Digital Commons Network^™

A Scoping Review Of The Objective Structured Assessment Of Technical Surgical Skills (Osats), David J. O'Regan, Christopher Caddy, Retnagowri Rajandram, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Objective structured assessment of technical skills (OSATS) offers an objective tool for assessing bowel anastomosis on a benchtop. It was developed in 1997 to set appropriate standards and expectations for the surgical trainee. OSATS have become the gold standard of assessment across many disciplines. A global Likert rating scale, including respect for tissues, instrument handling, economy of movement, and flow of the operation predominates the literature. This has led to many questioning OSATS objectivity, claiming the process to be time-consuming, subjective, demanding human resources, and requiring extensive training of the trainer. We believe OSATS scoring has omitted the 22-point …

A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long

Walden Dissertations and Doctoral Studies

The emergence of illicitly manufactured fentanyl has increased clinical uncertainty during buprenorphine induction in medication-assisted treatment for opioid use disorder. The purpose of this quantitative, retrospective cohort study, guided by the Transtheoretical Model (TTM), was to examine whether prescriber-level buprenorphine induction practices and experiences with precipitated withdrawal were associated with reported buprenorphine induction challenges, and whether county-level fentanyl prevalence contributed to these challenges after accounting for geographic clustering. Secondary, de-identified archival data were obtained from the National Institute on Drug Abuse Clinical Trials Network study CTN-0134 and included 64 prescribers practicing in fentanyl-endemic settings. Buprenorphine induction challenges were operationalized as …

Haynes County Ems Outreach Quality Improvement, Anna Parker, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

A Quality Approach To Pneumococcal Vaccination, Nimmy Joy, Michaela Mckissack

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Views, Knowledge, And Implications Of Abortion Law In Texas Obgyn Residencies, Jessica Harper, Sharon Barazani, Kate Mowry, Melissa Mendez

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Coverage, Traits, And Geographic Distribution Of Online Surgeon Reviews: Large-Scale Cross-Sectional Analysis, Michael Geng, Carlos Riveros, Yash B. Shah, Sanjana Ranganathan, Kai Fok, Renil Sinu Titus, Vatsala Mundra, Eusebio Luna Velasquez, Dharam Kaushik, Allan S. Detsky, Angela Jerath, Benjamin N. Breyer, Yusuke Tsugawa, Christopher J. D. Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

BACKGROUND: The use of online physician rating platforms has significantly increased and has been shown to influence physician selection. There are limited data on the use of these platforms for rating surgeons.

OBJECTIVE: In this study, we sought to assess the geographic distribution of and patterns in rating scores of surgeons in the United States. Additionally, we examined rating volumes across different surgical specialties and the association between peer-nominated and patient-initiated ratings on online rating platforms in the United States.

METHODS: We conducted a cross-sectional study by identifying 201,154 surgeons in the United States via the National Plan and Provider …

Acute Compartment Syndrome Following Lower Leg Vascular Injury: A Big-Data Approach To Estimating Incidence And Risk Factors, Harry Moroz, Edward J. Harvey, Yasser C. Bouklouch

Journal of Shock and Hemodynamics

Acute Compartment Syndrome (ACS) is a limb- and life-threatening complication of lower leg fractures. Rapid recognition and fasciotomy can prevent irreversible ischemic injury, but ACS is often under-recognized. Vascular injury may increase the risk of ACS by impairing perfusion and exacerbating swelling. This study aimed to determine the incidence, risk factors, and outcomes of ACS in patients with lower leg fractures, with particular emphasis on the impact of vascular injury. This retrospective cohort study used data from the 2017 American College of Surgeons Trauma Quality Programs database to perform a multicenter analysis of patients with lower leg fractures. Patients were …

Prognostic Significance And Interplay Of Circulatory Pcsk-9–Apociii–Chemokine Axis In Type 2 Diabetes And Its Complications: A Pilot Study In North Indian Patients, Mohd Waiz, Sahir S. Alvi, Parvej Ahmad, Bodor Bin Sheeha, Paridhi Puri, Irfan Ahmad, Saheem Ahmad, M. Salman Khan

School of Medicine Publications

Background: Proprotein convertase subtilisin kexin/type-9 (PCSK-9) regulates cholesterol homeostasis through lysosomal degradation of LDL-R and also acts as a pleiotropic mediator of inflammation. Emerging evidence links PCSK-9 to diabetes pathogenesis. Given the genetic diversity and distinct lifestyle of the Indian population, investigating role of PCSK-9 in Indian type-2 diabetes mellitus (T2DM) patients is crucial. Notably, its association with ApoCIII and chemokines such as CXCL2 and MCP-1 remains unexplored.

Results: A total of 187 participants were included: Heathy control (HC; n = 50), T2DM (n = 49), T2DM with nephropathy (T2DM-N; n = 43), and T2DM with dyslipidaemia (T2DM-DL; n = …

Health Data And Policy Related To Methamphetamine-Use Suicide In Mississippi, Mary C. Drane

Honors Theses

The purpose of this research is to investigate how methamphetamine use in Mississippi, especially in its rural areas, intersects with public health, policy, and suicide outcomes in the state. Mississippi's methamphetamine crisis has evolved significantly, shifting from locally produced drugs to cartel-supplied crystal methamphetamine, while state and federal policies have struggled to keep pace with the scale and complexity of the problem. Using a convergent parallel mixed-methods design, this research analyzed CDC Wonder multiple causes of death data and SAMHSA Treatment Episode Data Set Admissions (TEDS-A) data from 2018 to 2024 alongside four qualitative key informant interviews with stakeholders across …

Assessing Current Telehealth Mobile Applications In The United States: Accessibility, Privacy, And Care Delivery, Rosemary K. Frugé

Honors Theses

Telehealth has improved patient access by reducing barriers to convenient, cost-effective, and quality health care. Telehealth mobile applications allow individuals to remotely access services through smartphone-based platforms. The purpose of this study was to evaluate leading telehealth applications available in the United States, analyzing key factors that influence platform selection, including cost, prescribing and diagnostic capabilities, user feedback, and data privacy practices. Applications were identified through keyword-based searches of major app stores using the term “telehealth,” and each app was systematically evaluated using predefined criteria. Findings highlight variability across platforms in pricing transparency, service offerings, and privacy disclosures, despite generally …

Digital Touchpoints: Investigating Contact Page Accessibility And Visual Authenticity Within Medical Tourism Health Websites, Alicia Mason, Elizabeth Spencer, Kristen Livingston, Treyton Meyers, Sakshi Bhati, Himika Akram

Faculty Submissions

This study examines two critical digital touchpoints on medical tourism provider (MTP) websites: (1) the accessibility of contact pages which often function as entry points for inquiries, scheduling, and pre-travel coordination, and (2) the authenticity of visual imagery used to shape expectations about care environments, personnel, and technological capacity. A sample of 105 MTPs across all six World Health Organization regions were analyzed using quantitative web accessibility testing and qualitative visual analysis. Results indicate pervasive accessibility errors on contact-page touchpoints and extensive reliance on inauthentic imagery to depict patients, providers, and medical technologies. Together, these practices may distort user expectations …

Health Insurance Literacy Among College Students At The University Of South Carolina, Emma J. Smith, Lorie Donelle Phd, Rn, Fcan, Robin Dawson

Caroliniana Undergraduate Research Journal

Purpose: This study aims to investigate the health insurance literacy skills of graduate college students and undergraduate college students.

Methods: A cross-sectional research design incorporated a 20-item questionnaire to examine college students’ knowledge of common health insurance terms and definitions, as well as their perceived understanding of health insurance. Descriptive analyses were conducted of participant demographics, health insurance literacy scores were summarized, and common health insurance policies were tested through a readability checker.

Results: The majority of students were between the ages of 18-25 and undergraduate students. More than half of the participants were female, and more …

Bio-Cybersecurity: Securing The Healthcare Industry, Amanda D. Coleman

Cybersecurity Undergraduate Research Showcase

Bio-cybersecurity refers to the aspect of cybersecurity that applies to the biological sciences and the protection of digital biomedical information. Today’s healthcare industry has evolved with the enhancement of internet and biomedical technology. While hospitals and private medical providers remain compliant with the Health Information Portability and Accountability Act (HIPAA) through traditional means of securing documented patient information, the emergence of beneficial internet-based healthcare services like virtual appointments and digital patient records requires new policies and healthcare cybersecurity frameworks to protect sensitive information from unauthorized access. This paper examines the role of cybersecurity in healthcare, the vulnerabilities that exist and …

Empowerment Of Patients Through Sexual Wellness Programming, Carly M. Busby

OTD Capstone Projects

Abstract:

This doctoral capstone project was completed in collaboration with Dr. Jenny Archer with Archer Physical Pelvic Floor Therapy. This project highlights empowerment of Dr. Archer and her team through administrative tasks and empowerment of clientele through education materials. The primary deliverable of my project is a six week ‘course,’ addressing pelvic pain through evidence-based therapy practices. Other deliverables include education materials that cover an expanse of pelvic floor and pregnancy related topics. The prominent goal of this capstone project was empowerment through education.

Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal

Walden Dissertations and Doctoral Studies

Traumatic brain injury (TBI) is a major public health concern associated with long-term disability and high healthcare utilization. Evidence guiding post-acute rehabilitation for medically complex TBI populations remains limited, particularly in long-term acute care hospital (LTACH) settings serving medically unstable patients. This study examined clinical and system-level factors associated with functional rehabilitation outcomes among adults with moderate-to-severe TBI in LTACHs. Guided by the Socioecological Model, recovery was conceptualized as interactions across individual, clinical, and organizational levels. This dissertation included three manuscripts using cross-sectional logistic regression and CMS Section GG measures. In Manuscript 1, longer time from injury to LTACH admission …

Navigating A Delicate Balance: Antibiotic Allergy In The Setting Of Renal Infection And Diabetic Ketoacidosis, Aun Bangash, Muhammad Bangash, Ruben M. Martinez Meza

School of Medicine Publications

Acute pyelonephritis is a bacterial infection of the renal parenchyma that requires prompt recognition and antibiotic therapy to prevent complications such as sepsis and chronic renal inflammation. We present a case of a 26-year-old woman with poorly controlled type 1 diabetes mellitus and a documented beta-lactam allergy who presented with atypical symptoms, including flank pain without urinary complaints. Laboratory evaluation demonstrated leukocytosis with a negative urinalysis. CT of the abdomen revealed left lobar nephronia with early contralateral involvement of the right kidney. Given her allergy history, she was treated with levofloxacin. During her hospital stay, she developed nausea, vomiting, and …

Investigating The Effect Of Kcl Stress In Raphanus Sativus, Mason P. Oelke

ATU Scholars Symposium

Presented by Stephanie Nelms at the Arkansas INBRE Conference on November 7-8, 2025.

Presented by Mason Oelke at Arkansas Tech Scholar's Symposium on April 9th, 2026.

Potassium is an essential macronutrient for plant growth and development, yet excessive potassium fertilization can induce salt stress with detrimental consequences for crop productivity and nutritional quality. Despite its agricultural relevance, potassium chloride induced stress remains significantly understudied compared to classical sodium-based salinity. This thesis investigates the physiological, biochemical, and molecular responses of Raphanus sativus to KCl stress using an integrated approach that combines germination assays, mineral profiling, and gene expression analysis.

Radish seeds …

Examining Outcomes Of Client Education Interventions To Reduce Caffeine Intake In The College-Age Population, Mackenzie Leonard, Mikayla Evans

James Madison Undergraduate Research Journal (JMURJ)

This scoping review aimed to explore health interventions that address excessive caffeine consumption in college students aged 18–23 years. Excess caffeine intake is associated with a range of health concerns, including neurological, cardiovascular, and behavioral issues, highlighting the need for effective interventions to mitigate its impact on overall wellness. The literature exploring interventions aimed at modifying health behaviors among the college student population is notably limited. Furthermore, there has been a lack of studies replicating interventions aimed at reducing caffeine intake. These gaps suggested the need for further investigation and exploration of reports pertaining to health promotion. The results of …

Maladaptive Influences Of Direct-To-Consumer Pharmaceutical Advertising: The Moderating Influence Of Age And Consumer Loneliness, Sanjay Puligadda

Atlantic Marketing Association Proceedings

No abstract provided.

Caring For Caregivers: A Health Care Marketing Opportunity, Yvette Lynne Bonaparte Dr.

Atlantic Marketing Association Proceedings

No abstract provided.

Connectivity, Classroom, And Contagion: An Ecological Analysis Of Testing Availability, Sex Education, And Sti Rates In The Upper Midwest, Macey M. Boerhave

Honors Thesis

Rural and frontier communities in the Upper Midwest face unique challenges that shape how young people access sexual health information and testing. While sexually transmitted infection (STI) rates continue to rise nationally, less is known about how sexual health education, digital access, and geographic distance influence these trends at a county level. This study examines the relationship between broadband internet access rates, poverty rates, proximity to free or low-cost STI testing sites, and county-level STI rates among individuals aged 15-24 in selected counties across South Dakota, North Dakota, Minnesota, Iowa, and Nebraska. Using an ecological, cross-sectional design, county-level STI surveillance …

Effects Of A Major Disruption On Mental Health Of Pregnant Women In South Carolina, Lizmarie Maldonado

MUSC Theses and Dissertations

Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, …

Identifying Major Sources Of Leptospira Interrogans In San Juan Bay And Río Grande De Loíza Estuaries Of Puerto Rico, Logan Mccullers, Dave Bachoon

Biology Theses

This study evaluated the presence of pathogenic Leptospira interrogans, potential carriers, and environmental factors influencing their occurrence in the San Juan Bay Estuary (SJBE) and Río Grande de Loíza (RGDL) watersheds of Puerto Rico from 2024–2025. Detection of this pathogen from water samples was performed using the lipL32 PCR assay. The likely hosts of L. interrogans were determined using fecal source tracking (FST) assays for human (HF-183), canine (BacCan-UCD), equine (HoF597), and rat mitochondrial DNA NADH dehydrogenase subunit 2 gene (RatMt) markers. In 2024, 91 samples were collected (March: 50; June: 41), and in 2025, 124 samples were collected …

Epigenome-Wide Association Study Of Blood Proteome In The Atherosclerosis Risk In Communities Study, Yang Li, Aditya Surapaneni, Zulema Rodriguez-Hernandez, Pascal Schlosser, Eugene P Rhee, Eric Boerwinkle, Bing Yu, Megan L Grove, Kelly V Ruggles, Josef Coresh, Morgan Grams

Faculty, Staff and Student Publications

Characterizing the relationship between DNA methylation and circulating proteins is critical to understanding the epigenetic regulation of the human plasma proteome. Here, we performed an epigenome-wide association study of 5,032 circulating proteins in 1,449 White and 315 Black participants from the Atherosclerosis Risk in Communities cohort. We identified 12,500 significant protein quantitative trait methylation (pQTM)-protein associations involving 1,647 proteins. Among 7,796 unique pQTMs, 14.7% were classified as cis-pQTMs, which were enriched for fundamental cellular processes, whereas trans-pQTMs were predominantly linked to immune-related functions. Trans-pQTMs also exhibited stronger associations with demographic, lifestyle, and clinical traits as compared with cis-pQTMs. We identified …

The Role Of Intravascular Ultrasound Imaging In 30-Day Readmissions Among Acute St-Elevation Myocardial Infarction Patients, Britta Watson

MUSC Theses and Dissertations

Cardiovascular disease (CVD) remains one of the leading causes of death in the United States. Coronary artery disease (CAD) is the largest contributor to deaths that result from cardiovascular disease. When CAD is left untreated, it can result in an acute ST elevation myocardial infarction (STEMI). To treat coronary blockages caused by CAD, a percutaneous coronary intervention (PCI) is performed. A PCI is a non-invasive procedure that uses coronary balloons and stents to open a narrowed or blocked coronary artery and restore blood flow.

An acute ST elevation myocardial infarction (STEMI) is a major cause of early hospital readmissions. Technological …

Diabetes Mellitus And Its Association With Tuberculosis Clinical Presentation And Treatment Outcomes: Results From A Prospective Cohort Study In Ghana, Monica Baaba Jones, Kwadwo Ansah Koram, Francis Anto, Michael Lauzardo, Blanca I. Restrepo, Margaret Lartey, Hafisatu Gbadamosi, Awewura Kwara

School of Medicine Publications

Background: Tuberculosis (TB)-diabetes is a growing public health threat in TB-endemic settings. We aimed to determine diabetes prevalence among TB patients in Greater Accra and its association with TB clinical presentation and treatment outcomes.

Methods: We enrolled 204 adults (≥20 years) with bacteriologically confirmed pulmonary TB across 14 health facilities. At treatment initiation, participants were screened for diabetes using self-report, fasting plasma glucose, and glycated hemoglobin, following standard diagnostic criteria. Baseline characteristics were recorded, and participants were followed to determine TB treatment outcomes. Associations between diabetes, baseline characteristics and treatment outcomes were assessed using bivariate and multivariate analysis in STATA. …

Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray

Walden Dissertations and Doctoral Studies

Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological …

Costs, Demographics, And Causative Agents In Patients Hospitalized For Drug Induced Liver Injury: Trends In A Large Academic Healthcare System, Megan Kozar, Yunisse Gonzalez, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

PURPOSE: Drug-induced liver injury (DILI) is an uncommon but potentially life-threatening condition. To date, the burden of DILI on a single, large healthcare system has not been investigated, preventing adequate resource allocation. This study aims to quantify DILI-related healthcare utilization within the Jefferson Health System (JHS) and identify case-related factors associated with high resource requirements; such information is crucial to focus efforts toward resource reduction.

PATIENTS AND METHODS: This study characterizes trends of 48 DILI cases within JHS, including demographics, payer status, causative agent, and DILI pattern. These variables were correlated with length of stay (LOS) and cost relating to …

Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have been associated with adverse health outcomes in adulthood; however, less is known about their relationship with preventive health behaviors such as cervical cancer screening. The purpose of this quantitative, correlational study was to examine associations between selected ACEs and cervical cancer screening among women aged 18–65 in South Carolina. Data were drawn from the 2020 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and included 1,323 women. Binary logistic regression analyses were used to examine unadjusted and adjusted associations between ACE exposures and being up to date with Pap testing, controlling for age, race/ethnicity, income, …

Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher

Walden Dissertations and Doctoral Studies

Adolescent dating violence (ADV) is a significant public health issue that disproportionately affects youths in southern rural communities, yet these populations remain underrepresented in research. The purpose of this quantitative cross-sectional study was to examine the association between ADV and sociodemographic factors (gender, race, age, and education level), alcohol consumption, and bullying among adolescents in Alabama, Arkansas, and Mississippi using data from the 2021 Youth Risk Behavior Surveillance System. Guided by the social-ecological model, binary logistic regression analyses were conducted to assess relationships between ADV victimization and the selected predictors. Results indicated that females had significantly higher odds of reporting …