Digital Commons Network^™

Implementing A Risk-Stratified Fall Prevention Bundle To Reduce Inpatient Falls,, Nana A. Tabiri

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Step-Down Unit (SDU) had a high fall rate of 4.8 falls/ 1,000 patient days, falling short of the 3.0 falls/1,000 patient days organizational target. Despite the high fall rate, the unit used a one-size-fits-all approach, which was ineffective. Also, nursing practices in the unit were unevenly adopted.

Project Objective: The project aimed to lower the fall rate in SDU by 10% and increase compliance with risk-stratified documentation to at least 90%.

Evidence Review: A huge pool of evidence supported the adoption of a multifactorial, person-centered fall prevention approach as opposed to universal precautions. The AHRQ …

Spell: A Scalable Nlp Method Using Regular Expressions And Large Language Models For Clinical Information Extraction, Ricardo Kleinlein, David W Bates, Carolyn Guan, Kathryn J Gray, Vesela P Kovacheva

Faculty, Staff and Students Publications

Background and objectives: Electronic health records (EHRs) contain valuable information for research and decision-making, but much resides in unstructured notes that are challenging to analyze at scale. We developed SPELL (Snippet-Primed rEgex LLM Pipeline), a scalable natural language processing workflow that combines regular-expression-based snippet retrieval with locally hosted large language model (LLM) inference to extract structured variables from large collections of clinical narratives.

Methods: SPELL uses task-specific regular expressions to retrieve short context windows ("snippets") from unstructured texts and applies task-prompted LLM inference on snippets rather than full documents. All processing occurs within institutional computing environments. Accuracy was evaluated on …

Dean's Report- Fall 2026, Marina K. Holz

GSBMS Dean’s Report

No abstract provided.

A Prospective Natural History Study Protocol For Clinical Trial Readiness In Synaptic Disorders, Jillian L Mckee, Sarah M Ruggiero, Kristin Cunningham, Joeylynn Coyne, Ian Mcsalley, Michael C Kaufman, Bintou Bane, Torrey Chisari, Jonathan Toib, Carlyn Glatts, Sarah Tefft, Julie M Orlando, Viveknarayanan Padmanabhan, Alexander K Gonzalez, Alicia Harrison, Charlene Woo, Stephanie A Zbikowski, Rency Dhaduk, Johanna Mercurio, Macie Mccarthy, Jan H Magielski, Zachary Grinspan, Megan Abbott, Juliet Knowles, Hsiao-Tuan Chao, Katherine Xiong, Elizabeth Berry-Kravis, Sepideh Tabarestani, J Michael Graglia, Kathryn Helde, Virginie Mcnamar, Charlene Son Rigby, James Goss, Scott Demarest, Andrea Miele, Benjamin Prosser, Michael J Boland, Samuel R Pierce, Ingo Helbig

Faculty, Staff and Students Publications

Objective: STXBP1-related disorder (STXBP1-RD) and SYNGAP1-related disorder (SYNGAP1-RD) are two common genetic synaptopathies that are associated with epilepsy, developmental delay, intellectual developmental disorder, and behavioral problems. Both STXBP1-RD and SYNGAP1-RD are potential targets for disease-modifying therapies, but there is limited information in the literature describing the natural history of either disorder, which impedes outcome selection for future clinical trials. The objective of this study is to develop a framework to better define and outline the clinical spectrum and longitudinal trajectories of STXBP1-RD and SYNGAP1-RD natural history, including development, behavior, seizure histories, and electrophysiology.

Methods: Here, we describe a protocol, regulatory …

Early Prediction Of The Breast Cancer Response To Neoadjuvant Chemotherapy Based On Intratumoral Interstitial Fluid Pressure Using 3-D Subharmonic-Aided Pressure Estimation, Sung In Choi, Basak Dogan, Corinne E. Wessner, Jessica H. Porembka, Priscilla Machado, B. Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Kenneth Hoyt, Flemming Forsberg, Kibo Nam

Department of Radiology Faculty Papers

Elevated intratumoral interstitial fluid pressure (IFP) may negatively impact the efficacy of neoadjuvant chemotherapy (NAC). This study aimed to predict the breast cancer response to NAC based on intratumoral IFP using 3D contrast-enhanced ultrasound (CEUS) with subharmonic-aided pressure estimation (SHAPE). This prospective study enrolled breast cancer patients undergoing NAC from two clinical sites. 3D CEUS was performed at 0%, 10%, and 30% of NAC completion using a GE Logiq E9 with Definity. The pressure gradients between the tumor and adjacent normal tissue were estimated by SHAPE, utilizing the inverse linear relationship between the ultrasound contrast agent’s subharmonic signal amplitude and …

A Deep-Learning Based Biomarker Of Systemic Cellular Senescence Burden To Predict Mortality And Health Outcomes, Shangshu Zhao, Chia-Ling Kuo, Eric J Lenze, Julie L Wetherell, Laura Haynes, Perla El-Ahmad, Richard Fortinsky, George Kuchel, Trevor Harris, Breno S Diniz

2020-Current year OA Pubs

The accumulation of senescent cells is a recognized hallmark of biological aging and is associated with the onset of multiple chronic medical conditions. Senescent cells exhibit a distinct secretory profile, known as the senescence-associated secretory phenotype (SASP), which can propagate cellular senescence to neighboring and distant tissues. Measuring SASP factors in blood serves as a practical proxy for cellular senescence burden and may help track disease states and intervention outcomes. We developed and validated a composite SASP Score by integrating large-scale population proteomics data with a semi-supervised deep learning framework. The analytical workflow included: (1) selection of biologically curated SASP …

Sex-Based Disparities In Artificial Intelligence For Cardiovascular Disease: A Scoping Review, Maurgan Lee, Tarek Atasi, Michael Mclellan, Yodit Beru, Jason Booza

Population, Patient, Physician and Professionalism Projects

No abstract provided.

Prevalence Of Vitiligo In East Africa: Systematic Review And Meta-Analysis, Kedir Seid, Chala Getaneh Jaleta, Sintayehu Samuel Lorato, Mitiku Desalegn, Dawit Tesfaye Rundasa, Yohannes Godie Ashebir, Olyad Kuma Getahun, Gebeyehu Lakew, Mathewos Mekonnen Gemmechu, Mulualem Endeshaw Zeleke, Yibeltal Assefa Atalay, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Abiy Hailu Tikuneh, Abas Ali Hassen, Eyasu Alem Lake, Tadesse Nigussie, Bushra Bibi, Fikiru Yigezu Y. Jaleta, Abebe Gedefaw Belete, Genanew Kassie Getahun

Research outputs 2022 to 2026

Background: Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, resulting in depigmented macules and patches. No accurate estimate has been made of the prevalence of vitiligo in East Africa.

Objectives: To determine the prevalence of vitiligo in East Africa via a systematic review and meta-analysis of the literature.

Methods: A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines. Eleven articles were retrieved from PubMed/MEDLINE, Embase, Scopus, Google Scholar, Science Direct, Web of Science and African Journals Online. Microsoft Excel was used to extract the data, which were then exported to STATA 17 …

Women's Experiences Of Menstrual Pain And Perceptions Of Acupuncture: A Qualitative Study, Weiting Liu, Amanda Towell-Barnard, Khui Hung Lee

Research outputs 2022 to 2026

Introduction: Menstrual pain is a common reproductive health concern that can substantially disrupt physical, emotional, and social well-being, yet it is frequently normalised and insufficiently addressed within healthcare encounters. Acupuncture is increasingly used as a complementary approach for menstrual pain management; however, little qualitative research has explored how women understand, interpret, and navigate this option within their menstrual care.

Methods: A qualitative descriptive study was conducted using four online focus groups with 14 women aged 19–46 years residing in Australia who self-reported primary dysmenorrhea. Participants were purposively sampled from respondents to a previous cross-sectional survey study who had indicated willingness …

Training Apart, Together: Team Dynamics In Individual Sports And Surgical Residency, W. Jack Palmer, Dylan Bertoni, Elizabeth E. Cottrill, Colin T. Huntley

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery …

Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey

Department of Surgery Faculty Papers

Objective: Early surgical exposure may potentially influence medical students' decision to pursue a surgical career. At our urban, academic medical school, senior medical students developed a Surgical Externship Program (SEP) to provide first-years with hands-on OR experience. This program is a structured 1- to 2-week immersive experience in which first-year students scrubbed into operations, participated in rounds, and engaged with surgical teams under resident and attending supervision. This study evaluates the SEP's impact on surgical interest, OR confidence, and clinical exposure.

Setting: Academic tertiary care hospital.

Participants: First-year medical students.

Design: First-year students participated in a 1- or 2-week SEP …

Shsp Dean's Newsletter, Fall 2026, Brian J. Nickerson

SHSP Dean’s Newsletter

No abstract provided.

A Profile Of Assisted Living Direct Care Workforce Training Requirements Across The United States, Erh-Chi Hsu, Paula Carder, Lindsey Smith, Zhiqing E. Zhou, Olga Yakusheva, Anna S. Beeber, Eric Jutkowitz, Kali Thomas

Institute on Aging Publications

Objectives

To characterize assisted living (AL) direct care worker (DCW) training requirements across the United States and how these regulations have changed over time. Specifically, we examine state-level profiles of training regulations, including duration, frequency, content, source of materials, evaluation, and changes in regulatory coverage.

Design

Cross-sectional and longitudinal descriptive study using state policy data and AL directories from 2019, 2021, and 2023.

Setting and Participants

All US states' AL training–related regulations; all ALs and AL beds governed by those regulations.

Methods

We used a mixed-methods approach with an explanatory sequential design (QUAN → qual), first conducting health services regulatory …

Caribbean Hearing Health Readiness: A Data-Guided Method For Doctor Of Audiology Study-Abroad And Service Learning, Chelsea Tynes, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Access to audiology care is essential, as unmanaged hearing loss carries significant communicative, social, and health consequences. Across many Caribbean nations, access to audiologic care remains limited, with substantial variation in workforce, diagnostic services, hearing-health infrastructure, and system readiness. The Caribbean Audiology Research Project (CARP), established by the Hearing Loss Prevention Laboratory, characterized hearing-health capacity across eight Caribbean countries: Antigua and Barbuda, Barbados, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, and The Bahamas. Publicly available data on the audiology workforce, healthcare infrastructure, diagnostic and rehabilitative services, public-health programs, demographic indicators, and logistical factors were …

Loma Linda Nurse - Vol. 35, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | From Behind the Lens to by the Bedside—Nicole Mackey

6 | Coming Home— CRNA Alumni Faculty Feature

8 | From NICU Miracle Baby to Nurse—Nito Gil

10 | Change the Game— Miguel Aguayo

12 | Standing in the Shadow of a Miracle—Joyce Rusch

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-29 | ACADEMICS

30-33 | HOMECOMING

34-38 | FACULTY UPDATES

Enhancing Collaboration Through Post-Round Huddles, Kristen Ramirez

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: On a 16-bed medically supervised detoxification unit at a northeast Ohio community hospital, the interprofessional team had no consistent, structured way to communicate after physician rounds, fragmenting coordination and threatening patient safety for a complex, co-occurring population. Organizational HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) communication scores fell below the 80% national benchmark, confirming a modifiable, systems-level concern.

Aim of the Project: The quality improvement (QI) project aimed to enhance care quality and coordination by standardizing a shared plan of care across the interprofessional team.

Review of the Evidence: A systematic search retained 12 …

Chronic Pain And Mobile Health: Are The Apps That Occupational Therapists Recommend Of High Quality?, Jessica Smith, Thuy Tran, Jacqui Hunt, Katrina Liddiard

Research outputs 2022 to 2026

Introduction: Chronic pain is a biopsychosocial experience that can impact peoples' ability to participate in everyday occupations. Mobile health applications, or apps, have the potential to make chronic pain services more effective and accessible. However, the quality of many health apps is not known, which creates a critical challenge for occupational therapists who aim to deliver evidence-informed intervention. This study rated the quality of apps available for Australian occupational therapists to use with clients who have chronic pain.

Consumer and Community Involvement: No consumer and community involvement.

Methods: This study used a cross-sectional descriptive design to (1) identify chronic pain-relevant …

Flourishing Childhood Frameworks: A Scoping Review, Jacqueline A. Davis, Zenobia Talati, Lisa Y. Gibson, Jack Kennare, Christina Bethell, Christina Hinton, Hannah Block, Tara D'Silva, Desiree Silva, Susan L. Prescott

Research outputs 2022 to 2026

Objectives: Experiences in early life impact childhood, lifelong flourishing, and overall well-being. Yet a framework to guide promoting and measuring flourishing in early childhood has not emerged. The objective of this study was to identify frameworks and measures related to promoting and assessing early-childhood flourishing (0-5 years) to build on a preexisting, community-informed framework.

Methods: A systematic search was conducted across electronic databases and the gray literature for articles published between 2014-2026. Of 13 902 total references, 8592 were eligible for screening. A machine learning-assisted tool (Research Screener) was used to streamline screening of the abstracts against the inclusion criteria. …

Enantioselectivity Of The Photochemical Continuous-Flow Isomerization Of Humulones, Gregory M. Giovine, Trevor Smith, Bruce Hamper

Undergraduate Research Symposium

Humulones, the primary natural product present in the historically significant hop flower, represent a largely unexplored candidate for structure-based pharmaceutical design.  Showing promising biological activity as an anti-bacterial and anti-inflammatory agent, humulones are of interest both for their bioactive properties and for their long-established tolerability and natural abundance.  Humulones undergo a characteristic isomerization reaction, where the six-membered substituted phloroglucinol ring contracts to a five-membered ring isohumulone, under a variety of conditions, including those enabled by brewing conditions (thermal, metal-catalyzed) and by exposure to UV light.  Optimization of the photocatalyzed isomerization of n-humulone to n-isohumulone in flow conditions resulted in a …

Exploring The Contextual Relationships Between Match Day Load And Recovery Biomarkers In Professional Soccer Players, Carina Hanson-Evans, Ryland Morgans, Rafael Oliveira, Jule Scholten, Roi Gil, Ben Ryan, Jon Oliver, Piotr Żmijewski, Michael G. Hughes

Baltic Journal of Health and Physical Activity

Background: This study examined the relationship between match-day (MD) load and contextual factors on recovery biomarkers in professional soccer players across the 2024/2025 competitive season. Materials and Methods: Twenty-six male professional soccer players provided blood samples following 38 competitive matches. High-sensitivity C-Reactive Protein (hs-CRP), Free-Oxygen Radicals Test (FORT), Free-Oxygen Radicals Defence Test (FORD) and Oxidative Stress Index (OSI) were analyzed. Physical MD load was measured via a Global Positioning System (GPS). Results: Differences in High-Load vs Low-Load matches did not significantly influence post-match levels of hs-CRP, FORD, FORT or OSI. Increased high-intensity running and elevated inflammation, with non-significant moderate-to-large effects …

Bacterial Biomass As A Versatile Platform For Functional Materials: Structural Insights And Sustainable Applications, Hasan M. Agha

AUIQ Complementary Biological System

Bacterial biomass has emerged as a versatile material with strong potential in environmental, material, and biotechnological applications, as well as broader uses such as bioplastics, packaging materials, and agricultural systems, owing to its rapid growth, controllable production, and surface chemistry enriched with carboxyl, hydroxyl, amino, phosphate, sulfate, and sulfhydryl groups. These features enable multiple interaction mechanisms, including electrostatic attraction, ion exchange, surface complexation, hydrogen bonding, and π –π interactions, supporting applications in pollutant removal, wastewater treatment, composite development, and bioenergy systems. Bacterial biomass can be sourced from natural environments, industrial fermentation, and waste streams, particularly activated sludge, making it compatible …

Effectiveness Of An Integrated Activity-Based And Tele-Monitoring Intervention On Mental Health Literacy And Resilience Among Urban Older Adults In Thailand: A Quasi-Experimental Study, Khunatpakorn Makkabphalanon, Pramote Thangkratok, Jutamast Wongjan, Natchaya Palacheewa

Journal of Health Research

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes …

Descriptive Epidemiology Of Tuberculosis Case With Diabetes Mellitus Identified Through Screening Activities In Indonesia, 2024, Chrisshanti Putri Pasaribu

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major public health problem, particularly among individuals with diabetes mellitus (DM), who are at an increased risk of developing TB disease. Screening activities conducted through health facility-based screening and active case finding (ACF) provide opportunities to identify TB cases with DM comorbidity. This study aimed to describe the epidemiological characteristics of TB-DM cases identified through screening activities in Indonesia in 2024. This descriptive study used routine secondary program data obtained from the Tuberculosis Information System (SITB). The source population consisted of 615,357 individuals screened for TB in 2024, among whom 14,727 TB cases were identified. Of …

Situational Analysis Of Maternal And Child Health Problems In Dki Jakarta Province In 2024, Jennifer Irene Amorita Hadiono, Helda Helda, Tri Yunis Miko Wahyono, Inggariwati Inggariwati

Jurnal Epidemiologi Kesehatan Indonesia

Maternal and child health (MCH) is a critical indicator of national health development aligned with SDGs targets. DKI Jakarta, as a densely populated capital city, faces unique challenges in providing equitable MCH services. This study aims to analyze the situational status of MCH problems in DKI Jakarta Province in 2024 and to determine health priorities using the PAHO-adopted Hanlon method. A descriptive study using quantitative and qualitative approaches was conducted at the DKI Jakarta Provincial Health Office from October 2024 to January 2025. Primary data were collected through structured interviews, while secondary data were sourced from reports of the Nutrition …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

The Impact Of Evidence-Based Benzodiazepine Tapering Guidelines In An Outpatient Psychiatric Setting: A Quality Improvement Project, Addeh Tosin

Doctor of Nursing Practice Projects

Long-term benzodiazepine use is associated with dependence, withdrawal, cognitive impairment, falls, and overdose, yet tapering practices remain inconsistent in outpatient psychiatric care. This quality improvement project examined whether evidence-based deprescribing education improved psychiatric mental health nurse practitioners' (PMHNPs) self-efficacy, adherence to benzodiazepine tapering guidelines, and active prescription outcomes. The Plan-Do-Study-Act cycle guided implementation, the ADKAR Model guided change, Bandura’s Self-Efficacy Theory provided the theoretical framework, and the Stetler Model supported evidence translation. The project employed a quantitative, quasi-experimental, single-group pretest-posttest design and involved three PMHNPs from one outpatient psychiatric practice. Participants received one 20-minute educational session based on American Society …

Improving Provider Confidence In Suicide-Risk Screening Through Training On A Safe-T-Guided Pathway At Intake, Shukairo Mack Baker

Doctor of Nursing Practice Projects

Evidence supports structured suicide-prevention education, but inconsistent pathway use at outpatient intake prompted this quality improvement project to evaluate provider confidence. The aim was increased confidence after training on a Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) guided pathway. Donabedian's structure, process, and outcome model and the Awareness, Desire, Knowledge, Ability, and Reinforcement change model guided implementation through one Plan, Do, Study, Act cycle. A single-group pre-test and post-test design involved seven clinicians at one hybrid outpatient behavioral health clinic. All available eligible staff (100%) completed a 2.5-hour training and both surveys. The Suicide Risk Assessment Confidence Scale was administered …

Modelling Acute Haemorrhagic Conjunctivitis In East Africa: An Integrated Approach To Transmission Dynamics And Outbreak Response Strategies, Geofrey Wingi Sikazwe

Tanzania Journal of Science

Acute hemorrhagic conjunctivitis (AHC) poses a significant global health risk, with the potential for rapid spread during outbreaks. For instance, a localized outbreak in Yunnan Province, China, recorded infection rates of up to 48%, illustrating how transmission can intensify under favourable epidemiological and environmental conditions. Existing mathematical models of AHC transmission overlook seasonal variations, a critical factor in epidemic spread. This study combines species distribution models (SDMs) and epidemiological modelling to analyse key drivers of AHC in East Africa. We use the SEIR type (Susceptible-Exposed-Infected-Recovered - incorporating waning immunity) framework with temperature-dependent infectivity rate as the key driver of an …

Building Health Resilience Against The Threat Of “Jakarta Sinking”: A Scoping Review, Risky Kusuma Hartono, Dewi Shinta

Journal of Indonesian Health Policy and Administration

In Jakarta, land subsidence amplifies flood risks—often described as the city “sinking”—which increases exposure to waterborne and vector-borne diseases, disrupts essential health services, and undermines health system resilience. This review examines how subsidence-induced flood amplification impacts health and its implications for system resilience. This study employs a literature review approach that combines narrative synthesis with scoping-oriented evidence mapping. Peer-reviewed articles in English or Indonesian (2015–2025) were searched across PubMed, Scopus, ScienceDirect, Google Scholar, and Portal Garuda using the following terms: flooding, Jakarta land subsidence, health impacts, and health system resilience. Data on hazards, populations, health outcomes, and resilience functions were …

Biosensor Development In East Africa: A Systematic Review Of Technologies, Applications, Challenges, And Future Directions, Ally Mahadhy

Tanzania Journal of Science

Biosensors integrate biological recognition elements with signal transduction systems to generate quantitative or semi-quantitative analytical information and have applications across healthcare, food safety, agriculture, environmental monitoring, and wildlife health. Despite substantial global advances, biosensor development in East Africa remains poorly characterized. This systematic review, conducted according to PRISMA 2020 guidelines, evaluated published evidence from 1995 to 2025 within a predefined East African Community geographical scope. Eligibility was based on IUPAC-aligned operational criteria requiring an integrated biological recognition element, transduction mechanism, and quantitative or semi-quantitative signal output. Three locally developed biosensors met the criteria: an electrochemical nano-biosensor for schistosomiasis diagnosis in …