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Cochlear Micropump Drug Delivery System: A Noninvasive Technique For Murine Intracochlear Drug Delivery, Janette Collins Jan 2026

Cochlear Micropump Drug Delivery System: A Noninvasive Technique For Murine Intracochlear Drug Delivery, Janette Collins

Theses

In a 2018 World Health Organization (WHO) study, over 400 million people worldwide were affected by hearing loss (World Health Organization, 2023). Cochlear implants have provided a conventional route to aid inner ear issues but are ineffective either delivering to unintended targets or delivering unknown concentrations of a particular drug and create toxicity to the user. With medical advances and using 3-D printing technology, new opportunities to use programmable drug delivery systems to treat auditory disorders have been created. Borkholder Labs in Rochester, NY have created and improved a miniaturized implantable and scalable peristaltic micropump that provides programmable and accurate …


Evaluating The Effectiveness Of Scenario-Based Virtual Escape Rooms To Improve Student Confidence In Dosage Calculations, Jennifer A. Cuevas Jan 2026

Evaluating The Effectiveness Of Scenario-Based Virtual Escape Rooms To Improve Student Confidence In Dosage Calculations, Jennifer A. Cuevas

Theses

Abstract

Background: Accurate dosage calculations (DCs) are critical for patient safety, as medication errors contribute to approximately 7,000-9,000 preventable deaths annually. Nearly 30% of nursing students exhibit weakness in foundational mathematical skills, and a significant confidence gap exists: 70% feel confident in mathematical abilities, yet only 45% feel confident in clinical application, necessitating innovative educational interventions.

Purpose: The purpose of this project was to implement and evaluate a scenario-based virtual escape room intervention to enhance undergraduate nursing students' confidence in DCs.

Methods: Grounded in Kolb’s experiential learning theory, this online asynchronous intervention engaged students through concrete experience, reflective observation, abstract …


Increasing Confidence Of Respiratory Therapy Students In Cardiopulmonary Resuscitation Using Rapid Cycle Deliberate Practice, Heather Ashley Jan 2026

Increasing Confidence Of Respiratory Therapy Students In Cardiopulmonary Resuscitation Using Rapid Cycle Deliberate Practice, Heather Ashley

Theses

Background: Rapid Cycle Deliberate Practice (RCDP) simulation has emerged as an innovative approach to strengthening confidence among healthcare learners and professionals. Grounded in Kolb’s Experiential Learning Theory, RCDP emphasizes structured repetition, immediate feedback, and skill refinement through cycles of performance, reflection, and reapplication.

Methods: Senior-level respiratory therapy students participated in either a traditional cardiopulmonary resuscitation (CPR) simulation or an RCDP CPR simulation as part of their scheduled coursework. After completing the simulation, students participated in a post‑simulation survey, and scores were compared between the two groups.

Results: Confidence was evident across both simulation methods, and students indicated increased self‑confidence following …


From Tension To Teaching: Combating Incivility And Bullying Behaviors Directed At Nursing Students, Shelley Dyal Jan 2026

From Tension To Teaching: Combating Incivility And Bullying Behaviors Directed At Nursing Students, Shelley Dyal

Theses

Background: The phrase “nurses eat their young” has long been used to describe the culture of incivility and bullying often directed at nursing students. These behaviors in the nursing clinical learning environment break down nurse-student relationships. To address this issue, nursing staff must have the tools to fulfill their roles as educators and mentors in clinical settings. The purpose of this project is to implement and evaluate the effectiveness of an evidence-based asynchronous educational workshop focused on incivility reduction and student mentorship among nursing staff in a rural hospital setting.

Methods:  This study used a quantitative, one-group pretest–posttest intervention design …


Empowering Change: Impact Of Motivational Interviewing On First-Semester Nursing Students' Perceived Confidence And Communication Skills, Norma L. Branyon Jan 2026

Empowering Change: Impact Of Motivational Interviewing On First-Semester Nursing Students' Perceived Confidence And Communication Skills, Norma L. Branyon

Theses

Background: Effective communication is vital when interacting with others, regardless of the profession. When healthcare providers lack the skills to facilitate conversations about behavior changes, poor patient outcomes can be produced. New graduate nurses often encounter difficulties in effectively communicating with patients and display reluctance to engage with patients and their families. Ineffective communication may lead to increased anxiety, miscommunication, and mistrust. This communication gap can hinder therapeutic relationships, patient engagement, and overall health outcomes. Communication plays a crucial role in student nurses’ self-confidence, motivation, and personal and professional growth. Therefore, role transition for new nurses can be difficult and …


'Guide The Tide' - Supervision Of International Medical Graduates In The Emergency Department: A Mixed Methods Study, Purnasankar Bhowmik Jan 2026

'Guide The Tide' - Supervision Of International Medical Graduates In The Emergency Department: A Mixed Methods Study, Purnasankar Bhowmik

Theses

Australia’s emergency departments (EDs) have experienced significant stress since the COVID-19 pandemic. An increase in the number of patient presentations, a lack of in-patient beds for the disposition of admitted patients and long waiting times are contributing factors jeopardising patient safety. In addition, the shortage of skilled staff to look after patients in the ED is the paramount concern currently and moving forward. Similarly to many other specialty areas of medicine, EDs rely on international medical graduates (IMGs) to fill the gaps in the medical workforce. However, concerns have been raised regarding IMG diversity in training requirements, clinical skills and …


Compassion In Crisis: A Study Of Compassion Fatigue Among Nurses Working In The Emergency Department At A Western Australian Metropolitan Tertiary Hospital, Sonu Susamma Sam Jan 2026

Compassion In Crisis: A Study Of Compassion Fatigue Among Nurses Working In The Emergency Department At A Western Australian Metropolitan Tertiary Hospital, Sonu Susamma Sam

Theses

Compassion fatigue (CF) is defined as the emotional depletion caused by ongoing involvement in caring for another individuals experiencing trauma or hardship, pain, distress, and critical incidents. It is characterised by a decline in emotional capacity, reduced ability to empathise, and feelings of helplessness, that could potentially lead to burnout and secondary traumatic stress. While CF affects many healthcare providers including physicians, social service professionals, mental health practitioners, but nursing staff are particularly vulnerable due to their close and continuous engagement with patients.

Compassion fatigue has been extensively examined in oncology, palliative care, and intensive care, where exposure to patient …


Caring For Your Heart During Survivorship After Pediatric Cancer: A Visual Education Guide On Chemotherapy-Induced Cardiotoxicity, Bryona Rose Hamilton Jan 2026

Caring For Your Heart During Survivorship After Pediatric Cancer: A Visual Education Guide On Chemotherapy-Induced Cardiotoxicity, Bryona Rose Hamilton

Theses

Chemotherapy is an effective weapon in the fight against pediatric cancer. However efficient, treatment can lead to side effects that last long after a patient finishes their last round of chemotherapy. This thesis examines current research on chemotherapy-induced cardiotoxicity, a side effect of chemotherapy treatment caused by a class of chemotherapy drugs called Anthracyclines (such as doxorubicin and daunorubicin). While effective chemotherapy agents, these drugs have been known to cause late long-term heart damage when used to treat pediatric cancers such as Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML) and Pediatric Sarcoma. A written portion of this thesis project …


A Novel Nephron: 3d Visualization Of Glomerular Filtration In The Kidney, Cassie Young Jan 2026

A Novel Nephron: 3d Visualization Of Glomerular Filtration In The Kidney, Cassie Young

Theses

Renal physiology, particularly the process of glomerular filtration, remains one of the most conceptually challenging topics in medical education due to its microscopic scale, dynamic pressure relationships, and structural complexity. Understanding how plasma passes through the glomerular filtration barrier requires spatial reasoning across multiple levels—from the gross anatomy of the kidney to the ultrastructure of capillaries, podocytes, and the glomerular basement membrane. This thesis addresses these challenges through the development of a scientifically accurate three-dimensional (3D) animation that illustrates glomerular filtration within its anatomical and physiological context. Designed as a visual teaching aid, the animation aims to improve comprehension of …


Dna Landscape Tool: An Interactive Webpage, Kerstyn Gay Jan 2026

Dna Landscape Tool: An Interactive Webpage, Kerstyn Gay

Theses

Deoxyribonucleic acid (DNA) is a molecule that carries genetic information that makes up every organism. DNA is typically introduced into the biology curriculum starting in high school and depending on an individual's educational path can continue through college. Although taught frequently during school, elements of DNA can be difficult for students to grasp, due to the different visual representations of DNA found in various resources. For instance, when comparing an illustration of a chemically accurate nucleotide base to an abstract visualization of a chromosome learners often aren’t given enough scaffolding to see how one representation relates to the other, which …


Understanding Computer-Mediated Human Experience In Digital-Physical Hybrid Space, Jiangnan Xu Jan 2026

Understanding Computer-Mediated Human Experience In Digital-Physical Hybrid Space, Jiangnan Xu

Theses

With the rapid development of mobile and immersive technologies, the boundary between the digital and real world is increasingly blurred, giving rise to hybrid spaces. Hybrid spaces have permeated daily life and reshaped spatial meaning-making and social interaction. Despite their growing prevalence, empirical understanding of human experiences in hybrid spaces remains limited. If left unexamined, hybrid spaces risk becoming technology-centered rather than human-centered environments that overlook socio-cultural dimensions, potentially leading to harmful consequences for individuals and society. To investigate human experience in hybrid spaces, this thesis comprises five studies and uses gameful systems as research probes. Prior literature identifies collaboration …


Predicting Undergraduate Fallout And Success, Ammar Ahmed Alzarooni Jan 2026

Predicting Undergraduate Fallout And Success, Ammar Ahmed Alzarooni

Theses

Universities need to uncover students who are likely to drop out early and do something about it. It should be easy to find and use this information. This thesis evaluated interpretable machine-learning models (MLMs) for predicting three final student outcomes including Dropout, Enrolled and Graduate, using solely demographic, administrative/financial and first-semester academic variables. Study employed publicly accessible Portuguese UCI student retention dataset (4,424 records) and incorporated end-of-Semester-1 feature window to prevent look-ahead leakage and align with actual advising cycles. We trained and compared models using stratified validation, explicit class-imbalance handling and decision-threshold optimization to make dropout detection most critical factor. …


Tranquil Talismans, Yayan Zhang Jan 2026

Tranquil Talismans, Yayan Zhang

Theses

My series aims to delve deep into my personal experiences, narrating the uncertainty of graduating, the imbalance between study and work, and the anxiety brought about by countless rejections that have gradually disrupted the rhythm of my life. This disruption manifests in physiological symptoms such as insomnia, irregular menstrual cycles, emotional fluctuations, and the discovery of bodily lumps.My thesis work is separated into three parts of my journey. The first part portrays a dark period marked by chaos and confusion as I underwent a transition in my social roles and visually metaphorizes the onset of anxiety as darkness and chaos …


Optimisation Of Sampling For A New Skin Microbiome Assay Pilot Study, Anita Smith Jan 2026

Optimisation Of Sampling For A New Skin Microbiome Assay Pilot Study, Anita Smith

Theses

Recent interest in the diverse ecosystem of bacteria, fungi and viruses that make up the skin microbiome has led to numerous studies investigating the microbiome in healthy skin and in dermatological diseases. An imbalance of the normal skin microbial flora can cause some skin diseases, and current culture techniques are often unable to detect a microorganism to further our understanding of the clinical–microbiological correlates of disease and dysbiosis. Atopic dermatitis and rosacea are presentations that General practitioners (GPs) often manage that may have an infective or microbiological component and can be challenging to treat. Further research using culture-independent techniques is …


Reflux Micro-Aspiration: Natural History, Pathophysiology, Clinical Presentation And Treatment, Oleksandr Khoma Jan 2026

Reflux Micro-Aspiration: Natural History, Pathophysiology, Clinical Presentation And Treatment, Oleksandr Khoma

Theses

Background

The accurate diagnosis of gastro-oesophageal reflux pulmonary micro-aspiration has only become possible recently with the introduction of a novel technique of reflux micro-aspiration scintigraphy study combined with single photon emission computed tomography (SPECT) combined with x-ray tomography (CT) in a hybrid instrument (1-3). This has allowed the accurate diagnosis of pulmonary and airway contamination with refluxate. Previously only patients with large volume symptomatic reflux aspiration were diagnosed clinically (Mendelson syndrome) or by 2-dimentional barium meal or an older plantar (2 dimensional) technique of scintigraphic aspiration studies. The concept of reflux micro-aspiration has been implicated in multiple pulmonary diseases but …


Examining Preoperative Health And Lifestyle Risk Factors In Patients Awaiting Surgery During Covid-19 In Western Australia, Nadine Radin Jan 2026

Examining Preoperative Health And Lifestyle Risk Factors In Patients Awaiting Surgery During Covid-19 In Western Australia, Nadine Radin

Theses

This study investigated the prevalence of modifiable preoperative lifestyle risk factors among patients undergoing upper gastrointestinal and colorectal surgery at a metropolitan hospital in Perth, Western Australia (WA). It aimed to characterise behaviours such as smoking, alcohol and drug use, nutritional risk, physical fitness, frailty, and body mass index (BMI), and to examine whether these changed during the early phase of the COVID-19 pandemic in 2020 compared to 2019.

A retrospective audit of 2,340 patient medical records was conducted, with data extracted from routinely collected preadmission documentation. Regression models compared the prevalence of risk factors across matched calendar periods, adjusting …


Phytoremediation Potential Of Selected Plant Species (Ambrosia Artemisiifolia L. And Erigeron Canadensis L.) For Reducing Priority Heavy Metal And Metalloid (As, Cd, Cr, Cu, Hg, Pb, Zn) Contamination In Anthropogenically Impacted Soils Of Ukraine, Volodymyr Laptiev Jan 2026

Phytoremediation Potential Of Selected Plant Species (Ambrosia Artemisiifolia L. And Erigeron Canadensis L.) For Reducing Priority Heavy Metal And Metalloid (As, Cd, Cr, Cu, Hg, Pb, Zn) Contamination In Anthropogenically Impacted Soils Of Ukraine, Volodymyr Laptiev

Theses

Soil contamination with priority heavy metals and metalloids of anthropogenic origin represents one of the most pressing environmental challenges of the present day, directly associated with risks to public health, ecosystem degradation, and the achievement of the Sustainable Development Goals, particularly those of the World Health Organization and the United Nations aimed at ensuring a healthy environment, safe ecosystems, and sustainable land management. Under conditions of long-term technogenic pressure, compounded by the additional impact of military activities on the territory of Ukraine, the search for scientifically substantiated, environmentally safe, and economically feasible approaches to reducing soil contamination has become especially …


The Impact Of Pre-Trial Attitudes And Educational Jury Instructions : Juror Decision-Making In Mens Rea Cases Involving Mental Illness, Victoria E. O'Connell Jan 2026

The Impact Of Pre-Trial Attitudes And Educational Jury Instructions : Juror Decision-Making In Mens Rea Cases Involving Mental Illness, Victoria E. O'Connell

Theses

Juror decision-making in cases involving mental illness is shaped by legal understanding and subjective attitudes. This study examined how juror attitudes and jury instruction type influence the application of mens rea defenses—Not Guilty by Reason of Insanity (NGRI), Diminished Capacity (DC), and Guilty but Mentally Ill (GBMI)—in criminal case vignettes involving defendants with mental health presentations. Enhanced jury instructions improved understanding of mens rea concepts but did not improve the application of these concepts to verdict decisions. Biases against mens rea defenses were associated with DC verdict decisions, with more negative NGRI attitudes predicting less legally accurate but more confident …


Down The Rabbit Hole : A Journey Of Writing And Liberation, Mckenzie Sharp Jan 2026

Down The Rabbit Hole : A Journey Of Writing And Liberation, Mckenzie Sharp

Theses

Down the Rabbit Hole: A Journey of Writing and Liberation is a hybrid creative thesis composed of poetry, memoir, and auto-fiction that explores trauma, mental illness, abuse, and resilience through non-linear narrative and surrealist imagery. This collection examines writing as both a survival practice and reclamation of agency after prolonged silencing by drawing on feminist theory, trauma studies, and experimental literature techniques. Structured as an anthology, the thesis mirrors fractured memory and identity and the cyclical nature of healing. Organized into three chapters— “Awakening,” “Deconstruction,” and “Enlightenment”—the collection traces recognition of harm, dismantling of inherited belief systems, and the ongoing …


The Impact Of Stereotype Threat And Grit On The Experience Of Imposter Syndrome, Lindsey C. Davis Jan 2026

The Impact Of Stereotype Threat And Grit On The Experience Of Imposter Syndrome, Lindsey C. Davis

Theses

Imposter syndrome (IP) is a psychological phenomenon in which one has an internal experience of intellectual phoniness. Past researchers have found that overall females tend to report higher levels of IP than men, with Stereotype Threat (ST) being a cited explanation. A common denominator in much of the literature is how belongingness can activate ST in females. It has been found that individuals high in IP, especially females, tend to experience poor mental health outcomes. Past research has also established a link between IP and conscientiousness in females, a personality trait related to the facet of grit. The current study …


Modeling And Characterization Of Pond And Fresh Ash Leaching In Citric Acid, Christina Fleming Jan 2026

Modeling And Characterization Of Pond And Fresh Ash Leaching In Citric Acid, Christina Fleming

Theses

Resourcing rare earth elements (REEs) from coal ash offers the opportunity to recycle industrial waste and reduce national dependence on foreign suppliers. In this research, the leaching behaviors of pond and fresh ash were studied to evaluate their suitability for REE recovery. Concentrations of REEs in leachates were measured and compared to kinetic models from literature, and the ash was analyzed using Scanning Electron Microscopy (SEM) and X-ray Diffraction (XRD) to characterize the observed behaviors. The pond ash leachate exhibited lower REE concentrations with steady release patterns, likely due to the acid resistant, REE-bearing aluminosilicate glass phases. In contrast, the …


Modelling Novel Planar Nozzle Geometries For A Z-Pinch Fusion Propulsion System, Stephanie Manasterski Jan 2026

Modelling Novel Planar Nozzle Geometries For A Z-Pinch Fusion Propulsion System, Stephanie Manasterski

Theses

Interplanetary travel using chemical or electrical propulsion faces two major obstacles: the long mission timelines and the health risks to human crews from prolonged radiation exposure. Fusion propulsion offers a potential solution through high specific impulse and moderate thrust values. Z-pinch fusion, a pulsed magneto-inertial fusion approach, is promising for propulsion as the plasma is confined through current-driven compression, eliminating the need for external confinement coils to achieve ignition conditions, and the confinement configuration is simple. A 3-dimensional model of a novel linear magnetic nozzle geometry was developed with the propellant, dissociated ammonia, oriented sideways in the nozzle, assuming prior …


Mapping Cave Vulnerability And Priority Areas For Biospeleological Conservation, C. Lael Anderson Jan 2026

Mapping Cave Vulnerability And Priority Areas For Biospeleological Conservation, C. Lael Anderson

Theses

Alabama contains some of the highest levels of subterranean biodiversity in North America, yet no statewide assessment of cave vulnerability has previously been conducted. A spatially explicit vulnerability assessment was developed for Alabama caves using species occurrence records, landscape characteristics, anthropogenic threat data, and groundwater vulnerability metrics. Distribution maps were generated for cave- obligate and bat species, and vulnerability was assessed using human population, land- use, groundwater quality, groundwater quantity, and modified DRASTIK models. Results identified numerous single-site endemic species, regional biodiversity hotspots, and cave systems facing elevated anthropogenic threats. Conservation priority rankings highlighted species and caves of greatest management …


Design And Characterization Of A Low-Power Bulk-Driven Two-Stage Ota In 65nm, 90nm, And 130nm Cmos Technologies For 0.4v-0.6v Biomedical Applications, Raihan Khan Akash Jan 2026

Design And Characterization Of A Low-Power Bulk-Driven Two-Stage Ota In 65nm, 90nm, And 130nm Cmos Technologies For 0.4v-0.6v Biomedical Applications, Raihan Khan Akash

Theses

Biomedical instrumentation requires low-power amplifiers to maximize battery life. Due to threshold voltage limitations, standard gate-driven operational transconductance amplifiers (OTAs) require higher supply voltages. To overcome this, a differential bulk-driven two-stage OTA is introduced for low-power applications. The proposed topology is implemented in 65nm, 90nm, and 130nm complementary metal-oxide-semiconductor (CMOS), with supply voltages ranging from 0.4V to 0.6V. Key metrics such as DC gain, gain-bandwidth product (GBWP), phase margin, common-mode rejection ratio (CMRR), slew rate, power, and noise are measured. The analysis confirms the robustness of the low-power solution provided by the proposed topology.


A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante Dec 2025

A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante

Theses

The warehousing industry in New Jersey remains a vital component of the region's logistics network, employing more than 200,000 workers who routinely engage in lifting, bending, overhead reaching, and other physically demanding activities. These exposures contribute to musculoskeletal disorder (MSD) rates that exceed national averages, particularly affecting the low back and shoulders. Nationally, MSDs account for an estimated $420 billion in combined direct and indirect costs each year, underscoring the need for interventions that can effectively reduce biomechanical strain. Industrial exoskeletons have emerged as a potential solution, with prior research demonstrating reductions in muscle activation, perceived exertion, and fatigue during …


Evaluating Stormwater & Carbon Benefits Of Urban Street Trees, Anthony J. Rodriguez Diaz Dec 2025

Evaluating Stormwater & Carbon Benefits Of Urban Street Trees, Anthony J. Rodriguez Diaz

Theses

Urban areas experience a multitude of environmental challenges, including flooding and air pollution. In response to these pressures, urban forests have emerged as an essential nature-based strategy to enhance resilience and reduce climate-related risks. The implementation and expansion of urban street trees further contribute to this effort by mitigating stormwater runoff and reducing atmospheric carbon emissions.

Fortunately, advances in environmental modeling have made it increasingly possible to quantify these ecosystem services using specialized software. The United States Department of Agriculture (USDA) Forest Service's i-Tree suite exemplifies this progress. The software provides a comprehensive set of tools designed to quantify environmental …


Optimizing Crime Response Time Using Predictive Analytics Models, Mohammad Hassan Bin Yaqoob Dec 2025

Optimizing Crime Response Time Using Predictive Analytics Models, Mohammad Hassan Bin Yaqoob

Theses

Timely and efficient emergency response is essential for public safety, particularly in high- risk urban environments. However, existing dispatch systems often rely on reactive decision- making, leading to delays and inefficient resource allocation. This thesis explores how artificial intelligence (AI) and data modeling can enhance police response times through predictive analytics. A systematic review of 17 peer-reviewed studies identified key predictors such as dispatch behavior, crime history, temporal characteristics, and geographic location. Using real-world emergency response and crime data, predictive models were developed and evaluated through algorithms including XGBoost, Linear Support Vector Machine (LSVM), Generalized Linear Model (GLM), and Neural …


A Comprehensive Study Of Integration And Alternatives For Concrete In The Construction Industry, Saee Sawlikar Dec 2025

A Comprehensive Study Of Integration And Alternatives For Concrete In The Construction Industry, Saee Sawlikar

Theses

Concrete dominates the building industry as a construction material, frequently used due to its versatile, enormous application properties and the flexibility it offers. When just traditional concrete is considered, it contributes to only 8% of the total global warming potential. However, due to its countless vast applications, it’s energy and emissions consumption is up to roughly 35% and 38% respectively when compared with other industries. The study focuses on proposing three alternative low-carbon concrete materials with modified component chemical properties with reference to concrete itself and will test if any material could replace and surpass the benefits offered by concrete …


Relationship Between Muscle Activation And Kinematic Features During Baseball Pitching, Maxwell Skene Dec 2025

Relationship Between Muscle Activation And Kinematic Features During Baseball Pitching, Maxwell Skene

Theses

Background: Baseball pitching is a biomechanically complex, high-velocity movement that places substantial demands on the upper extremity. Inefficient coordination between muscle activation and kinematic sequencing has been associated with reduced performance and increased injury risk, particularly at the shoulder and elbow. However, the integrated relationship between muscle activation patterns and three-dimensional kinematic features during pitching is not well-documented. Purpose: The purpose of this study was to examine the relationship between throwing-arm muscle activation patterns and three-dimensional kinematic characteristics during fastball pitching, with particular emphasis on segmental accelerations, proximal–distal sequencing, and the directional structure of movement quantified using Relative Dimensional Contribution …


Evaluating The Feasibility Of Digital Twin Adoption For Mep Systems, Tejas Adana Dec 2025

Evaluating The Feasibility Of Digital Twin Adoption For Mep Systems, Tejas Adana

Theses

MEP systems dominate building operational costs, yet facility teams continue battling reactive maintenance cycles that result in unexpected equipment failures, emergency callouts, and continuous energy inefficiencies. Digital twin technology presents a practical solution by creating live virtual replicas that shift operations from firefighting breakdowns to anticipating issues before they escalate. However, adoption remains limited due to fragmented implementation guidance, short-term validation studies, and minimal research addressing emerging market contexts. This research employs a grounded approach combining systematic literature analysis, candid discussions with MEP engineers and facility managers across UAE commercial properties, and practical prioritization frameworks assessing real-world impact against implementation …