Digital Commons Network^™

Roselle And Red Ginger: A Potential Combination Of Medicinal Plants For Hypertension Therapy, Ranum Wanudya Yunas, Siti Irma Rahmawati, Fadlina Chany Saputri, Asep Bayu, Giuseppina Chianese, Masteria Yunovilsa Putra

Pharmaceutical Sciences and Research

Hypertension is a prevalent cardiovascular condition that significantly increases the risk of heart disease and stroke. Effective management is essential to prevent severe complications. Roselle (Hibiscus sabdariffa L.) and red ginger (Zingiber officinale var. rubrum) are two medicinal plants known for their antihypertensive properties. Roselle contains bioactive compounds such as anthocyanins that exhibit vasodilatory and angiotensin-converting enzyme (ACE) inhibition, while red ginger is rich in gingerols and shogaols, which possess anti-inflammatory and vasodilatory properties. The complementary mechanisms of action of these two plants, including ACE inhibition, antioxidant activity, and modulation of vascular tone, result in a more …

Decreasing Antibiotic Turnaround Time In The Medical Intensive Care Unit: A Quality Improvement Project, Kacie Wright

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project aimed to increase the percentage of first-dose antibiotics administered within one hour of order placement to 80% in the ICU by 12/31/24.

Background: Antibiotic Turnaround Time (ATT) is the time between antibiotic order placement and administration. Prolonged ATT can cause adverse outcomes by delaying treatment. In 2023, only 54% of first-dose antibiotics were given within the EBP standard of one-hour in our 36-bed Medical ICU.

Methodology: The Six Sigma DMAIC model identified barriers and interventions to achieving target ATT using stakeholder input, process mapping, and root cause analysis. Multidisciplinary Plan-Do-Study-Act (PDSA) cycles were created to evaluate …

Wilson’S Disease Presenting As Acute Hepatitis In Pregnancy With Successful Maternal And Neonatal Outcomes: A Case Report, Paribesh Gyawali, Ranjan Regmi, Shambu Khanal, Rajan Bhandari, Shivani Gupta, Gunjan Arora

Graduate Medical Education Research Journal

Background: Wilson’s disease is a rare genetic disorder characterized by copper accumulation, leading to multi-organ symptoms. It affects between 1 in 30,000 to 1 in 100,000 individuals, with a mean age at diagnosis of 13.2 years. The diagnosis may be overlooked due to its numerous presentations, which can range from non-specific symptoms such as fever, fatigue, and behavioral changes to fulminant hepatic failure. Its clinical manifestations vary widely, making diagnosis during pregnancy particularly challenging. Wilson’s disease complicates pregnancy, as untreated cases can lead to significant morbidity and mortality; excess copper can disrupt metabolic processes and contribute to recurrent miscarriages.

Case: …

Pumping Iron, Straining Hearts: Androgen Building Cardiomyopathy In A Middle Aged Bodybuilding Enthusiast, Milan Terzic, Yash B. Patel

Graduate Medical Education Research Journal

A 46-year-old bodybuilder presenting with new onset dyspnea found to have a new onset non-ischemic cardiomyopathy (CM) attributed to exogenous trenbolone and testosterone use. Steroid cessation and guideline-directed heart failure therapy led to notable recovery in left ventricular function supported by global longitudinal strain, ejection fraction and symptomatology.

Anabolic steroid-induced CM involves multiple mechanisms including lipid disturbances, hypertrophy, reduced receptor sensitivity, and cell damage. This case emphasizes the importance of recognizing anabolic steroid misuse as a potential cause of non-ischemic cardiomyopathy in middle aged men. With prompt discontinuation of steroids, remained abstinence and early initiation of guideline-directed medical therapy, myocardial …

The Use Of Abdominal Fascial Plane Blocks For Post-Operative Analgesia In Intestinal Rehabilitation Patients – A Retrospective Comparative Study, Brittany A. Brown, Lauren E. Costello, Elizabeth C. Ternent-Recht, Trevor J. Wilke, Cale A. Kassel

Graduate Medical Education Research Journal

Background: Short gut syndrome affects both pediatric and adult patients often requiring multiple surgical procedures to improve intestinal function. Identifying methods to improve pain control and reduce opioid consumption is an important consideration for this patient population.

Methods: A retrospective chart review of 115 patients less than 12 years of age undergoing abdominal procedures between August 1, 2012, and December 31, 2019, was performed. From this group, 64 patients had a perioperative abdominal wall fascial plane block performed and were compared to 51 patients who did not have a block performed.

Results: Mean opioid use defined as morphine equivalent daily …

A Novel Interactive Video Module For Providers Improves Knowledge Of Best-Practices For Treating Alcohol Use Disorder, Patrick Twohig, Zachary P. Slocum, Alena Balasanova, Nathalie Khoury, Allison Ashford, Kyle Scholten, Josh Warner, John Gallagher, Thoetchai Peeraphatdit

Graduate Medical Education Research Journal

Background: Despite the availability of efficacious treatment for alcohol use disorder (AUD), providers and patients are often unaware of available treatment options and how to pursue them. Prior studies have found that providers desire more training to effectively treat AUD. Our aim was to develop a standardized video to educate providers about AUD treatment.

Methods: Prospective single-center cohort study evaluating the impact of a novel, interactive educational video module (EVM) for providers about AUD treatment. The EVM discusses treatment, motivational interviewing (MI) and harm reduction strategies, and case examples. The EVM was hosted on our hospital’s website, and available to …

Factors Associated With Healthcare Students’ Cognitive Levels Measured By The Classroom Test Of Scientific Reasoning., Alberto J. De Armendi, Amir L. Butt, Kathryn M.L Konrad, Mohanad Shukry, Edmund A. Marek Ii

Graduate Medical Education Research Journal

Introduction: Healthcare student acceptance into graduate and professional school is based on Grade Point Average (GPA), Graduate Record Examination (GRE) scores, interviews, and letters of recommendation, but not on cognition levels. However, educators need to understand students’ cognitive levels to facilitate constructivist learning theory and inquiry-based learning. The aim of this study is to understand the influence of cognition in healthcare students through the administration of the Classroom Test of Scientific Reasoning (CTSR).

Methods: Medical and baccalaureate nursing students were enrolled to answer demographic questions and complete the CTSR. The CTSR rubric score were used to define four operational cognitive …

Perioperative Outcomes And Mortality In Liver Transplant Patients 65 And Older, Nathaniel S. Pester, Trevor J. Wilke, V K. Shostrom, Cale A. Kassel

Graduate Medical Education Research Journal

Background: The number of patients over the age of 65 awaiting liver transplantation (LT) continues to grow and an increasing number of patients will undergo liver transplantation. While age is not an absolute contraindication to liver transplantation, understanding the risks to older patients remains essential to ensure good outcomes with the limited number of grafts available.

Methods: This retrospective study included patients undergoing LT at the University of Nebraska Medical Center. A total of 421 patients were enrolled and stratified to patients under 65 years old (351 patients) and patients over 65 (70 patients). Geriatric patients were defined as aged …

Prosthetic Valve Endocarditis With Cardiobacterium Hominis: A Case Report, Kaci Griffin, Timothy Jang, Rees Adomako, Jasmine R. Marcelin, Jonathan H. Ryder

Graduate Medical Education Research Journal

Background: Cardiobacterium hominis (C. hominis) is an uncommon cause of infective endocarditis and often presents sub-acutely with fevers, cardiac murmurs, or embolic phenomena. We present a rare case of C. hominis infective prosthetic valve endocarditis that presented with new-onset atrial flutter and systemic emboli.

Case: A 38-year-old male presented to the emergency department with palpitations, shortness of breath, and chest tightness and was found to be in atrial flutter. He underwent a transesophageal echocardiogram-guided cardioversion and was incidentally found to have a one-centimeter echodensity on the ventricular side of his prosthetic aortic valve. (Figure 1.) He …

Effective Strategies In Improving Internal Medicine In-Training Exam Performance - A Systematic Review, Derek Clar, Ryan Juneau, Valentina Mcneal, Dhara Patel, Prutha Patel, Amro Ilaiwy

Graduate Medical Education Research Journal

Background: The IM-ITE is administered annually to provide residents and program leadership with a measure of the residents' knowledge compared with that of their peers nationwide. Several approaches have been used to improve IM-ITE scores as a means of achieving higher first-time board examination pass rates. While these interventions helped improve outcomes in target programs, it remains unclear whether one approach was superior to another and how different program demographics may have played a role in the outcome of the intervention. Objective: To identify the most effective methods used to improve IM-ITE scores in the literature. Methods: We searched MEDLINE …

Occupational Therapy Using Cbt To Improve Work Productivity In Schizophrenia: A Case Study, Artha Nisa Thohiroh Triyantari, Reza Nur Arsyi, Muhammad Luthfi, Ayleen Alicia K, Hermito Gideon, Zulfa Khoirunisah, Putri Dirgantara, Purnama Betty R. Sitorus

Jurnal Fisioterapi Terapan Indonesia

Schizophrenia is a chronic mental disorder that often impairs an individual's social and occupational functioning, including productivity-related activities. Patients with schizophrenia frequently face challenges in maintaining employment or running an independent business due to cognitive and emotional disturbances affecting their adaptive skills. This single-case study integrates Cognitive Behavioral Therapy (CBT) into occupational therapy to enhance productivity in a schizophrenia patient through an entrepreneurial activity—independently opening a coffee shop. The study subject is a 50-year-old male diagnosed with schizophrenia undergoing psychosocial rehabilitation at RSJ Dr. Soeharto Heerdjan. The CBT-based intervention was designed to develop adaptive thinking patterns and occupational skills through …

Enhancement Of Functional Ability In Supraspinatus Tendinitis Using Ultrasound And Isotonic Exercise: Case Study, Tu Lidya Ike Putri, Christabelle Aurelia

Jurnal Fisioterapi Terapan Indonesia

Supraspinatus tendinitis is an inflammation of the supraspinatus tendon caused by the supraspinatus muscle tendon overlapping with the caput longus bicep tendon so that friction and repetitive pressure occur over a long period of time and result in damage to the supraspinatus muscle tendon and supraspinatus tendinitis occurs. Characterized by complaints of pain around the shoulder followed by limitation of motion in the shoulder joint. The clinical question arises "can the application of ultrasound and isotonic exercise reduce pain and functional ability improvement?". To be able to answer this question, an evidence search was conducted on 3 data bases, namely …

Perbandingan Konservatif Fisioterapi Dengan Core Stability Exercise Pada Kasus Nyeri Punggung Bawah, Angria Pradita, Nurul Halimah

Jurnal Fisioterapi Terapan Indonesia

ABSTRACT: Low back pain is a major complaint caused by multifactorial conditions. The most common factors of low back pain complaints are due to age, occupation and gender. This study aims to compare the differences in therapeutic effects of conservative physiotherapy with the provision of electrotherapy, namely; microwave diathermy combined with transcutaneous electrical nerve stimulation (TENS), core stability exercise techniques and a combination of electrotherapy with core stability exercise (CSE). This type of research is quasi experimental with a pre-post test design in a population of 90 low back pain patients who seek treatment at the Physiotherapy clinic. By using …

Pengaruh Religiusitas Terhadap Intensi Boikot Mahasiswa Ui Untuk Produk Terafiliasi Israel, Muhammad Haiqal Fauzi, Rifkanissa Azzahra, Raditya Akhdan Nirwasita, Muhammad Izzan

Jurnal Manajemen dan Usahawan Indonesia

This study aims to analyze the factors influencing students at Universitas Indonesia (UI) in participating in the boycott movement against products affiliated with Israel. Data were collected through an online survey of 408 UI students from the 2021–2024 cohorts. The sample was selected using the purposive sampling method. Analysis using Covariance-Based Structural Equation Modeling (CB-SEM) demonstrates that anger, empathy, and subjective norms have a positive and significant impact on boycott intentions, while religiosity is not significant. Economic threats are found to increase anger, which in turn drives boycott intentions. These findings emphasize that emotional factors and social pressure play a …

Governor's Office Of Diversity Business Enterprise (Go-Dbe) Annual Report 2024, Tennessee. Department Of General Services.

GO-DBE Report

No abstract provided.

Effect Of Alternative Rearing Substrates On The Growth, Reproduction And Nutritional Composition Of The African Field Cricket Gyrllus Bimaculatus (Orthoptera: Gryllidae), Atujune Katabaro, Blanka Joseph, Anitha Philbert

Tanzania Journal of Science

The increasing demand for animal protein to cater to the ever-growing human population has prompted the quest for alternative protein sources from insects. The field cricket Gyrllus bimaculatus, is one of the species of major interest, however, rearing of this species depends on the commercial chicken feed, which is expensive. This study explored the suitability of food remains in the rearing of this species. Three experimental food types were formulated from various food remains, and fed to crickets along with the commercial chicken feed for 14 weeks. Crickets that were fed on a combined diet of mixed food types performed …

Single-Step Sol-Gel Synthesis Of Cuo/Tio2 Nanoparticles: Microstructure And Materials Characterization, Godlisten N Shao

Tanzania Journal of Science

Copper oxide modified titanium dioxide (CuO/TiO2) nanoparticles have been widely reported owing to their excellent performance in heterogeneous photocatalysis. However, their industrial and large-scale production is hampered by tedious and expensive preparation methods. The present study presents a single step sol-gel synthesis of CuO/TiO2 nanoparticles with improved physicochemical properties. A series of CuO/TiO2 nanoparticles were synthesized by a modified sol-gel approach using titanium oxychloride as a TiO2 precursor in the absence of additives. The samples were examined by high-resolution TEM, SEM-EDAX, XRD, XRF, XPS, Raman spectroscopy, nitrogen gas physisorption studies, and UV-visible DRS analyses. It was found that the proposed …

“Religion’S Firm-Rooted Truths:” Richard Polwhele, Pulpit Oratory And Loyalist Romanticism In The English Province, Dafydd Moore

School of Law, Humanities and Social Sciences

This article explores the rearguard action fought by the clergyman and writer Richard Polwhele against what he saw as the threat of Anglican Evangelicalism and Methodism in Cornwall during the French Revolutionary period, highlighting the connections between religious experience, rhetorical performance and politics. Whether it be through his theorizing of pulpit oratory, his rows with those he considered Enthusiasts or his understanding of ordination oaths, Polwhele maintained that religious belief should be regulated by rhetorical distance. Explaining this stance, the article shows how Polwhele’s theological and ecclesiological opposition to the Enthusiasm he regarded as dangerously inherent in Evangelical Protestantism also …

Advancing Statistical Literacy In Eye Care: A Series For Enhanced Clinical Decision-Making: Part 1: Introduction To Statistical Tools For Eye Care Research, Daniela Oehring, Pedro Miguel Serra

School of Health Professions

Purpose. Advancements in eye and vision care hinge on therigorous application of research and the precise interpretationof clinical data. However, the field of Eye and Vision Research(EVR) frequently encounters research waste attributed tomethodological flaws and improper statistical analyses, un-dermining the validity of studies and inefficiently utilisingsubstantial financial resources. This paper, the first instalmentin the series “Advancing Statistical Literacy in Eye Care: A Se-ries for Enhanced Clinical Decision-Making,” aims to addressthese challenges by enhancing the statistical literacy of eyecare professionals.Material and Methods. Through a comprehensive narrativeliterature review and the generation of simulated clinicaldatasets, this study identifies essential statistical concepts,common pitfalls, and …

Biostatistik In Ophthalmologie Und Optometrie: Eine Artikelserie Zur Unterstützung Evidenzbasierter Entscheidungsprozesse, Daniela Oehring, Pedro Miguel Serra

School of Health Professions

Zweck. Fortschritte in der Augen- und Sehversorgung basieren auf der Anwendung von Forschungsergebnissen und der präzisen Interpretation klinischer Daten. Dennoch treten in der Augen- und Sehforschung (EVR) häufig Forschungsverschwendungen auf, bedingt durch methodische Mängel und unangemessene statistische Analysen. Dies untergräbt die Validität von Studien und führt zu ineffizienter Nutzung erheblicher finanzieller Ressourcen. Dieser Artikel, der erste Teil der Serie „Entwicklung statistischer Kompetenzen in der Augenheilkunde: Eine Reihe zur Unterstützung evidenzbasierter Entscheidungsprozesse”, zielt darauf ab, diese Herausforderungen anzugehen, indem er die statistische Kompetenz von Fachkräften in der Augenheilkunde stärkt.Material und Methoden. Anhand einer umfassenden narrativen Literaturübersicht und der Erstellung simulierter klinischer …

Technology Emancipative And Traditionalist Value In Cross-Cultural Market Segmentation, Maria Petrescu, Burak Cankaya, Marie-Odile Richard, Aidin Namin

Publications

This article identifies five key consumer segments based on digital technology-related behavior, attitudes toward technology (ATT), and cultural values, using cross-cultural data from the large-scale World Values Survey and national data from Pew Research data, and a combination of traditional clustering, latent class analysis, and explainable artificial intelligence (XAI) methods. The segments— Moderate Tech Enthusiasts, Highly Religious Traditionalists, Tech-Savvy Cosmopolitans, Secular Emancipatives, and Conservative Technophobes— reveal varying degrees of technology adoption and cosmopolitanism across cultures. The results indicate the interconnectedness between consumer behavior and attitudes toward technology, emancipative values, religiosity, political orientation, and cosmopolitanism, as well as the influence of …

The Radical Oxidation Of Hydroxyacetone: An Insight Into The Reaction Mechanism And Potential Tetraoxide Intermediates, Edward Buck

Master's Theses

This thesis presents the reaction of hydroxyacetone, a common volatile organic compound (VOC), with chlorine radicals in the presence of oxygen. Chapter one explores VOCs and their specific reactions and how tetraoxide intermediates could be formed from them. Chapter two analyses the experimental and computational methods used and the key theoretical concepts behind these methods. Experimental data was collected using multiplexed photoionization mass spectrometry at the Advanced Light Source Chemical Transformations Beamline, Lawrence Berkeley National laboratory. This data is combined with theoretical data using the CBS-QB3 composite method to determine the key reaction intermediates and mechanisms.

The main chapter of …

Treating Type Ii Medial Tibial Stress Syndrome With Primal Reflex Release Technique: A Novel Approach, Shelli Green, Jenna Morogiello, Kurrel Fabian, James May, Alan Nasypany

Clinical Practice in Athletic Training

Five NCAA Division I cheerleaders (age 20 ± 1.4; 3 males, 2 females) presented with Medial Tibial Stress Syndrome (MTSS). Following an evaluation, all patients diagnosed with MTSS were treated using Primal Reflex Release Technique (PRRT). Immediate improvements in reported pain were demonstrated after one treatment. Improvements in perceived dysfunction were demonstrated after 4.2 (± 0.84) treatments over 15.4 (± 5.86) days with no time lost. All improvements were maintained at two-week follow-up. Type II MTSS patients treated with PRRT may experience an immediate, lasting reduction in pain, improvement in function, and shorter time to overall resolution.

A Descriptive Examination Of Perceived Stress And Coping Among Athletic Trainers Employed In The National Collegiate Athletic Association, Stephanie M. Singe, Elisabeth M. Mckenna, Alexandrya Cairns, Christianne Eason

Clinical Practice in Athletic Training

Time and work demands are high for the collegiatea athletic trainer, which can increase work stress and burnout may result. High perceived levels of stress and burnout can impact an athletic trainer’s mental health and wellness. Data were collected via an online descriptive, cross-sectional survey (Qualtrics) examining the perceived stress and coping strategies used among athletic trainers employed in the collegiate setting. Respondents completed the pereceived stress scale (ɑ=.90), and a series of close-ended questions related to their self-reported strategy of coping. Data was collected during September of 2022. We had 987 (men 371, women 607, did not disclose 9) …

Driving After A Concussion In Adolescents And Young Adults, What Is The Current Research And Consensus?, Melanie Kwok, Tamara Valovich Mccleod

Clinical Practice in Athletic Training

N/a

Comparison Of Patellar Taping And Strapping For Treating Patellofemoral Pain, Kaison Ames, Eric G. Post

Clinical Practice in Athletic Training

Among collegiate athletes, patellofemoral pain (PFP) represents nearly one-third of all sport-related injuries. There have been multiple studies using a patellar tendon strap as an intervention to treat PFP that showed an improvement in knee pain, as well as studies showing improvement in knee pain when using patellar taping for PFP. However, there is very limited research written that compares the effectiveness of a patellar tendon strap versus a patellar tendon taping technique for patients with PFP. Therefore, the purpose of this study was to compare the effectiveness of patellar taping versus patellar strapping to reduce PFP in collegiate athletes. …

Thoracic Mobility And The Effects It Has On The Human Body: An Evidence To Practice Review, Megan Kurzec, Barton E. Anderson

Clinical Practice in Athletic Training

Decreased thoracic mobility, stability, and strength are prevalent issues in athletes, contributing to various musculoskeletal problems. This Evidence to Practice Review synthesizes findings from a guiding systematic review that identified exercises targeting the thoracic spine in athletes. The review included a comprehensive search across six databases, five journals, and five social media platforms, yielding 38 exercises designed to improve thoracic mobility, motor control, work capacity, and strength. Despite the low level of evidence (Level D), these exercises are widely used in clinical practice. This review provides a framework for exercise prescription, offering athletic trainers a range of exercise options to …

Educating Mental Healthcare Staff On Using The Phq-9 In Telehealth, Anoopa M. Jacob

Walden Dissertations and Doctoral Studies

I developed a quality improvement staff educational program aimed at addressing the inconsistent use of the Patient Health Questionnaire (PHQ-9) at the project facility, which could adversely affect the quality and continuity of patient care. The need for the program was prompted by the increasing use of telehealth services and the necessity for consistent mental health evaluation tools. I aimed to educate mental health staff about evidence-based practices using the PHQ-9 in telehealth to enhance the quality of care for patients with depression in remote settings. Analytical methods included administering pre- and postintervention tests to measure changes in staff knowledge …

Rural Volunteer Emergency Personnel’S Perceptions Of Stressors During The Covid-19, Janette Lynn Nichols, Phd

Walden Dissertations and Doctoral Studies

Emergency personnel are expected to handle all situations without affecting their psyche. Distinct differences exist between urban and rural EMS personnel, with rural personnel frequently needing more organizational resources or support to manage stress. With the onset of COVID-19 in December 2019, rural emergency personnel were placed in exhaustive specific situations not experienced previously within the United States. This study was conducted to focus on how they internalize their stressors. This generic qualitative study aimed to determine the perceptions of stressors experienced by rural volunteer emergency personnel during the COVID-19 pandemic. A qualitative survey was completed by 11 participants who …

Do Intangible Assets Impact Financial Statement Comparability? A Case Study Of Washington State Hospitals, Andrew Brajcich, Dan Friesner, Matthew Q. Mcpherson

The North American Accounting Studies

Firms are becoming increasingly reliant on intangible assets to create value and differentiate themselves from their peers. Intangible assets are typically reported in the balance sheet using general categories such as “goodwill” or “other intangible assets.” Intangible assets are often unique in their attributes and productive lifespans, which makes them challenging to accurately and precisely record in accounting statements. While the assets themselves provide unique value creation opportunities, it is unclear whether specific intangible assets impact assessments of financial statement comparability. This study investigates whether the existence of various types of intangible assets leads to differences in financial statement comparability …