Digital Commons Network^™

Community School Hubs: A Path To Literacy For English Learners And Families, Elizabeth Ortiz-Wright

The Reading Professor

This qualitative narrative study examined the perceptions of community school hub members and Hispanic English learner parents at an elementary school in a suburban district. Eighty-four percent of the students at the study site were economically disadvantaged. The inquiry drew on sociocultural theory and Bronfenbrenner's ecological systems theory to explore how these hubs support families. Data were gathered through semi-structured interviews and field observations and analyzed using Quirkos software. The findings demonstrate the overall value of community school hubs in addressing basic needs, increasing the potential for academic success. However, a significant lack of clarity exists; many parents were unaware …

Beyond Screening: Using Multiple Sources Of Evidence To Inform Early Literacy Instruction, Cheryl Kahn

The Reading Professor

Educators today collect more literacy data than at any previous point in history, yet many students continue to experience reading difficulties that are identified far later than they should be. This article argues that the problem is not a lack of information but a failure to integrate available evidence to prompt timely instructional action. Drawing on research in reading development, early identification of reading difficulties, teacher knowledge, assessment literacy, instructional decision-making, and responsive literacy instruction, this article proposes the Multiple Sources of Evidence Framework to strengthen early literacy decision-making. Rather than relying on any single assessment or screening result, the …

Investigation Of The Functional Dimensions Of Teats Up To Mid-Lactation In Bulgarian Murrah Buffaloes Established By Ultrasonography, Ivan Fasulkov, Pencho Penchev, Yordanka Ilieva, Manol Karadaev

The Thai Journal of Veterinary Medicine

The aim of this study was to monitor the changes in teat measurements from early to mid-lactation in the Bulgarian Murrah buffaloes. The experiment was carried out with twenty (10 primiparous and 10 pluriparous) lactating buffaloes. Five series of ultrasound measurements were performed, each consisting of two sessions for each animal corresponding to the phases of lactation: first lactation month (day 1 to day 30 postpartum) and mid- lactation (day 122 to day 152). The studied parameters were teat canal length (TCL), teat diameter (TD), teat wall thickness (TWT), and teat cistern diameter (TCD). The data were processed using the …

Profanity And Perceptions, Elizabeth Lefrancois

Undercurrents: A Journal of Undergraduate Student Composition

Lizzie is an Exercise and Health Science major from Blackstone, Massachusetts. Assigned by her Composition II instructor to research an aspect of language that interested her, Lizzie chose to research swearing, which was never allowed in her home. Lizzie’s research enabled her to “open [her] eyes and see much more than a lack of vocabulary” when she heard others using profanity. She explains, “I felt as if I was programmed to think that swearing was this terrible thing that no one should do, and, because of that, I never thought about the positive side of this language.” Lizzie’s essay explores …

Advancing Occupational Therapy Practice: Evaluating A Continuing Education Module To Support The Integration Of 3d Printing Into Clinical Care, Sophia Wilkes, Rebecca Ozelie

Student Journal of Occupational Therapy

This study aimed to evaluate whether a continuing education module could improve occupational therapy practitioners’ perceived knowledge, awareness, confidence, and clinical utilization of 3D printing in occupational therapy practice, while also examining how access to resources may influence implementation A 14-week cross-sectional pre–post design was used with occupational therapy practitioners participating in a one-hour educational session followed by a three-week trial of 3D printer access. Participants completed pre- and post-surveys assessing perceived knowledge, awareness, and confidence, and maintained a utilization log to track clinical use.

Results indicated a statistically significant increase in perceived knowledge and awareness of 3D printing following …

Saudi Heart Association Scientific Statement On Cardiovascular–Kidney–Liver-Metabolic (Cklm) Syndrome, Waleed Alhabeeb, Abdulhalim J. Kinsara, Ahmed Mitwalli, Ali A. Alshehri, Faisal Aba-Alkhail, Ismail Raslan, Khalid Aljohani, Mohammed Arafah, Muthana Sahlawi, Saud Alsifri, Suleiman M. Kharabsheh

Journal of the Saudi Heart Association

Background: Cardiovascular, kidney, metabolic, and liver diseases are closely interconnected and frequently coexist. While the cardiovascular–kidney–metabolic (CKM) framework provides a unified model, increasing evidence supports a central role for hepatic disease, particularly metabolic dysfunction–associated steatotic liver disease (MASLD), in this continuum. The Saudi Heart Association (SHA) therefore aimed to introduce the cardiovascular–kidney–liver–metabolic (CKLM) syndrome as an expanded framework and provide expert guidance on its pathophysiology, staging, screening, and management, with relevance to the Saudi population.

Methods: A multidisciplinary expert panel convened under the auspices of the SHA conducted a comprehensive, non-systematic literature review and developed consensus-based recommendations through iterative discussion …

Integrated Llm-Powered Framework For Real-Time Monitoring In Machining Using Smartphone And Ai Agent Orchestration, Mustafa H. Hadi, Hussam L. Alwan, Atiya Al-Zuheri, Sang-Heon Lee, Yousef Amer

Engineering and Technology Journal

Reliable tool condition monitoring is essential for maintaining machining quality, reducing production downtime, and preventing unexpected tool failures. Conventional tool condition monitoring systems can accurately detect tool wear but typically provide limited support for automated diagnosis and maintenance decision-making. To address this limitation, this paper proposes an economical AI agent-driven maintenance framework for milling operations that integrates smartphone-based vibration sensing, one-dimensional Convolutional Neural Networks (1D-CNNs), and Large Language Model (LLM)-powered AI agents. Vibration signals acquired using a smartphone-embedded accelerometer are preprocessed and analyzed using a 1D-CNN to classify tool conditions into fresh and worn states. The classification results are then …

Occurrence And Distribution Of Polychlorinated Naphthalenes In Consumer Products And Landfill Matrices: A First Assessment In South Africa, Vhodaho Nevondo, Raissa Okwuosa, Okechukwu Jonathan Okonkwo

Engineering and Technology Journal

Polychlorinated Naphthalenes (PCNs) are persistence organic pollutants (POPs) which have been used extensively and continue to be a source of environmental and human health issues in spite of the international ban on their production. This work represents the first report of PCNs in consumer goods, landfill leachate, and sediment samples in South Africa. In this study, a total of 24 consumer goods belonging to eight categories were analyzed along with landfill leachates and sediments from the Hatherly and Goudkoppies landfills, Gauteng Province, South Africa, for some selected PCN congeners by gas chromatography mass spectrometry (GC-MS) analysis. Quality assurance procedures and …

Investigation Of Plasma-Induced Surface Modification Of Pmma Using Nd:Yag Laser-Induced Breakdown Spectroscopy, Shaimaa S. Mahdi, Asmaa J. Kadhim, Zainab Salam Khaleefah

Engineering and Technology Journal

Poly(methyl methacrylate) (PMMA) plays an important role in many applications, including biomedical, industrial, and optical applications. Due to its surface properties, which are essential to its performance. The PMMA samples were exposed to a dielectric barrier discharge (DBD) air plasma with a duration time of 300 s. In this investigation, laser-induced breakdown spectroscopy (LIBS) in combination with Fourier transform infrared spectroscopy (FTIR) was used to study the surface properties of exposed to plasma samples. The laser pulses were set to (60, 80, and 100) mJ. The resulted spectra were recorded over a wide spectral range from 200 to 1100 nm. …

Bim-Safety Integration In The Nigerian Construction Industry Using The Unified Theory Of Acceptance And Use Of Technology (Utaut) Model, Ranti T. Adebiyi, Ganiyu Amuda-Yusuf, Olubola Babalola, Nurudeen A. Bello, Aminat D. Amuda, Kaosarat A. Olowookere

Engineering and Technology Journal

Health and Safety (H&S) challenges are a significant concern in the Nigerian construction industry, largely due to the lack of a reliable national accident database and the persistence of a fatalistic safety culture. Building Information Modelling (BIM) is a transformative digital framework that enables visual hazard identification and proactive risk simulation; however, its use in site safety management remains limited and inconsistent. This study investigates the behavioural, social, and structural determinants influencing the adoption of BIM-based H&S practices among construction professionals, utilising the Unified Theory of Acceptance and Use of Technology (UTAUT). A hypothetical multi-level design was used to model …

Techniques For Handling Unstable Agents In Agent-Based Networks, Ashwini S Kulkarni, Sushmitha Vatsal, Priyanka Bansal, Vivek Kumar Singh, Ghulam Ghaus Arshi

Defensive Publications Series

Proposed herein are a system and techniques that facilitate stability-aware metadata synchronization in agent-based networks. The system includes a closed-loop adaptive stability orchestration layer that utilizes a time-sensitive exponential-decay mechanism and historical recovery telemetry to dynamically tune suppression and reuse thresholds, thereby reducing control-plane churn and cascading failures. Rather than relying on binary health checks, the system uses a time-weighted stability score to support granular, policy-driven agent lifecycle management.

The Everyday Monument: Architectural And Spatial Transformations Of Rome's Nasoni, 1874–Present, Sandra L. Santos

McNair Summer Research Program

Rome's nasoni are small public drinking fountains that have provided free water throughout the city since 1874. There are approximately 2,500–2,800 nasoni in Rome, actively supplying people with free drinking water. Although they are usually understood as ordinary and mundane hydraulic infrastructure, their persistence across different political periods makes them useful objects for examining the relationship between architecture, public service, and political meaning. This research asks how the forms, materials, and spatial contexts of late-nineteenth-century nasoni differed from fountains constructed or modified during the Fascist era.

Over my three weeks of fieldwork in Rome, I documented seventy-five public drinking fountains …

Promoting Safety And Confidence: Standardizing Intimate Partner Violence Screening And Improving Staff Screening Confidence In A Predominantly Latinx Community Health Center, Jordan Jiang

Master's Projects and Capstones

Objective: Intimate partner violence (IPV) is a prevalent public health problem that is screened far less consistently than comparably common conditions and disproportionately affects vulnerable groups, including low-income, Spanish-speaking, and undocumented individuals. This quality improvement project was conducted in an outpatient community health center serving a primarily Latinx, Spanish-speaking population in San Francisco, where screening across the Adult Health, Women's Health, and Teen Clinics was inconsistent, with a baseline rate of 4.1% in June 2026. Aim: The project aimed to increase overall IPV screening by 10 percentage points, from 4.1% to 14.1%, by July 31, 2026. Methods: Rogers' Diffusion of …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Standardizing Intimate Partner Violence Screening Among Latinx Patients In A Community Clinic Setting, Peyton O'Callaghan

Master's Projects and Capstones

Intimate partner violence (IPV) is a significant public health concern that may go unrecognized when screening practices are inconsistent. Objective: To standardize IPV screening practices and improve staff confidence across the Adult Health, Women’s Health, and Teen/Pediatric clinics of a community health center serving a predominantly Latinx, monolingual Spanish-speaking, and underserved population. Aim: To increase the overall IPV screening rate by 10% during a three-week implementation period. Methods: The project team developed and implemented a standardized four-question printed screening tool, medical assistant scripts in English and Spanish, and a staff educational in-service. These interventions addressed low screening rates, limited staff …

Nourish And Flourish: Building Confidence In Healthy Food Selection Among Older Adults In An Independent Living Facility, Emily Nguyen

Master's Projects and Capstones

The nutrition education program aims to increase confidence in selecting and maintaining healthier food choices and dietary habits for chronic conditions through weekly workshops. This quality improvement project was conducted in an independent senior living facility in Richmond, CA serving the elderly population ages 65 and up. To address the concern of low confidence levels and management of dietary patterns and chronic health conditions pertaining to nutrition, a comprehensive nutrition education program was developed with pre- and post-intervention assessment surveys to compare baseline confidence levels. The weekly workshops for this nutrition education program aims to increase confidence levels of the …

Reducing Variation, Improving Outcomes: Standardizing Gestational Diabetes Mellitus Education In A Clinical Microsystem, Thanh Le

Master's Projects and Capstones

Objective: Variations in referral, scheduling, delivery of educational information, patient materials, and documentation hampered the quality of gestational diabetes mellitus (GDM) education in the outpatient maternal-fetal medicine clinic. Purpose: The aim of the quality improvement project was to boost adherence to a standardized GDM group education framework from 0 to 50% in the course of 12 weeks and assess attendance at group visits. Methods: The microsystem analysis was conducted based on observations of group visits conducted in Spanish and English, examination of current processes and resources in use, educator pre-survey, SWOT analysis, and cause and effect analysis. The implementation of …

Standardizing Group Visits For Gestational Diabetes Education: A Quality Improvement Initiative In An Outpatient Maternal-Fetal Medicine Clinic, Nha Nguyen

Master's Projects and Capstones

Objective: At an outpatient maternal-fetal medicine clinic in Northern California, gestational diabetes mellitus (GDM) education is delivered inconsistently across nurse practitioners (NPs) and registered dietitians (RDs), with no standardized curriculum, referral criteria, or educational materials. Aim: By August 12, 2026, this project aimed to develop and implement a standardized GDM group visit framework for NPs, RDs, and scheduling staff in maternal-fetal medicine clinic, increasing compliance with standardized referral, enrollment, and educational processes from a baseline of 0% to 50%. Methods: Using baseline observations, workflow assessment, stakeholder input, and a literature review, the QI team developed standardized bilingual slide …

Seeing A Need, Creating A Solution, August 13, 2026, Tisa Mason Ed.D.

Heart of a Tiger Columns

No abstract provided.

Cover And Contents

Turkish Journal of Medical Sciences

No abstract provided.

Face Mask Littering: Environmental Impacts, Regulatory Challenges, And Ai-Driven Waste Management Strategies For The Post-Pandemic Era, Pri̇yanka Rathee, Sari̇ta Khatkar, Renu Sehrawat, Pooja Rathee, Anurag Khatkar, Esra Küpeli̇

Turkish Journal of Medical Sciences

The widespread use of polypropylene-based face masks during the COVID-19 pandemic created a significant and persistent source of plastic pollution. This review aims to provide an integrative assessment of the environmental, toxicological, and public health implications of face mask litter and evaluate current waste management challenges and emerging technological solutions in the postpandemic context. A narrative review approach was employed, synthesizing literature published between 2020 and 2025 and indexed in major scientific databases including Web of Science, Scopus, and PubMed. Studies were selected based on their relevance to the issues of environmental contamination, microplastic generation, toxicological effects, regulatory frameworks, and …

Hearing Loss In Behçet’S Syndrome: Prevalence And Associated Factors In A Nationwide Cross-Sectional Analysis ​, Alper Doğanci, Serdar Can Güven, Nuray Yilmaz Çakmak, Nurhan Güven, Sali̇h Başer, Nesli̇han Öztürk, Şuayi̇p Bi̇ri̇nci̇, Nai̇m Ata

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to investigate the prevalence of hearing loss in Behçet’s syndrome and its associations with other disease manifestations, comorbidities, and treatment agents. To the best of our knowledge, this is the most comprehensive study to date addressing this issue.

Materials and methods: The study was designed as a cross-sectional, nationwide study. The Turkish Ministry of Health National Electronic Database (e-Nabız) was used under the supervision of the Ministry of Health to extract patient data. A nationwide cohort was established from patients who had been assigned an ICD-10 code for BS (M35.2) on at least …

A Comparative Analysis Of Clinical Quality And Readability Of Neuropathic Pain Patient Information Leaflets: Türkiye Versus The United States, Gonul Sari, Argun Pire

Turkish Journal of Medical Sciences

Background/aim: Neuropathic pain management requires high patient adherence and complex dose-titration regimens, making the readability of patient information leaflets (PILs) a critical patient safety factor. This study aimed to compare the clinical content quality and linguistic readability of PILs for neuropathic pain medications between Türkiye (TİTCK) and the United States (DailyMed).

Materials and methods: A total of 11 pairs of innovator medications were analyzed. Clinical content was assessed using the 15-item Keystone Clinical Content Checklist (KCCC). Readability was assessed using the Ateşman index for Turkish texts and the Flesch Reading Ease Score (FRES) for English texts. Information quality and reliability …

Demographic And Clinical Characteristics Of Frequent Users Of Emergency Medical Services In Türkiye ​, Burak Bekgöz, İshak Şan

Turkish Journal of Medical Sciences

Background/aim: Overuse of emergency medical services (EMS), particularly unnecessary ambulance requests, places considerable strain on limited healthcare resources and can delay responses to urgent cases. The present study analyzes the demographic characteristics, diagnoses, urgency, and hospital transfer status of frequent users of EMS in Türkiye.

Materials and methods: Included in the study were 41,113 patients who requested EMS four or more times within a year (defined as frequent users for the purpose of the study), excluding interhospital transfers. Data were accessed from the Emergency Medical Services Automation System (ASOS) database, which contains details of patient demographics, diagnoses, triage codes, reasons …

Comparing Age Of Obesity Onset, Concerns About Weight And Body Shape, And Quality Of Life In Individuals Seeking Bariatric Surgery ​, Vi̇ldan Çakir Kardeş, Özge Saraçli, Nuray Atasoy, Levent Ati̇k, Si̇bel Kahraman Gi̇rgeç

Turkish Journal of Medical Sciences

Background/aim: This study explored the relationship between concerns about weight and body shape and quality of life in bariatric surgery candidates with morbid obesity regarding the onset of the weight problem in childhood, adolescence, or adulthood.

Materials and methods: We included 453 patients who applied to our center for preoperative bariatric surgery assessment between January 2010 and April 2019. We reviewed the sociodemographic information, psychiatric diagnoses, and results of the Body Shape Questionnaire-34, Quality of Life Scale, Beck Depression Inventory, and Beck Anxiety Inventory of all patients.

Results: Concerns about weight and body shape were increased in women (p < 0.001), unemployed patients (p = 0.001), those with a comorbid psychiatric disorder (p < 0.001), and those with childhood- or adolescent-onset of weight problems (r = –0.170; p < 0.001). Concerns about weight and body shape had a relationship with the vitality (r = –0.434), mental health (r = –0.464), social functioning (r = –0.418), pain (r = –0.307), and general health (r = –0.352) subscale scores of quality of life. Physical functioning was higher (p = 0.037) in patients with childhood- or adolescent-onset obesity compared to patients with adult-onset obesity, while mental health was higher (p = 0.001) in the latter group. Individuals with childhood- or adolescent-onset obesity inquired about bariatric surgery options at an earlier age (p < 0.001).

Conclusion: …

Changes In T-Cell Subsets And Their Relationships With Disease Severity In Patients With Alopecia Areata, Hati̇ce Türk Daği, Hülya Özdemi̇r, Mehmet Akyürek, Fatma Tunçez Akyürek, Hasi̇be Artaç

Turkish Journal of Medical Sciences

Background/aim: Alopecia areata (AA) is a nonscarring hair loss disorder characterized by genetic susceptibility, environmental triggers, and T-cell–mediated autoimmunity. While various CD4+ and CD8+ T-cell subsets are implicated in its pathogenesis, the roles of follicular T-cell (Tfh), peripheral T-cell (Tph), and regulatory T-cell (Treg) subsets– particularly within the CD8+ population–remain incompletely defined. This study aimed to characterize circulating CD4+ and CD8+ T-cell subsets in Turkish patients with AA and to evaluate their associations with disease activity, duration, and severity.

Materials and methods: A total of 40 patients with AA and 40 healthy controls were enrolled. CD4+ and CD8+ T-cell subsets—including …

Perioperative Effects Of The Quadratus Lumborum Block In Percutaneous Biliary Drainage: A Prospective Randomized Controlled Study ​, Seyyi̇d Furkan Kina, Can Ozan Yazar, Cem Koray Çataroğlu, Erdi̇ Tangobay, Sadik Ahmet Uyanik, Savaş Altinsoy, Reyhan Polat, Jüli̇de Ergi̇l

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to evaluate the effect of the quadratus lumborum block (QLB) on intraoperative opioid consumption in patients undergoing percutaneous biliary drainage (PBD).

Materials and methods: A total of 57 patients who met the inclusion criteria were randomized into two groups: the sedation group (Group 1, n = 26) and the sedation with QLB group (Group 2, n = 26). The groups were compared in terms of intraoperative anesthetic consumption, vital parameters, postanesthesia care unit (PACU) recovery times, postoperative visual analog scale (VAS) scores, postoperative analgesic consumption, and clinician and patient satisfaction. The study was …

Evaluation Of Acne Vulgaris Patient Care In Outpatient Clinics: Guideline Adherence And Patient Education ​, Mefküre Durmuş, Betül Sena Çavdar, İbrahi̇m Etem Arica, Sena Ustaömer, Sena Güzel Karahan, Seçi̇l Çolak, Selcen Şenol

Turkish Journal of Medical Sciences

Background/aim: Acne vulgaris, affecting over 85% of adolescents, is the most prevalent chronic inflammatory skin disorder. Its management is severity-based, with specific drug selections and combinations according to guidelines. However, adherence to these guidelines and the adequacy of patient counseling remain uncertain in real-world practice. The aim in this study was to evaluate prescribing patterns in acne management, assess compliance with guidelines, and promote awareness among healthcare professionals.

Materials and methods: A prospective observational study was conducted in the dermatology outpatient clinic of a tertiary hospital in Türkiye between February and May 2025. Demographic and clinical data were collected, and …

Rna Sequencing Detects More Challenging Cases Of Somatic Hypermutation In The Ighv Gene In Patients With Chronic Lymphocytic Leukemia ​, Fatma Arikan, Pinar Ata, Şenol Demi̇r, Meral Uluköylü Mengüç, Fahi̇r Özkalemkaş, Bedretti̇n Orhan, Özgür Mehtap, Arda Bayar, Asu Fergün Yilmaz, Ayşe Tüli̇n Tuğlular, Işik Atagündüz, Tayfur Toptaş

Turkish Journal of Medical Sciences

Background/aim: Chronic lymphocytic leukemia (CLL) exhibits marked biological heterogeneity, and immunoglobulin heavy chain variable (IgHV) mutation status remains a key prognostic biomarker. We evaluated patient IgHV status via RNA sequencing (RNA-seq) and examined real-life clinical outcomes in a retrospective CLL cohort.

Materials and methods: Eighty-seven adults diagnosed with CLL between 2020 and 2022 at three centers were included. Total RNA from peripheral blood underwent anchored multiplex polymerase chain reaction with the Immunoverse BCR-IGH IGKL v1.0 kit (Integrated DNA Technologies) and was sequenced on the MiSeq platform (Illumina). IgHV mutation status was determined according to ERIC 2022 guidelines, specifically regarding classification …

Association Between Mri-Based Tumor-To-Skin Distance And Axillary Lymph Node Metastasis In Breast Cancer ​, Hi̇kmet Pehlevan Özel, Seçi̇l Gündoğdu, Eda Şahi̇ngöz, Ebru Menekşe, Mesut Tez

Turkish Journal of Medical Sciences

Background/aim: Axillary lymph node (ALN) status is a major prognostic factor in breast cancer and influences both survival outcomes and treatment planning. Noninvasive predictors of nodal metastasis are of clinical interest. Tumor-to-skin distance (TSD) has been proposed as a potential anatomical marker; however, standardized data based on magnetic resonance imaging (MRI) remain limited.

Materials and methods: This retrospective study included 98 female patients with pathologically confirmed breast cancer who underwent preoperative breast MRI between 2020 and 2025. Patients with prior breast or axillary surgery, distant metastasis, multifocal or multicentric disease, or inadequate MRI quality were excluded. TSD was measured on …