Digital Commons Network^™

Calcium Carbonate Microparticles As Acid Responsive Targeted Drug Delivery Carriers For Oral Diseases And Its Anti-Bacterial Activity, Hem Raj Joshi

Dissertations and Theses

Dental diseases are mostly caused by bacterial infections in the teeth, forming biofilms that release acids and decay the enamel of the teeth. More than half of the world's population were affected by oral diseases, including periodontitis (gum disease), dental caries (cavities), and oral cancer. Chlorhexidine (CHX) is the mostly used antimicrobial drug for dental diseases, but its overexposure to the healthy teeth causes many side effects, such as tooth staining, taste alteration, and many more. Taking advantage of the acidic environment of infected teeth, we designed a pH responsive targeted drug delivery system using calcium carbonate microparticles (CCMPs) as …

Convergence In Cancer: Integrative Multi-Modal Modeling For Pan-Cancer Drug Response Prediction, Jessica Zylla

Dissertations and Theses

Heterogeneity and rarity can make cancer difficult to study and treat. Cancer's heterogeneity, evident in tumor locations, tumor cell types, subtypes, and microbiota within the tumor microenvironment, complicates diagnosis, prognosis, and treatment. Research into the tumor microenvironment and its microbiota is an evolving area of oncology that may advance cancer drug-patient response. Cancer-omics signatures are crucial to drug response, yet there is no tool that physicians use as a gold standard. Research indicates that microbial presence can alter drug metabolism and immune response, affecting cancer-drug efficacy on a patient-specific basis. This work highlights the need for training readiness in transdisciplinary …

American Indian Survivors Of Domestic Violence And Self-Perceived Mental Health After Seeking Domestic Violence Services, Arial Swallow

Dissertations and Theses

Domestic violence has long-term impacts on women’s emotional, psychological, and physical health, with American Indian women experiencing disproportionately high rates of violence and face unique barriers in overcoming challenges of healing. As part of a larger study, this research aimed to better understand the healing process of American Indian women domestic violence survivors in rural areas. This study examined findings from a mixed methods approach, which investigated the significance of identifying co-occurring mental health needs and providing support, education, and resources to address these needs. The research utilized a quantitative method of descriptive statistics, identifying survivors who endorsed mental health …

Your Foot Is Not A Brick: Using A Multi-Segment Foot Model To Explore The Actions Of The Ankle-Foot Complex During Uneven Terrain Gait., Tayler Jon Hoekstra

Dissertations and Theses

The field of biomechanics has seen continued development of models to be used and circumstances to be considered. An increasing number of more complex models for the foot known as multi-segment foot models (MSFMs) have created opportunities to better understand the compensatory motion of this vital portion of human anatomy. This research seeks to utilize one such MSFM model to increase understanding in how human ambulation changes in uneven terrain environments. Unique inner-foot joints defined by the Rizzoli foot model (RFM) were measured for and compared for subjects traversing both even and uneven terrain to quantify joints that experienced significant …

An Exploration Of The Experiences And Factors Influencing Physical Activity In People With Parkinsons, Heather Hunter

School of Health Professions Theses

Abstract:Background: Physical activity plays a crucial role in enhancing the well-being and quality of life of people with Parkinsons. Despite substantial evidence supporting its benefits, people with Parkinson’s struggle to maintain an active lifestyle. This thesis explored the perspective of people with Parkinsons on their engagement in physical activity.Methodology: This research employed a person-centred approach, comprised of three sequential phases. Phase One: A systematic review utilising the JBI approach of meta-aggregation synthesised the best available qualitative evidence of people with Parkinson's' views and preferences regarding physical activity interventions. Phase Two: Constructive Grounded Theory was used to explore the beliefs, attitudes, …

Home-Based High-Intensity Interval Training For People With Parkinson’S : The Hiit-Home4parkinson’S Study, Conrad Harpham

School of Health Professions Theses

BackgroundExercise, particularly of high intensity, is considered to be important for people with Parkinson’s (PwP). However, PwP are less active than healthy individuals, and face disease specific and logistical barriers to exercise participation such as lack of outcome expectation, symptom exacerbation, travel logistics due to motor symptoms, expense and perceived lack of time. High-intensity interval training (HIIT) is a low volume exercise modality, evinced to be beneficial and time efficient for people within various healthy and clinical populations. HIIT therefore, particularly undertaken in the home could be apposite for PwP, although evidence is currently limited. Therefore, this study aimed to …

The Role Of A Pelvic Orthotic In The Management Of Chronic Pregnancy-Related Pelvic Girdle Pain: A Feasibility Study And Validation Of A Novel Body Perception Measure, Bradley Halliday

School of Health Professions Theses

Chronic pregnancy-related pelvic girdle pain (PPGP) affects an estimated 10% of post-partum women and is typically recalcitrant to conservative management. One novel option to manage this is a customised Dynamic Elastomeric Fabric Orthosis (DEFO), however, currently non studies have evaluated the clinical and cost-effectiveness or acceptability of this orthotic in post-partum women. Further, the mechanism of action of this orthotic is unknown. One mechanism may be to impart an effect on the disturbed body perception, which preliminary evidence has demonstrated is affected in women with PPGP. Current understanding is limited by an absence of research into women with PPGP and …

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 …

The Role Of Oral Nitrate Reducing Bacteria In Cardiovascular Health: Impacts Of Diet And Exercise, Craig Clarke

School of Health Professions Theses

This thesis investigated the important role of oral bacteria in blood pressure regulation and vascular function through the NO3--NO2--NO pathway following exercise or dietary interventions. Study 1 examined the effect of antibacterial mouthwash on the oral microbiome and nitrate metabolism in vegetarians and omnivores. Notable alterations in bacterial composition were observed after mouthwash administration, including reductions in the Prevotella genus (from 27.7% to 9.6%, P = 0.001) and Actinomyces genus (from 9.5% to 5.7%, P = 0.001), along with decreases in Prevotella melaninogenica (from 18.1% to 6.2%, P = 0.001) and Rothia dentocariosa (from 0.09% to 0.04%, P = 0.001). …

The Revolving Door Of Epilepsy Emergencies, Sarah Lennard

School of Health Professions Theses

This thesis explores the revolving doors of epilepsy emergencies, focusing on the key factors that contribute to repeated attendances at emergency departments (ED) following seizures. The study is based on five peer-reviewed journal articles that provide a comprehensive review of current evidence, risk factors for ED attendance, clinicians' perspectives, and the use of technology in epilepsy management. The research identifies several critical factors influencing ED attendances, including mental health issues, medication adherence, and social determinants such as deprivation and homelessness. The findings highlight the need for integrated care pathways, improved communication between healthcare providers, and targeted interventions for vulnerable populations. …

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 …

Investigating The Link Between The Oral Microbiome And Cardiovascular Health In Regards To Nitrate/Nitrite Metabolism., Lisa Du Toit

School of Health Professions Theses

This thesis evaluated nitrate metabolism and the link between cardiovascular health and periodontal disease. The first study compared effects of high-nitrate vegetables and pharmacological salt supplementation on the oral microbiome composition in hypertensive individuals. Seventy participants (50-70-y-old, clinical systolic BP (SBP) 130-159 mmHg, diastolic BP (DBP) <110 mmHg) were randomly allocated to group 1 (n = 24) consuming 300 mg/d nitrate in green leafy vegetables form, group 2 (n = 23) consuming 300 mg/d potassium nitrate in form of pills and low-nitrate vegetables, and group 3 (n = 23) consuming potassium chloride pills (placebo) and low-nitrate vegetables. Groups 1 and 2 showed similar microbial salivary changes, increased Neisseria species, and decreased Veillonella species post treatment, suggesting nitrate-dependent changes.The second study investigated oral health and microbiome composition of pregnant women with pre-eclampsia (n = 10, SBP = 150 ± 8 mmHg, DBP = 98 ± 9 mmHg) compared to normotensive pregnancies (n = 11, SBP = 111 ± 5 mmHg, DBP = 80 ± 9 mmHg). Pregnant women with pre-eclampsia showed higher plaque levels compared to normotensive pregnant women (P = 0.038), although activity of oral nitrate-reducing bacteria (P = 0.088) was not statistically significant. Plasma nitrate levels were significantly were lower in women with pre-eclampsia (P = 0.024). The third study evaluated the effect of chlorhexidine (CHX-M n= 21) and propolis (PROP-M n= 24) mouthwashes on abundance and activity of nitrate-reducing bacteria in healthy individuals. CHX-M increased relative abundance of nitrate-reducing bacteria (P < 0.001), but significantly impaired nitrate-reducing activity (P < 0.001) compared to baseline and PROP-M. PROP-M significantly increased plasma nitrate levels (P = 0.047) and reduced systolic BP (P = 0.022).The fourth study compared the effect of CHX-M, PROP-M, amoxicillin (AMX) and metronidazole (MTZ) on salivary nitrate-reducing activity within a 24-hour period using an in-vitro protocol. Results showed that MTZ significantly increased nitrate-reducing activity after 24-hours (P = 0.001) compared to all the other treatments (AMX, P = 0.025; CHX-M, P = 0.01; PROP-M, P = 0.023). Overall, this thesis suggests that poor oral health may impair the oral nitrate–nitrite pathway, thereby reducing nitrate bioavailability in women with pre-eclampsia. Diets rich in high-nitrate vegetables showed beneficial changes in the oral microbiome; however, these were not associated with blood pressure reduction. In contrast, use of propolis mouthwash increased plasma nitrate bioavailability, contributing to blood pressure reductions. Finally, it was observed metronidazole significantly enhanced nitrate-reducing activity.

Factors Affecting Metabolism And Metabolic Control In Phenylketonuria, Alex Amorim Pinto

School of Health Professions Theses

Phenylketonuria (PKU) is an inherited metabolic disorder treated by a phenylalanine restricted diet in order to avoid neurocognitive impairment. Blood phenylalanine is the main outcome marker which is modulated by many dietary factors. Traditionally, L-amino acid-based protein substitutes are the main nitrogen source but more recently glycomacropeptide-based protein substitutes (GMP) have been introduced and are associated with several health benefits. The following aspects were studied in this thesis: 1) metabolic control achieved in patients with PKU compared with the European PKU guidelines; 2) life-long change in natural protein tolerance; 3) impact on metabolic control of different natural protein sources (animal …

Effectiveness And Safety Of Intravenous Iron Therapy In Outpatient Obstetrical Clinic For Treatment Of Iron-Deficiency Anemia During Pregnancy, Ellen M. Murrin, Olivia S. Lebeau, Lillian Singer, Mark A. Kassab, Peyton Kalan, Julie Costanzo, Scott A. Sullivan, George L. Maxwell, George R. Saade, Antonio F. Saad

Department of Obstetrics & Gynecology Faculty Publications

Background

Iron-deficiency anemia (IDA) affects over one-third of pregnant patients globally, contributing to severe maternal morbidity and adverse neonatal outcomes. Oral iron supplementation, while cost-effective, is limited by poor absorption, significant gastrointestinal side effects, and poor adherence. The use of intravenous (IV) iron addresses many of these concerns, including eliminating GI side effects and the need for daily therapy. However, administration of IV iron in pregnant patients is typically restricted to specialized infusion centers or hospitals due to concerns about acute side effects, cost, resource utilization, the need for fetal heart rate monitoring, and extended infusion times.

Methods

This descriptive …

Llms Enhance Emotional Expression While Maintaining Analytical Depth In News Writing, Samuel Mazzone, Jonah Harlan, Larry Zhiming Xu, Terence T. Ow

Management Faculty Research and Publications

As the impact of generative artificial intelligence (GenAI) becomes increasingly evident in automated journalism, leveraging its potential while mitigating the risks becomes a priority in research. To address this need, our study evaluated the performance of large language models (LLMs) in news writing. We tested 11 LLMs by having them rewrite headlines and content from articles published by Milwaukee Neighborhood News Service (NNS) between 2011 and 2023. The analysis and comparison of 3,623 human-written and 39,853 AI-adapted news pieces showed that different LLMs consistently enhanced emotional expression in headlines (Cohen’s d = .33) and in news content (Cohen’s d = …

Reproductive Innovation And Reproductive Exceptionalism: How Private Health Insurance Coverage Of Fertility Treatment Complements Hostile Governmental Action And Expands Access To Assisted Reproduction In The United States, Myrisha S. Lewis

Faculty Publications

The use of fertility treatment and assisted reproductive technology (ART) in the United States and globally is increasing over time. As of April 2023, the World Health Organization estimates that approximately one in six individuals have faced infertility globally. Fertility treatment includes the use of drugs to stimulate egg production, in vitro fertilization (IVF), and, for some, the use of gestational surrogacy to aid in childbirth. Debates have abounded and continue to abound in federal legislatures, state legislatures, and society more broadly about the morality of abortion, contraception, and assisted reproduction, as well as whether governments, public insurers, and private …

Bringing Self-Determination Theory To The Forefront: Examining How Human Resource Practices Motivate Employees Of All Ages To Succeed, Rick A. Laguerre, Janet L. Barnes-Farrell

Management Faculty Research and Publications

Self-determination theory (SDT) is widely used in human resource (HR) practice studies to explain how HR practices impact work outcomes. However, there is little empirical evidence establishing the complete SDT mediational process in the HR domain, which entails basic psychological needs and motivation acting as mediators of relations between HR practices and work outcomes. The present study addresses this issue with a mixed methods approach. Using an item classification task with subject matter experts (N = 48), HR practices were classified as autonomy-, competence-, and relatedness-supportive. Based on this scheme, we tested an SDT-based conceptual model in a three-wave …

Graduate Catalog 2025-2026, Southwestern Oklahoma State University

Graduate Catalogs

No abstract provided.

Protocol For Development And Validation Of An Early Intervention Device And Its Influence Using Structured Early Physiotherapy (Preemiestep) Intervention On Neuromotor Development In Preterm Infants, Indira D. B. Naidu Boddapati, Sivakumar Gopalakrishnan, Sonia Khurana, Jayashree Purkayastha, Bhaskar Bhatt, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Early physiotherapy interventions for Moderate to Late Preterm (MLP) infants often lack continuity of care from hospital to home settings. This research aims to develop an Early Intervention (EI) device for home program and determine its influence using STructured Early Physiotherapy (Preemie STEP) intervention in MLP infants. For phase I, qualitative interviews will be conducted with healthcare professionals and parents, to understand user needs on developed prototype. Based on identified needs, an EI device will be developed using a human-centered design approach and iterative design process. In phase II, usability and validity of EI device will be …

Functional Outcome Of Radial Head Replacement And Lateral Ulnar Collateral Ligament (Lucl) Repair In Terrible Triad Injuries Of The Elbow: Can Associated Type I Coronoid Fractures Be Neglected?, Ansarul Haq Lone, Azad Ahmad Shah, Nadeem Ali, Imtiyaz Hussain Dar

Digital Journal of Clinical Medicine

Introduction: Type III coronoid fractures associated with terrible triad injuries of the elbow joint should always be stabilized. However, management of type I and type II fractures is debatable. In this study, we evaluate the functional outcome of neglecting type I coronoid fractures associated with terrible triad injury.

Methods: This prospective study was conducted on 20 patients with a type I coronoid fracture in terrible triad fracture dislocations of the elbow. All the patients were managed by radial head replacement and repair of the lateral collateral ligament without any fixation of the coronoid fracture. All the patients were evaluated clinically …

Adult Attention Deficit Hyperactivity Disorder: A Case Report, Anju Abraham, Kishor M, Bhawna Sharma

Digital Journal of Clinical Medicine

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that manifests in both childhood and adulthood. It is characterized by core symptoms such as inattention, hyperactivity and impulsiveness and impairment persisting into adulthood. Adult ADHD often coexists with other disorders including mood disorders, anxiety disorders, and substance use disorders, which complicate its diagnosis. Adults with ADHD may struggle with difficulties in focusing, organization, planning and impulsivity making it hard to sit still during exams or complete tasks efficiently. Restlessness, verbal outbursts and intrusiveness can strain relationships. These challenges impact academics, interpersonal relationships and daily functioning. Thus, there is a need …

Havana Syndrome: A Scientific Review Of An Unresolved Medical Mystery, Aishik Dutta

Digital Journal of Clinical Medicine

Background

Since 2016, U.S. and Canadian officials have reported Anomalous Health Incidents (AHIs), or "Havana Syndrome," characterised by a strange sensory experience followed by chronic neurological, cognitive, and vestibular issues. The cause is intensely debated, with primary hypotheses pointing to either psychosocial factors or a directed-energy weapon, creating a significant medical and geopolitical puzzle.

Methods

This review critically assesses the current evidence by analysing peer-reviewed clinical studies and major institutional reports.

Results

The findings are deeply contradictory. A 2020 NASEM report identified directed, pulsed radiofrequency energy as the most plausible mechanism for a core set of symptoms. Conversely, comprehensive 2024 …

Whipple’S Procedure Under Combined Segmental Spinal And Epidural Anesthesia With Enhanced Recovery: A Case Report, Abhirami Ravindran, Imran Ahmed Khan, Naresh Wamanrao Paliwal

Digital Journal of Clinical Medicine

The Whipple’s procedure (pancreaticoduodenectomy), is a complex surgery performed for various indications, usually under general anesthesia (GA). However, GA carries a significant perioperative risk, especially in patients with comorbidities. Combined segmental spinal and epidural anesthesia (CSSE) with low doses of local anesthetics and adjuvants may be a feasible alternative owing to hemodynamic stability, potentially reducing complications and promoting enhanced recovery.

We present a 43-year-old male with periampullary adenoma with high-grade dysplasia who underwent a Whipple’s procedure under CSSE due to high-risk features (e.g., severe jaundice, low blood pressure, and anemia) and chronic smoking and alcoholism. Thoracic epidural (T7–T8) and spinal …

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

Gender And The ‘Natural’ Environment In The Middle Ages, Edited By Theresa L. Tyers And Patricia Skinner, Danielle Allor

Medieval Feminist Forum: A Journal of Gender and Sexuality

No abstract provided.

Shaping Pakistan's Future, Sdsb 360 Magazine

Faculty Research - Newspaper and Magazine Articles

SDSB 360 is in conversation with Dr. Ishrat Husain, an influential Pakistani banker, economist, and reformer whose leadership has shaped Pakistan’s financial landscape. From steering the State Bank of Pakistan (1999–2006) to driving educational excellence as Dean of IBA Karachi (2008–2016) and championing institutional reforms as Advisor to the Prime Minister (2018–2022), Dr. Husain’s career is a testament to visionary leadership and a relentless pursuit of progress.

Her2 Alterations Across Solid Tumors: Implications For Comprehensive Testing, Ahmed Ismail, Chimay Jani, Nusrat Jahan, Malla Midhun, Arnab Basu, Garima Gupta, Bassel El-Rayes, Sejong Bae, Tyler Mattox, Cyntanna Hawkins, Rebecca C. Arend, Mehmet Akce, Yanis Boumber, Aakash Desai

Department of Medicine Faculty Publications

Purpose

ERBB2 (HER2) alterations (e.g., overexpression, amplification, and mutations) are known to drive tumor progression. These changes, particularly in non-breast and gastric/gastroesophageal cancers, remain poorly characterized. With pan-tumor approval of HER2-targeted therapies like Trastuzumab deruxetecan (T-DXd), understanding ERBB2 alterations across diverse cancers is crucial.

Methods

HER2 analysis was conducted on 653 solid tumor specimens at the University of Alabama, using immunohistochemistry (IHC), copy number (CN) variation (CNV) assessment, and mutational profiling. The correlation between CN amplification and IHC expression was evaluated using Somers' D ordinal association.

Results

Of the 653 cases, HER2 IHC scores were distributed as 3 + (3.1%), …

Analisis Pengaruh Kualitas Institusi Politik Terhadap Konsentrasi Pm2.5 Di Negara G20, Afif Dhia Pratama, Dwi Rahmayani

Jurnal Ekonomi dan Pembangunan Indonesia

This study aims to analyze the influence of political institutional quality, proxied by democracy, political globalization, and good governance, on PM2.5 concentration in G20 countries as well as prove the Environmental Kuznets Curve (EKC) Hypothesis and Pollution Halo Hypothesis (PHH) from 1998 to 2022. The Autoregressive Distributed Lag (ARDL) method is employed in this analysis. The results show that democracy reduces PM2.5 concentration only in the long run. However, good governance decreases PM2.5 concentration in the short term but increases it in the long run. Political globalization shows no significant influence on PM2.5 concentration. Furthermore, the study also revealed that …