Digital Commons Network^™

Exploring Systemic Challenges In The Western North Carolina Dental Safety Net: A Qualitative Analysis, Blaire Mirmow, Bill Milner, Nadia Laniado

Journal of Appalachian Health

Introduction: Despite statewide growth, rural communities in Western North Carolina (WNC) face persistent barriers to oral health care driven by chronic dental workforce shortages and systemic geographic disparities. Within this Appalachian region, the dental safety net serves as a vital yet strained support system, struggling with limited financial resources and a lack of provider participation that leaves many underserved populations without essential oral health services.

Purpose: This study aims to explore the experiences of individuals working within the WNC dental safety net to identify barriers and strategies required to strengthen the delivery of oral health care in high-need rural settings. …

Infective Endocarditis Hospitalizations In Kentucky, 2008-2018: Spatial And Temporal Trends, Meera Marji, Steve Browning, W. Jay Christian, Richard Charnigo, Steve W. Leung, Anna Kucharska-Newton

Journal of Appalachian Health

Introduction: Infective endocarditis (IE) hospitalization rates have increased significantly in the last decade, primarily due to the opioid epidemic. In 2016, Kentucky (KY) ranked among the top ten states for opioid-related overdose deaths, but limited data exist on IE trends in KY.

Purpose: This study seeks to examine county-level spatial and temporal trends in IE hospitalization rates in KY.

Methods: Hospital inpatient discharge data from 2008–2018 for KY residents aged 18 and older were analyzed. IE admissions and drug use status were identified using ICD-9 & 10 diagnosis codes. U.S. Census data calculated yearly IE hospitalization rates per 100,000 residents. …

The Effects Of Hurricane Helene On Mental Health And Physical Activity, Hunter Smathers, Robyn York, Jarrett Walbolt

Journal of Appalachian Health

Introduction: Hurricane Helene brought widespread damage to Southern Appalachia, disrupting utilities, health care, and recreation. While natural disasters are linked to declines in mental and physical health, few studies have examined their effects on distinct types of physical activity (PA).

Purpose: This study evaluated the effects of Hurricane Helene on perceived stress, depressive symptoms, post-traumatic stress disorder (PTSD) symptomology, and intentional (exercise for health benefits) and incidental (physical labor or transportation) PA. Evacuation status influence was also explored.

Methods: Twenty participants completed assessments four weeks before (BASE), immediately after (0POST), and four weeks after landfall (4POST). Measures included the Perceived …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Keefektifan Teknik Relaksasi Untuk Menurunkan Stres Akademik Siswa Sma

Jurnal Pendidikan Humaniora

This study aims at examining the effectiveness of relaxation techniques to release students’ stress and tension regarding academic within Senior High School Assádah in Gresik City. This study employed quasi-experiment design using one group pretest-posttest model. The data of this study were obtained through academic stress inventory to attain a depiction of stress level encountered by the subject. The subjects of this study were seven students of Tenth Graders in SMA Assaadah Bungah Gresik who experienced low to average stress regarding exam preparation. The data were, then, analyzed by using Wilcoxon Statistic Analysis. The result of the study indicated that …

Utility Under Uncertainty: A Critique Of Singer's Disability Replacement Argument, Jillian L. Wynne

University of Montana Conference on Undergraduate Research (UMCUR)

Peter Singer’s preference utilitarian defense of selective infant replacement in cases of severe disability remains one of the most controversial arguments in contemporary bioethics. The core of Singer’s position relies on the claim that replacing a severely disabled infant with a non-disabled infant increases overall preference satisfaction and is therefore morally permissible. In this paper, I argue that Singer’s argument fails to justify this conclusion. Singer’s replacement premise requires a utilitarian calculus that depends on reliable predictions about future preference satisfaction. While some critics maintain that Singer underestimates the quality of life of disabled individuals, I contend that, once this …

A New Framework For Intellectual Property In The Age Of Ai, Mitchell R. Clarkson

University of Montana Conference on Undergraduate Research (UMCUR)

This paper will argue that the courts’ traditional view of damages inhibits its ability to uphold the principles of intellectual property in the climate of Artificial Intelligence (AI). Language learning models (LLMs), using the practice of scraping, allow large systems to train using the copying of copyright protected work. This harms creative communities in ways that intellectual property laws could help prevent were it not for the courts limited understanding of damages. The courts hold the economic consequentialist view which sees damage as having only two components, the tortfeasor and the victim. I propose the use of a deontological framework …

Feminism, Misdiagnoses Of Women And The Scope Of Medical Negligence Doctrine, Abigail J. Engstrom

University of Montana Conference on Undergraduate Research (UMCUR)

Are the objective standards in medical malpractice law, including reasonableness and professional norms, neutral in a general manner or do they encode gendered assumptions that are disadvantageous to women in the system? Women are 66% more likely to encounter the disparity of misdiagnoses than men. One view point that is demonstrative of this question is that the negligence doctrine supposes courts avoid bias on gender and remain neutral by applying the negligence doctrine and professional norms. Through this view the very disparity of misdiagnoses in women is seen as medical failures instead of structural legal doctrine failures. In Miss Diagnosis: …

250 Years Of Political Assassinations: An Exploratory Look Into Attacks On Political Figures In The United States, Jj Wesley

University of Montana Conference on Undergraduate Research (UMCUR)

Despite the salience of political assassinations in American history and culture, there isn’t a database that focuses on them, and those that do exist often lack detail and focus on broad trends over locations and time. This absence of centralized information has led to the creation of a database on these rare events, which contains political assassinations between 1777 and 2026.  The cases rely heavily on a variety of open-source data, which includes books, newspapers, databases, and other relevant information and documents. This presentation will be an exploratory descriptive analysis that emphasizes a general overview of contextual trends in these …

The Potential Role Of Soil Depth And Land Management History In Rangeland Soil Seed Bank Community Dynamics., Owen K. Palsic, Akasha Faist, Madeline Mayorga

University of Montana Conference on Undergraduate Research (UMCUR)

Rangelands provide critical ecosystem services for societies across the globe, yet land use changes, climate change, and invasive species are causing large-scale rangeland degradation. To maintain effective rangeland ecosystem function, it is critical we understand the comprehensive ecological dynamics of these systems. One crucial ecological variable that is often overlooked is the soil seed bank, which is otherwise defined as the community of germinable seeds stored in the soil of a given system. Many ecological studies and models leave out soil seed bank communities, despite their undeniable importance in rangeland ecosystems, and instead only consider the aboveground vegetation community. In …

Head Contact Incidence Study, Shane O. Jefferson, Hunter Naugle

University of Montana Conference on Undergraduate Research (UMCUR)

Due to the physical nature of the sport of hockey, head contacts are a common occurrence in games and practice alike. Youth athletes that are exposed to repeated head contact may be at risk for both acute conditions as well as neurological health conditions as they age. The purpose of this study was to identify head contacts and examine patterns and trends seen in those contacts in a population of 9–12-year-old youth hockey athletes during both game and practice. While checking is not allowed at these age groups, the physical aspect of hockey, still generates head contact exposures at a …

Documenting Supportive Communication Strategies In Prom Administration For Persons With Aphasia, Tyra Kucinski

University of Montana Conference on Undergraduate Research (UMCUR)

Documenting Supportive Communication Strategies in PROM Administration for Persons With Aphasia

Tyra Kucinski, Allison Marr, Emilia Waters

Introduction: Aphasia is an acquired language disorder that impairs speaking, listening, writing, and/or reading, with intelligence remaining intact. Aphasia also disrupts mental health, quality of life, and communicative participation. Patient reported outcome measures (PROMs) are standardized questionnaires that allow patients to reflect on their functional health status, providing insight into how persons with aphasia (PWAs) perceive their condition and/or the treatment they are receiving. Speech-language pathologists (SLPs) frequently provide a number of supportive communication strategies to ensure accuracy of patient responses on PROMs …

Combating Overdose: Production And Analysis Of Fentanyl Specific Antibodies, Elizabeth J. Florian

University of Montana Conference on Undergraduate Research (UMCUR)

Fentanyl overdose deaths are on the rise from both intentional use and accidental exposure. Our work focuses on identifying additional treatment options to Narcan, an opioid receptor antagonist which reverses overdose effects by receptor competition. One alternative method, that has been approved by the FDA, is the development of monoclonal antibodies (mAbs). This therapeutic method works by antibodies binding fentanyl in the bloodstream and preventing it from crossing the blood-brain barrier. Our group has begun identifying mAbs by vaccinating mice with a fentanyl hapten (F1) vaccine adjuvanted with a TLR 7/8 agonist. Vaccination leads to the production of antibodies that …

Quantity Vs Quality Tradeoffs In Black Brant Geese: What Is The Relationship Between Clutch Size And Egg Volume?, Bella Adams

University of Montana Conference on Undergraduate Research (UMCUR)

Trade-offs between offspring quantity and quality are fundamental to life-history variation among species and may lead to fitness variation within populations of organisms. The purpose of this research is to explore the relationship between clutch size and egg volume in black brant (Branta bernicla nigricans) geese while controlling for age and quality of the parents to accurately gauge this relationship. Research on a brant population breeding at the Tutakoke River, Alaska, began in 1984, resulting in a dataset spanning >40 years. In 2025, I spent three months in Alaska contributing to the data collection for this long-term study. I assisted …

Pharmacogenetics To Enhance Personalized Proton Pump Inhibitor Therapy In Montana, Shivika Agrawal, Jon Graham, Shayna R. Killam

University of Montana Conference on Undergraduate Research (UMCUR)

Purpose:

Cytochrome P450 2C19 (CYP2C19) is the primary drug-metabolizing enzyme for most proton pump inhibitors (PPIs), commonly prescribed for gastrointestinal disorders such as heartburn. Guidelines developed by the Clinical Pharmacogenetics Implementation Consortium (CPIC) indicate that genetic variants in CYP2C19 may influence PPI response and the likelihood of side effects, and they provide drug and dose recommendations. We systematically evaluated PPI prescribing patterns in Montana’s patient population to inform implementation strategies for pharmacogenetic (PGx)-guided PPI therapy.

Methods:

We analyzed the electronic data from the health information exchange, Big Sky Care Connect, of 1.15 million Montanans between 2017 to 2024. We identified …

Beyond Words: Unlocking The Child's Perspective In Speech Therapy, Olivia Lacasse

University of Montana Conference on Undergraduate Research (UMCUR)

Speech-language pathologists strive for patient-centered care, yet clinicians often face limitations when making collaborative decisions with children. Understanding a child’s unique emotional experience is vital for developing effective treatment plans for speech sound disorders; however, traditional assessments rely heavily on the perspectives of parents and teachers. This leaves the child’s internal world largely undiscovered. Our project evaluates the Sound Effects Study Drawing Protocol (SESDP) as a multimodal tool to bridge the gap between external observations and a child’s inner perspective.

We asked: During a drawing task, what developmental milestones and symbolic skills are evident over time for preschool-aged children with …

Distributed Iot Cyber-Physical System For Non-Invasive Acoustic Mineral Extraction Via Z-Scanning Phased Arrays, Nathan Johnson, Oliver Trost

University of Montana Conference on Undergraduate Research (UMCUR)

A Distributed IoT Cyber-Physical System for Non-Invasive Acoustic Mineral Extraction via Z-Scanning Phased Arrays

Abstract: Traditional placer mineral extraction relies on energy demanding mechanical mobilization and high-water usage. This research introduces a novel Cyber-Physical System (CPS) that achieves non-invasive vertical migration of high-density within non-Newtonian slurries using low power usage for targeted depths. Unlike conventional vibration which induces segregation (sinking), this system utilizes a floating, waterproof phased acoustic array to generate a Z-Scanning Helical Wavefront carrying Orbital Angular Momentum. This acoustic vortex, in concert with Time-Reversed Acoustics (TRA), creates a "telescoping funnel" logic that entraps particles via centripetal force …

Questioning The Accusation That Francois Duvalier Impersonated Baron Samedi, Tess Rosbarsky

University of Montana Conference on Undergraduate Research (UMCUR)

Historians, anthropologists, and journalists have all claimed that Haitian dictator Francois Duvalier modeled his personal style after the Vodou spirit, or Loa, Baron Samedi. Guarding the crossroads between life and death, Baron Samedi is a member of the Gede family, a group of vulgar and mischievous spirits who mock authority. The Baron wears a top hat, dark suits, and sunglasses with one lens popped out. Duvalier’s signature look also included a black suit and hat which he paired with his thick lens glasses. This research provides evidence against this claim holding that these stylistic choices could more easily be explained …

When Lightning Strikes Twice: Synchronous Appendiceal Neoplasms, Alston Gremillion, Eriq Krugman, Michaela Abraham, Farris Obaid, William Kliefoth

Research Day

Appendiceal neoplasms are often clinically silent until later stages, when they may mimic appendicitis with right lower quadrant (RLQ) or nonspecific abdominal pain. Neuroendocrine tumors, while rare in the overall population, are the most common appendiceal malignancies, with a prevalence of approximately 7 per 100,000. In comparison, low-grade appendiceal mucinous neoplasms (LAMNs) make up 0.2-0.3% of appendectomy specimens. Mucoceles, frequently associated with mucinous neoplasms, vary in size, with the largest reported measuring 17cm by 4cm in 2005. We report a rare case of a large appendicular mucocele, measuring 10.7cm by 7.0cm, with final pathologies of both a LAMN and a …

Exploring The Misdiagnosis Of Schizophrenia In The Setting Of Underlying Neurological Disorders, Jade M. Mcnulty, Andrea N. Weir

Research Day

Introduction: Hallucinations, delusions, and thought disorganization are hallmark features of schizophrenia; however, these symptoms are not pathognomonic and may occur in a variety of neurological conditions. Current guidelines from the American Psychiatric Association during initial evaluation of psychosis recommend comprehensive psychiatric assessment and medical history, but routine neuroimaging is not considered standard of care in typical presentations. Failure to adequately investigate organic causes may result in delayed diagnosis and suboptimal treatment. In cases of atypical features or poor response to antipsychotics, clinicians should broaden the differential diagnosis and reconsider underlying neurological etiologies.

Methods: A narrative literature review was conducted to …

Language-Based Exclusion In Depression Clinical Trials: Implications For Generalizability, Kruti Patel, Natalia Santiago

Research Day

Background: Major depressive disorder (MDD) affects approximately 21 million U.S. adults annually. Nearly 22% of individuals in the United States speak a language other than English at home. Language-based exclusion criteria in clinical trials may limit participation of non-English-speaking populations and reduce external validity in psychiatric research.

Objective: To evaluate the prevalence of English-language requirements in U.S.-based adult depression clinical trials and assess the availability of translation accommodations.

Methods: We conducted a cross-sectional review of U.S.-based interventional clinical trials listed on ClinicalTrials.gov. Adult (≥18 years) trials focused on major depressive disorder were included. Pediatric-only trials were excluded. Trials were assessed …

Alzheimer’S Is A Delivery Problem: A Neurosurgery-Enabled Evidence Map Of Focused Ultrasound Blood-Brain Barrier Opening As A Cns Delivery Platform, Gargee Sree Nallanukala, Veer Nallanukala, Lauren Noto-Bell, Jacquelyn Gerhart

Research Day

Introduction: Disease-modifying therapies for Alzheimer’s disease (AD) provide modest benefit in selected early-AD populations, but their use is limited by safety risks (e.g., amyloid-related imaging abnormalities [ARIA]) and intensive monitoring. A key reason many therapies underperform is that the blood–brain barrier (BBB) acts like a protective “filter,” allowing only a small fraction of systemically delivered drugs, especially large molecules, to reach the brain. MRI-guided focused ultrasound, paired with intravenously administered microbubbles, can temporarily and locally “loosen” the BBB at a chosen brain region, then allow it to reseal. This approach is being studied as a noninvasive delivery platform that could …

An Extensive Abdominal Aortic Aneurysm In A 95 Year-Old: A Cadaver Case Study, Manisha Kodavatiganti, Mia Cudmore, Stephanie E. Evans, Mallory P. Gersh, Lucie V. Ngaba, Kayla R. White, Michael Mcguinness

Research Day

An aneurysm is defined as a localized abnormal dilation of a blood vessel caused by weakening of the vessel wall. Common types include abdominal, thoracic, cerebral, and peripheral aneurysms.

According to the Mayo Clinic, risk factors for AAAs include tobacco use, age, sex (men are at higher risk than women), being caucasian, family history of AAAs, and history of prior aneurysms.

Dissection of a 95 year old female, whose cause of death was listed as an abdominal aortic aneurysm (AAA) revealed an enlarged aorta throughout the thorax and abdomen. The width of the enlarged aorta was compared with the average …

Postpartum Depression, Anxiety, And Psychological Flexibility In Nicu Mothers: Implications For Acceptance And Commitment Therapy, Riya Desai, Alexa Bonacquisti

Research Day

Pregnancy and the postpartum period may be physiologically and psychologically demanding for women as they navigate a multitude of factors. This experience may be further complicated by stressful reproductive events, such as newborn admission into the Neonatal Intensive Care Unit (NICU). Having a baby admitted to the NICU is often particularly challenging for mothers from a psychological perspective, serving as an added layer that may contribute to postpartum depression and anxiety. Psychological flexibility is the concept of openness, adaptability, and readiness in the face of adversity. For NICU mothers, psychological flexibility serves as a possible therapeutic target to address postpartum …

A Preliminary Investigation On The Relationship Between Established Dietary Habits And Willingness To Adopt New Food Groups, Graziella Greco, Rasika Singh, Kristen Berry, Autumn Dye

Research Day

Introduction: Obesity is a nationwide health crisis that predisposes individuals to a host of other diseases including hypertension and diabetes. In Philadelphia alone, approximately 41% of children between the ages of 6-17, and 33% of adults are obese. It has been shown that education on nutrition positively correlates with healthy eating behaviors, which can minimize the chances of obesity developing into its comorbidities. This study aims to see if food demonstrations and healthy recipe samples will lead to patients incorporating new foods into their diets. Adult patients in a combined adult and pediatric primary care office are offered three healthy …

Cardioprotective Role Of Spermidine In Ischemia-Reperfusion Injury, Isabella Brosious, Robert J. Barsotti, Lindon H. Young, Qian Chen

Research Day

Introduction: Timely reperfusion of the heart to restore blood flow and oxygen is critical to rescue ischemic myocardium in the setting of myocardial infarction and reduce cardiac morbidity and mortality. However, reperfusion following prolonged ischemic injury exhibits salvaging, but paradoxically, additional cellular damage, contributing to a larger infarct size. Termed ischemia-reperfusion injury (IRI), the myocardium undergoes various pathophysiological changes following reperfusion – such as apoptosis, oxidative stress, and mitochondrial dysfunction – thus exacerbating cellular damage and death caused by ischemic injury. The research on attenuation of IRI is critical to maximize the benefit of reperfusion. Spermidine is a natural polyamine …

Factors Associated With Concussion Knowledge And Misconceptions In Students Depending On Athlete Status, Joseph Fontanals, Ruta Clair

Research Day

Introduction: Concussions represent a significant public health concern, with widespread implications across various populations from athletes and military personnel to the general public. Despite increased attention in both research and public discourse, substantial gaps in knowledge and persistent misconceptions continue to influence concussion recognition, reporting, and management behaviors. Research consistently demonstrates variable levels of concussion knowledge across different populations. Misconceptions about concussions persist even among populations with higher general awareness. Despite education and public awareness campaigns many adults have surface knowledge of symptoms and misunderstand injury and recovery. These identified knowledge gaps and misconceptions have significant implications for public health, …

Significant Response To Third-Line Zenocutuzumab In Metastatic Nrg1 Fusion–Positive Pancreatic Adenocarcinoma: A Case Study, Sarah Davis, Sukhrob Makhkamov, Vladimir Limonnik

Research Day

Background

Pancreatic adenocarcinoma is an aggressive malignancy with limited treatment options. In metastatic disease, first‑line regimens like FOLFIRINOX or gemcitabine plus nab‑paclitaxel provide modest survival benefits and are commonly limited by toxicity and disease progression.

Recent advances in precision oncology have identified genomic alterations in a subset of pancreatic cancers. Neuregulin‑1 (NRG1) gene fusions occur in < 1% of pancreatic adenocarcinomas and lead to activation of HER3 signaling through interaction with HER2, promoting tumor growth and survival.

Zenocutuzumab is a bispecific monoclonal antibody designed to target HER2 and HER3. By binding HER2 and preventing ligand-induced activation of HER3, zenocutuzumab disrupts NRG1-driven signaling while preserving HER2 receptor engagement for antibody-mediated targeting. In the eNRGy trial, zenocutuzumab achieved an objective response rate of …

Increasing Lead (Pb) Screening Participation Rates In The Pediatric Patient Population At The Philadelphia College Of Osteopathic Medicine Lancaster Avenue Community Healthcare Center, Jacob P. Varrato, Autumn Dye

Research Day

Elevated blood lead levels (EBLLs) are an ongoing public health crisis predominantly affecting children under six in low-income communities located in major cities across the United States. Chronic lead exposure due to outdated housing, polluted water, and contaminated soil is especially harmful in early childhood when a high rate of hand to mouth contact increases the risk of ingesting particulate matter containing lead (CDC). EBLLs can lead to neurocognitive deficits, cardiovascular disease, and epigenetic modifications to gene expression patterns. While precautionary measures and timely screening protocols greatly reduce the risk of developing severe disease, families within these communities continue to …

Rehabilitation Of Dipeptidyl-Peptidase-Like Protein 6 (Dppx) Encephalitis: A Case Report, Madison James, Emily Andrews, Mithra Maneyapanda

Research Day

Introduction

A 50 year old man presented to the emergency department after a seizure. He had gastrointestinal upset, cognitive impairments, ataxia, and myoclonus. Workup was normal except for an inflammatory CSF profile. The patient was trialed on carbidopa-levodopa, intravenous methylprednisone, and intravenous immunoglobulins with minimal improvement. Myoclonus was resolved with clonazepam. The patient was discharged with a diagnosis of possible autoimmune encephalitis.

One month later, serum and CSF analysis resulted positive for DPPX antibodies. He was readmitted to the hospital for plasma exchange with minimal neurologic improvement. Subsequent treatment with Rituxan resulted in mild improvement. He was then transferred to …