Digital Commons Network^™

Circulating Pre-Treatment T-Cell Receptor Repertoire As A Predictive Biomarker In Advanced Or Metastatic Non-Small-Cell Lung Cancer Patients Treated With Pembrolizumab Alone Or In Combination With Chemotherapy, A. Abed, Aaron B. Beasley, Anna L. Reid, N. Law, L. Calapre, M. Millward, Johnny Lo, Elin S. Gray

Research outputs 2022 to 2026

Background: The circulating T-cell receptor (TCR) repertoire is a dynamic representation of overall immune responses in an individual. Materials and methods: We prospectively collected baseline blood from patients treated with first-line pembrolizumab monotherapy or in combination with chemotherapy. TCR repertoire metrics were correlated with clinical benefit rate (CBR), progression-free survival (PFS), overall survival (OS) and immune-related adverse events (irAEs). We built a logistic regression classifier by fitting all four TCR- repertoire metrics to the immune checkpoint inhibitor (ICI) CBR data. In the subsequent receiver operating characteristic (ROC) analysis of the resulting logistic regression model probabilities, the best cut-off value was …

Quality Assessment Of Hydroquinone, Mercury, And Arsenic In Skin-Lightening Cosmetics Marketed In Ilorin, Nigeria, Olasunkanmi David Bamidele, Blessing A. Kayode, Oluwasegun I. Eniayewu, Adebanjo J. Adegbola, Raphael S. Olatoye, Ngaitad S. Njinga, Sa’Ad T. Abdullahi, Moji T. Bakare-Odunola

Research outputs 2022 to 2026

Hydroquinone, Mercury (Hg), and Arsenic (As) are hazardous to health upon long-term exposure. Hydroquinone, Hg, and As were analysed in skin-lightening cosmetics randomly purchased from different cosmetic outlets within the Ilorin metropolis, Nigeria. The amount of hydroquinone in the samples was determined using a UV-spectrophotometry method at 290 nm. Hg and As were quantified using atomic absorption spectrophotometry (AAS). UV-spectrophotometry method validation showed excellent linearity (r2 = 0.9993), with limits of detection (0.75 g/mL), limits of quantification (2.28 g/mL), relative standard deviation (0.01–0.35%), and recovery (95.85–103.56%) in the concentration range of 5–50 g/mL. Similarly, r2, LOD, and LOQ for Hg …

Leveraging Igg N-Glycosylation To Infer The Causality Between T2d And Hypertension, Haotian Wang, Yuan Li, Weijie Cao, Jie Zhang, Mingyang Cao, Xiaoni Meng, Di Liu, Youxin Wang

Research outputs 2022 to 2026

Background: Observational studies demonstrated a bidirectional association between type 2 diabetes (T2D) and hypertension, whereas Mendelian randomization (MR) analyses supported the causality from T2D to hypertension but not causal from hypertension to T2D. We previously found that IgG N-glycosylation is associated with both T2D and hypertension, and thus IgG N-glycosylation might link the causality between them. Methods: We carried out a genome-wide association study (GWAS) to identify IgG N-glycosylation-quantitative-trait loci (QTLs) integrating GWAS for T2D and hypertension and then performed bidirectional univariable and multivariable MR analyses to infer the causal association among them. The inverse-variance-weighted (IVW) analysis was performed as …

Effects Of Exercise Training On Muscle Quality In Older Individuals: A Systematic Scoping Review With Meta-Analyses, Tibor Hortobágyi, Tomas Vetrovsky, Jennifer S. Brach, Martijn Van Haren, Krystof Volesky, Regis Radaelli, Pedro Lopez, Urs Granacher

Research outputs 2022 to 2026

Background: The quantity and quality of skeletal muscle are important determinants of daily function and metabolic health. Various forms of physical exercise can improve muscle function, but this effect can be inconsistent and has not been systematically examined across the health-neurological disease continuum. The purpose of this systematic scoping review with meta-analyses was to determine the effects and potential moderators of exercise training on morphological and neuromuscular muscle quality (MMQ, NMQ) in healthy older individuals. In addition and in the form of a scoping review, we examined the effects of exercise training on NMQ and MMQ in individuals with neurological …

Frailty And Pain In An Acute Private Hospital: An Observational Point Prevalence Study, Rosemary Saunders, Kate Crookes, Karla Seaman, Seng Giap Marcus Ang, Caroline Bulsara, Max K. Bulsara, Beverley Ewens, Olivia Gallagher, Renée Graham, Karen Gullick, Sue Haydon, Jeff Hughes, Kim-Huong Nguyen, Bev O’Connell, Debra Scaini, Christopher Etherton-Beer

Research outputs 2022 to 2026

Frailty and pain in hospitalised patients are associated with adverse clinical outcomes. However, there is limited data on the associations between frailty and pain in this group of patients. Understanding the prevalence, distribution and interaction of frailty and pain in hospitals will help to determine the magnitude of this association and assist health care professionals to target interventions and develop resources to improve patient outcomes. This study reports the point prevalence concurrence of frailty and pain in adult patients in an acute hospital. A point prevalence, observational study of frailty and pain was conducted. All adult inpatients (excluding high dependency …

Type 2 Diabetes Modifies The Association Of Cad Genomic Risk Variants With Subclinical Atherosclerosis, Natalie R Hasbani, Kenneth E Westerman, Soo Heon Kwak, Han Chen, Xihao Li, Daniel Di Corpo, Jennifer Wessel, Joshua C Bis, Chloè Sarnowski, Peitao Wu, Lawrence F Bielak, Xiuqing Guo, Nancy Heard-Costa, Gregory L Kinney, Michael C Mahaney, May E Montasser, Nicholette D Palmer, Laura M Raffield, James G Terry, Lisa R Yanek, Jessica Bon, Donald W Bowden, Jennifer A Brody, Ravindranath Duggirala, David R Jacobs, Rita R Kalyani, Leslie A Lange, Braxton D Mitchell, Jennifer A Smith, Kent D Taylor, April P Carson, Joanne E Curran, Myriam Fornage, Barry I Freedman, Stacey Gabriel, Richard A Gibbs, Namrata Gupta, Sharon L R Kardia, Brian G Kral, Zeineen Momin, Anne B Newman, Wendy S Post, Karine A Viaud-Martinez, Kendra A Young, Lewis C Becker, Alain G Bertoni, John Blangero, John J Carr, Katherine Pratte, Bruce M Psaty, Stephen S Rich, Joseph C Wu, Rajeev Malhotra, Patricia A Peyser, Alanna C Morrison, Ramachandran S Vasan, Xihong Lin, Jerome I Rotter, James B Meigs, Alisa K Manning, Paul S De Vries

Faculty, Staff and Student Publications

BACKGROUND: Individuals with type 2 diabetes (T2D) have an increased risk of coronary artery disease (CAD), but questions remain about the underlying pathology. Identifying which CAD loci are modified by T2D in the development of subclinical atherosclerosis (coronary artery calcification [CAC], carotid intima-media thickness, or carotid plaque) may improve our understanding of the mechanisms leading to the increased CAD in T2D.

METHODS: We compared the common and rare variant associations of known CAD loci from the literature on CAC, carotid intima-media thickness, and carotid plaque in up to 29 670 participants, including up to 24 157 normoglycemic controls and 5513 …

What Can The Plasma Proteome Tell Us About Platelets And (Vice Versa)?, Steven Bruzek, Marisol Betensky, Jorge Di Paola, Thomas Diacovo, Neil Goldenberg, Vera Ignjatovic

2020-Current year OA Pubs

Multi-omics approaches are being used increasingly to study physiological and pathophysiologic processes. Proteomics specifically focuses on the study of proteins as functional elements and key contributors to, and markers of the phenotype, as well as targets for diagnostic and therapeutic approaches. Depending on the condition, the plasma proteome can mirror the platelet proteome, and hence play an important role in elucidating both physiologic and pathologic processes. In fact, both plasma and platelet protein signatures have been shown to be important in the setting of thrombosis-prone disease states such as atherosclerosis and cancer. Plasma and platelet proteomes are increasingly being studied …

Normalization Of Drug And Therapeutic Concepts With Thera-Py, Matthew Cannon, James Stevenson, Kori Kuzma, Susanna Kiwala, Jeremy L Warner, Obi L Griffith, Malachi Griffith, Alex H Wagner

2020-Current year OA Pubs

OBJECTIVE: The diversity of nomenclature and naming strategies makes therapeutic terminology difficult to manage and harmonize. As the number and complexity of available therapeutic ontologies continues to increase, the need for harmonized cross-resource mappings is becoming increasingly apparent. This study creates harmonized concept mappings that enable the linking together of like-concepts despite source-dependent differences in data structure or semantic representation.

MATERIALS AND METHODS: For this study, we created Thera-Py, a Python package and web API that constructs searchable concepts for drugs and therapeutic terminologies using 9 public resources and thesauri. By using a directed graph approach, Thera-Py captures commonly used …

Diroximel Fumarate In Patients With Relapsing-Remitting Multiple Sclerosis: Final Safety And Efficacy Results From The Phase 3 Evolve-Ms-1 Study, Barry A Singer, Robert T Naismith, Et Al.

2020-Current year OA Pubs

BACKGROUND: Diroximel fumarate (DRF) is approved for adults with relapsing-remitting multiple sclerosis (RRMS) in Europe and for relapsing forms of MS in the United States. DRF and dimethyl fumarate (DMF) yield bioequivalent exposure of the active metabolite monomethyl fumarate. Prior studies indicated fewer gastrointestinal (GI)-related adverse events (AEs) with DRF compared with DMF.

OBJECTIVE: To report final outcomes from EVOLVE-MS-1.

METHODS: EVOLVE-MS-1 was an open-label, 96-week, phase 3 study assessing DRF safety, tolerability, and efficacy in patients with RRMS. The primary endpoint was safety and tolerability; efficacy endpoints were exploratory.

RESULTS: Overall, 75.7% (800/1057) of patients completed the study; median …

Continuous Subcutaneous Foslevodopa/Foscarbidopa In Parkinson's Disease: Safety And Efficacy Results From A 12-Month, Single-Arm, Open-Label, Phase 3 Study, Jason Aldred, Susan R Criswell, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Foslevodopa/foscarbidopa, a soluble formulation of levodopa/carbidopa (LD/CD) prodrugs for the treatment of Parkinson's disease (PD), is administered as a 24-hour/day continuous subcutaneous infusion (CSCI) with a single infusion site. The efficacy and safety of foslevodopa/foscarbidopa versus oral immediate-release LD/CD was previously demonstrated in patients with PD in a 12-week, randomized, double-blind, phase 3 trial (NCT04380142). We report the results of a separate 52-week, open-label, phase 3 registrational trial (NCT03781167) that evaluated the safety/tolerability and efficacy of 24-hour/day foslevodopa/foscarbidopa CSCI in patients with advanced PD.

METHODS: Male and female patients with levodopa-responsive PD and ≥ 2.5 hours of "Off" time/day …

Survival Of Veterans Treated With Enzalutamide And Abiraterone For Metastatic Castrate Resistant Prostate Cancer Based On Comorbid Diseases, Martin W Schoen, Kenneth R Carson, Seth A Eisen, Charles L Bennett, Suhong Luo, Melissa A Reimers, Eric M Knoche, Alison L Whitmer, Yan Yan, Bettina F Drake, Kristen M Sanfilippo

2020-Current year OA Pubs

BACKGROUND: Comorbid diseases influence patient outcomes, yet little is known about how comorbidities interact with treatments for metastatic castrate-resistant prostate cancer (mCRPC). No head-to-head trials have compared the efficacy of abiraterone and enzalutamide - oral androgen-receptor targeted agents (ARTAs) for mCRPC. In patients with comorbid disease, outcomes with ARTAs may differ due to disparate mechanisms of action, adverse events, and drug interactions.

METHODS: Retrospective observational study of US veterans initiating treatment for mCRPC with abiraterone or enzalutamide between September 2014 and June 2017. Treatment duration and overall survival (OS) was compared based on age and comorbid diseases. The association between …

Patterns In Winter Stonefly Distribution Along A River Continuum And Land-Use Gradient In Northwest Arkansas Streams, Zachary Tipton

Graduate Theses and Dissertations

Freshwater ecosystems are facing a crisis with extinction rates of aquatic species exceeding those of their terrestrial counterparts by up to fivefold. This decline is predominantly attributed to evolving land use patterns within watersheds, leading to chemical and physical transformations in freshwater habitats. Northwest Arkansas (NWA) represents one of the fastest-growing regions in the United States, undergoing substantial shifts in land use. Consequently, the status of aquatic life in this region remains uncertain. Addressing this concern, the latest Arkansas Wildlife Action Plan emphasizes the necessity of distribution and population data to guide conservation efforts for Species of Greatest Conservation Need …

A Framework Of Flow Models For The Development And Testing Of Cardiovascular Devices, Megan Laughlin

Graduate Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death worldwide and its treatment continues to improve due to the advancement of innovative cardiovascular medical devices. In vitro and in silico models serve to replicate the in vivo environment for the development and testing of these devices prior to using animals for testing, and eventually humans in clinical trials. However, limitations related to these models exist in multiple areas including general, cardiac, and venous applications. Specifically, current gaps have been identified with customizable, tissue-mimicking phantoms (general), 2D Blood Speckle Imaging (BSI) (cardiac) and a bioprosthetic venous valve (venous). This dissertation focuses …

Impact Of Reducing Ammonia Concentration By Ozone Technology And Its Potential Improvement On Broiler Performance, Odilpio Quintana Ortega

Graduate Theses and Dissertations

The employment of ozone in livestock production as a means of mitigating ammonia is used for enhancing air quality within animal confinement facilities, such as swine or poultry barns. Ammonia is a byproduct of animal excrement. Elevated ammonia concentrations can adversely affect the well-being of both animals and humans. The aim of this thesis was to investigate the effects of Ozone Technology Machine Unit (OTMU) utilization in poultry barns regarding ammonia concentration and its potential benefit in terms of broilers performance and welfare. In recent years, there has been a significant boom in technological advances. New devices that help mitigate …

Examining The Effects Of Mental Health Barriers On Black Undergraduate Students Attending Predominantly White Institutions, Patrice N. Storey

Graduate Theses and Dissertations

Black college students are experiencing mental health issues at an alarming rate. There is, however, a reluctance among Black college students to seek assistance. There is a stigma surrounding mental health. An individual with a mental illness is often stereotyped as weak, uncontrollable, or paralyzed by demons. Historical incidents such as slavery, the Tuskegee Experiment, Jim Crow, and the forced sterilization of Black women have led the Black community to distrust the medical system. The stigma embedded in the Black community is passed down from generation to generation. This literature review examines existing research on Black students and their perception …

Assessment Of Needs And Priorities For Precision Agriculture And Soil Testing In Arkansas, Solomon Frimpong

Graduate Theses and Dissertations

Optimum crop production is needed to meet the growing population's food, water, fiber, and energy needs. However, agricultural productivity is hampered by many destabilizing factors such as pest management challenges, declining water quantity, and climate change which threaten long-term food security. Maximizing productivity will require optimizing resources through Precision Agriculture (PA) by supplying inputs based on crop needs. Precision Agriculture offers tools that can be used to optimize crop management practices globally. However, stakeholders’ perceptions and the lack of data-driven site-specific recommendations limit stakeholders’ ability to fully harness the potential benefits of PA. Identification of stakeholder needs and approaches to …

The Use Of Culturally Relevant Pedagogy In Esol Classes, Beth A. O. Haddinger

Graduate Theses and Dissertations

This dissertation is organized into five distinct chapters addressing multiple aspects of learning and engagement as it relates to English Language Learners (ELLs) in the classroom. First, the problem of practice is identified and explored. We, as educators, must look closely at instructional and systemic issues, actionable elements, broader strategies of improvement, and leverage, which refers to the ability of a program to motivate students and to generate a sense of practical value in academics. The next aspect of this dissertation proposal reviews the existing research literature. This literature review focuses on the specific learning needs of ELL students. Specifically …

The Impact Of Eye-Movement Desensitization And Reprocessing On Self-Reported Test Anxiety In College Students, Renee Wilson

Graduate Theses and Dissertations

Test Anxiety (TA) has become a major concern for college students. Experiencing mental concern about test-taking perpetuated by physiological hyperarousal directly affects students’ ability to be successful in college. Eye Movement Desensitization and Reprocessing (EMDR) is a multi-faceted therapeutic approach that aims to process dysfunctional negative cognitions which originate with negative past experiences to an adaptive state. Developed by Francine Shapiro in 1989, the Adaptive Information Processing (AIP) model undergirds the 30-second, therapist-initiated, bi-lateral eye-movements. These movements identify and reprocess emotionally disturbing experiences, linked to an individual’s emotional expression, by deliberatively triggering a connected trauma network. This dissertation examined the …

A Mixed-Methods Exploration Of Emergency Service Use In Autistic Youth And Young Adults, Rebecca S. Bradley

Graduate Theses and Dissertations

Autistic youth are at an increased risk for needing emergency services as compared to neurotypical peers. In fact, approximately 20% of autistic youth will interact with police by the age of 21, and rates of emergency department visits are 30 – 70% higher among autistic individuals than neurotypical peers. While research has begun to explore the nature of emergency service use in this group, researchers have not yet assessed important individual-, family-, and community-level factors that may be associated with these encounters. This study aimed to address this gap in the field by 1) characterizing families of autistic children who …

A Cross-Sectional Study On The Impact Of The Covid-19 Pandemic On Sport-Related Concussion Clinical Presentation Within Adolescents And Adults, Emily Mcindoe

Graduate Theses and Dissertations

Introduction. The COVID-19 pandemic spanned across the globe in March 2020 and has since significantly impacted human life. There is evidence that supports symptom exacerbation and an increase in anxiety and depression in clinical presentation post-COVID-19 pandemic compared to pre-COVID-19 for multiple medical diagnoses. These medical diagnoses include migraines, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and mild cognitive impairment. The effect that the pandemic had on the clinical presentation of sports-related concussions is understudied. It is possible that the COVID-19 pandemic has altered the clinical presentation of concussions as seen in other medical diagnoses. Given the increased reporting of …

Ism-Band Energy Harvesting Wireless Sensor Node, Fnu Naveed

Graduate Theses and Dissertations

In recent years, the interest in remote wireless sensor networks has grown significantly, particularly with the rapid advancements in Internet of Things (IoT) technology. These networks find diverse applications, from inventory tracking to environmental monitoring. In remote areas where grid access is unavailable, wireless sensors are commonly powered by batteries, which imposes a constraint on their lifespan. However, with the emergence of wireless energy harvesting technologies, there is a transformative potential in addressing the power challenges faced by these sensors. By harnessing energy from the surrounding environment, such as solar, thermal, vibrational, or RF sources, these sensors can potentially operate …

Examining The Hormonal Underpinnings Of Affiliation Motivation In Oral Contraceptive Users, Hormonal Iud Users, And Naturally Cycling Women, Mikayla Tolliver

Graduate Theses and Dissertations

Affiliation is important for women during times of stress. Although, affiliation has been linked to women’s hormones across the menstrual cycle, many women use hormonal contraceptives which disrupt the links between hormones, psychology, and behavior. This study examined how hormonal contraceptives (hormonal IUD vs. the oral contraceptive pill) and menstrual cycle phase (follicular vs. luteal) are associated with affiliative motivations following the Trier Social Stress Test (TSST). Further, this study examined women’s cortisol reactivity and whether cortisol reactivity mediated affiliative motivation following the stressor. I found that oral contraceptive pill users projected more stress and rejection onto others’ faces and …

3d Printed Microdialysis-Based Microsampling Probes, Patrick Pysz

Graduate Theses and Dissertations

This work will show the development of a fully 3D printed device platform in which a complex microsampling probe geometry is fabricated in a simple two-step process. This process includes the combination of 2-photon polymerization (2PP) and masked-stereolithography (MSLA). The cutting edge neurotechnology needed to monitor brain internal communication and will require multiple sensing modalities including temperature, pressure, electrophysiological, and optogenetics. Microsampling is an integrally important function for any future biosensing device platform as it allows for chemical delivery and unparalleled specificity through offline analysis of collection samples. Stereolithography (SLA) 3D printing has emerged as a powerful fabrication method capable …

Modeling The Peak Ground Acceleration And Assessing The Economic Loss And Casualty Due To Potential Earthquakes Of Various Magnitudes In The New Madrid Seismic Zone, Mahmud Afroz

Graduate Theses and Dissertations

The New Madrid Seismic Zone (NMSZ) is one of the active tectonic zones capable of producing big earthquakes in the southcentral USA. The objective of this study was to assess the economic losses and casualties that might be caused by various magnitudes of seismic events in the NMSZ. The manifestation is the estimation for each magnitude which is using the Peak Ground Acceleration (PGA) that might occur during an earthquake. It is calculated using an attenuation function that correlates the intensity of local ground movement, the earthquake magnitude, and the distance from its epicenter. The assessment of casualties was conducted …

Exploring The Interrelationships Among Structural Complexity, Multi-Trophic Biodiversity, And Ecosystem Productivity In Forested Ecosystems., Ayanna St. Rose

Graduate Theses and Dissertations

Forests play a pivotal role in sustaining global biodiversity and mitigating the global climate, as they serve as the primary refuge for terrestrial biodiversity and effectively capture and store atmospheric carbon dioxide. However, changing climate and land use are altering the geographic distribution, physical structure, and productivity of forested ecosystems that can have profound impacts on biodiversity conservation, forest productivity, and global climate. This dissertation contributes to our understanding of multifaceted interactions between the physical and biological structural complexity and ecosystem functions in forested landscapes across the United states by using openly available data from two national networks: the National …

Evaluation Of Oxyfluorfen For Use In Roxy Rice, Casey Hunter Arnold

Graduate Theses and Dissertations

Mid-southern U.S. rice (Oryza sativa L.) producers are challenged every year to control problematic barnyardgrass [Echinochloa crus-galli (L.) Beauv.] and weedy rice (Oryza sativa L.) because they have evolved resistance to most labeled herbicides. Oxyfluorfen is a Herbicide Resistance Action Committee (HRAC)/Weed Science Society of America (WSSA) Group 14 herbicide that inhibits protoporphyrinogen oxidase within the plant. Currently, there are no HRAC/WSSA Group 14 herbicides labeled for barnyardgrass or weedy rice control in midsouthern rice production. Therefore, oxyfluorfen is being evaluated for barnyardgrass and weedy rice control. Plant breeders at the University of California – Davis were able to breed …

How Does Rolling Conformity Affect State Tax Revenue?, Tyler Johnson

Graduate Theses and Dissertations

Recent federal tax legislation has dramatically altered the landscape of state taxation. A product of this change is the increased interest in rolling conformity among corporate income taxing states. Under rolling conformity, states adopt federal tax provisions on a continual basis without the need for legislative approval. Despite its benefits, academic literature theorizes that rolling conformity is associated with several attributes that may negatively impact state budgets. I assess the merits of these concerns by examining the effect of rolling conformity on state corporate tax revenue. My results suggest that corporate tax revenue in rolling conformity states is more sensitive …

The Intersection Of Employee Engagement And Employee Health: A Quantitative Evaluation Of The Use Of Engagement Tactics In Improving The Health Of A Workforce, Andrew Buffenbarger

Graduate Theses and Dissertations

Employers have a vested interest in the health of employees, but employee wellness programs have not proven themselves an effective tactic for employers to motivate employees to live healthier lives. Employees who suffer from chronic disease are less productive than healthier peers, are more expensive to insure, have higher rates of absenteeism, and are more prone to suffer from performance-reducing levels of stress and burnout (Shuck et al., 2021; Jones et al., 2019; Mattke et al., 2013). The problem is that employee wellness programs are often not effective at improving the health of employee populations (Song & Baicker, 2019; Jones …

Social Media And Mental Health: The Public Health Impact And Future Policy Directives, Renae A. Merrill

Graduate Theses and Dissertations

The relationship between social media use among young people and the increasing concerns of mental health problems in the U.S. and globally is on systemic agendas. Furthermore, research on social media use and mental health indicate reasons to suspect a causal relationship, but more work needs to be done. Therefore, this three-article dissertation seeks to explore (1) associations between social media use, personality, and depression; (2) associations between social media emotional support, anxiety, and personality; and (3) the relationship between social media use and mental health using Deborah Stone’s causal stories framework. Findings from this study provide an improved understanding …

A Generic Qualitative Inquiry Of The Challenges For Black African American Men Who Have Experienced Trauma, Randall Lee Maurice Shakir

Graduate Theses and Dissertations

Black African American Men (BAAM) suffer disproportionately from trauma related challenges and have a higher risk of encountering trauma across the lifespan. The negative impact of trauma is a major public health concern in the United States, evidence suggests trauma negatively impacts the physical well-being, mental health, and mortality rate. BAAM have increased rates of trauma exposure and their traumatic experience is historically complex involving a variety of contemporary issues (i.e. Adverse Childhood Experiences (ACEs), depression, victimization and desensitization, stress). This research aims to explore the complex nature of their trauma-related challenges among a purposeful sample of BAAM participants in …