Digital Commons Network^™

Extracellular Matrix-Mycaf Signatures Correlate With Resistance To Neoadjuvant Apd-L1 Immune Checkpoint Inhibition With Durvalumab + Metformin In Hpv+ Hnscc, Pablo Llerena, Hani Samarah, Kathryn Nunes, Zhao Lin, Kelly Bridgham, Sruti Tekumalla, Amiti Jain, Larry A. Harshyne, Sanket Kumar Shukla, Ioannis Vathiotis, Madalina Tuluc, Stacey Gargano, John R. Eisenbrey, Scott W Keith, David Cognetti, Voichita Bar-Ad, Adam J. Luginbuhl, Rita S. Axelrod, Rajanikanth Vadigepalli, Hushan Yang, Diana Whitaker-Menezes, Megan Roche, My G. Mahoney, Athanassios Argiris, Charalambos C. Solomides, Jennifer Johnson, Md, Mouadh Barbirou, Amanda Miller, Andrew P. South, Ramkrishna Mitra, Alban J Linnenbach, Ubaldo E. Martinez-Outshoorn, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

PURPOSE: Immune checkpoint inhibitors (ICI) have demonstrated clinical benefit in head and neck squamous cell carcinoma (HNSCC); however, single-agent efficacy is limited, leaving significant unmet needs. Metformin may synergize with ICIs, offering promise to improve response rates. We leveraged multiomic data from a randomized, presurgical neoadjuvant trial (NCT03618654) evaluating a single infusion of the anti-PD-L1 ICI durvalumab with or without daily, standard dose metformin in previously untreated, nondiabetic patients with HNSCC to understand predictors of response and the effect of combination therapy.

PATIENTS AND METHODS: Clinical, pathologic, and correlative data were analyzed to investigate response and resistance mechanisms. We present …

Medical Cannabis Conversation Between Adult Oncology Patients And Provider: The Impact Of Provider Education, Jodi Mcclain

DNP and Student Works

Background: It is estimated up to 40% of adult oncology patients use medical cannabis (MC) for a myriad of symptoms, including not limited to, nausea, pain, appetite, and anxiety. Conversely, less than one-third of oncology health care providers (HCPs) feel confident making cannabis recommendations. Furthermore, studies have shown low disclosure rate and poor communication between oncology patient and provider regarding integrative medicine, which includes cannabis. This study sought to examine the degree of correlation between the desire for information regarding cannabis in the adult oncology population, the level of communication regarding cannabis between patients and providers, and educational efforts to …

Results Of The 2024 Immunization Status Survey Of 24-Month-Old Children In Tennessee, Tennessee. Department Of Health.

Immunization Rates

No abstract provided.

Pronatalism In The United States: How Political Ideals Surrounding Family And Reproductive Health Care Contribute To Neglect In The Foster Care System, Carson Sebree

Undergraduate Honors Theses

Within the past decade, conservative reproductive politics in the United States have experienced an ideological shift from pro-life toward pronatalism. This has been intensified through the rollback of reproductive rights and the rise of Christian nationalism. However, there has been no commensurate additional funding for the foster care system. This project asks the interrelated questions of: “how is pronatalism linked to neglect within the foster care system?; and, how do theories of democratic care highlight the necessity to rethink support for the foster care system and create policies that will address its shortcomings, given the rise of pronatalist aw and …

Eyetracking Measures Of Performance On The Traveling Salesperson Problem, Kanan Levy

Undergraduate Honors Theses

Human solutions to the Traveling Salespersons Problem (TSP) have been proposed to employ heuristics integrating global and local spatial information (Pizlo et al., 2006). Because different neuroanatomical regions may be involved in local vs. global processing, as well as attentional shift between levels, performance on the TSP may provide useful insight into changes that occur in the brain as a result of age or of neurodegenerative disorders (Slavin, 2002). In a previous study, we compared the cognitive processes used to solve spatial problems on a large scale (moving through space) and on a small scale (on a sheet of paper). …

The Effects Of Educational Materials On Knowledge And Attitudes Toward Psilocybin, Lindsey Elise Wade

Master's Theses

Depression is one of the most prevalent and burdensome mental health conditions worldwide, affecting millions and contributing to over 700,000 deaths by suicide annually. Nearly half of patients with major depressive disorder fail to respond adequately to standard antidepressant treatments such as selective serotonin reuptake inhibitors (SSRIs). Psilocybin-assisted therapy (PAT) has emerged as a promising alternative for treatment-resistant depression (TRD), yet public understanding of this therapy remains limited. The present study examined whether a brief psychoeducational intervention could affect knowledge and attitudes toward PAT among members of the general public in the United States. Participants were randomly assigned to read …

Prioritization Of Risks Detected In Comprehensive Audits Using Neutrosophic Topsis And Hausdorff Distance, Sol David Lopezdominguez Rivas, Dixie Marisol Lopezdominguez Rivas, Leili Genoveva Lopezdominguez Rivas

Neutrosophic Sets and Systems

This study addresses the phenomenon of prioritization of risks during large-scale audits as risks evident in the complicated environment and uncertain information are challenging to mitigate. The importance of the topic is that for complicated entities with high uncertainty, high impact, and low/high probability of audit detection, proper allocation in this resource sensitive 21st century is needed for effective audit. The literature demonstrates means to assess and rank risk for subsequent corrective actions that traditional statistical methods cannot capture. The developed hybrid model combines Random Forest, fuzzy logic, and neutrosophic logic are used to process homicide data, demographic variables, and …

Evolutionary Optimization Of Interdisciplinary Methodological Strategies Using Neutrosophic Genetic Algorithms To Develop Artistic Drawing Based On Text Comprehension, Yadyra De La Caridad Pinera Concepción, Nelly Hodelín Amable, Elizabeth Esther Vergel De Salazar, Braulio David Murillo Sánchez, Karla Yerina Toalombo Mancilla

Neutrosophic Sets and Systems

This research constructs aims to address a current pedagogical issue in art teaching—what are the most effective and efficient interdisciplinary interdisciplinary methodological combinations for development of art drawing from a text based on understanding the text. This is a current problem of pedagogical practice as it applies to today's classrooms because the simultaneous combination of linguistic and artistic, expressive capabilities will help cultivate the diversification of creative and critical thinking processes. This problem is not extensively explored within the literature—but noted gaps and inadequacies suggest that such an interdisciplinary approach has not been assessed, especially since few researchers seek to …

Representation Of Motivational Dynamics In School Environments Through Plithogenic N-Superhypergraphs With Family Participation, Nelly Hodelín Amable, Elizabeth Esther Vergel De Salazar, Martha Gloria Martínez Isaac, Olivia Catalina Olavarría Sánchez, Johanna Mariuxi Solís Palma

Neutrosophic Sets and Systems

The study aimed to expand on motivational phenomena that transpires at the school level via Plithogenic n-SuperHyperGraphs via family guidance as one of the dominant features in establishing effective school/motivational environments. The study was conducted via a mixed-method quantitative and qualitative approach, including a questionnaire sent to parents/students, semi-structured interviews with teachers, and an observational approach for the grounded theory. All data were reflected via Plithogenic n-SuperHyperGraphs due to the interconnectedness of phenomena of motivation and pedagogical approaches and family guidance. The analysis of the study suggests that more motivated students are those who have more guided parents as they …

Inelastic Behavior Of Three-Story Buildings With Concrete-Filled Composite Plate Shear Walls Subjected To Wind Loads, Joshua John Blom

Theses and Dissertations

Although elastic design of the main wind force resisting system in a building is the conventional approach it is not always desirable. In this study, nonlinear static and dynamic analyses are used to predict the inelastic behavior of a three-story building with concrete-filled composite plate shear walls subjected to wind loads. To explore the potential for inelastic design, two types of planar composite shear wall buildings are examined: individual shear walls designed using an elastic approach, and coupled shear wall pairs designed using an inelastic approach adopted from seismic design provisions. Nonlinear static "pushover" analyses are run using an assumed …

A Shattered World: Jews And Israel After October 7, Michael Berenbaum, Gilbert N. Kahn

The Jewish Role in American Life: An Annual Review

October 7, 2023, was a watershed event in contemporary Jewish history. What took place on that date challenged the two most basic assumptions of post-Holocaust Jewish life: that the future security of the Jewish people would be assured by an independent Jewish state backed by an army, and that the freedom for Jews in the Diaspora to live as Jews would be secured by democratic rights and liberties. The pogroms of October 7 and the worldwide explosion of antisemitism that followed—even preceding Israel taking military action against Hamas—challenged both assumptions. The Israel Defense Forces could not prevent a slaughter from …

Consumer Lessons From A Pandemic, Nicole J. Olynk Widmar, Michael L. Smith, Erin Robinson

Purdue University Press Books

What did we learn about consumer behavior when the world was turned upside down due to COVID-19? Consumer Lessons From a Pandemic examines how a global crisis exposed and reshaped the values, priorities, and decision-making patterns of everyday people. From disrupted routines to supply-chain shocks, this volume explores the consumer behaviors that emerged in response to extreme uncertainty and how those behaviors continue to evolve. Topics include pandemic-induced grocery spending shifts, the importance of consumer trust, lessons from the infant-formula shortage, and the rise of remote work both as a preference and a negotiation point.

Fundamental Hydraulics Principles For Agricultural Systems Management And Technology, Robert M. Stwalley Iii, Roger Tormoehlen

Purdue University Press Books

Hydraulic systems have spread throughout modern technology, particularly in mobile equipment. The exercises presented in Fundamental Hydraulic Principles for Agricultural Systems Management and Technology are designed for the second-generation Parker Hydraulic Trainer to provide a basic understanding of hydraulic components and systems for technology and engineering students. Readers will learn how hydraulic pumps function, how linear actuators and their control circuits work, and how hydraulic motors operate and are controlled. Readers are also provided with the opportunity to attempt more advanced exercises. Aligned with beginning technology-based experiential hydraulics courses, this book emphasizes familiarity with common hydraulic components and circuit diagrams, …

Towards Spatial Inversion Of Aerial Gamma-Ray Survey Data For Measurement Of Naturally Occurring Radioactivity, Daniel A. Haber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aerial gamma-ray surveying (AGRS) is used in geologic and environmental contexts to provide data on the surface spatial distribution of naturally occurring radioactive material (NORM) or other gamma-ray-emitting isotopes. The standard data reduction workflow for AGRS data involves a process whereby pointwise gamma-ray spectral data are denoised, corrected for numerous sources of background radiation and aircraft height, and are finally converted to physical values by empirical conversion factors. The reduced pointwise data are then typically spatially interpolated to form a continuous surface map.

This dissertation introduces and explores a novel spatial inversion method for reduced AGRS data that considers aircraft …

Ankimedbench: Evaluating Hierarchical Medical Knowledge In Language Model Embeddings, Neel Patel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite achieving over 90% accuracy on medical benchmarks, recent studies show physicians cannot effectively leverage language models to improve clinical reasoning. Current benchmarks test isolated factual recall, but clinical practice requires hierarchical navigation through diagnostic categories—starting broad and narrowing systematically from chest pain to cardiovascular pathology to myocardial infarction to specific STEMI types. Existing evaluations cannot measure whether models preserve this taxonomic structure essential for clinical reasoning.

We introduce AnkiMedBench, built from 16,512 medical flashcards used by students preparing for licensing exams. Cards are organized across six hierarchy levels spanning 16 broad medical specialties to 672 specific diseases and conditions. …

A Competency Based Pressure Injury Management Program, Madina Qadir

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project aims to implement a simulation-based wound management program to address critical gaps in nurses’ competencies for managing pressure injuries (PIs). The initiative seeks to enhance nurses’ knowledge, clinical skills, and confidence in wound assessment and advanced therapies, fostering evidence-based practice and consistent care delivery. Effective PI management is vital for improving patient outcomes, reducing healing times, and minimizing complications. Yet, nursing education and competency gaps often lead to inconsistent care and increased healthcare costs. A structured competency-based pressure injury management (CB PIM) program integrates evidence-based didactic lectures and interactive simulation-based skills stations to cover essential topics, including wound …

Perceptions And Behaviors Of Female Title I Principals And Faculty Trust In The Post-Covid-19 Educational Environment, Jessica A. Robbins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Faculty trust in principals is essential to a healthy school culture, yet it remains one of the most fragile and complex aspects of leadership, particularly in Title I schools (Tschannen-Moran, 2007, 2014; Tschannen-Moran et al., 2015). While trust has been widely studied, fewer investigations have focused on the specific behaviors female principals use to build trust in the post-COVID era (Berkovich, 2018; Bukko et al., 2021; Handford & Leithwood, 2013; Jeanquart-Barone, 2013; Zajda et al., 2023; Zheng et al., 2021). Research suggests that women in leadership must be deliberate in fostering trust, yet their behaviors are often judged more harshly …

“I Can Gossip With Anybody, I Can’T Chisme With Everybody”: Chisme, Gossip, And Identity In Latina-Americans, Alexa B. Romero

UNLV Theses, Dissertations, Professional Papers, and Capstones

As individuals adjust to their belonging to two distinct cultures, there are various ways of adapting to their navigation of the two cultures (Berry, 1980). The way(s) an individual chooses to adjust to their two cultures can have varying effects on identity. When directly translated, chisme (Spanish) means gossip. Although the two include overlap in function and uses, chisme offers unique purposes for the Latinx community and further, Latina-Americans (González Ybarra & Player 2024; Gutierrez, 2017; Uribe, 2025). By using the communication theory of identity (Hecht, 1993) the purpose of this thesis was to investigate the role of chisme and …

Understanding The Musical Theatre Female Mixed Belt Through The Lens Of The Operatic Tenor: A Comparative Study, Courtney Schwalbe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since its emergence in the early 20th century, the female belt voice has become central to musical theatre, yet it still receives less systematic attention than classical singing in both scholarship and collegiate pedagogy. This document frames the contemporary female belt, especially the high or mixed belt, in dialogue with the Western operatic tenor to demystify belt production for teachers trained in classical vocal pedagogy. Drawing on historical context, voice science, and applied pedagogy, the study compares defining characteristics, vocal challenges, registration, and resonance strategies across the two traditions. Both voices extend chest-dominant qualities above the primary register transition and …

Building Your Epic Life: Your Journey, Your Way, Your Masterpiece, Luciano Castillo

Purdue University Press Books

Building Your Epic Life empowers young people to understand that failure is an inevitable—and essential—part of the journey to success. The author shares his own challenges and struggles, showing that no path to success is linear and without setbacks. The book teaches the value of building a healthy body, mind, and spirit, and includes exercises that offer actionable plans for individuals to realize a meaningful, self-defined life based on their core values. A proven roadmap workbook and short lectures guide readers through a series of practical steps to discover their purpose, vision, and understand the value of mentorship—and why each …

Decisions That Shape Supply Chains, Nicole J. Olynk Widmar, Michael L. Smith, Erin Robinson

Purdue University Press Books

What drives consumer decisions, and how do those decisions ripple through our food and agricultural systems? In Decisions That Shape Supply Chains, readers are invited to look beyond conventional models of behavior and explore the complex, sometimes counterintuitive factors influencing real-world consumer choices. Drawing on behavioral science and applied research, this volume examines how decisions made in grocery aisles, drive-through lines, and online shopping carts ultimately inform what gets planted, processed, packaged, and promoted across the food-supply chain. From attitudes toward GMO foods to parenting as a form of consumerism and emotional decision-making under stress to the environmental tradeoffs consumers …

Markets We Thought We Knew, Nicole J. Olynk Widmar, Michael L. Smith, Erin Robinson

Purdue University Press Books

Markets We Thought We Knew explores the evolving nature of markets and how they shape—and are shaped by—consumer behavior. From essential life necessities such as water to everyday commodities and products including locally sourced foods, this book covers a variety of topics and invites readers to examine a diverse range of markets through a reflective lens. By revisiting past market dynamics and real-world examples, readers are encouraged to rethink how preferences are formed, how opinions shift over time, and how value is assigned—sometimes in unexpected ways. What insights might you gather from a deeper understanding of local and global markets, …

150 Years Of Purdue Engineering: Celebrating Our Consequential Impact On The World, Arvind Raman, Jim Small

Purdue University Press Books

Since its founding 150 years ago, Purdue University’s College of Engineering has profoundly shaped and improved the world, amassing breakthroughs spanning nearly all facets of society. Highlighting the indomitable spirit, ingenuity, and achievements of more than 100 Boilermaker alumni and faculty members, 150 Years of Purdue Engineering describes the program’s journey to become one of the most consequential engineering colleges in the United States. Richly illustrated with archival and contemporary images, this book includes stories that focus on Purdue innovators who have created everything from the barcode and the electronic TV receiver to the soft-serve ice cream machine and artificial …

Soil And Water Education For Grades 3-12, Natalie J. Carroll, Christian Y. Oseto, Timothy J. Gibb

Purdue University Press Books

Soil and Water Education for Grades 3–12 was written for youth who enjoy learning about science and two critical natural resources: soil and water. Level 1 introduces basic terms and concepts, and is intended for youth in grades 3–5. Activities focus on understanding important soil and water processes. Designed for students in grades 6–8, Level 2 offers readers more concrete examples of advanced soil and water concepts. The exercises in Level 3, which is geared toward grades 9–12, are divided into sections based on how readers might use the information they have learned, placing them in the shoes of homeowners, …

Laozi’S "Daodejing": A New Translation With Environmentalist Commentary, Steve Hallett

Purdue University Press Books

Laozi’s “Daodejing”: A New Translation With Environmentalist Commentary offers a new translation and fresh interpretation of the eighty-one-verse Daodejing, one of the central texts of Eastern philosophy. Likely written during the late Zhou Dynasty between 600–400 BCE, this foundational work is generally attributed to an individual named Laozi, although it is unlikely that any such person actually existed. Here, author Steve Hallett employs contemporary poetic form when translating the document’s approximately 5,000 Chinese characters and provides short analytical essays that illuminate the verses with a specific focus on the teachings they offer about social and environmental sustainability. His examination of …

Maritime Trade And Imperial Ambitions: Yemeni Politics And Trade In The Indian Ocean World (626/1228-858/1454), Beck Sjostedt

Theses and Dissertations

This thesis explores the role of Yemen, particularly under the Rasūlid dynasty (626/1228-858/1454) in the medieval Indian Ocean trade. I argue that the Rasūlids attempted to create an “imperial maritime space” wherein Yemen would be the imperial core, and the western Indian Ocean and Red Sea the subjugated peripheries. While the Rasūlids managed to organize state power towards their imperial project via diplomacy, military and naval expansion, and a robust and efficient bureaucracy, they never fully realized their goal of creating a thalassocratic empire in the western Indian Ocean. Nonetheless, medieval Yemen played a significant role in the political, social, …

From Transparency To Complexity: Enhancing English Reading Skills In Turkmen-Speaking Adults, Mahrijemal Taganova

Education Dissertations

The recent increase in Turkmen immigration to the United States has highlighted

significant challenges these immigrants face due to language barriers, despite their high

educational qualifications and professional backgrounds. This study investigates whether a linguistics-based approach to reading instruction can improve English literacy among Turkmen-speaking adults.

Drawing on a comprehensive review of empirical studies, this paper evaluates the impact

of phonological awareness on reading and listening skills, the role of orthographic knowledge in

decoding and spelling, and the importance of morphological awareness for vocabulary

development and reading comprehension among EFL (English as a foreign language) learners. The analysis reveals that …

The Negotiation Of Identities Through Humorous Discourse In Political Resistance: An Analysis Of Bassem Youssef's 'The B+ Show', Howaida Aref

Theses and Dissertations

This study examines the strategic use of humorous discourse in negotiating identities and expressing political resistance during the 2011 Egyptian Revolution, focusing on Bassem Youssef's satirical YouTube show, "The B+ Show." Employing a mixed-method approach that combines Grice's maxims of cooperative communication and Fairclough's critical discourse analysis framework, the research investigates how humor functioned as a tool for challenging hegemonic narratives and power dynamics through constructing and deconstructing identities in a volatile sociopolitical context. The analysis reveals that Youssef skillfully exploited various discursive resources, particularly intertextuality and the flouting of conversational maxims, to generate implicatures that effectively debunked negative representations …

Soil Fertility Forecasting With Neutrosophic-Based Uncertainty Management, Franklin Parrales-Bravo, Roberto Tolozano-Benites, Dayron Rumbaut-Rangel

Neutrosophic Sets and Systems

This study presents a machine learning framework that combines Random Forest classification with neutrosophic logic to predict soil fertility from 16 physicochemical properties. The model achieves robust classification accuracy (95%) while introducing a novel uncertainty quantification mechanism through neutrosophic truth (T ), indeterminacy (I) and falsity (F ) values derived from prediction probabilities, assigning high-confidence (T = 0.9) to probabilities ≥0.9, indeterminacy (I = 0.3) to borderline cases (0.5≤p

Objective Vs. Perceived Maternal Smartphone Use And Observed Mother-Infant Interaction Quality, Alison K. Ventura, Lara N. Wolfers, Sarah M. Coyne, Rachel Pfafman, Sabrina Uva, Karla I. Ceja Almontes, Aniruddha S. Shinde, Adam M. Galovan, Brandon Mcdaniel

Health Services and Informatics Research

Introduction:

Prior research links maternal smartphone use to reduced sensitivity and responsiveness to infant cues, but emerging evidence suggests that mothers' perceptions of their smartphone use - such as feelings of empowerment or distress - may also shape the quality of mother-infant interactions. This study examined how both objective and perceived smartphone use related to mother-infant interaction quality in naturalistic settings.

Method:

Participants were 147 mother-infant dyads from a longitudinal study of smartphone use and infant development. When infants were 2 months old, mothers completed 5 days of ecological momentary assessment (EMA), reporting time spent with their infant, perceived smartphone-related …