Digital Commons Network^™

New Frontiers: The Intern Experience In A Newly Established Integrated Plastic Surgery Program, Hendrik Lintel, Imran Rizvi, Michael Haydon, Erik S Marques, Matthew R Greives, Mohin A Bhadkamkar

Faculty, Staff and Student Publications

The plastic surgery residency pathway has undergone many changes since its inception. The advent of integrated training has largely taken over as the predominant residency model with the addition of a few new programs every year. There is currently a paucity of literature describing the experiences of first-year interns in a new integrated residency program transitioning from the independent model. In this article, we seek to elucidate some of the advantages and difficulties encountered by the initial residents of a newly established integrated program and the steps taken to pave the way for future matched integrated trainees.

Assessment Of Contextualized Reinforcement Pathology In A Community Sample Of Young Adult Substance Users, Ángel García-Pérez, Alba González-Roz, Roberto Secades-Villa, Gema Aonso-Diego, Sara Weidberg, Jin H Yoon

Faculty, Staff and Student Publications

Background: Alcohol, tobacco, and cannabis are the most commonly used substances among young populations, often leading to polysubstance use, which correlates with problematic consumption and adverse health outcomes. The contextualized reinforcer pathology (CRP) model explains addictive behaviors through several constructs, including the following: drug demand, delay discounting (DD), and substance-free and substance-related reinforcement. Most previous studies have focused on a single CRP construct and the couse of only two substances. This study aimed to characterize three subgroups of young adults reporting past month use of alcohol only, alcohol + tobacco or cannabis, and alcohol + tobacco + cannabis, in terms …

Pharmacogenetics Of Plasma Dolutegravir Exposure During 1-Month Rifapentine/Isoniazid Treatment Of Latent Tuberculosis, Nia Covington, Anne F Luetkemeyer, Marjorie Z Imperial, Rodney Dawson, Yoninah Cramer, Sue Rosenkranz, Susan Swindells, Irina Gelmanova, Anchalee Avihingsanon, Roberto C Arduino, Wadzanai Samaneka, Kelly E Dooley, Rada Savic, Anthony T Podany, David W Haas

Faculty, Staff and Student Publications

In Advancing Clinical Therapeutics Globally protocol A5372, a pharmacokinetic study of dolutegravir with 1-month of daily rifapentine/isoniazid, twice-daily dolutegravir offset the induction effects of rifapentine on plasma dolutegravir trough concentrations (C trough ). Here, we characterize the impact on dolutegravir C trough of UGT1A1 , AADAC , and NAT2 polymorphisms that affect dolutegravir, rifapentine, and isoniazid, respectively. People with HIV receiving dolutegravir-based antiretroviral therapy with an indication to treat latent tuberculosis underwent pharmacokinetic sampling during dolutegravir 50 mg once daily alone, and on day 28 of dolutegravir 50 mg twice daily with rifapentine/isoniazid. Multivariable linear regression models characterized genetic associations …

Three-Dimensional Printed Models To Accelerate Resident Surgical Learning Curve For Standard Endoscopic Sinus Surgery Techniques, Jumah G Ahmad, Alexander J Citardi, Amber U Luong, William C Yao

Faculty, Staff and Student Publications

Background: Endoscopic sinus surgery presents significant visuospatial challenges to surgical trainees. We tested the utility of novel 3D printed models to simulate sinus surgery tasks to improve endoscopic skillsets in resident trainees.

Methods: This was a prospective quality improvement study of 10 ENT residents (PGY1-5). Participants rotated through 4 stations with different 3D simulation training modules designed to enhance endoscopic skillsets in the axial, sagittal and coronal planes (e.g., straight forceps to grasp a bead from a ledge, angled instruments to cannulate openings). Participants completed a self-assessment survey on the subjective sinus surgical skills using a visual analog …

Placenta Accreta Spectrum, Present And Future: The Eunice Kennedy Shriver National Institute Of Child Health And Human Development Workshop Summary, Christina M Duzyj, Brett D Einerson, Yalda Afshar, Karin A Fox, Antonio F Saad, Daniela A Carusi, Christina L Herrera, Deirdre J Lyell, Alfred Z Abuhamad, Michaela K Farber, Anne C Roberts, Sebastian R Hobson, Loic Sentilhes, Baha M Sibai, Koji Matsuo, Kristen Terlizzi, Scott A Shainker, Robert M Silver, Helena C Bartels, Thomas D Shipp, Marilyn Huang, Alison G Cahill, Jason D Wright, George R Saade, Monica Longo

Faculty, Staff and Student Publications

Placenta accreta spectrum (PAS) disorder poses significant risks to maternal health, given the complexities of screening, diagnosis, and management. To address these challenges, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) hosted a workshop on June 10-11, 2024, bringing together expert health care professionals, researchers, stakeholders, and patient advocates to identify knowledge gaps, with an overarching goal of informing future research and best practices for PAS. Key discussions revolved around the resources and infrastructure needed to advance screening, diagnosis, and clinical management of PAS, alongside ways to enhance collaboration across disciplines. Participants considered strategies to …

Psychometrics Of Inflammatory Back Pain Criteria In The Us Population, Mark C Hwang, Seokhun Kim, Shervin Assassi, Alexis Ogdie, Michael H Weisman, John Reveille, Charles Green

Faculty, Staff and Student Publications

Objectives: Evaluation of axial spondyloarthritis relies on capturing various inflammatory back pain (IBP) features represented in different criteria. These criteria are likely to be interpreted differently across demographic subpopulations. We examined IBP criteria dimensionality and differential item functioning (DIF) among different age, gender, and race groups using a nationally representative sample.

Methods: We utilised the National Health and Nutrition Examination Survey (NHANES) 2009-2010 dataset, a US nationally representative data collection with demographic weighting. The Arthritis Questionnaire (ARQ) within NHANES included questions from published Calin, European Spondyloarthropathy Study Group, and Berlin criteria (8a and 7b). Confirmatory factor analysis (CFA) was performed …

Design Of Conquest, A Novel, Randomized, Placebo-Controlled, Phase 2b Platform Clinical Trial To Investigate New Treatments For Patients With Early Active Systemic Sclerosis With Interstitial Lung Disease, Dinesh Khanna, Luke B Evnin, Shervin Assassi, Wade W Benton, Gregory Gordon, Karina Maslova, Juergen Steffgen, Toby M Maher

Faculty, Staff and Student Publications

Objective: Safe, effective therapies are urgently needed for patients with systemic sclerosis. However, clinical trial recruitment is challenging given the limited number of people with systemic sclerosis and further restrictions imposed by eligibility criteria. Innovative approaches are needed to accelerate development of new therapies. This article describes the rationale and trial design for CONQUEST (NCT06195072), a novel platform clinical trial sponsored by the Scleroderma Research Foundation, a not-for-profit organization.

Methods: CONQUEST is a multicentre, double-blind, randomized, placebo-controlled, Phase 2b platform trial evaluating the efficacy, safety and pharmacodynamics of multiple investigational products to treat early active systemic sclerosis with …

Perceptions Of The Intensity Of Heart Failure Medications Among Hospitalized Older Adults: A Pilot Qualitative Study, Nuzha A Amjad, Saeed Shoar, Catherine Bryant, Meghan Hunt, Min Ji Kwak

Faculty, Staff and Student Publications

Background: Guidelines for heart failure (HF) management recommend high target doses for medications. These targets are based on standardized dosing regimens that rarely consider the complex challenges faced by older patients. However, little is known about such challenges perceived by older adults. We assessed older adults' perceived challenges with HF medication utilization, which may guide a more patient-centered definition of the target intensity for HF medications.

Methods: We conducted a pilot qualitative study using one-on-one, semi-structured interviews with older adults. We included patients over the age of 65 years admitted to the acute cardiac care units (cardiac intensive care unit …

One Cutoff Is Not Enough: Assessing Different Area Deprivation Index Cutoffs For Insurance Types On Surgical Desirability Of Outcome Ranking (Door), Susanne Schmidt, Michael A Jacobs, Daniel E Hall, Karyn B Stitzenberg, Lillian S Kao, Bradley B Brimhall, Chen-Pin Wang, Laura S Manuel, Hoah-Der Su, Jonathan C Silverstein, Paula K Shireman

Faculty, Staff and Student Publications

Background: Social Determinants of Health impact health outcomes. Area Deprivation Index (ADI) is used to risk-adjust for neighborhood affluence/deprivation but guidance on choosing deprivation cutoffs is lacking. We hypothesize that different ADI cutoffs are required for different insurance types.

Methods: National Surgical Quality Improvement Program data 2013-2019 merged with electronic health records from three academic healthcare systems. Desirability of Outcome Ranking (DOOR) assessed the association of ADI cutoffs for different insurance types, adjusted for operative stress, frailty, and case status (elective, urgent, emergent). Secondary analyses assessed the association of ADI with case status.

Results: Patients with Private insurance living in …

Building Open Finance, Douglas W. Arner, Ross P. Buckley, Christine M. Wang, Dirk A. Zetzsche

Notre Dame Journal of International & Comparative Law

As one of the most digitalized sectors of the economy, finance is increasingly dependent on data. Over the past decade, the implementation of Open Banking and Open Finance in an increasing number of major jurisdictions around the world, including the European Union (EU), the United Kingdom (UK), Australia, Brazil, and the United Arab Emirates (UAE), seeks to break down data silos, empower consumers, and increase competition among financial service providers, aiming to maximize the value of financial data for innovation, growth, and competitiveness. In addition to mandatory requirements, other governance approaches to Open Finance, including collaborative arrangements and voluntary initiatives, …

The Influence Of Black Soldier Fly Residue On Watermelon Growth And The Properties Of A Coarse-Textured Ultisol, Benedict Onyebuchi Unagwu, Chidiebere Fransica Odu, Chinedu Felix Amuji, Michael Onyedika Eze, Nancy Ekene Ebido, Chidike Ude Abara, Chioma Rosita Igboka, Uchechukwu Paschal Chukwudi

Chemistry Faculty Research & Creative Works

Improving the fertility status of nutrient-depleted soils is critical to achieving food security. The negative effects of chemical fertilizers on soils necessitate the global quest for eco-friendly, effective, and sustainable alternatives. This work assessed the effect of black soldier fly (BSF) residue application on soil properties and watermelon growth. The study was set up in a completely randomized design with six replications. The treatments were BSF1 (BSF applied at 10 t ha⁻¹), BSF2 (20 t ha⁻¹), BSF3 (30 t ha⁻¹), and control. The plant data collected in this study were vine length, leaf width, …

United Seas For Resilient Reefs: A Blueprint For Coral Conservation Through International Cooperation, John J. Bohorquez, Maoz Fine, Dana I. Grieco, David A. Gill, Ali Al-Swalimih, Jacqueline Padilla-Gamino, Isaiah W. Bolden, Margaux Hein, Callum Backstrom, Melanie Mcfield, Raphael Martinez, Benjamin Midberry, Fahd Al-Guthmy, Ellen K. Pikitch, Natalia Benejam, Chen Azulay, Britt Ronen, Oren Levy, Anne Mcelroy, Karine Kleinhaus

School of Marine & Atmospheric Sciences Faculty Publications

Coral reefs are one of Earth’s most vital and threatened ecosystems. They protect coastlines, generate billions of dollars of tourism revenue, support valuable fisheries, and contribute to the development of vital medicines. Yet half of the world's coral reefs have been lost in the last 50 years, and 90% of remaining reefs are projected to die off by the middle of this century, mainly due to warming seas from climate change.

Despite these challenges there is reason for hope. Some coral reefs – such as in the northern Red Sea and Gulf of Aqaba – have demonstrated remarkable resilience to …

2025 June, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for June of 2025.

The Moderating Effect Of Its Working Capital Management Policy On The Relationship Between Dividend Policy And Stock Price: A Case Study On The Manufacturing Sector On The Kuwait Stock Exchange For The Years 2019-2023, Barham Hassan, Shakhawan Sangawi, Hadi Ahmed

Journal of Economics and Administrative Sciences

This study aims to examine the moderating effect of working capital management policies on the relationship between dividend policy and stock prices in the manufacturing sector of the Kuwait Stock Exchange (KSE) from 2019 to 2023. Grounded in signaling theory and agency theory, the research investigates how dividend decisions affect market valuation and how investment and financing strategies, particularly aggressive or conservative working capital approaches, influence this relationship. To achieve this, panel data from 21 manufacturing firms listed on the KSE were analyzed using panel regression techniques method in EViews software. The market price per share (MPS) was used as …

Individual Or Team Analyst Reports? The Organization Of Analyst Research Activities, Xia Chen, Ning Jia, Dan Wang

Research Collection School Of Accountancy

Given the importance of research resource allocation within brokerage firms, we examine key factors that influence the issuance of individual vs. team analyst reports. Using a comprehensive sample of analyst reports from China for the 2008-2021 period, we find that this decision is influenced by (1) the brokerage firm's client interests, whereby firms held by the brokerage firm's mutual fund clients and firms that are the brokerage firm's underwriting clients receive more team than individual reports from the brokerage firm, and (2) the nature of corporate events, whereby routine events receive more team reports and nonroutine events receive more individual …

Higher Education Is Under Siege: It Needs To Reinvent Itself, Lily Kong

Research Collection School of Social Sciences

In an op-ed for The Straits Times, SMU President Professor Lily Kong reflects on the urgent need for universities to respond to the growing convergence of pressures facing higher education – including political scrutiny, funding constraints, technological disruption, and public scepticism. She calls for a reimagining of the university’s purpose: one that moves beyond knowledge acquisition and employment outcomes to embrace holistic student development, lifelong learning, and social relevance. Highlighting the importance of resilience, self-awareness, and adaptability, Prof Kong emphasises that learning happens as much outside the classroom as within it – through mentoring, community engagement, reflection, and lived experience. …

‘Workism’ Isn’T The Enemy, Matthew Hammerton

Research Collection School of Social Sciences

In a commentary, SMU Associate Professor of Philosophy Matthew Hammerton opined that "workism" – finding meaning and identity in one’s job – should not be dismissed outright. He distinguished it from "statusism," which ties self-worth to social hierarchy and often leads to competition and misplaced values. In contrast, non-competitive workism can promote collaboration and meaningful engagement. While acknowledging concerns that workism may lead to imbalance or risk, he cautioned against pathologising the choice of those who derive deep fulfilment from their work.

Surgical Management Of An Intracranial Injury Caused By A Handcrafted Arrow In Sub-Saharan Africa: A Global Neurosurgical Relevance., Allie L Heineman, Quinn Jackson, Chris Karas, Robert Galler, Victor Awuor, Hiren Patel

Trauma and Acute Care Articles

This case report and literature review describe an intracranial injury resulting from a handcrafted arrow that required emergent surgical management in a patient treated at a public hospital in Sub-Saharan Africa. The authors are members of the non-profit organizations Chunilal Initiative and Kisumu Intuitive, which deliver charitable neurosurgical care to the region on a quarterly basis. This unique neurotrauma case, involving a penetrating, contaminated, metallic object, highlights the surgical and antibacterial management of intracranial arrow injuries and emphasizes the importance of neurosurgical missions to underserved regions globally. The patient is a 16-year-old male tribal member with no known or reported …

Silent But Deadly: A Case Of Obtuse Marginal Artery Occlusion., Austin M Miller, Vishal Tharani, Erin Fraser, Howard W Levitin

Heart and Vascular Articles

The obtuse marginal artery (OMA) is a key branch of the left circumflex coronary artery, supplying blood to the lateral wall of the left ventricle. OMA occlusions can result in myocardial ischemia and serious cardiac events, often presenting with subtle or atypical electrocardiogram (EKG) changes, unlike the more pronounced alterations observed with left anterior descending artery occlusions. This case report discusses a 57-year-old female presenting with chest pain and shortness of breath, indicative of acute coronary syndrome. The patient's initial EKG showed occasional premature ventricular contractions (PVCs), T-wave flattening in aVL, and 1 mm ST elevation in V6, but otherwise, …

Investigation Of Endotracheal Tube Versus Laryngeal Mask Airway Emergence Times For Surgical Patients., Samir M Patel, Rayyan Bhutta, Michelle Pershing, John Dillis, John O Elliott, Matthias J Franzen

OhioHealth Research Institute Articles

During surgical procedures requiring general anesthesia, an airway device is often placed to allow for adequate ventilation of the patient. Most commonly, endotracheal tubes (ETTs) or laryngeal mask airways (LMAs) are placed by the anesthesia provider. The difference between these two methods of ventilation is based on the location; ETTs pass through the glottis into the trachea, whereas the LMA sits above the glottis. This difference in placement may lend benefit to LMAs over ETTs, one of which includes a faster removal of the airway device. That is, after the surgical procedure is completed, there is a period when the …

Utility Of Readily Available Sugammadex For Emergent Neuromuscular Blockade Reversal., Theodore Renner, Kevin Varner, Austin Shaffer, Elizabeth Johnson-Gray, Noah Le, Matthias Franzen

Surgery Articles

INTRODUCTION: Anesthesia providers are often called upon to assist with other providers during can't intubate, can't ventilate (CICV) scenarios. The current availability of doses of sugammadex sufficient to provide emergent reversal of neuromuscular blockade in an operating room environment requires visits to multiple operating rooms at our institution. The Anesthesiology Department at OhioHealth Doctors Hospital sought to evaluate the practicality of administering a rescue dose of sugammadex (16 mg/kg) in a CICV scenario. The current storage of sugammadex is six 200 mg vials maximum per operating room, which would provide insufficient dosing for emergent reversal dosing for most adult patients. …

Facilitators And Barriers To Neurologist Referral Of Patients For Epilepsy Surgery Evaluation., Chloé E Hill, Daniel Hochster, Jessica E Baker, Alison L Herman, Nishad Shaheid, Susanna S O'Kula, Jack M Parent, Darin B Zahuranec, Lesli E Skolarus

Neuroscience Articles

OBJECTIVE: Epilepsy surgery offers a potential cure for drug-resistant epilepsy (DRE), yet surgery is underutilized. An estimated 5% of patients with DRE undergo long-term EEG monitoring (LTM) annually, the requisite first step of evaluation for surgical candidacy. Much of the variation in LTM referral may be attributable to individual neurologist practice rather than patient characteristics. We explored neurologist behaviors and practices in epilepsy surgery referral to guide future interventions to expand patient access to surgery.

METHODS: This qualitative interview study recruited neurologists who treated adults with epilepsy. Interviews were grounded in the Theoretical Domains Framework (TDF) of behavior change to …

Epidemiology Of Hip Dislocations In The United States From 1990 To 2019: A Temporal Study Using The Global Burden Of Disease Database., Ambrose Loc T Ngo, Gabrielle Dykhouse, Taylor J Manes, Phillip C Mckegg, Cameron J Sabet, Brett Barthman, Robert Golden

Trauma and Acute Care Articles

Introduction Hip dislocations are devastating injuries that require urgent intervention to minimize the development of severe complications. This study aimed to evaluate the epidemiology of hip dislocations in the United States (U.S.) from 1990 to 2019. Methods This study is a descriptive retrospective epidemiological study. The Global Burden of Disease (GBD) database was used to collect epidemiological data on hip dislocation in the U.S. from 1990 to 2019. Data included years lived with disability (YLDs), prevalence, and incidence rates per 100,000 people. Data were regionally stratified into Northeast, Midwest, South, and West by the U.S. Census definition. Bartlett's test was …

Alterations In Gut Microbiome Composition And Increased Inflammatory Markers In Post-Covid-19 Individuals, Tatiana Barichello, Bruno Kluwe-Schiavon, Laura A Borba, Lucas C Pedro, Flávia S Niero, Laísa N Dos Santos, Letícia M Leonardo, Zuleide M Ignácio, Rodrigo Morales, Luciane B Ceretta, Gislaine Z Reus

Faculty, Staff and Student Publications

Dysfunctions in the immune system and alterations in the microbiome composition following SARS-CoV-2 infection contribute to persistent neurological issues observed in long COVID-19 survivors. We hypothesize that alterations in the gut microbiome composition and peripheral inflammatory profile following COVID-19 may play pivotal roles in behavior changes among individuals experiencing long-term illness. This cross-sectional study included a sample of post-COVID-19 and non-COVID-19 subjects. We assessed the presence of psychiatric conditions utilizing standardized diagnostic criteria, Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Biological Rhythms in Neuropsychiatry Assessment Interview (BRIAN), and Functional Assessment Short Test (FAST). Plasma samples …

Exploring Potential Ethnic Bias Among Mmpi-3 Scales In Assessing Personality Psychopathology, Nicole Shumaker, Tessa Long, Andy Torres, Alfonso Mercado, Ryan J Marek, Jaime L Anderson

Faculty, Staff and Student Publications

This study examined statistical bias in the measurement of personality psychopathology in the Latinx population using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Data were extracted from two studies that yielded a composite data set of 103 White individuals and 250 Latinx individuals. All participants were administered the MMPI-2-Restructured Form-Extended Battery (MMPI-2-RF-EX) or MMPI-3 and the Personality Inventory for the DSM-5 Short Form (PID-5-SF). First, we conducted correlation analyses between theoretically overlapping scales of the PID-5-SF and the MMPI-3 among White and Latinx individuals. The majority of theoretically associated scales were found to be at least moderately associated in the …

A Comparative Case Study On Special Education Administrator’S Education And Experience: Perceptions Of The Effectiveness Of The Support Provided To Probationary Special Education Teachers, Diane Smith Glover

Educational Leadership & Workforce Development Theses & Dissertations

The purpose of this research study was to explore the education and experience of special education administrators (SEAs) and their perceptions of the effectiveness of the support they provide to probationary special education teachers (SETs), particularly in relation to the teachers' professional growth and job satisfaction. This qualitative study employed an interpretive approach, focusing on the perspectives of SEAs regarding their knowledge in special education, the workplace supports they provide, and the impact of these supports on SETs' professional development and career decisions. Data was collected from interviews with 11 SEAs who had experience supervising probationary SETs.

The findings revealed …

Understanding Anti-Racism In Counselor Education: A Narratology Of Anti-Racist Pedagogy In Sociocultural Courses, Danielle G. Rodgers

Counseling & Human Services Theses & Dissertations

Counselors have the privilege to join children, adolescents, and adults from all walks of life in a journey of working towards mental and emotional wellness. Our code of ethics outlines “honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts” (p.3) and promoting social justice as two of our core professional values (American Counseling Association [ACA], 2014). The ACA also stated in their Antiracist Statement in 2020 that “we have a moral and professional obligation to deconstruct institutions which have historically been designed to benefit White …

The Financial Sector And Global Dollar System, Gary Gensler, Lev Menand, Joshua Younger

Faculty Scholarship

The second Trump administration’s approach to financial markets and institutions mixes familiar deregulatory policies with a range of other policies (financial and non-financial) that are largely without precedent and may lead to significant structural change in the long term. Combined, these policies have the potential to affect the financial sector in at least four ways. First, they could threaten the foundations of the global dollar system – mutual cooperation, trust, and interdependency, both between the producers and consumers of financial instruments and among the nations that constitute the dollar bloc. Second, they may undermine financial stability by loosening prudential standards, …

Evolution Of The Family Medicine Clerkship: A Cera Secondary Analysis., Bryce A Ringwald, David Banas, Allison Macerollo, Ericka Bruce, Matthew Farrell

Medical Education Articles

BACKGROUND AND OBJECTIVES: The family medicine clerkship has been found to influence medical students' decision-making regarding specialty choice. Understanding how the family medicine clerkship has changed over the past decade may assist in recruitment efforts. Our study explored trends in family medicine clerkship design, length, and format and correlated these characteristics with high proportions of medical school graduates choosing family medicine.

METHODS: We performed a secondary analysis of the Council of Academic Family Medicine Educational Research Alliance annual family medicine clerkship director surveys from 2012 to 2023. We analyzed standard family medicine clerkship structure questions that were asked in each …

Don’T Mess With Mr. In-Between, Brian Langille, Ben Mayer-Goodman

Dalhousie Law Journal

In a separate, related paper, we reveal and criticize an important “methodical error” which is commonly made in labour law jurisprudence. In this paper, we undertake a review of the attempts by Canadian and UK legislators and decision makers to overcome some of the problems of applying labour law’s traditional orthodoxy in the face of an ever more complex world by creating new categories “in between” the existing classes of employees and independent contractors. These attempts often fail precisely because they perpetuate the traditional approach and its methodological error, maintaining its perverse incentive structures. Our advice: “Don’t mess with Mr. …