Digital Commons Network^™

Utility Of Ebus-Tbna In Evaluating Mediastinal And Hilar Lymphadenopathy In Patients With Silica Exposure: A Retrospective Single-Center Study, Tarake M. Aljarod, Atul C. Mehta, Saroj Sigdel, Mark Jason Akers, John L. Saylor, Caleb S. Clark, Yousef Shweihat

Pulmonology

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used effectively in staging lung cancer and in the evaluation of benign causes of mediastinal and/or hilar lymphadenopathy (MHL), such as sarcoidosis. However, evidence for its utility in the diagnostic workup of silicosis is limited.

Methods: This single-center retrospective study included patients with occupational silica exposure who underwent EBUS-TBNA to evaluate MHL on computed tomography (CT). Cytology specimens were re-examined by an independent pathologist under polarized microscopy, and cytologic criteria for the diagnosis of LN silicosis were formulated from the findings. Primary outcomes were the determination of the diagnostic yield (DY) of …

U.S. Withdrawal From Afghanistan And Realignment Of Eurasian Rival Powers, Toghrul Seyidbayli

Journal of Strategic Security

This article explores the geopolitical ramifications of the U.S. withdrawal from Afghanistan, focusing on how it has catalyzed strategic realignments among China, Russia, and Iran in Eurasia. By examining the withdrawal’s impact on the regional power dynamics, the article analyzes how these revisionist states have exploited the resulting power vacuum to assert their influence and challenge the existing international order. China has used this moment to expand its Belt and Road Initiative, Russia has felt emboldened to escalate its military actions in Ukraine, and Iran, despite regional setbacks, remains determined in pursuing its revisionist strategy in Eurasia. The study employs …

Navigating Transit Governance: Wto Rules And Unclos With A Focus On Nepal And Afghanistan, Dr.Neeru Sidana, Disha Tiwari Ms.

Journal of Strategic Security

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Many developing, landlocked countries, such as Nepal and Afghanistan, face significant challenges in accessing international markets, which hinders their development. These issues inspired the United Nations Convention on the Law of the Sea (UNCLOS) in 1982, which grants landlocked states the right to navigate through coastal territories for trade. This article investigates how UNCLOS has influenced the transit and trade of Nepal and Afghanistan since the treaty's signing. The research examines the macroeconomic impacts of UNCLOS on these countries, focusing on trade trends and regional cooperation agreements. It analyzes how UNCLOS has facilitated increased trade and new economic activities …

Terrorism And Counterterrorism In The Taliban’S Afghanistan, Jonathan Schroden

Journal of Strategic Security

This article focuses on terrorist groups and efforts to counter them in Afghanistan after the Taliban takeover of the country in August 2021. It begins with a brief overview of the most significant international and regional terrorist groups in the country and where these groups stood when the Taliban came to power. It then discusses the efforts of the United States, Pakistan, and the Taliban to counter (or not) those terrorist groups. Specific attention is paid to real or potential cooperation between these efforts. The chapter ends with a discussion of trendlines of the past three years and what those …

Afghanistan, Wargaming, And Human Behavior, John A. Kirbow

Journal of Strategic Security

This article seeks to show how our successes and overall strategic failing in Afghanistan – in particular, the swift takeover by Taliban forces despite two decades of nation-building and partnering – can be a teachable moment. Specifically, how a more realistic, grounded understanding of human nature and decision making, informed by concepts of human incentives, uncertainty, and risk, can assist us in certain warzones. This understanding may be critical in current and future conflicts where the (1) the formal governing system is ineffective, (2) said government tends to be unresponsive to the needs of lower-level leaders and the population, and …

Human Security And Afghan Refugee Resettlement In The Us: A Case Study Of Camp Atterbury, Arif Akgul, Jennifer Grimes, Samuel Valentine

Journal of Strategic Security

This study examines the application of human security theory in the humanitarian operation at Camp Atterbury, which provided temporary resettlement for over 7,200 Afghan evacuees in the State of Indiana as part of Operation Allies Welcome (OAW). Afghan evacuees were admitted to the US under humanitarian parole and experienced a transitional period since their arrival on August 2021. Using the three pillars of human security: freedom from fear, freedom from want, and freedom to live in dignity, conceptualized by the United Nations Development Program (UNDP) and Kofi Annan, this analysis explores the security measures, essential services, and accommodations implemented to …

From Uncertainty To Strategic Failure: U.S. Military Interventions And The Complexity Of Nation-Building In Afghanistan, Goddy Uwa Osimen, Oluwamurewa Newo

Journal of Strategic Security

The American occupation of Afghanistan from 2001-2021 is widely regarded as a strategic failure, particularly after the Taliban took over the government in 2021. This work seeks to observe the strategic flaws of the 20-year occupation from the perspective of nation-building within the state. Using the theoretical lens of strategic culture and borrowing from Huntington’s discourse on the clash of civilizations, this article notes that nation-building failure in Afghanistan can be attributed to the ideological differences between the West and the Middle East. Using a descriptive qualitative approach and secondary sources such as books and peer-reviewed articles, the study employs …

Three-Dimensional Printed Swabs For Diagnostic Testing, Summer J. Decker, Jonathan Ford, Todd Hazelton, Todd Goldstein, Kami Kim, Michael Teng, John Sinnott

USF Patents

A three-dimensional printed swab may include a shaft defining a longitudinal axis of the swab, and a tip portion integrally formed with the shaft. The tip portion may include a plurality of protrusions each extending outward from the shaft and transverse to the longitudinal axis. A method for fabricating a three-dimensional printed swab may include receiving a digital three-dimensional model corresponding to the swab, and integrally forming, via three-dimensional printing and based at least in part on the digital three-dimensional model, a shaft and a tip portion of the swab. The shaft may define a longitudinal axis of the swab. …

Atomic Clock Utilizing Spin-Dependent Recombination, Denis Karaiskaj

USF Patents

A silicon-based atomic clock for use in an electronic device structured to employ spin-dependent recombination in the silicon crystal. In at last one implementation, a source of energy configured to excite the impurity atoms within the silicon crystal includes a source of thermal energy but not a source of light or a source of broadband light that is not matched to said energy level transition of the impurity atoms.

Schizophrenia Care Among People Experiencing Homelessness In The Matanuska Susitna Borough, Mary K. Wargo

Consortium Library Prize Winners

Schizophrenia is a chronic mental disorder that often manifests in early adulthood (Jauhar et al., 2022). Positive symptoms include reality distortions, disordered thinking, hallucinations, or delusions; while negative symptoms are seen in an individual’s lack of motivation and expression (Jauhar et al., 2022; Norris, 2019). Cognitive deficits are also a clinical feature (Harvey et al., 2022; Jauhar et al., 2022). Schizophrenia affects an estimated 0.3 – 1.6% of the United States population (Finnerty et al., 2024). Most recent data from Alaska reveals 1,664 Alaskans live with schizophrenia (Heun-Johnson et al., 2019). Despite the small percentage of the population with a …

Exploring Communication In Multi-Agent Cooperative Reinforcement Learning, Matthew Kalarickal

Math and Computer Science Honors Theses

This work focuses on communication strategies within a cooperative multi-agent reinforcement learning system. The goal is to explore how communication can be used among agents to potentially improve performance. The research operates within the scope of “learning tasks with communication,” where the primary aim is to solve domain-specific tasks through information exchange using explicit communication protocols. Three distinct communication strategies were implemented and explored: Combinatorial Ghost, Feature Sharing Ghost, and Move Sharing Ghost. Fully Centralized Training and Execution and Centralized Training with Decentralized Execution training approaches were based on the different communication strategy used. Performance metrics were recorded for these …

Roper Center For Public Opinion Research: Over 25,000 Datasets!, Joanne Romano

TMC Library Newsletter (2015-)

Roper iPoll provides access to nearly one million public opinion survey questions and responses, including valuable health-related data. You can find it listed in our A to Z Databases or access directly here. Need help getting started? Check out the Roper iPoll tutorial available on their homepage!

Influence Of Human Activity On Rafting Behavior And Group Dynamics Of Southern Sea Otters, Enhydra Lutris Nereis, In Central California, Sierra Fullmer

Capstone Projects and Master's Theses

Coastal development and tourism have increased human-wildlife interactions, raising concerns for southern sea otters, Enhydra lutris nereis, an ecologically important and charismatic species that often rests in nearshore habitats near active harbors and tourist centers. This study examined the effects of human activity and group dynamics on rafting behaviors across three sea otter subpopulations with varying exposure to human stimuli. I hypothesized that sea otters would exhibit more resting and parental behaviors in low human activity areas and larger rafts, and that increased human activity within an area would lead to larger raft sizes, supporting the many-eyes hypothesis. Fieldwork involved …

Why Are Men So Obsessed With Pornography? Andrea Dworkin Was Right, Robert Jensen

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Sex-Based Differences In The Representation Of Top Youth Athletes, Jessica J. James, Sandra K. Hunter, Elizabeth P. Bueckers, Michael J. Joyner, Jonathon W. Senefeld

Exercise Science Faculty Research and Publications

Although emerging research demonstrates that male athletes outperform female athletes before puberty, the effect of these sex-related advantages on ordinal ranking of top performances remains unclear.

Objectives

Among overall top performances of youth track and swimming athletes, we aimed to determine 1) the proportional number of male compared with female athletes represented and 2) at what age females are no longer represented.

Methods

Finishing times and sex of the top 10 and top 100 performances of youth runners and swimmers between 5 and 18 yr were abstracted from online U.S.-based databases for four running (100 m–800 m) and six freestyle …

Lianas Reduce Tree Height With Negative Consequences For Carbon Storage And Growth Estimates, Xingyan Cao, Frieke Van Coillie, Sruthi M. Krishna Moorthy, Kasper Coppieters, Barbara D'Hont, Stefan A. Schnitzer, Geertje M. F. Van Der Heijden, Hans Verbeeck, Félicien Meunier

Biological Sciences Faculty Research and Publications

1. Current evidence suggests that liana (woody vine) competition with trees could be threatening the carbon sink by reducing carbon uptake and storage in tropical forests. Previous studies investigating forest demography in liana removal experiments have, however, assumed similar allometries for trees, regardless of the amount of lianas they support. Yet, recent observations suggest that liana load may alter tree shape and structure, including height, which could result in an underestimation of the liana effects on forest carbon stocks and tree growth.
2. In this study, we used terrestrial laser scanning (TLS) in a liana removal experiment in Gigante Peninsula, Panama, collected …

Building Bilingual Education Programs In Japan: Insights From Administrators In Private And International Schools, Megan C. Roe

Doctor of Education (Ed.D)

This qualitative study examined the lived experiences of school administrators who lead bilingual programs in private and international schools in Japan. Through in-depth interviews with 11 administrators, the study examined how leaders navigate program design, curriculum choice, and program oversight in response to their community’s needs and stakeholder expectations. This research aimed to contribute to the limited literature on bilingual education within Japan’s unique cultural and educational context. Data were collected through semistructured interviews and analyzed using a phenomenological approach to identify four emerging themes: Designing Responsive Bilingual Programs, Instructional Approaches that Support Bilingual Learners, Aligning Expectations and Operational Realities, …

The Lived Experiences Of Education Instructors At Abc Vocational School For The Incarcerated, Artemas R. Holloway

Doctor of Education (Ed.D)

This qualitative phenomenological study explored how specialized community college trade instructors' lived experiences influence classroom strategies, management, and teaching methods when educating incarcerated students at ABC Vocational School (ABCV), a college campus within a correctional setting. Grounded in social constructionism, the study examined how instructors develop professional knowledge through interactions with students, colleagues, and the institutional environment. Ten instructors with at least one year of experience teaching incarcerated students participated in semi-structured interviews conducted through Zoom. Interview transcripts were examined using descriptive coding and thematic analysis supported by manual procedures and Delve qualitative data analysis software. Five themes emerged: (a) …

Patient-Centered Approach To Decrease Length Of Stay, Erika Beck

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Unmet social needs contribute to hospital readmissions and extended inpatient stays, placing strain on care coordination and hospital throughput. Social Determinants of Health (SDOH), such as housing instability, lack of transportation, or food insecurity, are often unaddressed in clinical workflows. At the project site, a gap in effectively integrating SDOH into the discharge planning process led to delayed discharges and increased length of stay (LOS). Additionally, 41.20% exceeded the Geometric Mean Length of Stay (GMLOS), surpassing the organizational benchmark of 40.17%. Gaps in standardized assessment and communication of SDOH data limited the ability to plan timely discharges and connect …

Enhancing Diabetes Care In Adult Patients With Type 2 Diabetes In An Outpatient Setting, Osayanmo Ojo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition associated with significant morbidity, particularly among underserved populations. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to improve diabetes care among adult patients with poorly controlled T2DM (A1C > 9%) in an outpatient primary care clinic by increasing referrals to the Diabetes Self-Management Education (DSME) program. Guided by the Plan-Do-Study-Act (PDSA) cycle and the OhioHealth Change Management (OHCM) model, the project implemented structured interventions including standardized DSME referral workflows, electronic health record (EHR) prompts, provider education, and culturally tailored communication strategies.

The 12-week initiative targeted 68 eligible patients. …

Preventing 30-Day Rehospitalization In Congestive Heart Failure Utilizing Transitional Care Teams, Esther Baminrin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Congestive Heart Failure (CHF) continues to be a prevalent and challenging health issue, contributing significantly to hospital readmissions within the first 30 days of patients transitioning to home health care. Rehospitalization affects the patient's quality of life and the agency's revenue, as reimbursements are paused when patients are hospitalized during the first 30 days of admission to a home health agency. The agency experienced a 22% rehospitalization rate within a year, slightly higher than the national average of 10%.

Aim of the Project: The primary objective of this project was to decrease rehospitalization of patients with CHF within the …

Effect Of Standardized Phone Call Protocol On The Achievement Of Target Hba1c Levels, Felicia Choyce

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Type 2 Diabetes Mellitus is a common chronic illness with far-reaching health and financial consequences. At the project’s primary care clinic, the average hemoglobin A1c among adults with Type 2 Diabetes Mellitus was 9.6%, exceeding the recommended clinical goal of less than 7% (American Diabetes Association, 2023). The absence of a standardized follow-up protocol and inconsistent use of health literacy-based communication contributed to persistent hyperglycemia and failure to reach target HbA1c levels. These factors indicated an urgent need for an evidence-based intervention.

Aim of the Project:
The aim of this project was to reduce HbA1c levels among adults with …

Improving Depression Screening For Young Adults In Outpatient Settings, Addie Smith

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Depression among young adults aged 25 to 35 years in the United States has been among the second highest at 19.9%. Depression underdiagnosis stems from many patient-level causes, including a lack of standardized screening, inadequate provider education, and stigma of mental illness. Untreated depression results in low quality of life, comorbidities, suicidality, and socioeconomic issues.

Aim of the Project: The aim of this project was to address the gap in practice by implementing a standardized screening process for young adults to enhance diagnoses and increase screening rates.

Review of the Evidence: A comprehensive review of the evidence …

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Improving Hospital Throughput Through Flash Rounds And Standardized Discharge Readiness Assessments, Erin D. Dobda

All Doctor of Nursing Practice (DNP) Scholarly Projects

• Problem: The target hospital faced serious throughput challenges, with emergency department overcrowding and discharge inefficiencies impacting patient outcomes and organizational performance. Discharge order to depart times exceeded the 90-minute benchmark, averaging 154 minutes, while 41.2% of patients exceeded the geometric mean length of stay (GMLOS) target of 40.17%. Gaps included inconsistent discharge planning, poor communication, and limited follow-through on barriers.
• Aim of the Project: The project aimed to improve hospital throughput by reducing GMLOS and discharge order to depart times on Unit A. This was achieved through implementation of proactive, evidence-based interventions to streamline discharges, reduce delays, and support safe …

Improving Provider Documentation For Procedure Authorizations: A Nursing Perspective On Enhancing Outcomes And Compliance, Juli Legg

All Doctor of Nursing Practice (DNP) Scholarly Projects

Insurance denials resulting from non-standardized documentation and communication gaps in the prior authorization process adversely impacted financial performance and patient care within the electrophysiology (EP) department of a large Midwest academic medical center. High denial rates for costly procedures revealed a need for improved alignment with payer medical necessity criteria. This quality improvement (QI) project aimed to enhance provider documentation, reduce denials, improve care delivery, and increase revenue by implementing standardized documentation templates. A review of the literature supports that standardized documentation and clinical decision support tools enhance consistency, reduce errors, and improve prior authorization success rates. Guided by the …

Improving Colorectal Cancer Screening Referrals In A Rural Health Clinic, Kysha Mcbee

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Colorectal cancer is the second leading cause of cancer death in the United States. Preventive screening for colorectal cancer has been associated with early detection and improved 5-year survival rates. The referral rates for colorectal cancer screening at the practicum site were 17.7%, well below the national benchmarks of 71.8%.

Aim of the Project: The aim of this project was to increase the screening referral rates in adults aged 45 to 75 years by 50% over a ten-week period by implementing an evidence-based toolkit.

Review of the Evidence: Literature review highlighted barriers to colorectal cancer screening, such as knowledge …

Optimizing Transfer Classification: Enhancing Accuracy And Reducing Readmission Rate Penalties For Cardiovascular Care In Short-Term Rehab, Aeshia Hicks

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a short-term rehabilitation (STR) setting, misclassification of planned hospital transfers as unplanned readmissions among elderly cardiovascular patients inflated CMS-reported readmission rates, distorted performance metrics, and led to financial penalties under the Hospital Readmissions Reduction Program (HRRP). A gap analysis revealed a 14% misclassification rate, significantly higher than the CMS benchmark of 8.65%, which was attributed to inconsistent documentation and a lack of standardized classification criteria.

Aim of the Project: To reduce transfer misclassification by 20% through the implementation of a standardized electronic health record (EHR) template and targeted staff education, thereby improving CMS compliance and documentation integrity in …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

Investigating Environmental And Socioeconomic Contributors To Adult Obesity In The Rio Grande Valley, John Nicholas Cauba, Jihoo Woo, Russel Wiggins, Shizue Mito

School of Medicine Publications

Obesity in the Rio Grande Valley (RGV) of Texas remains a critical public health concern, with rates (46.9%) significantly exceeding those of Texas (36%) and the U.S. (34%) (p < 0.001). This study used 2024 County Health Rankings data to analyze environmental and socioeconomic contributors to obesity across 240 Texas counties, with a population-weighted focus on Hidalgo, Cameron, Starr, and Willacy counties. The RGV exhibited markedly poorer access to exercise, higher rates of physical inactivity, lower Food Environment Index scores (FEI = 4.3 vs. 5.7 in Texas), higher rates of uninsurance, worse patient-to–primary care physician (PCP) ratios (2152:1 vs. Texas 1660:1), and increased preventable hospitalizations. Multiple linear regression identified physical inactivity (β = 0.6, p = 0.01) and access to exercise (β = −0.02, p = 0.02) as significant predictors of obesity. Notably, higher uninsured rates were associated with lower reported obesity, likely due to underdiagnosis in the absence of routine care. These findings emphasize the need for targeted interventions addressing food access, environmental and recreational infrastructure, along with healthcare infrastructure in the RGV, where socioeconomic disadvantage and structural barriers magnify the impact of national obesity trends on the regional level.