Expanding The Role Of Muscle Stem Cell Fusion In Muscle Under Hypertrophic Stimulus, Jensen Goh Zhong Sheng

Theses and Dissertations--Physiology

Muscle stem cells (MuSCs) are a unique stem cell population that can activate in response to both injury and growth stimuli. Studies on muscle regeneration have shown MuSC activation follows a uniform progression through proliferation, differentiation, and fusion. Therefore, to determine whether MuSC replication is a prerequisite for differentiation under hypertrophic stimulus, I used a lineage-tracking mouse model (Pax7^rtTA; TRE-H2B-GFP) to label MuSC nuclei and simultaneously tracked DNA synthesis via EdU incorporation. This dual-labeling approach allowed us to not only distinguish MuSC-derived nuclei but also demarcate which MuSC had proliferated prior to fusion. I then employed a mechanical …

A Tale Of Two Serpins: Pathologic And Protective Roles Of Agt And Pai-1 In Metabolic And Cardiovascular Disease, Alex C. Pettey

Theses and Dissertations--Physiology

Metabolic and cardiovascular diseases are leading causes of morbidity and mortality worldwide. Conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), aortic aneurysm, and cardiac fibrosis have limited pharmacological therapies, underscoring the need for deeper mechanistic investigations. Serine protease inhibitors (serpins) have been implicated in these pathologies and represent potential therapeutic targets. Despite structural homology, serpins regulate diverse physiological processes through both protease inhibition and non-inhibitory mechanisms. This dissertation examines the roles of two serpins, angiotensinogen (AGT) and plasminogen activator inhibitor-1 (PAI-1), in preclinical models of metabolic and cardiovascular disease to identify novel mechanisms that may inform future therapeutic strategies. …

Investigation Into The A/Ss Of Cervical Cancer And Its Effects On Tumor Control Probability In Radiation Therapy, Cameron Thayer-Freeman

Theses and Dissertations--Radiation Medicine

The standard of care for locally advanced cervical cancer is chemoradiation, consisting of conventional external beam therapy (EBT) followed by a boost of high dose rate (HDR) brachytherapy. These two radiation treatments will illicit different degrees of biological response depending on the tissue in question, and quantifying the overall effect the combined treatments will have require some form of biological modeling. The linear quadratic (LQ) model of cell survival is the most widely used radiobiological model in clinics across the nation.

It is quantified by the parameters a and ß, which model how radiation generates lethal damage in a population …

Outcomes And Implications Of Patients Included Vs. Excluded For Extracorporeal Cardiopulmonary Resuscitation After Initial Activation, Kevin George, Joshua B. Wiener, Michael Zacharias, Frank Forde, Yasir Abu-Omar, Colin Mccloskey

Division of Cardiology Faculty Papers

BACKGROUND: The aim of this study is to describe the implementation of a new Extracorporeal Cardiopulmonary Resuscitation (ECPR) program in Cleveland, Ohio, USA. We also provide a novel comparison of outcomes between patients cannulated vs excluded from cannulation for ECPR after initial field activation.

METHODS: A prospective observational study of ECPR activations between September 2021 and February 2025. Patients meeting initial eligibility criteria for out-of-hospital cardiac arrest (OHCA)-namely based on age, bystander-CPR, and initial shockable rhythm-were transported to the emergency department where the ECPR team completed cannulation based on further biochemical criteria. Medical records were used to collect data after …

A Quality Improvement Project: Nurse-Led Nutritional Support To Reduce Missed Chemotherapy Appointments, Eva Balboa

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction/Background

Malnutrition affects approximately 43% of cancer patients nationally and is associated with missed chemotherapy appointments, treatment interruption, and poor clinical outcomes. At a 30-chair outpatient cancer center in South Texas, a retrospective chart review revealed that 45% of patients experienced malnutrition-related symptoms contributing to appointment disruptions. Despite evidence-based recommendations for routine nutritional screening and support, no standardized protocol existed at this site.

Objectives

 The purpose of this quality improvement project was to implement a nurse-led nutritional support protocol and evaluate its effectiveness in (1) reducing the missed chemotherapy appointment rate from 10% to 5%, (2) achieving 100% compliance with …

A Guideline For Underserved Adult Residents In Need Of Affordable Transportation Access To Healthcare, Tammie E. Walker

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

During the development of the 2022 Tarrant County Public Health Community Health Assessment, two gaps were identified that contribute to disparities: transportation and access to healthcare in areas of high need (Y. M. Wingate, Ed.D., Community Health Assessment Division Manager, Tarrant County Public Health, personal communication, June 20, 2025). As of 2017, 5.8 million individuals reported delaying medical care due to a lack of accessible transportation in the U.S. (Wolfe et al., 2020). The National Health Interview Survey (NHIS) of 2022 reported that 5.9% of residents living in the West South-Central region, which includes Texas, found that, within the …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Sepsis In Sight: Immersive Vr Simulation For Pediatric Training, Kelsey Wagler

DNP Projects

Abstract

Objectives: This project aimed to decrease the time required to administer antibiotics and fluid boluses to pediatric patients with sepsis by implementing a virtual reality (VR) simulation program. The initiative sought to enhance bedside nurses’ and pediatric residents’ knowledge, clinical reasoning, and confidence in sepsis assessment, early recognition, and evidence-based management. A secondary objective was to evaluate the effectiveness of VR simulation as an educational strategy for nurses in a high-acuity pediatric setting.

Design: This quality improvement project used a quasi-experimental design that incorporated a VR simulation intervention followed by a structured debriefing and targeted education session. Participants completed …

Stronger Together: Exploring The Impact Of Peer Support Meetings On Stress And Burnout In Ambulatory Nurse Managers, Sara Wellman

DNP Projects

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. …

Treatment Of Clear Cell Renal Cell Carcinoma (Ccrcc) In Interventional Radiology, Silvia M. Mendoza

Student Research Poster Presentations 2026

This project focuses on clear cell renal cell carcinoma (ccRCC) and the role that interventional radiology plays in treating this form of cancer. Clear cell renal cell carcinoma is the most common form of kidney cancer and is often diagnosed using diagnostic imaging such as CT scans, MRIs, and biopsies. This research includes information explaining what ccRCC is, its common symptoms, prognosis, methods of treatment, and what interventional radiology is. Some forms of treatment include surgery and immunotherapy. The main treatment of this project is minimally invasive ablation therapy. Techniques such as radiofrequency ablation, microwave ablation, and cryoablation use imaging …

Magnetic Resonance Imaging Of Multiple Sclerosis, Olivia Finlay

Student Research Poster Presentations 2026

Magnetic resonance imaging (MRI) is a key tool in the diagnosis and monitoring of multiple sclerosis (MS). MRI allows doctors to see lesions in the brain and spinal cord and track disease activity over time. MS is an autoimmune neuroinflammatory disorder affecting the central nervous system. MS affects an estimated 900,000 people in the United States. MS most often develops in young adults, typically between the ages of 20 and 30. MS can lead to physical disability, cognitive difficulties, and a reduced quality of life. Globally, studies show that the incidence and burden of MS have increased over the past …

Mobile Stroke Units: Improving Stroke Care, Alysha Gargone

Student Research Poster Presentations 2026

This project examines the role of Mobile Stroke Units (MSUs) in improving stroke diagnosis and treatment time in emergency care. Strokes occur when blood flow to the brain is interrupted, requiring rapid evaluation to reduce brain damage and improve patient outcomes. This study focuses on how MSUs, which are specialized ambulances equipped with computed tomography (CT) scanners and trained medical personnel, allow imaging and clinical decision-making to occur before hospital arrival. The project highlights the importance of CT imaging in quickly identifying stroke type, including ischemic and hemorrhagic strokes, which directly impacts treatment selection. MSU workflow allows for faster diagnosis, …

The Effects Of Virtual Reality Interventions On Gait And Balance In Patients With Chronic Stroke: A Systematic Review, Meghan Darrough, Stephanie Layland, Breena Kravchick

Student Research Poster Presentations 2026

Background: Chronic stroke survivors often experience long-term gait and balance impairments that impact their functional abilities and activities of daily living. Emerging interventions, such as virtual reality (VR), are being evaluated on their potential to enhance rehabilitation outcomes.

Objective: This systematic review aimed to evaluate the effects of virtual reality interventions on gait and balance in individuals with chronic stroke.

Methods: Two literature searches were performed in September 2025 and January 2026 using the CINAHL Complete, MEDLINE, and PubMed databases.

Results: Fourteen studies met the inclusion criteria and were categorized based on balance outcome measures (Berg Balance Scale, Tinetti Performance-Oriented …

Computed Tomography: Contrast Induced Acute Kidney Injury, Keileen E. Trochez Tome

Student Research Poster Presentations 2026

Abstract

Computed tomography is a widely used imaging modality in clinical practice due to its ability to produce detailed cross-sectional images of the body. The administration of iodinated contrast agents enhances the visualization of internal structures and diagnostic accuracy. While pre-contrast scans provide important baseline information, contrast enhanced imaging can further aid in the detection of various pathologies. However, the use of contrast media has raised concerns regarding its potential to contribute to acute kidney injury (AKI), a sudden decline in renal function typically identified in changes in creatinine levels and glomerular filtration rate (GFR). This research reviews current evidence …

Contrast-Enhanced Spectral Mammography, Alyza Vega

Student Research Poster Presentations 2026

Contrast-Enhanced Spectral Mammography (CESM) is an advanced breast imaging technique that enhances the detection and characterization of breast lesions, more specifically in patients with dense breast tissue where conventional mammography is limited. This research explores the principles, clinical applications, advantages, and limitations of CESM. The technique utilizes dual-energy imaging combined with intravenous iodinated contrast to highlight areas of increased vascularity, which are often seen with malignancy. CESM provides both anatomical and functional imaging in one efficient examination. Studies demonstrate that CESM offers higher sensitivity and comparable specificity to traditional mammography, with diagnostic performance approaching that of breast MRI while being …

Alignrt In Radiation Therapy, Collin N. Domozych

Student Research Poster Presentations 2026

This project focuses on the implementation of AlignRT, a surface-guided radiation therapy (SGRT) system, and its impact on improving precision, safety, and efficiency in radiation therapy. AlignRT uses real-time 3D surface imaging to monitor patient positioning and detect motion throughout treatment, allowing for accurate and consistent radiation delivery. This study examines how AlignRT enhances clinical workflows by reducing the need for permanent skin markings and limiting additional imaging, ultimately decreasing unnecessary radiation exposure to patients. Emphasis is placed on its role in high-precision treatments such as stereotactic body radiation therapy (SBRT), where even small positional errors can significantly affect outcomes. …

The Effects Of A Core Strengthening Program On Functional Walking Endurance And The Perception Of Fall Risk In Individuals Over The Age Of 65, Melissa Cencetti, Nicole Evanosky, Amber Hackenberg, Angela Shander, Nick Dworetsky, Ryan Zuch, Andrew Layne

Student Research Poster Presentations 2026

No abstract provided.

The Impact Of A Wellness Program Consisting Of Meditation And Dietary Education On The Symptoms Of Parkinson’S Disease: A Protocol, Kylee Cush, Maureen Romanow Pascal, Genevieve Montanye, Arden Mccoy, Jillian Mallon, Mason Hayward

Student Research Poster Presentations 2026

Individuals with Parkinson’s Disease (PD) often experience many motor and nonmotor symptoms that impact their ability to participate in their daily life. This protocol aims to address the symptoms of PD by utilizing complementary strategies to manage chronic stress and unhealthy dietary lifestyles, both of which have been identified as risk factors for PD. This eight-week mixed-design randomized controlled trial will take place at Misericordia University, Rock Steady Boxing Old Forge, and the University of Scranton, and will utilize convenience sampling through flyer outreach. Individuals will be randomized into two groups: group one will complete a whole foods diet as …

Rural Oral Health Access Coordination Program Proposal, Anna Luu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Oral health disparities remain a major public health issue in the United States, particularly in rural Kentucky, with barriers such as limited access to preventive dental services, transportation, and insurance coverage contributing to delayed treatment and worsening oral health outcomes. In response, the proposed Rural Oral Health Access Coordination Program aims to improve care access by strengthening referral systems, integrating oral health screenings into public health settings, and enhancing care coordination for high-risk populations. The program intends to focus on the Kentucky River District Health Department Region, connecting individuals to existing services rather than providing direct clinical care. Expected outcomes …

Perry County Perinatal Access Navigator Program (Pc-Pamp) A Public Health Program Proposal To Improve Timely Prenatal Care Access In Perry County, Kentucky, Amber E. Mcguire-Chun

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Delayed initiation of prenatal care remains a significant public health concern in rural Appalachian communities, including Perry County, Kentucky, where structural barriers such as limited provider availability, transportation challenges, and fragmented referral systems contribute to inadequate access to timely care. This capstone project proposes the Perry County Prenatal Access Navigator Program (PC-PANP), a community-based patient navigation model designed to improve initiation of prenatal care in the first trimester. The program is led by the local health department and leverages partnerships with healthcare providers, the University of Kentucky College of Public Health, WIC, Extension services, and community organizations to support early …

Wastewater Surveillance For Sars-Cov-2 In Rural Kentucky, 2021–2023, James W. Keck, Reuben Adatorwovor, Ann Noble, Savannah Tucker, William Strike, Soroosh Torabi, Mohammad Dehghan Banadaki, Blazan Mijatovic, Steven K. Roggenkamp, Donna Mcneil, Lindell Ormsbee, Scott M. Berry

Family and Community Medicine Faculty Publications

Wastewater testing for SARS-CoV-2 provided useful public health information during the COVID-19 pandemic yet was underutilized in rural communities. We addressed this gap by implementing wastewater surveillance and assessing its performance in 10 communities in Eastern Kentucky. We collected wastewater samples 1–2 times weekly at 10 wastewater treatment plants (WWTPs) from May 2021 until April 2023 and measured SARS-CoV-2 RNA concentrations using polymerase chain reaction testing. We calculated time-lagged correlations between wastewater concentrations and county-level reported COVID-19 cases by site. We developed a generalized linear model to estimate COVID-19 incidence from wastewater SARS-CoV-2 concentrations. The 10 participating WWTPs served 2430 …

Perceptions Of The Proposed Food And Drug Administration Graphic Cigarette Warnings Among Adults Who Smoke On A Nondaily Or Daily Basis: A Within-Subjects Experiment, Bethany Shorey Fennell, Renee E. Magnan, Jennifer I. Vidrine, Damon J. Vidrine

Family and Community Medicine Faculty Publications

Introduction: People who smoke nondaily represent nearly one third of U.S. adults who smoke and experience significant smoking-related morbidity and mortality, yet they are rarely considered when evaluating the efficacy of graphic cigarette warnings.

Method: In October 2019, U.S. adults who smoked nondaily ( n =59) and daily ( n =183) evaluated 13 Food and Drug Administration–proposed graphic warnings and 13 equivalent text-only warnings on the extent to which they elicited understanding, perceived new knowledge, worry about smoking, and discouragement to smoke and were believable. Repeated-measures ANOVA and planned comparisons tested for between-subjects (smoking status) and within-subjects (warning type) effects. …

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Succession Planning As A Tool For Nursing Recruitment, Retention, And Resilience, Natalie Kennett

DNP Scholarly Projects

Background: Healthcare is facing a significant nursing shortage. This shortage not only impacts bedside nurses but also nurse leaders. Succession planning is a method for recruiting, retaining, and building resilience among nurse leaders.

Purpose: This quality improvement project applied principles of succession planning, including leadership education, training, and assessment of leadership retention and resilience.

Methods: Two interventions were implemented in this quality improvement project. The first was an assessment of a modification in nursing leadership organizational structure that was made in 2024 with the purpose of improving succession planning. This evaluation was completed with the use of …

Enhancing Psychiatric Education And Training For Family Nurse Practitioners In Rural Health Settings, Jared Sanders

DNP Scholarly Projects

Abstract

Title: Enhancing Psychiatric Education and Training for Family Nurse Practitioners in Rural Health Settings

Background: Mental health conditions represent a significant and growing proportion of primary care encounters, particularly in rural and underserved regions where psychiatric specialist access remains critically limited. In these settings, Family Nurse Practitioners (FNPs) frequently serve as the sole point of contact for patients presenting with mental health concerns, often without the benefit of embedded behavioral health support or readily available consultation. Despite carrying this clinical responsibility, many FNPs report gaps in formal psychiatric training, particularly in psychopharmacology and diagnostic differentiation, that contribute to variability …

Reducing School Absenteeism In Children With Avoidance Behaviors, Kimberly Carey

DNP Scholarly Projects

Background: Chronic absenteeism and school avoidance are a problem facing schools across the nation following the COVID-19 pandemic. Chronic absenteeism is financially, emotionally, and academically expensive for society. Purpose: This quality improvement project aimed to decrease absences by 50% over a 6-week timeframe when compared to the same timeframe from the previous year. Methods: Utilizing a Plan-Do-Study-Act framework, an intervention based on tracking multi-day consecutive absences and reaching out to families to provide education and support was implemented. At three days of absence, the school nurse would either call the family for absence with unknown etiology or email with an …

Improving Confidence In Certified Registered Nurse Anesthetists In Providing Care For Patients Undergoing Transcatheter Aortic Valve Replacements, Justin Alley

DNP Scholarly Projects

Abstract

Title: Improving Confidence in Certified Registered Nurse Anesthetists in Providing Care for Patients Undergoing Transcatheter Aortic Valve Replacements (TAVR)

Background: Anesthesia staffing for complex, high-risk procedures like Transcatheter Aortic Valve Replacements (TAVR) is challenging due to a national shortage of anesthesia providers and the company's heavy reliance on non-permanent (locum tenens and 1099) Certified Registered Nurse Anesthetists (CRNAs). At this TAVR procedure location, 70% of the team is comprised of non-permanent staff. A lack of specialized training and experience in TAVR procedures led to a decrease in provider confidence and staffing shortages for these critical cases.

Purpose: The primary …

Nurse Leader Burnout: Exploring Ways To Improve Wellness And Resilience, Kimberly Leger Kenney

DNP Scholarly Projects

BACKGROUND: Burnout among nurse leaders is a growing concern, driven by increasing workload, operational demands, and challenges with work-life balance. Addressing burnout is critical to maintaining stability within the leadership team and to delivering high-quality patient care.

LOCAL PROBLEM: Prior to the development of the QI proposal, engagement survey results showed scores 0.11 points below the benchmark in leadership responsiveness, and more than 50 nurse leader positions have turned over in the past 5 years. The specific aims of this project include: 1. 75% of nurse leaders report that they would implement an activity from the toolkit. 2. Fewer than …

“Eres Mujer Y Te Tienes Que Aguantar”: Hispanic Maternal Wellbeing, Stephanie Reyes Bravo

CISLA Senior Integrative Projects

No abstract provided.