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Articles 92161 - 92190 of 93175
Full-Text Articles in Entire DC Network
Methodology For Enhanced Filtration And Dewatering Of Fine-Grain Amd Precipitate Using Geocomposites For Rare Earth Elements Recovery, Iuri Lira Santos
Methodology For Enhanced Filtration And Dewatering Of Fine-Grain Amd Precipitate Using Geocomposites For Rare Earth Elements Recovery, Iuri Lira Santos
Graduate Theses, Dissertations, and Problem Reports (ETD)
Research performed by the West Virginia Water Research Institute (WVWRI) in partnership with the Department of Energy (DOE) has identified that coal mining by-products contain significant amounts of Rare Earth Elements (REEs). REEs currently are in high demand, and extraction from coal mining reject presents a potential for commercialization if extraction is feasible. The coal mining reject include Acid Mine Drainage (AMD) in the aqueous phase and sludge from AMD treatment. A novel two split selective precipitation method was implemented to remove gangue metals, increasing the concentration of REEs in the sludge.
This process presents a two-fold benefit: 1) treatment …
A Monte Carlo Simulation Of Rat Choice Behavior With Interdependent Outcomes, Michelle A. Frankot
A Monte Carlo Simulation Of Rat Choice Behavior With Interdependent Outcomes, Michelle A. Frankot
Graduate Theses, Dissertations, and Problem Reports (ETD)
Preclinical behavioral neuroscience often uses choice paradigms to capture psychiatric symptoms. In particular, the subfield of operant research produces nested datasets with many discrete choices in a session. The standard analytic practice is to aggregate choice into a continuous variable and analyze using ANOVA or linear regression. However, choice data often have multiple interdependent outcomes of interest, violating an assumption of general linear models. The aim of the current study was to quantify the accuracy of linear mixed-effects regression (LMER) for analyzing data from a 4-choice operant task called the Rodent Gambling Task (RGT), which measures decision-making in the context …
Selectively Targeting Disease-Restricted Secretogranin Iii To Alleviate Choroidal Neovascularization, Liyang Ji, Prabuddha Waduge, Lili Hao, Avinash Kaur, Wencui Wan, Yan Wu, Hong Tian, Jinsong Zhang, Keith A Webster, Wei Li
Selectively Targeting Disease-Restricted Secretogranin Iii To Alleviate Choroidal Neovascularization, Liyang Ji, Prabuddha Waduge, Lili Hao, Avinash Kaur, Wencui Wan, Yan Wu, Hong Tian, Jinsong Zhang, Keith A Webster, Wei Li
Faculty, Staff and Students Publications
Choroidal neovascularization (CNV), a leading cause of blindness in the elderly, is routinely treated with vascular endothelial growth factor (VEGF) inhibitors that have limited efficacy and potentially adverse side effects. An unmet clinical need is to develop novel therapies against other angiogenic factors for alternative or combination treatment to improve efficacy and safety. We recently described secretogranin III (Scg3) as a disease-selective angiogenic factor, causally linked to diabetic retinopathy and acting independently of the VEGF pathway. An important question is whether such a disease-selective Scg3 pathway contributes to other states of pathological angiogenesis beyond diabetic retinopathy. By applying a novel …
Analysis Of Forensically Relevant Evidence Using Electrochemistry, Spectroscopy, And Mass Spectrometry Tools, Colby Edward Ott
Analysis Of Forensically Relevant Evidence Using Electrochemistry, Spectroscopy, And Mass Spectrometry Tools, Colby Edward Ott
Graduate Theses, Dissertations, and Problem Reports (ETD)
Forensic science relies on the use of multiple techniques in the assessment of evidence to increase the accuracy and reliability of the results. However, with the rapidly changing drug landscape due to the introduction of novel psychoactive substances, many traditional screening methods are no longer sensitive or selective enough for use. Additionally, many screening methods such as chemical color tests are prone to false positive and negative results and are subjective. Therefore, the goal of this dissertation was to develop a novel analytical scheme that can provide a more efficient, rapid, and sensitive method that will facilitate adoption in the …
Reinforcement Learning For Process Control: Applications To Energy Systems, Elijah Ballard Hedrick
Reinforcement Learning For Process Control: Applications To Energy Systems, Elijah Ballard Hedrick
Graduate Theses, Dissertations, and Problem Reports (ETD)
Reinforcement learning (RL) is a machine learning method that has recently seen significant research activity owing to its successes in the areas of robotics and gameplaying (Silver et al., 2017). However, significant challenges exist in the extension of these control methods to process control problems, where state and input signals are nearly always continuous and more stringent performance guarantees are required. The goal of this work is to explore ways that modern RL algorithms can be adapted to handle process control problems; avenues for this work include using RL with existing controllers such as model predictive control (MPC) and adapting …
Investigating The Mitochondrial Protein Mitoneet In C. Elegans Models Of Aging And Alzheimer's Disease, Jacob Ryan Boos
Investigating The Mitochondrial Protein Mitoneet In C. Elegans Models Of Aging And Alzheimer's Disease, Jacob Ryan Boos
Graduate Theses, Dissertations, and Problem Reports (ETD)
Oxidative stress is an imbalance between reactive oxygen species production and elimination, favoring the former. Reactive oxygen species serve as important signaling molecules for physiological homeostasis. However, when produced in excess, these once important signaling molecules become detrimental, disrupting cellular functions, and ultimately leading to cell death. In aging, reactive oxygen species production is increased, accompanied with reductions in oxidative stress resistance, increasing the risk for developing age-related diseases including cardiovascular disease, cancer, stroke, and neurodegenerative diseases. The outer mitochondrial membrane iron-sulfur cluster containing protein mitoNEET (CISD1; gene CISD1) has shown to be a mediator of mitochondrial function and …
Performance Of Peltier Cooled Technology During Preconcentration Of Volatile Organic Compounds Analyzed By Gas Chromatography-Mass Spectrometry (Gc-Ms) Using Niosh Manual Of Analytical Methods (Nmam) 3900, Elizabeth Ann Fernandez
Performance Of Peltier Cooled Technology During Preconcentration Of Volatile Organic Compounds Analyzed By Gas Chromatography-Mass Spectrometry (Gc-Ms) Using Niosh Manual Of Analytical Methods (Nmam) 3900, Elizabeth Ann Fernandez
Graduate Theses, Dissertations, and Problem Reports (ETD)
Using evacuated canisters for whole-air sampling allows for sampling without specific knowledge of the environment and potential analytes. Evacuated canisters are able to tolerate concentrations ranging from parts per trillion (PPT) to parts per million (PPM). The U.S. Environmental Protection Agency (EPA) has used evacuated canisters for years to sample volatile organic compounds (VOCs) from ambient air using their method TO-15 (LeBouf, et al., 2019). The GC-MS system used for the development of NMAM 3900 used liquid nitrogen to cool sorbent traps in the preconcentrator. Liquid nitrogen allows for cooling of specified points below ambient temperature. An alternative to liquid …
Machine Learning Approach To Health Risk Determination, Levi Butcher Cole
Machine Learning Approach To Health Risk Determination, Levi Butcher Cole
Graduate Theses, Dissertations, and Problem Reports (ETD)
In the United States, cardiovascular disease is the leading cause of death for both men and women. The factors that contribute to heart disease are well known but it is still an ever-evolving field of research. The possible benefits to being able to determine an individual’s Health Risk could provide the early insights needed to combat cardiovascular disease. However, two major problems within this area are the public availability of a dataset and the label imbalances for the dataset. In this thesis, we present a framework for exploring health risk using a combination of the NHANES dataset and open-source machine …
Repercussions: The Pressure To Be Thin, Shuhan Liu
Repercussions: The Pressure To Be Thin, Shuhan Liu
Graduate Theses, Dissertations, and Problem Reports (ETD)
My MFA thesis and supporting exhibition will highlight ceramics work I have created with the intention of dissecting the relationship between a soul and reality to convey the story of tension and anxiety and show it in a way that would let viewers identify with my discomfort and anxiety. The inspiration for my work came from the severe body anxiety that I faced that broke out during the three years of psychological stress caused by the pandemic. Using personal narratives as a starting point, I created object-based artwork that addresses the external pressures I feel to be skinny. As an …
Mountain Biking Mountaineers: Insights Into The West Virginia Mountain Biking Community, Connor Mullin
Mountain Biking Mountaineers: Insights Into The West Virginia Mountain Biking Community, Connor Mullin
Graduate Theses, Dissertations, and Problem Reports (ETD)
Mountain biking is one of the most popular recreational activities in the United States. Beyond the increasing popularity of the sport, the technology is also changing, especially in terms of electric mountain biking. This new type of bike blends traditional mountain bikes with electric bikes, creating a potential new group of recreationists. The research on mountain biking, and more specifically electric mountain biking, is limited. The purpose of this study is to examine West Virginian mountain bikers by studying behaviors and motivations. There are no published studies focused on mountain biking in West Virginia, and therefore a need to fill …
Evaluate The Efficacy Of A Mixture Of Peroxyacetic Acid And H2o2 Against The Survival And Cross-Contamination Of The Salmonella Surrogate Enterococcus Faecium On Tomatoes During Triple-Wash, Corey Waitman Coe
Graduate Theses, Dissertations, and Problem Reports (ETD)
Triple-wash with a mixture of peroxyacetic acid and H2O2 (SaniDate-5.0) during post-harvest processing of fresh produce has been recommended by West Virginia Small Farm Center to improve microbial safety. It has been well recognized that the washing of produce is more important for preventing cross-contamination than reducing foodborne pathogens. Furthermore, it may help improve public confidence in that the produce they obtain from locally grown farmers is safe for their consumption. determine the efficacy of SaniDate-5.0 for reducing the survival and preventing cross-contamination of the Salmonella surrogate Enterococcus faecium on tomatoes during triple-wash.
E. faecium ATCC-8459 (resistant to 100-ppm nalidixic-acid) …
Stylistic Changes In The Music Of Ruth Crawford Seeger, Xinlei Chu
Stylistic Changes In The Music Of Ruth Crawford Seeger, Xinlei Chu
Graduate Theses, Dissertations, and Problem Reports (ETD)
While the body of Ruth Crawford Seeger’s works is not extensive, her musical legacy cannot be ignored. As a central member of the “ultramoderns,” her work influenced the next generation of American composers such as Elliot Carter. This research document examines the stylistic changes of Crawford’s music throughout her career as a composer. Taking into account the various influences that could have impacted her compositional style over time, three pieces were selected for in-depth analysis from different times in Crawford’s life. The first two pieces analyzed are the first movement of Diaphonic Suite No. 2 and the third movement of …
Direct Ink Writing Printability – Ashby-Like Plots For Guided Design, Domenic Cipollone
Direct Ink Writing Printability – Ashby-Like Plots For Guided Design, Domenic Cipollone
Graduate Theses, Dissertations, and Problem Reports (ETD)
Direct Ink Writing (DIW), an extrusion-based 3D printing technique, offers a broad application space. As such, the technique continues to find use in biomedical, flexible electronic, ceramic, and energy device applications, among others. With this broad application space comes an expanding material library of inks with diverse rheological and microstructural properties. This begs the question: what constitutes a printable ink? How does one define printability? And how does one design for printability?
Researchers currently have a broad understanding of what constitutes a printable ink. However, time and time again, inks with unique rheological properties and formulations are printed. Currently, ink …
Assessment Of User Environmental Perceptions Associated With Gray's Reef National Marine Sanctuary, Marieke Johanna Lemmen
Assessment Of User Environmental Perceptions Associated With Gray's Reef National Marine Sanctuary, Marieke Johanna Lemmen
Graduate Theses, Dissertations, and Problem Reports (ETD)
Resource management in marine protected areas is confronted with the challenging conflict of use and conservation of resources. Increased visitation in marine environments has led to the need of management due to negative ecological and social impacts. Understanding environmental values, attitudes, and perceptions is important to the success of environmental protection. Using online surveys sent via Qualtrics asking questions regarding the users’ knowledge, attitudes, and perceptions of ocean resources, goods and services, this research is focusing on identifying user profiles and understanding their environmental perception associated with Gray’s Reef National Marine Sanctuary, an offshore marine protected area, and surrounding coastal …
Multi-Task Neuromuscular Generalization And Changes Through The Lifespan, Hannah Delaney Carey
Multi-Task Neuromuscular Generalization And Changes Through The Lifespan, Hannah Delaney Carey
Graduate Theses, Dissertations, and Problem Reports (ETD)
Mobility in everyday life requires executing and shifting between a broad assortment of functional tasks and resisting disturbances that could cause falls. Though the importance of successfully performing a variety of functional tasks is recognized and incorporated in clinical assessments (e.g., the Timed-Up-and-Go Test, Berg Balance Scale), little is understood about the underlying neuromuscular control required, or how it changes with age. The neuromuscular control for functional tasks such as walking is typically studied in isolation, or with variations on the same task. Characterizing the coordination required to produce and shift between a wider variety of tasks and resist external …
Exploiting Modulation Of The Blood-Brain And Blood-Tumor Barrier Permeability By Translational Focused Ultrasound For Therapeutic Delivery To Cns Metastases, Tasneem A. Arsiwala
Exploiting Modulation Of The Blood-Brain And Blood-Tumor Barrier Permeability By Translational Focused Ultrasound For Therapeutic Delivery To Cns Metastases, Tasneem A. Arsiwala
Graduate Theses, Dissertations, and Problem Reports (ETD)
Transcranial low-intensity focused ultrasound is a unique technology to modulate the integrity of tight endothelial junctions and transiently increase BBB/BTB permeability to enhance therapeutic delivery. Despite promising early studies, present literature lacks agreement on key experimental conditions, which restricts our knowledge and the technique's widespread translation. This dissertation first provides a critical review of the current gaps in knowledge regarding the universal use of LiFUS in preclinical and clinical use. We then identify key parameters for translational and predictable opening of the BBB using a 3T MRI coupled with a clinical device. Our investigation highlights that passive permeability of the …
Understanding Vaccine-Induced Memory Responses To Develop The Next Generation Of Pertussis Vaccines, Kelly L. Weaver
Understanding Vaccine-Induced Memory Responses To Develop The Next Generation Of Pertussis Vaccines, Kelly L. Weaver
Graduate Theses, Dissertations, and Problem Reports (ETD)
Bordetella pertussis is a Gram-negative respiratory pathogen that can infect individuals of all ages and is notably responsible for infant fatalities. Pertussis (whooping cough) is a vaccine-preventable respiratory disease for which vaccines have been available in the United States since the 1940s. Whole cell pertussis vaccines kept incidence of pertussis under 5,000 cases per year, but were associated with reactogenicity issues. Following the introduction of less reactogenic acellular pertussis vaccines in the late 1990s, there have been noteworthy outbreaks of pertussis. For example, in 2012 there were over 50,000 reported cases of pertussis and 20 deaths in the U.S. The …
Dual Orexin Receptor Antagonists For Treatment Of Insomnia: A Systematic Review And Meta-Analysis On Randomized, Double-Blind, Placebo-Controlled Trials Of Suvorexant And Lemborexant, Habibolah Khazaie, Masoud Sadeghi, Sepideh Khazaie, Max Hirshkowitz, Amir Sharafkhaneh
Dual Orexin Receptor Antagonists For Treatment Of Insomnia: A Systematic Review And Meta-Analysis On Randomized, Double-Blind, Placebo-Controlled Trials Of Suvorexant And Lemborexant, Habibolah Khazaie, Masoud Sadeghi, Sepideh Khazaie, Max Hirshkowitz, Amir Sharafkhaneh
Faculty, Staff and Students Publications
Study objectives: Recent treatment guidelines for chronic insomnia recommend pharmacological and non-pharmacological therapies. One of the contemporary drug options for insomnia includes dual orexin receptor antagonist (DORA), such as suvorexant and lemborexant. We conducted a systematic review and meta-analysis for the treatment of insomnia with suvorexant and lemborexant based on randomized, double-blind, placebo-controlled Trials.
Methods: We conducted a comprehensive search on three databases (PubMed/Medline, Web of Science, and Cochrane Library) till August 14, 2021, without any restrictions to retrieve the relevant articles. The effect sizes were computed presenting the pooled mean difference or risk ratio along with 95% confidence interval …
Obesity And Asthma: A Focused Review, Rubabin Tooba, Tianshi David Wu
Obesity And Asthma: A Focused Review, Rubabin Tooba, Tianshi David Wu
Faculty, Staff and Students Publications
No abstract provided.
Sex Differences In Response To A Large 200-Person Audience Using The Trier Social Stress Test In Pre-Recorded Virtual Reality, Garrett Byron
Sex Differences In Response To A Large 200-Person Audience Using The Trier Social Stress Test In Pre-Recorded Virtual Reality, Garrett Byron
Psychology
The Trier Social Stress Test (TSST) induces stress in the lab by having participants complete challenging tasks in front of an audience. The TSST has been adapted to virtual reality (VR), eliminating in-person audience variability that could explain sex differences in stress responses. Furthermore, the VR-TSST facilitates the examination of factors difficult to investigate in person, such as the effect of a large, 200-person audience. This study compared male and female physiological and psychological responses to an in-person 2-person TSST and a prerecorded VRTSST with audience sizes of 2 and 200 persons. Results indicated that only males had statistically significant …
Longitudinal Examination Of Sleep And Chrononutrition, Allison Christine Veronda
Longitudinal Examination Of Sleep And Chrononutrition, Allison Christine Veronda
Psychology
Chrononutrition (i.e., circadian timing of food intake) offers promising opportunities to improve weight management strategies, but many fundamental aspects of chrononutrition are still unknown. While research to date has suggested that unhealthy chrononutrition behaviors are linked to weight gain, chrononutrition preferences are markedly understudied, and research has not yet determined whether chrononutrition preferences and behaviors are variable or stable over time in the natural environment. Potential mechanisms underlying chrononutrition’s impact on weight are still being explored. Recent evidence suggests that weight gain is the result of an imbalance of energy consumption and expenditure that is influenced by sleep duration. Though …
Development Of Quantification And Diagnosis Methods For Cereal Bacterial Leaf Streak Pathogens, Eunhye Hong
Development Of Quantification And Diagnosis Methods For Cereal Bacterial Leaf Streak Pathogens, Eunhye Hong
Plant Pathology
Bacterial leaf streak (BLS) has been a major disease on wheat and barley in the Northern Great Plains. It is caused by Xanthomonas translucens pv. undulosa (Xtu) on wheat and X. translucens pv. translucens (Xtt) on barley. Many questions remain unclear on pathogen biology and BLS epidemiology. Based on previous study, I identified an Xtu/Xtt specific region and established a qPCR quantification method for the bacterial pathogens. The method was shown to be effective to detect and quantify the bacterial pathogen in seeds and leaves. In addition, molecular markers were developed to differentiate Xtu and Xtt. Those markers were successfully …
Equity Battles: Multicultural Leadership For English Language Learner Students, Alfredo Pargas
Equity Battles: Multicultural Leadership For English Language Learner Students, Alfredo Pargas
Electronic Theses and Dissertations
The focus of this study was to increase teachers’ and school leaders’ capacity and awareness to be better multicultural leaders for English Language Learner (ELL) students. This study produced several recommendations to address this issue. During this study, I used improvement science as the methodology and included a variety of stakeholders as participants. The conceptual framework used to guide this study included community cultural wealth and funds of knowledge. Using both the voices of ELL families and the input of the school equity team, which includes teachers and a school leader, we collaboratively created a six-stage intervention program to increase …
Historias De Una Pandemia: Documenting Latina/O/X Stories During Covid-19 Through Performed Storytelling, Elena Foulis
Historias De Una Pandemia: Documenting Latina/O/X Stories During Covid-19 Through Performed Storytelling, Elena Foulis
Spanish Faculty Publications (Archived)
Using oral histories and narratives collected during the Covid-19 pandemic, a student-led performance invites consideration about the role of language, cultural, and social pluralities in creating a socially just world.
Hypermethylation Of Pi3k-Akt Signalling Pathway Genes Is Associated With Human Neural Tube Defects, Tian Tian, Xinyuan Lai, Kuanhui Xiang, Xiao Han, Shengju Yin, Robert M Cabrera, John W Steele, Yunping Lei, Xuanye Cao, Richard H Finnell, Linlin Wang, Aiguo Ren
Hypermethylation Of Pi3k-Akt Signalling Pathway Genes Is Associated With Human Neural Tube Defects, Tian Tian, Xinyuan Lai, Kuanhui Xiang, Xiao Han, Shengju Yin, Robert M Cabrera, John W Steele, Yunping Lei, Xuanye Cao, Richard H Finnell, Linlin Wang, Aiguo Ren
Faculty, Staff and Students Publications
Neural tube defects (NTDs) are a group of common and severe congenital malformations. The PI3K-AKT signalling pathway plays a crucial role in the neural tube development. There is limited evidence concerning any possible association between aberrant methylation in PI3K-AKT signalling pathway genes and NTDs. Therefore, we aimed to investigate potential associations between aberrant methylation of PI3K-AKT pathway genes and NTDs. Methylation studies of PI3K-AKT pathway genes utilizing microarray genome-methylation data derived from neural tissues of ten NTD cases and eight non-malformed controls were performed. Targeted DNA methylation analysis was subsequently performed in an independent cohort of 73 NTD cases and …
Privacy And Online Social Networks: A Systematic Literature Review Of Concerns, Preservation, And Policies, Damion Mitchell, Omar F. El-Gayar
Privacy And Online Social Networks: A Systematic Literature Review Of Concerns, Preservation, And Policies, Damion Mitchell, Omar F. El-Gayar
Research & Publications
Background: Social media usage is one of the most popular online activities, but with it comes privacy concerns due to how personal data are handled by these social networking sites. Prior literature aimed at identifying users’ privacy concerns as well as user behavior associated with privacy mitigation strategies and policies. However, OSN users continue to divulge private information online and privacy remains an issue. Accordingly, this review aims to present extant research on this topic, and to highlight any potential research gaps. Method: The paper presents a systematic literature review for the period 2006 - 2021, in which 33 full …
Improving North Dakota's Arboreta: Utilizing Living Museums To Their Greatest Capacity, Stephen Lee Ahrenholz
Improving North Dakota's Arboreta: Utilizing Living Museums To Their Greatest Capacity, Stephen Lee Ahrenholz
Natural Resources Management
North Dakota has roughly 20 arboreta, though many of them are in decline. NDSU Extension developed an arboretum improvement project that included field visits, site inventories, and educational programming. North Dakota’s arboreta are a diverse group with over 70 genera and more than 500 tree and shrub species represented. Soil Conservation District (SCD) arboreta have an average of 31 species per arboretum while non-SCD arboreta average about 70. Labeling methods and accuracy, condition, and maintenance varied greatly. We conducted four educational workshops for arboretum managers, but attendance was relatively low: only 21 individuals attended. Attendees include SCD employees, Extension agents, …
The Impacts Of Exotic Species On Native Bee Communities And Interactions In Novel Northern Great Plains Grasslands, C. K. Pei
Natural Resources Management
Human alterations to landscapes impose novel conditions on native plant and animal species. Exotic plants are among these changes and are presently common and prevalent across Northern Great Plains (NGP) grasslands. Their introductions alter plant communities and influence the wildlife species that rely on the resources provided by plant communities. Exotic plants displace native plant species, but we do not understand how or if some exotic plants can provide resources to pollinating insects requiring floral resources. Considering the spread of exotic plants and the important ecological services bees provide, it is important to understand how native bees value and interact …
Plant Blindness Represents The Loss Of Generational Knowledge And Cultural Identity, Stacie Blue
Plant Blindness Represents The Loss Of Generational Knowledge And Cultural Identity, Stacie Blue
Natural Resources Management
Elders from the Turtle Mountain Band of Chippewa Indians (TMBCI) who have gathered plants within the region have seen the plant numbers reduced and species of plants disappear. Their statements of concern for the plants and their hope for increased plant diversity led to the development of the current research study. Increasing plant knowledge is vital to rebuilding and maintaining the diversity of vegetation within the forest, grassland, and wetland habitats. The present study used an online survey to assess citizens’ ability to identify plants that belong in wetland, grassland, and forest habitats in the area; names of plants; learn …
Implementing Trauma-Informed Care Through A Multi-Agency Learning Collaborative: A Theory-Driven Analysis Of Outcomes And Sustainability, Mira D H Snider M.S.
Implementing Trauma-Informed Care Through A Multi-Agency Learning Collaborative: A Theory-Driven Analysis Of Outcomes And Sustainability, Mira D H Snider M.S.
Graduate Theses, Dissertations, and Problem Reports (ETD)
Learning collaboratives (LCs) are often used in large-scale implementation initiatives to promote evidence-based practice across provider networks. Although the outcomes and stakeholder perspectives of many LCs have been documented, support for the effectiveness of LCs is equivocal, and the means by which LCs achieve long-term improvements in clinical care are not understood. The current study investigated outcomes and sustainability of a multi-agency LC for implementing trauma-informed care in 23 rural Pennsylvania counties. Changes in outcomes (i.e., trauma symptom screening, trauma-informed care training attendance, clinician confidence with using trauma informed-care, utilization of trauma-related diagnostic codes, retention in service, service unit density) …