Digital Commons Network^™

Self-Assembling Peptides As Immunomodulatory Biomaterials, Andrea Hernandez, Jeffrey D Hartgerink, Simon Young

Faculty, Staff and Student Publications

Self-assembling peptides are a type of biomaterial rapidly emerging in the fields of biomedicine and material sciences due to their promise in biocompatibility and effectiveness at controlled release. These self-assembling peptides can form diverse nanostructures in response to molecular interactions, making them versatile materials. Once assembled, the peptides can mimic biological functions and provide a combinatorial delivery of therapeutics such as cytokines and drugs. These self-assembling peptides are showing success in biomedical settings yet face unique challenges that must be addressed to be widely applied in the clinic. Herein, we describe self-assembling peptides' characteristics and current applications in immunomodulatory therapeutics.

Safety Of Concurrent Radiation Therapy With Brentuximab Vedotin In The Treatment Of Lymphoma, Susan Y Wu, Penny Q Fang, Ethan B Wang, Sairah Ahmed, Madeleine Duvic, Preetesh Jain, Luis E Malpica Castillo, Ranjit Nair, Raphael E Steiner, Paolo Strati, Auris O Huen, Swaminathan P Iyer, Chelsea C Pinnix, Bouthaina S Dabaja, Jillian R Gunther

Faculty, Staff and Student Publications

PURPOSE: Purpose: Radiation therapy (RT) and the antibody-drug conjugate brentuximab vedotin (BV) are standard-of-care treatment options for patients with certain B and T-cell lymphomas; however, there are limited data exploring the safety of concurrent BV and RT (BVRT).

METHODS AND MATERIALS: We performed a single institutional retrospective review of 44 patients who received BVRT.

RESULTS: Twenty percent of patients (9/44) developed new grade 2 or higher (G2+) hematologic toxicity (HT) after BVRT, which was associated with radiation dose (median dose of 35 Gy in those with new G2+ HT compared with 15 Gy in those without;

CONCLUSIONS: Our analysis demonstrates …

Il-8 Produced Via Bidirectional Communication Between Prostate Cancer And M2 Macrophages As A Potential Diagnostic And Prognostic Biomarker, Huihui Fan, Zheng Tang, Yaling Tian, Qingsong Lv, Fangyin Zeng

Faculty, Staff and Student Publications

PURPOSE: Owing to the mortality associated with metastatic prostate cancer and the shortcomings of the current parameters in predicting the disease prognosis, we require the identification of viable biomarkers, which would help in the diagnosis and prognosis of the disease. We aimed to determine whether the interleukin-8 level in the tumor microenvironment could serve as a potential clinical diagnostic marker and prognostic factor for prostate cancer.

METHODS: The migration assay of prostate cancer cells was performed in an in vitro co-culture model. Cell lines PC3 and DU145 were divided into two groups and co-cultured with M0 and M2 macrophages, respectively. …

Ifabp Levels Predict Visceral Malperfusion In The First Hours After Open Thoracoabdominal Aortic Repair, Panagiotis Doukas, Cathryn Bassett, Hanif Krabbe, Jelle Frankort, Michael J Jacobs, Moustafa Elfeky, Alexander Gombert

Faculty, Staff and Student Publications

INTRODUCTION: Intestinal ischemia after open thoracoabdominal aortic repairs, is a rare but devastating complication, associated with high mortality. Notoriously challenging to diagnose, visceral malperfusion necessitates immediate surgical attention. Intestinal fatty acid-binding protein (IFABP) has been proposed as a biomarker for the diagnosis of intestinal wall damage. In this prospectively conducted, observational study we evaluated the diagnostic capacity of IFABP levels in patients' serum and their correlation with visceral malperfusion.

METHODS: 23 patients undergoing open thoracoabdominal aortic repairs were included in this study and 8 of them were diagnosed postoperatively with visceral malperfusion-defined as a partial or complete thrombotic occlusion of …

Deep Learning-Based Dose Prediction For Automated, Individualized Quality Assurance Of Head And Neck Radiation Therapy Plans, Mary P Gronberg, Beth M Beadle, Adam S Garden, Heath Skinner, Skylar Gay, Tucker Netherton, Wenhua Cao, Carlos E Cardenas, Christine Chung, David T Fuentes, Clifton D Fuller, Rebecca M Howell, Anuja Jhingran, Tze Yee Lim, Barbara Marquez, Raymond Mumme, Adenike M Olanrewaju, Christine B Peterson, Ivan Vazquez, Thomas J Whitaker, Zachary Wooten, Ming Yang, Laurence E Court

Faculty, Staff and Student Publications

PURPOSE: This study aimed to use deep learning-based dose prediction to assess head and neck (HN) plan quality and identify suboptimal plans.

METHODS AND MATERIALS: A total of 245 volumetric modulated arc therapy HN plans were created using RapidPlan knowledge-based planning (KBP). A subset of 112 high-quality plans was selected under the supervision of an HN radiation oncologist. We trained a 3D Dense Dilated U-Net architecture to predict 3-dimensional dose distributions using 3-fold cross-validation on 90 plans. Model inputs included computed tomography images, target prescriptions, and contours for targets and organs at risk (OARs). The model's performance was assessed on …

Examining The Role Of Autonomy Support, Goal Setting, And Care Coordination Quality On Hiv Prep Adherence In Black Men Who Have Sex With Men: Hptn 073, Donte T Boyd, Laron E Nelson, Mandy J Hill, Darren Whitfield, S Raquel Ramos, Samuel Akyirem, Lynda Emel, Leo Wilton, Lisa Hightow-Weidman, Steve Shoptaw, Manya Magnus, Kenneth H Mayer, Estelle Piwowar-Manning, Stephaun E Wallace, Sheldon D Fields, Darrell P Wheeler

Faculty, Staff and Student Publications

Autonomy support is a concept that is derived from self-determination theory. Autonomy refers to the freedom to act as one chooses. The current study aimed to examine if autonomy support was associated with dried blood spot validated pre-exposure prophylaxis (PrEP) adherence, and whether the association was mediated by PrEP adherence goal setting and progress toward PrEP adherence goals. Our sample was drawn from Black men who have sex with men (MSM) from across three cities (Chapel Hill, NC; Los Angeles, CA; and Washington, DC) in the United States between February 2013 and September 2014. We used logistic regression to evaluate …

Analysis Of Immune Intratumor Heterogeneity Highlights Immunoregulatory And Coinhibitory Lymphocytes As Hallmarks Of Recurrence In Stage I Non-Small Cell Lung Cancer, Alejandro Francisco-Cruz, Pedro Rocha, Alexandre Reuben, Santhoshi N Krishnan, Priyam Das, Runzhe Chen, Kelly Quek, Jun Li, Edwin R Parra, Luisa M Solis, Souptik Barua, Mei Jiang, Rossana Lazcano, Chi-Wan Chow, Carmen Behrens, Curtis Gumb, Latasha Little, Junya Fukuoka, Neda Kalhor, Annikka Weissferdt, Humam Kadara, John V Heymach, Stephen Swisher, Boris Sepesi, Arvind Rao, Cesar Moran, Jianhua Zhang, J Jack Lee, Junya Fujimoto, P Andrew Futreal, Ignacio I Wistuba, Christine B Peterson, Jianjun Zhang

Faculty, Staff and Student Publications

Our understanding of the molecular mechanisms underlying postsurgical recurrence of non-small cell lung cancer (NSCLC) is rudimentary. Molecular and T cell repertoire intratumor heterogeneity (ITH) have been reported to be associated with postsurgical relapse; however, how ITH at the cellular level impacts survival is largely unknown. Here we report the analysis of 2880 multispectral images representing 14.2% to 27% of tumor areas from 33 patients with stage I NSCLC, including 17 cases (relapsed within 3 years after surgery) and 16 controls (without recurrence ≥5 years after surgery) using multiplex immunofluorescence. Spatial analysis was conducted to quantify the minimum distance between …

Accommodating Time-Varying Heterogeneity In Risk Estimation Under The Cox Model: A Transfer Learning Approach, Ziyi Li, Yu Shen, Jing Ning

Faculty, Staff and Student Publications

Transfer learning has attracted increasing attention in recent years for adaptively borrowing information across different data cohorts in various settings. Cancer registries have been widely used in clinical research because of their easy accessibility and large sample size. Our method is motivated by the question of how to utilize cancer registry data as a complement to improve the estimation precision of individual risks of death for inflammatory breast cancer (IBC) patients at The University of Texas MD Anderson Cancer Center. When transferring information for risk estimation based on the cancer registries (i.e., source cohort) to a single cancer center (i.e., …

Computed Tomography: State-Of-The-Art Advancements In Musculoskeletal Imaging, Hamza Ahmed Ibad, Cesar De Cesar Netto, Delaram Shakoor, Alejandro Sisniega, Stephen Z Liu, Jeffrey H Siewerdsen, John A Carrino, Wojciech Zbijewski, Shadpour Demehri

Faculty, Staff and Student Publications

Although musculoskeletal magnetic resonance imaging (MRI) plays a dominant role in characterizing abnormalities, novel computed tomography (CT) techniques have found an emerging niche in several scenarios such as trauma, gout, and the characterization of pathologic biomechanical states during motion and weight-bearing. Recent developments and advancements in the field of musculoskeletal CT include 4-dimensional, cone-beam (CB), and dual-energy (DE) CT. Four-dimensional CT has the potential to quantify biomechanical derangements of peripheral joints in different joint positions to diagnose and characterize patellofemoral instability, scapholunate ligamentous injuries, and syndesmotic injuries. Cone-beam CT provides an opportunity to image peripheral joints during weight-bearing, augmenting the …

Exaptation And Evolutionary Adaptation In Nociceptor Mechanisms Driving Persistent Pain, Edgar T Walters

Faculty, Staff and Student Publications

Background: Several evolutionary explanations have been proposed for why chronic pain is a major clinical problem. One is that some mechanisms important for driving chronic pain, while maladaptive for modern humans, were adaptive because they enhanced survival. Evidence is reviewed for persistent nociceptor hyperactivity (PNH), known to promote chronic pain in rodents and humans, being an evolutionarily adaptive response to significant bodily injury, and primitive molecular mechanisms related to cellular injury and stress being exapted (co-opted or repurposed) to drive PNH and consequent pain.

Summary: PNH in a snail (Aplysia californica), squid (Doryteuthis pealeii), fruit fly (Drosophila melanogaster), mice, rats, …

Oral Small Molecule Agents In Management Of Ulcerative Colitis: Fact Or Fancy?, Benan Kasapoğlu, Atilla Ertan

Faculty, Staff and Student Publications

Ulcerative colitis is a chronic, immune-mediated disease characterized by recurring episodes of mucosal inflammation in the colon and rectum. The primary pathogenic mechanism of ulcerative colitis is the dysregulation of the mucosal immune response. The disease follows a relapsing-remitting course, and the goal of management is to successfully induce and then maintain remission. Effectively managing this chronic disease requires addressing all aspects of it. Currently, we have various antitumor necrosis factor agents and novel biologics available for treating ulcerative colitis patients with moderate-to-severe disease. However, none of the existing treatments are considered entirely satisfactory or ideal in these cases. After …

The Involvement Of Kynurenine Pathway In Neurodegenerative Diseases, Lais B Martins, Ana L M Silveira, Antonio L Teixeira

Faculty, Staff and Student Publications

BACKGROUND: A growing body of evidence has shown the involvement of the kynurenine pathway (KP), the primary route of tryptophan (TRP) catabolism, in the pathophysiology of neuropsychiatric disorders.

OBJECTIVE: The study aims to provide a comprehensive and critical overview of the clinical evidence on the KP involvement in the pathophysiology of Alzheimer's disease (AD) and Parkinson's disease (PD), discussing therapeutic opportunities.

METHODS: We searched for studies investigating KP metabolites in human subjects with AD and/or PD.

RESULTS: Postmortem studies showed altered levels of KP metabolites in the brain of AD and PD patients compared with controls. Cross-sectional studies have reported …

Effect Of Concurrent Mitral Valve Surgery For Secondary Mitral Regurgitation Upon Mortality After Aortic Valve Replacement Or Coronary Artery Bypass Surgery, Shyamal R Asher, Chin Siang Ong, Raymond J Malapero, Mahyar Heydarpour, Gregory W Malzberg, Jasmine T Shahram, Thy B Nguyen, Douglas C Shook, Stanton K Shernan, Prem Shekar, Tsuyoshi Kaneko, Rodolfo Citro, Jochen D Muehlschlegel, Simon C Body

Faculty, Staff and Student Publications

OBJECTIVES: It is uncertain whether concurrent mitral valve repair or replacement for moderate or greater secondary mitral regurgitation at the time of coronary artery bypass graft or aortic valve replacement surgery improves long-term survival.

METHODS: Patients undergoing coronary artery bypass graft and/or aortic valve replacement surgery with moderate or greater secondary mitral regurgitation were reviewed. The effect of concurrent mitral valve repair or replacement upon long-term mortality was assessed while accounting for patient and operative characteristics and mitral regurgitation severity.

RESULTS: Of 1,515 patients, 938 underwent coronary artery bypass graft or aortic valve replacement surgery alone and 577 underwent concurrent …

G-Quadruplexes And Associated Proteins In Aging And Alzheimer’S Disease, M J Vijay Kumar, Rodrigo Morales, Andrey S Tsvetkov

Faculty, Staff and Student Publications

Aging is a prominent risk factor for many neurodegenerative disorders, such as Alzheimer's disease (AD). Alzheimer's disease is characterized by progressive cognitive decline, memory loss, and neuropsychiatric and behavioral symptoms, accounting for most of the reported dementia cases. This disease is now becoming a major challenge and burden on modern society, especially with the aging population. Over the last few decades, a significant understanding of the pathophysiology of AD has been gained by studying amyloid deposition, hyperphosphorylated tau, synaptic dysfunction, oxidative stress, calcium dysregulation, and neuroinflammation. This review focuses on the role of non-canonical secondary structures of DNA/RNA G-quadruplexes (G4s, …

Role Of Microrna-34a In Blood-Brain Barrier Permeability And Mitochondrial Function In Ischemic Stroke, Cole T Payne, Sidra Tabassum, Silin Wu, Heng Hu, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren

Faculty, Staff and Student Publications

Over the past decade, there has been an uptick in the number of studies conducting research on the role of microRNA (miRNA) molecules in stroke. Among these molecules, miR-34a has emerged as a significant player, as its levels have been observed to exhibit a substantial rise following ischemic events. Elevated levels of miR-34a have been found to have multiple effects, including the modulation of inflammatory molecules involved in the post-stroke recovery process, as well as negative effects on the blood-brain barrier (BBB) permeability. Interestingly, the increase of miR-34a appears to increase BBB permeability post stroke, through the negative effect on …

Antimicrobial Activity Of Plasma Rich In Platelets (Prp) On The Ocular Microbiota Of Healthy Horses From Minas Gerais, Luis E C Torres, Camilo O Florez, Jéssica G Oliveira, Giovanna D Vieira, Ilza S Ribeiro, Kelly M Keller, Fabíola O P Leme, Priscila Fantini, Renata P A Maranhão

Faculty, Staff and Student Publications

In equine ophthalmology, ulcerative keratitis is among the most common conditions and, in general, arises as a consequence of some trauma suffered. Secondarily, subsequent contamination by pathogenic or resident bacteria of the horse's ocular microbiota may have undesirable consequences. Under physiological conditions, the normal microbiota coexists with the immune status of the host, serving as a barrier, ensuring the health of the ocular surface, and inhibiting the proliferation of pathogens. However, in the imbalance of immune barriers, the normal microbiota can become pathogenic and lead to infection, acting as an opportunistic agent. The present study aims to demonstrate the antimicrobial …

Hepatocellular Carcinoma With Hepatic Vein And Inferior Vena Cava Invasion, Akash Shukla, Abhinav Jain

Faculty, Staff and Student Publications

Hepatocellular carcinoma (HCC) invades intrahepatic vessels causing tumor thrombosis. Infrequently, there is involvement of the hepatic vein (HV) and inferior vena cava (IVC). In this review, we summarize the epidemiology, classification, clinical features, and management of HCC with HV and IVC invasion. While the involvement of HV and IVC usually portends an overall poor survival, selected patients may be candidates for aggressive treatment and thus improving outcomes.

The Association Of Student Achievement And The Frequency Of Curriculum Supervision And Evaluation Practices Of Principals Across Comparable School Clusters, James S. Reynolds Iv

Theses and Dissertations

This study examined the frequency of principals’ curriculum supervision and evaluation practices across comparable school clusters. It was hypothesized that principals of the schools at the top of each cluster, sorted by student achievement, are more frequently involved in practices pertaining to the evaluation and supervision of written, taught, and tested curricula. Schools were grouped based on their enrollment and demographics using a cluster analysis approach, sorted from greatest to least by their composite student achievement score, then classified as a top or bottom-performing school within their cluster. This study identified differences in the frequency of the principal's curriculum leadership …

Correlation Between Intraoral Markers And The Risk Of Obstructive Sleep Apnea In Children, Linda K. Powers

Theses and Dissertations

Specific aims: The purpose of this study was to explore the association between various intraoral markers and the risk of Obstructive Sleep Apnea (OSA) in children. Specifically, nine intraoral clinical characteristics were analyzed: ankyloglossia, palatal vault height, presence and level of dental wear, tonsillar grade, Friedman's classification, skeletal and dental classification, and posterior crossbite. The correlation between these features and the Pediatric Sleep Questionnaire (PSQ) and Pediatric Symptoms Checklist (PSC) scores were assessed.

Methods: Orthodontic patients aged 8-17 were recruited at the VCU Graduate Clinic. Intraoral measurements were collected from patients (n=100) by treating doctors. At this time, the PSQ …

Isoprenylation Inhibition Significantly Reduces Ige Mediated Mast Cell Function And Allergic Disease, Jordan Dailey

Theses and Dissertations

Allergic disease is the 6^th leading cause of chronic illness in the US and accounts for billions of dollars in healthcare annually. Mast cells are tissue resident innate immune cells linked to allergic disease and activated by IgE and other ligands. Upon activation, they release histamine, cytokines, chemokines, proteases, and lipid mediators evoking allergic symptoms. New ways of targeting mast cells could greatly benefit allergic disease therapy. Previous findings supported repurposing statin drugs, such as Fluvastatin, as a therapeutic treatment of allergic disease reduced allergic symptoms in vitro and in vivo. We found that Fluvastatin suppressed IgE-mediated mast cell …

Assessing Drug Development Proporties Of Antithrombotic And Anti - Cancer Agents, Elsamani I. Abdelfadiel

Theses and Dissertations

The current GAG anticoagulants such as heparin, heparin derivatives, and vitamin K antagonists, such as warfarin continue to be the backbone of anticoagulant therapy. These drugs act through an indirect mechanism to convey inhibition of several coagulation enzymes. However, xv their use leads to several serious adverse effects, such as excessive bleeding risk and unpredictability of patient response. Regardless of their clinical achievement, every individual agent is accompanied by several side effects, particularly major/minor bleeding, thrombocytopenia, drug-food or drug-drug interactions, or absence of antidote. Of all these side effects, bleeding, and a lack of an effective antidote to reverse excessive …

Molecular Mechanisms Of Prdm16 As A Tumor Suppressor In Pancreatic Ductal Adenocarcinoma, Eric Hurwitz

Theses and Dissertations

The transcription factor Prdm16 functions as a potent suppressor of transforming growth factor-beta (TGF-b) signaling, whose inactivation is deemed essential to the progression of pancreatic ductal adenocarcinoma (PDAC). Using the Kras^G12D-based mouse model of human PDAC, we surprisingly found that ablating Prdm16 did not block but instead accelerated PDAC formation and progression, suggesting that Prdm16 might function as a tumor suppressor in this malignancy. Subsequent genetic experiments showed that ablating Prdm16 along with Smad4 resulted in a shift from a well-differentiated and confined neoplasm to a highly aggressive and metastatic disease, which was associated with a striking deviation …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

Cooperative Driving Automation For Self-Interested Agents, Adam Morrissett

Theses and Dissertations

Driving is inherently interactive, and drivers must coordinate with other vehicles, cyclists, and pedestrians to avoid collisions. Furthermore, drivers typically prefer some interaction outcomes over others. People in a rush typically cut others off and drive aggressively, while those on a leisurely outing tend to move slowly and behave more altruistically. Even as passengers in autonomous vehicles, people may exhibit these preferences. Unfortunately, autonomous vehicles do not share these preferences, instead sharing only minimal information or operating in isolation. Existing coordination and management methods do not consider these preferences when making decisions. They focus specifically on minimizing the trip duration …

A Standardized Pipeline For Isolation And Assembly Of Genomes From Symbiotic Bacteria In Whole Louse Genomic Sequence Data., Mohammad Mikail I. Bala

Theses and Dissertations

Many insects are known to harbour intracellular and heritable bacteria (endosymbionts), which provide their hosts with adaptive traits. Whole insect gDNA shotgun sequencing projects often sequence the genome of endosymbiont, in addition to the insect’s genome. There are approximately 600 whole genome shotgun libraries from insects available on the public repository (NCBI), which can be mined to obtain endosymbiont genomes. The assembly and annotation of endosymbiont genomes can contribute towards the exploration of their role as obligate symbiotic partners. However, de novo assembly of an endosymbiont genome, continues to be challenging, when the host and/or enteric bacterial gDNA is present …

Religiously Responsive Pedagogy In Christian Schools: A Qualitative Exploration Of Faculty Perceptions Of Faith Integration, Andrea R. Woodard

Theses and Dissertations

This qualitative study introduced a theoretical framework of Religiously Responsive Pedagogy (RRP) and explored the ways in which RRP is enacted in Christian schools, along with the barriers and supports that may exist for effective RRP within those schools. The study investigated PK-12 faculty perceptions of faith integration, responsiveness to students, and school support in order to develop this new framework. Twelve teachers participated in a semi-structured interview via Zoom, which included four scenarios to probe teacher perspectives on RRP. The data was coded recursively using Boeije’s (2002) constant-comparative method.

The primary research questions addressed were:

• How do teachers at …

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Morphometric Analysis Of Premolars And Its Relevance To Root Canal Anatomy, James Degracie

Theses and Dissertations

Introduction: Premolars are especially challenging to treat endodontically due to their small size and often-intricate anatomy. While the majority of premolars present with one or two root canals, the presence of three root canals has been reported. The aim of this study was to investigate the correlation between the root-to-crown width ratio (RCWR) and number of root canals in maxillary and mandibular premolars.

Methods: Data was retrieved from the electronic health records of patients treated at Virginia Commonwealth University School of Dentistry. A total of 100 premolars which had both periapical radiograph (PA) and cone beam computed tomography scans (CBCT) …

Vesptures, Nyasha T. Chigama Ms

Theses and Dissertations

Abstract

This is an invitation into the delicate space of living between two worlds, of having feelings of happiness and sadness at the same time. Delicate emotions and situations which are not easy to share but are paramount in my research of what it takes to want more out of being just a parent, come from a certain country than the one I am living in, and navigate between two cultures. This is a journey around some of the experiences I have faced when I found myself in a different space other than the one I grew up in. The …

Factors Associated With College Students' Intention To Use Telehealth For Primary Care, Conor Duffy

Theses and Dissertations

College students are less likely than the general population to have a regular primary care provider and engage in routine health visits. Recent research provides evidence that telehealth is a convenient alternative to in-person primary care and that college students are comfortable using this technology, suggesting that telehealth has the potential to mitigate this disparity. However, little research has examined which factors are associated with college students’ intention to use telehealth and attitudes toward telehealth specifically in the primary care context. The overarching goal of this study was to address this gap in the literature and identify factors associated with …

Psychiatric Diagnostic Decision-Making: Investigating The Theory Of The Dual-Process Model, Christopher S. Kleva

Theses and Dissertations

Diagnostic decision-making is an important component of clinical practice; however, there is substantial diagnostic unreliability within mental health diagnoses. The lack of reliability emphasizes the importance of investigating diagnostic decision-making; however, the research to date is limited, primarily relying on a vague definition of decision-making based on the dual-process model. The present study is an exploratory attempt to apply the dual-process model to explain how mental health clinicians (n = 30, 73.3% cisgender female, 96.7% psychologists) arrive at making diagnostic decisions through the use of an interactive interview mechanism. For each participant, we are able to create a figure …