Digital Commons Network^™

Mortality Prediction After Major Surgery In A Mixed Population Through Machine Learning: A Multi-Objective Symbolic Regression Approach, Pietro Arina, Davide Ferrari, Nicholas Tetlow, Amy Dewar, Robert Stephens, Daniel Martin, Ramani Moonesinghe, Vasa Curcin, Mervyn Singer, John Whittle, Evangelos B Mazomenos

Peninsula Medical School

INTRODUCTION: Understanding 1-year mortality following major surgery offers valuable insights into patient outcomes and the quality of peri-operative care. Few models exist that predict 1-year mortality accurately. This study aimed to develop a predictive model for 1-year mortality in patients undergoing complex non-cardiac surgery using a novel machine-learning technique called multi-objective symbolic regression.

METHODS: A single-institution database of patients undergoing major elective surgery with previous cardiopulmonary exercise testing was divided into three datasets: pre-operative clinical data; cardiorespiratory and physiological data; and combined. A multi-objective symbolic regression model was developed and compared against existing models. Model performance was evaluated using the …

Serious Games For Constipation Management For People With Intellectual Disabilities: A Scoping Review And Narrative Synthesis, Serena Daniel, Ruth Bishop, Ellie Killner, Alison Whight, Sarah Lennard, Stephen Howard, Richard Laugharne, Rohit Shankar

Peninsula Medical School

Introduction: People with intellectual disability (PwID) are 2% of the UK population. Constipation and bowel movement (BM) problems (diarrhoea/faecal incontinence etc.) affects over a third of PwID and is a serious cause of morbidity and mortality. Pw ID rely heavily on outside support (family/professional carers/healthcare professionals), many of whom are ignorant to bowel related harms. There is significant stigma to discuss BM particularly constipation. Serious Games (SG) are increasingly used for education of health needs. This review examines if game-based technology can assist improving knowledge and reducing stigma of BM problems particularly constipation. Objective: To identify and gain evidence of …

From Attention To Action: Advancing Inclusivity In The Landscape Of Anatomy Education, Siobhan M. Moyes, Lily Evans, Katie Snow, Aiden Jayanth

Peninsula Medical School

Conversations about inclusivity in anatomy education are at a critical juncture. While the need for a more equitable discipline is widely recognised, significant challenges remain. As this project aimed to reimagine what a truly inclusive learning experience could like and how it might be best achieved, an inclusive approach to research methodology was essential to ensure robust and representative results. Due to the paucity in anatomical literature on this topic, the authors applied concepts from sociological research methodology and innovative methods of demographic data collection to their own discipline.

The study utilised questionnaires and focus groups to collect diverse data …

The Added Value Of Narrow Band Imaging In Sinonasal Tumour Resection And Surveillance: Our Experience, Yazan Kanaan, Ra'ed Al-Ashqar, Hisham Khalil, Konstantinos Geronatsios, Marios Stavrakas

Peninsula Medical School

BACKGROUND & PURPOSE: Narrow Band Imaging (NBI), developed by Olympus Medical Systems, has played a role in diagnosing digestive tract lesions and cancers, diagnosing and characterizing bladder cancers during cystoscopy and in the diagnosis and management of Head and Neck cancers. We aim to explore the potential use of NBI in the diagnosis, management, and follow-up of sinonasal tumours.

METHODS: We present a series of cases treated at our institution, where NBI played a crucial role in the diagnosis, surgical management, intraoperative decision-making, and follow-up. The cases include a patient with sinonasal lymphoma, 2 patients with sinonosal malignant melanoma and …

Tolerance Of Ambiguity And Psychological Wellbeing In Newly Qualified Doctors: An Analysis Over Multiple Time Points, Tom Gale

Peninsula Medical School

Introduction: There is evidence of an association between tolerance of ambiguity and psychological wellbeing in doctors, but this relationship is not well understood. We explored this relationship, and the individual or workplace factors moderating it, in a population of newly qualified doctors. Methods: We examined the experiences of newly qualified doctors in the UK as they started a novel interim role (Time 1) and later moved into foundation year 1 roles (Times 2 and 3) during the COVID-19 pandemic. Doctors completed the Tolerance of Ambiguity of Medical Students and Doctors scale (TAMSAD Range: 0–100), the Perceived Stress Scale (PSS: 0–40), …

Systematic Review Of Paediatric Sudep And Epilepsy-Related Deaths To Inform A Safety Counselling Checklist For Clinical Practice, Rohit Shankar

Peninsula Medical School

BackgroundOne in 200 children - in the UK have epilepsy. Approximately, 1 in 1,000 children with epilepsy die yearly from Sudden unexpected death in epilepsy (SUDEP), a leading cause of death in epilepsy. Various risk factors contributing to epilepsy mortality particularly SUDEP, some modifiable, have been identified. Structured discussion of risks results in behavioural change that reduces individual risk factors.AimTo investigate and collate risk factors for SUDEP and epilepsy mortality in children to propose a structured communication tool (“Checklist”) for person centred communication.MethodsA Systematic review for children’s epilepsy mortality risk factors was conducted. The search strategy was developed by clinical …

Evidence For Alcohol-Mediated Hemolysis And Erythrophagocytosis, Chaowen Zheng, Siyuan Li, Johannes Mueller, Cheng Chen, Huanran Lyu, Guandou Yuan, Ane Zamalloa, Lissette Adofina, Parthi Srinivasan, Krishna Menon, Nigel Heaton, Stephan Immenschuh, Ines Silva, Vanessa Rausch, Seddik Hammad, Steven Dooley, Shilpa Chokshi, Antonio Riva, Songqing He, Sebastian Mueller

Peninsula Medical School

Alcohol-related liver disease (ALD) is the most common liver disease worldwide; however, its underlying molecular mechanisms remain poorly understood. Here, we identify ethanol-mediated hemolysis and erythrophagocytosis as major contributors to ALD pathogenesis using both in vitro and in vivo models, as well as surrogate markers such as heme oxygenase-1 (HO-1) and CD163, a scavenger receptor for hemoglobin-haptoglobin complexes. A key initial observation was the direct optical evidence of serum hemolysis in heavy drinkers, which diminished after one week of alcohol withdrawal. In parallel, soluble CD163 (sCD163) levels declined during alcohol detoxification correlating with liver damage and fibrosis stages. Moreover, red …

How Epilepsy Risks Might Be Introduced And Discussed In Clinical Consultations, Rohit Shankar

Peninsula Medical School

AbstractAdverse impacts of epilepsy (e.g., injury, depression, and Sudden Unexpected Death from Epilepsy (SUDEP) can be mitigated by factors that patients may control, such as medication adherence, improved sleep and diet, reduced alcohol and taking care around pregnancy. New guidelines state that risk should be discussed at the time of diagnosis but some clinicians express concern about not wanting to raise anxiety.ObjectiveTo explicate practices by which epilepsy expert clinicians broach discussions of risk in specialist epilepsy clinics.Methods24 recordings of initial telephone appointments at specialist clinics where epilepsy is diagnosed from two specialist outpatient epilepsy services in England were subjected to …

Consensus-Based Research Priorities For Post-Collision Care In The Western Cape Province Of South Africa, Naseef Abdullah, Tim Nutbeam, Colleen J. Saunders, Craig Wylie, Nigel Lang, Willem Stassen

Peninsula Medical School

Introduction: Road traffic injuries constitute a significant global health burden, causing 1.3 million deaths and 50million injuries annually, with 92 % of fatalities occurring in low-and middle-income countries (LMICs). Despitethis disproportionate impact, research priorities in post-collision care often reflect high-income country contexts,creating a critical misalignment between evidence generation and contextual realities in LMICs.Methods: This mixed-methods study employed a three-phase approach to identify research priorities for postcollision care in the Western Cape, South Africa. Phase 1 consisted of a comprehensive literature review toidentify preliminary thematic areas and research questions. Phase 2 involved a stakeholder engagement workshop using modified nominal group techniques …

Letter-To-The-Editor To The Study By Bartek J Et Al “Multidisciplinary Consensus-Based Statement On The Current Role Of Middle Meningeal Artery Embolization (Mmae) In Chronic Subdural Hematoma (Csdh)” – A Letter From The International Csdh Research Group Committee, Icoric, T.S.R. Jensen, J. Duerinck, D. Holl, C. Iorio-Morin, J. Soleman, E. Edlmann

Peninsula Medical School

No abstract provided.

A Time-Dependent Spectral Analysis Of Γ Cassiopeiae, Sean J. Gunderson, David P. Huenemoerder, José M. Torrejón, Dustin K. Swarm, Joy S. Nichols, Pragati Pradhan, Richard Ignace, Hans Moritz Guenther, A.M.T. Pollock, Norbert S. Schulz

Publications

We investigated the temporal and spectral features of γ Cassiopeiae’s X-ray emission within the context of the white dwarf (WD) accretion hypothesis. We find that the variabilities present in the X-ray data show two different signals, one primarily due to absorption and the other due to flickering like in nonmagnetic cataclysmic variables. We then use this two-component insight to investigate previously unreported simultaneous XMM and NuSTAR data. The results of model fitting find WD properties consistent with optical studies alongside a significant secondary, thermal source. We propose a secondary shock between the Be decretion disk and WD accretion disk as …

Investigation Of A Busemann Intake At Negative Angle Of Attack, Mark E. Noftz, Andrew N. Bustard, Nicholas J. Bisek, Thomas J. Juliano, Joseph S. Jewell

Publications

A high-speed, shape-transitioned, inward-turning intake was tested in Purdue’s Boeing/AFOSR Mach 6 Quiet Tunnel. The inlet model, called the Indiana Inlet (INlet), had a total contraction ratio of 4.68:1 and a design point of Mach 6 at 0° angle of attack. The model was outfitted with a suite of high-frequency pressure transducers, and the external flowfield was imaged with high-speed schlieren photography. The INlet was tested under low freestream disturbance levels for a variety of freestream unit Reynolds numbers and at-4° angle of attack. An unsteady shockwave near the leading edge of the inlet forebody, indicative of boundary layer separation, …

Proximal Tibia Biplanar Anterior And Lateral Closing Wedge Osteotomy With Concomitant Revision Anterior Cruciate Ligament Reconstruction: A Case Report, Shane H. Johns, Lisandro Nardin, Jessica A. Nelson, Robert Schenck

Western Journal of Orthopaedics

This report documents a unique, successful strategy to manage a failed anterior cruciate ligament reconstruction (ACLR) in the setting of coronal and sagittal plane malalignment. The patient is a 38-year-old man with a history of a failed ACLR who presented with recurrent knee instability. Imaging revealed a posterior tibial slope (PTS) of 17° complicated by a varus malalignment of 10°. A single-stage anterior and lateral closing wedge tibial osteotomy (biplanar) with simultaneous revision anterior cruciate ligament reconstruction was performed. Final radiographic evaluation revealed that the tibial osteotomy healed with correction of coronal alignment to a physiologic 3° varus and a …

Artificial Intelligence And Seeing The Invisible In Arts - From The Wane Of Axiality And Symmetry To The Wax Of Invisibility And Emptiness, M. Samir Abou El-Seoud

Computer Science

Function has been always an important driver in architectural design. It is the request to generate form directly from purpose and utility. In 1896, Louis Sullivan projected that ‘form follows function’ and that the beauty of a building derives directly from its function and not from references of the built heritage. The assumption was that beauty would naturally derive from design once functional requirements are met. Thus, fitness for purpose equals beauty. In 1908, Adolf Loos even went so far as to ask for the total abandonment of decoration. In 1947, Mies van der Rohe made his paradigm shift, function …

Practical Pointers: How To Lead A Smooth Church Board Meeting, Fernando Ortiz

Faculty Publications

No abstract provided.

Effect Of Implementing An Educational Program About Post Kidney Transplant Care On Critical Care Nurses' Knowledge, Marwa Abdo, Asmaa Ibrahim Aboseda

Nursing

Background: Critical care nurses (CCNs) play a pivotal role in post-kidney transplant care, necessitating a comprehensive understanding of transplantation procedures, complications, and patient management. So, any knowledge gaps among CCNs may impact the quality of care provide to kidney transplant program. Aim: This study aimed to assess the effect of implementing an educational program about post-kidney transplant care on critical care nurses’ knowledge. Methods: A quasi-experimental study was conducted among 50 critical care nurses. A structured educational program was implemented, and nurses’ knowledge was assessed pre- program, post- program, and three months follow-up. Data was collected using a kidney transplantation …

Archiving Erasure: Trans Absence In The Bennett Hammer Lgbt Collection, Isaac Suarez Flint

2026 Award Winners

No abstract provided.

Creativity As Activism: Girl Zines And The Redefining Of Modern Feminism, Alina Barney

2026 Award Winners

No abstract provided.

'Spatial Solutions: Examining The Intersections Of Design, Policy, And The Housing Affordability Crisis In New Mexico', Maya E. Jio

2026 Award Winners

No abstract provided.

The Sublimity Of Vampirism And Vampiric Transformation In Stoker’S Dracula, Raychel Giles

2026 Award Winners

No abstract provided.

Exploring The Role Of Online Discussion Forums In Endorsing Egyptian Undergraduates’ Efl Learning, Wesam Khairy Morsi

English Language and Literature

eLearning Management systems (eLMS) are software applications used in universities worldwide to implement specific educational goals. eLearning platforms have several features that support traditional Face to Face (FTF) teaching and provide valuable opportunities for independent, self-paced learning. One of these features is the Online Discussion Forums (ODFs). This research paper investigates the role of ODFs in endorsing English as a Foreign Language (EFL) learning by examining students' perceptions of its accessibility, peer/instructor interaction, assessment criteria, and discussion topics. The paper also investigates the influence of gender on students' perceptions of the role of ODFs. This is a non-experimental research design, …

Managing Compliance: The Role Of Leadership Styles In Information Security Practices In Nigerian Public University Libraries” Insights From North-East Nigeria, Musa Giade Ya'u Musagiade, Gaberial O. Alegbeleye, Madukoma Ezinwanyi

Library Philosophy and Practice (e-journal)

Background: Information security compliance comprises adhering to established policies, protocols and to ensure absolute security. Despite the importance of security compliance in academic libraries, evidence from previous studies reported a low level of information security compliance among personnel in public university libraries in North-East Nigeria. However, proper leadership styles influence information security compliance leading to absolute protection of information systems. So, this study explored the influences of leadership styles in security compliance in public university libraries in North-East, Nigeria.

Method: This study adopted a survey research design. The population consisted of 618 library personnel from the 14 public university libraries …

Co-Producing Healthcare Guidance For Children And Young People With Ataxia Telangiectasia (A-T) Including The Exploration And Design Of A Home-Based Complex Intervention, Munira Khan

School of Health Professions Theses

This doctoral research aimed to co-produce allied healthcare guidance to improve therapeutic care, self-management, and quality of life for children and young people (CYP) living with ataxia telangiectasia (A-T), a rare and complex neurodegenerative condition. Addressing significant gaps in non-medical care provision, the project was structured into four interrelated work packages (WPs), each contributing original insights and practical tools for families and professionals. WP1 involved a comprehensive scoping review of published and grey literature to map the existing evidence on allied health and nursing management of A-T related symptoms in CYP. The review synthesises 50 sources of evidence and highlighted …

A Critical Exploration Of Social Transformation Through Occupation, Miranda Cunningham

School of Health Professions Theses

Background: In occupational therapy and occupational science, scholars and practitioners advocate for a stronger focus on social transformation. However, there is limited evidence on how occupation-based interventions contribute to addressing inequalities and fostering change for marginalised populations. Methods: This study applied critical occupational science and realist theoretical frameworks to examine the use of arts-based occupations for social transformation. It comprised three strands: (1) a narrative review of arts-based occupations in social change, (2) a realist review of participatory photography, and (3) a realist evaluation of a socially engaged art group in primary schools. Findings: Arts-based occupations have been employed by …

Factors Affecting The Integration Of Dental Services Into Health And Social Care For People With Complex Needs, Afsha Musa, Joelle Booth, Hannah Wheat, Robert Witton, Martha Paisi

Peninsula Dental School

Background: People with complex social and medical needs require a high level of support and face multiple barriers in accessing health and social care services. With limited access to dental care, their high oral health needs go largely unaddressed. Integration of oral healthcare into primary care, alongside improved cross-sector working, has been advocated to bring together services across the system to achieve oral health equity. Aim: To explore the factors affecting integration of dental services into health and social care for people with complex needs. Methods: A qualitative research study was undertaken across two sites in the southwest of England, …

Shedding Light To The Rights To Light In England And Wales: The Need For Reform, Goodtime Okara

School of Law, Humanities and Social Sciences

The right to light is unarguably a right that could hinder the development of the servient land. Owing to the possibility of granting a mandatory injunction when breached, this right could lead to extra costs and delays in the efficient development of the servient land by real property developers, even when the dominant tenement does not wish to enjoy the right. Hence, this paper critically reflects on rights to light in England and Wales to determine the impact of this right on the servient land. It explores the direction of travel across the Courts – by briefly examining rights to …

Epistolary Technologies Of Separation And Archives Of Emotion, James Daybell

School of Law, Humanities and Social Sciences

No abstract provided.

Transatlantic Solidarity In The Shadow Of The Russian–Ukrainian War: A Neorealist Explanation, Lorenzo Cladi

School of Law, Humanities and Social Sciences

The threat posed by Russia, which was exposed most clearly following the invasion of Ukraine in February 2022, provided the impetus to strengthen solidarity among the transatlantic allies. Notable consequences included a renewed sense of purpose for NATO and the strengthening of the EU’s resolve in responding to a crisis in its backyard and a willingness by many European states to do more to contribute to defence. Whilst there is apparent unity of intent in supporting Ukraine in the long term, this article argues that solidarity rests upon a familiar working pattern in transatlantic relations. This can be elucidated most …

Exploring Islamophobia Through Intersectionality., Suparna Bagchi

School of Law, Humanities and Social Sciences

No abstract provided.

Utilizing Cocoso And Interval Neutrosophic Magdm With Superhypersoft For Competitiveness Assessment In Rural Tourism Of Surrounding Cities, Aiping Cui, Zhiyao Liu

Neutrosophic Sets and Systems

With rising living standards, rural tourism near cities has rapidly developed, playing a key role in the sustainable development of urban economies and societies. Factors like ecological environment, historical and cultural resources, and landscape significantly influence the competitiveness of rural tourism. However, current research on this topic is still in its early stages, with a focus on tourism benefits to cities, often overlooking other impacts. Rural tourism boosts employment, promotes rural industries, and increases farmers' incomes, accelerating rural urbanization and economic growth. Therefore, evaluating the competitiveness of rural tourism near cities is essential for its development. The evaluation of rural …