Digital Commons Network^™

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Daily Outdoor Pm2.5 Exposure Characterization And Road Edge Effect During A 2022 - 2023 Monitoring Campaign In Gambia, Kenya And Mozambique, Terence Mushore, Handsome Nyoni, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Anotida Chapunza, Stanley Luchters, Matthew Chersich, Marleen Temmerman, Angela Koech

Centre of Excellence in Women and Child Health

Air pollution is a major contributor to mortality and adverse health outcomes, particularly in pregnant women and children, with vehicular emissions as a key source. This study aimed to characterize long-term exposure to fine particulate matter (PM2.5), evaluate potential health risks, and quantify the contribution of road transport and proximity to roads in The Gambia, Kenya, and Mozambique. Multi-temporal personal exposure data were interpolated into continuous spatial surfaces and aggregated into daily averages, which were then compared with World Health Organization (WHO) guidelines to assess potential health impacts. Multi-distance buffers at 10 m intervals up to 1000m from major roads …

Article Iii's Constraints On The Legislative Power, Elizabeth Earle Beske

William & Mary Law Review

Article III’s heightened concreteness standard for statutory harms takes federal judges deep into legislative terrain, jeopardizing statutory damage provisions and confining Congress to post hoc solutions rather than preemptive strikes. The Supreme Court has insisted that creating a cause of action is a legislative function. At the same time, its recent standing cases instruct lower federal courts to permit suit on statutory injuries only when they find actual harm that bears a tight connection to injuries recognized at common law. This new harm requirement rests uneasily with countless statutes featuring statutory damage provisions that are in place precisely because damages …

Is It Credit?, Jim Hawkins

William & Mary Law Review

Earned wage access companies advance money to workers based on wages they have already earned but have not yet been paid. Then, one of three things happens to reimburse the earned wage access provider: (1) the worker’s employer sends the provider money directly, (2) the provider withdraws money from the worker’s bank account on payday, or (3) nothing. The last of these is the most interesting. If the earned wage access provider does not receive the funds from the worker’s employer or bank account, the worker just walks away. Even more remarkable, many providers do not charge any mandatory fees …

Measure Theory, Probability, And The Structure Of Economic Models, Grace Etzel

Math Honors Theses

No abstract provided.

The Impact Of Mindfulness Strategies In An Elementary Classroom, Trinity Lawless

Master's Theses & Capstone Projects

School districts across the globe have adopted social-emotional initiatives throughout their schools to better the mental health of students and instill crucial soft skills within them. Implementing mindfulness strategies is one way that teachers are helping their students become more emotionally self-regulated learners. Although there is a plethora of research surrounding mindfulness, research on the specific mindfulness strategies that work best and the ones that students prefer is missing from the existing research. To mend this research gap, the current researcher sought to discover how mindfulness strategies impact students’ overall mindfulness score, what strategies are most beneficial, and which strategies …

Improving Bullying Victimization And Supports For Autistic Students, Sidney Swanson

Master's Theses & Capstone Projects

Bullying and peer victimization remain persistent concerns for students with autism spectrum disorder (ASD), who experiences higher rates of peer exclusion, rejection, and social isolation than their neurotypical peers. These experiences can negatively affect school engagement, emotional well-being, peer relationships, and long-term mental health outcomes. This practitioner inquiry study examined how classroom based social emotional learning (SEL) and inclusion strategist influenced peer relationships, student belonging, and bullying related behaviors for students with autism in an elementary school setting. This study was conducted over a six-week period in one first grade general education classroom and one Strat II ID/ LD classroom …

Jfl Insider: A Newsletter To Keep You In The Know, Liberty University

Jerry Falwell Library Newsletter

No abstract provided.

Precision Or Invasion? Mapping The Personalization Paradox, Shyamala N. Chalakudi, Gnana Bharathy

Journal of Applied Marketing Theory

AI-driven personalization has transformed consumer engagement, yet existing research offers no systematic way to determine when personalization shifts from helpful to intrusive. Current research and models explain privacy concerns or expectancy violations but do not measure the point at which personalization triggers user discomfort, creating the personalization paradox. This study introduces the Discomfort Threshold Assessment & Measurement (DTAM) framework, a conceptual model that identifies and evaluates this threshold by integrating Dual Process Theory, Expectation Violation Theory, and Privacy Calculus Theory. DTAM distinguishes between affective discomfort reactance and cognitive discomfort reactance and outlines how these constructs could, in future empirical studies, …

Impact Of Age And Rurality On Colorectal Cancer Outcomes In The United States, Caitlyn Grunert, Meng Han Tsai, Charles R. Rogers, Sydney Howard, Rachel Hogg-Graham, Courtney Martin, Darwin Conwell, Adetunji T. Toriola, Avinash Bhakta, Justin Moore

Surgery Faculty Publications

Background: While overall colorectal cancer (CRC) rates have declined in the United States (U.S.), early-onset CRC (EO-CRC), diagnosed before age 50, has increased. Rural U.S. residents face higher CRC incidence than non-rural counterparts. We aimed to examine the relationship between age at diagnosis and EO-CRC outcomes and whether rurality modify these associations. Methods: We analyzed data from 835,907 patients aged 20–79 years in the 2006–2020 SEER Program. Rurality was defined using U.S. Department of Agriculture Rural–Urban Commuting Area (RUCA) codes. Multivariable logistic regression models were used to examine associations between age, rurality, and late-stage CRC diagnosis. Competing-risk regression models were …

Building Qualitative Research Capacity In The Global Health Workforce And Developing A Community Of Practice In Parts Of Sub-Saharan Africa: A Case Study, Jack Lumsdon, Catherine Dotchin, Albert Akpalu, Benedict Calys-Tagoe, Dilraj Sokhi, Momodou Cham, Njideka Okubadejo, Richard Morton, Violet Naanyu, Richard Walker

Internal Medicine, East Africa

Background Qualitative research offers unique insights into the lived experience of individuals with chronic conditions which can tie directly into public health priorities and identifying the need for additional support. More participatory approaches and qualitative data surrounding chronic diseases are needed in sub-Saharan Africa (SSA). Valuable “insider” insights are often missing as the conceptualisation of research often overlooks the value of such interactions. For successful and meaningful global health research, it is imperative to involve in-country experts and strengthen the capacity of research teams with qualitative skills.

Methods To address this, two hybrid qualitative research skills workshops were conducted in …

Renal Adverse Effects Of Antiangiogenic Agents In A Tertiary Hospital In Kenya, Joan Wambugu, Joyce Bwombengi, Jasmit Shah, Manel Haj Mansour

Internal Medicine, East Africa

Introduction Anti-angiogenic therapies, including vascular endothelial growth factor (VEGF) inhibitors and tyrosine kinase inhibitors (TKIs), have transformed cancer management by targeting tumor vasculature and suppressing metastasis. However, these agents can induce renal toxicities such as hypertension, proteinuria, and acute kidney injury (AKI), which may affect treatment continuity and outcomes. Data from sub-Saharan Africa on these adverse effects remains scarce.

Methods This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Nairobi, oncology clinic. Medical records of adult patients receiving anti-angiogenic therapy between January 2020 and December 2024 were reviewed. Demographic data, comorbidities, treatment regimens, renal parameters, and …

Transfusion In Transit: A Decade Of Prehospital Blood Transfusion In Pediatric Trauma, Krysta M Sutyak, Eunise C Chen, Lea Mock, Rudolfo Cabrera, Jeannette M Joly, Kuojen Tsao, Bryan A Cotton, David E Meyer, Charles S Cox, Kevin P Lally, Natalie A Drucker

The Brown Foundation: Institute of Molecular Medicine

Background: Prehospital blood transfusion improves mortality in adults, with limited evidence in children. This study describes prehospital blood transfusion in pediatric trauma patients and the impact on shock index, pediatric adjusted (SIPA).

Methods: This study is a retrospective cohort study of trauma patients younger than 18 years who received blood transfusions during helicopter transport to a Level 1 pediatric trauma center from 2011 to 2023. Primary outcome was change in SIPA at time of emergency department (ED) arrival with prehospital transfusion. Secondary subgroup analysis was performed based on transport origin.

Results: Of 137 patients, 58% (80 of 137 patients) were …

Affinity-Optimized Trop2 Antibodies Support Potent Antitumor Activity In Antibody-Drug Conjugates, Aiko Yamaguchi, Junping Hong, Leike Li, Kiyotaka Kobayashi, Chisato M Yamazaki, Summer Y Y Ha, Yasuaki Anami, Wei Xiong, Junquan Liu, Zhiqiang An, Ningyan Zhang, Kyoji Tsuchikama

The Brown Foundation: Institute of Molecular Medicine

Background: Trophoblast cell surface antigen 2 (TROP2) is frequently overexpressed in epithelial tumors and is associated with poor prognosis, making it an attractive therapeutic target. Antibody-drug conjugates (ADCs) directed against TROP2 show clinical benefit, but expression in normal tissues such as skin raises concerns about on-target, off-tumor toxicity. Strategies that improve antitumor efficacy without increasing toxicity are needed.

Methods: Using an in-house phage library, we identified and characterized a novel fully human monoclonal antibody recognizing a unique conformational epitope of TROP2 with reduced binding affinity. This antibody was engineered into homogeneous ADCs carrying auristatin and/or duocarmycin payloads. Comparative studies with …

Telomerase Knockout In Myeloid Cells Predisposes Mice To Foam Cell Formation, Dyslipidemia, Lung Fibrosis, And Cardiac Dysfunction, Zhanguo Gao, Yongmei Yu, David Wiggins, Eva M Sevick-Muraca, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

Aging-associated changes in myeloid cells are incompletely understood. One of the culprits of aging is the downregulation of the Tert gene coding for the catalytic subunit of telomerase. Studies of mouse models with Tert knockout (KO) in specific cells have revealed the importance of the telomere-independent noncanonical function of TERT in supporting mitochondrial metabolism and protection from cell senescence. To investigate the role of TERT in myeloid cells (MCs), we analyzed mice with Tert KO in the LysM+ lineage, indelibly labeled with membrane green fluorescent protein (mG). Macrophage numbers and properties in various organs were compared. Changes in the vasculature, …

Describing Psychosocial Risk In The Mexican Working Population By Sex, Generation, And Industry: A Cross-Sectional Study, Courtney Blondino, Karla M. Téllez, Noémie Le Pertel, Ariel Joab Almazan, Lorna Friedman

Health Studies Faculty Publications

Objectives

Methods

Results

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Getting Across That Stage: Identifying And Addressing Barriers To Degree Completion For Undergraduates At A Selective Four-Year Institution, Karen G. Afre

Dartmouth College Master’s Theses

Selective institutions, like Dartmouth College, offer students extensive academic opportunities and institutional support. Despite large endowments and strong alumni networks that provide holistic support for students, selective institutions still experience student drop-out and extended time-to-degree. For Dartmouth undergraduate students who matriculated in Fall 2018, the six‑year graduation rate was 96%, while only 75% graduated within four years. This gap indicates that 25% of students took longer than four years to complete their degrees and 4% had not graduated within six years. 

This thesis examines barriers to college completion at selective institutions to inform retention efforts and institutional initiatives. I use …

2026 April, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for April of 2026.

Evaluating The Environmental Parameters Impacting Spawning Movement Of Gulf Sturgeon (Acipenser Desotoi) In The Bouie River System., Olivia St. Germain

Honors Theses

The anadromous Gulf Sturgeon (Acipenser desotoi) is federally listed as “threatened” and is natal to seven rivers from Louisiana to Florida. Only one spawning reach for Gulf Sturgeon natal to the Pascagoula River has been verified via the collection of eggs and larvae; a reach of the lower Bouie River. This reach is anthropogenically modified by four gravel mining formations, hereafter referred to as pits. The greater depths associated with this area have prompted previous researchers to suggest that Gulf Sturgeon may over-summer in pit formations instead of migrating to downstream holding areas in the Pascagoula River after spawning. The …

Leveraging Wearables And Vehicle Technologies To Automate Injury Severity Detection, Alexander Macgregor

Honors Capstone Projects and Theses

No abstract provided.

Natural Language Generation In Healthcare: A Review Of Methods And Applications, Mengxian Lyu, Xiaohan Li, Ziyi Chen, Jinqian Pan, Cheng Peng, Sankalp Talankar, Yonghui Wu

Faculty, Staff and Student Publications

Objective: This study presents a systematic review of natural language generation (NLG) methods and applications in the medical domain, providing quantitative and qualitative analyses to answer four key research questions regarding methods, evaluation, applications, and challenges of NLG in healthcare.

Methods: We searched PubMed, ACM Digital Library, Web of Science, Science Direct, Scopus, Embase, and ACL Anthology for NLG-related studies in healthcare from 2018 to 2024. Out of 3,988 research articles, 113 met the inclusion criteria and were analyzed across data modality, model architecture, evaluation metrics, and application domain.

Results and conclusion: NLG in healthcare has grown substantially, with annual …

A New Standard: Default Inclusion Of Children In Clinical Trials, Megyn Gordon

Colorado Law Student Scholars

No abstract provided.

Traumatic Brain Injury And Risk Of Early-Onset Dementia: A Population-Based Cohort Study, Aishwarya Saravanan, Katherine Giorgio, Natalia Lakomski, Andrea L C Schneider, Barbara A Olson-Bullis, Behnam Sabayan, James S Pankow, Paul S De Vries, Kristine Yaffe, Alexa Beiser, Abbas Dehghan, Elizabeth A Peterson, Rachel Zmora, John J Stephen, Denise Scholtens, Maxwell Mansolf, Lenore J Launer, Richard F Maclehose, Pamela L Lutsey, Norrina B Allen, Sanaz Sedaghat

Faculty, Staff and Student Publications

Introduction: We investigated the association between traumatic brain injury (TBI) and incidence of early-onset dementia (EOD) versus late-onset dementia (LOD).

Methods: We included 501,710 UK Biobank participants (average age 56.5). Over a median 13.6 years of follow-up, 836 developed EOD (before 65) and 8947 developed LOD (after 65). We estimated hazard ratios (HRs) for TBI's association with EOD and LOD using Cox proportional hazard models with TBI as a time-varying exposure and coefficient.

Results: TBI was associated with higher risk of both EOD (HR: 4.06 [95% confidence interval: 3.13, 5.26]) and LOD (HR: 2.51 [2.31, 2.72]. Among participants included in …

Double-Crispr Knockout Simulation (Dkosim): A Monte-Carlo Randomization System To Model Cell Growth Behavior And Infer The Optimal Library Design For Growth-Based Double Knockout Screens, Yue Gu, Traver Hart, Luis Leon-Novelo, John Paul Shen

Faculty, Staff and Student Publications

Advances in functional genomic technology, notably CRISPR using Cas9 or Cas12, now allow for large-scale double perturbation screens in which pairs of genes are inactivated, allowing for the experimental detection of genetic interactions (GIs). However, as it is not possible to validate GIs in high-throughput, there is no gold standard dataset where true interactions are known. Hence, we constructed a Double-CRISPR Knockout Simulation (DKOsim), which allows users to reproducibly generate synthetic simulation data where the single gene fitness effect of each gene and the interaction of each gene pair can be specified by the investigator. We adapted Monte-Carlo randomization methods …

Continuous Versus Bolus Norepinephrine Administration To Treat Hypotension After Induction Of General Anaesthesia In Low-To-Moderate Risk Noncardiac Surgery Patients: A Randomised Trial, Kristen K Thomsen, Finn Külls, Christina Vokuhl, Linda Krause, Dominik Müller, Max Bossemeyer, Mirja Wegge, Alina Kröker, Alina Bergholz, Christian Zöllner, Daniel I Sessler, Bernd Saugel

Faculty, Staff and Student Publications

Background: Hypotension after induction of general anaesthesia (postinduction hypotension) is common in patients undergoing noncardiac surgery and frequently requires treatment with vasopressors such as norepinephrine. We tested the hypothesis that giving norepinephrine continuously using a syringe infusion pump, compared with giving it as repeated manual boluses, reduces postinduction hypotension within 15 min after starting induction of general anaesthesia in low-to-moderate risk noncardiac surgery patients.

Methods: Patients undergoing elective noncardiac surgery were randomised to either continuous norepinephrine infusion or manual bolus norepinephrine administration intravenously during induction of general anaesthesia. In both groups, norepinephrine was administered through a peripheral venous catheter. Blood …

Unwelcomeness Reconsidered: Adapting Sexual Harassment Law In The Long Wake Of #Metoo, Collin Christner

Michigan Law Review

The federal cause of action for sexual harassment in employment grew out of Title VII’s prohibition of workplace sex discrimination. In many circuits, for sexual harassment claims to be actionable, the plaintiff must show they found the referenced conduct “unwelcome.” Commentators have criticized that requirement since its inception; nonetheless, it has been wielded by courts that are either resistant or reluctant to abandon it. “Unwelcomeness” (or lack of evidence thereof) has been used to permit swaths of inappropriate workplace conduct— enshrining old, sexist stereotypes into America’s employment regulations. This Note evaluates the current approach to the unwelcomeness requirement and proposes …

Fatigue Survival And Biomechanical Behavior Of Two-Piece Titanium And Zirconia Dental Implants, Jefferson David Melo De Matos, Guilherme Da Rocha Scalzer Lopes, Nathália De Carvalho Ramos, Mário Alexandre Coelho Sinhoreti, Alexandre Luiz Souto Borges, Daher Antonio Queiroz, Marco Antonio Bottino

Faculty, Staff and Student Publications

Background: Titanium implants are considered the gold standard for oral rehabilitation; however, zirconia implants have emerged as a metal-free alternative with promising esthetic and biological properties. Despite these advantages, limited evidence is available regarding their long-term fatigue behavior and fracture resistance.

Material and methods: In this in vitro experimental study conducted at São Paulo State University (UNESP), Brazil, forty implants were divided into two groups (n = 20): zirconia implants (ZZ) and titanium implants (TZ) (4.1 × 10 mm). Implants were embedded in polyurethane blocks according to ISO 14801:2016 specifications. Monolithic zirconia crowns were fabricated using CAD/CAM technology and cemented …

Maternal Infection At Delivery And Risk Of Stillbirth And Early Neonatal Death: Nested Case-Control Studies In East African Pregnancy Cohorts, Anna Seale, Meron Kebede, Rosanna Glazik, Mussie Brhane, Mulu Berihun, Zelalem Teklemariam, Dadi Marami, Joseph Oundo, Tadesse Gure, Angela Koech

Centre of Excellence in Women and Child Health

Background Stillbirths and early neonatal deaths remain common in low- and middle-income countries. Maternal infections are likely contributors, but data are extremely limited. We aimed to describe maternal infections at delivery and their association with perinatal death.

Methods We investigated maternal infections at delivery in two hospitals in East Africa: in Kilifi County Hospital (2011–2017), Kenya, and Hiwot Fana Comprehensive Specialised Hospital (2019–2020), Ethiopia. We compared 642 mothers delivering stillbirths/newborns dying in the first 24 h after birth (cases) and 855 mothers with newborns surviving ≥ 24 h (controls) from pregnancy cohorts. We tested maternal blood with molecular diagnostic panels …