Digital Commons Network^™

Exploring Hepatic Stellate Cell-Driven Fibrosis: Therapeutic Advances And Future Perspectives, Alka Singh, Ansab Akhtar, Prashant Shukla

School of Medicine Faculty Publications

BACKGROUND AND PURPOSE: Liver fibrosis, a progressive liver disease arising from viral or metabolic causes, poses a major global health challenge due to its potential progression to cirrhosis and hepatocellular carcinoma. Due to the complex aetiology and epidemiology of liver fibrosis, most therapies fail in the clinic, and very few drugs have been approved by the US FDA. APPROACH: This review highlights the pathophysiological features of liver fibrosis, with a focus on novel targets in hepatic stellate cells (HSCs), key players in the fibrogenesis process, to develop successful therapeutic approaches using both pharmacological agents and active targeting strategies. The review …

The Impact Of The Implementation Of A Code Lavender Stress Management Program On Post-Surgical Critical Care Nurses’ Stress, Solange Ngoundjou

Student Scholarly Projects

Practice Problem: Post-surgical critical care nurses face a variety of stressful events when providing patient care. And there is a strong relationship between job stress, provision of patient care, patient satisfaction, and the overall well-being of the organization.

PICOT Question: For post-surgical critical nurses who are part of a stressful event (P), do evidence-based stress management strategies (I) compared to the current practice (C), reduce stress (O) within 8 weeks (T)?

Evidence: The evidence that guided this project change is based on John Hopkins’ nursing evidence-based practice model, and Lewin’s Change theory.

Intervention: The Code Lavender …

Artificial Ignorance: Understanding The Role Of Ai In Modern Agnotology, Amit Ray, Michael Nolan

Articles

This paper explores the concept of agnotology, the deliberate production of ignorance, within the context of modern scientific endeavors, particularly in the corporate and technological sectors. It examines how industries use various tactics to manipulate public understanding of scientific issues, often to protect profits and limit liability. The rise of private sector funding and the increasing reliance on technologies like AI and machine learning have exacerbated this process by making scientific inquiry more opaque and less accountable. Ultimately, we argue that as knowledge production becomes more entangled with corporate interests and technological systems, traditional methods of oversight and regulation are …

Gated Recurrent Unit With Decay Has Real-Time Capability For Postoperative Ileus Surveillance And Offers Cross-Hospital Transferability, Xiaoyang Ruan, Sunyang Fu, Heling Jia, Kellie L Mathis, Cornelius A Thiels, Schaeferle M Gavin, Patrick M Wilson, Curtis B Storlie, Hongfang Liu

Faculty, Staff and Student Publications

Background: Ileus, a postoperative complication after colorectal surgery, increases morbidity, costs, and hospital stays. Assessing risk of ileus is crucial, especially with the trend towards early discharge. Prior studies assessed risk of ileus with regression models, the role of deep learning remains unexplored.

Methods: We evaluated the Gated Recurrent Unit with Decay (GRU-D) for real-time ileus risk assessment in 7349 colorectal surgeries across three Mayo Clinic sites with two Electronic Health Record (EHR) systems. The results were compared with atemporal models on a panel of benchmark metrics.

Results: Here we show that despite extreme data sparsity (e.g., 72.2% of labs, …

Factors Influencing Covid-19 Vaccine Uptake Among Vulnerable Communities In Texas: Perceptions Of 2-1-1 Helpline Callers, Lara S Savas, Paula Cuccaro, Kehe Zhang, Rodrigo Hernandez, Meghan E Haffey, Belinda Reininger, Anais Mendiola, Olivia Dominguez, Maribel Sifuentes, Cici Bauer, Maria E Fernandez

Faculty, Staff and Student Publications

Background: Vaccination effectively and safely prevents serious illness from coronavirus disease 2019 (COVID-19). This study examines the complex factors associated with vaccination uptake among economically disadvantaged adults calling the Texas/United Way 2-1-1 helpline. Results informed the development of strategies to increase COVID-19 vaccine uptake among vulnerable populations disproportionately impacted by COVID-19-related morbidity and mortality.

Material and methods: We conducted a cross-sectional survey among 2-1-1 adult callers (May 2021-September 2022). The survey examined demographic, sociocultural, healthcare access, and psychosocial factors, as well as mistrust in health agencies. We used multivariable logistic regression models to examine factors associated with vaccination uptake, and …

Socioecological Factors And Age Of Diagnosis For Autism Spectrum Disorder Among U.S. Children, Richline Wilson

Walden Dissertations and Doctoral Studies

As autism spectrum disorder (autism/ASD) diagnoses rise, understanding the influence of socioecological factors on the age of diagnosis among children in the United States is critical for timely intervention and improved quality of life. The purpose of this study was to examine how socioecological factors influence the age at which children are diagnosed with autism/ASD. The quantitative causal-comparative design, which was informed by Bronfenbrenner’s socioecological model, involved analysis of secondary data from the 2021 National Survey of Children’s Health (N=1416). Ordinal logistic regression analysis revealed that race and ethnicity moderated the relationship between socioeconomic status (caregiver educational and employment status …

Staff Education For Improved Diabetes Management: Enhancing Knowledge And Patient Outcomes, Carissa Martine Bolden

Walden Dissertations and Doctoral Studies

An increase in patients’ hemoglobin A1c levels in a South Mississippi organization suggests that inadequate type 2 diabetes (T2DM) knowledge among the staff hindered them from delivering competent care. The gap in practice at the site revealed a deficiency in knowledge in nutrition education for healthcare providers and staff, which led to the practice question: Does educating providers and staff on nutrition for adults with type 2 diabetes improve knowledge, as evidenced by pre- and post-surveys? This educational initiative employed the analysis, design, development, implementation, and evaluation (ADDIE) model, the John Hopkins evidence-based practice (JHEBP) model, the Walden University Doctor …

Staff Education To Enhance Nonmedical Staff Competency In Withdrawal Management, Katherine Hedrick

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a significant gap in staff training at a behavioral health residential treatment facility. Nonmedical staff, including substance abuse counselors, lacked formal education in recognizing, assessing, and escalating symptoms of substance withdrawal. This lack of competency posed a risk to patient safety, regulatory compliance, and quality of care. The goal of the project was to evaluate the impact of a structured, simulation-based training program on nonmedical staff’s knowledge and confidence in using validated withdrawal assessment tools and monitoring vital signs. Six nonmedical staff participated in the training, which incorporated lecture, hands-on simulation, and …

Effective Strategies For Mitigating Skills Gaps Postpandemic In The Automotive Industry, Neil Shah

Walden Dissertations and Doctoral Studies

Inadequate approaches to filling employee skill gaps can seriously weaken workforce stability and organizational performance. Canadian automotive sector leaders are concerned about the risk of persistent employment shortages, high employee turnover, and decreased productivity. Grounded in Alderfer's existence, relatedness, and growth theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the strategies employed by Canadian auto manufacturers to address skill shortages in their workforce in the wake of the pandemic and subsequent digitalization. Six senior executives from Canadian auto manufacturers who led successful skill-development and retention initiatives participated in semistructured interviews, complemented by a review of …

African American Men's Perceptions Of Law Enforcement, Dr. Dedrie Reshell Leonard-Francis

Walden Dissertations and Doctoral Studies

African American Black men are more likely to report unreasonable, unnecessary, and unwarranted experiences with U.S. law enforcement than men of other racial groups, and they higher mistrust toward law enforcement than any other racial group. These experiences have been described as unjustifiable due to the level of force used by police. In some cases, excessive force by law enforcement has resulted in the death of Black men. The purpose of this phenomenological study was to explore Black men’s perceptions of law enforcement and to understand their distrust. The study centered on the facilitators and barriers to Black men trusting …

Breast Cancer Survival Rates And Determinants In Ethiopia: A Systematic Review And Meta-Analysis Of Longitudinal Studies, Abenezer M. Tafese, Meseker T. Fentie, Beminate L. Seifu, Angwach A. Asnake, Bikiltu D. Dirbaba, Abdisa G. Jara, Elsabeth Tizazu Asare, Brandon George

College of Population Health Faculty Papers

BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer mortality among women in Ethiopia, accounting for 32% of new cancer cases and 17.6% of cancer deaths. Despite its growing burden, comprehensive data on survival rates and contributing factors remain limited. This systematic review and meta-analysis aimed to synthesize existing data on breast cancer survival in Ethiopia and identify key determinants influencing outcomes.

METHODS: A comprehensive systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and CINAHL to identify studies on breast cancer survival in Ethiopia published between January 2014 and August 2024. Eligible …

How Name, Image, And Likeness Has Affected Ncaa Legislation, Lauren Versteeg

Honors Thesis

This paper analyzes the impact that name, image, and likeness (NIL) has affected the National Collegiate Athletic Association (NCAA) legislation. To answer this question, I reviewed the NCAA’s website on their legislative body and rules that related to financial compensation. I also analyzed court cases about NIL that were brought against the NCAA. What I found was that NIL has been a short and recent change to the NCAA’s operations, but it has been an impactful one nonetheless. Over recent years, the legislation for NCAA has changed in order to accommodate athletes’ name, image, and likeness. A distinct outlook from …

Explicit Instruction’S Role In Phonemic Awareness And Phonics In Early Childhood Education, Sydney J. Fisher

Masters Projects

Research consistently demonstrated the impact that explicit instruction has on young children’s acquisition of phonemic awareness and phonics skills, critical foundations for later reading success. These skills are linked to achievement in reading in the upper elementary grades and beyond. Children reading below often face challenges across subject areas, and low literacy levels can limit meaningful participation in the community. This project examines research on developing phonemic awareness and phonics skills. With proper training and knowledge, teachers can improve student outcomes in these areas. However, teacher preparation programs and professional development does not adequately address these skills and how to …

Evaluating Parotid Gland Dose Between Electronic Tissue Compensation And Field In Field Treatment Techniques For Parotid Sparing In Whole-Brain Radiotherapy, Joesph E. Bodgonas

Masters Projects

Purpose:

The parotid glands are essential to salivary function and patient quality of life, yet they are not routinely prioritized as organs at risk (OARs) during whole-brain radiotherapy (WBRT). With growing recognition of long-term side effects like xerostomia in patients with prolonged survival after WBRT, parotid-sparing techniques warrant investigation. This study compares radiation dose to the parotid glands using three different 3D conformal WBRT planning approaches: field-in-field (FiF) with blocking, electronic tissue compensation (eCOMP) without blocking, and eCOMP with blocking.

Methods and Materials:

A retrospective study was conducted on 20 patients previously treated with 3D conformal WBRT. Original eCOMP plans …

A Comparative Study Of Vmat Beam Arrangements In Large Field Nodal Prostate Treatment Plans, Laura R. Black

Masters Projects

Treatment of extensive prostate and pelvic lymph node volumes for prostate cancer patients provide unique challenges related to limitations in multileaf collimator (MLC) design in many modern linear accelerators. A strategy to overcome this challenge is by restricting the field size, improving modulation as well as using overlapping arcs to ensure complete coverage of the target. Using too few arcs can result in suboptimal target coverage, while too many arcs can lead to prolonged time on the table, increasing the risk of patient movement and potential side effects that may compromise treatment accuracy. This study aims to evaluate the optimal …

Exploring Parenting Students’ Experiences With Institutional Support Using The Loss/Momentum Framework, Paula Kwok Jung

LMU Theses and Dissertations

The California Community College system serves as the primary entry point for our marginalized student populations. According to Cruse et al. (2019), approximately 22% of nontraditional students in colleges and community colleges identify as student parents. Student parents are highly motivated to succeed in their academic journey. However, due to various factors including institutional barriers and the lack of support, it was found that only 37% of all parenting students complete a degree or certificate within six years, compared to 60% of non-parenting college students (Reed et al., 2021). Research has shown that institutional actions and support play a crucial …

Integrating Ctdna Analysis And Radiomics For Dynamic Risk Assessment In Localized Lung Cancer, Everett J Moding, Mohammad Shahrokh Esfahani, Cheng Jin, Angela B Hui, Barzin Y Nabet, Yufei Liu, Jacob J Chabon, Michael S Binkley, David M Kurtz, Emily G Hamilton, Aadel A Chaudhuri, Chih Long Liu, Zhe Li, Rene F Bonilla, Alice L Jiang, Brianna C Lau, Pablo Lopez, Jianzhong He, Yawei Qiao, Ting Xu, Luyang Yao, Saumil Gandhi, Zhongxing Liao, Millie Das, Kavitha J Ramchandran, Sukhmani K Padda, Joel W Neal, Heather A Wakelee, Michael F Gensheimer, Billy W Loo, Ruijiang Li, Steven H Lin, Ash A Alizadeh, Maximilian Diehn

Faculty, Staff and Student Publications

The complementarity and clinical utility of combining liquid biopsies and radiomic image analysis has not been demonstrated. Circulating tumor DNA (ctDNA) minimal residual disease after chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) is highly prognostic, but on-treatment biomarkers are needed to enable response-adapted therapies. Here, we analyzed 418 patients with NSCLC undergoing CRT to develop and validate a novel dynamic risk model that accurately predicts ultimate progression-free survival during treatment. We optimize tissue-free variant calling from plasma samples to facilitate ctDNA monitoring and demonstrate the importance of accounting for persistent clonal hematopoiesis variants. We show that mid-CRT ctDNA concentration …

Car-Macrophage Cell Therapy: A New Era Of Hope For Pancreatic Cancer, Daoyan Wei, Liang Wang, Yi Liu, Xiangsheng Zuo, Xiling Shen, Robert S Bresalier

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest malignancies, characterized by late diagnosis, early metastasis, and resistance to conventional therapies. A major barrier to effective treatment is its desmoplastic and immunosuppressive tumor microenvironment (TME), which restricts T cell infiltration and dampens responses to immune checkpoint inhibitors (ICIs). These features highlight the urgent need for innovative immunotherapeutic strategies capable of overcoming PDAC's immunologic and physical barriers. Chimeric antigen receptor (CAR)-macrophage (CAR-M) therapy has emerged as a promising approach to address these challenges. Unlike CAR-T or CAR-NK cells, CAR-Ms can efficiently infiltrate tumors, remodel the TME, phagocytose tumor cells, and stimulate …

Depletion Of Effector Regulatory T Cells Associates With Major Response To Induction Dual Immune Checkpoint Blockade, Xianli Jiang, Nils-Petter Rudqvist, Bo Jiang, Shengbin Ye, Shan He, Qingnan Liang, Jinzhuang Dou, Michelle D Williams, Joe Dan Dunn, Jason M Johnson, Keiko Akagi, Weihong Xiao, Shaoheng Liang, Satvik Elayavalli, Baohua Sun, Edwin R Parra, Renata Ferrarotto, Adam S Garden, Clifton David Fuller, Jay Reddy, Neil D Gross, Miriam N Lango, Cheuk Hong Leung, Suyu Liu, Diane D Liu, Meng Li, J Jack Lee, Michael A Curran, Jack Phan, Ken Chen, Maura L Gillison

Faculty, Staff and Student Publications

In a phase II trial, patients with local-regionally advanced human papillomavirus-positive oropharyngeal carcinoma (n = 35) received ipilimumab (anti-CTLA4) and nivolumab (anti-PD-1) as induction immunotherapy and concurrently with radiotherapy (NCT03799445). Coprimary endpoints included 6-month complete metabolic response rate (94%) and 2-year progression-free survival (84%). Induction yielded a 46% major histopathologic response rate. Single-cell profiling revealed responders had higher baseline intratumoral CD8+ T cells with a tumor-reactive, tissue-resident memory (TRM) phenotype and a treatment-related decrease in effector regulatory T (eTreg) cells. The eTreg decrease correlated with CD8+ T-cell clonotype transitioning from TRM to effector memory and IFNG+ effector cells. …

The Role Of Leopard Spot Technique Acupuncture For Shoulder Impingement With Myofascial Pain Syndrome, Dewi Ratnasari, Sri Wahdini

Sultan Qaboos University Medical Journal

Shoulder impingement syndrome can be defined as a collection of symptoms and signs in the shoulder caused by pathology within the intrinsic or extrinsic that cause pinching in the narrowed space between the acromion and the head of the humerus. Myofascial pain yndrome can occur because of shoulder impingement syndrome. We report a 66-year-old male patient who presented with complaints of limited motion in the right shoulder area accompanied by pain to a medical acupuncture clinic in Jakarta, Indonesia, in 2024. Leopard spot technique manual acupuncture was performed at the palpable myofascial trigger point area in each therapy session. After …

Mechanistic Role Of Heavy Metals In Driving Antimicrobial Resistance: From Rhizosphere To Phyllosphere, Rahul Kumar, Tanja P. Vasić, Sanja P. Živković, Periyasamy Panneerselvam, Gustavo Santoyo, Sergio De Los Santos Villalobos, Adeyemi Nurudeen Olatunbosun, Aditi Pandit, Leonard Koolman, Debasis Mitra, Pankaj Gautam

Research Outputs: 2025-Present

Heavy metal pollution represents a pervasive environmental challenge that significantly exacerbates the ever-increasing crisis of antimicrobial resistance and the capacity of microorganisms to endure and proliferate despite antibiotic interventions. This review examines the intricate relationship between heavy metals and AMR, with an emphasis on the underlying molecular mechanisms and ecological ramifications. Common environmental metals, including arsenic, mercury, cadmium, and lead, exert substantial selective pressures on microbial communities. These induce oxidative stress and DNA damage, potentially leading to mutations that enhance antibiotic resistance. Key microbial responses include the overexpression of efflux pumps that expel both metals and antibiotics, production of detoxifying …

Lanthorn, Vol. 60, No. 01, August 4, 2025, Grand Valley State University

Volume 60, August 4, 2025 – April 20, 2026

Lanthorn is Grand Valley State's student newspaper, published from 1968 to the present.

The George-Anne Daily, Georgia Southern University

George-Anne Media Group: Newsletters & Magazines

No abstract provided.

Patient Engagement Strategies In Weight-Loss Programs, Olufunmilayo M. Bishop

Walden Dissertations and Doctoral Studies

Weight regain after pharmacological weight-loss interventions remains a pervasive challenge in primary care, with over 70% of patients reverting to baseline weight within six months. This quality improvement project aimed to enhance healthcare providers’ patient engagement skills to improve retention and long-term outcomes in weight-loss programs. A structured staff training program focusing on motivational interviewing, goal-setting, and barrier recognition was implemented among a multidisciplinary team. The program’s effectiveness was evaluated through a mixed-methods approach, incorporating quantitative pre- and post-assessment scores and qualitative staff satisfaction surveys. Results demonstrated a significant increase in staff knowledge, with average scores rising from 68% to …

Pica Syndromes And Iron Deficiency Anemia Treatment: A Mini Review, Humza Mallick, Samir Dalia

Student Publications

Background/Objectives: Pica, the compulsive ingestion of non-nutritive substances, has long been observed in patients with iron deficiency anemia (IDA). This behavior is particularly noted in adults, including pregnant women, and poses both diagnostic and management challenges. We conducted a review of studies from the past decade to evaluate the epidemiology and nature of pica in adult IDA patients and the outcome of various treatment strategies on anemia and pica behaviors. Methods: We searched PubMed, Scopus, and Cochrane Library for peer-reviewed articles (including observational studies, clinical trials, and reviews) published in English between 2015 and 2025. Inclusion criteria targeted studies of …

Hemispherotomy For Drug-Resistant Epilepsy In Bilateral Sturge-Weber Syndrome: Illustrative Cases, Eveline Teresa Hidalgo, Eric A Grin, Yosef Dastagirzada, Nealen Laxpati, Judith Bluvstein, Julia R Schneider, Daniel Miles, Michal Tzadok, James Riviello, Howard L Weiner

Faculty, Staff and Students Publications

Background: Sturge-Weber syndrome (SWS) is a congenital neurocutaneous disorder characterized by angiomas of the face, choroid, and leptomeninges. Seizures in these children often present within the first 2 years of life. SWS is typically unilateral, but bilateral SWS occurs in approximately 15% of cases. Bilateral SWS is associated with earlier seizure onset and poorer cognitive, developmental, and functional outcomes. More than half of children with SWS develop drug-resistant epilepsy requiring surgical intervention. Hemispherotomy has been established as a successful treatment for unilateral SWS, but resective surgery has traditionally not been considered a treatment option for patients with bilateral disease.

Observations: …

How Much Variance Exists Among Published Definitions Of Proximal Junctional Kyphosis? A Retrospective Cohort Study Of Adult Spinal Deformity, Tim T Bui, Karan Joseph, Alexander T Yahanda, Samuel Vogl, Miguel Ruiz-Cardozo, Camilo A Molina

2020-Current year OA Pubs

No abstract provided.

Long-Term Follow-Up Of Left Atrial Appendage Exclusion: Results Of The V-Clip Multi-Center Post-Market Study, Elias Zias, Katherine G Phillips, Marc Gerdisch, Scott Johnson, Ahmed El-Eshmawi, Kenneth Saum, Michael Moront, Michael Kasten, Chanderdeep Singh, Gautam Bhatia, Hiroo Takayama, Ralph Damiano

2020-Current year OA Pubs

No abstract provided.

Detection Of Brain Cancer Using Genome-Wide Cell-Free Dna Fragmentomes, Dimitrios Mathios, Et Al.

2020-Current year OA Pubs

UNLABELLED: Diagnostic delays in patients with brain cancer are common and can impact patient outcome. Development of a blood-based assay for detection of brain cancers could accelerate brain cancer diagnosis. In this study, we analyzed genome-wide cell-free (cfDNA) fragmentomes, including fragmentation profiles and repeat landscapes, from the plasma of individuals with (n = 148) or without (n = 357) brain cancer. Machine learning analyses of cfDNA fragmentome features detected brain cancer across all-grade gliomas (AUC = 0.90; 95% confidence interval, 0.87-0.93), and these results were validated in an independent prospectively collected cohort. cfDNA fragmentome changes in patients with gliomas represented …

An Ethanol-Induced Loss Of The Lipid Droplet-Associated Segregase Vcp/P97 Leads To Hepatic Steatosis, Sandhya Sen, Shaun Weller, Ryan J Schulze, Donglin Ding, Carol A Casey, Conrad Weihl, Mark A Mcniven

2020-Current year OA Pubs

The liver stores substantial numbers of neutral lipid organelles termed lipid droplets (LDs) that accumulate within hepatocytes in response to chronic ethanol (EtOH) consumption leading to hepatic steatosis. Mass spectrometry analysis of LDs isolated from EtOH-damaged rat livers revealed a substantial reduction in the valosin-containing protein ATPase (VCP/p97) that acts to remove targeted proteins from cellular membranes for degradation. Experimental disruption of VCP function resulted in an increase in LD content in hepatocytes and mouse livers along with a marked increase in LD-associated hydroxysteroid dehydrogenase (HSD17β13) known to contribute to hepatic steatosis. Surprisingly, treatment of hepatocytes with the proteasome inhibitor …