Medicine and Health Sciences Commons^™

Orthosis Versus Surgical Repair Outcomes Of Developmental Dysplasia Of The Hip In Children, Avery G. Hays

The PA Department Journal of Medical Science

Introduction:

            Developmental dysplasia of the hip (DDH) is one of the most common orthopedic malformations in children. Late detection of DDH can lead to more invasive treatment, higher risk of treatment related complications, and long-term sequelae like early onset osteoarthritis. The purpose of this clinical review is to analyze current treatments for DDH and provide a rationale for individualized treatment decisions and future implications.

Methods:

            A PubMed search was preformed using a specific strategy with key terms “developmental dysplasia of the hip,” “orthosis,” “surgical reduction,” and “complications.” Boolean operators and filters were used to narrow the results to 6 relevant, …

Hydroxyurea Versus Chronic Blood Transfusion Therapy For Reducing Vaso-Occlusive Crises In Children With Sickle Cell Disease: A Review Of Current Evidence, Stefanie L. Pertiller

The PA Department Journal of Medical Science

Introduction: Sickle cell disease (SCD) is one of the most common inherited hemoglobinopathies worldwide and is associated with significant chronic morbidity and early mortality in children, underscoring the need for effective long-term disease-modifying therapies. The purpose of this review is to evaluate the current evidence comparing hydroxyurea therapy with chronic blood transfusion therapy in children with sickle cell disease, with particular emphasis on their effectiveness in reducing the frequency of vaso-occlusive crises.

Methods: PubMed was searched with a specific search strategy using key terms “children with sickle cell disease”, “chronic blood transfusion therapy”, and “hydroxyurea therapy”. MeSH terms and Boolean …

Rimegepant For Migraine Prevention: A Review Of Current Evidence, Alexi N. Payne

The PA Department Journal of Medical Science

Introduction:

Migraine is a common neurologic disorder that causes substantial disability and negatively affects quality of life worldwide. This literature review evaluates the current evidence regarding the efficacy, safety, and tolerability of rimegepant for the preventive treatment of migraine.

Methods:

PubMed was searched using the key terms migraine, rimegepant, and prevention. After applying predefined eligibility criteria, five studies were included: two randomized controlled trials, one open-label extension study, one post hoc analysis, and one systematic review.

Results:

Overall, the included studies demonstrated that rimegepant significantly reduced monthly migraine days, improved health-related quality of life and patient-reported outcomes, and was generally …

Prevention Of Chronic Migraine With Injection Medications: Onabotulinumtoxina Vs Monoclonal Antibodies, Jillian Jesser

The PA Department Journal of Medical Science

Introduction: Adults diagnosed with chronic migraine (CM) frequently experience severe pain, nausea, vomiting, sensitivity to light or sound, and blurred vision. All of which are not conducive to routine daily functioning. The purpose of this review article is to explore the efficacy of preventative medications for CM such as OnabotulinumtoxinA injections (onabotA) and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs).

Methods: PubMed was searched using “OnabotulinumtoxinA,” “chronic migraines,” and “monoclonal antibodies”, and related branch terms. The 263 results of this search were reduced to 20 with the following filters: published date 2020-2025, randomized controlled trials (RTCs), systematic review, meta-analysis, free …

Selenium Supplementation For Treatment Of Subclinical Hypothyroidism And Autoimmune Thyroiditis, Lael Smith

The PA Department Journal of Medical Science

Hashimoto's thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regions of the world. It is characterized by autoimmune destruction of the thyroid gland, chronic inflammation, and progressive thyroid dysfunction. Selenium is an essential trace element involved in antioxidant defense of thyroid tissue and has been proposed as an adjunctive therapy. This review evaluates current evidence regarding the effects of selenium supplementation on thyroid function in patients with Hashimoto's thyroiditis and subclinical hypothyroidism. Three peer-reviewed studies, including randomized controlled trials, systematic reviews, and meta-analyses, were evaluated to examine the primary outcome of thyroid function by measurement of thyroid-stimulating hormone …

The Effects Of Low Dose Aspirin And Low Molecular Weight Heparin In Preventing Preeclampsia, Madison A. Deslatte

The PA Department Journal of Medical Science

Introduction: Preeclampsia is a prevalent hypertensive disorder of pregnancy that can lead to increased maternal and neonatal morbidity and mortality. The purpose of this review is to evaluate if low-molecular-weight heparin (LMWH) combined with low-dose aspirin (LDA) is more efficacious in preventing preeclampsia than the standard therapy of LDA alone.

Methods: PubMed was searched with a precise search strategy using key terms “preeclampsia”, “low-dose aspirin”, and “low-molecular-weight heparin”. Filters and operators narrowed the results to 4 relevant and high-quality articles that were used for the review.

Results: Three articles directly compared the use of LDA and LMWH combined to standard …

Restrictive Fluid Resuscitation With Early Vasopressor Initiation Vs Liberal Fluid Resuscitation In Adults With Septic Shock: A Review Of Mortality And Clinical Outcomes, Gabriel Locke

The PA Department Journal of Medical Science

Introduction

Septic shock is a life-threatening medical emergency characterized by profound hypotension, impaired organ perfusion, and significant risk of mortality. While large fluid resuscitation has been considered the commonplace, emerging evidence of increased adverse outcomes has prompted further investigation into restrictive fluid strategies in combination with early vasopressor use.

Methods

PubMed was searched with key terms “septic shock”, “vasopressors”, “norepinephrine”, “restrictive fluid resuscitation”, “liberal fluid resuscitation”, and “mortality”. Operators and filters were implemented such as randomized control trial, systematic reviews, meta-analyses published between 2021 and 2026. After applying these filters. Of the 39 results, 4 articles were selected based on …

Lifestyle Modifications Versus Antihypertensive Therapy: Efficacy In Blood Pressure Control Among Adults With Hypertension, Alexander J. Butler

The PA Department Journal of Medical Science

Hypertension is one of the leading causes of cardiovascular disease and preventable deaths in the United States. Pharmacological treatment remains the standard of care despite challenges such as cost, adherence, and side effects. The purpose of this article is to discover the effectiveness of non-pharmacological treatment in comparison to pharmacological treatment for reducing blood pressure in patients with hypertension. PubMed was searched using key terms such as “HTN,” “antihypertensive,” “antihypertensive agents,” “exercise,” “physical activity,” and “running.” Operators and filters were used to narrow results down to 31 where 4 quality articles were selected for review. Non-pharmacological treatment/lifestyle changes produced reductions …

Treating Adult Adhd: Comparing The Effectiveness And Tolerability Of Stimulant And Non-Stimulant Medications, Sara Dahbour

The PA Department Journal of Medical Science

Introduction: Adult ADHD can impair work, relationships, and quality of life. Stimulants are commonly first-line treatment, but adverse effects, misuse concerns, contraindications, and medication availability can limit use. This review compared stimulant and non-stimulant medications in adults with ADHD for effectiveness and tolerability.

Methods: PubMed was searched using the terms “ADHD,” “stimulant medications,” and “non-stimulant medications.” Filters were applied for English-language, free full-text articles published from 2021 through 2026, including randomized controlled trials, systematic reviews, and meta-analyses. Of 38 filtered results, four articles were selected for relevance to effectiveness, tolerability, adverse effects, and quality of life in adults …

Targeting Downstream Nmda Receptor Pathways In Ischemic Stroke: A Literature Review Of Emerging Adjunctive Therapies, Lauryn P. Pergal

The PA Department Journal of Medical Science

In the United States, an estimated 795,000 people experience a first or recurrent stroke each year.¹ Despite advances in early recognition protocol, reperfusion therapies, and rehabilitation, stroke is still the fourth leading cause of death, after heart disease, cancer, and accidental injury. Ischemic strokes account for around 87% of all strokes.¹ Long-term sequelae of ischemic stroke survivors include disability, dementia, depression, and ongoing fatigue.² As a result, stroke causes decreased quality of life, economic burden, and caregiver stress.

Management strategies for ischemic stroke have evolved considerably over the past several decades. The current acute treatment strategy focuses …

Evaluating Finerenone For Kidney Disease Progression In Patients With Type Two Diabetes And Chronic Kidney Disease, Erin C. Elgas

The PA Department Journal of Medical Science

Introduction: Type two diabetes contributes to chronic kidney disease progression in a multitude of ways within metabolic and hemodynamic factors. Finerenone, a non-steroidal mineralocorticoid receptor antagonist, offers new solutions in slowing or stopping kidney disease progression in type two diabetics. The purpose of this review is to understand if adding finerenone can help slow kidney disease progression in adults with type two diabetes already receiving RAS inhibition.

Methods: A specific PubMed search with keywords including “type two diabetes”, “kidney disease” and “finerenone”, with filters and operators applied, supplied four articles for review.

Results: Finerenone was associated with decreased primary kidney …

The Bidirectional Effects Of Traumatic Brain Injury And Caudal Fin Amputation On Regeneration In Zebrafish (Danio Rerio), Makenna Wiebe

Theses and Dissertations (Comprehensive)

Traumatic brain injury (TBI) and caudal fin amputation initiate robust regenerative responses in adult zebrafish (Danio rerio), yet whether regenerative activity in one tissue influences repair at a distant site remains unclear. This study investigated the bidirectional effects of concurrent brain and peripheral injury on regeneration and functional recovery. Specifically, we assessed the effects of TBI on caudal fin regeneration, caudal fin amputation on neural stem cell-associated cellular responses, and combined injury on behaviour. Adult zebrafish received no injury, TBI, caudal fin amputation, abdominal puncture, or combined TBI and caudal fin amputation. I assessed caudal fin regeneration morphometrically and evaluated …

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

From State To Nation: A Federal Framework For Breast Cancer Primary Prevention Informed By California's Paths To Prevention, Serena Padda

Master's Projects and Capstones

The United States’ federal government should adopt a primary prevention framework for breast cancer modeled after Breast Cancer Prevention Partners’ (BCPP) Paths to Prevention: the California Breast Cancer Primary Prevention Plan. The plan focuses on systemic actions to reduce breast cancer risk through a social and racial justice lens. Breast cancer is the leading diagnosed cancer among women in the United States, with incidence rates increasing annually by 1% since 2012. Disparities persist in communities disproportionately burdened by chemical and environmental exposures, contributing to unequal and preventable risk. Current federal policy focuses primarily on secondary prevention through screenings, which does …

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Deep Brain Stimulation In Early-Stage Alzheimer's Disease: A Systematic Review Of Neuropsychological Outcomes, Nora Huey

Doctoral Dissertations

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory impairment, and disruption of neural networks involved in cognitive functioning. Although existing treatments may provide symptomatic benefit, there remains a need for interventions capable of slowing or stabilizing disease progression. Deep brain stimulation (DBS) has emerged as a potential neuromodulatory intervention for early-stage AD through stimulation of memory- and cognition-related neural circuitry. This dissertation employed a systematic review research methodology to examine teh neuropsychological and neurobiological outcomes associated with DBS targeting the fornix (DBS-f) and nucleus basalis of Meynert (DBS-NBM) in individuals with early-stage AD over 12–24 …

Interplay Of Autophagy And Mtor Signaling On Amyloid-Beta, Samuel Wycoff

WUSM Theses and Dissertations – All Programs

Alzheimer's disease (AD) is characterized by the accumulation of amyloid-β (Aβ), a process thought to result from an imbalance between Aβ production and clearance. Autophagy, a major intracellular degradation pathway regulated by the mechanistic target of rapamycin (mTOR), has emerged as a potential therapeutic target for restoring Aβ homeostasis, although its precise role in Aβ metabolism remains unclear. This study investigated how pharmacological modulation of autophagy and mTOR signaling influences Aβ levels in both in vitro and in vivo models.

Wild-type SH-SY5Y neuroblastoma cells were treated with a panel of autophagy-modulating compounds, and extracellular Aβ secretion was quantified alongside the …

Surveillance And Comparative Genomics Of Bacteria From Hospital And Human Reservoirs, Emily E. Benedict

WUSM Theses and Dissertations – All Programs

Bacteria are diverse and adaptable and, consequently, present in a wide variety of environments. They are capable of growing under intense pressures, including those brought on by the human immune system and disinfection strategies. To survive these pressures, bacteria develop resistances. Antimicrobial resistance, which occurs when a microbe is no longer responsive to the antibiotic intended to control it, is one such adaptation that presents an especially serious threat, as it limits treatment options for infections caused by antimicrobial resistant microbes. Similarly, the ability of bacteria to survive in environments subjected to heavy disinfection efforts, such as intensive care units …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Multiomic And Single-Cell Analysis Of Tumors And Their Immune Microenvironment For Personalized Cancer Therapy, Kartik Singhal

WUSM Theses and Dissertations – All Programs

Precision oncology aims to match cancer treatment to the biology of an individual patient’s tumor. However, tumors that share a diagnosis can differ in their molecular features, cellular composition, clinical course, and response to therapy, making it difficult to determine which treatment will benefit an individual patient. This dissertation integrates genomic, transcriptomic, and single-cell multiomic computational analysis to characterize tumors across their somatic alterations, transcriptional cell states, microenvironment, and the immune response they elicit.

The first study describes a rare case of donor-derived follicular lymphoma following kidney transplantation. Genomic profiling showed that the donor and recipient tumors shared 31 somatic …

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

Proactive Recognition Of Patient Violence Risk: Enhancing Emergency Department Staff Awareness Through Structured Education, Lindsey Frasure

Doctoral Projects

Background: Workplace violence is a significant concern in emergency departments (EDs), where early recognition of behavioral and situational warning signs may help prevent escalation. However, warning signs may be missed, misinterpreted, or recognized too late.

Purpose: This project evaluated a structured educational intervention designed to improve ED staff knowledge of early warning signs and risk factors associated with patient violence. Lewin’s Change Theory guided the project.

Methods: A quasi-experimental pre-/post-intervention design was conducted with 10 ED staff members. Participants completed baseline assessments of knowledge and confidence, received structured education on violence risk factors and early warning signs, and completed post-intervention …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Development Of A Standardized Evidence-Based Onboarding Process For Primary Care Providers In A Rural Health Setting, Corrie Goodier

Doctoral Scholarly Projects & Capstones

Primary care in the United States continues to face a critical provider shortage. This shortage is especially elevated in the rural regions of the country and is exacerbated by longstanding issues with subpar onboarding and high turnover rates. Failure to retain advanced practice providers in rural primary care settings further diminishes patient access to services, negatively impacts continuity of care, and complicates efforts to maintain patient trust in the nation’s delicate healthcare system.

Improved provider orientation and support processes within rural healthcare systems have the potential to increase satisfaction rates and productivity. The purpose of this DNP scholarly project was …