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Articles 19681 - 19710 of 1791776
Full-Text Articles in Entire DC Network
Tribute To The Dead Is Honor To The Living: Uncovering The Evolution Of Funerary Monuments In Black Cemeteries Throughout Charleston, Sc, Lorena Garrod
All Theses
Black burial grounds throughout Charleston have long been understudied, and their funerary architecture even less so. Within the City of Charleston’s Urban Growth Boundary, many undocumented Black cemeteries are threatened by development. Previous scholarship is scant, as these sites have gone without dedicated research for many years. As awareness of their historical significance grows, attempts are being made to document and understand Black burial grounds, both within the context of Charleston, but more so within the context of the descendant communities these burial grounds serve. To this end, this research asked the question, “What material and formal shifts can be …
Laser-Induced Acoustic Signal Generation, Resonance Characterization, And Optical Sensing In Metallic Plates, Xinghang Zhao
Laser-Induced Acoustic Signal Generation, Resonance Characterization, And Optical Sensing In Metallic Plates, Xinghang Zhao
All Theses
This thesis investigates laser-induced acoustic signal generation, resonance characterization, and optical sensing in metallic plates as a foundational study for damage-sensitive inspection. Rather than presenting a complete defect-detection system, the work focuses on how measurable acoustic responses can be generated, amplified, and interpreted in a controlled laboratory setting. Experiments showed that pulsed-laser excitation can produce strong and repeatable acoustic responses in metallic structures. Repetition-rate sweeping identified narrow resonant responses, including a cantilever resonance at 57.862 kHz and a maximum circular-disk response at an FFT frequency of 48.8 kHz with a laser repetition rate of about 49.1 kHz. High-Q resonances exceeding …
Quantifying Macrophyte Ecosystem Services And Improving Environmental Nonprofit Messaging, Peyton R. Hughey
Quantifying Macrophyte Ecosystem Services And Improving Environmental Nonprofit Messaging, Peyton R. Hughey
All Theses
Environmental nonprofits are essential to the management and restoration of our natural spaces. They are also tasked with engaging the public via outreach, education, and advocacy. As natural spaces are degraded, the ability of environmental nonprofits to deliver on their missions will become increasingly important. This study aimed to improve two approaches to environmental nonprofits’ missions: ecological restoration and social media communication.
Environmental nonprofits operate with limited resources, and ecological restoration can be an exhaustive task; therefore, we explore functional restoration as a tool. In this study, we focus on the use of functional, trait-based restoration to restore ecological function …
An Appalachian Approach To Urban Flooding In South Carolina, North Carolina, And Kentucky, Boyce A. Clardy Iii
An Appalachian Approach To Urban Flooding In South Carolina, North Carolina, And Kentucky, Boyce A. Clardy Iii
All Theses
Urban flooding poses an ever-growing threat to the built environment worldwide, as it is the leading natural hazard contributing to fatalities globally. Planners stand in a unique position to produce plans and policies that reflect and combat this threat, yet the capacity and obligation to do so varies considerably depending on where a community sits within the broader legislative and institutional landscape. This thesis focuses on the Southeastern subregion of Appalachia, a part of the United States characterized by mountainous terrain, steep foothills, and narrow valley communities. This region was chosen as much attention in the broader literature is focused …
Mining The Usda Snap Bean Association Panel For Resilience: Genetic Dissection Of Heat And Disease Tolerance In Snap Bean, Atiya F. Khan
Mining The Usda Snap Bean Association Panel For Resilience: Genetic Dissection Of Heat And Disease Tolerance In Snap Bean, Atiya F. Khan
All Theses
Snap bean (Phaseolus vulgaris L.) is an economically and nutritionally important vegetable crop whose production is increasingly threatened by rising temperatures and emerging bacterial diseases, particularly in the southeastern United States. Heat stress during reproductive development can significantly reduce yield, while newly emerging pathogens such as Pseudomonas capsici present additional risks to crop productivity. This study leveraged the USDA Snap Bean Association Panel (SnAP) to investigate the genetic basis of heat tolerance and disease resistance and to identify germplasm and genomic regions useful for breeding resilient cultivars.
To evaluate heat tolerance, a subset of the SnAP panel was …
Identity, Party, And Politics: A Discourse Analysis Of Democratic Elites In Pod Save America, Geneva Lei P. Luteria
Identity, Party, And Politics: A Discourse Analysis Of Democratic Elites In Pod Save America, Geneva Lei P. Luteria
All Theses
The rise of popular podcasts has shaped public discourse and influenced millions worldwide on how they ought to think, imagine, and act about controversial subjects. Podcasts create an avenue for stories about power and technology to co-create a narrative that viewers buy into. This thesis analyzes one of these essential podcasts, Pod Save America, in how Democratic elite guests approach identity politics, a phenomenon best described as advocacy based on one position’s in society. I begin the thesis by considering the differences in scholarly interpretation of how identity politics functions conceptually and practically. Then, I integrate ideas about how …
The Impact Of The Video Assistant Referee On Aggregate Match Outcomes And Measured Home-Field Advantage In European Soccer, Christopher P. Vetter
The Impact Of The Video Assistant Referee On Aggregate Match Outcomes And Measured Home-Field Advantage In European Soccer, Christopher P. Vetter
All Theses
The introduction of Video Assistant Referee (VAR) in European soccer aimed to improve referee decision accuracy in high-impact situations. This study examines the association between VAR implementation and match outcomes across Europe’s five major leagues. Exploiting the staggered adoption of VAR in Europe’s leagues between 2017 and 2019, the analysis utilizes both OLS and event study frameworks to evaluate average and dynamic patterns in match outcomes.
The results do not provide clear or consistent evidence of systematic changes in aggregate match outcomes following VAR implementation. While some event-time estimates suggest possible delayed movements in outcomes such as goals and yellow …
Romanticizing 'Monsters': Sexualized Digital Fandom Of The Menendez Brothers, Kimberly M. Brooks
Romanticizing 'Monsters': Sexualized Digital Fandom Of The Menendez Brothers, Kimberly M. Brooks
All Theses
This study was conducted to explore the expressions of sexualized fandom and parasocial relationships within the context of true crime. The Menendez Brothers were chosen as the case to focus on due to the Netflix dramatization ‘Monsters: The Lyle and Erik Menendez Story’ release and online popularity. Reddit was the platform chosen for data collection because of the longstanding presence of true crime followers participating in dialogue on the platform. The r/MenendezBrothers thread was chosen to collect data from because of its large following and large number of weekly contributions. Sprinklr, the social media analytics platform, was employed to gather …
The Impact Of Dipeptides On Product Quality In Chinese Hamster Ovary Cells, Louise C. Herman
The Impact Of Dipeptides On Product Quality In Chinese Hamster Ovary Cells, Louise C. Herman
All Theses
Biopharmaceuticals are medicines produced in cells which are used to treat diseases such as cancer. Monoclonal antibodies (mAbs) represent the majority of approved biotherapeutics. MAbs are mostly produce using Chinese hamster ovary (CHO) cells. CHO cells are favored for resiliency, scalability, and established safety, and are considered the “workhorse” organism for biopharmaceuticals. Amino acids are a key component of cell culture media, however several amino acids have solubility limits, such as cysteine, cystine, and tyrosine. At neutral pH, these amino acids are poorly soluble. However, dipeptides, such as N,N'-di-L-Alanyl-L-Cystine (ACCA) have been reported to increase cysteine and cystine availability. Further, …
How Mindfulness Influences The Frequency Of Flow In Collegiate Athletes, Kelly Torres
How Mindfulness Influences The Frequency Of Flow In Collegiate Athletes, Kelly Torres
All Theses
Flow is defined as a state of optimal experience characterized by deep focus and total absorption that has been consistently linked to enhanced performance (Csikszentmihalyi, 1990; Jackson and Csikszentmihalyi, 1999). Mindfulness, defined as present-moment awareness with acceptance and nonjudgement, has been widely used in sport psychology interventions to improve both performance and well-being (Harris et al., 2023; Kabat-Zinn, 2015; Reive, 2019). However, less is known about how and why mindfulness contributes to performance outcomes and what role flow plays. This study examined the relationship between trait mindfulness and dispositional flow among Clemson University collegiate athletes (N=144), while exploring …
Fluorescence-Based Quantification Of Hepatic Ldl Uptake And Donor Hepatocyte Engraftment Using Atto 700–Labeled Ldl, Victor Agustin Cortes Flores
Fluorescence-Based Quantification Of Hepatic Ldl Uptake And Donor Hepatocyte Engraftment Using Atto 700–Labeled Ldl, Victor Agustin Cortes Flores
All Theses
Familial hypercholesterolemia (FH) is an inherited disorder characterized by elevated low-density lipoprotein cholesterol (LDL-C) that increases the risk of premature atherosclerotic cardiovascular disease. In severe FH, including low-density lipoprotein receptor (LDLR), hepatic LDL clearance is profoundly impaired and many lipid lowering treatment strategies have limited effectiveness. Current advances in ex vivo CRISPR–Cas9 hepatocyte gene editing in vivo and ex vivo approaches for treatment of FH are under development.
However, a central barrier to translation is the ability to quantitatively measure the percentage of healthy gen edited hepatocytes in the liver while simultaneously assessing functional hepatic LDL handling. This thesis establishes …
Increasing The Number Of Injections Per Cycle In A Gasoline Compression Ignition Strategy: An Experimental Study, Joshua Murray
Increasing The Number Of Injections Per Cycle In A Gasoline Compression Ignition Strategy: An Experimental Study, Joshua Murray
All Theses
Gasoline Compression Ignition (GCI) is an advanced compression ignition strategy which utilizes the high octane number of gasoline to improve diesel soot and NOx emissions by enabling partially premixed injections of fuel. GCI work in the literature typically uses single, double, or triple injection strategies, with higher numbers of injections noted for their ability to achieve low MPRRs, improved soot and NOx emissions, and higher efficiency. Thus, this study extends the literature by evaluating quadruple and quintuple injection strategies for continued improvement in engine efficiency and emissions.
The experiments in this work are conducted on a heavy-duty Detroit Diesel DD13 …
The Cost Of Her Journalism: Technology-Facilitated Gender-Based Violence Against Women Journalists In The Former Soviet Union Countries, Kamila Eshalieva
The Cost Of Her Journalism: Technology-Facilitated Gender-Based Violence Against Women Journalists In The Former Soviet Union Countries, Kamila Eshalieva
All Theses
Although offline gender-based violence has been studied for decades, technology-facilitated gender-based violence (TFGBV) remains a prevalent yet underrecognized phenomenon. Journalism is a field in which this form of violence is especially persistent, and women journalists face disproportionate targeting. From cyberbullying and harassment to doxxing and disinformation, TFGBV comes in a myriad of forms, each leaving lasting scars on reporters who already face elevated professional risks. The post-Soviet region is particularly concerning, given its history of repressive regimes and hostile environments for journalism. While technology has expanded the ways for new forms of violence to emerge, these incidents are often not …
Exercise-Induced Muscle Damage As A Model For Exploring The Effects Of Pain On Gait, Sydney Savage
Exercise-Induced Muscle Damage As A Model For Exploring The Effects Of Pain On Gait, Sydney Savage
All Theses
Persistent gait asymmetry following anterior cruciate ligament reconstruction (ACLR) is a recognized contributor to post-traumatic knee osteoarthritis, yet the independent role of pain in driving altered movement patterns remains poorly understood due to confounding factors inherent to clinical populations. This study used exercise-induced muscle damage (EIMD) as a controlled experimental model to isolate the effects of musculoskeletal pain on gait, independent of kinesiophobia, structural damage, and proprioceptive disruption. Eighteen healthy adults underwent unilateral eccentric calf-raise protocols to induce delayed onset muscle soreness (DOMS), with gait assessed at baseline, 48 hours, and 168 hours post-exercise using bilateral inertial measurement units. Outcomes …
Portrayals Of Miscarriage In Film And Television: A Qualitative Analysis, Geovana Leonetti Saraiva
Portrayals Of Miscarriage In Film And Television: A Qualitative Analysis, Geovana Leonetti Saraiva
All Theses
Entertainment media may serve as a primary source through which individuals learn about miscarriage; however, little research has examined how miscarriage is portrayed in film and television. This study addresses this gap by conducting a textual analysis of five films and five television shows using a constructivist grounded theory approach. Guided by the model of stigma communication (MSC), communication privacy management theory (CPM), and social support frameworks, the analysis explores how miscarriage is represented in entertainment media.
Findings indicate that the analyzed content frequently includes stigma-related cues—such as marks, labels, responsibility, and peril—that may contribute to the formation and reinforcement …
Biology, Ecology And Control Of Eye Gnats In An Open Pine Ecosystem, Leela Hospach
Biology, Ecology And Control Of Eye Gnats In An Open Pine Ecosystem, Leela Hospach
All Theses
Eye gnats of the genus Liohippelates are bothersome flies of the family Chloropidae. They breed in moist, disturbed, sandy soils that contain organic matter, and have been implicated as vectors of conjunctivitis, bovine mastitis, and yaws. We conducted research into some basic biological and ecological characteristics. Using wild-caught gnats in a temperature-controlled incubator, we found that their activity peaks between 27°C and 41°C. Trapping at different heights above the forest floor in an open-pine savannah, we captured most gnats at 7.5 m off the ground. This may have to do with the attractiveness of the rotten egg lures we used, …
Scrolling For Support: Social Media Use, Health Information Seeking, And Social Support In Individuals With Type 1 Diabetes, Loren Myers
All Theses
Type 1 diabetes (T1D) is a lifelong chronic illness that is rapidly increasing in prevalence. Continuous treatment is necessary for proper management, but barriers to care can cause some to turn to other sources for health-related information, like social media. Given the limited research on social media use and health information seeking behaviors in people with T1D, this study aims to gain an understanding of how people with T1D use social media, where they get their health information, and how social support is related to social media behaviors among people with T1D. Adult T1D participants completed an online survey that …
Anxiety And Intuitive Eating: Examining Dispositional Mindfulness As A Protective Factor, Jordan Signorelli
Anxiety And Intuitive Eating: Examining Dispositional Mindfulness As A Protective Factor, Jordan Signorelli
All Theses
Intuitive eating (IE) is an anti-diet approach focused on listening to internal hunger and fullness cues and is associated with reduced disordered eating patterns and improved dietary intake. However, anxiety negatively impacts IE. Dispositional mindfulness (DM) – one’s innate, present-centered, nonjudgmental awareness of thoughts, emotions, and bodily sensations – is associated with lower anxiety and greater IE. Yet, whether DM mitigates the negative impact of anxiety on IE remains underexplored. Grounded in the Cognitive Behavioral Therapy Framework, this study aimed to: 1) examine the relationship between anxiety and IE, 2) examine the relationship between DM and IE, 3) examine whether …
Addressing Medical Mistrust Among Women: Effects Of Narratives Acknowledging Mistrust On Identification, Credibility, And Persuasive Outcomes, Kylie A. Friday
Addressing Medical Mistrust Among Women: Effects Of Narratives Acknowledging Mistrust On Identification, Credibility, And Persuasive Outcomes, Kylie A. Friday
All Theses
This study examines the effectiveness of narratives addressing medical mistrust in addressing medical mistrust and promoting preventive sexual health behaviors among women. Drawing on narrative persuasion frameworks, this research investigates how tailoring to aspects of medical mistrust influences identification, transportation, credibility, emotions, and persuasive outcomes. Particular attention is given to the role of medical mistrust as a key audience characteristic that may influence how individuals engage with and interpret health messages. By considering both emotional and cognitive mechanisms of persuasion, this study advances a more nuanced understanding of how narratives may function differently across audiences with varying levels of trust …
The Development And Evaluation Of A Group Therapy Program For Perinatal Loss In Rural Appalachia, Hope O'Neill
The Development And Evaluation Of A Group Therapy Program For Perinatal Loss In Rural Appalachia, Hope O'Neill
Electronic Theses and Dissertations
Perinatal loss can have vast adverse psychological consequences and has limited psychotherapeutic options to assist with those outcomes. Currently, there is no gold standard psychotherapy for the treatment of perinatal grief. Group therapy has proven to be an effective modality for various populations and has been shown to be beneficial for perinatal loss and the subsequent psychological outcomes. This study utilized a previously conducted systematic review to develop and evaluate a group psychotherapy for perinatal loss. The ten sessions of the group were completed by two participants and several constructs were explored pre- and post-intervention: grief, depression, anxiety, post-traumatic stress, …
“Better Late Than Never” – Exploring The Challenges And Triumphs From Late-Diagnosed Autistic Women, Angela C. Altomare
“Better Late Than Never” – Exploring The Challenges And Triumphs From Late-Diagnosed Autistic Women, Angela C. Altomare
Electronic Theses and Dissertations
The diagnostic process for adult autistic women is a transformative experience that reshapes identity, their histories, and self-understandings. This study examines the impact of a late-in-life autism diagnoses on women through the examination of narratives from the Reddit community r/AutismInWomen, and autoethnography.
Drawing on personal experience as a late-diagnosed autistic researcher, and the shared stories within r/AutismInWomen, the research demonstrates the challenges experienced, such as navigating stigma, negotiating identity, and seeking support.
The research reveals that online platforms serve as critical spaces for stigma negotiation, identity validation, self-advocacy, and community building among autistic women. Furthermore, these narratives underscore …
Academic Self-Efficacy Of Black, White, And Hispanic Students Pursuing Professional Education Degrees And Licensure At An Hbcu In Midwest Ohio, Nathan Boles
Electronic Theses and Dissertations
The purpose of this comparative quantitative study was to determine, using three self-efficacy scales, General Self-Efficacy (GSE), Academic Self-Efficacy (ASE), and Educational Self-Efficacy (ESE), the differences in academic and educational self-efficacy among Black, White, and Hispanic students seeking a Professional Education degree and licensure at a Historically Black College and University in Midwest Ohio. Pre-service students’ self-efficacy and goal commitment can affect their likelihood of graduating with a license and may directly affect the number of novice teachers of color in the classroom. The literature examines factors that disrupt students’ self-efficacy, academic confidence, and persistence through the theoretical frameworks of …
Stochastic Universal Differential Equations For Epidemiological Modeling: Uncertainty Quantification In Disease Transmission Dynamics, Alice Menaya Armah-Bonney
Stochastic Universal Differential Equations For Epidemiological Modeling: Uncertainty Quantification In Disease Transmission Dynamics, Alice Menaya Armah-Bonney
Electronic Theses and Dissertations
Epidemic forecasting requires not only predictions of expected case counts, but also quantification of uncertainty, although existing surrogate modeling frameworks for agent-based models remain fundamentally deterministic. In this thesis a Stochastic Universal Differential Equation framework is presented that extends the deterministic Universal Differential Equation approach by incorporating a learnable stochastic diffusion term, enabling calibrated probabilistic forecasts while preserving the mechanistic interpretability and computational efficiency of the deterministic baseline. In doing so, a two-phase training algorithm is introduced to ensure stable convergence and the framework is validated against the ensemble output from ExaEpi, an exascale agent-based model of a COVID-19 outbreak …
Attendance Matters: Incentive Programs And Chronic Absenteeism In Elementary Schools, Aubryn Street
Attendance Matters: Incentive Programs And Chronic Absenteeism In Elementary Schools, Aubryn Street
Electronic Theses and Dissertations
Chronic absenteeism is a common challenge in elementary education. Schools often use attendance incentive programs, such as rewards or recognition, to encourage students to attend regularly. However, it is not always clear whether these programs actually improve attendance. This study examined whether attendance incentive programs are effective and how school staff view and use these programs.
This mixed-methods study used both school attendance data and interviews with school personnel. Attendance data from two school years showed that schools with incentive programs did not have lower absenteeism rates than schools without them. However, attendance improved overall from one year to the …
University Student Mental Health: Service Utilization, Equity Gaps, And Strategies To Improve Access, Richard Mutua Kilonzo
University Student Mental Health: Service Utilization, Equity Gaps, And Strategies To Improve Access, Richard Mutua Kilonzo
Electronic Theses and Dissertations
Student mental health and access to care are pressing concerns in higher education. This study assesses mental health outcomes and access to campus mental health services at East Tennessee State University. Survey data from the 2023–2024 Healthy Minds Study were analyzed to report the prevalence of depression, anxiety, and suicidal ideation across the student population. The study evaluates disparities in these outcomes and barriers to care across student groups, with particular attention to equity-impacted students, especially sexual and gender minority students.
Findings indicate widespread psychological distress alongside persistent barriers, including long wait times, limited-service availability, and stigma-related concerns. These barriers …
Bergsonian Blend: Subjective Temporality Within Modernist Aesthetics Of Mental Illness, Lydia Victoria Gervais
Bergsonian Blend: Subjective Temporality Within Modernist Aesthetics Of Mental Illness, Lydia Victoria Gervais
Electronic Theses and Dissertations
Henri Bergson was a modernist French philosopher who wrote extensively on the topic of the lived experience of time, which he called durée, or duration. His contemporary, Sigmund Freud, was developing psychoanalytic theory in a growing field of psychological study, which serves as a prominent ancestor to modern psychiatry and current psychoanalytical literary studies. Fiction writers of the 1900s absorbed the zeitgeist of melded chronology and consciousness, interweaving themes of time and trauma in their works. Utilizing Henri Bergson’s durée as a philosophical framework, I examine the moralization of time-consciousness in connection with mental illness and investigate representations of …
Malnutrition And Frailty Risk Among Community Dwelling Older Adults In Northeast Tennessee, Shreeyesha Pradhan
Malnutrition And Frailty Risk Among Community Dwelling Older Adults In Northeast Tennessee, Shreeyesha Pradhan
Electronic Theses and Dissertations
Frailty and malnutrition are prevalent conditions among community-dwelling older adults, affecting approximately 10% and 25% of this population, respectively. Despite overlapping symptoms such as functional decline, their relationship remains underexplored in community dwelling older adults. This cross-sectional feasibility study examined the association between frailty and nutritional status among 47 older adults in the East Tennessee Tri-Cities area using the Fried’s Frailty Phenotype (FFP) and the Mini Nutritional Assessment-Long Form (MNA-LF®). Results indicated 13% were pre-frail, 24% were frail, 21% were at risk for malnutrition, and 2% were malnourished. Regression analyses revealed that self-perceived nutritional status (37.6%), daily meal frequency (29.0%), …
Addressing Substance Use Disorder In Rural Appalachia: Improving Access And Treatment Outcomes For Justice-Involved Individuals, Jessica Muldowney
Addressing Substance Use Disorder In Rural Appalachia: Improving Access And Treatment Outcomes For Justice-Involved Individuals, Jessica Muldowney
Electronic Theses and Dissertations
Background: Opioid use disorder (OUD) represents a critical public health crisis disproportionately affecting justice-involved (JI) populations, with approximately 65% of incarcerated individuals having substance use disorders (James & Beatty, 2006). Rural Appalachian communities face compounded challenges due to limited healthcare access, provider shortages, and cultural stigma surrounding addiction treatment. Despite evidence demonstrating that medication-assisted treatment (MAT) reduces recidivism and overdose deaths, only 20% of correctional facilities offer these services (Klein & Seppala, 2019).
Objective: This mixed-methods study evaluated organizational readiness and infrastructure capacity for implementing evidence-based OUD interventions, specifically MAT programs across three rural counties in northwestern North Carolina.
Methods: …
Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford
Electronic Theses and Dissertations
Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …
Ethical Engagement In Global Missions: A Qualitative Inquiry Into Planner Motivations And Host Experiences, Harrison J. Ihrig
Ethical Engagement In Global Missions: A Qualitative Inquiry Into Planner Motivations And Host Experiences, Harrison J. Ihrig
Electronic Theses and Dissertations
Short-term mission (STM) trips are limited duration service experiences, commonly organized by faith-based organizations (FBO), in which volunteers travel domestically or international to provide ministry, community outreach, and/or health-related services. In recent decades, the number of these trips organized by organizations in the United States has increased exponentially, but the phenomenon is difficult to accurately measure due to its decentralized nature and the lack of standardized terminology. Despite their prominence, limited research has been conducted to examine planning, implementation, and evaluation processes of international STMs organized by FBO, particularly through a public health lens. The purpose of this study was …