Digital Commons Network^™

Patient Safety Culture Among Healthcare Professionals In Jeddah First Health Cluster: A Multi-Professional Cross-Sectional Study, Saad S. Alyazidi, Salah S. Alshagrawi

Saudi Medical Journal

Objective: Patient safety culture (PSC) is essential to improve healthcare quality and reduce preventable harm. Despite ongoing healthcare transformation in Saudi Arabia, there is limited evidence on healthcare professionals' (HCPs) perceptions of PSC in newly established health clusters. Methods: We conducted a cross-sectional study among HCPs in 6 government hospitals within the Jeddah First Health Cluster, Saudi Arabia. Data were gathered utilizing the Hospital Survey on PSC (HSOPSC). Descriptive measurement sand multiple linear regression analyses were used to evaluate perceptions of PSC and associated factors. Results: A total of 256 HCPs participated in the study. Overall, PSC was perceived as …

The Al-Bahah Paradox: Divergent Patterns Of Increased And Decreased Infectious Disease Incidence Relative To National Saudi Rates Over 12 Years Of Surveillance, Mohammed A. A. Alqumber

Saudi Medical Journal

Objective: To identify statistically significant deviations in notifiable infectious disease incidence between Al-Bahah region and national Saudi averages, and to generate hypotheses that may inform future epidemiological, microbiological, and public health investigations. Methods: In April 2026, a 12-year retrospective ecological study (2013–2024) was conducted using surveillance data from the Saudi Ministry of Health for 37 notifiable infectious diseases across 20 health regions. Cumulative incidence rates, standardized morbidity ratios (SMRs), and Z-tests compared observed cases in Al-Bahah against national estimates. Results: Overall incidence was 15.8% lower in Al-Bahah than nationally (86.42 versus 102.68; incidence rate ratios = 0.842; p …

Preoperative Urine Albumin-To-Creatinine Ratio Predicts Acute Kidney Injury After Coronary Artery Bypass Grafting, Ahmed M. Alkhunaizi, Jumana A. Al Naser, Khaled D. Algarni, Suhaib M. Ahmed, Amro M. Moubarak, Haralabos D. Parissis

Saudi Medical Journal

Objective: To prospectively evaluate whether baseline urine albumin-to-creatinine ratio (uACR) predicts acute kidney injury (AKI) and postoperative decline in kidney function in elective, isolated coronary artery bypass grafting (CABG) patients and explore the magnitude of effect across clinically relevant uACR strata. Preoperative uACR is a marker of glomerular endothelial dysfunction and systemic microvascular injury that may identify patients at increased risk for AKI after CABG. Methods: In this single-center prospective cohort study, 111 adults undergoing elective, isolated CABG between January 2020 and December 2024 were stratified by baseline uACR (< 30, 30–300, > 300 milligram/gram[mg/g]). The primary outcome was AKI defined by Kidney …

The Role Of F-18 Fdg Pet/Ct In The Evaluation Of Solitary Pulmonary Nodules, Erdal Cetinkaya, Fatih Guzel, Sadiye Altun Tuzcu, Ilbey Erkin Cetin, Ibrahim Ibiloglu, Esref Argin, Feray Altun Cetin, Bekir Tasdemir

Saudi Medical Journal

Objective: Fluorine-18 fluorodeoxyglucose positronemissiontomography/computedtomography (F-18 FDG PET/CT) is commonly used in the evaluation of solitary pulmonary nodules (SPNs). This study aimed to investigate the predictive value of maximum standardized uptake value (SUVmax) and its ratios to liver and mediastinal blood pool SUVmax values for malignancy in SPNs, using histopathological findings as the reference standard. Methods: The study included 130 patients who underwent F-18 FDG PET/CT and had either histopathological confirmation or at least two years of radiological follow-up. Demographic data (age and sex), nodule size, location, contour characteristics, nodule SUVmax, nodule-to-liver SUVmax ratio (NLR), and nodule-to-mediastinal blood pool SUVmax ratio …

The Case For Gulf Region-Specific Peripheral Artery Disease Trials: A Comprehensive Literature Review, Hosaam H. Nasr, Faisal A. Almudaiheem

Saudi Medical Journal

Peripheral artery disease (PAD) research is globally underrepresented, with landmark trials like Best Endovascular Surgical Therapy for Patients with Critical Limb Ischemia and Bypass versus Angioplasty in Severe Ischemia of the Leg predominantly featuring white, Western populations. These studies fail to account for the unique clinical landscape of the Gulf region, where PAD prevalence reaches up to 13.7%. Gulf patients present at younger ages and face a disproportionately high diabetes burden, with regional prevalence near 18%, nearly double that of Europe. Beyond metabolic factors, the Gulf population exhibits distinct genetic architectures, including high rates of consanguinity and familial hypercholesterolemia. Because …

The Role Of Chimeric Antigen Receptor Regulatory T Cells In Promoting Immune Tolerance In Solid Organ Transplantation: Mechanisms And Therapeutic Potential, Maher S. Alwethaynani

Saudi Medical Journal

Solid organ transplantation (SOT) is a life-saving procedure for patients with end-stage organ failure; however, lifelong immunosuppressant use is needed to prevent allograft rejection. These drugs increase the risk of non-Hodgkin lymphoma, liver, kidney, and lung cancers, and heighten susceptibility to oncogenic viruses, including hepatitis B and Epstein-Barr virus. The usage of chimeric antigen receptor (CAR) regulatory T (Treg) cells is a promising approach to induce transplant tolerance while minimizing dependence on immunosuppressants. The CAR Tregs offer the potential to enhance graft survival and quality of life by reducing immunosuppressant-related morbidity and mortality. Despite remarkable progress in transplantation tolerance, challenges …

Meta-Analysis On The Effect Of Tai Chi Chuan On Human Biomechanics And Health From (2021–2025), Bijad S. Alqahtani, Husam A. Almalki

Saudi Medical Journal

Objective: Prior reviews emphasize overall health outcomes of Tai Chi Chuan (TCC) but rarely resolve the biomechanical intermediates (such as Center of Mass (CoM)–Center of Pressure (CoP) control, joint loading) that link practice to clinical function—knowledge that matters for balance, fall risk, and osteoarthritic knee load management. This systematic review and meta-analysis aim to test the null hypothesis that TCC produces no improvement versus comparators in (i) biomechanical stability indices (mediolateral/anterior–posterior CoM–CoP separation; COP Root Mean Square RMS) and (ii) related clinical functions (such as Time up and go (TUG), Berg balance scale (BBS), Western Ontario and McMaster Universities Osteoarthritis …

Developmental Dysplasia Of The Hip In Saudi Arabia And The Gulf Countries: A Genetic Systematic Review Study, Naif Z. Alrashdi, Ahmed M. Almansour, Azfar Jamal

Saudi Medical Journal

Objective: To describe the available research on genetic determinants with special emphasis on the developmental dysplasia of the hip (DDH), in Saudi Arabia and Gulf nations, with reference to the genetic variants, family trend, and environmental factors. Methods: The literature search was conducted in PubMed, Embase, Scopus, Web of Science, and the Saudi Digital Library and Google Scholar through a broad literature search since the beginning of the databases until 2023. Studies that conducted in Saudi Arabia or Gulf countries which evaluated the relationships of genetic factors in DDH were included. Case reports, conference abstracts, and studies that did not …

Exploring Translational Medical Research Progress In G20 Countries: 5-Year Study, Hana A. Alhumud, Fars K. Alanazi, Edward B. Devol

Saudi Medical Journal

Objectives: Biomedical research is crucial for advancing medical knowledge and improving public health. However, the research process is often disjointed and lacks seamless progression, leading to delays and missed opportunities. To address this, the concept of translational research has emerged, focusing on the smooth transition of research results to the next stage of inquiry. Methods: This study analyzed approximately 40,000 research publications from the Web of Science database to identify research activities associated with translational research. Publications from Group of 20 (G20) countries over the past 5 years were examined to explore patterns of research focus and progress in this …

Indigenous Ontologies And Architecture, Reconstructing Interrelational Relationships, Arlene Garcia Guzman

McNair Summer Research Program

Contemporary architecture faces a growing pressure to respond to the socioecological crises with regard to the consequences of design that so often accept environmental systems as separate from the living. In contrast, many Native systems, often referred to as Traditional Knowledge (TK), comprehend cumulative, place-based bodies of knowledge that are developed through extended histories of interaction with specific environments. In this context, Traditional Knowledge encompasses resource use practices, sustainability, spirituality, and an emphasis on a relational worldview. It is characterized in such a framework that different layers of existence, such as humans, animals, plants, water, climate, and materials, are understood …

Facilitating Palliative Care In The Intensive Care Unit, Crystal Sanchez

Master's Projects and Capstones

Abstract

Problem: Critically ill patients in the intensive care unit (ICU) frequently experience unmet palliative care needs due to inconsistent identification processes and delayed goals‑of‑care (GOC) discussions. Prior to this project, palliative care consultation practices were highly variable and lacked standardized criteria, resulting in missed opportunities for early communication and symptom management. This gap underscored the need for a structured, nurse‑driven approach to improve timely palliative care integration.

Context: This quality improvement project was conducted in a 20‑bed adult ICU within a large community‑based hospital system where palliative care integration was inconsistent and not systematically monitored.

Interventions: A nurse‑driven palliative …

Artificial Intelligence In Central Arkansas School Districts: A Phenomenological Study Of Practices, Polices, And Perceptions, Alana M. Graham

ATU Theses and Dissertations 2021 - Present

Artificial intelligence (AI) has evolved at a fast rate and has created both opportunities and challenges for public school districts. As AI technologies continue to emerge, limited research exists regarding how school districts in central Arkansas are integrating AI into instructional and administrative practices. The purpose of this phenomenological study was to explore district-level administrators’ perceptions and experiences regarding the integration of artificial intelligence in public school districts in central Arkansas. The study was guided by Diffusion of Innovations Theory and the Technology Acceptance Model, and examined current AI practices, policy development, perceived benefits and challenges, and barriers associated with …

Escherichia Coli Concentrations In Sand And Water At Tributary-Influenced Lake Michigan Beaches, Josie Elaine Kuhlman

Masters Theses

Contamination of public recreational water and sand is a human health concern, creating a management challenge for public health officials. Past research has shown that Escherichia coli can persist in sediment and can be washed into recreational water. Currently, beach monitoring practices only utilize E. coli concentrations in water samples to determine beach safety and do not consider potential exposure to sediment/sand concentrations. In this study, I investigated the relationship between E. coli concentrations in water and sand samples, which will aid public health officials in making more informed decisions about beach closures. I utilized culture-based measurements of E. coli …

Evaluation Of Implementation Of An Evidence-Based Screening Tool For Genitourinary Syndrome Of Menopause, Anna L. Myers

Doctor of Nursing Practice Projects

Genitourinary syndrome of menopause (GSM) is a prevalent yet underrecognized and undertreated condition despite evidence-based therapies in the urology setting. The purpose of this Doctor of Nursing Practice quality improvement was to provide education on the 2025 American Urological Association/ Society of Urodynamics and Female Pelvic Medicine & Urogenital Reconstruction/American Urogynecological Society GSM guidelines and integrate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire into practice, evaluate outcomes of acceptability, appropriateness, and feasibility of the intervention, and the impact on diagnosis and associated GSM prescribing. The aim was to impact provider screening and treatment of patients with GSM. Kolcaba's Comfort …

Public Blame And Prevention Preferences Following K-12 School Shootings: Mean World Beliefs And Doomscrolling, Jennifer L. Lemanski, Gordon A. Crews

Communication Faculty Publications

This study examines how routine digital media use shapes public blame attribution and prevention preferences following K-12 school shootings. Drawing on Mean World Syndrome (MWS) and research on doomscrolling, the study investigates whether habitual exposure to threatening and sensationalized content is associated with patterns of digital engagement and interpretations of responsibility for school shooting events. Using a nationwide survey of U.S. adults (N = 540), the study measured MWS, doomscrolling tendencies, political orientation, blame attribution, and engagement behaviors such as seeking information, sharing, and commenting on school violence–related content. Canonical correlation analyses indicate that higher levels of MWS and doomscrolling …

Knowledge Organization As A Cognitive Framework: Integrating Metacognition And Executive Function In Higher-Order Thinking, Arwa Alsultan

Library Philosophy and Practice (e-journal)

This paper proposes a theoretical framework that positions knowledge organization as a cognitive mechanism rather than merely a technical or informational process. Drawing on an integrative review of literature across knowledge organization, metacognition, executive function, and schema theory, the study examines how structured knowledge environments may support higher-order thinking among researchers. The proposed model suggests that knowledge organization, metacognition, and executive function operate as an interconnected cognitive system: knowledge organization provides the structural foundation for processing information, metacognition enables monitoring and reflective regulation, and executive function supports cognitive control processes such as working memory, inhibition, and cognitive flexibility. Four theoretical …

Surgical Outcomes Of Hidradenitis Suppurativa Excision: Factors Impacting Wound Healing Time, Christina Huang, Scott H. Koeneman, Sherry Yang, Sami Tannour

Department of Surgery Faculty Papers

Hidradenitis suppurativa (HS) can be treated surgically to excise recurrent and recalcitrant regions of disease activity. However, surgical outcomes are highly variable depending on closure method, concomitant medical management and area of excision. In this study, we aim to characterise the healing courses from HS excision in a case series. To reduce operator variability, we opted to conduct a case series from a single surgeon. Surgeries conducted from June 2024-December 2025 by surgeon S.T. were included, and the postoperative course was followed until February 2026. Surgical details and postoperative course for 34 sites of HS across 20 patients were analysed. …

Design And Implementation Of An Intelligent Electronic Circuit To Control Laser Power In Real Time Using Built-In Thermal Feedback, Zainab Hussam Al-Araji

Mesopotamian Journal of Artificial Intelligence in Healthcare

One of the challenges of laser thermal therapy is to balance treatment effectiveness with the protection of healthy tissues from unintentional thermal damage. The aim of this study is to regulate the laser thermal dose with high accuracy using commercially available microcontrollers through the design and implementation of a low-cost closed-loop control system. The proposed system uses an adaptive control algorithm (PID) to adjust the laser power in real time, supported by a safety mechanism that calculates the equivalent cumulative minutes (CEM43) to prevent tissue charring. A binary verification methodology was adopted to assess the system's reliability, in which a …

High-Flow Nasal Cannula Oxygen Therapy Versus Standard Oxygen Therapy On Perioperative Outcomes In Patients Undergoing Transcatheter Aortic Valve Replacement, Kirsten B. Whiteside, Jacqueline M. Case

Graduate Theses, Dissertations, and Capstones

Abstract 

Background and Purpose: Transcatheter aortic valve replacement (TAVR) is increasingly performed under monitored anesthesia care (MAC) to facilitate faster recovery and reduce complications associated with general anesthesia. Standard oxygen therapy (SOT) may be insufficient in maintaining adequate oxygenation in this high-risk population. High-flow nasal cannula (HFNC) therapy has emerged as a potential alternative. This literature review evaluates the effects of HFNC compared with SOT on perioperative outcomes in patients undergoing TAVR under MAC. 

Methods: A comprehensive review of the literature was conducted to identify studies evaluating HFNC versus SOT during TAVR procedures performed under MAC. Six studies met inclusion …

Improving Diabetic Retinopathy Screening Among Adults With Diabetes In Boston, Massachusetts: A Policy Brief For Primary Care Implementation, Amber L. Auger

Capstones

No abstract provided.

Mountain Development In Nepal: Settlements, Infrastructure, And Economic Transformation, Keshav Bhattarai, Ambika P. Adhikari

Himalayan Research Papers Archive

As Nepal urbanizes, expands infrastructure, strengthens local governments, and explores deeper connectivity with India and China, climate change is increasing floods, landslides, heat, and water insecurity. Rapid internal migration, rising disaster risks, youth outmigration, and dependence on remittances are also revealing the limits of conventional urban development, especially in the mountainous region. The central challenge for Nepal is no longer just to accommodate growing towns and cities, but to build settlements that are safe, productive, environmentally resilient, and capable of sustaining long-term prosperity.

This paper argues that Nepal's urban future must be guided by a new development paradigm centered on …

Vocabulary Knowledge Within Young Children With Autism Spectrum Disorder, Hannah A. Lord

Masters Projects

Young children with Autism Spectrum Disorder (ASD) are consistently experiencing a “definitional gap”, where they are able to process vocabulary breadth within labeling but are unable to comprehend text due to the lack of vocabulary depth. The four week vocabulary unit titled “Our World in Words” is created to bridge the gap between vocabulary breadth and depth for first graders. Research in Dual Coding Theory and Cognitive Load Theory provides insight into the use of stable visual anchors with orthographic facilitation, which allows for the disregard of auditory processing, along with an overloaded cognitive load. This framework includes four important …

Inclusion Support For Early Childhood Educators, Victoria Parker

Masters Projects

Some general education teachers are not prepared to support the diverse needs of young students with disabilities being included in general education classrooms. Research shows that teacher preparation is a vital component to creating high-quality inclusive classrooms for young children. Preparing teachers for teaching in inclusive classrooms starts in college, and needs to continue throughout teaching careers to encourage and support the implementation of new strategies. Research also shows that training and preparedness for the challenges of working with students with diverse needs in the general education classroom affects staff attitudes and willingness to collaborate. The purpose of this project …

Methodologies For Encouraging Creative Expression Within The Curriculum, Ian D. Martzke

Masters Projects

Many students struggle to find creative expression within the school curriculum. Indeed, since the 1990s we have seen a rise in average IQ but a reduction in scores through the Torrance Test for Creative Thinking (TTCT) (Kim, 2011). In the course of this project several methodologies for creative problem solving will be described and several lessons will be described that will both explain and model these methodologies of creative problem solving. These lessons will utilize the creative process (Wallas, 1926) and be written to include student choice (Hogan et al. 2020) specifically, within the instructional framework known as Teaching for …

Demographic Influences On Awareness Of Speech-Language Pathology Services In The U.S., Phil Weir-Mayta, Joshua Ayala

Communication Sciences and Disorders Faculty Articles and Research

Introduction

Methods

Becoming A Therapist In A Foreign Land: Narratives Of International Trainee Clinicians Of Color In The U.S., Prathma Sharma

Electronic Theses and Dissertations

The focus of this dissertation project is on the community of trainee clinicians of color, who have been consistently overlooked in the literature on mental health. This dissertation employed narrative analysis as a methodological framework to explore the experiences of international trainee clinicians of color as they navigated the complex landscape of mental health training in the United States. In an increasingly globalized world, the voices and perspectives of these individuals offered critical insights into the challenges, triumphs, and unique pathways that shaped their professional development. Much of the literature on diversity and inclusion tends to individualize the challenging experiences, …

Lessons From Tanzania’S Ujamaa For Smart Settlements In Nepal: Social Justice And Economic Development, Keshav Bhattarai, Ambika P. Adhikari

Himalayan Research Papers Archive

Nepal’s constitutional commitment to a “socialism-oriented” state places social justice, equitable access to resources and housing, and protection of marginalized populations at the center of national development discourse. However, persistent landlessness, informal settlements, unemployment, youth outmigration, and unequal access to infrastructure reveal a significant gap between constitutional aspirations and socioeconomic realities.

This article examines lessons Nepal can draw from Tanzania’s experience with Ujamaa, the African socialist development model initiated by President Nyerere in 1967. Using comparative policy analysis, published research, official documents, and exploratory field observations from selected Tanzanian locations, including the capital and villages in the Iringa Region, the …

Building Agentic Ai Systems With Langgraph: From Llm Pipelines To Multi-Agent Decision Workflows, Mohammad Amin Kuhail

All Works

Recent advances in large language models (LLMs) have enabled the development of increasingly sophisticated agentic AI systems capable of reasoning, planning, tool use, memory management, and collaborative problem solving. Agentic AI refers to AI systems that can autonomously pursue goals and execute tasks by combining reasoning, decision-making, memory, interaction with external tools, and adaptive workflows. Unlike traditional LLM applications that primarily rely on single-prompt interactions or fixed sequential pipelines, agentic AI systems can iteratively analyze problems, coordinate multiple steps, invoke external resources, refine intermediate outputs, and dynamically adapt their behavior in response to evolving context and feedback. Recent developments in …

Shock-Absorption Capacity In Menaap: A Regional Diagnostic Using The Policy Space Index, Alexei Kireyev

Arab Economic and Business Journal

This paper assesses the short-term shock-absorption capacity of the Middle East, North Africa, Afghanistan, and Pakistan (MENAAP) using the Policy Space Index (PSI). The PSI integrates fiscal, monetary, and reserve indicators and adjusts them for institutional constraints to measure nominal and effective shock-absorption capacity. The key finding is that MENAAP effective policy space averaged about 11 percent of GDP in 2024, roughly half the global average and heavily concentrated in oil exporters. The constraints lie in MENAAP's institutional arrangements and insufficient fiscal discipline. Easing them requires fiscal consolidation alongside structural reforms to address the institutional bottlenecks.

Exploring The Effectiveness Of A “How-To-Teach” Book Club For Preservice Teachers, Rina Bousalis, Eden Greene, Robyn Klein, Abigail Woods, Isabella Mandoeng

Journal of Educational Research and Practice

As teacher training programs continue seeking ways to prepare their preservice teachers to teach, many have turned to “how-to-teach” books written by veteran teachers, viewing them as a valuable source that could offer teacher candidates additional support. This study, which developed from the idea of creating a book club with instructors and members of a university’s future educators’ organization, used a qualitative textual analysis approach to explore concepts that emerged from how-to-teach books, how participants’ perceived those concepts, and how the books benefited participants. The study revealed that although authors’ perspectives often conflicted with participants’ beliefs, the authors’ engaging activities …