Digital Commons Network^™

Prevalence And Determinants Of Diabetes-Related Psychological Distress In A Tertiary Care Setting In Tamil Nadu: India: Cross-Sectional Study, Rohit Shankar, Samuel Tromans

Peninsula Medical School

BackgroundDiabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.AimsTo determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.MethodThis prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress …

Involving Parents In Prevention: A Case Example Of Research And Intervention Development To Improve Financial Well-Being Support, Nick Axford, Gisella Hanley, Rebecca Summers, Kristin Liabo, Amy Bond, Eleanor Bryant, Georgia Smith, Rachel Silcock, Vashti Berry

Peninsula Medical School

The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children’s …

Measuring Outcomes In Evaluations Of Interventions To Prevent Youth Crime And Violence: Challenges And Potential Solutions, Sajid Humayun, Finlay Green, Helen Downham, Nick Axford

Peninsula Medical School

There is a clear imperative to prevent youth crime and violence owing to the significant social and economic costs for individuals involved and wider society. A considerable evidence base for ‘what works’ in this space exists but gaps remain. To address these, it is necessary to evaluate intervention effectiveness. The aim of this article is to explore challenges and potential solutions regarding outcome measurement in such evaluations. To do this we draw on the literature and our experience as evaluators. We argue that outcome selection should be informed by a robust theory of change, and that normally this will mean …

Small-Molecule Therapies Targeting Tumor-Associated Macrophages In Glioma: Mechanisms And Potential, Hua Wang, Heng Luo, Haijian Zhong, Amy Ockleton, Feng Jiang, Renhui Yi, Shaochun Yang, Ming Li

Peninsula Medical School

Glioblastoma, a highly prevalent and aggressive primary brain tumor, is marked by poor prognosis due to the blood-brain barrier and chemoresistance, which limit conventional pharmacotherapy. Recent research has pivoted toward targeting the tumor microenvironment, where tumor-associated macrophages (TAMs) drive gliomagenesis and malignant progression through immunosuppressive signaling. Small-molecule agents targeting TAMs have emerged as promising therapeutics, capable of reprogramming macrophage polarization, modulating immune cell dynamics, and suppressing glioma growth. This review explores the mechanistic roles of TAMs in glioma and evaluates how small-molecule compounds exert antitumor effects via TAM modulation. These insights lay a foundation for developing next-generation TAM-targeted therapies, offering …

Enhancing Offshore Wind Resource Assessment Through Neural Network-Based Hf Radar Data Analysis, Nikolas Martzikos, Matthew Craven, David Walker, Daniel Conley

School of Engineering, Computing and Mathematics

The increasing demand for offshore wind energy underscores the need for accurate wind speed estimation to support the design and operation of offshore wind farms. High-Frequency Radar (HFR), a widely used remote sensing technology in oceanographic research, offers promising potential for wind resource assessment, particularly in areas where conventional measurements are limited. This study explores the application of artificial neural networks (ANNs) for offshore wind speed prediction using HFR-derived data, addressing key challenges in model development and training. A key feature of this approach is the use of a decade-long dataset from the Celtic Sea, off the southwest UK coast, …

Usable Authentication: Are We There Yet?, Nathan Clarke, Steven Furnell

School of Engineering, Computing and Mathematics

With technology increasingly embedded in everyday life, the demand for secure and usable authentication methods has never been greater. Traditional password-based systems continue to dominate, despite well-known usability and security challenges. This paper explores the evolution of user authentication technologies, from secret knowledge and tokens to biometrics and emerging approaches such as Passkeys. It critically evaluates the extent to which usability has been achieved, identifying both successes—such as biometrics integrated into smartphones—and persistent issues, including inconsistent guidance, ecosystem dependence, and accessibility barriers. Drawing on academic and commercial developments, the discussion highlights the growing burden on users who must authenticate across …

Diagnosing Long-Term Divergence In Build Back Better Outcomes In Low- And Lower-Middle-Income Communities, E. A. Opabola, M. Baiguera, A. Raby, T. Rossetto, A. Pomonis, E. Meilianda, Y. Idris, S. Nurdin, K. Adams, D. J. Mcgovern, N. Acikgoz, H. Mistry, F. Marafini

School of Engineering, Computing and Mathematics

Low-income communities in disaster-prone regions face persistent challenges in translating post-disaster recovery investments into sustained resilience, as they navigate trade-offs among engineering objectives, policy constraints, and evolving socio-economic needs. Despite the widespread adoption of Build Back Better (BBB) principles, evidence on the long-term sustainability of outcomes remains limited, particularly in low- and lower-middle-income contexts. This study examines the sustainability of BBB outcomes in two Indonesian case studies: Banda Aceh (approximately 18 years after the 2004 Indian Ocean tsunami) and Central Sulawesi (approximately 4 years after the 2018 earthquake, liquefaction, and tsunami). Drawing on structured housing assessments, household surveys, semi-structured interviews, …

Investigating The Potential For First Year Residential Field Courses To Facilitate The Establishment Of Teacher-Student Relationships In Biological Sciences Undergraduate Degrees, Anne Plessis, Alison Stokes

School of Biological and Marine Sciences

Teacher-student relationships (TSRs) in higher education impact many aspects of the student experience, including engagement and performance. However, relatively little is known about the mechanisms of establishment of TSRs, and in particular how these are influenced by specific learning environments and contexts. Here, we undertake an exploratory investigation using first year biological sciences undergraduate residential field courses to examine how this teaching context affected the frequency and nature of teacher student interactions, and consequently the development of TSRs. Data were collected from teacher and student participants using questionnaires and focus groups. We found that interactions during fieldwork took place frequently …

Groundwater Spatial Variability Within An Atoll Island: Assessing Shallow Aquifer Heterogeneity With Geophysical And Physicochemical Measurements, N. I. Tobon-Velazquez, G. Masselink, T. J. O’Hare, R. Bates, F. K.J. Oberle, C. D. Storlazzi, D. C. Conley

School of Biological and Marine Sciences

This study examines the spatial variability of shallow groundwater on Dhigelaabadhoo Island using electromagnetic induction surveys, groundwater monitoring, and sediment analyses. The research reveals how variations in island morphology—such as differences in elevation, reef flat width, and sediment composition—affect the spatial distribution of groundwater lenses and the overall aquifer dynamics. Saltwater intrusion is especially pronounced in low elevated areas, with narrow reef flat plate and areas where higher hydraulic conductivity—driven by the presence of coarser sediments—is observed, whereas regions characterized by finer sediments, higher elevation, and wider reef flat plates tend to support more symmetric and less saline groundwater lenses. …

Critical Success Factors For An Effective Security Risk Management Program: An Exploratory Case Study, Jason A. Williams, Humayun Zafar, Saurabh Gupta

Faculty Articles

This paper evaluates the perceived effectiveness of the security risk management (SRM) programs at a Fortune 500 firm. Layers of management and staff participated in the study. Perceived effectiveness of their SRM programs was based on nine critical success factors (CSFs). Interviews confirmed six initial CSFs (Executive Management Support, Organizational Maturity, Open Communication, Risk Management Stakeholders, Team Member Empowerment, and Holistic View of an Organization) that were extracted from the literature. They were confirmed and synthesized with three additional CSFs (Security Maintenance, Corporate Security Strategy, and Human Resource Development). Implications for SRM are discussed.

Affirmatively Misled: The Commutation Instruction That Distorted Louisiana’S Death Penalty, G. Ben Cohen

Akron Law Faculty Publications

In 1997, Louisiana voters amended the state constitution to mandate that capital juries be instructed on the governor’s power to commute life and death sentences. This amendment, urged by the Louisiana District Attorneys Association, followed a Louisiana Supreme Court ruling that found an earlier clemency instruction violated the state constitution.     The instruction was fundamentally false. Louisiana governors, it turns out, lacked the unilateral authority to commute sentences; such actions require a favorable vote from the Parole Board. This reality became starkly clear in 2023, when the clemency petitions of fifty-six condemned prisoners—many sentenced by juries affirmatively given this instruction—were terminated …

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Publications 2026-present

No abstract provided.

06.01.02. Antillean Nighthawk, Chordeiles Gundlachii, M. Davis, Ann Hodgson, Florida Ornithological Society

06.01. <i>Caprimulgidae</i> - Nightjars and Allies

The Antillean Nighthawk is a widespread summer resident across the Greater Antilles and is rare but regular in the Florida Keys and extreme southern Florida mainland.

Activist Judicial Restraints, Michael Gentithes

Akron Law Faculty Publications

For decades, jurists and scholars have touted the virtues of judicial restraint—a characteristic of judges who only adjudicate issues they are competent to resolve, thereby avoiding political thickets and preserving their authority. Judicial restraint is ingrained in justiciability doctrines that emanate from Article III of the Constitution. When applied evenhandedly, standing requirements, the political question doctrine, and prudential manageability prerequisites to litigation help the Court maintain an appropriately restrained docket.

The Roberts Court falls well short of this restrained ideal in potentially dangerous and destructive ways. The Court has changed justiciability doctrines into “activist judicial restraints” that, rather than avoiding …

The Inward Gaze: Byung-Chul Han's Achievement-Subjectivity In David Foster Wallace's Short Fiction, Ivan Marquez

All Student Theses and Dissertations

David Foster Wallace stated that the aim of his fiction and art was to reflect what it meant to be alive and form a relationship with the reader. In "E Unibus Plurum", Wallace posited that the tenets of Post-Modern fiction were once used to criticize the hypocrisies of the 1950's and 60's American had been subsumed by television and were no longer effective tools of criticism. Wallace argues for a move away from irony and stunt pilotry of postmodern fiction towards a fiction which espoused "single entendre values" (Wallace 192). While Wallace advocated for a return to more traditional story-telling, …

Unseen Motherhood, Kylie Zieminski

All Student Theses and Dissertations

Unseen Motherhood is a series of photographs that shows what first-time motherhood is really like, starting with pregnancy and going through birth and everything after. I did not want to just show the happy or perfect moments. I wanted to capture the hard parts, the big feelings, and how much a person's identity can change.

There are eighteen black-and-white photographs in this series, all showing my twin sister as she goes through becoming a mother. These images follow her before, during, and after birth. I wanted to show that motherhood is more than just one happy photograph.

I based this …

Binding The Visual Experience Of Law, Nicholas Mignanelli

Articles, Chapters in Books and Other Contributions to Scholarly Works

No abstract provided.

Psychometric Properties Of A Novel Affective Bias Task And Its Application In Clinical And Nonclinical Populations, Prathik Kalva, Kourtney Kanja, Brian A Metzger, Xiaoxu Fan, Brian Cui, Bailey Pascuzzi, John Magnotti, Madaline Mocchi, Raissa Mathura, Kelly R Bijanki

Faculty, Staff and Students Publications

To mitigate limitations in self-reported mood assessments, we introduce a novel affective bias task (ABT). The task quantifies instantaneous emotional state by leveraging the phenomenon of affective bias, in which people interpret external emotional stimuli in a manner consistent with their current emotional state. This study establishes task stability in measuring and tracking depressive symptoms in clinical and non-clinical populations. Initial assessment in a large non-clinical sample established normative ratings. Depressive symptoms were tracked relative to task performance in a non-clinical sample, as well as in a clinical cohort undergoing surgical evaluation for severe epilepsy. In both cohorts, a stronger …

Brain Death Versus Circulatory Death: How Functional Warm Ischemia And Cold Storage Impact Myocardial Membrane Repair In Human Donor Hearts, Shiyi Li, Rishav Bhattacharya, Abdussalam E Elsenousi, Katherine V Nordick, Adel M Hassan, Syed B Peer, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

Faculty, Staff and Students Publications

This study compares myocardial injury responses in human donor hearts from donation after brain death (DBD) and donation after circulatory death (DCD), with a focus on myocardial membrane integrity, pyroptosis, and damage. Unlike DCD hearts, which are exposed to varying durations of functional warm ischemic time (fWIT), DBD hearts, which are never subjected to warm ischemia, served as controls. A total of 24 human hearts were procured, consisting of 6 from the DBD group and 18 from the DCD group. All procured hearts were placed in cold normal saline and stored for up to 6 h. Left ventricular biopsies were …

Tau In Alzheimer’S Disease: Shaping The Future Patient Journey, Catherine J Mummery, Christopher Chen Li-Hsian, Cristian A Lasagna-Reeves, Rik Ossenkoppele, Christopher C Rowe, Douglas W Scharre, Huali Wang, Simon Kyaga, Jeffrey L Cummings

Faculty, Staff and Students Publications

Alzheimer's disease is a complex and multifactorial disease characterized by two key pathological hallmarks: amyloid-beta plaques and tau neurofibrillary tangles. Recent progress has led to the development and approval of disease-targeted therapies for Alzheimer's disease in the form of anti-amyloid-beta monoclonal antibodies. However, findings suggest that amelioration of multiple pathological drivers may be required to maximize clinical effect. An increasing body of evidence suggests that tau is a critical player in Alzheimer's disease pathophysiology, contributing significantly to neurodegeneration and cognitive decline. There are now several tau-targeting drugs in clinical development. In this review, we build on research and advancements in …

In Vivo Volumetric Visualization And Quantification Of Cumulus Expansion In Mice With Intravital Optical Coherence Tomography, Kohei Umezu, Frank J Brooks, Irina Larina

Faculty, Staff and Students Publications

Ovulation is preceded by a critical physiological process known as cumulus expansion, during which the cumulus cell layer surrounding the oocyte undergoes structural remodeling. Despite the recognized importance of this process for reproductive success, live quantitative imaging of cumulus expansion has not been previously achieved due to limitations of current imaging technologies for deeply located ovaries. In this study, we employed intravital optical coherence tomography for three-dimensional visualization of mouse follicles containing cumulus-oocyte complexes (COC) within the physiological context of the ovary, both ex vivo and in vivo. This method enabled time-lapse measurement of cumulus layer thickness and COC …

Evolving Burden Of Metabolic Dysfunction-Associated Steatotic Liver Disease And Its Complications In A Us Nationwide Healthcare System, Basim Ali, Ronald Samuel, Jennifer R Kramer, Liang Li, Xian Yu, Yumei Cao, Roxanne Desiderio, George Cholankeril, Steven M Asch, Hashem B El-Serag, Fasiha Kanwal

Faculty, Staff and Students Publications

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing public health problem. Measuring the burden of cirrhosis and its complications in people with MASLD is important to inform health care delivery.

Methods: We aimed to quantify the changes in the burden of MASLD-related cirrhosis and hepatocellular carcinoma (HCC) in a nationwide U.S. healthcare system. We used data from the Veterans Health Administration to examine temporal trends between 2010 and 2021 in the annual incidence and prevalence of cirrhosis and HCC in a large cohort of patients with MASLD, and to compare them to those in patients with hepatitis C …

Platelet Extravasation In The Microvasculature: An Under-Appreciated Role For Platelets, Justin A Courson, Vahid Afshar-Kharghan, Alan R Burns, Rolando E Rumbaut

Faculty, Staff and Students Publications

In recent years, evidence has accumulated highlighting the presence and role of platelet extravasation - wherein platelets accumulate in tissue parenchyma - at a variety of sites throughout the body. While platelets are traditionally known for their roles in hemostasis and thrombosis, it is evident that platelets are potent mediators of inflammation across an array of physiological and pathological contexts. While anucleate and small in size, platelets contain a rich diversity of molecules in their granules capable of modulating cell proliferation, tissue repair, and a host of immune responses. There is growing evidence that platelet extravasation out of the vascular …

Survodutide For Treatment Of Obesity: Baseline Characteristics Of Participants In A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial (Synchronize™-1), Carel W Le Roux, Sean Wharton, Biykem Bozkurt, Elke Platz, Gabriele Bleckert, Samina Ajaz Hussain, Martina Brueckmann, Elena Startseva, Isabel M Kloer, Lee M Kaplan

Faculty, Staff and Students Publications

Aims: Survodutide, a novel glucagon receptor and glucagon-like peptide-1 (GLP-1) receptor dual agonist, elicited significant weight loss in a phase 2 trial in individuals with obesity without type 2 diabetes (T2D). Two multinational phase 3 trials are investigating survodutide for obesity management in individuals with or without T2D. We report the baseline characteristics of participants in the SYNCHRONIZE-1 trial in adults with obesity without T2D (ClinicalTrials.gov: NCT06066515).

Materials and methods: Participants aged ≥18 years with BMI ≥30 or ≥27 kg/m2 with ≥1 obesity complication without T2D were randomized 1:1:1 to double-blind, once-weekly, subcutaneous injections of survodutide (up-titrated to 3.6 …

Improving Efficiency In Noma Schemes Having Inter-User Interference Using Mechanism Design, Zory Marantz

Publications and Research

Modern wireless systems utilize non-orthogonal multiple access to increase their rate capacities; however, the efficiency of the individual utility defined in bits per Joule has yet to be considered. Multiple variations of non-orthogonal multiple access have the interference of the signal-to-interference-plus-noise ratio as a function of the received power from multiple other users due to code implementations that are non-orthogonal or non-ideal cancellation in successive-interference-cancellation methods. Game theoretic concepts are used to improve user bits-per-Joule performance. Previous solutions increment transmit power and are not based on closed form systematic methods. The mechanism design presented here led to a non-cooperative Nash …

A Brief Measure Of Decisional Balance For Health Equity Engagement Among Health Professionals, Amanda Lee Almond

Publications and Research

Racial health and healthcare inequities are sustained in part by health professionals’ beliefs about the benefits and costs of equity-focused action, yet no validated decisional balance measure exists for this domain. This study introduces and evaluates the Health Equity Decisional Balance (HEDB) scale. Eighty-eight health professionals completed the scale of ten proposed items assessing perceived pros and cons of engaging with health and healthcare equity work, along with a measure of Anti-Racist Efficacy (ARE) (Eschmann et al., 2023). Confirmatory factor analysis and structural equation modeling were used to test the latent structure of the scale and its predictive validity. A …

Infection Control Across Clinical And Laboratory Dental Settings Protocols, Risks, And The Role Of Emerging Technologies, Khrystyna Vyprynyuk, Laura Andreesku

Publications and Research

This article explores infection prevention strategies and disease transmission pathways in dental settings, emphasizing the critical connection between clinical practice and dental laboratories. It highlights the risks of cross-contamination, disinfection and sterilization challenges, and the growing role of technology in enhancing infection control.

Archives And Children's Knowledge, Elliott Kuecker, Ashley Rockenbach

Publications and Research

This article argues for the importance of collecting works created by children—not just about and not just for—in formal archival collections. Framed through the ideas of legitimate knowledge and epistemic injustice, this piece combines notions important to children’s rights activists and childhood studies scholars with the role archives can play in preserving children’s knowledge through child-created materials. The authors describe how researchers struggle to find work created by children within archives, impacting the ability to create child-centered research that centers children’s views of the world as prominently as adult views of the world. Some collections that do include child-created materials …

Ancient Wisdom & Its Cultural Relevance: Reimagining Deeper Learning In Science Classrooms Through The Lens Of Yoga And Vedānta, Raaghav Pandya

Publications and Research

Contemporary calls to reconceptualize how science is taught and understood have brought deeper learning to the forefront of education at-large for its emphasis on critical perspectives, creativity, and student-centered inquiry. Yet this paper argues that its prevailing framework remains constrained by Cartesian dualism, a materialist foundation that disassociates the individual from self, other, and nature, and falls short of addressing the mental health, environmental, and cultural challenges facing youth today. To address this limitation, this paper proposes a complementary convergence between deeper learning and the contemplative traditions of Yoga and Vedānta, whose ancient paradigms of self-inquiry, interconnectedness, and well-being offer …

What Race Means For Health Among Black Americans: How Microaggressions Shape Self-Efficacy And Readiness For Behavior Change, Amanda Lee Almond

Publications and Research

Objectives: Persistent racial disparities in cardiovascular health among Black Americans reflect not only structural inequities in the United States, but also the racialized meanings of cardiovascular disease reproduced through public and private health communication. Drawing on ecological systems theory, this research examines how beliefs linking race and cardiovascular disease are reinforced through routine clinical interactions and how these meanings shape health behavior change. Method: Across two experimental mixed-methods studies, a model integrating ecological, social–cognitive, and behavior change frameworks was tested. In Study 1 (N = 374), health-message framing was experimentally manipulated to examine effects on self-efficacy and decisional balance while …