Digital Commons Network^™

Deliberately Indifferent: Institutional Liability For Further Harassment In Student-On-Student Title Ix Cases, Jacob R. Goodman

Vanderbilt Law Review

Sexual harassment is an unfortunate problem far too many have experienced. Universities and other educational institutions owe a duty, both legal and moral, to protect students from sexual harassment, and in turn to allow students to receive the full benefits of their education. But a circuit split has limited students' ability to hold educational institutions liable. This circuit split results in the absurd scenario where an individual must experience sexual harassment more than one time to hold their educational institution liable. This Note attempts to fix that by proposing Title IX (the law governing sexual harassment at educational institutions) adopt …

Girls On The Map: Mapping For Program Planning And Social Change, Eva Roca

Adolescents and Young People

This guide explores ways in which maps can add depth to the learning process as practitioners design programs for girls. Mapping leads practitioners through a cycle of information collection and analysis. It supports decision-making about where, with whom, and when to work, and how programs can make a real difference in girls’ lives. Programs increasingly recognize the importance of household and community characteristics in shaping girls’ lives, yet it is relatively less common to measure or map community features as part of program planning. Mapping relevant populations of girls and the features of the communities they live in can inform …

Can Research Be Sacred Ministry?, Desmond Murray

Faculty Publications

No abstract provided.

Understanding And Cultivating Mathematical Resilience In Students, Anthony Bosman, Adam Heck

Faculty Publications

No abstract provided.

Bone Metastases In Non-Small Cell Lung Cancer: A Narrative Review, Brendan J. Knapp, Siddhartha Devarakonda, Ramaswamy Govindan

2020-Current year OA Pubs

Background and Objective: Bone metastases are common in patients with non-small cell lung cancer (NSCLC) and remain a significant source of morbidity, mortality, and diminished quality of life, despite the considerable progress made in the overall management of patients with metastatic NSCLC over the last decade. Understanding the molecular pathogenesis of bone metastases is critical to improving survival, preserving function, and managing symptoms in this patient population. The objective of our review is to provide a comprehensive review of the pathophysiology, clinical presentation, management, and factors predicting the development and prognosis of patients with NSCLC with bone metastases.

Methods: An …

Randomized, Clinical Trials On The Effects Of Robotic-Assisted Gait Training For Stroke Subjects: A Scoping Review, Daniel K. Hufnagel

University Honors Theses

Robotic-assisted gait training has been cited as a potential rehabilitation intervention for the recovery of ambulation in hemiplegic stroke patients. Previous reviews on robotic gait training have elicited a need for more randomized, clinical studies on robotic gait training for the development of evidence-based intervention protocols and elimination of research bias. The purpose of this scoping review was to provide an updated examination of the clinical research on robotic assisted gait training and address any research gaps to be considered for future research. This review included randomized, clinical trials on stroke patients with a robotic-assisted treatment (RAGT) and conventional gait …

The Interaction Between Serotonin Transporter Allelic Variation And Maternal Care Modulates Instagram Sociability In A Sample Of Singaporean Users, Andrea Bonassi, Ilaria Cataldo, Giulio Gabrieli, Moses Tandiono, Jia Nee Foo, Bruno Lepri, Gianluca Esposito

Research Outputs: 2025-Present

Human social interactions ensure recognition and approval from others, both in offline and online environments. This study applies a model from behavioral genetics on Instagram sociability to explore the impact of individual development on behavior on social networks. We hypothesize that sociable attitudes on Instagram resulted from an interaction between serotonin transporter gene alleles and the individual’s social relationship with caregivers. We assess the environmental and genetic components of 57 Instagram users. The self-report questionnaire Parental Bonding Instrument is adopted to determine the quality of parental bonding. The number of posts, followed users (“followings”), and followers are collected from Instagram …

Adopting Green Practices: Challenges For University Libraries Of Pakistan, Muhammad Asim, Pervaiz Ahmad Prof. Dr.

Library Philosophy and Practice (e-journal)

A green or sustainable library seeks to maximize the use of natural and renewable resources. The adoption of green practices in libraries of developing countries like Pakistan is much needed where water and energy resources are scarce and unsustainable. This move from conventional to green libraries also poses certain challenges. This study aims to explore the challenges encountered in the adoption of green library practices in the university libraries of Pakistan. The scholarly literature is reviewed to encompass the dimensions and challenges of a green library in the global context. The feedback from the selected, senior university librarians of Pakistan …

Anxiety Symptoms Among Patients With Systemic Lupus Erythematosus Persist Over Time And Are Independent Of Sle Disease Activity, Daphne Lew, Xinliang Huang, Sara R Kellahan, Hong Xian, Seth Eisen, Alfred H J Kim

2020-Current year OA Pubs

OBJECTIVE: The objectives of this study are to identify patterns of anxiety symptomology over time among patients with systemic lupus erythematosus (SLE) and to assess the longitudinal relationship between SLE disease activity and anxiety symptomology.

METHODS: Longitudinal data from 139 patients with American College of Rheumatology or Systemic Lupus International Collborating Clinic (SLICC)-classified SLE were analyzed. Anxiety symptomology was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress: Anxiety Short Form 8a. SLE disease activity was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 (S2K) and S2K Responder Index 50 (S2K RI-50). Group-based trajectory modeling (GBTM) …

Optimization Of Care For Patients With Hereditary Angioedema Living In Rural Areas, Marc A Riedl, Douglas T Johnston, John Anderson, J Allen Meadows, Daniel Soteres, Stephen B Leblanc, H James Wedner, David M Lang

2020-Current year OA Pubs

BACKGROUND: People living in rural areas of the United States experience greater health inequality than individuals residing in urban or suburban locations and encounter several barriers to obtaining optimal health care. Health disparities are compounded for patients with rare diseases such as hereditary angioedema (HAE), an autosomal dominant genetic disorder characterized by recurrent, severe abdominal pain and life-threatening oropharyngeal or laryngeal swelling.

OBJECTIVE: To explore the challenges of managing patients with HAE in rural areas and suggest possible improvements for optimizing care.

DATA SOURCES: PubMed was searched for articles on patient care management, treatment challenges, rural health, and HAE.

STUDY …

Poems Syndrome: Real World Experience In Diagnosis And Systemic Therapy - 108 Patients Multicenter Analysis, Artur Jurczyszyn, Mark Fiala, Ravi Vij, Et Al.

2020-Current year OA Pubs

POEMS syndrome, a rare plasma cell disorder, is challenging both in the diagnostic and therapeutic management. We present real word retrospective analysis of 108 cases analyzing clinical features and therapeutic modes. We compare our results with the available literature. This is the first description with such wide use of proteasome inhibitors in first line treatment. POEMS (Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) syndrome is a rare and challenging plasma cell disorder, both in the diagnostic and therapeutic management of the disease. Currently, the literature on POEMS is sparse with most evidence being case reports and small case studies. We present …

Two Cases Of Wolfram Syndrome Who Were Initially Diagnosed With Type 1 Diabetes, Francesca Silvestri, Valeria Tromba, Francesco Costantino, Nila Palaniappan, Fumihiko Urano

2020-Current year OA Pubs

OBJECTIVE: Early diagnosis of syndromic monogenic diabetes allows for proper management and can lead to improved quality of life in the long term. This report aimed to describe 2 genetically confirmed cases of Wolfram syndrome, a rare endoplasmic reticulum disorder characterized by insulin-dependent diabetes mellitus, optic nerve atrophy, and progressive neurodegeneration.

CASE REPORT: A 16-year-old Caucasian male patient and a 25-year-old Caucasian female patient with a history of diabetes mellitus and optic nerve atrophy presented at our medical center. Both patients were initially diagnosed with type 1 diabetes but negative for islet autoantibodies. Their body mass indexes were under 25 …

Peripheral Neuropathy Evaluations Of Patients With Prolonged Long Covid., Anne Louise Oaklander, Alexander J Mills, Mary Kelley, Lisa S Toran, Bryan Smith, Marinos Dalakas, Avindra Nath

Department of Neurology Faculty Papers

Background and objectives: Recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears exponential, leaving a tail of patients reporting various long COVID symptoms including unexplained fatigue/exertional intolerance and dysautonomic and sensory concerns. Indirect evidence links long COVID to incident polyneuropathy affecting the small-fiber (sensory/autonomic) axons.

Methods: We analyzed cross-sectional and longitudinal data from patients with World Health Organization (WHO)-defined long COVID without prior neuropathy history or risks who were referred for peripheral neuropathy evaluations. We captured standardized symptoms, examinations, objective neurodiagnostic test results, and outcomes, tracking participants for 1.4 years on average.

Results: Among 17 patients (mean age …

Wildlife Associates Of Nine-Banded Armadillo (Dasypus Novemcinctus) Burrows In Arkansas, Brett A. Degregorio, John T. Veon, Andrhea Darleen Massey

Biological Sciences Faculty Publications and Presentations

The Nine-banded Armadillo (Dasypus novemcinctus) is a widespread burrowing species with an expanding geographic range across the southeastern and midwestern United States. Armadillos dig numerous, large burrows within their home ranges and these burrows are likely used by a diverse suite of wildlife species as has been reported for other burrowing ecosystem engineers such as Gopher Tortoises (Gopherus polyphemus), Desert Tortoises (Gopherus agassizi), and Black-tailed Prairie Dogs (Cynomys ludovicianus). We used motion-triggered game cameras at 35 armadillo burrows in 4 ecoregions of Arkansas and documented 19 species of mammals, 4 species of …

Exploring The Role Of Metabolites In Cancer And The Associated Nerve Crosstalk, Inah Gu, Emory A. Gregory, Casey Atwood, Sun-Ok Lee, Young Hye Song

Biomedical Engineering Faculty Publications and Presentations

Since Otto Warburg's first report on the increased uptake of glucose and lactate release by cancer cells, dysregulated metabolism has been acknowledged as a hallmark of cancer that promotes proliferation and metastasis. Over the last century, studies have shown that cancer metabolism is complex, and by-products of glucose and glutamine catabolism induce a cascade of both pro- and antitumorigenic processes. Some vitamins, which have traditionally been praised for preventing and inhibiting the proliferation of cancer cells, have also been proven to cause cancer progression in a dose-dependent manner. Importantly, recent findings have shown that the nervous system is a key …

The Clinical Cell-Cycle Risk (Ccr) Score Is Associated With Metastasis After Radiation Therapy And Provides Guidance On When To Forgo Combined Androgen Deprivation Therapy With Dose-Escalated Radiation, Jonathan Tward, Hiram A. Gay, Jeff Michalski, Et Al.

2020-Current year OA Pubs

PURPOSE: The clinical cell-cycle risk (CCR) score, which combines the University of California, San Francisco's Cancer of the Prostate Risk Assessment (CAPRA) and the cell cycle progression (CCP) molecular score, has been validated to be prognostic of disease progression for men with prostate cancer. This study evaluated the ability of the CCR score to prognosticate the risk of metastasis in men receiving dose-escalated radiation therapy (RT) with or without androgen deprivation therapy (ADT).

METHODS AND MATERIALS: This retrospective, multi-institutional cohort study included men with localized National Comprehensive Cancer Network (NCCN) intermediate-, high-, and very high-risk prostate cancer (N = 741). …

Impact Of Consensus Guidelines For Breast-Conserving Surgery In Patients With Ductal Carcinoma In Situ, Abigail Tremelling, Rebecca L Aft, Amy E Cyr, William E Gillanders, Katherine Glover-Collins, Virginia Herrmann, Julie A Margenthaler

2020-Current year OA Pubs

BACKGROUND: Consensus guidelines published in 2016 recommended a 2 mm free margin as the standard for negative margins in patients undergoing breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). The goal of the guideline recommendation was standardization of re-excision practices.

AIMS: To evaluate the impact of this consensus guideline on our institutional practices.

METHODS: We identified all patients at our institution with pure DCIS who were initially treated with BCS from September 2014 to August 2018 using a prospectively-maintained institutional database. A retrospective chart review was performed to determine margin status and re-excision rates during the 2 years before …

Endogenous Metabolic Markers For Predicting The Activity Of Dihydropyrimidine Dehydrogenase, Jihyun Kang, Andrew Hyoungjin Kim, Inseung Jeon, Jaeseong Oh, In-Jin Jang, Seunghwan Lee, Joo-Youn Cho

2020-Current year OA Pubs

Five-fluorouracil (5-FU) is a chemotherapeutic agent that is mainly metabolized by the rate-limiting enzyme dihydropyrimidine dehydrogenase (DPD). The DPD enzyme activity deficiency involves a wide range of severities. Previous studies have demonstrated the effect of a DPYD single nucleotide polymorphism on 5-FU efficacy and highlighted the importance of studying such genes for cancer treatment. Common polymorphisms of DPYD in European ancestry populations are less frequently present in Koreans. DPD is also responsible for the conversion of endogenous uracil (U) into dihydrouracil (DHU). We quantified U and DHU in plasma samples of healthy male Korean subjects, and samples were classified into …

Strategies To Prevent Central Line-Associated Bloodstream Infections In Acute-Care Hospitals: 2022 Update, Niccolò Buetti, Jonas Marschall, Marci Drees, Mohamad G Fakih, Lynn Hadaway, Lisa L Maragakis, Elizabeth Monsees, Shannon Novosad, Naomi P O'Grady, Mark E Rupp, Joshua Wolf, Deborah Yokoe, Leonard A Mermel

2020-Current year OA Pubs

No abstract provided.

Sars-Cov-2 Infection And Covid-19 Outcomes In Rheumatic Diseases: A Systematic Literature Review And Meta-Analysis, Richard Conway, Alfred H J Kim, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The relative risk of SARS-CoV-2 infection and COVID-19 disease severity among people with rheumatic and musculoskeletal diseases (RMDs) compared to those without RMDs is unclear. This study was undertaken to quantify the risk of SARS-CoV-2 infection in those with RMDs and describe clinical outcomes of COVID-19 in these patients.

METHODS: We conducted a systematic literature review using 14 databases from January 1, 2019 to February 13, 2021. We included observational studies and experimental trials in RMD patients that described comparative rates of SARS-CoV-2 infection, hospitalization, oxygen supplementation/intensive care unit (ICU) admission/mechanical ventilation, or death attributed to COVID-19. Methodologic quality …

Applying Diagnosis Support Systems In Electronic Health Records To Identify Wild-Type Transthyretin Amyloid Cardiomyopathy Risk, Connor Willis, Alexandre H Watanabe, Justin Hughes, Kimberly Nolen, Jason O'Meara, Alexander Schepart, Marianna Bruno, Joseph Biskupiak, Kensaku Kawamoto, Nawar Shara, Thomas Kannampallil

2020-Current year OA Pubs

No abstract provided.

Hold That Pose: Capturing Cervical Dystonia's Head Deviation Severity From Video, Zheng Zhang, Joel S Perlmutter, Et Al

2020-Current year OA Pubs

OBJECTIVE: Deviated head posture is a defining characteristic of cervical dystonia (CD). Head posture severity is typically quantified with clinical rating scales such as the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Because clinical rating scales are inherently subjective, they are susceptible to variability that reduces their sensitivity as outcome measures. The variability could be circumvented with methods to measure CD head posture objectively. However, previously used objective methods require specialized equipment and have been limited to studies with a small number of cases. The objective of this study was to evaluate a novel software system-the Computational Motor Objective Rater …

Physician-Scientists In The United States At 2020: Trends And Concerns, Howard H Garrison, Timothy J Ley

2020-Current year OA Pubs

Physician-scientists comprise a unique and valuable part of the biomedical workforce, but for decades there has been concern about the number of physicians actively engaged in research. Reports have outlined the challenges facing physician-scientists, and programs have been initiated to encourage and facilitate research careers for medically trained scientists. Many of these initiatives have demonstrated successful outcomes, but there has not been a recent summary of the impact of the past decade of effort. This report compiles available data from surveys of medical education and physician research participation to assess changes in the physician-scientist workforce from 2011-2020. Several trends are …

Cd19 + Cd21lo/Neg Cells Are Increased In Systemic Sclerosis-Associated Interstitial Lung Disease, Erin M Wilfong, Katherine N Vowell, Kaitlyn E Bunn, Elise Rizzi, Narender Annapureddy, Rosemarie B Dudenhofer, April Barnado, Rachel H Bonami, Joyce E Johnson, Leslie J Crofford, Peggy L Kendall

2020-Current year OA Pubs

Interstitial lung disease (ILD) represents a significant cause of morbidity and mortality in systemic sclerosis (SSc). The purpose of this study was to examine recirculating lymphocytes from SSc patients for potential biomarkers of interstitial lung disease (ILD). Peripheral blood mononuclear cells (PBMCs) were isolated from patients with SSc and healthy controls enrolled in the Vanderbilt University Myositis and Scleroderma Treatment Initiative Center cohort between 9/2017-6/2019. Clinical phenotyping was performed by chart abstraction. Immunophenotyping was performed using both mass cytometry and fluorescence cytometry combined with t-distributed stochastic neighbor embedding analysis and traditional biaxial gating. This study included 34 patients with SSc-ILD, …

Physician Perceptions And Use Of Reduced-Dose Direct Oral Anticoagulants For Extended Phase Venous Thromboembolism Treatment, Danielle Groat, Karlyn A Martin, Rachel P Rosovsky, Kristen M Sanfilippo, Manila Gaddh, Lisa Baumann Kreuziger, M Elaine Eyster, Scott C Woller, Venous Thromboembolism Network Us (Venus) Vte Treatment, Anticoagulation Management Group

2020-Current year OA Pubs

Background: The direct oral anticoagulants (DOACs), apixaban and rivaroxaban, have been studied for extended-phase treatment of venous thromboembolism (VTE). Yet, scant evidence exists surrounding clinician practice and decision-making regarding dose reduction.

Aims: Report clinician practice and characteristics surrounding dose reduction of DOACs for extended-phase VTE treatment.

Methods: We conducted a 16-question REDCap survey between July 14, 2021, and September 13, 2021, among ISTH 2021 Congress attendees and on Twitter. We explored factors associated with dose reduction using logistic regression. We used k-means clustering to identify distinct groups of dose-reduction decision-making. Random forest analysis explored demographics with respect to identified groups. …

Bedside Nurses' Perceptions Of Effective Nurse-Physician Communication In General Medical Units: A Qualitative Study, Hirotaka Kato, Jessica M. Clouser, Preetham Talari, Nikita L. Vundi, Akosua K. Adu, Kishore Karri, Kathy B. Isaacs, Mark V. Williams, Romil Chadha, Jing Li

2020-Current year OA Pubs

Background There is a dearth of research on successful interventions to improve nurse-physician communication (NPC). An important step is identifying what matters to bedside nurses and their perceptions of effective NPC communications and actions. Methods We conducted three focus groups with a total of 19 medical unit nurses across two hospitals in one academic medical center in the United States. Using a convenience sampling strategy, five to eight nurses voluntarily participated in each focus group. The recording was transcribed verbatim and two independent coders performed coding and resolved any discrepancies in codes. Qualitative content analysis was pursued to identify themes …

Veliparib Plus Carboplatin And Paclitaxel Versus Investigator's Choice Of Standard Chemotherapy In Patients With Advanced Non-Squamous Non-Small Cell Lung Cancer, Ramaswamy Govindan, Et Al

2020-Current year OA Pubs

BACKGROUND: This open-label Phase III trial (NCT02264990) evaluated the PARP inhibitor, veliparib, combined with carboplatin/paclitaxel versus chemotherapy alone for first-line treatment of patients with advanced non-squamous non-small cell lung cancers (NSCLC). A 52-gene expression classifier (LP52) previously shown to identify patients more likely to respond to veliparib was evaluated as a planned correlative analysis.

MATERIALS AND METHODS: Adult current or former smokers with advanced non-squamous NSCLC were randomized 1:1 to veliparib (120 mg daily for 7 days/cycle) with carboplatin and paclitaxel or to investigators' choice of platinum doublet chemotherapy (up to 6, 21-day cycles), with optional pemetrexed maintenance. Prospective analysis …

A Systematic Review Of Patient-Reported Outcome Measures Patients With Chronic Limb-Threatening Ischemia, Philip Goodney, Samir Shah, Yiyuan David Hu, Bjoern Suckow, Scott Kinlay, David G Armstrong, Patrick Geraghty, Megan Patterson, Matthew Menard, Manesh R Patel, Michael S Conte

2020-Current year OA Pubs

Chronic limb-threatening ischemia (CLTI) causes significant morbidity with profound negative effects on health-related quality of life. As the prevalence of peripheral artery disease and diabetes continue to rise in our aging population, the public health impact of CLTI has escalated. Patient-reported outcome measures (PROMs) have become common and important measures for clinical evaluation in both clinical care and research. PROMs are important for the measurement of clinical effectiveness and cost effectiveness and for shared decision-making on treatment options. However, the PROMs used to describe the experience of patients with CLTI are heterogeneous, incomplete, and lack specific applicability to the underlying …

Functional Analysis Of A Novel De Novo Variant In Ppp5c Associated With Microcephaly, Seizures, And Developmental Delay, Sara M Fielder, Jill A Rosenfeld, Lindsay C Burrage, Lisa Emrick, Seema Lalani, Ruben Attali, Joshua N Bembenek, Hieu Hoang, Dustin Baldridge, Gary A Silverman, Undiagnosed Diseases Network, Tim Schedl, Stephen C Pak

2020-Current year OA Pubs

We describe a proband evaluated through the Undiagnosed Diseases Network (UDN) who presented with microcephaly, developmental delay, and refractory epilepsy with a de novo p.Ala47Thr missense variant in the protein phosphatase gene, PPP5C. This gene has not previously been associated with a Mendelian disease, and based on the population database, gnomAD, the gene has a low tolerance for loss-of-function variants (pLI = 1, o/e = 0.07). We functionally evaluated the PPP5C variant in C. elegans by knocking the variant into the orthologous gene, pph-5, at the corresponding residue, Ala48Thr. We employed assays in three different biological processes where pph-5 was …

Complexity Of Ballooned Hepatocyte Feature Recognition: Defining A Training Atlas For Artificial Intelligence-Based Imaging In Nafld, Elizabeth M. Brunt, Et Al.

2020-Current year OA Pubs

BACKGROUND & AIMS: Histologically assessed hepatocyte ballooning is a key feature discriminating non-alcoholic steatohepatitis (NASH) from steatosis (NAFL). Reliable identification underpins patient inclusion in clinical trials and serves as a key regulatory-approved surrogate endpoint for drug efficacy. High inter/intra-observer variation in ballooning measured using the NASH CRN semi-quantitative score has been reported yet no actionable solutions have been proposed.

METHODS: A focused evaluation of hepatocyte ballooning recognition was conducted. Digitized slides were evaluated by 9 internationally recognized expert liver pathologists on 2 separate occasions: each pathologist independently marked every ballooned hepatocyte and later provided an overall non-NASH NAFL/NASH assessment. Interobserver …