Digital Commons Network^™

The Journey Of The Soul In Aboriginal Australia, Ian S. Mcintosh

International Journal of Religious Tourism and Pilgrimage

For the past decade, I have been studying pilgrimage in all its dimensions in what my colleagues and I have been calling a kaleidoscopic inquiry (McIntosh et al., 2024). In my current investigations, I have been exploring the journey of the soul upon the death of its host. My focus in this working paper is the myths and traditions of the Yolngu Indigenous peoples of northeast Arnhemland in remote northern Australia with whom I lived and worked in the 1980s and 90s. The Yolngu go to great lengths to prepare the dying for their ultimate journey, painting the body with …

The Link March 17, 2026, Access To Justice Institute

The Link Newsletter

No abstract provided.

Carroll County Advisory Council March 2026 Meeting Minutes, Extension

Advisory Council

No abstract provided.

Development And Validation Of The Emergency Department Transitions Measure, Sara Beachy, Danielle M. Mccarthy, Julianna Lenoir, Alexzandra Gentsch, Richard W. Hass, Marissa Witmer, Paula Ostroff, Melissa Tupas, Lindsey Shughart, Hailey Shughart, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Transitions of care are high-risk periods for patient safety in the emergency department (ED), particularly for patients who are still in the diagnostic process and are discharged with diagnostic uncertainty. Care transitions must be improved for these patients, as one third of discharged ED patients have diagnostic uncertainty. Yet there are no validated measures that assess the quality of care transitions from the ED, limiting the ability to assess the impact of interventions. Thus, we developed and validated the ED Transitions (EDT) measure.

METHODS: This mixed methods study was conducted across a large healthcare system in three phases: item …

Efficacy And Safety Of Approved Cellular Therapies And Bispecific Antibodies In Solid Tumors: The Current State, Rabab Zehra Jafry, Saba Bilal Qamar, Sohaib Irfan, Muhammad Abbas Abid, Virginia Mohlere, Neha Maithel, Syed Hassan Jafri, Sanjay Awasthi, Samer Srour, Irfan A Vaziri, Muhammad Bilal Abid

Faculty, Staff and Student Publications

Cancer immunotherapy is a broad term including naked antibodies, bispecific antibodies (BsAbs), immune-checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell (CAR-T) therapy, cancer vaccines, activated immune cells, and allogeneic hematopoietic cell transplantation. Recent advances in immune-engaging T-cell therapies have led to significant progress in novel treatments across various cancer types, resulting in prolonged patient survival, mainly in patients with hematologic malignancies. Several CAR T-cell constructs and BsAbs have been approved by regulatory authorities worldwide for relapsed, refractory leukemia, non-Hodgkin lymphoma, and multiple myeloma. Solid tumors are characterized by an immunosuppressive, fibroinflammatory tumor microenvironment (TME) and immune-suppressive cells, such as regulatory T-cells …

Fungal Meningitis In Us Patients Who Received Epidural Anesthesia In Matamoros, Mexico, Dallas J Smith, Elizabeth Misas, Jeremy A W Gold, Nicole Evert, Thi Dang, Emilie Prot, Simone Godwin, Julieanna Rivas, Jessica Pearson, Lori Koenecke, Nirma D Bustamante, Maria Julia Marinissen, Gabriel Garcia Rodriquez, Irma López-Martínez, Caitlyn Lutfy, Samantha Williams, Axel A Vazquez Deida, Katrina M Byrd, Julian A Villalba, Sarah Reagan-Steiner, Lindsay Parnell, Lalitha Gade, Romney M Humphries, Nathan P Wiederhold, Charles Y Chiu, Joshua A Lieberman, Anastasia P Litvintseva, Tom Chiller, Luis Ostrosky-Zeichner, Fungal Meningitis Response Team

Faculty, Staff and Student Publications

Background: Fungal meningitis outbreaks are rare and entail high mortality rates. Beginning May 2023, we investigated fungal meningitis caused by Fusarium solani species complex occurring in US patients who received epidural anesthesia in Matamoros, Mexico.

Methods: Early epidemiological information suggested US patients with suspected fungal meningitis had undergone mostly cosmetic procedures under epidural anesthesia performed in 2 Matamoros clinics. US patients known to have received surgery at these clinics during 1 January-13 May 2023 (clinic closures date) were identified and notified by public health officials. Epidemiological and clinical data were used to update diagnostic and clinical guidance for outbreak response, …

A Tibial Osteotomy Of The Medial Collateral Ligament Insertion To Improve Visualization Of The Medial Tibial Plateau: A Cadaveric Study, Kathryn A Barth, Ricardo R Tijerina, Adeet Amin, Avrey A Novak, Erik N Mayer, Sabir K Ismaily, John W Munz, Andrew M Choo, Timothy S Achor, Steven J Warner, Jonathan G Eastman, Patrick J Kellam

Faculty, Staff and Student Publications

Objectives: To compare visualization of the medial tibial plateau articular surface using three surgical approaches: medial collateral ligament (MCL) split, femoral epicondyle osteotomy of the MCL origin, and tibial osteotomy of the MCL insertion.

Methods: Seven matched pairs of fresh-frozen adult cadaveric lower extremity specimens (14 knee specimens total) with no evidence of previous surgery were utilized. Through a medial approach to the proximal tibia, the MCL split technique was performed followed by a sub-meniscal arthrotomy. Standardized distraction of the joint was applied using a universal distractor. A three-dimensional digitizer probe was utilized to map the visible articular surface. These …

Is The Long-Horned Grasshopper Ruspolia Differens (Orthoptera: Tettigoniidae) A Novel, Nutritious, Functional, And Safe Alternative Food Product? A Review, Margaret Kababu, Collins Mweresa, Dorothy Nakimbugwe, Geoffrey Ssepuuya, Karlmax Rutaro, Nicodemus Matojo, Faith Nyamu, Robert Mbeche, Sevgan Subramanian, Sunday Ekesi, Chrysantus Tanga

All Peer-Reviewed Publications

Ruspolia differens Serville (Orthoptera: Tettigoniidae) is among the most widely consumed edible insect in Eastern and Central Africa, where it contributes to both household nutrition and income generation. As a nutrient-dense food source, it offers a promising alternative to curb food insecurity and malnutrition. Despite this, the consumption and use of the grasshopper is limited to its seasonal availability when it is collected from the wild. Coupled with this, is limited evidence on its domestication despite research advances to optimize conditions for mass production. This review was conducted to highlight research advances and gaps on production, processing, nutritional profile, and …

The Business Of Ai-Producing Startups: Evidence From A Worldwide Survey, James Bessen, Stephen Michael Impink, Robert Seamans

Faculty Scholarship

We report results from a multi-year, worldwide survey of artificial intelligence (AI)-producing startups to describe the types of technologies, frameworks, data protection, and partnerships nascent firms use to develop their AI products. Analyses of our survey findings also inform how startups gather the resources to commercialize their AI applications in alignment with their entrepreneurial strategies, address competitive barriers, and respond to regulations. These data provide initial evidence of the perceived impact of these products on their customers’ tasks and industries, suggesting that these firms’ AI products not only reduce labor costs but augment human capabilities.

Infectious Aortitis Secondary To Gastrointestinal Pathogens: A Case Series And Syndromic Review, Natasa Kostic, Ilana Goldberg, Devin Weber

Division of Internal Medicine Faculty Papers & Presentations

Aortitis is a rare but serious complication of infection that results in high morbidity and mortality. The most common location is in preexisting aneurysmal disease in a patient with multiple chronic comorbidities. The pathogens often reflect gastrointestinal bacteria, the classic example being Salmonella spp., but also include other enteric flora, Staphylococcus aureus, Streptococcus spp., and more. Herein, we describe 2 cases of aortitis caused by gastrointestinal bacteria and review management of this complex syndrome.

Re: Comment Letter For The 2020 Through 2024 Surface Water Compliance Evaluation Technical Memorandums Silver Bow Creek Area Npl Site, Butte Priority Soils Operable Unit (Bpsou) Consent Decree-Civil Action No. Cv89-039-Bu-She (Dated February 3, 2026), Emma Rott

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Use Of Tpa And Dnase Or Tpa Alone For Fibrinolysis, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. In this report, the panel provides recommendations for intrapleural fibrinolysis with tissue plasminogen activator (tPA) alone over tPA and dornase alfa (DNase) in children (3 months to 18 years) with complicated parapneumonic effusion and empyema. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according …

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Choice Of Chest Tube Size, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Infectious Diseases Society of America. In this paper, the panel provides recommendations on the appropriate size of thoracostomy tube for drainage. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

Visdb 20: A Manually Curated Resource Of Viral Integration Sites And Their Regulatory Maps In Human Diseases, Citu Citu, Ajeet Singh, Xinyi Liu, Mounika Ashannagari, Rinki Ratnapriya, Zhongming Zhao

Faculty, Staff and Student Publications

The integration of viral sequence into the human genome plays critical role in the onset of various diseases, especially cancers. To facilitate systematic analysis of these events, we present VISDB 2.0, an expanded and updated database of human viral integration sites (VISs). The current release contains more than 270,000 manually curated VISs derived from 209 peer-reviewed publications, covering 11 viruses, including four retroviruses and seven DNA viruses. This represents a 3.5-fold increase in VIS entries compared with the previous version. Each VIS record includes standardized genomic coordinates and annotations describing local genomic context, CpG islands, repetitive elements, chromosomal fragile sites, …

System-Level Drivers For The Adoption Of Evidence-Based Practices In Schools, Marijne Medhurst, Jen Jackson, Pru Mitchell, Romany Manuell

School and system improvement

This report outlines strategies that education system leaders can use to support the adoption of evidence-based teaching practices within schools, recognising the importance of teaching quality to lift student outcomes. It is based on an adapted systematic review of available evidence conducted by the Australian Council for Educational Research (ACER) for and in collaboration with the Australian Education Research Organisation (AERO). The report begins by identifying considerations or approaches that system leaders can apply to selecting strategies to support schools, to ensure that they are culturally reflexive, aware of contextual enablers and barriers, and aligned with the approaches evident in …

Re: Conditional Approval Letter For The Butte Priority Soils Operable Unit (Bpsou) Butte Treatment Lagoons (Btl) Groundwater Treatment System Quarterly Operation And Maintenance Report – Quarter 3 2025 (Dated December 23, 2025), Emma Rott

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Multimodal Imaging Reveals A Lysosomal Drug Reservoir That Drives Heterogeneous Distribution Of Parp Inhibitors, Carmen R Moncayo, Lauren Pendergast, Priyanka Verma, Et Al.

2020-Current year OA Pubs

For all drugs, effective target engagement requires sufficient intracellular concentrations of drug to be reached, but whether tumour heterogeneity impacts drug distribution and efficacy is poorly studied. Poly (ADP-ribose) polymerase (PARP) inhibitors have transformed treatment opportunities for women with high-grade serous ovarian carcinoma, but resistance remains a clinical hurdle in this highly heterogeneous tumour type. Here, we present a patient-derived explant multi-modal imaging pipeline, which demonstrates that cell-intrinsic PARP inhibitor accumulation is highly variable, both between patients and within tumours. Spatial transcriptomics reveals enrichment of apoptotic and lysosomal signatures in high-drug regions. Rucaparib, an intrinsically fluorescent PARP inhibitor, accumulates heterogeneously …

Genomic Medicine In Pediatrics: What Pediatricians Need To Know Now, Michael Smith, Scott T. Younger

Pediatrics in Practice: A CME Podcast

Genomic medicine is playing an increasingly important role in pediatric care, but it can feel complex for general pediatricians. In this episode of Pediatrics in Practice, Scott Younger, PhD, discusses how genomics is already influencing pediatric diagnosis and care today, common scenarios where genetic insights may be helpful, and why genomic testing can be valuable even when it doesn’t lead to a targeted therapy. This conversation offers practical guidance on when to consider genomics, when to refer, and how pediatricians can partner with genetics and subspecialty teams to support patients and families.

Click here to stream the podcast episode.

Nursing Interventions To Reduce Anxiety And Psychological Distress In Breast Cancer Patients In The Us, Alexis Abboud, Al Araydeh Mifleh

The Cardinal Edge

Background Breast cancer patients frequently experience psychological challenges, such as anxiety, distress, and diminished quality of life (QoL). Nursing interventions show promise in addressing these issues; however, a comprehensive synthesis of their impact is lacking. This review evaluates the effectiveness of nursing interventions in reducing anxiety and psychological distress while improving QoL.

Research Question What nursing interventions effectively reduce anxiety and psychological distress and improve QoL among breast cancer patients in the United States?

Methods A systematic review was conducted following PRISMA 2020 guidelines. Searches of CINAHL, APA PsycInfo, and Medline identified studies published in the last five years in …

Evolving Solutions For Red Blood Cell Preservation, Ali Alkafaji, Charles A. Elder, Mohammad Zaidi, Kavin Parthiv, Michael A. Menze

The Cardinal Edge

In emergencies such as natural disasters, armed conflicts, or during outer space missions, the availability of transfusable blood can mean the difference between life and death. Red blood cells (RBCs) must be stored at +4 ± 2 °C and have a shelf life of just 42 days, which makes maintaining a stable blood supply during adverse conditions extraordinarily challenging. This challenge was especially apparent during the COVID-19 pandemic when hospitals faced severe blood shortages. Freeze-drying, or lyophilization, offers a promising avenue to extend the shelf life of RBCs for transfusion during crises. However, a significant hurdle in dry preservation is …

Filifactor Alocis Disrupts Efferocytosis To Sustain Inflammation In Periodontitis, Ella Dye, Silvia Uriarte, Ruth Idowu

The Cardinal Edge

Background: Filifactor alocis is a Gram-positive, obligate anaerobe that has emerged as a diagnostic marker of periodontitis. Neutrophils and macrophages are key players in oral immune homeostasis. Neutrophils are short-lived cells and constitutively undergo apoptosis. This apoptotic program can be accelerated or delayed by bacterial interactions. Macrophages clear apoptotic neutrophils via “efferocytosis,” a crucial mechanism for resolving inflammation and preventing tissue damage. The efferocytic process downregulates the expression and release of proinflammatory cytokines such as interleukin (IL)-6 and IL-23 while promoting anti-inflammatory responses. Our previous findings demonstrated that F. alocis delays neutrophil apoptosis, with fewer apoptotic cells observed after 18 …

How Medical Students Use Comforting Language When Taking A Sexual History For Different Presenting Complaints, Abigail Breeze, Emily J. Noonan, Laura Weingartner

The Cardinal Edge

No abstract provided.

Patient Presentation Affects Medical Student Comfort During Sexual Health Encounters, Harshith Jella, Emily J. Noonan, Laura Weingartner

The Cardinal Edge

BACKGROUND

Previous research has identified some disparities between the care that masculine- and feminine-presenting patients experience with regards to sexual health. These disparities could cause feelings of unease and also difficulty with patient-physician communication. In medical education, standardized patients can help students identify and address implicit biases that could propagate as providers.

METHODS

The study population consisted of second year medical students (n=100) from the University of Louisville who completed sexual history-taking during a standardized patient encounter. Coders evaluated the phrases used, perceived comfort levels, and SP feedback among masculine- and feminine-presenting standardized patients.

RESULTS

While the patient presentation did …

Egf Enhances Re-Epithelization In Our Ex-Vivo Pig Eye Model, Andrew D. Le, Lisandra Plana-Ramos, Kate Tarvestad, Brian Ceresa

The Cardinal Edge

The cornea, the foremost anterior portion of the eye, plays a critical role in vision by refracting light and serving as a protective barrier. Its three distinct layers—the outermost epithelial layer, the thick stromal layer, and the innermost endothelial layer work together to maintain corneal transparency and function. The epithelial layer is particularly susceptible to damage, which can compromise the eye’s defense against foreign particles such as bacteria and viruses, potentially leading to infection and blindness. In this study, we established an ex vivo porcine corneal model to quantitatively and qualitatively investigate corneal re-epithelialization. Using adult pig eyes sourced from …

Exploring The Impact Of Perceived Patient Age And Gender On Medical Students' Comfort And Confidence With Sexual History-Taking, Haven Gabrielle V. Romero, Laura Weingartner

The Cardinal Edge

BACKGROUND

Many medical students lack confidence when navigating a patient sexual history. Discomfort may stem from a lack of experience, societal taboos surrounding sexual health discussions, or concerns about maintaining professionalism while addressing sensitive topics. We aimed to investigate comfort and confidence among student genders and patient age.

METHODS

We analyzed 107 standardized patient (SP) encounters of second-year students across three sexual health cases with different presenting complaints. Perceived comfort and confidence were inferred from student body language, language, and conversational tone, which were categorized as: comfortable/confident, fairly comfortable/confident, not comfortable/confident.

RESULTS

Across cases, students were comfortable/confident in half (50%). …

The Impact Of Linguistic Discrimination On The Mental Health Of International College Students: A Systematic Review Protocol Design, Isabella G. Hausladen, Chinarah D. Winston, Maria Kondaurova, Lidiya Grote

The Cardinal Edge

The analysis of education data from the National Foundation for American Policy demonstrates that between 50% and 82% of the full-time graduate students in STEM fields at United States universities are international students who provide a wide range of expertise, knowledge, and skills needed to participate in the STEM workforce (National Foundation for American Policy, 2017). One of the challenges international college students face is self-perceived linguistic discrimination, defined as a person’s individual experience of feeling unfairly treated due to their accent, proficiency, or choice of language. The objective of this study is to develop a protocol for a systematic …

Hsp90 Inhibitor In Reducing Integrated Stress Response In An Experimental Mouse Model Of Spinal Cord Injury, Yousef Abozaid, Aditya Sarkar, Lukasz P. Slomnicki, Michal Hetman

The Cardinal Edge

Spinal cord injury (SCI) initiates a complex cascade of molecular events, including protein misfolding and neuroinflammation, contributing to neural damage and impaired functional recovery. Heat Shock Protein 90 (HSP90), a critical molecular chaperone involved in cellular stress responses, emerges as a promising therapeutic target to mitigate secondary damage after SCI. This study was designed to validate the in-vivo effects of different doses of HSP90 inhibitor, HSP990-i, administered acutely after moderate T9 SCI mouse model. The level of HSP70 protein level is measured through western blot from the injury epicenter. Adult mice underwent experimental contusive SCI at the T9 level, followed …

Effects Of Phosphorus Addition On Fungal Colonization In Little Bluestem, Isabel M. Zanartu, Alexx Nicholas, Mckenzie Goodwyn, Connor Morozumi

The Cardinal Edge

Little Bluestem (Schizachyrium scoparium) is a North American perennial grass that is able to tolerate high heat and droughts. This is possible by its extensive underground root network that taps deep into the ground for resources. Within the same soil systems are fungal endophytes, which are symbionts that live within plant tissues including roots. Fungal endophytes can affect host growth and nutrient acquisition, but the functional role these endophytes play in plant health may be dependent on the abiotic conditions the plant is facing. In the modern era, one large driver of abiotic conditions is synthetic fertilizer use which alters …

Light As An Environmental Toxin: Impacts Of Temporal Circadian Misalignment On Physiology, Behavior, And Lifespan In Drosophila, Aubrey Reitzel, Krish Patel, Breanna Beard, Dae-Sung Hwangbo

The Cardinal Edge

In the modern world, we are exposed to irregular light patterns, which can disturb circadian rhythms. Circadian rhythms are patterns of behavior that operate on a 24-hour cycle and are regulated by the interactions between external signals and the internal circadian clock, which regulates sleep/wake patterns, feeding and sleep behavior, and resistance to starvation. Little is known about the impact of misalignment of these circadian rhythms as related to dietary composition on the lifespan, behaviors, and physiological changes of Drosophila. We hypothesized that circadian misalignment would significantly reduce lifespan and alter behaviors and physiologies. In this study, mated female …

Avaren-Fc, A Novel Immunotherapeutic, Recruits Nk Cells In B16f10 Melanoma Tumor Tissue, Vatsa Vemuri

The Cardinal Edge

Avaren-Fc, a Novel Immunotherapeutic, Recruits NK Cells in B16F10 Melanoma Tumor Tissue

Sreevatsa Vemuri¹, Katarina Mayer M.S.¹, Nobuyuki Matoba, Ph.D.^{1, 2, 3}

Department of Pharmacology and Toxicology¹, UofL Health-Brown Cancer Center², Center for Predictive Medicine³, University of Louisville School of Medicine

Abstract

Avaren-Fc (AvFc) is an experimental antibody-like molecule, consisting of a recombinant Avaren lectin translationally fused to the Fc region of human IgG1. This unique design targets N-linked high-mannose glycans, which are overrepresented on the surface of malignant cells, including melanoma. With limited effective therapies available for …