Digital Commons Network^™

A Staff Education Project For Administration Of Phq-9 To Adult Patients In The Emergency Department, Jessica Leigh Ionno

Walden Dissertations and Doctoral Studies

Depression is a global healthcare crisis impacting millions worldwide. In the United States, over 8% of adults experience depression, leading to significant disability and increased healthcare costs. Many individuals with depression seek initial treatment in emergency departments (EDs). This project aims to reduce the burden of depression by training ED nurses to identify at-risk patients early and provide timely interventions and referrals. Benefits include improved patient outcomes, decreased healthcare costs, and social change to address the mental health crisis. Utilizing Malcolm Knowles’ adult learning theory, the project emphasizes collaborative learning relevant to the clinical setting. The partner site is a …

Using Triangulation And Crystallization To Make Qualitative Studies Trustworthy And Rigorous, Hani Morgan

The Qualitative Report

Qualitative research is often criticized for lacking rigor and consisting of opinions that result from researcher bias. But like well-designed quantitative research, qualitative studies can be trustworthy. Qualitative researchers generally agree that some practices, such as triangulation, can be used to increase the credibility of the kind of research they conduct. Unfortunately, many researchers are confused about or unaware of the different types of triangulation strategies, leading them to write papers without accurately identifying which ones they used. Triangulation is also a contested approach for many qualitative researchers because it is oftentimes associated with a post-positivist paradigm. Unlike quantitative researchers, …

Parg Is Essential For Polθ-Mediated Dna End-Joining By Removing Repressive Poly-Adp-Ribose Marks, Umeshkumar Vekariya, Leonid Minakhin, Gurushankar Chandramouly, Mrityunjay Tyagi, Tatiana Kent, Katherine Sullivan-Reed, Jessica Atkins, Douglas Ralph, Margaret Nieborowska-Skorska, Anna-Mariya Kukuyan, Hsin-Yao Tang, Richard T. Pomerantz, Tomasz Skorski

Department of Biochemistry and Molecular Biology Faculty Papers

DNA polymerase theta (Polθ)-mediated end-joining (TMEJ) repairs DNA double-strand breaks and confers resistance to genotoxic agents. How Polθ is regulated at the molecular level to exert TMEJ remains poorly characterized. We find that Polθ interacts with and is PARylated by PARP1 in a HPF1- independent manner. PARP1 recruits Polθ to the vicinity of DNA damage via PARylation dependent liquid demixing, however, PARylated Polθ cannot perform TMEJ due to its inability to bind DNA. PARG-mediated de-PARylation of Polθ reactivates its DNA binding and end-joining activities. Consistent with this, PARG is essential for TMEJ and the temporal recruitment of PARG to DNA …

Chronic Eosinophilic Leukemia With A Novel Jak1 Mutation Responds Well To The Jak1/2 Inhibitor Ruxolitinib, Qing Wei, Jie Xu

Faculty, Staff and Student Publications

No abstract provided.

Emerging Biomedical And Clinical Applications Of 3d-Printed Poly(Lactic Acid)-Based Devices And Delivery Systems, Allan John R Barcena, Prashanth Ravi, Suprateek Kundu, Karthik Tappa

Faculty, Staff and Student Publications

Poly(lactic acid) (PLA) is widely used in the field of medicine due to its biocompatibility, versatility, and cost-effectiveness. Three-dimensional (3D) printing or the systematic deposition of PLA in layers has enabled the fabrication of customized scaffolds for various biomedical and clinical applications. In tissue engineering and regenerative medicine, 3D-printed PLA has been mostly used to generate bone tissue scaffolds, typically in combination with different polymers and ceramics. PLA's versatility has also allowed the development of drug-eluting constructs for the controlled release of various agents, such as antibiotics, antivirals, anti-hypertensives, chemotherapeutics, hormones, and vitamins. Additionally, 3D-printed PLA has recently been used …

Implementation Of A Standardized Nursing Handoff In A Pediatric Intensive Care Unit, Tori Keeven

Dissertations

Handoff communication is critical in healthcare and is associated with patient safety outcomes. Various tools and interventions are available to improve handoff communication as inadequate communication contributes to medical errors, patient adverse events, and increased mortality. The implementation of a standardized handoff tool has been shown to be effective. Findings revealed a significant 60% reduction in reported patient harm events, despite the study's limited sample size and lack of statistical significance (p = .614). Challenges such as low utilization (18.62%) were attributed to concerns about tool organization, spatial constraints, and staff resistance to change. Recommendations include refining the tool to …

Staff And Provider Perspectives On A Low-Barrier Buprenorphine Program In Portland, Maine, Emily Follo

Integrative Learning Experience (ILE) Theses

Background: Homelessness and opioid use disorder are at the forefront of public health issues in Maine. Substance use accounts for a higher proportion of deaths among those experiencing homelessness than it does in the overall population. In 2022, Maine ranked third in the U.S. for fatal overdoses involving opioids. The clinic at the center of this evaluation is a low-barrier buprenorphine bridge program serving people experiencing homelessness that provides same-day prescriptions and other supports, while connecting patients to ongoing care for substance use disorder. Methods: This was a qualitative program evaluation that used semi-structured key informant interviews. The evaluation focused …

Emergent Emm4 Group A Streptococcus Evidences A Survival Strategy During Interaction With Immune Effector Cells, Chioma M Odo, Luis A Vega, Piyali Mukherjee, Sruti Debroy, Anthony R Flores, Samuel A Shelburne

Faculty, Staff and Student Publications

The major gram-positive pathogen group A Streptococcus (GAS) is a model organism for studying microbial epidemics as it causes waves of infections. Since 1980, several GAS epidemics have been ascribed to the emergence of clones producing increased amounts of key virulence factors such as streptolysin O (SLO). Herein, we sought to identify mechanisms underlying our recently identified temporal clonal emergence among emm4 GAS, given that emergent strains did not produce augmented levels of virulence factors relative to historic isolates. By creating and analyzing isoallelic strains, we determined that a conserved mutation in a previously undescribed gene encoding a putative carbonic …

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Arturo Serize, Jorge Perez

All Publications

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

National Narcotics Policy Influence On Youth Substance Abuse In Yendi, Ghana, Imran Abdel-Rahman Gomdah

Walden Dissertations and Doctoral Studies

Possession of small quantities of narcotics for personal use in Ghana could result in years in detention under the Narcotic Drugs Law of 1990, with youth constituting a large number of offenders. The government proposed a drug policy change in 2017 as the prevailing one failed to achieve its goals even with such stringency, resulting in Act 1019’s adoption in May 2020 as a new national drug policy to replace the Narcotic Drugs Law of 1990. The purpose of this generic qualitative study was to assess public perception of the impact of the new policy on the incidences of youth …

Modeling Interprofessional Excellence Transforming Medical Education For Collaborative Care, Kerry Miller, Paige Hardy, Neil Kalsi, Nathan Gollehon, Brianna Brei, Jason Burrows, Liliana Bronner

Posters and Presentations: Family Medicine

In our medical school, we designed an innovative interprofessional education (IPE) experience to prepare medical students for collaborative healthcare. Through a family-centered NICU high-risk follow-up clinic, students observed and engaged with a diverse team, including a developmental specialist, neonatal nurse practitioner, physician, and nurse. We developed a rubric based on the four IPEC competencies, evaluating students’ understanding before and after the rotation. Results from 118 participants showed significant improvement (p < .001) across competencies, with large effect sizes (Cohen's d: 1.02 to 2.14). This experience highlights the effectiveness of clinical modeling in enhancing interprofessional practice skills among medical students.

Disappearing Dysphagia And The Spontaneous Intraesophageal Hematoma, A Wayne Wheeler, Stephen Landreneau

School of Medicine Faculty Publications

No abstract provided.

Reflections On The Past, Present, And Potential Futures Of Knowledge Hierarchies In Ocean Biodiversity Governance Research, Holly J. Niner, David Wilson, Kelly Hoareau, Mia Strand, Jennifer Whittingham, Dylan Mcgarry, Bolanle Erinosho, Sulley Ibrahim, Sirkka Tshiningayamwe, Senia Febrica, Alana Malinde S. N. Lancaster, Milica Prokic

School of Biological and Marine Sciences

Governance of the ocean and its biodiversity is deeply entangled within social, political and cultural histories. The evolution of marine science has been subject to similar influences, and we (the authors) consider these factors to create, embed and reinforce knowledge hierarchies in ocean governance processes and associated research that set societal patterns of prioritisation and exclusion. Such knowledge hierarchies have constructed dominant Western-oriented knowledge systems as ‘rational’ and ‘objective’ approaches to environmental governance in contrast to non-Western knowledge systems and have led to a dominance of natural (normal) sciences over centralised biodiversity governance. The extraction and incorporation of traditional knowledge …

Clonal Hematopoiesis Driven By Mutated Dnmt3a Promotes Inflammatory Bone Loss, Hui Wang, Kimon Divaris, Bohu Pan, Xiaofei Li, Jong-Hyung Lim, Gundappa Saha, Marko Barovic, Danai Giannakou, Jonathan M Korostoff, Yu Bing, Souvik Sen, Kevin Moss, Di Wu, James D Beck, Christie M Ballantyne, Pradeep Natarajan, Kari E North, Mihai G Netea, Triantafyllos Chavakis, George Hajishengallis

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) arises from aging-associated acquired mutations in hematopoietic progenitors, which display clonal expansion and produce phenotypically altered leukocytes. We associated CHIP-DNMT3A mutations with a higher prevalence of periodontitis and gingival inflammation among 4,946 community-dwelling adults. To model DNMT3A-driven CHIP, we used mice with the heterozygous loss-of-function mutation R878H, equivalent to the human hotspot mutation R882H. Partial transplantation with Dnmt3a

Intrinsically Disordered Membrane Anchors Of Rheb, Rhoa, And Diras3 Small Gtpases: Molecular Dynamics, Membrane Organization, And Interactions, Chase M Hutchins, Alemayehu A Gorfe

Faculty, Staff and Student Publications

Protein structure has been well established to play a key role in determining function; however, intrinsically disordered proteins and regions (IDPs and IDRs) defy this paradigm. IDPs and IDRs exist as an ensemble of structures rather than a stable 3D structure yet play essential roles in many cell-signaling processes. Nearly all Ras superfamily GTPases are tethered to membranes by a lipid tail at the end of a flexible IDR. The sequence of the IDR is a key determinant of membrane localization, and interaction between the IDR and the membrane has been shown to affect signaling in RAS proteins through the …

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Erin Thorpe, Taylor Williams, Chad Shaw, Evgenii Chekalin, Julia Ortega, Keisha Robinson, Jason Button, Marilyn C Jones, Miguel Del Campo, Donald Basel, Julie Mccarrier, Laura Davis Keppen, Erin Royer, Romina Foster-Bonds, Milagros M Duenas-Roque, Nora Urraca, Kerri Bosfield, Chester W Brown, Holly Lydigsen, Henry J Mroczkowski, Jewell Ward, Fabio Sirchia, Elisa Giorgio, Keith Vaux, Hildegard Peña Salguero, Aimé Lumaka, Gerrye Mubungu, Prince Makay, Mamy Ngole, Prosper Tshilobo Lukusa, Adeline Vanderver, Kayla Muirhead, Omar Sherbini, Melissa D Lah, Katelynn Anderson, Jeny Bazalar-Montoya, Richard S Rodriguez, Mario Cornejo-Olivas, Karina Milla-Neyra, Marwan Shinawi, Pilar Magoulas, Duncan Henry, Kate Gibson, Samuel Wiafe, Parul Jayakar, Daria Salyakina, Diane Masser-Frye, Arturo Serize, Jorge E Perez, Alan Taylor, Shruti Shenbagam, Ahmad Abou Tayoun, Alka Malhotra, Maren Bennett, Vani Rajan, James Avecilla, Andrew Warren, Max Arseneault, Tasha Kalista, Ali Crawford, Subramanian S Ajay, Denise L Perry, John Belmont, Ryan J Taft

Center for Medical Ethics and Health Policy Staff Publications

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

The Symbiosis Of Volunteerism: A Story Of One Academic Library Welcoming Volunteers, Shan Martinez

The Christian Librarian

Although public and school libraries, as well as many non-profit organizations regularly utilize volunteers, academic libraries are less likely to welcome them. This article describes the variety of volunteers received at Brown Library of Abilene Christian University and the tasks that they perform. It also presents a discussion of the motivation to accept volunteers, perhaps a faith practice.

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Erin Thorpe, Marwan Shinawi, Et Al.

2020-Current year OA Pubs

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

Dual-Localized Pptc7 Limits Mitophagy Through Proximal And Dynamic Interactions With Bnip3 And Nix, Lianjie Wei, Mehmet Oguz Gok, Jordyn D Svoboda, Keri-Lyn Kozul, Merima Forny, Jonathan R Friedman, Natalie M Niemi

2020-Current year OA Pubs

PPTC7 is a mitochondrial-localized phosphatase that suppresses BNIP3- and NIX-mediated mitophagy, but the mechanisms underlying this regulation remain ill-defined. Here, we demonstrate that loss of PPTC7 upregulates BNIP3 and NIX post-transcriptionally and independent of HIF-1α stabilization. Loss of PPTC7 prolongs the half-life of BNIP3 and NIX while blunting their accumulation in response to proteasomal inhibition, suggesting that PPTC7 promotes the ubiquitin-mediated turnover of BNIP3 and NIX. Consistently, overexpression of PPTC7 limits the accumulation of BNIP3 and NIX protein levels, which requires an intact catalytic motif but is surprisingly independent of its targeting to mitochondria. Consistently, we find that PPTC7 is …

Combination Of Dual Jak/Hdac Inhibitor With Regorafenib Synergistically Reduces Tumor Growth, Metastasis, And Regorafenib-Induced Toxicity In Colorectal Cancer, Prachi Bajpai, Moh'd Khushman, Et Al.

2020-Current year OA Pubs

BACKGROUND: Treatment with regorafenib, a multiple-kinase inhibitor, to manage metastatic colorectal cancers (mCRCs) shows a modest improvement in overall survival but is associated with severe toxicities. Thus, to reduce regorafenib-induced toxicity, we used regorafenib at low concentration along with a dual JAK/HDAC small-molecule inhibitor (JAK/HDACi) to leverage the advantages of both JAK and HDAC inhibition to enhance antitumor activity. The therapeutic efficacy and safety of the combination treatment was evaluated with CRC models.

METHODS: The cytotoxicity of JAK/HDACi, regorafenib, and their combination were tested with normal colonic and CRC cells exhibiting various genetic backgrounds. Kinomic, ATAC-seq, RNA-seq, cell cycle, and …

Digital Critical Pedagogy: A Collaborative Narrative Literature Review, Ashley Hinck, Lauren Angelone, Ashley Theuring, Karin Admiraal, Jody Googins, Teresa Young, Wendy Maxian

Mid-Western Educational Researcher

At the intersection of an ongoing global pandemic and equity-focused social movements, critical and digital pedagogies became both necessary and important. Digital ways of teaching made education possible when we could not be in person, and provided alternative modes of learning and thinking, but also exacerbated existing inequalities. In this project, we engage in a narrative literature review to examine how digital critical pedagogy (DCP) has been encountered and framed in higher education pedagogy research from 2020-2022. We ask the question: How is DCP being defined, operationalized, and enacted in the emerging research literature? We argue that the analysis of …

Sampling Potential Hydrologic Impacts From An Underground Fire Lit By The Gray Road Fire, West Medical Lake, Isaac T. Dunmore

2024 Symposium

Eastern State Hospital (ESH) dumped and buried construction related material along the south west shores of West Medical Lake. Based on aerial photos from 1957, the dump was established with pine trees growing on the landfill. The dump is approximately 400 feet long, 50 ft wide and about 30 ft deep or about 6000,00 cubic feet of material. On August 18, 2023, during the Gray Road Fire, the buried site was ignited and has since continued to burn underground. Department of Health Services hired a consultant to analyze soils from the dump using the TCLP method for standard RCRA metals …

Cultivating Leadership: Female Leaders In The Royal Bahamas Defense Force, Jason Styles, Lisa Knowles, Kutisha Ebron

The Journal of Values-Based Leadership

Lessons learned from the impact of COVID-19 have significant implications on crisis management for those serving in the military. Leadership must bear the full brunt of directing subordinates while addressing the crisis at hand. So how do we learn from those volatile, uncertain, complex, and ambiguous (VUCA) situations that arise with no notice? Even more so, those in leadership positions in military branches are instrumental as first responders coming to the national aid of their people. Females continue to enter nontraditional occupational roles, including joining the ranks of leadership in military organizations. This is true in the Royal Bahamas Defense …

Rupert Murdoch: Altruism Inverted, Elizabeth Summerfield

The Journal of Values-Based Leadership

American entrepreneur, television producer, media owner and philanthropist, Ted Turner, once described Rupert Murdoch as “the most dangerous man in the world” (Beahm, 1). This is not an unusual judgement. But it is also one which may contribute to sustaining the Murdoch “brand”, his notoriety and appeal to supporters.

This article examines the deep origins of Murdoch’s cynical worldview, and the source of an ambition that drove him from ownership of a small provincial Australian newspaper to global media mogul. What compelled the need to disseminate often dangerously divisive views on as large a stage as possible, while purporting to …

Changes In Values And Perception Of Life: Natural Disaster Devastates A Mountain Community, Sharifullah Baig, Abida Begum

The Journal of Values-Based Leadership

The mountain communities of Karakorum and the Himalayas in Pakistan are frequently experiencing climate change-induced natural disasters, which are inflicting irreparable losses to their generation's old value system and socio-economic life. Focusing on the value system, this small-scale study explored the change in values and perceptions of a disaster-affected mountain community about natural hazards and its implications for their future lives. Twenty participants from the affected community, including local political activists, religious leaders, teachers, and youth activists, were thoroughly interviewed. The study explored significant deviations from their traditional values of connectedness to each other and with their ancestors' land. The …

A Story Of Resiliency And Success: Beyond The Native American Boarding School, Ritch Eich

The Journal of Values-Based Leadership

No abstract provided.

Remote Work: How Leaders Impact Employee Wellbeing, Russ Carfagno, Jonas Strömbäck, Cheryl Joyner, Gilbert Franco

The Journal of Values-Based Leadership

Leaders face many challenges in motivating team members including maintaining remote workers' sense of organizational inclusion. Remote work and flexible working arrangements (FWA) have increased the complexity. Flexible working arrangements (FWA) provide value to employees and may help with work-life balance yet FWA can create employee loneliness and contribute to higher turnover. This quantitative study looked at whether leadership behavior affected remote workers’ loneliness, and the intention to quit. An online survey was conducted through LinkedIn sampling 92 adults who worked remotely at least 20 hours per week in the United States. The study found that the leader-member relationship does …

Employees Speak Up: Engaging Voices From The Human Services Field, Henry J. Davis, Janna C. Heyman, Linda White-Ryan, Dana Marlowe

The Journal of Values-Based Leadership

This qualitative study aims to understand the perceptions and experiences of human services professionals working within urban communities with respect to their work experiences, compensation, and work-life balance. Focus groups were used to collect data from direct service staff and executive leadership from diverse agencies. This study examined the words and stories, generating the following overarching themes: (1) dedication to agency model and communities served; (2) compensation and responsibilities; (3) reality of work-life balance; and (4) desire for professional growth and personal growth. The results show that while employees expressed personal fulfillment with their work, the issues of compensation, workload, …

The Leader As Life Coach — A Transformative Leadership Perspective, Cam Caldwell

The Journal of Values-Based Leadership

The focus of this paper is on the need for organizations to address the failures of ineffective leadership by adopting a transformative leadership perspective and incorporating seven roles of a Life Coach to encourage, support, and assist employees as they guide them in achieving organizational objectives and excelling personally and professionally. The paper begins by explaining what is meant by a transformative leadership perspective and identifies why that approach to leading organizations is so important. Describing seven roles of the Life Coach, the paper explains how these roles enhance individual and organization performance and offers practical insights for leaders seeking …

Leadershift Today: Balancing Ego And Altruism, Joan F. Marques

The Journal of Values-Based Leadership

This article addresses a behavioral dichotomy that seems to be a prerequisite in proper leadership performance in today’s world, especially in organizational settings that cultivate a culture of wellness and reciprocal progress. While the involved concepts - ego and altruism - are generally familiar human traits, the need for a shift from one to the other once leadership has been attained, has not been discussed as such before. This article therefore aims to evoke within leaders the awareness of the need to shift their mindset, and therefore their behavior, from ego-driven to collective-focused once elevated into a leadership position. The …