Medicine and Health Sciences Commons^™

Development Of Ultrafast Protein Digestion And Standards Free Quantitation Methods For Mass Spectrometric Analysis, Praneeth Ivan Joel Fnu

Dissertations

A wide variety of biologically important molecules, such as enzymes, antibodies, hormones, transporters and receptors are proteins by composition and they play key roles in biological functions such as cellular regulation, communication, metabolism and physiological function. Protein dysfunctions and abnormalities are associated with numerous diseases, making proteins critical targets for understanding disease mechanisms and developing therapeutic interventions. Protein-based therapeutics such as monoclonal antibodies, hormones and vaccines gained popularity due to their high specificity, efficacy, and ability to treat complex diseases that are often difficult to address with small-molecule drugs.

Given the important role of proteins in a variety of biological …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

Tracking Towards Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Carolina Maria Gerodias Cayetano

Master's Projects and Capstones

Background: Central line-associated bloodstream infections (CLABSIs) remain among the most serious and costly healthcare-associated infections in acute care settings, with each event associated with significant excess mortality, prolonged hospital stays, and avoidable healthcare costs. At Hospital A, a 239-bed acute care facility, two of six total CLABSI events over a 12-month period were associated with peripherally inserted central catheters (PICCs), representing 33% of all facility CLABSIs and exposing a critical gap in standardized PICC line surveillance and maintenance bundle monitoring.

Problem: The PICC team lacked a systematic, real-time tracking mechanism to monitor central line maintenance bundle adherence across seven adult …

Effect Of Partial Ablation Of Skeletal Dynamin Related Protein 1 On Mitochondrial Health, Inflammation, And Fibrosis In A Mouse Model Of Duchenne Muscular Dystrophy, Tessa L. Duzz

Graduate Masters Theses

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder characterized by muscle weakness, degeneration, fibrosis, and impaired muscle regeneration. Mitochondrial dysfunction is an early pathological feature of DMD and has been linked to excessive mitochondrial fission. Dynamin-related protein 1 (Drp1) is a central regulator of mitochondrial fission, a key process in regulating mitochondrial quality and function. Inhibition of Drp1-mediated mitochondrial fission has shown promise as a potential therapeutic target for alleviating pathology and dysfunction in dystrophic muscle. The objective of this study was to determine whether partial skeletal muscle-specific ablation of Drp1 could improve muscle pathology and mitochondrial health in …

Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh

Graduate Doctoral Dissertations

The Multicultural Counseling Competencies (MCC) and Multicultural and Social Justice Counseling Competencies (MSJCC) are well-researched and supported counseling practices for decreasing microaggressions in therapy and consequent attrition, lack of satisfaction, and maltreatment (Ratts et al., 2016; Sue et al., 1982). However, scholars critique existing methods for measuring therapists’ cultural responsiveness for being disconnected from therapeutic process and outcomes (Hays, 2020; Wilcox et al., 2020). This study examined which MSJCC measures associated with variables clinically and ethically relevant to better treatment outcomes and lower microaggressive, neglectful, and stereotypical treatment for hypothetical Black, female clients by White therapists. 62 White psychologists in …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

Association Between Athletic Trainers And Frequency Of Pediatric Orthopedic Visits, Abaigeal Field, James M. Mensch, Courtney Meyer, Susan W. Yeargin

Clinical Practice in Athletic Training

Context: There is sparse research on the relationship between athletic trainer (AT) employment and the number of athletes presenting to orthopedic clinics with sports-related injuries. The purpose of this study is to determine if athletic training services are associated with the frequency of first-time orthopedic office visits for sports-related injuries.

Methods: A retrospective chart review collected injuries between January 1, 2018 and December 31, 2020 from the electronic health records system for a hospital network in the Southeast United States with 6 orthopedic clinics and included 48 high schools hosting 20 sports with at least 1 AT per school. Patients …

Implementation Of Medical Documentation Sign-In Sheets For Patient Evaluations And Treatments: A Quality Improvement Project, Madicyn Barnes, Beth Davis, Kaitlyn L. Holland, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Context: Medical documentation of athletic training services at a large, public secondary school was limited to clinically significant or legally sensitive information entered into the electronic medical record (EMR) system. There are only 2 full-time athletic trainers (ATs) providing medical services to over 800 student-athletes across 45 different teams throughout the school year. Due to the large patient load, documentation is difficult to complete and, therefore, limited to the most “significant” information. The purpose of this quality improvement project was to improve medical documentation at this secondary school by implementing physical sign-in sheets in the athletic training facility (ATF) to …

Building On A Strong Foundation: Celebrating Our Past And Looking Toward The Future, Zachary K. Winkelmann

Clinical Practice in Athletic Training

No abstract

The Correlation Between Ankle Proprioception And Lower Extremity Muscle Reactions In Response To Simulated Ankle Sprains, Erin Carroll, Justin Stanek, Abby Salvadore

Clinical Practice in Athletic Training

Context: Neurological structures of the somatosensory system provide proprioceptive and neuromuscular input regarding joint positioning to the brain. Lower extremity motor control relies on local proprioceptive input to the central nervous system and neuromuscular control of individual joints to produce coordinated, global responses to external events. The purpose of this study was to investigate the relationship between ankle proprioception and lower extremity muscle reaction time in response to an unexpected ankle inversion perturbation.

Methods: Twenty healthy college-aged volunteers were recruited to participate by word of mouth. Absolute and exact errors for passive joint position sense (PJPS) were assessed using a …

The Evaluation Of A Soft Skills Curriculum In Athletic Training Education: A Mixed Methods Study, Emily A. Duckett, Heather Schugar, Alison Gardiner-Shires, Jacqueline S. Hodes

Clinical Practice in Athletic Training

Context: Developing athletic training students’ soft skills to effectively engage in patient-centered care is integrated throughout multiple Commission on Accreditation of Athletic Training Education Curricular Content Standards. Despite evidence supporting the importance of compassionate care, there is currently data to suggest that health care is experiencing a compassion crisis. The purpose of this study was to investigate the ways pre-professional athletic training students transfer knowledge from a soft skills curriculum to clinical experiences as students in an entry level master’s program.

Methods: This study is an explanatory sequential mixed methods design. Phase 1 includes participants (n = 19) enrolled in …

Electrical Stimulation And Localized Heat After Dry Needling Treatment To Reduce Low Back Pain, Morgan M. Mersola, Amanda Hawkes, Adam Mendenhall

Clinical Practice in Athletic Training

Context: Chronic low back pain (CLBP) is a musculoskeletal condition that often leads to reduced quality of life, prompting the need for effective conservative interventions such as dry needling (DN). A randomized controlled pilot study involving 12 participants was conducted at a physical therapy clinic.

Methods: The final subject pool consisted of a convenience sample of adults with CLBP lasting > 3 months. Participants were randomly assigned to either a dry needling-only group (DNO) or a dry needling plus modalities group (DN+M). The DNO group received a single dry needling treatment located at various sites along the multifidus by a physical …

Cost Effectiveness Analysis Of Psychopharmaca Therapy Combination Compared With Psychopharmaca Therapy And Ect Combination In Schizoaffective Inpatients At The Rsj Provinsi Jawa Barat, Yasmin Fadillah, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Mental disorders constitute an economic burden on health, estimated at USD 2.5 trillion in 2010 and expected to increase to USD 6 trillion by 2030. Treatment of schizoaffective disorder involves a combination of medication and psychotherapy. Pharmacoeconomics is an important consideration in drug selection. This study aims to determine the cost-effectiveness of psychopharmaca therapy combination compared with psychopharmaca therapy and ECT combination in schizoaffective inpatients at the RSJ Provinsi Jawa Barat. Data collection was conducted retrospectively from patient medical records for the period December 2023–December 2024. Total costs, based on a health perspective, include psychopharmaca drug costs, inpatient care costs, …

Evaluation Of Antibiotic Use Using The Gyssens Method On Clinical Outcomes In Ischemic Stroke Patients, Juniarto Mende, Graciano A. Maturbongs, Yohana K. A. Mbulang

Pharmacology and Clinical Pharmacy Research

Ischemic stroke is a health problem that causes death and neurovascular disability worldwide. The inflammatory response due to infection can increase ischemic stroke and increase brain damage through changes in blood pressure, coagulation, immune response, and endothelial function. This study aims to evaluate the rationality of antibiotic use on clinical outcomes in ischemic stroke patients. This study used a cross-sectional design. Retrospective data were taken from the medical records of Jayapura Regional Hospital for the period January 1, 2023, to May 31, 2025. The study subjects were all patients who suffered ischemic stroke and received antibiotics. Evaluation of the rationality …

Retrospective Analysis Of Antimicrobial Resistance Patterns In Gram-Positive And Gram-Negative Blood Isolates, Helman Kurniadi, Timbul Partogi Haposan Simorangkir, Ros Sumarny, Fitria Heldiana

Pharmacology and Clinical Pharmacy Research

Bloodstream infections are an important cause of morbidity and mortality, while antimicrobial resistance limits treatment options. This retrospective study evaluated bacterial distribution and antimicrobial susceptibility in blood cultures at RSPAD Gatot Soebroto, Jakarta, using microbiology and medical record data from January-December 2019. Clinically significant isolates were included, while duplicates and contaminants were excluded. Identification and susceptibility testing followed standard procedures and CLSI 2019 guidelines. Data were analyzed descriptively. Among 482 isolates, 246 (51.0%) were Gram-positive and 236 (49.0%) were Gram-negative. The Gram-positive isolates were mainly coagulase-negative staphylococci, including Staphylococcus epidermidis (62, 25.2%), S. hominis (61, 24.8%), and S. haemolyticus (50, …

Analysis Of Pharmacotherapy And Non-Pharmacotherapy Burden From The Ina-Cbgs Package For Cesarean Section Surgery At The Regional General Hospital Dr. Soedarso In 2023, Ananda Rizky Awwaliyah, Nurmainah Nurmainah, Ridha Ulfah

Pharmacology and Clinical Pharmacy Research

The prevalence of cesarean sections has been increasing each year. Previous studies show that the cost of medications and medical supplies for cesarean patients accounts for one-third of the total care costs. In the era of National Health Insurance (NHI), medications and medical supplies are considered operational expenses for hospitals rather than sources of income. This condition requires proper medication management and the use of medical supplies. This study aims to analyze the percentage of pharmacotherapy and non-pharmacotherapy, including the types and quantities of medications as well as disposable medical supplies used on patients undergoing cesarean section procedures at the …

Alexithymia In Substance Use Disorders: A Scoping Review Of Therapeutic Approaches, Pratami Diah Herliani, Shelly Iskandar, Angela Vera Herman Efendi

Pharmacology and Clinical Pharmacy Research

Alexithymia, defined as the inability to recognize and express emotions, has a high prevalence (40–50%) among individuals with substance use disorders (SUD), particularly alcohol use disorder, and is associated with poorer clinical outcomes. Despite this, comprehensive mapping of psychotherapeutic interventions targeting this condition within the SUD population remains limited. This study aimed to systematically map the therapeutic approaches investigated to address alexithymia among individuals with substance use disorders and to summarize the reported outcomes. A scoping review was conducted in accordance with the PRISMA-ScR guidelines using systematic literature searches in the PubMed and Scopus databases. Relevant studies were screened based …

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …

Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells

The Qualitative Report

This paper introduces relational–developmental autoethnography (RDA), a qualitative method for exploring psychological growth through personal writing and reflection. Developed through lived experience, RDA traces psychological development through sustained, recursive engagement with personal writing. Drawing on an archive of my journals, letters, clinical records, and correspondence spanning more than 30 years, I show how writing and reflection were first tools for my survival, and later became catalysts for insight, healing, and transformation. RDA is grounded in two developmental frameworks: Dąbrowski’s theory of positive disintegration, which views emotional intensity and inner conflict as signs of developmental potential, and relational-cultural theory, which …

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Variation In Meningioma Recurrence Risk Estimates Across Observational Cohorts: The Influence Of Calendar Time, Who Classifications, Geographical Settings, And Healthcare Systems, Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Luca Bertero, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Soichi Oya, Satoru Miyawaki, Nobuhito Saito, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Jennifer Moliterno, Ricardo Prat-Acin, Stéphane Goutagny, Vikram C Prabhu, John T Tsiang, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Karthikeyan Perumal, Mustafa K Baskaya, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W Mcdermott, Fang Wang, Pedro Góes, Manoel Antonio De Paiva Neto, Ricardo Komotar, Michael E Ivan, Aria Jamshidi, Evan Luther, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Olivia Claire Barrett, Randy Jensen, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen, Andrea Daniela Maier

Duncan NRI Faculty and Staff Publications

Purpose: Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables.

Results: Recurrence risk …

The Impact Of Partner Support On Vaginismus Treatment Outcomes: A Mixed Methods Study, Anna R. Ames, Alisha H. Redelfs, Nana Mensah

ScholarsArchive Data

A mixed-methods design was used to gain a nuanced understanding of how partner support affects the experiences of people with vaginismus.

Study aim: To guide partners of people with vaginismus in understanding how they can best help their partners with their vaginismus experience. 

• Quantitative Data: cross-sectional survey to reveal correlations in the relationship between vaginismus treatment outcomes and partner support [Available]
• Qualitative Data: Individual interviews to explore specific ways that people with vaginismus receive, or want to receive, support from their partners and the significance that they place on partner support  [Not Available]

Survey Data
Survey participants were recruited in …

Mitochondrial Trna-Derived Fragments As Candidate Metastasis-Modifying Rna, Katy L. Swancutt, R. Mckinnon Walsh, Sydney Quijano, Emily Schueddig, Devin C. Koestler, Adam D. Scheid, Tony Vanden Bush, Yi Jing, Isidore Rigoutsos, Danny R. Welch

Computational Medicine Center Faculty Papers

UNLABELLED: How mitochondrial DNA (mtDNA) polymorphisms influence complex phenotypes remains poorly understood. Using mitochondrial-nuclear exchange mice, we previously showed that mtDNA single-nucleotide polymorphisms (SNP) modify metastasis, cardiovascular disease, and epigenetic marks independently of metabolic differences. The only mtDNA SNP correlating with these phenotypes resides in the gene encoding mitochondrial transfer RNA (tRNA)-arginine [mt-tRNAArg (UCG), mt-TR], suggesting a role for non-protein-coding loci. In this study, we identify and preliminarily characterize previously undescribed tRNA-derived fragments (tRF) generated from mt-TRs. Northern blotting revealed distinct tRF that are differentially expressed among mtDNA SNPs, between lung and liver, and between sexes. Surprisingly, small RNA sequencing …

Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Scholarly productivity is a key marker of achievement in academic ophthalmology, influencing promotion, research support, and leadership opportunities. Prior studies have reported variation by gender, subspecialty, and rank, but few applied regression methods to identify independent predictors.

Purpose: To evaluate demographic, academic, and subspecialty factors associated with research productivity among U.S. academic ophthalmologists and to identify independent predictors through multivariable regression.

Methods: This cross-sectional study included 4,028 ophthalmologists across 126 accredited U.S. residency programs using the U.S. Academic Ophthalmology Faculty Database (US-AOFD). Faculty demographics and academic information were obtained from institutional websites, and bibliometric data (publications, …

Do Social Determinants Of Health Affect Tooth Retention For American Indian/Alaska Native (Ai/An) Adults?, Vae Day

Summer Research Showcase

American Indian/Alaska Native (AI/AN) adults face severe dental disparities due to social determinants of health (SDOH). This study examines how socioeconomic, functional, and cognitive factors influence access to dental care. Quantitative analysis was conducted using SPSS Statistics. Chi-square testing and logistic regression evaluated relationships between variables. Using a strengths-based approach to this research, the outcome variable was recoded to measure “teeth retained” instead of “teeth removed due to tooth decay or gum disease”. Analyses revealed that tooth retention and healthcare access significantly increase with favorable SDOH, including reliable transportation, household income, ability to complete errands independently, having insurance, and retained …

Contextualizing Second Language Anxiety In Multilingual Higher Education: Classroom Conditions And Clinical Settings, Busayo O. Ige

International Journal of Teaching and Learning in Higher Education

In South African universities, multilingual students whose first language is not English face distinct challenges that impact academic participation and success. This qualitative study examines how second language (L2) anxiety shapes first-year students’ classroom and clinical experiences at the University of Cape Town. Drawing on open-ended survey data, the study reveals that fear of negative evaluation, communicative apprehension, and prevailing language ideologies contribute to students’ reluctance to speak, feelings of invisibility, and withdrawal from engagement. Although anxiety tends to lessen over time, it rarely disappears completely. Notably, students experienced anxiety differently across settings: classroom discussions elicited greater fear and self-censorship, …

A Language We Built Together: A Physician Assistant’S Reflection On A Renal Transplant, Oviya Mahendran, Sampathkumar Sakthi Selvakumar

Journal of Wellness

This is not just a story of kidney transplantation in a tertiary care hospital in a tier-2 city of South India. It is all about a true clinical journey of resilience, where a young woman with congenital hearing loss, battling chronic kidney disease, discovered hope, understanding, and companionship through a physician assistant's compassionate communication.

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh

Walden Dissertations and Doctoral Studies

Patient falls remain a major patient safety concern, particularly among hospitalized stroke patients who are at increased risk because of impaired mobility, neurological deficits, and cognitive changes. The inpatient stroke unit selected for this quality improvement project consistently reported the highest fall rates within the hospital system, highlighting the need for evidence-based interventions. The purpose of this project was to determine whether a structured fall-prevention education program incorporating evidence-based practices and the 4Ps of purposeful rounding (pain, potty, position, and possessions) would improve staff knowledge, increase compliance with fallprevention practices, and reduce patient falls over a 2-month period. Guided by …

Sexual Harassment In Dentistry: Understanding The Issue And Steps To Prevent It From Happening

Journal IDA

The #MeToo Movement in 2017 shone a light on how widespread sexual abuse and sexual harassment were in the workplace.1 A survey completed in 2020 reported that 38 percent of women experienced different forms of sexual harassment in the workplace, while approximately 15 percent of men reported similar experiences.2 The data indicate, that sexual harassment was not unique to women as men, as well as nonbinary people also reported facing sexual harassment.