Medicine and Health Sciences Commons^™

Ocular Surface Disease Following Lasik And Cataract Surgery: A Review Of Their Interrelated Complications, Matthew D. Spangler, Nila Kirupaharan, John D. Sheppard

Department of Ophthalmology Faculty Publications

Background: Ocular surface disease is a multifactorial condition that is very commonly caused by dry eye disease (DED). Ophthalmic procedures intended to improve visual outcomes, laser-assisted in situ keratomileusis (LASIK) and cataract surgery, can paradoxically cause or exacerbate underlying ocular surface disease. This results in worsening vision and quality of life.

Areas covered: This review examines the pathophysiological mechanisms contributing to ocular surface disease development following LASIK and cataract surgery. Both procedures are associated with the transection of corneal nerves, leading to decreased tear production, surface instability, altered neurotrophin production, and impairment of the blink reflex. Furthermore, these incisional procedures …

Development Of A Semi-Mechanistic Population Pharmacokinetic Model For Predicting Tenofovir Disoproxil Fumarate And Tenofovir Alafenamide Exposure In Plasma And Cellular Matrices During Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora Joseph Davey, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Background and Objective

Tenofovir (TFV)-based regimens are backbones of both HIV treatment and pre-exposure prophylaxis during pregnancy. Multiple studies have shown up to one-third decreases in dried blood spot tenofovir-diphosphate concentrations during pregnancy among participants taking tenofovir disoproxil fumarate (TDF). Currently, there are no mechanism-based models describing the pharmacokinetics of tenofovir diphosphate (the active anabolite) in peripheral blood mononuclear cells (PBMCs) of pregnant individuals receiving TDF or tenofovir alafenamide (TAF), and the mechanisms behind observed differences between dried blood spots and PBMCs remain unclear.

Methods

To address this gap, we developed a semi-mechanistic model to simultaneously describe the pharmacokinetics of …

Identifying Relevant Covariates In Rna-Seq Analysis By Pseudo-Variable Augmentation, Yet Nguyen, Dan Nettleton

Mathematics & Statistics Faculty Publications

RNA-sequencing (RNA-seq) technology allows for the identification of differentially expressed genes, which are genes whose mean transcript abundance levels vary across conditions. In practice, RNA-seq datasets often include covariates that are of primary interest in addition to a set of covariates that are subject to selection. Some of these covariates may be relevant to gene expression levels, while others may be irrelevant. Ignoring relevant covariates or attempting to adjust for the effect of irrelevant covariates can compromise the identification of differentially expressed genes. To address this issue, we propose a variable selection method that uses pseudo-variables to control the expected …

Utilizing Machine Learning Techniques For Computer-Aided Covid-19 Screening Based On Clinical Data, Honglun Xu, Andrews T. Anum, Michael Pokojovy, Sreenath Chalil Madathil, Yuxin Wen, Md Fashiar Rahman, Tzu-Liang (Bill) Tseng, Scott Moen, Eric Walser

Mathematics & Statistics Faculty Publications

The COVID-19 pandemic has highlighted the importance of rapid clinical decision-making to facilitate the efficient usage of healthcare resources. Over the past decade, machine learning (ML) has caused a tectonic shift in healthcare, empowering data-driven prediction and decision-making. Recent research demonstrates how ML was used to respond to the COVID-19 pandemic. This paper puts forth new computer-aided COVID-19 disease screening techniques using six classes of ML algorithms (including penalized logistic regression, random forest, artificial neural networks, and support vector machines) and evaluates their performance when applied to a real-world clinical dataset containing patients’ demographic information and vital indices (such as …

Outcomes Of Allogeneic Ocular Surface Stem Cell Transplantation, Albert Y. Cheung, Natalia Quiroz-Casian, Enrica Sarnicola, Gautam C. Ramanathan, Siddharth Nath, Edward J. Holland

Department of Ophthalmology Faculty Publications

Allogeneic ocular surface stem cell transplantation (OSST) is an established therapeutic approach for limbal stem cell deficiency, utilizing techniques such as keratolimbal allograft (KLAL), living-related conjunctival limbal allograft (lr-CLAL), allogeneic cultivated limbal epithelial transplantation (allo-CLET), and allogeneic simple limbal epithelial transplantation (allo-SLET). This review synthesizes evidence from 35 studies encompassing 1, 268 eyes with at least 24 months of follow-up to evaluate intermediate- and long-term outcomes. Overall, OSST is associated with improvement in visual acuity and restoration of ocular surface stability, although success rates vary widely by technique, ranging from 13% to 87%. Outcomes appear to be influenced by the …

Investigation Of Genx Exposure To Pathways Associated With Colorectal Cancer Risk, Emily J. Ferguson

Theses and Dissertations--Toxicology and Cancer Biology

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants widely detected in drinking water and food sources, resulting in chronic human exposure. Among these compounds, hexafluoropropylene oxide dimer acid (HFPO-DA), commonly known as GenX, has been introduced as a short-chain replacement for legacy PFAS such as perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Although GenX is believed to be a safer alternative, emerging research suggests it can still affect human health.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related death in the United States, highlighting the need to better understand environmental …

Production, Characterization, And Diagnostic Application Of Monoclonal Antibodies Against The N-Protein Of Avian Metapneumovirus Subgroup B, Ravi Gupta

Electronic Theses and Dissertations

Avian metapneumovirus (aMPV) is a respiratory pathogen that causes Turkey Rhinotracheitis (TRT) in turkeys and Swollen Head Syndrome (SHS) in chickens. The infection leads to facial swelling, nasal discharge, reduced egg production, and poor growth. This virus is classified into four subgroups: aMPV-A, B, C, and D, with two other novel subgroups, in which aMPV-A, B, and C are most prevalent in the commercial flocks. In early 2024, aMPV-A and B outbreaks have been reported in the US, resulting in severe economic losses. An economic assessment estimates around $112 million in losses in Minnesota and up to $434 million in …

Strong Foundations: Supporting Mental Well-Being In School-Age Youth, Skylar Simpson

Occupational Therapy | OTD Capstone Projects

School-age youth in the United States increasingly face stressors that disrupt their overall mental well-being, highlighting a need for accessible preventative interventions. To address this gap, this doctoral capstone project developed a program titled Strong Foundations: Supporting Mental Well-Being in School-Age Youth, an evidence- and occupation-based program consisting of various interventions designed to enhance the well-being of youth attending a San Francisco Recreation and Park (SFRPD) community-based summer camp. Through embedding occupational therapy-based programming into an environment that currently lacks dedicated mental well-being promotion methods, the Strong Foundations aims to foster mental well-being among school-age youth through occupational engagement that …

Access Resource Guide For Bay Area Cultural Arts Organizations Developed In Collaboration With People With Intellectual And Developmental Disabilities, Clarissa Junio

Occupational Therapy | OTD Capstone Projects

Background: Hidden access barriers persist within cultural arts organizations. As a result, people with IDD continue to experience reduced levels of community participation, limiting the associated benefits to health, well-being, and quality of life. Organizational-level occupational therapy (OT) consultation can address barriers and expand organizational capacity to meet the needs of people with IDD.

Purpose: The project aimed to strengthen organizational capacity of Bay Area cultural arts organizations and expand existing accessibility resources by co-developing a resource guide centered on lived experience to maximize community social participation for people with IDD. The guide was disseminated to cultural arts …

The Role Of Occupational Therapy In Developing Aquatic Programs For Children Diagnosed With Autism, Giavanna Stavros

Occupational Therapy | OTD Capstone Projects

There is a need for inclusion in therapeutic aquatic programming for children diagnosed with autism (ASD), as their increased participation in aquatic interventions and activities promotes safety and well-being for this population. Pediatric occupational therapists (OTs) are vital to fill this gap in skill, as pediatric OTs consistently work with children diagnosed with ASD (Jaicks, 2024), and core principles of the occupational therapy (OT) profession include enhancing one’s safety and well-being (American Occupational Therapy Association (AOTA), 2025). Children diagnosed with ASD must have the opportunity to engage in swimming and aquatic therapy, as this population is at a higher risk …

Sensory Modulation For Adults With Developmental Disabilities: An Occupational Therapy Approach For Adult Day Programs, Aveen Dulai

Occupational Therapy | OTD Capstone Projects

This occupational therapy (OT) doctoral capstone project focused on the development and implementation of a proactive sensory modulation program with the use of Assistive Technology (AT) for adults with Developmental Disabilities (DD) at an adult day program. Adults with DD have diverse needs such as - motor, communication, behavioral, cognitive, and sensory processing challenges. These varying abilities often require AT and environmental adaptations to afford meaningful participation in occupations.  Providing customized and accessible programing for adults with DD arediversity, equity, inclusion, justice and accessibility (DEIJA) issues (Kripke, 2018). Often, adult day programs are limited in OT services, including accessible sensory …

Strengthening Communication And Collaboration Between The Student Support Triad (Teachers, Caregivers, And Health Professionals) In Schools, Jasmine E. Henley

Occupational Therapy | OTD Capstone Projects

Teachers, caregivers, and health professionals, who are key stakeholders that form a student support triad, each face a range of challenges and barriers that impact their ability to communicate and collaborate with one another, therefore impacting the student and their ability to access and participate in meaningful occupations. Though these challenges and barriers for each stakeholder are well-documented individually, there is limited evidence on solutions to strengthen communication across the triad and solutions that center the student and their engagement in meaningful occupations. This project aims to bridge this gap, despite the greater systemic barriers, by developing remedial solutions that …

Sensory Friendly Summers: Designing Inclusive Camp Experiences For Children With Sensory Processing Challenges, Isandla Blanc

Occupational Therapy | OTD Capstone Projects

Children with sensory processing challenges may experience barriers to participation in everyday activities. While summer camps offer opportunities for social development, play, and growth, staff may have limited training and resources to support children with different sensory needs. This can create challenges to participation and inclusion within traditional summer camp environments. The purpose of this capstone project was to develop, implement, and evaluate a staff training program aimed at increasing staff understanding of sensory processing and providing practical strategies to support campers with sensory processing challenges.

A project-level needs assessment was conducted through informal staff conversations, observations of daily camp …

Occupational Therapy’S Role In Promoting An Accessible Playground Environment For Parents With Physical Disabilities, Molly M. Busby

Occupational Therapy | OTD Capstone Projects

Limited implementation of the Americans with Disabilities Act (ADA) accessibility standards and concepts of universal design in the playground environment restrict parents with physical disabilities' engagement in the co-occupation of visiting the playground with their children. The outdoor playground environment promotes the child’s physical, social, emotional, and cognitive development and has positive benefits on the mental health of the parent. Local community park organizations have the power to make accessibility changes to playgrounds in the community but often they lack the knowledge to do so. The purpose of this capstone project is to facilitate increased inclusivity and physically accessible playground …

A Digital Resource To Support Occupational Therapy Fieldwork Students And New Graduates In Applying Occupation-Based Practice In Inpatient Adult Settings, Alyssa Vessel

Occupational Therapy | OTD Capstone Projects

Occupation-based practice is a core concept within the occupational therapy profession. However, Level II fieldwork students and new graduate occupational therapists may struggle to translate their knowledge of occupation-based practice into clinical practice. This doctoral capstone project aimed to support the implementation of occupation-based practice in adult inpatient settings by developing a website with educational and practical resources. Stakeholder needs and existing evidence on barriers and supports to occupation-based practice informed project development. A questionnaire was distributed to Level II fieldwork students, while discussions with new graduate occupational therapists provided an informal needs assessment. Findings guided the development of website …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

A Pull Toward Independence: Improving Pessary Removal Ease And Patient Independence Using Dental Floss, Stephanie Haly

West Chester University Graduate Theses, Dissertations, and Final Projects

Pelvic Organ Prolapse and Stress Urinary Incontinence are the most common medical conditions for prescribing a vaginal pessary. Treating these conditions is vital to improve patient outcomes and quality of life. Treatment options vary from surgical options to less invasive alternatives. Due to various reasons, a patient might opt to avoid surgical management which leaves a vaginal pessary as the next best treatment option. Barriers to pessary self-management are seen frequently and can reduce patient independence and compliance. This quality improvement project sought to answer the following research question: In women using vaginal pessaries for pelvic organ prolapse or stress …

Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

Assessing The Mentorship Role In Neonatal Outcomes, Patricia Juhline Brunner

West Chester University Graduate Theses, Dissertations, and Final Projects

The complex environment of neonatal intensive care requires a skilled, engaged nursing workforce to maintain high‑quality outcomes. Structured mentorship is an evidence‑based strategy shown to enhance professional engagement and support improved clinical outcomes. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of a structured clinical mentorship program on evidence‑based practice beliefs, nurse engagement, and selected neonatal outcomes in a Level III academic intensive care nursery.

Guided by the Donabedian model, the project evaluated structure through mentorship design and preparation, process through mentor–mentee interactions and workflow integration, and outcomes through nursing and patient metrics. Lewin’s change …

Examining The Flow State In College Football, Nicholas R. Reynolds Jr., Selen Razon

West Chester University Graduate Theses, Dissertations, and Final Projects

The flow state, first defined by Csikszentmihalyi (1990) as a state of total absorption in an activity characterized by effortless control, heightened focus, and peak functioning, has been well-documented in sport but has received limited attention in the context of college football. This study examined the flow state experiences of varsity football players at West Chester University, including their awareness of the concept, the frequency and subjective nature of their experiences, the strategies they use to reach this state, and their perceptions of its relationship to team success. A researcher-developed survey was administered to team members during the offseason, yielding …

Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

Legislating Equity: A Qualitative Policy Analysis Of Healthcare Access And Health Literacy In Medically Underserved Communities In New Jersey, Korlu Y. Howard

West Chester University Graduate Theses, Dissertations, and Final Projects

Access to healthcare has always been a major policy challenge in the United States and contributes to ongoing disparities. Reform efforts have focused on expanding insurance coverage, yet less attention has been focused on whether the healthcare system is navigable. This study examines three New Jersey statutes using Kingdon’s Multiple Streams Framework and the Health Equity Framework. The purpose of this examination is to better understand how statutory language shapes healthcare access. The findings show that access is primarily structured through coverage requirements, procedural protections, and established legal rights. At the same time, these systems often involve added complexity, requiring …

Pbms And Exploitation Of America's Prescription Drug System, Ayaan Nihal Unni

A with Honors Projects

This project aims to tackle the issue of America's disproportionately expensive  prescription drug system by tracking the issue to its powerful intermediaries: PBMs. I then analyze procedures both the government and the people can undertake in order to overcome this faulty system.

Wearable Biosensors For Continuous Monitoring Of Chronic Kidney Disease: Materials, Biofluids, And Digital Health Integration, Anupamaa Sivasubramanian, Shankara Narayanan, Gymama Slaughter

Center for Bioelectronics Publications

Chronic kidney disease (CKD) is a progressive and irreversible disorder affecting over 850 million individuals globally and is associated with significant morbidity, mortality, and healthcare burden. Conventional diagnostic approaches rely on intermittent laboratory measurements, including serum creatinine, estimated glomerular filtration rate (eGFR), and urinary albumin, which provide limited temporal resolution and fail to capture dynamic physiological changes. Recent advances in wearable biosensing technologies offer new opportunities for continuous, non-invasive monitoring of biochemical and physiological markers relevant to renal function. This review provides a comprehensive analysis of wearable biosensors for CKD monitoring, focusing on sensing mechanisms (electrochemical, optical, and field-effect transistor), …

Ai-Assisted Surface-Enhanced Raman Spectroscopy For Cardiovascular Diagnostics: From Plasmonic Materials To Clinical Translation, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

Raman spectroscopy (SERS) has emerged as a powerful analytical technique, offering molecular fingerprint specificity and ultrasensitive detection of cardiac biomarkers. Recent advances in plasmonic nanostructures, surface functionalization strategies, and flexible sensing platforms have significantly improved the analytical performance of SERS-based biosensors. In parallel, the integration of artificial intelligence (AI) and machine learning has enabled robust interpretation of complex spectral datasets, facilitating automated biomarker classification and improved diagnostic accuracy in heterogeneous biological environments. Despite these advances, the field remains fragmented, with limited integration between nanomaterial design, biomarker selection, and data-driven analysis, and persistent challenges related to reproducibility, standardization, and clinical validation. …

Modulation Of Prussian Blue Redox Signaling By Molecular Imprinting For Reagent-Free Electrochemical Detection Of Emtricitabine, Abdellatif Ait Lahcen, Gymama Slaughter

Center for Bioelectronics Publications

Reagent-free electrochemical sensors offer significant benefits for rapid, affordable point-of-care drug testing. In this study, we introduce a novel, reagent-free electrochemical sensor based on a molecularly imprinted polymer (MIP) specifically designed for the selective detection of Emtricitabine (FTC), a common antiretroviral used in HIV therapy. The sensor uses laser-induced graphene (LIG) electrodes, renowned for their high conductivity and porosity, ideal for electrochemical sensing. To enable reagent-free operation, the LIG surface was electrochemically coated with Prussian Blue, serving as a redox-active layer. Next, an MIP-PPy film was electropolymerized onto the Prussian Blue surface in the presence of FTC as a template, …

Gender, And Socioeconomic Status In School-Based Speech-Language Pathology Decision-Making For Adolescents With Traumatic Brain Injury: A Critically Appraised Topic, Geneva Renee Toledo

Selected Full-Text Master Theses 2021-

Purpose: Adolescents are at greater risk for traumatic brain injury (TBI), and TBI-related symptoms may contribute to disciplinary actions that increase their risk of entering the school-toconfinement pipeline. Given the disproportionate representation of racially marginalized male adolescents within this pipeline, this critically appraised topic (CAT) examined how race, gender, and socioeconomic status may influence school-based speech-language pathology (SLP) services and clinical decision-making following TBI. Method: A structured search of five electronic databases was conducted to identify studies examining speech-language pathologists’ (SLPs’) clinical decision-making and management of adolescents with TBI in relation to race, gender, and socioeconomic status. Relevant studies were …

The 2025 American Society Of Pediatric Otolaryngology Workforce And Compensation Survey: Current State And Future Directions, Lyndy J. Wilcox, Cristina M. Baldassari, Amy C. Brenski, Emily Boss, John Carter, David H. Chi, William O. Collins, Charles E. Elmaraghy, Andrew J. Tompkins, Craig S. Derkay, The Aspo 2025 Workforce And Compensation Committee

Department of Otolaryngology (ENT) Faculty Publications

Objective

To provide an updated comprehensive assessment of the Pediatric Otolaryngology workforce in the United States inclusive of compensation, productivity, practice patterns, and on-call burden.

Study Design

Cross-sectional electronic survey.

Methods

A structured electronic survey was developed by members of the American Society of Pediatric Otolaryngology (ASPO) Workforce and Compensation Committee. The survey evaluated six domains: demographics, compensation, workforce dynamics, productivity, on-call burden, and future priorities, and was distributed to all 480 presumedly actively-practicing, domestic ASPO members.

Results

The survey response rate was 68% (327/480). Ninety-one percent of respondents held an academic appointment with relatively equal percentages of each rank …

Covid-19 Pandemic-Induced Social Isolation: A Hermeneutic Phenomenological Exploration Of Age And Time, Renee Reedy

Dissertations and Theses

Lockdown measures during the COVID-19 pandemic fundamentally altered social functioning, creating an urgent need to understand the lived experience of isolation across life stages. This qualitative hermeneutic phenomenological study explored how age and time shaped social isolation during the pandemic. Sixteen participants from three-generation households—adolescents (n=5), adults (n=6), and older adults (n=5)—were interviewed approximately five years post-isolation. Recruitment occurred through ResearchMatch, and interviews were conducted between February and March 2025. Participants represented diverse racial, ethnic, and geographic backgrounds, with isolation periods ranging from 27 to 426 consecutive days (¯x = 165 ± 124 days). Data analysis followed Gadamer’s hermeneutic circle …