Digital Commons Network^™

Validation Of A Scoring System To Predict Difficult Laparoscopic Cholecystectomy In A Tertiary Hospital In Saudi-Arabia: A Retrospective Study, Hazem A. Megahed, Lamiaa Z. Elmoursi, Rakan A. Al-Etebi, Nawaf M. Al-Enazi, Ahmed M. Lashin, Sarah Marie, Ahmed Taki-Eldin

Saudi Medical Journal

ABSTRACT Objectives: To confirm a preoperative scoring system devised by the Modified Randhawa Model. Methods: This retrospective study was performed in the period between October 2017 to October 2023 on every patients hospitalized for elective laparoscopic cholecystectomy in the Surgery Department, National Guard Hospital in Riyadh, Saudi Arabia. A preoperative scoring system, devised using the Modified Randhawa Model, was applied to each patient retrospectively. The preoperative score was compared to the intraoperative degree of difficulty. Results: The history of previous biliary inflammation, the impacted stone, the palpable gall bladder, the more gall bladder wall thickness, the higher body mass index …

Nutritional Knowledge Of The Phenylketonuria Diet Among Healthcare Providers In Saudi Arabia, Nouf A. Alghamdi, Rouba K. Naaman

Saudi Medical Journal

ABSTRACT Objectives: Phenylketonuria (PKU) is associated with detrimental impacts on factors contributing to the etiology of obesity, and metabolism disorders. Therefore, we hypothesized that physicians and dietitians demonstrate a sufficient level of nutritional knowledge of the PKU type diet. The aim of this study is to assess understanding of the PKU diet in relation to current guidelines among dietitians and metabolic physicians in Saudi Arabia. Methods: This study involved 238 participants, primarily Saudi and non-Saudi dietitians and metabolic physicians working in Saudi Arabia, who asked to complete an electronic questionnaire assessing their nutritional knowledge of the PKU diet. The questionnaire …

Public Engagement In Small-Town Planning: A Case Study Of The Wellsville Trails And Active Transportation Plan, Tayli R. Hillyard

All Graduate Reports and Creative Projects, Fall 2023 to Present

This thesis presents a qualitative case study of public engagement in the Wellsville Trails and Active Transportation Plan, developed in Wellsville, Utah—a small municipality with limited staff and resources. Drawing from planning literature on effective community participation, the study evaluates outreach strategies based on their reach, feasibility, and replicability. Outreach strategies in the plan’s development included surveys, stakeholder meetings, a public open house, digital tools, and informal conversations. While early outreach efforts, such as the interest survey and personal invitations, generated meaningful input, the process fell short in sustaining engagement, reaching underrepresented groups, and maintaining consistent communication. The analysis highlights …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Advancing Anesthesia Provider Proficiency In Airway Assessment Using Point-Of-Care Ultrasound: An Osce-Based Educational Initiative, Austin Fike, Trevor Jordan, Sam Sherrill Iii

Doctoral Projects

Airway management is one of the fundamental pillars of anesthesia. Traditionally, tools such as the Mallampati classification and the thyromental distance are used for airway assessment in the perioperative area. However, often, these methods fail to reliably predict difficult intubations. The use of point-of-care ultrasound (POCUS) has emerged as a valuable adjunct in airway assessment. However, a knowledge deficit exists among anesthesia providers regarding its application in airway assessments for perioperative adult patients. This doctoral project addressed the knowledge deficit in POCUS airway assessment among Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) through the development and …

Factors Shaping Data-Based Decision-Making: The Role Of Self-Efficacy, Anxiety, And School Culture In Mississippi’S State Tested Subjects, Cymone E. Bradford

Dissertations

This quantitative study examined the factors influencing Mississippi state-tested teachers’ engagement in data-based decision-making (DBDM). The purpose of the study was to explore how self-efficacy, anxiety, and school culture shape teachers’ experiences using data to guide instruction. A researcher-developed instrument measuring four constructs self-efficacy in data interpretation, anxiety related to DBDM, self-efficacy and engagement in DBDM, and school culture and DBDM was administered to Mississippi teachers of state-tested subjects. Descriptive statistics, a one-way ANOVA, correlation analysis, and multiple regression were used to analyze the data.

Results revealed significant differences in demographic characteristics of age and frequency of data use when …

The Genetic And Environmental Determinants Of Stress Resilience Across Model Systems, Carson Len Stacy

Graduate Theses and Dissertations

Survival in fluctuating environments demands that organisms effectively anticipate and respond to future challenges. This capacity is shaped by both genetic background and environmental context. In this dissertation, I apply a population aware lens to explore how genetic diversity and environmental conditions intersect to shape stress survival. Integrating functional genomics and transcriptomics in Saccharomyces cerevisiae (brewer’s yeast) and a vertebrate (common canary) system, I dissect gene-by-environment (GE) interactions that underpin resilience. First, I move beyond a single reference genome by using a pan-genomic CRISPR knockout screen to assess osmotic stress survival across diverse S. cerevisiae isolates. This analysis reveals a …

Institutional Sustainability In Ai Governance: Comparing Paths In The Eu, Japan, And Taiwan, Kuan-Wei Chen

Yearbook of Antitrust and Regulatory Studies

This article explores the concept of institutional sustainability in AI governance by comparing the approaches in the European Union, Japan, and Taiwan. It begins by arguing that the relationship between AI and sustainability extends beyond environmental concerns, encompassing the sustainability of governance institutions themselves. The article posits that institutional sustainability, referring to the capacity of governance frameworks to remain effective over time, is essential in the context of rapidly evolving and future-oriented AI governance. The analysis proceeds by examining the EU’s strategy of normative anchoring through legal codification, Japan’s agile governance model based on collaboration and coordination, and Taiwan’s digital …

Development And Optimization Of Moxifloxacin Solid Lipid Nanoparticles Via Double Emulsion Organic Solvent Free Technique Applying Box–Behnken Experimental Design, Esraa M. Elshazly, Mona G. Arafa, Samia A. Nour

Pharmacy

The current research proposes the preparation of Moxifloxacin-loaded solid lipid nanoparticles through a solvent-free double emulsion technique, to overcome chronic wound healing limitation. The independent variables: stearic acid, Span 80, and Tween 80 were optimized via Box–Behnken design, based on entrapment efficiency (EE%), zeta potential (ZP), and particle size (PS). To statistically optimize the formulation variables, a three-factor, three-level (3³) design involving 15 runs was employed and optimization was carried out to attain maximum EE% and ZP and minimum PS yielding an overall desirability of 0.851. Results indicated that increasing stearic acid enhanced EE%, Span 80 increase PS, and Tween …

‘Boomers’ And ‘Gen Zs’: More Alike Than You’D Think, Michelle C. Dziurgot

The Journal of the Michigan Dental Association

This month's editorial compares Baby Boomer (born 1946–1964) and Generation Z (born 1997–2012) members of the MDA, highlighting unexpected similarities. Both generations share a strong dedication to hard work, social justice, and pride in MDA membership. They also both experienced economic downturns (Boomers: 70s/early 80s recessions; Gen Z: 2008-09 Great Recession), leading them to be cautious with savings. Although communication methods differ (Boomers prefer phone calls, Gen Z prefers texting), both desire concise conversations. They also share traditional goals like marriage, family, and a strong desire for financial security and home ownership.

Impact In Action: Your Michigan Dental Association Foundation, Anne Berquist

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) Foundation, a 501(c)3 non-profit, works to promote better dental health and support the future dental workforce through educational scholarships. The Foundation’s impact is increasing yearly, evidenced by a 42% increase in scholarship awards in 2024, providing $44,000 to 15 recipients. It also provides grants to statewide organizations delivering dental care to uninsured, impoverished, and underserved populations, awarding $141,500 in 2025. A high-profile program is the biannual Michigan Mission of Mercy (MOM), which provided over $1.1 million in donated care in Flint in 2024. Support is generated through various fundraisers, including the Year-End Fundraising Campaign.

Intrinsic Disinfection Byproducts In Free Chlorine And Chloramine Systems: Formation Of Chlorite, Chlorate, Perchlorate, And Chloronitramide Anion, Julian L. Fairey, Ashley D. Pifer, David G. Wahman

Civil Engineering Faculty Publications and Presentations

Intrinsic disinfection byproducts are formed by reactions between disinfectant species and/or their decomposition products. In this review, we focus on a subset that accumulates in free chlorine and chloramine drinking water systems. First, we review the sequential formation of chlorite, chlorate, and perchlorate in hypochlorite feedstocks. Model simulations indicate chlorate and perchlorate can accumulate under realistic dosing conditions and can be managed with less concentrated feedstocks and climate-controlled storage. Second, we review the formation pathways of dichloramine and chloronitramide anion. Chloronitramide anion accumulation may be mitigated by increasing monochloramine stability and quenching reactive nitrogen species in its formation pathway.

Impact Of Intravenous Drug Use On Neck Abscess Outcomes: 30-Day Readmission & 5-Year Survival Rates, Elliott Sina, Bryce Hambach, Eric Mastrolonardo, Sruti Tekumalla, Meghan Crippen, Richard A. Goldman

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Injection drug use (IDU) is a known risk factor for neck abscesses, often requiring urgent surgical intervention by acute-care Otolaryngologists. However, data on the prevalence and long-term outcomes of IDU-related neck abscesses are limited. This study investigates differences in 30-day readmission rates and 5-year all-cause mortality between patients with and without a history of IDU hospitalized for neck abscesses.

METHODS: This is a retrospective cohort study utilizing the TriNetX national clinical database. Patients hospitalized for neck abscesses (ICD-10: L02.11) were categorized into two cohorts: IDU (current/previous) and non-IDU. Demographics, 30-day readmission rates, and 5-year survival were analyzed. 1:1 Propensity …

Supporting The Efficacy Of Admission Counselors When Working With Neurodivergent Students: A Study For An Equitable Review Process, Rose Llanos

Graduate Student Dissertations, Theses, Capstones, and Portfolios

The focus of the study was to investigate the effectiveness of utilizing a universal design learning training module for college admission professionals to help assess student fit during the application review process. The conceptual framework in the research design followed that of the Universal Design of Learning (UDL) framework, which upholds the United Nations Sustainable Developmental Goals (UN-SDG), specifically goal four of quality education and goal 10 of reduced inequalities. The hypothesis for using an equitable training module is that an improved understanding of working with diverse students will lead to more confident admission professionals holistically recommending an admission decision …

Structural Racism And Intimate Partner Violence Perpetration Among Racially Diverse Men Transitioning Into Fatherhood: An Anti-Racist Approach To Ipv Prevention, Tiara C. Willie, Sabriya Linton, Leslie B. Adams, Nicole Overstreet, Shannon Whittaker, Theresa Faller, Deja Knight, Trace S. Kershaw

Psychology

Background: Young couples transitioning into parenthood are at elevated risk of experiencing intimate partner violence (IPV), in part, due to the social and economic stressors associated with this critical time. Interpersonal racial discrimination is a known risk factor for male-to-female IPV perpetration, however few studies have examined this relationship among men transitioning to fatherhood. Similarly, structural racism acknowledges how inequitable systems reinforce racial discrimination; yet, few studies have investigated whether structural racism relates to the discrimination-IPV perpetration association. This study examined relationships among structural racism, racial discrimination, stress, and IPV perpetration among racially diverse men transitioning into fatherhood. Methods: Using …

Study Protocol For The Rainbow Austrian Longitudinal Family (Ralf) Study: A Longitudinal, Multi-Method, Multi-Rater Investigation Of Risk And Resilience Factors In Austrian Lgbtq+ Parent Families, Betty Geidel, Magdalena Siegel, David Steryl, Abbie E. Goldberg, Guy Bodenmann, Martina Zemp

Psychology

Background: Research on LGBTQ+ parent families is evolving to include a growing range of family systems, identities, methodologies, and topics. However, studies that examine minority-specific risk and resilience factors and their associations with within-family processes remain scarce, particularly outside a US-American context. Addressing these research gaps quantitatively poses challenges for researchers, because traditional modelling techniques based on (generalized) linear models are not ideally suited to capture the complexity and intersectionality of family experiences. Within this study protocol, we introduce the Rainbow Austrian Longitudinal Family (RALF) study. Its main goal is to comprehensively investigate general and minority-specific factors that affect the …

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

Exploring Factors Informing The Choice Of Caesarean Sections Among Couples, And Healthcare Workers: A Case Of The Nairobi Hospital, Kenya, Mercy Mukubwa

MSc in Advanced Practice Midwifery

Background: A caesarean section (C/S) is a lifesaving procedure to reduce maternal and newborn morbidity and mortality. It is associated with more risks compared to a vaginal birth. The rates of C/S have been on an upward trend globally and are expected to continue to rise further. C/S predisposes neonates to poor outcomes, some of which could be life-threatening compared to vaginal birth. Similarly, C/S mothers are at greater risk for serious complications.

Objective: The primary objective of this study was to investigate the factors influencing the decision to undergo a caesarean section among couples and healthcare workers …

Lived Experiences Of Chemotherapy-Induced Nausea And Vomiting Among Patients Diagnosed With Cancer At Machakos Level Five Hospital, Nancy Njeri Kamau

MSc in Advanced Practice Nursing

Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the most prevalent and distressing adverse effects of cancer treatment, affecting a substantial proportion of patients and significantly compromising their physical functioning, nutritional status, treatment adherence, and overall quality of life. However, there is a paucity of localized evidence on the magnitude and functional burden of CINV among patients diagnosed with cancer receiving chemotherapy at county referral hospitals, such as Machakos Level 5 Hospital, hence the current study.

Aim of the study: The study aimed at exploring the lived experiences of chemotherapy induced nausea and vomiting among patients diagnosed with …

Opioids And Oblivion: Corporate Bankruptcy And The Erosion Of Accountability In Big Pharma, Ying Yuan

Washington Law Review

In June 2024, the United States Supreme Court ruled in Harrington v. Purdue Pharma that nonconsensual releases for nondebtors are unconstitutional. The decision marked a key development in mass tort litigation involving Purdue Pharma, the company at the center of the opioid crisis. The Sackler family sought to use Purdue’s bankruptcy proceedings to shield themselves from liability, but the Court’s ruling invalidated the use of nondebtor releases to protect third parties from claims without the full consent of affected parties. While the ruling strengthens creditor protections, it creates uncertainty regarding how mass tort bankruptcies can efficiently compensate victims, particularly in …

Self-Determination Through Children's Rights: Resisting The Paradoxical Pretext Of Parents' Rights Legislation, Jeremiah Chin

Washington Law Review

Washington state law balances the interests of parents and the state in education, healthcare, and the general wellbeing of children. Despite the fact that children are at the center of emerging controversies, children’s rights are rarely discussed in state legislation debating the obligations and relationships between the state of Washington and parents. In education, for example, RCW 28A.605.005 finds “[p]arents are the primary stakeholders in their children’s upbringing.” While this may be true relative to the state, it overlooks the fact that children are the primary actors, agents, and rights bearers in their own personhood. This Article therefore considers ongoing …

From The Bench To The Feed: Conflict Between Public Official Accounts And The First Amendment, Betty Yu

Washington Law Review

Imagine one day waking up, opening Facebook, and discovering that the official White House account blocked you because you left a comment expressing a viewpoint. In this case, your First Amendment right to free speech would most likely be violated. However, what happens if your local official blocks you or deletes your comments? Are your First Amendment rights violated? Well, it depends.

Historically, public officials have used public forums such as town halls to meet with citizens and answer questions. However, as social media platforms like X and Facebook have become increasingly crucial tools for communication, the distinction between personal …

Lsab Minutes December 2025, Shawna Battle, Maryke Barber

WRL: Library Student Advisory Board Minutes

No abstract provided.

Mckee Minute December 2025/January 2026, Southern Adventist University

McKee Minute – McKee Library This Month

The December 2025 McKee Minute features information on returning library materials, library apps, custom reading lists, Christmas break hours, and streaming media.

Genodermatosis Among The Southwestern Saudi Population: The Pattern And The Need For A Premarital Genetic Screening Protocol, Hamad A. Alfahaad

Saudi Medical Journal

ABSTRACT Objectives: To characterize the clinical and genetic spectrum of genodermatoses in Southwestern Saudi Arabia, the present study examines the impact of consanguinity on this particular population, and proposes a tailored premarital genetic screening protocol. Methods: A retrospective cross-sectional study of 32 patients diagnosed with genodermatoses during the study period at a tertiary hospital (King Khalid Hospital, Najran) were included. Genetic screening was performed for patients with suspected genodermatoses based on clinical findings, using whole-exome sequencing (WES), specifically employing next-generation sequencing (NGS) technology. Clinical and genetic analysis data were extracted from medical records. Results: Among 32 patients diagnosed with genodermatoses, …

Examining Public Satisfaction With The Saudi Health System: Findings From The 2019 Kingdom Of Saudi Arabia World Health Survey, Ali M. Khashab

Saudi Medical Journal

No abstract provided.

Combating Antimicrobial Resistance In Asia: A Comprehensive Review Of Strategic Action Plans, Policies, And The Role Of The Who, Saud Almawash

Saudi Medical Journal

ABSTRACT Over the past 70 years, antimicrobial resistance (AMR) has emerged as a critical public health concern in Asia. Regional challenges such as dense population, scarce resources, and diverse healthcare systems further complicate the containment efforts. To address this, Asian countries have adopted several strategies and policies. A comprehensive review of published literature was conducted to identify key policies and interventions. Findings revealed diverse approaches to AMR containment, including surveillance and monitoring systems, antibiotic stewardship programs, infection control measures, vaccination strategies, and public health awareness campaigns. However, implementation of these strategies is hindered by resource, political, and regulatory barriers. The …

Unlocking Hidden Health Risks: Exploring Community-Based Screening For Kidney Disease, Rehab B. Albakr, Fadel Alrowie, Ibrahim A. Sandokji, Omar A. Alshammari, Hadeel A. Mitwalli, Hamood Alsudais, Abdulaziz B. Albacker, Mohamad-Hani Temsah, Ahmed H. Mitwalli, Khalid A. Alhasan

Saudi Medical Journal

ABSTRACT Objectives: To conduct a community-wide screening of the Saudi population for chronic kidney disease risk factors. Methods: This study utilized a non-selective, exploratory point-of-care screening approach involving 215 participants in Riyadh, Saudi Arabia, during a kidney disease awareness campaign for World Kidney Day in March 2022. Participants were randomly selected, and their estimated glomerular filtration rates (eGFRs) were measured to assess kidney function. Results: The findings revealed that 4% of participants had eGFRs less than 60 mL/min/1.73 m², 34% had eGFRs between 60 and 90 mL/min/1.73 m², and the rest had eGFRs over 90 mL/min/1.73 m². Key risk factors …

Staff Matters: How To Get Creative With Staff Benefit Offerings, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

Small practices must be intentional and creative with benefits to distinguish themselves in the competitive labor market. Strategies include offering Individual Coverage Health Reimbursement Arrangements (HRAs) or covering dental/vision care. Work-life balance benefits are highly valued, such as flexible scheduling, additional paid time off beyond the state-mandated Earned Sick Time Act, or time off for birthdays. Practices should consider financial wellness options like retirement savings plans or student loan repayment assistance. Professional development, like covering certifications and offering mentorship, is crucial. Using platforms like TASC or Fringe to provide flexible "lifestyle" benefits allows employees to choose perks that matter most …