SACM - United States of America
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9668
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Item Restricted DEEP LEARNING ALGORITHMS FOR BIOMEDICAL IMAGE SEGMENTATION IN LOW-DATA SCENARIOS(University of Delaware, 2025) Alblwi, Abdalrahman Hmod; Barner, KennethAutomatic segmentation via deep learning plays a major role in biomedical imaging, enhancing diagnostics by dividing images into regions of interest. This procedure helps medical experts understand disease characteristics, lesion sizes, and other crucial details. Despite its potential, deep learning-based automatic segmentation often relies on large annotated data to accurately predict lesions and other critical regions. Among imaging modalities, ultrasound, widely used for its accessibility, real-time capabilities, and effectiveness in detecting lesions, remains inadequately investigated due to the inherent challenges in medical imaging, such as data availability and privacy concerns. This work identifies key research gaps in ultrasound imaging segmentation to address these challenges and contributes to advancements in this critical area. This dissertation focuses on three key areas for advancing ultrasound image segmentation and improving biomedical image analysis. First, it aims to improve supervised learning-based architectures for tumor segmentation, particularly U-Net models, which, despite their success in biomedical segmentation, often lack reliability for clinical use, especially when tested on out-of-dataset samples. Second, it addresses the challenges posed by limited annotated ultrasound data, which restricts the performance of supervised models. Finally, it addresses the scarcity of ultrasound datasets paired with corresponding masks, a significant issue caused by data privacy concerns, the lack of datasets from various countries, and the high costs of expert-level annotations. This dissertation introduces an improved supervised model based on a refined U-Net architecture incorporating ReSidual U-blocks (RSU) and Attention Gates to address segmentation challenges in scenarios with limited data. These enhancements improve the model’s ability to capture critical features and long-range dependencies, improving lesion segmentation performance in ultrasound images. Building on this, we integrate a Denoising Diffusion Probabilistic Model (DDPM) with the RSU architecture to create a deeper network capable of handling the high variability and noise in ultrasound datasets. This combination enhances segmentation mask accuracy and addresses challenges posed by samples with diverse characteristics, such as size and shape variations of regions of interest. Next, we improve data augmentation by enhancing the Mixup technique to address limited data scenarios in image segmentation. Using K-means clustering, ultrasound images are grouped into clusters of similar samples, and Mixup applies within clusters. This approach has the potential to reduce randomness, avoid mixing unrelated regions like tumors and dark backgrounds, and ensure more effective augmentation. It also diversifies the dataset by generating new samples and masks, mitigating data scarcity. Building on this contribution, we extend the application of Cluster Mixup to unsupervised segmentation. The goal is to leverage unlabeled ultrasound images by augmenting healthy samples with Cluster Mixup, followed by unsupervised learning to detect suspected tumors. This approach could show the potential to qualitatively and quantitatively improve the segmentation of regions of interest and enhance diagnostic capabilities. Additionally, we build upon Cluster Mixup by proposing a variant of D-DDPM, a diffusion-based model, to learn the distributions of combined images and masks, enabling the simultaneous and joint generation of synthetic images and annotations. This technique expands the dataset with a large number of image-mask pairs. We involve medical experts in evaluating the synthetic dataset, ensuring the selection of relevant samples, and improving dataset quality. Statistical analysis obtained from medical experts shows the reliability of our approach and its potential application to real-world problems.24 0Item Restricted Healthcare in Crisis: Assessing Medication Adherence, Health Care Access, Telehealth Utilization, and Variations of Depression Treatment in the Era of COVID-19 for US Hypertensive Patients(Howard University, 2025) alharbi, Rehab; La’Marcus, WingateBackground: Coronaviruses (CoVs) are highly contagious viruses that cause respiratory and gastrointestinal illnesses. It disrupted global healthcare systems and affected access to care for chronic conditions like hypertension. It is a major risk factor for cardiovascular disease and a leading cause of death in the U.S. However, the pandemic shifted healthcare focus to COVID-19. Telehealth emerged as a critical tool for maintaining continuity of care. The pandemic also intensified mental health issues, such as depression. This study explores medication adherence, healthcare access, telehealth utilization, and depression treatment patterns among U.S. hypertensive patients during COVID 19. Methods: This cross-sectional analysis used secondary data from the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS).Outcomes included medication adherence among hypertensive patients, telehealth use, healthcare delay during the pandemic, and depression treatment variations in adults with both hypertension and depression. Descriptive statistics were utilized to describe patients’ characteristics, while logistic regression identified predictors of outcomes. Results: Medication adherence varied across antihypertensive classes, with ARBs having the lowest (53.4%) and beta-blockers having the highest (60.6%) levels of adherence. Older adults had lower adherence (adjusted odds ratio (AOR) = 0.87, p < 0.05) compared to younger adults (18-34). Whites were more likely to utilize telehealth than Blacks (AOR = 1.13, P = 0.05). Older individuals faced higher odds of delayed care, with those aged 50–64 having an (AOR = 1.19 ,p = 0.02), and v those aged 65 and above having an (AOR=1.29,p < 0.001). Additionally, Older adults aged 50–64 were more likely to receive depression treatment (AOR: 2.81, p < 0.001), and whites had 2 times higher odds of receiving depression treatment compared to blacks, with a p-value of 0.05. Those with poor physical health had the highest odds of receiving treatment (AOR = 5.99, p < 0.001), compared to those with excellent physical health status. Conclusions: The study highlights disparities in medication adherence, healthcare access, telehealth use, and depression treatment among hypertensive patients during COVID-19. Influenced by age, race, physical health, and gender. These findings highlight the need for policy interventions to improve access to chronic disease care.5 0Item Restricted Nonlocal Boundary Value Problems for Linear Hyperbolic Systems(Florida Institute of Technology, 2025-05) Almutairi, Afrah; Kiguradze, TarielBoundary value problems in a characteristic rectangle Ω = [0, ω1]×[0, ω2] for second order linear hyperbolic systems are considered. For initial–boundary value problems there are established: (i) Necessary and sufficient conditions of well–posedness; (ii) Necessary conditions of solvability; (iii) Effective sufficient conditions of solvability of two–point initial–boundary value problems; (iv) Effective sufficient conditions of solvability of initial–periodic problems; (v) Necessary and sufficient conditions of solvability of ill–posed initial–boundary value problems; (vi) Necessary and sufficient conditions of solvability of ill–posed initial–periodic problems. For nonlocal boundary value problems there are established: (i) Necessary and sufficient conditions of well–posedness; (ii) Necessary conditions of solvability; (iii) Effective sufficient conditions of solvability of problems with Nicoletti type boundary conditions; (iv) Effective sufficient conditions of solvability of problems with boundary conditions of periodic type ; (iv) Effective sufficient conditions of solvability of doubly–periodic problems; (v) Necessary and sufficient conditions of solvability of ill–posed doubly–periodic problems.17 0Item Restricted Simulation-Enhanced Interprofessional Education: A Best Practice for Collaborative Healthcare Training(University of Rochester, 2025) Almutairi, Rima; Miller, DavidSimulation-Enhanced Interprofessional Education (SIM-IPE) has emerged as a transformative strategy to bridge gaps left by traditional interprofessional education (IPE) methods in preparing healthcare students for real-world collaborative practice. This paper critically examines SIM-IPE as a best practice for fostering teamwork, communication, and role clarity among students from diverse health professions. Grounded in experiential learning theory and supported by empirical evidence, SIM-IPE offers immersive, high-fidelity clinical scenarios that enhance students' readiness for team-based care. The paper synthesizes seven core themes, including SIM-IPE’s ability to address limitations in traditional IPE, promote psychological safety, develop core interprofessional competencies, and provide strategies for sustainable curriculum integration. It further explores the influence of faculty development, institutional support, and logistical innovation on successful implementation. While challenges such as financial constraints, faculty resistance, and professional silos persist, the findings underscore SIM-IPE’s pivotal role in advancing collaborative, patient-centered care and call for systemic reforms to embed it as a core component of health professions education.20 0Item Restricted The Accuracy of The Static Computer-aided Implant Surgery in The Different Extraction Sockets: An In Vitro Study(Indiana University, 2025) Alqahtani, Dhafer; Chaochieh, YangPurpose: To evaluate the accuracy of guided surgery in a healed ridge and different types of maxillary anterior teeth extraction sockets. Material & Methods The extraction site of the maxillary right central incisor (ADA#8) was designed and printed with bone simulation resin. A total of 40 maxillary radiopaque bone models were divided into four groups. Group H (n=10) included the healed edentulous ridge at site #8. Group L (n=10) included #8 extraction socket positioned against the labial cortex. Group C (n=10) included a centralized #8 extraction socket not engaging either the palatal or labial cortices. Group P (n=10) consisted of #8 extraction socket positioned against palatal cortical. Bone models were scanned and saved as STL files. At site #8, a virtual 4.1 mm diameter x 10 mm Straumann bone level tapered implant was planned sub-crestal in a prosthetically-driven position using CoDiagnostiX implant planning software. Surgical guides were fabricated for each bone model according to the implant planning. Straumann BLT implant shape alloy implants were placed following the fully guided s-CAIS protocol. After implant placement, the position was scanned with an intraoral scan, the angular deviation and 3D deviation at the crest and apex levels between the planned and actual implant placement were measured using a treatment assessment function in the implant planning program. One-way ANOVA was used to assess whether the extraction socket form affected the degree and amount of deviation. Result The center group showed the highest global offsets at both the crest (0.83±0.34mm) and apex (0.98±0.29mm), whereas the labial group had the lowest offsets at the crest (0.38±0.17mm) and apex (0.49±0.26mm). Depth deviation of the implant at crest and apex were not significantly different among the groups. The healed ridge group exhibited the highest mean angular deviation (2.91±1.37°), while the center group had the lowest (1.87±1.11°). At the crest, the center group had greater global discrepancies (p < 0.001). ANOVA results indicated that the type of extraction socket significantly affects global, labial-palatal, and mesial-distal deviations at both the crest and apex (p < 0.05). At the apex, the labial group had significantly lower global deviations than the others (p < 0.001). Conclusions The extraction socket types impact the accuracy of s-CAIS. Implants placed immediately in extraction sockets centered within the alveolar ridge showed less accurate crestal positions. In contrast, the labial-positioned socket exhibited greater accuracy in global deviations at the apex. Furthermore, the accuracy of s-CAIS for immediate implant placement was comparable to healed ridge placement with a potential tendency toward a more labial position.30 0Item Restricted Zinc Pretreatment as a Strategy to Improve Silver Diamine Fluoride Therapy: A Translational Approach to Reducing Discoloration and Enhancing Aesthetic Outcomes in Dentistry(University of Rochester, 2025) Almulhim, Abdullah; Xiao, Jin; Li, YihongSilver diamine fluoride (SDF) has gained widespread recognition as a minimally invasive treatment for early childhood caries (ECC), but its aesthetic drawback, permanent black discoloration of carious lesions, remains a significant barrier to broader clinical acceptance. This dissertation explores zinc pretreatment as a translational strategy to mitigate SDF-induced discoloration while maintaining its antimicrobial and functional efficacy. Through a series of in vitro investigations modeled on clinically relevant conditions, this work advances the development of more acceptable, patient-centered alternatives to conventional SDF therapy. In this dissertation, I conducted three interconnected studies to evaluate the role of zinc pretreatment in modifying SDF outcomes. The first study assessed the effect of zinc pretreatment on sound dentin prior to SDF application. Results demonstrated reduced surface discoloration, with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) confirming modified silver deposition patterns and the presence of zinc on treated dentin. The second study extended these findings to an artificial caries model, simulating cariogenic conditions using dual-species biofilms of Streptococcus mutans and Candida albicans. Zinc pretreatment preserved SDF’s antimicrobial activity while disrupting biofilm structure and reducing biomass, suggesting a potential synergistic effect. The third study focused on primary dentition, where aesthetics are of heightened concern, demonstrating that zinc reduced discoloration on carious and sound dentin of extracted primary teeth, with SEM/EDS corroborating altered silver distribution. Although statistical significance in discoloration reduction was borderline, consistent trends across experiments support the mechanistic role of zinc in modifying silver behavior on dentin surfaces. The results of this dissertation provide foundational evidence for incorporating zinc into caries-arresting treatments to overcome aesthetic limitations without compromising therapeutic efficacy. In addition to establishing zinc’s potential to reduce staining, this work proposes future directions including nanoparticle-based delivery systems, expanded surface and functional analyses, and clinical trials in pediatric populations. Collectively, this research bridges the gap between laboratory-based discovery and real-world application. It contributes to the broader mission of translational biomedical science by advancing minimally invasive, aesthetically acceptable, and biologically effective therapies for managing caries, particularly in young children and underserved populations.15 0Item Restricted The Relationship Between Caregivers' Contribution to Heart Failure Self-Care and Patient Self-Care: Exploring the Moderating Effect of Patient Cognitive Status(Case Western Reserve University, 2025-05) Aldossary, Heba Mohammed; Dolansky, Mary; Irani, Elliane; Schiltz, Nicholas; Sundaram, VarunHeart failure (HF) impacts millions worldwide and necessitates ongoing self-care, including maintenance, monitoring, and management, to prevent symptom worsening and hospitalization. Cognitive impairment, impacting memory, attention, and decision-making, is prevalent among patients with HF and may impede their self-care capabilities. In these instances, family caregivers frequently offer essential assistance. The effectiveness of this support in cases of cognitive impairment is not well established. Furthermore, other factors, including patient and caregiver self-efficacy, mental quality of life, and satisfaction with dyadic care may impact self-care, yet they remain insufficiently examined. This research employed a secondary analysis of data from 277 HF patient-caregiver dyads (N = 554) participating in a descriptive cross-sectional study conducted in Italy. Regression analyses, both multiple and moderated, were performed to investigate the relationships between caregiver contributions and patient HF self-care behaviors while evaluating the moderating effect of patient cognitive status and the impact of the covariates. The findings indicated that caregiver contributions were significant predictors of patient self-care in the domains of maintenance, monitoring, and management. Patient self-efficacy was identified as a significant and reliable predictor in all domains of self-care. The relationship between caregiver contribution and patient self-care maintenance and monitoring was significantly moderated by cognitive status, with caregiver support proving more effective for patients without cognitive impairment. Furthermore, caregiver satisfaction with dyadic care exhibited a negative correlation with self-care maintenance, while showing a positive correlation with self-care monitoring. The findings underscore the critical importance of caregiver support and patient self-efficacy in HF self-care, while also indicating that caregivers provide more support when there is no cognitive impairment. The results highlight the necessity of regular cognitive assessments and caregiver training when cognitive impairment exists to assist with HF self-management. The role of caregiver satisfaction indicates that relational dynamics may affect different aspects of self-care, necessitating further investigation. This research informs the creation of tailored interventions that include caregivers, with the goal of enhancing HF management.10 0Item Restricted Weather, Sustainability and Islamic Finance(University of New Orleans, 2025) AlKatheery, Nouf; Hassan, MohammadThe first essay examines how weather conditions affect stock market performance in the Saudi Stock Exchange (TASI). To investigate this relationship, the study employs multiple regression analysis in conjunction with the GJR-GARCH model. we analyze the effects of Air Temperature, Relative Humidity, Wind Speed, and Rainfall on TASI returns. Results indicate Air Temperature has the most significant influence. The impact of weather weakened after foreign investors entered the market, suggesting a shift in investor behavior. Sectoral analysis reveals that the Energy, Information Technology, and Utilities sectors are the most resilient to weather variations. This second essay examines the impact of Environmental, Social, and Governance factors on the profitability of conventional and Islamic banks. Using structural equation modeling, the findings reveal that the Environmental pillar positively impacts profitability in Islamic banks. The Social pillar negatively affects profitability in Islamic banks, while the Governance pillar increases profitability in conventional banks but reduces it in Islamic banks. These results highlight the need for Islamic banks to optimize social initiatives and governance frameworks while conventional banks should enhance environmental strategies.13 0Item Restricted INVESTIGATING THE NATURE AND IMPLEMENTATION OF GOVERNMENTAL POLICIES ON THE INCLUSION OF STUDENTS WITH MILD/MODERATE DISABILITIES IN GENERAL EDUCATION SETTINGS IN SAUDI ARABIA(Kent State University, 2025) Alanazi, Hani Hulayyil; Stevenson, NathanThe government of Saudi Arabia has made significant efforts to provide inclusive education for students with disabilities. Inclusive education enables students with disabilities to receive the same educational services and opportunities as their non-disabled peers. However, the current educational system still faces challenges in achieving effective inclusion. The broad goal of effective inclusion is to provide appropriate services and accommodations for individual educational programs and supports that ensure quality education for all children. Many governments, including Saudi Arabia, have advanced specific policies for the inclusion of students with disabilities, particularly those with mild to moderate disabilities, in general education programs. Nevertheless, Saudi Arabia is still in the preliminary stages of integrating students with disabilities into general educational environments. This study focuses specifically on the perspectives and lived experiences of special education teachers working in elementary schools in Riyadh. The study examines the extent to which existing educational policies in Saudi Arabia encourage the inclusion of students with moderate to severe disabilities in general education classrooms, according to teachers charged with enacting such policies. By analyzing how these teachers interpret and apply inclusive education policies in their everyday practice, the study seeks to illuminate the real-world challenges and contextual dynamics influencing policy implementation. The study identifies systemic gaps and areas where major changes or further improvements are needed to increase the number of students with disabilities in inclusive educational settings. By investigating the current state of inclusive education policies and practices in Saudi Arabia, this research aims to contribute to the development of a more equitable and inclusive educational system for all students.5 0Item Restricted The Impact of Privacy Awareness on Sharenting and Privacy Management Practices Among Saudi Parents(Kent State University, 2025) alnemre, Afnan; Hollenbaugh, Erin; Egbert, NicholeIn the digital age, parents frequently engage in the practice of sharenting—sharing their children's photos and information on social media—raising concerns about privacy and its implications for identity theft and other risks. This phenomenon has significant impacts on the violation of children’s privacy and their psychological and social well-being. Guided by communication privacy management (CPM) theory, this study aimed to identify the role of privacy awareness and religiosity in sharenting and privacy management practices among Saudi parents, using a quantitative approach and relying on a survey as a data collection method, N =139 were collected from Saudi parents. The findings revealed that extrinsic religiosity demonstrated positive relationship with all sharenting dimensions self-control, social behaviors and implications also with boundary linkages and boundary permeability in CPM. Also, intrinsic religiosity has a negative correlation with boundary permeability, while the study does not find a relationship between intrinsic religiosity and all sharenting dimensions. Additionally, there was a significant negative correlation between privacy awareness and boundary ownership in CPM. Moreover, the study has shown gender differences in sharenting behavior, showing that mothers post more pictures of children. This research aspires to inform initiatives promoting privacy-conscious digital practices among parents and aims to support the development of child protection policies in Saudi Arabia to safeguard children's online privacy.25 0