Digital Commons Network^™

The Impact Of Educating Interprofessional Healthcare Workers On The Role Of Occupational Therapy In The Cardiac Acute Care Setting, Jennifer L. Taosuvanna

UNLV Theses, Dissertations, Professional Papers, and Capstones

The acute care setting has been a vastly growing practice area for the occupational therapy profession. Occupational therapists assist clients in the acute care setting with activities of daily living retraining and functional transfer training to increase independence. Each client demonstrates a different discharge course from the acute care setting and occupational therapists play a key role in assisting the clients the most appropriate rehabilitative setting. All professionals in the acute care setting work cohesively to provide clients with the best outcome.

The doctoral project explored the importance of interprofessional healthcare worker education about occupational therapy practices in the acute …

Availability And Utilization Of Endoscopic Retrograde Cholangiopancreatography At Children's Hospitals., Sagar J. Pathak, Thomas M. Attard, Matthew Hall, Mustafa Arain, Melvin B. Heyman, Emily R. Perito

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: No study has explored whether availability of endoscopic retrograde cholangiopancreatography (ERCP) is adequate and equitable across US children's hospitals. We hypothesized that ERCP availability and utilization differs by geography and patient factors.

METHODS: Healthcare encounter data from 2009 to 2019 on children with pancreatic and biliary diseases from the Pediatric Health Information System were analyzed. ERCP availability was defined as treatment at a hospital that performed pediatric ERCP during the year of service.

RESULTS: From 2009 to 2019, 37,946 children (88,420 encounters) had a potential pancreatic or biliary indication for ERCP; 7066 ERCPs were performed. The commonest pancreatic diagnoses …

Optimized Scoring Of End-To-End Dosimetry Audits For Passive Motion Management – A Simulation Study Using The Iroc Thorax Phantom, Alex Burton, Mathieu Gaudreault, Nicholas Hardcastle, Jessica Lye, Sabeena Beveridge, Stephen F Kry, Rick Franich

Faculty, Staff and Student Publications

Dosimetry audits for passive motion management require dynamically-acquired measurements in a moving phantom to be compared to statically calculated planned doses. This study aimed to characterise the relationship between planning and delivery errors, and the measured dose in the Imaging and Radiation Oncology Core (IROC) thorax phantom, to assess different audit scoring approaches. Treatment plans were created using a 4DCT scan of the IROC phantom, equipped with film and thermoluminescent dosimeters (TLDs). Plans were created on the average intensity projection from all bins. Three levels of aperture complexity were explored: dynamic conformal arcs (DCAT), low-, and high-complexity volumetric modulated arcs …

Cross-Vendor Multiparametric Mapping Of The Human Brain Using 3d-Qalas: A Multicenter And Multivendor Study, Shohei Fujita, Borjan Gagoski, Ken-Pin Hwang, Akifumi Hagiwara, Marcel Warntjes, Issei Fukunaga, Wataru Uchida, Yuya Saito, Towa Sekine, Rina Tachibana, Tomoya Muroi, Toshiya Akatsu, Akihiro Kasahara, Ryo Sato, Tsuyoshi Ueyama, Christina Andica, Koji Kamagata, Shiori Amemiya, Hidemasa Takao, Yasunobu Hoshino, Yuji Tomizawa, Kazumasa Yokoyama, Berkin Bilgic, Nobutaka Hattori, Osamu Abe, Shigeki Aoki

Faculty, Staff and Student Publications

Purpose: To evaluate a vendor-agnostic multiparametric mapping scheme based on 3D quantification using an interleaved Look-Locker acquisition sequence with a T2 preparation pulse (3D-QALAS) for whole-brain T1, T2, and proton density (PD) mapping.

Methods: This prospective, multi-institutional study was conducted between September 2021 and February 2022 using five different 3T systems from four prominent MRI vendors. The accuracy of this technique was evaluated using a standardized MRI system phantom. Intra-scanner repeatability and inter-vendor reproducibility of T1, T2, and PD values were evaluated in 10 healthy volunteers (6 men; mean age ± SD, 28.0 ± 5.6 y) who underwent scan-rescan sessions …

Deep Learning-Based Automatic Classification Of Ischemic Stroke Subtype Using Diffusion-Weighted Images, Wi-Sun Ryu, Dawid Schellingerhout, Hoyoun Lee, Keon-Joo Lee, Chi Kyung Kim, Beom Joon Kim, Jong-Won Chung, Jae-Sung Lim, Joon-Tae Kim, Dae-Hyun Kim, Jae-Kwan Cha, Leonard Sunwoo, Dongmin Kim, Sang-Il Suh, Oh Young Bang, Hee-Joon Bae, Dong-Eog Kim

Faculty, Staff and Student Publications

Background and purpose: Accurate classification of ischemic stroke subtype is important for effective secondary prevention of stroke. We used diffusion-weighted image (DWI) and atrial fibrillation (AF) data to train a deep learning algorithm to classify stroke subtype.

Methods: Model development was done in 2,988 patients with ischemic stroke from three centers by using U-net for infarct segmentation and EfficientNetV2 for subtype classification. Experienced neurologists (n=5) determined subtypes for external test datasets, while establishing a consensus for clinical trial datasets. Automatically segmented infarcts were fed into the model (DWI-only algorithm). Subsequently, another model was trained, with AF included as a categorical …

Survival Outcomes Of Patients With Her2/Neu-Positive Breast Cancer With Germline Brca Mutations, Fatma Nihan Akkoc Mustafayev, Mihir Amitabh Shukla, Amanda Lanier, Denái R Milton, Angelica M Gutierrez, Stephen K Gruschkus, John E Lewis, Rashmi K Murthy, Banu K Arun

Faculty, Staff and Student Publications

Background: Breast cancer (BC) with germline BRCA1/2 mutations and their association with triple-negative BC has been thoroughly investigated. However, some carriers of BRCA1/2 mutations have human epidermal growth factor receptor 2 (HER2/neu)-positive BC, which has a different targeted therapy approach, and data are scarce for this patient population. The authors sought to characterize the clinical characteristics and outcomes of patients with HER2/neu-positive BC who had germline BRCA1/2 mutations.

Methods: This was a retrospective analysis of data from 1099 patients diagnosed with HER2/neu-positive BC who were screened for germline BRCA mutations between 1996 and 2022. Clinicopathologic features and survival rates were …

The Constitutively Active Form Of A Key Cholesterol Synthesis Enzyme Is Lipid Droplet-Localized And Upregulated In Endometrial Cancer Tissues, Hudson W Coates, Tina B Nguyen, Ximing Du, Ellen M Olzomer, Rhonda Farrell, Frances L Byrne, Hongyuan Yang, Andrew J Brown

Faculty, Staff and Student Publications

Cholesterol is essential for both normal cell viability and cancer cell proliferation. Aberrant activity of squalene monooxygenase (SM, also known as squalene epoxidase), the rate-limiting enzyme of the committed cholesterol synthesis pathway, is accordingly implicated in a growing list of cancers. We previously reported that hypoxia triggers the truncation of SM to a constitutively active form, thus preserving sterol synthesis during oxygen shortfalls. Here, we show SM truncation is upregulated and correlates with the magnitude of hypoxia in endometrial cancer tissues, supporting the in vivo relevance of our earlier work. To further investigate the pathophysiological consequences of SM truncation, we …

Serial Cytoreductive Surgery And Survival Outcomes In Recurrent Adult-Type Ovarian Granulosa Cell Tumors, Jeffrey A How, Alejandra Flores Legarreta, Katelyn F Handley, Bryan Fellman, Katherine I Foster, Deanna Glassman, Veena K Vuttaradhi, Allison L Brodsky, Barrett Lawson, Michael Frumovitz, Shannon N Westin, Lois M Ramondetta, David M Gershenson, Anil K Sood, R Tyler Hillman

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the role of cytoreductive surgery in patients with recurrent adult granulosa cell tumors of the ovary. Despite a multitude of treatment modalities in the recurrent setting, the optimal management strategy is not known. Cytoreductive surgery offers an attractive option for disease confined to the abdomen/pelvis. However, few studies have evaluated the role of surgery compared with systemic therapy alone following the first recurrence and subsequent disease progressions.

OBJECTIVE: This study aimed to determine the impact of secondary, tertiary, and quaternary cytoreductive surgery on survival outcomes in recurrent adult granulosa cell tumors of the ovary.

STUDY …

The Catalyst For Preservation: Assessing The Impact Of Historic Tax Credit Leverage On Surrounding Property Values In The State Of South Carolina, John Sutton

All Theses

The historic rehabilitation tax credit, in its many forms, is the single greatest driver of historic preservation investment in the United States. Despite this, very little research has been done regarding the secondary effects of historic tax credit leverage. The goal of this thesis is to assess the impact that substantial historic tax credit projects have had on the value of the properties that surround them in the state of South Carolina. Property tax assessment records were solicited from three different county governments within South Carolina to analyze the change in the assessed value induced by the introduction of tax …

Entropy-Infused Deep Learning Loss Function For Capturing Extreme Values In Wind Power Forecasting, Mucun Sun, Sergio Valdez, Juan M. Perez, Kevin Garcia, Gael Galvan, Cesar Cruz, Yifeng Gao, Li Zhang

Electrical and Computer Engineering Faculty Publications

Extreme scenarios in wind power generation occur with higher frequency and larger magnitude in the recent years due to the ever-increasing extreme meteorological factors. Accurate forecasting of the occurrence of extreme values in wind power generation is of great concern to ensure reliable power system operation. Recently, deep learning models have surged in popularity for wind power forecasting, with the mean squared error (MSE) loss function being commonly used. However, the MSE loss function, being sensitive to extreme values, disproportionately penalizes larger errors, cannot adequately capture the extreme values present in wind energy data, and novel loss functions have seldom …

Compliance And Efficacy Of Orthodontic Medicaid In Southern Nevada: A Retrospective Study, Troy Mccartney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The study’s main objective is to evaluate efficacy and compliance in Medicaid orthodontic patients compared to private insurance and cash (self-pay) patients in Southern Nevada. In addition, the paper will study the trends in approval selection such gender, age, race/ethnicity, and case type. This information will be used to discuss the barriers that Medicaid patients face and offer solutions for the issues found in the orthodontic Medicaid system.

Introduction: Medicaid coverage was brought forward by the Federal Social Security Act in July of 1965. Since then, there have been many discussions on how orthodontic treatment should be covered under …

Mindfulness For Middle School Students Receiving Adapted Physical Education Services: Quality Improvement Program, Kaila Mangrum

UNLV Theses, Dissertations, Professional Papers, and Capstones

Middle school students with disabilities are often isolated from their peers with decreased opportunities for participation, struggle with social emotional regulation, and self-efficacy. This has been evident among students with various disabilities who are from various age groups receiving special education services including adapted physical education (APE). Research has shown mindfulness amplifies learning and promotes a positive environment that supports children’s overall wellbeing. This quality improvement project focused on developing an occupational therapy centered mindfulness program to enhance social participation, self-efficacy, and social-emotional regulation. Data collection occurred pre and post program from specialized program teacher assistants (SPTAs) using the School …

Effectiveness Of A Virtual Simulation Program As A Novel Approach To Improve Clinical Judgment In Prelicensure Nursing Students, Monica Millard

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: Limited clinical placement opportunities for practicing decision-making skills have widened the academic-practice gap. Research shows a disturbing decline in entry-level competency among newly graduated registered nurses. Innovative strategies like virtual patient simulation may foster decision-making skills and prepare prelicensure nursing students for practice. However, research is lacking in examining virtual patient simulation (VPS) as an effective approach for developing clinical judgment in prelicensure nursing students. The American Association for Academic Nursing has determined that clinical judgment is an essential nursing attribute. Moreover, the National Council of State Boards of Nursing developed the Next Generation National Council Licensure Exam based …

Parsing The Plains: Placing Emporia, Kansas In The Great Plains Midwest, Joseph Noce

UNLV Theses, Dissertations, Professional Papers, and Capstones

This thesis examines the formation of a region that can be called the Great Plains Midwest. It shows this formation through the city of Emporia, Kansas, which grew in tandem with the region. The thesis also examines Emporia as a case study of the cycle of birth, growth, and stagnation visible across the Great Plains between the 1850s and 1910s. This era traces Emporia from its humble beginnings to a period of population stagnation that followed the Panic of 1893. Three chapters cover Emporia’s agriculture, railroads, and colleges and universities, comparing each to the same elsewhere in both the midwestern …

The Operatic Innovation And Musical Language Of Rodion Shchedrin's Choral Opera Boyarina Morozova, Valeria Ore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rodion Shchedrin is an outstanding composer who uses the deep tradition of Russian musical culture in his compositions. Shchedrin’s style is very individual and consists of the universality of world perception and originality of musical language, which encompasses a sensitive assimilation of a new, careful, and respectful approach to Russian traditions. By reasonably and fragmentarily using the elements of dodecaphony, sonorics, and aleatoric music, he developed his own musical language. Thus, the purpose of this work is to explore Shchedrin’s compositional style and to discover his innovation and individual style in the opera Boyarina Morozova. Shchedrin’s compositions are unusual: …

Needs Assessment For Implementation Of A Dedicated Admission And Discharge Nurse Position, Connie Ngo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Patient turnover refers to when patients are admitted, discharged, or transferred to or from a clinical unit or another facility. Rapid patient turnover compels nurses to provide care in an environment where clinical demands exceed nursing care capacity. The excess of clinical demands can lead to rationing of nursing care and culminate in nursing stress and dissatisfaction. These negative effects on the nursing workforce subsequently have undesirable implications for patient and hospital outcomes. Implementation of a dedicated admission and discharge nurse (ADN) position can optimize patient flow, improve nursing satisfaction, and ultimately promote positive patient outcomes. Purpose: The purpose …

Adapting Traditional Flamenco Music For The Modern Marimba Artist, Gabriela Ordoñez Villalobos

UNLV Theses, Dissertations, Professional Papers, and Capstones

This document is a compilation of information and exercises for the percussionist to learn how to play Traditional Flamenco on marimba. The document contains a brief history of flamenco and the explanation of the elements of four different palos flamencos (subgenres) to introduce the marimbist to the basic musical elements and structure of each palos flamencos. It also includes musical exercises written specifically for marimba. These exercises are traditional components of authentic Flamenco music and can be used in performances as a soloist or as part of a Flamenco ensamble.

Flamenco music has three main elements: El cante, el toque, …

Increasing Swim Instructors' Perceived Knowledge Of Sensory-Based Strategies When Coaching Children Who May Have Sensory Differences, Gabrielle Palmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Although swim instructors are solely taught water safety regulations and correct swimming techniques, they are nonetheless viewed as mentors by the kids they work with. They are required to finish both their basic swim instructor (BSI) course and their cardiopulmonary resuscitation (CPR) certification, which primarily covers the fundamentals (American Red Cross Training Services, 2023; Kraft & Leblanc, 2018). However, neither provides a method of teaching swimming to children who might have sensory processing differences. This lack of education may affect both the child's participation and the swim instructor's capacity to impart knowledge. Research revealed that swim instructors are not very …

Boron-Doped Diamond As A Resilient Electrode Material In Molten Salts, Hannah Katherine Patenaude

UNLV Theses, Dissertations, Professional Papers, and Capstones

Molten salt chemistry has a range of applications within nuclear technology, including for the Molten Salt Reactors (MSRs) and pyroprocessing to recover valuable actinides for energy and national security needs. However, the high-temperature, corrosive nature of molten salts makes them particularly challenging to deploy on an industrial scale and study in benchtop measurements. Material accountability and corrosion monitoring of MSR fuels are essential components to the successful deployment of MSRs, and electroanalytical techniques like cyclic voltammetry (CV) and spectroelectrochemistry (SEC) can provide a wealth of information to describe salt systems in situ. To perform such measurements, it is imperative to …

Africanities In Selected Art Songs For Voice And Piano By Babi De Oliveira, Ana Elisa Portes Lima

UNLV Theses, Dissertations, Professional Papers, and Capstones

This document explores Africanities on the music and texts of selected art songs by the Brazilian composer Babi de Oliveira (1908-1993), providing the historical context of how the Brazilian Portuguese appropriated the vocabulary and culture of African people brought to the New World during the period of slavery between the 15th and 19th centuries. The purpose of this document is to provide additional background information on the Afro-Brazilian musical heritage, its relevance to the composer, and its aesthetics in the history of Brazilian music, in order to give voice students and performers, especially non-Portuguese speakers, a broader perspective on this …

Students’ Learning About Occupation In An Occupational Therapy Program, Erik Regalado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Describe the learning activities that occupational therapy students found helpful for learning the concept of occupation and describe what students know about the concept of occupation.

Design: Descriptive correlational

Setting: Occupational therapy program in the U.S

Participants: Occupational therapy students

Measure: Survey

Results: These students had a general understanding of occupation and its relationship to health, however, lacked the more conceptual understanding of occupation found in occupational science. Participants reported that activities such as fieldwork, group discussion, and lecture helped them understand the concept of occupation.

Conclusion and Relevance: These students missed aspects of occupation and would benefit from …

Development Of A Cue-Based Feeding Education Program To Enhance The Self-Efficacy Of Nicu Caregivers, Jazmin Rivera

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the neonatal intensive care unit (NICU), a neonate may experience feeding difficulties due to their prematurity, physiological, and neurological status. Under these circumstances, a caregiver’s role can be diminished and cause a loss of self-efficacy due to the inability to provide care and feed their infant in the NICU. After examining the literature, guided by the Model of Human Occupation and the Transformative Learning Theory framework, a cue-based feeding (CBF) program was developed and implemented at the University Medical Center (UMC) Hospital NICU department to enhance the caregiver’s self-efficacy through an occupational therapy perspective. A feasibility evaluation of the …

The Effects Of Nicotine On Growth, Surface Marker Expression, And Osteogenic Capacity Of Stem Cells From Human Exfoliated Deciduous Teeth (Shed) And Dental Pulp Stem Cells (Dpsc), Kaileen Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The gaining popularity of electronic nicotine delivery systems (ENDS) and inhaling aerosols (“vaping”) among young people have exposed them to unprecedented amounts of nicotine. Fourth generation ENDS manufacturers attract the adolescent demographic with a smooth vaping experience with enticing flavors such as “Piña Colada” or “Peppermint Blast.” Components of e-liquids in cartridges of ENDS combine protonated nicotine, also referred as nicotine salts, with flavors in a propylene glycol or vegetable glycerin solvent. Unregulated, high amounts of nicotine in ENDS products have been associated with increased levels of nicotine in the circulating blood of users with an average concentration of …

Plant-Plant Interaction In Early- Vs. Late-Successional Varieties Of The Hawaiian Landscape-Dominant Tree, Metrosideros Polymorpha, Tomoko Sakishima

UNLV Theses, Dissertations, Professional Papers, and Capstones

Plant-plant interactions play an important role in assembling plant communities. Interactions between neighboring plants can vary as a result of the genetic relatedness of neighbors, impacting rates of growth and patterns of resource allocation. When growing alongside close relatives, some species decrease their growth in a form of cooperation, while others grow faster through facilitation. A complication of plant interaction studies arises because decreased growth in the presence of close relatives can also be due to competition for resources, which increases with phenotypic similarity. Further complicating matters, mycorrhizal fungi, through their connections with plant roots, may strongly influence plant interactions. …

Assessment Of Success Factors And Comparative Analysis Of Public Private Partnership (P3) Project Performances Against Design-Build And Design-Bid-Build Project Delivery, Bandana Shrestha

UNLV Theses, Dissertations, Professional Papers, and Capstones

Public-private partnerships (P3s) projects have gained widespread popularity in both developed and developing countries due to their ability to access new financing sources and shift specific project risks to the private sector. P3s has been an active area of research with a particular focus on the concept of Critical Success Factors (CSF). The growing interest and the diverse outcomes associated with P3s emphasize the need for a thorough investigation into the factors that contribute to successful P3 projects. This study focused on identifying the CSFs for P3 highway and building projects towards project objectives of achieving cost efficiency and schedule …

Evaluation Of The Extent Of Floods In 2022 In Different Land Cover And Land Use Classes In Sindh Province, Pakistan Using Sentinel-1 And Sentinel-2 Imageries, Alina Shrestha

UNLV Theses, Dissertations, Professional Papers, and Capstones

Floods are one of the most frequent and most devastating natural disasters, which cause widespread destruction and pose significant risks to human life, infrastructure, and the environment. Advancement in remote sensing technologies and methodologies have demonstrated their efficacy in disaster-related applications, such as the detection, monitoring, and analysis of floods. This study explores the utilization of Synthetic Aperture Radar (SAR) and optical imagery for flood extent mapping and studying the extent of flood over various land cover and land use classes in Pakistan's Sindh province, utilizing the cloud computing power of Google Earth Engine. The change detection method identified extensive …

The Effects Of A Low-Intensity Aerobic Exercise Program To Enhance Occupational Performance And Quality Of Life In Diabetic Patients, Asia Suriyachottakul

UNLV Theses, Dissertations, Professional Papers, and Capstones

Globally, diabetes mellitus (DM) is a prevalent chronic condition many people encounter. DM is one of the primary causes of mortality due to individuals struggling to manage or prevent the condition. The healthcare field is also failing to provide sufficient education on DM. Individuals with this condition may begin to experience co-morbidities and depressive symptoms, which make it difficult for them to engage in meaningful occupations, in addition to decreased quality of life (QOL). This project examines the effectiveness of a low-intensity aerobic exercise (LIAE) program to enhance occupational performance (OP) and QOL in those diagnosed with the condition or …

Quaternary Ammonium Compound Resistance Of Klebsiella Pneumoniae And Klebsiella Quasipneumoniae Strains Isolated From The International Space Station, Natasha Svetlana Sushenko

UNLV Theses, Dissertations, Professional Papers, and Capstones

The International Space Station (ISS) has been continuously inhabited for twenty-three years and harbors a diverse population of microorganisms under conditions of microgravity, elevated radiation, and relative isolation, including Biosafety Level 2 (BSL-2) opportunistic pathogens. To sanitize surfaces on the ISS, astronauts use a combination of four antimicrobial quaternary ammonium compounds (QACs). As the stresses of space flight are known to stimulate virulence and antimicrobial resistance in bacteria, the frequent use of QAC disinfectants on the ISS is of concern to NASA. This not only poses risks to astronauts during future long-term space travel, but there is also a concern …

Online Learning For Acid-Fast Bacilli Detection In Histopathological Images, Shizhao Wang

UNLV Theses, Dissertations, Professional Papers, and Capstones

The acid-fast stain is frequently used for laboratory diagnosis of tuberculosis. It is a labor intensive task requiring thorough examination of extremely high-resolution images to pinpoint the presence of the mycobacteria. This paper presents a machine learning assisted slide image analysis tool with the aim of aiding histopathology professionals in the accurate diagnosis of tuberculosis in patients through the analysis of microscopic imagery. The proposed tool combines a digital whole slide image viewer with an online learning framework. We also conducted a survey of different state-of-the-art online learning methods, and found that MIR with pre-training has the best performance on …

Approach To Multi-Criteria Decision-Making In A Neutrosophic Picture Hyper-Soft Set Environment Using Generalized Neutrosophic Topsis, Manpreet Kaur, Akanksha Singh

Neutrosophic Sets and Systems

Given the complexity of today’s world, we might need to work with numbers requiring multi-attribute functions, such as those having positive, neutral, and negative membership and those having truth, indeterminacy, and falsity membership. Adding these numbers together to get a single real number is the most important factor. In situations like this, decision-makers have more difficult choices and are unable to apply the single attribute function of the soft set theory. To address this constraint, the hyper-soft set theory with multi-attribute functions is introduced. We combine the notion of neutrosophic hypersoft set with picture fuzzy hypersoft set to form a …