Medicine and Health Sciences Commons^™

Can Eastern Wisdom Solve Western Problems? A Book Review On Sun Tzu’S “The Art Of War”, Tian Qin

Health Care Administration Faculty Research

This paper explores how Eastern philosophical wisdom, specifically Sun Tzu’s The Art of War, can be applied to address modern Western organizational challenges. By drawing parallels between Sun Tzu’s military strategies and Bolman and Deal’s (2008) organizational theory—particularly the structural, political, and human resource frames—the review highlights how strategic evaluation, environmental awareness, and adaptive leadership can drive success in contemporary institutions. It critically examines Sun Tzu’s authoritative leadership style and its limitations, while emphasizing the continued relevance of strategic thinking, stakeholder analysis, and resource management in complex organizations such as higher education. The analysis suggests that while some of Sun …

A Path Analysis Of Predictive Factors Affecting Kangaroo Mother Care Practice Among Mothers In Communities In Upper East Region, Ghana, Francis Anaba Agana

Chulalongkorn University Theses and Dissertations (Chula ETD)

This cross-sectional descriptive correlational study aimed to explore the level of KMC practice among the mothers in communities in Upper East Region, Ghana, and to explore the direct and indirect effects of socioeconomic status, social support, maternal autonomy, self -efficacy and sociocultural norms on the practice of KMC in communities in Upper East Region, Ghana. The sample were 300 mothers of preterm and/low birth weight babies recruited by using stratified random sampling technique. This study applied the Socio-Ecological Model as a theoretical framework. Data were collected using questionnaires including socioeconomic status, social support, maternal autonomy, self-efficacy, sociocultural norms and KMC …

The Effects Of An Integrated Application Supported Mindfulness-Based Cognitive Therapy Program On Depression Among Adolescents With Non Suicidal Self-Injury, Russunan Jantarapakdee

Chulalongkorn University Theses and Dissertations (Chula ETD)

This randomized controlled trial with repeated measures aimed to evaluate the effectiveness of an integrated application supported MBCT program in reducing depression among adolescents with NSSI. The sample consisted of 96 participants who met the inclusion criteria and were randomly assigned to either the experimental group or control group, with 48 participants in each group. The experimental group received the program, was developed based on the MBCT framework proposed by Segal et al. (2013) once a week for 60 minutes over eight weeks. Sessions were delivered through both on-site activities at schools and online meetings via the LINE application, supplemented …

Molecular Investigation Of Clade Classification, Knockdown Resistance And Pathogen Detection Of The Head Louse (Pediculus Humanus Capitis) Collected From Children In Ang Thong, Thailand, Urooj Gul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Human head lice (Pediculus humanus capitis) are medically significant ectoparasites due to their capacity to harbor pathogenic bacteria and the increasing prevalence of insecticide resistance. A total of 112 head lice specimens were collected from children in Ang Thong, central Thailand. Phylogenetic analysis of the mitochondrial cytb gene identified two well-supported clades, with clade A (69.2%) predominating over clade C (30.8%) in the studied population. Molecular screening revealed a high incidence of bacterial associations, with Staphylococcus aureus detected in 96.4% of specimens and Acinetobacter spp. in 2.7%. Furthermore, genotypic analysis of the voltage-sensitive sodium channel (VSSC) gene demonstrated a strikingly …

Recommendations For The Novel Assessment System In The Doctor Of Medicine Program From The Medical Students’ And The Educators’ Perspectives, Tanat Tabtieang

Chulalongkorn University Theses and Dissertations (Chula ETD)

The 2024 Doctor of Medicine curriculum at Chulalongkorn University introduced a new assessment system comprising outcome-based assessment system with milestones, a non-tiered grading model with recognition of excellence, a professional development dashboard (PDD), remediation with re-examination, and a faculty-level student profile (FLSP). This study employed a quantitative cross-sectional survey design, complemented by a sequential exploratory element, to compare student and faculty perspectives using a questionnaire across five themes, analyzed with descriptive statistics, Mann-Whitney U tests, and effect sizes (ES). A total of 490 students and 285 faculty responded. When analyzed by theme, students showed greater confidence than faculty in the …

Antimicrobial Activity Of Silver Nanoparticles Synthesized Using Thai Herbal Extracts, Charuwan Pradabsang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Synthesis of silver nanoparticles (SNP) using Thai herbal plants, namely Garcinia cowa Roxb. ex Choisy (S1), Boesenbergia rotunda (L.) Mansf. (S2), Curcuma mangga Valeton & Zijp (S3), Momordica charantia L. forma abbreviata (Ser.) W. J. de Wilde & Duyfjes (S4), Persicaria odorata (Lour.) Soják (S5), Litsea elliptica Blume (S6), Gnetum gnemon Linn. var. tenerum Markgr (S7), Phaleria macrocarpa (Scheff.) Boerl. (S8), Salacia chinensis Linn. (S9) and Brachypterum scandens (Roxb.) Miq. (S10), is considerably economical and safe. Plants and preparation methods can affect properties and bioactivity such as controlled temperature of SNP. This study aimed to assess the ability of aqueous …

The Development Of Surveillance And Monitoring Tools For Pharmaceutical Supply Chain Management System For Public Health Emergencies, Kakanang Tosanguan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Thailand frequently experiences public health emergencies (PHEs) that severely disrupt pharmaceutical supply chain (PSC) management. This study addresses the urgent need for a specialized assessment tool to identify system weaknesses, support timely risk management, and enhance national preparedness planning.Methods: Utilizing a sequential exploratory mixed-methods design (July 2022–July 2024), the study began with a scoping review to identify existing frameworks. Following this, in-depth interviews with 36 key stakeholders synthesized conceptual domains. The draft tool underwent rigorous content validity assessment by 63 experts and was then pilot tested with 62 participants to confirm reliability (Cronbach’s alpha).Results: The evidence synthesis resulted in …

Optimization And Efficacy Of Car T Cells Derived From Newly Generated Anti-Cd22 Monoclonal Antibody For Blood Cancer Treatment, Wipawadee Ruengdej

Chulalongkorn University Theses and Dissertations (Chula ETD)

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of B-cell malignancies. Nevertheless, relapse due to loss of CD19 expression remains a major clinical challenge. CD22 serves as an alternative target because of its consistent expression on malignant B cells, even in CD19-negative disease. Optimization of CD22-directed CAR design is therefore critical to enhance antitumor potency and persistence. Two novel anti-CD22 CAR constructs were generated from monoclonal antibody clones 24A7G6 and 29H9C8, each incorporating either a 4-1BB or CD28 costimulatory domain. The resulting CAR T cells were evaluated for proliferation, phenotype, and cytotoxicity against CD22-positive (Raji, Nalm-6) and CD22-negative …

Bridging University And Hospital Libraries: Evidence-Based Strategies For Developing A New Medical School Library, Dana Thimons, Nancy Hampton, Kelly Fogarty

Faculty and Staff Publications

This poster, presented at the Medical Library Association (MLA) Annual Meeting, describes how Xavier University of Louisiana and Ochsner Health partnered to establish a new medical school, requiring library leaders to address LCME Standard 5.8 (Library Resources/Staff) within the data collection instrument and self-study for preliminary accreditation. A cross-institutional workgroup undertook a multi-method approach to building an evidence-based case for library planning, including a literature review, comparator institution database analysis, mapping of needs to LCME Standards, informal stakeholder interviews, consultation of AAHSL statistics and Doody's resources, evaluation of current holdings, and price estimation for needed resources. Key challenges included communicating …

Effect Of Walking With An Active Ankle Exoskeleton On The Biomechanical Responses Of The Lumbar Spine, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Sridevi Nagaraja, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Objective: Musculoskeletal injuries pose a health threat to U.S. Service members. In particular, the physical demands of walking and running with load carriage contribute to a high incidence of musculoskeletal injuries of the lower back. Active ankle exoskeleton devices are promising technologies that may help mitigate the impact of load carriage on the incidence of these injuries. However, the safe extended use of these devices requires an understanding of their beneficial or detrimental effects on the lumbar spine. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on lumbar biomechanical responses.

Methods: We collected …

The Role Of Advocacy And Occupational Justice In Increasing The Accessibility Of Parks For Parents With Disabilities, Nathan Burke-Tan

Doctoral Projects

The purpose of this doctoral capstone project was to address ongoing accessibility barriers experienced by adults with disabilities, particularly those in caregiving roles, in public parks and playgrounds in the greater San Diego region. Although many parks meet the minimum requirements of the Americans with Disabilities Act (1990), research shows that caregivers with disabilities continue to encounter obstacles that limit safe, meaningful participation in community spaces (Dalpra, 2022; Fernelius, 2017; Firkin et al., 2024; Movahed et al., 2023; Ogletree et al., 2020; Prellwitz & Skar, 2007). These persistent gaps indicate a need for stronger advocacy and clearer public awareness of …

Grounded In Experience: A Collaborative Approach To Resource Development For Adults With Ehlers-Danlos Syndrome, Morgan Kam

Doctoral Projects

Background: Ehlers-Danlos syndrome (EDS) is a complex connective tissue disorder that significantly affects daily occupations, participation, and quality of life, yet early support for individuals pursuing or newly receiving a diagnosis remains limited. Occupational therapy (OT) is uniquely positioned to address these challenges through interventions that promote self-management and functional engagement.

Purpose: This project aimed to develop an experience- and evidence-informed educational resource for individuals undergoing or newly receiving an EDS diagnosis, while increasing awareness of OT’s role in managing this chronic, multisystemic condition.

Methods: A mixed-methods approach integrated qualitative insights from interviews, online support groups, and practitioner feedback. A …

Family-Level Impacts Of Equine-Assisted Occupational Therapy For Children With Disabilities: An Exploratory Mixed-Methods Pilot Study, Emily Canigiula

Doctoral Projects

Equine-assisted occupational therapy (EAOT) has been shown to enhance functional, social, and quality-of-life outcomes for children with disabilities (McDaniel Peters & Wood, 2017; Prieto et al., 2022). While child-focused outcomes are well documented, significantly less is known about how EAOT participation may influence caregivers and the broader family unit, as existing research largely prioritizes individual outcomes over family experiences (Peters et al., 2017; Tan & Simmonds, 2018; Trzmiel et al., 2019; Xiao et al., 2023). Emerging qualitative studies suggest potential family-level impacts including family engagement, reduced parental stress, and enhanced feelings of pride, empowerment, and connection (Kalmback et al., 2020; …

Bridging Gaps With Occupational Therapy: The Unique Role Of Occupational Therapy In Women’S Day Shelters, Alex Sato

Doctoral Projects

Homelessness is a multifaceted, complex issue that we face as a society. Mainstream services provided to homeless or vulnerable populations tend to focus on housing and basic services. While these are essential and meaningful, literature suggests there is a lack in trauma and self-care support (Marzana et al., 2023; Milaney et al., 2020). Looking through an Occupational Therapy (OT) lens, there are a multitude of ways the profession can provide holistic care. Current OT service provision within this population most commonly focuses on obtaining and maintaining housing and addressing the survival occupations these individuals may be engaging in (Cunningham & …

Applying Occupational Empowerment Principles In A Life Skills Program For Unhoused Transitional-Aged Youth: Feasibility And Early Outcomes, Eriza Navarro

Doctoral Projects

The purpose of this occupational therapy doctoral capstone project was to address a gap in community-based services for unhoused transitional-aged youth (TAY) by promoting life skill acquisition and supporting participation in meaningful activities in order to enhance self-efficacy. This project aimed to design, implement, and evaluate a structured occupation-based life skills program that builds upon existing services at a local drop-in center. The program incorporated life skill education and activity-based, experiential interventions tailored to meet the needs and learning styles of the population. Methods included conducting a needs assessment, developing the program curriculum, and piloting the 6-week program consisting of …

Promoting Participation And Self-Efficacy Among Youth With Disabilities In Community-Based Vocational Education, Allison Hollender

Doctoral Projects

Occupational therapy, with its focus on participation, contextual adaptation, and strength-based practice, is uniquely suited to support the growth and inclusion of youth in transition (Angell et al., 2018; Cahill et al., 2020; Carroll et al., 2025). Research indicates that transitional-aged youth (TAY) with disabilities, ages 14-24, are less likely to graduate from high school, pursue postsecondary education, or live independently (BLS, 2024; Cheng & Shaewitz, 2022; Cook et al., 2015). These disparities are compounded by occupational deprivation, or limited opportunities for meaningful participation, which can negatively impact long-term self-efficacy and belonging (Arbesman & Logsdon, 2011; Cahill et al., 2020). …

From Silos To Synergies: How To Enhance Interdisciplinary Collaboration Among Graduate Students, Jennifer Jimenez

Doctoral Projects

Interprofessional education (IPE) is essential for preparing collaborative healthcare practitioners, yet opportunities at San José State University (SJSU) have been limited, inconsistent, and largely dependent on individual faculty initiative. This capstone project aimed to strengthen IPE at SJSU by assessing institutional capacity and developing feasible, sustainable strategies to enhance exposure and participation across health-related programs. Guided by the Person–Environment–Occupation–Performance (PEOP) model and adult learning theory, the project combined a needs assessment, literature review, and partnership with the Healthy Development Community Clinic (HDCC) to create an instructor implementation guide and student introductory modules for HDCC service-learning onboarding. An IRB-approved mixed-methods faculty …

A Guide To Falls In A Skilled Nursing Facility, Sarah Ghione

Doctoral Projects

Approximately one in four older adults experiences a fall each year in the United States (Centers for Disease Control and Prevention [CDC], 2024b; Kakara et al., 2023). Among those residing in nursing homes for either short-term rehabilitation or long-term care, the risk of falls is doubled (Acker & Janssen, 2017; Shao et al., 2023). The purpose of this doctoral capstone project was to develop an educational resource aimed at enhancing staff education and fall prevention efforts within a single nursing home, supporting the facility’s goal of reducing fall rates. Methods included a needs assessment, observational experiences, resource development, and the …

Identification Of Potential Prophylactic Medical Countermeasures Against Acute Radiation Syndrome (Ars), Kia T. Liermann-Wooldrik, Arpita Chatterjee, Elizabeth A. Kosmacek, Molly Myers, Oluwaseun Adebisi, Louise Monga-Wells, Liu Mei, Michelle P. Takacs, Patrick H. Dussault, Daniel R. Draney, Robert Powers, James W. Checco, Chittibabu Guda, Tomáš Helikar, David B. Berkowitz, Kenneth W. Bayles, Alan H. Epstein, Lynnette Cary, Daryl J. Murry, Rebecca E. Oberley-Deegan

Journal Articles: Pathology and Microbiology

Acute radiation syndrome (ARS) occurs when hematopoietic or gastrointestinal cells are damaged by radiation exposure causing DNA damage to the bone marrow and gastrointestinal epithelial stem cell populations. In these highly proliferative cell types, DNA damage inhibits stem cell repopulation. In humans and animals, this inability to regenerate stem cells is lethal. Within this manuscript, several compounds, Amifostine, Captopril, Ciprofloxacin, PrC-210, 5-AED (5-androstene-3β,17β-diol), and 5-AET (5-androstene-3β,7β,17B-triol), are assessed for their ability to protect against ARS in an in vitro and/or in vivo setting. ARS was accomplished by irradiating mouse bone marrow cells or rat intestinal epithelial (IEC-6) cells in vitro …

Aneurysmal Dilatation Following Common Femoral Artery Directional Atherectomy, Timothy H.H. Kam, Bryan P. Yan, Guangming Tan

Journal of the Hong Kong College of Cardiology

Aneurysmal dilatation is an uncommon but serious complication of directional atherectomy for heavily calcified lower extremity arterial disease. In the absence of established treatment guidelines, this case report describes the successful endovascular management of a common femoral artery aneurysm following directional atherectomy using covered stents.

Iatrogenic Femoral Arteriovenous Fistula After Leadless Pacemaker Implantation Treated With Balloon-Expandable Stent: A Report Of Three Cases, Cheuk Yin Lai, Timothy Ho Him, Mark Tk Tam, Guang-Ming Tan, Bryan P Yan

Journal of the Hong Kong College of Cardiology

Endovascular covered stenting is a minimally invasive option for treating iatrogenic femoral access site complications, including arteriovenous femoral fistula (AVF). Reports on AVF repair mainly concern small bore devices, but large bore devices such as leadless pacemakers post unique challenges. We present 3 cases of iatrogenic femoral AVF after large-bore, 27Fr access sheath insertion for leadless pacemaker implantation. Both underwent endovascular balloon-expandable covered stenting, with resolution of AVF and durable long-term results. As patients referred for leadless pacemaker implantations are often frail with co-morbidities, endovascular stenting is an appealing alternative to open surgical repair for AVF.

Examining Differences In Rural And Urban Medicare Ffs Beneficiaries’ Emergency Department Use Before And During Covid-19, Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat

ETSU/NORC Rural Health Research Center Policy Briefs

No abstract provided.

Effects Of Round-Up On The Environment, Sandra J. Marcu

Journal of Earth and Life Science

Many people around the world have used and still currently use Roundup but are unaware of the effects it has on the environment. Roundup is a spray on application weedkiller that is widely used around the world today both residentially and commercially. It enables its user to grow a garden or a field of crops with a no-tilling approach to eliminate weeds. It is a well-known and popular choice for killing weeds that has been around since the mid 1970’s (Oca, 2017). John Franz, a Monsanto scientist discovered that glyphosate (main ingredient in Roundup) was an herbicide or weedkiller, and …

Back Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

A Brief History Of Opioid-Use Disorder In The United States, Effect On Orthopaedics, And Current Management Options, William Curtis, Nicholas Newcomb, Eric S. Kruger, Christopher L. Shultz

Western Journal of Orthopaedics

Declared a public health emergency in 2017 and leading to 11 million years of life lost worldwide, the American opioid crisis has impacted millions of people, with up to 7 million experiencing opioid use disorder. In orthopaedic surgery, opioid analgesia has been associated with various complications, including infections, deep vein thrombosis, prolonged hospital stays, and overall inferior outcomes after surgical procedures. Orthopaedic surgeons commonly rely on opioids to provide postoperative analgesia and may frequently encounter patients with opioid use disorder. It is therefore essential that orthopaedic surgeons understand opioid use disorder, its effect on orthopaedic outcomes, and management of opioid …

Scar Tissue Adhesions, Neuromuscular Guarding, And Functional Recovery: A Case Report Of Physical Therapy Post-Cholecystectomy, Raeisa Griñe, Adam Walsh

Western Journal of Orthopaedics

Scar tissue from abdominal surgeries, such as cholecystectomy, can lead to long-term issues such as restricted movement, painful spasms, and impaired function. Laparoscopic adhesiolysis is a common surgical treatment for pathological scar tissue impairments. Conservative care, such as physical therapy, is a commonly used approach for managing pathological scar tissue. In this case, manual therapy techniques and targeted exercises successfully reduced the intensity and frequency of abdominal spasms, improved core strength and endurance, and enhanced overall functional mobility. These improvements were reflected in enhanced scores on the Lower Extremity Functional Scale and the Vancouver Scar Scale in a 59-year-old woman …

Treatment Sequence With Tebentafusp And Immune Checkpoint Inhibitors In Patients With Metastatic Uveal Melanoma And Metastatic Gna11/Gnaq Mutant Melanocytic Tumors, Florentia Dimitriou, Marlana Orloff, Erica Koch Hein, Phil Cheng, Isaac Hughes, Ester Simeone, Kamaneh Montazeri, Piyush Grover, Inderjit Mehmi, Camille Gerard, Caroline Gaudy-Marqueste, Jean-Jacques Grob, Olivier Michielin, Omid Hamid, Georgina Long, Ryan Sullivan, Ellen Kapiteijn, Douglas Johnson, Paolo Ascierto, Anthony Joshua, Richard Carvajal, Marcus Butler, Jessica Hassel, Reinhard Dummer

Kimmel Cancer Center Faculty Papers

BACKGROUND: Metastatic uveal melanoma (mUM) is rare. Immune checkpoint inhibitors (ICIs) have shown modest efficacy in mUM. Tebentafusp prolonged overall survival (OS) in a phase 3 study. We aimed to investigate the efficacy and safety of the sequence of tebentafusp and ICIs.

METHODS: Patients with HLA-A * 02:01 positive mUM, or metastatic GNA11/GNAQ mutant melanocytic tumors treated with tebentafusp followed by ICIs (group 1) or the inverse sequence (group 2) at any treatment line were retrospectively identified. The primary objective was OS rate at 2 years.

RESULTS: 131 patients were included; 51 in group 1 and 80 in group 2. …

Effects Of Liraglutide On The Gut Bacterial Community, Jami Anne Bull

Graduate Theses/Dissertations

Overweight and obesity are major health concerns associated with metabolic disorders and gut dysbiosis. Treatment options such as GLP-1 receptor agonists, like liraglutide, promote weight loss and improve insulin sensitivity; however, their impact on the gut bacterial community remains unclear. This study investigated the effects of liraglutide on the gut bacterial community of diet-induced obese (DIO) mice using Illumina DNA sequencing of the bacterial 16S rRNA gene. My study used twelve-week-old male C57BL/6J DIO mice. They were placed on a high-fat diet and treated with liraglutide (0.2 mg/kg) via daily subcutaneous injection for 14 Days. High-fat and low-fat diets control …

Preventing Chemical And Biological Attacks: Enhanced Threats Requiring Enhanced Solutions, Alex Elliot Ottoni-Belval

Graduate Theses/Dissertations

Chemical weapons (CW) and biological weapons (BW) are becoming more dangerous for experts to employ and more accessible to amateurs. Despite CW and BW attacks throughout history that killed and maimed millions of people, the international community has failed to establish meaningful consequences to prevent them. Agreements such as the Chemical Weapons Convention and the Biological Weapons Convention vow to eliminate and reduce the effects of CWs and BWs but lack respected response precedents and capabilities. The limited and inconsistent enforcement has inadvertently allowed CWs and BWs to become plausible weapons, especially to gain asymmetric advantages, while modern developments exasperate …

Alpha-Synuclein Interaction With Gedunin, Tony Matundura Nyabayo

Graduate Theses/Dissertations

Parkinson’s disease (PD) and other Proteinopathies develop when α-synuclein misfolds and aggregates into toxic amyloids. While existing treatments for PD are primarily focused on managing its symptoms, a viable solution for slowing down the progress of Parkinson’s disease involves targeting the toxic α-synuclein amyloids. Gedunin, a natural inhibitor of heat shock protein 90, has been extensively used to treat malaria. Also, recent research investigations have shed light on its potential beyond malaria therapy, indicating that Gedunin may offer a possible solution for treating a variety of neurodegenerative diseases. Using plate-based assays, we examined how Gedunin influences α-synuclein fibrillation and its …