Medicine and Health Sciences Commons^™

The Impact Of Tgfβ Conditioning And Socs3 Expression On Cytokine Signal Transduction And Inflammatory Gene Expression In Fibroblasts, Morgan Anderson-Crannage

NYMC Student Theses and Dissertations

Inflammation is a major driver in many aspects of recessive dystrophic epidermolysis bullosa (RDEB) pathology, including impaired wound healing, fibrosis, and potentially cutaneous squamous cell carcinoma development. Fibroblasts, as key stromal cells in the dermis, are responsible for orchestrating inflammatory responses through the secretion of cytokines and chemokines upon stimulation with IL-1α or IL-6. Suppressor of Cytokine Signaling 3 (SOCS3) functions as a negative feedback regulator of cytokine signaling and has emerged as a key modulator of inflammatory responses in immune cells and fibroblasts. Transforming Growth Factor Beta (TGFβ), a known driver of fibrosis in RDEB, has been implicated in …

Increasing Near-Miss Reporting: An Evidence-Based Approach, Rosalud H. Sanchez-Lozada

Doctoral Projects

Near-miss events, defined as errors intercepted before reaching the patient, offer valuable opportunities for learning and prevention, particularly in high-acuity intensive care units (ICUs). Despite the availability of electronic reporting systems and national emphasis on patient safety, near-miss reporting remains inconsistent in many critical care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of a structured educational intervention on near-miss reporting within a cardiovascular intensive care unit (CVICU) at a large academic medical center. A single-group pre–post design was used to examine changes in reporting trends following a three-week intervention that included staff education, leadership …

Imbalance In Wnt: Retinoic Acid Signaling Dysregulates Hox Gene Expression: Implications For Cancer Stem Cell Heterogeneity And Crc Patient Survival, Brian Osmond, Chi Zhang, Pascal K. Kataboh, Caroline O. B. Facey, Lynn M. Opdenaker, Bruce M. Boman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

How HOX transcription factors play a role in the stem cell (SC) origin of cancer is unclear. Our goal is to determine how dysregulation of HOX gene expression promotes colorectal cancer (CRC) development through aberrant SC regulatory mechanisms. We investigated retinoic acid (RA) and WNT signaling because they regulate HOX expression and both pathways are dysregulated in cancer. Previously, we reported WNT and RA pathways are functionally linked, and in CRC, APC mutation generates a WNT:RA imbalance leading to incomplete differentiation and SC overpopulation. We hypothesize that aberrant WNT- and RA-signaling dysregulates HOX expression that contributes to the SC origin …

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Beyond The Ban: Chhaupadi Abolition And The Governance Of Menstrual Autonomy In Western Nepal, Nikita Paudel

Master in Public Policy Theses

This thesis examines how two decades of efforts to abolish chhaupadi have shaped the everyday conditions under which women and girls experience menstruation in western Nepal. Chhaupadi, commonly understood as menstrual seclusion, has been addressed through Supreme Court directives, national policy, criminal law, municipal implementation instruments, hut demolition campaigns, public health programming, and rights-based advocacy. Yet the practice has persisted, adapted, and in some cases moved into less visible spaces. Rather than treating this as a simple gap between law and practice, this thesis asks how abolition efforts themselves have become part of the regulatory regime through which menstruation is …

Dna Strand Breaks By Small Molecules: From Genomic Hazard To Therapeutic Strategy, Clerin John

Honors Scholar Theses

DNA strand breaks are among the most critical forms of genomic damage, arising from endogenous metabolic activity, environmental stress, radiation, and diverse chemical agents. Single-strand breaks and double-strand breaks contribute to genome instability, mutagenesis, carcinogenesis, and neurodegenerative disorders. Cells rely on DNA repair pathways to detect these breaks and initiate repair. In this review, we conducted a comprehensive literature review to systematically compile and examine the mechanisms underlying small-molecule-induced DNA strand breaks. This review highlights the underlying mechanisms by which these molecules interact with DNA and trigger damage. We further discussed the current methods used for detection and quantification of …

Early Neurodevelopmental Outcomes In A Child With Tuberous Sclerosis Complex Treated With Everolimus And Vigabatrin, Sarah Ml Wilson, Megan Samuels, Luana Pimentel, Shelley Varnado, Claire Sartwell, Rosleen Mansour, Deborah Pearson, Hope Northrup, Mary Kay Koenig

Faculty, Staff and Student Publications

Objectives: To report early neurodevelopmental outcomes in a child with Tuberous Sclerosis Complex (TSC) treated with everolimus and vigabatrin.

Methods: The authors report a five-year-old girl with Tuberous Sclerosis Complex who was initiated on vigabatrin at seven weeks old to treat infantile spasms and on everolimus at two months of age to treat a subependymal giant cell astrocytoma. Neuropsychological assessments were conducted in this patient at 12, 24, and 36 months using the Bayley-III and Vineland-II.

Results: On the Bayley-III, the patient had a high average cognitive composite score at 12 months and a high average language composite score at …

Cohort Study Of Opioid Utilization In Post-Tonsillectomy Pediatric Patients, Sainiteesh Maddineni, Varun Vendra, Hareem Khan, Noor Ali, Tulio Valdez, Anna Messner, Iram Ahmad

Faculty, Staff and Students Publications

Objectives: Prospective observational cohort study at a tertiary care academic center to evaluate the post-operative use of oxycodone in pediatric tonsillectomy patients and caregiver knowledge of opioid disposal.

Methods: Pediatric patients 6-18 years old undergoing tonsillectomy were enrolled. Patients were excluded if they required prolonged inpatient care, had a history of organ transplantation, chronic pain or narcotic use, congenital or chromosomal disorders, inability to take acetaminophen or ibuprofen, and other significant medical diagnoses that could potentially alter postoperative pain management. All patients were prescribed a standard amount of oxycodone to be used for breakthrough pain in addition to ibuprofen and …

Measuring Treatment Burden With The Treatment Burden Questionnaire (Tbq): A Narrative Literature Review And Implications For Geriatric Research And Clinical Practice, Jennifer Li-Wang, Sophia Hernandez, Sahana Ramasamy, Lawrence Qu, Jack Banks, Rafael Samper-Ternent, Holly Holmes, Aanand Naik, Dana Giza

Faculty, Staff and Student Publications

Background: Treatment burden refers to the demands that healthcare places on a patient's daily life, including managing appointments, medications, and lifestyle adjustments. It is a critical concern for older adults, particularly those with multiple chronic conditions. High treatment burden has been associated with poorer treatment adherence, increased disruptions in care, and diminished quality of care. The Treatment Burden Questionnaire (TBQ) is a validated tool that has been successfully used to measure treatment burden in a variety of geographic, clinical, and research settings.

Methods: We conducted a narrative literature review to identify studies that have applied the TBQ in older adult …

Caregiving Experiences And Challenges Among Caregivers Of Children With Epilepsy In Thailand: A Qualitative Study, Arthittaya Kaenkrai, Pramote Thangkratok, Pawanrat Panjatharakul, Apasri Lusawat, Moritz Tacke

Journal of Health Research

Background: Childhood epilepsy requires long-term management and places substantial responsibilities on caregivers. In Thailand, limited public awareness and persistent stigma surrounding epilepsy may intensify caregivers’ psychosocial and practical burdens. This study aimed to explore the lived experiences of caregivers of children with epilepsy in Thailand.

Methods: A qualitative study using two semi-structured focus group discussions (FGDs; 5 participants per group) and 15 in-depth interviews (IDIs) was conducted with primary caregivers of children with epilepsy receiving care at a neurological referral institute in Thailand. Participants were purposively selected to capture a diverse range of caregiving experiences. Data were audio-recorded, transcribed verbatim, …

Comparison Of Selected Supply Chain Management Practices Of Three Major Regional/Metropolitan Hospitals, Alan D. Smith

Atlantic Marketing Association Proceedings

No abstract provided.

Investigating Racial Differences In The Receipt Of Antenatal Interventions Prior To Periviable Delivery, Niurka Monteserin, Whitney Bender

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Society for Maternal Fetal Medicine (SMFM) provides guidance on the use of antenatal corticosteroids, antibiotics, and cesarean delivery in the periviable period. Although racial differences exist in postnatal active management of periviable neonates have been described, less is known about racial differences in antenatal interventions preceding delivery.

OBJECTIVE: To evaluate differences in the receipt of antenatal interventions before periviable delivery by birthing parent race.

METHODS:  We conducted a population-based cohort study using the National Center for Health Statistics database including periviable deliveries (20w0d-25w6d) from 2016-2021. Individuals delivering a non-anomalous live singleton gestation in a hospital were included. Births …

Rehabilitation Belief And Engagement Transformation (Rbet) Model: A Grounded Theory Approach, Jade Ibhar V. Cuambot, Marc Eric S. Reyes, Karen Katrina V. Trinidad

Makara Human Behavior Studies in Asia

Competitive sports injuries have significant physiological and psychological consequences for athletes. While rehabilitation medicine effectively addresses the physical aspects of injury recovery, the psychological and emotional journey of injured athletes remains neglected. Thus, the current study addresses this gap by examining athletes’ transforming belief systems and emotional experiences during injury rehabilitation. A qualitative research design grounded in grounded theory principles was conducted with professional athletes to understand how their beliefs toward rehabilitation evolved over time. Findings revealed a dynamic process of belief transformation consisting of seven interconnected stages, captured in the Rehabilitation Belief and Engagement Transformation (RBET) Model: (1) Pre-rehabilitation …

Implementation Of A Nurse-Driven Early Mobility Algorithm In Critically Ill Adults, Andrea Saito

Doctoral Projects

Background: Early mobilization of critically ill patients is recommended in clinical practice guidelines to mitigate ICU-acquired weakness, delirium, and improve recovery. This intervention is inconsistently implemented in many health systems due to a variety of barriers. One frequent barrier is uncertainty regarding whether patients meet safety criteria for mobilization. Purpose: The purpose of this quality improvement project was to implement a nurse-driven early-mobility algorithm with a clinical safety screen in an adult medical-surgical ICU and evaluate its impact on patient mobility scores, delirium rates, and ICU length of stay.​ Methods: The intervention was evaluated using a quasi-experimental before and after …

Demystifying Longitudinal Melanonychia: Low-Cost 3d-Printed Nail Models For Patient Education, Nuran C. Golbasi, Zachary J.K. Neubauer, Nataliedeana Badillo, Shari R. Lipner

Student Papers, Posters & Projects

No abstract provided.

Use Of Tyrx Antibacterial Envelope In Inflatable Penile Prosthesis Surgery: A Prospective Pilot Study., Jack T. Rifkin, Julia A. Baran, Brian H. Im, Tej J. Desai, Jordan Dehoratius, Oleksandr Kolesnikov, Paul Chung

Department of Neurology Faculty Papers

BACKGROUND: Infection remains a major concern in inflatable penile prosthesis (IPP) surgery. Medtronic's TYRX Absorbable Antibacterial Envelope is a polypropylene mesh pocket delivering minocycline and rifampin for 7 days and fully absorbing in 9 weeks. It is currently FDA-approved for use with cardiac pacemakers and neuromodulation devices. There is no indication for use in IPP surgeries, particularly for enveloping the scrotal pump during implantation.

AIM: This pilot study evaluates the feasibility, safety, and early patient-reported outcomes with the use of the absorbable antibacterial envelope during IPP surgery.

METHODS: Fifteen men who underwent primary or revision IPP placement by a single …

Dental Hygienists' Views On Salivary Diagnostics, Julie Justice

Dental Hygiene ETDs

This study assessed dental hygienists’ views on salivary diagnostic testing in the United States, including awareness, utilization, perceived barriers, and whether years of experience, clinical setting, or education level influenced these views. A descriptive cross-sectional design was used to collect data via an 18-item email survey distributed through the American Dental Hygienists’ Association’s mailing list. Eligible participants were licensed dental hygienists currently practicing in the United States. The survey included demographic items and Likert-scale questions on knowledge, clinical use, perceived value, and limitations of salivary diagnostic testing. Survey responses were analyzed using descriptive statistics, frequency distributions and Spearman correlations. Despite …

Policy Concerning Student Use Of Magnification Loupes By American Dental Hygiene Schools, Amye M. Burruss

Dental Hygiene ETDs

This descriptive study was to assess whether dental hygiene schools require students to purchase magnification loupes, at what point in the program they implement the use of loupes, and which type of loupes they require students to purchase. A survey link through Microsoft Forms consisting of nineteen multiple-choice questions was emailed to 327 dental hygiene program directors and was open for a total of three weeks. With a response rate of 13% (45 respondents), results indicate that most dental hygiene programs mandate or strongly encourage the use of magnification loupes and allow students to start wearing loupes in the first …

Tiktok And The Brain: Neuropsychological Correlates Of Short-Form Video Consumption, Caty Enders

Psychology ETDs

Short-form video platforms like TikTok have quickly become the fastest growing segment of social media, thanks to powerful algorithms serving up personalized content driven by large quantities of user data. This study investigates the neuropsychological correlates of digital media use, with a particular focus on TikTok and smartphone screen time among young adults. Combining correlational analyses and an experimental design (n = 49; n = 44 included in final sample), we examined the relationship between digital media use and cognitive and emotional functioning across multiple domains. Objective measures of digital media consumption (daily average screen time and time on TikTok) …

Thoughts From The Pit: Can Raving Change The World? A Literature Review Exploring Rave Culture As Expressive Arts Healing, Marissa Rose Renella

Expressive Therapies Theses

This literature review examines the structural and philosophical commonalities between expressive arts therapy (EXA) and rave culture. Drawing on scholarship from anthropology, cultural studies, health sciences, transpersonal psychology, neuroscience, and expressive arts therapy, this review identifies five core principles shared between the two fields: transformational experiences, multimodality, entrainment and flow, containment and ritual, and community and social action values. Across each principle, the literature reveals not surface-level similarity but deep convergence — two fields that have, independently and through different lineages, arrived at the same understanding of what human beings need in order to heal, grow, and connect. To the …

Re-Painting Motherhood: A Community-Based Expressive Arts Project Exploring Motherhood’S Myths, Realities, And Hopes Through A Narrative Therapy Lens, Lauren Grignaffini-Morris

Expressive Therapies Theses

This thesis examines how socially constructed ideals of motherhood shape maternal identity, distress, and isolation, and explores the potential of addressing these experiences through a community-based expressive arts project. Drawing on motherhood studies, expressive arts therapy, and narrative therapy, the project highlights the potential benefits of utilizing expressive arts in a community setting to ease the tension between romanticized cultural narratives and the lived realities of mothers. Conducted with a support group for mothers in rural Vermont, the project used visual art, movement, creative writing, and collaborative mixed-media painting to examine problem-saturated motherhood stories, connect through embodied experience, and explore …

Playfulness And Awe: How Ecodramatherapy Can Facilitate The Experience Of Positive Emotional States To Reduce Perceived Stress, Corey Jennifer Maier

Expressive Therapies Theses

This paper investigates the question, “can a play and awe-based Ecodramatherapy intervention help to reduce levels of perceived stress in a group of food forest volunteers?” Methods for investigation and subsequent discussion of results draw from the Biophilia Hypothesis, Stress Reduction Theory, and Trait Activation Theory to guide conceptualization. Based on a review of the literature suggesting that playfulness and awe have an effect on both perceived and physiological stress, the author created an Ecodramatherapy intervention designed to evoke playfulness and awe for a group of 4 stressed food forest volunteers. The volunteer group was of mixed ethnicities and genders …

Embodied Identity In Dementia: Art Therapy As A Pathway To Selfhood, Sarah E. Southwick

Expressive Therapies Theses

Older adults living with dementia have often been erroneously perceived as inhabiting a singular lived experience marked by degeneration in cognitive functioning and considerable losses in self-identity. There is substantial literature to suggest that multisensory stimulation and art therapy are well-positioned as conduits for self-expression. However, a gap exists related to artistic media and how they may be implemented and tailored for people with dementia. This capstone explores the paradigm of selfhood as a subjective essence of being that may be accessed through creative expression and sensory engagement. Arts-based directives were implemented through a person-centered expressive arts therapy framework. Two …

Opening Space For Joy: Play As A Pathway In Dance/Movement Therapy With Adults In Addiction Recovery, Brittany M. Walsh

Expressive Therapies Theses

This literature review examines the cultivation of joy through play in dance/movement therapy (DMT) for adults in addiction treatment. Substance use disorders (SUDs) and addictive behaviors are complex, multifaceted conditions influenced by biological, psychological, social, and systemic factors; however, treatment approaches often prioritize symptom reduction and traditional talk-based models. Although necessary, these approaches often fail to honor the whole person, and can inadvertently reinforce shame, stigma, isolation, and dehumanization. Drawing on trauma-informed, neurobiological, relational, and decolonizing frameworks, this review positions joy as a fundamental aspect of human experience and an affirmation of dignity. Playful processes in DMT have the potential …

From Worry To Invention: Developing The Lunch Bunch As A Multimodal Expressive Arts Model For Regulation, Collaboration, And Peer Connection In Elementary Schools, Pascale Lauren Mimran-Ugbabe

Expressive Therapies Theses

This thesis documents the development of the Multimodal Expressive Arts Lunch Bunch, a small group intervention for elementary students delivered during the school lunch period at a public elementary school in Boston, Massachusetts. Grounded in multimodal expressive arts therapy, intermodal transfer theory, polyvagal-informed co-regulation, and principles of externalization, the intervention was designed as a low-barrier creative support group accessible regardless of diagnosis, referral status, or family pursuit of clinical services. Two cohorts of teacher-nominated students, one group of fourth-grade girls and one mixed-gender third-grade group, participated in a sequenced arc moving from worry externalization through collaborative invention, prototype construction, and …

Rhythms Of Hippocampal Function And Memory After Moderate Prenatal Alcohol Exposure, Lilliana May Sanchez

Psychology ETDs

Fetal Alcohol Spectrum Disorders involve morphologic and neurobiological abnormalities in offspring subjected to prenatal alcohol exposure. Although not as well studied as high exposure, moderate prenatal alcohol exposure represents the most common and undetected form in humans. While learning and memory deficits have been well characterized at the behavioral level in humans with Fetal Alcohol Spectrum Disorders and in animal models of moderate prenatal alcohol exposure, few studies have determined the circuit or systems level mechanisms of the behavioral deficits. A complete understanding of the neural bases of memory deficits after moderate prenatal alcohol exposure is needed to ultimately identify …

Urobiome Composition Varies With Vesicoureteral Reflux Grade And History Of Febrile Urinary Tract Infection, Theresa C. Barrett, Kelvin Li, Adam Fitch, Asha Patel, Bhanu Sharma, Jacqueline Holden, Kermina Abdelsayed, Nina N. Kowalewski, Sridhar Narla, Daniel Bushnell, Barbara A. Methé, Catherine S. Forster

Department of Medicine Faculty Papers

Vesicoureteral reflux (VUR) is a risk factor for urinary tract infection (UTI). However, data describing the urobiome in children with VUR are limited. Here, we characterized the urobiome in children with and without VUR to better understand its potential role in VUR pathogenesis. Catheterized urine samples were obtained from children who presented for voiding cystourethrogram (VCUG) between 12/1/2020 and 10/3/2023. Children were excluded if they had any surgical procedures of the genitourinary tract in the 30 days prior to VCUG or were on treatment antibiotics at the time of VCUG. 16S rRNA gene sequencing and taxonomical classification identified the urobiome. …

Pneumomlpred: Innovating Pneumonia Management With Guideline Adherence Review And Explainable Machine Learning-Based Mortality Prediction - A Single-Centre Retrospective Study, Kamel A. Samara, Hiba Jawdat Barqawi, Saryia Adra, Batool Aldaher, Drishti D. Kampani, Enad Haddad, Hebah Soudan, Islam Ibrahim Anwar, Mohamad Besher Adi, Omar Hamadi, Yumna Almour, Mohamed Nassef, Zaher Al Aghbari, Eman Abu-Gharbieh

Abington Jefferson Health Papers

Introduction: Community-acquired pneumonia (CAP) is one of the leading causes of death globally. Changing antibiotic resistance profiles, paucity of reliable CAP mortality prediction models, and ageing populations will increase its burden. This study aims to evaluate adherence to CAP management guidelines as well as develop an ML-based mortality prediction model.

Methods: This retrospective, chart review included all CAP cases between 2016 and 2021. Variables collected included patients' demographics, comorbidities, vitals, laboratory, imaging, and culture findings, as well as initial and targeted antibiotic regimens. Data was pre-processed and analysed in python-3. Adherence to the American thoracic society/infectious diseases society of America …

Improving Health Literacy And Self-Management In Adults With Heart Failure: A Nurse-Led Virtual Intervention In Outpatient Support Groups, Vivian Efosa Osunde

Doctoral Projects

Heart failure is a leading cause of morbidity and hospital readmissions, with limited health literacy contributing to poor self‑management and adherence challenges. The purpose of this Doctor of Nursing Practice project was to evaluate the feasibility and preliminary outcomes of a nurse‑led, virtual education-intervention designed to improve health literacy, self‑care behaviors, and medication adherence among adults with chronic heart failure who participate in an outpatient support group. A quality improvement design was used. Convenience sampling yielded nine adult participants with a documented diagnosis of chronic heart failure who attended at least one virtual support group session. The intervention consisted of …

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …