Digital Commons Network^™

Monitoring The Hematologic Markers In Patients Undergoing Single-Stage Exchange Arthroplasty For Periprosthetic Joint Infection, Wenbo Mu, Juan D. Lizcano, Boyong Xu, Wentao Guo, Abudousaimi Aimaiti, Xiaogang Zhang, Javad Parvizi, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication that necessitates a complex treatment strategy. Single-stage exchange arthroplasty, combined with intravenous and intra-articular antibiotic infusions, has shown high efficacy in treating complex PJIs. However, the impact of this approach on hematologic parameters remains underexplored. This study aims to evaluate the postoperative trends in blood platelet count, white blood cell (WBC) count, and neutrophil count in patients undergoing single-stage exchange arthroplasty.

METHODS: A retrospective analysis was conducted on 313 patients who underwent single-stage revision for PJI between June 2010 and October 2022. Hematologic parameters were monitored for the first seven postoperative …

Tom Wingfield Is The Villain: A Re-Examination Of The Glass Menagerie, Genevive K. Bevell

SPARK Symposium Presentations

This essay is an exploration of the play The Glass Menagerie, by Tennessee Williams, through a feminist lens that offers a new interpretation of the famous play, supported by evidence from Williams’s own personal history, feminist interpretations of Williams’s work, and the discussion of what a protagonist really is. I argue that Tom, who is traditionally considered the protagonist, operates as an unreliable narrator and, therefore, the antagonist to Amanda and his sister Laura, impeding their happiness and sense of well-being. I propose that The Glass Menagerie is not about a man defying societal expectations or choosing happiness in …

Dilemmas Encountered While Planning Social And/Or Political Elementary Mathematics Tasks, Amanda Sugimoto, Simon Byeonguk Han, Courtney Koestler, Eva Thanheiser, Mathew Felton-Koestler, Molly Robinson

Mathematics and Statistics Faculty Publications and Presentations

A mathematical task rooted in social and/or political contexts has the potential to engage students in exploring their own real-ities and learning about the realities of others while building their mathematical knowledge. While there are planning and in-structional practices recommended for these types of tasks, no single practice can fully capture the nuances and challenges thatteachers might encounter. Therefore, this study identified dilemmas encountered by a team of mathematics education research-ers while planning a mathematical task rooted in social and/or political contexts. Using qualitative analysis, the researchersidentified three planning dilemmas: (a) what social and/or political goal to establish, (b) how …

Nonfinancial Factors Shape Food Insecurity Among U.S. Older Adults, Madonna Harrington Meyer, Colleen M. Heflin

Population Health Research Brief Series

Nonfinancial factors such as poor physical and mental health, lack of access to healthy food, and transportation challenges make it more difficult for older adults to obtain, prepare, and consume healthy food. Based on the book, Food for Thought: Understanding Older Adults Food Insecurity, this brief summarizes how nonfinancial factors function as both causes and consequences of food insecurity in old age.

Practice Patterns In Management Of Low- To Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study, Mirabelle Sajisevi, Kenny Nguyen, Peter Callas, Andrew Holcomb, Emre Vural, Kyle Davis, Carissa Thomas, John Stein, Ameya Asarkar, Ricardo Aulet, Rebecca Bell, Michael Blasco, Vanessa Bowmaster, Clayton Burruss, Jeffson Chung, Kimberly Chan, Brent Chang, Charles Coffey, David Cognetti, Dylan Cooper, Joehassin Cordero, John Donovan, Yue Jennifer Du, Yusuf Dundar, Rogerio Dedivitis, Heather Edwards, Boban Erovic, Antoine Eskander, Philip Feinberg, Emily Garvey, David Goldstein, Joseph Goodman, Rafael Goulart, Neerav Goyal, Stefan Grasl, Jonathan Giurintano, Nikita Gupta, Andy Habib, Trevor Hackman, Jared Hara, Christina Henson, Michael Hinni, Nadia Hua, Stephanie Johnson-Obaseki, Aditya Juloori, Noah Kalman, Alexandra Kejner, Sobia Khaja, Jamie Ku, Arnaud Lambert, Bao Luu, Kelly Magliocca, Luiz Medina Dos Santos, Cara Michael, Brett Miles, Giulianno De Melo, Michael Moore, Gregoire Morand, Kauê Moura, Hesameddin Noroozi, Rusha Patel, Joseph Paydarfar, Karolina Plonowska-Hirschfeld, Nader Sadeghi, Fabrice Savaria, Nicole Schmitt, Justin Shapiro, Timothy Shaver, Sandro Stoeckli, William Stokes, Anita Sulibhavi, Jason Tasoulas, Varun Vendra, Daniel Vinh, Celina Virgen, Neil Woody, Geoffrey Young, Kiran Kakarala, Danny Enepekides, Michael Hier, Louise Davies, William Ryan

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.

METHODS: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.

RESULTS: Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was …

Debt Accumulation In Fossil Fuel-Reliant Localities During The Shale Boom And Implications For The Energy Transition, Brandon Charles

Center for Policy Research

The energy transition away from fossil fuels poses long-term economic risks for communities reliant on oil and natural gas production and some may face exceptionally difficult challenges in adapting to the change. Bonds issued by these localities during the shale boom may undermine their financial resilience as shale activity dwindles. Declining tax revenue may undermine their ability to service the debt and maintain the associated physical assets. This study addresses the extent to which local governments in oil- and natural gas-producing communities accumulated significantly more municipal debt during the shale boom than other communities. The analysis uses bond issuance data …

The Dangers Of (Mis)Reading: Tolkien, Naming, And Abstraction, Howard Schaap

Faculty Work Comprehensive List

"When we twist the meanings of words, we get doublespeak; when we separate word from idea—so far that we can’t see the problems in front of us—we abstract."

Posting about ­­­­­­­­reading in context from In All Things, an online hub that offers insight into maintaining and faithful and orthodox Reformed Christian worldview while fearlessly engaging in every aspect of contemporary life – until all is made new.

The Dangers of (Mis)Reading

Mt1-Mmp Inhibition Rejuvenates Ageing Brain And Rescues Cognitive Deficits In Obesity, Pallavi Asthana, Liguo Li, Lin Lu, Jiayan Wu, Shuo Zhang, Ningning Li, Sheung Kin Ken Wong, Susma Gurung, Yijing Zhang, Yuwan Lin, Yufeng Peng, Zongtang Xu, Kui Ming Chan, Lixiang Zhai, Aiping Lyu, Zhao-Xiang Bian, Xin Ge, Ashok Iyaswamy, Min Li, Ya Su, Zhongjun Zhou, Pingyi Xu, Hoi Leong Xavier Wong

The Brown Foundation: Institute of Molecular Medicine

Obesity has been linked to an increased risk of cognitive impairment and dementia in later life. Although aging and obesity are both associated with cognitive decline, it remains unclear how they interact to affect cognitive function across the lifespan and how brain function might mediate their relationship with cognition. Our previous findings and other studies have shown that membrane type 1-matrix metalloproteinase (MT1-MMP/MMP14), which increases with age, regulates energy homeostasis. Inhibiting MT1-MMP improves insulin sensitivity, reduces body fat, and lowers serum cholesterol. Here, we demonstrate that MT1-MMP links neuroinflammation to cognitive decline in aging and obesity. Inflammatory responses in the …

The Mediated Message Model: Understanding Faculty Genai Adoption Decision-Making And Guiding Optimal Faculty Development, Jennifer R. Banas, Sandra Beyda-Lorie

Health Sciences and Physical Education Faculty Publications

This study highlights that understanding how faculty adopt technology requires integrated theoretical frameworks rather than the single-theory models often seen in current research. Faculty responses to disruptive technologies, such as generative AI (GenAI), involve complex psychological processes that are frequently overlooked by traditional models. To address this, we developed the Mediated Message Model (MMM) by combining communication theory, behavioral prediction, and motivational psychology, targeting four gaps: fragmented focus, lack of contextual sensitivity, limited process understanding, and constraints. We utilized this framework to design and evaluate a faculty development program featuring a book club format, involving fifty-six faculty members across two …

China Maritime Report #50: Foggy With A Chance Of Surprise Attack: Pla Amphibious Deception In A Taiwan Scenario, Ian Easton

CMSI China Maritime Reports

Main Findings

• The People’s Liberation Army (PLA) views deception as a force multiplier and war-winning weapon. The PLA leadership reserves a special place of veneration for wartime commanders who can employ deception to obtain surprise, something Xi Jinping refers to as “excelling at stratagem.”
• In January 1955, the PLA launched a surprise attack on the Yijiangshan islands, then controlled by the Republic of China (ROC) government in Taipei. This campaign remains a case study in the People’s Republic of China (PRC) for how to conduct amphibious operations and catch defenders off guard.
• Empirical historical research shows that amphibious operations, while …

Language Teacher Agency Of Dual Language Bilingual Education Teachers: Incorporating Translanguaging And Funds Of Knowledge In Blended Learning, Grace Jue Yeon Kim

Faculty Journal Articles

Bilingual teachers enact agency as language policymakers and advocate for

students in providing holistic support. This ethnographic study examines 2nd

and 4th grade Spanish-English dual language bilingual education teachers’

agentive actions in implementing pedagogical strategies informed by translanguaging

and funds of knowledge during blended learning in 2021. The

findings revealed that the teachers identified challenges and posed questions

as they transitioned to blended learning for the first time. They celebrated

the positives of returning to in-person schooling, agentively

navigated the new environment, and provided holistic support for the

students. The teachers also supported emergent bilingual students’ language

and content learning …

Occupational Health Equity: A Call To Consider Social-Structural Factors In Injury Prevention Research, Shannon Guillot-Wright, Elizabeth S Mcclure, Marizen R Ramirez, Alexis Grimes Trotter, David B Richardson

Faculty, Staff and Student Publications

Occupational health equity scholarship has been growing over the past decade, including social-structural determinants of health research that centres the voices and experiences of historically marginalised communities. In our commentary, we focus on the intersection of work-related and non-work-related factors and how they impact the health of workers, their families and their communities through community-engaged research. Case studies include the implementation of mobile clinics that are developed alongside communities, community organising to examine and reduce health disparities among racially segregated workers, the development of research instruments and measures to study racism and discrimination, and a focus on how the distribution …

Understanding Cancer Survivorship Care Needs Using Amazon Reviews: Content Analysis, Algorithm Development, And Validation Study, Liwei Wang, Qiuhao Lu, Rui Li, Taylor B. Harrison, Heling Jia, Ming Huang, Heidi Dowst, Rui Zhang, Hoda Badr, Jungwei W. Fan, Hongfang Liu

Department of Medical Oncology Faculty Papers

BACKGROUND: Complementary therapies are being increasingly used by cancer survivors. As a channel for customers to share their feelings, outcomes, and perceived knowledge about the products purchased from e-commerce platforms, Amazon consumer reviews are a valuable real-world data source for understanding cancer survivorship care needs.

OBJECTIVE: In this study, we aimed to highlight the potential of using Amazon consumer reviews as a novel source for identifying cancer survivorship care needs, particularly related to symptom self-management. Specifically, we present a publicly available, manually annotated corpus derived from Amazon reviews of health-related products and develop baseline natural language processing models using deep …

College Persistence And Tribal Nation-Building Among American Indian Undergraduate Students, Brittany Ann Boone

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study was that little is known regarding attempts at higher education persistence and tribal nation-building affecting each other among American Indian (AI) undergraduate college students in Oklahoma. The purpose of this qualitative study was to explore the experiences of AI undergraduate students enrolled at a college or university in Oklahoma regarding higher education persistence and tribal nation-building. Astin’s theory of student involvement was the conceptual framework that guided this study because of its focus on the connection between student involvement and persistence. The research question addressed how AI undergraduate students describe their experiences …

Next-Gen Tools In Cancer Neuroscience, Vera Thiel, Debpali Sur, Caroline C Picoli, Tamara Mcerlain, Katalina Couto, David J Simon, Yuan Pan, Karen Olivia Dixon, Rajan P Kulkarni, Sebastien Talbot, Alexander Birbrair

Faculty, Staff and Student Publications

The emerging field of cancer neuroscience is rapidly evolving, driven by novel technologies and tools. These include advances in single-cell and spatial transcriptomics; genetic mouse models paired with automated high-throughput; and innovative optical electrophysiological approaches, optogenetics, chemogenetics, engineered viruses, and new methods for visualizing neuronal activity. Collectively, these technologies are revolutionizing how we investigate, manipulate, and characterize distinct components that contribute to the nervous system-cancer interface. In the present review, we discuss the key technologies that are closing the gap between oncology and neuroscience, highlighting the innovations that are propelling the cancer neuroscience field forward.

Identifying Independent Predictors Of Malignancy In Indeterminate Thyroid Nodules: A Systematic Review, Tirath Patel, Jabez David John, Arnesh Shukla, Ayesha Salma, Dev Patel, Anaya Noor, Gayatri Misra, Pragnesh Kalyandrug, Harshitha Nookala, Nikhilesh Anand

School of Medicine Publications

Introduction: Considering the importance of differentiating between benign and malignant thyroid nodules, this study explores the individual predictors of malignancy. Recent research has focused on individual predictors of isolation, but a comprehensive assessment of these predictors is essential to improve diagnostic accuracy and patient outcomes.

Methods: This comprehensive systematic review included seven articles after a rigorous screening of PubMed, PubMed Central, and MEDLINE databases and thus analyzed 1419 patients with indeterminate thyroid nodules using different determinants, such as genetic, biochemical, clinical, radiological, and cytological.

Results: Numerous independent indicators, such as a history of Hashimoto's thyroiditis, multinodular goiter, and past malignant …

Effect Of Clays On The Spontaneous Imbibition Behavior Of Surfactant Solutions In Shale Oil Reservoirs, Ning Xu, Yanling Wang, Baojun Bai, Chuanbao Zhang, Shizhang Cui, Yu Zhang, Di Li, Wenjing Shi, Wenhui Ding

Geosciences and Geological and Petroleum Engineering Faculty Research & Creative Works

Surfactant-enhanced spontaneous imbibition is a proven method of enhancing oil recovery from shale reservoirs. However, a significant knowledge gap concerning the impact of clay minerals on surfactant-enhanced imbibition in shale reservoirs remains. Therefore, this study first analyzed the mineral composition and pore structure of the shale reservoirs. Subsequently, three surfactants were selected for spontaneous imbibition experiments. The influence of various clay minerals on the surfactant imbibition was assessed by considering various properties of the imbibition system. The results showed that the shale pores primarily consisted of macropores (44.03%) and mesopores (43.94%). Surfactants enhance the imbibition recovery by altering the wettability …

Understanding Cancer Survivorship Care Needs Using Amazon Reviews: Content Analysis, Algorithm Development, And Validation Study, Liwei Wang, Qiuhao Lu, Rui Li, Taylor B Harrison, Heling Jia, Ming Huang, Heidi Dowst, Rui Zhang, Hoda Badr, Jungwei W Fan, Hongfang Liu

Faculty, Staff and Students Publications

Background: Complementary therapies are being increasingly used by cancer survivors. As a channel for customers to share their feelings, outcomes, and perceived knowledge about the products purchased from e-commerce platforms, Amazon consumer reviews are a valuable real-world data source for understanding cancer survivorship care needs.

Objective: In this study, we aimed to highlight the potential of using Amazon consumer reviews as a novel source for identifying cancer survivorship care needs, particularly related to symptom self-management. Specifically, we present a publicly available, manually annotated corpus derived from Amazon reviews of health-related products and develop baseline natural language processing models using deep …

Sars-Cov-2 Nsp13 Interacts With Tead To Suppress Hippo-Yap Signaling, Fansen Meng, Jong Hwan Kim, Chang-Ru Tsai, Jeffrey D Steimle, Jun Wang, Yufeng Shi, Rich G Li, Bing Xie, Vaibhav Deshmukh, Shijie Liu, Xiao Li, James F Martin

Faculty, Staff and Students Publications

The Hippo pathway controls organ development, homeostasis, and regeneration primarily by modulating YAP/TEAD-mediated gene expression. Although emerging studies report Hippo-YAP dysfunction after viral infection, it is largely unknown in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we analyzed RNA sequencing data from human-induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) and SARS-CoV-2-infected human lung samples, and observed a decrease in YAP target gene expression. In screening SARS-CoV-2 nonstructural proteins, we found that nonstructural protein 13 (NSP13), a conserved coronavirus helicase, inhibits YAP transcriptional activity independent of the upstream Hippo kinases LATS1/2. Consistently, introducing NSP13 into mouse cardiomyocytes suppresses …

Atrial Fibroblast-Derived Macrophage Migration Inhibitory Factor Promotes Atrial Macrophage Accumulation In Postoperative Atrial Fibrillation, Joshua A Keefe, Jose Alberto Navarro-Garcia, Shuai Zhao, Mihail G Chelu, Xander Ht Wehrens

Faculty, Staff and Students Publications

New study: Blocking MIF protein prevents irregular heartbeats after surgery by reducing harmful immune cell buildup in the atria.

Dietary Methionine Restriction Primes T Cell Metabolism For Activation And Tumor Inhibition And Enhances The Efficacy Of Immune Checkpoint Blockade, Xiaoqing Qing, Binita Chakraborty, Panpan Liu, Sandeep Artham, Patrick K Juras, Dongyin Guan, Kristen E Pauken, Ching-Yi Chang, Xia Gao

Faculty, Staff and Students Publications

The proliferation of many cancer cells is methionine dependent and dietary methionine restriction (MR) has shown anti-tumor effects in a wide variety of immunodeficiency preclinical models. Yet, whether MR exerts an anti-tumor effect in the presence of an immune-competent background remains inconclusive. Accumulating evidence has shown an essential role of methionine in immune cell differentiation and function. Thus, competition for methionine between tumor cells and immune cells in the tumor microenvironment may drive tumor growth and tumor response to therapy. Here, we aim to define the impact of MR on tumor growth and associated immunity. We first assessed the effect …

Adsl Deficiency Is A Secondary Mitochondrial Disease Affecting Organelle Homeostasis And Erk2/Akt Signaling In A Linear Genotype-Phenotype Relation, Matteo Bordi, Beatrice Testa, Claudia Compagnucci, Fiorella Colasuonno, Francesca Cipressa, Elisabetta Betterini, Andrea Mancini, Claudia Carsetti, Illari Salvatori, Caterina Ferraina, Ming Yang, Rossella De Cegli, Eugenio Del Prete, Chiara Veroni, Salvatore Rizza, Sofia Mauri, Elena Ziviani, Marina Macchiaiolo, Davide Vecchio, Filippo Maria Panfili, Teresa Rizza, Gerrit Weber, Rosalba Carrozzo, Alberto Ferri, Silvia Campello, Andrea Ballabio, Christian Frezza, Gianluca Cestra, Marco Tartaglia, Andrea Bartuli, Francesco Cecconi

Duncan NRI Faculty and Staff Publications

Adenylosuccinate lyase deficiency (ADSLd) is a rare autosomal recessive purine metabolism disorder with several clinical manifestations. While toxic substrate accumulation is a known hallmark, no additional molecular mechanisms have been established. Here, we show that ADSLd is associated with mitochondrial dysfunction, including increased fragmentation, impaired respiration, and reduced ATP production. The severity of mitochondrial impairment correlates with ADSLd pathology, especially in mitochondria-dependent tissues. We also identify defects in mitochondrial dynamics and transport linked to ERK2 and AKT suppression. Notably, overexpressing constitutively active ERK2 or supplementing purine intermediates partially rescues the mitochondrial phenotype. These findings suggest an alternative disease mechanism and …

Deciphering The Mycn-Driven Metabolic Microenvironment Of Neuroblastoma, Amber Wolf, Davide Leardini, Lingzhi Li, Riccardo Masetti, Costas A Lyssiotis, Eveline Barbieri

Faculty, Staff and Students Publications

Oncogenic MYCN drives aggressive disease in many cancers including neuroblastoma (NB). Metabolic reprogramming is essential to support cancer cell homeostasis and survival under nutrient- and oxygen-deprived conditions. MYCN directly reprograms many nodes of tumor-intrinsic metabolism, which have significant repercussions on the cells of the tumor microenvironment (TME), resulting in complex intercellular metabolic circuits that contribute to the immunosuppressive microenvironment of NB. These metabolic circuits are also regulated by the organismal and cellular circadian clock and host diet to further impact the TME and NB oncogenesis. This review discusses the mechanisms by which MYCN regulates the metabolic crosstalk between tumor, TME, …

A Humanistic Approach To Graduate Student Research Consultations, Tyler Manolovitz

Journal of Graduate Librarianship

This paper examines the benefits of a humanistic approach to research consultations with graduate students due to their unique research needs and lived experiences. Graduate students undertake complex, long-term research projects that require sophisticated information literacy skills and specialized support. Beyond these technical needs, graduate students often experience library anxiety and academic pressure stemming from their varied backgrounds, demanding lives, and a wide range of research knowledge and experience. Personalized, one-on-one research consultations offer an ideal platform to address both the technical and emotional needs of graduate students. By infusing research consultations with humanistic principles, including empathy, authenticity, emotional intelligence, …

Symptoms Of Pain And Fatigue Among Adults With Gaucher Disease Type 1, Shauna L. Mangum, Stephen H. A. Hernandez, Elizabeth L. Dickson, Wendy Packman, Beth B. Tigges

International Nursing Research Congress (INRC)

People with rare disease have lower health-related quality of life (HRQoL) than the general population (Megari, 2013). Gaucher disease type 1 (GD1) is a rare, autosomal recessive, lysosomal storage disorder, caused by a deficiency of the lysosomal enzyme, glucocerebrosidase, that affects multiple bodily systems and is classified by the absence of neurodegenerative disease (Mistry et al., 2015; Stirnemann et al., 2017). An estimated 125,000 people have GD1 worldwide with about 6,000 people in the U.S. Pain and fatigue are the most commonly reported symptoms (Hayes et al., 1998), but both have been understudied (Drelichman et al., 2016; Zion et al., …

Prevalence Of Stress And Depression In Nursing Students: A Systematic Review And Meta Analysis, Ling Xu, Michael Joshua Gozum Morales, Thomas Hoffmann, Cherry Leung

International Nursing Research Congress (INRC)

Background: Undergraduate nursing students have a high level of stress and depressive symptoms. Despite growing awareness of mental health issues in nursing students, no recent systematic review assessed the global prevalence of stress and depressive symptoms in undergraduate nursing students, nor the contributing sociodemographic and interpersonal factors.

Purpose Statement: The purpose of this review is to 1) identify the prevalence of stress and depressive symptoms among undergraduate nursing students, and 2) identify the sociodemographic and interpersonal factors that contribute to these symptoms.

Methods: This review follows the PRISMA guidelines. Four databases were searched. Narrative synthesis was used to explore …

Student Perspectives On Social Responsibility In Nursing, Crystal Shannon

Journal of Community Engagement and Higher Education

Social responsibility (SR) is a core component of the nursing profession. However, nursing ed-ucation is challenged in delivering meaningful translation of this topic to students. This poten-tially reduces the readiness of newly licensed nurses to care for underserved populations. This study explored nursing students’ understanding of SR and the impact on role formation. Results showed students have a limited understanding of SR and limited experiences for development. Recommendations for improvement are offered.

Book Review: Service Learning And Literary Studies In English By Grobman & Rosenberg (2015), Zak K. Montgomery

Journal of Community Engagement and Higher Education

No abstract provided.

A Total Modernity And Alternative Avant-Garde Art In China, Ming-Lu Gao 高名潞

Zhou Documents

In this paper, Gao discusses "twentieth century Chinese avant-garde in two major periods: the avant-garde of the 1920s and 1930s; and the contemporary avant-garde of Post-Mao era - the 1980s and 1990s." (Nicole Wang '26)

Sycamore Readers: All Stakeholders Win, Kathryn L. Bauserman, Debra Knaebel

Journal of Community Engagement and Higher Education

Sycamore Readers is an after-school tutoring program that serves struggling elementary students from local schools. It is housed at the local library in their Lifelong Learning Center. The program has positively impacted the library through increased usage, the community by increasing high school graduation rates, the parents by providing free help and support, the tutors through experiential learning, and the students who receive one-on-one help and improved literacy skills. The biggest impact on students has been an increase in their reading levels and their improved attitudes toward reading.