Digital Commons Network^™

Investigating The Impacts Of Facial Gestures On Global Participants’ Perception Of The Speaker, Perception Of The Message, Emotional Responses, And Engagement During Video Conferencing, Hanan Mohammed Alghamdi

Theses and Dissertations

Facial expressions play a crucial role in shaping communication and emotional understanding during virtual interactions. This study investigated how facial expressions influence participants’ perceptions of the speaker, perceptions of the message, emotional responses, and engagement during video conferencing across diverse cultural contexts. A hybrid experimental design was implemented using self-administered questionnaires to collect quantitative data and examine cause-and-effect relationships. Participants were randomly assigned to one of three facial-expression conditions Positive (smiling and joyful), Negative (angry or nervous), or Neutral (expressionless) and viewed speakers representing three ethnic backgrounds: White American, Black American, and Middle Eastern. Using a seven-point semantic differential scale, …

Examining The Relationship Between Title 14 Code Of Federal Regulations (Cfr) Part 147 Maintenance School Aviation Maintenance Technician (Amt) Instructor Experience And Instructor Pass Rates For Airmen Certification Standards (Acs) Element Subject Areas, Richard Lyman Johnson

Theses and Dissertations

This quantitative, correlational study examined the relationship between Aviation Maintenance Technician (AMT) instructor experience and student pass rates in 14 CFR Part 147 maintenance schools. Data were collected from February to August 2025 using purposive and snowball sampling, which yielded 67 complete responses. Instructor experience, measured in months of A&P-rated maintenance work prior to teaching, ranged from 1 to 684 months (M = 253.54, SD = 197.97). Student pass rates, defined as the proportion of students passing ACS element subject area courses, ranged from .52 to 1.00 (M = .95, SD = .07). Most instructors were male, White, over 50 …

Conflict Management: Values-Based Training Effects On Shifts In Strategy Preference Among Formerly Incarcerated Individuals, Candace Renae Fay

Theses and Dissertations

Problem-solving refers to a behavior evoked by a problem in which the behaver manipulates, supplements, and consequently, generates discriminative stimuli (SD) that they subsequently respond to (Donahoe & Palmer, 2004; Skinner, 1957, 1968). The use of problem-solving when faced with interpersonal conflict reflects pro-social behavior patterns, while providing a learning opportunity for identifying relevant variables and contingencies, and possible reductions of extended conflict or escalation in anti-social behavior patterns. Patterns of preference can be identified following multiple opportunities, given an array of options, resulting in consistency of choice responses (Martin, 2006). When less prosocial (avoiding, yielding), or antisocial (forcing) conflict …

Qualitative Stereo Vision Using Distributed Extended Waltz Filtering, Ben Mathew

Theses and Dissertations

Stereo vision is a fundamental problem in computer vision, aimed at reconstructing three-dimensional scene structure from two or more two-dimensional images. Traditional stereo algorithms rely on quantitative disparity estimation, often constrained by calibration precision, lighting variations, and surface texture. In contrast, our proposed Qualitative Stereo Vision seeks to understand depth relationships and spatial configurations from multiple planar views through symbolic reasoning and constraint satisfaction, offering a more flexible and cognitively plausible approach to scene interpretation.

This dissertation presents a novel framework called Distributed Extended Waltz Filtering, designed to provide qualitative stereo vision, particularly in the presence of occlusions—a persistent challenge …

Implications Of Cooccurring Adhd For The Cognitive Behavioural Treatment Of Anxiety In Autistic Children, Elise Ng-Cordell, Eric A Storch, Philip C Kendall, Jeffrey J Wood, Amori Yee Mikami, Connor M Kerns

Faculty, Staff and Students Publications

Background: Childhood mental health conditions commonly cooccur, with potential treatment implications. Autistic children frequently experience anxiety and attention deficit/hyperactivity disorder (ADHD). We investigated the implications of this cooccurrence for Cognitive Behavioural Therapy (CBT), a front-line treatment for anxiety in autistic children. We tested whether (1) ADHD predicts anxiety treatment response, (2) ADHD improves in response to anxiety treatment and (3) ADHD improvement is related to reductions in anxiety.

Method: Autistic children with elevated anxiety (N = 167) enrolled in a multisite, randomised controlled trial comparing standard CBT, autism-adapted CBT and treatment as usual. ADHD symptoms and severity were assessed via …

Differential Microrna Profiling Of Blood L1cam And Bulk Extracellular Vesicles In Bipolar Disorder, Gabriel R Fries, Salahudeen Mirza, Jun Wang, Camila N C Lima, Wei Zhang, Marcela Carbajal Tamez, Giselli Scaini, Jair C Soares, Joao Quevedo

Faculty, Staff and Students Publications

Objective: This preliminary study aimed to identify microRNA (miRNA) signatures associated with bipolar disorder (BD) by profiling blood-derived extracellular vesicles (EVs) of both putative neuronal origin and from all sources.

Method: In two parallel studies of individuals with BD and controls (CON), we characterized miRNA expression profiles of blood EVs selected for L1CAM, a putative marker of neuronal origin (n = 20 BD/20 CON), as well as bulk EVs (n = 21 BD/20 CON). For each study, analyses identified miRNAs differentially expressed between groups, followed by functional interrogation and testing for associations with clinical features.

Results: Results of …

Plasma Metabolomic And Proteomic Signatures Of Blood Pressure Management After Bariatric Surgery Among Adolescents, Shudi Pan, Zhenjiang Li, Juan Pablo Lewinger, Jesse A Goodrich, Hongxu Wang, Sarah Rock, Carmen Chen, Todd M Jenkins, Stephanie Sisley, Stephen R Daniels, Douglas I Walker, Max T Aung, Erika Garcia, Rob Mcconnell, Sandrah P Eckel, Michele A La Merrill, Tanya L Alderete, Zhuanghua Chen, Frank D Gilliland, Thomas H Inge, David V Conti, Justin R Ryder, Lida Chatzi

Faculty, Staff and Students Publications

Background: Emerging omics approaches, including metabolomics and proteomics, can be integrated into obesity treatment for better blood pressure management. We tested whether preoperative metabolomic and proteomic profiles predict long-term elevated blood pressure (EBP) changes better than known risk factors in adolescents undergoing bariatric surgery.

Methods: We included 108 participants from the Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery). Plasma untargeted metabolomics (via liquid chromatography with high-resolution mass spectrometry) and Olink proteomics were assessed pre surgery. An elastic net model with stability selection was used to identify features predictive of EBP reductions 5 years post surgery. Models including identified metabolites, proteins, and …

Difficult Conversation Case: Death Notification, Charles Lei, Tiffany Moadel, Suzanne Bentley, Amrita Vempati, David Fernandez, Daniela Ortiz, Anita Rohra, Stephanie Stapleton, Hillary Moss

Faculty, Staff and Students Publications

Audience: This case is meant for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine Certifying Exam. However, it is applicable for EM residents at all levels of training.

Introduction: Difficult conversations are an integral part of the practice of emergency medicine. Competent EM physicians routinely engage in challenging conversations with patients and their families (eg, delivering bad news, disclosing medical errors, providing death notifications).1 Despite their importance, communication skills are often not formally taught in residency training.2 Instead, learners frequently rely on role modeling to develop the skills necessary to navigate …

Emerging Tick-Borne Disease Risk In An Urban Center Of Harris County, Texas, Alisa Nelson, Michelle Downey, Maya Murry, Brianna Weber, Erik Aguirre, Richard Scott Mccrea, Jerrod Mims, Max Vigilant, Courtney Standlee, Kristy O Murray, Alex Kneubehl, Eric L Brown, Heather T Essigmann, Sarah M Gunter

Faculty, Staff and Students Publications

Background: Tick-borne diseases are an endemic and emerging public health concern in the United States. Ongoing tick range expansion, invasive species, and newly identified pathogens are rapidly altering disease epidemiology. Surveillance is critical to understanding vector ecology and disease risk. Harris County, Texas, with nearly five million residents and diverse ecological zones, offers a unique setting to study local tick dynamics.

Methods: From January 2021 to December 2022, we conducted weekly tick surveillance across 63 sites in Harris County (City of Houston), Texas. Ticks were morphologically identified and tested for Rickettsia, Borrelia, Ehrlichia, and Anaplasma via real-time PCR. Samples positive …

Fibroblasts Are The Primary Contributors To A Disrupted Micro-Environment In End-Stage Pediatric Hypertrophic Cardiomyopathy, Hanna J Tadros, Diwakar Turaga, Yi Zhao, Chang-Ru Tsai, Iki A Adachi, Xiao Li, James F Martin

Faculty, Staff and Students Publications

Background: Hypertrophic cardiomyopathy (HCM) is a relatively rare but debilitating diagnosis in the pediatric population, and patients with end-stage HCM require heart transplantation. Here, we have examined the transcriptome in ventricular tissue from this patient group to identify cell states and underlying cellular processes unique to pediatric HCM.

Methods: We performed single-nucleus RNA sequencing (snRNA-seq) on explanted hearts at transplant in 3 pediatric patients with end-stage HCM and compared findings to pediatric control and adult HCM.

Results: We identified distinct underlying cellular processes in cardiomyocytes, fibroblasts, endothelial cells, and myeloid cells compared with controls. Pediatric HCM was enriched in cardiomyocytes …

Patient-Centered Communication Case: Threatened Miscarriage, Anita Rohra, Daniela Ortiz, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Charles Lei, Alaa Aldalati, Stephanie Stapleton, David Fernandez

Faculty, Staff and Students Publications

Audience: This communication case is intended for EM residents of all levels.

Introduction: Patient-centered communication is a necessary skill in the practice of emergency medicine. This style of communication is crucial for promoting high-quality healthcare by prioritizing patient needs, perspectives, and values. This patient-centered communication case centers on miscarriage, a diagnosis where patient-centered communication is requisite. Approximately one in six or 17.1% of patients with a final diagnosis of miscarriage, also known as early pregnancy loss, present initially to the emergency department.1 Advising a patient of the diagnosis of miscarriage requires excellent communication skills including facile rapport building, empathy, nonverbal …

Managing Conflict Case: The Difficult Consultant, Amrita Vempati, Suzanne Bentley, Anita Rohra, Daniela Ortiz, David Fernandez, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Stephanie Stapleton, Tiffany Moadel

Faculty, Staff and Students Publications

Audience: This communication case is intended for emergency medicine (EM) resident physicians and junior faculty preparing for the ABEM Certifying Exam.

Introduction: Conflict management is a common and significant challenge in the emergency department (ED), with potential negative impact on both physicians and patients. At the individual level, hospital-based conflicts can lead to emotional stress, impaired concentration, decreased trust among providers, and feelings of dehumanization.1 For patients, conflicts between physicians can compromise the quality of care and contribute to delays in treatment.1 In the ED, conflict often arises between emergency physicians (EPs) and various stakeholders, including patients, family members, nursing …

Where, How, And How Much? A Multicenter Cohort Study Of The Relationship Across Lupus Decision-Aid Modality, Place Of Administration, Interruption And Viewing Completeness, And Patient-Reported Outcomes, Jasvinder A Singh, Mark Beasley, Larry R Hearld

Faculty, Staff and Students Publications

Objective: We assessed whether shared decision-making (SDM) and patient acceptability, feasibility, and overall satisfaction with a computerized patient decision aid (PtDA) for patients with systemic lupus erythematosus (SLE) differs by PtDA setting, modality, and the viewing experience.

Methods: Patients with SLE were invited to view a self-administered computerized SLE PtDA during regular clinic visits at 15 rheumatology clinics in an implementation trial. Patients completed a survey that included SDM measures including the decision conflict scale (DCS), Preparation for Decision Making (PDM) scale, and CollaboRATE scale, and we measured perceived patient acceptability, feasibility, and satisfaction. Patients viewed the SLE PtDA in …

The Neonatal Gut Microbiome In Health And Disease, Geoffrey A Preidis

Faculty, Staff and Students Publications

No abstract provided.

Differential Microrna Profiling Of Blood L1cam And Bulk Extracellular Vesicles In Bipolar Disorder, Gabriel R Fries, Salahudeen Mirza, Jun Wang, Camila N C Lima, Wei Zhang, Marcela Carbajal Tamez, Giselli Scaini, Jair C Soares, Joao Quevedo

Faculty, Staff and Student Publications

Objective: This preliminary study aimed to identify microRNA (miRNA) signatures associated with bipolar disorder (BD) by profiling blood-derived extracellular vesicles (EVs) of both putative neuronal origin and from all sources.

Method: In two parallel studies of individuals with BD and controls (CON), we characterized miRNA expression profiles of blood EVs selected for L1CAM, a putative marker of neuronal origin (n = 20 BD/20 CON), as well as bulk EVs (n = 21 BD/20 CON). For each study, analyses identified miRNAs differentially expressed between groups, followed by functional interrogation and testing for associations with clinical features.

Results: Results of …

Promoting Professionalism In Medical Education: A Toolbox For Effective Feedback And Remediation, Matthew R Carroll, Gal Barak, Tracy Byrne, Huma Farid

Faculty, Staff and Students Publications

No abstract provided.

A Model For Developing Subspecialty Clinical Practice Guidelines: The Geriatric Emergency Department Guidelines 20, Satheesh Gunaga, Christopher R Carpenter, Maura Kennedy, Lauren T Southerland, Alexander X Lo, Sangil Lee, Kirby Swan, Fabrice Mowbray, Rachel M Skains, Teresita M Hogan, Martin F Casey, Kei Ouchi, Naomi R George, Kerstin De Wit, Cameron J Gettel, Katherine Selman, Luna C Ragsdale, Anita N Chary, James D Van Oppen, Glenn Arendts, Charles L Maddow, Katherine M Hunold, Katren R Tyler, Danya Khoujah, Ula Hwang, Shan Liu

Faculty, Staff and Students Publications

The original consensus-based Geriatric Emergency Department (GED) Guidelines, published in 2014, established a framework of core principles for delivering high-quality, age-appropriate emergency care for older adults. In response to significant advances in geriatric emergency medicine research and evolving clinical priorities, we developed the GED Guidelines 2.0 to ensure continued relevance, clinical utility, and evidence-based rigor. This concept paper describes the systematic and iterative process undertaken to update the guidelines, including the formation of multidisciplinary working groups and the application of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Unlike the original GED Guidelines, our approach prioritized methodological transparency, …

Ataxia-Telangiectasia Mutated Activation Mediates Transforming Growth Factor Beta Signaling In Acetaminophen-Induced Liver Injury In Mice, Matthew Mcmillin, Christopher S Chu, Elaina Williams, Juliet Venter, Kiersten Bell, Anca D Petrescu, Patrick Mireles, Sharon Demorrow

Faculty and Staff Publications

Acetaminophen (APAP) overdose is associated with increased transforming growth factor beta 1 (TGFβ1) signaling and elevated oxidative stress, which exacerbate DNA damage. TGFβ1 has been shown to regulate ataxia-telangiectasia mutated (ATM) signaling and DNA repair in other cell types. This study investigates the DNA damage response (DDR) during APAP-induced liver injury, focusing on ATM-mediated regulation of TGFβ1 signaling. APAP administration in vitro and in vivo resulted in DNA damage, increased ATM signaling, accumulation of γH2AX, and activation of phosphorylated ataxia telangiectasia mutated (pATM) and phosphorylated checkpoint kinase 2 (pChk2). Pretreatment with an ATM inhibitor, KU55933, attenuated APAP-induced hepatocyte damage and …

Decreasing Barriers To The Utilization Of Cryopreserved Sperm In Male Cancer Survivors: An Expert Review And Guide, Megan V Alexander, Hailie Ciomperlik, Anna Claire Reynolds, Allyson Nevins, Luwam Ghidei, Jordan Kassab, Kevin Campbell, John Sullivan, Michael D Jochum, Laura Detti, Terri L Woodard, Larry I Lipshultz, Laurie J Mckenzie

Faculty, Staff and Students Publications

Background: Sperm cryopreservation offers male cancer patients a critical opportunity to preserve fertility prior to gonadotoxic therapy, yet utilization of banked sperm remains modest, typically under 10%. A structured understanding of barriers across the cancer survivorship continuum is needed to support patients in utilization of cryopreserved sperm in alignment with their reproductive goals.

Materials and methods: This expert review synthesizes current evidence and clinical experience to explore the multifaceted barriers to cryopreserved sperm use and propose specific solutions. Key intervention timepoints are examined, including the post-treatment fertility return visit, long-term cryopreservation while remote from family building, readiness for family building, …

Diabetes-Induced Mitral Valve Degeneration: Tissue-Engineered Solutions And Antioxidant Therapy, Samantha Hahn

All Theses

Mitral valve (MV) fibrosis is a progressive pathological condition characterized by leaflet thickening and stiffening, ultimately compromising valve function. This process is accelerated in diabetes, where chronic hyperglycemia elevates reactive oxygen species (ROS) and alters the mechanics of the extracellular matrix (ECM), collectively promoting the activation of valvular interstitial cells (VICs). Under healthy conditions, VICs maintain a quiescent, fibroblast-like phenotype responsible for sustaining ECM homeostasis. However, pathological biochemical cues or mechanical stress drive VICs toward a myofibroblast phenotype. While this transformation is essential for short-term repair, its persistence contributes to maladaptive MV remodeling and fibrosis. Diabetic stressors may be mitigated …

The Influence Of High School Art Courses On Graphic Communications Students, Mackenzie Crawford

All Theses

This study examines the influence of high school art courses on students’ pursuing a degree in graphic communications (GC) at Clemson University. The purpose is to explore how prior high school art courses impact students’ major choice, preparedness, and academic success within GC. While creativity is central to the field, limited research addresses how early exposure to art integration shapes students’ readiness for college-level technical and design programs.

Grounded in theories of experiential learning and career development, this study builds upon the research by Moss, Benus, and Tucker (2018), who found that school-based arts programs enhance executive function and academic …

Digital Solutions For Bridging Language Barriers: Designing And Testing An App For Construction Spanish Safety Communication On Construction Jobsites, Adrian Cappella

All Theses

Language barriers between English-speaking supervisors and Spanish-speaking workers create safety risks on U.S. construction jobsites. Hispanic workers face higher injury and fatality rates, with miscommunication being a major contributing factor. Existing translation tools lack the accuracy, cultural context, and jobsite relevance needed for effective safety communication.

In this study a mobile application with construction-specific safety phrases in English and Spanish was designed and field tested. The research included a literature review, phrase collection and validation with industry experts, application development and design with a computer science collaborator, and usability testing with supervisors and workers. Surveys and field trials measured navigation, …

Factors Influencing Employees’ Ai Adoption Intentions In Occupational Settings, Emma G. Wituk

All Theses

Artificial intelligence (AI) is a burgeoning technology whose development has many implications for organizations and employees. Using a modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, this study tested performance expectancy (PE; the belief that AI will enhance personal job performance) and prior AI experience (EXP) as predictors of behavioral intention (BI) to use an AI coaching tool, Nadia. We expected both PE and EXP to be positively related to adoption intentions. Additionally, social influence (SI; respondent’s belief that other individuals think they should adopt AI) and facilitating conditions (FC; appropriate infrastructure and adequate …

Investigating The Impacts Of Azole Antifungals On Growth Of Cryptococcus Neoformans, Gnanambika Sindhe

All Theses

Cryptococcus neoformans, an opportunistic fungal pathogen is responsible for cryptococcosis, leading to approximately 181,000 deaths annually, predominantly in regions such as Sub-Saharan Africa. Fluconazole, a widely used fungistatic azole, is often administered due to its relative affordability and lower toxicity. However, resistance to fluconazole in C. neoformans can arise through aneuploidy, complicating treatment efforts. This study aims to deepen our understanding of resistance mechanisms to azole drugs by comparing fluconazole with other azoles, including both clinical and agricultural azole antifungals. Disk diffusion assays were performed to evaluate the ability of C. neoformans to develop resistance to these compounds, focusing …

Exploring Augmented Reality Non-Driving-Related-Task Locations To Enhance Driver Situation Awareness In Conditionally Automated Vehicles, Tyler Riley

All Theses

With the approval of conditionally automated vehicles, or SAE Level 3 automated vehicles, drivers can now engage in non-driving related tasks (NDRTs) during automation. However, conditionally automated vehicles require drivers to resume vehicle control when the system prompts them, and the decreased situation awareness due to NDRT engagement may impact drivers’ takeover performance. This thesis investigates the prospective use of wearable augmented reality (AR) glasses by conditionally automated vehicle drivers to engage in visual NDRT. Specifically, this study examined how NDRT display location affects drivers’ situation awareness in a driving simulation experiment with 60 participants. Three NDRT display locations were …

Reproduction And Larval Development Of The Invasive Asian Longhorned Beetle In South Carolina, Lindsey A. Stone

All Theses

The Asian longhorned beetle (Anoplophora glabripennis Motschulsky; ALB) is a major threat to forest health due to the damage done by larval feeding in host trees. In 2020, ALB was discovered in Charleston County, South Carolina, which presents a novel climate for this invasive pest in North America. I investigated the reproductive biology and larval development of ALB to support detection and management efforts. By exposing 19 host trees to mated pairs of adults, I was able to determine rates of oviposition success (55%), egg viability (55%), and early larval survival (56%). On average, females chewed nearly 1 egg …

Environmental Sanitation In Long-Term Care Facilities: A Focus On Regulations And Implementations, Ruwan Dissanayake Dissanayake Mudiyanselage

All Theses

Environmental sanitation is a fundamental component of infection prevention in long-term care facilities (LTCFs), where residents are at increased risk due to advanced age, underlying health conditions, and communal living arrangements. Despite its critical role, significant gaps remain in implementing environmental sanitation procedures and the regulatory frameworks that guide them.

This study combines two components: (1) an across-state regulatory review of environmental sanitation in LTCF regulations and (2) a cross-sectional survey assessing environmental sanitation characteristics of nursing homes (NHs) and assisted living facilities (ALFs) and Rural and Urban LTCF observation study in South Carolina (SC) . For the regulatory review …

Study On The Knock Resistance Offered By Thermally Stratifying Water Injections In A Single Cylinder Spark Ignition Engine, Aditya Datar

All Theses

Stochastic end-gas autoignition in SI engines, commonly called ‘knock’, limits attainable engine efficiencies. Multiple pathways to extend SI engine operation into knock-limited regions have been studied, including direct water injection (DWI). This study employs single-cylinder engine experiments and modeling to investigate the knock resistance offered by compression stroke water injections, which have shown to thermally stratify the cylinder in HCCI. In SI, thermally stratifying injections are expected to forcibly widen the cylinder temperature distribution by preferentially cooling the cylinder periphery. The end-gas is in the cylinder periphery; therefore, a cooler end-gas would result in longer ignition delays, thus providing knock …

Tradespace Exploration For Multiple Collaborative Vehicles, Mrunal Deshmukh

All Theses

Modern military operations demand systems that adapt to uncertain, rapidly changing missions across diverse terrains. Traditional single-platform vehicle design is insufficient for such complexity. This research introduces a hierarchical tradespace exploration framework for designing and evaluating families of heterogeneous ground vehicles under a System-of-Systems (SoS) architecture. The framework treats vehicle design as a co-optimization problem, where a “parent” vehicle (e.g., a Squad Multipurpose Equipment Transport) coordinates specialized “child” vehicles for reconnaissance, amphibious tasks, terrain traversal, and stealth missions. Unlike conventional approaches that optimize vehicles individually, this study emphasizes collaborative performance, resource sharing, and adaptability at the family level. Central to …

Comparison Of The Recent Icrp Occupational Intakes Of Rradionuclides Series To Annual Limits On Intake (Ali) In The United States For Select Radionuclides, Aidan B. Barker

All Theses

Dose coefficients (DCs) and secondary limit values (such as the annual limit on intake [ALI] and derived air concentration [DAC]) are useful and convenient quantities in radiation protection (RP) for estimation of radiological dose and the practical application of dose limits. DCs link radioactivity intake to dose while secondary limit values express a dose limit in terms of the type and extent of exposure. The International Commission on Radiological Protection (ICRP), an international organization which provides guidance and recommendations for RP, calculates, tabulates, and updates DCs following new findings and updated knowledge relevant to dose determination (e.g. improved human biokinetics, …