Digital Commons Network^™

Investigation Of Patients' Use Of Non-Pharmacological Substances In Dental Pain Management, Neslihan Yılmaz Çırakoğlu, Özgenur Kaya

Journal of Dentistry Indonesia

Background: Dental pain is a complex condition influenced by biological, biochemical, environmental, and psychological factors. Before seeking professional care, many patients attempt to relieve dental pain using self-administered, non-medical agents. This study aimed to investigate patients’ use of non-pharmacological substances in dental pain management and to identify factors influencing these practices.

Methods: The questionnaire consisted of four sections addressing demographic characteristics, oral hygiene habits, pain characteristics, and pain-relief agents. Categorical variables were analyzed using Pearson’s chi-square test. Categorical data are presented as frequencies and percentages, while continuous data are expressed as mean ± standard deviation and median values. …

Cost Effectiveness Analysis Of Psychopharmaca Therapy Combination Compared With Psychopharmaca Therapy And Ect Combination In Schizoaffective Inpatients At The Rsj Provinsi Jawa Barat, Yasmin Fadillah, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Mental disorders constitute an economic burden on health, estimated at USD 2.5 trillion in 2010 and expected to increase to USD 6 trillion by 2030. Treatment of schizoaffective disorder involves a combination of medication and psychotherapy. Pharmacoeconomics is an important consideration in drug selection. This study aims to determine the cost-effectiveness of psychopharmaca therapy combination compared with psychopharmaca therapy and ECT combination in schizoaffective inpatients at the RSJ Provinsi Jawa Barat. Data collection was conducted retrospectively from patient medical records for the period December 2023–December 2024. Total costs, based on a health perspective, include psychopharmaca drug costs, inpatient care costs, …

Retrospective Analysis Of Antimicrobial Resistance Patterns In Gram-Positive And Gram-Negative Blood Isolates, Helman Kurniadi, Timbul Partogi Haposan Simorangkir, Ros Sumarny, Fitria Heldiana

Pharmacology and Clinical Pharmacy Research

Bloodstream infections are an important cause of morbidity and mortality, while antimicrobial resistance limits treatment options. This retrospective study evaluated bacterial distribution and antimicrobial susceptibility in blood cultures at RSPAD Gatot Soebroto, Jakarta, using microbiology and medical record data from January-December 2019. Clinically significant isolates were included, while duplicates and contaminants were excluded. Identification and susceptibility testing followed standard procedures and CLSI 2019 guidelines. Data were analyzed descriptively. Among 482 isolates, 246 (51.0%) were Gram-positive and 236 (49.0%) were Gram-negative. The Gram-positive isolates were mainly coagulase-negative staphylococci, including Staphylococcus epidermidis (62, 25.2%), S. hominis (61, 24.8%), and S. haemolyticus (50, …

Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Scholarly productivity is a key marker of achievement in academic ophthalmology, influencing promotion, research support, and leadership opportunities. Prior studies have reported variation by gender, subspecialty, and rank, but few applied regression methods to identify independent predictors.

Purpose: To evaluate demographic, academic, and subspecialty factors associated with research productivity among U.S. academic ophthalmologists and to identify independent predictors through multivariable regression.

Methods: This cross-sectional study included 4,028 ophthalmologists across 126 accredited U.S. residency programs using the U.S. Academic Ophthalmology Faculty Database (US-AOFD). Faculty demographics and academic information were obtained from institutional websites, and bibliometric data (publications, …

Distribution Of Urinary Calculi And Its Association With Clinical And Laboratory Findings In Dogs And Cats With Stone Analysis At Chulalongkorn Animal Teaching Hospital, Thailand (2020-2024), Tanattha Ladabornvidhaya, Natkrita Baikloy, Theaparak Thipjaroen, Parapond Kongrakchang, Warisara Kaechaiya, Sumonwan Chamsuwan, Monkon Trisiriroj, Chollada Buranakarl

The Thai Journal of Veterinary Medicine

Urinary calculi are commonly encountered in veterinary practice; however, information regarding their distribution of stone that underwent analysis and associated clinical findings remains limited. This study investigated the distribution of urolithiasis and the associations between stone types and clinical and laboratory findings in dogs and cats presented to the Chulalongkorn Small Animal Teaching Hospital between 2020 and 2024. The three most common stone types in both species were calcium oxalate (CaOx), struvite, and urate, with relatively stable trends over the 5-year period. Small-breed dogs had a higher risk of developing CaOx urolithiasis than medium-breed dogs (OR = 10.4, 95% CI …

Ayurvedic Herbs In The Management Of Benign Prostatic Hyperplasia: A Comprehensive Narrative Review, Latha Damle, Chandrasekhar C

International Journal of Traditional Knowledge

Benign Prostatic Hyperplasia (BPH) is a common, non-cancerous enlargement of the prostate gland, primarily affecting older men. It frequently leads to lower urinary tract symptoms (LUTS) such as increased urinary frequency, urgency, nocturia, and weak urine flow, which can significantly impair quality of life. Standard treatments for BPH include alpha-blockers, 5-alpha reductase inhibitors, and surgical interventions. However, limitations in efficacy and potential adverse effects have driven interest in complementary and traditional therapies, including Ayurveda. In Ayurvedic medicine, BPH is described as Mutraghata and Vatashthila, conditions attributed to an imbalance of Vata and Kapha doshas that disrupt normal prostate and …

Gaining From Captured Indian Traditional Knowledge Systems: Paths Taken And Way Forward, Ramasami T

International Journal of Traditional Knowledge

India’s scientific heritage is deeply reflected in Ayurveda, a tradition of integrative medicine documented for over two millennia. P.C. Ray, the father of modern chemistry in India, highlighted the depth of ancient chemical knowledge and early use of mercury compounds, while M.S. Valiathan later revived and analyzed the classical texts of Charaka, Sushruta, and Vagbhata to bridge Ayurveda with modern science. Building on this foundation, the Government of India launched initiatives linking Ayurveda with genomics, personalized medicine, and rasayana therapies, yielding promising insights such as the genetic basis of prakriti classifications and protective effects of Amalaki Rasayana. Efforts like the …

Artificial Intelligence And Social Equities: Navigating The Intersectionalities In A Digital Age (Editorial), Daisuke Akiba, Julie Albright

Publications and Research

This editorial article introduces and synthesizes the Special Issue, “Artificial intelligence and social equities: navigating the intersectionalities in a digital age,” which examines how AI systems intersect with race, ethnicity, and interconnected identity dimensions across global contexts. The eight contributions span healthcare, digital media, higher education, organizational communication, and speculative futures, addressing anti-racist psychiatric algorithms, AI-generated visual disinformation, epistemic injustice between the Global North and South, algorithmically mediated rural–urban divides, culturally untranslated technology transfer, accessibility auditing across the AI lifecycle, and the tension between mechanical objectivity and empathic understanding. Read together, they show that AI is neither inherently …

Act And Posttraumatic Growth In Military Veterans: Growth Through Flexibility After Adversity, Andrew J. Moller

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Military veterans are disproportionately exposed to potentially traumatic events across service eras. While much of the clinical and research literature has focused on posttraumatic stress disorder (PTSD) and symptom reduction, a growing body of work highlights the possibility of posttraumatic growth (PTG) following adversity. PTG refers to positive psychological changes that may emerge through engagement with traumatic experiences, including enhanced appreciation for life, renewed purpose, personal strength, deepened relationships, and reintegration into community roles. Importantly, PTG does not imply the absence of distress but may coexist alongside ongoing trauma-related symptoms. Understanding processes that facilitate growth alongside suffering may support more …

Umbilical Artery Doppler In Fetal Growth Restriction, Britanie Dollard

Lynchburg Journal of Medical Science

Umbilical artery (UA) Doppler velocimetry is a noninvasive tool used to assess placental vascular resistance and improve risk stratification in pregnancies complicated by suspected fetal growth restriction (FGR). Placental insufficiency remains a leading cause of stillbirth and neonatal morbidity, making early identification critical for optimizing perinatal outcomes. This clinical review synthesizes current evidence regarding the role of UA Doppler in identifying placental insufficiency, outlines key waveform interpretations, and evaluates how Doppler findings guide clinical management and delivery planning. Evidence and major society guidelines support UA Doppler as a targeted surveillance tool in high-risk pregnancies complicated by suspected FGR. Progressive abnormalities, …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Cells And Networks In Flux: Rethinking Ontogenesis And Pathogenesis, Mark L. Tykocinski

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Organ and tissue functions emerge from the coordinated activity of cell networks. Therapeutics that act on pathogenic cell networks, modulating their cellular interplay, follow naturally. Over several decades, our laboratory has developed a series of approaches for rewiring cell networks, culminating in a class of cell surface-directed signal converter proteins (SCPs) that do so by modulating juxtacrine and autocrine signaling in and among their nodal cells. A first such SCP has now produced encouraging clinical data for cancer immunotherapy. Yet, these early network-directed fusion proteins rest on a deliberately simplified picture: discrete end-cell types plugged into graphically tractable networks. That …

Osteoarthritis In Saudi Arabia: Current Evidence, Public Perceptions, And Future Research: A Narrative Review, Khalid Yaseen

Journal of Medical Rehabilitation Science

Background and Purpose: Osteoarthritis (OA) is a leading cause of pain and disability worldwide and represents a growing public health concern in Saudi Arabia. This narrative review synthesises current evidence on OA in the Saudi context, with particular emphasis on epidemiology, risk factors, public perceptions, clinical management patterns, and the utilisation of physiotherapy and other conservative interventions. The aim is to inform clinical practice, public health strategies, and health system planning in alignment with Saudi Vision 2030.
Methods: A narrative review was undertaken, drawing on evidence from PubMed/MEDLINE, Scopus, Web of Science, Saudi Digital Library, Ministry of Health (Saudi Arabia) …

Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening condition that can rapidly lead to organ dysfunction, septic shock, and death if not recognized and treated early. Older adults in skilled nursing facilities (SNFs) are especially vulnerable because of age-related physiological changes, chronic conditions, weakened immunity, and increased exposure to infections. Consequently, sepsis remains a major cause of hospital readmissions, mortality, and healthcare utilization among SNF residents. The SNF serving as the site for this Doctor of Nursing Practice (DNP) project experienced increased hospital readmissions associated with recurrent sepsis, highlighting the need for a standardized, evidence-based approach to sepsis recognition and management. The practice-focused question …

2026 Focused Update Of The Saudi Heart Association Guidelines On Best Practices In The Management Of Chronic Coronary Syndromes, Owayed Alshammeri, Halia Alshehri, Shukri Alsaif, Mirvat Alasnag, Fatema Qaddoura, Fahad Alqahtani, Yosra Abdulahad A Turkistani, Walid Alharbi, Adel Tash, Mohammad Alshehri, Khalid Al Faraidy, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Chronic coronary syndromes (CCS) continue to impose a substantial clinical and economic burden in Saudi Arabia. Since publication of the 2022 Saudi Heart Association (SHA) CCS guidelines, important advances have emerged in diagnosis, pharmacotherapy, cardiometabolic risk reduction, antiplatelet management, and revascularization. This 2026 focused update selectively revises and clarifies key recommendations to reflect these advances within the Saudi context.

Methods: A multidisciplinary SHA expert panel conducted a structured review of randomized trials, meta-analyses, and relevant international guidance published since 2022. Updates were restricted to areas with substantive new evidence or evolving clinical practice. Recommendations were formulated through expert consensus …

Spcc: Inferring Spatial Cell-Cell Interaction By Integrating Single-Cell And Spatial Transcriptomics, Tiangang Wang, Yu Zhou, Xi Liu, Sijia Wu, Liyu Huang, Kexin Huang, Xiaobo Zhou

Faculty, Staff and Student Publications

Study of single-cell spatial biology reveals the importance of integrating single-cell and spatial data for capturing spatial structure at individual cell resolution in various fields. With the lack of cellular-level information in most spatial data, it is necessary to integrate single-cell and spatial data. Here, we developed a deep learning computational framework for alignment and mapping of unpaired single-cell and the spatial data by using adversarial joint-variational autoencoder and Random Forest model (SPCC). SPCC will generate a mapping matrix for single-cell and spatial positions that can transfer spatial location to individual cells. SPCC can be used to perform downstream analysis, …

Internet Use And Decision-Making Processes Among Pregnant Women: A Cross-Sectional Study, Ayça Balmumcu, Endam Çetinkaya Ak, Sabriye Uçan Yamaç

Makara Journal of Health Research

Background: The coronavirus disease 2019 (COVID-19) pandemic restricted access to in-person health services, especially in rural areas. This increased reliance on the internet for health information and decision-making was particularly notable among pregnant women. This study aimed to investigate the role of internet use in decision-making among pregnant women.

Methods: This analytical, cross-sectional study examined 384 pregnant women living in a rural district of Turkey who attended family health centers for prenatal care. Data were collected using the Internet Decision-Making Scale in Pregnancy and a questionnaire assessing internet use patterns during the pandemic.

Results: Pregnant women demonstrated …

E-Health Literacy And Cyberchondria Severity Among Adolescent High School Students: A Cross-Sectional Study, Seyda Çavmak, Adem Bilgin

Makara Journal of Health Research

Background: Amid rapid digitalization and the growing use of artificial intelligence-based search engines, adolescents increasingly seek health information online. This study examined the relationship between high school students' e-health literacy and their cyberchondria tendencies.

Methods: This quantitative, cross-sectional study included 683 students from public high schools in Mersin, Türkiye. Data were collected using a Demographic Information Form, the e-Health Literacy Scale (eHEALS), and the Cyberchondria Severity Scale Short Form (CSS-12). Descriptive statistics, comparative tests, and Pearson correlation were applied (p < 0.05).

Results: Students' e-health literacy and cyberchondria severity were moderate. Significant positive correlations emerged between e-health literacy …

Validity And Reliability Of The Turkish Nursing Students’ Self-Perceptions About Safe Medication Management, Derya Şimşekli, Bedriye Cansu Koyunoğlu, Elanur Yilmaz Karabulutlu

Makara Journal of Health Research

Background: Safe medication management is central to nursing education and patient safety. To the best of our knowledge, there is currently no validated Turkish instrument specifically designed to assess nursing students’ self-perceptions regarding safe medication management. This study aimed to evaluate the validity and reliability of the Turkish version of the Nursing Students’ Self-Perceptions about Safe Medication Management (NURSPeM).

Methods: This methodological study was conducted at a single university using convenience sampling. Data were collected from a sample of 400 nursing students using the NURSPeM. Construct validity was examined with confirmatory factor analysis (CFA). Internal consistency was evaluated …

Needlestick Injury Risk And Preventive Behaviors Among Nursing Students, Angga Wilandika, Riandi Alfin, Rosa Intan Khoerunnisa

Makara Journal of Health Research

Background: Needlestick injury (NSI) remains a persistent occupational safety risk for nursing students during clinical practice, with implications for worker safety, patient care, and healthcare safety systems. Understanding preventive safety behavior within clinical training environments is essential for improving workplace safety in healthcare settings.

Methods: A cross-sectional study was conducted among nursing students undertaking hospital-based clinical placements. Using a purposive sampling, participants completed a structured self-administered questionnaire assessing NSI exposure, preventive safety behaviors, clinical supervision, safety training, and perceived safety within the clinical learning environment. Data was analyzed to identify patterns of NSI risk and associated preventive behaviors. …

Assessing Healthcare Access Among Overweight And Obese Individuals In Türkiye Using Latent Variable Modeling, Banu Beyaz Sipahi

Makara Journal of Health Research

Background: Overweight and obesity are critical determinants of healthcare access, yet evidence on how the COVID-19 pandemic reshaped these dynamics in Türkiye remains limited. This study investigates whether the early post-pandemic recovery period altered healthcare access patterns for individuals with excess weight.

Methods: Using nationally representative microdata from the 2014, 2016, 2019, and 2022 Turkish Health Surveys, we constructed a latent Healthcare Access Index based on six indicators of unmet care needs. Probit models were estimated to assess associations between BMI categories and healthcare access, controlling for socioeconomic and demographic factors. The 2022 wave serves as the early …

The Safe Fishbowl Model: Psychological Safety By Design In Counseling Skills Training, Mike Mariska

Journal of Counselor Preparation and Supervision

Skills training in counselor education can be constrained by performance anxiety, which may reduce participation, limit deliberate practice repetitions, and shift demonstrations to the instructor. This applied-practice manuscript introduces the SAFE (Structured Avatar and Feedback Experience) Fishbowl model, a simulation architecture designed to address performance anxiety while scaling participation. SAFE Fishbowl integrates rotating counselor roles, a real-time coaching loop, structured observation grounded in experiential learning theory, and purposeful debriefing. An implementation example for group counseling leadership skills is provided, along with adaptation guidance across multiple skill domains and delivery modalities. Descriptive course-evaluation feedback illustrates feasibility and perceived usefulness. Implications include …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

Modernizing Career Counseling In Counselor Education: A Conceptual Exploration, Yuhyun Park, Se Hoon Kim, Rasheed Adeyemo, Sarah Ebner, Mallory Redmond, Breeana Donayre, Carly Steves

Journal of Counselor Preparation and Supervision

Career development is often confined to a single course despite its relevance across counseling practice. This conceptual article reframes it as an integrative foundation for counselor preparation, supervision, and professional identity. It examines connections among work, mental health, education, disability, relationships, and social context across counseling specializations. The article also considers doctoral training and the ethical use of artificial intelligence in career-related practice. Recommendations address curriculum design, supervision, and future research on integrated career preparation.

The Role Of Reassurance Messages In Pediatric Oncology, Isabelle Faller

Doctoral Dissertations

Despite decreasing mortality rates, the high prevalence and incidence of pediatric cancer necessitate the need for advancements in the treatment of psychological concerns, specifically the reduction of patient distress and anxiety. A more comprehensive understanding of current reassurance messages in clinical practice can aid in developing a standardized framework for providing reassurance in pediatric oncology. Qualitative Content Analysis was employed to examine the types of messages nurses use to reassure patients (to reduce their anxiety about a future health-related event) and how effective nurses perceive these messages to be in relieving patients' anxiety. The adult participants, located at hospitals throughout …

Le Défi Mondial : Panorama Comparatif Des Soins Néonatals Au Maroc Et Aux États‑Unis, Manasi Joshi

NEXUS: The Liberty Journal of Interdisciplinary Studies

Cette étude comparative examine les soins néonatals au Maroc et aux États-Unis après un stage dans une clinique privée à Rabat. Bien que les pratiques médicales principales soient universelles, leur application varie dans différents pays selon les circonstances socio-économiques et culturelles. Basée sur des observations directes, des entretiens avec des professionnels de soins néonatals marocains et une analyse de la littérature sur ce sujet dans ces deux pays, cette recherche discute de quatre différences principales : la disponibilité des ressources, l’accès aux soins de qualité, l’influence culturelle et les obstacles financiers. Malgré la pénurie évidente de personnel dans les hôpitaux, …

Face Mask Littering: Environmental Impacts, Regulatory Challenges, And Ai-Driven Waste Management Strategies For The Post-Pandemic Era, Pri̇yanka Rathee, Sari̇ta Khatkar, Renu Sehrawat, Pooja Rathee, Anurag Khatkar, Esra Küpeli̇

Turkish Journal of Medical Sciences

The widespread use of polypropylene-based face masks during the COVID-19 pandemic created a significant and persistent source of plastic pollution. This review aims to provide an integrative assessment of the environmental, toxicological, and public health implications of face mask litter and evaluate current waste management challenges and emerging technological solutions in the postpandemic context. A narrative review approach was employed, synthesizing literature published between 2020 and 2025 and indexed in major scientific databases including Web of Science, Scopus, and PubMed. Studies were selected based on their relevance to the issues of environmental contamination, microplastic generation, toxicological effects, regulatory frameworks, and …

Male Osteoporosis: Pathophysiology, Risk Assessment, And Evidence-Based Management, Seli̇n Teki̇n, Alper Gürlek

Turkish Journal of Medical Sciences

Osteoporosis in men is a common yet underrecognized condition associated with substantial fracture-related morbidity and excess mortality. Although men generally attain higher peak bone mass than women, age-related changes in bone microarchitecture, progressive cortical bone loss, declining sex steroid bioavailability, and a high prevalence of secondary causes contribute to a significant lifetime fracture risk. Importantly, a large proportion of fragility fractures in men occur at bone mineral density (BMD) values above the osteoporotic threshold, highlighting the limitations of BMD-based diagnosis alone. This review provides a comprehensive overview of the epidemiology, pathophysiology, and clinical characteristics of osteoporosis in men, with particular …

Daam2 Gene Variants P.(Asp165glu) And P.(Asn614thrfster2) In Pediatric Cryptorchidism: A Hypothesis-Generating Pilot Case-Control Study From The Eastern Black Sea Region Of Türkiye ​, Onur Yalçin, Çağri Doğan

Turkish Journal of Medical Sciences

Background/aim: Cryptorchidism is the most common congenital anomaly of the male genitourinary system, characterized by a multifactorial etiology. The disheveled-associated activator of morphogenesis 2 (DAAM2) gene regulates androgen receptor (AR)- dependent transcription; its variants are associated with partial androgen insensitivity. Since the inguinoscrotal phase of testicular descent is androgen-dependent, we hypothesized that DAAM2 variants contribute to cryptorchidism susceptibility. This pilot study, designed to generate hypotheses rather than to establish association, investigated the frequency of two functionally characterized DAAM2 variants, p.(Asp165Glu) and p.(Asn614ThrfsTer2), in pediatric cryptorchidism.

Materials and methods: This prospective case-control study included 40 male pediatric cryptorchidism patients and 39 …