Digital Commons Network^™

Improving Follow-Up After School-Based Dental Screenings Using Koha Data In Monterey County, Andre N. Edmond

Capstone Projects and Master's Theses

Limited follow-up after school-based oral health screenings is a major issue for young children in Monterey County, especially for those who do not have a regular source of dental care. This project focused on improving how screening data is used to connect students to needed services. The internship was completed with the Monterey County Oral Health Program and aimed to develop a better system for tracking KOHA (Kindergarten Oral Health Assessment) data and improving follow-up care for students identified with dental needs. Key activities included analyzing screening data, entering into a tracking system, and comparing results from different schools. The …

Reducing Childhood Dental Decay: Fluoride Education Campaign With The Monterey County Health Department, Shelby L. Minter

Capstone Projects and Master's Theses

Dental decay is a significant problem for youth across Salinas, contributing to preventable oral health disparities. The Monterey County Health Department Oral Health Program provides oral health education and prevention services across Monterey County. This project focused on improving parental knowledge and confidence about fluoride usage in areas where pediatric dental caries rates are high. Its purpose was to support the prevention of dental decay through the promotion of fluoride benefits. Two educational campaigns were conducted at elementary schools in Salinas; Monte Bella Elementary School and Alisal Community School. The expected outcomes were increased knowledge, confidence, and positive attitudes towards …

Cultivating Connection: A Culturally Responsive Mental Wellbeing Curriculum For Latine Youth In Santa Cruz County, Suzzy Landeros

Capstone Projects and Master's Theses

Latine adolescents experience high rates of stress, depression, and stigma surrounding mental health, in part due to limited access to culturally responsive support and safe spaces for connection. The purpose of this internship project was to develop and implement a trauma-informed, culturally responsive, mental wellbeing curriculum to address barriers related to stigma, limited culturally responsive support, and disconnection, while supporting emotional awareness, connection, and use of grounding strategies among youth. The project was implemented through United Way Santa Cruz County in partnership with Watsonville High School and Soquel High School and served high school-aged youth. Development of the curriculum included …

The Birthing Ground Podcast: Assessing The Impact Of Shared Doula Experiences On New Doula Confidence, Arrieanna D. Martinez

Capstone Projects and Master's Theses

There are too few confident, experienced doulas available in Monterey County to meet the needs of birthing families. Community-based maternal health programs face challenges related to limited confidence and experience among newly trained doulas, which affect the quality and consistency of care provided to families. This project addressed the needs of new doulas serving Medi-Cal–eligible families in Monterey County. The purpose of this capstone project was to increase confidence and preparedness among new doulas through a mentorship-based learning intervention. The project was implemented at the Parenting Connection of Monterey County and included new doulas and experienced mentor doulas. Key activities …

Digital Outreach For Environmental Equity: Bridging The Nature Gap In Castroville, California Through Social Media, Phoebe C. Deacon

Capstone Projects and Master's Theses

Too many low-income residents of Castroville are not spending enough time in nature, causing negative impacts on both physical and mental health. Ventana Wildlife Society provides programs including after-school programs, Single Day Adventures, and summer camps for youth and families in Monterey County, particularly those from underserved communities. This project focused on the Castroville program. Castroville is a low-income, agricultural, isolated pocket of Monterey County, one of the communities where Ventana allocates its resources. This project implemented an outreach and educational intervention through use of social media by updating the Instagram page for Ventana’s North County Outdoor Program and posting …

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

Combined Middle Meningeal Artery Embolisation And Subdural Evacuation Port System Drainage For Chronic Subdural Haematoma: A Systematic Review, Single-Arm Meta-Analysis, Meta-Regression, And Cost-Benefit Analysis, Shiva A. Nischal, Santosh Guru, Shaan Patel, Ashviniy Thamilmaran, Mary Murphy

Department of Neurosurgery Faculty Papers

BACKGROUND: Chronic subdural haematoma (cSDH) is an increasingly prevalent condition in older, anticoagulated, and medically frail patients, in whom recurrence and perioperative risk remain substantial despite standard surgical evacuation. Growing recognition of cSDH as an angiogenic, inflammatory disorder has prompted interest in minimally invasive strategies that combine mechanical decompression with targeted modulation of the underlying vascular pathology. This study aimed to evaluate the safety, effectiveness, and health-economic profile of combined middle meningeal artery embolisation and subdural evacuation port system (MMAE-SEPS) drainage for cSDH, compared with conventional burr-hole evacuation.

METHODS: MEDLINE, Embase, and CENTRAL were searched from inception to 24th August …

Tiny Tusks Internship: Factors That Affect Breastfeeding In Public, Caroline E. Bene

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this review was to explore factors that impact women’s decision to breastfeed in public or not. The PICOT question used was: ‘What Factors Affect Women’s Decision to Breastfeed in Public or Not?’ Two platforms, EBSCOhost and The National Library of Medicine, were used to identify 15 peer-reviewed journal articles on factors affecting women’s decision to breastfeed in public or not. The factors that impact a women’s decision on whether it is acceptable to breastfeed in public stems from the media stigmatizing that breastfeeding should be a private action. Research done yielded results of both positive and negative …

Miserly Thinking: Understanding The Factors Shaping Public Support Towards Project Wolbachia In Singapore, Shirley S. Ho, Agnes S. F. Chuah, Fiona J. W. Goh, Nova Mengxia Huang, Mengxue Qu, Hye Kyung Kim, Sonny Rosenthal

Research Collection College of Integrative Studies

Project Wolbachia is a vector control method that releases male Wolbachia-infected Aedes mosquitoes to curb dengue transmission in Singapore. While research has primarily focused on its efficacy, few studies have examined public opinion. This study draws upon the cognitive miser model and scientific literacy model to examine the factors shaping public support for Project Wolbachia. A nationally representative door-to-door survey was conducted in Singapore (N = 1,000) using multi-stage stratified random sampling. Our findings revealed that while knowledge about Project Wolbachia explains public support, laypeople may often rely on cognitive shortcuts, such as value predispositions, media attention, and pre-existing perceptions, …

Leading With Hope: A Clinical Communication Campaign To Promote Partner Hiv Testing In Assisted Partner Notification And Antenatal Care Programs In Uganda., Emily A. Hurley, Violet Gwokyala, Linda Kisaakye Nabitaka, Jolly Beyeza Kashesya, Mercylynn Agasha, Florence Namaganda, Nikolaus Schuetz, J Nalubega Ross, Joseph K B Matovu, Rhoda Wanyenze, Glenn Wagner, Kathy Goggin

Manuscripts, Articles, Book Chapters and Other Papers

Among heterosexual couples in sub-Saharan Africa, fears of relationship dissolution and inability to bear healthy children following an HIV-positive result remain barriers to HIV testing. Recently expanded availability of pre-exposure prophylaxis (PrEP) affords a critical opportunity to promote HIV testing with reassuring communication that highlights use for relationship preservation and healthy childbearing. We aimed to develop a theoretically-grounded communication intervention to promote partner HIV testing within assisted partner notification (APN) and antenatal care (ANC) programs in Uganda. Through an 18-month iterative co-creation process, we developed the HOPE Clinical Communication Campaign (HOPE-CCC) in collaboration with a project advisory board (PAB) of …

A Pilot Study Of A Culturally Responsive Cognitive-Behavioral Intervention For Black American High School Students With Social Anxiety, Hannah Thomas

Theses, Dissertations and Culminating Projects

Cognitive-behavioral interventions have been shown to be effective for treating social anxiety, yet few have been evaluated for racially and ethnically minoritized youth, including Black American adolescents. These interventions also do not address sociocultural factors, including racial discrimination and mental health stigma, that may shape the experience of social anxiety among Black American youth and serve as barriers to care. Therefore, the aim of this study was to conduct a pilot evaluation of the feasibility, acceptability, and preliminary outcomes of Interacting and Changing Our Narratives (ICON), a culturally-responsive, school-based cognitive-behavioral group intervention for Black American high school students with social …

Caregiver Self-Reflection: Does It Matter? A Study Of The Relationship Between Caregiver Self-Reflection And Participation In Home Programs In Outpatient Pediatric Physical Therapy Settings, Andrea Myane

Graduate Theses and Dissertations

Despite evidence that caregiver coaching can improve patient outcomes and caregiver participation, little information exists on the effects of its individual components. Additionally, previous research has highlighted the importance of home programs in improving pediatric physical therapy outcomes. The aim of this study is to explore the role that caregiver self-reflection, a component of caregiver coaching, plays in facilitating outcomes in the pediatric physical therapy outpatient setting. Caregivers will be asked to complete a series of self-reflection questions based on Gibbs’ Reflective Cycle, while also recording the number of minutes they spend facilitating a prescribed home program. All study participants …

Exploring Policy Change To Support Early Diagnosis Of Congenital Heart Defects (Chd) In New Mexico, Kelsey Carson Leibenhaut

Doctor of Nursing Practice Scholarly Projects

Congenital heart disease (CHD) is not a new or rare problem; it has likely always been a leading cause of childhood morbidity and mortality and clocks in today as the most frequently occurring birth defect, affecting an estimated 1 in 100 newborns (CDC, 2025). Prior to the middle of the 20th century, there was little to be done about CHD, as no treatments existed. Everything changed with the advancement of options for surgical repair of CHDs, significantly prolonging lifespans and improving quality of life for affected individuals. Despite these incredible advancements, babies are born with CHD every day, leading to …

Ambient Air Pollution In New Mexico: Nurse Practitioner Awareness, Mckenzie Hemmes, Grayson Kemp

Doctor of Nursing Practice Scholarly Projects

Ambient air pollution is a significant public health concern in New Mexico and contributes to respiratory disease, cardiovascular illness, and adverse pregnancy outcomes (Dominski et al., 2021; Di et al., 2022). Despite well-established evidence linking environmental exposures to health outcomes, environmental exposure screening is not routinely incorporated into clinical practice. The purpose of this Doctor of Nursing Practice (DNP) project was to improve environmental health literacy (EHL) among advanced practice registered nurses (APRNs) in New Mexico and to increase their intention to integrate ambient air pollution exposure screening and mitigation counseling into routine clinical practice. A virtual educational intervention guided …

Robots And Ageing Population – Rehabilitation And Social Robots, Yuzhou Qian, Keng Siau

Research Collection School Of Computing and Information Systems

Population ageing is placing increasing pressure on healthcare and caregiving worldwide. Governments in different countries are looking into the use of advanced information technologies such as artificial intelligence and robotics to help in caring for ageing population. Older adults often need both physical assistance and psychological support, and robots have emerged as a promising technological approach to supplement eldercare. This paper provides an overview of the current state of robots in eldercare. It reviews the major definitions, categories, and features of robots used in healthcare and eldercare. The paper also examines the potential benefits of robotic technologies, such as reducing …

Eptinezumab In Treatment-Resistant Chronic Migraine: Four-Year Real-World Effectiveness And Treatment Persistence, Wan-Jen Hsieh, Kelly Nicol, Chai Ching Ng, Tsung-Wei Hou, Phillip Phan, Scott W. Keith, Brittany Heckel, Michael J. Marmura, Hsiangkuo Yuan

Department of Neurology Faculty Papers

AimTo evaluate 48-month real-world outcomes of eptinezumab users in chronic migraine (CM), including longitudinal effectiveness, treatment persistence, reasons for discontinuation, and post-discontinuation anti-calcitonin gene-related peptide (CGRP) treatment patterns.MethodsWe conducted a retrospective cohort study of 112 CM subjects initiating eptinezumab at a tertiary headache center between 2019 and 2021. Monthly headache days (MHD), migraine disability assessment (MIDAS), and average pain intensity (API) were extracted at baseline and every 6 months for up to 48 months using a predefined outcome form at each visit. Longitudinal changes were analyzed using generalized estimating equations (GEE) with an unstructured correlation matrix, adjusting for age, sex, …

Experiences Of Hispanic/Latine Graduate Students In Unco’S Audiology And Speech-Language Pathology Programs Within A Hispanic-Serving Institution Context: Qualitative Thematic Analysis From A Moderated Focus Group, Ashley Fuhrman

Undergraduate Honors Theses

Existing literature has examined workforce diversity in healthcare as a factor that may shape patient rapport and the delivery of culturally responsive, patient-centered care. Given the increasing demand for audiologists (AuDs) and speech-language pathologists (SLPs) with diverse and multilingual backgrounds, it is important to understand how graduate programs prepare students to serve linguistically and culturally diverse populations. This qualitative study examines the experiences of Hispanic/Latine graduate students in Communication Sciences and Disorders (CSD) at the University of Northern Colorado (UNC), a recently designated Hispanic-Serving Institution (HSI). The study explores students’ perceptions of training, support, and experiences in serving diverse populations. …

Health Disparities In El Paso's Low-Income Hispanic Communities: A Mixed-Methods Analysis Of Acculturation, Obesity Metrics, And Socio-Cultural Determinants, Karen Del Rio

Open Access Theses & Dissertations

Health disparities among low-income Hispanic immigrants in the United States are shaped by complex interactions between acculturation, structural inequality, and socio-cultural determinants that behavioral and epidemiological models have not fully explained. This dissertation examines the relationship between acculturation and obesity-related outcomes among uninsured and low-income Hispanic adults of Mexican descent in El Paso, Texas, using a three-article, sequential, explanatory, mixed-methods design grounded in Latina/o Critical Race Theory (LatCrit).Article 1 presents a systematic review of 20 peer-reviewed studies examining acculturation and obesity among Mexican Americans, finding consistent evidence that longer U.S. residence is associated with increased BMI and obesity prevalence, mediated …

Prediabetes Prediction Before Disease Onset Using Multimodal Health Data: A Machine Learning Approach, Luisa Veronica Gracia Mazuca

Open Access Theses & Dissertations

Prediabetes is a critical health condition that increases the risk of developing type 2 diabetes. The hemoglobin A1c (HbA1c) test diagnoses patients with prediabetes, but the disease has already caused metabolic alterations. Early detection is essential for timely interventions, and machine learning models offer a promising approach to identify prediabetic individuals through the analysis of biomarkers such as cytokines. We compared four classifiers-logistic regression, decision tree, random forest, and k-nearest neighbors - using cytokines (TNF-α, MCP-1, IL-1β, IL-6, IFN-γ), age, BMI, and waist-to-hip ratio (WHR). Models were evaluated using stratified 5-fold cross-validation and ROC-AUC. K-Nearest Neighbors (k-NN) achieved the highest …

Human Papillomavirus (Hpv) Vaccine Acceptance: A Mixed-Methods Study And Randomized Controlled Trial Examining Messengers Of Hpv Vaccine Information Among Hispanic Parents, Alyssa Andrea Martinez

Open Access Theses & Dissertations

Hispanics make up 19.5% of the U.S. population, making them the nation's largest ethnic minority. Hispanics are disproportionately impacted by health outcomes, including many different types of cancers that are caused by the Human Papillomavirus (HPV). An HPV vaccine is available that can prevent 90% of HPV associated cancers. The purpose of this mixed-methods study and randomized experiment is to develop and test data-driven digital health messages to promote the HPV vaccine in Hispanic parents. Four specific aims were conducted among three major studies. Aim 1 (Study 1): A cross-sectional survey was conducted to obtain preliminary evidence on trusted messengers …

Crispr/Cas-Mediated Genome Editing Of Staphylococcus Aureus For Studying Phage-Pathogenicity Island-Host Interactions, Annalise Williams

Undergraduate Theses and Capstone Projects

Staphylococcus aureus is a gram-positive cocci that is a common member of our microbiota, living frequently on our skin and in our nasal passages. It is known for its wide variety of clinical manifestations, including endocarditis, scalded skin syndrome, toxic shock syndrome, food poisoning, sepsis, folliculitis, impetigo, and many other infections. It is widely recognized for being acquired in both hospital and community settings and is often resistant to multiple drugs. This poses a major problem, both in the United States and globally, as many treatments are no longer effective. MRSA, or Methicillin-Resistant Staphylococcus, is one example of the many …

Sympathetic And Parasympathetic Ganglion Blocks For Treatment Of Long Covid-19 Symptoms: A Scoping Review, Abhay Tyagi, Khushboo Singh, Preet Mohinder Singh, Frederic J Gerges

2020-Current year OA Pubs

BACKGROUND: Long COVID-19 affects approximately 10-30% of individuals who are infected with SARS-CoV-2 and is associated with persistent functional impairment and reduced quality of life. The heterogeneous, multisystemic nature and nonspecific symptomatology of long COVID-19 makes its treatment challenging. This scoping review evaluates existing evidence on sympathetic and parasympathetic ganglion blocks as potential interventions for patients suffering from long COVID-19.

OBJECTIVE: Our primary objective was to assess the effectiveness of sympathetic and parasympathetic ganglion blocks in treating patients with long COVID-19 by identifying the most commonly reported symptoms, symptom response to different block regimens, and any adverse effects associated with …

Sustainment Of Hydroxyurea Adherence In Patients With Sickle Cell Disease, Andrew M Heitzer, Zachary Wooten, Guangjin Luo, Marsha Treadwell, Allison A King, Victor R Gordeuk, Nirmish Shah, Christina M Abrams, Sarah Mccuskee, Siera Gollan, Jennifer Longoria, Jane S Hankins, Sickle Cell Disease Implementation Consortium

2020-Current year OA Pubs

IMPORTANCE: Despite established treatment guidelines and strong therapeutic benefit, hydroxyurea remains underused among patients with sickle cell disease.

OBJECTIVE: To assess the change in self-reported hydroxyurea use (ie, taking the medication at all) and adherence (ie, the number of days taken per week) over time and to examine factors associated with the trajectory of hydroxyurea use and adherence.

DESIGN, SETTING, AND PARTICIPANTS: Data were collected through the Sickle Cell Disease Implementation Consortium, a longitudinal, multicenter, observational cohort study that recruited patients from 8 centers across the US. Data collection occurred from 2017 to 2022, and analyses were performed from January …

Cognitive Behavioral Therapy For Individuals With Low Literacy And Perinatal Depression: A Randomized Clinical Trial, Eliza Kleban, Ashleen Lee, Aminata Koroma, D Taylor Hendrixson, Joshua Duncan, Mark J Manary, Kevin B Stephenson

2020-Current year OA Pubs

IMPORTANCE: Perinatal depression is common in sub-Saharan Africa, yet treatment gaps are substantial. Cognitive behavioral therapy (CBT) is effective but relies on written materials.

OBJECTIVE: To evaluate the efficacy of a culturally adapted CBT intervention delivered by lay counselors to women with perinatal depression in rural Sierra Leone.

DESIGN, SETTING, AND PARTICIPANTS: This study was an individually randomized, outcomes assessor- and investigator-blinded, clinical trial of an adapted CBT intervention vs enhanced usual care. The trial was conducted in 6 government-run antenatal clinics in Pujehun District, Sierra Leone, which has limited infrastructure, low literacy, high maternal undernutrition, and no perinatal mental …

Differences In Injury Rates By Competition Level Among Scholastic And Collegiate Female Lacrosse Athletes: A Systematic Review, Carrie J Froemming, Daniel C Touhey, Robert H Brophy, Derrick M Knapik

2020-Current year OA Pubs

BACKGROUND: Women's lacrosse is an increasingly popular sport. Current rules allow incidental body and stick-to-stick contact, with limited required protective equipment. Injuries to the head, face, and lower extremities are common, especially at higher levels of competition. Differences in injury rates and types based on competition level remain largely unknown.

PURPOSE: To systematically review the literature to better understand injury differences between scholastic and collegiate female lacrosse athletes.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: Under PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), 543 studies were identified in September 2025 in PubMed, Scopus, Google Scholar, …

Synovial Fluid Biomarkers Associated With Anterior Cruciate Ligament Injury And Reconstruction: A Systematic Review, Daniel C Touhey, Derrick M Knapik, Sina Tartibi, Varun Gopinatth, Tanya Boghosian, Matthew J Matava, Matthew V Smith, Robert H Brophy

2020-Current year OA Pubs

BACKGROUND: Synovial fluid biomarkers reflect the inflammatory response after joint injury and surgery. Previous studies have identified synovial fluid biomarker concentrations in the knee after both anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR).

PURPOSE: To systematically review the literature to summarize reported changes in synovial fluid biomarkers and their concentrations after acute ACL injury/ACLR.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: Studies published in the PubMed, EMBASE, and the Cochrane Library databases reporting in English on humans sustaining ACL tears and undergoing ACLR from inception to August 2025 were identified and included if postinjury/preoperative and/or postoperative …

Consensus Guidelines On Inferior Petrosal Sinus Sampling: A Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Farhan Siddiq, Hunter Brooks, Esra Demirtas, Ibrahim Ahmad Bhatti, Sami Al Kasab, Adam De Havenon, Robin Novakovic, Ossama Y. Mansour, Cynthia L. Kenmuir, Ameer E. Hassan

School of Medicine Publications

Background: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold-standard test to distinguish Cushing disease (CD) from ectopic adrenocorticotropic hormone (ACTH) secretion when biochemistry confirms ACTH-dependent Cushing syndrome and pituitary magnetic resonance imaging is equivocal. However, practice varies widely between centers, leading to false negatives, misinterpretation, sampling errors, and avoidable risk. Neurointerventionalists performing BIPSS have lacked dedicated, procedure-focused guidance.

Methods: Using the Society of Vascular and Interventional Neurology Guidelines and Practice Standards framework, a multidisciplinary panel (endocrinology, interventional neuroradiology, and endovascular neurosurgery) performed a systematic review through August 2025 and developed recommendations graded by class of recommendation and level of …

Towards Dementia-Inclusive Digital Text-Based Health Information: A Multi-Method Investigation Of Cognitive And Affective Accessibility, Margi Engineer

All Dissertations

This dissertation examines the accessibility, readability, emotional tone, and trustworthiness of digital, text‑based dementia information and investigates how older adults with and without dementia cognitively and affectively engage with such content. It further explores the potential of generative AI to improve dementia information delivery through the development of a domain‑specific retrieval‑augmented generation (RAG) large language model (LLM) chatbot designed to deliver accessible, stigma‑free information. The dissertation comprises four studies using complementary quantitative and qualitative methods. Study I conducts a large‑scale content analysis of 300 medical articles, 35 websites, and 50 blogs, applying readability metrics, LIWC‑based linguistic and sentiment analysis, and …

Growth Hormone Pathway As A Prognostic And Therapeutic Biomarker In Patients With Unresectable Hepatocellular Carcinoma Treated With Radiation Therapy, Joe R Eid, Safa Kaseb, Lianchun Xiao, Ryan Sun, Mahesh Kumar Kannan, Asif Rashid, Hesham M Amin, Eugene J Koay

Faculty, Staff and Student Publications

Purpose: Radiation therapy (RT) has emerged as an effective local therapy option for patients with unresectable hepatocellular carcinoma (HCC) and is associated with improved overall survival (OS). However, some patients still have poor outcomes after RT, and biomarkers are needed to stratify prognostic groups. High circulating growth hormone (GH) levels promote HCC proliferation and survival and are associated with aggressive disease. In this study, we evaluated whether pretreatment GH levels are associated with OS and progression-free survival (PFS) in patients who underwent RT for unresectable HCC.

Methods and materials: Patients undergoing RT for HCC during 2017-2023 were identified from a …

Optimized Ultrasound Imaging Of Phase-Change Nanodroplets, Charles R Dyall, Dmitry Nevozhay, Andy Liu, Trevor M Mitcham, George J Lu, Richard R Bouchard

Faculty, Staff and Student Publications

Phase-change nanodroplets (PCNDs) continue to generate significant research interest due to their potential to extravasate into tissue, to be targeted for molecular imaging and drug delivery, and to undergo an induced phase-change to "activated" microbubbles (MBs) for ultrasound (US) imaging. To accurately quantify molecular markers, however, one assumes a consistent proportion of PCNDs in a region of interest (ROI) are stably activated and imaged. Herein we present a framework for developing a diagnostic sequence that is optimized for PCND activation uniformity, contrast, and acquisition time. To develop this framework, activation was examined at three scales of increasing complexity: single, adjacent, …