Digital Commons Network^™

Evolving Burden Of Metabolic Dysfunction-Associated Steatotic Liver Disease And Its Complications In A Us Nationwide Healthcare System, Basim Ali, Ronald Samuel, Jennifer R Kramer, Liang Li, Xian Yu, Yumei Cao, Roxanne Desiderio, George Cholankeril, Steven M Asch, Hashem B El-Serag, Fasiha Kanwal

Faculty, Staff and Students Publications

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing public health problem. Measuring the burden of cirrhosis and its complications in people with MASLD is important to inform health care delivery.

Methods: We aimed to quantify the changes in the burden of MASLD-related cirrhosis and hepatocellular carcinoma (HCC) in a nationwide U.S. healthcare system. We used data from the Veterans Health Administration to examine temporal trends between 2010 and 2021 in the annual incidence and prevalence of cirrhosis and HCC in a large cohort of patients with MASLD, and to compare them to those in patients with hepatitis C …

Using Medication Pass Analysis To Examine Longitudinal Changes In Va Inpatient Nurse Staffing And Workload Before And Through The Covid-19 Pandemic: 2019-2022, Melissa K Knox, Chase S Eck, Lynette Dorsey, Paras D Mehta, Christine Yang, Laura A Petersen

Faculty, Staff and Students Publications

Background: The COVID-19 pandemic resulted in extended disruption to the health care system. National-level data-driven comparisons of inpatient nurse staffing and workload before and during the pandemic have been limited.

Objectives: Assess the extent to which registered nurse (RN) staffing and workload changed from prepandemic levels in a national integrated health care system.

Research design: Longitudinal descriptive analysis. Medication pass analysis using bar code medication administration data for the peak-time medication pass (PTM) assessing year-over-year changes from 2019 to 2022. To assess significance of year-over-year changes in means we used the Welch 2-sample t test.

Subjects: Staff (N=42,999) administering PTM …

Molecular Heterogeneity Of Hpv-Associated Cancers And Strategies To Overcome Treatment Resistance, Sara Rasouli, Weiyi Gong, Raegan Wood, Danyal Daneshdoust, Anam Khan, Rani Mahyoob, Chongwen Cao, Zihao Yu, Nagireddy Putluri, Gennady Shvets, Haichang Li, Bo Zhao, Xuefeng Liu, Jenny Li

Faculty, Staff and Students Publications

Human papillomavirus (HPV) is a major driver of global cancer incidence, responsible for nearly all cervical cancers and a significant proportion of oropharyngeal, anal, and other anogenital cancers. Despite the availability of effective vaccines, HPV-associated cancers persist due to persistent infection, immune evasion, and the virus's ability to integrate into the host genome, contributing to molecular heterogeneity and therapeutic resistance. Here, we summarize molecular heterogeneity and the emerging combined therapeutic strategies. High-risk HPV types, notably HPV16 and HPV18, initiate carcinogenesis through persistent infection of epithelial basal cells and through the actions of the E6 and E7 oncoproteins, which disrupt the …

Latent Factor Modeling Reveals Unexpected Spatial Heterogeneity In Human Alzheimer's Disease Brain Transcriptomes, Rami Al-Ouran, Chaozhong Liu, Linhua Wang, Zhijian Yu, Ying-Wooi Wan, Chaohao Gu, Xiqi Li, Gerarda Cappuccio, Mirjana Maletic-Savatic, Aleksandar Milosavljevic, Joshua M Shulman, Hu Chen, Zhandong Liu

Faculty, Staff and Students Publications

Alzheimer's disease is characterized by complex molecular and cellular heterogeneity, which complicates efforts to identify consistent biomarkers and therapeutic targets. To better characterize the heterogeneity, we applied latent factor modeling to RNA sequencing data from approximately 2,500 human Alzheimer's disease brain samples, uncovering underlying patterns in gene expression. These transcriptional groups demonstrated unique gene expression profiles related to synaptic and neuronal pathways, vasculature development, and protein folding and antigen processing. Notably, this latent factor reflects variation in spatial sampling. Adjusting for the latent factor improved the identification of differentially expressed genes in disease samples. This finding suggests that spatial heterogeneity …

The Words Community Dwelling, Spanish-Preferring Mexican/Mexican American Adults Use To Talk About Alzheimer’S Disease And Genetic Testing: Implications For Education And Outreach, Jamie C Fong, Fatima I Chavez, Karla Silos, Mirna L Arroyo-Miranda, Gabriela Castro Castro, Mark E Kunik, Joshua M Shulman, Luis D Medina

Faculty, Staff and Students Publications

Introduction: Hispanic/Latino (H/L) adults are more likely than non-Hispanic White individuals to have Alzheimer's disease (AD), yet fewer than one in five H/L adults has apolipoprotein E (APOE) Ɛ4, underscoring gaps in understanding genetic risk across H/L heritage groups. H/L adults remain underrepresented in AD research that uses genetic data for participant stratification. To inform culturally appropriate educational materials for 16 million U.S. Spanish speakers, we identified culturally salient words Spanish-preferring H/L adults use to describe AD and genetic testing beyond APOE.

Methods: Community-residing, Spanish-preferring Mexican/Mexican American adults (n = 14) completed freelisting interviews, a method eliciting …

Circle Actions On Oriented 4-Manifolds, Donghoon Jang, Oleg R. Musin

School of Mathematical & Statistical Sciences Faculty Publications

In this present paper, we consider an action of the circle group on a compact oriented 4-manifold. We derive the Atiyah–Hirzebruch formula for the manifold, and associate a graph in terms of data on the fixed point set. We show in the case of isolated fixed points that if an abstract graph satisfies the Atiyah–Hirzebruch formula, then there exists a corresponding 4-dimensional oriented S1-manifold.

The ‘Obesity Paradox’ In Patients Undergoing Transcatheter Aortic Valve Implantation. A Specialized Narrative Review, Johao Escobar, Iqra Riaz, Muzamil Khawaja, Hafeez Ul Hassan Virk, Joshua Hahn, Fu''Ad Al-Azzam, Zhen Wang, Mahboob Alam, Markus Strauss, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Obesity has long been identified as a noteworthy risk factor for cardiovascular diseases, including aortic stenosis. Nevertheless, an unexplained phenomenon known as the obesity paradox has arisen in the context of transcatheter aortic valve implantation (TAVI), inquiring conventional beliefs. The obesity paradox refers to better clinical outcomes observed in obese individuals undergoing TAVI. These include reduced all-cause mortality, lower rates of procedural complications, and improved long-term survival rates compared to their lean counterparts. Several theories have been proposed to explain the obesity paradox in TAVI. One of the most popular is the adipose tissue-mediated cardioprotective effect hypothesis. It is known …

Hyena: An Observing System Simulation Experiment For Hypothetical Energetic Neutral Atom Imagers, Joel Tibbetts, Amy Keesee, Matina Gkioulidou, Robert Demajistre, Viacheslav Merkin

Faculty Publications

Mesoscale plasma sheet flows are widely understood to be a critical component of the overall picture of energy, particle, and magnetic flux transport during periods of geomagnetic activity. Without simultaneous measurements with true global coverage, the short lifetime (~10 min) and localized spatial extents (~1–3 R_E in azimuth) of these structures make obtaining a global picture of their contributions to stormtime magnetosphere dynamics difficult to characterize. Energetic neutral atom (ENA) imaging can enable remote mapping of plasma energization in the magnetosphere; however, its line-of-sight integrated nature, coupled with the challenging-to-characterize attributes of the target physical phenomena, means that numerous …

Workshop Outcomes Report: 2nd International Workshop On Seismic Resilience Of Arctic Infrastructure And Social Systems, Majid Ghayoomi, Daniela Morganti

Faculty Publications

The report provides an overview of the second international workshop on Seismic Resilience of Arctic Infrastructure and Social Systems. The report discusses agenda, workshop activities, interdisciplinary working groups, and results. It ends with several strategic questions and investigation plans that were developed as part of the workshop activities.

Comparing Rotational Thromboelastometry And Standard Coagulation Assays For Predicting Intraoperative Bleeding In Pediatric Liver Transplantation, Kirby Deshotels, Trung Nguyen, Jun Teruya, Muhammed Umair M Mian, Kelby Fuller, Sanjiv Harpavat, Anna Banc-Husu, Amir Navaei, John Goss, Moreshwar Desai, Arun Saini

Faculty, Staff and Students Publications

Background: Utility of preoperative rotational thromboelastometry (ROTEM) over standard coagulation assays (SCAs) in predicting intraoperative bleeding during orthotopic liver transplantation (OLT) in children with liver failure (LF) remains unclear.

Methods: In this single-center retrospective cohort of pediatric OLT recipients, we compared the predictive values of preoperative ROTEM parameters (intrinsic pathway (INTEM) maximum clot firmness (MCF), extrinsic pathway (EXTEM) clotting time (CT), INTEM CT, and fibrinogen-based (FIBTEM) MCF) and the corresponding SCAs (platelet count, international normalized ratio (INR), activated partial thromboplastin time (aPTT), and fibrinogen level, respectively) for significant intraoperative bleeding (blood loss of > 22 mL/kg; i.e., ≥ 85th percentile for …

Definitions Of Arginine Availability: A Critical Metabolic Marker Of Physiological Processes, Mustafa Tosur, Farook Jahoor, Ashok Balasubramanyam

Faculty, Staff and Students Publications

No abstract provided.

Modulation Of Corneal Sensory Processing And Pain Responses By Dry Eye And Corneal Wounding, Ebru Yaman, Yangluowa Qu, Kaylin C Arpaia, Fairouz Elsaeidi, Uma Lakshmi Balakrishnan, Lance He, Henry Skrehot, Jehan Alam, Rui Chen, Mary Ann Stepp, Cintia S De Paiva, Stephen C Pflugfelder

Faculty, Staff and Students Publications

Background: Dry eye disease (DED) is a multifactorial disorder of the ocular surface in which tear film instability, epithelial barrier disruption, and neurosensory dysfunction contribute to symptom generation. Although several contributing factors have been identified, how different forms of ocular surface stress affect sensory pathways and behavioral responses remains unclear.

Purpose: This study aimed to evaluate corneal barrier function, sensory responses, and pain-related behaviors across acute and chronic dry eye and corneal injury models, and to assess stimulus-specific responses associated with TRPV1 and TRPM8 mediated pathways.

Methods: Female C57BL/6 J wild type and Mmp9KO mice were evaluated in acute desiccating …

‘She Dared Not’: Authority In The Monasteries Of The Diocese Of Lincoln, 1400-1540, Morgan Mcminn

Graduate Theses, Dissertations, and Problem Reports (ETD)

Within monastic life, the Benedictine Rule prioritized the role of the abbot, and much of the everyday running of the house was left to his discretion. He was the elected father of the community, the pastor of the flock, the educator who instructed by word and example. He should discipline firmly but be loved and not feared, and he should play no favorite but rather adapt to the situation at hand. His brethren should obey him without question as the representative of Christ in the monastery, their self-will and earthly possessions submitted to him. These elements are also present in …

Survival, Cause-Specific Mortality, Resource Selection, Movement Rates, And Population Dynamics Of White-Tailed Deer (Odocoileus Virginianus) In West Virginia, Usa, Brett P. Skelly

Graduate Theses, Dissertations, and Problem Reports (ETD)

White-tailed deer (Odocoileus virginianus) are one of the most culturally and economically important big game species in the United States. At the turn of the 20th century white-tailed deer were almost extirpated due to market hunting and unsustainable forestry practices that destroyed habitat. The creation of game laws that eliminated market hunting and created seasons and bag limits for deer hunting along with restocking efforts by sportsmen’s groups and state wildlife agencies aided in deer population recovery. These efforts have led to the abundant deer populations that are currently enjoyed by hunters and wildlife viewers. Deer populations require …

Assessment Of Emissions Factors For Produced Water And Other Atmospheric Liquid Storage Tanks On Natural Gas Sites, David Glenn Childs

Graduate Theses, Dissertations, and Problem Reports (ETD)

As the US natural gas (NG) sector continues to grow, concerns have increased regarding the effects and increasing volume of greenhouse gases emitted into the atmosphere. While NG is a cleaner burning fuel than diesel and gasoline, unburned methane (CH₄) has a global warming potential (GWP) 27-30 times that of carbon dioxide (CO₂). To better quantify CH₄ emissions on NG sites, the US Department of Energy (DOE) granted West Virginia University (WVU) funding to collect direct measurements at well sites and compressor stations.

In this work, a total of 18 sites, including controlled and uncontrolled …

Cultural Perceptions And Willingness Or Reluctance To Use Ai Chatbots For Emotional Support By International African Students In Higher Educational Institutions In The United States, Zakariah Issah

Graduate Theses, Dissertations, and Problem Reports (ETD)

The increasing use of artificial intelligence (AI) chatbots for emotional support underscores the need to understand how cultural perceptions shape their adoption among international African students in higher education institutions in the United States. Guided by the Technology Acceptance Model (TAM) and Social Stigma Theory, this qualitative study explored the perceptions, motivations, and barriers influencing the use of AI chatbots for emotional support. Semi-structured interviews were conducted with 20 undergraduate and graduate students from 10 African countries. The findings reveal that participants viewed AI chatbots as conditional and situational sources of emotional support rather than replacements for human relationships. Convenience, …

An Assessment Of Disease Risks, Population Genetics, And Spatial Ecology Of Appalachian Cottontails (Sylvilagus Obscurus) And Snowshoe Hares (Lepus Americanus) In West Virginia, Usa, Madison Leigh Miller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Snowshoe hares (Lepus americanus) occupy a large range across the United States and Canada. While snowshoe hare populations are generally considered stable in the interior of their range, populations along range edges are experiencing declines, possibly driven by climate-related factors such as seasonal coat color mismatch. West Virginia represents one of the southernmost extents of the species’ range, yet little is known about the population genetic status or population sizes of snowshoe hares in the state. Appalachian cottontails (Sylvilagus obscurus) are another lagomorph species found in West Virginia. This species experienced a historical decline and currently …

Promoting The Use Of Smoke Evacuation Systems In The Operating Room: A Quality Improvement Initiative, Andrea Leigh Drayer

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Surgical smoke produced during procedures poses serious health risks to operating

room (OR) staff and patients, yet many hospitals, including an academic medical center in

northern West Virginia, have underutilized smoke evacuation systems. The imminent

enforcement of West Virginia House Bill 4376, mandating smoke evacuation use, provided both

urgency and opportunity for an intervention.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project

was to increase timely compliance with the use of smoke evacuation systems during all smoke-

producing procedures, ensuring alignment with safety standards and legislative requirements.

Methods: A systematic evidence review of academic …

Influences Of Response Rate And Distribution On Accuracy Estimates: The Value Of Replications Based On Analytic Approach, Olivia Brianne Harvey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Accurate observational data are essential for drawing correct conclusions about behavioral phenomena and ensuring the replicability of research findings. Accuracy is the extent to which an observer’s recorded responses correspond with true values (i.e., the actual occurrence of behavioral events). Correspondence is quantified using one of several percentage-based algorithms. However, these accuracy estimates may be influenced by characteristics of the data, such as response rate and response distribution, as well as the algorithm used to calculate them. The purpose of this dissertation was to evaluate how response rate, response distribution, and the algorithm used to evaluate accuracy influences estimates. Across …

Factors Influencing Eastern Wild Turkey (Meleagris Gallopavo Silvestris) Productivity And Nesting Chronology In West Virginia, Kirstin Palumbo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Identifying drivers of variation in the timing of breeding behaviors, such as courtship activities and nesting chronology, is important for the effective management of avian species. Likewise, productivity is an important component of game bird population dynamics and can be broken up into multiple components such as the probability of nesting, clutch size, and nest success. One species that experiences a relatively long reproductive season is the Eastern wild turkey (Meleagris gallopavo silvestris). Contemporary research in the southeastern United States has raised concerns regarding declines in both wild turkey populations and overall productivity. West Virginia, however, is unique …

Cell-To-Pack Modeling Of Lithium-Ion Batteries: From Bayesian Parameterization To Pack-Level Optimization, Derek Slack

Graduate Theses, Dissertations, and Problem Reports (ETD)

One of the major hurdles for electric or hybrid aviation is the comparative energy density between lithium-ion batteries and jet fuel. To help obtain maximal power-to-weight ratio in electric or hybrid powertrains the battery pack design should be optimized to be as light as possible while meeting thermal safety and power requirements. The proposed solution is an optimization routine beginning with a cell-level parameter estimation of lithium-ion battery cells, where data driven Bayesian Gaussian Processes replace empirically or analytically derived parameters in a first principles electrochemical model in PyBaMM, as functions of the transient state of the cell. The resulting …

Essays On Public Policy, Labor Markets, And Regional Economics, Toby Heaney

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three empirical essays examining how economic and political outcomes respond to changes in public policy, information, and local economic conditions. Across the three studies, the dissertation applies empirical methods to questions in political economy, economic forecasting, and regional economics, with particular attention to how the effects of economic shocks and policy changes vary across individuals, markets, and geographic areas.

The first essay examines the role of policy salience in electoral outcomes. Building on rational-choice and median-voter models, it argues that voters may respond disproportionately to policies that impose concentrated and highly visible costs, even when those …

Technology-Driven Approaches For Invasive Species Detection And Management, Kushal Naharki

Graduate Theses, Dissertations, and Problem Reports (ETD)

Invasive species pose significant ecological, economic, and management challenges globally. Purple loosestrife (Lythrum salicaria), Japanese knotweed (Fallopia japonica), tree of heaven (Ailanthus altissima), and mile-a-minute (Persicaria perfoliata) are widespread invasive plants across the eastern United States and present persistent challenges, particularly in remote and inaccessible landscapes. Effective management of these species requires an integrated approach that combines early detection, targeted intervention, public engagement, and spatial modeling. This dissertation used emerging technologies to improve invasive species detection, monitoring, and management.

Unmanned aerial vehicle (UAV)-based platforms equipped with optical sensors were used to establish …

Data Augmentation And The Reliability Of Conformal Prediction For Uncertainty Quantification In Medical Imaging, Rizwan Ahamed

Graduate Theses, Dissertations, and Problem Reports (ETD)

The safe clinical deployment of deep learning models for high-stakes medical imaging tasks requires more than high average accuracy; it requires demonstrable, per-case reliability. Uncertainty quantification (UQ) provides the missing signal that tells a clinician when a model prediction can be trusted and when a case should be escalated for expert review. Among UQ approaches, conformal prediction (CP) is especially attractive because it produces prediction sets that are guaranteed, under the assumption of exchangeability, to contain the true label with a user chosen probability, and it does so without assumptions about the model or the data distribution. This report first …

Romantic Narrative In Three Early Piano Cycles By Robert Schumann: Papillons, Op. 2; Fantasiestücke, Op. 12; And Kinderszenen, Op. 15, Lingqing Huang

Graduate Theses, Dissertations, and Problem Reports (ETD)

This research project compares Romantic instrumental narrative in Robert Schumann’s Papillons, Op. 2; Fantasiestücke, Op. 12; and Kinderszenen, Op. 15, with particular attention to how pianists communicate cyclic continuity in performance. In this study, narrative continuity refers to relationships formed across ordered short pieces through contrast, interruption, return, literary association, fantasy, memory, tonal and motivic recall, and the shaping of sound and time. Comparative score analysis shows that Schumann creates a distinct form of continuity in each cycle. In Papillons, he creates a public, ballroom-based form through masquerade, waltz-like dance, abrupt entrances, interruption, and the gradual dissolution of the social …

The Coal Mining Kids: Constructing A Working-Class Gay World In West Virginia (1900-2001), Hannah Ford

Graduate Theses, Dissertations, and Problem Reports (ETD)

Located in southwestern West Virginia, Bluefield has been the site of Bluefield State University, the Norfolk & Western Railway headquarters, the Baldwin-Felts Detective Agency, and the Shamrock Bar. The Shamrock was a gay bar opened by Helen Compton, in operation from the late 1960’s until 2001. Bluefield’s early industrial success in coal mining and the railroad quickly urbanized the space between 1900 and 1930, facilitating a diverse, working-class cultural foundation for Bluefield’s gay world. In the 1960’s, urban renewal efforts initiated by the War on Poverty, in combination with public awareness of homosexuality induced by the Lavender Scare, set the …

Macroinvertebrate Response To Two Highway Construction Projects In West Virginia, Brenden Nauman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Highway development and construction are frequently required to provide efficient transportation for an increasing human population. Specific to the Appalachian region, highway development has been a major goal since the mid 1900’s, with the aim of promoting economic growth and ease of travel. While highways provide necessary services to humans, their construction and presence often impact nearby waterways through multiple mechanisms including sedimentation and urbanization. To understand the degree of impact, streams are often monitored using biological data, which can be used to quantify effects. In this work I used freshwater macroinvertebrate communities to monitor changes in stream health surrounding …

How Do Reading Specialists Shape Their Identities As Literacy Leaders? An Exploration Of Competence, Performance, And Recognition Within Communities Of Practice, Christina Glance Petrone

Graduate Theses, Dissertations, and Problem Reports (ETD)

This qualitative multiple-case study explored how reading specialists enact literacy leadership within elementary schools in West Virginia. Although reading specialists are increasingly expected to support schoolwide literacy improvement, leadership responsibilities are not always explicitly defined within their roles. Guided by a communities of practice framework and an identity model, this study examined how reading specialists develop and demonstrate literacy leadership through their daily interactions with teachers, administrators, and other school personnel. Data sources included participant questionnaires and semi-structured interviews with participants, their principals, and colleagues from their school. Participants in this study included three reading specialists (interventionists) working in K-5 …

A Survey Of Disability-Inclusive K-12 Public School Music Programs In The United States Where Best Buddies Friendship Programs Have Been Established, Geena Louise Jeffries Mattox

Graduate Theses, Dissertations, and Problem Reports (ETD)

This study examines the presence and structural characteristics of disability-inclusive band, orchestra, and choir programs serving students with intellectual and developmental disabilities (IDDs) in K-12 public schools across the United States that implement the Best Buddies School Friendship Program. Intellectual and Developmental Disabilities is defined as group of chronic, lifelong conditions that originate before age 22, affecting physical, learning, language, or behavior areas. Despite federal legislation, peer reviewed scholarship specifically addressing access to performance-based music ensembles for students with IDDs remain comparatively limited. Employing a survey distributed nationwide within a defined population of schools implementing Best Buddies Programs, administered via …

Evaluation Of Finger-Tightening Torque Applied To Implant Healing Abutments By Dental Providers With Varying Experience And Physical Characteristics: An In-Vitro Study., Bayan Abuhalimeh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Aim: The primary objective of this project is to measure the actual torque applied by dental providers when finger-tightening a healing abutment and assess the variability among individuals. A secondary objective is to analyze the correlation between applied torque and: provider experience level (residents, general dentist, specialist); gender; age; and, physical attributes (e.g., grip strength, hand size, and dominant hand used for tightening). The null hypothesis is that there is no difference in the mean finger-tightening among the three groups of dental providers, and there are no significant differences in torque values among practitioners based on demographic and professional variables. …