Digital Commons Network^™

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Criterion Validity Of The Functional Status And Pain Assessment Scale Versus Pain And Length Of Stay In Hospitalized Adults With Scd, Wally R. Smith, Daniel M. Sop, Yue May Zhang, Margaret S. Guy, Rehan Qayyum

Department of Medicine Faculty Publications

Objectives

In prior research we demonstrated face, construct, discriminant, and preliminary convergent validity of the newly developed, 10-item Functional Status Pain Assessment (FSPA) scale (0-50) in adult SCD patients hospitalized with VOC. We aimed in this study to further demonstrate criterion validity of the FSPA.

Methods

This was a prospective observational study of 561 daily functional and pain assessments from 91 hospitalized adults with SCD from January 2018 to June of 2019. Principal Component Analysis (PCA) Partial Least Squares (PLS) models determined the relationship between LOS, pain intensity, and FSPA. A Generalized Linear Model (GLM) to quantified the impact of …

Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Incidence, Predictors, And Association With Reduced Ischemic Stroke Risk, Omar Saleh, Nicholas J. Valle, Shinjer Li, Saleh Mostafa, Israa Saleh, Raymond Benza, Deepak R. Talreja, Matthew R. Summers

Department of Medicine Faculty Publications

Background

Development of conduction abnormalities requiring pacing after transcatheter aortic valve replacement (TAVR) is relatively common. The effects of post-TAVR permanent pacemaker (PPM) implantation on mortality, ischemic stroke, and cardiovascular outcomes remain incompletely characterized. AIMS: To evaluate the incidence, predictors, and cardiovascular outcomes of post-TAVR permanent pacemaker implantation, including its association with 1-year ischemic stroke risk.

Methods

Adults undergoing TAVR (2008-2019; n = 1101) were evaluated. Patients with prior PPM (n = 104) and/or valve-in-valve or redo TAVR (n = 11) were excluded. PPM placement was identified post-indexed TAVR admission based on procedure codes, including both in-hospital and post-discharge implantations. …

Aggressive Natural Killer Cell Leukemia: A Rare And Rapidly Progressive Hematologic Malignancy—Case Report And Literature Review, Jennifer Priessnitz, Ali Hariri, Yuliya Levkiavska, Kyle E. Bonner, Stephan I. Fisher, Joshua M. Sill

Department of Medicine Faculty Publications

Aggressive natural killer cell leukemia (ANKL) is a rare, fulminant hematologic malignancy characterized by neoplastic proliferation of mature NK cells. It is frequently associated with Epstein-Barr virus (EBV) infection, although EBV-negative cases have also been reported. While typically observed in young to middle-aged adults of East Asian descent, increasing recognition has led to identification of ANKL across diverse age groups and ethnicities. The disease is defined by a rapid clinical course and poor prognosis, underscoring the importance of early diagnosis and effective treatment. We present a case of a 71-year-old Caucasian male who developed fever, altered mental status, hepatosplenomegaly, pancytopenia, …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

T-Cells May Represent A Novel Biomarker For Female Pattern Hair Loss, Juan Marrero Berrios, Iain Noel Encarnacion, Noelle Desir, Aman Prasad, Matthew Hedberg, Susan Taylor, John T. Seykora

Department of Medicine Faculty Publications

[Introduction] Androgenetic alopecia (AGA) is a common non-scarring alopecia classically attributed to androgen sensitivity and genetics. Histopathologic studies have identified perifollicular and perivascular lymphocytic and histiocytic infiltrates, through the composition and clinical relevance of this infiltrate have not been fully characterized.¹ Our study aims to address this gap through detailed quantitative immunohistochemical characterization (IHC) of the inflammatory infiltrate in female patients with AGA compared to telogen effluvium (TE), a non-inflammatory control.

Drug-Induced Lichen Planus Associated With Ocrelizumab, Avery Seward, John D. Strickley, Jeffrey P. Callen

Department of Medicine Faculty Publications

This case report highlights recurrent cutaneous lichen planus as a rare adverse effect of ocrelizumab, with flares occurring after each infusion and improving with prophylactic prednisone. Recognizing this association may help clinicians diagnose and manage similar cases while allowing patients to continue an otherwise effective therapy.

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Element-Based Predictive Modeling Of Hydrothermal Liquefaction Bioproducts Derived From Corn Stover, Isamu Umeda, Meicen Liu, Yi Zheng, Jiefu Wang, Zhiwu Wang, Sandeep Kumar

Civil & Environmental Engineering Faculty Publications

The hydrothermal liquefaction (HTL) process offers an energetic advantage over pyrolysis because it does not require prior drying of the biomass feedstock. However, there are significant challenges in simultaneously estimating both the yields and characteristics of products from the HTL of biomass with theoretical support. This study developed a unique element-based kinetic model to predict the yields, higher heating values, and fuel characteristics of solid residue and heavy bio-oil, based on the temperature, residence time, solid loading, and elemental composition (C, H, N, and O) of corn stover. Furthermore, the model predicted the weights of dissolved carbon and nitrogen in …

Harnessing Activated Sludge For The Treatment Of Hydrothermal Liquefaction Wastewater: A Proof-Of-Concept Study, Cyrus Li, Jiefu Wang, Meicen Liu, Yi Zheng, Sandeep Kumar, Isamu Umeda, Chandan Mahata, John Norton

Civil & Environmental Engineering Faculty Publications

Although hydrothermal liquefaction (HTL) is the leading technology in converting wet biomass into bioenergy, the treatment of its toxic-laden aqueous phase wastewater presents a major challenge on its path toward commercial viability. This study presents the first-ever assessment of sewage sludge-fed HTL wastewater (SS-HTLWW) treatment and toxic compound removal using municipal activated sludge (AS) by optimizing its cultivation condition. It was found that AS with optimized pretreatment can remove up to 91.2% of the soluble chemical oxygen demand (sCOD) in SS-HTLWW, of which up to 82% can be attributed to biological mineralization and adsorption of sCOD by AS. Conventional bioprocess …

Assessing Positive Digital Experiences: A Spanish Validation Of The Digital Flourishing Scale For Adolescents, Alfredo Zarco-Alpuente, Victor Ciudad Fernández, Jasmina Rosič, Sophie Janicke-Bowles, Tamara Escrivà-Martínez, Paula Samper-García

Communication Faculty Articles and Research

Background: Adolescents are immersed in digital communication, which can benefit or harm their well-being. Digital flourishing captures positive perceptions of this communication-connectedness, authentic self-presentation, positive social comparison, civil participation, and self-control-and how it contributes to well-being. In Spain there is still no validated instrument for adolescents. Method: We adapted and validated the Digital Flourishing Scale for Adolescents (DFSA) for Spanish adolescents. Study 1 involved a pilot survey (n = 13) and cognitive interviews (n = 10) to improve clarity and cultural relevance. Study 2 used a cross-sectional survey (n = 1,786) to examine the DFSA’s latent structure, measurement invariance by …

A Note On The Novel Passive Sampling In Environmental Dna (Edna) Collection Technique To Detect Yellow Mud Turtle (Kinosternon Flavescens): Field And Laboratory Approaches In Turtle Edna, Sakib Tahmid Rishan, Richard J. Kline, Md. Saydur Rahman

School of Integrative Biological & Chemical Sciences Faculty Publications

Environmental DNA (eDNA) is a powerful and sensitive method for monitoring aquatic and terrestrial organisms, offering insights into their distribution. Usually, eDNA is collected using a filter membrane through water filtration. However, the passive eDNA method can simplify sampling and broaden its scope, offering new insights for ecological surveillance. This study examined the efficacy of six different membrane filters in detecting the yellow mud turtle (Kinosternon flavescens) through a novel passive eDNA method. After being immersed in water for 12 h, only the mixed cellulose ester (MCE) membrane filter consistently demonstrated specific polymerase chain reaction (PCR) amplification using …

Frontline Aspiration Versus Stent Retriever Thrombectomy For M2 Occlusions: Insights From The Star Registry, Michael Gaub, Rahim Abo Kasem, Ilko Maier, Ansaar Rai, Pascal Jabbour, Joon-Tae Kim, Brian Howard, Ali Alawieh, Stacey Quintero Wolfe, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Justin Dye, Ali Alaraj, Mohamad Ezzeldin, Shinichi Yoshimura, David Fiorella, Omar Tanweer, Daniele G Romano, Pedro Navia, Hugo Cuellar, Isabel Fragata, Adam Polifka, Joshua Osbun, Fazeel Siddiqui, Mark Moss, Kaustubh Limaye, Maxim Mokin, Charles Matouk, Min S Park, Waleed Brinjikji, Ergun Daglioglu, Richard Williamson, David J Altschul, Christopher S Ogilvy, Roberto Crosa, Michael R Levitt, Benjamin Gory, Alexandra Paul, Peter Kan, Walter Casagrande, Shakeel Chowdhry, Michael F Stiefel, Ramesh Grandhi, Alejandro Spiotta, Justin Mascitelli

Faculty, Staff and Students Publications

Background: Recent trials have furthered uncertainty regarding the endovascular benefit for medium vessel occlusions (MeVO). Stent retrievers (SR) were employed in the first attempt in most interventional arm participants. We sought to compare outcomes in acute MCA M2 occlusions between frontline aspiration and SR, and to delineate procedural and anatomical covariates associated with differential treatment effect.

Methods: Retrospective analysis of a multicenter stroke thrombectomy cohort identified cases of MT for M2 occlusions. Unmatched and propensity score-matched (PSM) cohorts were generated comparing frontline aspiration to standalone and combined SR. The primary outcome was functional independence (mRS 0-2) at 90 days. Recanalization, …

Old Lesions And New Targets: Seeg-Identified Onsets In Traditionally Inoperable Epilepsy Lesions And Associated Surgical Outcomes, Yosef M Dastagirzada, Spencer Frome, Daniel J Curry, Howard L Weiner

Faculty, Staff and Students Publications

Background: Patients with epilepsy who do not respond to pharmacotherapy are often offered a noninvasive diagnostic workup to localize an epileptogenic focus that might be treated with resection, neuromodulation, or ablation. Yet in many cases, this evaluation fails to identify surgical candidates.

Summary: Patients with tuberous sclerosis, periventricular nodular heterotopia, or polymicrogyria may have clearly visible lesions on MRI, but the resulting epileptogenic onset zones/networks are often too complex for scalp electroencephalography to decode. Similarly, seizures arising from the cingulate gyrus originate in deep structures that are inaccessible to noninvasive techniques. In post-traumatic epilepsy without a dominant lesion such as …

Optimizing Tbi Care: Brain Oxygen Monitoring In Nursing - An Evidence-Based Practice, Alyssa Grisham

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims

This DNP project aims to enhance the care of patients with traumatic brain injury (TBI) by improving nurses’ knowledge, clinical decision-making, and early intervention strategies through the integration of brain oxygenation data into routine neurocritical care assessments. This project seeks to promote personalized patient care, reduce secondary brain injury, and improve neurological outcomes for critically ill adults with TBI by implementing an educational protocol designed to deepen understanding of brain oxygen monitoring.

Background of Problem & Description of Current Practice

TBI remains a leading cause of death and disability worldwide and continues to pose a significant public health burden. …

Patient And Practitioner Workshops For An Intellectual Disabilities And Epilepsy Neuropsychiatric Genetic Research Database Register: Ethical Dilemmas For Study Design, Rohit Shankar, Jon Allard, Dannielle Bilkey, Brendan Mclean, Pamela Bowman, Chloe Staples, Lance Watkins, Anna Simpson, Elizabeth Boardman, Sarah Mitchell, Sarah Lennard

Peninsula Medical School

BackgroundThere is a need for more research studies focussed on People with ID (PwID) and Epilepsy and for the design of these studies to be shaped by this complex and vulnerable population and those who care for and support them.AimsTo develop understanding as to how a future NHS genetic research database register for PwID and Epilepsy should be conducted in a way which is inclusive, suitable and appropriate for them, their carers and the NHS settings where the research would be undertaken.MethodsThree workshops were completed with 17 formal participants: (1) PwID and Epilepsy (n2); (2) carers of PwID and Epilepsy …

Involving Parents In Prevention: A Case Example Of Research And Intervention Development To Improve Financial Well-Being Support, Nick Axford, Gisella Hanley, Rebecca Summers, Kristin Liabo, Amy Bond, Eleanor Bryant, Georgia Smith, Rachel Silcock, Vashti Berry

Peninsula Medical School

The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children’s …

Designing A Mobile App For Post Traumatic Stress Disorder: Insights From Lived Experience And Clinical Practice, Rohit Shankar, Richard Laugharne, Michael Loizou, Marius Varga, Sivia Lin, Bojana Daw Srdanovic, Roger Farrell

Peninsula Medical School

Post-traumatic stress disorder (PTSD) is a disabling anxiety disorder precipitated by severe trauma. Many people with this condition have little access to clinical interventions, especially in low-middle-income countries. For the development of any digital health intervention, it is vital to know the opinions of PLE and clinicians to guide the developers. We conducted two focus groups, one with clinicians (n = 5) and one with people with lived experience (PLE) (n = 11), to gain knowledge of their views on the development of a PTSD App. Transcripts of both focus groups were coded and thematically analysed. The key themes that …

“The True Me”: Unravelling The Dual Narrative Of Borderline Personality Disorder And Autistic Spectrum Disorder, Robin Iliffe-Lewis, Alison Bacon

School of Psychology

Objectives: There is growing recognition that some individuals who receive a diagnosis of Borderline Personality Disorder (BPD) are later diagnosed with autism. However, existing literature on this topic remains limited. This study aimed to explore the experiences of individuals diagnosed with BPD prior to autism, how they made sense of these diagnoses, navigated clinical systems, and learnt to manage the complex challenges associated with this diagnostic sequence.Methods: Thirteen (6 male, 6 female, 1 non-binary) adult participants took part in semi-structured interviews exploring their diagnostic journeys. Reflexive thematic analysis was used to develop a nuanced understanding of their experiences.Results: Three themes …

Psychophysiological Recovery From Viewing Nature And Urban Settings: A Multisite Replication, A. E. Van Den Berg, K. Dijkstra, D. Meuwese, F. Beute, P. M. Darcy, S. Dewitte, B. Gatersleben, C. J. Gidlow, C. M. Hägerhäll, J. A. Hipp, Y. Joye, Y. A.W. De Kort, S. C.M. Lechner, C. Neale, Sang Ode Sang, J. Roe, D. T. Scheepers, K. Smolders, H. Staats, R. S. Steensma, K. J. Wyles, S. L. Koole

School of Psychology

The idea that merely viewing nature can promote stress recovery has profound societal implications, driving the use of nature imagery in the design of environments where access to real nature is limited. Scientific support for this concept originates from a pioneering study by Ulrich et al. (1991), which demonstrated superior psycho-physiological stress recovery during exposure to nature videos compared to urban videos. Despite its influence, this foundational study has never been systematically replicated. To address this gap, ten research teams across the Netherlands, Belgium, the UK, Sweden, and the USA collaborated on a multisite replication. A final sample of 959 …

Integrating Neuroscience And Social Psychology In Researching Interprofessional Education: The Inspire Framework, Kimberley Schenke, Pamela Rae, Jaysan Charlesford, Phil Gee

School of Psychology

There is an increasing focus on the importance of interprofessional education as an integral part of health and social care training. However, the fundamental psychological processes underlying successful interprofessional education are not well understood. Here we propose a single framework, Integrating Neuroscience and Social Psychology In Researching Interprofessional Education (INSPIRE), grounded in evidence from social psychology and neuroscience that could be used to generate testable hypotheses to inform the design, development and evaluation of interprofessional education. The application of this framework offers a novel, scientifically grounded approach to improving the learning outcomes of interprofessional education and provides a foundation for …

The Career Choices Of Final Year Nursing Students In The United Kingdom: A Qualitative Study., Kevin Hambridge, Frazer Underwood, Gosia Bettache, Matt Carey, Halil Kaya, Lisa Burrows, Rachel Tims, Christian Brailsford

School of Nursing and Midwifery

Aim: The aim of this study is to explore the career choices of final year under-graduate nursing students in the United Kingdom. Background: Worldwide there is a decreasing number of nurses and in the United Kingdom there is a decreasing amount of nursing students. There is sparce evidence relating to the career's choices of nursing students and reasons for those choices. Obtaining a deeper comprehension of these choices may aid healthcare employers, in partnership with universities, to design the future nursing workforce. Design: A qualitative design was used. Methods: Twenty-one final year under-graduate nursing students from across a range of …

Staphylococcus Aureus Strain Heterogeneity Modulates Virulence Traits Associated To Dual-Species Biofilms With Candida Albicans, Laure Nicolas Annick Ries, Beata Adrienn Brezniczky, Binduja Srelatha Pradeep, Esther Olabamiji, Lee Hutt, Glenn M. Harper, Alexander Strachan, Gyorgy Fejer

School of Biomedical Sciences

Staphylococcus aureus is a commensal Gram-positive bacterium and opportunistic pathogen that exhibits substantial variation in antimicrobial resistance and virulence traits. S. aureus is frequently co-isolated with the fungus Candida albicans, and together they represent the most common microorganisms recovered from biofilm-associated infections originating from both biotic and abiotic surfaces. Despite this clinical relevance, the impact of bacterial intra-species variation on interkingdom interactions remains poorly understood. This study therefore investigated how S. aureus strain heterogeneity influences C. albicans within dual-species biofilms. The majority of the 60 S. aureus strains tested suppressed fungal growth in a contact-dependent manner across different nutrient conditions …

Assessing The Application Of Optical-Photothermal Infrared Spectroscopy For Single-Grain Chemical Palynology, Laura Scoble, Hao Meng, Simon J. Ussher, Mark F. Fitzsimons, Lauren Ansell, Mustafa Kansiz, Billy Simmonds, Nick Stone, Ralph M. Fyfe

School of Geography, Earth and Environmental Sciences

Single-grain pollen analysis is essential for advancing chemical palynology, which classifies morphologically similar taxa based on taxon-specific pollen and sporopollenin chemistry. Fourier-Transform Infrared (FT-IR) spectroscopy and microspectroscopy (μFT-IR) are widely used to differentiate morphologically similar grains but face limitations from Mie scattering and coarse spatial resolution. Here, we present the first application of Optical-PhotoThermal Infrared (O-PTIR) spectroscopy to chemically treated single pollen grains, using Molinia caerulea as a model taxon to fully test and evaluate the technical capabilities and limitations of this technique. O-PTIR achieves sub-micron “super-resolution” infrared spectroscopy through non-contact, non-destructive measurements by exploiting the photothermal effect. O-PTIR spectra …

What Is The Evidence For Effective Teaching Of Clinical Reasoning In Pre-Registration Dentistry?, Sally Hanks

Peninsula Dental School

A Commentary on: The impact of different teaching methods on clinical reasoning and clinical decision-making of dentistry students: a systematic review. Journal of Dental Education, 2026, 90(1), pp.33–42 Design: This systematic review examined evidence on educational interventions aimed at developing clinical reasoning and decision-making skills in undergraduate dental students. Searches of PubMed, MEDLINE (Ovid), Cochrane Library, and Scopus were conducted to 15 September 2023. Eighteen studies met the inclusion criteria for qualitative synthesis. Study designs included cross-sectional and case–control approaches. PRISMA guidance was followed, and a flow diagram was provided. Case selection: Eligible studies were English-language reports evaluating clinical reasoning …

Integrated Incubators: A Novel Framework For Technology-Based Creative Arts Education, Brad Phelps Nisbet

Theses: Doctorates and Masters

This thesis investigates the development and impact of an educational framework designed to bridge the gap between academia and industry within the media and entertainment sector. It addresses the prevalent "skills mismatch" where graduates often lack the specific technical competencies, foundational knowledge, practical experience, or soft skills required for entry-level positions in a rapidly evolving landscape influenced by advancements like virtual production, real-time VFX, immersive media, and Al. Grounded in both theoretical and practical insights, the framework aims to foster student creativity, technical proficiency, industry readiness, transferable skills, and adaptability, prioritising a transformative, student-centric learning experience.

The research employed a …

Synergistic Removal Of Microplastic Fibres: Integrating Chitosan Coagulation In Hybrid Water Pre-Treatment Systems, Jayasuriya Arachchilage Nimesha Thathsarani

Theses: Doctorates and Masters

Microplastic fibres (MPFs) are the most prevalent form of microplastics detected in the influents of water and wastewater treatment plants. Owing to their elongated shape and low density, MPFs frequently evade removal even during tertiary processes such as membrane filtration. Enhancing pretreatment, particularly through cost-effective coagulation-flocculation can reduce the treatment burden on downstream systems. However, conventional inorganic coagulants often necessitate high dosages and can leave residual ions, posing environmental concerns.

As a sustainable alternative, the use of environmentally friendly coagulants such as Chitosan has gained attention for MPF removal. While Chitosan exhibits favourable qualities, its practical application is hindered by …