standards as essential for nursing excellence. While HWEs improve patient and staff outcomes, they may be underutilized in academia. As faculty and clinical staff face record burnout and turnover, the nursing pipeline's survival depends on a unified HWE approach that bridges clinical practice and academia through intentional collaboration.

Age And Congressional Leader Success: Are They Getting Too Old, Edward N. Drinkwine, Scot Schraufnagel

Honors Capstones

Congressional leaders play a central role in shaping legislative agendas, maintaining party cohesion, and negotiating policy outcomes. Despite the important roles they play, our nation's congressional leaders continue to grow older, and research has rarely examined how age influences their effectiveness in these roles. This study asks whether older congressional leaders are less effective at advancing legislation than their younger counterparts. Using data on leaders serving in the U.S. House and Senate from the 93rd through the 118th Congress, the analysis compares leaders’ ages with their Legislative Effectiveness Score Ratios, controlling for legal experience, state legislative experience, elite education, ideology, …

The Influence Of Financial Literacy On The Financial Behavior Of Students In The Higher Learning Institutions In Tanzania, Lisa John Baltazar, Evelyn Mweta Richard

Business Management Review

This study examines how financial literacy influences financial behavior as measured by spending, saving and investment and borrowing behavior of university students. The study was informed by the theory of planned behavior. Explanatory research design was used to test the research hypothesis. Data was collected through using a structure questionnaire which was administered both physically and online.  446 random selected students across Universities in Tanzania participated in the study, and simple linear regression analysis was used to establish the effect of financial literacy on financial behavior.  It was established that majority of the students are considered financially illiterate. However, the …

Unpacking The Nexus Between Financial Inclusion And Tax Compliance In Tanzania, Sarah Senso, Henry Zeno Chalu, Cosmas Renatus Masanja

Business Management Review

The study examined the influence of financial inclusion and tax compliance in Tanzania, focusing on access to financial services, quality of financial services, and usage of financial services. Guided by the positivist philosophy, the study employed a deductive approach utilizing the supply-leading theory and economic deterrence theory as the guiding frameworks. A cross-sectional survey design was employed, and multistage sampling was employed to obtain a sample of 386 bank agents by using a multistage sampling method. The study used primary data that was collected through structured questionnaires, which contained closed-ended questions measured on a 7-point Likert scale, and analyzed data …

Embeddedness Of Corporate Social Responsibility Practices Of Listed Local Firms In Tanzania: Analysis Of Communication And Organisation Dimensions, Lilian Julius Kishimbo

Business Management Review

This study explores the embeddedness of Corporate Social Responsibility (CSR) practices among listed Tanzanian firms from 2020 to 2024, focusing on both communication and organisational dimensions within a theoretically grounded framework. The study is guided by Institutional and Stakeholder theories, analysing how CSR is integrated into corporate strategies and operational structures, with particular emphasis on variation across banking and finance, telecommunications, manufacturing, extractive, agriculture, and transport industries. Using a mixed-methods approach combining qualitative content analysis of annual reports with organisational indicators, the study draws on 20 firms (95 firms annual reports) to identify significant industry-specific differences in CSR embeddedness, with …

Inbreeding And The Fall Of The Spanish Habsburg Dynasty, Kira L. Kent

Honors Theses

Inbreeding and the Fall of the Spanish Habsburg Dynasty examines how centuries of consanguineous marriages within the Spanish Habsburg family contributed to the dynasty’s decline and eventual extinction. Focusing on the reign and health of Carlos II of Spain, this study explores how dynastic marriage strategies, which were designed to consolidate political power and preserve royal lineage, ultimately produced severe genetic consequences. This thesis analyzes patterns of intermarriage beginning with Carlos I and continuing through the next four monarchs, highlighting the repeated marriages between close relatives. These practices significantly increased the likelihood of inheriting harmful recessive traits. In addition, this …

Evolving Art Therapy In Virtual Environments: Exploring Telehealth Art Therapy Within Gaming, Kathleen A. Wilber

Expressive Therapies Theses

The rapid expansion of virtual therapy following the COVID-19 pandemic has prompted art therapists to reconsider how creative processes can be facilitated through digital means. This capstone thesis explores how art therapy practices can evolve within virtual environments by exploring the video game The Sims 4 as a novel digital medium for virtual art therapy. A qualitative approach was used within an intensive outpatient program (IOP), including a preliminary peer session and two individual client sessions. The intervention involved therapist-facilitated gameplay, where the clinician acted as a “third hand,” guiding clients in an effort to support identity and values-based exploration. …

Returning To Play: Play-Centered Art Therapy With Parentified Adult Caregivers, Paola Andrea Mendez Carreno

Expressive Therapies Theses

This research investigates the impact of play-centered art therapy on parentified adult caregivers, focusing on how creative interventions utilizing elements of play can support identity development, self-compassion, and relational capacity. The literature indicates that childhood parentification leads to identity loss and burnout, but creative play can foster neuroplasticity and emotional processing by allowing adults to externalize harmful narratives that have been internalized. To explore these concepts, the author conducted four sessions over six weeks with an adult participant at a private outpatient practice in Massachusetts. Play-centered activities included free collaging, puppet-making, and clay modeling, often involving moments of parallel play …

Modulating The Plastisphere: Inhibiting Biofilm Formation Of Vibrio Spp., Kacian Clayton

Harriet L Wilkes Honors College Theses

According to the United Nations Environment Programme (UNEP), approximately 19-23 million tons of plastic are released into the aquatic environment each year. Vibrio spp. are diverse gram-negative bacteria that inhabit these environments, capable of colonizing and forming biofilms on these plastic surfaces. In an age when anthropogenic activity exerts an undeniable influence on ecosystems, elucidating a way to regulate the interactions between plastic and vibrios is essential. In previous studies, Polymyxin B has demonstrated high efficacy against biofilm formation in gram-negative bacteria, including Vibrio cholerae. The purpose of this study is to investigate the efficacy of cyclic lipopeptide antibiotics toward …

Law-Related Education: An Alternative To School Suspension, Tammy Thurman, Huma Zia

Justice, Law, and Public Safety Studies Department Faculty Conferences

This session explores the intersection of law-related education and youth courts through a demonstration from the presenter's 'Legal Literacy' program, which was implemented in a school district as an alternative to out-of-school suspension.  The program exposes students to practical and relevant legal principles and promotes student accountability and skill-building.

Chemometric Analysis Of Dissolved Organic Matter Using Fluorescence, Dani Fellner, Ken Overway

Honors Projects

Univariate spectroscopic techniques have been utilized to measure dissolved organic matter (DOM), but challenges arise in the separation and characterization due to similarities in chemical structures and spectral overlap. Multivariate techniques utilize a combination of known analytes with their unique excitation and emission spectra from fluorescence measurements to quantify amount of each analyte present in the mixture using parallel factor analysis. Tryptophan, tyrosine, and phenylalanine are common amino acids found in environmental samples and can be quantified due to their intrinsic fluorescence qualities. These amino acids can be utilized to estimate the amount of DOM in a sample since proteins …

Healing The Gap, Maria Gavriilidou

Honors Projects

This project examines healthcare accessibility in Greece, focusing on the disparities between urban centers and remote island and mountainous communities. It addresses systemic limitations within public healthcare infrastructure, including insufficient facilities, limited medical personnel, and transportation barriers that restrict timely access to medical services. Grounded in personal experience and observational research, particularly from the Cyclades islands and mainland medical contexts, the study highlights how geographic isolation and environmental conditions further intensify these challenges.

The work proposes an architectural response aimed at improving healthcare delivery in underserved regions through the design of sustainable, accessible, and adaptable healthcare facilities. It explores how …

Reimagining Occupational Therapy Fieldwork Mentorship Through A Cultural Wealth Lens: A World Café Study, Nandita A. Singh, Mph, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy (OT) fieldwork education plays a critical role in professional socialization; however, supervision models often privilege dominant sociocultural norms, disadvantaging students from non-dominant cultural and linguistic backgrounds and potentially limiting equitable workforce preparation.

Objectives: To examine how OT fieldwork partners conceptualize reciprocal mentorship within fieldwork education identify strategies grounded in Community Cultural Wealth (CCW) to support inclusive communication and strengths-based professional development.

Methods: Participatory qualitative study using a virtual World Café methodology, involving United States-based academic and clinical OT fieldwork contexts. Data were collected through audio-recorded discussions, digital whiteboards, and reflexive memos, and were analyzed using Braun …

How Do Autobiographical Memory Abilities Compare With Other Cognitive Functions In An Adult Presenting With Hsam (Highly Superior Autobiographical Memory) And Autism? A Case Study., Emilia Rzeszutek, Dr. Jamie Mayer

Honors Capstones

Autism Spectrum Disorder (ASD) is a condition widely researched in relation to social communication differences and challenges in areas such as memory and executive functioning. Many areas of research highlight ASD’s deficits, shortcomings, and risk factors. However, research has begun to recognize that autistic individuals demonstrate cognitive strengths that differ from typical patterns of functioning. An example of such ability is Highly Superior Autobiographical Memory (HSAM), a rare phenomenon characterized by the ability to recall specific life events with remarkable accuracy and detail. This study was conducted on a 25-year-old male diagnosed with ASD and presents with characteristics of HSAM. …

Developing Engagement Programming To Increase Leisure Participation Among Individuals Living With Cognitive Impairments, Anthony Valentino, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Low-cost leisure activities are implemented at The Bridge Center to increase engagement and promote health and well-being. This program incorporates occupational therapy perspectives to promote engagement through meaningful activities to expand people with cognitive impairments opportunities. The results of this project will provide intrinsic benefits to people with cognitive impairments and aid the development of future projects at The Bridge Center.

The Efficacy Of An Educational Program On The Benefits Of Aquatic Therapy: An Occupational Therapy Perspective, Matile Kaplan, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

Aquatic therapy has been a therapeutic modality since 2400 B.C and offers multisystem physiological effects including cardiovascular, musculoskeletal, immune, gastrointestinal, and more. The aquatic environment offers buoyancy, hydrostatic pressure, resistance, and drag force to ease engagement and recovery. Individuals have a higher rate of participation in aquatic therapy compared to on-land therapy, although referral rates are low due to the existing perceptions and insufficient awareness of the benefits.