Digital Commons Network^™

The Case For Gulf Region-Specific Peripheral Artery Disease Trials: A Comprehensive Literature Review, Hosaam H. Nasr, Faisal A. Almudaiheem

Saudi Medical Journal

Peripheral artery disease (PAD) research is globally underrepresented, with landmark trials like Best Endovascular Surgical Therapy for Patients with Critical Limb Ischemia and Bypass versus Angioplasty in Severe Ischemia of the Leg predominantly featuring white, Western populations. These studies fail to account for the unique clinical landscape of the Gulf region, where PAD prevalence reaches up to 13.7%. Gulf patients present at younger ages and face a disproportionately high diabetes burden, with regional prevalence near 18%, nearly double that of Europe. Beyond metabolic factors, the Gulf population exhibits distinct genetic architectures, including high rates of consanguinity and familial hypercholesterolemia. Because …

The Role Of Chimeric Antigen Receptor Regulatory T Cells In Promoting Immune Tolerance In Solid Organ Transplantation: Mechanisms And Therapeutic Potential, Maher S. Alwethaynani

Saudi Medical Journal

Solid organ transplantation (SOT) is a life-saving procedure for patients with end-stage organ failure; however, lifelong immunosuppressant use is needed to prevent allograft rejection. These drugs increase the risk of non-Hodgkin lymphoma, liver, kidney, and lung cancers, and heighten susceptibility to oncogenic viruses, including hepatitis B and Epstein-Barr virus. The usage of chimeric antigen receptor (CAR) regulatory T (Treg) cells is a promising approach to induce transplant tolerance while minimizing dependence on immunosuppressants. The CAR Tregs offer the potential to enhance graft survival and quality of life by reducing immunosuppressant-related morbidity and mortality. Despite remarkable progress in transplantation tolerance, challenges …

Exploring Translational Medical Research Progress In G20 Countries: 5-Year Study, Hana A. Alhumud, Fars K. Alanazi, Edward B. Devol

Saudi Medical Journal

Objectives: Biomedical research is crucial for advancing medical knowledge and improving public health. However, the research process is often disjointed and lacks seamless progression, leading to delays and missed opportunities. To address this, the concept of translational research has emerged, focusing on the smooth transition of research results to the next stage of inquiry. Methods: This study analyzed approximately 40,000 research publications from the Web of Science database to identify research activities associated with translational research. Publications from Group of 20 (G20) countries over the past 5 years were examined to explore patterns of research focus and progress in this …

Feasibility And Acceptability Of A Home-Health Aide-Delivered Loneliness Reduction Program In A Small Home Care Agency: The Caring Connections Quality Improvement Project, Tontalayia L. Robinson

Doctor of Nursing Practice (DNP) Manuscripts

Loneliness is a significant public health concern that adversely affects mental, cognitive, and physical health, with consequences comparable to smoking 15 cigarettes per day. Home care recipients experience loneliness at rates of 15.9% to 24.2%, yet home-health aides (HHAs), who often have the most consistent contact with homebound clients, lack structured tools for recognizing and responding to loneliness. This gap highlights the need for practical, evidence-based strategies that can be integrated into routine home care practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the feasibility, acceptability, and appropriateness of a home-health aide–delivered loneliness …

Impact Of Music On Patient Comfort During Mr Scans: A Literature Review, He Yan

Radiologic Sciences

Purpose To investigate the influence of auditory stimuli on patient comfort levels during magnetic resonance (MR) imaging, with particular emphasis on indicators of distress, duration of patient positioning, and utilization of emergency signaling devices.

Method An integrative literature review was undertaken utilizing peer-reviewed research articles sourced from journals within the fields of radiology, music therapy, and clinical practice. A comprehensive search was conducted across databases such as PubMed, ScienceDirect, SpringerLink, and Oxford Academic employing keywords including MR anxiety, music therapy, and patient comfort.

Results The body of literature consistently indicated that auditory stimuli significantly mitigate patient anxiety and distress in …

Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …

Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …

Premarket Clinical Evidence Strength And Recalls Of High-Risk Therapeutic Medical Devices, Maryam Mooghali, Faaizah Arshad, Vinay K Rathi, Kushal T Kadakia, Alexander O Everhart, Joseph S Ross, Sanket S Dhruva

2020-Current year OA Pubs

IMPORTANCE: High-risk medical devices approved through the US Food and Drug Administration (FDA) premarket approval (PMA) pathway may be supported by limited premarket clinical evidence, leaving uncertainties about safety. Whether device, premarket clinical evidence, or regulatory characteristics are associated with subsequent device recalls is unknown.

OBJECTIVE: To examine the association between device, premarket clinical evidence, and regulatory characteristics and serious recalls among high-risk therapeutic devices.

DESIGN AND SETTING: This cross-sectional study reviewed 193 high-risk therapeutic medical devices approved through the FDA's PMA pathway between January 1, 2014, and December 31, 2023. Data were analyzed between August 2025 and December 2025. …

High-Definition Healing: Investigating Ai-Driven Mr Reconstruction Methods, Jerell R. Jones

Radiologic Sciences

Purpose To analyze recent artificial intelligence (AI)-driven magnetic resonance (MR) reconstruction methods aimed at addressing long acquisition times, image artifacts, and workflow inefficiencies.

Method A systematic literature review was conducted using PubMed, Scopus, and Scopus AI, targeting peer‑reviewed studies published between 2015 and 2026. Search terms included “MRI,” “magnetic resonance imaging,” “artificial intelligence,” “deep learning,” and “machine learning.” Eligible studies included methodology, validation, and review papers. Extracted data included algorithm type, study design, key findings, and limitations. Themes were identified through content analysis and generative AI use.

Results Prominent themes identified were the emergence of generative adversarial networks, advanced neural …

Administrative And Clinical Impacts Of Theranostic Program Expansion In Nuclear Medicine, Karmela Kljajic Pascual

Radiologic Sciences

Purpose To synthesize current evidence on theranostic trials, nuclear medicine clinical workflow models, and organizational readiness, with a focus on how healthcare organizations and medical imaging leaders are adapting to the rapid expansion of theranostic services.

Method A comprehensive search was conducted across Scopus, PubMed, MEDLINE, and Google Scholar. Inclusion criteria required peer‑reviewed articles published between 2002 and 2026 addressing nuclear medicine leadership, theranostic implementation, workflow design, and organizational factors influencing theranostic program development. Exclusion criteria removed editorials, blog posts, and nonpeer‑reviewed sources.

Results Four major themes emerged: workforce and staffing demands, infrastructure and resource requirements, regulatory and administrative pressures, …

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

Hitl Ai For Digital Transformation In Healthcare, Ntando S. Sibanda, Petronella Muziti, Priscilla Mataure

African Conference on Information Systems and Technology

Limited labor capacity, disjointed information flows and delays in clinical decision-making are among the ongoing issues that primary health care (PHC) systems in resource-constrained settings must deal with. These issues limit service delivery and impede efforts to undergo digital transformation. This study investigates how improved decision support at the primary care level can facilitate incremental digital transformation through human-in-the-loop (HITL) artificial intelligence (AI). In order to identify system gaps, design a context-sensitive HITL AI prototype and assess its viability, usability and integration within standard PHC workflows, the study employs a design-based implementation research approach that incorporates qualitative interviews, workflow observations …

Assessment Of Parents' Informational Needs Before Pediatric Day Care Surgery In Makkah City, Saudi Arabia, Ammar H. Habiballah, Raghad Y. Shosho, Raed M. Babukur, Sultan M. Banser, Sarah S. Almohammadi, Muhannad M. Alharbi, Thekra A. Alwafi, Shahad S. Alkabkabi, Raed F. Alsufi

Saudi Toxicology Journal

Introduction Pediatric surgical procedures can be highly stressful for children and their parents due to factors such as limited understanding, lack of control, and anxiety. The study aims to assess the informational needs of parents of children scheduled to undergo day care surgery in Makkah City, Saudi Arabia. Methodology A cross-sectional study was conducted over six months. The study included parents or caregivers of children scheduled for day care surgery in Makkah City, Saudi Arabia.A convenient sampling techniques was used for participant selection. Data were analyzed using SPSS software. Results The study included 380 participants and assessed parental informational needs …

Reducing Urinary Tract Infections In Long-Term Care Residents, Felicity Antwi

Walden Dissertations and Doctoral Studies

This quality improvement (QI) project addressed delays in diagnosing urinary tract infections (UTIs) at a skilled nursing facility (SNF), where reliance on urine culture testing and patient monitoring resulted in an average diagnostic period of 72 hours. A high UTI incidence and UTI-involved hospitalization rate are both nurse-sensitive indicators that are important to address in the nursing practice context because they portend negatively for nursing quality and safety. This quality improvement (QI) project addressed the practice-focused question: among long term care (LTC) residents with suspected UTIs in a nursing home (NH), how does reducing the diagnostic period from 72 hours …

Perceived Trustworthiness As A Pathway Linking Adhd Traits To Large Language Models Dependency: Evidence From Uk And Chinese Samples, Ala Yankouskaya, Mohammad Amin Kuhail, Haibo Yang, Xiaokun Wang, Jiaojiao Chen, Tina Yunsi Ma, Sameha Alshakhsi, Guandong Xu, Raian Ali

All Works

Large language models (LLMs) create contexts in which individual differences may shape reliance on digital systems. Drawing on neurodiversity, this study examined whether perceived trustworthiness of user’s primary LLM mediates associations between attention-deficit/hyperactivity disorder (ADHD) traits and LMM dependencyinstrumental and relationship LLM dependency. Adults in the UK (n = 567) and China (n = 577) reported ADHD traits, perceived LLM trustworthiness of LLM, and both types of dependency. Across samples, higher ADHD traits were associated with lower trustworthiness, whereas greater trustworthiness was associated with greater instrumental and relationship dependency, yielding negative indirect effects. In the UK, direct ADHD-dependency associations were …

Prompt Framing And Evidence Requirement For Ai-Generated Educational Responses In Dental Education: Experimental Study., Man Hung, Corban Ward, Owen Cohen, Jacob Marx, Zachary Smit, Jacob Newman, Martin S. Lipsky

Institute on Aging Publications

Large language models are increasingly used in health professions education; however, the role of prompt design in shaping their outputs remains poorly understood in clinical training contexts. In dentistry, where information presentation, perceived credibility, and procedural reasoning are important, the effects of instructional framing and evidence requirements on AI-generated educational responses are particularly relevant.

Self-Medication Experience And Healthcare Trust Among Youth: A Regionally Concentrated Digital Survey In Indonesia, Wahyudi Wahyudi, Azra Muzaiyana Nasution, Arini Dwi Rahmadani, Alysa Rahmadani Hasibuan

Patient Experience Journal

Self-medication has become a central experience for youth transitioning toward independent medical decision-making. In the digital era, young people must navigate a complex landscape of health information while seeking independent health solutions. This study investigates self-medication experiences and healthcare trust among youth, utilizing a regionally concentrated digital survey approach in Indonesia. Data were collected via a cross-sectional approach using digital platforms (Instagram, TikTok, and Twitter/X), facilitated by 76 trained enumerators. While respondents from all 38 provinces participated, the sample (N = 2,790) exhibits a major geographical concentration in the Sumatra region. The study employed a validated 16-item instrument to evaluate …

Childhood Cancer Predisposition Study: A Prospective Registry And Biorepository Protocol, Melissa R Perrino, Suzanne P Macfarland, Luke Maese, Jennie Vagher, Junne Kamihara, Surya Rednam, Philip J Lupo, Garrett M Brodeur, Joshua Schiffman, Lisa Diller, Lauren Desrosiers-Battu, Sharon E Plon, Kim E Nichols, Samuel L Volchenboum, David Malkin, Anita Villani, Christopher C Porter

Faculty, Staff and Students Publications

Introduction: Cancer is the most common cause of disease-related mortality in children, highlighting the urgent need for improved care in this population. It is estimated that >15% of children diagnosed with cancer harbour a germline pathogenic variant in a cancer predisposition gene which confers an increased risk to develop cancer. There are over 100 genes associated with cancer predisposition syndromes (CPSs) and greater availability and acceptability of genetic testing in the last decade has facilitated their recognition in childhood. However, individually, each of these CPSs is rare, impeding robust research and advancement of clinical care. Once a specific CPS is …

Automated Flim-Fret Segmentation Within Rnp Condensates, Noah D Powell, Joshua M Marcus, Leyla E Fahim, Jason E Lee

Faculty, Staff and Students Publications

Ribonucleoprotein (RNP) condensates are membraneless organelles that exist alongside many RNA-driven processes, such as transcription and splicing. Despite their ubiquity, the biological necessity of forming a condensed phase remains unclear, particularly because the same RNP components exist both within these organelles and in the surrounding dilute phase. Most current methods for studying biochemical interaction dynamics within condensates rely on in vitro reconstitution of minimal factors or low-throughput single-molecule studies. However, RNP condensates are complex organelles containing tens to hundreds of proteins and hundreds to thousands of different RNAs. Here, we describe a scalable, high-throughput fluorescence microscopy–based approach to analyze protein–protein …

Improving Fluoride Varnish Application Rates In A Pediatric Primary Care Microsystem, Roman G. Roxas

Master's Projects and Capstones

Problem

Childhood caries is a preventable public health issue disproportionately affecting the underserved. National guidelines recommend fluoride varnish (FV) application during well‑child visits. In California, fewer than 15% of children under age six received FV. In a pediatric primary care clinic, baseline performance was 11% in 2025.

Context

A six‑month quality improvement project was implemented. Key barriers included reduced team cohesion, workflow variability, unclear roles, and underutilized electronic health record (EHR) prompts.

Interventions

The change package standardized medical assistant–led workflows, activated EHR prompts, and provided targeted education. Leadership reinforcement through regular huddles supported adoption, consistency, and team engagement.

Measures

Outcome …

Unfolded Protein Response As A Therapeutic Target: 4-(Heptyloxy)Phenol Induces Programmed Cell Death In Ewing Sarcoma, Nenggang Zhang, Mary Perez, Gaye N Jenkins, Terzah M Horton, Scott R Gilbertson, Debananda Pati

Faculty, Staff and Students Publications

Ewing sarcoma is a rare and aggressive pediatric malignancy with limited therapeutic options, particularly for relapsed or refractory cases, highlighting the urgent need for innovative treatment strategies. In this study, we identify endoplasmic reticulum stress (ERS) and the unfolded protein response (UPR) as critical therapeutic vulnerabilities in Ewing sarcoma and introduce 4-(heptyloxy)phenol (AC-45594) as a novel small-molecule agent that exploits these stress pathways. AC-45594 selectively inhibited the growth of Ewing sarcoma cells among 13 cancer and 6 noncancerous cell lines, demonstrating marked tumor specificity. Structure-activity relationship studies revealed that both the phenolic hydroxyl group and an optimal alkoxy chain length …

Effectiveness Of The Smart Me-De Digital Program On Health Literacy And Glycemic Control In Newly Diagnosed Type 2 Diabetes, Nongnaphat Rungnoei, Siriporn Kruttakart, Natthapan Phianthanyakam, Pakaporn Klinhom, Umaporn Nokpaet, Jintipa Sirikunwiwat, Burong Jaitham

Journal of Health Research

Background: Individuals newly diagnosed with type 2 diabetes often have limited knowledge and self-management skills, leading to poor glycemic control and increased complications. This study evaluated the effectiveness of the Smart ME-DE Digital Program in improving health literacy and glycated hemoglobin levels among newly diagnosed individuals with type 2 diabetes.

Methods: A quasi-experimental study was conducted with seventy participants recruited from diabetes clinics at three hospitals in a central province of Thailand. They were selected using simple random sampling and matched by gender, age, and baseline HbA1c levels, and allocated to an experimental or comparison group. The experimental group received …

Quality Improvement Project Simulating Ethics: Improving Ethical Decision-Making In Nursing Undergraduates Through Simulation And Faculty Training, Shannon Brown

Doctor of Nursing Practice Projects

Nursing faculty often report limited confidence in teaching ethical principles, despite the essential role ethics plays in preparing students for complex clinical decision-making. This quantitative, quasi-experimental pre/post quality improvement project evaluated whether a structured ethics education module incorporating simulation could impact faculty confidence in teaching ethical principles. Guided by Lewin’s Change Theory and the Jeffries Simulation Framework, the project examined how organizational readiness for change and structured simulation design influence faculty development outcomes. Nursing faculty in a baccalaureate program participated in a single simulation-enhanced ethics session. Data were collected through anonymous pre/post Qualtrics surveys, and faculty confidence was measured using …

Hypothermia Management In Adult Trauma Patients: Enhancing Nursing Knowledge And Self-Efficacy In The Emergency Department, Shannon M. Rapert

Doctor of Nursing Practice Projects

Trauma-induced hypothermia is a significant, preventable condition that contributes to increased mortality. Evidence suggests that inconsistent recognition and management of hypothermia persist in the emergency department (ED), highlighting the need to strengthen ED nurses’ knowledge and self-efficacy in evidence-based warming strategies. The purpose of this quality improvement project was to evaluate the impact of an educational intervention on ED nurses’ knowledge and self-efficacy in managing trauma-induced hypothermia. Guided by the Iowa Model of Evidence-Based Practice, the ADKAR Change Model, and the Plan-Do-Study-Act framework, this quantitative, quasi-experimental, pretest–posttest project evaluated the effect of an instructor-led educational intervention in ED nurses at …

Utilization Of An On-Site Primary Care Clinic – An Evaluation, Joulvous Jarvis Drake

Doctor of Nursing Practice Projects

Background: Employers incorporate on-site primary care clinics into their workplace health strategies to improve employees’ access to timely care and chronic disease management and reduce absenteeism and healthcare-related costs. Yet despite the demonstrated organizational and health benefits, many worksite clinics experience lower-than-expected utilization. Purpose: This evaluation project aimed to identify the behavioral and structural factors that influenced employee utilization of a corporate on-site primary care clinic. Method: A quantitative, cross-sectional design was used to evaluate the factors contributing to employees’ low utilization of the on-site primary care clinic. Approximately 1,000 eligible full-time employees at a large corporate campus in Texas …

Evaluating The Discus Throw As An Ancient Greek Combat Training Tool Through Modern Performance Metrics, Daniel R. Porter

All Graduate Reports and Creative Projects, Fall 2023 to Present

This study’s purpose was to explore the correlations between peak velocity in a rotational throw with a medicine ball, peak force (PF) and rate of force development (RFD) in an isometric mid-thigh pull, time to failure in a plank test, and peak velocity in a sword thrust task, which was also tested for reliability. Twenty-seven recreationally trained male participants between the ages of 18-35 completed the study. The sword thrust task was significantly correlated with the medicine ball throw (p = 0.012, r = 0.475, r² = 0.226, 95% CI [0.724, 0.116]) and PF (p = 0.045, r …

Youth Agricultural Engagement And Its Association With Dietary Diversity, Household Food Insecurity, And Nutritional Status In Southwest Nigeria, Sherif Olasoji

All Graduate Theses and Dissertations, Fall 2023 to Present

Youth remain underserved in nutrition research, policy, and programming despite being an integral part of the food systems. While the nutrition-sensitive agriculture framework has been established, there is limited evidence demonstrating how youth engagement in agriculture can serve as a pathway to improve nutritional outcomes. The study assessed youth agricultural engagement and its association with household dietary diversity, household food insecurity, and nutritional status in southwest Nigeria.

Using a cross-sectional design, data on socio-demographic characteristics, agricultural engagement, dietary diversity, household food insecurity, body mass index, and skin carotenoids were collected from 143 youth aged 15 to 35 from Ekiti, Osun, …

Standardized Training Methodologies For Medical Laboratory Science Students And Their Importance For Student Success, Maria Simpson

Medical Laboratory Science Independent Study Projects

Clinical education is a critical component of Medical Laboratory Science (MLS) programs, serving as the primary bridge between academic instruction and professional practice. However, traditional clinical rotation training models often struggle to keep pace with rapid advancements in laboratory technology, expanding professional responsibilities, workforce shortages, and heightened patient safety expectations. The purpose of this capstone project is to examine the key factors driving the need to update training methodologies in MLS clinical rotations and to evaluate contemporary educational approaches that better prepare students for entry-level practice. This project addresses systemic challenges faced by clinical laboratories, such as staffing constraints, heavy …

Race-Associated Egfr And Kras Mutation Profiles In Lung Adenocarcinoma, Lovyanne Vergel De Dios, Catherine Wu, Salique Hassan Shaham, Manish K. Tripathi

School of Medicine Publications

Background: Lung adenocarcinoma (LUAD) is the most prevalent histologic subtype of non-small cell lung cancer (NSCLC) and exhibits considerable molecular heterogeneity. Among the most clinically significant driver alterations are mutations in EGFR and KRAS, both of which influence treatment selection and oncologic outcomes. The prevalence of these mutations varies by race, yet racial minority populations remain underrepresented in genomic studies. EGFR alterations are more frequently observed in Asian patients, while KRAS mutations predominate in non-Asian cohorts. This study aimed to characterize race-associated differences in driver mutation prevalence among Asian, Black, and White patients with LUAD. Methods: A retrospective secondary cohort …

The Effectiveness Of Treatment Options For Localized Prostate Cancer: A Meta-Analysis Of Cross-Sectional And Cohort Studies, Pius Omolewa, John Bressan, Nassrine Noureddine

All Faculty Scholarship

Background: Prostate cancer is one of the most common malignancies among men worldwide, with incidence rates rising steadily over the past decades. Although the widespread adoption of PSA screening has improved early detection, it has also sparked extensive debate regarding overdiagnosis and overtreatment. Against this backdrop, balancing the avoidance of unnecessary interventions with the need to ensure favorable patient outcomes has become a central challenge in clinical decision-making. Methods: Articles published from 2010 through 2025 were searched in five databases. The cross-sectional and cohort studies examined the effects of treatment options on localized prostate cancer. Results: From the analysis of …