Digital Commons Network^™

Isolated Transverse Colon Perforation During Corticosteroid Tapering In Quiescent Systemic Lupus Erythematosus: A Histopathology-Supported Diagnosis Of Exclusion, Ridwan A. Lawal, Nestor Malaga, Nida Asif, Fatimah Bello, Juliana Yang

School of Medicine Publications

Gastrointestinal perforation in systemic lupus erythematosus (SLE) is uncommon but potentially fatal, and attribution is clinically consequential because perforation may reflect lupus enteritis with mesenteric vasculitis, infection, diverticular or stercoral disease, malignancy, inflammatory bowel disease (IBD), medication-related injury, or a combination of mechanisms. Corticosteroid-associated perforation is therefore best treated as a diagnosis of exclusion rather than as an isolated novel observation. We report a 62-year-old woman with SLE who developed sudden severe right-sided abdominal pain, nausea, vomiting, leukocytosis, lactic acidosis, and radiographic pneumoperitoneum while tapering prednisone from 60 mg/day to 10 mg/day over three months, with 10 mg/day documented at …

Nurses’ Knowledge And Practices Regarding Infection Prevention Measures In Cardiac Intensive Care Unit, Marwa G. Abouheiba, Maha Adel Salem, Jean Bertin Mudenge

Nursing

Abstract: Background: Healthcare-associated infections (HAIs) remain a major global patient safety challenge, contributing substantially to morbidity, mortality, prolonged hospitalization, antimicrobial resistance, and increased healthcare costs. Patients admitted to cardiac intensive care units (ICUs) are particularly vulnerable because of their critical illness, frequent exposure to invasive devices, and complex cardiovascular interventions. Nurses play a pivotal role in preventing HAIs through the consistent implementation of evidence-based infection prevention and control (IPC) measures. Therefore, assessing both nurses' knowledge and their observed clinical practices is essential for identifying strengths, potential gaps, and opportunities for quality improvement. Aim: To assess nurses' knowledge and observed practices …

Slc Transporter-Mediated Functional Imaging In Cancer Diagnosis, Lumeng Zhang, Jun He

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Functional imaging has become an important approach for evaluating tumor physiology in vivo beyond morphologic assessment. Radiotracers used for cancer imaging are designed to mimic endogenous substrates or substrate analogues, and their accumulation can depend on membrane transport, intracellular metabolism, and clearance from normal tissues. Specifically, SLC transporters contribute to tracer uptake and signal formation, linking transporter activity with measurable imaging signals in cancer. While [18F]FDG PET/CT remains the most widely used example of transporter-associated metabolic imaging, SLC transporter-mediated imaging strategies have been developed to assess amino acid transport, sodium-dependent glucose uptake, redox metabolism, lactate exchange, nucleoside metabolism, choline metabolism, …

Depression And Anxiety In Pulmonary Hypertension Associated With Congenital Heart Disease: Pathophysiology And Clinical Implications Of The Heart–Brain Axis, Nicodemus N. Triatmojo, Valerinna Y.S. Putri

Journal of the Saudi Heart Association

Pulmonary hypertension associated with congenital heart disease or PH-CHD is an increasingly prevalent disorder in modern cardiology. It is characterized by progressive pulmonary vascular remodeling, chronic right ventricular (RV) pressure overload, and abnormal cardiopulmonary hemodynamic. Due to advances in congenital cardiology and treatments for pulmonary hypertension, survival rates have increased. As a result, the focus has switched to long-term functional status and quality of life. Depression and anxiety are currently recognized as prevalent and clinically significant manifestations in PH-CHD; nonetheless, they remain underdiagnosed and undertreated within cardiovascular care frameworks.

More study shows the disease's severity or symptom count cannot explain …

Transforming Advising And Improving Outcomes: Assessing Impacts Of Advising Changes, Amy S. White, Tailisha Gonzalez, Elgloria Harrison

Publications and Research

Abstract

Background: Earning full-time credit loads and persisting are how college students successfully graduate.

Objective: We measured whether credits and persistence at an urban, commuter Hispanic/Minority-Sserving Iinstitution improved after implementing a social work-based advisement strategy.

Methods: Using a quasi-experimental methodology on a college’s enrollment database, we measured the impact of a new advisement model on earned and attempted credit loads to compare traditional student advisement within control groups (n = 171 and n = 899) relative to intervention (n = 130).

Findings: In 2024, the intervention group attempted an average of 14.7 credits and earned an average of 14.3 credits, …

Feasibility Study Of An Artificial Intelligence Chatbot-Powered Cognitive-Behavioral Lifestyle Modification Program, Evans Forman, Charlotte Hagerman, Asher Hong, Zhuoran Huang, Hannah Mccausland, Jasmine Sun, Lauren Taylor, Meghan Butryn, Preetha Chatterjee, Ramtin Ehsani, Nawal Syed

Department of Family & Community Medicine Faculty Papers

Background: Approximately 2 billion adults seek lifestyle modification to improve their health and well-being. However, because of cost and access barriers, only a tiny fraction receive gold-standard lifestyle modification programs led by trained coaches. Digital programs without human coaches are more disseminable but have limited efficacy. Recent advances in large language model (LLM) AI chatbots have the potential to revolutionize digital programs by emulating human coaches, offering a safe, low-cost, and scalable lifestyle modification intervention. Yet, no studies have developed and tested such a program. Purpose: This study aims to evaluate the feasibility, safety, and user engagement of a new …

A Phase Ii Trial Of Defactinib Combined With Avutometinib In Patients With Metastatic Uveal Melanoma, Rino S. Seedor, Mizue Terai, Sergei A. Koshkin, Andrew E. Aplin, Marlana Orloff, Erin Sharpe-Mills, Madeleine Naccarato, Aurora Mills, Alfredo A. Molinolo, J. Silvio Gutkind, Takami Sato

Kimmel Cancer Center Faculty Papers

Background: Treatment options are limited, and outcomes remain poor for patients with metastatic uveal melanoma (MUM). We conducted an investigator-initiated, prospective, single-arm, single-institution, phase II study evaluating the combination of an FAK inhibitor (defactinib) with a RAF/MEK inhibitor (avutometinib) for the treatment of MUM. Methods: From February 2021 through January 2023, 12 patients with MUM were treated with the combination of defactinib and avutometinib. Defactinib was given 200 mg twice daily, and avutometinib was given 3.2 mg twice a week. Both drugs were given for 3 weeks on and 1 week off (28-day cycle). Disease control rate was the primary …

Leveraging Health Information Exchange (Hie) Data To Demonstrate The Impact On Health Outcomes Of Community Based Organization Interventions: Case Studies Of Housing Placement And Medically Tailored Meal Program, Kevin Kramer, Harm Scherpbier, William Marella

College of Population Health Faculty Papers

Objective

Methods

Impact Of Social Media-Driven Feeding Practices On The Gut Microbiome Of Captive Asian Elephants (Elephas Maximus) In Surin, Thailand, Pongpreecha Malaluang, Nuttapon Bangkaew, Jaruwan Chaiyakhot, Patinya Patikae, Nattaya Watwiengkam, Phimphanit Choklikitumnuey, Thanaphat Phupanna, Sudachanok Phowiset, Prim Chuesaard, Tarid Purisotayo

The Thai Journal of Veterinary Medicine

This study investigated the effects of social media-driven live-streaming dietary supplementation on the gastrointestinal microbial community of captive Asian elephants (Elephas maximus) at the Elephant Kingdom, Surin Province, Thailand. A hierarchical two-tier observational design was used: Tier 1 compared a minimal-supplementation control group (Group H, n = 6) with a frequent heterogeneous-supplementation group (Group L, n = 18); Tier 2 compared, within Group L, low-frequency (Group A, ≤ 3 sessions per week, n = 7) and high-frequency (Group B, > 3 sessions per week, n = 11) live-streaming sub-groups. Faecal microbial profiles were obtained by 16S rRNA gene (V3–V4) …

Gentle Beginnings: Innovative Use Of Melatonin And Triclofos Sodium For Uncooperative Children-An Invivo Study, Rohan Shrivastava, Sonal Gupta, Charu Aggarwal, Akil Prawin S.S

International Arab Journal of Dentistry

Objectives: To compare the pre- and post-use of oral melatonin and oral triclofos as oral sedative drugs on anxiety, sedation, and cognitive and psychomotor function to perform satisfactory dental treatment on uncooperative children.

Methods: A total number of 100 patients aged between 4 and 9 years who were scheduled for dental treatment were randomly divided into two groups, Group I and Group II, and administered melatonin and triclofos sodium, respectively, to determine changes in anxiety, cognitive, psychomotor, and sedation scores pre- and post-treatment. Data were analyzed using an unpaired/paired t-test, and P < 0.05 was contemplated as statistically significant.

Results: Post-treatment assessments revealed a significant reduction in …

Antibacterial Efficacy Of Resin-Based Dental Composites Modified With Antibacterial Agents Against S. Mutans: A Systematic Review, Ahmad Setiawan Jarigau, Erwin Gunawan, Muhammad Akira Takashi Dharma, Fanny Dinda Nur Aulia, Lenni Indriani Hatta, Nurhayati Natsir

International Arab Journal of Dentistry

Introduction: Dental caries caused by Streptococcus mutans is a leading cause of dental restoration failure. Enhancing composite resins with antibacterial agents aims to inhibit bacterial growth and prolong restoration life.

Objectives: This review evaluates the anti-bacterial agents efficacy of these modified composites against S. mutans and explores their mechanisms and potential clinical benefits.

Methods: A comprehensive literature search was conducted across multiple databases following PRISMA guidelines, focusing on in vitro studies published between 2015 and 2025. Studies evaluating composites with antibacterial additives against S. mutans using standard microbiological assays were included. The quality of eligible studies was assessed using the …

Effect Of Home Bleaching With Carbamide Peroxide And Over-The-Counter Products On Stained Supra-Nano-Filled Composite: An In-Vitro Study., Lynn Harrouk, Pascale Habre, Samar Bou Jaoude, Carina Mehanna Zogheib

International Arab Journal of Dentistry

Objective: This study evaluated the impact of home and over-the-counter (OTC) bleaching products, compliant with SCCS regulations, on color changes in tea-stained supra-nano filled composite, using the CIEDE2000 formula.

Methods: One hundred Estelite® Sigma Quick discs were fabricated, thermocycled, and tea-stained for 12 days. Samples were divided into four groups: Opalescence 15% carbamide peroxide (CP) gel, White Dental Beauty 6% hydrogen peroxide (HP) strips, Pola Luminate 6% HP brush-on gel, and a control. Color was measured at baseline, post-staining, and post-bleaching using a VITA EasyShade spectrophotometer. ΔE₀₀ values were analyzed with Kruskal-Wallis and Dunn’s post-hoc tests (p < 0.05).

Results: All bleaching …

Comparison Of Three Intraoral Scanners For Digital Impressions Of Biologically Oriented Preparation: An In-Vivo Study, Lara Habli, Pascale Habre-Hallage, Hani Tohme, Dany Noujaim, Maryse Nassif, Camille Haddad

International Arab Journal of Dentistry

Introduction: The accuracy of intraoral scanners (IOSs) in capturing a Biologically Oriented Preparation Technique (BOPT) remains uncertain. The aim of this study was to evaluate the accuracy of digital impressions obtained with three intraoral scanners for recording BOPT preparations.

Methods: A maxillary central incisor was prepared following BOPT. After temporization, a conventional polyvinyl siloxane impression was scanned with a desktop scanner to obtain a reference model. Forty-two scans (n D 14 per scanner) were recorded with three IOSs—Trios 3, Sirios, and Helios 680—by a single operator under standardized conditions. Accuracy was assessed using Geomagic Control X by calculating 3D surface …

Evaluation Of Optimal Force For Intrusion Of A Periodontally Compromised Maxillary Anterior Dentition Treated With Fixed Orthodontics – A Finite Element Analysis, Tanzim Ahmed, Amrita Puri, Aatira Nair, Anshul Singla, Mathew Koshy Vaidyan, Shruti Sharma, Chhavi Singh

International Arab Journal of Dentistry

Introduction: Adult orthodontic treatment is increasingly sought due to aesthetic and functional concerns, often involving periodontally compromised patients with altered biomechanics. Reduced bone support shifts the center of resistance and necessitates lower, carefully controlled forces, while finite element modeling has become a key tool to analyze tissue response under such conditions.

Objectives: The study aimed to determine the optimal intrusive force for periodontally compromised maxillary anterior teeth using Finite Element Analysis (FEA).

Methods: A 3D finite element model of the maxillary anterior dentition was created and divided into healthy and compromised halves, the latter with one-third alveolar bone loss. A …

Impact Of Antihypertensive Medications On Implant Success: A Retrospective Cohort Study On Monomedicated Patients, Antony Chidiac, Stephanie Mrad, Charbel Kachouh, Richard M. Sadaka, Joseph Bassil

International Arab Journal of Dentistry

Objective: The aim of this study main is to analyze the influence of antihypertensive treatments on the failure and survival rates of dental implants.

Methods: Medical records of 586 patients who received a total of 1,814 dental implants between 2012 and 2022 met the inclusion criteria and were retrospectively reviewed. Patients were divided into two groups: a control group comprising 512 systemically healthy patients with 1581 implants, and a group of 74 patients taking only antihypertensive medications who received a total of 233 implants. Implant failure was assessed according to criteria defined by the International Congress of Oral Implantologists.

Results: …

Influence Of Veneer Thickness On Double Bond Conversion Of Preheated Composite And Self-Adhesive Resin Cement Under Lithium Disilicate Restorations: An In-Vitro Study., Vanessa Kanaan, Marie Abboud, Alexandre Monnier, Dani Irani, Vana Mardirossian, Cynthia Kassis

International Arab Journal of Dentistry

Introduction: This study evaluated the influence of lithium disilicate restoration thickness on the degree of conversion (DC) of a self-adhesive dual-cured resin cement (Bifix SE®; VOCO GmbH, Cuxhaven, Germany) and a preheated composite resin (VisCalor Bulk®; VOCO GmbH, Cuxhaven, Germany).

Methods: Sixty IPS e.max CAD (LTB1) specimens (2 mm, 4 mm, 6 mm; n D 10 per group) were fabricated and divided into six groups. Groups 1–3 were luted with Bifix SE, and Groups 4–6 with preheated VisCalor Bulk. Specimens were conditioned with 5% hydro_uoric acid and silane, then cemented and light cured. Raman spectroscopy was used to determine DC. …

Hypo-Responsiveness Of The Dental Pulp In Patients With Type 2 Diabetes And Hypertension: A Cross-Sectional Study, Kavitha M, Mallolu Anthony Sanjana Vijay, Niveditha B, Fathima A.I, Pavithra D, Vigneshwaran J

International Arab Journal of Dentistry

Introduction: Diabetes mellitus and hypertension, two of the most prevalent metabolic disorders worldwide, exert profound and progressive effects on multiple physiological systems. While their systemic complications are well documented, their subtle yet clinically significant impact on oral structures, particularly the dental pulp, remains underexplored.

Objectives: This study aims to assess the functional responsiveness of dental pulp nerves in individuals with type 2 diabetes mellitus and systemic hypertension, and to compare the findings with responses from healthy individuals, using an Electric pulp tester (EPT) as a diagnostic tool.

Methods: A total of 600 teeth from 75 adult patients (25 diabetic, 25 …

The Efficacy Of Mini-Screw Rapid Palatal Expansion (Marpe) In Late Adolescents And Young Adults: A Systematic Review, Afaf El Merouani Drissi, Hajar Ben Mohimd, Hicham Benyahia, Fatima Zaoui

International Arab Journal of Dentistry

Introduction: Mini-screw assisted rapid maxillary expansion (MARPE) emerged as a less invasive alternative treatment for transverse maxillary expansion, and designed to overcome the limitations of conventional rapid maxillary expansion for patients from post-pubertal growth spurt period onwards, often presenting with an interdigitated suture. The aim of this systematic review is to evaluate the efficacy of this treatment on skeletal, dento-alveolar and periodontal levels based on CBCT studies, by comparing it to the conventional rapid maxillary expansion (RPE).

Methods: a literature search of five databases (PubMed, Scopus, Web of Science, ScienceDirect and the Cochrane library) was conducted from 2010 until July …

Minimally Invasive Decompression And Long-Term Follow-Up Of An Orthokeratinized Odontogenic Cyst Of The Mandible: A 7-Year Case Report, Akram Belmehdi, Karima El Harti

International Arab Journal of Dentistry

Introduction: Orthokeratinized odontogenic cyst (OOC) is a rare developmental jaw lesion with indolent behavior and low recurrence potential.

Case presentation: A 33-year-old healthy male was referred after incidental discovery of a mandibular radiolucency. Cone-beam CT revealed a well-defined unilocular lesion in close relation to the inferior alveolar canal. Aspiration confirmed its cystic nature, and a conservative decompression was performed using a rubber drain to reduce lesion size and preserve adjacent structures. Histopathologic examination identified orthokeratinized epithelium consistent with OOC. After seven months of decompression, the lesion showed marked ossification, allowing safe enucleation and peripheral curettage. Radiographic follow-ups at 19 months …

Employing Artificial Intelligence For Non-Invasive Diagnosis Of Craniofacial Deformities: A Systematic Review Of Non-Ionizing Radiation Methods, Nurul Mutmainnah, Harun Achmad, Lusy Damayanti

International Arab Journal of Dentistry

Introduction: Craniofacial deformities, like craniosynostosis and plagiocephaly, require early diagnosis, but traditional methods like CT scans use harmful ionizing radiation. Artificial Intelligence (AI) offers a non-invasive, radiation-free alternative, using 2D and 3D imaging for accurate diagnosis, improving safety and accessibility, especially in remote areas.

Objective: This review evaluates the use of AI in diagnosing craniofacial deformities without ionizing radiation, focusing on its strengths, limitations, and challenges in clinical implementation.

Methods: The literature was searched across five databases—PubMed, Google Scholar, ScienceDirect, Wiley, and Cochrane—over the last decade, following PRISMA guidelines. Inclusion criteria were AI-based, non-invasive imaging techniques for craniofacial deformities. The …

Comparative Evaluation Of A-Prf+ Or Collagen Membrane On Hard And Soft Tissue Changes Following Immediate Implant Placement: A Randomized Clinical Trial, Raagul S, Rahul Chopra, Sumit Malhotra, Prashansa Sharma, Ankur Tyagi, Nancy Singh

International Arab Journal of Dentistry

Objectives: To evaluate and compare clinical and radiographic parameters viz. Gingival Index (GI), Plaque Index (PI), Width of Keratinized Tissue (WKT), Midbuccal & Midlingual/Midpalatal soft tissue thickness (STT), ISQ values and crestal bone levels (CBL) using CBCT at baseline and 6 months in Group I (Immediate implant placement & A-PRF+) and Group II (Immediate implant placement & Collagen Membrane).

Methods: A total of 20 sites indicated for extraction were selected and randomly divided into: GROUP I : 10 sites were treated with immediate implant placement and covered with an A-PRF+ membrane and GROUP II : 10 sites were treated with …

Predictive Analysis For Success And Complications In Dental Implant Therapy Using Artificial Intelligence Models, Vishnu Priya Veeraraghavan, Aysha Jebin A, Isha Dusane, Govind Baheti, Ankita Agarwal, Santosh R Patil

International Arab Journal of Dentistry

Introduction: Dental implant therapy is a predictable treatment for tooth replacement, but its success is influenced by multiple patient, surgical, and systemic factors. Traditional statistical models, such as logistic regression, are limited in capturing nonlinear relationships among these variables. Artificial intelligence (AI) can integrate diverse predictors to enhance clinical risk assessment and improve treatment outcomes.

Objective: To identify key predictors of dental implant success and develop AI-based models capable of accurately forecasting implant outcomes using clinical and surgical parameters.

Methods: This retrospective cohort study analyzed data from 172 patients (219 implants) placed between 2020 and 2021. Patient demographics, systemic health …

Enhancing Nursing Competency In The Ambulatory Surgery Center, Rachael Owokole

Walden Dissertations and Doctoral Studies

In this project, I addressed a persistent practice problem among agency nurses working in an ambulatory surgery center (ASC) in Southern California, who often enter the facility with varying familiarity with its policies and procedures. I designed this staff education, evidence-based practice (EBP), quality-improvement initiative to strengthen nursing knowledge and competency among agency nurses at the facility. The practice question was designed to assess on whether their knowledge and self-perceived competency improved after participating in the education program. I obtained evidence for the project from peer‑reviewed research, clinical guidelines, and national competency frameworks. I identified sources through systematic searches of …

Staff Education To Instruct Nurses On How To Use The Braden Scale To Increase Their Knowledge, Anna Shedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

The Effectiveness Of Anterior Torque Control By Clear Aligners In Extraction And Non-Extraction Cases : Systematic Review, Houda Ousli, Kawtar Chadli, Fatima Zaoui, Hicham Benyahia

International Arab Journal of Dentistry

Introduction: Clear aligner treatment has gained popularity in recent years. Accurate torque expression of the upper incisors is crucial for orthodontic treatment outcomes but remains challenging in invisible orthodontic treatment.

Objectives: This systematic review aims to evaluate the existing literature and critically assess the clinical effectiveness of aligners in controlling anterior torque or bucco-lingual root inclination, in both extraction and non-extraction cases.

Methods: A systematic search of Scopus, PubMed, Web of Science, Ebsco, and the Cochrane Library was conducted for peer-reviewed articles published between 2014 and March 2025. A total of 257 records were identified (Scopus: 32; Web of Science: …

Specific Carbohydrate Diet Versus Mediterranean Diet In Adult Patients With Mild To Moderate Ulcerative Colitis: A Randomized Controlled-Feeding Trial, Albert Sheng-Yin Chen, Long Nguyen, Brianna Gray, Katherine Williams, Jenny Gurung, Lauren Canha, Jessica Mcgoldrick, Jane Hubbard, Hamed Khalili

Student Papers, Posters & Projects

Background and aims: This pilot randomized controlled-feeding trial compared the effect of Specific Carbohydrate Diet (SCD) and Mediterranean diet (MeD) in mild to moderate ulcerative colitis (UC).

Methods: Seventeen adults were randomized to a 6-week SCD (n = 8) or MeD (n = 9) intervention. Primary outcome was change in partial Mayo Clinic score (pMCS).

Results: The study was discontinued early due to significant dropout (n = 9, 52.9%). There was no significant between-group differences observed for pMCS change (SCD, -0.8; MeD, -1.3; p = 0.499) or secondary outcomes. Exploratory metagenomic analysis revealed enrichment of Parasutterella excrementihominis …

Progesterone And Cerclage Together For Short Cervix: Evaluating Potential Complementary Effects For Improved Preterm Birth Prevention, Vincenzo Berghella, Ilaria Paladino, Moti Gulersen, Lauren Sayres, Amanda Roman, Rupsa C. Boelig

Department of Obstetrics and Gynecology Faculty Papers

Management of patients with a short cervical length (CL) on transvaginal ultrasound (TVU) often involves therapy with vaginal progesterone and/or cervical cerclage. Although these interventions are frequently viewed as alternative strategies, they may also represent complementary approaches targeting different mechanisms involved in spontaneous preterm birth. As in other areas of medicine, therapies with different mechanisms are often used together rather than as mutually exclusive options. In line with current level 1 evidence from randomized controlled trials (RCTs) and meta-analyses of RCTs on either vaginal progesterone or cerclage, in singleton gestations with no prior spontaneous preterm birth (SPTB), vaginal progesterone is …

Signal And Substance: Why Methodological Sophistication Fails To Guarantee Inference, Aamir Rashid, Rizwana Rasheed

Publications and Research

Despite increasing analytical sophistication, empirical research in organization studies continues to suffer from fragile inference, uneven theoretical accumulation, and contested credibility. This paper seeks to explain why these problems persist by shifting attention from authors’ methodological choices to the evaluative dynamics of peer review. Adopting a conceptual and theory-analytic approach, the paper theorizes peer review as an inferential gatekeeping system. Drawing on research design, theory evaluation, and philosophy-of-science literatures, this study develops an analytical framework to examine how evaluative routines shape what constitutes empirical rigor during the review process. The analysis identifies five recurring reviewer blind spots: inferential scope inflation, …

Influence Of Dietary Protein On Levodopa Effectiveness, Meghan Decker Rn

Nurse Residency

In adult patients with Parkinson's disease how does carbidopa-levodopa administration with protein vs without protein impact levodopa absorption and patient signs and symptoms?

Improving Patient And Staff Safety During Intrahospital Transport: Implementation Of A Nurse-Driven Checklist, Leah D. Kvintus Rn, Bsn

Nurse Residency

In hospitalized adult patients requiring intrahospital transport, how does the implementation of a standardized nurse-driven transport checklist and structured, facility-wide transport safety protocols compared to current practice without standardization affect patient and staff safety outcomes, including patient falls, safety incidents, and staff injuries or workflow disruption?