Digital Commons Network^™

Letrozole Vs Clomiphene Citrate For Treating Anovulation In Women With Pcos, Britney Landis

The PA Department Journal of Medical Science

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, often leading to infertility. First line treatment for ovulation induction is currently clomiphene citrate, a selective estrogen receptor modulator (SERM), but some patients with PCOS have become resistant. The purpose of this paper is to evaluate if letrozole is a safe and effective alternative to clomiphene citrate for ovulation induction in women with PCOS.

Methods: PubMed was searched with a specific search strategy using key terms “letrozole,” “clomiphene citrate,” and “PCOS”. Operators and filters narrowed the results to 3 relevant and quality articles for review. …

Patellar Vs Hamstring Grafts For Acl Reconstruction, Taylor Jernigan

The PA Department Journal of Medical Science

Abstract

Introduction: The anterior cruciate ligament (ACL) is one of the most common injuries in orthopedic medicine, resulting in 400,000 reconstructions every year in the United States. Bone-Patellar Tendon-Bone (BPTB) and Hamstring Tendon (HT) grafts are the most common graft types used. The objective of this review is to compare HT grafts and BPTB grafts when it comes to return to sport, returning to pre-injury level, and overall long-term functional outcomes.

Methods: A complete search was conducted using Pub Med to look for randomized controlled trials (RCTs), systematic reviews, and meta-analyses on HT vs BPTB grafts. The variables studied were …

Aspirin Use For The Prevention Of Preeclampsia: A Clinical Update, Megan Murray

The PA Department Journal of Medical Science

Introduction: Preeclampsia is a serious and deadly complication in pregnancy that affects thousands of women every year. The purpose of this clinical review is to analyze the efficacy of aspirin therapy to prevent the occurrence of preeclampsia in high-risk pregnancies.

Methods: PubMed was searched using the key terms “pregnant,” "aspirin," “high-risk,” "preeclampsia," and “prevention”. Operators and filters narrowed results to 21 quality articles with 5 relevant to the topic for review.

Results: One article is an RCT comparing the prevention of preeclampsia with aspirin therapy to no therapy. Four articles are meta-analyses of multiple RCTs. Three of …

The Efficacy And Safety Of Baricitinib In The Treatment Of Alopecia Areata, Ireny Sharkawy

The PA Department Journal of Medical Science

Introduction: Alopecia Areata (AA) is an autoimmune disorder that causes inflammatory circular, coin-shaped patches of hair loss on the scalp and other body parts. Baricitinib, a Janus Kinase (JAK) inhibitor, is a new medication approved for the treatment of AA. This review paper evaluates the effectiveness and safety of baricitinib in treating hair loss in patients with alopecia areata compared to no intervention.

Methods: The efficacy and safety of baricitinib in treating AA patients were evaluated by utilizing five (5) clinical articles, including randomized controlled trials, systematic reviews, and meta-analyses, sourced from PubMed.

Results: Baricitinib JAK inhibitor was shown …

Semaglutide Vs Liraglutide For Weight Loss In Adults With Obesity, Orian Bar

The PA Department Journal of Medical Science

Introduction: Obesity is a growing chronic condition worldwide with limited effective and safe treatment options. Semaglutide and liraglutide are two GLP-1a medications with encouraging outcomes for the treatment of obesity. The purpose of this paper is to compare semaglutide to liraglutide for weight loss and obesity

Methods: Pubmed was searched for randomized controlled trials, systematic reviews, and meta- analyses from 2019 to 2024 to assess efficacy of semaglutide and liraglutide. Five articles were selected for clinical review.

Results: In 4 out of the 5 studies there was a greater reduction in weight in patients receiving semaglutide compared to liraglutide. Statistically …

Do Oral Contraceptives Increase Breast Cancer Risk In Adult Women?, Melinda Behney

The PA Department Journal of Medical Science

Introduction: Breast cancer ranks as the most frequently diagnosed cancer globally. These numbers are on the rise annually, possibly influenced by changes in shifts in women’s lifestyles including sedentary lifestyle, obesity, consumption of alcohol, and oral contraceptive use. This paper aims to assess whether the use of oral contraceptives elevates the risk of breast cancer in adult women.

Methods: A search via PubMed using the key terms “contraceptives, oral” AND “breast neoplasms” resulted in 1,398 articles. After applying operators and filters for the last five years (January 2019 through June 2024), the results were narrowed down to five high-quality studies, …

Combined Low/Moderate-Intensity Statin With Ezetimibe Vs High-Intensity Statin Alone: A Comparison, Haden Baker

The PA Department Journal of Medical Science

Introduction: Hyperlipidemia is a continually rising global health crisis and is one of the leading contenders in chronic disease, with traditional statin monotherapy being at the foundation of LDL lowering treatment interventions. The purpose of this review is to compare two different therapy options, 1.) combined low/moderate-intensity statin with ezetimibe, and 2.) monotherapy high- intensity statin, and assess their efficacy in reducing LDL values in patients with hyperlipidemia.

Methods: PubMed was searched using the search "high intensity" statin AND "ezetimibe" AND "lipid.” Operators and filters were added to narrow the results to four relevant, quality articles for review.

Results: Three …

Dual Antiplatelet Vs Monotherapy As Secondary Prevention For Myocardial Infarction In Coronary Artery Disease, Ana Patricia Dorado

The PA Department Journal of Medical Science

Introduction: Coronary artery disease (CAD) is the leading cause of death globally, with myocardial infarction (MI) being the biggest contributor. While aspirin monotherapy is standard for preventing ischemic events in CAD patients, dual antiplatelet therapy (DAPT) combining aspirin with P2Y12 inhibitors may offer greater efficacy. This review examines whether DAPT reduces MI incidence compared to aspirin monotherapy (AM), weighing the benefits against potential bleeding risks to guide optimal treatment strategies.

Methods: Inclusion criteria included studies in English, published between 2019 and 2024, randomized controlled trials (RCTs), systematic reviews, and meta-analyses. The following key terms we used in the PubMed database, …

A Clinical Review Of The Efficacy Of Masks In Preventing Spread Of Sars-Cov-2, Harrison Nobles

The PA Department Journal of Medical Science

Introduction:

The COVID-19 pandemic, caused by SARS-CoV-2, has sparked debate over the effectiveness of masks in reducing viral transmission. This clinical review aims to evaluate the efficacy of cloth masks, medical masks, and N95 respirators in preventing COVID-19 transmission.

Methods:

A literature search was conducted on PubMed for articles published between January 2020 and August 2024. Out of 27 screened articles, 5 met the inclusion criteria, focusing on mask efficacy in preventing SARS-CoV-2 transmission.

Results:

Of the 5 studies included, three were systemic reviews, one was a metanalysis and one was a systemic review and meta-analysis. The largest …

Prophylactic Aspirin For The Prevention Of Pre-Eclampsia In High-Risk Pregnant Women, Nia Walker

The PA Department Journal of Medical Science

Introduction: Pre-eclampsia is a leading cause of maternal mortality worldwide. The purpose of this clinical review is to analyze the efficacy of aspirin vs placebo in the prevention of pre- eclampsia in high-risk pregnant women.

Methods: PubMed, COCHRANE, and JAMA Network were searched with terms “pre- eclampsia” AND “prevention” AND “aspirin." Operators and filters were added to find RCTs, reviews, and meta-analyses within the last five years. One article was found using article reference searching. Four articles were chosen for review.

Results: One article was a randomized controlled trial comparing low dose aspirin against placebo in women identified as high …

Efficacy Of Virtual Reality Incorporation In Post-Stroke Rehabilitation, Chloe Lissauer

The PA Department Journal of Medical Science

Introduction: Stroke is one of the leading causes of death and morbidity in the United States, with one of the largest concerns being persistent neurological deficits. Traditionally, conventional rehabilitation has been initiated as soon as possible in post-stroke patients in attempt to improve function and neuroplasticity either back to patient baseline levels or to a new maintained baseline. Recently, virtual reality (VR) supported rehabilitation has been studied in comparison to traditional therapy to determine if there is potential for its utilization in patient care.

Methods: A PubMed database search was used and narrowed down to 6 articles to be interpreted …

Ablation Vs Drug Therapy For Long-Term Outcomes Of Atrial Fibrillation, Taylor Yaw

The PA Department Journal of Medical Science

Introduction: Atrial fibrillation (AF), a rapid and irregular arrhythmia, is the most common cause of cardiac-related stroke and other serious complications for those affected. The first-line treatment for long-term rhythm control of AF remains in question and simplification of therapy would be a significant development. This review aims to determine the efficacy of ablation versus antiarrhythmic drug therapy for the treatment of AF.

Methods: A search via PubMed using the keywords ablation* AND drug therapy* AND atrial fibrillation* AND long-term effects produced 770 results. Results were consolidated by excluding those without full text. Filters were set to randomized control trials …

Transcatheter Mitral Valve Repair And Heart Failure: A Clinical Review, Caroline Robbins

The PA Department Journal of Medical Science

Introduction: Secondary Mitral Regurgitation due to heart failure is a major cause of morbidity and mortality. There is debate about surgical versus medical treatment options. This paper aims to evaluate the efficacy of adding transcatheter mitral valve repair (TMVR) with standard treatments for heart failure.

Methods: Using Pubmed, the search terms “transcatheter mitral valve repair” AND “heart failure” resulted in 835 articles that were then filtered to <5 >years, English language, and type of article. This produced 22 articles that matched the search criteria. In total, 6 articles were used to analyze all-cause mortality and rehospitalization of heart failure patients receiving …

End-Stage Renal Disease: A Clinical Review On Renal Replacement Therapy Outcomes, Mckenzie T. Lawrence

The PA Department Journal of Medical Science

Introduction: End-stage renal disease (ESRD) is a worldwide issue that occurs when the kidneys fail to filter out harmful waste from the blood. The only treatment options for patients with this diagnosis are kidney transplant, hemodialysis (HD), and peritoneal dialysis (PD). HD involves surgical prep with vascular access and is only performed in clinic. HD is also the most commonly used form of renal replacement therapy (RRT). Peritoneal dialysis is performed through the peritoneum and can be done in clinic or at home. The purpose of this paper is to investigate the overall patient outcomes in those undergoing HD compared …

Mohs Surgery Versus Surgical Excision: A Clinical Review Of Skin Cancer Recurrence Rates, Gabriella H. Malone

The PA Department Journal of Medical Science

Introduction: Skin cancer is a serious, yet preventable disease that impacts individuals worldwide. Skin cancer is treated through both surgical and non-surgical interventions. Designed to preserve healthy skin tissue, Mohs surgery has shown favorable outcomes in lessening skin cancer recurrence. The purpose of this paper is to evaluate whether Mohs surgery is superior to traditional surgical excision in reducing recurrence rates in patients with skin cancer.

Methods: PubMed was searched for clinical trials to assess the effectiveness of Mohs surgery compared to surgical excision in cancer recurrence. Five articles were selected for clinical review.

Results: In 5 studies, there was …

Arrest Unbound, Eisha Jain

Faculty Publications

Arrest has long been legally defined as a seizure, or temporary restraint on liberty, under the Fourth Amendment. But when the government arrests someone today, it imposes far more than a seizure. The government also marks individuals with arrest records, which enable wide-ranging penalties, such as deportation, civil detention, loss of a professional license, and disruption of custody. One consequence is that this regulatory structure unravels arrest from the key institutional checks that would permit the public or key actors to examine whether the government-imposed consequences stemming from arrest are fair and justified. Proportionality depends on the public at large …

Tax Compliance, Social Norms, And Influencers, James Alm, Jay A. Soled, Kathleen Delaney Thomas

Faculty Publications

While attaining perfect tax compliance is unachievable, more can and must be done. In the past, the country has relied primarily on a traditional system of sticks (e.g., audits and penalties) and carrots (e.g., refunds and whistleblower awards) to help narrow the “tax gap,” or the difference between what taxpayers owe in taxes and what they actually pay. Now, in the social media era, Congress and the Internal Revenue Service (IRS) should look beyond these traditional enforcement mechanisms. To achieve an even higher voluntary compliance rate, this Article advocates for policymakers to invest greater resources to enhance the social norm …

The Nuances Of Prosecutorial Nonenforcement, Meighan R. Parsh, Carissa Byrne Hessick

Faculty Publications

The academic literature on prosecutors is divided: Some commentors believe that prosecutors should more aggressively use their ability to decline to bring charges, decreasing the overall number of criminal cases and helping to address the problem of mass incarceration. Others believe that broad prosecutorial nonenforcement poses significant risks to our constitutional order and public safety. While the visibility of this debate has increased—spilling over from the pages of law reviews into political campaigns and headlines—the terms of this debate are at times unclear. Prosecutorial nonenforcement is a multifaceted phenomenon, and discussions about its costs and benefits can obscure necessary tradeoffs …

Exploring Postsecondary Students’ Beliefs Relative To Behavior That Promotes Sleep, Levi T. Kirkpatrick

Dissertations and Theses @ UNI

Sleep research has extensively quantified poor sleep among postsecondary students and established associations with adverse consequences; however, research exploring students’ beliefs toward sleep-promoting behavior is scarce. The current qualitative study explored postsecondary students’ beliefs toward behavior that promotes sleep at a midwestern state university. Using the integrated behavioral model, the current study aimed to expand the understanding of how students perceive and engage with behaviors that promote better sleep. The primary research question was: “How do currently enrolled postsecondary students attending a state university located in the Midwest region of the United States describe their beliefs relative to behavior that …

A Proposal For One “Super” Independent Accountability Mechanism, Daniel D. Bradlow

Perspectives

This essay will discuss how the MDBs- for example, the World Bank Group, the African, Asian, and Inter-American Development Banks, and more recently the European Bank for Reconstruction and Development, Asian Infrastructure Investment Bank, and the New Development Bank – are dealing with the issue of accountability. It will argue that, although the MDBs have been leaders in promoting international organizational accountability, their mechanisms of accountability are not keeping up with the evolution in their operations. In the interests of promoting new and creative thinking about these issues, it will also make an ambitious proposal for how the MDBs jointly …

Collaborative Dispute Resolution: Five Essential Questions, Scott Adams, Aparna Mukerjee

Perspectives

This essay identifies five key questions regarding the dispute resolution process and explores the answers to these. The five questions are:

1. How Should Parties Decide Whether to Participate in Dispute Resolution?
2. What are the Roles of Advocates and Advisors?
3. Does Dispute Resolution Provide Accountability and Remedy?
4. How Can Dispute Resolution Foster Institutional Learning for dfis?
5. Why Is it Important for Dispute Resolution to be Independent rather Than Embedded in DFI Management?

Should Decisions Of Independent Accountability Mechanisms Be Binding?, Lalanath De Silva, Giada Giacomini

Perspectives

In this essay, it is argued that IAMs should be empowered with binding decision-making authority to enhance their effectiveness and ensure that justice is served, and remedies delivered. This argument is supported by analyzing the right of access to justice. Further, this essay analyses existing mechanisms with binding decision-making power that have already been created or acknowledged by IFIs; these mechanisms include IFI administrative tribunals for employees, arbitration processes for commercial disputes, integrity related sanctions regimes, and the appeal bodies that hear access to information decisions. The IFIs’ embrace of binding decisions in these contexts demonstrates that nothing prevents IFIs …

Reflections On The Launch Of The Inspection Panel And People-Centered Accountability, David B. Hunter

Perspectives

No abstract provided.

Leadership Perceptions Of Employee Identity: How Leaders Facilitate An Inclusive Environment, Arian Sullivan

Dissertations and Theses @ UNI

Workers spend one-third of their lives at work. Therefore, they deserve to work for organizations that focus on equity and inclusion. Despite laws that aim to protect employees, workers still experience discrimination. This thesis explores how leaders perceive their role in fostering an inclusive culture that encourages employees to bring forward workplace concerns. Through qualitative interviews with locally recognized leaders, this study examines how inclusion is understood and enacted in leadership practices. While participants largely demonstrated inclusive leadership values such as shared perspectives, worker empowerment, and collaboration, I found that participants spoke of their employees in terms of personality traits …

Refining Population-Level Measures Of Early Childhood Vaccination Coverage Using National Immunization Survey-Child Data, Alexandria Nicole Albers

Graduate Student Theses, Dissertations, & Professional Papers

Background: From 2011-2021, the U.S. Advisory Committee on Immunization Practices (ACIP) recommended 10 vaccine series by age 24 months, with guidelines for minimum vaccination age, maximum age for rotavirus vaccination, minimum dose intervals, and a catch-up schedule for delayed series initiation. National vaccination surveillance evaluates series completion based on whether children received the recommended number of doses, including a combined 7-vaccine metric (completed seven series collectively). However, this approach overlooks: 1) vaccinations given too early, too late, or too close together, 2) catch-up schedule vaccinations, and 3) completion of all 10 recommended vaccines.

Purpose: To refine national childhood vaccination coverage …

A Social-Ecological Justice Approach To Ecotourism: Examples From Cockpit Country, Jamaica, Laurel Ann C. Curry

Graduate Student Theses, Dissertations, & Professional Papers

Ecotourism aims to support local social, ecological, and economic systems sustainably, but its implementation often perpetuates social and environmental injustices. This work applies a new social-ecological justice (SEJ) framework to ecotourism, combining Pope et al.’s holistic approach with principles like ecological stewardship, economic repositioning, and collaboration tailored to specific contexts. Importantly, basic capabilities for full functioning of humans and other species were used in this research to measure areas of justice and injustice. Using a case study approach with the Southern Trelawny Environmental Agency (STEA) in Jamaica's Cockpit Country, co-created interview data were analyzed to evaluate its ecotourism program’s alignment …

Evaluating The Accuracy Of Stature Estimation From Tibial Radiographs Using Known And Newly Developed Regression Formulas, Atlantis Kae Baron

Graduate Student Theses, Dissertations, & Professional Papers

This study assesses the accuracy of stature estimation from tibial radiographs using digital measurements as an alternative to traditional osteometric tools. Stature estimation is crucial in forensic anthropology for identifying individuals, especially cases involving skeletal remains. Traditional methods rely on physical measurements and established regression formulas, such as those by Trotter & Gleser (1958).

This research analyzed tibial radiographs from the Forensic Anthropology Skeletal Trauma (FAST) database with ImageJ software to measure tibial lengths digitally. The sample included 59 tibiae, with measurements compared against three regression formulas; Trotter & Gleser (1958), Simon et al. (2023), and a new regression formula …

Juvenile Arthritis, Body Image, And Disordered Eating: An Exploration Of Experiences, Katelyn Ann Melcher

Graduate Student Theses, Dissertations, & Professional Papers

This qualitative study examined eating and body experiences among youth with juvenile arthritis (JA). JA, an autoimmune condition affecting nearly 300,000 youth in the United States, poses significant challenges including chronic pain, disability, and psychological concerns such as anxiety and depression. Adolescence is a critical developmental time for body image and disordered eating concerns to emerge. However, no qualitative research has explored the interactions of JA, body image, and eating behaviors among youth. Twelve youth with a JA diagnosis participated in a semistructured qualitative interview examining their experiences with JA and their feelings about their bodies and food as they …

Examining Pathways For Front-Country Camping Access In The Rural American West: An Application Of Access Theory, Hayley Ann Johnson

Graduate Student Theses, Dissertations, & Professional Papers

Access to front-country camping on North American public lands has historically been preferential to those who are White, relatively wealthy, and highly educated. In theory, however, all activities on public lands are available to all people, and everyone has equal right to enjoy the benefits from recreational activities like camping in these spaces. Since the 1960s, research on access has focused on the barriers, or constraints, that influence overall participation in leisure activities; however, few studies have examined access specific to front-country camping.

As a complement and extension of traditional leisure constraints theory, this study presents a unique application of …

An Overview Of Nagpra And The 2024 Revisions, Emily V. Owens-Barber

Graduate Student Theses, Dissertations, & Professional Papers

Section 11 of the National Museum of the American Indian Act (NMAIA) was added to public law in 1989. This required the Smithsonian Museum to repatriate any human remains or funerary objects associated with Native American Ancestry back to their tribes. In 1990, The Native American Graves Protection and Repatriation Act (NAGPRA) was added to federal legislation expanding on this section and requiring that every federally funded institution in the United States that held Native American Remains or funerary objects in their collection must follow this regulation to continue to receive federal funding. Nearly 33 years later in the autumn …