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A Longitudinal Analysis on the Environmental and Travel Behavior Effects in Suburban and Urban Areas from Transit-Oriented Development in the Denver Region
No full textTransit-oriented development (TOD) is an established method for reducing greenhouse gas (GHG) emissions and vehicle miles traveled (VMT). TOD strategies include higher density residential housing with retail and commercial mixed-use, and walkable neighborhoods coupled with high-capacity transit services such as commuter or light rail service. The existing literature on TOD and environmental benefits has mostly centered on large, urban core areas, with limited studies evaluating the impacts in suburban communities which this research addresses.
The objectives of my research were threefold: 1) to evaluate how TOD affects the environment, specifically carbon dioxide (CO2) and VMT, differently in suburban and urban TOD zones; 2) to evaluate how commuter travel modes in TOD zones change by age and density level; and 3) to understand how changes in VMT correlate with ridership, density, and commuter travel modes. My research plan included a longitudinal analysis of two rail lines (the A and H Lines) in the Denver Regional Transit District jurisdiction over an approximate 10- and 20-year period between 2009–2022 and 2000–2022 using U.S. Census data. A half-mile buffer around each rail station was used as the TOD zone and was classified by density level and age. I calculated CO2 and VMT based on the average kilograms (kg) of CO2 emission factors per passenger mile and commute distances by travel mode (automobile, bus, rail, bike, and walk) and period.
I hypothesized that urban TOD zones had substantially higher reduced VMT than suburban TOD zones; non-motorized travel alternatives (biking and walking) changed at a higher rate than public transit; and that substantial changes in VMT and traveler behavior required at least 10 years of rail service and maturity. The results revealed that the urban TOD zones saw a reduction in VMT per capita that was two to three times higher than their suburban equivalents. The TOD zones with the oldest stations (built in 1994) saw declines in VMT per capita that were more than double those built in 2006 and 2016. I also determined that it took at least 10 years to reduce the automobile mode share by 10 percentage points. Overall, between 2009–2022, both lines combined saw an increase in CO2 emissions and total VMT of 25% and 35%, respectively, but also saw a decline in VMT per capita of 9%. The significance of these findings stems from the strong correlation between the change in VMT and TOD variables. The policy implications stress the value of cohesive transportation and land use plans at regional and local levels. Moreover, a longitudinal analysis, or before-and-after study, such as this underscores the importance for TOD programs and projects to be monitored and evaluated as they can yield vastly different results by location and typology, and when leveraged with census data can deepen the understanding of commuter travel behaviors by demographic groups.Extension Studie
Thriving from Work Questionnaire Frequently Asked Questions
No full textThe Thriving from Work Questionnaire Frequently Asked Questions document describes thriving from work and the Thriving from Work Questionnaires, as well as what these instruments measure and why measuring thriving from work is important.Version of Recor
Interpret, Improve, Implement, Iterate: Designing and Testing District Implementation of Cooperative Learning
No full textThe Kagan Publishing and Professional Development company (Kagan) provides support in classroom instructional strategies surrounding cooperative learning. This capstone provides an overview of my strategic project, working directly with the founder and one of the executive directors, Dr. Spencer Kagan. The project addressed the question: How might Kagan interpret, improve, implement, and iterate its system-implementation approach to guide partner districts towards successful implementation of cooperative learning instructional strategies?
Despite abundant research supporting effective educational practices, closing the gap between these strategies and their implementation within school systems remains challenging. A second gap exists between existing research-based implementation frameworks and their use by educational consulting organizations. The Strategic Project described in this Capstone aimed to integrate research-based practices from implementation science and institutional theory into Kagan's system implementation approach through an internal design process.
From this project, I share implications: for the education sector, for Kagan, and for myself in my continued development as a leader. For the education sector, implications include the benefits of using shared leadership models to inform design processes, including those involving implementation. For Kagan, implications include the challenges of considering outside research on implementation science, which potentially contradicts the ideas based on the experience of current team members and leaders. Finally, implications for myself include being more assertive in involving key leaders in the cultivation and analysis of emerging ideas from the field, such as implementation science.Educatio
Impact of Post Operative Recovery Pathways on Peri-Operative And Oncologic Outcomes in Head and Neck Squamous Cell Carcinoma Patients
No full textImpact of Enhanced Recovery After Surgery protocols on short term outcomes following Laryngectomy with or without pharyngectomy
An IPTW Analysis
Importance
Enhanced Recovery After Surgery (ERAS) protocols have demonstrated improvements in postoperative outcomes following major head and neck surgical procedures. However, their impact on patients undergoing Total Laryngectomy with or without pharyngectomy, with or without neck dissection and reconstruction procedures (TL ± P) remains unclear.
Objective
To assess the association of ERAS protocol implementation in patients undergoing TL ± P procedures with short-term postoperative outcomes, including length of stay (LoS), incidence of unplanned return to the operating room (RTOR) and readmission in the 30-days following TL ± P, surgical and donor site infections (SSI; DSI), and pharyngocutaneous fistula (PCF) formation, and time to initiation of enteral and oral feeds.
Study Design, Participants and Setting
This was a retrospective cohort study of 240 adult patients who underwent the TL ± P procedures for any indication between January 2016 and June 2023 at a single academic subspecialty hospital in the United States. Inverse probability weighted regression models were used in the analysis.
Exposure
This study compared a cohort of patients who underwent surgery under a site-specific Enhanced Recovery After Surgery (ERAS) protocol, implemented in June 2019, with a historical cohort of patients who received the standard Traditional Recovery After Surgery (TRAS) care.
Main Outcomes and Measures
The primary outcome measures were the postoperative LoS, incidence of readmission and RTOR in the first 30-days following TL ±P. The secondary outcomes were the incidence of SSI, DSI, PCF, and the time to enteral and oral feed initiation.
Results
Among the 240 patients who underwent TL ± P procedures (83 TRAS,157 ERAS) (Mean age 67 years, 82 % Male). The ERAS cohort did not demonstrate significant differences in LoS (ERAS Median 10 days [IQR 8 – 13] vs TRAS Median 9 days [IQR 8 – 15] ; p = 0.53), and 30-day RTOR incidence(21 % vs. 10 %; p = 0.23). ERAS was associated lower incidence of readmission within the first 30-days of TL ± P (TRAS 35 % vs ERAS 26 %; p = 0.05), fewer incidences of surgical site infections (TRAS 48 % vs ERAS 37 %; p = 0.03), with earlier enteral (TRAS : Mean 1.5 days vs ERAS : Mean 1.25 days; p = 0.002) and oral feed initiation (TRAS : Mean 17 days vs ERAS : Mean 12 days; p = 0.005), with no significant differences in the incidence of donor site infections (TRAS 7 % vs. ERAS 10 %; p = 0.17), or pharyngocutaneous fistula formation (TRAS 21 % vs ERAS 16%; p = 0.12).
Conclusion/Relevance
Implementation of site-specific ERAS protocols was associated with earlier enteral and oral feed initiation, fewer incidences of 30-day readmissions and SSI, but was not associated with shorter LoS, RTOR incidence, or short-term complications (DSI, and PCF).
IMPACT OF ENHANCED RECOVERY AFTER SURGERY PROTOCOLS ON SURVIVAL AND PERI-OPERATIVE OUTCOMES IN HEAD AND NECK CANCER SURGERY
AN IPTW WEIGHTED RETROSPECTIVE COHORT STUDY
Importance
Enhanced Recovery After Surgery (ERAS) protocols are widely adopted for their peri-operative benefits across multiple surgical disciplines. However, their association with long-term oncologic outcomes in head and neck squamous cell carcinoma (HNSCC), remains unexplored, especially considering the heterogeneity of tumor subsites.
Objective
To evaluate the association between ERAS protocols and long-term oncological outcomes, and peri-operative metrics, in patients undergoing curative-intent surgery for mucosal HNSCC.
Study Design, Setting, and Participants
This retrospective, single-center cohort study included 389 adult patients with histologically confirmed mucosal HNSCC of the oral cavity, oropharynx, hypopharynx, and larynx who underwent ablative and reconstructive surgery between January 2016 and August 2024 at a tertiary academic medical center. Inverse Probability of Treatment Weighting (IPTW) was use to balance the baseline characteristics between the ERAS and Traditional Recovery After Surgery (TRAS) cohorts.
Intervention/Exposure
Patients were assigned to either an ERAS-based postoperative care pathway (implemented institutionally in June 2019) or a TRAS pathway, determined by the date of surgery.
Outcomes
The main outcomes were 60-month overall survival (OS), loco-regional recurrence-free survival (LRFS), metastasis-free survival (MFS), and disease-free survival (DFS). Secondary outcomes included the rate of starting adjuvant therapy within 8 weeks, time to adjuvant treatment, length of hospital stay (LoS), and 30-day rates of readmission and return to the operating room (RTOR), incidence of surgical and donor site infections (SSI, DSI) and time to initiation of per-oral feeds.
Results
Of 389 patients, 294 received ERAS-based care and 95 received TRAS based care. After IPTW adjustment, baseline characteristics were well-balanced. In the analysis of the entire cohort, no significant association was observed between the ERAS pathway and evaluated survival endpoints (OS : HR 1.09; 95% CI, 0.75,1.56; p = 0.64; LRFS : HR 1.13, 95% CI: 0.76,1.68; p = 0.53; MFS: HR 1.40, 95% CI: 0.83,2.36; p = 0.19 and DFS: HR 1.05, 95% CI: 0.76,1.46; p = 0.75). However, a statistically significant interaction was identified between the recovery pathway and primary tumor site for all survival outcomes (all p 0.001). In site-specific analyses, ERAS was associated with worse survival outcomes for oral cavity cancers (OS HR 1.67; LRFS HR 1.98; MFS HR 2.64 and DFS HR 1.65; all p 0.05). In contrast, an association with improved survival was observed for patients with oropharyngeal and hypopharyngeal cancers (OS HR 0.40; LRFS HR 0.26 and MFS HR 0.30; all p 0.05, and laryngeal cancers(OS HR 0.50; LRFS HR 0.44; MFS HR 0.48 and DFS HR 0.45; all p 0.05. Perioperatively, ERAS implementation was associated with a shorter LoS (median ERAS: 10 vs. TRAS: 12 days; p = 0.05) and lower incidences of RTOR (ERAS: 15 % vs TRAS: 29%; p = 0.003). No statistically significant association was observed between the ERAS and RIOT rate (TRAS: 42% VS ERAS: 45%; p = 0.67), time to initiation of adjuvant treatment (Median - TRAS: 56 days vs ERAS 55 days; p = 0.58), 30- day readmission (TRAS: 29 % vs ERAS: 29%; p = 0.46), post-operative infections [(SSI – TRAS: 58% vs ERAS: 48%; p = 0.37); (DSI - TRAS: 20% vs ERAS: 16%; p = 0.60)] and per-oral feed initiation (Median TRAS: 15 days vs ERAS: 10 days; p = 0.83).
Conclusion/Relevance
In this cohort, the association between ERAS protocols and long-term oncologic outcomes in HNSCC surgery appears to be dependent on the primary tumor site. The implementation of this protocol was associated with survival benefits for patients with oropharyngeal, hypopharyngeal, and laryngeal tumors but with worse survival outcomes among patients with oral cavity cancers. These findings highlight the potential limitations of a "one-size-fits-all" ERAS approach and suggest that the relationship between recovery pathways and oncologic outcomes in HNSCC is complex and may require the development of site-specific protocols.MMSC
House Rules: Urgency, Gridlock and Institutional Culture in North Shore Massachusetts
No full textCape Ann located north of Boston on the Atlantic Coast is widely recognized as a coherent place and cultural destination. Yet, it lacks a co-located administrative boundary within the structures of United States federalism and home rule in Massachusetts. Unlike many other states, Massachusetts does not maintain intermediary governance such as counties. As a result, Cape Ann faces a fragmented landscape for addressing the intensifying pressures of climate uncertainty and aging infrastructure. The absence of the ‘middle scale’ provides a critical lens to understand how territorial identity operates independently of formal jurisdictions. Through an investigation of regionalism and the institutional patchwork in Cape Ann, an organizational logic is developed to assess how these dynamics shape the conversation around practical challenges. This thesis not only describes Cape Ann’s institutional culture but also proposes novel perspectives on regional capacity to navigate gridlock in the face of shared risk and accelerating change.Department of Urban Planning and Desig
Align. Activate. Agitate: Designing a Professional Learning Network for Community and Systems Transformation
No full text“Change happens when a vast number of people come together and defend a vision of the future they’d like to see.”
-Angela Davis, Civil Rights Leader—
The Community Schools strategy is a national reform model with proven results. Yet still, its expansion and sustainability has been hindered for a myriad of reasons, including: lack of awareness, systemic capacity gaps, fragmented implementation, and the lack of supportive legislation and funding. As the United Way of Massachusetts Bay (UWMB), a credible intermediary with a 90-year track record of social impact, joined the movement to expand the Community Schools strategy locally while mobilizing Massachusetts Coalition for Community Schools, the central question was: What role might they play in supporting learning to ground this school improvement reform strategy across the state? .
This capstone proposes three strategic dispositions for intermediaries — Align, Activate, Agitate — and explores the catalytic power at the intersection of professional learning and networks to transform local practice while creating systems change. Grounded in research on effective networks, professional development, intermediary organizations, Mark Moore’s strategic triangle, and my experience as a principal and school district administrator, I designed the Aligned Regional Competencies (ARC) of Learning and Leadership for Community Schools Professionals, a conceptual blueprint for building a Professional Learning Network (PLN) infrastructure. Aligning with the three stages of Community Schools development the ARC guided the PLN’s sequence, coherence, and learning design. This capstone examines these efforts, including the launch and learning from a PLN pilot, and concludes with implications for my own leadership, UWMB’s role as an intermediary, and the sector at large.
Keywords: Professional Learning Network, intermediary, Community Schools strategy, liberatory leadershipEducatio
Architecture of Elsewhere: A Center for Accountability at the Site of Extraction
No full textContemporary building and design practices suffer from an inherent detachment
from the harmful extractive processes that sustain them. To transition
away from a carbon-based economy, architecture must become an
active agent in narrowing the gap between itself and these hidden externalities
elsewhere. The Center for Accountability seeks to address the issue
of elsewhere by offering a new model for hyper-local mine governance in
Minnesota’s Arrowhead Region, where several harmful copper and nickel
mines await regulatory approval. It functions as a regulatory facility that
incentivises best practices, centers local and indigenous knowledge, and
challenges the neoliberal underpinnings of contemporary extraction.
The center not only employs a Federal Land Trust model as its conceptual
framework, but it architecturalizes the many regulatory and supporting
bodies within it in functional and perceptual ways. Regulatory bodies shift,
rotate and float around the user, who is given open access to the facility
through a pedestrian circuit. Visitors may visit the Center to protest mine
operations, collaborate with activists and scientists, or simply eat a meal
alongside mine workers, all while bearing witness to the transforming
landscape around them.
The Center’s largest components - its structure, cladding and foundation
- reuse elements from the abundant shuttered mine facilities that dot its immediate
site, allowing the building’s form to act as a floating datum against
which the landscape might be measured.Department of Architectur
An Introduction to Reinforcement Learning
No full textThis thesis presents a new course textbook on reinforcement learning (RL) with a focus on algorithms and their properties. The textbook is suitable for a one-semester introductory undergraduate course on RL for students with prior experience in basic probability, linear algebra, and multivariable calculus. We systematically cover the fundamentals of Markov decision processes, optimal control, multi-armed bandits, fitted dynamic programming algorithms, policy gradient methods, imitation learning, and tree search-based planning methods. Our contribution to the RL literature is an approachable and concise presentation of core RL algorithms that balances practical considerations with theoretical rigour. Each chapter includes extensive bibliographic notes that survey recent advances. We hope this textbook will equip the reader with a workable mental model for navigating modern RL research.Computer Scienc
Frequentist Properties of Adaptive Bayesian Uncertainty Quantification
No full textAdaptive experiments provide increased flexibility and accuracy when constructing efficient estimators. Examples of such adaptive sampling frameworks include reinforcement learning, multi-armed bandit algorithms, Bayesian optimization procedures, and other dynamic systems. However, the inherent sequential dependency within these adaptive systems makes statistical inference more challenging. In general, adaptive sampling may break many of the useful properties of estimation procedures that hold in i.i.d. sampling contexts, such as consistency and asymptotic normality of the MLE.
In this project, we present a version of the Bernstein von Mises theorem which analyzes the frequentist behavior of the Bayesian posterior distribution. Our result is that under mild assumptions, the posterior distribution is asymptotically normal with mean equal to the MLE and variance equal to the inverse Fisher Information in the adaptive setting. Thus, many positive results shown in adaptive frequentist inference imply that adaptive Bayesian uncertainty quantification is asymptotically valid and statistically efficient from a frequentist perspective. Furthermore, we show that if the number of samples from each treatment goes to infinity, the posterior distribution is asymptotically not dependent on the prior; then, from a Bayesian perspective, a credible interval will be asymptotically valid even if the prior is misspecified, provided the prior's support contains the support of the true parameter distribution.
Our result also gives a counterexample that even in an adaptive setting where the prior is supported on an entire finite-dimensional parameter space and the number of samples from each treatment goes to infinity in a way where Bayesian inference asymptotically does not depend on the prior, the resulting Bayesian uncertainty quantification need not be asymptotically frequentist-valid.Computer Scienc
Bivalent drug repurposing and evolutionary escape modelling
No full textAntimicrobial resistance (AMR) poses a formidable global health challenge, challenging the efficacy of existing antibiotics and necessitating innovative solutions. In this project, an framework to combating AMR through bivalent drug targeting was explored. First, a framework for searching for proteins is described, leveraging the use of FATCAT to search for global and local similarities pairwise between various proteins. Here, two proteins in the folate pathway, folB and folX were found to have striking global similarity, and were chosen for further analysis. Ancestral sequence reconstruction was performed on the proteins to examine the plausibility of a common ancestor, and what such a sequence might look like.
From there, a strategy for virtually screening compounds to find potential candidates that would bind to both folB and folX. A shortlist of compounds was found, at which point \emph{in vitro} experimental validation of the compounds on the proteins was conducted, encapsulating antibacterial growth measurements, IC50 determination, and recovery and overexpression experiments. Many compounds indicated promise in antifolate activity.
Finally, evolutionary models were initialized on data previously available from experiments on folZ. While these models were less than successful, the modularity and ease of iteration makes for easy future improvements, given incoming data from evolution experiments.
Ultimately, a promising workflow has been presented towards developing and/or repurposing therapeutics to combat AMR, providing a roadmap for the development of effective antimicrobial strategies amidst the evolving landscape of resistance.Computer Scienc