Digital Commons Network^™

Evaluation Of Retrieval-Augmented Generation (Rag) With Gpt-4o For Maxillofacial Prosthodontics Clinical Questions, Vinsensia Launardo, Merve Koseoglu, Lucky Susanto, Michael Kase, Amanda Colebeck, Heidi Huber, Maribeth Krzesinski, Derry Wijaya, Muhammad Ruslin, Alvin Gerard Wee, Heng-Li Huang, Lih-Jyh Fuh, Cortino Sukotjo

Journal of Dental Sciences

Background/purpose: Large language models (LLMs) offer promising education and clinical decision support to help address the global shortage of maxillofacial prosthodontists. To overcome the lack of source traceability in base LLMs, this study evaluated a retrieval-augmented generation (RAG) architecture for answering complex clinical questions.

Materials and methods: An expert panel consisting of five maxillofacial prosthodontists selected 15 high-complexity clinical questions. Responses were generated using base GPT-4o and a naive RAG-GPT-4o model built with domain-specific literatures. Outputs were evaluated across five parameters using a 5-point Likert scale and analyzed via Mann-Whitney U tests.

Results: No statistically significant differences …

Biological Performance Enhancement Of Ni-Free Zr-Based Bulk Metallic Glass For Dental Implants Via Nitrogen Plasma Immersion Ion Implantation, Hsun-Miao Huang, Ying-Sui Sun, Ya-Lin Huang, Kai-Yi Lin, Thantrira Porntaveetus, Thanaphum Osathanon, Wei-Cheng Chen, Her-Hsiung Huang

Journal of Dental Sciences

Background/purpose: Improving the biocompatibility of bulk metallic glass (BMG) alloys is critical for expanding their applications in biomedical fields, particularly in dental implants. This study systematically investigated the suitability of nitrogen plasma immersion ion implantation (NPIII)-treated Zr-based BMG alloy for next-generation dental implant applications, focusing on protein adsorption, platelet responses, and cell behavior.

Materials and methods: NPIII was employed as a surface modification approach to enhance the biological performance of a Ni-free Zr₆₂.₅Cu₂₂.₅Fe₅Al₁₀ BMG alloy. The effects of NPIII treatment on surface characteristics, including crystallinity, chemical composition, layer thickness, roughness, and hydrophilicity, were comprehensively analyzed. Protein adsorption …

Integration Of Planetary Health In Health Professions Education And Training In Low- And Middle-Income Countries: A Scoping Review, Rayishnee Pillay, Veena S Singaram

Health Professions Education

Purpose: This review explored the integration of planetary health and sustainable healthcare education in health professions education and training in low- and middle income countries (LMICs), by mapping capacity development initiatives, pedagogical approaches and contextual barriers to implementation. Method: A literature search was conducted using the following databases, MEDLINE (PubMed), EBSCOhost (Academic Search Complete), ERIC, ProQuest, Redalyc, Sabinet, Scielo, ScienceDirect, Scopus, Web of Science, and grey literature search on CORE, Google and Google Scholar for publications on the incorporation of planetary health and sustainable healthcare education in health professions education and training in LMICs between 1 January 2014 to 30 …

Exploring Job Stressors And Burnout Among Core Faculty In Entry-Level Physical Therapist Education Programs: A Convergent Mixed Methods Study, Jj Ferguson, Adam Fritsch, Jodi L. Young

Health Professions Education

Purpose This study explored burnout among core faculty in Doctor of Physical Therapy (DPT) programs, identifying its most prevalent aspects and key organizational correlations. Methods A convergent parallel mixed-methods design integrated quantitative data from the Maslach Burnout Inventory–Educators Survey and the Areas of Worklife Survey with qualitative data from semi-structured interviews. Data were collected concurrently, analyzed independently, and merged during interpretation. Quantitative analyses used multiple linear regression, while qualitative data underwent thematic analysis. Results Eighty-one faculty completed the survey and 20 participated in interviews. Emotional exhaustion emerged as the most prevalent burnout dimension, with 51.9% reporting moderate to high levels. …

Professional Identity Development Among Nursing Students: The Impact Of Structured Reflective Practice, Abdelmonim El Fadely, Kamal Takhdat, Charaf-Eddine Ahraiba, Rahma Bouali, Sabah Selmaoui, Boujemaa Agorram

Health Professions Education

Purpose This study aimed to assess the impact of a structured reflective practice intervention on the development of professional identity among nursing students. Method A mixed-methods design was adopted. The intervention, based on guided reflective practice, was implemented with a voluntary sample of 58 participants. The evaluation relied on a quasi-experimental quantitative approach using the Macleod Clark Professional Identity Scale, with a comparison group and both pre-test and post-test measurements. A qualitative component was also included to explore the dimensions of the studied concept in greater depth. Results Quantitative findings showed a statistically significant difference between the post-test means (p < 0.001), indicating that the reflective practice intervention had a positive effect on the experimental group compared to the control group. The qualitative results further illuminated students’ reflections, which were organized into ten themes corresponding to the study’s conceptual framework: professional knowledge and skills, values and ethics, the nursing role, leadership, professional self-image, social image of the profession, sense of belonging, identification with role models, theory–practice integration, and career choice. These dimensions provided a comprehensive and nuanced understanding of professional identity, capturing the complexity of the concept. Conclusion These results support the integration of reflective practice as a pedagogical approach to fostering the construction and development of a positive professional identity. Professional identity, as a rich and multidimensional concept, goes beyond the process of professionalization—it represents its ultimate achievement.

Attitudes Toward Dementia Among Nursing Students: A Cross-Sectional Study, Ngoc Ha Vo Thi, Thuy Nga Tran Thi, Ngoc Sen Hoang Thi

Health Professions Education

Purpose: Dementia is the loss of cognitive function, including thinking, memory, and communication, due to brain disorders. The global prevalence of dementia is increasing, affecting younger populations. Caring for individuals with dementia requires preparedness to manage behavioral and psychological symptoms. As future healthcare providers, nursing students are expected to have the necessary knowledge and attitudes to support dementia patients. To describe nursing students' attitudes toward dementia and explore related factors.

Methods: A cross-sectional study was conducted on 520 nursing students at Da Nang University of Medical Technology and Pharmacy. A structured questionnaire assessed demographic characteristics, academic information, knowledge, and attitudes …

Preparedness Of Recent Australian And New Zealand Podiatry Graduates: Insights From Practising Podiatrists, Katrina Reynolds, Michelle Mclean

Health Professions Education

Purpose. Transitioning to the workforce can be challenging for health professional graduates when they are not adequately prepared for clinical practice. This study explored the perceptions of practising podiatrists, including those who were also clinical supervisors, regarding the preparedness of recent graduates for clinical practice and identified potential improvements in podiatry education to enhance readiness.

Method. Registered, practising podiatrists in Australia and New Zealand (ANZ) were recruited from December 2018 to May 2019 via professional organisations and social media. Data were collected through an online survey comprising closed and open-ended questions exploring perceptions of recent graduate preparedness, suggested program changes, …

Assessing The Implementation Of National Sodium Reduction Policies In Nigeria: An Interim Qualitative Evaluation Of Stakeholder Perspectives, Chisom Obiezu-Umeh, Erica L Jamro, Guhan Iyer, Mark D Huffman, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Population-wide dietary sodium reduction is a global priority and a highly cost-effective strategy to lower blood pressure and reduce cardiovascular disease risk. In response, the Nigerian government launched the National Multi-sectoral Action Plan (NMSAP) in 2019, recommending evidence-based policy actions including limiting sodium in processed foods, restricting food advertising especially for children, promoting public awareness, integrating nutrition education in schools, and front-of-package labeling. We conducted a qualitative study to examine progress, barriers, and facilitators in implementing these policy actions 3 years post-launch.

METHODS: Between March and September 2024, we conducted 47 key informant interviews and 5 focus group discussions …

Deep Brain Stimulation For The Management Of Non-Motor Symptoms Related To Parkinson’S Disease, Kyla A. Wallaszek

The PA Department Journal of Medical Science

Introduction: Deep brain stimulation (DBS) is a modern neurosurgical technique where electrodes are implanted in specific brain areas and deliver electrical impulses in order to help regulate abnormal brain activity. DBS is used for the management of several neurological conditions and was approved by the FDA for the treatment of Parkinson’s disease in 2003. The purpose of this review is to analyze the effectiveness of DBS for the management of the non-motor symptoms related to Parkinson's disease.

Methods: PubMed was searched using the key terms “Parkinson disease,” “deep brain stimulation,” “voice,” “sleep,” “mood,” “cognition,” and “dysphagia.” Operators and filters narrowed …

Glp-1 Agonists For Pediatric Obesity: A Clinical Review, Grace Burgin

The PA Department Journal of Medical Science

Introduction: Pediatric obesity is a chronic disease with multiple complex causes and many potential consequences if carried into adulthood. Lifestyle modifications alone have not been effective for all patients in the treatment of pediatric obesity. GLP-1 RAs already being prescribed in the adult population were also recently approved for pediatric patients. The purpose of this clinical review is to analyze the efficacy of GLP-1 RAs in decreasing markers associated with obesity, such as BMI, cholesterol, etc. in pediatric patients diagnosed with obesity.

Methods: PubMed was first searched using synonyms of the keywords “pediatric obesity,” “GLP-1 agonists,” “lifestyle modifications,” and “biomarkers …

Psilocybin Treatment For Refractory Depression: A Clinical Review, Hailey A. Jensen

The PA Department Journal of Medical Science

Introduction:

Depression is a widespread mental illness that affects a large portion of the world population and many of those who suffer from depression are resistant to treatment currently available. The purpose of this review is to compare the efficacy of psilocybin to the current available methods for the treatment of refractory depression.

Methods:

PubMed was searched with the key search terms: resistant depression, psilocybin therapy, and adults. Operators and filters narrowed down the search to 43 results. Four articles were then chosen based on quality and specificity with this review.

Results:

The articles included in this review compare the …

Effectiveness Of Behavioral Cough Suppression Therapy In A Closed Enrollment Group Telehealth Delivery Model And Comparison To A Rolling Enrollment, Kinsey Louise Roberts

Graduate Student Theses, Dissertations, & Professional Papers

Background:

Refractory chronic cough (RCC) is a subtype of chronic cough (CC) that persists

despite guideline-based treatment and can negatively affect quality of life. Behavioral cough

suppression therapy (BCST), typically delivered by speech-language pathologists (SLPs), is an

effective treatment for RCC. However, access to BCST remains limited due to geographic

barriers and a shortage of trained providers. Group-based telehealth may help expand access to

treatment. This study evaluated the effectiveness of BCST delivered via telehealth using

a closed enrollment group model and compared outcomes to a rolling enrollment group model.

Methods:

In this prospective sequential cohort study 32 participants attended …

Metabolic Syndrome Beyond Diagnostic Criteria: Population-Scale Integrative Metabolomics Characterization, Marwa Talal

Theses and Dissertations

Background: Metabolic syndrome (MetS) is a complex cluster of interrelated metabolic abnormalities associated with elevated cardiometabolic risk. While diagnosis is based on well-established five clinical criteria, these may overlook early or atypical metabolic alterations. Large-scale metabolomic profiling offers an opportunity to identify biochemical signatures of MetS beyond diagnostic bias and to evaluate their relative importance across different presentations of the syndrome.

Methods: Data from 117,147 UK Biobank participants were analyzed in a cross-sectional design. High-throughput NMR quantified 75 circulating metabolites, for. Univariate analyses, MetS subtype stratification, and elastic net models with SHAP interpretation were applied to assess feature …

Benign Painful Soft Tissue Tumors Of The Digits: A Contemporary Review, Nethmi Withanage, Athikur Rahman, Lawrence Hurst, Samantha Muhlrad

Purpose: Benign painful tumors of the digit are commonly encountered in hand surgery yet frequently pose diagnostic challenges due to overlapping clinical presentations. This review synthesizes current evidence on eight benign soft tissue tumors and cystic lesions that commonly cause digital pain: glomus tumor, giant cell tumor of the tendon sheath (GCTTS), digital mucous cyst, digital ganglion cyst, epidermoid inclusion cyst, pyogenic granuloma, nerve sheath tumors, and angioleiomyoma.

Methods: A comprehensive review of PubMed/MEDLINE was performed, supplemented by hand surgery textbooks and online educational resources. Case series, retrospective cohort studies, and review articles were included.

Results: Each tumor exhibits a …

Dnp Final Report: Poverty Stigma: The Effects Of A Poverty Simulation On Undergraduate Nursing Students And Their Attitudes Toward Caring For Impoverished Patients, Jessica P. Bowen

DNP Final Reports

Background: Current evidence demonstrates that stigma toward individuals living in poverty persists among undergraduate nursing students and negatively influences patient outcomes. Evidence-based educational strategies addressing social determinants of health have been shown to improve nursing students’ perceptions of vulnerable populations.

Purpose: This quality improvement project intended to evaluate the feasibility of integrating an interactive Community Action Poverty Simulation© (CAPS) activity into an undergraduate nursing (BSN) program at an academic health system university in East Texas.

Methods: Guided by the Plan Do Study Act (PDSA) quality improvement framework and The Johns Hopkins Evidence-Based Practice (JHEBP) Model, Missouri's Community Action Poverty Simulation …

Nanoparticle Carriers Enhance The Prophylactic Antiviral Effects Of Dsrna In Vitro And Ex Vivo, Shayne Oberhoffner, Stephanie Dewitte-Orr, Starla Richardson, Leah Haile, Dominique Daniels, Erin Cooper, Aizah Ijaz, Janet Velasquez Perez, Mathilde Peruzzi, Bertrand Collet, Paul Craig, Kristof Jenik

Theses and Dissertations (Comprehensive)

Aquaculture now outpaces traditional capture fisheries as the world population and demand for sustainable protein sources increases. Wild and farmed species are increasingly susceptible to pathogen spread as global temperatures rise and stocking densities increase. Despite the devastating losses experienced by aquaculture due to viral infections, there remain few effective prophylactic antiviral therapeutics. Long double-stranded (ds)RNA is a uniquely viral molecule produced by nearly all viruses during their replication cycle, and its detection by salmonids like rainbow trout (Oncorhynchus mykiss) and chinook salmon (Oncorhynchus tshawytsha) leads to the establishment of a defensive antiviral state. Previous in vitro studies demonstrated a …

The Disruption Of Gastrointestinal Hormonal Control Of Digestion In Nile Tilapia By Omeprazole, Rema Abutaha

Theses and Dissertations (Comprehensive)

Stomach acidity is a critical feature of the digestive system, facilitating the breakdown of protein through the activation of the protease pepsin. Gastric acid is secreted by H⁺/K⁺ ATPase, the gastric proton pump. A previous study on Nile tilapia (Oreochromis niloticus) showed that inhibiting the production of stomach acid using the proton pump inhibitor omeprazole (omz), reduced growth that correlated with an acceleration of the rate of gastric emptying. This contrasts with omz exposure studies in mammals in which there is a delay in gastric emptying and no impact on growth. To understand the mechanism …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Investigating The Immunostimulatory Potential Of Dsrna-Silk Nanoparticle Complexes In Melanoma, Samuel J. Peters

Theses and Dissertations (Comprehensive)

The rate of resistance to immune checkpoint inhibitor treatment in metastatic melanoma is quite high, with an overall rate of 70%. Melanoma achieves these high rates of resistance by suppressing the immune response in the tumour microenvironment (TME), making them immunologically “cold”. The type 1 interferon response could be leveraged to initiate immune responses in melanoma, making their “cold” TMEs “warm” again. Double-stranded ribonucleic acids (dsRNAs) are potent activators of an innate immune response; however, they are susceptible to degradation by nucleases present in the body and need a carrier. Silk nanoparticles (SNPs) are an ideal drug-delivery platform as they …

Lumbosacral Orthosis Can Improve Postural Control In Older Adults With Chronic Low Back Pain, Régis M.-L. D'Assomption, Christian Lariviere, Hakim Mecheri, Suzy Ngomo, Rubens A. Da Silva

Études primaires

Background

Older adults with chronic low back pain may report poor postural control and increased fall risks. Possible key mechanisms are altered lumbar spine proprioception, stiffness and mobility, which could be enhanced through lumbar stabilization approaches. The purpose of this study was thus to evaluate the immediate effects of two lumbar stabilization approaches on postural control measures, namely a lumbosacral orthosis and the abdominal drawing-in maneuver.

Methods

57 older adults (> 65 yrs): 22 with chronic low back pain and 35 healthy controls performed two trials (30 s) of a semi-tandem balance task on a force platform, while three experimental …

The Effects Of Cigarette Smoke And Heated-Tobacco Aerosol On Streptococcus Mutans Adhesion And Surface Topography Of Dental Hard Tissues In Vitro, Mahmoud Bakr, Mohamed Shamel, Mahmoud Al Ankily

Dentistry

No abstract provided.

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Understanding Cancer Information Burden And Quality Concerns: The Roles Of Medical Statistics Literacy, Online Health Information Confidence, And Social Media, Aditya Chakraborty, Sikta Das, Amy Myat Phyo

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Understanding factors shaping perceptions of cancer-related information is important for public health communication. This study examined associations of three information-related predictors, understanding medical statistics, confidence in online health information, and difficulty interpreting social media information, with two outcomes: cancer information was too hard to understand (CTU) and concern about cancer information quality (CCQ). Data came from the 2022 Health Information National Trends Survey. The cross-sectional study included 1972 participants. Survey-weighted univariable and multivariable logistic regression models assessed associations between the three predictors and CTU and CCQ, adjusting for sociodemographic characteristics, health insurance, and cancer history. LASSO logistic regression, random forest, …

The Effects Of Micro- And Nanoplastics On Human Monocytes, Caitlin G. Valerian

Honors Theses and Capstones

No abstract provided.

Exploring Biopsychosocial Influences On Hookup Culture And Disrupting Compulsory Behaviors In Emerging Adults: A Multidisciplinary Analysis Of A Contemporary Public Health Concern, Catherine Benjamin

Honors Theses and Capstones

Multidisciplinary analysis, including biology, psychology, and sociology, to better understand the compulsory Hookup Culture that exists as a contemporary public health concern among the age group defined as emerging adults. Sexually Transmitted Infections (STIs) diagnoses are steadily rising in the United States and disproportionately affecting college students. Early socialization and current educational resources that contribute to shame and stigma are discussed to explain how lifestyle and social conditions can act as risk factors for individual health outcomes.

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design:

Prospective observational pilot study of adult spinal deformity surgery patients.

Objective:

To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data:

Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods:

We prospectively enrolled 18 patients undergoing adult …

Accuracy Of The Phenotypic 1g Test To Detect Mycobacterium Tuberculosis And Drug Resistance From Sputa In The Us-Mexico Border, Mia Aguirre, Doris Ayala, Juan Ignacio Garcia, Yoscelina Estrella Martinez-Lopez, Amberlee Hicks, Nadine M. Chacon, Ashley Gay-Cobb, Alyssa Schami, Selena Zavala-Perez, Blanca I. Restrepo

School of Medicine Publications

Background: With >10 million new tuberculosis (TB) cases/year, a limitation to TB control is the lack of simple and accurate tests for TB diagnosis and drug-susceptibility testing (DST) in endemic regions. We evaluated the accuracy of the first-generation, low-complexity phenotypic TB test (1G test), designed for simultaneous Mtb detection and resistance to isoniazid, rifampicin and moxifloxacin, suitable for resource-limited settings.

Methods: A cross-sectional study was conducted using sputa from 426 possible pulmonary TB subjects from two small Mexican cities bordering Texas. The 1G test was compared against phenotypic TB detection tests in the region [acid fast bacilli smear microscopy and …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

The Effects Of Speak Out! On Hypokinetic Dysarthria In Individuals With Idiopathic Parkinson’S Disease, Linden King

Murray State Theses and Dissertations

The purpose of this single subject research study was to prove the efficacy of SPEAK OUT! therapy in improving loudness, rate of speech, and quality of life for individuals who have hypokinetic dysarthria due to Parkinson’s Disease. In this A-B-A design, five weeks of SPEAK OUT! therapy was provided twice a week to four individuals with a diagnosis of Parkinson’s disease. Results showed an increase in loudness in conversation and improved quality of life measured by statistical and visual analysis. These findings contribute to the research behind the use of SPEAK OUT! therapy for individuals with HKD due to PD.

Cytocompatibility, Osteogenic Potential, Antibacterial And Antibiofilm Efficacy Of A Calcium-Silicate-Based Intracanal Medication, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

This study assessed the biological and antimicrobial properties of a calcium silicate-based material and calcium hydroxide (CH) when used as intracanal medications. MTT assay, osteogenic differentiation of human periodontal stem cells (hPDLSCs), cell mineralization-assay, and determination of ALP activity were assessed to investigate the biological properties. While the agar well diffusion, crystal violet (CRV) assay and LIVE/DEAD staining of dentin slices infected with a mature E. faecalis biofilm were used to assess the antimicrobial properties. Normally distributed data were analyzed using one and two-way ANOVA and post hoc Tukey test, while for non-normally distributed data Kruskal Wallis and Dunn's tests …