Medicine and Health Sciences Commons^™

Pseudoachondroplasia, A Case Report (Preprint), Alec J. Pupo, Connor J. Stinson, Autumn Dye

Internal Medicine Resident Research

No abstract available.

Wearable-Derived Heart Rate Variability Reveals Autonomic Dysfunction In Schizophrenia (Preprint), Alec J. Pupo, Stephanie H. Felgoise

Internal Medicine Resident Research

Autonomic dysfunction has long been implicated in schizophrenia, yet objective physiological markers remain underutilized in psychiatric research. Heart rate variability (HRV), a noninvasive measure of autonomic regulation, is conventionally derived from short electrocardiographic recordings. In this study, we tested whether continuous, wearable-derived HRV can identify physiologic alterations in schizophrenia-spectrum disorders. Using the NIH All of Us database, we analyzed second-level Fitbit heart rate data from 26 individuals with schizophrenia-spectrum diagnoses and 26 matched controls. Frequency-domain analyses focused on ultra-low frequency (ULF), very low frequency (VLF), and truncated low frequency (tLF) bands, given sampling constraints. Schizophrenia participants showed significantly reduced power …

Elevated Neutrophil-To-Lymphocyte Ratios In Schizophrenia: Insights From A Precision Medicine Cohort (Preprint), Alec J. Pupo, Connor J. Stinson, Chinwendu Madukwe, Stephanie H. Felgoise

Internal Medicine Resident Research

Systemic inflammation has been increasingly implicated in the pathophysiology of schizophrenia. The neutrophil-to-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has not been thoroughly investigated in large, demographically-matched schizophrenia cohorts. Using data from the All of Us Research Program, we analyzed participants with schizophrenia (n = 396) matched to controls (n = 396) by sex, race, and age. NLR was calculated as the ratio of each participant’s median neutrophil count to median lymphocyte count across all available measurements, excluding extreme values (NLR > 7). Distribution normality was assessed using the Shapiro–Wilk test, and group differences were evaluated with the …

New Graduate Nurse Professional Perseverance Strategies In A Time Of Crisis, Jennifer E. Smith Edd

Dissertations of Practice

This qualitative grounded theory study examined how new graduate nurses who entered practice just prior to and during the COVID-19 pandemic developed and sustained resilience while navigating extraordinary professional and personal challenges. The study focused on associate degree nurses who graduated between December 2018 and May 2022 and were employed in acute and sub-acute care settings with direct patient care responsibilities, including the care of patients with COVID-19. Data were collected through semi-structured interviews and reflective journal entries and analyzed using open, axial, and selective coding.

Findings revealed that resilience was not a static characteristic but an evolving process influenced …

Beyond Grit: Structural Determinants Of Resilience Among College Women With Children In The U.S., Juliana Kahrs

Dissertations of Practice

This critical quantitative analysis explores how social determinants of health, including basic needs security, caregiving and work responsibilities, healthcare access, discrimination experiences, and institutional support predict resilience among U.S. college women with dependents. Using data from the Spring 2021 ACHA-NCHA III survey (n = 4,417), this study integrated the Health Equity Framework with the Social Ecological Theory of Resilience to examine multilevel influences on resilience. Descriptive analyses highlighted disproportionate burdens among single, first-generation, and racially minoritized groups. Bivariate chi-square tests revealed significant associations between resilience and sense of belonging, basic needs security, employment, healthcare utilization, and self-assessed overall health. Multinomial …

Summary Of: Ai Diabetic Retinopathy Screening In A Primary Care Setting In Rural Maine, Rachel Heuer Md, Emma Daybranch Mph, Anastasia Tsomides Do, Jessica F. Dibiase Mph, Neil Korsen Md, Brian Nolan Md

Northern New England Clinical & Translational Research

Diabetic retinopathy (DR) is the leading cause of blindness globally. Early diagnosis and treatment reduce the risk of vision loss by 98%.

Study found @ "AI Diabetic Retinopathy Screening in a Primary Care Setting in Rural M" by Rachel Heuer, Emma DayBranch et al.

Understanding The Challenges And Satisfaction Among The Medical Professional Preceptors, Cornelia Ko

West Chester University Doctoral Projects

This study evaluates the Penn Medicine Family Medicine Clerkship program through a mixed-methods approach, exploring the challenges and factors influencing the satisfaction of medical professional preceptors when precepting students. A quantitative survey with 54 preceptor participants reveals the top challenges preceptors face: workload, conflicts with patient care, and limited clinical space. Despite this, there is strong support for the program, with 89% of preceptors enjoying the role and 85% expressing willingness to continue to precept for the next three years. Finally, data analysis shows no statistical correlation between preceptor motivation with gender, ethnicity, age group, years of serving, or total …

Infant Health Equity In Oklahoma: A Mixed-Methods Exploration Of Personal, Organizational, Environmental, And Policy Factors Contributing To Black Infant Mortality, Ayesha M. Lampkins

West Chester University Doctoral Projects

Black women experience higher rates of adverse birth outcomes, including infant mortality. There is a gap in the literature on multilevel strategies to achieve infant health equity and engage Black women. This study is unique in that no others have looked at the views of Oklahoma Black women to inform and address infant health equity strategies and utilize these views to provide context to existing infant mortality data. The study research questions are: 1) What views on infant health equity and infant mortality are held by Black women in Oklahoma? 2) What differences exist between Black and White mothers in …

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …

Screening For Relative Energy Deficiency In Sport (Reds) And The Female Athlete Triad In Female Undergraduate Collegiate Athletes: A Quality Improvement Project, Maria A. Marziano

West Chester University Doctoral Projects

This quality improvement (QI) project investigated female collegiate athletes’ knowledge and prevalence of Relative Energy Deficiency in Sport (REDs) and the Female Athlete Triad (Triad). The increase in female athletics brings a growing concern for performance-related health risks, including low energy availability (LEA), menstrual dysfunction, and low bone mineral density (BMD). This study assessed the effectiveness of education and self-screening in identifying at-risk athletes and encouraging resource application for intervention. A mixed-methods design was employed, utilizing retrospective data along with pre- and post-intervention surveys. The study involved 33 female collegiate athletes from lean endurance sports, assessing knowledge, risk factors, and …

Distinguishing Symptoms Of Racial Trauma From Conventional Trauma, Michelle Yoong

West Chester University Doctoral Projects

Trauma research in psychology has traditionally been shaped by a White-centric framework, leading to the underrepresentation of racial and ethnic minority experiences. This study aims to establish racial discrimination as a distinct traumatic stressor with significant psychological consequences by exploring the distinction between racial and conventionally recognized traumatic stressors and posttraumatic stress symptoms (PTSS). It also aims to address inconsistent and exclusionary assessment methodology involving underrepresented racial minority (URM) populations, including the neglect of racial trauma and discrimination measures in trauma research. Participants consisted of URMs who sought enrollment in a clinical trial for opioid use disorder at a community …

A Question For The Ages: The Relationship Between Nurse Staffing And Quality In Appalachian Skilled Nursing Facilities, Eric Jason Pulice

Theses, Dissertations and Capstones

Nurse staffing levels have been shown to have a critical impact on nursing quality in skilled nursing facilities (SNFs). Sociodemographic disparities in Appalachian areas have the potential to impact SNF nurse staffing levels and quality. This study examined the relationship between nurse staffing levels and quality in Appalachian SNFs, as well as compliance with the Biden Administration’s minimum staffing mandates as set forth in CMS-3442-F enacted on June 24, 2024.

The study applied Resource Dependency Theory (RDT) through Donabedian’s Structure-Process-Outcome (SPO) conceptual framework to assess how external resource constraints and regulatory policies impact nurse staffing levels and quality in Appalachian …

Circadian Variation In Mgmt Promoter Methylation And Expression Predicts Sensitivity To Temozolomide In Glioblastoma, Maria F. Gonzalez-Aponte, Yitong Huang, William A. Leidig, Tatiana Simon, Omar H. Butt, Marc D. Ruben, Albert H. Kim, Joshua B. Rubin, Erik D. Herzog, Olivia J. Walch

Mathematics Sciences: Faculty Publications

Purpose Recent studies show that glioblastoma (GBM) is more sensitive to temozolomide (TMZ) in the morning. In cells, inhibiting O6-Methylguanine-DNA-Methyltransferase (MGMT) abolished time-dependent TMZ efficacy, suggesting that circadian regulation of this DNA repair enzyme underlies daily TMZ sensitivity. Here, we tested the hypotheses that MGMT promoter methylation and protein abundance vary with time-of-day in GBM, resulting in daily rhythms in TMZ efficacy.

Methods We assessed daily rhythms in MGMT promoter methylation in GBM in vitro and retrospectively analyzed MGMT methylation status in human GBM biopsies collected at different times of day. Next, we measured MGMT and BMAL1 protein …

Radiographic Assessment Following Maxillary Bone Augmentation Using Patient Specific Titanium Meshes Loaded With Bone Marrow Aspirate Mixed With Xenograft Versus Xenograft Mixed With Autografts Only: A Randomized Clinical Trial, Moataz Bahaa Dr., Ahmed Moustafa Abdelmaksoud Dr., Mohamed Mounir Dr., Yasmin Nassar Prof

Dentistry

Aim: The aim of the study is to evaluate the efficacy of three-dimensional bone augmentation in maxillary atrophied alveolar ridges by comparing the utilization of bone marrow aspirate concentrate along with a mix of autograft and xenograft versus autograft and xenograft alone. utilizing patient-specific titanium meshes. Subjects and methods: Ten patients experiencing severe vertical and horizontal deficiencies in the entire maxillary arch underwent guided bone regeneration. Utilizing specialized software, virtual bone augmentation were performed for the deficient ridge across the entire maxillary alveolus. This process involved generating virtually augmented models to guide the preoperative prebending of titanium meshes. In the …

Validation Of Salivary Proteomic Biomarkers For Early Detection Of Oral Cancer In The Egyptian Population, Dalia Ghalwash, Ahmed M. Ammar, Ayman El-Gawish

Dentistry

Purpose: The present study evaluated the sensitivity and specificity of important proteomic salivary biomarkers; IL-6, IL-8, and sCD44 in the early detection of oral cancer, and any poss associations with risk factors of oral cancer in an Egyptian population Methods: The present investigation was conducted on 100 individuals; 25 healthy controls, 25 patients having oral potentially malignant disorders (OPMDs) with dysplasia; 25 patients having OPMDs without dysplasia, and 25 oral cancer patients. Demographic data modified gingival index, oral hygiene level, and salivary levels of the biomarkers were assessed. Results: Salivary levels of IL-6, IL-8, and sCD44 progressively increased with increased …

Synergistic Potential Of Ivermectin And Doxorubicin In Oral Squamous Cell Carcinoma: An In Vitro Investigation, Dalia Ghalwash, Shereen Nader, Rana Tantawy

Dentistry

Background Doxorubicin (DOX) is widely used in cancer therapy, but its role in oral squamous cell carcinoma (OSCC)is limited by resistance and dose-related toxicities. Ivermectin (IVM), an antiparasitic agent with emerging anticancer properties, may enhance DOX efficacy. This study evaluated the effects of IVM alone and in combination with DOX on OSCC cell lines.

Methods In vitro assays, including MTT viability, apoptosis (Annexin V/PI), cell cycle analysis, RT-qPCR of apoptotic, proliferative, and inflammatory markers, and oxidative stress assays, were performed on HN9 and HEp-2 OSCC cell lines, with OEC as control.

Results IVM reduced cancer cell viability in a dose-dependent …

Heritability And Shared Environmental Effects Of Brain Diseases In 12,040 Extended Families, Janna I R Dijkstra, Marc Hulsman, Lisa Waterink, Henne Holstege, Charlotte E Teunissen, Wouter F L Christiaansen, Bryan A De Jong, Peter Kochunov, Brian Donohue, Marissa D Zwan, Anouk Den Braber, Lisa Vermunt, Sven J Van Der Lee

Faculty, Staff and Student Publications

Brain diseases have complex patterns of genetic and environmental risk factors, and better understanding of these risks is required for more effective prevention strategies. Participants of the Dutch Brain Research Registry provided detailed information on family structure and occurrence of brain diseases. A total of 12,040 participants (73% female, aged 64.9 ± 11 years) provided information on 101,379 family members (53% female, aged 62 ± 25 years). We estimated heritability (h2) of the nine most common brain diseases using polygenic modeling in SOLAR and assessed variations in h2 through bootstrapping; Alzheimer’s disease (AD) (h2 = …

Reunion With A Peer Partner Reduces Pvn Oxytocin Neuron Immunoreactivity In Socially Selective Voles, Nastacia L. Goodwin, Al M. Licata, Kelley C. Power, Kara M. Reitz, Yasmin Kamal, Annaliese K. Beery

Psychology: Faculty Publications

Friendships—i.e. selective peer relationships—are an important aspect of human behavior, but are rare in rodent species. Meadow voles are seasonally social rodents that form non-reproductive social groups in winter/short day lengths that are selective in nature. Across rodents, oxytocin neurons in the paraventricular nucleus (PVN) of the hypothalamus are typically active during socially salient events, including interaction with novel individuals as well as social separation. To assess whether familiar and novel peer interactions produce different patterns of immunolabeling in a species that forms bonds with familiar individuals, we measured oxytocin neuron immunoreactivity and colabeling with the immediate early gene product …

The Contributions Of Language And Inhibitory Control To False Belief Reasoning Over Time, Jill De Villiers, Peter A. De Villiers

Psychology: Faculty Publications

Introduction: The role of language in false belief reasoning has been much debated for twenty-five years or more, especially the relative contributions of general language development, complement syntax, vocabulary, and executive function. However, the empirical studies so far have fallen short, in that they generally have too few participants for adequate statistical modeling; they do not include control variables; or they are cross-sectional rather than longitudinal, making inferences about causal direction much more tenuous.

Methods: The present study considers the role of these different variables in the development of false belief reasoning over several months of testing, with 258 children …

Investigating The Extent To Which Diet-Induced Obesity Alters Gene Expression In Hematopoietic Stem And Progenitor Cells Following Influenza Immunization In Mice, Chaitanya Lahari Chowdary Pathipati

Theses, Dissertations and Capstones

Vaccines are a vital tool in preventing diseases, but their effectiveness varies depending on factors like diet and body weight. Obese individuals often experience reduced vaccine protection, as seen with influenza vaccines, where they have twice the risk of getting the flu compared to healthy-weight individuals after vaccination. This study aims to understand why obesity weakens vaccine effectiveness, focusing on the role of blood-forming stem cells in the bone marrow, known as hematopoietic stem and progenitor cells (HSPCs). These cells are crucial for producing immune cells that defend the body against infections. Previous research has shown that diet-induced obesity alters …

Magnetic And Ph-Sensitive Dual Actuation Of Biohybrid Microswimmer Of Targeted Drug Release Suitable For Cancer Cell Microenvironment, Richa Chaturvedi, Yumin Kang, Yunji Eom, Sri Ramulu Torati, Cheolgi Kim

Center for Bioelectronics Publications

The chemotherapeutic agents most frequently used in cancer treatment often have limited effectiveness because of their low specificity for tumors and poor therapeutic performance. In addition to the aforementioned therapeutic challenges the drug delivery carriers conjugated with the drug encounter early detection and elimination from the immune system before arriving at the affected area continues to be a significant research focus among researchers. To address this prevalent issue, an effective approach has been developed that leverages the physiological differences between normal and tumor tissue to enhance the efficacy of anticancer drugs. This drug delivery system is designed based on pH-sensitive …

Cost-Effective Hierarchical Cobalt Nanostructured Laser-Induced Graphene For Enhanced Uric Acid Detection, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

This study presents an innovative, cost-effective strategy to develop a flexible, enzyme-free biosensor for the sensitive detection of uric acid (UA). Utilizing electrochemically modified cobalt nanostructured on laser-induced graphene electrodes (CoNCs/LIG), this approach surpasses traditional noble metal-based electrocatalysts in sensitivity and affordability. The one-step electrochemical modification method is efficient and straightforward, enabling the uniform deposition of hierarchical flower-like cobalt nanostructures. These structures synergistically enhance the performance of the LIG, resulting in a broad detection range of 5 to 700 µM with a sensitivity of 6.75 µA µM^-¹ cm^-² and a low detection limit of 3.66 µM for UA. …

Reducing Pain Surrounding Im Injections In A Pediatric Outpatient Setting, Tara Sangster

DNP Projects

Background

Many children experience discomfort when receiving routine vaccines via IM injections. The thought of this discomfort can lead to anxiety for the children when visiting their primary care providers. The use of vapocoolant spray prior to IM vaccine administration can help decrease pain/discomfort experienced by children, resulting in increased patient and parent satisfaction.

Project Goals

1. Develop an educational packet reviewing use of topical anesthetics in pediatrics
2. Staff will use vapocoolant spray prior to vaccine administration
3. Children will experience less pain during vaccine administration and parents will feel more satisfied with their child's experience

Methods

Education on the use of …

Endoneurial Immune Interplay In Peripheral Nerve Repair: Insights And Implications For Future Therapeutic Interventions, Alina Sprenger-Svačina, Martin K R Svačina, Husniye G Otlu, Tong Gao, Kazim A Sheikh, Gang Zhang

Faculty, Staff and Student Publications

The mechanisms underlying axonal injury and repair in peripheral nerves, whether due to traumatic damage or autoimmune neuropathies, are complex and not yet fully understood. Recent research indicates that an orchestrated interplay between damaged neurons, Schwann cells, and especially endoneurial immune cells such as macrophages or T cells is crucial to achieve satisfactory nerve recovery. Following axonal injury, degenerating axons and reactive Schwann cells release chemoattractants and cytokines that recruit immune cells into the endoneurium. Among them, macrophages play a pivotal role by clearing axonal and myelin debris and subsequently creating a pro-regenerative microenvironment that supports axonal outgrowth. There is …

From Misinformation To Policy Solutions: Teaching Herd Immunity And Vaccine Hesitancy Through Real-World Case Studies Of Measles Outbreaks, Laurieann Klockow

Biomedical Sciences Faculty Research and Publications

Vaccine hesitancy threatens herd immunity, contributing to the resurgence of measles outbreaks. This lesson engages upper-level biomedical science students in analyzing the complex interplay between vaccination rates, herd immunity and vaccine exemption policies through examination of the 2019 New York measles outbreak that threatened the United States’ measles elimination status. Students critically evaluate anti-vaccine misinformation, analyze epidemiological data and develop evidence-based policy recommendations to increase vaccination rates. The lesson combines team-based learning with authentic assessment through vaccine policy development, moving beyond knowledge acquisition and content to building scientific literacy and evidence-based reasoning skills essential for scientifically literate citizens and future …

Implementing Gallup 12+ Employee Engagement Survey In A Critical Access Hospital, Catherine R. Hardwick

Honors Theses and Capstones

Objective: To utilize the Gallup Q12+ survey to assess baseline staff engagement among nurses and nursing assistants at a critical access hospital, implement direct education intervention, and evaluate its impact on staff engagement rates, with the goal of identifying micro and macro-problems.

Methods: This quality improved project was conducted at Littleton Regional Hospital, a level Ⅲ trauma center and critical access hospital. The PDSA cycle started on March 1 and ended May 10. The Gallup Q12+ survey was sent to Registered Nurses, Licensed Nursing Assistants, and Nursing Technicians to establish baseline staff engagement levels and areas that need improvement. Directed …

Noise In The Acute Care Patient Setting, Taylor A. Cota, Brynn Roberts

Honors Theses and Capstones

Noise levels in hospital environments can negatively impact patient satisfaction and recovery, particularly in high-acuity units such as Progressive Care Units (PCUs) (Choiniere, D. B., 2010). Patient satisfaction surveys at the PCU at Exeter Hospital have consistently identified noise as a concern, highlighting the need for rigorous quality improvement (QI) planning phase to determine whether a structured intervention, such as white noise implementation, is indicated.

This project focuses on the initial planning phase of the Plan-Do-Study-Act (PDSA) cycle (Institute for Healthcare Improvement, n.d.) to assess the feasibility and necessity of introducing white noise machines to enhance patient experience on the …

18s Metabarcode Analyses Of Eukaryotic Species In The Respiratory Microbiomes Of Wild Canids From New Hampshire, Collin Sinclair Blake

Honors Theses and Capstones

This study is of an exploratory nature and focuses on characterizing the eukaryotic microbiota present in the respiratory tissues of six wild canids and one domestic canine. The contents of this document largely pertain to dry lab analyses of 18S barcodes in bioinformatics programs – primarily QIIME2 running in the GitBash command line, service for which was hosted by the UNH Ron Bioinformatics training server. All procedures listed within the section below were performed by second parties at the UNH Hubbard Center for Genomics Studies (HCGS), the New Hampshire Veterinary Diagnostics Lab (NHVDL), and the UNH Microbial Ecology and Emerging …

Implementing A Gerontological Nursing Competencies Programme In Aged Care: Participant Experiences, Victoria Traynor, Nicole Britten, Diane Gibson, Stephanie Munk, Lynn Chenoweth, Jolan Stokes, Tracey Moroney, Karen Strickland, Toni Donaghy, Kasia Bail

Research outputs 2022 to 2026

Aims: To explore the experience of registered nurses and their mentors in the implementation of the Gerontological Nursing Competencies in long-term aged care and the perceived effectiveness and suitability of the programme to support nurse development. Background: The global population is ageing and needs a reliable aged-care nursing workforce. Introduction: Opportunities for education and mentorship for newly qualified and experienced aged-care nurses warrant investigation. Methods: Qualitative evaluation using semi-structured focus groups was conducted following the implementation of the programme into five not-for-profit long-term aged-care organisations and analysed by a reflexive qualitative thematic approach and reported according to COREQ criteria. Results: …

Sleep Discrepancy And Cognitive Function In Community-Dwelling Older Adults, Nadia Soh, Stephanie R. Rainey-Smith, James D. Doecke, Rodrigo Canovas, Romola S. Bucks, Melissa Ree, Michael Weinborn

Research outputs 2022 to 2026

This was the first study to use cluster analysis to characterise sleep discrepancy (the discordance between self-reported and objective sleep) across multiple sleep parameters, in community-dwelling older adults. For sleep efficiency, negative discrepancy (the tendency to self-report worse sleep than objectively-measured) was associated with poorer memory, independent of insomnia severity, depressive symptoms and objective sleep. This suggests a unique role for sleep discrepancy as a possible risk factor for future cognitive decline, and warrants the need for further research.