Digital Commons Network^™

Increasing Utilization Trends Of Robotic Assistance In Orthopaedic Surgery, Anish K. Ponna, Alec Giakas, Anthony A. Khoudary, Spencer N. Uggla, Sina Ramtin, Yousef A. Soliman, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Robotic-assisted surgeries in orthopaedics have increased, particularly in hip and knee arthroplasty and spine surgeries. This study evaluates national utilization trends of robotic-assisted orthopaedic surgeries and demographic and geographic distribution of patients undergoing these surgeries.

METHODS: A retrospective cohort study was conducted on patients who underwent total hip arthroplasty, total and partial knee arthroplasty, or spine arthrodesis from 2017 to 2023 using the TriNetX database. Relevant International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes identified patients who underwent a primary surgery with a corresponding robot-assisted code on the same day. Temporal trends in procedural volume were …

The River Of Life In Flannery O'Connor's "The River", Abbi L. Peo

Undergraduate Honors Theses

This thesis examines the role of the River in “The River” by Flannery O’Connor.  O’Connor’s fiction consistently explores the workings of grace and “The River” is no exception. In the story, the River functions as a metaphor for Christ’s grace. Most literary critics focus on the disconcerting drowning of the young protagonist, Harry Ashfield, an example of O’Connor’s signature use of the grotesque to facilitate her characters’ encounters with grace. However, this emphasis on Harry often obscures the broader role of the River within the narrative. When the story’s analysis is limited to Harry’s death, critics overlook how the River …

The Importance Of Sports Physical Leading To The Diagnosis Of Loeys–Dietz Syndrome, Fnu Varnika, Anastasia Dihel, Michael Bereisha, Nergess Taheri

Cooper Rowan Medical Journal

Abstract

The pre-participation school or sports physical, introduced in the mid-20th century, remains a cornerstone of adolescent health screening, primarily aimed at ensuring athletic safety. While most evaluations reveal benign conditions, these encounters occasionally uncover critical yet asymptomatic disorders. This report highlights the incidental discovery of Loeys–Dietz syndrome (LDS) type 4 in a 17-year-old male during a routine sports physical, underscoring the clinical value of thorough cardiovascular assessment and recognition of subtle phenotypic cues in preventive settings.

Significance: Loeys–Dietz syndrome is a rare, autosomal dominant connective tissue disorder affecting fewer than 1 in 100,000 individuals, often misdiagnosed as Marfan syndrome …

Impact Of Burnout And Sleep Deprivation On The Clinical Performance Of Neurology Residents: A Cross-Sectional Country Wide Study, Bandar N. Aljafen, Walaa S. Alkhamis, Rahmah M. Alsawad, Israa B. Alhamoud, Zahra B. Alamer, Waad A. Alshanqiti, Rawan M. Alenez

Neurosciences

Objective: To assess burnout (BU) and sleep deprivation (SD) among neurology residents and their impact on clinical performance (CP). This study is based on a neurology residents from Saudi Arabia.

Methods: This multi-centric, cross-sectional study invited 214 registered neurology residents in the country; 179 participated in the study. The Maslach Burnout Inventory (MBI), the Pittsburgh Sleep Quality Index (PSQI), and the Medical Council of Canada’s Physicians’ Self-Assessment Questionnaire (PSAQ) were used to evaluate burnout (BU) and sleep deprivation (SD) among neurology residents and their impact on clinical performance (CP).

Results: Of the total 214 registered neurology residents, 179 participated in …

Predictors Of Long-Term Outcome And Recurrence Of Intramedullary Spinal Ependymomas: A Multicenter Study, Reem Albuhairan, Laila Alqahtani, Ahmed Gamal Sayed, Ali Alkhaibary, Sami Khairy, Faisal Farash, Ali H. Alassiri, Ahmed Alkhani

Neurosciences

Objectives: To define prognostic factors that affect clinical outcome of patients after surgical resection of spinal intramedullary ependymoma.

Methods: A retrospective multi-center study, including all cases operated on from 2007 through 2024 at 3 institutes. Data on surgical factors included: resection extent, intraoperative neurophysiology monitoring methods, and intraoperative/postoperative complications.

Results: A total of 19 patients were included with a mean age of 37.8 years (SD = 13.2, range 8–57 years). The majority of ependymomas (n = 14, 73.7%) were in the cervical region. The most common presenting symptoms included pain in 14 patients (73.7%), sensory deficits in 11 patients (57.8%), …

(W)Holistic Approaches: Empowering The Whole Of Child, Annette Johnson, Tiarnah Hamlin, Jack Lundie-Jenkins, Erin King, Karen Malyon, Jennifer Cartmel

International Journal of Playwork Practice

Holistic approaches are an evolving pedagogy in the Outside of School Hours Care (OSHC) sector that, despite its recognised value, remain an elusive practice for many educators. This ambiguity has been acknowledged in My Time Our Place (MTOP): Framework for School Age Care in Australia 2.0 (AGDE, 2022). In alignment with this process, the ability for OSHC and extended learning to empower children’s self-identities is fundamental to supporting their holistic development. In a world emerging from the coronavirus pandemic, the ongoing impacts on children – the result of physical separation and societal stressors – cannot be ignored. Accordingly, the child’s …

Unl Authorship And Open Access Citation Impacts After A Decade (2015-2024): A Preliminary Report On Articles Indexed By Elsevier’S Scopus, David C. Tyler, Pei-Ying Chen, Erica Defrain

University of Nebraska-Lincoln Libraries: White Papers

The authors addressed the following research questions:

• Did the articles with UNL Lead Authors produce more citations than articles with UNL Contributing Authors?
• Did OA, as identified by Scopus at the journal and article levels, generate more citations?
• Were citation totals associated with the number of extra-publisher OA avenues?
• Were some publishers associated with higher citation counts than others?
• Did some subjects, by Library of Congress classification, generate more citations than others?

Who Let The Werewolves Into The Manuscripts: Written And Pictorial Representations Of Werewolves In English Manuscripts, Allison Slowiak

LSU Master's Theses

The werewolf – a fictional figure that transforms from human to wolf – serves as a compelling example of how medieval thought shaped ideas about identity and transformation. The motif of the werewolf, present in a small corpus of works from the tenth through the fourteenth century, emerged to explore the limits of change while also comparing the likeness of humanity to its animal counterpart. This paper explores medieval literature - Beowulf, Bisclavret, Biclarel, and Melion – from both French or English descent to offer overlapping and contrasting thoughts about human likeness to wolves. The manuscripts - The Nowell Codex, …

Identifying Risk Factors For The Rising Prevalence Of Multiple Sclerosis In Saudi Arabia: A Case-Control Analysis, Omar Babateen, Jamil Adnan Samkari, Rewaa Abdulaziz Alkaki, Sadin Ayman Alamri, Manal Mutlaq Alzahrani, Mussaed Saleh Alharbi, Ali Abdulrazaq Alghamdi, Amwaj Sultan Aljurays, Amjad Faleh Aldosari, Seraj Makkawi

Neurosciences

Objective: This study aims to identify risk factors linked to the increasing prevalence of multiple sclerosis (MS) in Saudi Arabia. Multiple sclerosis is a chronic autoimmune condition affecting the central nervous system, marked by inflammation and damage to nerves and the myelin sheath.

Method: A case-control study conducted from September 2022 to January 2024 included 832 participants—263 diagnosed with MS and 569 controls. Controls were matched by age, gender, residence, and employment status. Data was collected using a validated questionnaire, with written consent obtained from participants aged 18 and older. Logistic regression analysis was used to ascertain risk factors.

Results: …

Efficacy Of Erenumab In Patients With Treatment-Resistant Chronic Migraine And Medication Overuse Headache, Mohamed F. Binfalah, Anwar A. Alrayyes, Hussein H. Alhafnawi, Moiz O. Bakhiet

Neurosciences

Objective: To evaluate the efficacy and safety of erenumab, a monoclonal antibody that targets the calcitonin gene-related peptide (CGRP) receptor, in patients with treatment-resistant chronic migraine and medication overuse headache.

Methods: A single-center, retrospective observational study conducted at University Medical Center on 73 patients with both medication-overuse headache and treatment-resistant chronic migraine who failed at least three oral preventive medications and/or botulinum toxin injections. Clinical data were extracted from the medical records and patient interviews. The patients received monthly erenumab injections 70 mg. Key outcomes included monthly migraine days, headache severity (visual analog scale [VAS]), headache impact test (HIT-6), acute …

Association Between Extracranial Artery Stenosis And Cerebral Small-Vessel Disease In Patients With Ischemic Stroke, Ahmad Ghoochani-Khorasani, Seyed Hadi Aghili, Seyed Zakaria Hosseini, Seyed Amir Hasan Habibi, Mehri Farhangranjbar, Mahdi Abdi

Neurosciences

Objective: To review the relationship between extracranial artery stenosis (ECAS) severity and total cerebral small-vessel disease (CSVD) burden and evaluated 5-year mortality, disability, and stroke recurrence in ischemic stroke patients. Cerebral small-vessel disease and ECAS often share risk factors such as hypertension and atherosclerosis and coexist in ischemic stroke. Although ECAS affects large-artery disease, its impact on total CSVD burden on MRI and subsequent clinical outcomes is not well defined.

Methods: We retrospectively reviewed the medical records of 348 patients older than 35 who had suffered acute ischemic stroke and were admitted to selected hospitals in Tehran, Iran from March …

The Incidence Rate Of Post-Stroke Epilepsy: A Multi-Center, Retrospective Study In Taif City, Adnan A. Mubaraki, Shomoukh A. Alhumyani, Arwa M. Altowairqi, Liyan K. Abu Rukbah, Hanouf H. Alhamyani, Alhanouf A. Alkhaldi, Mohammed S. Alhamyani, Mohammed M. Algethami

Neurosciences

Background: The International League Against Epilepsy in 2014, defined epilepsy in any patient who has experienced one unprovoked seizure and has a probability of further seizures similar to the general recurrence risk (at least 60%) after 2 unprovoked seizures occurring over the next 10 years. Epilepsy patients are classified into 2 groups: early post-stroke seizures (EPSS), including patients who experience a seizure within 1 week of stroke onset, and late PSS (LPSS), including those who have a seizure more than 1 week after the stroke.

Methods: This retrospective, record-based study was conducted between January 2021 and December 2024. A total …

Vagal Nerve Stimulation As Therapy For Drug-Resistant Epilepsy: A Tertiary Hospital Experience Of Outcomes And Efficacy In King Abdullah Medical City, Bassam G. Sef, Abeer S. Albalawi, Ahmed M. Alhajji, Muhammed M. Irfan, Hanadi M. Abu Alela

Neurosciences

Objective: To determine the efficacy and safety of vagus nerve stimulation (VNS) for reducing the frequency of seizures and complications in drug-resistant epilepsy.

Methods: This was a retrospective case series study conducted in King Abdullah Medical City from January 2015 to December 2021 hospital record. All patients undergoing VNS were enrolled according to inclusion and exclusion criteria. Patients were followed up for 12 months, and the seizure frequency and number of epileptic drugs used were evaluated. A paired sample t-test was applied to compare the outcome variables considering p-value < 0.05 as significant.

Results: Among 9 enrolled patients, four were females, and five …

Insights Into Stroke Risk And Prediction For Underweight Individuals, Saeed Awad M. Alqahtani, Moutasem S. Aboonq

Neurosciences

This review explores the relationship between underweight status and stroke risk and outcomes. Although the impact of obesity on stroke is well-documented, the harmful effects of being underweight are often overlooked. Drawing on evidence from observational studies, case-control studies, and meta-analyses, this review highlights that underweight individuals face increased mortality, poorer functional recovery, and higher rates of major adverse cardiovascular events and recurrent strokes post-stroke. Challenges in stroke prediction for this population are examined, including the limited research focus, shortcomings of existing risk assessment tools such as the CHA₂DS₂-VASc score, and population-specific factors affecting underweight prevalence …

Key Attributes Of An Ideal Neurology Residency Candidate: Program Directors’ Perspectives, Bandar N. Aljafen, Ruwa A. Alneseyan, Rahmah M. Alsawad, Mohamed Bahr

Neurosciences

Objectives: To guide medical students and interns interested in neurology by identifying the key attributes of an ideal neurology candidate from the perspectives of neurology program directors (PDs).

Methods: In this cross-sectional study, former and current neurology PDs were contacted across Saudi Arabia to complete a self-administered survey sent via email or text. The survey included seven questions: six on PD demographics and a seventh with 51 items evaluating candidate attributes on a 7-point Likert scale from disadvantage to advantage.

Results: Thirty-two neurology PDs filled out the questionnaire. Among the key attributes PDs prioritized in a candidate is their letter …

Clinical Characteristics, Aetiologies, And Disposition Outcomes Of Patients Presenting With Altered Mental Status In An Academic Emergency Department, Zohair A. Al Aseri, Omar M. Alotaibi, Ibrahim M. A. Albarrak, Saif A. S. Aljaghwani, Ahmed M. A. Alkhars, Marwan M. Althubaiti, Abdulaziz A. Alkathami, Abdullah R. A. Alanazi, Fahad I. Abuguyan

Neurosciences

Objectives: To assess the clinical characteristics, aetiologies, and disposition outcomes of patients presenting with altered mental status (AMS) in an academic emergency department, as well as to explore factors associated with hospitalization, intubation, and mortality.

Methods: This retrospective cross-sectional study included 142 AMS patients presenting to the Emergency Department of (Blinded for Review) between December 2019 and December 2022. Adults (≥ 18 years) with documented AMS were enrolled, excluding those who died upon arrival or with iatrogenic AMS. Demographic, clinical presentation, comorbidity, medication, aetiology, intervention, and disposition outcome data, were extracted from the electronic System for Integrated Health Information.

Results: …

Novel Enpp1 Gene Mutation Causing Generalized Arterial Calcification Of Infancy: A Case Report, Haifa M. Alturki, Haya S. Alfaris, Mohammed A. Al-Owain, Musaad F. Abukhalid

Neurosciences

Generalized Arterial Calcification of Infancy (GACI), a complex disorder affecting multiple systems, stems from an autosomal recessive mutation in the ENPP1 gene. This condition is marked by arterial stenosis and usually manifests prenatally or in the initial months following birth. High mortality rates characterize the first few months, a phase often termed the ``critical period.'' The report presents a case study of a four-year-old female with a new mutation in the ENPP1 gene, which broadens our understanding of this rare genetic disorder.

Afghanistan Prior To The Reign Of Abdur Rahman Khan, Ethan Connor Copeland

Student Work

This project aims for a visually driven historical and comparative atlas showcasing the 19th century transformation of Afghanistan under Abdur Rahman Khan. While modern scholarship focuses on the last half-century of conflict, his reign served as a foundational period of national consolidation and policy making. Using a comparative framework, the atlas will trace punitive campaigns, administrative consolidation, and territorial redefinition to clarify how power, borders, and key places were reorganized across the Emirate of Afghanistan. The research conducted will synthesize primary and secondary materials, including chronicles, provincial histories, and modern geographic studies. These sources, evaluated systematically by authorship, date, relevance, …

Knowledge Creation And Information Sharing Through Open Education Resources, Dr. Sankar P

Library Philosophy and Practice (e-journal)

Open Educational Resources (OER) are materials that anyone can use for studying, teaching, and learning because they are free to use and share. Textbooks, courses, multimedia, software, and tests are all examples of these resources. This way, everyone can get a good education, no matter where they live or how much money they have. Open Educational Resources (OER) make it easier for people all over the world to share and work on educational materials. This makes information available to more people and lowers the cost of materials. Programs like MIT OpenCourseWare make it possible for people to get free textbooks …

Reconstruction Of Information System Acceptance Model In The Era Of Integrated Artificial Intelligence: A Systematic Literature Review, Ilham, Merlin Apriliyanti

Library Philosophy and Practice (e-journal)

This study aims to explain the rapid development of Artificial Intelligence (AI) which has driven significant transformations in the development and use of information systems. However, most classical information system acceptance models, such as the Technology Acceptance Model (TAM) and  (UTAUT), have not been able to fully explain the unique characteristics of AI-based systems that are autonomous, adaptive, and complex. This study aims to reconstruct the information system acceptance model in the era of integrated AI through a Systematic Literature Review (SLR) approach. This study was conducted using the PRISMA protocol on 130 leading scientific articles indexed by Scopus and …

Just City And Racialized Media: How A Non-Profit Provokes Policy And Fights Criminal Injustices, Isabella L. Wollfarth

LSU Master's Theses

This study explored the intersection of racialized media narratives, nonprofits, and penal policy through a case study of Just City, a nonprofit criminal justice organization located in Shelby County, Tennessee. Through the lens of Just City, this study explored how nonprofits resist racialized media narratives regarding crime and how in turn this contributes to penal policy reforms. This is accomplished using a thematic analysis to draw larger conclusions from coding Just City’s Instagram and through extensive interviews with Just City staff and local Shelby County and Tennessee politicians. These methods are guided by framing theory, an ideological framework that explains …

Fort Hays State University Tiger Weekly, March 27, 2026, University Relations

Tiger Weekly Newsletters

No abstract provided.

Novel Electrical Interfaces For Bionic Limbs, Matthew Aaron Melton

USF Tampa Graduate Theses and Dissertations

Advancements in neural interfaces are pivotal for enhancing the functionality and longevity of implantable biomedical applications, particularly in the field of neuroprosthetics. This dissertation is focused on the continuing development of a novel neural interface fabricated from silicon carbide (SiC). SiC has demonstrated superior performance over traditional silicon-based material systems due to its exceptional biocompatibility, hemocompatibility, and electrochemical stability. The research herein explores silicon carbide’s semiconductor properties, with a highlighted focus on a unique and innovative design structure - centered around a p-n junction. This work examines detailed fabrication steps of an all-SiC device, acute-style packaging (for future in vivo …

The Living Archive: Photography, Social Media, And The New Frontier Of Activism, Lundyn C. Herring

LSU Master's Theses

This thesis seeks to analyze the discursive field and technology of photography and its multi-faceted role in the oppression of colonized people under Western imperialism. Among the main collection highlights of many established state-run archival institutions are photographic records consisting of surveillance images, mugshots, and other visual media as representations of the political hegemony that is exerted over governed peoples. From the mid-19th century to 2026, much has shifted in the realm of photography with the introduction of smartphones, accessible technology, and social media platforms during the beginning of the twenty-first century. As states and powerholders apply the technology of …

Wearable Sensor System Used To Measure Linear And Angular Acceleration Of The Head Of American Football Players, David A. Emerson

LSU Master's Theses

American football players are repeatedly subject to high-velocity impacts; collisions can exceed 100 g in the NFL [1]. Rotational accelerations of the head caused by high-velocity collisions have been proven to be extremely damaging to the highly organized brain fibers at the brain-skull interface [2]. The sensor system (SS) measures the nonplanar acceleration at four locations on a chin strap using ADXL314 accelerometers and utilizes rigid-body kinematics to estimate the head rotational state from the measured acceleration of the SS [3]. The SS was validated through progressive testing, including steady-state, linear impact, and rotational impact testing. The ADLX314 sensor exhibited …

Stacks, Pamela C. (1950-2026), San Jose State University

Emeritus and Retired Faculty Biographies

University of California, Los Angeles, Department of Chemistry, Biochemistry Ph.D. 1979

University of California, San Diego, Revelle College, Biology A.B. 1972

When Ai Writes The Doctoral Thesis: Reclaiming The Oral Defence As A Learning Development Intervention, Valerie A. Storey

All Faculty and Staff Scholarship

Large language models have fundamentally challenged traditional methods of verifying doctoral competency as AI-generated text becomes increasingly difficult to distinguish from human scholarship. This paper argues that thesis committees and doctoral supervisors must reclaim the oral defence as a critical checkpoint for assessing authentic threshold crossing rather than a ceremonial rite of passage. Drawing on historical examples from medieval oral disputations through to the rise of written theses, this paper asserts the necessity of returning to rigorous oral assessment. Given the limitations of detection technologies and the growing use of AI in thesis writing, oral defences must move from confirmatory …

Quantifying Provider Relief Fund Allocation Trends: A Descriptive Analysis Of Rural And Urban Hospitals, 2014-2023, Wendell C. Mcclurg

MUSC Theses and Dissertations

Rural hospitals operate on thin margins, have limited access to capital, and face a heightened risk of closure. During the COVID-19 pandemic, the Provider Relief Fund (PRF) distributed more than $170 billion to health care providers to offset revenue losses and preserve access to care. Most evaluations of PRF have focused on profitability, which may overstate financial resilience by overlooking liquidity. Using Hospital Cost Reports for hospitals from 2014-2023, we examined trends in Days Cash on Hand (DCOH), operating margin, total margin, and PRF funding intensity by rurality and ownership. Liquidity rose sharply during 2020-2021, coinciding with the peak of …

Associations Between Caregiver-Provider Communication Quality And Unmet Care Needs Among Older Adults, Jiaming Liang, Rafael Samper-Ternent, Brian Downer, Zhigang Xie

Faculty, Staff and Student Publications

BACKGROUND: Unmet care needs (lack of assistance with daily activities) among older adults are common and linked to adverse health outcomes, greater healthcare utilization, and caregiver burden. While effective patient-provider communication is known to improve care quality, less is understood about the role of caregiver-provider communication, particularly across sociodemographic, health, and caregiving contexts. METHODS: We conducted a cross-sectional secondary analysis of pooled 2021–2023 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data, restricted to community-dwelling older adults (65 + years) who received assistance from caregivers due to difficulty with daily activities, and had at least …

Mechanistic Prediction Of Apixaban And Rivaroxaban Secretion Into Human Milk And Infant Systemic Exposure Through An Integrated Physiologically Based Pharmacokinetic Framework, Bofang Yi, Sung Hun Bae, Yongzong Yang, Linda Jiang, Shirley Chen, Allesandra Stratigakis, Zhongyuan Zhao, Mohammad Asikur Rahman, Yanyan Li, Xinrui (Sarea) Wang, Peng Zou, Tao Zhang

Pharmacy Faculty Scholarship

Accurately characterizing the transfer of apixaban and rivaroxaban into human milk is essential for evaluating their safety during lactation and for guiding anticoagulant therapy in breastfeeding patients. This study aimed to establish a mechanistic physiologically based pharmacokinetic (PBPK) modeling approach linking maternal exposure, mammary drug transport, and infant systemic levels for both anticoagulants. Passive permeability and efflux transport across the mammary epithelium were measured using an in vitro human mammary epithelial cell model, providing information on diffusion and transporter-mediated clearance, whereas milk protein binding was determined using rapid equilibrium dialysis to account for unbound drug available for transfer. These experimentally …