Digital Commons Network^™

Evaluation Of Mycoplasma Genitalium Positivity And Co-Infection With Chlamydia Trachomatis And/Or Neisseria Gonorrhoeae At Various Care Sites Across The United States, Rebecca Lillis, Stacey House, Et Al.

2020-Current year OA Pubs

OBJECTIVES: We evaluated Mycoplasma genitalium (MG) positivity and co-infection with Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG), based on results from a trial assessing clinical performance of the Cobas® Liat CT/NG/MG point-of-care test.

METHODS: A prospective, US, multicenter, noninterventional study assessed MG positivity in prospective urine samples (male) and clinician-collected vaginal swabs (female) from symptomatic/asymptomatic patients aged ≥14 years attending various clinical settings. Participants were designated positive or negative for MG, CT, and NG based on combined results from three US Food and Drug Administration-approved assays and one laboratory-developed test. MG co-infection with CT and/or NG was assessed.

RESULTS: Among …

Influence Of Obesity And Insulin Resistance With Hepatic Steatosis On The Human Plasma Lipidome, Max C Petersen, Gordon I Smith, Aaron M Armando, Xiong Su, Oswald Quehenberger, Edward A Dennis, Samuel Klein

2020-Current year OA Pubs

Insulin resistance accompanied by hepatic steatosis is a common complication of obesity. In an effort to identify plasma lipids that could be biomarkers or causes of insulin resistance with steatosis in people with obesity, we evaluated the plasma lipidome in three distinct groups separated by adiposity, hepatic steatosis, and insulin sensitivity, assessed by using the hyperinsulinemic-euglycemic clamp procedure: i) insulin-sensitive lean (ISL, n = 13); ii) insulin-sensitive obese (ISO, n = 14); and iii) insulin-resistant obese with hepatic steatosis (IROS, n = 13). We evaluated 759 complex lipid species in 16 subclasses (including phospholipids, glycerolipids, sphingolipids, acylcarnitines, and cholesteryl esters) …

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 …

Beyond Restless Sleep: A Cross-Sectional Study Of Obstructive Sleep Apnea Risk, Aging Biomarkers, And Chronic Low Back Pain, Khalid W Freij, Fiona Bat Agbor, Philemon Domoyeri, Kiari R Kinnie, Asia M Wiggins, Demario S Overstreet, Tammie L Quinn, Shivraj S Grewal, S Justin Thomas, Walid W Freij, Shameka L Cody, Michael A Owens, Robert E Sorge, Burel R Goodin, Edwin N Aroke

2020-Current year OA Pubs

This secondary data analysis aimed to determine the nature of the relationship between obstructive sleep apnea (OSA) risk, biological age acceleration, and nonspecific chronic low back pain (CLBP). In total, 199 adults aged 18-82 years who filled both STOPBANG and pain questionnaires subsetted for secondary analysis. Based on the STOPBANG questionnaire, 104 had a low OSA risk and 95 had an intermediate or high OSA risk. Dunedin Pace of Aging Computed from the Epigenome (DunedinPACE), Horvath's, Hannum's, PhenoAge, and GrimAge clocks were used to determine biological age and pace of biological aging. Individuals with low OSA risk reported increased DunedinPACE …

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

Abnormalities In Sensorimotor Brain Function Are Related To Chronicity Of Low Back Pain, Jo Armour Smith, Rongwen Tain, Kelli G Sharp, Laura M Glynn, Linda R Van Dillen, Jesse V Jacobs, Steven C Cramer

2020-Current year OA Pubs

Maladaptive plasticity in the brain may contribute to chronic low back pain (LBP) and underlie the altered postural control of the lumbopelvic musculature that is evident in some individuals with LBP. We recently described an MRI-compatible leg-raise paradigm to measure brain activity associated with lumbopelvic postural control. The objective of this study was to compare brain function in young adults with and without a history of LBP and to determine relationships between brain function, pain, and postural control characteristics. We recruited 55 participants with a history of LBP, who were asymptomatic when studied, and 30 healthy controls. Postural control during …

Modeling Clinical Relevance And Risk In Yttrium-90 Radioembolization Of The Liver: Lung Shunt Fraction Variability According To Imaging Modality, Cancer Type, And Tumor Size, M Allan Thomas, Tharun Alamuri, Ryan C Lee, Dan Giardina, John Karageorgiou, Naganathan Mani, Daniel A Braga, Christopher D Malone

2020-Current year OA Pubs

PURPOSE: To test the hypothesis that lung shunt fraction (LSF) in yttrium-90 (

MATERIALS AND METHODS: This was a retrospective analysis of 354 consecutive cases from a 34-month period at a single institution. Cancer type (hepatocellular carcinoma [HCC] vs non-HCC) and maximum tumor size were tracked. LSF was computed from planar imaging (LSF

RESULTS: Median LSF was significantly different (all P < .001) among LSF

CONCLUSIONS: Despite significant variations with imaging modality and correction methods, consistent trends in LSF magnitude with cancer type and tumor size were still uncovered. The relative risk of observing clinically relevant LSF can be modeled for different liver tumor …

Knowledge, Interest, And Willingness Of Hematologists And Oncologists To Care For Adults With Vascular Anomalies, Bryan A Sisk, Anna M Kerr, Sally Cohen-Cutler, Margaret T Lee, Katie Harmoney, Alexandra Borst, Shelley E Crary, Shelbie Fishman, Stephanie Chen, Danielle Cicka, Stephanie Milam, Christine Bereitschaft, Kristen M Sanfilippo

2020-Current year OA Pubs

BACKGROUND: Vascular anomalies (VAs) are rare diseases that cause significant morbidity. Adults with VAs struggle to access expert care. Hematologists and oncologists in adult medicine are positioned to provide expert care, but no prior studies have characterized their openness to this role.

OBJECTIVES: This study characterized the experience, confidence, willingness, and motivating factors for hematologists/oncologists to care for adults with VAs.

METHODS: We surveyed United States hematologists and oncologists in adult medicine between October 2024 and March 2025. The questionnaire assessed knowledge, experience, confidence, and willingness to care for adults with VAs, as well as open-ended questions assessing factors influencing …

¡Salud! Sacrificing The Sacred Sip: A Critical Analysis Of The Impact Of The Spiritual Conquest On Alcohol Traditions In Central México, Elizabeth Vilchis

Graduate Theses/Dissertations

By thoroughly investigating the available primary sources, this thesis will convey the importance of the Mesoamerican inebriating drink pulque in both the ethos and mythos of ancient Nahua society, examining how the ritual use of pulque became problematic in the eyes of the Spaniards, by investigating the cultural and ideological contradictions or double standards that enabled the tensions, struggles, and violence with which the Spanish colonial regime repressed the ritual use of pulque. This thesis compares the Nahua ethos and mythos of pulque to the Christian ethos and mythos of wine, highlighting the parallels perceived by Spaniards in Central México …

Drone Dichotomy: Investigating The Application Of Unmanned Aerial Systems For Offensive And Defensive Chemical, Biological, Radiological, And Nuclear-Related Tasks, Evan Jacob Martinovitch

Graduate Theses/Dissertations

This thesis investigates the application of unmanned aerial systems (UAS) for both offensive and defensive chemical, biological, radiological, and nuclear (CBRN) tasks to determine if they serve as a force multiplier on the modern battlefield. As CBRN weapons reemerge as realistic threats alongside the rapid proliferation of UAS, the intersection of these fields presents unique challenges and opportunities. Through a methodology that examines the history of the UAS-CBRN intersection, military doctrine, and the status of UAS technology, this research evaluates the capability of current and emerging UAS against specific CBRN delivery, reconnaissance and surveillance, and decontamination tasks. The analysis conducted …

Nonbinary Gender Performance And Self-Identification In Mary Shelley's Frankenstein, Lillian R. Durr

Graduate Theses/Dissertations

Mary Shelley’s 1818 novel Frankenstein, a text informed by a rich Romantic era philosophical tradition, has produced an expansive contemporary body of transgender studies scholarship. Building on transgender literary studies of Frankenstein, my thesis analyzes the difference between the monster’s internalized self-perceived identity and their externally performed and perceived identity. I interpret the difference between the monster’s internal and external identity as an analogy through which to understand contemporary nonbinary experiences. The “performance” of gender that Judith Butler describes is a limited expression of an internal, inescapable, ontological experience of self-identification. The monster’s own social experience illustrates the …

The Confidence-Man Goes To The Moving Panorama: Herman Melville’S Confidence Narrator And United States Imperialism, Bradley J. Lee

Graduate Theses/Dissertations

This thesis argues that Herman Melville fashioned his novel The Confidence-Man; His Masquerade (1857) after the moving panorama, a popular entertainment technology contemporary with the novel. More specifically, the thesis argues that the novel recalls Banvard’s Mississippi Panorama (1846). Using Jay Leyda’s The Melville Log and John Hanners’ record of Banvard’s performances, I establish beyond reasonable doubt the possibility that Melville saw this painting, or, at the very least, was aware of it, its content, and its social position. Tracing the novel’s engagement with this panorama reveals what seems at first to be its imperialist, Manifest Destinarian undertones. The novel’s …

Northern Luzon In A Taiwan Flashpoint: The Philippines’ Place In U.S. Strategy, Carson Keller

Graduate Theses/Dissertations

While the defense of Taiwan from a potential invasion by the People’s Republic of China (PRC) has long been a topic of debate and scrutiny in U.S. strategic thinking, the role of its southern neighbor, the Philippines, has received far less attention. This thesis argues that northern Luzon would constitute key terrain in a cross-strait conflict and may become an early target of People’s Liberation Army (PLA) operations. Its proximity to Taiwan and position along the Luzon Strait, particularly the Bashi Channel, places it at the center of efforts to control access to the hypothetical battlespace. Drawing on PLA and …

Gene Editing And The Accessibility Of Bioterrorism: Rethinking Global Biosecurity In The Post-Covid-19 Era, Nicholas Morales

Graduate Theses/Dissertations

COVID‑19 demonstrated how a single biological event can strain health systems, disrupt supply chains, undermine national security, and erode public trust. This shock occurred as biotechnology became dramatically more accessible: gene editing and synthetic biology tools once limited to specialized laboratories are now widely available through inexpensive equipment, open‑source data, and decentralized expertise.

This expanded access accelerates innovation but also broadens the threat landscape. The ability to reconstruct pathogens using publicly available sequences and mail‑order DNA shows that complex biological synthesis is no longer confined to state programs. These risks are amplified by opaque biotechnology activities in China, Russia, and …

When Speech Speaks Louder Than Truth: Language Variation And Credibility In The Courtroom, Melanie E. Spinnie

Graduate Theses/Dissertations

This study aims to investigate how linguistic variation affects perceptions of credibility in courtroom settings. It focuses on how jurors, judges, and other individuals in the legal system may exhibit bias (consciously or unconsciously) based on how a defendant or witness speaks-- this could include speech disorders as well as differences in dialect, accent, and speech style. Through review of relevant literature, review of a relevant historical case, conducting a survey, and conducting a semi-structured interview, this study explores whether certain speech patterns or characteristics are disproportionately associated with negative judgments during legal proceedings, such as reduced credibility and trustworthiness. …

Europe In The Indo-Pacific - Implications For The United States, Joshua G. Zinicola

Graduate Theses/Dissertations

Within the last five years the Indo-Pacific has become a region of increasing interest to European NATO members. In particular, the United Kingdom, France, and Italy have assigned strategic importance for their national security to the region, signing cooperative agreements with regional allies of the United States and deploying significant forces to the region. These agreements include commitments to jointly develop new technologies and combat systems for employment in both Europe and the Indo-Pacific, such as the Global Combat Air Programme (GCAP), and the Trilateral security partnership between Australia, the United Kingdom, and the United States (AUKUS). They also include …

A Geospatial Assessment Of Groundwater Salinization In A Multi-Aquifer System: Durango, Mexico, Juan Lopez-Sierra

Graduate Theses/Dissertations

Groundwater salinization poses a critical environmental concern for water resource sustainability in arid and semi-arid regions. This study evaluates spatial and temporal patterns of groundwater salinity across the state of Durango, Mexico, using total dissolved solids (TDS), sodium adsorption ratio (SAR), as salinity indicators and nitrate-nitrogen (NO₃–N) as an anthropogenic indicator. Groundwater quality data were obtained from (CONAGUA), a Mexican water agency. To assess salinity variations with respect to time, while minimizing interannual sampling bias, two multi-year sampling periods were selected: 2012-2013, and 2020-2021. Final datasets consisted of 122 wells for 2012–2013 and 131 wells for 2020–2021. The wells were …

Stopping The Buck: What Made The Truman Committee Uniquely Successful In Its Oversight Of World War Two Military Contracts, Victoria Kelley-Chiarelli

Graduate Theses/Dissertations

During World War Two, Harry S. Truman led the Senate Select Committee to Investigate the National Defense Program, also known as the Truman Committee, in its oversight of military contracts and the war effort. The Truman Committee saved the U.S. government billions by identifying and discouraging waste, fraud, and abuse, and saved many armed forces personnel’s lives through identifying defective products. Truman’s background in World War One service and his time as a local official in Missouri show signs of the integrity and commitment to good governance that made the Truman Committee so successful. The Truman Committee’s membership, staff, principles, …

Corpus Meum, Mea Electio, Kara L. Coonrod

Graduate Theses/Dissertations

The right to bodily autonomy and reproductive freedom is something I hold very close to my heart. Women who did not wish to embrace motherhood, or who grew beyond the walls of the hearth and home, have been far more often persecuted than praised. Over the past two years, I have created artwork borrowing the visual and material language of the Catholic church (along with personally relevant folklore) to elevate my freedom of choice and bodily autonomy in the face of religiously driven political oppression. Using a less frequently referenced organ from my reproductive system to represent my struggle against …

Herp Count 2025, Camryn Gulledge

Graduate Theses/Dissertations

Herp Count 2025 is a process-based project in which I log and document every herp (reptile or amphibian) I encounter in the wild while investigating the realities of human impact on ecosystems. During 2025, I observed 1,406 individual herps, most of which appeared not in remote wilderness but in the compromised margins of human spaces. When I observe them in a littered area, I collect nearby trash and bring it back to my studio to combine it with a detailed drawing of that specific individual. In my Contact series, I use a clean-touch printmaking process that involves a stretched plastic …

The Effect Of Sex On A-To-I Editing In Skeletal Muscle During Inflammation, Skyler Lee

Graduate Theses/Dissertations

Adenosine-to-inosine (A-to-I) RNA editing is a post-transcriptional mechanism mediated by ADAR enzymes that can alter RNA sequence, protein function, and gene regulation. Because ADAR1 is upregulated during inflammation and plays a critical role in innate immunity, previous studies investigated the effects of acute inflammation on RNA editing in male and female mice. Lipopolysaccharide (LPS) was used to induce inflammation, and RNA editing levels were examined in the heart, brain, and skeletal muscle. While editing levels in the heart and brain remained unchanged, skeletal muscle exhibited tissue- and sex-specific differences in editing. In this thesis, LPS treatment affected selective editing, increasing …

Flood-Regime Shifts Across The Lower Midwest, Usa: Identifying Patterns Through Flood Magnitude–Frequency Analysis And Clustering, Kaiser Mostafiz

Graduate Theses/Dissertations

Flood regimes describe how flood behavior changes in magnitude, recurrence, and occurrence through time. Changes in these flood characteristics can affect flood hazards, river systems, infrastructure, and floodplain management. This thesis examines flood-regime change across the Lower Midwest, focusing on Nebraska, Iowa, Kansas, and Missouri from 1961 to 2020. Records from 1,452 U.S. Geological Survey gaging stations were initially compiled, and 208 stations were retained after screening for record availability and analytical consistency. Flood-regime change was evaluated between two 30-year study periods: Period 1 (1961–1990) and Period 2 (1991–2020). The analysis combined Log-Pearson Type III flood-frequency analysis using L-moments in …

American Elderberry's Next Top Pollinator: Evaluating The Role Of Arthropods In Pollination, Jenny K. Burrow

Graduate Theses/Dissertations

American elderberry (Sambucus nigra subsp. canadensis) is a woody deciduous shrub native to eastern North America. In addition to its long history of use by indigenous peoples, there is renewed interest in cultivating and consuming American elderberry, primarily driven by expanding health supplement markets. Despite recent advances in horticultural development of American elderberry, its pollination ecology remains poorly understood. In this field study, I evaluated the contribution of arthropod visitors to pollination of American elderberry. To do this, I first characterized the identities and abundances of arthropod visitors via timed arthropod collections and floral observations during peak flowering …

Student Perspectives Of A Rubric-Based Performance Assessment In A Secondary Large Ensemble Classroom: Fairness, Clarity And Learning, Jeffrey S. Payne

Graduate Theses/Dissertations

The purpose of this study was to investigate student perceptions of a rubric-based performance assessment within a secondary large ensemble music program.  Seventy high school students enrolled in a high school band class completed a rubric-based performance assessment that featured personalized feedback and opportunities for resubmission  Using a mixed-methods approach, 17 students in the class voluntarily participated in a survey, the results of which I used to study my own use of assessment.  The survey consisted of eight Likert-scale questions and four open-response questions which were used alongside data regarding the resubmission rate and teacher documentation of instruction. Results indicated …

Advancing Hate Speech Detection: Binary And Multiclass Approaches From Traditional Methods To Parameter-Efficient And Ontology-Guided Language Models, Mahmoud Abusaqer

Graduate Theses/Dissertations

The widespread proliferation of hate speech on social media platforms poses significant challenges for content moderation and user safety, requiring automated systems that are simultaneously accurate, efficient, and capable of fine-grained distinctions. This thesis investigates hate speech detection through five published manuscripts organized into two complementary threads: binary detection (hateful vs. non-hateful) and multiclass detection across demographic targeting categories. The binary thread progresses from a broad 38-model baseline spanning traditional machine learning, deep learning, and transformer architectures (where RoBERTa reaches 91.48% accuracy and CatBoost remains competitive at 88.60%) to parameter-efficient adaptation, in which Low-Rank Adaptation (LoRA) of large language models …

Knowledge And Attitudes Of Medical Students About Research Methodology, Statistics, And Statistical Inference: An Assessment For Clinical Research Comprehension Skills, Laith Ashour, Lama Al-Mehaisen, Afnan Rababa, Osama Alrjoob, Moutaz Amayrh, Malak Al-Rabe'e, Qusai Al-Anasweh, Hala Al-Miqdadi, Nada Freihat, Mohammad Al Khreisha, Ala' Al Doaikat, Al-Mo'tasem Bellah Al-Rahamneh, Hamzeh Hatamleh, Fayez Zedat

Health Professions Education

Objectives: Medical students require a solid understanding of statistics in research papers. However, literature lacks sufficient studies on their proficiency, especially on Jordanian aspect. Methods: We performed a cross-sectional study on 361 medical students to evaluate their attitudes toward statistics, their knowledge in research methodology, and their ability to correctly interpret commonly used statistics in medical research. Statistical attitudes were assessed using three scales (value, difficulty, and interest) from the SATS-36 scale. Additionally, a novel author's-validated scale was created to measure students' research methodology knowledge. The scale validity was assessed using Confirmatory Factor Analysis (CFA). Multiple linear regression analysis was …

Beyond Clinical: A Proposed Policy Literacy Pathway In Health Sciences Education, Zarina Syed

Health Professions Education

Purpose: Health sciences graduates require not only clinical competence but also the ability to interpret, engage with, and enact policy. Yet, undergraduate curricula often emphasize technical skills, leaving gaps in policy literacy. Method: This conceptual paper proposes a scaffolded Policy Literacy Pathway to progressively integrate policy understanding across health sciences curricula. Results: Policy is framed as a dynamic, context-dependent process, aligning global ethical frameworks such as the Sustainable Development Goals with regional legislation and professional regulations. The pathway comprises four stages: Encounter, Iterative Engagement, Critical Reflection, and Policy Enactment. These guide students from initial exposure to policy issues through analysis …

Healthcare Students' Perspective On The Clinical Placement Learning Environment: A Cross-Sectional Study Of Third- And Fourth-Year Students At A College Of Health Sciences In The Uae., Wuni Abdul Razak, Fatima Alrayssi, Arwa Alkarbi, Latifa Al Saedi, Suliman Salih, Ajnas Alkatheeri, Mohamed Hassaneen, Mohd Nazmi Nordin, Mbambo Collen, Emne Hammoud, Shaik Balkhis Banu, Monika Sachdeva, Noon Kamil

Health Professions Education

Purpose: This study evaluates the clinical placement learning environment from the standpoint of Year 3 and Year 4 healthcare students in the UAE. Methods: The perspectives of healthcare students on clinical learning environments were studied using the validated Undergraduate Clinical Education Environment Measure (UCEEM). Third- and fourth-year (fifth-year pharmacy students inclusive) undergraduate healthcare students (radiography and medical imaging, emergency health, midwifery, nursing, pharmacy, physiotherapy, and psychology) (n=647) at a United Arab Emirates university were invited to participate in the study. The UCEEM contains 25 items under two overarching aspects, experiential learning and social engagement, with four subscales: learning opportunities at …

The Role Of Application Questions In Identifying Underrepresented Applicants In A Doctor Of Physical Therapy Program: A Retrospective Cross-Sectional Study, Michael Bourassa, Allison Bourassa, Saurabh Mehta

Health Professions Education

Purpose: The underrepresentation of U.S minority groups in the physical therapy profession remains a persistent challenge, with student enrollment in U.S doctoral education programs being the main pipeline to increase representation within U.S healthcare fields. This study aims to examine the association between non-academic application questions and applicant diversity in a Doctor of Physical Therapy program. Methods: The main outcomes measured in this study include demographic and cognitive variables, as well as non-academic application questions, for a single DPT program admissions cycle. Demographic variables include race, gender, and age, while cognitive variables include GRE scores and GPA. General non-cognitive question …

Effectiveness Of 3d-Printed Models In Undergraduate Dental Endodontic Education: A Systematic Review., Razi Jalali, Shankargouda Patil, Frank W Licari, Kamran H Awan, Shilpa Bhandi

Health Professions Education

Purpose: With the development of flexible polymers and stereolithography, 3D printed models have been proposed for dental education to overcome the shortcomings of extracted natural teeth and artificial resin blocks. This review aimed to systematically review the literature available for the effectiveness of the use of 3D printed tooth models for undergraduate endodontic education. Methods: Based on the inclusion and exclusion criteria, PubMed, Scopus, Web of Science, and Google Scholar electronic databases were searched. Clinical studies with full-text articles available in the English language were selected. Data extraction, risk of bias assessment using the ROBINS-I tool, and assessment of the …