Digital Commons Network^™

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

Great Power Competition In Africa: U.S. Aid Responses To Chinese Aid And Investment, Ebenezer Nana Botsio

All Graduate Theses and Dissertations, Fall 2023 to Present

Over the past two decades, China’s rapid expansion of aid and investment throughout sub-Saharan Africa has raised questions about how the United States responds to growing competition in the region. While the impact of China’s aid has been the subject of considerable study, far less attention has been given to how other donors shift their strategies to adjust. This thesis asks a simple but rather consequential question: does the US change how it gives aid in Africa in response to China’s ever-growing footprint? 

With data from 54 African countries, I find that the United States does not attempt to directly …

Long Covid Persistence And Surveillance Gaps Across 58 Us Hospitals, Jiazi Tian, Alaleh Azhir, Matthew Decaro, Ngan Chau, Jonas Hügel, Michele Morris, Jingya Cheng, Pedram Fard, Ingrid V Bassett, Douglas S Bell, Elmer V Bernstam, Shyam Visweswaran, Jeffrey G Klann, Shawn N Murphy, Hossein Estiri

Faculty, Staff and Student Publications

Importance: Surveillance of postacute sequelae of SARS-CoV-2 infection (PASC) depends on diagnostic coding systems that capture fewer than one-half of affected individuals, rendering millions invisible to health systems and policymakers.

Objective: To quantify the gap between true PASC burden and diagnostic code-based estimates, determine the proportion representing chronic disease, and characterize organ system heterogeneity and temporal trends across diverse populations.

Design, setting, and participants: This retrospective cohort study used electronic health record data from 58 hospitals and affiliated clinics in 4 US regions, from 2017 to 2025. Adults (aged ≥18 years) with laboratory-confirmed SARS-CoV-2 infection or a COVID-19 diagnosis code …

Phenotypic Diversity And Outcomes In Pediatric Nmda Receptor Encephalitis: A 15-Year Retrospective Study From The Largest Children's Hospital In The United States, Alexander J Sandweiss, Timothy Erickson, Yike Jiang, Varun Kannan, Jonathan M Yarimi, Kristen S Fisher, Nikita Shukla, Tim Lotze, Eyal Muscal, Kristy O Murray

Faculty, Staff and Students Publications

Anti‐NMDAR encephalitis (NMDARE) is an autoantibody‐mediated disorder characterized by seizures, movement disorders, neurocognitive deficits, and psychosis, but the complete phenotypic heterogeneity, and outcomes are incompletely understood in children. This single‐center retrospective analysis of NMDARE at the largest pediatric hospital in the United States between 2009 and 2024 screened 115 patients diagnosed with NMDARE. 103 had sufficient clinical data available for analyses. Two‐thirds were Hispanic, disproportionate to the Houston metro area demographics, and Hispanic patients had a higher CSF white cell count and antibody titer. Approximately one‐half of the patients with idiopathic NMDARE presented with a focal cortical phenotype that localized …

Hiding In Plain Sight: A Call To Prevent Cutaneous Leishmaniasis Transmission In The United States, Juan David Ramírez, Sarah M Gunter, Megan Coffee, Norman Beatty, Dawn M Wetzel

Faculty, Staff and Students Publications

Cutaneous leishmaniasis (CL), once considered a travel-associated tropical disease, is increasingly transmitted within the United States, particularly in southern regions. Despite mounting evidence of local transmission, public health recognition and preventive infrastructure remain limited. This Viewpoint highlights the urgent need to shift the U.S. CL response from questioning endemicity to preventing transmission. We review ecological, clinical, and surveillance data demonstrating the presence of competent vectors, animal reservoirs, and autochthonous human cases. Diagnostic delays, underreporting, and insufficient provider training contribute to missed prevention opportunities. Climate change and peri-urban rodent-human contact data further heighten future risk. A coordinated response is essential, including …

Human Trafficking Of Children Efficacy Of Counter Trafficking Programs For Youth, Alma Rodriguez

Electronic Theses, Projects, and Dissertations

Human trafficking is a global problem, and it is a significant problem within the United States. Children are a vulnerable group that become victims of human trafficking operations. Human trafficking prevention programs are available to address this issue, but there is much needed research to test the effectiveness of the countertrafficking programs for high-risk children. This study is a systematic review of studies on countertrafficking programs. This study will use a mixed methods approach to analyze quantitative and qualitative data from selected studies. This study hopes to find if current counter-trafficking programs are effective in preventing at-risk youth from becoming …

Tips For Health Care Practitioners: A Guide For Adolescent Obesity, Regina Santana

Electronic Theses, Projects, and Dissertations

Adolescent obesity continues to be a significant public health concern that is associated with long term physical consequences. The purpose of this project was to develop an evidence based, user friendly guidebook that supports healthcare professionals in the education of adolescents with obesity and their families. A structured literature review development process was used to inform the current development of the guidebook. The guidebook includes components of obesity management such as nutrition and physical activity recommendations. The validity of the content was established through the evaluation of five healthcare professionals that include registered dietitians and licensed therapists. The guidebook was …

Analyzing Social Implications Of The Gender Wage Gap, Jessie A. Clarke

Electronic Theses, Projects, and Dissertations

The researcher seeks to understand the gender wage gap in the United States. The research question studied is “Why do women in the United States on average earn less income than men?” Women gain less power and resources as they earn less income than men. The researcher explores the phenomenon in this paper. This research proposal utilizes qualitative methods via interviews, and analysis through coding. In previous research, there is a lack of inclusion on the gender wage gap regarding various identities such as sexual orientation, other gender identities, and race/ethnicity. The researcher hopes to fill in these gaps in …

High Concordance Of Physician-Attestation With Manual Data Abstraction For Sickle Cell Type: An Ash Rc Data Hub Study, Alexis A Thompson, Ashima Singh, Donna S Neuberg, Amanda M Brandow, Allison A King, Sophie Lanzkron, Emily A Semmel, Sam Walters, Susan Rogers, Kathleen Torres, William A Wood

2020-Current year OA Pubs

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The American Society of Hematology Research Collaborative (ASH RC) has built an SCD Data Hub (DH) to facilitate research and quality improvement using real-world data. To our knowledge, we report here the first analyses from the DH, focusing on cohort demographics and accurate identification of SCD diagnosis type. DH sites have data use agreements with ASH RC to extract and transfer electronic health record (EHR) data at least quarterly. Principal investigators (PI) provided additional attestation of SCD diagnosis based on existing local data sources deemed …

Guide To The Jean Stor Collection, Columbia College Chicago

CBMR Collection Guides / Finding Aids

Jean Stor was the pseudonym of William Astor Morgan (1890-1961). He was a composer, conductor, multi-instrumentalist, playwright, publisher, and teacher who lived and worked primarily in New York City. The collection consists of the handwritten and reproduced manuscripts of most of Stor’s major compositions, as well as a limited number of personal papers, published scores, writings, correspondence, photographs, and recordings.

Changes In Clinician Time Expenditure And Visit Quantity With Adoption Of Artificial Intelligence-Powered Scribes: A Multisite Study, Lisa S Rotenstein, A Jay Holmgren, Robert Thombley, Aditi Sriram, Reema H Dbouk, Melissa Jost, Debbie Aizenberg, Scott Macdonald, Naga Kanaparthy, Brian Williams, Allen Hsiao, Lee Schwamm, Sara Murray, Maria Byron, Jacqueline G You, Amanda J Centi, Christine Iannaccone, Michelle Frits, Adam B Landman, Karandeep Singh, Ming Tai-Seale, Jie Cao, Katharine Lawrence, Devin Mann, Christopher Holland, Bryan Blanchette, Jesse Ehrenfeld, Edward R Melnick, David W Bates, Julia Adler-Milstein, Rebecca G Mishuris

Faculty, Staff and Students Publications

Importance: Artificial intelligence (AI)-enabled scribes have been proposed to reduce electronic health record (EHR) burden and improve clinician satisfaction. There is limited evidence about their associated results across multiple sites and relative benefits for different clinician groups.

Objective: To assess the association of AI scribe adoption with changes in EHR time expenditure and visit volume and how associations vary by clinician characteristics.

Design, setting, and participants: Multisite, longitudinal cohort study of AI scribe adoption conducted at 5 US academic health care institutions that introduced AI scribes to their clinicians between June 2023 and August 2025. Participants were ambulatory clinicians.

Exposures: …

High Concordance Of Physician-Attestation With Manual Data Abstraction For Sickle Cell Type: An Ash Rc Data Hub Study, Alexis Thompson, Ashima Singh, Donna Neuberg, Amanda Brandow, Allison King, Sophie Lanzkron, Emily Semmel, Sam Walters, Susan Rogers, Kathleen Torres, William Wood

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The American Society of Hematology Research Collaborative (ASH RC) has built an SCD Data Hub (DH) to facilitate research and quality improvement using real-world data. To our knowledge, we report here the first analyses from the DH, focusing on cohort demographics and accurate identification of SCD diagnosis type. DH sites have data use agreements with ASH RC to extract and transfer electronic health record (EHR) data at least quarterly. Principal investigators (PI) provided additional attestation of SCD diagnosis based on existing local data sources deemed …

Governing Addiction: An Anthropological Comparison Of Care In The United States And The Netherlands, Kiren K. Bagga

Bates College Journal of Political Studies

This article examines addiction care as a form of moral governance through a comparative anthropological analysis of the United States and the Netherlands. Drawing on a Foucauldian theory of biopolitics alongside this study argues that approaches to addiction treatment reveal how states differentially value life, citizenship, and vulnerability. Joan Tronto's relational definition of ethical care is used to move beyond a solely moral context, towards an ethical understanding of both caretakers and those who require care. In the United States, addiction policy has historically functioned as a punitive and moralizing project, shaped by racialized drug criminalization, neoliberal ideals of individual …

Difference In Weather Delays At U.S. Large Hub Airports By Season, Momoka Okabe, Mitchell Riordan Rivers, Julian Waller, Vivek Sharma, Brooke E. Wheeler

Aeronautics Student Publications

At 31 large hub airports in the United States, there was a statistically significant difference in weather delays between Fall and both Winter and Summer, and Summer and Spring.

How Social Media Provides Access For Human Traffickers To Victimize Children: A Literature Review With Combative Measures., Ashton Lamb

Honors Theses

This literature review focuses on how human sex traffickers utilize social media to groom children. Social media is utilized by a great number of people around the world, including many children. While social media is intended to be fun and interactive, it does provide new access for dangerous people to reach victims. There is a very real, growing issue online that is not widely known to the public. This hidden danger is known as human trafficking. Human trafficking is defined as the involvement of any force, fraud, or coercion to obtain some labor or commercial sex act (Department of Homeland …

Redefining Inclusion: The Lived Experience Of Physically Disabled Nurses In The United States, Vanessa Cameron

Creating Healthy Work Environments (CHWE)

Purpose: The purpose of this phenomenological study was to explore the lived experiences of inclusion among physically disabled nurses actively working in the United States, including how those experiences differ based on disability timing—before or after licensure. Current literature largely centers on sensory or learning disabilities within academic settings; thus, this study addresses a critical gap by focusing on inclusion within professional nursing practice.

Significance: Physically disabled nurses remain underrepresented and underexamined in nursing research and workforce discussions. Applying Critical Disability Theory (CDT)—a framework never before used in nursing—this study explores how ableism and inclusion shape workplace experiences and opportunities …

Perceived Inadequate Neighborhood Food Shopping And Cardiovascular Disease Risk: The Multi-Ethnic Study Of Atherosclerosis, Amier Haidar, Ghadi Ghanem, Rishi Rikhi, Karol E Watson, Shreela V Sharma, Michael D Shapiro

Faculty, Staff and Student Publications

Background: Individuals with access to healthy food have healthier diets, improved cardiometabolic risk profiles, and decreased cardiovascular disease (CVD). However, previous studies have focused on the neighborhood food environment as distance to and density of food retailers. Our study examines the association between an individual's perceived adequacy of neighborhood food shopping and incident CVD.

Methods: We analyzed data from 6814 participants in the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective cohort study of individuals aged 45 to 84 who were enrolled in the study between 2000 and 2002 and followed longitudinally. Cox proportional hazards models estimated hazard ratios (HRs) for …

Changes In Internet Search Term Popularity In Elder Mistreatment (2018-2023): Infodemiology Study Of Google Trends Data, Nicholas Sevey, Melvin Livingston, Kristin Lees-Haggerty, Olanike Ojelabi, Randi Campetti, Jason Burnett, Carolyn E Z Pickering, David Hancock, Rachit Sabharwal, Michael Brad Cannell

Faculty, Staff and Student Publications

Background: Elder mistreatment (EM) is a significant public health problem that is frequently underdetected and underreported. Insufficient public recognition and engagement have been hypothesized as one contributor to this underreporting; however, few data sources exist to quantify public awareness or engagement with EM at the population level.

Objective: This study examined relative internet search interest in EM compared with other forms of abuse (child abuse and domestic violence) in the United States using Google Trends data.

Methods: We analyzed Google Trends data to compare the Relative Search Index (RSI) for the terms "elder abuse," "child abuse," and "domestic violence" in …

Out-Of-Pocket Costs And Antihypertensive Medication Use Among Veterans: A Natural Experiment, Alexander R. Zheutlin, Alexander Chaitoff, Daniel Addo, Joshua A. Jacobs, Catherine G. Derington, Eric L. Stulberg, Peter A. Glynn, Bernardo Modenesi, Jordana B. Cohen, Adam P. Bress

Department of Neurology Faculty Papers

BACKGROUND: Blood pressure (BP) control remains suboptimal in the United States despite available low-cost antihypertensive medications. Even small out-of-pocket medication costs may contribute to adherence. We determined whether $0 versus >$0 out-of-pocket costs for antihypertensive medications is associated with differences in adherence, discontinuation, BP control, and cardiovascular outcomes.

METHODS: We included veterans with newly diagnosed hypertension who initiated antihypertensive medication in the Veterans Health Administration from 2004 to 2022. A fuzzy regression discontinuity design with 2-stage residual inclusion leveraged differences in medication copay policy at a 50% service-connected disability threshold (≥50% service-connected disability: $0 out-of-pocket cost versus < 50%: $8 monthly cost). Outcomes included 1-year medication nonadherence (proportion of days covered < 80%), 1-year medication discontinuation (no medication in the final 90 days of the study year), 1-year BP control (systolic BP/diastolic BP < 140/90 mm Hg and < 130/80 mm Hg) and cardiovascular disease events (myocardial infarction, coronary revascularization, peripheral artery disease, or stroke).

RESULTS: Among 417 …

Coverage, Traits, And Geographic Distribution Of Online Surgeon Reviews: Large-Scale Cross-Sectional Analysis, Michael Geng, Carlos Riveros, Yash B. Shah, Sanjana Ranganathan, Kai Fok, Renil Sinu Titus, Vatsala Mundra, Eusebio Luna Velasquez, Dharam Kaushik, Allan S. Detsky, Angela Jerath, Benjamin N. Breyer, Yusuke Tsugawa, Christopher J. D. Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

BACKGROUND: The use of online physician rating platforms has significantly increased and has been shown to influence physician selection. There are limited data on the use of these platforms for rating surgeons.

OBJECTIVE: In this study, we sought to assess the geographic distribution of and patterns in rating scores of surgeons in the United States. Additionally, we examined rating volumes across different surgical specialties and the association between peer-nominated and patient-initiated ratings on online rating platforms in the United States.

METHODS: We conducted a cross-sectional study by identifying 201,154 surgeons in the United States via the National Plan and Provider …

Medicaid Expansion And Frequent Mental Distress Among U.S. Adults: Staggered Did Using Brfss, 2011 To 2024, Abimbola Adegoke, Kola Adegoke, Olajide Alfred Durojaye, Deborah Dawodu, Abiodun Isola Aluko, Akorede Adekoya, Kenneth A. Knapp

Health & Biomedical Sciences Faculty Publications

The Affordable Care Act (ACA) allowed states to expand Medicaid eligibility, potentially improving access to care and reducing psychological distress among lower-income adults. However, evidence on population-level mental health effects remains mixed, and conventional two-way fixed-effects difference-in-differences (DiD) estimates can be biased under staggered adoption. This study estimates the effect of Medicaid expansion on frequent mental distress (FMD) among non-elderly adults, with emphasis on lower-income adults. We used Behavioral Risk Factor Surveillance System (BRFSS) data from 2011 to 2024 and restricted the sample to adults aged 18 to 64 years. FMD was defined as ≥14 days of poor mental health …

Contraception In The Ed: Understanding Education And Opportunities For Clinicians To Advise Patients, Hannah B. Lewis, Teagan R. Mccarthy, Dara Kass, Jennifer L. Kahoud

Department of Emergency Medicine Faculty Papers

Introduction: The United States faces a high rate of unwanted pregnancies. Despite this, many people continue to face barriers to accessing contraception. The emergency department (ED) can help bridge these gaps, but emergency clinicians must first feel comfortable offering contraceptive services. In this study, we sought to determine emergency clinician comfort in prescribing contraceptives and educating patients on their use. We also gauged clinician interest in receiving education specifically geared toward contraceptive care.

Methods: We conducted an online survey of ED residents, attendings, and advanced practice clinicians at Thomas Jefferson Univerity Hospital and affiliates in both the urban and suburban …

High-Throughput Multiplex Detection Of Respiratory Pathogens: Multicenter Evaluation Of The Nxtag Respiratory Pathogen Panel V2 Assay., Marisa C. Nielsen, Ping Ren, Sri Bharathi Kavuri, Karissa Culbreath, Rangaraj Selvarangan, Dithi Banerjee, Blake W. Buchan, Rachel Behounek, Janet Farhang

Manuscripts, Articles, Book Chapters and Other Papers

Respiratory tract infections remain a major cause of global morbidity, highlighting the need for rapid and accurate diagnostic testing. This multicenter study evaluated the clinical and analytical performance of the updated NxTAG Respiratory Pathogen Panel v2 (RPPv2), a high-throughput multiplex molecular assay designed to detect 21 viral and bacterial respiratory pathogens. A total of 2,145 nasopharyngeal swab specimens, including both prospectively enrolled and archived specimens, were analyzed across five U.S. clinical sites. The NxTAG RPPv2 was assessed against FDA-cleared molecular assays and bi-directional sequencing, with contrived specimens used to supplement low-prevalence targets. Valid results were obtained for 99.7% of specimens …

Relative Impact Of Multidomain Lifestyle Interventions On Deficit Accumulation Frailty Over 24 Months In The U.S. Pointer Trial, Mark A Espeland, Kayloni Olson, Christy C Tangney, Darren R Gitelman, Maryjo Cleveland, Amber A Thro, Yitbarek N Demesie, Heather M Snyder, Rachel A Whitmer, Pankaja Desai, Rifat Alam, Lucia Crivelli, Thomas M Holland, Olivia Preissle, Rema Raman, Michele K York, Laura D Baker

Faculty, Staff and Students Publications

Background: Multidomain lifestyle interventions hold promise as approaches to slow aging. Deficit accumulation frailty indices (FIs) are increasingly used to capture aging processes. Frailty is highly associated with increased mortality and chronic disease risk, but the degree to which multidomain lifestyle changes impact frailty is not clear.

Methods: The U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk (U.S. POINTER) was a 2-year randomized clinical trial to compare two multidomain lifestyle interventions designed to increase exercise, improve diet, and promote social and cognitive stimulating activities and health monitoring. The Structured intervention incorporated greater structure, intensity, and accountability …

Untangling Impacts Of Socioeconomic Position, Chronic Disease, And Low-Level Pm2.5 Exposure On Mortality Among Native American Medicare Beneficiaries, Judy Wendt Hess, Wenyaw Chan

Faculty, Staff and Student Publications

Ambient fine particulate matter (PM2.5) is associated with increased mortality at concentrations below current regulatory standards. Studies of low-level exposure often rely on large administrative cohorts whose geographic and demographic composition may influence observed associations. In a prior analysis, we observed an association between long-term PM2.5 and all-cause mortality among Native American Medicare beneficiaries living in zip codes within the lowest decile of PM2.5 exposure. The present study, a case-control analysis of 1,713,399 low-PM2.5-exposed beneficiaries enrolled in traditional Medicare during 2015-2016, evaluated whether this association could be explained by geographic context, socioeconomic position (SEP), or baseline health status. We used …

Implementing Measurement-Based Care In Virtual Mental Health Services For Rural Veterans: Provider Insights From A Pre-Implementation Evaluation, Amanda Heeren, Kimberly Mccoy, Lindsey Fuhrmeister, Natalie Suiter, Jan A Lindsay, Chloe Hoang, Laura Marsh, John Fortney, Carolyn Turvey

Faculty, Staff and Students Publications

Background

Measurement-Based Care (MBC) uses repeated standardized psychological assessments to monitor treatment progress and guide clinical decision-making. Although MBC improves outcomes when results are discussed collaboratively, adoption across the Veterans Health Administration (VHA) remains below 50%, particularly in virtual and rural settings. This pre-implementation evaluation explored provider perspectives to inform development of a digital MBC workflow for rural tele-mental health settings.

Methods

Using the Alacrity Center’s Discover, Design, Build, and Test model and User Centered Design, we conducted a pre-implementation survey of mental health providers at a VHA Medical Center providing care to rural and highly rural Veterans in South …

Organ Procurement Organization Utilization Of Portable Hypothermic Oxygenated Machine Perfusion In Liver Transplantation: The First Us Experience, Christine E. Haugen, Muhammad Bilal Moeen-Ud-Din, Abdalla M. Hadhoud, Achintya Kaw, James R. Butler, James V. Guarrera, Sherry Quire, Ralph C. Quillin

Department of Surgery Faculty Papers

BACKGROUND: Advanced machine perfusion techniques have increased the use of hard-to-place organs, effectively changing the liver transplantation landscape. Liver transplantation machine perfusion has been driven largely by industry or individual transplant centers. We describe the implementation of a portable, organ procurement organization-initiated hypothermic oxygenated machine perfusion strategy for liver transplantation as a proof of concept.

METHODS: Surgeons and staff at a regional organ procurement organization (Indiana Donor Network) were trained to use and cannulate liver allografts using a portable hypothermic oxygenated machine perfusion platform. We evaluated all liver transplantations recovered and placed on hypothermic oxygenated machine perfusion (N = 18) …

Res Historica, Volume 5, Alpha Rho Epsilon Phi Alpha Theta, Lindsay Rae Smith Privette Phd

Res Historica

The 2026 journal of historical research by Anderson University students, Res Historica.

The editorial team for this edition of Res Historica was Dr. Lindsay Rae Smith Privette, Julia Ackerman, Callyn Wright, Logan Davis, and John Hinton. Cover art by Mary Beth Lee.

Integrated Mortality Surveillance In The United States, Colombia, & Zambia: Facilitators, Barriers, & Lessons, Chinwe Lucia Ochu, Erin Nichols, Abdisalan Noor, Karen A. Mcdonnell

GW Research Showcase 2021-2026

No abstract provided.

"Transgender Insanity" And Scapegoating: President Donald Trump's Political Rhetoric Regarding Transgender Americans, Savannah Torres

Presentations - 2026

The political rhetoric used by President Donald Trump to refer to transgender Americans results in their scapegoating.