Digital Commons Network^™

Early Identification For Spasticity Patient Referral Needs: An Inter-Rater Reliability Study Of The Post-Stroke Spasticity Referral Tool, Jorg Wissel, Atul Patel, Ganesh Bavikatte, Xiao Li, Sophie L Musson, Elizabeth Torres, Nabilah Alibhai, Tiziana Musacchio, Gerard E Francisco

Faculty, Staff and Student Publications

Background: The post-stroke spasticity (PSS) Referral Tool was developed to assist health care professionals in the early identification of patient referral needs. An inter-rater reliability (IRR) study using videos of patients with different stages of or without predictors of PSS was performed to validate its utility in clinical practice.

Research design and methods: This prospective study had 3 parts: patient video production (Part A); expert panel classification of patient videos into PSS Referral Tool categories (Part B; Urgent Referral [UR; red], Routine Referral [RR; yellow], Periodic Monitoring [PM; green]), and an IRR analysis from global clinician raters (Part C). IRR …

Real-World Disease Burden And Health Care Resource Utilization For Patients With Barth Syndrome, Lindsay Marjoram, Yonglin Huang, Mary Kay Koenig, Bruce H Cohen, Eric Anderson

Faculty, Staff and Student Publications

Background: Barth syndrome (BTHS) is an ultra-rare, X-linked genetic disorder for which there is limited economic data. Because compiling such data that target rare indications is difficult, we assessed real-world data to increase understanding of the cost of BTHS based on disease burden and health care resource utilization (HCRU).

Methods: A search of the published medical literature identified individual case studies and registry data used to assess the burden of disease and potential costs associated with BTHS, including the potential ability of developing treatments to positively impact those costs. In addition, a claims database analysis was conducted to assess HCRU …

Trends In Preservation Rhinoplasty Publications: A Bibliometric Analysis Of Presented Data Originality, Rakan Saadoun, W Katherine Kao, Tang Ho

Faculty, Staff and Student Publications

Background: Recent literature on dorsal preservation rhinoplasty (DPR) has seen a resurgence. This study performs a bibliometric analysis of publications and co-authorships within this research area, considering factors such as gender, country of origin, international collaboration, and the originality of the presented data.

Methods: The PubMed-indexed literature on DPR from 2018 to 2024 was extracted and reviewed, limited to English publications. Descriptive statistics were performed regarding the contributors by gender, country, publishing journal, authorship rank, and department of affiliation. Association tests were used to determine the association between the originality of the data presented and the affiliation's country and department. …

Whipple Disease Initial Presentation As Supraclavicular Lymphadenopathy In A Patient With Rheumatoid Arthritis: A Diagnostic Challenge, Sara E Amin, Swati Gite, Audrey Wanger, Violeta Chavez, Jacob Armstrong, Beenu Thakral, Patricia Navarro, Jennifer Makhoul, Amer Wahed, Navneet Narula, Karan Saluja

Faculty, Staff and Student Publications

Whipple disease is a rare systemic disease caused by Tropheryma whipplei. It can present with a wide range of nonspecific symptoms that might overlap with underlying medical conditions, posing a diagnostic challenge. We present a 61-year-old man with a past medical history of rheumatoid arthritis and chronic inflammatory demyelinating polyneuropathy, who presented with persistent leukocytosis and supraclavicular lymphadenopathy. A positron emission tomography scan revealed hypermetabolic activity in the supraclavicular, abdominal, and pelvic lymph nodes along with a myocardial hypermetabolic lesion, concerning a lymphoproliferative disorder versus sarcoidosis. A supraclavicular lymph node excisional biopsy revealed complete architectural effacement by a diffuse foamy …

Nocturnal Oxygen Therapy For Central Sleep Apnea In Patients With Heart Failure: A Multisite, Double-Blind, Sham-Controlled Randomized Clinical Trial (Loft-Hf), Susan Redline, Dongdong Li, Shahrokh Javaheri, Sanjay R Patel, Sairam Parthasarathy, James C Fang, Lee K Brown, Mark Dunlap, M Safwan Badr, Neomi Shah, Luqi Chi, Ruckshanda Majid, Mihaela Teodorescu, Garrick Stewart, Eileen Hsich, Tamar Polonsky, Justin Vader, Maryl R Johnson, Dennis Auckley, Henry Klar Yaggi, Andrew Kao, Ali Azarbarzin, Raichel Alex, Michael Rueschman, Lisa Wolfe, Daniel J Gottlieb, Scott A Sands, Phyllis C Zee, Reena Mehra, Babak Mokhlesi, Rami Khayat, Eldrin F Lewis, William T Abraham, Rui Wang

Faculty, Staff and Student Publications

Rationale: There are insufficient data to inform the management of central sleep apnea (CSA) in patients with heart failure with reduced ejection fraction (HFrEF). Nocturnal oxygen therapy (NOT) has been postulated to benefit CSA patients with HFrEF but has not been rigorously studied. Objectives: To compare NOT with sham NOT (control) in heart failure (HF) patients receiving guideline-based HF therapy on the composite outcome of first occurrence of either mortality due to any cause, a lifesaving cardiovascular intervention, or an unplanned hospitalization for worsening HF, together with other secondary outcomes.

Methods: A multisite, double-blind, sham-controlled randomized clinical trial was conducted …

Combining Pirfenidone With Mycophenolate Mofetil For Systemic Sclerosis-Related Interstitial Lung Disease (Scleroderma Lung Study Iii): An Investigator-Initiated, Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial, Dinesh Khanna, Cathie Spino, Donald P Tashkin, Elana J Bernstein, Jonathan Goldin, Eric C Kleerup, Airi Harui, Grace Ibrahim, Grace Hyun J Kim, Suiyuan Huang, Richard Mclain, Yi-Hsuan Tu, Vivek Nagaraja, Richard M Silver, Virginia D Steen, S Samuel Weigt, Joyce S Lee, Aryeh Fischer, Mary Beth Scholand, Jessica K Gordon, Paul F Dellaripa, Ivan O Rosas, Gary M Hunninghake, Marcin A Trojanowski, Robert W Simms, Jane E Dematte, Vivien M Hsu, Robyn T Domsic, Ganesh Raghu, Maureen D Mayes, Ryan D Boente, Michael D Roth

Faculty, Staff and Student Publications

Objective: Mycophenolate mofetil (MMF) can stabilize or improve lung function in systemic sclerosis-related interstitial lung disease (SSc-ILD). We hypothesized that combining MMF with pirfenidone (PFD) would produce a significantly more rapid and/or greater improvement in lung function.

Methods: A randomized (1:1), double-blind, placebo (PLA)-controlled phase 2 trial was conducted in SSc-ILD in which patients received PFD or PLA (801 mg three times daily) along with MMF (1,500 mg twice daily) for 18 months. The primary outcome was change in percent predicted forced vital capacity (FVC-%). Linear mixed-effects models assessed treatment differences in a modified intention-to-treat population.

Results: Only fifty-one of …

Revisiting Soluble Guanylate Cyclase Pharmacology: Additive Potential Of Stimulators And Activators, Alexandra Petraina, Mahmoud H Elbatreek, Christopher T Neullens, Theodora Saridaki, Vu Thao-Vi Dao, Rebecca D Szepanowski, Emil Martin, Wolfgang Sippl, Ana I Casas, Harald H H W Schmidt

Faculty, Staff and Student Publications

Nitric oxide (NO) is a key gasotransmitter that binds to soluble guanylate cyclase (sGC), thereby stimulating cGMP production. Under disease conditions, reactive oxygen species disrupt this signaling by either: (1) scavenging NO, or (2) promoting heme-free, NO-insensitive apo-sGC due to impaired heme incorporation or oxidative damage. To counteract these conditions, two pharmacological approaches have emerged: sGC stimulators, which allosterically enhance sGC sensitivity to low NO levels; and sGC activators, which directly activate apo-sGC (heme-free sGC) by binding to its empty heme pocket, inducing a conformation that mimics NO-bound sGC. Thus, sGC stimulators are thought to target only sGC. Instead, we …

Alk5 Inhibitor Impact On Bleomycin-Induced Systemic Sclerosis Mouse Model Via Multifunctional Optical Coherence Tomography, Pavel V Nikitin, Harshdeep S Chawla, Jessica Gutierrez, Geethangili Madamanchi, Manmohan Singh, Salavat R Aglyamov, Minghua Wu, Jerry Alonso, Matthew Fronheiser, Juliana Coculo, Shuyan Du, Shervin Assassi, Kirill V Larin

Faculty, Staff and Student Publications

Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis, vascular dysfunction, and immune dysregulation, leading to significant morbidity and mortality. Noninvasive imaging techniques are critical for monitoring disease progression and evaluating therapeutic interventions. This study investigates the technical feasibility of multifunctional optical coherence tomography (OCT)-based methods for longitudinal assessment of skin thickness, stiffness, and microvasculature in a murine SSc model as a translational, noninvasive, and quantitative method to study disease progression and treatment response. Our findings demonstrate significant structural, biomechanical, and vascular changes in the skin's stiffness, indicative of fibrosis, a hallmark of SSc. The application of SB …

Fam13a Polymorphism Is Associated With A Usual Interstitial Pneumonia Pattern In Patients With Systemic Sclerosis-Associated Interstitial Lung Disease, Elana J Bernstein, Francesco Boin, Brett Elicker, Yiming Luo, Yawen Ren, Meng Zhang, John Varga, Shervin Assassi

Faculty, Staff and Student Publications

Objectives: The MUC5B promoter single nucleotide polymorphism (SNP) rs35705950 has been associated with idiopathic pulmonary fibrosis (IPF) and RA-related interstitial lung disease (ILD), but not with SSc-ILD. We hypothesized that the MUC5B promoter polymorphism or other IPF susceptibility loci are associated with an increased risk for the uncommon SSc-usual interstitial pneumonia (UIP) endophenotype, rather than SSc-ILD in general.

Methods: We performed a cross-sectional study of SSc-ILD patients from four US Scleroderma Programs to investigate the frequency of MUC5B rs35705950 and 12 additional IPF susceptibility loci. SSc-ILD patients were stratified by high resolution chest CT (HRCT) imaging findings into UIP and …

Utilizing Functional Neuroimaging To Study Early Language Development, Halie A Olson, Trevor K M Day, Kelly J Hiersche, Brittany L Manning, Holly Bradley, Soujin Choi, Gavkhar Abdurokhmonova, Sarah A Mccormick, Amy L Conrad, Dustin Scheinost, Kelly A Vaughn

Faculty, Staff and Student Publications

Language develops rapidly over the infant and toddler period and has been a key area of research within the field of developmental cognitive neuroscience. Understanding the neural basis of early language development may help us predict delays or disorders, recommend early interventions, and provide a deeper mechanistic understanding of how the brain supports language learning. While the ontogeny of many cognitive functions can be studied in animal models, language development can only be studied in human children. Thus, functional neuroimaging is critical for uncovering the neural basis of language in early development. The purpose of this review is to take …

Social Media Listening Study To Understand The Journey And Unmet Needs Of Patients Living With Post-Stroke Spasticity, Stefano Carda, Jörg Wissel, Damon Hoad, Gerard E Francisco, Monica Verduzco-Gutierrez, Daniela Gallardo, Matteo Vacchelli, Jorge Jacinto

Faculty, Staff and Student Publications

Purpose: Stroke survivors may develop spasticity (post-stroke spasticity [PSS]) that can challenge activity and participation. Recognising the needs and expectations of people with PSS is crucial for enhancing care. This study is the first to employ social media listening to explore the experiences, unmet needs, and quality of life (QoL) of people with PSS.

Materials and methods: A subset of 417 patient-centric PSS-related posts published on major social media platforms was identified for analysis from 31 600 retrieved.

Results: Posts mainly discussed patient journey (centred around treatment options and management techniques), the impact of PSS on QoL, and patient interactions …

Navigating Health Literacy: Comparison Of Assessment Tools In A Surgical Safety-Net Population, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Gabrielle E Hatton, Jackson G Burns, Lillian S Kao, Krislynn M Mueck

Faculty, Staff and Student Publications

Health literacy as measured by three validated assessment tools.

Refractory Hypoxemia In An Asymptomatic 6-Year-Old: It Is Not Always The Heart, Aymen Mirza, Bibek Bista, Vidhya Annavajjhala, Chinyere O'Connor

Faculty, Staff and Student Publications

No abstract provided.

50+Years Of Restaurant Tipping Research Part Ii: An Analysis Of Research Subthemes And Suggestions For Future Research, Nick E. Johnston, Cortney L. Norris, H. G. Parsa

General Human Environmental Sciences Faculty Publications and Presentations

Tipping reflects a complex interplay of cultural norms, economic incentives, and operational challenges, especially within the U.S. foodservice industry. Building on the systematic literature review and themes presented in Part I, this study examines the subthemes identified across 319 peer-reviewed articles published between 1974 and 2024. Findings reveal saturation points, underexplored topics and intersections, as well as debates surrounding regulations and policies of tipping practices and alternative compensation models. This review integrates a fragmented body of research, provides an overview of key findings, highlights critical gaps, and offers a roadmap for future scholarship and practical reforms in service compensation systems.

Accepting Film: A Study On Tradition, Values Change And Continuity In Tebuireng Pesantren, Jombang, Nurman Hakim

Antropologi Indonesia

The pesantren tradition contains values that become a guide for life and become a source for the actions of santri and kiai. The values in the pesantren tradition in the form of akhlak (morals), ibadah (worship) and barokah (blessings) become an anchor for kiai and santri in responding to films that are considered products of modernity emerging from the west. In the past the act of watching and making films was rejected and considered contrary to the pesantren tradition, but slowly now films are used by pesantren to preserve the tradition itself. This article explores how values in the …

Enhancing Management Of Transportation Projects: Integration Factors For Using Smart Contracts, Mariam Elazhary, Islam H. El-Adaway

Civil, Architectural and Environmental Engineering Faculty Research & Creative Works

The US Department of Transportation (USDOT) delivers a wide range of infrastructure projects, backed by a fiscal year 2023 budget exceeding $100 billion. These projects face mounting pressures to meet performance, accountability, and delivery standards, driven by their dependence on public funding and their operational complexity. Transportation infrastructure presents sector-specific challenges - such as time-sensitive user disruptions, multiparty coordination, and asset intersection risks - that demand more robust, automated, and transparent project delivery mechanisms. Blockchain-enabled smart contracts have emerged as a promising solution to address these operational pain points through real-time automation, immutable data records, and decentralized transaction processing. However, …

Paradise Here?, Mary Dengler

Pro Rege

No abstract provided.

Lanthorn, Vol. 60, No. 08, December 1, 2025, Grand Valley State University

Volume 60, August 4, 2025 – April 20, 2026

Lanthorn is Grand Valley State's student newspaper, published from 1968 to the present.

The Role Of Barriers, Perceptions, And Strategic Gaps In Attracting International Students, Maqsood Saadi Mohammad

Journal of Economics and Administrative Sciences

This paper examined the administrative outlooks of the Kurdistan Region of Iraq regarding the issue of recruiting international students, based on the perceived obstacles, institutional approaches, and the desired support of the government. The study is based on institutional theory and strategic management in higher education, which offers a strong theoretical framework for investigating how universities can ensure their internal capabilities are aligned with external policy structures. Quantitative research design was incorporated, and a structured survey was introduced to the presidents, deans, vice presidents, and directors of international relations and admissions of various universities. The collected data were analyzed using …

Reliability And Validity Of A Self-Administrated Online Assessment Of Intrinsic Capacity: A Singapore Cohort Study, Paulin Tay Straughan, William Tov, Lay Khoon Lau, Li Ling Grace Cheong, Chong Sheng Micah Tan, William Tov, Yew Yoong Ding, Wee Shiong Lim

Research Collection School of Social Sciences

Objective: To ascertain the construct validity and reliability of a self-administered web-based assessment of intrinsic capacity (IC). Design: Cross-sectional data analysis of a prospective cohort study. Settings and Participants: We included data from 6,434 respondents (age, mean (SD): 65.33 (5.81) years; 52.4% women) of the Singapore Life Panel population study who participated in the online surveys in March 2022 and May 2022.MethodsIncremental nested factor structures of IC were modelled with confirmatory factor analysis (CFA) and their goodness-of-fit were assessed mainly with root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), and standardized root mean square …

Attachment To Artificial Intelligence: Development Of The Ai Attachment Scale, Construct Validation, And The Psychological Mechanisms Of Human-Ai Attachment, K Tennakoon Appuhamillage Sandeeshwara Kasturiratna, Andree Hartanto

Research Collection School of Social Sciences

Artificial intelligence (AI) systems are increasingly integrated into daily life, not only as tools but also as social partners that people may turn to for interaction and support. This raises important questions about whether, how, and why individuals form attachment-like bonds with AI, and the psychological implications of such attachments. Across five studies involving 1259 unique participants from Singapore and the U.S., the current work developed and validated the 15-item AI Attachment Scale and investigated the dispositional and motivational factors associated with attachment to AI, as well as its emotional and social outcomes. The AI Attachment Scale displayed strong psychometric …

Privately Owned Companies Dominate Renewable Energy Generation Ownership Around The World, Dyaran Bansraj, Theodor Florian Cojoianu, Xi Hu, Khaladdin Rzayev, Francisco Urzua

Research Collection College of Integrative Studies

Global sustainable finance policies are premised on publicly listed companies driving decarbonization through transparency, investor pressure, and capital market access. Analysing c. 20,000 corporate owners of renewable and fossil-fuel assets worldwide, we show the opposite: private firms own approximately 75% of global renewable generation capacity. This private dominance holds across all major technologies and regions, with listed ownership of renewable assets being the majority only in the oil & gas and technology sectors. The Paris Agreement did not alter this balance. Instead, ownership of the energy transition reflects countries' financial structures, with similar patterns observed across manufacturing, construction, and financial …

Extracellular Domain Shedding Of Trop2 Activates Egfr Signaling To Drive Prostate Cancer Metastasis, Shiqin Liu, En-Chi Hsu, Merve Aslan, Fernando Garcia-Marques, Michelle Shen, Alifiani B Hartono, Francisco Solano, Kewei Le, Hyeonji Hwang, Chung S Lee, Abel Bermudez, Rosalie Nolley, Donna M Peehl, James D Brooks, Michael A Liss, Sharon J Pitteri, Tanya Stoyanova

Faculty, Staff and Student Publications

UNLABELLED: Metastasis is the main cause of prostate cancer-associated deaths, highlighting the urgent need to determine the mechanisms underlying prostate cancer progression. TROP2 (also known as tumor-associated calcium signal transducer 2) is an oncogenic transmembrane surface protein that is highly expressed in metastatic prostate cancer. Naturally occurring cleavage of TROP2 leads to a release of the TROP2 extracellular domain (TECD) into the extracellular environment. In this study, we identified an important functional role of TECD in prostate cancer metastasis. TECD was detectable in media from prostate cancer cells and serum from patients with clinically significant prostate cancer. Although shed TECD …

Acculturation, Values, And Acculturative Stress For Autistic Latino Emerging Adults And Spanish-Speaking Parents Participating In The ¡Iniciando! La Adultez Program, Antonio F Pagán, Miriam Ortiz, Erin Bernal, Katherine A Loveland, Ana Esparza, Cecilia Montiel-Nava, Ron Acierno

Faculty, Staff and Student Publications

Latino families with emerging adults diagnosed with Autism Spectrum Disorder (ASD) face unique challenges during the transition to adulthood, influenced by cultural values, acculturation, and systemic barriers. Acculturation and acculturative stress are particularly relevant in this population, as they navigate cultural adaptation while maintaining traditional values like familismo (family) and respeto (respect). These dynamics are further complicated by disparities in access to resources and culturally responsive interventions. This study explores the interplay of cultural values, acculturation, and acculturative stress among Latino emerging adults with ASD and their Spanish-speaking parents participating in a culturally adapted and translated intervention. Using a cross-sectional …

Obstetric And Neonatal Nurses' Experiences Of Caring For Immigrant Women From Culturally Diverse Backgrounds After Perinatal Death, Meredith Dickey

Student Dissertations

The ability of healthcare providers to meet the needs of immigrants from culturally diverse backgrounds has become increasingly essential as the United States faces the global migration crisis. Culturally diverse immigrant women, especially from areas of the world experiencing conflict, typically lack prenatal care and access to healthcare before coming to the United States, contributing to stillbirths and miscarriages among this population. The purpose of this qualitative research study was to explore obstetric and neonatal nurses’ experiences of caring for immigrant mothers from culturally diverse backgrounds after perinatal death. Knowledge gained from this study will contribute to a new understanding …

Love Affair With Thin Air: Mortality, Mastery, And The Consumerism Of Mountaineering, Kenneth Bates, Justine Rapp Farrell, Steven W. Kopp, Christopher Newman

Marketing Faculty Publications and Presentations

Mountaineering is arguably one of the most dangerous recreational challenges an individual may ever choose to undertake, yet millions of people annually venture above 8000 feet to challenge themselves in pursuit of personal goals, ideals, and support of individual values. But, why are consumers motivated to participate in such demanding and hazardous pursuits? This paper evaluates the psychological complexities surrounding adventure tourism as an act of consumerism, uncovering the pursuit of values, ideals, and identity transformation that is guided by one's own mortality salience. The present study seeks to examine consumer satisfaction beyond the simple pleasures of adventure and adrenaline …

Armando’S Case: Diagnostic Emergent Literacy Assessment For Children With Complex Communication Needs, Bronwyn A. Harris, Tonya R. Moore, Ashley E. Pennell

Journal of Case Learning & Exceptional Learners

This practice-based case study is designed to offer a tutorial on how to adapt an informal, diagnostic emergent literacy assessment to meet the needs of students like six-year-old Armando, a Latino, multilingual learner with autism spectrum disorder (ASD) and complex communication needs (CCN) in an inclusive kindergarten classroom. Armando’s informal literacy assessment adaptations and outcomes are discussed, including descriptions of his emergent literacy skills observed through his engagement in literacy stations, small group reading instruction in his classroom, and his use of alternative and augmentative communication (AAC) in both instructional and assessment settings. This case study illustrates how traditional literacy …

Policymaker Receptivity To Corporate Political Activity As Influenced By Activists, Mark E. Bateman

School of Public Service Theses & Dissertations

This dissertation considers the role of shareholder resolutions and employee strikes as representations of activist activities targeting corporations and their influence on corporate political activity (CPA). The study builds from the McDonnell and Werner (2016) study in Administrative Science Quarterly, “Blacklisted businesses: Social activists’ challenges and the disruption of corporate political activity” that assessed the role of consumer boycotts vis-à-vis CPA. Starting with the political marketplace framework, introducing the policy relationship framework, and using signal theory, the dissertation found some support that shareholder resolutions and employee strikes related to increases in PAC refunds, that temporal issue salience to the …

Interpersonal Communication: A Mindful Approach To Relationships 2nd Edition, Jason S. Wrench, Narissra M. Punyanunt-Carter, Katherine S, Thweatt

Milne Open Textbooks

Interpersonal communication is the way we connect with others. Whether engaging with a spouse, a coworker, a close friend, or a stranger, our daily lives are defined by the messages we send and receive. Interpersonal Communication guides students through the complex landscape of human interaction, helping them navigate relationships in the twenty-first century.

A Mindful Perspective

What distinguishes this textbook is its integration of mindfulness into the study of communication. Moving beyond simple skills training, the text encourages students to engage in mindful awareness and mindful practice. By learning to be fully present, open, and non-judgmental, students develop the …

Dietary Perennial Ryegrass Improves Meat Quality: Insights Into The Gut-Muscle Axis In Geese, Zeshan Zulfiqar, Muhammad Arslan Asif, Khawla Alharbi, Han Yao, Xiaoyan Zhu, Zhichang Wang, Hao Sun, Yalei Cui, Boshuai Liu, Shucheng Huang, Yinghua Shi

Poultry Science Faculty Publications and Presentations

The gut-muscle axis represents a key regulatory pathway linking intestinal microbiota to muscle development and meat quality, yet its mechanistic basis in geese remains unclear. This study investigated how dietary perennial ryegrass modulates meat quality through microbiota reshaping and AMPK/Akt-mTOR signaling. Geese were fed a commercial diet (CD) or a ryegrass feeding (GD) for 30 days. GD markedly improved breast muscle morphology, increasing fiber density and reducing cross-sectional area, while enhancing meat color, texture, protein conformation, and reducing cooking loss and shear force. Amino acid and fatty acid enrichment, together with elevated antioxidant activity in serum, ileum and muscle, further …