Digital Commons Network^™

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 …

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 …

Local Rulemaking, Zachary D. Clopton, Marin K. Levy

Duke Law Journal

Any case heard in a United States federal court must adhere to a set of rules—or rather, a few different sets of rules. Regardless of the subject matter of the suit, the parties (and the judge) must follow the relevant Federal Rules. But that is not all. Parties bringing the case must also comply with local rules—those important rules that govern litigation in the space between and around the Federal Rules. These district- and circuit-specific rules govern highly consequential aspects of federal litigation, such as how cases will be assigned to judges, how those cases will then be managed, and …

The End Of Means-End Scrutiny, Francesca Procaccini

Duke Law Journal

It is black-letter law that courts apply means-end scrutiny to evaluate laws that burden constitutional rights. Not anymore. Discreetly and pervasively, the Supreme Court has ousted means-end scrutiny from constitutional law. It has done so through a series of smaller and seemingly unconnected doctrinal incursions, including the introduction of history and tradition tests, the transformation of equality doctrines, and the embrace of formalist rules to govern constitutional law.

This Article provides a complete and interconnected critique of the numerous doctrinal transformations that together comprise the larger constitutional revolution of ending means-end scrutiny. It tracks how this upheaval now touches nearly …

Supervising The Omnipresent Casino: Evaluating The Role Of State And Local Regulation In Stemming Youth Addiction To Sports Gambling, Matthew Connor Flink

Duke Law Journal

Since 2018, state legalization of sports betting and the industry’s corresponding proliferation has driven an epidemic of youth addiction. Current state legislation and regulations do little to combat youth addiction. Many legal scholars emphasize the value that a federal regulatory regime would provide to reign in youth sports betting. This Note explores the value that state and local government can have in the sports gambling space. To illustrate the unique importance of state and local legislation and regulation of sports betting, this Note analogizes to another addictive product with a history of youth addiction: nicotine.

Nicotine has been a regulatory …

"The Persistent And Muddy Dispute": How The Facial/As-Applied Distinction Creates Problems For Constitutional Litigants, Sean P. Wilson

Duke Law Journal

The distinction between facial and as-applied challenges continues to play a central role in constitutional litigation, including at the Supreme Court. Yet, the distinction and its related rules have long suffered from a lack of doctrinal clarity and consistency. This Note sets out a descriptive taxonomy of three problems facing constitutional litigants because of the murkiness surrounding the facial/as-applied distinction.

First, the “Doctrinal-Test Problem” refers to the fact that many constitutional doctrines appear to require the courts to engage in facial adjudication, even if a litigant wishes to bring an as-applied claim. Thus, as-applied litigants are forced into facial challenges, …

Journal Staff

Duke Law Journal

No abstract provided.

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.

Aras V. B-U Realty Corp.

All Decisions

In this overcharge case, the Court of Appeals clarified the standard for applying the fraud exception to the Rent Stabilization Law's four-year lookback period. The court reiterated that a tenant need not prove every element of common-law fraud to invoke the exception. Instead, a tenant must only demonstrate "sufficient indicia of fraud" or a "colorable claim of a fraudulent scheme." The Court reversed the lower court's order, which had incorrectly applied a stricter common-law fraud standard, and remitted the case to the Appellate Division for reconsideration under the proper, more lenient standard, significantly favoring the tenant's ability to pursue their …

Mapping The Pathology Competencies For Medical Education (Pcme) To The Sidney Kimmel Medical College’S Jeffmd Gi Curriculum, Emma Sanders, Alexander Macnow, Md, Mhpe

Phase 1

Introduction/Purpose: Sidney Kimmel Medical College’s competency-based curriculum, JeffMD, is structured around SMART objectives. However, evaluation of the alignment of these objectives against the PCME, a collection of graduation competencies published by the Association for Academic Pathology, has not yet been performed. This study investigated how comprehensively the GI/Liver block of the JeffMD curriculum addresses the corresponding PCME learning objectives, thereby piloting a pathology curriculum map and allowing evaluation of this curriculum.

Methods: In this study, a curriculum map was created of all learning events covered within the JeffMD GI/Liver block. Each learning event was cross-matched with competencies within the gastrointestinal …

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 …

Interviewing Rural Primary Care Physicians To Inform Learning Objectives For A Rural Health Curriculum, Luke May, Caleb Gayman, Robert J. Motley, Md, Mhcds

Phase 1

Introduction/Purpose: Pennsylvania has a large rural population with too few physicians to meet medical needs. The Physician Shortage Area Program (PSAP) at SKMC works to address the shortage of primary care physicians in rural Pennsylvania. To adequately prepare future rural physicians, this project sought to obtain input from practicing PSAP graduates to inform learning objectives for a future curriculum intervention for preclinical PSAP students.

Methods: The target learner population is preclinical PSAP students at SKMC. A codebook was generated based on SKMC Graduation Competencies. Semi-structured interviews with PSAP graduates were conducted via video call, focused on those graduates practicing primary …

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 …

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 …

Interviewing Rural Primary Care Physicians To Inform Learning Objectives For A Rural Health Curriculum, Caleb Gayman, Luke May, Robert J. Motley, Md, Mhcds

Phase 1

Introduction/Purpose: There is a significant shortage of physicians in rural Pennsylvania. Programs like the Physician Shortage Area Program (PSAP) at SKMC aim to address this gap by providing support and guidance for medical students who grew up in rural areas and hope to return to practice in a rural area. This project focuses on identifying rural health topics and modes of delivery recommended by practicing primary care physicians to inform new learning objectives (LOs) for a future curriculum intervention for first and second-year medical students.

Methods: SKMC PSAP graduates practicing in rural areas were interviewed using semi-structured interviews that included …

Artificial Intelligence In Case-Based Learning: A Survey Of Student Current Practices In Small Group Self-Directed Learning Pedagogy, Clarice Pamplona, Joshua Kim

Phase 1

Introduction: Although Artificial Intelligence (AI) is expected to become an essential clinical tool, its incorporation into the undergraduate medical curricula is disproportionately lacking. Notably, limited research remains on medical student use and perspective on AI, specifically within small-group learning settings. This study explores AI use and perspectives among medical students within Case-Based Learning (CBL) groups at Sidney Kimmel Medical College (SKMC) with the aim to establish a formal AI curriculum.

Methods: The population studied includes the Class of 2028 at SKMC. An anonymous Qualtrics survey was distributed within the class Group Me between April and May 2025, exploring student demographics, …

Final 2022 Unreclaimed Sites Sampling: Ur-28 Site Evaluation Summary Report, Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Dynamic Soliton Solutions And Stability Analysis Of The (2+1)-Dimensional Wazwaz Kaur Boussinesq Equation Using An Efficient Method, Nivan Mohamed Elsonbaty, Hamdy Mohamed Ahmed, Niveen Mohamed Badra, Wafaa B. Rabie

Basic Science Engineering

This paper presents the first application of the Modified Extended Direct Algebraic (MEDA) method to the (2+1)-dimensional Wazwaz-Kaur-Boussinesq equation, a model governing wave dynamics in shallow waters. The approach successfully uncovers previously unreported classes of exact solutions, including combo dark–singular solitons and Jacobi elliptic function solutions. The spectrum of obtained solutions–which also encompasses bright, dark, and singular solitons, as well as hyperbolic, periodic, exponential, and rational functions–reveals rich and complex soliton dynamics. A comprehensive stability analysis confirms the robustness of these solutions under perturbation. These results significantly advance the understanding of wave propagation in nonlinear systems, providing valuable insights for …

Newsletter 2026.02.11, Fcrh Honors Program

What's Going On, Honors? (2025-26)

No abstract provided.