Digital Commons Network^™

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

Standardized Screening And Monitoring Of Bioidentical Hormone Replacement Therapy In Women Ages 35–50, Amanda Ellen Hampton

Walden Dissertations and Doctoral Studies

In this quality improvement project, I evaluated a pilot implementation of a standardized bioidentical hormone replacement therapy (BHRT) screening and monitoring tool embedded within the electronic health record (EHR) at an integrative medicine practice in the southeastern United States. Grounded in the Johns Hopkins evidence based practice (EBP) model, the project addressed a documented gap in consistent screening, initiation, and monitoring of hormone replacement therapy (HRT) for women ages 35 to 50 presenting with menopausal symptoms. The practice focused question examined whether a standardized, EHR embedded BHRT screening and monitoring tool could improve screening rate compliance, laboratory monitoring adherence, and …

Validation Of Next‑Generation Sequencing‑Derived Circulating Mrna Variants As Potential Diagnostic Tools In Hepatocellular Carcinoma And Cholangiocarcinoma, Daniel Zezulinski, Maarouf A. Hoteit, David E. Kaplan, Tingting Zhan, Cataldo Doria, Timothy M. Block, Aejaz Sayeed

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Liquid biopsy can transform oncology practice through early detection and real‑time monitoring of cancer progression and response to treatment. Circulating cell‑free tumor RNA offers promise as a novel and emerging alternative to circulating cell‑free tumor DNA for detecting the presence and understanding the biology of liver tumors. Both circulating DNA and RNA, which predominantly reside in extracellular vesicles, carry evidence of vital germline and somatic mutations. High impact single nucleotide changes, insertions and deletions in circulating RNA (ctRNA) serve a key role in cancer development and progression. Tumor cells exploit the RNA splicing machinery to induce structural and functional changes …

When Students Use Ai Before They Learn To Think Clinically: Cognitive Offloading In Communication Sciences And Disorders Education, Salim Alani

Teaching and Learning in Communication Sciences & Disorders

Generative artificial intelligence is becoming part of how students study, write, summarize, and prepare for coursework in communication sciences and disorders (CSD). Much of the current discussion in higher education has focused on plagiarism, academic integrity, and responsible technology use. Those concerns matter, but they do not fully address what may be a larger educational issue in professional preparation programs. Students can now generate polished explanations, study materials, treatment rationales, and clinical summaries quickly, sometimes before independently developing the reasoning skills those tasks are intended to build. This paper examines cognitive offloading in CSD education, defined here as the shifting …

Knowledge, Practice And Perceived Barriers Of Healthcare Provider Adherence To The Notifiable Disease Surveillance System (Ndss) In Government Hospitals And Primary Healthcare Centers In Jazan, Saudi Arabia: A Cross-Sectional Study, Moatasem F. Hakmi, Alaa Mathkour, Yousef Zahrani, Rayan I. Binduhayyim, Saad S. Alqahtani, Muhammad Z. Iqbal

Saudi Medical Journal

Objective: To assess and compare healthcare providers' understanding of the Notifiable Disease Surveillance System (NDSS), alongside reported and perceived challenges, across public hospitals and primary healthcare centers in Jazan, Kingdom of Saudi Arabia.
Methods: A cross-sectional study was conducted between 10 January 2025 and 30 December 2025 among health care providers at Jazan hospitals and primary healthcare centers (PHCs) (n = 420). Data were collected via structured self-administered questionnaire that included the following sections: demographic data, knowledge of the NDSS, reporting practices, competency of the Health Electronic Surveillance Network (HESN) and perceived barriers. Descriptive and inferential statistics were used to …

Scoping Review Of Mental Health Outcomes Of Cosmetic Procedures Among The Saudi Population, Hessah Alzahrani

Saudi Medical Journal

Objective: To comprehensively examine the mental health outcomes associated with cosmetic procedures among the Saudi population, with a particular focus on psychological well-being, self-esteem, anxiety, body image, and quality of life.
Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A structured search was performed across international databases, including PubMed, PsycINFO, Scopus, Web of Science, and Google Scholar, in addition to national Arabic databases. Studies investigating the psychological outcomes of both surgical (rhinoplasty and body contouring) and …

Mentorship As A Catalyst For Change Readiness: A Qualitative Study Of How Effective Mentoring Mitigates Burnout And Turnover During Organizational Transformation, Jeffery M. Camp

Journal of Online Mentoring

This qualitative study examined how effective mentorship mitigates burnout and attenuates turnover intention during organizational change, foregrounding the perspectives of experienced mentors. Drawing on Biggs’s presage–process–product (PPP) model, data were collected through semi-structured interviews (n = 12) and two focus group discussions (n = 6 each), engaging 18 unique mentors employed in organizations with 1,000 or more employees. Thematic analysis following Braun and Clarke’s six-phase protocol yielded four themes: (1) mentorship as strategic facilitation of organizational change; (2) mentorship as provision of emotional and psychological support; (3) empowering mentees through relationship-building; and (4) applying adaptive and reflective strategies. …

Graded Classification Of Sacral Dysmorphism And Its Impact On Osseous Fixation Pathways, Mia Nguyen, Logan Kasper, Stephen Warner

Summer Research Program Abstracts

No abstract provided.

Enhancing Hiv Knowledge And Resource Awareness Among Chief Nursing Officers, Susan Louise Cooper Bailey

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) remains a significant public health concern in rural communities, where limited specialty care, geographic isolation, transportation barriers, and stigma may delay testing and entry into care. The Texas Panhandle is a geographically expansive rural region served by rural hospitals with limited resources. Although area HIV services are available, they are inconsistently utilized. Although chief nursing officers (CNOs) influence practice and care coordination, knowledge gaps regarding HIV guidelines, prevention strategies, and regional resources may limit identification, referral, and continuity of care. The purpose of this doctor of nursing practice (DNP) project was to determine whether a targeted …

The C3-C3ar Axis Modulates Trained Immunity In Alveolar Macrophages, Alexander P Earhart, Rafael Aponte Alburquerque, Marick Starick, Lorena Garnica, Ayse Naz Ozanturk, Rahul Kumar Maurya, Xiaobo Wu, Jeffrey Haspel, Hrishikesh S Kulkarni, Et Al.

2020-Current year OA Pubs

Complement protein C3 is crucial for immune responses in mucosal sites such as the lung, where it aids in microbe elimination, and enhances inflammation. While trained immunity - enhanced secondary responses of innate immune cells after prior exposure - is well-studied, the role of the complement system in trained immune responses remains unclear. We investigated the role of C3 in trained immunity and found that alveolar macrophage (AM)

2026-2027 Dr. Kiran C. Patel College Of Allopathic Medicine Bylaws, Nova Southeastern University

Dr. Kiran C. Patel College of Allopathic Medicine Bylaws

No abstract provided.

When Children Cook: Food Experiences As Inquiry, Identity, And Learning, Marian S. Castillo, Carrie L. Ota

Spark! Innovations in Early Childhood Education: A Research-to-Practice Journal for Educators

This article explores the transformative potential of integrating cooking experiences into early childhood classrooms, arguing that food preparation offers much more than a simple activity. By drawing on classroom narratives such as shared meal preparation and spontaneous scientific inquiry this piece illustrates how cooking serves as a catalyst for wonder, problem-solving, and collaboration. It highlights how food-based activities naturally bridge home and school environments, fostering a sense of belonging and cultural identity among young learners. Grounded in developmentally appropriate practice, this article examines the teacher’s role in facilitating these experiences, emphasizing the importance of responsive planning, observation, and valuing the …

Pearls From Local Dentists: The Problem In Your Practice Probably Isn’T A Staffing Problem

West Michigan District Dental Society Bulletin

"Clinical Corner: Pearls from Local Dentists" is a section of the WMDDS Bulletin where local dentists share clinical wisdom for fellow practitioners. This edition discusses The Problem in Your Practice Probably Isn’t a Staffing Problem.

Wmdds Bulletin Summer 2026

West Michigan District Dental Society Bulletin

In the Summer 2026 issue, the reader will find the following feature articles: 

• 2026 WMDF Golf Outing Results
• MDA’s Speaker of the House Spotlight
• Fluoride Started Here—and the Fight Over it Never Really Ended
• Pearls from Local Dentists: The Problem in Your Practice Probably Isn’t a Staffing Problem

Also included are your monthly tripartite update, news from West Michigan counties, the President's Message and Editor's Letter.

Efficacy Of A Mouthwash Containing Standardized Centella Asiatica Extract (Eca 233) In Patients With Gingivitis: A Randomized Double-Blind Placebo-Controlled Trial, Alisa Awapark, Wanchai Chongcharoen, Mayuree H. Tantisira, Nattapon Rotpenpian

The Thai Journal of Pharmaceutical Sciences

Background: Gingivitis is the earliest and most reversible stage of periodontal disease, characterized by inflammation of the gingiva caused by the accumulation of plaque. In addition to removing plaque, mouthwash containing antiseptic or anti-inflammatory could be used as an adjunct therapy.
Objectives: The objective of this study is to evaluate the efficacy of a 0.10% standardized Centella asiatica extract (ECa 233) mouthwash compared to 0.12% chlorhexidine and placebo mouthwashes in individuals with gingivitis.
Materials and Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted in 75 patients assigned equally to ECa 233, chlorhexidine, or placebo groups. Participants used the assigned …

Development Of Micellar Sprays Containing Rhinacanthus Nasutus Extract For Dandruff Management, Suwipa Ungphaiboon Associate Professor, Sutasinee Ardhanwanich, Ketsuda Wongsuwan, Salwa Yanya, Nattanit Aekwattanaphol

The Thai Journal of Pharmaceutical Sciences

Background: Dandruff is a common scalp disorder associated with altered sebum secretion and microbial imbalance, particularly between Cutibacterium and Staphylococcus, which correlates with disease severity.
Objectives: This study aimed to develop and optimize a multifunctional leave-on hair and scalp spray with anti-dandruff, nourishing, and protective properties.
Materials and Methods: Micelles containing Rhinacanthus nasutus extract were prepared using eco-friendly methods, including film hydration and direct solubilization. The formulations were optimized and evaluated for physicochemical properties, drug release, and antibacterial activity.
Results: The optimized micellar spray (BP), prepared through direct solubilization in citrate buffer, exhibited a mean particle size of 192.45 …

Medetomidine As A Fentanyl Adulterant: Pharmacology, Detection, Clinical Presentation, And Management, Kory S. London, Phil Durney, Brendan Hart, Ashish Thakrar, Dennis Goodstein, Alex J. Krotulski, Daniel Teixeira Da Silva, Joseph D’Orazio, Lara Weinstein, Jeanmarie Perrone, Michael J. Lynch

Division of Internal Medicine Faculty Papers & Presentations

Purpose of Review Medetomidine is a veterinary α2-adrenergic agonist that has been an adulterant of illicitly manufactured opioids since 2022. We review its pharmacology, detection, intoxication, withdrawal, and management, and assess why severe withdrawal has emerged in some regions but not others. Recent Findings Medetomidine has spread through North American drug markets yet evades most toxicology testing. Roughly two hundred times more potent than xylazine, with greater α2 selectivity and imidazoline-1 activity, it causes intoxication resembling other α2 agonists: sedation and bradycardia. The dominant clinical problem is withdrawal: autonomic dysregulation, intractable vomiting, and encephalopathy frequently requiring intensive care. Treatment requires …

Good Grief: Finding Hope & Achieving Growth In The Face Of Loss, Daniel D. Cowell M.D.

Open Access Books

Grief has profoundly shaped Dr. Dan Cowell's life both professionally and personally. A board-certified psychiatrist, he spent 26 years in the U.S. Public Health Service, including leadership roles across federal health systems, before serving for 15 years as professor and chairman of psychiatry at the Marshall University School of Medicine, and was the Senior Associate Dean for Graduate Medical Education when he retired in 2009.  Throughout his career, he has accompanied individuals and families through some of life's most difficult losses. In his personal life, he has been touched by these losses himself, including the tragic deaths of an infant …

Evaluation Of The Association Between School Prevention Programs And Adolescents’ Opioid Abuse In The United States, Lida Moazezi

Walden Dissertations and Doctoral Studies

This study examined adolescent opioid misuse in the United States and the role of school-based prevention. Guided by the health belief model, the purpose was to test whether participation in school-based drug prevention lessons was associated with past-year opioid misuse among adolescents ages 14–17 and whether race and gender moderated that association. This quantitative, cross-sectional, nonexperimental secondary analysis used the 2019 National Survey on Drug Use and Health (N = 8,965). Analyses included weighted descriptives, chi-square tests, and complex-samples logistic regression controlling for age and socioeconomic status. The sample included adolescents ages 14–17 with complete data on school-based prevention participation, …

Characterization Of An Open-Channel Structure And Lateral Conduction Pathway In The Cation-Selective Pentameric Ligand-Gated Ion Channel, Elic, Mark J Arcario, Elizabeth J Wu-Chen, Yuna Shim, Jérôme Hénin, Grace Brannigan, Wayland W L Cheng

2020-Current year OA Pubs

Open-channel structures of multiple pentameric ligand-gated ion channels (pLGICs) have been determined, including the prokaryotic model pLGIC, Erwinia ligand-gated ion channel (ELIC). For many of these structures, it remains uncertain whether they represent a physiologic open-channel state because the conditions used for structure determination do not match those of functional measurements in cell membranes. Here, MD simulation is used to examine the ion conduction properties of the ELIC open-channel structure, which was determined using a non-desensitizing mutant called ELIC5. Results from simulations show that the pore remains stably open on the microsecond timescale, but computational electrophysiology measurements demonstrate a large …

Ai-Supported Analysis Of Jury Deliberation Impact Factors, Jennifer Siciliani Phd

Generative AI Teaching Activities

Students conduct a controlled, two-run generative AI jury simulation to examine how a single socio-legal variable affects simulated jury deliberation. They compare and manually code the AI-generated outcomes against peer-reviewed human jury research to evaluate the model’s accuracy, limitations, and potential biases.

The Promise Of Precision: Evaluating The Efficacy Of Robotic-Assisted Total Knee Arthroplasty, Jodi Wernikoff

SIU Journal of Medical Science Scholarly Works

Purpose: This article aims to review the treatment of patients diagnosed with primary knee osteoarthritis requiring a total knee arthroplasty and examine if the use of robotic- assisted surgery compared to traditional manual surgery results in improved functional outcomes and fewer post-operative complications.

Method: A PubMed literature search was conducted using the search terms total knee arthroplasty, robot surgical procedures, knee osteoarthritis, and quality of life. Nine articles were retrieved and served as the basis for this clinical review.

Results: While RA-TKA holds promise, more comprehensive comparative research is still required to assess the efficacy of RA-TKA in comparison to …

Preparation Of Physician Assistant Students To Manage Patients Living With Hiv/Aids In A Primary Care Setting, Austin Parrish

SIU Journal of Medical Science Scholarly Works

This study examined Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP) educational exposure among clinical-phase physician assistant (PA) students and evaluated how well current curricula prepare future providers for HIV prevention and care. A cross-sectional survey of 109 PA students assessed HIV-related knowledge, clinical exposure, and awareness of key public health concepts, while lecture materials from 30 PA programs were analyzed for curricular content. Students demonstrated moderate but incomplete baseline knowledge, and fewer than one-quarter reported observing PrEP prescribing during primary care rotations. Awareness of Undetectable = Untransmittable (U=U) was limited, with only …

Impact Of Erythropoietin Therapy On Inflammatory Biomarkers In Chronic Kidney Disease: A Comparative Study, Riyam Naji Al_Alwani, Jahanbakhsh Asadi, Zainab Mohammadi

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Background: Chronic kidney disease (CKD) is a progressive disorder frequently complicated by anemia and a persistent inflammatory state, both of which significantly contribute to morbidity and mortality. Reduced renal production of erythropoietin (EPO) is the primary cause of anemia in CKD. Emerging evidence suggests that EPO may exert anti-inflammatory and metabolic effects beyond its hematopoietic role. This study aimed to compare serum EPO levels and inflammatory biomarkers in CKD patients treated with EPO versus untreated CKD controls.
Material and Methods: This cross-sectional analytical study was conducted on 60 adult patients with CKD undergoing regular hemodialysis. Participants were divided into two …

Computational Design, Molecular Docking, Sar, And Admet Analysis Of Novel Jak1 Inhibitors As A Possible Treatment For Rheumatoid Arthritis, Sarah Ahmed Waheed

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Rheumatoid arthritis is an inflammatory autoimmune disease affecting the joints which eventually leads to systemic comorbidities. Its pathogenesis was attributed to disturbances in the Janus Kinase/Signal Transducer and Activator of Transcription signaling pathway. In this research, an innovative lead compound C6 was created and docked toward Janus Kinase1 (JAK1). The docking process was confirmed by re-docking of the co-crystallized ligand MI1 (Tofacitinib). C6 showed a predicted docking score of -9.17 kcal/mol, with enhancement of 1.26 kcal/mol over Tofacitinib. Evaluation of the interactions showed a framework of five hydrogen bonds within the binding site involving an important contact with Glu966 as …

Diagnostic Accuracy Of Quantitative Coronary Analysis As Compared With Instantaneous Wave-Free Ratio In Intermediate Coronary Lesions: A Prospective Vessel-Level Study, Tamer Mosaad Ragab, Khaled Ahmed Alkhashab, Mohamed Zaki Hussain, Ibrahim Mohammed Nosseir, Marwa Salah Sayed, Waleed Khaled Ali Salem

Journal of the Saudi Heart Association

Background: Instantaneous wave-free ratio (IFR) represents a new vasodilator-free innovative approach which is considered as a gold standard for functional assessment of the hemodynamic significance of intermediate coronary stenoses. Although relatively safe, iFR is still an invasive procedure that has its potential hazards, complications and cost. Two-dimensional quantitative coronary analysis (2D-QCA) is a non-invasive technique that has emerged robustly as an excellent and attractive tool for delineating coronary anatomy.

Aims: To assess the ability of two-dimensional quantitative coronary analysis (2D-QCA) to guide decision-making for quantification of severity of intermediate coronary stenoses (40–80% diameter stenosis) in each of the three main …

Pulmonary Adenocarcinoma Arising From Somatic-Type Malignant Transformation Of A Nonseminomatous Germ Cell Tumor: A Case Report, Abdel Martinez Borrego, Brandon Cantazaro, Fatimah Bello, Christine Vega, Natacha Vargas, Payal Bhakta, Renzo Arauco

School of Medicine Publications

Somatic-type malignant transformation (STM) is a rare but aggressive complication of nonseminomatous germ cell tumors (NSGCTs), most commonly arising from the teratomatous component and frequently occurring in metastatic sites. We report the case of a man in his 20s with a history of mixed NSGCT (50% yolk sac tumor, 40% teratoma, and 10% embryonal carcinoma) treated with left orchiectomy and chemotherapy in 2023, who initially responded to treatment but was subsequently lost to follow-up. He presented with one week of progressive dyspnea and pleuritic left-sided chest pain. Serum alpha-fetoprotein was markedly elevated at 2,966.7 ng/mL. Computed tomography demonstrated a progressive …

Colour Doppler-Guided Superthin Inferior Gluteal Artery Perforator Flap Elevation For Ischial Pressure Ulcer Reconstruction, Muhammed Said Aydin, Gökay Özler, Şükrü Kasap, Mustafa Nişanci

Sultan Qaboos University Medical Journal

Ischial pressure ulcer reconstruction requires durable coverage while preserving local donor options for possible recurrence. The inferior gluteal artery perforator (IGAP) flap is a muscle-sparing option, but superthin elevation requires precise knowledge of the superficial fascial plane and the subcutaneous course of the selected perforator. This technical note describes colour Doppler ultrasonography-guided superficial fascial plane mapping before superthin IGAP flap elevation in a 27-year-old paraplegic patient with a chronic left ischial pressure ulcer who presented in 2025 to a tertiary care university hospital in Muğla, Turkey. Preoperative high-frequency colour Doppler ultrasonography identified the dominant perforator, measured the relevant fascial intervals …

Single-Session Robot-Assisted Removal Of A Retained Ureteral Stent With Complex Proximal And Distal Encrustation: A Case Report, Maximo Alvarez, Cole Freedman, Emma Romero, Paul Kim, Alexis Garza, Harras Zaid

School of Medicine Publications

Retained encrusted ureteral stents represent a complex urologic problem, particularly in patients with limited healthcare access. We present a 28-year-old undocumented female with a 10-month retained ureteral stent who developed massive right-sided encrustation, including a 3 cm proximal renal stone near the renal pelvis and a 5-6 cm bladder stone, classified as FECal Grade IV-V. A single-session combined approach consisting of robot-assisted cystolithotomy, intraoperative ureteroscopy with stent exchange, and robot-assisted pyelolithotomy was performed successfully. Intraoperative ureteroscopy between operative phases confirmed ureteral clearance and enabled immediate stent placement without repositioning delay. This case supports the use of combined robotic approaches for …

Artificial Intelligence Models For Automated And Semiautomated Analysis And Interpretation Of Clinical Electroencephalography, Sándor Beniczky, Birgit Frauscher, Fábio Nascimento, Shobi Sivathamboo, Catalina Rojas, Michael Sperling, Samden Lhatoo, Philippe Ryvlin, Levin Kuhlmann

Department of Neurology Faculty Papers

Electroencephalography is the most commonly used diagnostic tool for epilepsy. However, interpreting electroencephalograms (EEGs) requires expertise that is not widely available. Advances in digital technology and wearables have enabled large-scale EEG recording, generating vast amounts of data that cannot be managed through traditional visual interpretation by experts. Artificial intelligence (AI) has the potential to augment human expertise and reduce workloads. The application of artificial neural networks in analysing clinical EEG recordings has led to major breakthroughs, bringing AI-based EEG interpretation closer to clinical implementation. In this Review, we summarise the most important research and development results in this field from …