Digital Commons Network^™

Real-World Evidence Of Nusinersen Treatment For Patients With Spinal Muscular Atrophy In The Kingdom Of Saudi Arabia: Initial Insights From The Saudi National Spinal Muscular Atrophy Program, Ahmed H. Al-Jedai, Hajer Yousef Almudaiheem, Tareef Y. Alaama, Fahad Abdo Bashiri, Mohammed Abdelrahman Almuhaizae, Fouad Abdullah Alghamdi, Aljohara A. Alsakran, Fahad Zuriqan Ibrahim

Saudi Medical Journal

ABSTRACT Objectives: To assess the clinical and functional outcomes of 110 patients with spinal muscular atrophy (SMA) program who received nusinersen treatment in the Kingdom of Saudi Arabia (KSA). Methods: Motor assessments were performed using the Children’s Hospital of Philadelphia infant test of neuromuscular disorder (CHOP-INTEND) and Hammersmith infant neurological examination (HINE) for type 1 SMA, the Hammersmith Functional Motor Scale–Expanded (HFMSE) for types 2 and 3 SMA; the 6-minute walk test (6MWT) for ambulant type 3 SMA, and the revised upper limb module (RULM) for types 2 and 3 SMA. Results: Data included all SMA types (type 1, 2.72%; …

Evaluation Of Simplified Arabic Matrix Test In Children With Normal Hearing, Medhat F. Yousef, Alia A. Asiri, Abdulmalik M. Marzuq, Abdulaziz A. Almalki, Mohammed N. Garrada, Manal A. Khoja, Ibrahim A. Busaad, Mahmoud M. Mahrous

Saudi Medical Journal

ABSTRACT Objectives: To evaluate the simplified version of the Arabic matrix test in individuals with normal hearing to derive reference ranges for future measurements with the test material. Methods The test was conducted in 80 native Arabic individuals (20 adults and 60 children across different age groups between 5-10 years) from November 2020 to Mar 2023. Evaluation measurements were conducted in adults and children to derive the reference psychometric functions and assess the training effect. The test list equivalence was verified only in the adults group. Results The reference ranges for speech-intelligibility in noise for 80% thresholds or speech-recognition threshold …

Correlation Of Clinical And Laboratory Findings Of Dehydration With Ultrasonographic Measurements, Yusuf Yilmazturk, Abdullah Sadik Girisgin, Mustafa Alpaslan, Necmi Baykan

Saudi Medical Journal

ABSTRACT Objectives: To assess bedside ultrasonographic readings in conjunction with laboratory and clinical results, as well as to look into the efficacy of these measurements while evaluating patients who are being monitored for dehydration and managing their therapy. Methods: We assessed 300 patients, 150 of whom were in the case group and 150 in the control group. Laboratory results throughout therapy, clinical dehydration, vital signs, and bedside ultrasonography results were all documented. A vena cava inferior collapsibility index of 50% or higher, dry oral mucosa, decreased skin turgor, and a fresh onset of altered consciousness were all considered clinical indicators …

Respiratory Distress Syndrome In Late Preterm Infants: Are We Doing Enough To Prevent It?, Adeeb Khawaji

Saudi Medical Journal

No abstract provided.

Prevention: Bend It Like Bekham, Mirvat Alasnag, Adel Tash

Saudi Medical Journal

No abstract provided.

Launch Of Online Learning Course On Using The Iarc Atlas Of Breast Cancer Early Detection

Saudi Medical Journal

No abstract provided.

Stronger Infection Prevention And Management, Better Maternal Outcomes

Saudi Medical Journal

No abstract provided.

The Lived Experiences Of Black Female Leaders At An Hbcu Whose Predecessors Are Non-Black Females, Patricia Pearsall Williams

All Dissertations

This study used a rigorous qualitative hermeneutic phenomenological approach to examine the lived experiences of eight Black female leaders at Historically Black Colleges and Universities (HBCUs) in one of the following geographic regions in the United States: the South Atlantic, Eastern South Central, and West South Central (U.S. Census Bureau, 2022). The leadership roles for this study included, but were not limited to, president, senior vice president, assistant provost, vice president, dean, executive director, director, assistant director, associate director, department head, manager, or supervisor.

By examining the essences, nuances, and differences of these experiences, the researcher aimed to understand how …

Design And Analysis Of Low-Cost Lora Mesh Network For Reliable And Secured Precision Agriculture, Yamini Swetha Nadella

All Theses

Rural precision agriculture requires reliable, low-cost, and energy-efficient communication systems that can cover large farmland areas. Traditional wireless technologies, such as Wi-Fi, cellular, and satellite communication, are either expensive, consume too much power or are even unreliable in maintaining connectivity in large farmlands, which is a common case in rural precision agriculture. LoRa-based networks support long-range communication with extremely low power consumption, making them an appropriate solution for precision agriculture applications in rural farmland areas. Current LoRaWAN systems employ star topology, which also limits their ability to offer efficient, multi-hop connectivity in rural environments.

This thesis presents the design, implementation, …

Make Ready: Productive Disruption And Interstitial Sites Of Graphic Design Practice, Peter Maybury

Theses

This thesis draws on five publications produced between 2010–22: My 2020 film installation Landfall; a series of four museum and gallery-published books made with artist Gerard Byrne (2010–18); Gall, my practice enquiry with Tom dePaor which encompasses film, writing, books, sculpture, curation, and gallery works; releases and live performances by my band Thread Pulls during the period 2010–12; and my exhibition, conference talk, and book Make Ready (2015), the structure of which is taken as ‘armature’ for the writing of the thesis. Through these wide-ranging pursuits, this thesis articulates a non-normative role for the graphic designer. It identifies my operative …

The World Of Color, Hannah Lee, Special Collections, Fleet Library

12th Baker & Whitehill Student Artists' Book Contest 2026

Entry for the 12th Baker & Whitehill Student Artists' Book Contest. Opening reception and award ceremony Wednesday, February 25, 2026 at 6:30pm, Fleet Library, 1st Floor Main Reading Room. Juror: Gabrielle Reed.

Borderplex Business Barometer, Volume 9, Number 12, Thomas M. Fullerton Jr., Steven L. Fullerton

Border Region Modeling Project

No abstract provided.

Metabolic Screening In Veterans On Antipsychotics Mood Stabilizer, Joy Nneka Eke

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was conducted to examine a quality improvement initiative that sought to address metabolic syndrome screening consistency for veterans on antipsychotic medications at a U.S. Department of Veterans Affairs health system located in the Midwest region of the United States. The project centered on whether the quality improvement program assessing compliance with the current metabolic syndrome screening process reflects increased early detection of metabolic syndrome to prevent cardiovascular complications. Data collection involved comprehensive chart reviews of 50 veterans’ records. The data collected were analyzed using a specially designed quality improvement initiative assessment form developed …

Executive Summary: Executive Leadership System Improvement Workplace Violence, Mercedes Ivette Tejada

Walden Dissertations and Doctoral Studies

Introduction This Doctor of Nursing Practice (DNP) Executive Leadership Project is focused on the reduction of workplace violence in a critical access hospital using an organized prevention program. Workplace violence in nursing is increasing, exposing the health of staff, patient safety, and quality of care in critical access hospitals. The question of the DNP project is: In nurses (P) in small critical access hospitals, how does implementing a structured workplace violence prevention program (I) compared to having no formal violence prevention strategy (C) impact the occurrence of workplace aggression and perceptions of safety among staff (O)? This practicum project used …

Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin

Walden Dissertations and Doctoral Studies

Pet ownership continues to be part of modern society in the United States. Researchers have explored pet ownership’s impact on chronic diseases and aging populations, but research on health-related quality of life is limited. Grounded in the socioecological model, this quantitative study analyzed data from the 2005-2006 National Health and Nutrition Examination Survey (N = 10,348) to investigate the impact of pet ownership on health-related quality of life among low-income adults aged 30-50 years. Chi-square tests were performed to analyze the associations between age, income, gender, and race with three health-related quality of life metrics. Results showed no statistically significant …

Elementary School Teachers’ Perspectives On Project-Based Learning Implementation In Commonwealth Of The Northern Mariana Islands, Xiao Tang

Walden Dissertations and Doctoral Studies

Elementary schools play an essential role in equipping students with 21st-century skills. Project-based learning (PBL) is a student-centered instructional approach that is associated with the development of these skills, yet PBL implementation in elementary schools is not well understood in Saipan, the Commonwealth of the Northern Mariana Islands (CNMI). The research problem addressed in this study was a lack of understanding of elementary teachers’ practices in implementing PBL in Saipan. Guided by constructivist theory, the purpose of this qualitative study was to examine elementary school teachers’ perspectives on the benefits of PBL, the ease or difficulty when implementing PBL, the …

The Effect Of Gender, Race, And Age On 30-Day Readmission Rates Among Heart Failure Patients In Mississippi, Patricia Ann Mondy

Walden Dissertations and Doctoral Studies

A sizeable number of U.S. heart failure patients are readmitted within 30 days of hospital discharge. There was a need to explore ways to reduce this number and improve the care of heart failure patients when they are discharged home. The purpose of this quantitative correlational study was to determine if there is a relationship between age, gender, and race of heart failure patients and 30-day readmissions in the U.S. state of Mississippi in 2019. The dependent variable was heart failure 30-day readmissions, and the independent variables were age, gender, and race. Wagner’s chronic care model was the theoretical framework …

Motivation And Productivity Of Female Employees In China With Scoliosis Pain, Shauna-Kay Reeves

Walden Dissertations and Doctoral Studies

A scoliosis diagnosis can impact an individual’s work performance, particularly if there is a lack of proper ergonomics or workplace accommodations that might lead to increased pain and discomfort. Organizational leaders must understand this impact as an indicator of employee motivation and productivity. The purpose of this qualitative, interpretative phenomenological analysis was to explore the lived experience of female employees in China with scoliosis pain and its impact on their motivation and productivity. The theoretical foundations used in this study were the job demands-resources model and the self-determination theory. The participants consisted of eight female employees with scoliosis pain working …

A Cultural Staff Education Project To Improve Hypertension Management In African American Adults, Rosemary Nguatem Folefa Fonya

Walden Dissertations and Doctoral Studies

In this evidence-based educational project, I identified the gap in practice with the lack of nurses' knowledge in culturally tailored hypertension management among nurses caring for African American adults at a family nurse practitioner clinic. In this Doctor of Nursing Practice (DNP) project, I focused on a staff education initiative to improve nurses' knowledge to reduce disproportionately high rates of hypertension, complications, and mortality due to factors such as limited access to care, medication nonadherence, mistrust of providers, and improve on culturally competent interventions. The guiding practice-focused question was: Does educating nurses on hypertension in the African American population improve …

Preventing Psychotropic Medication Duplication: Improving Communication Between Primary Care And Psychiatric Providers, Linda Nwachuku

Walden Dissertations and Doctoral Studies

This project is an education-based initiative designed to address the persistent problem of psychotropic medication duplication in integrated care settings. Duplication occurs when patients receive multiple prescriptions of the same or similar psychotropic drugs. The practice gap exposes patients to adverse drug events, complications of polypharmacy, and reduced adherence, and subjects the providers to liability. The practice-focused question guiding this project is: For primary care and psychiatric providers, will an education program on structured communication and medication reconciliation, compared to current usual practices, increase provider confidence and awareness of the risks of duplication, communication strategies, and increased the use of …

The Impact Of Top Management Team Heterogeneity On Corporate Green Innovation, Xueyan Luo

Dissertations and Theses Collection (Open Access)

At present, green innovation has become a key path for enterprises to achieve sustainable competitive advantage. However, existing research pays limited attention to how internal governance factors—especially top management team (TMT) heterogeneity—affect green innovation. Based on Upper Echelons Theory, managerial cognition theory, and institutional theory, this paper constructs a framework of “TMT heterogeneity–green strategic orientation–green innovation,” and explores the impact of different types of heterogeneity and the moderating role of regional innovation environments. Heterogeneity is categorized into conflict-type (gender, age, financial background) and complementary-type (educational, professional, overseas background) to better explain its mechanisms.

Using a sample of Chinese A-share listed …

A Study On The Influence Of Entity Internet Hospital Platforms And Health Literacy Facilitation On Postoperative Patients’ Platform Usage, Hong Ye

Dissertations and Theses Collection (Open Access)

Entity Internet Hospital (EIH) is emerging online medical service platforms in China. Currently, while EIHs in China are developing rapidly, their usage rates remain low. However, postoperative patients have substantial follow-up consultation needs. Consequently, incentivizing postoperative patients to use EIH from the demand side is a highly challenging proposition in the current era. Grounded in Technology Acceptance Model and Health Belief Model, this study examined the impacts of platform and health literacy facilitation on platform usage (including intention and frequency) among 631 postoperative patients with cardiovascular disease from four medical institutions in Wuhan, and explored the moderating role of literacy …

Research On The Impact Mechanism Of The Development Level Of Smart Agriculture On Farmers' Income, Baoping Liu

Dissertations and Theses Collection (Open Access)

Agriculture is a fundamental and strategic industry essential to national food security and farmers’ well-being. Faced with global population growth, climate change, and resource constraints, the traditional high-input agricultural model is unsustainable. Smart agriculture, empowered by IoT, big data, and AI, has become critical for agricultural transformation and sustainable development. However, existing research overemphasizes technical efficiency and neglects how smart agriculture systematically affects farmers’ income, especially its transmission mechanism and regional heterogeneity.

Against China’s rural revitalization and digital village strategy, this study investigates how smart agriculture development influences farmers’ income, using a hybrid framework of macro empirics and micro analysis. …

A Study On The Impact Of Ceos’ Financial And Technical Backgrounds On The Innovation Strategy Of The Enterprise, Jianyu Cheng

Dissertations and Theses Collection (Open Access)

Amid regional economic integration and market competition, innovation has become a key driver for enterprises to gain competitive advantages and ensure sustainable development. As primary decision-makers in corporate strategy and resource allocation, chief executive officers (CEOs) impact the selection and implementation of innovation strategies through their financial and technical backgrounds, which influence their strategic cognition and risk preferences, leading to heterogeneous innovation behaviors. While existing research has examined the relationship between CEOs and corporate innovation, studies have inadequately explored CEOs’ diverse background characteristics, particularly the interaction between financial and technical backgrounds. Given the rising trend of CFOs and CTOs advancing …

Corporate Strategic Changes In Response To Negative Performance Gaps: The Role Of Listing Board In China, Lei Yu

Dissertations and Theses Collection (Open Access)

This dissertation investigates how Chinese listed companies respond strategically to negative performance gaps under different institutional environments defined by the Main Board and ChiNext Board of China’s capital market. Drawing on Performance Feedback Theory and New Institutional Theory, it explores whether and how listing board heterogeneity moderates the relation between performance shortfalls and corporate strategic transformation, and further examines the boundary effects of internal governance factors including ownership type, CEO power, and resource slack.

Using panel data of A-share listed companies from 2009 to 2019 obtained from the CSMAR database, this study employs multiple regression analysis and interaction modeling to …

The Impact Of Value Co-Creation On Organizational Resilience In Small And Medium-Sized Traditional Foreign Trade Enterprises, Dan Yan

Dissertations and Theses Collection (Open Access)

Against the backdrop of increasing uncertainty in the global business environment, international scholarly attention to individual, group, and organizational resilience has risen significantly. Chinese export trading enterprises—especially small and medium-sized export trading enterprises(SMETEs)—face disadvantages such as small scale, weak financing capacity, limited access to information, and low brand strength. After experiencing shocks from digital transformation, the COVID-19 pandemic, the Russia–Ukraine war, and the European energy crisis, these firms have been compelled to reconsider how to enhance their organizational resilience in order to adapt to an increasingly turbulent external environment.

First, this study selects Company H as a representative case of …

Striking A Balance Between Personal Data Protection And Transactional Efficiency In The Context Of Data-Driven Mergers, Jun Hu

Dissertations and Theses Collection (Open Access)

The proliferation of data-driven mergers and acquisitions (M&A) has created a critical tension between the commercial value of integrated data assets and the fundamental privacy rights of users. This dissertation addresses the underexplored micro-foundations of user consent when personal data is transferred wholesale to an acquiring firm. It develops and empirically tests a sequential mediation model, anchored in Privacy Calculus and Signaling Theory, to explain how users' perceptions and intentions are shaped by different corporate data protection strategies.

A between-subjects experimental design was employed (N=532), exposing participants to one of three distinct protection mechanisms: procedural safeguards (emphasizing fairness and control), …

Fibroblasts Are The Primary Contributors To A Disrupted Micro-Environment In End-Stage Pediatric Hypertrophic Cardiomyopathy, Hanna J Tadros, Diwakar Turaga, Yi Zhao, Chang-Ru Tsai, Iki A Adachi, Xiao Li, James F Martin

Faculty, Staff and Students Publications

Background: Hypertrophic cardiomyopathy (HCM) is a relatively rare but debilitating diagnosis in the pediatric population, and patients with end-stage HCM require heart transplantation. Here, we have examined the transcriptome in ventricular tissue from this patient group to identify cell states and underlying cellular processes unique to pediatric HCM.

Methods: We performed single-nucleus RNA sequencing (snRNA-seq) on explanted hearts at transplant in 3 pediatric patients with end-stage HCM and compared findings to pediatric control and adult HCM.

Results: We identified distinct underlying cellular processes in cardiomyocytes, fibroblasts, endothelial cells, and myeloid cells compared with controls. Pediatric HCM was enriched in cardiomyocytes …

Hes V20 Surpasses Galad For Hcc Detection: A Review Of Multi-Dimensional Biomarker Scores And Studies, Fouad Jaber, Hashem B El-Serag

Faculty, Staff and Students Publications

This was a narrative review of select studies published through September of 2024. We review the shift toward multi-dimensional scores such as HCC early detection screening (HES), GALAD, ASAP, and mt-HBT represents a significant advancement in biomarker research for hepatocellular carcinoma (HCC) detection. Unlike single biomarker approaches, these scores integrate various clinical and biochemical factors to enhance predictive accuracy by reflecting different complementary aspects of disease progression and HCC oncogenesis. Proper testing and validation of biomarker scores in phase 3 biomarker studies is essential before wide use can be recommended. We also review the comparative performance of biomarker scores in …

Characteristics Associated With Eurolupus Versus Modified National Institutes Of Health Cyclophosphamide Regimen Use In Children And Young Adults With Lupus Nephritis, Christine S Wang, Rebecca E Sadun, Wenru Zhou, Kristen R Miller, Stacy P Ardoin, Christine Bearer, Emily Hause, Joyce Hui-Yuen, Nicole Ling, Maria Pereira, Meredith Riebschleger, Kelly Rouster-Stevens, Aliese Sarkissian, Julia Shalen, William Daniel Soulsby, Marinka Twilt, Eveline Y Wu, Laura B Lewandowski, Scott E Wenderfer, Jennifer C Cooper

Faculty, Staff and Students Publications

Objective: To determine the demographic and clinical characteristics associated with use of the EuroLupus or modified National Institutes of Health (NIH) cyclophosphamide (CYC) regimen for treatment of lupus nephritis (LN) at North American pediatric centers.

Methods: A retrospective cohort study was conducted at 11 North American centers. Patients < 22 years of age with active LN treated with CYC using the EuroLupus or NIH regimen between July 2014 and June 2021 were included. Data were extracted via electronic medical record review. Demographic and clinical characteristics were compared at CYC initiation. A multivariable generalized estimating equation with logit link was fit to model EuroLupus use. An exchangeable correlation structure was used to account for correlation within centers. Independent variables were chosen using elastic net regression.

Results: The cohort consisted of 191 patients (85 EuroLupus, 106 NIH) with a median age of 15.3 years at CYC initiation. In multivariable analysis, characteristics significantly associated with EuroLupus regimen use (vs NIH regimen use) included more recent year of CYC initiation, longer disease duration, Hispanic ethnicity and Asian race (as compared …