Medicine and Health Sciences Commons^™

Staff Education To Enhance Nonmedical Staff Competency In Withdrawal Management, Katherine Hedrick

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a significant gap in staff training at a behavioral health residential treatment facility. Nonmedical staff, including substance abuse counselors, lacked formal education in recognizing, assessing, and escalating symptoms of substance withdrawal. This lack of competency posed a risk to patient safety, regulatory compliance, and quality of care. The goal of the project was to evaluate the impact of a structured, simulation-based training program on nonmedical staff’s knowledge and confidence in using validated withdrawal assessment tools and monitoring vital signs. Six nonmedical staff participated in the training, which incorporated lecture, hands-on simulation, and …

Breast Cancer Survival Rates And Determinants In Ethiopia: A Systematic Review And Meta-Analysis Of Longitudinal Studies, Abenezer M. Tafese, Meseker T. Fentie, Beminate L. Seifu, Angwach A. Asnake, Bikiltu D. Dirbaba, Abdisa G. Jara, Elsabeth Tizazu Asare, Brandon George

College of Population Health Faculty Papers

BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer mortality among women in Ethiopia, accounting for 32% of new cancer cases and 17.6% of cancer deaths. Despite its growing burden, comprehensive data on survival rates and contributing factors remain limited. This systematic review and meta-analysis aimed to synthesize existing data on breast cancer survival in Ethiopia and identify key determinants influencing outcomes.

METHODS: A comprehensive systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and CINAHL to identify studies on breast cancer survival in Ethiopia published between January 2014 and August 2024. Eligible …

Patient Engagement Strategies In Weight-Loss Programs, Olufunmilayo M. Bishop

Walden Dissertations and Doctoral Studies

Weight regain after pharmacological weight-loss interventions remains a pervasive challenge in primary care, with over 70% of patients reverting to baseline weight within six months. This quality improvement project aimed to enhance healthcare providers’ patient engagement skills to improve retention and long-term outcomes in weight-loss programs. A structured staff training program focusing on motivational interviewing, goal-setting, and barrier recognition was implemented among a multidisciplinary team. The program’s effectiveness was evaluated through a mixed-methods approach, incorporating quantitative pre- and post-assessment scores and qualitative staff satisfaction surveys. Results demonstrated a significant increase in staff knowledge, with average scores rising from 68% to …

Evaluating Parotid Gland Dose Between Electronic Tissue Compensation And Field In Field Treatment Techniques For Parotid Sparing In Whole-Brain Radiotherapy, Joesph E. Bodgonas

Masters Projects

Purpose:

The parotid glands are essential to salivary function and patient quality of life, yet they are not routinely prioritized as organs at risk (OARs) during whole-brain radiotherapy (WBRT). With growing recognition of long-term side effects like xerostomia in patients with prolonged survival after WBRT, parotid-sparing techniques warrant investigation. This study compares radiation dose to the parotid glands using three different 3D conformal WBRT planning approaches: field-in-field (FiF) with blocking, electronic tissue compensation (eCOMP) without blocking, and eCOMP with blocking.

Methods and Materials:

A retrospective study was conducted on 20 patients previously treated with 3D conformal WBRT. Original eCOMP plans …

A Comparative Study Of Vmat Beam Arrangements In Large Field Nodal Prostate Treatment Plans, Laura R. Black

Masters Projects

Treatment of extensive prostate and pelvic lymph node volumes for prostate cancer patients provide unique challenges related to limitations in multileaf collimator (MLC) design in many modern linear accelerators. A strategy to overcome this challenge is by restricting the field size, improving modulation as well as using overlapping arcs to ensure complete coverage of the target. Using too few arcs can result in suboptimal target coverage, while too many arcs can lead to prolonged time on the table, increasing the risk of patient movement and potential side effects that may compromise treatment accuracy. This study aims to evaluate the optimal …

Integrating Ctdna Analysis And Radiomics For Dynamic Risk Assessment In Localized Lung Cancer, Everett J Moding, Mohammad Shahrokh Esfahani, Cheng Jin, Angela B Hui, Barzin Y Nabet, Yufei Liu, Jacob J Chabon, Michael S Binkley, David M Kurtz, Emily G Hamilton, Aadel A Chaudhuri, Chih Long Liu, Zhe Li, Rene F Bonilla, Alice L Jiang, Brianna C Lau, Pablo Lopez, Jianzhong He, Yawei Qiao, Ting Xu, Luyang Yao, Saumil Gandhi, Zhongxing Liao, Millie Das, Kavitha J Ramchandran, Sukhmani K Padda, Joel W Neal, Heather A Wakelee, Michael F Gensheimer, Billy W Loo, Ruijiang Li, Steven H Lin, Ash A Alizadeh, Maximilian Diehn

Faculty, Staff and Student Publications

The complementarity and clinical utility of combining liquid biopsies and radiomic image analysis has not been demonstrated. Circulating tumor DNA (ctDNA) minimal residual disease after chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) is highly prognostic, but on-treatment biomarkers are needed to enable response-adapted therapies. Here, we analyzed 418 patients with NSCLC undergoing CRT to develop and validate a novel dynamic risk model that accurately predicts ultimate progression-free survival during treatment. We optimize tissue-free variant calling from plasma samples to facilitate ctDNA monitoring and demonstrate the importance of accounting for persistent clonal hematopoiesis variants. We show that mid-CRT ctDNA concentration …

Car-Macrophage Cell Therapy: A New Era Of Hope For Pancreatic Cancer, Daoyan Wei, Liang Wang, Yi Liu, Xiangsheng Zuo, Xiling Shen, Robert S Bresalier

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest malignancies, characterized by late diagnosis, early metastasis, and resistance to conventional therapies. A major barrier to effective treatment is its desmoplastic and immunosuppressive tumor microenvironment (TME), which restricts T cell infiltration and dampens responses to immune checkpoint inhibitors (ICIs). These features highlight the urgent need for innovative immunotherapeutic strategies capable of overcoming PDAC's immunologic and physical barriers. Chimeric antigen receptor (CAR)-macrophage (CAR-M) therapy has emerged as a promising approach to address these challenges. Unlike CAR-T or CAR-NK cells, CAR-Ms can efficiently infiltrate tumors, remodel the TME, phagocytose tumor cells, and stimulate …

Depletion Of Effector Regulatory T Cells Associates With Major Response To Induction Dual Immune Checkpoint Blockade, Xianli Jiang, Nils-Petter Rudqvist, Bo Jiang, Shengbin Ye, Shan He, Qingnan Liang, Jinzhuang Dou, Michelle D Williams, Joe Dan Dunn, Jason M Johnson, Keiko Akagi, Weihong Xiao, Shaoheng Liang, Satvik Elayavalli, Baohua Sun, Edwin R Parra, Renata Ferrarotto, Adam S Garden, Clifton David Fuller, Jay Reddy, Neil D Gross, Miriam N Lango, Cheuk Hong Leung, Suyu Liu, Diane D Liu, Meng Li, J Jack Lee, Michael A Curran, Jack Phan, Ken Chen, Maura L Gillison

Faculty, Staff and Student Publications

In a phase II trial, patients with local-regionally advanced human papillomavirus-positive oropharyngeal carcinoma (n = 35) received ipilimumab (anti-CTLA4) and nivolumab (anti-PD-1) as induction immunotherapy and concurrently with radiotherapy (NCT03799445). Coprimary endpoints included 6-month complete metabolic response rate (94%) and 2-year progression-free survival (84%). Induction yielded a 46% major histopathologic response rate. Single-cell profiling revealed responders had higher baseline intratumoral CD8+ T cells with a tumor-reactive, tissue-resident memory (TRM) phenotype and a treatment-related decrease in effector regulatory T (eTreg) cells. The eTreg decrease correlated with CD8+ T-cell clonotype transitioning from TRM to effector memory and IFNG+ effector cells. …

The Role Of Leopard Spot Technique Acupuncture For Shoulder Impingement With Myofascial Pain Syndrome, Dewi Ratnasari, Sri Wahdini

Sultan Qaboos University Medical Journal

Shoulder impingement syndrome can be defined as a collection of symptoms and signs in the shoulder caused by pathology within the intrinsic or extrinsic that cause pinching in the narrowed space between the acromion and the head of the humerus. Myofascial pain yndrome can occur because of shoulder impingement syndrome. We report a 66-year-old male patient who presented with complaints of limited motion in the right shoulder area accompanied by pain to a medical acupuncture clinic in Jakarta, Indonesia, in 2024. Leopard spot technique manual acupuncture was performed at the palpable myofascial trigger point area in each therapy session. After …

Alternative To The Statistical Mass Confusion Of Testing For "No Effect", Josh L Morgan

2020-Current year OA Pubs

In cell biology, statistical analysis means testing the hypothesis that there was no effect. This weak form of hypothesis testing neglects effect size, is universally misinterpreted, and is disastrously prone to error when combined with high-throughput cell biology. The solution is for analysis of measurements to start and end with an interpretation of effect size. In this manuscript, I walk through some of the common critiques of significance testing and how they relate to experimental cell biology. I argue that careful consideration of effect size should be returned to its central position in the planning and discussion of cell biological …

Hemispherotomy For Drug-Resistant Epilepsy In Bilateral Sturge-Weber Syndrome: Illustrative Cases, Eveline Teresa Hidalgo, Eric A Grin, Yosef Dastagirzada, Nealen Laxpati, Judith Bluvstein, Julia R Schneider, Daniel Miles, Michal Tzadok, James Riviello, Howard L Weiner

Faculty, Staff and Students Publications

Background: Sturge-Weber syndrome (SWS) is a congenital neurocutaneous disorder characterized by angiomas of the face, choroid, and leptomeninges. Seizures in these children often present within the first 2 years of life. SWS is typically unilateral, but bilateral SWS occurs in approximately 15% of cases. Bilateral SWS is associated with earlier seizure onset and poorer cognitive, developmental, and functional outcomes. More than half of children with SWS develop drug-resistant epilepsy requiring surgical intervention. Hemispherotomy has been established as a successful treatment for unilateral SWS, but resective surgery has traditionally not been considered a treatment option for patients with bilateral disease.

Observations: …

An Ethanol-Induced Loss Of The Lipid Droplet-Associated Segregase Vcp/P97 Leads To Hepatic Steatosis, Sandhya Sen, Shaun Weller, Ryan J Schulze, Donglin Ding, Carol A Casey, Conrad Weihl, Mark A Mcniven

2020-Current year OA Pubs

The liver stores substantial numbers of neutral lipid organelles termed lipid droplets (LDs) that accumulate within hepatocytes in response to chronic ethanol (EtOH) consumption leading to hepatic steatosis. Mass spectrometry analysis of LDs isolated from EtOH-damaged rat livers revealed a substantial reduction in the valosin-containing protein ATPase (VCP/p97) that acts to remove targeted proteins from cellular membranes for degradation. Experimental disruption of VCP function resulted in an increase in LD content in hepatocytes and mouse livers along with a marked increase in LD-associated hydroxysteroid dehydrogenase (HSD17β13) known to contribute to hepatic steatosis. Surprisingly, treatment of hepatocytes with the proteasome inhibitor …

How Much Variance Exists Among Published Definitions Of Proximal Junctional Kyphosis? A Retrospective Cohort Study Of Adult Spinal Deformity, Tim T Bui, Karan Joseph, Alexander T Yahanda, Samuel Vogl, Miguel Ruiz-Cardozo, Camilo A Molina

2020-Current year OA Pubs

No abstract provided.

Long-Term Follow-Up Of Left Atrial Appendage Exclusion: Results Of The V-Clip Multi-Center Post-Market Study, Elias Zias, Katherine G Phillips, Marc Gerdisch, Scott Johnson, Ahmed El-Eshmawi, Kenneth Saum, Michael Moront, Michael Kasten, Chanderdeep Singh, Gautam Bhatia, Hiroo Takayama, Ralph Damiano

2020-Current year OA Pubs

No abstract provided.

Detection Of Brain Cancer Using Genome-Wide Cell-Free Dna Fragmentomes, Dimitrios Mathios, Et Al.

2020-Current year OA Pubs

UNLABELLED: Diagnostic delays in patients with brain cancer are common and can impact patient outcome. Development of a blood-based assay for detection of brain cancers could accelerate brain cancer diagnosis. In this study, we analyzed genome-wide cell-free (cfDNA) fragmentomes, including fragmentation profiles and repeat landscapes, from the plasma of individuals with (n = 148) or without (n = 357) brain cancer. Machine learning analyses of cfDNA fragmentome features detected brain cancer across all-grade gliomas (AUC = 0.90; 95% confidence interval, 0.87-0.93), and these results were validated in an independent prospectively collected cohort. cfDNA fragmentome changes in patients with gliomas represented …

Provider's Attitudes Towards Telehealth And Parenting Interventions During Covid-19 Pandemic: An Exploratory Cross-Sectional Study From Brazil And Mexico, Marina Kohlsdorf, Cole Hooley, Alejandro L Vázquez, Mariana M Juras, Grant Decker, Taylor Iskalis, Kayla Miller, Quinn Tompkins, Nancy G A Buenabad, Michela Ribeiro, Acileide C F Coelho, Ana A Baumann

2020-Current year OA Pubs

BACKGROUND: The COVID-19 pandemic presented challenges for mental health providers all over the world, since they had to abruptly change from in person assistance to remote meetings. The adverse effects from social isolation were critical in Latinx populations such as Brazil and Mexico, since these countries faced a great amount of social, health, and economic burden during the pandemic, which affected families' access to care and increased inappropriate parenting practices.

OBJECTIVE: This study aimed to understand the impacts of adapting parenting interventions to online sessions for Brazilian and Mexican providers, due to the COVID-19 pandemic.

METHODS: Sixty-two Brazilian and 49 …

Improving Icu Decolonization Compliance Among Nursing Staff, Sarah J. Moore

Student Scholarly Projects

Practice Problem: Hospital acquired infections (HAIs) burden patients and health care organizations by influencing extended hospital stays, increasing mortality risk, and increasing healthcare spending.

PICOT: The Doctor of Nursing Practice (DNP) Scholarly Project was guided by the PICOT question: In ICU nursing staff (P), how does the implementation of a standardized process with visual reminders and checklists (I) compared to no reminders or checklists (C) impact compliance with the decolonization protocol for HAI reduction (O) over four weeks?

Evidence: A review of evidence-based literature demonstrated efficacy in the reduction of HAIs through once daily bathing with 2% chlorhexidine gluconate (CHG) …

Enhancing Patient Positioning Accuracy: Evaluating Daily Cone Beam Computed Tomography In The Halcyon System., Duong Thanh Tai, Luong Tien Phat, Tran Trung Kien, Nguyen Ngoc Anh, Nguyen Xuan Hai, Peter Sandwall, David Bradley, James C L Chow

Oncology Articles

BACKGROUND: Precise patient positioning is crucial for successful radiotherapy, ensuring accurate delivery of radiation to tumors while minimizing exposure to healthy tissues. Positional errors can significantly impact treatment efficacy and increase side effects. This study evaluates the effectiveness of daily cone beam computed tomography (CBCT) imaging in the Halcyon system for detecting and correcting patient misalignments across various cancer types and treatment sites.

METHODS: A retrospective analysis was conducted on 411 patients treated with the Varian Halcyon linear accelerator from August 2022 to August 2024. Patients were grouped based on tumor location: Head and Neck (118 patients), Chest (188 patients), …

The Development Of A Remediation Policy For High-Stakes Standardized Tests, Abigail R. Brundige

Doctor of Nursing Practice Projects

Standardized testing serves as a measure of academic progress and readiness for licensure in nursing programs. Gaps in standardized testing performance emphasize the need for educational support. The problem identified for this Doctor of Nursing Practice (DNP) policy project is the lack of a formal standardized testing remediation policy within a community college nursing program in rural West Tennessee. The DNP project proposes the development and implementation of a standardized testing remediation policy to identify at-risk students early, provide individualized remediation plans, and improve program retention and licensure pass rates. The DNP project employed a quantitative design to assess the …

Barriers To Participation In Follow-Up Services In Oncology, Casey Wagman

DNP Projects

Background
Psychological distress is often seen in cancer patients due to the physical, emotional, and social burdens of diagnosis and treatment. Patient participation in support services remains low despite the readily available psychosocial resources. The Emotional Well-Being Tool (EWBT), a validated psychological distress screening tool, is often used in a Midwest cancer clinic, yet it was noted that its supportive services were underutilized.

Purpose
This quality improvement project aimed to analyze the perspective of cancer patients on the EWBT, their understanding of its purpose and outcomes, and the perceived barriers to utilizing supportive services.

Methods
It was an exploratory design, …

The Use Of Debriefing To Combat Compassion Fatigue Among Cardiac Intensive Care Nurses, Brittany Johnson

DNP Projects

Background:
Compassion fatigue has physical, emotional, and psychological impacts on nurses working in intensive care units. Debriefing sessions can be used to help reduce compassion fatigue by allowing nurses on a cardiac intensive care unit to discuss their thoughts and feelings after the death of a patient who has had a complex hospital stay or traumatic death.

Aim:
The purpose of this project was to assess the perception of compassion fatigue on work life among Cardiovascular Intensive Care Unit (CVICU) nurses and to evaluate whether debriefing sessions following demanding situations enhance nurses' coping abilities and emotional processing.

Methods:
Nurses working …

Evaluation Of Mrcat As A Surrogate For Traditional Ct Simulation In Proton Prostate Radiotherapy Planning, Karen Weeks

Masters Projects

Purpose:

This study evaluated whether Philips MRCAT-generated synthetic CT (sCT) can serve as a clinically viable substitute for traditional CT (CT) simulation in proton therapy planning for prostate radiotherapy using a double-scatter technique.

Methods:

Ten prostate cancer patients treated with proton therapy between 2024 and 2025 were retrospectively analyzed. Each patient underwent both CT and MRI in the treatment position. MRCAT sCT images were generated using atlas-based and segmentation algorithms. The original proton treatment plan was transferred onto the MRCAT dataset. Dosimetric parameters, target coverage, organ-at-risk (OAR) doses, and Hounsfield Unit (HU) values were compared. The sign(M) test …

Magnet Council Toolkit For Organizations Seeking Magnet Status And Recruitment, Andrew J. Boone

Student Scholarly Projects

Practice Problem: The problem was a lack of a standardized or structured process for the development of Magnet Councils. There is no clear pathway or materials to initiate the process, and one must start by applying to the American Nurses Credentialing Center (ANCC) with little guidance prior to seeking help on the Magnet Journey. PICO Question: The PICO question that guided this DNP Project Toolkit development was as follows: For healthcare organizations pursuing Magnet status (P), how does the development of a structured Magnet Council Toolkit (I) compared to the absence of a formal toolkit (C), contribute to the validation …

Partial Cystectomy For Muscle-Invasive Bladder Cancer, Peter S Palencia, Nethusan Sivanesan, Syed Rahman, Fady Ghali, David Hesse, John Colberg, Ashwin Sridhar, John D Kelly, Byron H Lee, Ashish M Kamat, Wei-Shen Tan

Faculty, Staff and Student Publications

Partial cystectomy is a surgical bladder-sparing option for selected patients with muscle-invasive bladder cancer (MIBC), urachal adenocarcinoma and diverticular bladder tumors. Partial cystectomy hold several advantages. It allows for definite pathology and accurate staging while avoiding side effects from radiation therapy and preserves the option for salvage radical therapy (radical cystectomy or radical radiotherapy). Patients should have a CT urogram, prostatic urethral biopsy and mapping biopsies or blue light cystoscopy to rule out multifocal disease or CIS. Small solitary MIBC patients without carcinoma in situ in an area of the bladder where resection can be performed with negative margin would …

Bcl-2/Bcl-Xl Dual Inhibition Triggers Gasdermin D-Mediated Pyroptosis In Mantle Cell Lymphoma, Yijing Li, Joseph Mcintosh, Vivian Jiang, Fangfang Yan, Jovanny Vargas, Yuxuan Che, Wei Wang, Ching-Fei Li, Yue Fei, Celeste Lee, Lei Nie, Yixin Yao, Michael Wang, Heng-Huan Lee, Yang Liu

Faculty, Staff and Student Publications

No abstract provided.

August 2025, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

• Yoga classes coming 9/16 - 10/14
• National Wellness Month
• 5 Habits of Self-Care
• Vaccines and Immunization
• Zucchini Brownies!
• Family Fun Month - Ideas!
• Standing Desks Available
• Word Search

Stem Cell-Derived Corneal Epithelium: Engineering Barrier Function For Ocular Surface Repair, Emily Elizabeth Fresenko, Jian-Xing Ma, Matthew Giegengack, Atalie Carina Thompson, Anthony Atala, Andrew J W Huang, Yuanyuan Zhang

2020-Current year OA Pubs

The cornea, the transparent anterior window of the eye, critically refracts light and protects intraocular structures. Corneal pathologies, including trauma, infection, chemical injury, metabolic diseases, genetic conditions, and age-related degeneration, can lead to significant visual impairment. While penetrating keratoplasty or full-thickness corneal transplantation remains a standard and effective intervention for severe corneal dysfunction, limitations in donor tissue availability and the risk of immunogenic graft rejection necessitate alternative therapeutic strategies. Furthermore, for cases of isolated epithelial disfunction, a full-thickness cornea graft may not be required or effective. This review examines the potential of corneal epithelial constructs derived from autologous stem cells …

Staff Education On Depression Screening In Young Adults, Irene Micere Njeru

Walden Dissertations and Doctoral Studies

Summary This doctoral project was on staff education. The practice problem was a knowledge deficit regarding depression screening by staff nurses at a local acute inpatient psychiatric facility. The practice-focused question was as follows: Will education on depression screening for young adults (18-to-28-year-olds) increase knowledge on the use of evidence-based depression screening tools by nursing staff in an inpatient psychiatric crisis facility? The purpose of the doctoral project was to educate staff nurses at a local acute inpatient psychiatric facility on the PHQ-9 depression screening tool for individuals aged 18 to 28 years. The project included a PowerPoint presentation, a …

Evaluating Virtual Group Coaching’S Impact On Self-Determination In Spinal Cord Injury, Alana Scalzo, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Spinal cord injury (SCI) is a lifelong condition that requires effort and adjustment for managing physical, psychological, and social well-being to have the ability to engage in meaningful activities. As people living with SCI have higher rates of isolation and social disconnect, it is important to study group level approaches for addressing mental health.

Objectives: To determine the impact of virtual group coaching to enhance occupational performance, satisfaction, self-efficacy and relationship closeness in people living with SCI.

Methods: A quasi-experimental single-group pre/post-test design was used. Adults with SCI were recruited through online flyers, social media, newsletters, support groups, clinics, …

The Efficacy Of Virtual Group Coaching On The Self-Determination Of People With Ehlers-Danlos Syndrome, Janine E. Rajauski, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

INTRODUCTION
The Ehlers-Danlos Syndromes (EDS) are a family of 13 genetic connective tissue disorders that affect negatively physical and psychosocial health which in turns have been found to decrease their quality of life and self-determination (Baeza-Velasco et al., 2019; Bennet et al., 2021; Estrella & Fraizer, 2024; Tinkle et al., 2017; Palomo-Toucedo et al., 2020). Limited supports and services, including occupational therapy, are available for those with EDS (Estrella & Frazier, 2024; McDonald et al., 2023; Reychler et al., 2021). Those with EDS have requested better services to support their self-determination (Estrella & Frazier, 2024). Coaching has shown positive impacts …