Digital Commons Network^™

Rectal Cancer Treatment: Sexual Function Is Not The Sole Determinant Of Quality Of Life, Sarah M. Popek

Biomedical Sciences ETDs

Colorectal cancer is the third most common cancer. Rectal cancer patients face genitourinary dysfunction, impacting physical, psychological, and social well-being. This study examined the prevalence of sexual dysfunction in rectal cancer patients to assess the impact of sexual dysfunction on quality of life (QoL).

This mixed method study included 19 completing the survey portion and 10 completing an interview, evenly split between men and women, and those with and

without a stoma. Most experienced significant sexual dysfunction, and discussion of sexual function was rare. Quality of life scores were high. Themes from the interviews included (1) the relationship between the …

The Relationship Between Operating Efficiency, Credit Score, And Small Business Sustainability, Garfield Henry

Walden Dissertations and Doctoral Studies

The first 5 years of a small business (SB) life are critical because 50-60% fail. SB leaders are concerned about the inability of many SBs to attain sustainability within 5 years, given their pivotal role in owner and community financial viability. Grounded in the resource-based view theory, the purpose of this quantitative correlational study was to examine the relationship between SB operating efficiency, credit score, and sustainability. Secondary data for 211 closed and 211 companies still operating from 2013 to 2023 were collected from the Data Axle website for analysis. The results of the binary logistic regression were significant, X2 …

Relationship Between Respect, Trust, And Turnover Intentions, Christina Love Harmon

Walden Dissertations and Doctoral Studies

Leaders in the U.S. federal government are concerned with employee intent to leave, as it is the number one predictor of actual employee turnover. Grounded in social exchange theory, the purpose of this quantitative ex-post facto correlation study was to examine the relationship between social exchange and employee intent to leave. The participants were 256 employees from all agencies within the U.S. federal government who completed the 2022 Federal Employee Viewpoint Survey, including the Intent to Leave Scale. The results of the multinomial logistics regression were significant, χ² (4) = 87.875, p = <.001. In the final model, two predictors were significant, respect for department leaders, χ² (12) = 43.631, p = <.001, and trust in direct supervisor, χ² (12) = 32.513, p = 001. A key recommendation is for business leaders to model positive attitudes and behaviors by fostering a culture of trust, respect, and integrity to contribute to employee satisfaction and retention significantly. The implications for positive social change include the potential to retain valued employees who are committed to achieving organizational goals and improving productivity for organizational success

Elementary Teachers’ Perceptions Of Teacher Retention, Jennifer Renee Turney

Walden Dissertations and Doctoral Studies

The problem that was addressed in this study is the high rate of teacher attrition at a K–8 Title I school in Arizona. The purpose of this basic qualitative study was to explore the perceptions of the teachers who have chosen to remain at this school rather than leave. The theoretical framework of the study was based on Herzog’s motivational theory pertaining to the factors that can influence job satisfaction and lead to higher employee retention. The research questions focused on the perceptions of teachers that contribute to their decisions to remain at the study site and what types of …

Controlled Delivery Of Rosuvastatin Or Rapamycin Through Electrospun Bismuth Nanoparticle-Infused Perivascular Wraps Promotes Arteriovenous Fistula Maturation, Allan John R Barcena, Joy Vanessa D Perez, Marvin R Bernardino, Erin Marie D San Valentin, Jossana A Damasco, Benjamin Martin, Biana Godin, Gino Canlas, Natalie Fowlkes, Richard R Bouchard, Jizhong Cheng, Steven Y Huang, Marites P Melancon

Faculty, Staff and Student Publications

In the context of arteriovenous fistula (AVF) failure, local delivery enables the release of higher concentrations of drugs that can suppress neointimal hyperplasia (NIH) while reducing systemic adverse effects. However, the radiolucency of polymeric delivery systems hinders long-term in vivo surveillance of safety and efficacy. We hypothesize that using a radiopaque perivascular wrap to deliver anti-NIH drugs could enhance AVF maturation. Through electrospinning, we fabricated multifunctional perivascular polycaprolactone (PCL) wraps loaded with bismuth nanoparticles (BiNPs) for enhanced radiologic visibility and drugs that can attenuate NIH—rosuvastatin (Rosu) and rapamycin (Rapa). The following groups were tested onto the AVFs of a total …

Exclusion Disguised As Access: A Critical Discourse Analysis Of Postsecondary Disability Service Websites, Lavonne Ciezadlo Kopca

Theses and Dissertations

College students with disabilities are an overlooked minority population. However, they comprise an ever-increasing student population in postsecondary institutions. Yet students with disabilities do not persist or graduate at rates similar to their able-bodied peers. People with disabilities have historically been viewed as a low-status group and have been excluded from various social, educational, and economic benefits of citizenship. This study used a critical theoretical lens of social dominance theory to explore ways that higher education may be complicit in perpetuating discrimination and inequities through policies or discourse found in the content of student disability and diversity office websites. Key …

Cutting-Edge Developments In Zinc Oxide Nanoparticles: Synthesis And Applications For Enhanced Antimicrobial And Uv Protection In Healthcare Solutions, Egwonor Loveth Irede, Raymond Femi Awoyemi, Babatunde Owolabi, Omowunmi Rebecca Aworinde, Rofiat Odunayo Kajola, Ajibola Hazeez, Ayuba Adawale Raji, Latifat Oluwatobi Ganiyu, Chimezie O. Onukwuli, Asishana Paul Onivefu, Ikhazuagbe Hilary Ifijen

Michigan Tech Publications

This paper presents a comprehensive review of recent advancements in utilizing zinc oxide nanoparticles (ZnO NPs) to enhance antimicrobial and UV protective properties in healthcare solutions. It delves into the synthesis techniques of ZnO NPs and elucidates their antimicrobial efficacy, exploring the underlying mechanisms governing their action against a spectrum of pathogens. Factors impacting the antimicrobial performance of ZnO NPs, including size, surface characteristics, and environmental variables, are extensively analyzed. Moreover, recent studies showcasing the effectiveness of ZnO NPs against diverse pathogens are critically examined, underscoring their potential utility in combatting microbial infections. The study further investigates the UV protective …

Strength Measurement Of The E_Α^Lab = 830 Kev Resonance In The Ne 22 ( Α , N ) Mg 25 Reaction Using A Stilbene Detector, Shahina S., R. J. Deboer, J. Gorres, R. Fang, Michael T. Febbraro, R. Kelmar, M. Matney, K. Manukyan, J. T. Nattress, E. Robles, T. J. Rutland, T. T. King, A. Sanchez, R. S. Sidhu, E. Stech, M. Wiescher

Faculty Publications

The interplay between the ²²Ne (α,γ)²⁶Mg reaction and the competing ²²Ne(α,n)²⁵Mg reaction determines the efficiency of the latter as a neutron source at the temperatures of stellar helium burning. In both cases, the rates are dominated by the α-cluster resonance at 830 keV. This resonance plays a particularly important role in determining the strength of the neutron flux for both the weak and main s process as well as the n process. Recent experimental studies based on transfer reactions suggest that the neutron and γ-ray strengths for this resonance are approximately equal. …

Ledoxy-Sl: A Placebo-Controlled, Double-Blind, Randomized, 24-Month Trial Of Six Weeks Of Daily Doxycycline Plus Hygiene-Based Essential Care For Reducing Progression Of Filarial Lymphedema In Sri Lanka, Thishan Channa Yahathugoda, Nirmitha Lalindi De Silva, Janaka Ruben, Sharmini Gunawardena, Mirani Vasanthamala Weerasooriya, John Horton, Philip Budge, Eric Ottesen, Sarah Mary Sullivan, Mariana Stephens, John Shen, Ute Klarmann-Schulz, Achim Hoerauf, Joseph Patrick Shott, Charles Mackenzie

2020-Current year OA Pubs

Morbidity management of filarial lymphedema remains a challenge even during the post-lymphatic filariasis elimination era in Sri Lanka despite provision of the predominantly hygiene-based WHO Essential Package of Care. Because prior studies have suggested that 6 weeks of doxycycline may reduce progression of limb lymphedema, we conducted a randomized, placebo-controlled, superiority study to evaluate this possibility in Sri Lanka. Patients aged 14 to 65 years with lymphedema in one or both legs received either 200 mg of doxycycline daily for 6 weeks or matching placebo. The primary efficacy endpoint was improvement or lack of progression in lymphedema stage at 24 …

Exploring Evidentiary Approaches And Reform Potential In The Allies In Change Program For Abusive Intimate Partners, Julie Melissa Conner

Dissertations and Theses

This thesis examines the Allies in Change batterer intervention program, analyzing its curriculum components, alignment with evidence-based practices, unique features, limitations, and implications for domestic violence intervention. The study employs a qualitative mixed-methods approach, including curriculum textual analysis, word frequency count, a semi-structured interview with Chris Huffine, the curriculum author and program founder, and observation of a forty-hour domestic violence training provided for batterer intervention programs and facilitators.

The research begins by reviewing the literature on domestic violence intervention, highlighting the importance of evidence-based practices, cognitive behavioral techniques, and cultural responsiveness. It then conducts a textual analysis of the Allies …

Concolic Testing For Scripting Languages, Zhe Li

Dissertations and Theses

Scripting languages, such as JavaScript and Lua, are becoming more and more popular. They are typically easy to learn and use, making them accessible to a wide range of developers, even those with limited programming experience. Lua, for instance, is a lightweight, efficient, and versatile scripting language. It is designed to be easy to integrate into other systems and is often used as an embedded scripting language in larger applications such as NMap, which is a network scanning tool.

As another example, web front-end development with JavaScript (JS) is a popular choice for developers due to its ability to add …

Acute Transverse Colon Diverticulitis: A Case Report And Literature Review, Ana L. Romero, Jesus Romero, Anuraag Sah, Angela Koomson, Naik Arun

Journal of Community Hospital Internal Medicine Perspectives

Diverticular disease is a condition that ranges from asymptomatic disease to severe complications, such as abscesses, fistulas, and perforations. It is prevalent in Western countries, with up to 60% of people aged 60 having diverticula. In Asian countries, the prevalence is lower, ranging from 13-25%. Diverticulitis can occur in any location of the diverticula, with increasing incidence with age. Complications occur in 12% of patients with diverticulitis, with phlegmon or abscesses being the most common. Perforation is a life-threatening complication with a 1-year mortality rate of 20%. Recent studies suggest that chronic inflammation and alteration of the gut microbiome may …

Sump Syndrome: The Forgotten Cause Of Painless Jaundice In The Elderly, Mark Ayoub, Amna Anees

Journal of Community Hospital Internal Medicine Perspectives

Painless jaundice is a common presentation of abdominal malignancy seen in elderly patients. While malignancy may be a common cause of obstructive jaundice in that population group, anchor bias should always be avoided. We present a case of an elderly woman who presented with painless jaundice and weight loss. She had a very remote history of cholecystitis. She was found to have Sump syndrome due to a stricture at the Choledochoduodenostomy (CDD) site. She underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent placement which shortly led to resolution of her jaundice. Biopsy from the stricture site came back negative for malignancy.

Successful Rapid Benzodiazepine Detoxification In An Acute Care Hospital: A Case Report, Taku Harada, Kazuki Tatebayashi, Mori Nakai

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Benzodiazepine (BZD) dependence and withdrawal are significant public health concerns, affecting 15–30% of regular users within 4-6 weeks of administration. Rapid BZD tapering protocols in acute care settings can mitigate withdrawal symptoms and facilitate rehabilitation, yet are challenging due to variability in patient responses. Case Presentation: We report a case of a 67-year-old male with a history of high-dose BZD use for panic disorder and depression and recent mild ischemic stroke, presenting with worsening left lower limb paralysis. The patient's complex medication regimen included multiple BZDs and other psychotropic drugs. Given the risks associated with high-dose BZD use, particularly …

Superior Mesenteric Artery Stenosis With Dissection Secondary To Fibromuscular Dysplasia : A Case Report, Jayasree Ravilla, Ping He, Steven Brant, Doantrang Du

Journal of Community Hospital Internal Medicine Perspectives

Superior Mesenteric Artery stenosis increases with advancing age and is usually associated with atherosclerosis or thrombosis. Mesenteric ischemia occurs when the blood flow to the visceral organs is inadequate to meet their metabolic needs. While it can be asymptomatic, the patient can experience chronic or acute mesenteric ischemia symptoms. Although not frequently encountered, SMA stenosis can be rarely caused by fibromuscular dysplasia (FMD). Here we report a case of a 66-year-old female with SMA stenosis and subsequent mesenteric ischemia secondary to FMD. The main objective of this case report is to raise awareness about the occurrence of mesenteric ischemia from …

Thromboembolic Event In Isolated Non-Compaction Cardiomyopathy With Multiple Sclerosis, Comfort Olayioye, Indira Acharya, Christopher J Haas

Journal of Community Hospital Internal Medicine Perspectives

Non-compaction cardiomyopathy (NCCM) is a complex, exceedingly rare form of cardiomyopathy. Transient ischemic attack/ stroke in NCCM may be cardioembolic or atherosclerotic in origin. While the connection between NCCM and neuromuscular conditions has been documented before, its association with neurological conditions, such as multiple sclerosis has not been established. Here, we present a case of a 45-year-old female with multiple sclerosis (MS) who presented in the context of a transient ischemic attack (TIA) and was found to have non-compaction cardiomyopathy complicated by thromboembolism. To our knowledge, this is the third reported case of NCCM with MS.

A Rare Case Of Anca-Negative Rapidly Progressive Glomerulonephritis, Jerry Kenmoe, Elizabeth Mikhail, Fahimeh Talaei, Arvind Kunadi

Journal of Community Hospital Internal Medicine Perspectives

ANCA-negative rapidly progressive glomerulonephritis (RPGN) is a rare condition caused by glomerular injury in the absence of detectable antineutrophil cytoplasmic antibodies (ANCAs). While comprehensive epidemiologic data is limited, ANCAnegative RPGN is known to comprise 5-20% of all glomerulonephritis cases. We report the case of a 43-year-old male who presented to the hospital after a snowmobile accident with symptoms of general malaise along with the emergence of a new-onset rash and tea-colored urine. Further workup with CT-guided kidney biopsy confirmed the diagnosis of RPGN by revealing histopathological findings of crescentic glomerulonephritis and significant glomerular inflammation. Treatment was promptly initiated with prednisone …

Harbinger Of Lyme Carditis: From Atrioventricular Block To Atrial Fibrillation, Maryam Barkhordarian, Mark Grijalva, Avani Kolla, Aaron Stein, Dmitry Nemirovsky

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Lyme disease is a tick-borne illness that is most commonly caused by Borrelia burgdorferi and transmitted by the Ixodes tick. Common manifestations are fevers, headache, arthralgia, erythema migrans, and, if left untreated, can progress to neuropathy and carditis. Lyme carditis most commonly presents with high degree atrioventricular block, however, may present with other arrhythmias.

Case presentation: We present a case of a 70 year old male with past medical history of hypertension and polycythemia vera who presented to the hospital with lightheadedness and bradycardia following 2 weeks of fever. His electrocardiogram showed atrial fibrillation with regularized conduction at 40 …

A Recurring Theme: A Rare Case Of Pembrolizumab-Induced Acute Interstitial Nephritis, Jonathan London, Sabrina Bulancea, Inaas Shirazi, Victoria Oriuwa, Olena Bolotova, Zubin Tharayil

Journal of Community Hospital Internal Medicine Perspectives

Pembrolizumab is utilized in the treatment of multiple different malignancies, including non-small cell lung cancer, head and neck squamous cell carcinoma, melanoma, renal cell carcinoma, endometrial cancer, and more. Pembrolizumab is an immune checkpoint inhibitor that inhibits the programmed cell death-1 (PD-1) signaling pathway. Despite its benefits in treating multiple cancers, there are many reported adverse effects of Pembrolizumab affecting various organ systems; rarely it can cause acute interstitial nephritis (AIN). We present the case of a 79-year-old male with metastatic retroperitoneal squamous cell carcinoma who was found to have recurrent acute interstitial nephritis after pembrolizumab therapy.

Temporomandibular Joint Disorder And Anterior Scleritis As Initial Presentations Of Undiagnosed Rheumatoid Arthritis, Nazmul Hasan, Daniel Yang

Journal of Community Hospital Internal Medicine Perspectives

Rheumatoid arthritis is an autoimmune inflammatory process that involves multiple organ systems. While symmetric joint swelling of the extremities are the most widely recognized symptoms, the disease can present in a myriad of different ways, of which scleritis and temporomandibular involvement are less recognized manifestations. While scleritis and temporomandibular disorder (TMD) may at times present in isolation, it is critical to consider their strong association with autoimmune disease as it allows for early diagnosis of inflammatory conditions and allow for the formulation of tailored treatment plans to halt their progression.

Transient Telangiectatic Purpura: A Rare Post-Operative Phenomenon, Zackary Anderson, Michael Schoeller, Rebecca Witherell

Journal of Community Hospital Internal Medicine Perspectives

Axillary lymph node dissection (ALND) is a surgical procedure for malignant disease with well known complications, that is less well known is its association with a painless dermatomal rash formally known as transient telangiectatic purpura. This is a case report describing a case of transient telangiectatic purpura, describing its natural history and inferring on its pathophysiology.

Menetrier Disease – A Rare Presentation Of Gastrointestinal Bleeding, Jayasree Ravilla, Ping He, Mahmoud Ali, Anish Patel

Journal of Community Hospital Internal Medicine Perspectives

Gastric polyps are extensions of the mucosa or submucosal space that are usually asymptomatic. One of the rare manifestations of gastric polyps is Menetrier's disease. Menetrier's disease (MD), also known as giant hypertrophic gastritis, is a progressive disease whose pathogenesis is not fully understood. Though a rare diagnosis, it needs to be well studied due to its association with the neoplasia. Here, we present a case of Menitriere's disease associated with gastrointestinal bleeding and describe its clinical course and outcome.

Iga Nephropathy Secondary To Covid-19 Infection - A Case Report, Sanjivani Shrestha, Sumanth Kumar Bandaru, Man Kit Michael Siu, Silvia Malvica, Joselito Cabacar

Journal of Community Hospital Internal Medicine Perspectives

We present a case of a 73-year-old African American lady with COVID-19 infection who developed Acute Kidney Injury (AKI) and significant proteinuria. Renal biopsy showed IgA nephropathy. Patient was eventually diagnosed with IgA nephropathy secondary to COVID Infection. This unique case highlights the complexity of renal involvement in COVID-19. Notably, the onset of IgA nephropathy in the patient occurred several weeks after her COVID-19 diagnosis, deviating from the typical synpharyngitic presentation with respiratory symptoms. This article contributes to the growing body of evidence regarding renal complications associated with COVID-19 and highlights the need for vigilance in assessing and managing renal …

Spontaneous Coronary Artery Dissection: A Case Series And Review Of The Literature, Shaikh B. Iqbal, Yakubu Bene-Alhasan, Shiavax J. Rao

Journal of Community Hospital Internal Medicine Perspectives

Although previously considered rare, spontaneous coronary artery dissection (SCAD) is increasingly recognized as an important cause of myocardial infarction in young women. We present three unique cases of SCAD: A 46-year-old woman with a history of trigeminal neuralgia and anxiety presenting elevated troponin-I and chest pain. A 36- year-old woman with recent miscarriage presenting with diffuse T wave inversions and elevated troponin-I. A 58-year-old man with a recent COVID-19 infection presenting with diffuse ST elevations. SCAD is associated with many risk factors. Conservative management is preferred due to spontaneous healing of vessels compared to PCI driven management of atherosclerotic acute …

Cardiovascular Interventions In Patients With Active And Advanced Malignancy: An Updated Review, Fahad Waqar, Ayesha Sultan, Romeet Raja Bathija, Amin Mehmoodi, Jahanzeb Malik

Journal of Community Hospital Internal Medicine Perspectives

In the context of active, advanced malignancies, the recommendation for invasive cardiac interventions is grounded primarily in evidence from trials focused on specific cardiovascular conditions. However, the inclusion of individuals with advanced malignancies in these trials has historically been limited, and the intricate interplay between cancer and cardiovascular disease poses unique challenges for treatment decisions. In this comprehensive review, we delve into the complex landscape of invasive cardiac interventions and their applicability in patients with active, advanced cancer. Our analysis encompasses a range of cardiovascular scenarios, including STsegment elevation myocardial infarction, non–ST-segment elevation acute coronary syndromes, multivessel coronary disease, severe …

Frailty Indices And Their Importance In Elderly Patients: A Perspective Review, Rachna Valvani, Nismat Javed, Timothy Vittorio, Moiud Mohyeldin

Journal of Community Hospital Internal Medicine Perspectives

The aging demographic landscape of the United States highlights a concomitant rise in chronic conditions and infectious diseases. Older adults face a heightened susceptibility to infections, particularly pneumonia and urinary tract infections, and comorbidities such as cancer, cardiovascular disease, and dementia. Frailty, defined by a set of phenotypic criteria, emerges as a crucial predictor of adverse outcomes in infections, affecting hospitalization and post-care interventions. In the context of cancer, various frailty indices demonstrate their utility in predicting complications, mortality, and long-term outcomes. Cardiovascular diseases, including acute coronary syndrome and myocardial infarctions, exhibit varied associations with frailty, influencing both short-term and …

Radioactive Iodine Treatment Of Graves' Disease: Predictors Of Time Interval Greater Than 90 Days For Treatment Success, Luis E. Joya, Joshua Fogel, Kaushik Mandal, David S. Rosenthal

Journal of Community Hospital Internal Medicine Perspectives

Objective: Radioactive iodine (RAI) is often used for treating Graves’ disease. We study predictors for a time interval greater than 90 days between RAI treatment and success.

Methods: This was a retrospective study of 106 patients with Graves’ disease seen at a public hospital in suburban New York City. Predictor variables were from demographics, prior treatment history, iodine 131 RAI treatment, and thyroid function prior to RAI treatment.

Results: There were 62.3% that had a time interval greater than 90 days between RAI treatment and success. Only the thyroid function prior to RAI treatment variable of free thyroxine (FT4) had …

Pengembangan Bahan Ajar E-Learning Berbasis Edmodo Pada Materi Litosfer Kelas X Sma, Dedi Sasmito Utomo, Sumarmi Sumarmi, Singgih Susilo

Jurnal Pendidikan Geografi: Kajian, Teori, dan Praktek dalam Bidang Pendidikan dan Ilmu Geografi

The objective of this research and development is to produce: (1) E learning materials based on the material Edmodo lithosphere grade X, (2) virtual classroom Edmodo, and (3) Edmodo guide books for teachers and students. Data were collected by using a validation sheet and questionnaire. Qualitative data are derived from expert validation of material, language, and learning design, while quantitative data derived from student questionnaires. Results of the research are: (1) E learning instructional materials contained in the web categorized of well, (2) the virtual classroom Edmodo contained at the http://edmodo.com/dedisasmito, and (3) guide book Edmodo entitled "learning Edmodo with …

Review Of Disabling Leadership: A Practical Theology For The Broken Body Of Christ, Elyse Penton

Liberty Theological Review

This is a review of Andrew T. Draper, Jody Michele, and Andrea Mae's book, Disabling Leadership: A Practical Theology for the Broken Body of Christ. This review includes a summary of the contents and engages in a critique of the overall book. This review discusses a practical theology of disability inclusive church leaders and how they can make their congregations into an accessible community.

Echoes Of Eden In Proverbs: Towards A Biblical Theological Ethic, Armen Oganessian

Liberty Theological Review

Abstract:

This study argues for a biblical-theological approach to the ethics of Proverbs. It proposes that the ethical foundation for Proverbs lies in the principles established in Genesis 1-4 The argument unfolds as follows: Tracing the Abrahamic and Davidic covenants, one sees Solomon, the author of Proverbs, as a partial fulfillment of the promised seed in Genesis 3:15. Furthermore, other biblical writers depict Solomon as an Adamic king ruling in an Eden-like context. Consequently, understanding Proverbs' position within redemptive history encourages readers to interpret it through an Edenic framework. In other words, a biblical-theological approach compels readers to interpret Proverbs …