Digital Commons Network^™

Glp-1ra Vs. Sglt-2i: Preventing Kidney Function Deterioration Among Patients With Type 2 Diabetes And Chronic Kidney Disease, Liang-Yuan Lin

Electronic Theses and Dissertations

Background: Emerging evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RA) may improve kidney outcomes in individuals with type 2 diabetes mellitus (T2DM). However, direct head-to-head comparisons of their renal effectiveness with sodium-glucose cotransporter 2 inhibitors (SGLT-2i)—the recommended first-line therapy for older adults with T2DM and chronic kidney disease (CKD)—remain limited.

Objectives: To compare the renal effectiveness of GLP-1RA and SGLT-2i among older adults with T2DM and CKD.

Methods: A new-user, active comparator, matched cohort study was conducted using 5% Medicare data from 2012 to 2020. Older adults (≥65 years) with T2DM and CKD who initiated either a GLP-1RA or an …

Racial And Ethnic Differences In The Associations Between Alcohol Use Disorder, Aggression, And Suicidality Among Adolescents With Ptsd, Gabrielle Armstrong

Electronic Theses and Dissertations

The comorbidity of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is well documented and associated with elevated risk of aggression and suicidality among certain populations. However, no research to date has examined these associations among adolescents. Using data from the National Comorbidity Survey-Adolescent Supplement (NCS-A), the present study examined whether the presence of AUD was associated with greater outward aggression, suicidal ideation, and attempts, and whether these associations differed across race/ethnicity, in a weighted sample of 737,996 adolescents with PTSD (10.3% Hispanic, 16.4% Black, 73.3% White). AUD presence was significantly associated with higher odds of breaking items, attacking …

A Road Less Traveled: Exploring The Motivators Influencing College Enrollment Decisions Among Youth Who Have Experienced Foster Care, John William Blue

Electronic Theses and Dissertations

Youth who have experienced the foster care system are an underserved student population in higher education. While higher education is an important pathway to upward mobility and civic participation, foster youth consistently face systemic barriers such as unstable placements, limited financial resources, and a lack of consistent adult guidance, resulting in significantly lower rates of college enrollment and degree attainment compared to their peers (Courtney & Okpych, 2020; Salazar, 2013). This three-manuscript dissertation investigates the challenges that youth who have experienced foster care face and the factors that influence them to pursue enrollment in four-year universities in Illinois, while also …

The Impact Of State-Mandated High-Stakes Standardized Testing On The Job Satisfaction Of Third-Grade Reading Teachers In Mississippi, Jenny Kate Ernst

Electronic Theses and Dissertations

This qualitative study examined how state-mandated standardized testing influences the job satisfaction of current and former third-grade reading teachers in Mississippi. Guided by Self-Determination Theory, Herzberg’s Two-Factor Theory, and the Job Demands-Resources Model, the research explored how accountability pressures shape teachers’ motivation, emotional well-being, and instructional autonomy. Data were collected through an open-ended online survey of current and former Mississippi third-grade reading teachers. Analysis of responses revealed four central themes: emotional strain and burnout, loss of autonomy and creativity, impact on instructional practices, and student impact. Findings indicated that teachers perceive standardized testing as a major source of stress that …

The Lived Experiences Of Lgbtq+ Individuals Living In Male Residential Spaces In The South, Bri Reda

Electronic Theses and Dissertations

While LGBTQ+ visibility on college campuses has increased, LGBTQ+ students still report negative experiences, particularly in residential environments where harassment and unwelcoming attitudes are common (Kortegast, 2017; Pryor, Ta, & Hart, 2016). Previous studies have shown that LGBTQ+ individuals often conceal their identities in residence halls due to discomfort, further diminishing their feelings of safety and connection to the campus community (Blakmon, O’Hara, & Viars, 2020; Pryor, Ta, & Hart, 2016). Despite efforts to implement inclusive policies, little research has explored the experiences of LGBTQ+ individuals in male-assigned residence halls, especially in states like Mississippi with gender-segregated housing requirements (Mississippi …

Out-Of-Pocket Costs, Treatment Pattern, And Disparities In Outcomes Among Adults With Chronic Lymphocytic Leukemia, Shishir Maharjan

Electronic Theses and Dissertations

The purpose of this dissertation was to: 1) determine out-of-pocket cost trend and the impact of Inflation Reduction Act (IRA) provisions on the out-of-pocket costs among Medicare-enrolled chronic lymphocytic leukemia (CLL) patients; 2) evaluate treatment patterns and comparative effectiveness of therapeutics classes for CLL treatment in adults; and 3) assess racial disparities and time to treatment initiation in survival outcomes among Medicare-enrolled beneficiaries with CLL.

In objective 1, a cohort study using SEER-Medicare linked data from 2006 to 2020 identified 13,356 eligible beneficiaries with incident CLL. Among them, 3,158 (23.7%) were projected to benefit from the IRA’s $2000 annual out-of-pocket …

Visualizing The Fretboard: Arpeggiated Patterns, Muscle Memory, And Neurocognitive Strategies For The 5-String Electric Bass, Matthew Alexander Woisin

Electronic Theses and Dissertations

Proficient navigation of the 5-string electric bass requires a comprehensive mastery of various techniques and a solid understanding of music theory. This includes a detailed grasp of arpeggios, chord extensions, and the development of deeply ingrained muscle memory for precise execution. This thesis introduces a structured methodology that refines existing fretboard visualization techniques and applies a unique manner of fretboard mapping, offering a more precise framework for comprehending and unlocking the full range of the instrument. By drawing insights from music theory, music education, cognitive science, neuroscience, and technology this approach is achieved by synthesizing research on visual pattern recognition, …

Investigating The Origins Of Symbiosis Using A Novel Mycorrhizal Interaction In Pasque Flowers (Pulsatilla Patens), Savannah Lane Draud

Electronic Theses and Dissertations

Mycorrhizal fungi form mutualistic symbioses with most land plants, occurring primarily as arbuscular mycorrhizal (AM) fungi or ectomycorrhizal (ECM) fungi. Pulsatilla patens, an herbaceous perennial widely distributed across Eurasia and North America, belongs to a plant family historically known only to form AM associations. However, recent discoveries of ECM P. patens individuals in northeastern Poland raise questions about the mycorrhizal status and evolutionary trajectory of this species. Because ECM formation in this lineage is likely evolutionarily recent, P. patens offers a valuable system for investigating the ecological and historical factors that facilitate the emergence of ECM symbiosis.

Chapter 1 assessed …

Adoptive Parents Use Of Social Media To Discuss Adoption Communicative Openness, Hannah Araba Baidoo

Electronic Theses and Dissertations

Adoption communicative openness (ACO) involves dialogue between adoptive parents and their adopted children about adoption-related issues. Through this communication, parents share information about birth families and address adoptees questions to support psychological well-being. Although ACO benefits adoptees, research rarely examines how adoptive parents themselves practice and experience openness. This study explores how adoptive parents discuss ACO with one another on the r/AdoptiveParents subreddit. Using qualitative discourse analysis, it examines how parents describe their challenges, and success surrounding communication openness. The analysis highlights parent’s concerns about when and how to disclose adoption information and the uncertainty that shapes their communication choices. …

The People’S Medicine: Modern Perspectives On Folk Medicine In South Central Appalachia, Stacey M. Horton

Electronic Theses and Dissertations

The study addresses the critical need to document Appalachian folk medicine conventions and cultural practices from a modern perspective. In so doing, it addresses folk medicine research gaps in understudied places in South Central Appalachia, particularly in Southwestern Virginia and Northeast Tennessee. This research utilizes participant observation and oral history interviews to research modern Appalachian folk medicine practices among a select group of practitioners. Interviews focused on individuals who center their professional careers and subsequent lifestyles around herbalism, foraging, folk medicine, ethnobotany, and botanicals. By utilizing a critical praxis framework, the study seeks to move beyond lists of symptoms and …

Behavioral Manifestations Of Childhood Abandonment: African-American Men's Reflections And Strategies To Support Teenage Boys In K-12 Education, Jarmel Bell

Electronic Theses and Dissertations

The purpose of this study was to explore the behavioral manifestations of childhood abandonment as reflected in the lived experiences of African-American men and to identify strategies that may support African-American boys in K–12 educational settings. Although there has been limited documentation regarding the direct connection between childhood abandonment and behavioral challenges in school environments, this study seeks to address that gap by capturing the reflections of African-American men who experienced abandonment during their formative years. These reflections provide insight into how abandonment may shape behavior in educational spaces and what types of interventions or supports might have made a …

A Comparative-Correlational Study On The Mental Health And Well-Being Of First-Generation Students At A Historically Black College And University, Shedred Jackson

Electronic Theses and Dissertations

The purpose of this study was to investigate the mental health and well-being of first-generation college students (FGCS) in comparison to non-first-generation college students (NFGCS) at a private Historically Black College and University (HBCU) in the Southeast. This study was undertaken to investigate students' mental health and well-being, as well as their use of, access to, and the availability of mental health services. A comparative-correlational research design was employed to collect and analyze the data. The study used a sample size of 388 responses from undergraduate college students enrolled at the private HBCU. Of the 388 students in the sample, …

A Leslie System For A Demographic Simulation: From An Actuarial Point Of View, David Kings

Electronic Theses and Dissertations

This thesis develops a discrete stochastic linear systems interpretation of age–stage demographic evolution grounded in Leslie operators and realized in a discrete-event simulation implemented with salabim. The central claim is that one annual cycle of the simulation constitutes a cone-preserving, stochastic affine transformation on a high- dimensional population state vector indexed by age, sex, marital status, household type, employment, and education, and that the composition of yearly operators yields a random matrix product whose top Lyapunov exponent is the stochastic counterpart of the Perron–Frobenius growth rate (Caswell, 2001; Tuljapurkar, 1997)[1, 2]. The actuarial bridge is constructed by mapping simulated survival …

Isolation, Chemical Characterization, And In-Vitro Cytotoxic Evaluation Of Novel Polar Flavonoids From Chromolaena Leivensis, Matthew Tohatsu Tetteh

Electronic Theses and Dissertations

This study focuses on isolation, chemical characterization, and in-vitro cytotoxic evaluation of novel polar flavonoids from chromolaena leivensis. A 95% ethanolic extract of c. leivensis shipped by Prof. Ruben Torrenegra from University of Applied and Environmental Sciences, Bogota, Colombia, was dissolved in 1:1 methanol/chloroform mixture and its purity analyzed by TLC. The sample was eluted with toluene/methanol in an increasing order of polarity on silica gel, resulting in 49 fractions labelled CLA1 to CLA49. Among these fractions, CLA10 (1) and CLA19 (2) obtained yellow and white crystals. They were analyzed by GCMS, IR, and …

Molecular Dynamics Simulations Of Biologically Relevant Interfaces: From Tear Film Lipid Layers To Rna Adsorption On Silica Surfaces., Mahbuba Khanom

Electronic Theses and Dissertations

Molecular dynamics (MD) simulation is an important tool in biochemical sciences for studying complex molecular processes and interfacial interactions at the molecular level. Biological interfaces play key roles in processes such as ocular lubrication and biomolecular adsorption. This dissertation studies interfacial phenomena involving two distinct yet conceptually related systems: the tear film lipid layer (TFLL) at the air–water interface at the surface of the human eye, and RNA adsorption on silica surfaces. These studies provide insight into how interfacial composition, structure, and environmental conditions affect larger-scale behavior. Atomistic MD simulations were used to model the TFLL. The TFLL is essential …

“The Moment You Are Disabled; You Are Cut Off From Society.” Assessing The Experiences Of Disabled Ghanaians And The Rights Enshrined In The United Nations Convention On The Rights Of Persons With Disabilities (Crpd)., Solomon Sackey Amoatey

Electronic Theses and Dissertations

As Ghana continues to pursue inclusion and equality for disabled citizens, considerable tension remains between international human rights frameworks and local social, legal, and cultural practices. Guided by social constructionism and Critical Disability Theory (CDT), this qualitative, chapter-based study examined how disability is constructed through law, policy, and culture in Ghana. It also explored how these constructions influence the interpretation and implementation of disability rights. To achieve this, the study employed semi-structured interviews and document analysis to examine how law, policy, and cultural beliefs intersect to influence the implementation of the CRPD and lived experience of disabled Ghanaians.

Findings show …

Impacts Of Biology Modeling Pedagogy On Student Cogitive And Non-Cognitive Elements Of Learning., Jessie K. Newhouse

Electronic Theses and Dissertations

This dissertation employed a quasi-experimental design used to investigate the use of a modeling pedagogy in high school biology. Modeling is a key element of the Science and Engineering Practices of the Next Generation Science Standards. While research of Model Based Pedagogy (MBP) in physics and chemistry is well established, the influence on biology instruction remains less understood. This research examined how MBP affected both cognitive and non-cognitive components of student learning compared to traditional biology instruction. Existing data collected by Dr. Kathy Malone in collaboration with Ohio State University (2016) were analyzed to study the effectiveness of the MBP. …

A Persistent Homology Framework For Scrna-Seq: Assessing Clustering Robustness And Quantifying Preprocessing And Integration Effects On Topological Features., Jonah Daneshmand

Electronic Theses and Dissertations

As single-cell RNA sequencing (scRNA-seq) data expands, robust methods for integrating diverse datasets are critical. This dissertation applies Persistent Homology (PH), a technique from Topological Data Analysis (TDA), to a collection of scRNA-seq datasets spanning eight tissue types to quantify how data integration affects topological features and biological interpretability. We assessed global topological structure using Betti curves, Euler characteristics, and persistence landscapes across raw, normalized, and integrated data representations. Our analysis revealed a performance inversion: while conventional methods excelled on unintegrated data, high-granularity topological methods, particularly those sensitive to global data structure, became superior after integration. This suggests a synergy …

Risk And Protective Factors For Suicidal Thoughts And Behaviors For Black Adolescent Males With Exposure To Adverse Experiences Post-Covid 19 Pandemic: Findings From The 2023 National Youth Risk Behavior Survey., Amanda Minogue

Electronic Theses and Dissertations

Suicide is the second leading cause of death among adolescents aged 10-24 in the United States. In 2022, 784 Black adolescent males died by suicide. Recent studies have found that traditionally common associations of risk factors of suicidal thoughts and behaviors are not experienced by Black adolescents, challenging how to determine and detect risk. This dissertation reviewed the variables in the national Youth Risk Behavior Survey that closely align with risk and protective factors of suicidal thoughts and behaviors, and the interaction between these and adverse experiences in Black adolescent males. Results of this study found that among the 9 …

The Role Of Fast-Food Consumption, Residential Fast-Food Exposures, And Urinary Essential Trace Heavy Metals In Colorectal Cancer (Crc) Outcomes., Jeevan Adhikari

Electronic Theses and Dissertations

Background: Colorectal cancer (CRC) is a public health concern. Within the United States (US), fast-food consumption and environmental exposure to heavy metals have increased. The impact of fast-food consumption frequency from fast-food restaurants, residential fast-food exposures, and urinary essential trace heavy metals in relation to CRC outcomes have not yet been rigorously evaluated in the US. Methods: Within the LEAPS-CRC study, we used geographic information systems (GIS) and logistic regression to study the association of fast-food consumption, residential proximity to a fast-food outlet, and urinary essential trace metals with CRC incidence. Additionally, within Kentucky Cancer Registry (KCR) CRC cases, the …

Characterizing Hexavalent Chromium Neurotoxicity Across Laboratory Models., Samuel Thomas Vielee

Electronic Theses and Dissertations

Hexavalent chromium [Cr(VI)] is a ubiquitous environmental pollutant and potent toxicant. Exposure to Cr(VI) in drinking water is primarily associated with cancers, inflammation, and hepatotoxicity; however, recent studies have identified Cr(VI) as a neurotoxicant in rodent and cell culture models. The literature suggest chromium accumulates in the brain, induces widespread neurodegeneration, and alters rodent behaviors. Despite these data, we lack a detailed and consistent assessments of Cr(VI) neurotoxicity across models, and interactions between aging and Cr(VI) neurotoxicity are not reported in the literature. In this dissertation, we characterize Cr(VI) neurotoxicity across 3 laboratory models: Sprague-Dawley rats, Caenorhabditis elegans, and …

Exposure To Pm2.5 And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

Inhalation of fine airborne particulate matter (PM_2.5) is an environmental risk factor for numerous health disorders, including cardiovascular diseases (CVD). While several studies have shown that PM_2.5 exposure can induce oxidative stress, DNA damage, and inflammation, the underlying mechanisms that translate these effects into systemic pathology remain poorly understood. Some recent studies have shown that PM_2.5 exposure can lead to telomere shortening in leukocytes, but the generality of this outcome and contribution to endothelial dysfunction has not yet been fully explored. We hypothesized that PM_2.5inhalation accelerates cellular aging and senescence in both circulating peripheral …

A Multilevel Analysis To Evaluate Variability In Sdoh Clusters Within Rurality And Its Effects On Cancer-Specific And All-Cause Mortality In The Us., Stephie Ann Abraham

Electronic Theses and Dissertations

Social determinants of health (SDOH) factors have consistently been shown to impact all-cause and cancer-specific mortality. Area-level SDOH factors that coexist to form “high-risk” clusters are more prevalent in rural than urban areas. However, heterogeneity within rural and urban areas may contribute to variations in SDOH factors that could influence higher mortality rates and is not considered in other studies. The primary objective of this study was to utilize ecological and individual-level data to determine if the composition of SDOH clusters within counties in the rural-urban continuum contributes to differences in all-cause (AC) and cancer-specific mortality rates of lung and …

Direct And Satellite-Based Quantification Of Greenhouse Gas Fluxes In Small Ponds., Mark Christopher Tierney

Electronic Theses and Dissertations

As evidenced by their historic losses due to anthropogenic activities, wetlands are undervalued ecosystems that provide numerous ecosystem services, from recreational opportunities to carbon (C) storage. However, these wetlands are also the largest natural source of atmospheric methane (CH₄). Additionally, small water bodies (< 10,000 m²) are disproportionately large emitters relative to larger lakes and reservoirs. As construction and restoration efforts proceed, it is crucial to identify wetlands that need restoration and to understand the factors driving both greenhouse gas (GHG) fluxes and the C balance of these systems. This dissertation investigates the drivers of greenhouse gas fluxes …

A Ralgef Inhibitor Suppresses Lung Cancer Stem Cell Development And Tumorigenesis., Raphael Ngozichi Suarez Jigo

Electronic Theses and Dissertations

The RALGEF family of proteins are direct downstream effectors of the RAS oncoprotein. RALGEFs act as guanine nucleotide exchange factors (GEFs) for downstream RAL proteins, thus tying RAS to the regulation of RAL. Genetic studies have demonstrated RAL proteins to be key drivers of RAS-driven transformation and metastasis. Furthermore, this pathway has been implicated in chemoresistance, exocyst-mediated transport, and the modulation of cancer stem cells. Previous work in our lab reported the activity of a novel pan-RALGEF inhibitor (C4-180) against RAS-driven pancreatic cancer models. Here we show the agent to be active against in vitro and in vivo models of …

An Exploration Of Factors Associated With Sport Fan's' Choice Of Ticketing Platforms., Jacob Owsley

Electronic Theses and Dissertations

This research study examined key experiential and demographic factors associated with sport consumers’ choice of online ticketing platforms. The research applied the technology acceptance model (TAM) to examine how trust, official sponsorship, user interface design, and price consciousness are associated with consumers’ choice between different online ticketing platforms.. Data were collected from 312 adult sport consumers in the United States through an online survey distributed across six Reddit communities focused on ticketing or research activities. Participants included individuals who bought tickets to professional sports events and attended these events during the last 12 months. The expert review process and two …

Further Characterization Of The Fungal Effector Mvlg-01732 In Planta And Heterologous Expression Of Fungal Effectors In Different Smut Fungi., Joseph Paul Ham

Electronic Theses and Dissertations

Host-pathogen interactions in smut fungi are characterized by effector proteins and their role in infection. The goal of this work is to better understand these interactions by further characterizing an effector from Microbotryum lychnidis-dioicae and heterologously expressing this and other effectors in heterologous species to see if the range of these effectors can play a role in pathogenicity when expressed in distantly and closely related fungal species. These effectors have been attuned over time to their host plant but have homologous interactors in other plant species. In this study, Microbotryum lychnidis-dioicae, Sporisorium reilianum, and Ustilago maydis, were all used …

Synthesis, Characterization, And Chemical Reactivity Of Calcium-Alginate Hydrogel Beads Containing Metal Nanoparticles And Nanoclusters., Rajiv Kumar Singh

Electronic Theses and Dissertations

This dissertation explores the synthesis, stability, and reactivity of various metal nanoparticles (NPs) and nanoclusters (NCs) of varied size and stabilizers contained within millimeter-sized calcium alginate (Ca-Alg) hydrogel polymer beads. Hydrogel beads synthesized by combining sodium alginate with Au or Ag NPs stabilized with trisodium citrate (Cit) and adding dropwise into a 4.0 M Ca²⁺ solution remained stable and contained within the beads. Those synthesized Au, Pd and AuPd NCs stabilized with glutathione (SG) became partially released from the hydrogel within a day. The synthesis of beads containing aggregated Cit Au NPs occurs by inducing aggregation with tetrakis(hydroxymethyl) phosphonium …

The Autonomic And Arrhythmogenic Effects Of Gestational E-Cigarette Exposure., Brittany Rachelle Reynolds

Electronic Theses and Dissertations

Introduction. E-cigarettes (e-cigs) have been shown to be pro-arrhythmic in both human and male rodent studies; however, little is known about how e-cig use impacts patients with a predisposed heightened risk for arrhythmias, including pregnant women. Both pregnancy and e-cig use have independently been shown to increase heart rate, diminish heart rate variability, and increase ventricular premature beats, which is suspected to be due to sympathetic dominance. Importantly, β-blockers have been shown to reduce sympathetic activity, reduce heart rate, increase HRV, and reduce arrhythmias. Thus, the use of β-blockers may help prevent adverse health effects driven by sympathetic dominance from …

Tumor Infiltrating Lymphocytes: From Discovery To Clinical Application., Lewis Clayton Chew

Electronic Theses and Dissertations

This thesis explores the evolution of TIL therapy from its discovery to clinical application, focusing on its use in treating metastatic cancer. Adoptive cell therapy (ACT), particularly TIL therapy, has emerged as a promising alternative to traditional treatments like chemotherapy. This review article traces the historical development of TILs, highlighting key experiments and clinical trials that have shaped its understanding and application as a therapeutic strategy for patients with metastatic and difficult to treat cancers including melanoma. Importantly, this article highlights recent advancements, including the FDA approval of Lifileucel, and explores emerging strategies to enhance therapeutic efficacy of TILs through …