Digital Commons Network^™

Use Of Non-Invasive Testing In Primary Care For Earlier Diagnosis Of Liver Fibrosis, Amy L. Cable

Doctor of Nursing Practice Projects

Chronic liver diseases, particularly those driven by metabolic risk factors, are frequently under-recognized in primary care settings until they reach advanced stages. Systematic screening using non-invasive testing is inexpensive and convenient, but baseline calculations remain low. The objective of this quality improvement project was to increase primary care providers' knowledge of early fibrosis identification and intent for utilization of testing. Pre- and post-intervention data were collected over a 16-week period. Post-intervention, providers' knowledge of non-invasive testing was improved by 28% and intention of utilization by 80%.

Closing The Gaps: Improving Opioid Overdose Prevention In African American Communities Through Education And Community Engagement, Tara Clinding

Doctor of Nursing Practice Projects

African Americans continue to experience high rates of opioid mortality, emphasizing the need for culturally relevant community education and overdose prevention strategies. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate community-based opioid overdose prevention education designed for individuals with substance use disorder, family and friends, and community members. Guided by Betty Neuman’s Model, the education focuses on recognizing opioid overdoses, administering naloxone when indicated, and identifying community treatment and recovery resources. A pre- and post-test design was used to evaluate changes in participants' knowledge and confidence following a structured educational session. …

A Systematic Review On Niosomes: Composition, Preparation, And Applications, Sanket Gawade Mr., Sunil Attimarad, Vishakha Desai Ms.

Manipal Journal of Medical Sciences

Conventional drug carrier systems are restricted owing to poor bioavailability, weak stability and non-specific localization, which causes systemic toxicities and reduced therapeutic efficacy. Niosomes, one of the nonionic surfactant vesicular systems, have been suggested that value to overcome these constraints. In this review, we give an account of recent progress in niosome research, highlighting their merits, composition, characterization, and applications.

Niosomes offer several advantages including increased drug bioavailability, targeted delivery and reduced toxicity. Bilayered niosomes can entrap both hydrophilic and lipophilic drugs, therefore allowing simultaneous delivery of actives components. We provide an overview of various techniques for niosome preparation including …

Predicting Tilt In Esports: A Psychophysiological Approach To Understanding Player Emotional Regulation, Nathan Rhea

University of the Pacific Theses and Dissertations

Emotional regulation and stress management are important to both casual and competitive esports players. When players become dysregulated, they experience a phenomenon known as “tilt” within the gaming community, where they often lose control of their emotions and their performance declines. This study aimed to investigate whether a psychophysiological variable in heart rate variability could predict tilt in college-age esports players. Additionally, the relationship between heart rate variability and emotions predicted by the Tiltometer system with gameplay performance and winning or losing was tested.

This study used a quantitative correlational research design. Participants for this study were college-age players (N=23) …

If I Only Had The Words (To Tell You): Billy Joel Lyrics In Legal And Medical Scholarship, Seuli Bose Brill, Christian H. Brill

Touro Law Review

Law and medicine are often considered to be among the least accessible professions, partly because of the heavy use of non colloquial jargon. This article examines more than 150 instances in which Billy Joel’s lyrics have been used to improve the accessibility of legal and medical scholarship. Legal and medical professionals have used the words of the “Piano Man” to discuss a variety of topics—everything from civil procedure to property rights and the COVID-19 pandemic to colorectal surgery. Nontraditional communications techniques of this type do not just contribute to the body of legal and medical scholarship; they also help professionals …

Assessing The Scope Of Knowledge And Decision-Making Patterns Regarding Healthy Eating During Pregnancy In Pregnant Female Adults In Southern California, Raegan Soffel

Loma Linda University Research Reports

While recognizing the link between prenatal nutrition and maternal-fetal health, this investigator-initiated study seeks to identify pregnant women's understanding of prenatal nutrition guidelines and the influences on their dietary choices. Thirty-eight eligible women completed an online, anonymous surveying assessing the scope of knowledge and decision-making patterns of healthy eating during pregnancy. The average knowledge score among the participants was 6.05/14. There was no significant difference in the knowledge scores among pregnancy periods or among total number of pregnancies. Perceptions of nutrition guidance in prenatal care, factors influencing eating behaviors, and primary sources of nutrition information were explored. The findings may …

Comparing Perceived Ideal Protein Intake In Plant-Based Versus Meat-Based Diet Consumers, Gysel Avendano, Saya Iwanaga

Loma Linda University Research Reports

High-protein diets have gained significant popularity in both social media and public discussion and more recently, a significant rise in protein consumption has been observed. Existing research has reported differences in actual protein intake across dietary patterns, with animal-based diets generally associated with higher total protein intake compared to plant-based diets. This growing focus on protein raises important questions about perceived ideal protein intake and the factors that shape it.

The primary objective is to compare perceived ideal protein intake among Southern California adults consuming meat-based versus plant-based diets. Additionally, we explored the influence of protein-related knowledge, beliefs, values, information …

Variability In Parainfluenza Virus Derived From Persistently Infected Lung Epithelial Cells, Cassidy R. Conte

Honors Undergraduate Theses

An acute infection (AI) with RNA virus can progress to a persistent infection (PI) where infected cells continue to grow and replicate while producing progeny virions. PIs with respiratory viruses are clinically important, as they can lead to prolonged shedding of viruses and generation of mutant viruses that are altered in pathogenesis and/or immune responses. Parainfluenza type 5 (PIV5) is a prototypic RNA virus shown to cause PIs in cell culture. Plaques in tissue culture from an acute infection with parental PIV5 were homogeneous in size and shape. By contrast, plaques from PIV5 persistently infected cells were heterogeneous, having a …

Perceptions, Expectations, And Attitudes About Adolescent Telepsychiatry Among Indian American Family Caregivers, Udayvir Jalf

Honors Undergraduate Theses

Adolescent mental health concerns have risen sharply in the United States. The COVID-19 pandemic marked a significant turning point in mental health care access, with telehealth having become a central mode of care delivery. With adolescent telehealth, caregiver involvement has shown to improve treatment adherence and outcomes. Little is known, however, about how Indian American caregivers experience and navigate their adolescent’s virtual mental health care. This qualitative study investigated the perceptions, expectations, and attitudes of Indian American family caregivers regarding adolescent telepsychiatry and caregivers’ involvement. In depth semi-structured interviews were conducted with Indian American caregivers of adolescents who completed at …

Succession Planning As A Tool For Nursing Recruitment, Retention, And Resilience, Natalie Kennett

DNP Scholarly Projects

Background: Healthcare is facing a significant nursing shortage. This shortage not only impacts bedside nurses but also nurse leaders. Succession planning is a method for recruiting, retaining, and building resilience among nurse leaders.

Purpose: This quality improvement project applied principles of succession planning, including leadership education, training, and assessment of leadership retention and resilience.

Methods: Two interventions were implemented in this quality improvement project. The first was an assessment of a modification in nursing leadership organizational structure that was made in 2024 with the purpose of improving succession planning. This evaluation was completed with the use of …

Empathy And Human-Centered Leadership In Community Health Center Dental Clinics, Pamela S. Alston Dds, Mpp, Facd

Journal of the American College of Dentists

A person-centered approach, with empathy toward patients, can improve satisfaction among both patients and dental health professionals. A dental director with a human-centered leadership style can improve the well-being of oral health team members. This article describes the role that empathy, a core value of humanism and professionalism, plays in accomplishing these improvements in community health center dental clinics. This article also describes the risks of empathy, as experienced by the author in her role as a dental director and practitioner, as well as documented in the literature. It further focuses on dental directors’ human-centered approaches to supporting oral health …

The Personal, Professional, And Practice: Integrating Health Humanities Into Dental Education, Margie Hodges Shaw Jd, Ma, Phd, Michael Yunker Dds, Nicholas Mercado Drph, Ms

Journal of the American College of Dentists

Dentistry’s evolution as a profession reflects both scientific progress and enduring tensions between commercial and service-oriented models of care. Despite long-standing commitments to ethical education, dental training continues to privilege technical mastery over professional identity formation, leaving some future practitioners underprepared for the ethical and relational complexities of clinical practice. This paper situates these challenges within the historical separation of dentistry and medicine and argues that integrating the health humanities into dental education can strengthen professional identity formation and clinical ethics competency. Using a case study, we demonstrate how biases, professional obligations, and patient trust intersect in practice. We introduce …

Dental Professionalism In A Changing World: Challenges & Opportunities, Robert P. Iovino, Dds, Ma Dds, Ma

Journal of the American College of Dentists

This manuscript examines the erosion of traditional dental professionalism amid rising educational costs, declining membership in professional associations, and the growing influence of corporate ownership and private equity in dentistry. Drawing perspectives from economics, sociology, philosophy, law, and ethics, it traces the historical development of professional licensure and its role in safeguarding clinical autonomy, ethical integrity, and public trust. The analysis highlights how deregulation and profit-driven practice models challenge the profession’s social contract. The manuscript argues that preserving strong civic institutions, restrictive licensure standards, and humanities-informed education is essential to sustaining dentistry as a learned profession rather than a commodified …

Lessons On Generative Artificial Intelligence From The American Association Of Dental Editors And Journalists (Aadej), Christopher J. Smiley

Journal of the American College of Dentists

The American Association of Dental Editors and Journalists (AADEJ) recently released "Guidance for Authors, Editors and Publishers on the Use of Generative AI". Developed by an 11-member stakeholder panel, this guidance paper serves a dual purpose: It provides practical strategies for mitigating the risks that generative artificial intelligence (GAI) poses to professional writing and explains how GAI creates these risks. Understanding both the underlying vulnerabilities of GAI and how to address them is critical for users at all levels, from authors and reviewers to editors, publishers, and general users, to maintain the validity and reliability of their written work. This …

How Dentists Can Remain Advisors Of Merit To Their Patients, Daniel L. Orr Ii, Dds, Ms (Anesth), Phd, Jd, Md, Facd (Nevada Section Chair)

Journal of the American College of Dentists

This article examines how members of the dental profession can sustain their longstanding reputation as trusted advisors amid declining public confidence in major institutions. Grounded in ethical principles, informed consent, and professional self-regulation, dentistry has historically ranked among the most trusted professions. The discussion explores challenges to credibility, including media scrutiny, concerns about anesthesia safety, controversial treatment hesitancy, and debates over community water fluoridation. Emphasizing the concept of the “advisor of merit,” the author argues that continued trust depends on truthful communication, transparency about risks, respect for patient autonomy, and freedom from conflicts of interest in clinical and public health …

Production, Characterization, And Diagnostic Application Of Monoclonal Antibodies Against The N-Protein Of Avian Metapneumovirus Subgroup B, Ravi Gupta

Electronic Theses and Dissertations

Avian metapneumovirus (aMPV) is a respiratory pathogen that causes Turkey Rhinotracheitis (TRT) in turkeys and Swollen Head Syndrome (SHS) in chickens. The infection leads to facial swelling, nasal discharge, reduced egg production, and poor growth. This virus is classified into four subgroups: aMPV-A, B, C, and D, with two other novel subgroups, in which aMPV-A, B, and C are most prevalent in the commercial flocks. In early 2024, aMPV-A and B outbreaks have been reported in the US, resulting in severe economic losses. An economic assessment estimates around $112 million in losses in Minnesota and up to $434 million in …

Life In Laughter: Comedy’S Impact On Student Health And Success, Julia Weinstein

Honors Undergraduate Theses

College students face rising rates of anxiety, depression, and stress, highlighting the need for accessible, stigma-free wellness interventions. While comedy is often seen as entertainment, research indicates laughter produces measurable psychological and physiological benefits, including reduced cortisol and increased endorphins. Life in Laughter, a creative-research hybrid project, investigates how live and digital comedy experiences affect college students’ mood, stress, and sense of belonging. Using mixed methods, data were collected through anonymous audience surveys, app-based reflections via JoyScroll, and interviews, supplemented by a mini-documentary. Findings suggest humor functions as both an emotional regulation tool and a means of fostering …

Recurrence And Co-Occurrence Of Enhancer-Promoter Interactions Across Human Samples, Satvik Gunjala

Honors Undergraduate Theses

Experimental mapping of enhancer-promoter interactions (EPIs) is resource-intensive, and current computational prediction methods struggle with intrinsic genomic complexity and reliance on limited training data. To address this bottleneck and provide insights for improved computational methods, this study systematically analyzed chromatin contact datasets to investigate the recurrence and co-occurrence of enhancer-promoter interactions across human samples. Putative interactions were evaluated across two HiChIP datasets comprising 218 total samples and one Hi-C dataset comprising 266 samples to assess recurrence across samples and assess sequencing depth related to unique EPIs. Additionally, a preliminary item-based collaborative filtering recommender model was developed to assess co-occurrence patterns …

Assessing The Effects Of A Novel Breathing Exercise On Respiratory, Postural, And Muscular Performances, Tristan P. Wilson

Honors Undergraduate Theses

Background: Breathing exercises are used in both clinical and home settings for a variety of purposes. Their functions range from reducing anxiety and stress to recuperating pulmonary function, depending on the technique and style employed. Existing literature has demonstrated that breathing exercises increase Forced Vital Capacity (FVC) and may be able to improve postural stability due to engagement of the diaphragm when regularly practiced.

Objective: The purpose of this study was to determine whether a novel breathing exercise would be effective in improving respiratory, postural, and muscular function.

Methods: In order to evaluate this claim, a randomized, double-blind, controlled study …

Bridging The Gap: Investigating The Impact Of Adequate Prenatal Care On Adverse Maternal Outcomes Among Black And African American Women, Ciaera Ambroise

Honors Undergraduate Theses

The United States continues to face a maternal health crisis marked by persistent racial disparities, with Black women experiencing pregnancy-related mortality rates three times higher than those of White women. Despite national efforts to expand access to prenatal services, inequities in maternal outcomes remain, indicating that the quality of prenatal care may be as critical as its timing and frequency. The purpose of this thesis is to examine whether adequate prenatal care, compared to inadequate prenatal care, is associated with reduced adverse maternal outcomes among Black and African American women in the United States. Guided by a PICO question, this …

Fgf19 As A Colorectal Cancer Serum Biomarker And Fgfr4 As A Mediator Of Anti-Her2 Resistance In Breast Cancer, Jordan Beardsley

Graduate Studies Theses and Dissertations 2026

The fibroblast growth factor 19 (FGF19)-fibroblast growth factor receptor 4 (FGFR4) signaling pathway regulates hepatic metabolism, bile acid (BA) synthesis, and hepatocyte proliferation. This signaling axis also is implicated in promoting tumor progression, therapeutic resistance, and metastasis in certain cancers.

In colorectal cancer (CRC) there is a critical need for non-invasive biomarkers for disease detection and monitoring. We identified FGF19 as a candidate CRC serum marker through meta-transcriptomics and found FGF19 to be expressed and secreted by CRC cell lines. Tumor-derived FGF19 was detectable in mouse serum at levels correlating with tumor volume in a subcutaneous xenograft model. RNA sequencing …

Pioglitazone Uncouples Macrophage Inflammatory Signaling From Epithelial Oxidative Stress During Map Infection Mimicking Crohn’S Disease Treatment, Sabera Akter Bushra

Graduate Studies Theses and Dissertations 2026

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterized by intestinal inflammation, epithelial barrier dysfunction, and abnormal immune signaling. CD pathophysiology is increasingly linked to Mycobacterium avium subspecies paratuberculosis (MAP) infection, which increases chronic macrophage activation and the production of inflammatory mediators that lead to epithelial damage. Among these mediators, CXCL10, TNF-α, and IL-6 contribute in inflammation, while NOX-1 and SERPINE-1 indicate epithelial oxidative stress and damage. Despite the role of macrophage-epithelial interaction in CD, selective pharmaceutical regulation of this axis remains unclear. Pioglitazone, an FDA-approved PPARγ agonist used for type 2 diabetes, is an appealing repurposing candidate, given …

Evaluating Novel Targeted Combination Therapies For Gastrointestinal Cancers, Joseph A. Goode

Graduate Studies Theses and Dissertations 2026

Gastrointestinal (GI) cancers remain among the leading causes of cancer-related mortality worldwide, with therapeutic resistance continuing to limit the effectiveness of current treatments. Three complementary studies were conducted to identify therapeutic vulnerabilities and evaluate novel combination strategies in pancreatic ductal adenocarcinoma (PDAC) and colorectal cancer (CRC).  First, dual inhibition of fibroblast growth factor receptor 4 (FGFR4) and phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling was investigated in PDAC models. A combination of targeted drug treatments reduced viability, clonogenic survival, migration, and suppressed signaling pathways involved in translational control. This supported a functional interaction between FGFR4 and PI3K-mTOR co-activation in …

Establishment Of An In Vitro Dss-Induced Epithelial Injury Model To Investigate Il-6 Signaling And Microbial Metabolite Mediated Barrier Recovery, Srijal Kunwar

Graduate Studies Theses and Dissertations 2026

Dextran sodium sulphate (DSS) is widely used in vivo to induce epithelial injury; however, the molecular effects of DSS on intestinal epithelial cells, that investigate inflammatory and metabolic repair mechanisms remain unclear. Here, we establish an in vitro DSS-induced epithelial damage model using differentiated Caco-2 cell monolayer. Exposure to 2.5%(w/v) DSS for 24 hours resulted in significant upregulation of pore forming protein Claudin-2(2.677-fold) and oxidative marker, NOX-1(1.866-fold), accompanied by increased ROS production confirmed via DHE staining. Increased epithelial permeability was observed by TEER analysis, without significant cytotoxicity. Surprisingly, ELISA analysis revealed significant downregulation of IL-6 (p-value …

The Diversity Of Flavivirus Antibody Dependent Enhancement (Ade) Profiles From A Pediatric Cohort In Mexico, Maiesha Samiha Mahmood

Graduate Studies Theses and Dissertations 2026

The Aedes mosquito-borne flaviviruses Zika (ZIKV) and dengue (DENV-1-4) cause an estimated 400 million annual infections globally and pose an increasing threat to public health. Typically, individuals infected with ZIKV or a DENV serotype generate neutralizing serotype-specific antibodies and non-neutralizing, cross-reactive antibodies that bind multiple flaviviruses. Upon secondary heterotypic infection, pre-existing antibodies can either protect or exacerbate disease through antibody dependent enhancement (ADE). ADE occurs when non- or sub-neutralizing concentrations of cross-reactive antibodies facilitate viral uptake into FcγR-bearing myeloid cells, enabling infection of otherwise non-permissive cells and driving severe disease. To date, ADE has not been characterized at a population …

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

Behavioral Economic Factors Implicated In Young Adult Drinking In The Natural Environment: An Ema Study, Tatiana Magri

Graduate Studies Theses and Dissertations 2026

Background: Young adult (YA) alcohol use remains a prominent public health concern. Despite research efforts aimed at mitigating harms related to drinking, rates of alcohol use and adverse outcomes related to use, remain high among YAs. Previous research has identified alcohol demand, craving, and delay discounting as risk factors for problematic drinking among YAs. However, few studies have concurrently examined these constructs using methodologies that maximize ecological and contextual validity. Method: YA individuals (N=104) completed an ecological momentary assessment (EMA) protocol assessing three demand indices (i.e., intensity, Omax, and breakpoint), delay discounting, craving, and alcohol use and problems. Participants received …

Examining Attrition In Rtms For Smoking Cessation: The Roles Of Perceived Research Burden And Delay Discounting, Miranda Proctor

Graduate Studies Theses and Dissertations 2026

This secondary analysis examined predictors of attrition in a randomized clinical trial conducted by Roswell Park Comprehensive Cancer Center evaluating repetitive transcranial magnetic stimulation (rTMS) for cigarette smoking cessation. Smoking cessation reduces cancer risk and mortality and improves mental health outcomes. Although rTMS shows promise for supporting sustained abstinence by targeting neurobiological mechanisms underlying nicotine dependence, participant attrition threatens statistical validity, reduces power, and limits generalizability. Identifying predictors of attrition is therefore critical for optimizing trial design and retention.

Research examining predictors of attrition in smoking cessation trials remains limited. Prior work in other clinical populations suggests that higher perceived …

Modulating Efferocytosis In The Intestinal Epithelial Cells During Colorectal Cancer, Laura Boeckaerts, Tania Løve Aaes, Evi Scheirlinckx, Sze Men Choi, Yunus Incik, Amanda Gonçalves, Tino Hochepied, Lars Vereecke, Kodi S Ravichandran

2020-Current year OA Pubs

INTRODUCTION: Colorectal cancer (CRC) is the thirdmost common cancer and a leading cause of cancer deaths worldwide, with over 1.9 million cases diagnosed in 2022. Due to poor response to classical cancer treatments, CRC is associated with low survival rates. This creates an urgent need for better understanding of CRC pathology. Cell death occurs continuously in solid tumors, and is also induced acutely, during chemotherapy. Dead cells are cleared by phagocytes via 'efferocytosis', an anti-inflammatory process that can lead to immune escape and reduced therapeutic efficacy. We hypothesized that efferocytosis might contribute to tumor development and that manipulating this process …

Postoperative Conductive Hearing Loss After Full-Arch-Implantation Surgery Under General Anesthesia In An Oral Submucous Fibrosis Patient: A Case Report, Hao-Chen Wang, Fu-Chuan Tsai, Chia-Che Wu, Chih-Yuan Fang

Journal of Dental Sciences

No abstract provided.