Digital Commons Network^™

Strategies For Catalyzing Supply Chain Innovation In Midsized Manufacturing Firms, Matthew J. Szukalowski Iii

Walden Dissertations and Doctoral Studies

Supply chain inflexibility results in reduced efficiency and profitability. Without supply chain flexibility, supply chain managers in manufacturing firms risk the loss of competitive advantage due to reduced efficiency and profitability. Grounded in business process engineering conceptual framework, the purpose of this qualitative multiple case study was to explore strategies supply chain leaders in manufacturing organizations use to achieve supply chain flexibility. The participants were five supply chain leaders in the manufacturing industry in the midwestern United States and successfully implemented innovative solutions to achieve supply chain flexibility. Data were collected using semistructured interviews and a review of company documents …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Strategies To Retain Seasoned Federal Acquisition Employees, Patricia Dianne Wells

Walden Dissertations and Doctoral Studies

Failure to retain seasoned acquisition employees negatively impacts an organization’s performance and outcomes. Managers need retention strategies to retain seasoned employees, as failure to retain seasoned employees results in capability gaps, decreased productivity, and increased expenses associated with recruiting and training new hires and transfers. Grounded in the social exchange theory, the purpose of this qualitative single case study was to explore strategies midlevel managers use to retain seasoned acquisition employees. The primary participants consisted of six midlevel federal acquisition managers of a federal agency who used strategies to retain seasoned acquisition employees. The secondary participants were five employees from …

Comparison Of Three Exercise Interventions With And Without Gemcitabine Treatment On Pancreatic Tumor Growth In Mice: No Impact On Tumor Infiltrating Lymphocytes, Priti Gupta, Charles F Hodgman, Claudia Alvarez-Florez, Keri L Schadler, Melissa M Markofski, Daniel P O'Connor, Emily C Lavoy

Faculty, Staff and Student Publications

Exercise has been shown to slow pancreatic tumor growth, but whether exercise interventions of differing volume or intensity yield differential effects on tumor outcomes is unknown. In this study, we compared three exercise training interventions implemented with and without chemotherapy on pancreatic tumor growth in mice. Methods: Male C57BL/6 mice (6-8 weeks old) were subcutaneously inoculated with pancreatic ductal adenocarcinoma tumor cells (PDAC 4662). Upon tumor detection, mice received gemcitabine 15 mg/kg intraperitoneally 3 days/week and were assigned to exercise: high volume continuous exercise (HVCE), low volume continuous exercise (LVCE), high intensity interval training (HIIT), or sedentary (SED). HVCE ran …

Semiparametric Copula-Based Regression Modeling Of Semi-Competing Risks Data, Hong Zhu, Yu Lan, Jing Ning, Yu Shen

Faculty, Staff and Student Publications

Semi-competing risks data often arise in medical studies where the terminal event (e.g., death) censors the non-terminal event (e.g., cancer recurrence), but the non-terminal event does not prevent the subsequent occurrence of the terminal event. This article considers regression modeling of semi-competing risks data to assess the covariate effects on the respective non-terminal and terminal event times. We propose a copula-based framework for semi-competing risks regression with time-varying coefficients, where the dependence between the non-terminal and terminal event times is characterized by a copula and the time-varying covariate effects are imposed on two marginal regression models. We develop a two-stage …

Emerging Current Trends And Research Focus Related To Pancreatic Cancer Metabolism: A Bibliometric And Visualized Analysis, Qian Shen, Chuanlong Zhang, Xiaochen Jiang, Junchen Li, Fudong Liu, Xiyuan Zhang, Ge'er En, Bo Pang

Faculty, Staff and Student Publications

BACKGROUND: As a malignant digestive system tumor, pancreatic cancer has unique metabolic characteristics. In recent years, the study of pancreatic cancer metabolism is in full swing, which provides a new direction for the treatment of pancreatic cancer patients. However, there is no systematic report of pancreatic cancer metabolism. In this paper, bibliometrics and visualization methods were used to analyze the number of publications, countries/regions, authors, institutions, journals, co-cited references, and keywords of pancreatic cancer metabolism articles, to summarize the research trends and predict research hotspots.

METHODS: We searched, screened and downloaded articles on pancreatic cancer metabolism through the Web of …

Neoadjuvant Checkpoint Inhibitor Immunotherapy For Resectable Mucosal Melanoma, Joel Ho, Jane Mattei, Michael Tetzlaff, Michelle D Williams, Michael A Davies, Adi Diab, Isabella C Glitza Oliva, Jennifer Mcquade, Sapna P Patel, Hussein Tawbi, Michael K Wong, Sarah B Fisher, Ehab Hanna, Emily Z Keung, Merrick Ross, Roi Weiser, Shirley Y Su, Michael Frumovitz, Larissa A Meyer, Amir Jazaeri, Curtis A Pettaway, B Ashleigh Guadagnolo, Andrew J Bishop, Devarati Mitra, Ahsan Farooqi, Roland Bassett, Silvana Faria, Priyadharsini Nagarajan, Rodabe N Amaria

Faculty, Staff and Student Publications

BACKGROUND: Neoadjuvant checkpoint inhibition (CPI) has recently demonstrated impressive outcomes in patients with stage 3 cutaneous melanoma. However, the safety, efficacy, and outcome of neoadjuvant CPI in patients with mucosal melanoma (MM) are not well studied as MM is a rare melanoma subtype. CPI such as combination nivolumab and ipilimumab achieves response rates of 37-43% in unresectable or metastatic MM but there is limited data regarding the efficacy of these agents in the preoperative setting. We hypothesize that neoadjuvant CPI is a safe and feasible approach for patients with resectable MM.

METHOD: Under an institutionally approved protocol, we identified adult …

Defective Dna Polymerase Beta Invoke A Cytosolic Dna Mediated Inflammatory Response, Shengyuan Zhao, Julia A Goewey Ruiz, Manu Sebastian, Dawit Kidane

Faculty, Staff and Student Publications

Base excision repair (BER) has evolved to maintain the genomic integrity of DNA following endogenous and exogenous agent induced DNA base damage. In contrast, aberrant BER induces genomic instability, promotes malignant transformation and can even trigger cancer development. Previously, we have shown that deoxyribo-5'-phosphate (dRP) lyase deficient DNA polymerase beta (POLB) causes replication associated genomic instability and sensitivity to both endogenous and exogenous DNA damaging agents. Specifically, it has been established that this loss of dRP lyase function promotes inflammation associated gastric cancer. However, the way that aberrant POLB impacts the immune signaling and inflammatory responses is still unknown. Here …

Evolutionary Action Score Of Tp53 Analysis In Pathologically High-Risk Human Papillomavirus-Negative Head And Neck Cancer From A Phase 2 Clinical Trial: Nrg Oncology Radiation Therapy Oncology Group 0234, Chieko Michikawa, Pedro A Torres-Saavedra, Natalie L Silver, Paul M Harari, Merrill S Kies, David I Rosenthal, Quynh-Thu Le, Richard C Jordan, Dzifa Y Duose, Saradhi Mallampati, Sanchit Trivedi, Rajyalakshmi Luthra, Ignacio I Wistuba, Abdullah A Osman, Olivier Lichtarge, Robert L Foote, Upendra Parvathaneni, D Neil Hayes, Curtis R Pickering, Jeffrey N Myers

Faculty, Staff and Student Publications

PURPOSE: An evolutionary action scoring algorithm (EAp53) based on phylogenetic sequence variations stratifies patients with head and neck squamous cell carcinoma (HNSCC) bearing

METHODS AND MATERIALS: Eighty-one resection samples from patients treated surgically for stage III or IV human papillomavirus-negative HNSCC with high-risk pathologic features, who received either radiation therapy + cetuximab + cisplatin (cisplatin) or radiation therapy + cetuximab + docetaxel (docetaxel) as adjuvant treatment in a phase 2 study were subjected to

RESULTS: At a median follow-up of 9.8 years, there was a significant interaction between EAp53 group and treatment for overall survival (

CONCLUSIONS: The docetaxel arm …

Cancer Treatment-Induced Nad+ Depletion In Premature Senescence And Late Cardiovascular Complications, Priyanka Banerjee, Elizabeth A Olmsted-Davis, Anita Deswal, Minh Th Nguyen, Efstratios Koutroumpakis, Nicholas L Palaskas, Steven H Lin, Sivareddy Kotla, Cielito Reyes-Gibby, Sai-Ching J Yeung, Syed Wamique Yusuf, Momoko Yoshimoto, Michihiro Kobayashi, Bing Yu, Keri Schadler, Joerg Herrmann, John P Cooke, Abhishek Jain, Eduardo Chini, Nhat-Tu Le, Jun-Ichi Abe

Faculty, Staff and Student Publications

Numerous studies have revealed the critical role of premature senescence induced by various cancer treatment modalities in the pathogenesis of aging-related diseases. Senescence-associated secretory phenotype (SASP) can be induced by telomere dysfunction. Telomeric DNA damage response induced by some cancer treatments can persist for months, possibly accounting for long-term sequelae of cancer treatments. Telomeric DNA damage-induced mitochondrial dysfunction and increased reactive oxygen species production are hallmarks of premature senescence. Recently, we reported that the nucleus-mitochondria positive feedback loop formed by p90 ribosomal S6 kinase (p90RSK) and phosphorylation of S496 on ERK5 (a unique member of the mitogen-activated protein kinase family …

Association Of Adenotonsillar Disease And Adenotonsillectomy With The Development Of Vitiligo: A Nationwide Population-Based Cohort Study, Jong Seung Kim, Min Gyu Lee, Sang-Kyung Lee, Sang-Woo Yeom, Min-Gu Kang, Jong Hwan Lee, Il-Jae Lee, Jin Park, Seok-Kweon Yun, Kyung-Hwa Nam

Faculty, Staff and Student Publications

BACKGROUND: Vitiligo is a common acquired skin depigmentation disorder and is associated with various other autoimmune diseases which include thyroid disease and rheumatoid arthritis. Similarly, adenotonsillar disease (ATD) may induce inflammatory or autoimmune diseases in other organs which include the skin. However, the influence of ATD on the development of vitiligo has not been studied.

OBJECTIVES: To determine the association between ATD and adenotonsillectomy, and the development of vitiligo.

DESIGN AND METHODS: Using data from the National Health Insurance Service database, patients diagnosed with ATD between 2008 and 2010 were included in the study. We performed two rounds of 1:1 …

Aj Bellidodeluna, Claudia Sanchez

Latinx Civil Rights

Assistant Dean A.J. Bellido de Luna recounts his higher educational experience as a white passing Cuban Latino. He covers his upbringing, where his family is from, what it means to be Latino to him, and his experience as a Latino faculty member in higher education.

Daniel Gutiérrez, Yairy Mendez

Latinx Civil Rights

In this interview, Daniel discusses how Mexican American Studies is interpreted in Texas public schools and how this affected his own education and cultural identity. Daniel also shares how the COVID-19 pandemic affected his education during his transition from secondary to tertiary school.

Virginia Ibarra, Arthur Reyes

Latinx Civil Rights

Virginia discusses events of her childhood such as crossing the U.S.-Mexico border at Laredo, Texas and working as a babysitter. She also explains how she moved to Houston to work in a sheet metal factory and finally settled in the San Antonio area. Virginia recalls the processes of gaining residency and citizenship while pursuing her education.

Mary Nguyen, Victoria Van Winkle

Latinx Civil Rights

Dr. Nguyen discusses the struggles she faced keeping her office operating properly before the COVID-19 pandemic. She goes on to explain how she and her partner continued to operate their office during and after the COVID-19 outbreak.

Gerald Poyo, Claudia Sanchez

Latinx Civil Rights

Dr. Poyo recounts his educational experience as a Latino migrating from Latin America to the United States to study in university. He speaks about the influence that his Latino professors had on him and his journey of becoming a professor himself. Dr. Poyo also speaks on his role as O’Connor chair including his duties and influence on Latino students.

Abilene Solano, Yairy Mendez

Latinx Civil Rights

Abilene Solano discusses the interpretation of Mexican American Studies in public school education. She also shares insights about her experiences attending public school and some of the challenges she faced being a first-generation student. Abilene relays how her graduating cohort was affected by the COVID-19 pandemic and how that affected her everyday life

Lloyd Van Winkle, Victoria Van Winkle

Latinx Civil Rights

As a rural doctor, Dr. Van Winkle faces many challenges to keep his practice open and operating properly. Despite the problems that have surfaced due to COVID-19, he has managed to keep his office open every single day. His love for taking care of his patients overpowers the challenges that arise.

Experiences Of Women In Sierra Leone Relating To Accessing Breast Cancer Treatment, Anne Neville

Walden Dissertations and Doctoral Studies

There has been a lack of consistent access to breast cancer care and treatment for women in developing countries, especially in Sierra Leone. Limited access to breast cancer care and treatment is a significant problem for women diagnosed in the later stages of the disease. The purpose of this research was to understand the experiences of women diagnosed with different stages of breast cancer, how they went about accessing breast cancer care and treatment, and how those experiences can be used to improve access to breast cancer treatment in Sierra Leone. Andersen and Newman’s healthcare utilization model guided the study’s …

Strategies For Accessing Finance By Small And Medium Enterprises, Ezechiel Nibigira

Walden Dissertations and Doctoral Studies

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Birthplace Decision Making Experiences Of The Ugep Women Of Southern Nigeria, Thomas Okoi Ofem

Walden Dissertations and Doctoral Studies

The purpose of this basic qualitative study was to explore and describe how behavioral, normative, and control beliefs shape women's birthplace decision-making experiences. The study sought to better understand how Ugep women of southern Nigeria decided where to give birth after attending antenatal care. Using the theory of planned behavior as a framework, a purposeful sample of nine women aged 25 to 35 years who attended antenatal clinic at least twice at the selected primary health facility but gave birth at home during the past year was recruited. Data collection was through face-to-face, semistructured interviews. Audio recordings of interviews were …

Variables On The Proportion Of Children With Sickle Cell Hemoglobin, Oyekola Oluyimika Oloyede

Walden Dissertations and Doctoral Studies

AbstractThe case fatality rate among children living with sickle cell disease was approximately 50% to 90% in Sub-Saharan Africa. Though researchers have contributed social determinants of health more broadly, they have not provided adequate screening information on children living with sickle cell disease aged 6 months to 59 months. The purpose of this cross-sectional study was to examine the association between sickle cell disease status, infection prevention, pain and anemia management, demography, socioeconomic status, and healthcare use. This study included approximately 11,536 genotype results of children under 5-years-old in Nigeria. Bronfenbrenner’s systems theory and Krieger’s ecological theory formed the theoretical …

Influence Of An Afterschool Reading Program On Elementary Student Reading Achievement, Chapple Osborne-Arnold

Walden Dissertations and Doctoral Studies

AbstractMany elementary school students require and may benefit from supplemental reading support and interventions that can be provided by afterschool programs. The problem addressed in this study was that it was not known if third grade students benefited from an afterschool reading program in one East Tennessee District. The purpose of this quantitative study was to compare end of year scale scores on the Standardized Test for the Assessment of Reading (STAR) of third grade students who attended the afterschool reading program for 30 or more days and those who did not attend the afterschool reading program while controlling for …

Development Of An Insomnia Assessment Guideline For Bipolar Disorder, Daniel Oyewusi Oyewole

Walden Dissertations and Doctoral Studies

AbstractBipolar disorder (BD) affects more than 1% of the world’s population regardless of race, sex, ethnicity, or socioeconomic status. BD is a severe and chronic mental illness characterized by insomnia, depressed and elevated mood, racing thoughts, mood swings, anxiety and depression, and suicide. Insomnia is prevalent in BD and occurs across all stages of BD, yet no guidelines exist. The clinical practice guideline entitled the Insomnia Assessment Guideline for Bipolar Disorder (IAGBD) was developed using best-practice evidence from the published literature. The IAGBD is a step-by-step process for assessing insomnia in bipolar patients. Clinicians follow a series of questions in …

Exploring Infant Massage As Standard Nonpharmacological Treatment For Neonatal Opioid Withdrawal Syndrome, Christine Ann Perez

Walden Dissertations and Doctoral Studies

The opioid epidemic in the United States has increased opioid use in women of reproductive age, leading to in utero exposure causing withdrawal symptoms in newborns known as neonatal opioid withdrawal syndrome (NOWS). State perinatal quality collaboratives (SPQCs) have been used in hospitals with quality initiatives (QIs) to improve standardization for NOWS; however, there remains a gap in knowledge in interventions to support the mother-infant dyad such as infant massage. This general qualitative research study explored the process and experiences of implementing infant massage as a standard practice for NOWS to inform national, state, and local policy. Participants in the …

The Impact Of Wrongful Death Lawsuits On Police Officers, Richard Kevin Powers

Walden Dissertations and Doctoral Studies

Law enforcement has become known as one of the most stressful occupations. Stress can have negative impacts on police officers’ professional careers and their personal life. This qualitative research revealed the unseen pressure of wrongful death lawsuits involving police officers, especially those cleared of any criminal wrongdoings. The study explored the police officers' perceptions while gaining knowledge from their lived experiences of how wrongful death lawsuits impacted them professionally and personally. This qualitative study was guided by the person-in-environment theory, which means that the environment can affect the police officer. In return, the police officer can affect the environment. The …

Hiring Managers’ Perceptions Of Hiring Adults With Intellectual And Developmental Disabilities, Carol L. Price-Guthrie

Walden Dissertations and Doctoral Studies

AbstractMultiple barriers impede individuals with intellectual and developmental disabilities (IDDs) from gaining access to jobs that are competitive and integrated and that offer them a living wage. People with IDDs experience an inability to develop necessary employable skills and may be affected by hiring manager perceptions and lack of awareness of available job opportunities. The purpose of this basic qualitative study was to explore hiring managers’ perceptions of hiring individuals with IDDs in competitive integrated employment (CIE) settings in Tennessee. Critical disability theory was used to frame this study. Nine hiring managers in Tennessee who have worked with people with …

Strategies To Manage Reduced Demand Among Mattress Manufacturers In Puerto Rico, Damaris Rivera Perez

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic reduced consumer demand in Puerto Rico, resulting in manufacturing jobs decreasing from 76,000 in March 2020 to 72,600 in August 2020, and the PMI decreasing falling from 50.5 to 48.1 in the same period. Owners of mattress manufacturing firms in Puerto Rico who lack strategies to increase consumer demand risk financial losses. Grounded in the strategic management theory, the purpose of this qualitative multiple case study was to explore strategies owners of mattress manufacturing firms in Puerto Rico use to increase demand for mattresses. The participants included three owners of mattress manufacturing firms in Puerto Rico who …

Cost-Saving Strategies For Municipal Wastewater Treatment Plant Managers, Rosalie Rivera

Walden Dissertations and Doctoral Studies

Wastewater treatment plant (WWTP) managers deal with increased costs while facing declining budgets to meet treated water standards. Biological disinfection processes comprise 65% of a typical WWTP's energy use and are of significant concern to WWTP managers. Grounded in the resource-based view theory and Six Sigma DMAIC approach as the conceptual framework, the purpose of this qualitative embedded single case study was to explore strategies WWTP managers use to lower water disinfection costs. Data were collected using semistructured interviews with four plant managers of the same organization in the central region municipalities of Florida who successfully implemented strategies to lower …

Fire Safety Education And Increasing Functioning Smoke Detectors In Residential Apartments, Enrique Fernandez Robinson

Walden Dissertations and Doctoral Studies

The lack of functioning smoke detectors poses significant life safety risks to people in low-income residential communities. In 2019, a fire incident occurred in an urban Maryland community due to the lack of a functioning smoke detector. Although no deaths or injuries resulted, there was significant property damage and resident displacement. The purpose of this study was to assist a local fire department in an urban area of the state of Maryland with developing and implementing a fire safety community outreach program designed to reduce the percentage of residential homes in a low-income community without functioning smoke detectors. A qualitative …