Digital Commons Network^™

Evidence-Based Pain Management Bundle For Pediatric Postoperative Orthopedic Patients, Samantha Firmstone

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postoperative pain management in pediatric orthopedic patients is often inconsistent due to variability in provider practices and a lack of standardized protocols. At a Central Texas pediatric orthopedic clinic, all patients received opioid prescriptions post-knee surgery regardless of procedure severity, leading to frequent caregiver calls for clarification. This practice revealed a critical gap in preoperative education and multimodal pain management strategies, contributing to patient safety concerns and increased clinic workload.

Aim of the Project: The primary aim of the project was to improve pain control, reduce opioid reliance, and decrease postoperative pain-related follow-up calls by implementing a standardized, evidence-based …

Improving Colorectal Cancer Screening Referrals In A Rural Health Clinic, Kysha Mcbee

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Colorectal cancer is the second leading cause of cancer death in the United States. Preventive screening for colorectal cancer has been associated with early detection and improved 5-year survival rates. The referral rates for colorectal cancer screening at the practicum site were 17.7%, well below the national benchmarks of 71.8%.

Aim of the Project: The aim of this project was to increase the screening referral rates in adults aged 45 to 75 years by 50% over a ten-week period by implementing an evidence-based toolkit.

Review of the Evidence: Literature review highlighted barriers to colorectal cancer screening, such as knowledge …

Improving Medication Nonadherence In Clients With Attention Deficit Hyperactivity Disorder Using Medication Reminder Applications, Christian Durand

All Doctor of Nursing Practice (DNP) Scholarly Projects

At an outpatient clinic in Southern California, a 77% medication adherence rate was observed in August 2024 among clients with ADHD. Medication nonadherence in ADHD clients may result in difficulty reaching therapeutic levels, leading to adverse outcomes, such as family disruptions, substance addiction, injuries, criminal occurrences, and even suicide. The project aims to reduce the number of ADHD clients who are noncompliant with their medications and surpass the national benchmark of 80% medication adherence. Evidence has suggested that MRAs may improve medication nonadherence among ADHD clients. Current research has supported the use of MRAs for various chronic diseases including diabetes …

Implementing An Evidence-Based Transitional Care Toolkit To Reduce Postpartum Readmissions In Women With Chronic Conditions, Cassidy La Fleur

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postpartum women with preexisting chronic conditions are at increased risk of hospital readmissions due to fragmented care transitions and poor follow-up adherence. At the project site, the 30-day postpartum readmission rate was 10%, exceeding the national benchmark of 7.15%. Gaps in standardized discharge planning and limited patient engagement were identified as contributing factors.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce 30-day postpartum readmissions in women with chronic health conditions by implementing an evidence-based transitional care toolkit within a women’s outpatient clinic.

Review of the Evidence: Evidence supports the use of structured, …

Celebrity Politics: Construction And Validation Of A Scale To Measure The Political Influence Of Celebrities, Azmat Rasul, Donghee Shin

All Works

This study develops and validates the Political Influence of Celebrities Scale (PICS), designed to assess how entertainment celebrities influence young adults’ political attitudes and behaviors. Drawing on survey data collected from 498 university students in the United States, we applied exploratory and confirmatory factor analysis to test the scale’s structure and psychometric validity. The results support a three-factor model consisting of general attitudes toward celebrities, enjoyment of celebrity-centered political content, and behavioral outcomes such as political discussion and participation. Each subscale demonstrated strong internal reliability (Cronbach’s α ≥ .79). The PICS provides a theoretically grounded and empirically supported measure to …

The Indian Pharmacopoeia: Enabling Open Access And Crafting A ‘Sovereign Function Exception’ For Government Works, Aparajita Lath

National Law School Journal

Standardisation of drugs and access to such standards are important levers for effective drug regulation. The Indian Pharmacopoeia, the official book of standards for drugs in the country prescribed by the Union government under the Drugs and Cosmetics Act 1940, are legally binding and enforceable. Not only do the standards have the force of law but are also government-created. The Indian Pharmacopoeia Commission (IPC), a division of the Union Department of Health and Family Welfare, has a legal monopoly over creating and publishing this compendium. Though it is legally binding, the Indian Pharmacopoeia is neither in the public domain …

The Procedural Architecture Of Climate Justice: Comparative Lessons From Regional Human Rights Courts, Indira Boutier

National Law School Journal

Climate change, once narrated through scientific data and economic costs, is now unavoidably framed as a question of rights and justice. This article examines how litigation before the African, European, and Inter-American human rights courts makes the procedural dimensions of climate justice visible. Procedural justice here is understood capaciously and includes not only rules of access, standing, and evidence, but also the recognition of corporations as duty bearers in transnational accountability regimes. A comparison of the three regions shows how colonial legacies, institutional architectures, and political economies shape the channels through which communities can contest climate harm. Litigation emerges less …

Five Things You Think You Know About International Arbitration That You Do Not Know (Nlsiu-Siac Annual Arbitration Lecture 2025), Lucy Reed

National Law School Journal

In the second NLSIU-SIAC Annual Arbitration Lecture delivered in April 2025, Lucy Reed takes a practice- or procedure-focused approach. Specifically, she addresses some misconceptions about international arbitration held by students and practitioners alike. She also introduces some of the new procedures in the 7th Edition of the SIAC Arbitration Rules, in effect from 1 January 2025.

The Basic Structure In Malaysia: Less Than Meets The Eye, Benjamin Joshua Ong

Research Collection Yong Pung How School Of Law

At first glance, studying the basic structure doctrine in Malaysia can be frustrating due to its inconsistent judicial treatment. While early cases such as Loh Kooi Choon and Phang Chin Hock rejected the doctrine, it was later accepted in landmark decisions like Sivarasa Rasiah, Semenyih Jaya, and Indira Gandhi. In 2020, scholars such as Jaclyn Neo and Yvonne Tew suggested a judicial embrace of the doctrine and its global trend toward constitutional unamendability. However, the Federal Court’s 2021 decision in Maria Chin Abdullah appeared to reject it once more, illustrating the doctrine’s precarious status. The resurgence seen in Dhinesh a/l …

Operationalising The Social Licence To Operate Along The Belt And Road: The Case For A Mediation-Focused Approach, Mark Mclaughlin

Research Collection Yong Pung How School Of Law

This article examines the intricate dynamics of community representation and stakeholder influence in the realm of international investment law. More specifically, it considers the most effective method by which to operationalise the concept of the ‘social licence to operate’ when attempting to resolve investor-state disputes. By utilising disputes relating to China’s Belt and Road Initiative as a case study, it is shown that the social impact of foreign investment projects is often a catalyst for arbitration claims. Community interests are insufficiently represented at the stage of procurement or admission of investment, which has led to violent clashes between investors and …

Persistent Imbalance: Women’S Representation In North American Pediatric Cardiology Leadership Roles.Persistent Imbalance: Women’S Representation In North American Pediatric Cardiology Leadership Roles, Alaina K. Kipps, Audrey C. Marshall, Neha Bansal, Holly Bauser-Heaton, Nadine Choueiter, Devyani Chowdhury, Aarti Dalal, Molly Ehrlich, Lindsay R. Freud, Supriya S. Jain, Pei-Ni Jone, Kristin Laraja, Dalia Lopez-Colon, Sonal T. Owens, Christina Ronai, Ritu Sachdeva, Corey Stiver, Nicole Sutton, Terrie Vasilopoulos, Jennifer Co-Vu

Department of Pediatrics Faculty Papers

BACKGROUND: Despite recent gender parity of physicians entering pediatric cardiology, representation of women leaders lags their male colleagues.

OBJECTIVES: We sought to better understand the variation in women in leadership roles in pediatric cardiology.

METHODS: The gender of physicians in 16 prespecified leadership positions was collected by survey between July 2022 and January 2023 from pediatric cardiology programs with >5 cardiologists in North America. We analyzed the association of women leaders with center size (based on surgical volume), geographic region, presence of categorical fellowship program, and gender of division chief and department chair.

RESULTS: Across 99 centers, a median of …

Chapter 3. Moroccan Arabic-Spanish Bilinguals’ Linguistic Profile And Their Perspectives And Experiences On Learning Standard Arabic, Ramsés Ortín, Pilar Garrido

Writing and Language Studies Faculty Publications

We surveyed a group of Moroccan Arabic-Spanish speakers in the Region of Murcia, Spain, to examine their linguistic profiles, their attitudes towards their native Arabic dialect, their motivations to learn Standard Arabic and their learning experience with Standard Arabic. We found varying degrees of dominance in this group along with fluctuating patterns of dominance, proficiency and language use according to age and onset of acquisition of Spanish. This group displayed generally positive attitudes towards their own dialect and their motivation to learn Arabic was related to their religious and cultural connections. Most of them indicated that they had engaged in …

Dsk2-Mediated Degradation Of F-Box Protein Lao1 And Class I Tcps Modulates The Nitrogen Starvation Response, Yuanyuan Li, Shuyang Cheng, Xu Jin, Ruoxuan Wu, Yiyi Guo, Dezhi Wu, Jie Dong

Publications

Plants have evolved intricate strategies to cope with various abiotic stresses. Ubiquitin-mediated protein degradation plays a key role in plant development as well as abiotic stress tolerance. In this study, we identify LAO1, an F-box protein with unknown function, as a negative regulator of plant fitness during nitrogen starvation. DOMINANT SUPPRESSOR OF KAR 2 (DSK2) interacts with and mediates the autophagic degradation of LAO1 protein during nitrogen starvation. The loss of LAO1 improves the fitness of an autophagy-deficient mutant, atg5-1, under nitrogen starvation. Intriguingly, mutations in DSK2 facilitate rather than reduce plant growth after nitrogen starvation. This unexpected effect of …

Measuring Teaching Success In College Foreign Literature Programs: An Evaluation Perspective Using Double Framed Superhypersoft Set, Lingling Chen

Neutrosophic Sets and Systems

No abstract provided.

Histopathological Features Of Gastrointestinal And Pancreatic Neuroendocrine Neoplasms: An 11-Year Retrospective Study From A Tertiary Center In Saudi Arabia, Rana Y. Bokhary

Saudi Medical Journal

ABSTRACT Objectives: To evaluate the clinicopathological features of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) over 11 years at a single tertiary institution in Saudi Arabia. Methods: In a retrospective review, data from 71 patients diagnosed with GEP-NEN, at a tertiary academic center in Jeddah, Saudi Arabia, between January 2014 to December 2024, were analyzed for demographics, clinical presentation, tumor location, size, pathology, grade, and immunohistochemistry. The statistical analyses included Chi-square, Mann-Whitney-U, and Spearman’s correlation tests. Results: The cohort had a mean age of 54.9±15.1 years and comprised 62% males. Most tumors originated in the foregut (62.0%) and were unifocal (83.1%). Abdominal pain …

Impact Of Z-Spring Appliance And Clear Aligner Therapy On Oral Microorganisms In Children: A Clinical Trial, İrem Kapici, Özge Erken Güngör, Kubra Yildirim, Cemilenur Atas, Ahmet Yilmaz Coban

Saudi Medical Journal

Objectives: To evaluate the effect of Z-spring appliance and clear aligners, used in anterior crossbite treatment, on dental plaque colonization in children. Methods: A 2-arm randomized controlled trial included 30 patients aged 7-12 years with anterior crossbite. Participants were divided into 2 groups: clear aligner (group A, n=15) and Z-spring appliance (group B, n=15). Dental plaque samples were collected at treatment initiation and completion, inoculated onto selective media, and analyzed for colony counts (cfu/ml) of Streptococcus mutans ( S. mutans ), Streptococcus mitis ( S. mitis ), Streptococcus salivarius ( S. salivarius ), and Candida albicans ( C. albicans ). …

Knowledge, Attitudes, And Perceptions Of Developmental Dysplasia Of The Hip Among Pregnant Women In Jordan

Saudi Medical Journal

Objectives: To assess the awareness of developmental dysplasia of the hip (DDH) among pregnant women in Jordan. Methods: A descriptive cross-sectional study was carried out among pregnant females, aged 18 years and above, who had visited 3 hospitals in Jordan. Data were collected through face-to-face interviews, and responses were recorded using a Google form by the researchers. Results: A total of 605 women completed the questionnaire. Most participants correctly reported DDH as the cause of ambulation problems (n=531, 87.6%), and approximately 60% reported it as painful. The majority agreed that DDH is diagnosed using x-ray imaging (80.5%), usually in the …

Clinical Efficacy Of Simultaneous Versus Staged Stent Implantation After Percutaneous Mechanical Thrombectomy In Ivcs Patients With Acute Ifdvt

Saudi Medical Journal

Objectives: To assess the clinical outcomes and prognoses of various stent implantation timings after percutaneous mechanical thrombectomy (PMT) in patients with iliac vein compression syndrome (IVCS) complicated by acute iliofemoral deep vein thrombosis (IFDVT). Methods: A total of 99 patients diagnosed with IVCS with acute IFDVT from December 2016 to February 2024 at our institution were retrospectively analyzed. Patients were divided into 2 groups: Group A underwent simultaneous iliac vein stent implantation, while Group B received staged stent implantation after local urokinase thrombolysis. The 2 groups were compared on the basis of limb edema resolution within 3 days postsurgery, urokinase …

Diversity And Equity In Medical Education Over The Past Decade: Applications, Matriculations, And The Growing Gaps, Gang Lv, Xiangxiang Jiang, Jordan Franklin, Minghui Li, Jing Yuan, Z Kevin Lu Ph.D.

Faculty Publications

Background

Diversity and race-concordant relationships contribute to improved patient experiences and outcomes. In contrast, the representation of underrepresented in medicine (URiM) individuals in different medical specialties is declining. The essential pathway to improving diversity within the future workforce centers around the inclusion of a diverse cohort of medical students. We aimed to examine the diversity of medical school applications and admissions across sex, race and ethnicity over the past decade.

Methods

This study used data from the Association of American Medical Colleges from 2015 to 2024. URiM individuals refer to minority populations that are underrepresented in the medical profession, including …

Profile Of Trna-Derived Short Non-Coding Rnas During Monocyte Differentiation And Their Role In Macrophage Survival, Anahita Jayaram, Sanjeev Galande, Soroush Sharbati, Deepak A. Deshpande, Phd, Kamlesh Pawar

Center for Translational Medicine Faculty Papers

Monocytes, a type of leukocytes, are key players in immune responses, transitioning to macrophages at infection sites. Differentiation, which is crucial for macrophage survival and resistance to apoptosis, is a tightly regulated process. Based on our earlier findings implicating the 5'-fragment of tRNAHisGUG (5'-HisGUG) in macrophage biology, we specifically focused on these fragments to investigate its regulation during monocyte-to-macrophage differentiation and its role in macrophage survival. We performed small RNA sequencing during monocyte-to-macrophage differentiation using THP-1 cells and identified 5'-HisGUG as a prominently regulated tDR. Notably, transfection of 5'-HisGUG in macrophages decreased survival under apoptotic stress. We propose that 5'-HisGUG …

Prayer And Communion, Michael Hatcher

Faith and Philosophy: Journal of the Society of Christian Philosophers

No abstract provided.

Exceptions To The International Customary Law Rule On Head Of State Immunity Under International Criminal Law, Daniel D. Ntanda Nsereko

Cardozo International & Comparative Law Review

The article examines the tension between head of state immunity and the pursuit of justice in international criminal law. It argues that while some nations and regional bodies, like the African Union, assert immunity for heads of state, international institutions such as the International Criminal Court (ICC) reject this principle, emphasizing the rule of law and accountability. The ICC's jurisdiction, particularly through UN Security Council referrals, overrides state consent, challenging traditional notions of immunity. The article posits that states must adhere to their treaty obligations, such as the Rome Statute, and cannot unilaterally opt out for political expediency, reinforcing the …

The Impact Of Students' Attendance On Their Academic Success: A Ypar Study, Quennella Smith

Theses and Dissertations

Youth participatory action research (YPAR) is a collaborative research approach that empowers students to examine issues affecting their lives and communities. This action research aimed to investigate the relationship between students’ attendance and academic success on middle school students, focusing specifically on eighth-grade students based on the theoretical framework of the critical race theory (CRT) in education and the self-determination theory (SDT). Three research questions were explored related to the impact of students’ attendance on their academic success: 1) What do students consider factors that lead to their poor attendance? 2) How do students feel they can be supported in …

"Some Of Them Went To Yale": Ambition, Legal Careers, And Nominations To The Federal Bench, Abigail Violet Hassett

Theses and Dissertations

This dissertation theorizes and quantifies judicial ambition. Article III judges in the United States judiciary are nominated by a president, confirmed by the Senate, and may hold their seat for the remainder of their lifetime. This is a distinct process from other political actors, like congresspeople, presidents, elected judges, and local officials, who are beholden to voters. This dissertation posits that individuals who are high in judicial ambition should consciously choose career paths and interact in networks which will enable them to achieve their goal. After theorizing and quantifying ambition, the measure is replicated on an original dataset of 1300 …

Lgbtqia+ Materials In The Elementary School Library – Examining Purchase And Use: A Mixed Methods Approach, Valerie Byrd Fort

Theses and Dissertations

The need for and importance of diversity in children's literature is well documented, and this study adds to that body of research by addressing LGBTQIA+ materials in elementary school libraries. This mixed-methods study investigates the attitudes, selection, purchasing, and use of LGBTQIA+ materials written for an elementary school age audience by elementary school librarians in U.S. public schools.

Using a national survey distributed electronically to elementary school librarians, quantitative data from 325 participants were collected to examine the extent to which librarians purchase and use LGBTQIA+ materials. Additionally, qualitative insights were obtained through semi-structured interviews with 15 survey respondents, offering …

Relationships Between Modern Marching Percussion And Concert Percussion: An Investigation Of Selected Percussion Ensemble Repertoire, Ian Patrick Mahaffey

Theses and Dissertations

Percussion, as an expansive and diverse art form, encompasses a wide range of performance and cultural aesthetics, all unified by the foundational elements of rhythm, technique, and expression. Within this spectrum, the relationships between marching percussion and concert percussion presents a significant area of study. This document explores the relationships of marching percussion and concert percussion through the contextual analysis of specific percussion ensemble repertoire. By defining the distinct characteristics of concert and marching percussion, the study establishes a framework for comparison and analysis. It highlights how techniques, both musically and compositionally, and the roles of specific instrumentation has contributed …

First Detrital Zircon Provenance Data From Oligocene-Pleistocene Sediment In The Beaufort-Mackenzie Basin, Arctic Ocean, Joseph Martina

Theses and Dissertations

Sediment, runoff, and nutrient input to the Arctic Ocean plays a critical role in both physical and biological processes that impact regional and global systems. The Beaufort-Mackenzie Basin, situated in the Arctic Ocean offshore northwestern Canada, contains more than 14 km of clastic strata and provides a record of erosion and sediment transport from the Cretaceous to present. Pliocene sedimentation rates within the basin jump nearly 2000% relative to underlying units, but the cause of this shift remains unknown. We used cuttings from the N. Issungnak L-86 well, focusing on the Oligocene-lower Miocene Kugmallit and Mackenzie Bay sequences and the …

The Use Of Threat Assessment Protocols In K-12 Schools On Disciplinary Outcomes For Students With Disabilities, Natasha Lynn Mcdonald

Theses and Dissertations

School personnel utilize the BTAM process to investigate threats of violence made by students through identifying, assessing, and managing potentially dangerous situations. This process is not intended to be disciplinary in nature, and previous studies conducted have shown that when a BTAM model is implemented, students who make threats toward others receive fewer suspensions or other types of removal as a result of the threat; however data on threat assessment outcomes has not been conducted in South Carolina. The purpose of this study was to examine administrators' knowledge and perceptions of BTAM models and perceptions of discipline outcomes for students …

Novel Approaches To Combat Neuro-Degradation: Investigations Of Two Supplemental Strategies Aimed At Improving Warfighter Performance, Blaine Lints

Theses and Dissertations

This dissertation examines the efficacy of two distinct nutritional supplementation strategies for improving physical and/or cognitive performance under stress. The first study investigated the effects of 150 mg caffeine plus 150 mg theacrine ingestion in tactically trained individuals. Results indicated that the combination of caffeine and theacrine was associated with significant improvements in reaction time, accuracy, and measures of ocular control following high-intensity interval (HII) exercise. The HII exercise protocol consisted of ten repetitions of 60s high-intensity intervals (≥90% maximal oxygen uptake [VO_2max]) followed by 120s low-intensity intervals (~40% VO_2max) on a treadmill. These benefits were …

The Mediating Role Of Gratifications In Gamified Ai Chatbot Engagement: Astimulus-Organism-Response Approach, Deukmook Bae

Theses and Dissertations

Recent technological advancements and evolving consumer preferences have prompted a substantial shift from live sport attendance to mediated sport consumption, particularly among younger audiences. In response, enhancing the quality of mediated sport experiences has become a strategic priority for sport marketers seeking to maintain consumer engagement and market relevance. Although second-screen usage has been introduced to support this transition, its effectiveness remains uncertain due to limited interactivity, lack of personalization, and the potential for user distraction.

To address these limitations, AI chatbots have emerged as a compelling alternative, offering adaptive, user-centered interactions that promote deeper engagement and enrich the mediated …