Digital Commons Network^™

Separation Of Trichothecene Mycotoxins In A Matrix Of Hemp (Cannabis Sativa L.) Seed, And Quantification Of Deoxynivalenol In Hemp Grain Infected With Fusarium Graminearum, Isabelle A. Kagan, Magdalena Ricciardi, Henry S. Smith, Rachel R. Schendel, Robert Pearce, Nicole Gauthier

Plant and Soil Sciences Faculty Publications

Background: Fusarium graminearum, one of the causal agents of ear rot in maize and head blight of cereal grains, also infects hemp (Cannabis sativa L. containing a maximum of 0.3% tetrahydrocannabinol or THC). This fungal pathogen produces trichothecene mycotoxins when it infects maize and cereal grains, but little is known about its production of mycotoxins in hemp. A method was developed to separate mycotoxins deoxynivalenol (DON), 15-acetyldeoxynivalenol (15-ADON), and 3-acetyldeoxynivalenol (3-ADON) in commercial hemp seed and grain (harvested tissue), using high-performance liquid chromatography (HPLC) with ultraviolet detection. Results: In HPLC analysis of commercial hemp seed, DON was separated from matrix …

Hybrid Genome And Enzyme Characterization Uncover Novel Glycosyltransferases Associated With Benzylisoquinoline Alkaloid Chemodiversity In Lotus, Hedi Zhao, Xinyi Qi, Yan Liu, Zhuyin Chen, Yifan Wang, Jing Que, Yanyan Su, Ling Yuan, Gangqiang Dong, An Liu, Zhennan Wang, Sha Chen

Plant and Soil Sciences Faculty Publications

Introduction: Hybridization is a key evolutionary force that enriches genetic diversity and is associated with metabolic innovation. Lotus (Nelumbo), comprising Asian lotus (N. nucifera) and American lotus (N. lutea), is both a culturally important ornamental and medicinal plant rich in benzylisoquinoline alkaloids (BIAs). However, the genomic and biochemical basis of BIA glycoside biosynthesis remains poorly understood. Objectives: A high-quality hybrid lotus genome was presented to dissect the formation of benzylisoquinoline alkaloid glycosides and the mechanism underlying their synthesis. Methods: The chromosomal-level hybrid genome was constructed through PacBio HiFi, ONT Ultra-long, and Hi-C sequencing data combined assembly strategies. The metabolite and …

Characterizing The Human Metapneumovirus Matrix Protein And Its Role In Infection, Chase J. Heim

Theses and Dissertations--Molecular and Cellular Biochemistry

Human metapneumovirus (HMPV) causes severe respiratory tract infections in all cohorts, but especially in vulnerable groups such as children, older adults, and the immunocompromised. The matrix (M) protein of HMPV, like the M proteins of other members of the Mononegavirales order, is involved in virus assembly and budding. However, other functions of the HMPV M protein have yet to be elucidated. To investigate these various functions of the M protein, we used a peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) antisense agent designed to block translation of the M gene to reduce M expression during infection. Treatment with varying concentrations of an …

Predicting Self-Administered Biologic Nonadherence In Medicare Fee-For-Service Beneficiaries With Inflammatory Bowel Disease Using Machine Learning Models, Christian Rhudy, Courtney Perry, Cody Bumgardner, Michael J. Wesley, David W. Fardo, Terrence Barrett, Jeffery Talbert

Psychiatry Faculty Publications

BACKGROUND: Nonadherence to self-administered biologic therapies increases risk for disease flares and adverse outcomes in inflammatory bowel disease (IBD). OBJECTIVE: To use machine learning and Medicare fee-for-service claims to create models predictive of medication nonadherence. METHODS: This study included Medicare fee-for-service beneficiaries with at least 2 IBD claims separated by 30 days between 2017 and 2021 and analyzed claims data from 2021. Beneficiaries with missing data or fewer than 3 self-administered biologic dispenses (adalimumab, certolizumab, golimumab, ustekinumab) on different dates in 2021 were excluded. Beneficiary-level nonadherence was defined as a proportion of days covered less than 0.8, and dispenselevel nonadherence …

Cigarette Use And Smoking Cessation Goals Among Pregnant Women With Opioid Use Disorder, Elizabeth E. Krans, Daniel Lewis, Antoine Douaihy, Michelle R. Lofwall, Frankie Kropp, Peter R. Martin, Reesha S. Sanghani, Jesse N. Cottrell, T. John Winhusen

Psychiatry Faculty Publications

Introduction: Cigarette smoking rates among pregnant women with opioid use disorder (OUD), are significantly higher than those found in the general population. Methods: We conducted a secondary analysis of baseline data from a multisite, randomized clinical trial comparing two different buprenorphine formulations on outcomes during pregnancy. Cigarette use and smoking cessation goals were evaluated with the Fagerström Test for Nicotine Dependence and the Thoughts About Abstinence (TAA) questionnaire respectively. Factors associated with differences in cigarette use and smoking cessation goals were compared. Results: Among 156 participants, 85 (54.5 %) reported that they currently smoked cigarettes. Most participants had a desire …

Health Communication Campaign Performance During The Healing Communities Study, Nicky Lewis, Jennifer Reynolds, Diane Krause, Philip M. Reeves, Jamie Luster, Michael D. Stein, Sharon L. Walsh, Amy Farmer, Michelle R. Lofwall, Monica F. Roberts, Hilary L. Surratt, Brooke N. Crockett, Kara Stephens, Kelli Bursey, Kristin Mattson, Michael D. Slater

Psychiatry Faculty Publications

Background: Research on the effectiveness of digital health campaign strategies is lacking. Understanding performance outcomes is essential for the successful implementation of campaigns. Two studies examined platforms, tactics, and content of digital health campaigns using paid media performance data. Objective: This analysis compared 2 digital advertising methods (social media and banner or display) using click-through rate (CTR) and cost-per-click (CPC) as performance measures. Performance differences by state, community type, message approach, format, and image type were assessed. CTR and CPC served as measures in determining performance differences between social media and banner or display. Methods: This cross-sectional secondary analysis examined …

Positive Developmental Cascades, Melody R. Altschuler, Xiaoran Tong, Punit Shah, Edelyn Verona, Julianne M. Bowling, Robert F. Krueger, Roman Kotov, Jordan H. Mcallister, Michaela Voit, Sachina Paudel, Scott C. Leon, Shashwat Kala, John S. Lyons

Psychiatry Faculty Publications

Background: Strength development in children across a range of psychiatric diagnoses may reduce needs for mental health, social, and functioning support over time. A strength-based adjunct to child and adolescent mental health may foster the developmental context most helpful for achieving desired outcomes with positive developmental cascading effects. Methods: We longitudinally examined changes across 5 years in the Child and Adolescent Needs and Strengths Assessment in 2- to 18-year-old children (N = 30,103) from a public mental health system. Results: First, children who began with a greater number of strengths consistently had fewer support needs, not only at entry but …

Reach Of Community-Selected Strategies To Reduce Opioid-Related Overdose Deaths In The Healing Communities Study, Megan E. Hall, La Shawn Glasgow, Ja Nae Holloway, Rouba A. Chahine, Jill Davis, Miriam T.H. Harris, Hannah K. Knudsen, Jessica L. Neufeld, Emmanuel Oga, David W. Lounsbury, Nasim Sabounchi, Alissa Davis, Marissa Smith, Rachel P. Chase, Sylvia A. Ellison, Judy Harness, Hilary L. Surratt, Sharon L. Walsh, Peace Julie Nakayima, Redonna Chandler

Psychiatry Faculty Publications

Introduction: Despite recent declines, the U.S. opioid overdose crisis persists. The HEALing Communities Study (HCS) aimed to reduce opioid overdose deaths through community-level adoption of evidence-based practices (EBPs), including overdose education and naloxone distribution (OEND) and medications for opioid use disorder (MOUD). This paper describes the reach of OEND and MOUD strategies implemented by the 33 HCS wait-list control communities. Methods: We conducted descriptive statistical analysis of reach data collected from July 2022 through December 2023 to (1) summarize overall EBP implementation and reach and (2) compare the demographic representation of individuals reached to community demographic population estimates. Results: Communities …

The Association Between Naloxone Distribution, Buprenorphine Treatment And Retention And Incident High-Risk Opioid Prescribing With Opioid Overdose Death In Kentucky, Massachusetts, New York And Ohio, United States, Alexander Y. Walley, Debbie M. Cheng, Nathan Vandergrift, Marc Larochelle, Ja Nae Holloway, Jennifer L. Brown, Redonna Chandler, Laura C. Fanucchi, Daniel J. Feaster, Patricia Freeman, Timothy Hunt, Michelle R. Lofwall, Hannah K. Knudsen, Edward V. Nunes, Emmanuel Oga, Douglas R. Oyler, Jeffrey H. Samet, Jennifer Villani, Sharon Walsh, T. John Winhusen

Psychiatry Faculty Publications

Aim: We evaluated whether community-level naloxone distribution, medication for opioid use disorder treatment and retention and incident high-risk opioid prescribing rates were associated with opioid overdose death rates. Design: Observational cohort conducted using 2019 to 2023 community-level data as an exploratory analysis of the HEALing (Helping to End Addiction Long-term®) Communities Study (HCS). Exposures included: (1) community-level naloxone distribution, past 12-months, categorized as ≤1000 units per 100 000 population vs. 1001–3000 units per 100 000 population vs. >3000 units per 100 000 population; (2) individuals treated with buprenorphine per 100 000 adult population in the current quarter; (3) individuals retained …

Navigating Mercy: Ethical And Emotional Terrains In Carolingian Society And Politics, Wei-Ting Chen

Theses and Dissertations--History

This dissertation investigates mercy in the Carolingian period, especially its political dimensions. A sustained, holistic examination of mercy in the early medieval period remains lacking. This study examines mercy not only as a history of an idea but also as a history of emotion, tracing its transformation from the ancient Greek and Roman worlds through patristic literature and into Carolingian political discourse. This study argues that mercy played a central role in the construction of Christian kingship within Carolingian political discourse. Early Church Fathers reinterpreted mercy from a controversial concept in Roman Stoic philosophy into a positive virtue in Christian …

Rna-Micelles As Self-Assembling Structures For Efficient Co-Delivery Of Synergistic Sirna And Nucleoside Analogues To Treat Crc Lung Metastasis, Kai Jin, Piotr G. Rychahou, Daniel W. Binzel, B. Mark Evers, Peixuan Guo

Markey Cancer Center Faculty Publications

SiRNA has been widely studied in cancer gene silencing over the last 25 years. However, few siRNA-based therapeutics have been approved by the FDA. An RNA-micelle platform provides a powerful therapeutic tool through simple one-step, high-yield production that is capable of efficient colorectal cancer lung metastasis treatment, a current lethal condition with a short survival rate post-diagnosis. Here, it is reported that the use of RNA-micelles co-carrying siRNA and nucleoside analogues to completely inhibit lung metastasis of colorectal cancer (CRC). The major advantage of the RNA-micelle is the successful co-delivery of siRNA and chemotherapeutic agent in a single delivery vehicle …

Case Report: Prolonged Response To Cabozantinib And Pembrolizumab In Treatment-Refractory Metastatic Pancreatic Ductal Adenocarcinoma, Anna M. Reagan, Hannah G. Mcdonald, Jaewon Kang, Hoda Saghaeiannejad Esfahani, Caroline G. Wright, Charles J. Bailey, Carleton S. Ellis, Kaylyn R. Collette, Reema A. Patel, Mayte Murillo, Samantha F. Stokley, Michael J. Cavnar, Prakash Pandalai, Mautin T. Barry-Hundeyin, Jessica Moss, Joseph Kim

Markey Cancer Center Faculty Publications

Immunotherapy has yet to demonstrate durable efficacy in pancreatic ductal adenocarcinoma (PDAC) despite the fact that pancreatic cancer cells have higher levels of immune checkpoint expression than other cancer cell types in which immunotherapy efficacy has been well established. We observed effective cytotoxicity with the combination therapy of pembrolizumab (an anti-PD-1 monoclonal antibody, mAb) and cabozantinib (an anti-MET small molecule) in vivo. This served as the basis for an investigator-initiated phase II clinical trial (NCT05052723). The trial was open to patients with treatment-refractory metastatic PDAC with a single-arm treatment protocol of pembrolizumab and cabozantinib. Here, we report the case of …

Assessing The Value Of Sequential Next-Generation Sequencing And Multiple Molecular Tumor Board Reviews For Patients With Solid-Tumor Malignancies, Allison L. Swiecki-Sikora, Lydia Williams, Ning Li, Donglin Yan, Evan Bryon, Derek B. Allison, Rachel W. Miller, Charles S. Dietrich, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Purpose: Multidisciplinary molecular tumor boards (MTBs) have demonstrated improved clinical outcomes in various malignancies. Sequential next-generation sequencing (NGS) is widely performed at the time of recurrence, which may lead to multiple MTB reviews. This study assessed the clinical benefit of multiple MTB reviews for sequential NGS.   Methods: A retrospective cohort review was performed to compare patients reviewed once at a single-institution MTB and those reviewed multiple times for the same diagnosis with sequential NGS between January 2016 and December 2023. Demographics were compared, and regression and survival analysis was performed.   Results: In all, 3,702 patients were included, 3,446 (91.6%) were …

Case Report: Prostate Adenocarcinoma With Peritoneal Carcinomatosis And Elevated Cea Mimicking Colorectal Cancer: A Diagnostic Dilemma, Hala Majeed, Nathan R. Shelman, Jitesh A. Patel, Janeesh S. Veedu, Insija I. Selene, Ashlyn Whitesell, Zin W. Myint

Markey Cancer Center Faculty Publications

This case report describes an exceptionally rare manifestation of prostate adenocarcinoma presenting with peritoneal carcinomatosis, rectal obstruction, and markedly elevated carcinoembryonic antigen (CEA), closely mimicking colorectal cancer. A 65-year-old man with localized high-grade prostate adenocarcinoma (Gleason 4 + 4) underwent robotic prostatectomy in November 2020, followed by salvage radiation and stereotactic body radiation therapy for early biochemical recurrence. He achieved an excellent response to androgen deprivation therapy (ADT) combined with abiraterone and prednisone, maintaining an undetectable prostate-specific antigen (PSA) level for over 2 years. In late 2024, the patient developed hematochezia, narrow stools, and abdominal pain. Imaging revealed a rectal …

Eef2k Promotes Immune Evasion In Melanoma Via Cyclin D1–Mediated Stabilization Of Pd-L1, Yijie Ren, Darby J. Ballard, Anil Kumar, Andy F. Song, Mitiksha Gupta, Xiaofang Xiong, Xingcong Ren, Jugal Kishore Das, Jin-Ming Yang, Jianxun Song

Markey Cancer Center Faculty Publications

Eukaryotic elongation factor 2 kinase (eEF2K) is a stress-responsive regulator of protein synthesis implicated in melanoma progression, but its role in tumor immune evasion remains poorly defined. We investigated how eEF2K influences programmed death ligand 1 (PD-L1) expression through modulation of Cyclin D1. We analyzed gene expression and dependency datasets from The Cancer Genome Atlas and the Cancer Dependency Map. Protein–protein interactions were assessed by co-immunoprecipitation. Cyclin D1 was inhibited pharmacologically with palbociclib. Immune responses were evaluated in murine B16-OVA and human A2058 melanoma models using flow cytometry and immunohistochemistry after genetic or pharmacologic modulation of eEF2K and Cyclin D1. …

Characteristics Of The Health-Associated Oral Microbiome In Young Nonhuman Primates, J. L. Ebersole, O. A. Gonzalez

Markey Cancer Center Faculty Publications

Nonhuman primates have been shown to develop periodontitis with clinical and demographic features similar to humans. This preclinical disease model is well-positioned to advance the elucidation of novel biologic-based preventive and therapeutic approaches to controlling periodontitis, a chronic infection and immunoinflammatory disease. In this analysis, the oral microbiomes of younger (10–19 human years; n = 30) nonhuman primates are compared for matriline (an indicator of heritability), sex, and age variations. A holistic assessment of the microbiome similarities/differences suggested two primary conclusions in this younger group of orally healthy nonhuman primates. First, at the microbiome level of phyla, orders, and families, …

Prognostic Value Of Lung Injury Biomarkers In Patients Hospitalized With Covid-19 Without Respiratory Failure At Admission, Jennifer G. Wilson, Greg A. Grandits, Birgit Grund, Shweta S. Mistry, Carolyn Leroux, Angelika Ringor, Neil R. Aggarwal, Daniel D. Murray, Christina E. Barkauskas, Samuel M. Brown, Elizabeth Higgs, Kathryn Shaw-Saliba, Adam Rupert, Virginia L. Kan, Jeremy R. Beitler, Omar Awan, Jamie L. Sturgill, Halima Dawood, Andre C. Kalil, Ioannis Kalomenidis, Abhijit Duggal, Sarah C. Sasson, Minh Q. Ho, Hien H. Nguyen, Jens D. Lundgren, Adit A. Ginde, Wesley H. Self, H. Clifford Lane, Michael A. Matthay, Angela J. Rogers

Markey Cancer Center Faculty Publications

Objectives: – The COVID-19 pandemic highlighted an urgent need to more efficiently identify patients at highest risk for developing respiratory failure. We investigated whether plasma levels of lung injury biomarkers are associated with progression to respiratory failure among adults hospitalized with COVID-19 pneumonia without respiratory failure at admission. Design: – This was a nested case-control study of COVID-19 patients enrolled in the Accelerating COVID-19 Therapeutic Interventions and Vaccines-3 (ACTIV-3)/Therapeutics for Inpatients with COVID-19 (TICO) platform trial who were on less than 20 L/min supplemental oxygen at enrollment. We compared baseline measurements of lung injury biomarkers between participants who progressed to …

Implementing A Competency-Based Cross-Training Program To Enhance Patient Flow, Jill E. Shanklin

DNP Projects

Objective: To evaluate the effect of a competency-based cross-training program on perinatal nurses’ preparedness to care for medical-surgical (med-surg) overflow patients and to support patient flow.

Design: Quality improvement project using a quasi-experimental pre–post design.

Setting: A 44-bed perinatal unit within a university-affiliated medical center in the United States.

Participants: Registered nurses employed in the perinatal unit for ≥6 months; 24 completed the preintervention survey and 28 completed the postintervention survey.

Interventions: A competency-based cross-training program consisting of e-learning modules, simulation-based competency validation, and structured policy and procedure review.

Main Outcome Measures: Self-reported comfort, …

Riddle Me Resilient: Investigating The Impact Of Riddle Based Class Openings On Student Resilience And Well-Being, Carolyn T. Brown

DNP Projects

Abstract

Background: Burnout among nurses and nursing students is a widespread and well‑documented problem that adversely affects professional performance and psychological well‑being. Resilience serves as a key protective factor, helping buffer the effects of academic stress and reducing burnout over time. Incorporating brief, low‑stakes cognitive challenges—such as a riddle—can help foster resilience.

Purpose: This project evaluated the impact of incorporating riddles into a wellness-focused course, Introduction to Mindfulness and Wellness, on resilience and well-being among undergraduate nursing students.

Methods: This project employed an Institutional Review Board approved pre-post survey design to measure the effect of an intervention focused on …

Evaluating The Implementation And Use Of A Standardized Screening Process To Increase Flu Vaccine Uptake In A Rural Health Primary Care Clinic, Mackenzie L. Pierce

DNP Projects

Background: Research has shown that an annual influenza vaccine is the most effective way to both prevent and reduce the risk of hospitalization and severe health complications of the flu. A yearly influenza vaccination is recommended for everyone age 6 moths and older.

Local Problem: Rural communities have lower rates of influenza vaccination which can be due in part to a lack of screening and education on vaccines and their importance. No process for influenza vaccine status screening existed at the project site prior to this project.

Methods: A quality-improvement project was conducted to evaluate the implementation of a standardized …

Unintentional Medication Discrepancies In Outpatient Cardiac Procedures: Identifying Modifiable Barriers, Julie M. Turner

DNP Projects

Background: Medication reconciliation (MR) reduces medication errors during care transitions; however, unintentional medication discrepancies (UMDs) remain common due to variable practices and lack of standardization. Patients undergoing elective cardiac procedures are particularly vulnerable given complex medication regimens.

Purpose: This quality improvement project evaluated implementation of a Medication Reconciliation Barrier Identification Checklist (MRBIC) in the cardiac catheterization laboratory to identify patient, staff, and system-level contributors to UMDs.

Methods: A quasi-experimental pre–post design was conducted at a large academic medical center. During a six-week intervention, nurses and providers completed the MRBIC during pre-procedure MR. Barrier scores were compared with …

Advancing Rural Health Equity Through Systematic Sdoh Screening- A Quality Improvement Initiative, Laura C. Combs

DNP Projects

Background: Social determinants of health (SDoH) significantly affect health outcomes and healthcare utilization, particularly in rural communities. In 2024, the Centers for Medicare & Medicaid Services mandated SDoH screenings in the inpatient setting, with recommendation to implement in rural clinics without specifying a standardized tool, resulting in inconsistent identification of needs, e.g., food insecurity, housing instability, mental health concerns, financial strain, and transportation barriers.

Purpose: This quality improvement initiative implemented a standardized SDoH screening tool in a rural outpatient clinic to evaluate changes in referral rates to community-based resources pre- and post-implementation and to improve patient reporting of social needs. …

Implementation Of A Cardiomems Screening Tool To Increase Provider Awareness And Referrals In Eligible Patients, Monica Rios

DNP Projects

Background: Heart failure affects over 6 million Americans and causes more than one million hospitalizations annually. CardioMEMS, a remote pulmonary artery pressure monitoring device, effectively reduces hospitalizations, yet its use remains limited due to provider and system barriers. The purpose was to increase CardioMEMS referrals for eligible heart failure patients through targeted provider education and a standardized screening tool.

Local Problem: Kentucky experiences higher heart failure hospitalization rates than the national average, contributing to prolonged hospital stays and rising healthcare costs.

Methods: A pre—post quasi-experimental study was conducted at an academic medical center. Baseline chart review of 47 patients evaluated …

Improving Compliance With Preoperative Antibiotic Protocols For Cardiac Implanted Electronic Devices: A Quality Improvement Project, James Kaup

DNP Projects

Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained …

Implementing A Standardized App-Led Multidisciplinary Medication Review And Reconciliation To Improve Medication Safety Before Systemic Cancer Therapy: An Ambulatory Oncology Quality Improvement Initiative, Sarah R. Hines

DNP Projects

Background

Adult patients initiating systemic cancer therapy frequently present with pre-existing polypharmacy related to chronic comorbidities and cancer-related symptom management. The addition of anticancer therapies and supportive care medications further increases medication burden and the risk of medication-related harm. Although national organizations and institutional policies recommend comprehensive medication review before treatment initiation, implementation remains inconsistent in ambulatory oncology practice.

Purpose

To implement and evaluate a standardized Advanced Practice Provider (APP)-led multidisciplinary medication review and reconciliation process designed to identify medication medication-related safety risks before initiation of systemic cancer therapy in adult oncology patients receiving care in an ambulatory infusion center. …

Effects Of Student And School Technology Adoption On Student Reading Achievement In The United States: The Case Of Pisa 2018, Mikah J. Hughes

Theses and Dissertations--Educational, School, and Counseling Psychology

This study examined the relationship between student and school-level information and communication technology (ICT) factors and reading achievement using data from the Programme for International Student Assessment (PISA) 2018 in the United States. In an increasingly digital world, reading and information literacy are essential skills, yet significant gaps in digital competencies persist. This study investigated how ICT access, use, and perceptions relate to reading achievement in the context of student and school background factors.

A two-level hierarchical linear modeling (HLM) framework was employed to account for the nested structure of students within schools. The sample included approximately 4,000 students across …

Leading On An Uneven Playing Field: How Systems Of Race And Gender Shape African American Women’S Leadership Advancement, Nikki Goins-Hughes

DSW Capstone Projects

Systemic barriers to leadership for African American women are deeply rooted in historical and structural inequities within the United States. Intersecting identities of race and gender have historically shaped access to leadership advancement opportunities for African American women. Despite efforts to prioritize gender and racial equity in leadership, African American women continue to experience exclusion or are highly scrutinized in decision-making spaces, contributing to their continued marginalization in leadership. Therefore, this capstone draws on a systematic literature review, conceptual framework, and practice application to examine the systemic barriers that limit access to leadership advancement opportunities for African American women and …

Navigating Mental Wellness: A Peer-Led Journey Into Adult Services, Kristin G. Haberek

DSW Capstone Projects

Students with severe emotional disturbances (SED) occupy one of the most underserved intersections in American education and mental health care. As they age out of children’s services, they face abrupt service discontinuation, disrupted therapeutic relationships, and adult systems ill-equipped to meet their needs. These vulnerabilities, including heightened risks of crisis, hospitalization, homelessness, and justice involvement, constitute a central practice problem. This capstone addresses these transitions across three scholarly products: a systematic literature review, a theoretical concept paper, and a practical application paper, tracing a unified arc from diagnosing structural failures to proposing an evidence-informed, equity-oriented clinical response. Synthesizing key findings …

Preoperative Glucagon-Like Peptide-1 Therapy In Bariatric Surgery Patients With Morbid Obesity (Premo): Rationale And Study Design For A Randomized Controlled Trial, Varun Jain, Colleen A. Mcmullen, Joy I. Kimbrough, Anna K. Rockich, Daniel L. Davenport, Gregory S. Hawk, Barbara S. Nikolajczyk, Philip A. Kern, Simon J. Fisher, Joshua P. Steiner, William B. Inabnet Iii, Marlene E. Starr

Surgery Faculty Publications

Introduction: Bariatric surgery is the most effective treatment modality for individuals with morbid obesity, providing significant and durable weight loss and comorbidity resolution. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide receptor agonists have shown promise as weight loss drugs, in addition to their use in the treatment of metabolic disorders. While multimodal weight management is the standard of care for individuals with morbid obesity, the benefit of antecedent GLP-1 therapy prior to bariatric surgery has not been well-studied. The objective of this study is to conduct a clinical trial testing the hypothesis that preoperative treatment with a dual GLP-1/glucose-dependent insulinotropic …

Amustaline/Glutathione Pathogen-Reduced Red Cell Hemoglobin Utilization In Complex Cardiac Surgery, Ian J. Welsby, Michael E. Sekela, Edward L. Snyder, James D. Gorham, John S. Mcneil, Kathy Liu, Stanley Bentow, Thomas Gniadek, Laurence Corash, Nina Mufti, Richard J. Benjamin

Surgery Faculty Publications

Background: The ReCePI randomized, controlled trial compared amustaline/glutathione pathogen-reduced (PR) and conventional red blood cell (RBC) transfusions in cardiac surgery. Study design and methods: We performed a post-hoc analysis of hemoglobin (Hb) utilization and safety outcomes. Hb content of study RBCs was measured at manufacture. Subject Hb levels, estimated blood loss and blood product use were recorded during and for 7 days post-surgery. Acute kidney injury (AKI) incidence was graded over 7 days, and adverse events were assessed for 28 days. Results: PR-RBCs contained 5.2% less Hb (mean [SD] Test 58.1 [6.5] g; Control 61.5 [6.8] g Hb, p <.001) due to manufacturing volume losses. Four hundred fifty-six PR- and 524 conventional RBCs were transfused to 159 Test and 162 Control subjects, respectively. Mean subject baseline and post-surgery Hb levels, and blood loss were not different between groups. Test subjects tended to require fewer total RBCs (3.5 [2.7] Test vs. 4.0 [3.5] Control, p =.08) resulting in 17.6% significantly less mean total Hb transfused (Test 203.2 g; Control 246.8 g Hb, p =.01). The proportions of subjects transfused with, and the number of platelet and cryoprecipitate units transfused were not different. Test subjects received less plasma (2.3 [1.8] units Test vs. 3.5 [3.8] Control, p =.03). Overall incidence of adverse events and AKI were not clinically different. Imbalances in AKI severity (Grade III Test 15/159 [9.4%]; Control 7/162 [4.3%], p =.07) may suggest under-transfusion in the highest-risk Test subjects. Discussion: Test patients required less transfused Hb than control subjects to maintain equivalent daily hemoglobin levels following similar blood loss.