Digital Commons Network^™

The Uses Of Right Heart Catheterization In Cardio-Pulmonary Disease: State-Of-The-Art, Bhavesh Katbamna, Lingling Wu, Mario Rodriguez, Phillip King, Joel Schilling, Jamal Mahar, Ajith P Nair, Hani Jneid, Elizabeth S Klings, Gerald L Weinhouse, Sula Mazimba, Marc A Simon, Markus Strauss, Chayakrit Krittanawong

Faculty, Staff and Students Publications

The right heart catheterization (RHC) remains an important diagnostic tool for a spectrum of cardiovascular disease processes including pulmonary hypertension (PH), shock, valvular heart disease, and unexplained dyspnea. While it gained widespread utilization after its introduction, the role of the RHC has evolved to provide valuable information for the management of advanced therapies in heart failure (HF) and cardiogenic shock (CS) to name a few. In this review, we provide a comprehensive overview on the indications, utilization, complications, interpretation, and calculations associated with RHC.

Baroreflex Function In Cardiovascular Disease, Husam M Salah, Richa Gupta, Albert J Hicks, Kiran Mahmood, Nicholas A Haglund, Amarinder S Bindra, Steve M Antoine, Rachel Garcia, Amin Yehya, Dmitry M Yaranov, Pujan P Patel, Jason P Feliberti, Allman T Rollins, Vishal N Rao, Laurie Letarte, Vikram Raje, Amit H Alam, Patrick Mccann, Nirav Y Raval, Brian Howard, Marat Fudim

Faculty, Staff and Students Publications

The baroreflex system is involved in modulating several physiological functions of the cardiovascular system and can modulate cardiac output, blood pressure, and cardiac electrophysiology directly and indirectly. In addition, it is involved in regulating neurohormonal pathways involved in the cardiovascular function, such as the renin-angiotensin-aldosterone system and vasopressin release. Baroreflex dysfunction is characterized by sympathetic overactivation and parasympathetic withdrawal and is associated with several cardiovascular diseases, such as hypertension, heart failure, and coronary artery disease. Targeting the baroreflex system via invasive (eg, baroreflex activation therapy and endovascular baroreceptor amplification) and noninvasive approaches (eg, slow breathing exercises and exercise training) has …

Healthcare Utilization Unchanged In The Control Arm Of A Randomized Clinical Trial, Pratik Gongloor, Saad Nadeem, Xiaoying Yu, Mukaila Raji, Kristina D Mena, Elizabeth M Vaughan

Faculty, Staff and Students Publications

including among control groups. Increased access to care and heightened health awareness during trial enrollment could lead to altered behaviors, a phenomenon known as the Hawthorne effect, which may obscure true intervention impacts; however, this effect remains poorly studied in low-income environments.

Aim: To conduct a secondary exploratory analysis of healthcare utilization among control participants of a randomized clinical trial (RCT).

Methods: We retrospectively analyzed electronic medical records from the control arm (n = 26) of an RCT involving low-income Hispanic adults with type 2 diabetes receiving care at a community clinic. Before randomization to a 12-month diabetes education intervention …

The Utilization Of Microbial Cell-Free Dna Next-Generation Sequencing For The Detection Of Human Herpesvirus-8 In A Quaternary Care Center, Rebecca Berger, Jennifer Jacobe, Fernando H Centeno, Todd Lasco, Mayar Al Mohajer

Faculty, Staff and Students Publications

Background: Human herpesvirus-8 (HHV8) can present with cutaneous or extracutaneous manifestations. While violaceous skin lesions characterize cutaneous Kaposi sarcoma, extracutaneous HHV8 is challenging to diagnose due to nonspecific symptoms.

Objectives: We evaluated the role of microbial cell-free DNA next-generation sequencing (mcfDNA NGS) in diagnosing HHV8-related illness.

Design: Retrospective analysis.

Methods: Between 2017 and 2024, we reviewed the medical charts of 10 immunosuppressed patients at a quaternary care center who had positive HHV8 mcfDNA NGS results.

Results: The clinical and laboratory turnaround times of mcfDNA NGS were 3 and 1 days, respectively (8.5 and 7 days for immunohistochemistry vs 5.5 and …

A Pipeline For Rapid, High-Throughput Imaging And Quantitative Analysis Of Human Intestinal Organoids, Faith M Sawyer, Fabio Stossi, Erika Nachman, Robert A Britton, Michael J Bolt, Michael A Mancini, Mary K Estes, Sarah E Blutt

Faculty, Staff and Students Publications

Human intestinal organoids (HIOs) are a model system for studying human intestinal epithelium. Utilizing HIOs for high-throughput studies remains inefficient, as analyzing their cellular composition and responses to varying experimental conditions requires extensive time and labor. We describe a 96-well plate-based automated pipeline for rapidly imaging and quantifying fluorescent labeling in HIOs using a high-throughput confocal microscope and image analysis software. The pipeline was leveraged to quantify varying levels of cell proliferation among donor HIO lines in response to microbial products. Cytoplasmic fluorescence via antibody labeling was also quantified with the pipeline, enabling measurement of the prevalence of specific cell …

The Impact Of Structural Gamification On Student Motivation And Engagement In A Middle School Language Arts Classroom, Natalie Campbell

Dissertations and Theses @ UNI

Engagement through gamification can play a crucial role in enhancing student motivation. Gamification provides direct feedback, makes learning interactive, fosters collaboration, and makes learning more autonomous (Kuh, 2001; Reeve & Tseng, 2011). Including game-thinking and game mechanics in the classroom adds an aspect of engagement that may otherwise be lacking.

This action research study explored the impact of structural gamification on student engagement and motivation when incorporated in a middle school language arts classroom. Using a mixed-methods approach, the researcher measured student engagement and motivation. It reported detailed perceptions of participants through survey responses, examined achievement data from summative assessments, …

An Examination Of Middle School Girls’ Perceptions And Preferences Of Reading From A Device Versus Paper, Debra Kisch

Dissertations and Theses @ UNI

Schools have been impacted by the technological advancements of the world. With these changes, students have been increasingly using technology, especially since the Covid-19 pandemic. The use of devices to read, both for pleasure and academically, have increased, especially since the introduction of Amazon’s Kindle in 2007 (Ashburn, 2024). Additionally, schools have started issuing devices for students to use and it is reported that forty-five percent of schools have a computer for each student (National Center for Education Statistics, 20). They found an extra 37% reported having a computer for each student in some grades or classrooms. States are also …

Environmentally Persistent Free Radicals Lead To Selective Inhibition Of Cyp1 Monooxygenase Activities, And Increased Production Of Reactive Oxygen Species By Reaction Uncoupling, John Patrick Connick, Amari A. Stepter, George F. Cawley, Marilyn K. Eyer, Wayne L. Backes

School of Medicine Faculty Publications

This study focuses on the effect of Environmentally Persistent Free Radicals (EPFRs) on the P450 enzymes of the CYP1 family. EPFRs are a component of particulate pollutants, that are stable in the environment, but can generate free radicals, leading to oxidative stress and subsequent toxicity of the respiratory, cardiovascular, and immune systems once they enter an organism. The results show differences in the ability of EPFRs to inhibit CYP1-dependent substrate metabolism, with CYP1B1 being inhibited to the greatest extent. There also were differences in the ability of EPFRs to disrupt the POR•CYP1 complex, with CYP1B1 being the only form where …

Exploring Postsecondary Students’ Beliefs Relative To Behavior That Promotes Sleep, Levi T. Kirkpatrick

Dissertations and Theses @ UNI

Sleep research has extensively quantified poor sleep among postsecondary students and established associations with adverse consequences; however, research exploring students’ beliefs toward sleep-promoting behavior is scarce. The current qualitative study explored postsecondary students’ beliefs toward behavior that promotes sleep at a midwestern state university. Using the integrated behavioral model, the current study aimed to expand the understanding of how students perceive and engage with behaviors that promote better sleep. The primary research question was: “How do currently enrolled postsecondary students attending a state university located in the Midwest region of the United States describe their beliefs relative to behavior that …

Censorship: Through An Iowan’S Eyes, Erin Mcrae

Dissertations and Theses @ UNI

This is a collection of creative work prefaced by an introduction, which gives an overview of the development of these pieces. The pieces contained in this thesis are comprised of various genres, including creative nonfiction, poetry, and short fiction.

Cadherin 1 Germline Mutation Co-Occurs With Medullary Thyroid Cancer And Choroid Plexus Papilloma: A Case Report And Review Of Literature, Vijay Nitturi, Sricharan Gopakumar, Hsiang-Chih Lu, Akash J Patel

Faculty, Staff and Students Publications

Background: We describe the case of a 23-year-old woman with a history of medullary thyroid cancer (MTC) who presented with a choroid plexus papilloma (CPP) and review the literature regarding the co-occurrence of these two pathologies.

Case description: A 23-year-old woman with a history of MTC treated with thyroidectomy 3 months prior was referred to neurosurgery with an incidental fourth ventricular mass found on prior imaging of her neck. She presented to the clinic with intermittent headaches and underwent MRI which demonstrated a hyperintense, heterogeneously enhancing lobular mass at the obex of the fourth ventricle. She underwent suboccipital craniotomy and …

Defining Dysphoric Milk Ejection Reflex: Using Premenstrual Dysphoric Disorder As A Framework For Proposing Preliminary Diagnostic Criteria, Megan Howard, Teni Davoudian, Nicole H Cirino

Faculty, Staff and Students Publications

Dysphoric Milk Ejection Reflex (D-MER) is a distinct neurobiological condition characterized by negative alterations in mental state in response to milk letdown during lactation. Symptoms vary by patient and can include feelings of sadness, anxiety or agitation. Importantly, the symptoms are brief, typically lasting no more than 5 minutes. Prevalence has been found between 6 and 27% of lactating women, but studies show heterogeneity, due in part to inconsistent definition. D-MER is not currently classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), which presents a challenge for researchers of the …

Quality Of Life In Young Adults With Type 1 Diabetes, Marissa N Baudino, Samantha A Carreon, Randi Streisand, Tricia Tang, Sarah Lyons, Siripoom Mckay, Barbara J Anderson, Charles G Minard, Sridevi Devaraj, Ashley M Butler, Marisa E Hilliard

Faculty, Staff and Students Publications

Introduction: Challenges of young adulthood with type 1 diabetes (T1D) include transitioning to adult care, increased T1D self-management responsibilities, and normal developmental transitions. Recognizing patterns of health-related quality of life (HRQOL) across a demographically and clinically broad range of young adults with T1D may help identify who needs additional support as they transfer to adult healthcare. We hypothesized that young adults from specific demographic and clinical groups would report lower HRQOL.

Methods: At baseline of a behavioral RCT (≤2 months after last pediatric T1D clinic visit), 100 young adults (Mage=19.9 ± 1.3, MA1c=8.8 ± 2.0 %) self-reported demographics and HRQOL; …

Diagnostic Delay In Type I Autoimmune Pancreatitis: Clinical, Imaging, Endoscopic And Histologic Predictors Of Timely Diagnosis, Andres Urias Rivera, Travis Josephs, Shilpa Jain, Wasseem Skef, Tara Keihanian, Salmaan Jawaid, Wasif Abidi, Kalpesh Patel, Mohamed O Othman, Fares Ayoub

Faculty, Staff and Students Publications

Background: The diagnosis of autoimmune pancreatitis (AIP) can be challenging due to nonspecific symptoms, low sensitivity of serologic markers, and some overlap in presentation with pancreatic ductal adenocarcinoma (PDAC). We aimed to quantify delays in the diagnosis of AIP and identify factors associated with diagnostic delay.

Methods: This was a single-center retrospective study between 2013 and 2023 of adult patients diagnosed with type 1 AIP based on HISORt criteria. Patients were compared to a randomly selected group of controls with PDAC. Data on clinical presentation, lab results, imaging, procedures, and initial treatment regimen were collected. Timing to diagnosis and predictive …

Hypertriglyceridemia In New-Onset Type 1 Pediatric Diabetes, Colleen A Macke, Iman Al-Gadi, Nidhi Bansal, Sarah K Lyons, Aikaterini A Nella

Faculty, Staff and Students Publications

Hypertriglyceridemia (HTG) in the setting of newly diagnosed diabetes is common in both adult and pediatric populations, as insulin deficiency promotes lipolysis and impairs triglyceride (TG) clearance. Severe HTG (defined as TG levels above 1000 mg/dL) in pediatric patients with new-onset type 1 diabetes mellitus (T1D) is rare; the true incidence and sequela of this phenomenon have not been well characterized. We present a single-center experience on severe HTG in pediatric patients with new-onset T1D between 2013 and 2022 and summarize the cases previously reported in the literature. Our cases display variability in their presentation and in their association with …

Comment On “Effectiveness And Safety Of Oral Vancomycin For The Treatment Of Inflammatory Bowel Disease Associated With Primary Sclerosing Cholangitis: A Systematic Review And Pooled Analysis”, Richard Kellermayer, Peter Lewindon, Cynthia Buness, James Tabibian, Kevin Johnson, Shamita Shah, Parambir Dulai, Ahmad H Ali, Ayesha Shah, Gerald Holtmann, Harland S Winter

Faculty, Staff and Students Publications

No abstract provided.

Lipoprotein(A) Levels In A Population With Clinical Atherosclerotic Cardiovascular Disease In The United States: A Subanalysis From The Lp(A)Heritage Study, Michael D Shapiro, Tariq M Haddad, Howard S Weintraub, Seth J Baum, Khaled Abdul-Nour, Samiha Sarwat, Vadim Paluy, Wess Boatwright, Auris Browne, Imran Ayaz, Cheryl A Abbas, Christie M Ballantyne

Faculty, Staff and Students Publications

Background: Elevated lipoprotein(a) (Lp[a]) is the most common inherited dyslipidemia that is independently and causally associated with increased atherosclerotic cardiovascular disease (ASCVD) risk. However, data from diverse populations with ASCVD are lacking.

Objective: To evaluate Lp(a) levels in a diverse, contemporary United States (US) population with ASCVD, stratified by race, ethnicity, and sex.

Methods: Lp(a)HERITAGE (NCT03887520) was a multicenter study that estimated the prevalence of elevated Lp(a) in adults (18-80 years) with ASCVD. US participants with Lp(a) measured in nmol/L pre- or post-enrollment were included in this subanalysis. This study was descriptive; therefore, no statistical comparisons were made. …

Long-Term Mortality Following Sars-Cov-2 Infection In Rural Versus Urban Dwellers With Autoimmune Or Inflammatory Rheumatic Disease: A Retrospective Cohort Analysis From The National Covid Cohort Collaborative, A Jerrod Anzalone, Lesley E Jackson, Namrata Singh, Maria I Danila, Elizabeth Reisher, Rena C Patel, Jasvinder A Singh

Faculty, Staff and Students Publications

Objective: Autoimmune or inflammatory rheumatic diseases (AIRDs) increase the risk for poor COVID-19 outcomes. Although rurality is associated with higher post-COVID-19 mortality in the general population, whether rurality elevates this risk among people with AIRD is unknown. We assessed associations between rurality and post-COVID-19 all-cause mortality, up to two years post infection, among people with AIRD using a large nationally sampled US cohort.

Methods: This retrospective study used the National COVID Cohort Collaborative, a medical records repository containing COVID-19 patient data. We included adults with two or more AIRD diagnostic codes and a COVID-19 diagnosis documented between April 2020 and …

Quality Of Life Is Impaired In Shrimp Allergic Adults And Caregivers, Melissa L Hearrell, Sara Anvari, Sharon Chinthrajah, Sana Hasan, David P Huston, Evan Li, Chen-Hsing Lin, Edwin Kim, Andreas L Lopata, Sarbjit Singh Saini, Sayantani Sindher, Panida Sriaroon, Bin Su, Julie Wang, Carla M Davis

Faculty, Staff and Students Publications

Rationale: Shrimp (Litopenaeus vannamei) allergies (SA) can result in allergic reactions ranging from life threatening severe anaphylaxis to oral allergy syndrome. SA may pose lifestyle restrictions on daily life and interfere with social relationships and school performance, but this has not been thoroughly investigated. We examined the QoL in SA adults and caregivers.

Methods: A QoL online questionnaire adapted from the validated Food Allergy Quality of Life Questionnaire (FAQLQ) was administered between September 30, 2023-July 15, 2024 to adults and caregivers of at least one SA child. Descriptive statistics, Wilcoxon rank sum test, and Fisher exact test were …

Delayed Excretion Of High-Dose Methotrexate In Pediatric Acute Leukemia Correlates With Laxative And Constipation Management, Jennifer A Belsky, Ashley Chavana, Ankona Banerjee, Mark Zobeck, Eric S Schafer, Karen R Rabin, Monica Gramatges, Alex Sim, Audrey Leisinger, Trisha Reddy, Megan J Parod, Philip Lupo, Michael Scheurer, Austin L Brown, M Brooke Bernhardt

Faculty, Staff and Students Publications

Background: Delayed excretion of high-dose methotrexate (HD-MTX) in pediatric acute lymphoblastic leukemia (ALL) can result in significant morbidity. While methotrexate is primarily renally excreted, HD-MTX may overwhelm renal excretion and increase reliance on fecal elimination. This study evaluated the association between laxative use for constipation and delayed excretion of HD-MTX.

Methods: This multisite chart review included pediatric patients with ALL (2010-2020) who received HD-MTX (5 g/m2). Delayed excretion was defined as a serum MTX concentration greater than 0.4 µM at Hour 48. We identified use of laxative medications after each HD-MTX infusion, with receipt of two or more doses considered …

Age As More Than A Number: An Applied Geography Of Elderly Vulnerability To Heat Events In The Southeastern United States, John Darko

Dissertations and Theses @ UNI

No abstract provided.

Technical Considerations In The Tcd Evaluation Of Cerebral Circulatory Arrest In Death By Neurological Criteria, Alexandra S Reynolds, Jimmy Suh, Ahmedyar Hasan, Parth Upadhyaya, Venkatakrishna Rajajee, Mohammad I Hirzallah, David M Greer, Aarti Sarwal

Faculty, Staff and Students Publications

Background and purpose: Ancillary testing is essential for diagnosing brain death/death by neurologic criteria (BD/DNC) when clinical determination (neurologic exam and apnea testing) cannot be fully or safely performed. Transcranial Doppler ultrasound (TCD) has been recommended as an ancillary test; however, the technical descriptions have been heterogeneous. We aimed to consolidate the technical considerations related to the use of TCD as an ancillary test in the evaluation of BD/DNC.

Methods: We performed a scoping review of the available literature from inception to December 2024. Articles describing TCD as an ancillary test for BD/DNC were included using appropriate Medical Subject Headings …

Nuance As Praxis For Teaching About Mandated Reporting: Classroom Activities, Grace Pappas, Sam Harrell, Stéphanie Wahab

School of Social Work Faculty Publications and Presentations

As social work instructors, we have observed students increasingly wanting to engage in critical conversations about mandated reporting. Few resources are available to support instructors in facilitating these conversations. This teaching note offers content and lesson plans for exploring mandated reporting as a moral duty, a harm, an ethical dilemma, and a legal mandate in the classroom. Together, these pedagogical tools can help instructors embrace nuance as a practice for teaching about mandated reporting.

The Adaptive Roles Framework: Trauma Adaptations And Identity Formation, Steffannie Roache

School of Social Work Faculty Publications and Presentations

The Adaptive Roles Framework is a culturally grounded conceptual model that explains how individuals develop patterned behavioral, emotional, and relational strategies in response to family systems, culture, trauma exposure, and social environments. Rather than conceptualizing behavior through pathology or personality typology, the framework positions behavioral patterns as adaptive survival strategies, responses that increased safety, belonging, or stability within specific environments and were reinforced over time because they worked. The framework identifies seven adaptive roles observed consistently across individuals, families, workplaces, and communities: the Guardian, the Translator, the Assimilator, the Archive Keeper, the Time Jumper, the Intellectual Escape Artist, and the …

002-S4-Lna-114.01, Morehead State University. History Department.

Defending Savannah: History and Archaeology of the Gibson's Point Battery

No abstract provided.

Common Article 2 And Non-State Reciprocity In The Law Of Armed Conflict, Eric Talbot Jensen, J. Stone Wilson

Emory International Law Review

The majority of today’s armed conflicts are waged between States and non-State actors. Because these conflicts are not between States, they do not fall under the coverage of Common Article 2 (CA2) of the 1949 Geneva Conventions which invokes the full corpus of international humanitarian law. However, the third paragraph of CA2, the “Reciprocity Clause”, was written to provide a mechanism for non-Parties to the Geneva Conventions to invoke the provisions of the Conventions in a conflict with a Party. State Parties agreed to be bound by the Conventions, even in conflicts with non-Parties, as long as those non-Parties agreed …

War Crime Or Ecocide? Ukraine’S Prosecution Of Environmental Crimes Committed By Russian Forces, Michael J. Kelly

Emory International Law Review

No abstract provided.

Small Molecule-Based Regulation Of Gene Expression In Human Astrocytes Switching On And Off The G-Quadruplex Control Systems, Vijay Kumar M J, Jérémie Mitteaux, Zi Wang, Ellery Wheeler, Nitin Tandon, Sung Yun Jung, Robert H E Hudson, David Monchaud, Andrey S Tsvetkov

Faculty, Staff and Student Publications

A great deal of attention is being paid to strategies seeking to uncover the biology of the four-stranded nucleic acid structure G-quadruplex (G4) via their stabilization in cells with G4-specific ligands. The conventional definition of chemical biology implies that a complete assessment of G4 biology can only be achieved by implementing a complementary approach involving the destabilization of cellular G4s by ad hoc molecular effectors. We report here on an unprecedented comparison of the cellular consequences of G4 chemical stabilization by pyridostatin (PDS) and destabilization by phenylpyrrolocytosine (PhpC) at both transcriptome- and proteome-wide scales in patient-derived primary human astrocytes. Our …

Six Rivers National Forest Hazardous Fuels And Fire Management Project 2025 Orleans Complex Fire Effects From 9/13/25 - 9/14/25, James L. Parr, Nosheen Maung, Darby J. Lewis, Javier E. Margarito, Giancarlo Golloti

Environmental Science & Management Senior Capstones

The 2025 Orleans Complex affected the Klamath National Priority Landscape, designated by Congress as a priority to reduce fuel load and mitigate wildfire risk near rural, at-risk communities. To address the threat of large destructive wildfires, the 2023 Six Rivers Hazardous Fuels and Fire Management Project identified desired ecological conditions, using the right type of fire at the right time and place.

Outcomes Of Coronary Revascularization In Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review, Jacob J Gries, Hafeez Ul Hassan Virk, Zhen Wang, Mahboob Alam, Samin Sharma, Markus Strauss, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Introduction: A growing amount of evidence suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) may independently increase the risk of coronary artery disease and acute coronary syndrome, thus necessitating revascularization interventions such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) [2,3]. However, a limited number of studies have evaluated the impact of MASLD on the outcomes of these interventions.

Methods: A comprehensive search of the PubMed/MEDLINE and Embase databases was conducted to identify relevant studies from August 2015 to August 2025 using a combination of Medical Subject Headings (MeSH) terms and text words related to MASLD and …