Digital Commons Network^™

The Influence Of Scientific, Genetic, And Health Literacy On Carrier Screening Decision-Making, Brenna D. Albracht

Dissertations and Theses (Open Access)

For those wishing to assess their reproductive risks and make informed decisions in their reproductive planning, carrier screening for autosomal recessive and X-linked conditions, as well as cell-free DNA (cfDNA) screening for aneuploidy, are recommended during pregnancy. Despite similarities in purpose, sample requirements, insurance coverage, and safety, a lower percentage of individuals elect carrier screening than cfDNA screening, suggesting there may be a disconnect in what patients perceive as valuable information for their pregnancy. Previous studies have attempted to explain the factors associated with carrier screening uptake or decline; however, no models have yet accounted for a patient’s literacy level …

Achieving The Practice-Based Competencies: Are More Than 50 Cases Needed?, Farren Lopez

Dissertations and Theses (Open Access)

Genetic counseling graduate programs are required to provide didactic coursework and fieldwork experiences to foster development of the practice-based competencies (PBCs) in trainees. Currently, every graduating trainee must log a minimum of 50 participatory encounters to demonstrate readiness for entry-level practice of the PBCs. Previous studies have noted that many trainees exceed the 50-case standard, raising the question of whether this minimum satisfies the training needs of every student. To assess the perceived number of encounters needed for graduates to independently perform the PBCs, a survey was administered to 2023 and 2024 graduates of North American genetic counseling training programs. …

Role Of Mir-4732-3p In Breast Cancer Brain Metastasis And Brain Metastatic Tumor Microenvironment, Munazza Samar Khan

Dissertations and Theses (Open Access)

In this study, we aimed to identify microRNAs (miRNAs) that may play important roles in breast cancer brain metastasis (BCBM). To this end, we conducted miRNA-sequencing of extracellular vesicles isolated from the serum samples of 6 BCBM patients and 8 Stage I/II/III breast cancer patients, and identified 49 circulating miRNAs that were upregulated in BCBM patients compared to Stage I/II/III breast cancer. Upon further analysis, we identified miR-4732-3p to be upregulated in brain-tropic triple-negative breast cancer (TNBC) cell lines, compared to parental lines. MiR-4732-3p overexpression increased metastatic properties of TNBC cells, including proliferation, migration, invasion, and maintenance of a mesenchymal …

"Magic Computer In The Sky" - Participant Perspectives On Control And The Genetic Counseling Admissions Match, Jessica Clark

Dissertations and Theses (Open Access)

Since the 2018 admissions cycle, genetic counseling graduate programs in North America have utilized the Genetic Counseling Admissions Match (GCAM), a Match algorithm to place applicants. While a study prior to implementation found that most students were uninterested in a Match due to concerns of control, there has been no investigation into matched applicants’ experiences since its inception. A mixed-methods study explored the experiences and perceptions of control of genetic counselors and genetic counseling (GC) students who entered a program following the GCAM. An anonymous survey documenting GCAM experience and a validated measure for locus of control (LOC) was disseminated …

Exploring The Immunologic Consequences Of Atrx Deficiency In Glioma, Benjamin Whitfield

Dissertations and Theses (Open Access)

ATRX is a key chromatin regulator that is frequently mutated across multiple cancer types. One of the most common ATRX-mutated tumor types is the adult-type glioma, IDH-mutant, Astrocytoma. It is known that ATRX mutation leads to increases in DNA damage, replication stress, and global epigenetic regulation at a cell level; however, less is known about the impact of ATRX mutation on immune signaling. Furthermore, little is known about the interaction of ATRX loss with gain-of-function mutations in IDH. In this paper we set out to explore the impact of ATRX loss on immune signaling in gliomas, both in the context …

Investigating Prefrontal Cortex Neuronal Signatures Of Opioid-Induced Risk-Taking Behavior, Cana Quave

Dissertations and Theses (Open Access)

Opioid use disorder occurs alongside impaired risk-related decision-making, but the underlying neural correlates are unclear. We developed an approach-avoidance conflict task using a modified conditioned place preference procedure to study neural signals of risky opioid seeking in the prefrontal cortex, a region implicated in executive decision-making. Following morphine conditioned place preference, rats underwent a conflict test in which fear-inducing cat odor was introduced in the previously drug-paired side of the apparatus. While the saline-exposed control group avoided cat odor, the morphine group included two subsets of rats that either maintained a preference for the paired side despite the presence of …

Stat3, Nf-Κb, And Estrogen Receptor Beta: The Balance Of Inflammation In K-Ras Mutant Lung Adenocarcinoma, Michael J. Clowers

Dissertations and Theses (Open Access)

K-ras mutant lung adenocarcinoma (KM-LUAD) is a difficult-to-treat cancer subtype in which chronic inflammation pervades the tumor immune microenvironment (TIME). Pro-inflammatory pathways dampen the response to treatments, including immune checkpoint inhibitors, necessitating therapies that target this inflammatory signaling network in the TIME. This network is underpinned by interaction and coordination of two inflammatory pathways: signal transducer and activator of transcription 3 (STAT3) and nuclear factor kappa B (NF-κB). The balance of these transcription factors determines the degree of anti- vs. pro-tumor immunity, and a skewing towards STAT3 is known to promote tumor development and a pro-tumor TIME. It is also …

Automated To Ols For Contour Review In Radiotherapy, Barbara Marquez

Dissertations and Theses (Open Access)

Peer review of organ-at-risk and target volume delineation is essential for patient safety and optimization of treatment outcomes. Peer review makes a substantial impact on patient outcomes, reporting notable rates of plan changes when reviewed and worse survival when patient cases are not reviewed. In around half of revised cases, target volume change is the required cause for modification (related to tumor control); in one in ten cases, it is normal tissue sparing (related to treatment toxicity). Essentially all North American institutions with accredited residency training programs hold peer review to some capacity. However, accessibility to practicing routine peer review …

Evaluating Triage To Genetic Counseling Using An Online Reproductive Genetics Module, Grace Ra

Dissertations and Theses (Open Access)

The American College of Obstetricians and Gynecologists recommends genetic screening for all pregnant women. As clinical recommendations broaden and demand for prenatal screening increases, obstetric practitioners report time constraints and lack of genetics knowledge as challenges to providing sufficient pretest education. These challenges in offering routine screening are further compounded by the inequities in access to genetic counseling and testing. Thus, alternative education and service delivery models have emerged to meet the demands for prenatal genetics education and help mitigate challenges surrounding access. At UTHealth Houston, an online triage and education module, the Prenatal Genetics Education Program (PGEP), was created …

Denial Of Inpatient Genetic Testing: A Study On Outpatient Yield And Outcomes, Cindy Y. Canales

Dissertations and Theses (Open Access)

This study investigates the difference in diagnostic yield between patients approved for inpatient genetic testing compared to those denied inpatient testing and the effect of an earlier diagnosis on outcomes and medical/clinical care. In the literature, research has explored the impact of a diagnostic delay for patients with genetics conditions, assessed the utility of genetic testing in the inpatient setting, and described the impact to care of an earlier diagnosis. However, gaps remain on research exploring the diagnostic yields of inpatient versus outpatient settings and the potential impact to care an inpatient genetic testing request denial may pose. This is …

Differential Progression Of Pancreatic Premalignancy In Geographically Distant Murine Transgenic Cohorts Uncovers Key Role Of Microbial Metabolites, Rian M. Howell

Dissertations and Theses (Open Access)

Cancer is a leading cause of death worldwide. Despite recent advances in diagnostic and therapeutic modalities, pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer that remains highly lethal. Efforts have been made to increase the understanding of the underlying mechanisms driving early stages of tumor development, when the cancer is most susceptible to intervention. To this end, genetically engineered mouse models (GEMMs) have been developed with the mutations most commonly seen in the patient population. Expression of these mutations in select cellular compartments has resulted in the ability to recapitulate characteristics of human pancreatic cancer such as the development of …

The Dynamics Of Power Transfer In Organizations: Examining Downward Deference And Its Workplace Consequences, Hoang Bao My Nguyen

Dissertations and Theses Collection (Open Access)

This dissertation examines managerial power transfer as a core mechanism through which less-hierarchical management unfolds in organizations. While traditional management research has emphasized formal authority and top-down control, emerging organizational forms increasingly call on managers to share power with subordinates. Despite growing interest in constructs like empowerment, delegation, and participative leadership, the phenomenon of power transfer remains conceptually fragmented and undertheorized.

To address this, the dissertation defines power transfer as the intentional redistribution of authority, control, or resources by powerholders to lower-power individuals. Chapter 1 develops a typology of power transfer behaviors, organized along two key dimensions: extent of control …

The Sheriff's Constitution, Farhang Heydari

Vanderbilt Law School Faculty Publications

The county sheriff is unique among our nation's law enforcers, with an ancient pedigree, elected status, and special protections as a state constitu- tional officer. But these factors combine to cause a recurrent problem elected sheriffs often assert for themselves the power to refuse to enforce criminal laws of their choosing. Today's constitutional sheriffs-a group of sheriffs who view themselves as the highest authority in their county, answerable only to their electorate-are the latest manifestation of this ethos, declaring opposition to gun control measures, pandemic restric- tions, environmental protections, and more. Lest one think these nonen- forcement decisions are entirely …

Valuing Heat-Related Mortality Risks, W. Kip Viscusi, Clayton J. Masterman

Vanderbilt Law School Faculty Publications

Heat-related mortality risks are a substantial component of the looming costs of climate change in the United States and globally. This article presents the results from a risk-risk survey to test whether U.S. respondents place a valuation premium on mortality risks from heat relative to cancer and transportation risks. The questionnaire exploits exogenous shocks to temperatures during a heat wave and randomized elements to further test whether preferences vary with heat exposure or the age of individuals exposed to heat risks. The results provide strong evidence that there is no valuation premium in the U.S. for heat-related risks. Subjects valued …

Torts Mismatches, Edward K. Cheng

Vanderbilt Law School Faculty Publications

In torts, the damages required for full compensation of the victim and optimal deterrence of the injurer are normally the same. This correspondence is perfectly natural: If the injurer fully compensates the victim, then the injurer will completely internalize his externalities. Yet sometimes full compensation and optimal deterrence do not align. A well-known example is punitive damages, in which victims are purposely overcompensated to optimally deter injurers. What the literature has failed to acknowledge is that these torts mismatcheswhen full compensation of victims and optimal deterrence of injurers are incompatibleoccur elsewhere and explain controversial and unresolved doctrinal areas of torts. …

Retrofitting Farm Equipment With Airflow Sensors, Jacob Bybee

Undergraduate Honors Capstone Projects

In the Fall of 2024, our farm in Idaho upgraded our equipment from conventional seeding drills to more modern and sophisticated air seeder drills, particularly the John Deere 1900 Commodity Air Cart and John Deere 730 Air Disk Drill. In our case, this equipment was purchased used at an auction and had been a little modified. One modern convenience that this certain 730 Drill did not come with was a blockage monitoring system to alert the operator that a seed distribution tube was no longer distributing seeds. My question the became: Can an affordable, reliable airflow sensor system be designed …

Dumy And The Nation: How Folklore And Folk Songs Help Compose A Distinct Ukrainian Narrative, Amy Herd

FCRH Honors Program Theses

Historiography and ethnography have played a critical role in the development of modern Slavic nationalisms, particularly in Ukraine. As these studies became increasingly popular in the nineteenth century, scholars and members of the bourgeoisie identified folk culture as the key component for the making of the modern nation. Viewed as an authentic window into national history and tradition due to their limited interaction with the modernizing world, rural folk offered the perfect opportunity to illustrate how Ukraine had always been distinct from Russia and its other historical oppressors. As folk culture fervor gripped the intellectual elite of Eastern Europe, however, …

Understanding And Modeling Pooled Rideshare Acceptance: Influential Factors, Preferred User Experiences, And Implications, Rakesh Gangadharaiah

All Dissertations

Ridesharing allows people to share a vehicle with others traveling in the same direction, which can reduce costs and traffic congestion. Pooled rideshare (PR) services, such as UberX Share and Lyft Shared, offer an economical and environmentally friendly alternative by matching passengers traveling similar routes. However, despite these benefits, PR adoption remains low due to concerns about safety, privacy, and convenience. This research explores the factors influencing PR adoption and provides recommendations to improve user acceptance. A nationwide survey of 5,385 participants across the U.S. was conducted to understand why people choose or avoid PR. The study identified five key …

The Evolving Changes In The Regionalization Of Export Bans On U.S. Poultry Trade From The 2015 And 2022 Highly Pathogenic Avian Influenza Events, Kylie A. Roesler

Graduate Theses and Dissertations

As food security becomes a growing concern worldwide in a trading system dominated by globalization, the safeguarding of a bio-secure food system is at risk. One of the greatest risks to this stability of the system is, highly pathogenic avian influenza or HPAI which is growing in frequency and impact. Therefore, the global response to disease events is evolving into a newfound understanding of disease prevalence across the animal protein industries. This study will analyze the 2022 HPAI event in the United States regarding the regionalization of restrictions imposed by trading partners accounting for trade agreements executed. The examination of …

Door - To - Door Summer Sales And Other Summer Employment: A Cost And Benefit Analysis, Jentrie Gilliland

Undergraduate Honors Capstone Projects

Door-to-door summer sales is heavily marketed to college students, especially on university campuses in Utah. These employment options are marketed as having high financial rewards while giving students the opportunity to develop their professional skills. In this study, I examine whether these expected rewards are delivered and if door-to-door summer sales is a viable position for college students in comparison to other summer employment. Specifically, I focus on the financial benefits and skills gained from both job types as well as determinants for students who participate in door-to-door summer sales versus other summer employment. My findings indicate that there is …

Evaluating Bone Fracture Healing In A Rabbit Model Using Doppler Imaging Modes, Shear Wave Elastography, X-Ray, And Dual-Energy X-Ray Absorptiometry, Priscilla Machado, Rachel Blackman, Ji-Bin Liu, Collleen Dempsey, Flemming Forsberg, Traci Fox

Department of Radiology Faculty Papers

OBJECTIVE: This study investigated methods of evaluating the bone fracture healing process using superb microvascular imaging (SMI; two modes color SMI [cSMI] and monochromeSMI [mSMI]), and shear wave elastography (SWE), relative to X-ray, dual-energy X-ray absorptiometry (DXA), and platelet endothelial cell adhesion molecule 1 (PECAM-1) also know as cluster of differentiation 31 (CD-31) staining in a rabbit model.

METHODS: This IACUC-approved study involved eight rabbits that underwent a bilateral fibula osteotomy and were followed for 7 or 21 days (Groups 1 and 2 with 4 rabbits in each). Ultrasound examinations using cSMI, mSMI, and SWE were performed on Days 0, …

The Backdrop Of Leadership: How Environmental Awe Influences Charisma Attributions, Jack Mcguire, Nicolas Bastardoz, Leonie J. Hentrup, David De Cremer, Jochen I. Menges

Research Collection Lee Kong Chian School Of Business

Charisma is often attributed to leaders based on how they look, talk, and behave. Yet very little is known about the role of the physical environment in influencing attributions of leader charisma. The role of the physical environment is crucial because leaders inevitably occupy physical spaces that vary across contexts. In this research, we find that the grandeur of the physical environment, specifically in its ability to induce awe, enhances attributions of charisma for leaders who are not already known to be charismatic. First, in a field experiment, we show that a real business leader is attributed with more charisma …

Factors Associated With Men’S Skincare Sales At Shopee Indonesia E-Commerce, Muhamad H. Effendi, Lalu E.H Mulyono

Pharmacology and Clinical Pharmacy Research

Men's skincare use is increasing, along with the awareness of its importance. Shopee, as one of the largest e-commerce platforms in Indonesia, has become the main place for purchasing men's skincare products. However, study on the factors influencing men's skincare sales at e-commerce is still limited. This research aims to identify the factors associated with men's skincare sales at Shopee Indonesia e-commerce. A cross-sectional study, utilizing data from the 100 best-selling men's skincare products on Shopee until September 2024, was conducted. The dependent variable is the number of men's skincare sales, and the independent variables are the number of reviews, …

Symbiotic International Law: Combatting Uyghur Forced Labor, Preston Jordan Lim

Utah Law Review

Since 2017, the Chinese government has launched a campaign of repression against the Muslim Turkic minorities of Xinjiang, a region located in China’s Northwest. While most scholars have focused on the mass internment of Uyghurs and other minorities, this Article highlights an under-discussed aspect of China’s campaign: the construction of a sophisticated forced labor system. Minority forced labor supplies key sectors of the global economy—from the automotive to the energy sectors—and allows Chinese companies to outcompete foreign firms. The unprecedented scope and sophistication of what I term the “modern Xinjiang forced labor system” imperils the very future of the international …

Planning For Scale: Analysis Of Adaptations And Contextual Factors Influencing Scale-Up Of The Quali-Dec Intervention To Optimize Caesarean Section Use, Soha El-Halabi, Claudia Hanson, Alexandre Dumont, Amanda Cleeve, Helle Mölsted Alvesson, Charles Kaboré, Guillermo Carroli, Pisake Lumbiganon, Quoc Nhu Hung Mac, Ana Pilar Betran

Centre of Excellence in Women and Child Health

Background: Researchers are encouraged to plan for scale through purposeful and guided assessment of scalability of an intervention. This study analysed factors potentially influencing scale-up and synthesised early adaptations of the QUALI-DEC intervention aiming to improve the appropriate use of caesarean section. The intervention consists of opinion leader engagement, audit and feedback for caesarean section, a tool to help women make an informed decision on the mode of birth, and labour companionship.

Methods: We conducted a framework analysis, which was guided by the scalability assessment framework by Zamboni et al., a 34-item checklist with a three-point scale. We used data …

Pregnancy Care Integrating Translational Science, Everywhere (Precise): A Prospective Cohort Study Of African Pregnant And Non-Pregnant Women To Investigate Placental Disorders – Cohort Profile, Rachel Craik, Joseph Akuze, Marie-Laure Volvert, Hannah Blencowe, Moses Mukhanya, Angela Koech, Grace Mwashigadi, Marleen Temmerman, Marvin Ochieng, Emily Mwadime

Centre of Excellence in Women and Child Health

Purpose: The Pregnancies' Care Integrating translational Science, Everywhere Network was established to investigate specific placental disorders (pregnancy hypertension, preterm birth, fetal growth restriction and stillbirth) in sub-Saharan Africa. We created a repository of clinical and social data with associated biological samples from pregnant and non-pregnant women. Alongside this, local infrastructure and expertise in the field of maternal and child health research were enhanced.

Participants: Pregnant women were recruited in participating health facilities in The Gambia, Kenya and Mozambique at their first antenatal visit or at the time a placental disorder was diagnosed (Kenya and The Gambia only). Follow-up study …

Sensor Data Fusion For Air Quality Monitoring, Mirna Hesham

Theses and Dissertations

Since traditional air quality monitoring methods often rely on geographically sparse and costly air quality monitoring stations, image-based air quality method- ologies are recently offering a compelling alternative that utilizes images from sources like satellites, traffic cameras, and even smartphones to monitor pollution levels by using estimation models, image-processing techniques, and deep-learning models. In this thesis, we first conduct a systematic review, in which we categorize and discuss the existing literature work. Moreover, we introduce a novel, multi- modal dataset designed to address the limitations of existing datasets, which are restricted in size, geographical coverage, and fixed-scene imagery, impeding the …

Incidence Of Metabolic Syndrome From Atypical Antipsychotic Therapy In Schizophrenia Patients, Indah K. Utami, Yasinta Rakanita, Dea A. Tompa, Niluh P. Dewi

Pharmacology and Clinical Pharmacy Research

Schizophrenia is a psychiatric disorder impacting behavior, emotions, and communication. Atypical antipsychotics are increasingly prescribed due to their significant reduction of both positive and negative symptoms and low risk of extrapyramidal side effects (EPS) in schizophrenia patients. However, long-term effects of atypicals may include weight gain, insulin resistance, and hyperglycemia. This study was conducted in Palu, Madani General Hospital, and Anutapura General Hospital. It used a prospective cross-sectional design with a sample of 40 outpatient participants who received monotherapy or combination therapy with clozapine, olanzapine, and risperidone for more than three months. Blood samples were collected to determine the presence …

Effect Of Yellow Root Ethanol Extract (Fibraurea Tinctoria Lour.) On Liver Histopathology Of Paracetamol-Induced Male Swiss Webster Mice, Astina Safari, Juwita Ramadhani, Muhammad Fauzi, Rizki R. Pratama

Pharmacology and Clinical Pharmacy Research

The public most commonly uses paracetamol, an analgesic antipyretic drug available over-the-counter without a doctor's prescription. The use of toxic doses can cause centrilobular necrosis, where paracetamol will form excessive N-acetyl-p-benzoquinone-imine (NAPQI), causing there to be insufficient glutathione to convert NAPQI into non-toxic compounds. The antioxidant activity of yellow root (Fibraurea tinctoria Lour.) can shield the liver from paracetamol-induced liver damage. This study aims to determine the hepatoprotective effect of an ethanol extract of yellow root (Fibraurea tinctoria Lour.) on the liver histopathology picture of mice (Mus muscular) induced by paracetamol. The study used 30 mice divided into six groups, …

Clarifying Parens Patriae, James G. Dwyer

Faculty Publications

Throughout the Anglo-American legal world, the state claims an authority, termed parens patriae, to exert control over the lives of nonautonomous persons in ways it does not presume to control autonomous persons. Philosophers have given little attention to when and how that authority should be exercised, yet there is disagreement or confusion about this among courts and legal scholars. This article examines how parens patriae differs from other government roles, identifies which conceptions of the parens patriae role are coherent, and then presents a normative case for adopting a conception of the role as that of fiduciary for nonautonomous …