Digital Commons Network^™

Expanding The Mutation Spectrum Of Non-Syndromic Retinitis Pigmentosa In Consanguineous Pakistani Families: Unraveling Novel Pathogenic Variants In Rp1, Pde6b, And Prcd Genes For Precision Diagnosis, Tayyaba Shan, Nimra Mukhtar, Sayyed Hammad Ullah, Asad Ullah, Asfandyar Ahmad Khan, Yumei Li, Meng Wang, Raeesa Tehreem, Amtul Aziz, Kiran Afshan, Rui Chen, Sabika Firasat

Faculty, Staff and Students Publications

No abstract provided.

Culturally Tailored Materials For Smoking Cessation And Hiv Care Adherence Among Hispanic Adults: Protocol For Content Development And Formative Evaluation, Lorra Garey, Jacqueline J Charles, Ashley L Ruiz, Rodrigo Castillo-Avilés, Virmarie Correa-Fernández, Marshall K Cheney, Thomas P Giordano, Michael J Zvolensky

Faculty, Staff and Students Publications

Background: Hispanic people with HIV who smoke cigarettes experience unique stressors (eg, stigma), which contribute to health disparities. Anxiety sensitivity (AS) may worsen mood management problems, which are a leading barrier to smoking cessation. Interventions targeting AS can improve HIV-specific outcomes and smoking cessation. However, no prior research has culturally tailored an AS reduction program to improve quality of life among Hispanic people with HIV who smoke. The research team previously developed a mobile health (mHealth) intervention addressing AS reduction, smoking cessation, and HIV care management for Black people with HIV who smoke. Building on this work, this study represents …

Understanding The Implications Of Transitional Shifts In Leadership On Higher Education Employees' Departures: A Phenomenological Qualitative Study, Leya Deickman

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study was to understand the experiences of employees who chose separation amidst the transition of a new president at small private higher education institutions in the United States. This study aimed to understand how collegiate and university presidential leadership transitions influence employees’ perception of their decision making process to voluntary leave their respective institutions. The theory guiding this study was Homans’ social exchange theory, as it explains social interactions as an exchange using a cost benefit analysis. The central research question was: What are the lived experiences of employees who choose separation amidst the …

The Lived Experiences Of Generation X With Social Media Use And Body Image Perception: A Phenomenological Study, Consuela Coburn

Doctoral Dissertations and Projects

Social media use grows worldwide daily with several available applications having both positive and negative values. Several studies found negative effects on mental health and body dissatisfaction in adolescents and young adults. Existing literature predominantly focuses on young female participants, resulting in a gap in understanding the effects of social media use across other age cohorts. This phenomenological qualitative study explored the lived experiences of Generation X adults regarding social media use and the perceived effects on body image. Additionally, this study identified themes that emerged based on the semi-structured interviews of Generation X adults. NVivo 15, a computer assistance …

Behavior Change In A Young Woman: The Secret Lies In The Ovarian Tumor, Matthew Moritz, Md, Linh Tang Taylor, Md, Olivia L Snir, Stephanie Griffith, Md

Books, Presentations, Posters, Etc.

Introduction: Autoimmune encephalitis is a rare immune-mediated disorder characterized by neuropsychiatric symptoms. Anti-NMDA receptor (NMDA-R) encephalitis, the most common subtype, affects approximately 1 in 1.5 million people annually. We present a case of a young female with new-onset hallucinations, behavioral changes, and personality disturbance. Case Presentation: A 32-year-old female with remote methamphetamine use and recent trauma presented with acute mental status changes, aggression, emotional lability, and hallucinations. Vitals were normal; on exam she appeared confused, agitated, and displayed unusual behavior, including hallucinations. Initial evaluation revealed mild leukocytosis, but otherwise normal urine drug screen, chest radiograph, TSH, ANA, VDRL, heavy metal …

Diagnostic Overlap In Hus: An Atypical Case, Ryan Daily, Med, Do, Andrea Roast, Md

Books, Presentations, Posters, Etc.

Introduction: Atypical HUS (aHUS) is a rare type of Thrombotic Microangiopathy distinguished by complement dysregulation and overall clinical progression. We present a diagnostically ambiguous case with early intervention that preserved end-organ function with discussion of future pregnancy implications. Case Presentation: A 36yo F (G2P1) with hypothyroidism, Small Intestinal Bacterial Overgrowth (SIBO), and intermittent urticarial rashes presented with fever, abdominal pain, and 3 days of bloody diarrhea. Discussion: This case highlights an atypical presentation of aHUS with diarrheal prodrome and normal complement function, features that typically suggest Shiga toxin–mediated HUS. We saw clinical change after admission, allowing real-time monitoring. Maintaining a …

Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor

Books, Presentations, Posters, Etc.

Introduction: Eosinophilic fasciitis (EF), or Shulman’s disease, is a rare disorder of unknown etiology and poorly understood pathogenesis. It is characterized by fibroblast activation and interleukin-driven eosinophilia. Early clinical features include limb or trunk erythema, non-pitting edema, and progressive fascial thickening, often producing an “orange peel” appearance. Eosinophilia is a prominent laboratory finding in the early phase, but diagnosis often requires a full-thickness skin-to-muscle biopsy. Systemic corticosteroids are first-line therapy, with methotrexate as the steroid -sparing agent for refractory disease. We present a unique and diagnostically challenging case of EF confirmed by histopathology. Case Presentation: A 56-year-old man presented with …

Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md

Books, Presentations, Posters, Etc.

Introduction: Schistosomiasis is the second most common parasitic infection worldwide and is associated with significant morbidity and mortality. We present an unusual case of hepatic schistosomiasis presenting as a hepatic mass. Case Description: A 78-year-old male with no prior hepatobiliary disease with an incidental finding of a hepatic lesion on postoperative abdominal CT imaging after an endovascular aneurysm repair. He lived in China until immigrating to the United States over 50 years ago. Previously hospitalized for abdominal pain and diarrhea, at which time he was told he had an infection in his liver. Details of treatment are unknown. He has …

Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino

Books, Presentations, Posters, Etc.

59. Hypercalcemic Crisis After Open Mitral Valve Replacement Andrew Sunwood, DO Background: Hypercalcemic crisis is a rare manifestation of primary hyperparathyroidism characterized by a sudden increase in serum calcium levels to >14 mg/dL with symptoms of hypercalcemia including adverse gastrointestinal symptoms, abdominal pain, and even predisposition to cardiac arrhythmias. There is only one other documented case of hypercalcemic crisis occurring after open heart surgery. Case information: 69-year-old female with a history of primary osteoporosis on alendronate and valvular heart failure presented for mitral valve replacement. Preoperative lab work did not show evidence of electrolyte abnormalities. She under- went open bioprosthetic …

Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker

Books, Presentations, Posters, Etc.

The transition from medical student to intern is widely recognized as a challenging period, and numerous curricula have been developed to support this transition. However, the transition from intern to senior resident receives far less attention despite presenting its own unique challenges. Anecdotal feedback from internal medicine residents and emerging literature suggests that the transition to senior resident is associated with feeling emotionally overwhelmed from simultaneously being a learner, leader and educator.1,2 To address this gap, the Transition Series was developed as a novel curriculum to support internal medicine residents as they advance into their senior roles. Building on the …

Optimizing Behavioral Health Integration In Primary Care Through A Targeted Didactic, Ravneet Dhaliwal, M.A., Behavioral Health Intern, Joshua Morris

Books, Presentations, Posters, Etc.

Background: The integration of behavioral health into primary care settings is an essential strategy for improving patient outcomes, increasing access to mental health services, and achieving the Triple Aim of healthcare.1, 2 To maximize this integration and bridge the gap for primary care providers (PCPs), targeted didactic training and continued education are pivotal. National surveys indicate that PCPs often report low comfort levels in managing psychological concerns due to a lack of formal training, despite the high prevalence of these issues in primary care. 3, 4 Brief didactics facilitated by embedded behavioral health psychologists offer an accessible, adaptable method for …

Pulmonary Prelude: Ild As The Only Manifestation Of Rheumatoid Arthritis, Matthew Moritz, Md, Benjamin Hackett

Books, Presentations, Posters, Etc.

Abstract: Rheumatoid arthritis (RA), a systemic autoimmune disorder, classically presents with joint pain and prolonged morning stiffness. Extra-articular pulmonary manifestations are frequently observed but can be the primary initial presentation. We present a case of a women with chronic RA in remission who presented with shortness of breath and was found to have new RA-associated interstitial lung disease (RA-ILD). A 74-year-old female with a history of rheumatoid arthritis in remission, chronic obstructive pulmonary disease, and recent admission for septic shock presented with progressive dyspnea and hypoxia. Initial vitals noted an oxygen saturation in the low 80s. CT pulmonary angiography excluded …

Teacher Leadership Inventory Among The Nine Seventh-Day Adventist Unions Of The North American Division: A Quantitative Causal-Comparative Study, Adam C. Littell

Doctoral Dissertations and Projects

The purpose of this quantitative causal-comparative study was to determine if there was a difference in sharing expertise, sharing leadership, and/or supra-practitioner behaviors among the teachers of the nine Seventh-day Adventist Unions of the North American Division. This study is important because it meets an important gap in teacher leadership understanding, both within the broad context of education and specifically within the Seventh-day Adventist educational system. The sample was composed of 264 Seventh-day Adventist full-time teachers from across the North American Division (with the exception of the Seventh-day Adventist Church of Canada due to privacy laws prohibiting participation) who did …

Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair

Books, Presentations, Posters, Etc.

Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is most frequently associated with dermatomyositis with various degrees of clinical manifestations including rapidly progressive interstitial lung disease (RP-ILD), inflammatory arthritis, vasculopathy, and other cutaneous findings. Clinically amyopathic dermatomyositis (CADM) is frequently associated with RP-ILD and has high mortality rates. Here we present a case of anti-MDA5 associated RPILD but without other features of dermatomyositis that did not respond to standard immunosuppressive therapy. A 41-year-old woman with recently diagnosed interstitial lung disease and polyarthritis previously on methotrexate presented with progressive dyspnea and worsening hypoxemic respiratory failure. She was previously admitted for respiratory failure two …

Looking Past The Portal: A Hidden Origin Of Ascites, Paige Ruh, Do, Claudia Leonard, Md

Books, Presentations, Posters, Etc.

Introduction: The most common cause of ascites is portal hypertension secondary to cirrhosis and accounts for nearly 75% of cases. In contrast, pancreatic ascites is a rare presentation of ascites and occurs in less than 1% of patients. Because of its low prevalence, pancreatic ascites is often excluded from the initial differential diagnosis and rarely assessed in ascitic fluid analysis. This is a case in which pancreatic ascites was considered and ultimately confirmed based on the overall clinical picture, challenging the initial assumption of portal hypertension and cirrhosis. Case Presentation: A 47-year-old man with ongoing alcohol use disorder presented to …

Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient, Jobe Ashby, Omar Panhair

Books, Presentations, Posters, Etc.

Ofatumumab is the only anti-CD20 IgG1κ human monoclonal antibody therapy for relapsing forms of multiple sclerosis (MS) that patients can self-administer subcutaneously. Anti-CD20 agents are biologic therapies that carry an increased risk of serious infections, but rarely Legionellosis. We present the case of a young man taking ofatumumab for his MS who developed Legionella pneumoniae pneumonia. A 30-year-old man with MS diagnosed two years prior, stable on ofatumumab, presented with fevers, cough, and hemoptysis. A week earlier, he developed fevers and myalgias after administering ofatumumab, but these symptoms persisted longer than usual. Though initial vital signs were normal, he appeared …

Phenazopyridine-Induced Sulfhemoglobinemia: A Diagnostic And Management Dilemma, Natalie Bolton, Md, Linh Tang Taylor, Md, Kristy Poonyagarlyagorn, Md, Cameron Long, Md

Books, Presentations, Posters, Etc.

Introduction: Sulfhemoglobinemia is a rare dyshemoglobinemia which occurs when sulfur irreversibly binds to hemoglobin. Presents similarly to methemoglobinemia. Common offending medications: dapsone, acetanilide, phenacetin, and nitrates. Rarely observed secondary to phenazopyridine, an over-the counter medication used to treat dysuria. Few facilities are capable of testing for sulfhemoglobinemia Case Background: A 67-year-old woman with recurrent urinary tract infections and interstitial cystitis presented with encephalopathy and recurrent falls for three days. PMH: multiple sclerosis, recurrent urinary tract infections, asthma, neurogenic bladder, neuropathic pain, and obstructive sleep apnea. Chronically on multiple centrally acting medications. Not on medications for multiple sclerosis due to cost. …

Spur Cell Anemia: A Crucial Unanticipated Anemia In Critical Care, Jobe Ashby

Books, Presentations, Posters, Etc.

INTRODUCTION: Spur Cell Anemia (SCA) is a rare underrecognized non-autoimmune hemolytic anemia occurring in severe liver disease with prognostic implications. Since the 1980s there have been only a few dozen case reports and clinical images concerning SCA. We present a case of a young man managed in the ICU with multiorgan failure and a masked diagnosis of SCA. DESCRIPTION: A 33-year-old man was found down and presented to the ICU with hematemesis and hemorrhagic shock. He required massive transfusion for bleeding esophageal varices that were later banded and an expanding thigh hematoma. He was diagnosed with alcohol induced liver cirrhosis …

Grace And Generosity: A Nt Defense Of Christian Giving And Stewardship, Jermaine Mcinnis

Masters Theses

This thesis holds that Christian stewardship and giving remain divinely appointed activities in the NT, despite growing skepticism in modern ecclesial and academic circles. Firmly grounded in biblical theology and canonical exegesis, the research argues that the disciplines of tithing, giving, and sacrificial stewardship are not eliminated by grace but are redirected and intensified with Christ. The research examines OT assumptions, Jesus’ instruction, and apostolic instruction to illustrate consistency in God's expectation of His people's obedience regarding finances. Drawing on current scholarship, the thesis refutes assumptions that giving is optional or less culturally relevant, underlining its vital importance to church …

The Sacrificial Vs. The Luzhinian Figure: Comparing Sacrificial Love In Crime And Punishment, Pride And Prejudice, And A Tale Of Two Cities, Natalie Rose Kubala

Masters Theses

Many works of art and literature exploring the theme of love focus on trying to define what love is; in contrast, this thesis dives deeper into defining what love is not, specifically focusing on the relationship between love and sacrifice. This thesis argues that love is not the same as sacrifice because a true sacrifice requires that love is already present prior to the sacrifice being made. This thesis will compare those who perform true sacrifices to those who perform sacrifices for their own personal gain by exploring grandiose narcissistic characters who perform (or attempt to perform) sacrifices without love …

Patient Follow-Ups For Hospital Nurses: Addressing Nurse Well-Being After Rapid Response Events, Quean Brown, Cristin Phillips, Molly Liddell, Katherine Thompson, Tala Fuad Hatem Abu Zahra, Jacqueline Christianson

Creating Healthy Work Environments (CHWE)

Background: Bedside registered nurses (BRNs) in the hospital setting care for patients who may unexpectedly deteriorate. When nurses witness patient deterioration, it is helpful for them to engage in meaning-making and contextualization to facilitate compassion satisfaction, mitigate secondary traumatic stress, and improve job satisfaction (Kopacz et al., 2019; Sattler & Smith, 2020). When a rapid response team (RRT) intervention is called and the patient warrants transfer to intensive care (ICU), BRNs rarely receive formal follow-up regarding the outcomes of their patients. Lack of feedback regarding critical situations may contribute to secondary traumatic stress, moral distress, decreased job satisfaction among BRNs, …

Comparing Nurse Well-Being Across The Career Trajectory: An Analysis Of The Healthynurse Survey, Alison F. Cuccia

Creating Healthy Work Environments (CHWE)

Background: Nurses face persistent challenges in maintain well-being (Lönnqvist et al., 2025; Priano et al., 2018), which may contribute to the nurse staffing crisis. This analysis examines differences in well-being among nurses in different stages of their career trajectory.

Methods: Data from the HealthyNurse survey collected June 2024-May 2025 were examined (n=5006). Outcomes included fatigue, anxiety, depression, social ability, and physical functioning, measured using Patient-Reported Outcome Measurement Information System short form scales. Moderate to vigorous physical activity (MVPA, minutes/week), days of strength training per week, the Healthy Eating Index, and BMI were also measured and used as outcomes. …

Safe Starts: Leveraging Psychological Safety To Mentor And Retain Nurse Faculty, Eboni Takia Herbert Harris, Lan Angela Nguyen

Creating Healthy Work Environments (CHWE)

Faculty burnout and incivility are key factors in nurse faculty turnover, with a 2023 study noting 85% of faculty reporting burnout. As a strategy to retain nurse faculty, many institutions adopted structured onboarding and mentoring programs. Even with structured mentoring programs, institutions continue to experience faculty turnover and increased time to promotion. Creating a psychologically safe environment is a strategy for improving civility and supporting mental well-being, thus reducing faculty burnout.

The purpose of this project is to explore the integration of psychological safety strategies into structured faculty onboarding and mentoring programs and examine the impact on faculty retention and …

Medication Reconciliation In The Emergency Department: Whose Job Is It?, Courtney N. Loecker, Lori Gaver, Jadyn Brooks, Monica Hanus, Ally Smart

Creating Healthy Work Environments (CHWE)

Background: Medication reconciliation is a critical component of hospital admission, reducing medication errors, improving patient safety, and ensuring continuity of care.^1–3 Uncertainty persists over which healthcare providers (i.e., nurses, pharmacists, physicians) are primarily responsible for performing medication reconciliation when patients are admitted from the emergency department (ED).⁴ Understanding frontline nurses’ perspectives about medication reconciliation is key to informing practice improvements and patient outcomes.

Purpose: This project aimed to identify nurses' perspectives about current medication reconciliation practices including responsibility, barriers, and solutions to enhance safety, workflow efficiency, and interprofessional collaboration.

Methods: Guided by the Plan Do Study Act framework …

Life Lessons In Goodbye: Exploring Family Communication And End-Of-Life Depictions And Messages In Disney And Pixar Films Through A Content Analysis, Vanessa A. Gordon

Doctoral Dissertations and Projects

Death is a friend of ours said Francis Bacon, and Hargarten stated that death has an inevitable arrival. This research aimed to explore the depictions and messages of death in Disney and Pixar films. The qualitative content analysis research methodology coded 267 deaths in Disney films (1937–2003) and Disney and Pixar Films (2003–2024). The study centers on replicating the scholarship of three prior works, while extending the research by incorporating more recent films into the analysis. Additionally, this current study applies a new theoretical framework, family communication patterns, to all films, including those previously reviewed solely for depictions of death, …

Improving Transfer Portal Decision-Making Through A Microsoft Excel Optimization Model, Peyton Steffes

Honors Projects

The creation of the transfer portal has increased the mobility of collegiate athletes, giving players the autonomy to switch teams throughout their career. As a result, the roster development process has become more complex, as coaches are tasked with the challenge of recruiting from the transfer portal, which involves an extensive decision-making process. Coaches not only have to evaluate a substantial pool of players, but they also must consider the following constraints they are under: scholarship budget, roster spots available, and positional needs. To simplify this decision-making process, this analysis includes the results of a Microsoft Excel data optimization model …

Automated, Modular, Agentless Adversarial Emulation In Cloud Environments For Higher Education And Student Training, Doc Harley

Senior Honors Theses

Currently, the leading technologies in the market of adversarial emulation are MITRE Caldera, Atomic Red Team by IBM, and multiple proprietary products that come with support packages for different vendors like AttackIQ, Cymulate, SafeBreach, and many more. While it is clear that much work has been done in the broad category of adversarial emulation, when it comes to open source solutions, there are no agentless options with built in automation and modularity that have good support for cloud environments. Agentless adversarial emulation provides a unique advantage in that it can be both simpler and a better representation of the true …

Changing Employee Motivation From Obligation To Opportunity: Increasing Intrinsic Motivation In Non-Profit Organizations, Evelyn L. Williams

Senior Honors Theses

Motivation is a key driver behind tasks within the workforce. Harnessing employee motivation increases productivity, employee retention, efficiency, and output quality. Non-profit organizations, however, are often unable to devote resources to externally increasing motivation. This study presents a motivational model that is built from three motivation theories: Maslow’s Hierarchy of Needs, Herzberg’s Two Factor Theory, and Self-Determination theory. By incorporating principles from these theories this model helps organizations internalize and increase the effectiveness of their employees’ motivation through increasing the autonomy, competence, and relationality felt by each employee. The six tenets of the REWARD model give non-profit organizations a framework …

Lebesgue’S Theory Of Integration: An Introduction To Modern Integration Theory, Nathanael C. Krug

Senior Honors Theses

The depth and richness of integration theory far surpasses the introductory material presented in an elementary calculus classroom. The work of Bernhard Riemann and Henri Lebesgue demonstrates just a small sample of the richness of the field of analysis. In formulating and contrasting the Riemann and Lebesgue integrals, students can gain an enriched and well-rounded introduction to integration theory. This not only deepens understanding and love for previously learned material, but also enables further study within the fields of analysis and measure theory. An introductory primer to integration theory equips students with the tools needed to continue their exploration of …

A Deep Learning-Based Approach For Bot Detection In Trending Hashtags On X, Mehboob Hussain, Muhammad Rizwan Rashid Rana, Muhammad Imran, Muhammad Shoaib, Muhammad Hasaan Mujtaba

Makara Journal of Technology

The widespread presence of bots on social media platforms, such as X (formerly Twitter), poses a significant threat to the integrity of online information by facilitating the dissemination of misinformation and manipulating public discourse. This study proposes a robust deep learning-based framework, DeepBot, to detect bot participation in trending hashtags and discussions on X. The approach uses a dataset sourced from Kaggle, comprising user profile metadata, including follower count, tweet frequency, account verification status, and engagement metrics. The data were subjected to comprehensive preprocessing, including noise removal, part-of-speech (POS) tagging, and word embedding using the pre-trained GloVe model. RoBERTa is …