Digital Commons Network^™

Nurse Staffing Variation Viewed Through The Lens Of Institutional Isomorphism, Mara Raggi

Electronic Theses and Dissertations

Nurse staffing is strongly associated with organizational and patient quality outcomes. Existing studies have not adequately explained why nurse staffing levels vary across hospitals operating under similar external institutional isomorphic pressures. Secondary and administrative datasets, along with random-effects regression models, were used to analyze 6 years of data (2014-2019) and examine the relationship between institutional factors and hospital nurse staffing in the general acute care setting. The results indicate that coercive factors of state laws were significantly associated with nurse staffing. Staffing mandates and staffing committees were significantly associated with increases in nurse staffing, while public reporting was significantly associated …

Co-Designing Translanguaging-Informed Transformative Socioemotional Learning With Bilingual Kindergarten Teachers In Colombia, Catherine Restrepo-Widney

Electronic Theses and Dissertations

Emergent bilingual children enter early childhood classrooms with rich, dynamic linguistic repertoires that span languages, cultural practices, and ways of knowing. Socioemotional learning (SEL) often fails to meaningfully incorporate children’s linguistic and cultural repertoires, reflecting critiques that many SEL frameworks privilege individualistic, culturally narrow competencies that may marginalize learners from diverse backgrounds. This is particularly consequential in early childhood dual language bilingual education (DLBE), where children's heritage languages are central to authentic emotional connection and identity development, and where empirical models for culturally sustaining SEL remain limited. Through a participatory design research approach structured around iterative cycles of collaborative inquiry, …

A Systematic Literature Review Of Cvid Reveals Pervasive Detrimental Noninfectious Manifestations, Robert B Lindell, Samir U Sayed, Jose S Campos Duran, Sydney A Sheetz, Apoorva Babu, Montana S Knight, Andrea A Mauracher, Ceire A Hay, Peyton E Conrey, Julie C Fitzgerald, Nadir Yehya, Stephen T Famularo, Teresa Arroyo, Richard Tustin, Hossein Fazelinia, Edward M Behrens, David T Teachey, Lisa R Forbes Satter, Alexandra F Freeman, Jenna Re Bergerson, Steven M Holland, Jennifer W Leiding, Scott L Weiss, Mark W Hall, Deanne M Taylor, Rui Feng, E John Wherry, Nuala J Meyer, Sarah E Henrickson

Faculty, Staff and Students Publications

BACKGROUND

Sepsis is a leading cause of morbidity and mortality in critically ill children, yet heterogeneous immune responses complicate the development of targeted therapies and the host immune factors driving sepsis pathobiology remain unclear.

METHODS

We integrated deep immune phenotyping, plasma proteomics, single-cell transcriptomics, and phosphoflow cytometry in a prospective cohort of 88 critically ill children to elucidate the mechanisms underlying immune heterogeneity.

RESULTS

Unsupervised clustering of plasma cytokines identified 3 immunologic subgroups, including a high-severity group (“Group C”) characterized by hypercytokinemia driven by IL-6 and IFN-γ. Group C exhibited distinct alterations in immune cell frequency and activation, with a …

Design And Development Of A Novel Lxrβ/Pparδ Dual Agonist For Memory Impairment And Pathology In 3xtg-Ad Animal Model Of Alzheimer's Disease, Meenakshi Singh, Ian Steinke, Vishnu Suppiramaniam

Faculty Articles

The rising prevalence of Alzheimer’s disease (AD) underscores an urgent need for neuroprotective strategies that modulate cholesterol metabolism, neuroinflammation, improve pathology, and cognitive function. While Liver X receptors (LXRs) and peroxisome proliferator-activated receptors (PPARs) are validated targets for enhancing amyloid-β and tau clearance, clinical translation of first-generation LXR agonists has been hindered by LXRα-mediated hepatic steatosis and hypertriglyceridemia. Here, we report the structure-based design of AU403, a potent, isoform-selective LXRβ/PPARδ dual agonist designed to bypass LXRα-driven hepatotoxicity. Molecular modeling indicates that AU403 achieves LXRβ selectivity by engaging residues Phe329 and Leu330 while avoiding the corresponding LXRα residues Arg305 and Leu316. …

Strategies To Increase Attendance In Substance Use Disorder Group Treatment: Results From A Randomized Controlled Trial, Liliane Cambraia Windsor, Heather A Jones, Carla Ellis, Kennya Hooper, Andrea Rucker, Salma Musaad, Moses Okumu

Faculty, Staff and Students Publications

Background: Attendance in substance-use-disorder group-treatment is challenging with only 32% of patients attending at least one session (Substance Abuse and Mental Health Services Administration and Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2023 admissions to and discharges from substance use treatment services reported by single state agencies, Bethesda, 2025). The present study tested a set of strategies to increase group session attendance in Community Wise, an innovative evidence-based group-intervention delivered in harm-reduction-community-based agencies and designed to reduce alcohol and substance use among people with substance-use-disorders living in predominantly Black and disinvested communities. We examined: (1) …

Safe, Secure, And Affordable? The State Of Household Water Insecurity In California, Melissa Beresford, Wendy Jepson, Jeremiah Osborne-Gowey, Kristin Dobbin, Amanda Fencl, Silvia R. González, Gregory Pierce

Faculty Research, Scholarly, and Creative Activity

California's efforts to advance the Human Right to Water are constrained by limited household-level data on water insecurity. Using the 2021 CalSpeaks statewide probability survey (n = 628) this study offers the first representative look at water insecurity across California households. Results reveal significant water-related struggles: approximately 23% of respondents worried about having enough water to meet their household needs, 15% worried about perceived health impacts from water quality, and 7% struggled with affordability. Negative binomial regression models show that water insecurity is not randomly distributed: households with non-white residents, households which rely on private or small water companies for …

Pediatric Oncology Progress And Challenges In Southeast Asia: Strengthening Cancer Care Systems, Allison Tang, Teeradon Treechairusame, Esther Saguil, Adrian E. Go, Frederic Ivan L. Ting, Kevin Knopf, Avram Denburg, Sanjeeva Gunasekera, Nirmala Bhoo-Pathy, Edward Christopher Dee, Rod Carlo Columbres

Student Publications

No abstract provided.

Depressive Symptoms And Functional Disability Among Older Adults In Nakhon Ratchasima Province, Thailand: A Cross-Sectional Population-Based Study, Jiranya Bureemas, Atthawit Singsalasang

Journal of Health Research

Background: Depressive symptoms have been associated with activities of daily living (ADL) disability; however, evidence among Thai older adults remains limited and inconsistent. This study investigates the association between depressive symptoms and ADL disability in older Thai adults.

Methods: A cross-sectional analytic study was conducted among 312 older adults in Nakhon Ratchasima, Thailand, who were selected using a multistage sampling method. Data were collected between April and July 2023 using structured questionnaires covering demographic and environmental variables. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. ADL disability was measured using the Barthel and Chula ADL Indices. Multiple logistic …

Proceedings: Nownet Arts Conference 2019, Sarah Rose Weaver, Chris Chafe, Scott Oshiro, Margaret Schedel

Journal of Network Music and Arts

Proceedings of the 2nd Annual NowNet Arts Conference 2019 “Social Purpose in Contemporary Network Arts.” The conference was held November 7–10, 2019. The primary in-person site was the Institute for Advanced Computational Science (IACS), Stony Brook University. Satellite in-person sites included Center for Computer Research in Music and Acoustics at Stanford University, Edinburgh Napier University, Orpheus Institute in Belgium, and Electronic Studios at the Technical University, Berlin. More locations participated remotely via the internet.

High Burden Of Elevated Fib-4 In Metabolically At-Risk Primary Care Patients: Simple Predictors To Guide Hepatic Fibrosis Triage, Ridwan Ademola Lawal, Fatimah Bello, Rashmee Patil, Juliana Yang

Research Symposium

Background: Metabolic dysfunction–associated steatotic liver disease (MASLD), including metabolic dysfunction–associated steatohepatitis (MASH), is a leading cause of chronic liver disease worldwide. Current guidelines recommend fibrosis-based risk stratification using noninvasive tools such as the Fibrosis-4 (FIB-4) index in patients with metabolic risk factors, followed by secondary assessment (e.g., transient elastography or enhanced liver fibrosis(ELF) testing) for those with elevated scores. However, data on the real-world prevalence of elevated FIB-4 in U.S. primary care populations, particularly in safety-net settings, and the downstream implications for fibrosis evaluation remain limited. We aimed to quantify the burden of elevated FIB-4 in a primary care setting …

Mississippi Libraries Volume 88, Number 1 And 2

Mississippi Libraries

No abstract provided.

News Briefs, Tiffany Cline, Patsy C. Brewer

Mississippi Libraries

News and updates from members of the Mississippi Library Association.

Mississippi Library Association Annual Conference: 2025 Recap, Janessa Ullendorf

Mississippi Libraries

Recap from the 2025 annual conference of the Mississippi Library Association.

Full Issue: Volume 21, Issue 2 - Summer 2026

Jefferson Surgical Solutions

A publication for friends and colleagues of Jefferson’s Department of Surgery

In This Issue

Cover Story

Jefferson Transplant Institute Enters New Chapter of Innovation, Growth and National Impact - Page 1

Overview Science: Targeting the ‘Undruggable’ in Pancreatic and Other Cancers - Page 2

Clinical Integration Jefferson Trauma Surgeon and Resident Reflect on Honduras Medical Mission Trip - Page 2

In the Spotlight Joseph Boback, MBA - Page 2

Changing Lives Through Research Pilot Grant Lays Groundwork for New Standard in Ventral Hernia Recovery - Page 3

Please Welcome New Faculty - Page 3

Those Who Give Hollingsworth Family’s Gratitude …

New Faculty

Jefferson Surgical Solutions

David G. McKeown, MD, MCh, MRCS, FACS, FASCRS, has joined the Division of Colorectal Surgery. Dr. McKeown earned his medical degree and a Master in Surgery (MCh) from the Royal College of Surgeons in Ireland. In 2019, he graduated from our General Surgery Residency Program and then completed a colorectal surgery fellowship at Rutgers Robert Wood Johnson Medical School. He is double board-certified in Colon and Rectal Surgery and Surgery. In 2024, Dr. McKeown returned to Jefferson Abington Hospital as an attending surgeon and recently transitioned to Thomas Jefferson University Hospital, where he is also serving as director of the …

Pilot Grant Lays Groundwork For New Standard In Ventral Hernia Recovery

Jefferson Surgical Solutions

Over the past several years, the Department of Surgery Pilot Grant Program has supported a wide range of disease-oriented research among faculty and trainees. These projects explore ways to improve the quality and safety of surgical care. What follows is an update on one study funded in 2025 that has demonstrated meaningful progress and long-term potential to transform patient outcomes.

Study: Creation of an Evidence-Based Model for Physiotherapy-Enhanced Ventral Hernia Repair (IMPACT Study)

Patients who undergo orthopedic procedures, such as knee replacements, hip replacements or spine surgery, follow well-established rehabilitation protocols. The week-by-week progression is standardized, taught in physical therapy …

In The Spotlight

Jefferson Surgical Solutions

Joseph Boback, MBA, joined Jefferson in 2022 as a clinic operations assistant in the Department of Neurology and Neurosurgery. Although he initially viewed it as a “gap year” position before pursuing physician assistant (PA) studies, his manager had other ideas.

Recognizing his instincts with people and his potential as a leader, she encouraged him to apply for an open practice-manager position. He agreed, telling himself he’d give it a year or two. Within his first year, Boback had a change of heart.

“I think this is my calling,” he recalls realizing. He pivoted from PA school to Jefferson's MBA program, …

Jefferson Trauma Surgeon And Resident Reflect On Honduras Medical Mission Trip

Jefferson Surgical Solutions

For one week each February, Jefferson trauma surgeon Kris R. Kaulback, MD, trades the operating rooms of suburban Philadelphia for a surgical center in rural Honduras. While there, he performs procedures on patients who have often waited years, sometimes decades, for surgical care they couldn’t otherwise afford or access.

The annual medical mission trip, now in its fourth year, is led by Dr. Kaulback and Nina Kalawadia, MD, Chief of Anesthesiology at Paoli Hospital, and run through One World Surgery. This nonprofit operates a permanent surgical center on the grounds of Nuestros Pequeños Hermanos, a long-established orphanage on more than …

Science: Targeting The ‘Undruggable’ In Pancreatic And Other Cancers, Charles J. Yeo, Md, Facs

Jefferson Surgical Solutions

Scientific discoveries and advances often come in an unpredictable cadence. Over the course of my 40 years as a surgeon treating patients with pancreatic and related cancers, we have seen overall five-year patient survival rates improve more than six-fold from under 2% to over 13%. This improvement has its genesis in many areas – improved patient selection and surgical results, better imaging, advances in nursing and critical care and new oncologic treatment options. One area that has eluded progress for decades has been targeting the RAS oncogene mutations common in nearly all pancreatic cancers.

Therapeutic targeting of RAS with a …

Jefferson Transplant Institute Enters New Chapter Of Innovation, Growth And National Impact

Jefferson Surgical Solutions

When James V. Guarrera, MD, joined Jefferson last summer as the Nicoletti Family Professor of Transplantation Surgery and executive director of the Jefferson Transplant Institute, he arrived with a clear conviction about what makes a transplant program succeed.

“Transplantation is the epitome of a team sport,” Dr. Guarrera says. “My charge is to take all of the talent and dedication already present at Jefferson and continue building on it clinically and academically, including making this a destination for innovation and training the next generation of transplant surgeons.”

Since his appointment, this philosophy has been translated into measurable momentum across the …

Peer Attachment And Popularity Among Adolescents: The Mediating Role Of Relational Aggression, Katherine S. Fosco, Bailee Hill, Yan Li, Michelle F. Wright

DePaul Discoveries

Popularity during adolescence may pose a challenging social barrier, involving the desire for exclusivity and the need for broader peer connections. This study investigated the longitudinal effects of peer attachment on popularity among adolescents and the mediation process of relational aggression, expecting that peer attachment would be linked to reduced relational aggression, in turn relating to lower popularity at a later time point. The research participants (N = 569) included adolescents between the ages of 11 and 15 in the United States with data collection occurring at three time points. The path from Time 1 peer attachment to Time 2 …

Measuring And Mapping Spatial Distributions Of Soil Lead Concentrations Along Chicago Parkways: West Ridge And Near South Side, Alyssa M. Kain

DePaul Discoveries

Lead is a heavy metal that can be found in every part of our planet. Human activities like the extraction of fossil fuels and degradation of construction materials can release lead into the environment, where it travels and accumulates in places like our soil or water. Despite efforts to lower the use of lead-based materials within the last fifty years, lead contamination remains as a threat to public health and safety. Elevated blood lead levels are known to cause a variety of health issues particularly for young children and pregnant women. This study aims to measure, map, and analyze the …

Healthcare Access And The Persistent Racial Disparities In Low Birth Weight, Zaheda A. Hussain, Yadanar Moe

DePaul Discoveries

Low birth weight (LBW), defined as less than 2,500 grams, is an influential factor contributing to infant mortality in the United States, with significant racial disparities between Black and White mothers. This study analyzed data from 3,054 Black and White mothers collected from the 2018 National Health Interview Survey to explore the association between access to medical care and LBW within different racial groups. The prevalence of LBW was 8.0%. Overall, mothers without a usual place of medical care had, on average, an 18% higher risk of LBW than those with a usual place (OR = 1.18, 95% CI: 0.80–1.74). …

Greener Synthesis Of Pdi Ligands Using A Microwave Reactor, Gabrielle E. Leonhardt, Abbigale S. Holjes, Kyle A. Grice

DePaul Discoveries

Two pyridinediimine (PDI) ligands were synthesized using green chemistry principles to minimize environmental impact and maintain synthetic efficiency. Previous syntheses require hazardous solvents and long reaction times. The reaction was carried out with a safer solvent, ethanol, and more rapidly using a CEM Discover microwave reactor. The PDI ligand was chosen for the scaffold for the aromatic core and support for different aniline derivatives. Comparative investigation of aniline electronics showed that 2,6-dimethylaniline was more successful than the electron-withdrawing electronics of 2,6-dichloroaniline. Synthesized complexes were characterized with proton nuclear magnetic resonance (NMR). The environmentally conscious microwave reaction produced effective and reproducible …

Fish Tissue Digestion And Microplastic Polymer Identification Protocol Using Open-Source Ftir Database, Shawn L. Kissinger, Vick-Ariel Privert, Jason Bystriansky, Kyle A. Grice

DePaul Discoveries

Microplastic (MP) contamination in aquatic ecosystems poses significant concerns for environmental and public health, as seafood represents a critical food source worldwide. Despite increasing evidence of MP presence in marine organisms, efficient and accessible detection methods remain essential for characterizing contamination patterns and informing regulatory frameworks. This study extracted MPs from brain, gill, intestine, liver, and muscle tissues of gilt-head bream (Sparus aurata) and European sea bass (Dicentrarchus labrax), two commercially important species from the Gulf of Cádiz, Spain, using a NaOH–HNO₃ chemical digestion protocol. Isolated particles were characterized by Fourier Transform Infrared (FTIR) spectroscopy, with …

Crystal Structural Analysis Of Medieval Human Bones Using Wide-Angle X-Ray Scattering, Selly Altangerel, Leslie Gracia

DePaul Discoveries

Female human second metacarpal (mc2) bones from a medieval cemetery at Wharram Percy, England, were studied using high-energy Wide-Angle X-ray Scattering (WAXS) at beamline 1-ID of the Advanced Photon Source at Argonne National Laboratory. The age-at-death of 33 samples was determined from molar wear and classified into 3 groups:  18-30, 30-50, and 50+ years old.  Rietveld refinements of the WAXS data were performed to obtain lattice parameters of the hexagonal carbonated apatite phase (cAp). Individual fittings for cAp peaks 00.2, 00.4, and 31.0 were performed to obtain their widths and correlate them to collagen retention. For the three samples described …

Clearing The Air: Tracking Spatial And Temporal Pm2.5 Variability Along A Biking Transect In Chicago, Beau R. Rass

DePaul Discoveries

Fine particulate matter (PM₂.₅) poses significant risks to human health and disproportionately affects marginalized communities in urban environments (World Health Organization [WHO], 2021; Tessum et al., 2021). Using low-cost mobile sensors, this study explored spatiotemporal PM₂.₅ concentration patterns along a north–south transect of Halsted Street in Chicago. A 2B Technologies Portable Aerosol Monitor (PAM) mounted on a bicycle was used to continuously record PM₂.₅ concentrations with associated GPS coordinates at approximately two-second intervals during 16 sampling events between 08-12-2025 and 10-05-2025. PM₂.₅ concentrations did not differ significantly among the South Side, West Loop, and North Side regions, contrary to the …

Depaul Discoveries Volume 15 Cover Art, Dina Khdair

DePaul Discoveries

No abstract provided.

Caldwell Leqembi Home‑Safety & Support Engine (Clhse‑1.0) Unified Open‑Hardware Architecture Integrating Cudre‑1.0, Cng‑Loop V1.0, Cinhrs, Becds V2.0, Accs V4.0, And Caregiver/Clinic Integration Enhancements, Michael Victor Caldwell Mr.

Defensive Publications Series

Abstract

CLHSE‑1.0 is a unified, open‑hardware support architecture designed for patients receiving FDA‑approved LEQEMBI IQLIK (subcutaneous lecanemab‑irmb) for early Alzheimer’s disease. The system integrates five existing Caldwell inventions, each posted on the TDC site, and adds a caregiver micro‑dashboard, clinic integration packet, and minimal hardware starter kit to increase real‑world viability and testing potential.

CLHSE‑1.0 provides a non‑clinical safety and monitoring envelope around LEQEMBI IQLIK’s at‑home dosing model, addressing ARIA‑E/ARIA‑H symptom detection, injection‑reaction monitoring, neurologic changes, sleep‑linked deterioration, caregiver workflow, and functional decline tracking aligned with CDR‑SB domains.

CLHSE‑1.0 does not modify lecanemab, its dosing, its pharmacology, or its FDA‑approved …

Vertebrate Diversity In Cave Systems Of Colombia: An Approach Based On Environmental Dna Metabarcoding Analysis, Rita Daniela Martinelli Marín, Carlos Andres Lasso, Francesco Sauro, Susana Josefina Caballero

International Journal of Speleology

There is currently limited knowledge of the biological communities inhabiting cave ecosystems in South America. This study examines the vertebrate community composition of 21 caves across diverse subterranean ecosystems in Colombia using environmental DNA (eDNA) analysis. Water was collected from water bodies inside caves and subterranean systems in six of the eight speleological regions of Colombia in eight departments. Water was filtered manually through a 0.8 m pore size filter and preserved with Longmire solution. A 170-base pair (bp) fragment of the 12s mitochondrial gene specific for vertebrate identification was amplified by PCR and sequenced by Illumina (metabarcoding). Data corresponding …