Digital Commons Network^™

Safety And Efficacy Of 6% Hydroxyethyl Starch In Patients Undergoing Major Surgery: The Randomised Controlled Phoneics Trial, Wolfgang Buhre, Óscar Díaz-Cambronero, Simon Schaefer, Martin Novacek, Marina Soro Domingo, Bjorn Stessel, Aurelio Rodríguez-Pérez, Torsten Richter, Georg Rohe, Bernard Cholley, Matthias Gruenewald, Gerhardus Kuiper, Samir Jaber, Dianne De Korte, Javier Belda, Marcelo Gama De Abreu, Robert Baronica, Thomas Scheeren, Carlos Ferrando-Ortolá, Wojciech Szczeklik, Dana Tomescu, Tomas Vyzamal, Zejka Gavranovic, María Pilar Argente-Navarro, Guido Mazzinari, Sarah Thaler, Nuria García-Gregorio, Jeroen Vandenbrande, Diane Zlotnik, Jakob Wittenstein, Sonja Schmier, Susanne Rohn, Christoph Glasmacher, Martin Holler, Cornelius Jungheinrich, Ulf Niess, Daniel I Sessler, Martin Westphal

Faculty, Staff and Student Publications

Abstract

Background: Hydroxyethyl starch (HES) is often used for maintaining vascular volume during major surgery. Long-term high-dose HES in septic patients promotes renal injury, whereas meta-analyses of current HES products in surgical patients do not show such effects.

Objective: We studied if the peri-operative use of HES is noninferior to crystalloids in terms of acute kidney injury. Secondary outcome was the noninferiority of HES on worsening of renal injury and/or the incidence of a composite endpoint of major complications and mortality until postoperative day 90.

Design: Randomised double-blind trial in patients undergoing elective abdominal surgery with expected blood loss at …

Feasibility And Preliminary Outcomes Of A Remotely-Delivered Exercise Training Intervention For English-Speaking Hispanics/Latinos With Multiple Sclerosis: Results From The Ferla Ms Study, Victoria A Flores, Stephanie L Silveira, David X Marquez, Dominique Kinnett-Hopkins, Augusto Miravalle, Fabian Sierra-Morales, Robert W Motl

Faculty, Staff and Student Publications

Background: There is limited evidence on the feasibility of remotely delivered exercise interventions for English-speaking Hispanics/Latinos with MS.

Objectives: To evaluate the feasibility and exploratory efficacy of a remotely-delivered, home-based exercise program for English-speaking Hispanics/Latinos with MS and to explore associations among feasibility metrics, outcomes, and social determinants of health (SDOH).

Results: Of 340 individuals contacted, 112 were eligible (33%), 33 enrolled (9.7%), 30 randomized, and 26 completed (87% retention). Adherence averaged 81% (exercise) and 89% (control). No serious adverse events occurred. Exploratory within-group improvements were observed in the exercise group for physical activity (p = 0.03, d = …

Understanding Practices Of Lactation And Infant Feeding Together With Women With Hiv: The Uplift Observational Study Protocol, Christiana Smith, Emily Anne Barr, Karen Hampanda, Mark Trumbull, Hulin Wu, Jennifer Mckinney, Sarah Buisson, Carly Hoffmann, Ciarra Brown, Angela B Hutchinson, K Rivet Amico, Ifeyinwa V Asiodu, Elizabeth J Mcfarland, Margaret A Lampe, Preetam A Cholli, Olga Varechtchouk, Allahna Esber, Athena P Kourtis, Lisa Abuogi

Faculty, Staff and Student Publications

Introduction: There is a limited understanding of infant feeding decisions, practices, and outcomes for women living with HIV (WLHIV) and their infants since U.S. guidelines were updated in 2023 to support breastfeeding for virally suppressed women on antiretroviral treatment.

Methods and analysis: The Understanding Practices of Lactation and Infant Feeding Together with women with HIV (UPLIFT) study is a convergent mixed-methods, multisite, observational study designed to address key knowledge gaps. Twelve US sites will begin enrollment in early 2026 to accomplish three core activities (CA). In CA1, we explore infant feeding decision-making and experiences via in-depth interviews with pregnant/postpartum WLHIV …

Evaluating Differences In Nonsyndromic Orofacial Clefts By Infant Sex: National Birth Defects Prevention Study, 1997-2011, Victoria A Salinas, Natalie P Archer, Layla R Lustri, Katherine L Ludorf, Timothy Ihongbe, Wei Yang, Eva M Williford, Marilyn L Browne, Adrian M Michalski, Lindsay A Williams, Wendy Nembhard, Eirini Nestoridi, Gary M Shaw, Andrew F Olshan, A J Agopian, National Birth Defects Prevention Study

Faculty, Staff and Student Publications

Objective: To investigate nongenetic factors that may contribute to observed differences in nonsyndromic orofacial clefts by infant sex.

Study design: Using data for 1997-2011 deliveries from the National Birth Defects Prevention Study, a case-control study, we separately examined associations between 23 maternal factors and cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP) using multivariable logistic regression stratified by infant sex.

Results: We compared 2986 infants with CL/P and 1557 with CP to 11 271 control infants without birth defects. After adjusting for maternal age at conception and education, lower odds of nonsyndromic orofacial clefts were …

Cryptic Mechanisms Of Post-Fire Nitrogen Recovery In Northern Conifer Forests, Robert Edward Heumann

Graduate Student Theses, Dissertations, & Professional Papers

In recent decades, northern conifer forests have experienced larger, more frequent and more intense wildfires. Severe, stand-replacing wildfire substantially reduces forest nitrogen (N) stocks, a critical nutrient that often limits net primary productivity on land. Continued increases in wildfire activity may exacerbate forest N limitation in the future. Yet, while research shows N stocks in northern conifer forests recover following severe wildfire, the processes that contribute to rapid increases in N during post-fire regeneration are unclear. Atmospheric deposition of N and known sources of biological N fixation cannot explain the observed post-fire N accumulations. This paradox raises the question: How …

Skin Tone Inclusive Assessment To Reduce Missed Pressure Injuries, Sheena May Viste

IdeaFest 2026

Patients with high‑melanin skin are at increased risk of developing pressure injuries and experiencing more severe progression because early signs are frequently missed. This disparity is attributed to delayed PI recognition because standard visual skin assessments are biased toward light skin and fail to identify early tissue damage (Black et al., 2023; LaFond et al., 2025). Implementing the Skin Assessment for Dark Skin (SADS) technique—use of halogen light and multisensory palpation—during assessments helps nurses identify early pressure injury indicators. The overarching goal is to reduce diagnostic delays by using tools such as Skin Assessment for Dark Skin (SADS) to support …

Microbial Worlds Within: Sem Of Darlingtonia Pitchers, Sierra Vasinthascha

IdeaFest 2026

Darlingtonia californica relies on microbes within its pitcher fluid to break down captured prey into usable nutrients. This process is typically attributed to bacteria; however, fungi, are also found in the fluid, and their role remains largely unknown. For this project, scanning electron microscopy (SEM) was used to directly visualize microorganisms in pitcher fluid and on pitcher tissue. Cultured bacterial and fungal isolates from Darlingtonia’s fluid provided morphological references for identification. Tissues from the hood and lower pitcher were then processed and examined for comparison. Both bacteria and yeast-like fungi were observed in each region. The abundance of fungi found …

Bridging The Gap In Prediabetes Care: Improving Outcomes Among Socioeconomically Disadvantaged Adults, Becca Gilbride

IdeaFest 2026

Prediabetes disproportionately affects low-income adults, yet many remain unaware or untreated due to limited time and resources in community health care settings. Addressing prediabetes is a critical window of opportunity to prevent type 2 diabetes and is essential to reducing disparities and long-term complications. Guided by the Evidence-Based Practice Change model, this project implements multi-level interventions, including motivational interviewing, community education, and clinical decision support tools. Outcomes focus on improving self-efficacy and engagement and achieving at least a 0.5% A1C reduction within one year. These improvements are expected to enhance quality of life, lower the risk of serious complications, and …

Improving Diabetes Outcomes In Native American Populations, Meagan Shadle

IdeaFest 2026

Despite organized efforts, Humboldt County tribes have had little improvement regarding diabetes outcomes when compared to county and state data averages. These trends suggest that regardless of advancements in therapy, monitoring and prevention there is still an issue of equity among ethnic groups in Humboldt County. This data highlights the need for an integrative and culturally centered, community based strategy that aims to improve the health outcomes and longevity of the Indigenous peoples within this shared land. By providing individualized care plans and disease process management with community engagement programs focused on relevant and accessible diet and lifestyle education there …

Fad Diets Or Bad Diets?, Walker Dorris

IdeaFest 2026

A literature review on fad diets and their effectiveness and sustainability with regard to weight loss and overall health.

Promoting Hope And Resilience: Measuring The Psychological Effects Of An Undergraduate Climate Change Education Course, Clare Bridgett Maguire

Graduate Student Theses, Dissertations, & Professional Papers

The psychological effects of climate change are increasing, which has led to an increase in advocacy to research these effects. Current literature has included a focus on categorizing and understanding the psychological impacts, creating psychometrically sound instruments to measure the effects, and education as a tool to enhance coping strategies. However, limited research exists on measuring the emotional outcomes for students who engage in climate change education at the post-graduate level.

This dissertation explores the effects of an undergraduate-level climate change course on participants’ experiences of eco-anxiety, ecological grief, resilience, and hope to better understand the psychological effects of climate …

Growing Agroecology: Two Case Studies From The U.S. Student Farm Movement, Amelia B. Armstrong

Graduate Student Theses, Dissertations, & Professional Papers

Scholars and activists identify agroecology as a crucial science, practice, and movement to move towards more just, equitable, and sustainable agriculture and food systems. Yet, the exploitative industrial food system, that deepens inequalities like food insecurity (Clapp et al., 2025), reduces farmer autonomy (Rotz, 2015), and contributes to increased carbon emissions (Lin et al., 2011) and biodiversity decline (Rotz, 2015), still dominates. Understanding and mobilizing the different spaces that teach agroecology, then, is a crucial step in challenging the dominant industrial food system. Agroecology education in university settings is an important domain to investigate as potential contributors to this movement, …

Eureka Silvercrest, Avyonne Currington

IdeaFest 2026

During my College Corps fellowship at Silvercrest HUD housing, I supported low-income seniors and disabled residents as they navigated complex social systems in a rural setting. I provided case management by connecting individuals to vital resources, simplifying documentation, and advocating for accessible medical transit. This work is critical because it builds self-advocacy skills and mitigates the severe isolation associated with rural poverty. This experience bridged my academic theory with real-world practice, synthesizing my BSW education into applied clinical skills as I advance toward my MSW and ultimate LCSW licensure.

High Appetite: Cannabis And Its Relationship With Eating Patterns And Overall Nutrition, Jj O'Hara

IdeaFest 2026

My project is looking into the relationship between cannabis and nutrition. Specifically, disordered eating, diet content, and how it can help individuals who might struggle with undereating.

Resilience By Design: Evidence From The Richmond Resilience Initiative, Research Institute For Social Equity Rise, Morgan Woodle Phd, Albert Okwei, Yali Pang, Nakeina E. Douglas-Glenn

Research Institute for Social Equity

This report presents a programmatic evaluation of the Richmond Resilience Initiative (RRI), a guaranteed income program designed to support economic stability among Richmond Residents experiencing financial hardship. The evaluation focuses on participants in Cohort Two and Cohort Three, examining program impacts over the two-year periods during which participants received cash transfers. Guaranteed income (GI), the provision of recurring, unconditional cash transfers, has grown in popularity as a significant policy innovation for addressing economic insecurity and inequality in the United States.

Prediction Of Phytocompounds For Environmental Sustainability: A Framework Using Computational Tools, Ankita Halder, Sayoni Dam, Sisir Nandi, Asmita Samadder

Trends in advanced sciences and technology

In response to the abruptly elevated environmental impact caused by the usage of chemical-based synthetic compounds in agricultural fields and pharmaceutical pollution, phytocompound-based products have become the choice of use for their ability to foster environmental sustainability. The potential of new phyto-based compounds has been explored in agriculture, phytoremediation, etc. Computer-based in silico prediction through ADMETlab 2.0, SwissADME, and Way2Drug software secured an important role in screening of these phyto-based compounds in terms of lethal concentration (LC₅₀FM, LC₅₀DM), Bioconcentration Factors, IGC50, and role in the TOX21 pathway ahead of their environmental exposure. These aforementioned softwares also …

Predicting Tilt In Esports: A Psychophysiological Approach To Understanding Player Emotional Regulation, Nathan Rhea

University of the Pacific Theses and Dissertations

Emotional regulation and stress management are important to both casual and competitive esports players. When players become dysregulated, they experience a phenomenon known as “tilt” within the gaming community, where they often lose control of their emotions and their performance declines. This study aimed to investigate whether a psychophysiological variable in heart rate variability could predict tilt in college-age esports players. Additionally, the relationship between heart rate variability and emotions predicted by the Tiltometer system with gameplay performance and winning or losing was tested.

This study used a quantitative correlational research design. Participants for this study were college-age players (N=23) …

Lost In Instructions: Study Of Blind Users' Experiences With Diy Manuals And Ai-Rewritten Instructions For Assembly, Operation, And Troubleshooting Of Tangible Products, Monalika Padma Reddy, Aruna Balasubramanian, Jiawei Zhou, Xiaojun Bi, Iv Ramakrishnan, Vikas Ashok

Computer Science Faculty Publications

AI tools like ChatGPT and Be-My-AI are increasingly being used by blind individuals. Although prior work has explored their use in some Do-It-Yourself (DIY) tasks by blind individuals, little is known about how they use these tools and the available product-manual resources to assemble, operate, and troubleshoot physical/tangible products – tasks requiring spatial reasoning, structural understanding, and precise execution. We address this knowledge gap via an interview study and a usability study with blind participants, investigating how they leverage AI tools and product manuals for DIY tasks with physical products. Findings show that manuals are essential resources, but product-manual instructions …

Clickwrap Accountability, Alicia Solow-Niederman

GW Law Faculty Publications & Other Works

Picture a public-facing generative AI chatbot on a government website that can answer questions about benefits eligibility.  Systems like these expose a sociotechnical-legal divide: they route around the standard due process framework, because there has been no formal government determination, yet they induce reliance from users, above and beyond past rounds of automated legal guidance.  Moreover, if there is an error, current doctrine on government errors and equitable estoppel makes relief unlikely.

This Essay focuses on government deployment of public-facing generative AI chatbots and critically assesses the front-end power dynamics that determine who is filtered out of government programs before …

Eng 2100 - Writing 1 - Writing As Being, Jonathan Toro

Open Educational Resources

This is an Open Educational Resources (OER) syllabus for ENG 2100 - Writing 1 - Writing as Being. In this course, students will examine how their identities and communities shape their understanding of themselves and the world around them—how it affects the way they move and think in the spaces they occupy. Through the usage of personal narrative and critical writing, the students will study how language, culture, community, and socio-historical contexts influence their ways of knowing and being. Then, they will utilize these influences—the very systems that affect them in tremendous ways—to write themselves into being.  All course materials, …

Spn 316, Introduction To Hispanic Linguistics, Bernardita Chaigneau Castro

Open Educational Resources

The present syllabus includes the structure for an Introduction to Hispanic Linguistics class. The topics range from basic concepts in linguistics to the specific study of Spanish in the United States. The syllabus also includes different Open Access Resources in Spanish, as the class was thought to be taught mainly in Spanish.

Transitioning To Life After Sport: Empowering Former College Varsity Athletes To Live More Healthfully, Linda Piacentine, Taylor L. Wolf, Jacob J. Capin

Physical Therapy Faculty Research and Publications

Introduction: 

The transition out of competitive sport comes with a range of psychosocial challenges for athletes, particularly when retirement is involuntary (e.g., due to injury). Little is known about the health of former athletes who often manage prior injuries and changing biopsychosocial factors.

Purpose: 

Identify the unique experiences of varsity athletes during college and as they transition to life after college sports and determine the facilitators, barriers, and needs of college varsity athletes to engage in a physically active and healthy lifestyle after competitive sport retirement.

Methods: 

Thirty former college varsity athletes (15F, 15M; mean age 23 ± 1 yrs; …

Fabrication Of Urea With Amorphous Silica To Increase Rice Growth In Saline Soils, Thi Ha Chi Nguyen, Thi Hang Thuc Ha, Minh Phuong Nguyen, Ngoc Chuc Pham, Quang Bac Nguyen, Nguyen Huy Tuan Do, Ngoc Nhiem Dao, Trung Kien Nguyen

Applied Environmental Research

In recent decades, the decrease in rice cultivation areas in Vietnam, particularly in the Mekong River Delta, caused by climate change and soil salinization, has posed serious challenges for sustainable development. In addition to irrigation and agronomic practices, fertilizers that sustain rice growth under saline conditions play a crucial role in improving crop productivity. Amorphous silica has been reported to increase plant tolerance to drought, salinity, and heavy metal stress. In this study, nanosilica-coated urea (UCS) fertilizers were synthesized by coating urea granules with 1–5 wt% amorphous silica. The products were characterized by SEM, XRD, FTIR, TG‒DSC, and EDX to …

Structural Inequities, Environmental Toxicants, And Cardiometabolic Pathways In Cardiovascular Disease: Evidence From A Nationally Representative U.S. Population, Ese F. Oghaghare

Electronic Theses & Dissertations (2024 - present)

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States and continues to disproportionately burden racial/ethnic minorities and socioeconomically disadvantaged populations. Traditional risk factors and behavioral explanations fail to fully account for these persistent disparities, motivating increased attention to intermediate biological pathways and environmental toxicant exposures through which structural inequities may become biologically embedded. This dissertation investigates how cardiometabolic biomarkers, diet quality, and exposure to persistent organic pollutants jointly contribute to cardiovascular disease risk in a nationally representative U.S. population.

Using data from the National Health and Nutrition Examination Survey (NHANES), three complementary studies were …

After The Aid Boom: Government Responses To The Global Health Agenda And Political Commitment In Low- And Middle-Income Countries, Sana Abdelkarim

Electronic Theses & Dissertations (2024 - present)

How do governments respond to the global health agenda? Does external health assistance translate to sustained domestic political commitment in low- and middle-income countries? Over the past three decades, development assistance for health has expanded, accompanied by international agreements emphasizing country ownership, alignment, and domestic resource mobilization. Yet domestic fiscal commitment to health remains uneven across countries. These questions have become more pressing as the global aid landscape enters a period of contraction, with a significant decline in development assistance, including health financing, raising concerns about the sustainability of health systems that have become reliant on external support.  This raises …

Genomic Determinants Of Appetite Regulation And Their Role In Obesity Risk, Timothy J. Renier

Dartmouth College Ph.D Dissertations

Over 40% of US adults and 20% of children live with obesity. It is related to increased risks of diseases including type II diabetes and cancer, is a source of harmful stigma, and impairs child development. Appetitive traits describing patterns of food approach and avoidance behaviors may serve as windows into the underlying pathophysiology of obesity. As both obesity and appetitive traits are heritable, common genetic drivers of obesity may lead to phenotypic obesity through appetitive traits as a disease mechanism. Additionally, GLP-1 receptor agonists (GLP-1RAs) have been shown to exert their profound clinical effects in part by modulating appetite. …

Cross-Temporal Statistical Approaches For Evaluating Predictor-Outcome Relationships, Jeff Joseph

Dartmouth College Ph.D Dissertations

Central auditory function is linked with cognitive deficits, but few research projects use existing statistical approaches or develop new ones to forecast cognitive deficits using the results of central auditory tests. To address this limitation, we use a series of statistical learning frameworks for predicting a child’s cognitive abilities based on his/her central auditory performances and demographic factors. Two key challenges exist. First, children may start the study at a time when they are unable to perform the central auditory tests or cognitive tests. Second, cognitive performance is age-dependent, particularly in the early formative years of childhood and adolescence. To …

Understanding Dementia Challenges In Rural Ghana: A Systematic Review, Diana Maame Agyeiwaa Agyei, Sesi Sedegah, Abena Abokoma Asemanyi, Theresa Ayertey, Wendy Yeboah

Iowa Journal of Communication

Dementia poses an escalating public health challenge in Ghana due to an expanding aging population, yet rural awareness remains critically low. Guided by Mohan Dutta’s Culture-Centered Approach (CCA), this PRISMA-compliant qualitative systematic review synthesized ten peer-reviewed articles to examine cultural perceptions and lived experiences surrounding dementia in rural Ghana. The findings highlight that cognitive decline is widely misattributed to witchcraft or normalized as standard aging. Witchcraft misconceptions subject individuals—especially older women—to severe stigmatization, social exclusion, physical abuse, and banishment to "witch camps". Meanwhile, normalizing symptoms as ordinary aging delays critical medical care and shifts family decision-making away from patients. Furthermore, …

Parental Distress, Coercive Control With Food, And Child Self-Regulation, Kattie Nguyen

UNF Graduate Theses and Dissertations

Self-regulation is the management of one's emotions, thoughts, and behaviors to adapt to a situation (Smith-Donald et al., 2007). During infancy and toddlerhood, parents foster self-regulation through co-regulation (e.g., sensitivity, responsiveness), helping children manage their emotions, behaviors, and thoughts (Butler & Randall, 2013). Parents who experience distress (e.g., depression, stress, anxiety) are more likely to use less responsive and harsher, controlling practices like coercive control. Coercive control with food is a practice where parents use food as threats or bribes to control their child’s emotions and behaviors (Vaughn et al., 2016). The present study examined the associations between parental distress, …

Front Matter - Table Of Contents - Preface

Iowa Journal of Communication

No abstract provided.