Digital Commons Network^™

Urinary Incontinence's Prevalence, Risk Factors, And Quality Of Life Impact On Working Women In Saudi Arabia, Ahmed Mansor, Hatim Tagalsir Osman Ali, Maha Ali, Arwa Abd Al Salam Ashry, Ghala Abdullah Alharbi, Khalid Albasheer, Omer Munder, Isam Mohamed Babbiker Ahmed

Saudi Medical Journal

Background: This study aimed to investigate the prevalence and severity of Urinary incontinence (UI) among working women in Saudi Arabia (SA), identify the associated demographic, lifestyle, medical, and obstetric risk factors, and assess its effect on quality of life and work productivity. The UI is a common underreported condition that affects women's daily functioning and life quality, particularly in the workplace. Methods: During 2025, 390 working women in SA who were at least 18 years old and from various work sectors participated in a descriptive cross-sectional survey. Data were gathered using a validated, structured questionnaire; statistical analysis was carried out …

Artificial Intelligence In Pharmaceutical Care: Transforming Drug Discovery, Development, And Patient-Care Delivery, Abdulrahman G. Alharbi, Abdulrahman A. Aljabri

Saudi Medical Journal

The integration of artificial intelligence (AI) into pharmaceutical care represents a paradigm shift in healthcare delivery, offering unprecedented opportunities to revolutionize medication management, accelerate drug development, and enhance patient outcomes. This comprehensive review synthesized evidence from global literature (2021–2025) examining AI applications across drug discovery and development, clinical trials optimization, medication therapy management, and pharmacy operations. The AI demonstrated prediction accuracies of 86–98% in drug discovery, 80% improvement in clinical trial recruitment efficiency, and 32.7% increase in medication adherence over standard care. The global AI drug discovery market, valued at \$1.5 billion (2023), is projected to reach \$11.8 billion by …

Emerging Strategies For Cardio-Renal Protection Beyond Raas Blockade: Emphasis On Non-Diabetic Ckd And Resistant Hypertension, Fahad S. Alrashidi

Saudi Medical Journal

Non-diabetic chronic kidney disease (ND-CKD) complicated by resistant hypertension remains a high-risk phenotype even when renin–angiotensin system blockade is optimized. This review synthesizes contemporary evidence for cardio-renal protection beyond traditional renin-angiotensin-aldosterone system inhibition (RAASi), with emphasis on mechanisms, clinical trial data, and pragmatic sequencing. Sodium–glucose cotransporter 2 inhibitors provide hemodynamic and tubular benefits that translate into renal and heart failure risk reduction in many patients with ND-CKD. Non-steroidal mineralocorticoid receptor antagonism (MRA) like finerenone targets inflammatory and fibrotic signaling and may add incremental benefit when potassium is proactively managed. The GLP-1 receptor agonists offer cardiometabolic advantages with emerging kidney signals, …

The Use Of Platelet-Rich Plasma For De Quervain's Tenosynovitis: A Systematic Review With Limited Meta-Analysis, Abdullah W. Abumadian, Mohanad I. Binibrahim, Abdurrahman H. Sultan, Mohammed A. Addas, Hattan Y. Bamagaus, Sultan K. Alhaddad, Motasem O. Bamabad, Bayan A. Ghalimah

Saudi Medical Journal

Introduction: De Quervain's tenosynovitis (DQT) is a painful wrist condition that impairs daily activities. Corticosteroid (CS) injections are commonly used for symptom relief, but their effects may diminish over time. Platelet-rich plasma (PRP) has emerged as a regenerative alternative that promotes tissue healing rather than merely suppressing inflammation. This systematic review and limited meta-analysis compare the efficacy and safety of PRP versus CS injections in DQT. A limited meta-analysis was chosen due to the high heterogeneity between studies (I² = 98.7%). Methodology: A comprehensive literature search identified six studies comparing PRP and CS injections. Pain and functional outcomes …

Healthcare-Associated Infection Causes And Mitigation Strategies: A Systematic Review, Mohammad Irfan, Nahed Alquwez

Saudi Medical Journal

Objective: To describe the landscape of healthcare-associated infections (HAI) and, in particular, to pay attention to the types of infection that are usually seen, the most common infectious agents involved and the effective prevention strategies. Methods: A detailed search was performed using Google and PubMed, and studies that exclusively addressed healthcare associated infections or their mitigation. Studies published since 2000 were included. Data from individual articles were extracted and categorized by study focus, type of infection, causes and contributing factors, and documented mitigation strategies. Editorials, reviews, case studies, meta-analyses, and systematic reviews were excluded. Results: The analysis showed that infections …

Clinical Outcomes Of Decompression Versus Decompression With Instrumented Fusion For Lumbar Spinal Stenosis Secondary To Degenerative Spondylolisthesis: A Systematic Review And Meta-Analysis, Lama N. Alqahtani, Ahmed K. Alzahrani, Razan A. Almutairi, Abdulaziz M. Salah, Shahad F. Khan, Mohammad G. Sindi, Khalid E. Fassi, Abdulrahman M. Alshami, Ibrahim A. Hakami

Saudi Medical Journal

Objective: To compare decompression alone with decompression with fusion in patients with degenerative lumbar spondylolisthesis. Methods: PubMed, Google Scholar, Ovid, and Web of Science databases were searched up to March 2025 for randomized controlled trials (RCTs). The primary outcomes were the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. The secondary outcomes included operative time, length of hospital stay, intraoperative blood loss, reoperation, complications, and cost. Pooled analysis was performed using a random-effects model in Review Manager following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The quality of included randomized trials was evaluated using the …

The Role Of The Nlrp3 Inflammasome In Preeclampsia And Implantation Failure: A Molecular Review, Ari Budi Suryawinata, Mariel Tania Darmayani, Listyani Suhargo

Chulalongkorn Medical Journal

The NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome is a critical multiprotein complex of the innate immune system that functions as a molecular sensor for a wide array of danger signals. While its activation is essential for host defense and tissue homeostasis, its dysregulation is increasingly implicated in the pathophysiology of numerous inflammatory disorders. This review article synthesizes the current molecular understanding of the NLRP3 inflammasome, focusing on its dual role in health and disease. We first provide a concise overview of the canonical two-step mechanism of NLRP3 activation and the intricate molecular checkpoints including genetic factors, post-translational …

Effects Of Maternal Vitamin D Supplementation During Pregnancy And Lactation On Immune Development In Offspring: A Systematic Review, Kurnia Maidarmi Handayani, Ghaniyyatul Khudri, Laura Zeffira, Widia Sari

Chulalongkorn Medical Journal

Background: Vitamin D, a fat-soluble prohormone, is essential for skeletal health and plays a key role in immune regulation. Deficiency is common among pregnant and lactating women, raising concerns as fetal and neonatal vitamin D status relies entirely on maternal stores. Insufficiency during these periods is linked to preterm birth, low birth weight, and immune-mediated disorders. This review examines the effects of maternal vitamin D supplementation on the immune development of offspring.

Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251117397). Experimental rodent studies published between 2019 and 2022 that investigated maternal vitamin …

Skip Segment Hirschsprung's Disease: Report Of A Rare Case And Literature Review, Nimmita Srisan, Paisarn Vejchapipat, Natcha Wanpiyarat

Chulalongkorn Medical Journal

We present an unusual case of skip segment Hirschsprung’s disease which was initially diagnosed with total colonic aganglionosis. A term male newborn presented with distal intestinal obstruction underwent exploratory laparotomy at three days old after ultrasound-guided contrast enema. Intra-operative frozen section of the full-thickness biopsies of each part of the colon and terminal ileum reported no ganglion cells, so we performed double-end ileostomy. Although all the final pathology reports confirmed no ganglion cells similar to the frozen sections, we were curious about the problematic bowel because of preoperative imaging (at the age of 30 months) which showed dilated transverse colon. …

Pituitary Apoplexy In A 19-Year-Old Woman: An Uncommon Age And Gender Presentation, I Ketut Aryawan, Jovita Jutamulia

Chulalongkorn Medical Journal

Pituitary apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction of the pituitary gland. It is most frequently reported in men during the 5th and 6th decades of life and is rarely encountered in young women. We describe a 19-year-old woman who presented with acute visual disturbance accompanied by occasional mild headache. Ophthalmologic examination revealed bitemporal hemianopia, and head MRI demonstrated an intrasellar mass with suprasellar extension, intratumoral hemorrhage, and optic chiasm compression, consistent with pituitary macroadenoma with apoplexy. The patient also had a history of secondary amenorrhea, suggesting possible endocrine dysfunction. This case highlights the importance …

Association Between Underpants Fit And Semen Quality: A Hospital-Based Cross-Sectional Study, Harnam Kaur, Unnop Jaisamrarn, Paweena Thuwanut, Chanakarn Suebthawinkul, Jiayu Li

Chulalongkorn Medical Journal

Background: The effect of underpants type on semen parameters remains controversial. Conducting such a study in the Thai population will contribute valuable region-specific data.

Objectives: This cross-sectional research studied the influence of fit of underpants worn on various semen parameters including semen volume, sperm count, sperm motility, sperm morphology and sperm DNA fragmentation among Thai male partners in Bangkok, Thailand.

Methods: Thai male partners aged 20–55 years who sought infertility treatment from Reproductive Biology Unit, King Chulalongkorn Memorial Hospital, Bangkok were recruited from March to June 2024. All participants completed questionnaire covering socio-demographics, disease history, and type of underpants worn …

Effectiveness And Implementation Of The Shield Integrated Multi-Level Model To Reduce Adolescent Depression And Internet Addiction: A Cluster Randomized Waitlist-Controlled Trial In Wangchin District, Phrae Province, Seubtrakul Tantalanukul, Amornpan Samorn

Chulalongkorn Medical Journal

Background: Adolescent depression and internet addiction represent significant comorbid mental health challenges in rural Thailand, where access to evidence-based interventions remains limited. Traditional single-modality approaches often fail to address the complex interplay between individual, family, and systemic factors contributing to these conditions.

Objectives: To evaluate the effectiveness and implementation outcomes of the SHIELD (Screening & Surveillance, Health Literacy Enhancement, Internet Wellness Program, Empowering Families, Linkage to Care, Data-driven Monitoring) integrated multi-level intervention for reducing depression and internet addiction among at-risk adolescents in rural Thailand.

Methods: A cluster randomized waitlist-controlled trial was conducted across eight secondary schools in Wangchin District, Phrae …

Computed Tomography Findings Of Normal Appendix In Pediatric Population, Thanwarat Koonthong, Teerasak Phewplung*

Chulalongkorn Medical Journal

Background: Appendicitis remains the most common indication for emergency abdominal surgery in children. Computed tomography (CT) plays a vital role in the evaluation of pediatric patients with suspected appendicitis. Yet, there is limited of literature describing the normal appendiceal diameter in the pediatric Asian population.

Objectives: To characterize the normal pediatric appendix and to identify the variables that influence its diameter in pediatric patients aged one day to 18 years who underwent abdominal CT.

Materials and Methods: The study was approved by the IRB. We conducted a retrospective study of 358 children (≤18 years of age) who underwent abdominal CT …

Global Trends In School Disaster Preparedness Research: Bibliometric Analysis Impacts On Public Health And Safety, Muhammad Farid, Muhammad Agita Hutomo, Oktomi Wijaya, Dian Ika Puspitasari

Chulalongkorn Medical Journal

Background: Disasters disrupt daily human activities, arising from natural or artificial triggers, with varying impacts based on community vulnerability and resource capacity. Effective disaster management involves a cycle of mitigation, preparedness, response, and recovery. One of the mitigation measures is to establish school disaster preparedness that integrate education and capacity building.

Objective: The aim of this research is to conduct a bibliometric analysis based on Scopus publications regarding school disaster preparedness.

Methods: A bibliometric analysis was performed on publications indexed in Scopus from 1965 to 2024. Data were processed and visualized using VOSviewer to explore trends in annual outputs, contributing …

Leading Through Difference: Core Values, Neuroscience, And The Habits Of Transformative Leaders, Jaime E. Welborn

The Journal of Values-Based Leadership

Educational leaders are increasingly called to meet the demands of K-12 schools by managing diversity, navigating conflict, and leading change. One's core values, neuroscience, and cultural proficiency of educational practices play a very important role in how they lead organizations and interact with others. This conceptual paper explores the intersection of neuroscience, core values, and associated habits that support effective cross-cultural interactions. Drawing upon frequency count data from documents collected during professional learning activities in school organizations in New York, Missouri, and California from 2018 to 2025, empathy, open-mindedness, and communication emerged as the most frequently reported important core values …

Beyond The Romance Of Leadership: Shackleton, Self-Inflicted Crisis, And The Values Of Recovery, Carl Lee Tolbert

The Journal of Values-Based Leadership

Two men answered to the name Ernest Shackleton. One belonged to the ice, where he was pioneering, inspirational, and heroic. The other belonged to dry land, where he was restless, indebted, and unfulfilled (Smith, 2014). The 1914 to 1916 Endurance expedition has become the most celebrated leadership case study of the past century, a status the 2022 discovery of the ship's preserved wreck has only hardened. Public and scholarly sentiment runs overwhelmingly positive. This article reads that sentiment as a late expression of what Meindl and colleagues named the Romance of Leadership, the disposition to attribute outcomes to dramatic individual …

Sustaining Purpose In Organizations: Leadership Insights From The Psalms, Hershey H. Friedman, Xianfang Zeng

The Journal of Values-Based Leadership

This conceptual paper examines how the Book of Psalms offers an integrative moral framework that enriches contemporary purpose-driven leadership theory. Although modern management scholarship increasingly emphasizes purpose, stakeholder orientation, and meaningful work, it often focuses on strategic articulation rather than the ethical and relational practices that sustain purpose over time. Drawing on selected Psalms as a historically influential corpus of leadership reflection, this study identifies key leadership principles and situates them within established management literature. Purpose-driven leadership rooted in ancient values builds psychologically safe environments. In these spaces, employees view their work as a meaningful calling instead of a simple …

Irish-Americans Audie Murphy And William Donovan: A Celebrity And A Statesman, Ritch Eich

The Journal of Values-Based Leadership

In the long annals of Irish history, many leaders have distinguished themselves as warriors in battle or as civilian heroes, or both. Lieutenant Colonel Robert Blain “Paddy” Mayne, a founding member of the Special Air Service and a highly decorated World War II British Army officer from Northern Ireland, is one. Monsignor Hugh O’Flaherty, an Irish Catholic priest whose rescue network helped over 6,500, escaped Allied POWs, Jews, and other fugitives at risk of Nazi persecution evade capture by the Germans during World War II, is another.1 But, not all heroes of Irish descent are remembered equally. Take, for example, …

A Person For All Seasons: The Remarkable Leadership Of Mother Cabrini And Why It Matters Today, Emilio F. Iodice

The Journal of Values-Based Leadership

The history of organizational management is often written in the bold, sweeping strokes of industrial barons or the calculated maneuvers of political statesmen. Yet at the turn of the twentieth century, one of the most sophisticated examples of global institutional scaling was orchestrated by a woman who stood barely five feet tall, held no formal political title, and suffered from debilitating physical frailty. Frances Xavier Cabrini (1850–1917) did not merely practice charity; she engineered a global revolution of care. Over a twenty-eight-year executive career, she founded sixty-seven schools, orphanages, and hospitals across three continents, thereby transforming the social landscape of …

Student Perspectives On Professionalism In The Academic Classroom: Examining Instructor Traits And Student Preferences At A U.S. Service Academy, Jason Lackey, Justin White

The Journal of Values-Based Leadership

At the US Air Force Academy, student developmental paths occur under both military and academic components. The academic component includes the typical collegiate coursework taught by a combination of civilian and military instructors. In this study, we explored student values of instructor leadership traits and practices that influence the classroom culture. We found that overall, the instructor’s degree of academic knowledge (distinguished from military knowledge), their ability to clearly communicate class content, and ability to inspire student participation ranked highest. Conversely, the instructor clearly communicating military responsibilities, their professional etiquette, and providing constructive feedback pertaining to military bearing ranked least, …

The Philosophical Aspect Of Spirituality And Entrepreneurial Leadership In The Indian Knowledge System, Nidhi Kaushal

The Journal of Values-Based Leadership

Entrepreneurs have an obligation to conserve their literature, art, and culture in any format because it helps to fortify their cultural heritage and memories. In the context of entrepreneurship, a useful and insightful examination of the ancient Indian knowledge framework has proposed the growth of culture-based enterprises, which reflects the magnificent integration of human values with traditional wisdom-based work ethics. The nature of today's modern entrepreneurship is an adjusted specification based on innovative context, which is different from the ancient fundamental policies and practices. This study introduces cultural entrepreneurship and its originality through the traditional and indigenous art and skill …

Values-Based Leadership In Public Discourse: How University Leaders Frame Character And Commitment, Heather Carroll, Jeff Fritz, Sarah Williams, Cheryl A. Maurana

The Journal of Values-Based Leadership

Public leadership speech is a consequential site of ethical positioning where institutional values are named, contested, and interpreted under pressure, and where the choice of virtue language shapes where attention is directed. Analyzing published quotations from university leaders during the first 100 days of the second Trump administration, we examine how virtue language functioned as a public act of values-based leadership through a socio-ecological framework for flourishing that treats character as dynamic and relational. We find that leaders constructed ethical stances by anchoring commitment to moral virtues that named goods, intellectual virtues that narrated deliberative process, and occasionally pairing both …

The Character Fractal: A Theory Of Virtue Replication In Organizations, Kevin Davis, Scott Kozlak, Matthew M. Orlowsky, David Levy

The Journal of Values-Based Leadership

Organizational ethics has long been treated as an individual problem requiring individual solutions: the right traits, the right training, the right people in the right roles. This paper argues that framing is fundamentally insufficient. While character and virtue ultimately reside in persons, character development within organizations emerges through recursive ethical interactions shaped by incentives, narratives, feedback loops, and habituation structures cultivated by systems leaders. It replicates, or fails to, across every scale of human interaction, from the unobserved micro-decision of a single employee to the macro-level architecture of executive leadership. Drawing on Mandelbrot's fractal geometry, Lorenz's chaos theory, Kauffman's complexity …

From Betrayal To Blessing: Leadership Lessons From The Joseph Narrative, Hershey H. Friedman, Nakato Hirakubo

The Journal of Values-Based Leadership

This paper examines the enduring relevance of the biblical Joseph narrative as a study of human nature and leadership. Key themes include the transformative power of forgiveness and the intricate interplay between family dynamics and divine providence. While Joseph's moral integrity remains a central focus, the narrative also offers a sobering lesson in governance: his consolidation of land and wealth under Pharaoh created the very centralized power structure that eventually enabled the enslavement of his descendants. The narrative demonstrates how emotional vulnerability and tears serve as catalysts for healing, while Judah's transformation from complicity in betrayal to courageous advocacy exemplifies …

The Culture Metaphor: A Simple Guide To Creating Healthier Organizations, Matthew I. Horner, T. Daniel White, Rylan M. Charlton, Daphne Ds Deporres

The Journal of Values-Based Leadership

In this paper, culture is conceptualized as a living system where every organizational decision and interpersonal interaction is a source of nourishment. Employing this metaphor, a leader’s visible actions, such as policy and resource decisions, serve as macronutrients, while exchanges between organizational members, such as email correspondence and meeting behavior, act as micronutrients that feed culture. An organization’s cultural health, therefore, depends on a balanced diet in which behaviors align with stated values. Leaders, as chief dietitians, identify and resolve deficiencies to build trust, enhance well-being, and improve performance. Actionable strategies for diagnosing and feeding culture are provided to help …

Ethics: The Connective Tissue Of Human Life, Joseph P. Hester

The Journal of Values-Based Leadership

America needs to take a deep breath and reconsider the purposes of democracy, but more, infuse some modicum of commonsense into political decision-making. How many unnecessary wars and homeland killings must we endure and how many lies must we listen to as Trump filibusters his way onto the world’s stage? Seeking lucidity in Trump’s actions may be a stretch and even many of his supporters are asking for explanations, values’ consistency, and Constitutional clarity. I could go on, but this comment sets the tone for this editorial comment.

Summer/Fall 2026

The Journal of Values-Based Leadership

No abstract provided.

State And Federal Poster Requirements, Garland Gentry Dds

Virginia Dental Journal

No abstract provided.

Report Of The Ada Delegation, M. Joan Gillespie Dds

Virginia Dental Journal

No abstract provided.

Board Of Directors Actions In Brief - November 11, 2011

Virginia Dental Journal

No abstract provided.