Digital Commons Network^™

Impact Of Solid Organ Transplant History On Outcomes In Head And Neck Microvascular Reconstruction, Domenica Voli, Sarah R. Harrington, Daniel Uralov, Janvi J. Shukla, Hani Samarah, Marina Aweeda, Krishna Koka, Shaunak Ganju, Kelly Bridgham, Eric V. Mastrolonardo, Arielle G. Thal, Richard A. Goldman, Adam J. Luginbuhl, Larissa Sweeny, Mark K. Wax, Joseph M. Curry

Phase 1

Introduction/Purpose: Free tissue transfer (FTT) is a commonly used technique in head and neck reconstructions. Many factors influence FTT success, including immunosuppression. Patients with solid organ transplants represent a unique population, as the lifelong immunosuppression predisposes them to head and neck cancers and poor wound healing. This study assesses postoperative outcomes and long-term survival in patients with head and neck cancer requiring FTT with a history of solid organ transplant (SOT), compared to matched non-transplant controls.

Methods: Patients with head and neck cancer who underwent FTT were identified in multi-institutional databases and the national TriNetX database. Patients with a history …

Temperature Control Vest For Use In Acute Hyperthermic Episodes, Connor Coyle, David Azizi, Isaac Kravatz, Robert Pugliese, Pharmd

Phase 1

Introduction: In the acute treatment of acute hyperthermia that is treated in austere conditions, there is a lack of a portable, effective, and inexpensive device that can rapidly lower the temperature of the patient back to baseline levels. With rapidly rising global temperatures, we anticipate an increase in acute heat strokes where correction by cooling can save countless lives. We want to create a medical device that is effective in cooling a patient with hyperthermia to increase survival and recovery outcomes. Our main inquiry is whether it is reasonable to design, produce, and test a cooling device that fits within …

A 3d-Printed Enclosure To Improve Precision And Reduce Tearing In Laser Fenestration Of Endovascular Grafts, Tuyaa Bi, Babak Abai, Md, Robert Pugliese, Pharmd

Phase 1

Introduction

In-situ laser fenestration has become increasingly critical in endovascular surgery. However, the higher risk of endoleak and microthrombosis has raised concerns about achieving optimal outcomes.

In a previous study, researchers performed laser fenestration on several commonly used graft materials and compared fabric fraying and directional tear propagation. However, the experimental environment was suboptimal because the fenestration angle was not controlled. This may limit the validity of the results.

In this SI project, we aim to create a more controlled environment for laser fenestration by designing and 3D printing an enclosure that mimics the anatomy of the aorta and the …

Identification Of Socioeconomic And Demographic Predictors Of Somatic Genomic Testing Rates In Prostate Cancer, Erin Welch, Kevin K. Zarrabi, Khaldoun Hamade, Christopher Mcnair

Phase 1

Introduction/Purpose: Somatic genomic testing in metastatic prostate cancer (mPC) identifies genomic variants which provide clinical insight into the disease biology. Somatic testing results determine eligibility for standard of care targeted therapies and clinical trial eligibility. While national guidelines recommend testing for all mPC patients, patients with adverse social determinants of health (SDOH), racial minority groups and patients with low socioeconomic status (SES) have historically undergone lower rates of testing compared to national standards. This study aims to identify barriers to testing in mPC patients in the Jefferson system and ultimately understand the factors that influence testing rates.

Methods: Epic’s clinical …

Progression Of Optic Nerve Head And Macular Parameters From Optical Coherence Tomography In Glaucomatous Eyes With Concomitant Epiretinal Membrane, Alisha Desai, Fabio Lavinsky, Joel S. Schuman

Phase 1

Introduction/Purpose: Epiretinal membrane (ERM) can distort macular and peripapillary architecture, altering optical coherence tomography (OCT)–derived measurements and potentially obscuring glaucomatous progression. The present study aimed to determine whether glaucoma-related structural progression can still be detected over time in primary open-angle glaucoma (POAG) eyes with concomitant ERM by evaluating longitudinal changes in optic nerve head (ONH) and macular parameters. Understanding these changes may reduce the risk of delayed diagnosis and irreversible vision loss.

Methods: This retrospective longitudinal study included adults (>18 years) with POAG and ERM from two tertiary care centers. Eyes with at least three visits were included, while …

Auravena, Isaac Kravatz, Bassem Fayek, Robert Pugliese, Pharmd

Phase 1

Introduction: Over 200 million peripheral IVs are placed annually, serving as critical access points for medications and therapies, yet up to 40% fail on the first attempt. While heat is often used to support IV placement, current methods are insufficient compared to what the literature suggests. Therefore, we asked: how might heat be applied more efficiently and sustainably to improve first-attempt success rates for patients with difficult IV access?

Methods: We began by interviewing nursing staff at an outpatient infusion center, uncovering a significant gap in care for patients with difficult IV access. These insights drove iterative design cycles focused …

Effect Of Als-Associated Ubiquilin-2 Mutation On Autophagy In Ipsc-Derived Neurons, Marina Pilger, Dorothy Benton, Juliet Goldsmith

Phase 1

Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease that progresses to respiratory paralysis and death. Defective protein homeostasis is a major driver of disease pathogenesis, and autophagy, a cellular recycling and degradation system, is often disrupted in disease. UBQLN2 mutation is linked to a small percentage of familial ALS. Despite UBQLN2’s known role in protein homeostasis, the effect of its ALS-associated mutation on neuronal autophagy remains unclear. This study used iPSC-derived excitatory cortical-like (iCN) and lower motor (iLMN) neurons to quantify the effects of the familial UBQLN2 mutation (P506T) on autophagic flux. Live cell imaging and ImageJ were used …

Beyond Naloxone: A Human Centered Overdose Response And Education Kit To Destigmatize Opioid Use Disorder For First-Year Medical Students, Hope Friel, Justin Leggin, Madeleine Peele, Donya Zarrinnegar, Abigail Kay, Md

Phase 1

Introduction: Opioid related deaths are a leading cause of death in adults in the United States and Thomas Jefferson University equips each first year medical student (M1) with a box of Narcan at the White Coat Ceremony. Research has shown that there are knowledge and training gaps in M1s and harmful stigmas surrounding drug users. This project examines how we might provide an education-focused opioid overdose response kit and intervention for JeffMD M1s in order to reduce stigma and improve clinical readiness for drug-related emergencies.

Methods: Class of 2029 M1s will take a pre-post survey to capture the baseline level …

Beyond Naloxone: A Human-Centered Overdose Response And Education Kit To Destigmatize Opioid Use Disorder For First-Year Medical Students, Justin Leggin, Abigail Kay, Md, Madeleine Peel, Hope Friel, Donya Zarrinnegar

Phase 1

Introduction: Opioid overdose remains a leading cause of preventable mortality in the United States and is particularly prevalent in Philadelphia. While first-year medical students commonly receive brief training in overdose recognition and naloxone administration, such instruction often overlooks stigma toward people who use drugs(PWUD). Sidney Kimmel Medical College implemented a two-step model in which students received naloxone at their white coat ceremony and later completed a clinical skills–based overdose response session. This study assessed how this training influenced first-year students’ overdose knowledge and attitudes toward PWUD.

Methods: Students completed the Opioid Overdose Knowledge Scale (OOKS; 0–39)and Opioid Overdose Attitudes Scale …

Beyond Naloxone: A Human Centered Overdose Response And Education Kit To Destigmatize Opioid Use Disorder For First-Year Medical Students, Madeleine Peel, Justin Leggin, Hope Friel, Donya Zarrinnegar, Abigail Kay, Md

Phase 1

Introduction: Over 1,413 unintentional opioid-related deaths occurred in Philadelphia in 2022,indicating a public health crisis. Medical students can assist in overdose responses, driving our question: how might we provide an education-focused opioid-overdose response kit for first-year JeffMD students to reduce stigma and improve clinical readiness for opioid-related emergencies? We hypothesize that a naloxone kit with educational materials will improve preparedness and empathy and reduce stigma toward people who use drugs (PUD) compared with standard naloxone training.

Methods: A needs assessment was conducted among first-year JeffMD’s class of 2029 using pre- and post-surveys administered before and after a naloxone training. Surveys …

Beyond Naloxone: A Human Centered Overdose Response And Education Kit To Destigmatize Opioid Use Disorder For First-Year Medical Students, Donya Zarrinnegar, Justin Leggins, Madeleine Peel, Hope Friel, Abigail Kay, Md

Phase 1

Introduction: The opioid crisis remains a leading cause of accidental death among U.S. adults under 45. Yet, medical education often inadequately prepares trainees to recognize overdoses, administer naloxone, or provide stigma-free care for people who use drugs (PWUD). These gaps contribute to reduced treatment engagement and underutilization of lifesaving interventions. This project examined whether an education-focused opioid overdose response intervention for first-year JeffMD students (Class of 2029) reduces stigma and improves clinical preparedness for drug-related emergencies.

Methods: We administered a baseline survey prior to the White Coat Ceremony and a follow-up survey after a naloxone training. Surveys incorporated validated instruments, …

Impact Of Jackson-Pratt Drain Placement Location On Postoperative Pain In Breast Mastectomy And Reconstruction, Spencer Haber, Bs, Elizabeth Simon, Bs, Krishna Koka, Bs, Devin Williams, Bs, Andrew Newman, Md

Phase 1

Introduction: The Jackson-Pratt (JP) drain is routinely used after breast mastectomy and reconstruction. However, postoperative JP drain usage is associated with an increased incidence of surgical site pain (SSP), which negatively impacts quality of life (QOL). We hypothesize that the anatomical site of JP drain placement relative to major nerve densities leads to variation in SSP and QOL.

Methods: This prospective cohort study will enroll 30 adult female patients undergoing breast mastectomy or reconstruction. Drain placement location will be measured intraoperatively using X, Y coordinates based on midline, anterior axillary line, and jugular notch landmarks. Normalized spatial data will be …

The Correlation Between Pain And Placement Of The Jackson-Pratt Drain In Post-Mastectomy Patients, Krishna Koka, Bs, Elizabeth Simon, Bs, Spencer Haber, Bs, Devin Williams, Bs, Andrew Newman, Md

Phase 1

Introduction

The Jackson-Pratt Drain is a frequently used closed-suction, active drain system that prevents seroma and hematoma formation through negative pressure drainage. Prior research has revealed that some patients report increased surgical site pain that negatively impacts quality of life. We hypothesize that interpatient variability in pain may be associated with the location of drain placement relative to local innervation.

Methods

We are targeting 30 biologically female patients >30 years old undergoing bilateral mastectomy, excluding those with factors affecting chest wall innervation. Drain placement was measured bilaterally along an X-Y axis: X from the mid-axillary line (negative medial, positive lateral) …

The Need For Innovative Changes In The Jp Drain, Devin Williams, Bs, Elizabeth Simon, Bs, Krishna Koka, Bs, Spencer Haber, Bs, Andrew Newman, Md

Phase 1

Introduction: The Jackson Pratt (JP) Drain removes surgical site fluid postoperatively. It prevents surgical site complications, however mastectomy and breast reconstruction patients report varying states of pain and quality of life (QOL) during use. The anterior chest wall is densely innervated and drain placement is not precisely controlled. We hypothesize that placement variation contributes to inconsistent patient outcomes. This prospective cohort study aims to understand the impact of drain placement on pain and QOL.

Methods: The drain sites of 30 patients undergoing breast reconstruction or mastectomy and screened for exclusion criteria are measured intraoperatively using anatomical landmarks. A validated pain …

Creating A Student-Led Volunteer Doula Program At Thomas Jefferson University Hospital, Halleh Radvar, Elizabeth Liveright, Md

Phase 1

Introduction: Despite demonstrated improvement in birth outcomes, continuous labor support with a doula is underutilized due to access limitations. As a large academic medical center in Philadelphia, Thomas Jefferson University Hospital (TJUH) can reduce disparities in access with a student-led volunteer doula program. This project aims to create such a program.

Methods: A literature review was conducted to assess the effectiveness of existing hospital-based volunteer doula programs. Programs at the University of California and the University of North Carolina, as successful programs at academic medical centers, were adapted to be student-run. The program was presented to clinical and nursing leadership …

Chiefcomplaint: An Ai Based Application For Self Regulated Learning And Practicing Clinical Skills, Said Omer Sadat, Jeffrey Ratliff, Md

Phase 1

Introduction: As a constantly evolving field, medicine is prone to change with acquisition of new knowledge and information. As such, medical learners are obligated to practice Self-Regulated Learning (SRL); being behaviorally, metacognitively, and motivationally proactive in the learning process. With this project, we attempt to explore the use of AI as a tool to mimic clinical encounters and advance SRL.

Methods: Python was used to build an application that stimulates patient interactions under guidance of an instructor. Written case scenarios and AI instructions were parsed, chunked and stored into vectors using LangChain. To facilitate the clinician-patient interaction, OpenAI’s ChatGPT-4o-mini was …

The Need For Innovative Changes In The Jp Drain, Elizabeth Simon, Bs, Spencer Haber, Bs, Devin Williams, Bs, Krishna Koka, Bs, Andrew Newman, Md

Phase 1

Introduction: The Jackson-Pratt (JP) drain has been used post-mastectomy since 1980; however, little research has been done regarding the quality of life (QOL) associated with drains. How might we help JP drain patients following mastectomy have increased QOL during drain use? We hypothesize that specific drain placement locations relative to anatomical body wall landmarks correlate with QOL.

Methods: This is a prospective cohort study of thirty female sex patients undergoing breast mastectomy or reconstruction needing bilateral drains and excludes patients with significant confounding variables that interfere with pain data. The surgeon measures the JP drain location after placement in the …

Designing A Multilingual Instructional Language Tool For Patient Communication In Interventional Radiology, Samuel Almodóvar, Ahlam Houssein, Gregg Khodorov, Md, Mba, Sahib Sohal, Md, Robert Pugliese, Pharmd, David Dwyer, Md

Phase 1

Introduction: Current efforts to provide language-inclusive radiological care fall short, resulting in suboptimal imaging, increased procedural time, and greater radiation exposure. Inadequate language accessibility results in poor communication, suboptimal care, and increased patient dissatisfaction. A digital language tool was developed to provide patient instructions during interventional radiology (IR) procedures, addressing this gap and enhancing patient care.

Methods: Observations were carried out to better understand workflow during IR procedures and identify how to incorporate the tool. We conducted interviews with IR physicians, nurses, and technologists to gather common procedural phrases and patient instructions. Spanish and Mandarin were selected because they are …

Aura Vena, Bassem Fayek, Isaac Kravatz, Robert Pugliese, Pharmd

Phase 1

Introduction: Peripheral intravenous (IV) access remains a common problem faced across healthcare, leading to significant healthcare losses in terms of working hours, resources, as well as patient pain and discomfort. At Thomas Jefferson University Hospital’s (TJUH) infusion center, many healthcare workers utilize hot towels and disposable heat packs to warm patients’ arms if IV access is difficult- a wasteful solution that provides limited heating.

Methods: Nurses at TJUH’s infusion center were interviewed to define the problem and identify optimal product requirements for healthcare workers. In conjunction with market research, a heat-warming sleeve is designed and created. The design of the …

Patient Perceptions Of Medicare Annual Wellness Visits: Findings From A Pilot Survey, Payton Mccready, Amy Cunningham, Susan Parks

Phase 1

Purpose

Medicare Annual Wellness Visits (AWVs) were introduced in 2011 to promote preventive care among Medicare beneficiaries, yet patient satisfaction remains understudied. Participating in the  Age-Friendly Health Systems Initiative, Jefferson Health’s Center for Healthy Aging (CHA) is redesigning its AWVs to align with Age-Friendly principles. This study aimed to obtain baseline data on Medicare patients’ familiarity, experience, and satisfaction with AWVs in a geriatrics practice before implementing the redesigned model.

Methods

This cross-sectional survey was conducted in July 2025 at Jefferson Health’s CHA, a geriatrics practice serving about 2,000 Medicare patients. Eligible participants were Medicare-enrolled CHA patients. An eight-item survey …

The Effect Of Prior Work And Educational Experience On Medical School Small Group Case-Based Learning, Alexandra Kelleher, Alisa Losasso, Md

Phase 1

Purpose

Medical students have varied academic and professional backgrounds, many taking gap years in healthcare or research before matriculation. Prior studies suggest these experiences may reduce burnout, enhance patient skills, and improve teamwork capabilities, but their impact on early case-based learning (CBL) performance and perceived comfort level is unclear. This study explores how prior healthcare and research experience influence perceived preparedness and participation for first-year medical students in CBL at SKMC.

Methods

This mixed-methods study was conducted among 66 rising second-year JeffMD students. Participants completed an online 15-item survey assessing undergraduate background and self-reported confidence in CBL. Ten students were …

Understanding The Benefits Of Sustainable Ir Fellowship To A Large Public Hospital In Kenya, Abigael Gebremariam, Kevin Anton

Phase 1

In 2021, Kenya had 10 interventional radiologists for a population of about 54 million. RAD-AID, a non-profit organization improving global radiology, partnered with the University of Nairobi and Kenyatta National Hospital to establish the first IR fellowship program in Kenya in 2021. Through the program, the number of practicing IRs in Kenya has nearly doubled; however, their practice is limited by capital and supply resources. This study will demonstrate the benefit of the program to the hospital system and the patient population in Kenya.

The project employed a retrospective and comparative analysis of IR services at a large public hospital …

Staff Education On Preventing Benzodiazepines Related Falls In Older Adults, Dafnee Gilles

Walden Dissertations and Doctoral Studies

In geriatric psychiatric setting, falls rates are higher than general wards and could reach up to 13-25 falls per 1000 hospital days. High use of benzodiazepines in older adults is a major cause of increased falls despite recommendations to avoid its prescription to the population. This DNP staff education project focused on training nurses working in an 80 bed capacity geriatric psychiatric facility on best evidence based practice of preventing falls associated with use of BZDs. The identified practice issue was knowledge deficit on evidence based best practices to prevent falls in older adults under BZDs medications. The project aims …

Staff Education Project Staff Education To Integrate Nutrition Into Mental Health Care In An Acute Medical Setting, Yolene Auguste

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education initiative designed to support the implementation of a protocol that integrates nutrition and mental health screening in an acute medical setting. The practice problem addressed inconsistent identification of nutrition-related needs and mental health concerns, along with variable follow-through on referral pathways, limiting holistic care and contributing to unmet needs during and after hospitalization. Nutrition and mental health are bidirectionally related, with dietary quality and lifestyle factors influencing mental health outcomes and overall well-being (Dubois & Giroux, 2025). The practice-focused question guiding this project was: In adult patients receiving care …

Teachers And Administrators' Perceptions Of School Resource Officers, Shameka J. Duncan

Walden Dissertations and Doctoral Studies

School Resource Officers (SROs) play a significant role in middle and high schools in Metro Atlanta; however little research has included the perceptions of school administrators and teachers about their roles. The purpose of this descriptive qualitative study was to explore the perceptions of teachers and administrators regarding the roles of SROs and their perspectives on the practices that could enhance collaboration among these stakeholders in ensuring school safety. Informed by Gregory’s theory of perception, the study investigated how educators and administrators described their interactions with SROs. Data was gathered via semi-structured interviews with three teachers and three administrators and …

Exploring Strategies For Leadership In Small Businesses, Edward B. King

Walden Dissertations and Doctoral Studies

Small businesses face challenges in maintaining leadership continuity. Unstable leadership transitions can jeopardize business survival. Business leaders are concerned with selecting qualified succession leadership to avoid increased business costs and operational disruptions. Grounded in replacement planning theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore successful strategies used by business leaders in small Oklahoma enterprises to select qualified leadership successors. The participants were six leaders of small businesses in the U.S. state of Oklahoma who had successful strategies for selecting qualified leadership successors. Data were sourced from semistructured interviews and publicly available organizational documents. Thematic …

Effects Of The Efficient Implementation Of Corporate Finance Strategy On Company Performance, Benjamin Adewale Olugbemiro

Walden Dissertations and Doctoral Studies

The present global business environment requires organizations to be proactive, dynamic, innovative, and resilient in the face of increasing competition. Corporate executives must understand how effective implementation of finance strategies influences performance and how these strategies can be leveraged to support sustainable, socially responsible initiatives. The purpose of this qualitative case study was to improve the understanding of corporate executives’ perspectives about the effects of the efficient implementation of corporate finance strategy on company performance. The conceptual framework included Modigliani and Miller’s capital structure theory, stakeholder theory, and agency theory. The participants comprised 13 senior corporate executives and finance managers …

Patient Characteristics Associated With Telehealth Use In A Large Federally Qualified Health Center, Priyanka Gautom, Cara L. Eckhardt, Lisa K. Marriott, Cirila Estela Vasquez Guzman, Gloria D. Coronado

OHSU-PSU School of Public Health Faculty Publications and Presentations

The COVID-19 pandemic rapidly expanded telehealth services when in-person care was limited. Using primary care data from a large federally qualified health center in Washington state, this study aimed to: 1) describe trends in telehealth use among adult patients, and 2) provide disaggregated patient characteristic data associated with telehealth use, with a focus on patients speaking Asian Indian languages.

Platforms For The Development And Sustainability Of Practice Research In Social Work: An International Cross-Case Analysis, Bowen Mcbeath, Michael J. Austin, Ilse Julkunen, Maija Jappinen, Lynette Joubert, Ralph Hampson, Rosaleen Ow, Lars Uggerhoj

School of Social Work Faculty Publications and Presentations

Purpose:

This paper presents an institutional and organizational comparative case analysis of practice research platforms in social work, which are institutionally embedded partnerships of university-based research centers, organizations delivering social services and healthcare, and other knowledge intermediaries that connect social work practice and research.

Methods:

An institutional and organizational comparative case analysis is presented concerning four practice research platforms from the USA, Finland, Australia, and Singapore.

Results:

We identify similarities and differences in the platforms’ purpose and basic goals, administration and financing, and substantive and methodological foci in the development of social work practice research studies.

Discussion:

We conclude by …

From Strategy To Spectacle: Evaluating The Nfl’S Global Expansion Through Madrid 2025, Nickolas Bruscargin, Emma Steinweiss, Juan Carlos Vazquez-Valderas, Sherry Andre

Faculty and Staff Publications & Presentations

This was a poster presentation based on the inaugural NFL game in Spain. Observational data was collected on site that focused on how the NFL engages fans and adapts culturally to a new international market.