Digital Commons Network^™

An Integrated Analysis Of Three Medulloblastoma Clinical Trials Refines Risk-Stratification Approaches For Reducing Toxicity And Improving Survival, Kyle S Smith, Jeff M Michalski, Et Al.

2020-Current year OA Pubs

BACKGROUND: The identification of clinical and molecular heterogeneity in medulloblastoma has produced risk-stratified therapy, but establishing the most effective yet least toxic regimens has remained elusive owing to numerous treatment options. To improve risk-stratification, we performed an integrated analysis from three clinical trials.

METHODS: Medulloblastoma patients from ACNS0331/NCT00085735, ACNS0332/NCT00392327, and SJMB03/NCT00085202 were included if they had methylation profiling. Molecular groups [WNT, SHH, Group 3 (G3), and Group 4 (G4)], subgroups, and copy number variations were procured from methylation profiles and mutations from next-generation sequencing. Data was assembled into an interactive portal to capture patient characteristics. Cross-trial comparisons, univariable, and multivariable …

Identifying Disparities In Same-Day Surgery Cancellations: Impact Of Race And Socioeconomic Factors In A Pediatric Health System, Nicole M Santucci, Daniel Alligood, Amanda Maytin-Hevia, Danyi Wang, Kelly Chilson, Jesse Vrecenak, Andrew Yeh, Colin A Martin

2020-Current year OA Pubs

PURPOSE: Same-day surgery (SDS) cancellations have significant implications on patients and hospitals. This study aimed to identify demographic and socioeconomic factors that impact SDS cancellations across a single pediatric health system.

METHODS: A case-control retrospective review captured patients (age < 18) who underwent SDS procedures from July 2022 to August 2024. Patients were included if they underwent any procedure at three operative sites: a tertiary pediatric academic hospital (PAH) and two outpatient surgery centers (OSC). Patients whose SDS was cancelled (n = 2,034) were compared to those whose surgeries proceeded as scheduled (n = 25,573). Patient zip codes were matched to Child Opportunity Index (COI) 2.0 data.

RESULTS: The overall SDS cancellation rate was 7.37 %, with a significantly higher rate observed at the PAH compared to OSC (11.4 % vs 53 %, p < 0.001). Patients with cancelled cases were more likely to identify as Black and have the lowest quintile COI (p < 0.001). Cancelled in preop and no shows were two reasons with the most racial disparities. In a sub-analysis comparing cancelled cases between operating sites, PAH cancelled patients tended to be Black (23.8 % vs 11.7 %, p < 0.001) and have very low COI (20.1 % vs. 10.6 %, p < 0.001).

CONCLUSION: SDS cancellation rates are significantly higher amongst patients who identify as Black and reside in low opportunity neighborhoods. Disparities in cancellation rate are more significant in patients scheduled at the urban PAH compared …

An Integrated View Of The Structure And Function Of The Human 4d Nucleome, Job Dekker, Ting Wang, Daofeng Li, Et Al.

2020-Current year OA Pubs

The dynamic three-dimensional (3D) organization of the human genome (the 4D nucleome) is linked to genome function. Here we describe efforts by the 4D Nucleome Project

Clinical Outcomes Following Mechanical Thrombectomy In Pulmonary Embolism Response Team-Consulted Patients: A Retrospective Analysis, Ryan Nolan, Maanasi Samant, Suresh Vedantham, Westley Ohman, Nathan Droz, Kristen Sanfilippo, Pavan Kavali

2020-Current year OA Pubs

PURPOSE: To determine if use of mechanical thrombectomy (MT) impacts survival and additional outcomes in patients with acute intermediate-high-risk and high-risk pulmonary embolism (PE) who were evaluated by a Pulmonary Embolism Response Team (PERT).

METHODS: This retrospective, single-center study included patients with intermediate-high-risk and high-risk PE who received PERT evaluation over 3.5 years and were treated with anticoagulation (AC) alone or MT + AC. The primary outcome was 30-day all-cause mortality, measured with inverse probability of treatment weighting. Exploratory outcomes included survival during the study period, PE-associated/caused mortality, hospital length of stay (LOS), supplemental oxygen at discharge, and MT-related metrics. …

Retrenchment, Segregation, And Public Education: A Five-Year Analysis Of State Exclusionary School Discipline Legislation, Thalia Gonzalez, Will Martel

Faculty Scholarship

Notwithstanding the decision in Brown v. Board of Education formally ending educational segregation and more than two decades of state reform, the legislative landscape protecting minoritized children from the structural violence of exclusionary school discipline has dramatically shifted in less than five years. From the passage of state “Teacher’s Bills of Rights” to mandatory expulsions, rescissions of prior protections, and new categories of removal, a retrenchment of anti-inclusion legislation—and its corollary, educational carcerality— has occurred. While studies of other forms of legislative retrenchment in K–12 public schools, such as anti-Critical Race Theory and Don’t Say Gay laws, literacy bans, and …

Impact Of Occupational Therapy Within The Rosenbaum Family House: How Program Development Supports Health And Well-Being For Caregivers And Care Recipients, Zaccardi P. Muniz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Healthcare hospitality houses (HHH) are designed to accommodate patients and caregivers receiving medical treatment far from home. The Rosenbaum Family House (RFH) acts as the HHH adjacent to J.W. Ruby Memorial Hospital in Morgantown, West Virginia. The RFH offers amenities that meet the basic needs of guests; However, there is an opportunity for occupational therapy-based program development to help further assist caregivers and care recipients both inside and outside the RFH. During the doctoral capstone experience (DCE), a three-phase project was developed to support the health and well-being of guests and WVUMedicine clients through group programming, resource guide development, and …

Exploring The Role Of Occupational Therapy In A Pediatric Specialty Care Office, Sierra Leigh Hays

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The role of OT in primary and specialty care clinics is a rising area of interest in the field. There are also many multidisciplinary clinics that OTs can be or are apart of. This study aims to evaluate the consulting role of OT in primary and specialty care clinics, as well as to evaluate data collected by an OT in a pediatric brachial plexus and peripheral nerve clinic. Methods: The first objective was focused on analyzing functional outcomes, using the Active Movement Scale (AMS), of children following neurosurgery or onabotulinum toxin A injections. This was a retrospective study with …

Data-Driven Methodologies For Mapping Cultural Heritage: The Case Of The National Coal Heritage Area, West Virginia, Usa, Hossain Mohammad Nahyan

Graduate Theses, Dissertations, and Problem Reports (ETD)

The objective of this dissertation was to develop a comprehensive, data-driven spatial framework for characterizing the complex cultural landscape of the National Coal Heritage Area (NCHA) in West Virginia. By transitioning away from traditional, heuristic spatial mapping, this research integrates advanced spatial statistics, machine learning, and GIS-based methodologies to objectively quantify the physical, visual, and cultural dimensions of the post-mining environment. The research is structured around three interconnected empirical studies, each addressing a specific scale of the Landscape Character Assessment (LCA) framework to support heritage conservation and sustainable spatial planning. The first paper focused on landform classification, developing an automated …

Three Essays In Cpi Bias And Health Economics, Auderta Amoako-Nuamah

Graduate Theses, Dissertations, and Problem Reports (ETD)

The first essay estimates bias in the Consumer Price Index (CPI) for elderly individuals in the United States using Engel curve methodology and household-level data from the Panel Study of Income Dynamics (1999–2023). The analysis focuses on how well the CPI reflects changes in the cost of living for older Americans, with particular attention to differences by gender and marital status. Results show that from 1999–2011, the CPI overstated the increase in the cost of living for both elderly and non-elderly households. In contrast, from 1999–2023, the CPI understated cost increases, with the bias generally larger for non-elderly households. Within …

Focused Ultrasound-Enhanced Nose-To-Brain Delivery Of A Therapeutic Antibody In A Large-Animal Model, Siaka Fadera, Cristian Antonio Wieczorek Villas Boas, Yimei Yue, Zhaoning Gu, Jinyun Yuan, Debolina De, Buck E Rogers, Arash Nazeri, Hong Chen

2020-Current year OA Pubs

No abstract provided.

Phase I Trial Of Adp-A2afp Tcr T-Cell Therapy In Patients With Advanced Hepatocellular Or Gastric Hepatoid Carcinoma, Tim Meyer, Benjamin R Tan, Et Al.

2020-Current year OA Pubs

BACKGROUND & AIMS: Patients with advanced hepatocellular carcinoma (HCC) generally experience poor outcomes despite current therapies, necessitating the development of alternative treatments. ADP-A2AFP is an investigational autologous T-cell therapy with an affinity-enhanced T-cell receptor (TCR) targeting alpha-fetoprotein (AFP).

METHODS: We describe a phase I, open-label, first-in-human clinical trial of ADP-A2AFP (NCT03132792) in human leukocyte antigen-eligible participants with AFP-expressing HCC (or other tumor) not amenable to transplant/resection who progressed on, were intolerant to, or refused prior systemic therapy. Participants received lymphodepletion chemotherapy (cyclophosphamide 500 mg/m

RESULTS: Twenty-one participants, 20 with advanced HCC and one with gastric hepatoid carcinoma received ≥1 ADP-A2AFP …

Cutibacterium Adaptation To Life On Humans Provides A Potential C Acnes Infection Biomarker, Md Shafiuddin, Wen-Chi Huang, Gabriel William Prather, Jeffrey Ryan Anton, Andrew Lawrence Martin, Sydney Brianna Sillart, Jonathan Z Tang, Michael R Vittori, Michael J Prinsen, Jessica Jane Ninneman, Chandrashekhara Manithody, Jeffrey P Henderson, Alexander W Aleem, Ma Xenia Garcia Ilagan, William H Mccoy 4th

2020-Current year OA Pubs

Propionibacteriaceae appear to have adapted to life on humans during the domestication of cattle. These microbial immigrants formed the genus Cutibacterium, and a descendent of those microbial trailblazers (C acnes) now dominates 25% of human skin. C acnes colonization of human skin requires the protein RoxP. Although all Cutibacteria encode this adaptation to life on humans, nothing like RoxP has been found in any other organism. In this study, we report an extensive assessment of 21 RoxP orthologs, which identified conserved molecular surfaces linked to heme-dependent oligomerization and low pH stability. Our investigation suggests how RoxP helps C acnes dominate …

Mutations In Hsp40 Co-Chaperone Change The Canonical Interdomain Interactions Stimulating Lgmdd1 Myopathy, Ankan K Bhadra, Geetika Aggarwal, Anshuman Jaysingh, Daniel Chen, Jil Daw, Conrad C Weihl, Heather L True

2020-Current year OA Pubs

Limb-girdle muscular dystrophy D1 (LGMDD1) is a rare, dominantly inherited neuromuscular protein-misfolding chaperonopathy caused by mutations in the Hsp40 co-chaperone DNAJB6, primarily in the glycine-phenylalanine (GF) or J-domains. Currently, no treatments are available, and a challenge in understanding the disease is identifying a specific client protein for DNAJB6 in skeletal muscle. DNAJB6 has homology to the yeast DNAJ family member, Sis1. Our previous research indicated that LGMDD1 GF domain mutants in Sis1 exhibit substrate-specific effects, influenced by Hsp70 activity. Herein, we employed functional assays along with advanced molecular simulation studies to understand the regulatory interdomain interactions in disease-causing mutants of …

A Deep Learning Model To Guide Personalized Mechanical Circulatory Support Use In Cardiogenic Shock Patients Undergoing Pci, Amit P Amin, Richard G Bach, Darren C Tsang, Weili S Zheng, Raed A Qarajeh, Emmanouil S Brilakis, Hemant Kulkarni

2020-Current year OA Pubs

BACKGROUND: Cardiogenic shock (CS) in patients undergoing percutaneous coronary intervention (PCI) involves rapidly changing clinical, hemodynamic, and metabolic factors that current models cannot effectively integrate.

OBJECTIVES: The purpose of this study was to develop and validate a deep learning (DL) model to guide personalized use of mechanical circulatory support (MCS) devices in CS patients undergoing PCI.

METHODS: The authors analyzed data from 1,408 CS patients treated with intra-aortic balloon pump (IABP) or microaxial flow-pump (mAFP) at multiple hospitals (2004-2019). Clinical, hemodynamic, and metabolic variables from admission to MCS placement were compiled into longitudinal vectors. Using Python 3.7 and TabNet in …

Genome-Wide Gene-Sleep Interaction Study Identifies Novel Lipid Loci In 732,564 Participants, Raymond Noordam, Karen Schwander, Lisa De Las Fuentes, Mary F Feitosa, Anh Do, C Charles Gu, Changwei Li, Michael A Province, Dabeeru C Rao, Et Al.

2020-Current year OA Pubs

BACKGROUND AND AIMS: Deviations from the population mean in sleep duration have been associated with increased risk for developing dyslipidemia and atherosclerotic cardiovascular disease, but the mechanism of effect is poorly characterized. We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets.

METHODS: We collected data from 55 cohorts with a combined sample size of 732,564 participants (87 % European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) …

Oculomics And Ai: The Eye As A Biomarker For Health Span, Joy Le Yi Wong, Rajendra S Apte, Et Al.

2020-Current year OA Pubs

As the world's population ages, the focus of healthcare is shifting from extending life span to promoting health span. There is an unmet need to identify sensitive and reliable markers of health span through more cost-effective and non-invasive methods, to enable early and effective intervention on modifiable aging factors. The eye offers a unique window into systemic health, providing direct visualization of the body's vascular and neural health. This review presents an overview of how various ocular structures can serve as biomarkers of health span-drawing on insights from ocular imaging, metabolomics, and proteomics, with evidence from basic science, animal models, …

Enhancing Uncontrolled Hypertension Compliance And Self-Management In A Senior Center, Kimberly D. Strickland

Doctor of Nursing Practice Projects

Hypertension is a complicated, chronic condition that affects individuals worldwide. The prevalence of this condition has increased nearly 48% in the last decade in America. This project served to determine if participants in a targeted area/community would show increased knowledge and awareness of hypertension after implementation of educational sessions. A post-session survey was provided to determine if the educational sessions were effective. Data was collected and analyzed that showed an increase in awareness and knowledge regarding the prevalence of hypertension, diet modification, lifestyle, and compliance.

Increasing Teens' Knowledge On The Health-Related Effects Of Vaping, Anteja Gore

Doctor of Nursing Practice Projects

Vaping in teens has become an increasing public health issue related to the growth in the number of teens who are using vapes. Many teens are not aware of the potential associated risk of using vapes, as they perceive them to be a safer alternative to smoking cigarettes. The purpose of this project was to increase the middle school teens’ knowledge of the potential health risks associated with vaping through an educational awareness session. This project was implemented in the middle school setting, targeting students aged 12-14 years. The students who participated completed anonymous pre- and post- questionnaires that evaluated …

Lack Of Disparities In Postoperative Care After Ileocecal Resection In Patients With Crohn's Disease At Tertiary Inflammatory Bowel Diseases Centers, Shannon Coombs, Molly Powell, Kemmian Johnson, Jessica Hu, Mollie Webb, Philip Mcdaniel, Parakkal Deepak, Edward L Barnes

2020-Current year OA Pubs

BACKGROUND: Prior studies suggest that longer drive time (DT) to specialists and higher area deprivation index (ADI) are linked to worse outcomes in inflammatory bowel disease (IBD), but their impact on postileocolic resection (ICR) care in patients with Crohn's disease (CD) is not well defined.

OBJECTIVES: We aimed to evaluate disparities in post-ICR care based on DT and ADI.

METHODS: Spatial analysis was performed with ArcGIS Pro to geocode patient and medical facility addresses with StreetMap Premium locators. High DT was defined as >60 min from the center. Data were analyzed using basic statistics and multivariate logistic regression.

DESIGN: A …

Effect Of A Pregnancy Lifestyle Intervention Embedded Into A Home Visiting Program On Child Neurodevelopment, Sarah S Farabi, Rosemary Bass, Amit Mathur, Cindy Schwarz, Candice Woolfolk, Richard Stein, Samuel Klein, Debra Haire-Joshu, Alison G Cahill

2020-Current year OA Pubs

Maternal obesity is associated with a higher risk of abnormal child neurodevelopment. The aim of this study was to determine the effect of a lifestyle intervention embedded into a home visiting program, Parents as Teachers (PAT), on 18-month neurodevelopment in the offspring. Pregnant women (9-15 weeks) of African American Race, 18-45 years old, first-trimester BMI 25.0-45.0 kg/m

Reliability Of Remote Self-Administered Web-Based Digital Cognitive Measures And Comparison To In-Person Neuropsychological Tests: Stricker Learning Span, Symbols Test, And The Mayo Test Drive Screening Battery Composite, Morgan A Hughes, Jason Hassenstab, Et Al.

2020-Current year OA Pubs

INTRODUCTION: We describe the reliability of remote self-administered digital cognitive measures completed via the Mayo Test Drive (MTD) web-based platform.

METHODS: A total of 1846 participants (mean age = 70, SD = 12, range 31-101; 48% male; 96% White; 99% non-Hispanic; 97% cognitively unimpaired) with two to four complete MTD sessions at ∼7.5-month intervals were included. Test-retest reliability was assessed using single-rating, absolute-agreement, and two-way mixed intraclass correlation coefficients (ICCs) with 95% confidence intervals. ICCs for in-person-administered traditional neuropsychological measures were compared to MTD for a subset of 244 participants. Analyses also compared reliability across demographic, residential, and session context …

Application Of Machine Learning To Blood-Based Biomarkers Of Alzheimer's Disease In Down Syndrome, Patrick H Luckett, Melissa Petersen, Sid O'Bryant, Mark Mapstone, Brad T Christian, Benjamin Handen, Elizabeth Head, Beau M Ances, Alzheimer's Biomarker Consortium‐Down Syndrome

2020-Current year OA Pubs

INTRODUCTION: Blood-based biomarkers can improve Alzheimer's disease (AD) characterization in Down syndrome (DS). This study applied hierarchical clustering and machine learning-based feature selection to identify biomarkers associated with disease progression.

METHODS: Cross-sectional blood-based biomarkers were analyzed from 211 DS participants (

RESULTS: The strongest predictors overall were neurofilament light chain (NfL), tau/amyloid beta (Aβ)40, Aβ42/Aβ40, alpha-2-macroglobulin (A2M), and interleukin (IL)-10. Within the CS group, NfL, tau/Aβ40, A2M, and IL-10 were strong predictors. In MCI, Aβ42/Aβ40, NfL, A2M, and IL-10 were strong predictors. In DS-AD, Aβ42/Aβ40, NfL, and tau/Aβ40 were the top predictors. Cluster membership varied based on disease stage.

DISCUSSION: …

Synergistic Removal Of Microplastic Fibres: Integrating Chitosan Coagulation In Hybrid Water Pre-Treatment Systems, Jayasuriya Arachchilage Nimesha Thathsarani

Theses: Doctorates and Masters

Microplastic fibres (MPFs) are the most prevalent form of microplastics detected in the influents of water and wastewater treatment plants. Owing to their elongated shape and low density, MPFs frequently evade removal even during tertiary processes such as membrane filtration. Enhancing pretreatment, particularly through cost-effective coagulation-flocculation can reduce the treatment burden on downstream systems. However, conventional inorganic coagulants often necessitate high dosages and can leave residual ions, posing environmental concerns.

As a sustainable alternative, the use of environmentally friendly coagulants such as Chitosan has gained attention for MPF removal. While Chitosan exhibits favourable qualities, its practical application is hindered by …

Study Of Fire Regimes In Southwestern Australia Using Geospatial Techniques, Ana Do Carmo Carvalho

Theses: Doctorates and Masters

The Northern Jarrah Forest in Southwestern Australia (SWA), part of a global biodiversity hotspot, is home to fire-sensitive tree species such as marri (Corymbia calophylla) and jarrah (Eucalyptus marginata). As climate change intensifies drought and extreme fire events, understanding the drivers of fire severity is increasingly critical. This thesis analyses fire regimes within the Mundaring drinking water catchment to better understand the spatiotemporal complexity of fire severity in relation to fire history and environmental factors.

The thesis commences with a review of three Fire History Databases (FHDs) used in SWA, highlighting significant inconsistencies and data gaps across time and space. …

An Investigation Into The Mechanisms, Barriers, Degree And Sphere Of Risk Influence In Corporate Security, Nicola Lockhart

Theses: Doctorates and Masters

This study investigates the sphere of corporate security risk influence within organisations, addressing the conceptual and practical ambiguity surrounding the activity’s capacity to shape organisational decisions, behaviours, and risk priorities. While corporate security’s protective role is widely recognised, its broader organisational risk influence remains under-theorised. The study defines the sphere of risk influence as the range of organisational stakeholders and environments with which the corporate security activity interacts, and within which it may engage, persuade, and mobilise action. This sphere is analytically constituted through the intersection of three dimensions: the mechanisms through which influence is attempted, the barriers that constrain …

Getting Ready Right: The Impact And Influence Of The University Appointed Supervisor, Madlen Griffiths

Theses: Doctorates and Masters

Initial Teacher Education professional experience is a valued component of teacher education courses, where preservice teachers can practise applying what they have learned at university in classroom settings. Key to these experiences are supervisors, who are employed by the university and support these aspiring teachers during their professional experiences. This supervisory role is complex, underrated, under-theorised and under researched. Consequently, this research sought to address this shortfall through an investigation into the perspectives of two of the major stakeholders in these experiences: the preservice teachers and the supervisors.

Adopting a social constructivist methodology, this research examined the stakeholders’ perceptions of …

Development Of Virtual Reality Learning Environments In Science To Engage Secondary Students In Hazardous Activities, Luke Spartalis

Theses: Doctorates and Masters

This research examines the need for change in including hazardous activities in education. As different learning technologies develop, platforms that retain authentic outcomes via virtual reality are needed. The main objective of this research is to examine the inclusion of Virtual Reality Learning Environments (VRLEs) to determine their value in areas that include hazardous conditions. The research considered the ways that VR tools could be optimised to support these activities, as well as considering the challenges of VRLE implementation. The study examined whether VRLE’s allowed for authentic experiences to sufficiently drive an acceptance of VR to complement existing teaching and …

The Development Of A Midwifery Specific Tool To Identify The Barriers And Enablers To Change Within The Midwifery Setting, Sara Davis

Theses: Doctorates and Masters

Despite being well-positioned to identify service gaps and propose improvements, many midwives lack the knowledge, skills, confidence, or tools to effect practice change. Implementation science (IS) offers a structured approach to moving evidence-based innovations into practice; however, existing IS theories, models, and frameworks do not reflect the unique context of midwifery practice. The first step in the intentional implementation of an evidence-based practice innovation is to conduct a context assessment to identify factors that may facilitate or impede its uptake. There are numerous evidence-based checklists for this, but none capture all the influences on midwifery practice environments.

In this study, …

Enhancing Deep Reinforcement Learning With Expert Demonstrations For Mobile Robot Navigation In Unstructured Off-Road Environments, Dulitha Dabare

Theses: Doctorates and Masters

Advancements in the field of Deep Learning has ushered in a boom in autonomous navigation research. Most of the work being conducted in this space, however, has focused on on-road urban navigation scenarios, with unstructured outdoor terrain navigation receiving much more limited attention. Given the wide range of applications that exist for legged and wheeled ground robots in off-road environments in areas such as agriculture, mining and disaster recovery, there is a growing need for research work to improve the navigational capabilities of mobile robots deployed in these challenging environments.

A promising candidate for application to these navigation challenges in …

Understanding Climate Change And Wellbeing Through Bhutan's Pursuit Of Gross National Happiness, Tashi Dorji

Theses: Doctorates and Masters

Climate change has evolved into one of the biggest global challenges of the twenty first century reshaping ecological systems and social conditions with wide-ranging implications for human wellbeing. Bhutan offers a distinct context to explore interactions between climate change and wellbeing as it remains guided by its wellbeing-centred development philosophy of Gross National Happiness (GNH). At the same time, it remains highly vulnerable to climate change despite being the only carbon negative country in the world. Nonetheless, the intersections between climate change and GNH have not been systematically explored.

This research aims to explore the relationship between climate change and …