Digital Commons Network^™

The Femoral Head Edema Zone: A Novel Classification Scheme To Better Predict Osteonecrosis Progression, Deniz C Ince, Vivek P Shah, Kenichi Kikuchi, Kyle P O'Connor, Elizabeth L Yanik, John C Clohisy, Cecilia Pascual-Garrido

2020-Current year OA Pubs

BACKGROUND: This study proposed a new classification, the Edema Zone classification, that uses magnetic resonance imaging images to grade the extent of edema in osteonecrosis of the femoral head. The purpose of the study was (1) to examine how the Edema Zone classification compared to the Japanese Investigation Committee (JIC) classification's prognostic ability for early conversion to total hip arthroplasty (THA), and (2) to determine how accurately and reliably the Edema Zone classification performed as a classification system.

METHODS: This was a retrospective study of hips that converted to THA from a core decompression within 26 months compared to hips …

Methodological Progress Note: Logic Models, Molly J Horstman, Kyler M Godwin

Faculty and Staff Publications

Logic models are an accessible tool to organize the planning, management, and evaluation of programs across healthcare disciplines. This methodological progress note describes the five standard components of a logic model (Inputs, Activities, Outputs, Outcomes, and Impact) and provides guidance for developing a logic model. Logic models offer a visual representation of the work and theory of a program and should be created with input from all interested parties. Logic models are living tools that need to be revised as programs evolve and new information becomes available.

The Drones Of Cjng, Ryan Vilter, Tyler Mccoid, Lauren Bertelsen, Suat Cubukcu, Joel Elson, George Grispos, Austin C. Doctor

Reports, Projects, and Research

The Jalisco New Generation Cartel (Cártel de Jalisco Nueva Generación, or CJNG), is a U.S.-designated Foreign Terror Organization (FTO) and transnational criminal organization with a presence throughout Mexico and in at least 40 other countries. CJNG’s criminal activity and related revenue streams are diverse and include narcotics and firearms trafficking, human smuggling, and natural resource theft. In tandem with its violent and criminal activities, CJNG has widely integrated commercial Unmanned Aerial Systems (UAS), commonly referred to as drones, into its operations. Common UAS tactics by CJNG include weaponized attacks, surveilling U.S. and Mexican security and law enforcement personnel , and …

Medical-Legal Partnership As Value-Based Primary Care: Interprofessional Teamwork For Health-Related Social Needs, Jin K. Park, Andrew F. Beck, Keegan D. Warren, William M. Sage

Faculty Scholarship

Today’s primary care physicians are being asked to address patients’ health-related social needs (HRSN) as part of their routine care practices. An aging population, with a growing complement of intersecting medical and social needs, increases this burden on primary care. Medical-legal partnerships (MLP) are interprofessional collaborations that combine clinical and legal expertise to address HRSN involving housing, public benefits, employment, and other domains remediable by civil legal assistance. A value-based approach to integrating MLP into the health system may help primary care practices more effectively address HRSN and, in turn, better balance revenue and expenses. At the practice and healthcare …

Performance Of Multiple Multi-Cancer Detection Tests Using A Large Independent Reference Set (Alliance A212102), Marie E Wood, Mark Watson, Et Al.

2020-Current year OA Pubs

BACKGROUND: Reference sets are needed to evaluate performance of multi-cancer detection (MCD) assays. The National Cancer Institute funded the Alliance reference set study to assess MCDs for use in future trials.

METHODS: Individuals with cancer and controls were recruited; blood specimens were collected prior to cancer treatment. A performance evaluation study was designed utilizing reference set samples. Companies (n = 6) were selected to participate based on review of performance data and ability to utilize the blood collection tube. Companies received samples from cancer types their assay was designed to detect ("targeted"), plus additional "non-targeted" and control samples. Companies reported …

Use Of Inverse Probability Weighting In Cardiovascular Surgical Outcomes Research: Principles, Limitations, And Recommendations, Zhongjian Liu, Wei-Guo Ma, Lei Liu, Prashanth Vallabhajosyula, Haibo Wang

2020-Current year OA Pubs

This statistical primer presents a comprehensive introduction to the use of inverse probability of treatment weighting (IPTW), a method for rebalancing group confounders at baseline in cardiovascular surgical outcomes research. We leveraged a retrospective study comparing the outcomes of 2 different surgical approaches to aortic arch pathology to illustrate the essential aspects of performing IPTW, including basic theories, application, extreme weights, underestimated variance, heterogeneity of treatment effect, and multicollinearity. The limitations of IPTW were discussed with examples of solutions. Ten practical recommendations are made on avoiding the pitfalls in the use of IPTW. Proper use of IPTW may effectively reduce …

Mda5-Mavs And Interferon-Lambda Signaling In The Intestinal Epithelium Limit Murine Astrovirus Infection, Heyde Makimaa, Harshad Ingle, Leran Wang, Somya Aggarwal, Hongju Deng, Elizabeth A Kennedy, Lynne Foster, Yuhao Li, Megan T Baldridge

2020-Current year OA Pubs

Human astroviruses (HAstVs) are a global cause of pediatric gastroenteritis and can cause disseminated infection in immunocompromised hosts. Murine astrovirus (muAstV) causes acute asymptomatic infections in immunocompetent mice and chronic infection in immunodeficient models and has provided important insights into AstV pathogenesis in vivo. MuAstV can protect immunodeficient mice from other enteric viruses via robust induction of antiviral cytokine interferon-lambda (IFN-λ), with recent findings implicating goblet cells and enterocytes as both cell types infected by muAstV as well as potential sources of IFN-λ in vivo. However, the viral sensing pathways that regulate induction of IFN-λ, as well as the specific …

Exploring Nurses' Documentation Prioritization Strategies To Alleviate Ehr Documentation Burden: A Phenomenological Study, Rosemary Mugoya, Jennifer Thate, Fan Hao, Sarah C Rossetti, Po-Yin Yen

2020-Current year OA Pubs

OBJECTIVE: This study aims to understand how inpatient nurses determine and prioritize necessary documentation within the context of the Excessive Documentation Burden (ExDocBurden) in Electronic Health Records (EHRs).

METHODOLOGY: A phenomenological approach was used to explore inpatient nurses' lived experiences of prioritizing EHR documentation. Interpretive phenomenology guided the study design, focusing on how nurses prioritize documentation. Purposive sampling recruited 14 registered nurses (RNs) from acute and critical care settings. Data was collected through semi-structured interviews and analyzed using Colaizzi's 7-step and Smith's Interpretive Phenomenology Analysis.

RESULTS: Five themes emerged: (1) Advocating for Quality Patient Care Environment and Patient Needs, (2) …

Differential Regulation Of Cyclic Adenosine Monophosphate By Phosphodiesterase 3a Discriminates Thrombin-Induced Protease Activated Receptor 1- And 4-Dependent Platelet Activation, Izabella Andrianova, Abigail Ajanel, Jesse W Rowley, Darian C Murray, Yasuhiro Kosaka, Frederik Denorme, Paul F Bray, Robert A Campbell

2020-Current year OA Pubs

BACKGROUND: Human platelets express 2 thrombin-activated G protein-coupled receptors (GPCRs), protease activated receptor (PAR)1 and PAR4. Previous studies have demonstrated PAR1 activation to be fast on-fast off while PAR4 activation was slower but more sustained. However, how PARs regulate second messengers such as cyclic adenosine monophosphate (cAMP), a negative regulator of platelet activation, remain unknown.

OBJECTIVES: This study investigated how PAR1 and PAR4 activation by thrombin regulates cAMP levels and platelet activation.

METHODS: PAR1 and PAR4 on washed human platelets were inhibited with vorapaxar or BMS-986120, respectively, in the presence or absence of prostaglandin (PG)I

RESULTS: In the presence of …

Lyplal1 Rare Loss-Of-Function Variants In Humans And Deletion In Human Hepatoma Cells Protect Against Masld, Rawdat Hussain, Chinmay Raut, Ponnandy Prabhu, Akram Irshaid, Yash Hegde, Yue Chen, Asmita Pant, Antonino Oliveri, Xiaochao Wei, Lishi Yin, Tiffany L Russell, Brian Halligan, Clay F Semenkovich, Elizabeth K Speliotes

2020-Current year OA Pubs

Genetic variants near LYPLAL1 are associated with Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) in humans, but their impact on LYPLAL1 function is unknown. We identified LYPLAL1 loss-of-function variants from UK BioBank (UKBB) whole-exome sequencing data that had AlphaMissense or GPN-MSA scores in the top 20% of LYPLAL1 variants for being disruptive. We aggregated these variants and carried out burden analysis for effects on MRI Proton Density-Fat Fraction (MRI-PDFF) and ICD-based MASLD in UKBB. Rare loss-of-function LYPLAL1 variants were associated with reduced MRI-PDFF and ICD diagnosed MASLD across sexes. We used CRISPR to knockout and overexpress LYPLAL1 in human hepatoma cells …

Deep Learning In Fetal, Infant, And Toddler Neuroimaging Research, Jenna H Chin, Madeleine K Wyburd, Vladislav Ayzenberg, Laurie Bayet, Berkin Bilgic, Emily M Chen, Yuting Chen, Áine Dineen, Shohei Fujita, Janelle Liu, Yohan Jun, M Catalina Camacho, Lilla Zöllei

2020-Current year OA Pubs

Artificial intelligence (AI) is increasingly being integrated into everyday tasks and work environments. However, its adoption in medical image analysis has progressed more slowly due to high clinical stakes, limited availability of labeled data, and substantial variability in imaging protocols and population. These challenges are further pronounced in the field of fetal, infant, and toddler (FIT) neuroimaging, where datasets are especially scarce and subject to large amounts of anatomical variability. However, deep learning (DL), a specific method within machine learning, which is itself a subfield of AI, has emerged as a powerful framework to adapt to the challenges of medical …

Predictors Of Delayed Recovery In Ambulatory Advanced Endoscopic Procedures, Zoilo K Suarez, Alexandria Lenyo, Philip M Frasse, Derek J Platt, Thomas Hollander, Talwinder Nagi, Michael Dedonno, Vladimir Kushnir, Juan Reyes Genere

2020-Current year OA Pubs

BACKGROUND: There is a scarcity of data evaluating patient-related outcomes of advanced or complex endoscopy (ACE) through the post-anesthesia recovery course. Yet, gastrointestinal distress following ACE can occur commonly, and this may impact recovery length of stay and the approach to post-anesthesia care. This study aimed to describe post-procedural symptoms in patients undergoing ACE and identify factors that influence recovery time and course.

METHODS: We retrospectively reviewed a prospectively collected database of patients who underwent ambulatory ACE. Procedural-related symptoms, recovery time, dismissal rate, and adverse events (AE) were recorded. Factors associated with extended recovery time were analyzed using multiple regression …

Impact Of Self-Reported Anxiety On College Students’ Academic Performance And Physiological Responses, Rita Mitchell

Undergraduate Theses and Capstone Projects

Going to college may seem like the next obvious step for some graduating high school students, while for other students, it is not part of their plan. Even though some high school students have their college experience planned and are prepared to start this journey, their experience can drastically change. A myriad of problems for the new and upcoming students can arise, with one of those problems being generalized anxiety. High school provides students with structured eight-hour days, lunch breaks, and teachers who make sure they attend class. College, on the other hand, does not provide students with these luxuries. …

Examination Of Heart Rate Response To Performance Errors In Competitive Division Iii Field Hockey, Olivia Muir

Undergraduate Theses and Capstone Projects

This research examines the relationship between heart rate and performance outcomes in competitive DIII field hockey match play. In particular, the research examines the players of the Lynchburg Field Hockey Team, with a focus on player errors. Real-time heart rate data were collected using Beyond PulseTM monitors and synchronized with game footage from the SpiideoTM platform. Player errors were then identified using Spiideo’sTM AI software, and the corresponding heart rate values were recorded, spanning from 3 seconds before and 3 seconds after the player error occurred. The maximum heart rate for each player was also calculated using the equation: HRmax …

Assessing Aesthetic Responsiveness Among Patients In A Free Clinic Setting, Jack E. Pitts

Undergraduate Theses and Capstone Projects

Art therapy has been increasingly recognized as a complementary intervention in healthcare settings, with demonstrated benefits for stress reduction and overall biopsychosocial well-being (Liu 2022; Magsamen, 2014). However, limited research has explored aesthetic engagement within medically underserved and economically disadvantaged populations. This study uses the Aesthetic Responsiveness Assessment to examine the relationship between art and patients receiving care at the Central Virginia Free Clinic in Lynchburg. The survey consists of 14 Likert-scale questions assessing individuals’ cumulative aptitude across three domains: aesthetic appreciation, intense aesthetic experience, and creative behavior. There was an additional 15th qualitative question that assessed the desire for …

Natural Convection Of Cuo-Water Nanofluid Flow Along A Vertical Plate With Variable Thermophysical Properties And Discrete Heat Sources, Nepal Roy, Ioan Pop, Rama Subba Reddy Gorla

Faculty Publications

Effects of discrete heat sources along a vertical plate are of practical importance due their occurrence in electronic devices. For growing demand of electronic appliances and their advancement, cooling processes of them must be improved. As usual fluids have limited heat transfer, nanofluids made by dispersing nanoparticles into them are utilized to enhance thermal performance. However, flow characteristics and heat transfer of a nanofluid for discrete heat sources along a vertical plate need to be explored. For this reason, this study analyzes the natural convective heat transfer and flow behaviors of CuO-water nanofluid induced by discrete heat sources along a …

Radiation Protection Factor Research: The Keystone For Conventional-Nuclear Integration (Cni), Andrew W. Decker

Faculty Publications

This article briefly describes Defense Threat Reduction Agency (DTRA) vehicle Radiation Protection Factor (RPF) research and explains its critical role in enabling future Operations in a Nuclear Environment (ONE) and Conventional-Nuclear Integration (CNI) on behalf of the US Department of War (DoW).1 As such, the background and practical utility of RPF values is discussed, as well as the justification for renewed Army and DoW investment into RPF research to enhance Joint military planning, survivability, and lethality on tomorrow’s nuclear battlefields. Advances in DTRA RPF research directly strengthen US strategic and extended deterrence efforts and support all Agencies and Departments responsible …

Transcending Shelves And Seashells With The Writing Of Gloria E. Anzaldúa, Dr. Inmaculada Lara-Bonilla

LAII Events

Dr. Lara-Bonilla explores how Gloria E. Anzaldúa understood writing as an embodied, transformative practice that dissolves boundaries between the physical, the intellectual, and the spiritual. Drawing on her archival and posthumous work, it reflects on how her experimental, genre-crossing approach challenges academic conventions and invites new ways of thinking, feeling, and writing. Tracing a long-term engagement with her work, the talk narrates how Anzaldúa’s commitment to preserving lived, “poematic” experience has reshaped Dr. Lara Bonilla’s own scholarly and creative practice, pushing it beyond institutional limits toward more expansive and responsive forms of expression.

Prioritising Follow-Up For People With Suspected Epilepsy Using A Digital Eeg Biomarker, Rohit Shankar, John Terry

Peninsula Medical School

Lengthy waits for follow-up testing are common for people with suspected epilepsy. This delays diagnosis, prolongs uncertainty and increases seizure risk. Initial EEGs are frequently inconclusive, yet follow-ups are often dictated by referral date, and there is no established method for risk-based prioritisation. Here, we tested whether an established digital EEG biomarker could help prioritise those most likely to have epilepsy for expedited follow-up EEG testing. We analysed 196 normal non-contributory (non-diagnostic) initial EEGs collected from six National Health Service (NHS) sites in England. From these recordings, we extracted eight previously validated computational features that quantify the likelihood that the …

Partisan Differences In Risk-Taking In A Simulated Pandemic, Jan K. Woike, Sebastian Hafenbrädl, Patricia Kanngiesser, Ralph Hertwig

School of Psychology

Responses to COVID-19 in the United States were split along partisan political lines throughout the pandemic. People on the political left tended to take the medical threat more seriously and were more likely to adopt preventive health behaviors than those on the political right, resulting in clear differences in state-level policies and health consequences. Here, we examine the origins of these differences, investigating whether they are based on interindividual differences or in party dynamics. Two groups of participants (N=819), who had voted either for Donald Trump or Hillary Clinton in 2016, played the Transmission Game. Players made repeated decisions in …

Evidence Base To Inform Health Service Configuration For Abortion Provision: The Sacha (Shaping Abortion For Change) Multi-Component Study, Kaye Wellings, Rebecca S. French, Annette Aronsson, Paula Baraitser, Sharon Cameron, Caroline Free, Louise Keogh, Maria Lewandowska, Patricia Lohr, Rebecca Meiksin, Ona Mccarthy, Clare Murphy, Wendy Norman, Melissa Palmer, Jennifer Reiter, Natasha Salaria, Rachel Scott, Jill Shawe, Sally Sheldon, Geoff Wong

School of Nursing and Midwifery

Background: Significant changes to the nature and context of abortion provision are taking place in the United Kingdom. Empirical evidence is needed to guide efforts to respond to these changes. Objective(s): To provide an evidence base to inform optimal configuration of health services and systems in response to current and future changes in abortion provision in the UK. Design and methods: Observational study comprising five integrated components: (1) a realist review to generate evidence to guide optimal abortion provision and a scoping review of interventions aimed at preparing non-specialist health professionals to provide abortion care and support; (2) country-based case studies identifying transferable …

Conflict As Catalyst: The Role Of Conflict In Creating Political Space For Women, Christie S. Warren

Faculty Publications

Although the benefits associated with the presence of women in political decision-making positions are uncontested, global statistics relating to the number of women in political leadership roles paint a disappointing picture of underutilized resources. While rights-based advocacy, quotas, and economic incentives are commonly posited as effective strategies to increase the number of women active in public spaces, several studies have shown that the law alone is not sufficient to bring about changes in gender norms unless the underlying structural constructs that perpetuate inequalities privileging dominant groups are addressed first. Conflict, especially when driven by rejection of those inequalities, can hasten …

When Birth Control Turns Biliary: A Rare Case Of Profound Hyperbilirubinemia From Oral Contraceptives, Taiwo Ajani, Aura Calderon, Jose J. Loayza Pintado, Nayiri Derian, Catherine Matos, Ivan Mogollon, Andres Suarez Parraga

School of Medicine Publications

Oral contraceptives (OCs) are extensively utilized and generally considered safe (reference); nonetheless, infrequent hepatobiliary complications such as cholestasis and hyperbilirubinemia have been documented, particularly among individuals with a genetic predisposition. We present a case involving a 19-year-old female who exhibited significant conjugated hyperbilirubinemia shortly after the commencement of OC therapy. Comprehensive investigations ruled out alternative causes, and the findings from liver biopsy, in conjunction with the clinical context, indicated an estrogen-induced cholestatic injury, likely revealing an underlying Dubin–Johnson syndrome. This case underscores the critical necessity of acknowledging hepatic adverse effects associated with estrogen as well as the influence of genetic …

Predictors Of Total Hip Arthroplasty Among Patients With Chronic Comorbidities: A Multivariate Analysis Of A Medically Underserved Region, Blake C. Martin, Manoj Peiris

School of Medicine Publications

Background

THA is a common orthopedic procedure that is expected to increase in the coming years. Obesity and osteoarthritis are major factors that increase the risk of individuals requiring THA. The Rio Grande Valley (RGV) is a distinctive health professional shortage area with high rates of obesity, arthritis, and diabetes. This study aims to examine the relationship between chronic medical conditions and the need for THA in this at-risk, medically underserved population.

Methods

This investigation employed a retrospective chart review encompassing patient records from January 1, 2018, through January 1, 2025, using the University of Texas Rio Grande Valley electronic …

Trends In Meningioma-Related Mortality Among U.S. Adults: A Cdc Wonder Analysis From 2000 To 2023, Tirath Patel, Rai Muhammad Umar Khan, Fatima Hussain, Meer Murtaza, Muhammad Shayan Tariq, Abuzar Khan, Sara Aleem, Maryam Athar, Sharoz Shahid, Nikhilesh Anand

School of Medicine Publications

Background: Meningiomas are the most common primary intracranial tumors in the United States, comprising nearly 41% of central nervous system tumors. While the majority are benign, atypical (World Health Organization Grade II) and malignant (Grade III) subtypes are clinically significant due to their aggressive biology, higher recurrence, and increased mortality risk. Despite their burden, national mortality trends and demographic disparities in meningioma-related deaths remain underexplored.

Methods: We conducted a population-based analysis of meningioma-related mortality among U.S. adults aged ≥65 years from 1999 to 2023 using the centers for disease control and prevention (CDC) wide-ranging online data for epidemiologic research (WONDER) …

Platelet Rich Plasma Injection Treatment Outcomes In Patellar Tendinopathy, Hunter M. Butler, Aamir Ahmad

School of Medicine Publications

Background: Platelet rich plasma (PRP) refers to the processed product of autologous peripheral blood with a concentration of platelets higher than baseline. This product has garnered interest for 30 years as a potential method of regenerative medicine. PRP injections have shown to be an effective treatment for patellar tendinopathy. However, some concerns remain with regards to empiric treatment of tendinopathy with PRP injections.

Objective: This article aims to investigate the outcomes of platelet rich plasma injections in patients with patellar tendonitis.

Methods: A systematic literature search was conducted using the University of Texas Rio Grande Valley (UTRGV) online database. The …

Adultification Of Black Girls, Melanie Thompson

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Core Elements Of Policy Solutions, Audrey Morrissey

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Closing Remarks: Eyes Wide Shut, Sex Trafficking Of Women And Girls In The Black Community, Stephany Powell

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

1st Place Contest Entry: "Examining Experiences Of Search Committee Members For Deans Of Colleges Of The Arts", Connor Bogenreif

Eric M. Scandrett Graduate Library Research Prize

This is Connor Bogenreif's submission for the 2026 Eric M. Scandrett Graduate Research Prize, which won first place. It contains their essay on using library resources, a summary of their research project on the experiences of search committee members for deans of colleges of the arts, and their bibliography.

Connor is a student in the Ph.D. in Education program at Chapman University. Their faculty mentor is Dr. Doug Havard.