Digital Commons Network^™

Botulinum Toxin Combined With Robot-Assisted Therapy For Post-Stroke Spasticity: A Systematic Review, Salvatore Facciorusso, Stefania Spina, Mirko Filippetti, Rajiv Reebye, Gerard E Francisco, Andrea Santamato

Faculty, Staff and Student Publications

Background: Post-stroke spasticity limits motor recovery and independence. Combining botulinum toxin type-A (BoNT-A) injection with intensive, task-specific robot-assisted therapy (RAT) might enhance neuroplasticity and functional gains, but its additive effect and optimal timing are uncertain. (

Methods: We systematically searched major medical databases and trial registries up to April 2025 for randomized controlled trials in adults with post-stroke spasticity comparing botulinum toxin type-A injection plus RAT with toxin injection plus conventional therapy, or RAT alone with RAT combined with toxin injection. Risk of bias was assessed using the RoB 2 tool, and findings were synthesized narratively.

Results: Seven trials ( …

Identification Of Novel Tat-I24-Related Peptides With Antiviral Activities, Hanna Harant, Siegfried Hofinger, Reingard Grabherr, Zsolt Ruzsics, Hartmut Hengel

Michigan Tech Publications

To identify novel peptides with potential antiviral activities, a database search was performed based on the primary sequence of the peptide I24 (CLAFYACFC), the effective part of the antiviral peptide TAT-I24 consisting of peptide I24 and the cell penetrating TAT-peptide (amino-acids 48–60, GRKKRRQRRRPPQ). A Protein BLAST search identified several sequences with high similarity to I24 in diverse proteins, some of which are known to be involved in the interaction with nucleic acids. Selected sequences and newly designed variants of I24 were synthesized as TAT fusion peptides and tested for antiviral activity in two well-established models: baculovirus transduction of HEK293 cells …

Cpx-351 Vs. Conventional Chemotherapy Cardiotoxicity In High-Risk Aml: A Post Hoc Phase Iii Trial Analysis, Joshua D Mitchell, Michael Pfeiffer, John Boehmer, John Gorcsan, Shunsuke Eguchi, Yoshiyuki Orihara, Nalina Dronamraju, Sonja Dhani, Stefan Faderl, Tara L Lin, Geoffrey L Uy, Jeffrey E Lancet, Jorge E Cortes

2020-Current year OA Pubs

BACKGROUND: CPX-351, a dual-drug liposomal encapsulation of daunorubicin and cytarabine in a synergistic 1:5 molar ratio, has demonstrated significantly improved overall survival in acute myeloid leukemia (AML) compared with 7 + 3, but its impact on cardiac function remains unclear. In a post hoc analysis of the pivotal clinical trial, we sought to determine the relative cardiotoxicity of CPX-351 vs. 7 + 3 in high-risk AML.

METHODS: We evaluated cardiotoxicity in 102 patients with AML (CPX-351, n = 57; 7 + 3, n = 45) who had normal baseline left ventricular ejection fraction (LVEF) ≥ 53% and at least one …

Divorcees’ Experiences Of Hubristic Pride In Communication In Previous Marital Relationships, Amanda Harms

Walden Dissertations and Doctoral Studies

Poor communication practices have significantly strained marital relationships, contributing to increased divorce rates in the United States. As a self-conscious emotion, hubristic pride often leads to poor communication, which in turn exacerbates marital discord and contributes to the breakdown of families. The purpose of this basic qualitative study was to explore how divorcees perceive the impact of hubristic pride on communication in their previous marriages. The theoretical framework underpinning this study was Homans’s social exchange theory. Data were obtained from eight divorced participants not actively involved in ongoing custody proceedings through semistructured interviews and analyzed using Saldaña’s descriptive coding methodology. …

Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a …

Preservice Teachers’ Preconception Of Student Voice In Their Teacher Education, Joan Belfon

Walden Dissertations and Doctoral Studies

A 2022 Jamaican education report highlighted that student-centered pedagogy is crucial to educational outcomes. A problem exists in that there is limited research on how student voice practices within student-centered pedagogy are incorporated into teacher training. Before preservice teachers’ praxis can be transformed, greater understanding of their preconceptions about student voice is essential. Guided by conceptual change theory, the purpose of this generic qualitative study was to explore the preconceptions of preservice teachers in rural central Jamaica about student voice in their teacher education. Eight preservice teachers preparing for the secondary level in three Jamaican higher education institutions were purposefully …

Clinical Practice Guideline To Improve Medication Adherence In Posttraumatic Stress Disorder (Ptsd), Leroy Anagho

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a chronic and debilitating psychiatric condition characterized by intrusive memories, avoidance behaviors, hyperarousal, and alterations in mood and cognition following exposure to traumatic events. Although evidence-based pharmacotherapy is a cornerstone of PTSD treatment, medication nonadherence remains a pervasive barrier to effective symptom management and functional recovery. The purpose of this Doctor of Nursing Practice (DNP) project was to develop an evidence-based clinical practice guideline (CPG) aimed at improving medication adherence in adults diagnosed with PTSD in outpatient psychiatric settings. Guided by the Johns Hopkins Evidence-Based Practice Model and appraised through the AGREE II instrument, current …

Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is associated with significant health complications, including stroke, myocardial infarction, heart failure, and kidney disease. Despite advances in the treatment and management of HTN, a lack of medication adherence contributes to the persistence of HTN-related morbidity and mortality affecting men in The Bahamas. The purpose of this qualitative descriptive phenomenological study, guided by Pender’s health promotion model and Bandura’s social cognitive theory, was to explore the lived experiences of Bahamian men diagnosed with hypertension regarding their adherence to prescribed medications. Using Giorgi’s descriptive phenomenological method, in-depth, semistructured interviews were conducted with 11 participants. Data were analyzed through repeated …

The Impact Of Machine Learning Security Models On Cloud Data Security, Ali Sanad

Walden Dissertations and Doctoral Studies

Abstract Many information technology (IT) leaders face challenges in adopting machine learning (ML) models for cloud infrastructure, despite their potential to enhance data security. The extent to which IT leaders’ perceived security (PeS) and perceived privacy (PeP) influence their intent to adopt ML security models is critical for organizational success. Grounded in the technology acceptance model, the purpose of this quantitative correlational study was to examine the relationship between IT leaders’ PeS and PeP and their intent to adopt ML security models in cloud-based applications. Data were collected from 106 IT professionals in Chicago using a validated instrument. Results from …

Impact Of Community Factors On Naloxone Overdose Reduction In Ohio, Theophilus Oduro Frimpong

Walden Dissertations and Doctoral Studies

The opioid crisis in Ohio, driven by fentanyl, persists due to inequitable access to naloxone despite its proven effectiveness. This study examined how socioeconomic status (SES), race/ethnicity, population density, and hospital availability per capita predicted naloxone overdose reversals (dependent variable) in Ohio. Social-ecological theory guided this quantitative historical correlational analysis of Ohio’s Project DAWN index data (N = 5,280). Inclusion criteria included individuals ages 18 to 65 with naloxone-related overdose reversals (dependent), naloxone distribution (moderator), and community factors (independent). Multiple linear regression results showed that SES (p >.50), race/ethnicity (% White, p = .588; % Black, p = .495; % …

Dating In The Digital Age: The Effects Of Parental Rejection, Rejection Sensitivity, And Self-Esteem Among Gender-Diverse Gen Z, Crystal Currie

Walden Dissertations and Doctoral Studies

Gen Z, the first digital-native cohort, faces unique challenges in forming romantic relationships, including heightened dating anxiety. While there is extensive research with previous generations on dating anxiety, self-esteem, and early rejection, no study has examined parental rejection, self-esteem, and dating anxiety collectively, particularly in consideration of gender diverse individuals and digital dating platform use. The purpose of this correlational study was to examine (a) predictors of dating anxiety and (b) whether parental rejection during childhood and rejection sensitivity influenced dating anxiety, as well as the role of self-esteem in mediating those predictor variables. The conceptual framework was the interpersonal …

Effective Strategies To Address Poor-Quality Suppliers In The Automotive Industry, Virginia May Hartleigh

Walden Dissertations and Doctoral Studies

Poor-quality suppliers present a significant risk and cost liability across the manufacturing industry. Industrial automotive manufacturing leaders are concerned with this challenge because supplier quality directly affects production efficiency and accounts for over 70% of total production costs. Grounded in resource dependence theory, the purpose of this qualitative pragmatic inquiry was to explore successful strategies supply chain leaders use to identify and address poor-quality suppliers to improve manufacturing processes and achieve cost savings. The participants were six purposefully sampled supply chain leaders in the U.S. industrial automotive sector who were experienced in successful supplier mitigation strategies. Data were collected using …

Organizational Leaders’ Effective Strategies For Using Employee Training To Mitigate Threats To Cybersecurity Compliance, Oluwaseye Adekunle Fadare

Walden Dissertations and Doctoral Studies

Organizational leaders increasingly face challenges associated with employee noncompliance with cybersecurity controls, which expose business leaders to reputational and financial risks. Addressing this business problem is critical for cybersecurity leaders and business executives who aim to strengthen digital resilience and sustain profitability. The purpose of this qualitative pragmatic inquiry was to explore effective strategies organizational leaders use to enhance employee cybersecurity compliance through training. The project was grounded in the protection motivation theory and total quality management frameworks, which provide insight into the behavioral and continuous improvement dimensions of cybersecurity management. Six cybersecurity leaders from Nigeria participated in semistructured interviews. …

Experiences Of First-Generation College Students Engaging In Online Learning Amid A Global Pandemic, Anthony Capers Jr

Walden Dissertations and Doctoral Studies

The global pandemic, COVID-19, had an impact on the academic experiences of all college students. First-generation college students who often experience special challenges in adjusting to academia may have faced additional challenges given the transition to online learning. However, there has been little research focused on the impact of COVID on their adjustment to college. The purpose of this study was to explore the experiences of an unanticipated learning transition among first-generation college students pursuing higher education at a 4-year school, during a global pandemic. The theoretical framework for this study was based on an interactionalist theory focused on the …

Preserve The Harvest: Canning Goat Meat At Home, Callie Adams, Andrea Schmutz

All Current Publications

Due to its lean composition and nutritional profile similar to those of other tested meats, goat is well-suited for pressure canning. Follow USDA and Utah State University (USU) Extension altitude guidelines. This fact sheet provides guidelines for selecting high-quality meat, using proper equipment, and adhering to tested methods. Home canners can safely preserve goat meat and enjoy its benefits year-round.

Assessment And Management Of Albuminuria In Adults, Sophie E. Claudel, Debasish Kar, Azeem Majeed, Pamela S. Burgwinkle, Ashish Verma

Peninsula Medical School

No abstract provided.

Stra8 Links Neuronal Activity To Inhibitory Circuit Protection In The Adult Mouse Brain., Ming Huang, Shuwen Yue, Xiaoyu Zhang, Lan Wu, Jay L. Vivian, Zi-Jun Wang, Ning Wang

Manuscripts, Articles, Book Chapters and Other Papers

While neuronal activity is essential for brain function, it also poses threats to neuronal integrity. Here, we show that activity-induced expression of stimulated by retinoic acid gene 8 (Stra8) protects neurons from degeneration. Previously considered germline specific, Stra8 is expressed in the adult mouse brain and is induced by neuronal activity via calcium influx and N-methyl-D-aspartate (NMDA) receptor signaling. Neuron-specific Stra8 knockout mice display hallmark features of neurodegeneration, including DNA damage, impaired proteostasis, inflammation, nuclear envelope erosion, reduced dendritic plasticity, memory deficits, and heightened excitotoxic vulnerability. Electrophysiological studies reveal disrupted inhibitory circuit function. Mechanistically, Stra8 binds regulatory regions of neuromodulator …

Nivolumab Plus Ipilimumab Induce Hyper-Progression In Renal Medullary Carcinoma: Results Of A Phase Ii Trial And Preclinical Evidence, Jing Qian, Menuka Karki, Fei Duan, Hania Khan, Li Zhang, David H Peng, Mariah Williams, Rong He, Ziheng Chen, Luigi Perelli, Jianfeng Chen, Rebecca S Tidwell, Pankaj K Chauhan, Courtney N Le, Truong N A Lam, Nirjar Bhattacharya, Rutvi Shah, I-Lin Ho, Jason P Gay, Caroline C Carrillo, Ningping Feng, Kang Le, Guang Gao, Teresa L Perry, Faika Mseeh, Yongying Jiang, Quanyun A Xu, Niki Marie Zacharias, Rahul A Sheth, Tharakeswara K Bathala, Priya Rao, Najat C Daw, Durga N Tripathi, Cheryl L Walker, Mohammad M Mohammad, Jianhua Zhang, Guangchun Han, Yanshuo Chu, Ruiping Wang, Minghao Dang, Enyu Dai, Fuduan Peng, Yunhe Liu, Akshaya Jadhav, Wenhua Lang, Claudio A Arrechedera, Leticia Campos Clemente, Edwin R Parra, Hsinyi Lu, Cara L Haymaker, Ignacio I Wistuba, Andrew Futreal, Andrea Viale, Michael J Soth, Philip Jones, Joseph R Marszalek, Timothy Heffernan, Giulio F Draetta, Nizar M Tannir, Jianjun Gao, Linghua Wang, Giannicola Genovese, Pavlos Msaouel

Faculty, Staff and Students Publications

Therapeutic options for patients with renal medullary carcinoma (RMC) are limited. Here we report the results of a phase II clinical trial (NCT03274258) of anti-PD1 nivolumab plus anti-CTLA4 ipilimumab in patients with RMC, with objective response rate as primary outcome. Enrollment was halted for futility at a prespecified interim analysis as all 10 treated patients experienced rapid disease progression. 5/10 met radiological criteria for hyperprogression and median progression-free survival (secondary outcome) was 1.38 months (95% confidence interval: 1.28, 1.60). In a post-hoc single-cell RNA sequencing analysis, data from patients with RMC before and after nivolumab plus ipilimumab treatment indicated that …

Leaping Between Branches: Hybridisation And The Tangled Evolutionary History Of True Lemurs, Lukas F K Kuderna, Jeffrey Rogers, Tomàs Marques-Bonet, Giuseppe Donati, Riccardo Percudani, Cristian Capelli

Faculty, Staff and Students Publications

The true lemurs (genus Eulemur) are a genetically diverse and spatially widespread group of species inhabiting most of Madagascar's forests. Including 12 recognized species, the genus can be divided into four major evolutionary groups: E. rubriventer, E. mongoz, the Brown Lemur Species Complex (BLSC), and the coronatus-macaco-flavifrons complex (CMFC), although monophyly for the CMFC is not always supported. Recent genome-based studies highlighted topological and chronological differences between nuclear and mitochondrial phylogenies of true lemurs, which could be explained by events of hybridisation. In order to reconstruct the evolutionary history of the genus, we test for gene-flow between Eulemur clades using …

An Analysis Of Diagnostic Metabolomic Profiles Associated With Hepatotoxicity During Childhood All Induction Therapy, Philip J Lupo, Karen R Rabin, Olga A Taylor, Marley Roberts, John P Woodhouse, Ashley Chavana, Kathleen Ludwig, Laura Klesse, Kenneth Heym, Timothy Griffin, Rodrigo Erana, Juan Carlos Bernini, M Monica Gramatges, Joanna S Yi, Sandi L Pruitt, M Brooke Bernhardt, Hong Zhu, Steven D Mittelman, Van Huynh, Etan Orgel, Jeremy M Schraw, Austin L Brown

Faculty, Staff and Students Publications

Hepatotoxicity is a well-documented complication of induction chemotherapy for acute lymphoblastic leukemia (ALL), but our understanding of its biological mechanisms is limited. We identified 314 patients with ALL (aged 1-19 years) treated at Texas Children’s Hospital (2008-2019) with diagnostic bone marrow plasma available for metabolomic profiling: 234 for discovery and 80 for replication. Hepatotoxicity during induction was defined as follows: (1) transaminitis: grade ≥3 aspartate aminotransferase or alanine aminotransferase or (2) conjugated hyperbilirubinemia: conjugated bilirubin (c.bili) >3 mg/dL. Untargeted profiling detected 519 metabolites. Adjusted odds ratios (aORs) for each metabolite were calculated with logistic regression, accounting for sex, age, body …

Hemorrhage-Related Maternal Morbidity Of Secondary Compared To Primary Postpartum Hemorrhage, Susan M Leong-Kee, Laurie S Swaim, Mark A Turrentine

Faculty, Staff and Students Publications

Objectives: To compare a composite hemorrhage-related maternal morbidity in individuals with secondary to primary postpartum hemorrhage and treatment interventions utilized.

Methods: A retrospective case-control study of deliveries complicated by secondary postpartum hemorrhage was performed at a tertiary care center. To estimate a clinically relevant increase of 50 % in the composite maternal hemorrhage-related maternal morbidity (35-53 % absolute increase) in individuals with secondary postpartum hemorrhage, a correlation coefficient of 0.2, at an 80 % power with a p < 0.05 with a two-sided test would require 95 individuals with secondary postpartum hemorrhage be matched to 95 individuals with a primary postpartum hemorrhage. Logistic regression analysis was used to evaluate the outcome of the composite of hemorrhage-related maternal morbidity.

Results: From January 2018 through December 2022, 33,026 deliveries occurred, and 94 individuals were identified that were admitted with secondary postpartum hemorrhage, …

Turning Patients' Open-Ended Narratives Of Chronic Pain Into Quantitative Measures: Natural Language Processing Study, Anika Tahsin, Chadi G Abdallah, John Markman, Zhiyao Duan, Guillermo Cecchi, Paul Geha

Faculty, Staff and Students Publications

Background: Subjective report of pain remains the gold standard for assessing symptoms in patients with chronic pain and their response to analgesics. This subjectivity underscores the importance of understanding patients' personal narratives, as they offer an accurate representation of the illness experience.

Objective: In this pilot study involving 20 patients with chronic low back pain (CLBP), we applied emerging tools from natural language processing (NLP) to derive quantitative measures that captured patients' pain narratives.

Methods: Patients' narratives were collected during recorded semistructured interviews in which they spoke about their lives in general and their experiences with CLBP. Given that NLP …

Hemolysis Detection Using The Gem 7000 At The Point Of Care In A Pediatric Hospital Setting: Does It Affect Outcomes?, Hanna Uhrova, Brandy D Recio, Sridevi Devaraj

Faculty, Staff and Students Publications

No abstract provided.

Changing Perspectives In California: A Transformative Culture Exchange For Stockholm University And Sonoma State University Criminology Students, Bryan Burton, Sofie Hellmer, Vida Wåhlmark, Hope Ortiz, Diana Grant

csuglobalaction

From June 13 to 20, 2024, Sonoma State University (SSU) hosted 16 criminology students from Stockholm University (SU) for an educational and cultural exchange. Five SSU undergraduate “student ambassadors” participated, representing California and SSU while assisting the Swedish students. Surveys indicated the exchange was a meaningful academic and cultural experience for all participants. The Swedish students deepened their understanding of the U.S. criminal justice system through presentations by criminologists and discussions with practitioners on issues such as policing and prison reform. They also gained broader perspectives on California and the United States through interactions with SSU ambassadors and visits to …

Gc-0258 Safecircle:​ Ai And Micro-Radar-Based Remote Monitoring For Patients With Ad/Adrd​, Awan-Ur- Rahman, Soarov Borty, Shakib Quddus

C-Day Computing Showcase

Alzheimer's disease and related dementias (AD/ADRD) is an irreversible and degenerative neurological condition that severely impacts neurons, resulting in cognitive decline and memory loss. This study explores a mHealth system, including a SafeCircle iOS prototype, a novel solution that combines artificial intelligence with cutting-edge micro-radar technology. The platform offers a variety of features, including management of patient and caregiver profiles, real-time alerts in case of emergencies, emergency contact lists, one-touch SOS support, sharing of live locations, and recording of unusual events in video. It is a responsive and reliable care assistant that optimizes patient safety while reducing caregiver burden.

Grm-0267 Learned Heuristics For Efficient A* Search: Improving Pathfinding In Combinatorial Pathfinding Problems, Jamia Jackson

C-Day Computing Showcase

This work proposes a learned heuristic framework designed to improve planning efficiency in deterministic pathfinding tasks. Building on the classic 8-puzzle as an initial test domain, supervised models were trained to approximate heuristic values and guide node ordering during A* search. The proposed approach focuses on modifying and enhancing traditional heuristics such as Manhattan distance by incorporating learned corrections that reduce search depth and node expansions. Experimental results show that the learned heuristic consistently improves search efficiency over standard baselines. Although this evaluation began with the 8-puzzle, the framework establishes a foundation for scaling to significantly larger and more practical …

Grp-0200 Tadps: Thrashing-Aware Dynamic Priority Scheduler For Virtual Memory Systems, Nasim Ahmed

C-Day Computing Showcase

Modern operating systems use multiprogramming and virtual memory to run multiple programs efficiently. When memory demand is high, excessive page swapping causes thrashing, degrading performance. This work introduces a thrashing-aware dynamic priority scheduler (TADPS) that uses page fault frequency to guide CPU scheduling. Processes with high page faults get lower priority, allowing others to progress efficiently. Tests under different memory pressures show that this approach improves CPU use, throughput, and stability compared with baseline schedulers such as FCFS and RR. Specifically, TADPS maintained superior throughput and efficiency, and consistently lower average turnaround time than FCFS and RR.

Grp-0197 Evaluating The Ability Of Llms To Interpret, Optimize And Translate Llvm Ir, Reuven Mueller

C-Day Computing Showcase

This study investigates whether modern state-of-the-art Large Language Models (LLMs) can interpret, optimize, and translate low-level intermediate representations (IR) used in compilers and binary translation software. We evaluate LLM performance on LLVM IR across three tasks: 1) interpreting the underlying algorithmic behavior, 2) identifying missed optimization opportunities, and generating improved IR variants, 3) Translating IR between AArch64 and x86-64 targets. To ensure correctness, all LLM generated IR is checked using a validation pipeline that verifies its syntax, structural correctness, compiles it into machine code, and executes it on randomized test data. Early results show that LLMs can perform non-trivial IR …

Grp-0176 A Comparative Analysis Of Traditional Virtual Machines And Micro Virtual Machines, Tasnim Akter Onisha

C-Day Computing Showcase

Virtualization technologies form the backbone of modern cloud and serverless platforms, but the balance between performance efficiency and strong isolation remains a key research challenge. Using a comparative literature based methodology, benchmark data from empirical studies are synthesized and normalized across four metrics: startup latency, memory footprint, isolation strength, and scalability. The findings show that traditional VMs such as KVM and Xen provide robust, formally verified isolation but incur higher boot times and memory usage, whereas Micro VMs like Firecracker and Kata Containers achieve lower latency (often < 125 ms) and smaller memory footprints (5–30 MB) while preserving VM-level isolation. Overall, Micro VMs deliver near container responsiveness with VM-grade security, making them suited for serverless and edge environments. As a future direction, this study highlights the need for scalable, formally verified Micro VM architectures for next-generation cloud systems.

Grp-0165 Reinforcement Learning For Latency-Aware Priority Boosting In Linux Completely Fair Scheduler, Joseph Natter

C-Day Computing Showcase

Tail latency remains a persistent challenge in Linux’s Completely Fair Scheduler (CFS), particularly when short, latency-sensitive jobs compete with longer ones. Traditional boosting heuristics improve tail latency but require manual tuning and generalize poorly across workloads. This project evaluates whether a reinforcement-learning (RL) controller can dynamically apply priority boosts more effectively than fixed heuristics. Using a discrete-event Python simulator modeled after CFS, this project compares baseline CFS, heuristic boosting, and PPO-based learned boosting under mixed workloads. Results show that while heuristics achieve the lowest absolute latency, RL achieves competitive tail-latency reduction with significantly better fairness and adaptability. A state-space study …