Digital Commons Network^™

The Effects Of Sugammadex Vs. Neostigmine On Intraoperative Heart Rate In Pediatric Patients Under Two Years: A Scoping Review, Saumel Abston, Jackson Cobb, Elle Dean, Tanner Dillard, Pauline Dinh, Dwayne Accardo Dnp, Crna, Faana, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Neuromuscular blockade (NMB) reversal is a critical component of anesthesia care, particularly in infants under two years of age who have immature autonomic regulation and heightened vagal tone, predisposing them to bradycardia. Neostigmine, the traditional reversal agent, is associated with parasympathomimetic effects such as bradycardia, requiring anticholinergic co- administration. Sugammadex, a selective relaxant binding agent, offers rapid and predictable reversal of aminosteroidal neuromuscular blocking agents with less cholinergic side effects. Although the safety profile of sugammadex is well established in older pediatric populations, limited evidence exists regarding its cardiovascular effects in infants under two years of age.

Methods

A …

Discharge Education Bundles And Evaluating The Effect On Readmission And Satisfaction Rates: A Scoping Review, Jane Campo Bsn, Rn, Charlotte Edwards Bsn, Rn, Mary Catherine Hall Bsn, Rn, Sarah Moore Bsn, Rn, Allison Walker Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Transitioning children with a chronic medical condition from hospital to home is a critical and difficult process, leaving many families feeling anxious and unprepared. Nationally, 1 in 7 pediatric patients are readmitted within thirty days, making readmission rates an important quality indicator with both clinical and financial implications. To address these challenges, multiple discharge bundles have been developed; however, their effectiveness has not been consistently evaluated. The aim of this project is to summarize the current literature and highlight its positive outcomes, with the intention of promoting further research, reducing 30-day readmission rates, and increasing parental satisfaction (Shermont et …

Improving Access And Early Identification Of Anxiety Disorders Through Annual Gad-7 Screening In High Schools: A Scoping Review, Joshua Richard Yumul Bsn, Rn, Cindy Thao Msn, Rn, Justin Doyle Borden Bsn, Rn, Rebecca Lizette Johnston Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Background: Anxiety disorders affect nearly one-third of adolescents in the United States, yet many cases remain undiagnosed due to inconsistent screening and limited access to school-based mental health services. The Generalized Anxiety Disorder 7-item (GAD-7) questionnaire is a validated screening tool, but its routine use in high school settings is not well established.

Purpose: This scoping review aimed to synthesize current evidence on the use of the GAD-7 in high schools to support early identification of anxiety disorders and improve access to mental health care.

Methods: A comprehensive literature search was conducted using PsycINFO, ERIC, PubMed, CINAHL, and Google Scholar. …

Illuminating The Shadows: Building An Empirical Dataset To Analyze The Shadow Docket, Natalie Marx

Senior Honors Theses

No abstract provided.

Design, Simulation, And Experimentation Of A Box Barge Model Under Asymmetrical Conditions, Kylie Sink

Senior Honors Theses

This study investigates the ability of numerical simulations to predict vessel motion responses under asymmetrical loading conditions. A raked barge model was designed, constructed, and tested in a towing tank to evaluate the response amplitude operators (RAOs) for heave, roll, and pitch under various wave conditions. The model included six internal compartments that allowed different flooding scenarios to be simulated in order to create asymmetric loading conditions. Experimental testing was conducted under head seas (0 degrees) and beam seas (90 degrees) with multiple wave periods.

A numerical model of the vessel was developed using GHS to generate predicted RAOs for …

Experimentation To Study Ship Motions Under Asymmetrical Conditions, Elise Simon

Senior Honors Theses

The pioneers of ship motion analysis often used the symmetry assumption to reduce computation time and complexity. For the symmetry assumption to be valid, a ship must be upright with no heel angle, which is rarely the case. An increased interest in damaged ships has motivated further analysis of ship motions in the asymmetric condition; however, only a limited number of physical experiments have been conducted in towing tanks. This paper presents an experiment carried out to analyze vessel motions in the asymmetric condition for a box barge model. The method includes model construction, experiment setup, the test matrix, and …

Preservice Teachers’ Noticing Of Students’ Quantitative And Covariational Reasoning In Dynamic Mathematical Situations, Alfred M. Limbere, Joseph Dinapoli, Steven Greenstein

Department of Mathematics Faculty Scholarship and Creative Works

Understanding rate of change requires reasoning about measurable quantities and how one quantity changes relative to another. To support this kind of reasoning, teachers should develop the ability to notice students’ quantitative and covariational reasoning. This study examines how preservice teachers (PSTs) attend to, interpret, and respond to students’ quantitative and covariational reasoning in video-based analyses of water-filling rate-of-change tasks. Drawing on relevant research, professional noticing is examined through the lenses of quantitative reasoning and covariational reasoning. Using a design-based qualitative approach, secondary PSTs participated in structured analyses of students’ problem-solving discussions related to rate of change. Data were collected …

Are We Still Bowling Alone – Part Iii: Our Diminished Life In Public And Its Consequences, Kenneth Woodward

eJournal of Public Affairs

Editor’s note. The following is based on a panel session from the 2024 Public Affairs Conference, presented by Nancy Ammerman, Harry Bruinius, and Kenneth Woodward. The panel was a reflection on what has happened since authors Robert Putnam and Robert Bellah issued warnings on the decline of community in America.

Changes In Opioid Prescribing Patterns In Opioid Naive Patients Can Translate To Improved Outcomes In The Opioid Non-Naive Patients With Anterior Cervical Surgery: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Bhargav Ayloo, Trevor Ruesch, Adam Junn, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tang, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Though often necessary for adequate analgesia after spine surgery, continued opioid use can lead to chronic dependency. The Michigan Spine Surgery Improvement Collaborative (MSSIC) has demonstrated in prior work the promise of utilizing a multi-institutional morphine milliequivalent (MME) cutoff for elective anterior cervical surgery in the opioid naıve population. However, the effect of this cutoff in patients who were already on opioids pre-operatively have not previously been studied. The goal of this study was to evaluate whether changes in prescribing patterns in the opioid naıve population would also translate to the non-naıve populations, and whether the non-naıve population would …

Implementation Of A Multi-Institutional Enhanced Recovery After Surgery (Eras) For Elective Spine Surgery: Two-Year Michigan Spine Surgery Improvement Collaborative (Mssic) Experience, Anisse Chaker, Kylie Springer, Kari Jarabek, Michael Melhem, Heegook Yeo, Jian-Hui Hu, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, Victor Chang

Conference Presentation Abstracts

Introduction: Enhanced Recovery After Surgery (ERAS) protocols have been introduced to several surgical specialties with the intention to reduce peri-operative adverse events and improve various health-system quality metrics including length of stay and patient satisfaction. Though this has been studied in the setting of spine surgery, the vast majority are single institution protocols biased toward academic teaching hospitals. There is a paucity of literature studying the utilization of a multi-institutional ERAS protocols that is applicable to community hospitals without associated training programs. We present the Michigan Spine Surgery Improvement Collaborative (MSSIC) two-year experience implementing a multi-institutional ERAS protocol for elective …

The Impact Of Covid-19 On Spine Surgery: Temporal Trends In Complications And Patient-Reported Outcomes Across A Statewide Cohort, Ali Mehaidli, Richard Easton, Ahmad Almaat, Gary George, Alqasim Elnaggar, Victor Chang, Doris Tong, Jad Khalil, Kevin Taliaferro

Conference Presentation Abstracts

Introduction: The COVID-19 pandemic caused major disruptions in elective surgical care, including spine surgery, due to widespread hospital restructuring and resource limitations. Although previous studies have examined surgical volumes and safety during the pandemic, limited data exist on how outcomes varied across multiple phases of the pandemic, especially in real-world, multicenter spine surgery populations. Material and Methods: This retrospective cohort study used data from the Michigan Spine Surgery Improvement Collaborative (MSSIC) to compare outcomes in patients undergoing lumbar or cervical spine surgery across four COVID-19 timeframes: pre-COVID (1/2019-2/2020), onset-COVID (3/2020-9/2020), active-COVID (10/2020-2/2022), and post-COVID (3/2022- 12/2022). Patient demographics, surgical characteristics, …

Halo Effect Of Prescribing Guidelines For Opioid Naive Patients Translates To Opioid Non-Naive Patients Undergoing Lumbar Decompression: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Jawad Saad, Abdullah Al-Tekreeti, Kenneth Easton, Jad Khalil, Richard Easton, Doirs Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Chronic opioid dependency in spine surgery is an ongoing concern given the ongoing opioid epidemic. We have previously reported on our cohort of opioid-naıve patients, however the literature has shown that patients with opioid use at baseline are at higher risk of less favorable outcomes. Starting in 2022, MSSIC instituted state-wide prescribing guidelines for opioid naıve patients undergoing one- or two-level lumbar decompression surgery (laminectomy, laminotomy, foraminotomy, microdiscectomy) with performance goals of 80% compliance. The goal of this study was to evaluate whether there would be a form of a “halo” effect on prescribing patterns for patients with baseline …

Postoperative Ileus After Lumbar Spine Surgery: Modifiable Risk Factors And Impact On Outcomes, Ali Mehaidli, Richard Easton, Alqasim Elnaggar, Gary George, Ahmad Almaat, Victor Chang, Jad Khalil, Kevin Taliaferro

Conference Presentation Abstracts

Introduction: Postoperative ileus (POI) is an infrequent but impactful complication following lumbar spine procedures. While well-characterized in abdominal surgery, spine-specific data remain limited, particularly regarding modifiable risk factors. Materials and Methods: We analyzed 41,164 patients who underwent elective lumbar spine surgery between 2018 and 2023 using the Michigan Spine Surgery Improvement Collaborative (MSSIC) registry. Multivariable generalized estimating equation models were used to identify independent risk factors for POI. We also evaluated the association between POI and postoperative outcomes, including patient-reported outcome measures (PROMs). Results: POI occurred in 1.1% of patients (n = 447). Independent risk factors included older age (RR …

Accentuating Wetlands: Designing Restorative Wetlands To Clean The Red River Of The North Near Selkirk, Manitoba, Grace Stein

Landscape Architecture Theses

Research was conducted looking into how wetlands clean water with a focus on nutrient removal through plant uptake, sedimentation, and absorption. Additional research was done to determine the methods of constructing a wetland. This thesis focuses on improving water quality for the Red River of the North by intaking 720,000 gallons of water per day out of the river and treating it for different agricultural runoff pollutants. This is achieved by using a series of constructed wetlands, each designed to remove a specific nutrient from the water. After nutrients have been removed, the water will be pumped back into the …

The Green Spine: Reimagining The Central Campus Of North Dakota State University Through Social Green Spaces And Pedestrian Connections, Lydia Ham

Landscape Architecture Theses

This thesis studies how landscape architecture can reimagine university campuses as connected, flexible, and functional environments that enhance how people will interact with the outdoor environment. Focusing on North Dakota State University in Fargo, North Dakota, the project focuses on adding green space where there are currently underutilized open spaces. Key principles of successful campus landscapes focus on including well defined circulation systems, spatial variety, and multifunctional use. Where research has developed three focus zones including Bison Green, Prairie Common, and Herd Crossing to show how integrated landscape systems can support movement, learning, and recreation while still maintaining an overall …

Temporality Waters: Connecting People To The Brays Bayou Through Memory, Culture, And Identity Experiences In Houston, Texas, Khulda Aamir Obaid

Landscape Architecture Theses

Communities across Texas face increasing hydrological pressures from natural climate variability, changing precipitation patterns, and rapid urban growth. Although directly attributing extreme precipitation events to anthropogenic climate change is complicated by internal variability and observational limitations (de Vries et al., 2023; Griffin et al., 2024; IPCC, 2021; National Academies, 2016), cities such as Houston are preparing for more frequent and intense storms. Historical floods—including Tropical Storm Allison, the Memorial Day and Tax Day floods, and Hurricane Harvey—have exposed the limits of Houston’s predominantly hard-infrastructure flood management. The Brays Bayou watershed, particularly the Meyerland neighborhood, shows heightened vulnerability, where impervious surfaces, …

Significantly Elevated Procalcitonin In Aki Reliable Or Not Reliable?, Sally Othman, Sujata Kambhatla, Chadi Saad

Conference Presentation Abstracts

Introduction Procalcitonin (PCT) is a biomarker that helps distinguish bacterial infections from other causes of infection or inflammation and can be used as a helpful adjunct to clinical judgment to resolve diagnostic uncertainty. However, the reliability of procalcitonin goes down when a patient has Acute kidney injury (AKI). Yet is there any significance for procalcitonin if it is extremely high, in hundreds, same in our patient, despite the patient in AKI and can PCT still be used to help determine mortality along with all other markers, or independent from other markers. Case report 36 years old male with PMH of …

Assessing The Use Of Exon-Skipping Morpholino Antisense Oligonucleotides Targeting The Different Sumo Paralogs As Enhancers Of The Antitumor Activity Of Chemotherapeutic Agents, Andrea Teresa Garcia-Morin

Open Access Theses & Dissertations

Post-translational modifications (PTMs) are critical regulators of protein function, stability, and localization, with SUMOylation emerging as a key modulator of cellular stress response and survival in cancer. Non-small cell lung cancer (NSCLC) is characterized by heightened dependence on SUMOylation to sustain pro-survival signaling, DNA repair, and resistance to chemotherapy. This dissertation investigates a novel chemosensitization strategy based on the splice-switching of SUMO transcripts in NSCLC cells using exon-skipping morpholinos (ESMs), which redirect splicing toward non-conjugatable SUMO alpha isoforms, thereby reducing global SUMOylation. We hypothesized that decreasing global SUMOylation through forced alternative splicing of SUMO transcripts would impair the stress-protective functions …

Application Of Path Analysis To Determine The Impact Of Age And Sex On The Neural Circuits That Promote Nicotine Withdrawal Severity, Veronika Espinoza

Open Access Theses & Dissertations

The rising prevalence of electronic cigarette (e-cigarette) use presents a major public health concern, particularly in adolescent females who are most susceptible to nicotine use and its long-term negative health consequences. The goal of this dissertation was to utilize preclinical rodent models to understand how group differences in age and sex influence neural activation patterns in brain circuits believed to promote nicotine withdrawal. Prior pre-clinical work, conducted largely in male rodents, has established that there are two major brain pathways that modulate the behavioral effects of nicotine withdrawal. These include the mesolimbic and medial habenula-interpeduncular nucleus (MHb-IPN) pathways. To assess …

Provenance Analysis Of Advanced Persistent Threats In Operational Technology Environments, Laura Aminta Guevara

Open Access Theses & Dissertations

Live vulnerability testing and penetration assessments of critical infrastructure are costly, complex operationally and, in many cases, unsafe to conduct directly against live systems, whether these are commissioned in-house and through third-party providers. For Operational Technology environments specifically, these constraints are further aggravated by the limited vendor support and inconsistent security patching available that characterize many industrial communication protocols. This significantly restricts the scope and feasibility of conventional penetration testing. At the same time, the increasing overlapping of OT systems with enterprise networks and the internet has expanded the attack surface of ICS infrastructure, making more pressing the need for …

The Mouse At The Border: Magic, Money, And Manufactured Identity, Ricardo Manuel Hinojosa

Open Access Theses & Dissertations

This thesis investigates the methods by which The Walt Disney Company constructs and negotiates representations of Latine, gender, and queer identities within contemporary animation, with a particular emphasis on Coco (2017), Encanto (2021), and Wish (2023). Through a critical and intersectional lens, this research posits that Disney strikes a balance between cultural specificity and global market appeal, often leading to representations that are visually elaborate yet narratively limited. Both Coco and Encanto showcase a significant engagement with cultural traditions and themes such as memory and generational trauma; however, they ultimately fall short of thoroughly addressing systemic issues like colonialism and …

Impact Of Campus Leadership Behaviors On Teacher Experiences With Burnout, Carmen Imai

Open Access Theses & Dissertations

Teacher burnout continues to be a significant concern in K-12 education, contributing to emotional exhaustion, decreased job satisfaction, teacher attrition, and negative impacts on student learning. While previous research has examined the causes and symptoms of burnout, less attention has been given to how teachers perceive the role of campus leadership in either mitigating or contributing to burnout experiences. The purpose of this qualitative phenomenological study was to explore how teachers who have experienced burnout perceive the role of campus administrators within that process. The study was guided by three research questions focused on teachers' experiences with burnout, perceptions of …

Microcosms & Warscapes, Heather J. Lathers

Open Access Theses & Dissertations

This poetry collection features sensory-centered writing and common objects, scenes, and interactions to authentically capture the multi-perspective and nuanced experiences of wartime. Detailed language is critical when poets become mouthpieces for those enduring war's pain. Focusing closely on items such as teacups, boots, bones, mud, rice, and rats creates a kind of intimacy not often found in war writing. Specific conflicts addressed include World War I, Vietnam, and The Cambodian Genocide. The poems here, in various forms and voices, aim to spotlight the lost, marginalized, abused, and forgotten-- the much-needed humanity war stories tend to neglect. Ultimately, these pieces seek …

From Instructional Design To Student Experience: Engagement As Designed And Experienced In Asynchronous Graduate Education, Francisco Javier Maldonado

Open Access Theses & Dissertations

The expansion of asynchronous online learning in graduate education has reshaped instructional delivery; however, concerns persist regarding declining student engagement in fully online environments. While faculty often perceive engagement as sustained through structured course design and digital communication strategies, graduate students report experiences of disconnection, diminished motivation, and limited meaningful interaction. This misalignment in perception presents a significant challenge for graduate programs seeking to promote student success and retention. The purpose of this qualitative study is to explore how asynchronous online instructional practices influence graduate student engagement within a Master's-level Higher Education Leadership program. Guided by the Academic Constructs of …

Energy Poverty In U.S.-Mexico Border Communities: A Mixed-Methods Study Of Lived Experiences In El Paso And Laredo, Texas And Quantitative Patterns In Brownsville, Texas, Felipe Israel Martinez

Open Access Theses & Dissertations

Energy poverty in the U.S.-Mexico border region remains understudied, and much of the existing literature overlooks the lived experiences of households in this region. This thesis examines the lived experiences and coping strategies of residents in El Paso and Laredo, Texas, while also analyzing the sociodemographic variables associated with electric disconnection in Brownsville, Texas. The study employs a mixed-methods design that combines a quantitative ZIP code-year panel of electric disconnections in Brownsville, Texas from 2015 to 2024 with 14 qualitative interviews conducted with residents in El Paso and Laredo, Texas who had experienced electric disconnections or shutoff notices. These two …

Numerical Methods For Modeling Darcy-Forchheimer Flow In Heterogeneous Porous Media, Nate Mcnair

Open Access Theses & Dissertations

Classic approaches to modeling fluid flow in porous media rely on Darcy's Law, which assumes a linear relationship between volumetric flow rate and the pressure gradient. However, in recent years, applications such as enhanced geothermal systems have highlighted the need to model nonlinear flow behavior, since experimental and observational data show that, once flow velocity exceeds a certain threshold, the relationship between velocity and macroscopic pressure gradient becomes nonlinear. This requires alternative models that more accurately capture the physical behavior of these systems.The Darcy-Forchheimer model provides one such alternative by introducing a nonlinear velocity-pressure relationship. However, this nonlinearity creates additional …

Process Optimization Of Directed Energy Deposition Via Dmaic Methodology And Lean Manufacturing Principles, Erick Gerardo Molina Castaneda

Open Access Theses & Dissertations

Additive Manufacturing (AM), particularly Direct Energy Deposition (DED), has gained increasing relevance in industrial and research environments due to its capability to manufacture complex geometries and repair high-value components. However, despite its technological advantages, DED processes often lack standardization, clear documentation, and structured workflows, especially in academic laboratories. This research aims to optimize and standardize DED processes through the application of Lean Manufacturing principles using the DMAIC (Define, Measure, Analyze, Improve, Control) methodology. The study was conducted at the Keck Center for 3D Innovation, focusing on pre-printing and printing activities. Key issues were identified. Improvement actions included the implementation of …

Novel Roles Of G-Beta-Gamma Signaling In Microtubule Dynamics And Neurodegeneration, Diana I. Olivas

Open Access Theses & Dissertations

Neurodegenerative disorders (NDDs), including Alzheimer's disease (AD), are characterized by progressive neuronal dysfunction, cytoskeletal disruption, and cognitive decline. Although Tau hyperphosphorylation and neurofibrillary tangle (NFT) formation are classical hallmarks of AD, emerging evidence suggests that microtubule (MT) dysfunction may precede and occur independently of Tau pathology. Understanding upstream regulators of MT dynamics is therefore critical for elucidating early mechanisms of neurodegeneration. Previous work from our laboratory demonstrated that G protein βγ (Gβγ) subunits directly interact with tubulin and promote MT assembly. However, the mechanism of Gβγ signaling in neuronal cytoskeletal stability and neurodegeneration remained poorly understood. The present study investigated …

Linguistic Experiences And Identity Of Mexican-Origin New Teachers In A Rural District In The U.S.-Mexico Frontera, Patricia L. Ocana

Open Access Theses & Dissertations

This qualitative study is developed with the understanding that the linguistic experiences of Mexican-origin new teachers are situated in the socially constructed Institutional Discourses of U.S. schools in la frontera. Discourses that have historically marked Spanish-speaking identities as deficient while privileging English-only norms. Furthermore, the four maestras in this study are considered active agents in their development as bilingual educators and creators of counter-Discourses that affirm the linguistic and cultural identities of their emergent bilingual students. This study looks at Mexican-origin bilingual educators' vivencias as assets that shaped their journeys into the education profession and continue to shape their pedagogical …

Log Anomaly Detection With Parameter-Efficient Tiny Language Models: From Centralized Fine-Tuning To Privacy-Preserving Federated Learning, Isaiah Thompson Thompson Ocansey

Open Access Theses & Dissertations

System logs are a primary source of information for identifying faults, misconfigurations, and security incidents in computing infrastructure. As these logs grow in volume and complexity, manual inspection becomes impractical, and automated detection methods are needed. This thesis investigates how compact language models can be applied to the task of log anomaly detection under two operational conditions: when log data is centralized and when it is located at different data sites.

In the first part, we propose LogTinyLLM, which applies parameter-efficient fine-tuning through Low-Rank Adaptation and adapter-based techniques to adapt tiny language models for identifying contextual anomalies in log sequences. …