Digital Commons Network^™

Examining Nurse Burnout During The Covid-19 Pandemic: Causes And Mitigation Strategies, Melanie Sena

Honors Projects

Nurse burnout is a multidimensional occupational syndrome that predates the COVID-19 pandemic, yet the pandemic served as a catalyst that intensified its scope and severity in ways that the healthcare system was profoundly ill-equipped to manage. Characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, burnout among nurses accelerated dramatically between 2020 and 2022 as clinical workloads surged, personal protective equipment remained scarce, and moral distress became a near-universal experience across care settings. This review examines the primary systemic and individual contributors to nurse burnout during COVID-19, explores the consequences of burnout for both nurses and patients, …

Marching Health From Music To Injury: The Implications Of Marching Band Athletic Training Accessibility, Madelyn Liebhardt

Honors Projects

The following study explores the importance and need of athletic trainers (ATs) in marching band settings. Athletic Training is an essential backbone to many sports programs worldwide. Athletic Trainers are commonly seen as active staff members for many high school, collegiate, professional teams as well as in clinical office sites. Athletic Trainers are also staffed in non-traditional settings such as corporate settings, performing arts, military branches. Marching bands are categorized under non-traditional sports settings and ATs are becoming more highly preferred in this area. This study follows the Bowling Green State University (BGSU) Falcon Marching Band (FMB) during the 2025 …

Artificial Intelligence In Dental And Orthopedic Skeletal Imaging: A Scoping Review Of Methodological Convergence And Translational Gaps, Man Hung, Isabella Strickler, Annabella Jensen, Bayler Gunnell, Alicia Parry, Samuel Dyal, Martin S. Lipsky

Institute on Aging Publications

This scoping review aimed to answer the question: to what extent do artificial intelligence applications in dental and orthopedic skeletal imaging demonstrate true cross-disciplinary methodological convergence versus parallel development with shared translational barriers? This scoping review synthesizes AI applications across both fields to characterize methodological overlap, developmental asymmetries, and translational gaps, rather than assuming convergence. Following the PRISMA-ScR reporting standards, we searched PubMed, Scopus, Web of Science, IEEE Xplore, and EMBASE for peer-reviewed, English-language human studies published between January 2015 and May 2025. Eligible studies applied AI, machine learning, or deep learning to diagnostic, segmentation, or preoperative planning tasks in …

Contribution Of The M1 Vs M2 Phenotype Toward Macrophage Interactions With Streptococcus Mutans, The Dominant Bacteria In The Oral Cavity, Isabelle K. Wintz

Honors Thesis

We are all exposed to numerous pathogens every day. One of the sites for pathogens to interact with our body is in the mouth. To better understand these interactions between bacteria and host immune cells, I developed an assay to study the oral bacteria Streptococcus mutans and inflammatory macrophages. Our hypothesis was that the cytokines IL-4 and IFN-y would alter macrophage phenotypes with IL-4 reducing inflammatory responses and IFN-y increasing inflammation.  To test this, we performed experiments in cell culture as a first step toward understanding the severity of the host response at the cellular and molecular levels. Our results …

Garlic Breath And Beads Of Sweat: The Effects Of Garlic And Chili Peppers On The Growth And Ph Of Streptococcus Mutans., Lena Pitzer

Honors Projects

The purpose of this project is to provide a quantifiable and repeatable measurement of how the presence of garlic and chili pepper during the growth of a carious dentine strain of Streptococcus mutans affects the growth of the strain and surrounding pH level.This research project examines two possible alternative agents, garlic and chili peppers, due to the known antimicrobial effects of their active components, allicin and capsaicin. Prepared garlic and chili extracts were used during disk diffusion to assess and measure the zones of inhibition. The anticipated results are that there will be inhibition present with both the garlic and …

Implementing A Self-Administered Crafft Screening Tool In A Pediatric Mental Health Setting, Michael Nguyen

Doctoral Dissertations & Projects

Background: Adolescent substance use disorders (SUDs) require early identification in inpatient psychiatric settings, but inconsistent screening workflows limit systematic detection.

Aims: This quality improvement project evaluated implementation of the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) 2.1 screening tool to improve identification of adolescents at risk for SUDs and support multidisciplinary communication.

Methods: CRAFFT 2.1 screening was embedded into admission workflows for adolescents admitted to two inpatient psychiatric units. Admission nurses distributed self-administered forms during admission. Completed screenings were scored and entered into the electronic medical record. Scores were categorized as low (0), medium (1), or high (≥2). High-risk results …

The Accuracy Of Occlusal Splint Fabricated By The Different Materials With Different 3d Printers., Supisara Thamrongsak

Master's Theses (2009 -)

Aim: The purpose of this study is to evaluate the accuracy of occlusal splints fabricated by the different materials with different 3D printers in four different orientations (0°, 15°, 25°, 40°) using surface matching software. Materials and Methods: Occlusal splints were printed in 4 different orientations including 0°, 15°, 25°, and 40° based on the STL file of the designed occlusal splint with 3 different printers (Carbon® M3Max, SprintRay Pro S, Asiga Pro4K). A total of 120 occlusal splints were printed for the present study, 10 occlusal splints were printed for each group. Then all occlusal splints were scanned using …

Digital Assessment Of Subtractive And Additive Cad/Cam Fabrication Methods On The Fit And Accuracy Of Lithium Disilicate Veneers, Basma Refaat Fayad, Islam Heiba Dr, Sara Fikry Dr, Maha Nagy

Dentistry

Objectives: This study compared subtractive and additive fabrication methods regarding their impact on the marginal/internal fit, trueness, and precision of lithium disilicate ceramic veneers. Methods: Laminate veneer preparations on an acrylic tooth were duplicated into twenty-four additively manufactured resin dies. Veneers were digitally designed and fabricated via milling (subtractive) or 3D-printing (additive) (n=12/group). All veneers were scanned. For trueness, the final design served as the reference; for precision, pairwise comparisons were made within each group. For adaptation, the scanned die was the reference. Post-cementation and thermal cycling (10,000 cycles, 5–55°C), marginal adaptation was measured using a digital microscope (×100). Data …

Autoantibody Reactivity In Hidradenitis Suppurativa: Characterizing Keratinocyte And Apocrine Gland Targets Across Disease Progression And Anti-Tnf-Α Treatment, Talla Hamouche

Student Theses and Dissertations

Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease associated with impaired quality of life, representing one of the highest burdens among dermatological conditions. This debilitating disorder primarily affects apocrine-gland-bearing and flexural skin areas, most commonly the axillae, breast, buttocks, and groin. As lesions recur and new sites emerge, surgical excision does not guarantee prevention of disease reestablishment. Despite its substantial burden, HS remains among the least understood and most treatment-resistant inflammatory diseases. The mechanisms underlying this chronicity and the frequent failure of conventional anti-inflammatory therapies remain unresolved. An underappreciated autoimmune dimension may contribute to HS pathogenesis: the clonal …

Quality Improvement Project: Integrating Depression Screening Into Adult Wellness Visits In A Primary Care Clinic, Nina Denchukwu

Doctor of Nursing Practice Projects

Depression is a prevalent and debilitating mental health condition that remains significantly underdiagnosed in primary care, despite national recommendations for universal adult screening. At the project site, less than 40% of adults completing annual wellness visits had documented depression screening. The purpose of this quality improvement project was to evaluate whether integrating the evidence-based Patient Health Questionnaire (PHQ)-2 and PHQ-9 into the electronic health record (EHR) would improve completion of depression screening, documentation, and referrals to treatment. The project was guided by Rogers' Diffusion of Innovations Theory and the Plan-Do-Study-Act (PDSA) framework. A quantitative pre–post intervention design linked with the …

Quality Improvement Project: Impact Of Faculty Competency And Classroom Application Of Artificial Intelligence (Ai), Clydea Hale

Doctor of Nursing Practice Projects

The rapid integration of artificial intelligence (AI) in healthcare has created a growing need for nursing faculty to develop competency in AI to adequately prepare students for modern clinical practice. Despite this need, limited faculty knowledge and low classroom application of AI persist. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of an evidence-based AI educational intervention on nursing faculty competency and classroom application. Guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory, a quasi-experimental pretest-posttest design was implemented with nursing faculty at a rural community college in …

Promoting Trauma-Informed Practices Through Staff Education, Ediomi Enebong Oduwole

Doctor of Nursing Practice Projects

Front office staff in outpatient psychiatric settings are often the first point of contact for patients experiencing anxiety and emotional distress. However, existing evidence indicates that non-clinical, front office staff often lack formal training in trauma-informed care (TIC). This gap may limit early recognition and response to patient distress. This quality improvement project addressed this gap by evaluating the impact of a trauma-informed educational intervention of staff confidence and documentation of patient distress. The project was guided by Pender’s Health Promotion Model and Lewin’s Change Theory. It used a pre-and post-intervention quantitative design with sample of five front office staff …

Early Neurologic Red Flags In Pediatrics: What Primary Care Providers Need To Know, Bob Underwood, Justin Coogle

Pediatrics in Practice: A CME Podcast

Subtle neurologic symptoms can be easy to miss in primary care. Pediatric neurologist Justin Coogle, MD, reviews early red flags, age‑specific warning signs and referral considerations to help pediatricians identify neurologic disorders earlier and optimize care.

Click here to stream the podcast episode.

Spatial Distribution Patterns Of Determinants Of Hypertension In West Java In 2023, Meirina Nur Asih Susanti, Wahyu Septiono

Preventia: The Indonesian Journal of Public Health

Hypertension is a public health issue that is unevenly distributed across regions. The high prevalence in West Java (34.4%) with a large population makes the management of hypertension crucial. Differences in economic and environmental conditions are thought to influence the distribution of hypertension, thus requiring spatial analysis. This study used an ecological approach by analyzing data from districts/cities in West Java in 2023. Secondary data were used to measure hypertension prevalence and to assess socioeconomic and environmental factors. The analysis was conducted using univariate Moran's Index, Local Indicators of Spatial Association (LISA), and the Spatial Autoregressive Model (SAR). The prevalence …

Assessment Of Health And Medical Students' Awareness, Attitude, And Preventive Practices Toward Monkeypox Outbreak, Haneen Qahtan, Taher M. Al-Fahham, Sameerah Mohammed Saeed

Preventia: The Indonesian Journal of Public Health

Monkeypox is an infectious disease caused by the monkeypox virus, which is a primarily endemic disease in Western and Central Africa. Monkeypox infections among humans have been on the rise in certain areas of Africa in recent times, leading to its identification as a major health hazard. It is important for medical college students, who will become future healthcare professionals, to actively participate in educating the general population about this illness. Their readiness and capacity to properly handle such health emergencies are strongly influenced by their knowledge, attitudes, and preventive measures regarding newly emerging infectious diseases such as monkeypox. This …

Association Between The Combined Herbal Medicines And Risk Of Dental Diseases In Patients With Rheumatoid Arthritis: Insight From A Nationwide Database, Chiu-Hui Ling, Wei-Jen Chen, Ying-To Hsu, Hanoch Livneh, Ming-Chi Lu, Tzung-Yi Tsai

Leadership, Learning and Counseling Faculty Publications and Presentations

Background and Objectives:

Patients with rheumatoid arthritis (RA) are found to have a higher risk of dental diseases. Although herbal medicines (HMs) have long been used to treat various conditions, few studies focus on its impact on dental diseases. In this longitudinal cohort study, we assessed the correlation between HM use and risk of dental diseases in RA groups.

Materials and Methods:

A total of 2359 persons with RA aged 20–80 who were free of dental diseases between 2001 and 2010 were retrospectively enrolled from nationwide register-based data. They were then classified into HMs and non-HMs groups based on whether …

Understanding Adult Patients’ Experiences Of Trauma-Informed Care In Outpatient Healthcare, Jayme Aguero

Dissertations (1934 -)

Trauma is recognized as a universal human experience. Well-established evidence demonstrates the negative impact of trauma on health outcomes. In 2014, following a recommendation from SAMHSA, trauma-informed care (TIC) was implemented across human service sectors, including healthcare. While TIC has been in use for the past decade, adults’ experiences of receiving TIC in outpatient healthcare remain largely unknown. The purposes of this study were (a) to explore and describe how adults’ healthcare experiences aligned with the principles of TIC being implemented in outpatient healthcare settings and (b) to understand the perceived usefulness and meaning of TIC for adult patients. A …

Quality Improvement Project: Improving Adn Faculty Professional Development Through Simulation Training, Sharon Haley Peace

Doctor of Nursing Practice Projects

Lack of structured simulation training for nursing faculty, which has been identified as a gap in the literature, can negatively impact the quality of simulation-based education and student learning outcomes. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to develop, implement, and evaluate an evidence-based training intervention aimed at improving faculty self-efficacy and competence in simulation facilitation. The project was guided by Lewin’s Change Theory and Kolb’s Experiential Learning Theory to support faculty development. A quantitative, quasi-experimental pre-post design was used with a convenience sample of nine associate degree nursing faculty at a rural community …

Quality Improvement Project: Improving Provider Workflow And Documentation For Routine Mental Health Screening In An Outpatient Psychiatric Clinic, Sharon Uchechi Joshua

Doctor of Nursing Practice Projects

Depression and anxiety are leading causes of disability and are frequently underdiagnosed in outpatient psychiatric settings due to inconsistent screening and documentation practices. Evidence supports the use of standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to improve early detection and clinical outcomes. This quality improvement (QI) project evaluated whether implementing standardized electronic health record (EHR) templates and provider education would improve documentation of PHQ-9 and GAD-7 screenings. The aim was to increase the consistency of screening and documentation among psychiatric providers. The project was guided by the Plan-Do-Study-Act (PDSA) framework and Lewin’s Change …

B Cell Expression Of An Enzymatic Intermediary In Ether Lipid Biosynthesis Promotes Antibody Responses And Germinal Center Size, Sung Hoon Cho, Marissa A Jones, Kaylor Meyer, David M Anderson, Sergiy Chetyrkin, M Wade Calcutt, Richard M Caprioli, Clay F Semenkovich, Mark R Boothby

2020-Current year OA Pubs

The qualities of antibody (Ab) responses provided by B lymphocytes and their plasma cell (PC) descendants are crucial facets of responses to vaccines and microbes. Metabolic processes and products regulate aspects of B cell proliferation and differentiation into germinal center (GC) and PC states along with Ab diversification. However, there is little information about lymphoid-cell-intrinsic functions of enzymes that mediate ether lipid biosynthesis. Imaging mass spectrometry (IMS) results had indicated that concentrations of a number of these phospholipids were substantially enhanced in GC compared to the background average in spleens, but it was unclear if biosynthesis in B cells was …

Evaluating Glucagon-Like Peptide-1 Receptor Agonist Safety Before Upper Endoscopy: A Systematic Review And Meta-Analysis, Zohaib Ahmed, Amna Iqbal, Sami Ghazaleh, Abdallah Kobeissy, Ali Nawras, Yaseen Alastal, Hani Saad, Sarmed Mansur, Idrees Mohiuddin, Umair Iqbal, Dushyant Singh Dahiya, Syeda Faiza Arif, Connor Campbell, Wade Lee-Smith, Mohammad Asif, Faisal Kamal, Aamir Saeed, Omar Horani

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has remarkably increased in the past few years as they have demonstrated significant reduction in A1c and major cardiovascular outcomes and have led to weight loss with low risk of hypoglycemia. GLP-1 RA use has raised concerns about potential associations with increased gastric retention and adverse outcomes in upper endoscopy procedures.

METHODS: We conducted a comprehensive search across multiple databases to identify comparative studies evaluating the impact of GLP-1 RA exposure versus non-exposure on upper endoscopy outcomes. Studies comparing GLP-1 RAs to other medications were excluded. The primary outcome was …

Barriers Asian Adoptees Face In Screening For Inheritable Conditions Due To A Lack Of Family Medical History, Anna Shea

Honors Projects

Adoption has been increasingly common in the United States, with more than 7.8 million people in the United States adopted (Wexler et al., 2025) and over 280,000 children in the United States adopted internationally (Orr et al., 2024). Despite this, those who are adopted, especially internationally, often face medical disadvantages compared to those biologically related to their family. The differences in treatment between adoptees and those who are biologically related are largely due to the knowledge, or lack of knowledge, of the individual’s family medical history and genetic information. Genetic or inherited disease screening is often only completed or covered …

Handgrip Strength, Handgrip Endurance And Bmi: A Comprehensive Approach To Health Assessment Among The General Population Of Madikeri, Dr Asha S. Das, Dr Ravikiran Kisan, Dr Suhas Y. Shirur, Dr Narasimha Rai K, Dr Sanjay Bhagoji

Digital Journal of Clinical Medicine

Introduction: Being physically fit is essential for lowering the risk of illness and enhancing longevity. While Body Mass Index (BMI) is frequently used to evaluate body composition, Hand Grip Strength (HGS) and Hand Grip Endurance (HGE) are important indicators of general well-being. Goal: To assess BMI, HGS, and HGE and ascertain how they correlate in a selected group of subjects. Methods: Fifty participants between the ages of 20 and 40 years participated in a comparative cross-sectional study at the Department of Physiology, Kodagu Institute of Medical Sciences, Madikeri. Participants were divided into three BMI groups after anthropometric measurements were taken. …

Coordinated Telehealth For People With Parkinson’S Disease: A Qualitative Comparison Of Providers’ And Patients’ Experiences, Erin J. Bush, Reshmi L. Singh, Josephine Cox, Merrill R. Landers, Annalisa V. Piccorelli

The Qualitative Report

Telehealth increases access to allied healthcare in rural areas. People with Parkinson’s disease (PD) need improved access to health care, and from a patient-centered perspective, the coordination of their healthcare should be a priority. Four speech-language pathologists, two physical therapists, two pharmacists, and two study coordinators provided a coordinated allied healthcare intervention for people with PD in rural Wyoming and Nevada. Both the providers of the intervention, as well as the participants who received it, were interviewed about their experiences with the eight-week intervention and asked about aspects that were successful or unsuccessful. Through a naturalistic paradigm using a qualitative …

Response Of Reticulocyte And Red Blood Cell Indices To Single-Dose Intravenous Iron In Pregnant Women With Moderate Iron Deficiency Anemia: Secondary Analysis Of The Rapidiron Trial, Manjunath S. Somannavar, Sudhir Mehta, Dharmesh Kumar Sharma, Seema Mehta, Yogeshkumar S, Umesh Charantimath, Benjamin E. Leiby, Michael K. Georgieff, Zubair H. Aghai, Ashalata Mallapur, Umesh Ramadurg, Radha Sangavi, Praveen Patil, J. P. Akshaykirthan, Rupsa C. Boelig, Mrutyunjaya B. Bellad, Richard J. Derman

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Iron deficiency anemia in pregnancy is a significant health concern. Reticulocyte hemoglobin equivalent (Ret-He) and immature reticulocyte fraction (IRF) are emerging as early markers, yet their response to different iron therapies in pregnancy is underexplored.

OBJECTIVE: To determine whether intravenous single-dose iron administration produces a more favorable effect on reticulocyte indices than oral iron therapy in anemic pregnant women.

METHODS: This is a secondary analysis of the RAPIDIRON Trial, a multicenter, three-arm randomized controlled trial comparing ferric carboxymaltose (FCM), ferric derisomaltose (FDM) and standard oral ferrous sulfate. Reticulocyte hemoglobin equivalent (Ret-He), Immature Reticulocyte Fraction (IRF) and other red blood …

High-Precision Automated Bone Age: A Clinically Useful Tool In Monitoring Of Treatment Effects In Children And Adolescents, Hans Henrik Thodberg, Lise Aksglaede, Anders Juul, Shanlee M. Davis, Judith L. Ross

Department of Pediatrics Faculty Papers

The clinical value of serial bone age (BA) determinations in children during growth is limited by the manual rater variability (precision 0.63 years). The objective of this work was to determine the precision of automated bone age and bone health index (BHI) measurements by BoneXpert and to establish the time interval at which the automated method can detect a significant treatment effect. The data were from a case-control trial (oxandrolone/placebo) following 90 boys with Klinefelter syndrome (KS) with five visits over 2 years, recording X-rays of both hands. The precision of BA was 0.08 years [0.07; 0.09] 95% CI, leading …

Escaping Traditional Teaching: An Interactive Approach To Pediatric Oncology Nursing Education, Paige A. Ackerman Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Recovery Instruction Improvement Project, Jonathan Eyestone, Katy Germundson

Publications 2026-present

No abstract provided.

The Polymerized Protein Response (Ppr) Is Activated By Genetic Variants That Polymerize In The Er And Is Mediated By Nfκbp50, Admire Munanairi, David A Rudnick, Jiansheng Huang, David H Perlmutter

2020-Current year OA Pubs

In previous studies we have shown that accumulation of the polymerogenic variant ATZ that causes α1-antitrypsin deficiency (ATD) activates NFκB DNA binding. Here we discovered that this response, which we are naming the polymerized protein response (PPR), is characterized by NFκB p50 homodimers, distinct from the p50/p65 heterodimers in the canonical NFκB inflammatory response and the unfolded protein response (UPR). The PPR is also activated by other disease associated variants that polymerize in the ER whereas disease-associated variants that do not form polymers activate p50/p65 heterodimers and UPR. The PPR elicits a unique gene expression profile, including changes that stabilize …

How Survivors Of Exploitation Who Use Drugs Navigate Systems Of Care: An Analysis Of Survivor Insights Using The Intersectional Risk Environment, Theresa Anasti, Hilary Thibodeau, Nathaniel A Dell, Kathleen Preble, Lauren Grimes, Lindsay B Gezinski

2020-Current year OA Pubs

BACKGROUND: Drug-related risks such as adverse health outcomes, overdose, and violent victimization vary across populations due to the marginalization of identities, structural inequities, and differing environments. Discrimination and criminalization exacerbate drug-related risks specifically for survivors of sexual exploitation who use drugs. This study aims to understand how survivors who are not currently utilizing intensive treatment services perceive their risk environment, including available resources, and identify possible mechanisms to address health equity. Emphasizing the role of harm reduction and the expertise of lived experience, this paper encourages innovative approaches to supporting survivors.

METHODS: A research team conducted seventeen semi-structured interviews with …