Single Joint Posterior Chain Isometric Testing Using Force Plates: A Systematic Review Of The Methodologies And Reliability Of Testing Methods, Jack T. Fahey, Christopher Bramah, Richie Barber, James Williams, John J. Mcmahon, Paul Comfort, Nicholas J. Ripley

Research outputs 2022 to 2026

The posterior chain muscles (i.e. hamstring and gluteal) play an important role in performance and injury prevention. Posterior chain muscle injuries lead to time lost from training, competition and increased reinjury risk. Force plates enable valid and reliable assessment, current methods assessing isometric posterior chain (IPC) force production using force plates have yet to be reviewed. This review was designed to systematically review methods of single joint IPC force plate testing; establish existing reliability; and summarise descriptive data. A literature search was conducted using the following search terms: ‘force plat*’ AND ‘isometric’ AND (‘hamstring*’ OR ‘knee flex*’ OR ‘posterior chain’ …

Assessing The Academic Performance Of Medical Students In Face-To-Face And Online Examinations: A Comparative Study From A Leading Medical College Of Peshawar, Pakistan, Rizwan Faisal, Iftikhar Qayum, Lia Anwar, Usama Afridi, Abdul Rahman, Rehan Ahmad

Health Professions Education

Background: The world of medical education is rapidly replacing the traditional face-to-face assessments of students by switching to online systems, and Pakistan is also undergoing this transition in its medical colleges and universities. It is therefore essential to obtain data on the performance of medical students in this new mode of assessment so that a smooth transition is enabled. Objective: To evaluate the academic performance of medical students in face-to-face and online examinations based on gender and professional year. Methods: A comparative study was performed at Rehman Medical College, Peshawar, Pakistan, from November 2023 to January 2024, on face-to-face and …

Professional Identity Development Among Nursing Students: The Impact Of Structured Reflective Practice, Abdelmonim El Fadely, Kamal Takhdat, Charaf-Eddine Ahraiba, Rahma Bouali, Sabah Selmaoui, Boujemaa Agorram

Health Professions Education

Purpose This study aimed to assess the impact of a structured reflective practice intervention on the development of professional identity among nursing students. Method A mixed-methods design was adopted. The intervention, based on guided reflective practice, was implemented with a voluntary sample of 58 participants. The evaluation relied on a quasi-experimental quantitative approach using the Macleod Clark Professional Identity Scale, with a comparison group and both pre-test and post-test measurements. A qualitative component was also included to explore the dimensions of the studied concept in greater depth. Results Quantitative findings showed a statistically significant difference between the post-test means (p < 0.001), indicating that the reflective practice intervention had a positive effect on the experimental group compared to the control group. The qualitative results further illuminated students’ reflections, which were organized into ten themes corresponding to the study’s conceptual framework: professional knowledge and skills, values and ethics, the nursing role, leadership, professional self-image, social image of the profession, sense of belonging, identification with role models, theory–practice integration, and career choice. These dimensions provided a comprehensive and nuanced understanding of professional identity, capturing the complexity of the concept. Conclusion These results support the integration of reflective practice as a pedagogical approach to fostering the construction and development of a positive professional identity. Professional identity, as a rich and multidimensional concept, goes beyond the process of professionalization—it represents its ultimate achievement.

Undergraduate Research Experiences Toward Student Success: Challenges And Opportunities For Medical Science Students At A University Of Technology, Ziningi Nobuhle Jaya

Health Professions Education

Purpose: The study aimed to evaluate the research experiences of undergraduate medical science students at a university of technology to identify challenges and opportunities and determine the affordances of research participation for student success.

Method: The study population comprised all third-year medical science students (n=30) enrolled in the research methods module, which is the only such module offered as part of the medical science academic program. Participation was voluntary and so the final sample represents a self-selected subset of fourteen individual from the full cohort. The data collection tool comprised closed and open-ended questions evaluating challenges, lessons learned, skills developed, …

Students’ Views On Professionalism As A Window Into Their Professional Identity Formation, Jennifer H. Kwon, Charles F. Shuler, Judith Walker, Hsingchi Von Bergmann

Health Professions Education

Purpose: Professional identity formation (PIF) provides a process-based framework for understanding professionalism, focusing on how individuals integrate professional values and roles into their broader sense of self. Limited research has examined how dental students perceive professionalism and how these perceptions shape their developing professional identities. Understanding these perspectives may provide insight into their PIF journey and help inform the design of educational strategies to address their need.

Method: An online survey, consisting of both open-ended and close-ended questions, was emailed to undergraduate students in the Faculty of Dentistry at one Canadian university. Descriptive statistics were conducted using JASP (Version 0.16.1; …

Health Students’ Knowledge, Perceptions, And Willingness Toward Artificial Intelligence In Tackling Antimicrobial Resistance: A Cross-Sectional Study, Ikhwan Yuda Kusuma, Fauziah Fauziah, Afriza Pujiati, Dhiya Zulayta, Septi Nurkhasanah, Khamdiyah Indah Kurniasih

Health Professions Education

Background: Antimicrobial resistance (AMR) causes approximately 4.95 million deaths annually. Although artificial intelligence (AI) may enhance AMR detection, surveillance, and antimicrobial use, evidence remains limited regarding how health students’ knowledge, perception, and willingness influence AI adoption for AMR control.

Purpose: This study aimed to examine the direct and mediating relationships between health students’ knowledge, perception, and willingness toward AI-based approaches for combating antimicrobial resistance in Indonesia using structural equation modeling.

Methods: A cross-sectional study involving 4,369 health students across Indonesia was conducted using a validated questionnaire. Data on knowledge, perception, and willingness were analyzed using Structural Equation Modeling (SEM), SmartPLS, …

Development Of Colonic Polyposis In A Woman With Chronic Myeloid Leukemia Treated With Dasatinib, Guido Pelaez, Behram Suha Yildiz, Mert Candan, Mohammad Ismail, Francesca Vacca, Marianna B Ruzinova, Samuel Ballentine, Kathleen Byrnes, Armin Ghobadi

2020-Current year OA Pubs

INTRODUCTION: Chronic myeloid leukemia (CML) is a hematopoietic malignancy driven by constitutive tyrosine kinase activity. Dasatinib, a second-generation (2G) tyrosine kinase inhibitor (TKI), is a preferred treatment due to its superior, durable, and rapid response rates. While dasatinib has known gastrointestinal (GI) side effects, colonic polyposis is a rare complication, not well described in the literature.

CASE PRESENTATION: Upon routine colonoscopy, a 66-year-old woman with chronic-phase CML was incidentally discovered to have asymptomatic colonic polyposis after 11 months of dasatinib therapy. Histopathology revealed reactive inflammatory changes without evidence of dysplasia or neoplasia. The polyposis resolved completely after cessation of dasatinib. …

Criterion And Convergent Validity Of Plasma Biomarkers In Early-Onset Alzheimer's Disease: Initial Findings From Leads, Dustin B Hammers, Kyle Womack, Erik Musiek, Et Al.

2020-Current year OA Pubs

No abstract provided.

Embodying Policy Work: An Exploration Of Contexts, Actions And Meanings Towards New Possibilities For Physical Education Teacher Education (Pete), Victoria Evans, David Aldous, Dawn Penney

Research outputs 2022 to 2026

This theoretical paper presents a heuristic framework that is directed towards transformative thinking and practices in Physical Education Teacher Education (PETE). The research focus and direction, embodying policy work, applies and extends Bernstein’s concepts of the pedagogic and corporeal device to offer new directions for inquiry and explore the considerations these raise for PETE professionals and their practices. The paper affirms the importance of policy work in PETE, while recognising a need for more nuanced and critical understandings of the complex interrelationships between contexts and actions, and the potential meanings generated and ascribed to different forms of policy work and …

The Role Of Coursework In Promoting Doctoral Candidates’ Research Competence: A Case Study Of Professional Doctorates In Education, Fred Y. Mgata, Luqman Hakeem, Justo M. Lemesaya, Zhiyong Zhu, Huan Song, Jimmy E. Kihwele

Australian Journal of Teacher Education

Doctorate programs with coursework aim to develop research-competent graduates who can contribute knowledge and work outside academia. This study explored the influence of coursework on doctoral candidates' development of research competence. The study employed a qualitative case study approach within the Professional Doctorate in Education programs at a Chinese university. The researchers interviewed 13 doctoral candidates, reviewed 10 course syllabi, and conducted a thematic analysis of the data. The findings revealed that coursework contributes to candidates' knowledge base, research direction, skills, and critical thinking. Instructors and peers promote candidates' research competence through instruction, mentoring, collaborative research projects, and peer feedback. …

Perceptions Of Georgia Elementary School Administrators Toward Elementary Agricultural Education, Addie Tucker

Murray State Theses and Dissertations

Elementary agricultural education (EAE) is a growing component of K-12 agricultural education, yet limited research exists on how school leaders perceive its value. The purpose of this study was to explore the perceptions of Georgia elementary school administrators regarding the implementation and value of EAE programs. Specifically, this study examined elementary principals’ and district superintendents’ views on the benefits, effectiveness, and value of EAE. A descriptive research design was used. Georgia elementary principals and district superintendents with active EAE programs during the 2025-2026 academic year were surveyed in the fall of 2025. The sample consisted of 18 principals and 18 …

Identifying The Knowledge And Skills That Students Enrolled In Agricultural Systems Technology Degree Programs Need: Perspectives From University Faculty, Jerry Blake Kennedy

Murray State Theses and Dissertations

National trends have highlighted the need for a knowledgeable, skilled workforce in advanced agricultural systems. University-level Agricultural Systems Technology (AST) undergraduate degree programs and closely-related degree programs are vital to equipping the agricultural workforce with the knowledge and skills needed to support the industry. Ensuring that AST curricula are relevant and appropriate is vital to equipping undergraduate students in such programs with the knowledge and skills they need to succeed in the modern agricultural workforce. This study sought to identify the essential knowledge and skills needed by undergraduate AST degree program students from the perspectives of university-level faculty across the …

Beyond The Classroom: The Continuing Impact Of Brown V Board On Equitable Access To Career And Technical Education For Historically Underrepresented Students, Shannon Hood

Murray State Theses and Dissertations

Using a qualitative phenomenological design grounded in Critical Race Theory (CRT) and Culturally Relevant Pedagogy (CRP), this study examined how institutional structures, instructional practices, and community and industry partnerships shape equitable access, engagement, and outcomes in secondary Career and Technical Education (CTE) programs serving students from historically marginalized backgrounds. Semi-structured interviews were conducted with thirteen participants, including educators, administrators, and industry partners engaged in secondary CTE implementation. Thematic analysis identified recurring patterns related to leadership decision-making, instructional relevance, culturally responsive teaching practices, relational trust and advocacy, and authentic work-based learning (WBL) experiences. Findings indicate that equitable participation in CTE extends …

The Effect That Positive And Negative Self-Concepts Have On Adolescents' Behavior And Personalities, Portia L. Davis

Murray State Theses and Dissertations

Abstract

The development stage of adolescence is a complex process in which adolescents begin to explore their identity and form either a positive or negative self-concept. Self-concept plays a crucial role in shaping adolescents' personalities and behaviors. Self-concept includes how adolescents view themselves and how others see them. An adolescent's self-concept can influence their self-confidence, social relationships, and decision-making abilities. This study examines the relationship between overall self-concept and adolescents' personality traits and behaviors. To gather this information, a quantitative research design is used, in which adolescents complete assessments such as the Tennessee Self-Concept Scale (TSCS), the Woodcock-Johnson IV (WJ-IV), …

Exploring Pedagogical Content Knowledge Of Experienced Teachers In Agricultural Animal Reproduction: A Grounded Theory, Amanda Wooditch

Murray State Theses and Dissertations

Teaching agricultural animal reproduction requires a specialized integration of scientific content knowledge and instructional strategies, conceptualized as Pedagogical Content Knowledge (PCK). While PCK has been widely studied in other disciplines, research on its development and application in agricultural education has been limited. This qualitative study utilized grounded theory methodology to explore the PCK of experienced high school agriculture teachers in Georgia as they taught animal reproduction.

Twenty educators, each with a minimum of eight years of classroom experience, participated in the study through semi-structured interviews, lesson artifacts, and memos. Analysis, guided by Gess-Newsome’s (2015) Model of Teacher Professional Knowledge and …

Barriers To Mental Healthcare Among Men, Adrienne White

Murray State Theses and Dissertations

Men are consistently less likely than women to seek professional mental health services despite experiencing significant rates of depression and psychological distress. Traditional masculine norms and depression-related stigma have been proposed as major contributors to this disparity. The present study examined the relationships among depression stigma, conformity to masculine norms, depression severity, perceived barriers to care, and attitudes toward seeking professional mental health treatment among adult men with current or past depression. Seventy participants completed measures of depression severity (PHQ-9), conformity to masculine norms (CMNI-30), depression stigma (DSS), attitudes toward help seeking (MHSAS), and perceived barriers to care (BMHS). Contrary …

Understanding Climate Change And Wellbeing Through Bhutan's Pursuit Of Gross National Happiness, Tashi Dorji

Theses: Doctorates and Masters

Climate change has evolved into one of the biggest global challenges of the twenty first century reshaping ecological systems and social conditions with wide-ranging implications for human wellbeing. Bhutan offers a distinct context to explore interactions between climate change and wellbeing as it remains guided by its wellbeing-centred development philosophy of Gross National Happiness (GNH). At the same time, it remains highly vulnerable to climate change despite being the only carbon negative country in the world. Nonetheless, the intersections between climate change and GNH have not been systematically explored.

This research aims to explore the relationship between climate change and …

Promoting The Concept Healthy Ageing For Use In Gerontological Health And Social Care Policy And Practice, Claire Donnellan

Research outputs 2022 to 2026

Aims: The concept of healthy or successful ageing dates back to the 1960s, where its goal is more realistic in today's ageing society as a result of effective interventions to control and reduce disability and health risks. The aim of this paper is to outline the importance of defining ageing, the semantics and indicators used, and to identify common challenges for health professionals' understanding and application of a healthy ageing approach in their everyday clinical practice. Design and Methods: This discursive paper demonstrates how realistic ageing indicators are for highlighting the variation and impact of challenges associated with ageing. It …

Deconstructing Parenthood: A Critical Queer Analysis Of Gender, Law, And Bionormativity In India, Jwalika Balaji

National Law School of India Review

Parenthood (the legal connection to one’s child) is often assumed to be a biologically determined and natural status, but in reality, it is a legal and social construct shaped by historical, cultural, and political contexts. This paper critically examines the legal framework of parenthood in India, highlighting how it privileges a bionormative, dyadic, heterosexual parental unit, while marginalising LGBTQ+ individuals, unmarried couples, and alternative family structures. Through a critical queer method, the paper deconstructs the bio-essentialist juxtaposition of gender, conjugality, and reproduction that underpins Indian family law. It explores how the legal framework selectively acknowledges the constructed nature of parenthood …

Sglt2 Inhibitors In Cardio-Oncology: A Systematic Review And Meta-Analysis, Luigi Spadafora, Marco Bernardi, Gianmarco Sarto, Beatrice Simeone, Erica Rocco, Salvatore Carbone, Laura Adelaide Dalla Vecchia, Roberto Franco Enrico Pedretti, Valentina Valentine, Rachele Di Mario, Maurizio Forte, Giacomo Frati, Antonio Abbate, Michele Golino, Francesco Versaci, Mariangela Peruzzi, Pierre Sabouret, Giuseppe Biondi Zoccai, Sebastiano Sciarretta

EVMS School of Health Professions Faculty Publications

Background

According to available evidence, sodium-glucose cotransporter-2 inhibitors (SGLT2i) may confer cardioprotection in patients with cancer undergoing chemotherapy.

Objectives

The objective of the study was to evaluate the impact of SGLT2i on all-cause mortality and heart failure (HF) outcomes in this population.

Methods

We searched PubMed, Cochrane CENTRAL, and Embase through August 2025 for studies of SGLT2i in adult patients with cancer. Random-effects models were used to pool effects for all-cause mortality and an HF composite (new-onset HF and/or HF hospitalization) in cancer patients >18 years. Meta-regression tested effect modification by beta-blockers, statins, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, age, and …

Turnover Time In Neuroangiography Suites: Comparison Between Cases Performed At An Ambulatory Neurosurgery Center Versus A Tertiary Hospital, Pui Man Rosalind Lai, Vinay Jaikumar, Erika L. Leasher, Varun Sridhar, Gustavo M. Cortez, Aimee C. Degaetano, Elad I. Levy

EVMS School of Health Professions Faculty Publications

Background:

Efficient turnover time (TOT) and adherence to first-start time (FST) in operating and angiography suites are critical for optimizing workflow, reducing costs, and maximizing patient satisfaction. Hospitals face challenges in maintaining these metrics due to operational constraints and unexpected emergent cases. Our goal was to compare TOT, FST, and total admission time for elective cases performed in angiography suites at an ambulatory neurosurgery center (ANSC) versus a tertiary hospital (TH).

Methods:

We conducted a retrospective analysis of data for patients who underwent elective diagnostic or interventional neuroendovascular procedures at the TH or ANSC from January 2024 through October 2024. …

Implementation And Clinical Utility Of Ultra-Low-Field Portable Magnetic Resonance Imaging For Postprocedural Neurological Evaluation In Ambulatory Neurosurgery: Illustrative Cases, Devan Patel, Vinay Jaikumar, Taysia P. T. Morioka, Laz Rifkin, Kenneth S. Jacoby, Jaims Lim, Anais Andrade, Aimee C. Degaetano, Pui Man Rosalind Lai, Elad I. Levy

EVMS School of Health Professions Faculty Publications

BACKGROUND

Elective endovascular neurosurgical procedures are increasingly performed in ambulatory neurosurgery centers, enabled by advances in catheter technology, safety of conscious sedation, and refined patient selection. Although complication rates are low, rapid evaluation of postprocedural neurological deficits remains critical. Conventional MRI is often impractical in outpatient or procedural settings, whereas ultra-low-field portable MRI (ULF-pMRI) systems (such as Swoop) allow bedside imaging with favorable diagnostic performance.

OBSERVATIONS

Two women in their 60s developed acute neurological deficits at an ambulatory neurosurgery center (ANSC) after diagnostic cerebral angiography in one case and elective internal carotid artery flow diversion in the other. In both …

Mechanism-Driven Therapy For Diabetic Cardiovascular Disease, Fabian Sanchis-Gomar, Carl J. Lavie, Salvatore Carbone, Ian J. Neeland

EVMS School of Health Professions Faculty Publications

[Introduction] Diabetic cardiovascular disease is a network disorder, not a glucose-only complication

Diabetes accelerates cardiovascular (CV) target-organ damage through multiple interacting biological modules that amplify risk even when glycemia is modestly controlled^[1]. These modules include (i) adipose tissue dysfunction with altered adipokine secretion and immune-cell infiltration; (ii) ectopic lipid deposition in liver, myocardium, and perivascular/epicardial fat (iii) endothelial dysfunction with impaired nitric oxide bioavailability and heightened oxidative stress (iv) chronic kidney disease (CKD)-mediated volume, pressure, and uremic-toxin stress, and (v) autonomic and neurohormonal activation that promotes hypertension, arrhythmias, and remodeling^[1]. The clinical spectrum includes macrovascular disease …

Large Language Models For Neurology: A Mini Review, Donald C. Wunsch, Daniel B. Hier

Electrical and Computer Engineering Faculty Research & Creative Works

Large language models have the potential to transform neurology by augmenting diagnostic reasoning, streamlining documentation, and improving workflow efficiency. This Mini Review surveys emerging applications of large language models in Alzheimer's disease, Parkinson's disease, multiple sclerosis, and epilepsy, with emphasis on ambient documentation, multimodal data integration, and clinical decision support. Key barriers to adoption include bias, privacy, reliability, and regulatory alignment. Looking ahead, neurology-focused language models may develop greater fluency in biomedical ontologies and FHIR standards, improving data interoperability and supporting more seamless collaboration between clinicians and AI systems. Two future developments have the potential to be particularly impactful: (1) …

Performance Analysis And Optimization Of Fructose Memristor-Based Neuromorphic Systems, Harshvardhan Uppaluru, Shakil Mahmud Jiban, Shah Zayed Riam, Feng Zhao, Jinhui Wang

Electrical and Computer Engineering Faculty Research & Creative Works

Natural organic memristors have demonstrated promising synaptic behavior, positioning them as strong candidates for synaptic devices in neuromorphic systems. This paper presents the fabrication and evaluation of a neuromorphic system based on natural organic 16-level and 32-level fructose memristors. First, the manufacturing process of fructose memristors is described in detail. Second, the nonlinear property associated with fructose memristors is investigated, and an optimization method is applied to address the nonlinear effects. The performance of the fructose memristor-based neuromorphic system on MNIST with a multi-layer perceptron and on CIFAR-10 with VGG-8 is evaluated and reported under various conditions -with/without nonlinearity optimization …

New Metrics For Disambiguating Feature Overlap And Catastrophic Forgetting In Incremental Learning Contexts, Niklas M. Melton, Leonardo Enzo Brito Da Silva, Donald C. Wunsch

Electrical and Computer Engineering Faculty Research & Creative Works

Catastrophic forgetting remains a central challenge in lifelong learning, where newly acquired knowledge interferes with previously learned tasks, degrading performance over time. Mitigation strategies such as rehearsal and regularization have been proposed, but both introduce limitations, either by retaining old data or by constraining model updates in ways that may impair learning. Complicating matters, recent findings show that feature-space overlap between tasks can produce similar performance drops even in models that memorize data, making it difficult to distinguish true forgetting from representational interference. Current accuracy-based metrics fail to disentangle these effects, undermining diagnostic clarity. In this work, we introduce the …

Honey-Cnt Memristive Artificial Synaptic Device For Sustainable Neuromorphic Computing System, Md Mehedi Hasan Tanim, Zoe Templin, Harshvardhan Uppaluru, Jinhui Wang, Kuan Yew Cheong, Feng Zhao

Electrical and Computer Engineering Faculty Research & Creative Works

Brain-inspired neuromorphic computing systems require hardware components analogous to biological neurons and synapses. Honey based natural organic memristor has demonstrated promising nonvolatile memristive behaviors, with the advantages of sustainability, environmentally friendliness, and low-cost manufacturing. In this study, carbon nanotubes (CNTs) are added in honey to fabricate honey-CNT memristive artificial synaptic devices. Honey-CNT film is characterized by micro-Raman spectroscopy and the distribution of CNT bundles embedded in the honey-CNT composite layer by cross-sectional scanning electron microscopy for the first time. Critical synaptic functions of the honey-CNT memristor, including spike-rate-dependent plasticity, spike voltage dependent plasticity, learn-forget-relearn, and supralinear spatial summation are revealed, …

Enhancing Explainable Ai For Medical Imaging: Improved Lime Interpretation With Influence Mapping, Abiha Tahsin Chowdhury, Dhanush Bavisetti, Daniel B. Hier, Rahul Dubey, Tayo Obafemi-Ajayi

Electrical and Computer Engineering Faculty Research & Creative Works

The integration of artificial intelligence (AI) into medical imaging is progressing rapidly. It is essential for these AI tools to be transparent, interpretable, and explainable to gain the trust of clinicians and regulators. Current state-of-the-art explainable AI (XAI) techniques in imaging includes Local Interpretable Model-Agnostic Explanations (LIME), Shapley Additive Explanations (SHAP), and Gradient-weighted Class Activation Mapping (Grad-CAM). Recent studies have shown that LIME often suffers from inconsistency and unreliability which limits their utility in sensitive fields like medical imaging. This paper proposes Influence Map based Explanation (IME), an enhanced variant of the original LIME framework, that aggregates multiple runs to …

Lessons Learned In Teaching Electrochemistry, Alanah Fitch, Ingrid Fritsch, Carol Korzeniewski, Shelley D. Minteer, Johna Leddy

Chemistry Faculty Research & Creative Works

Students frequently encounter difficulties in learning the vast landscape of electrochemistry. Here are shared examples of methods to demystify electrochemistry based on the extensive experience of the authors. Topics include a perspective on the shape of a voltammogram viewed as Ohm's Law, an extrapolation to electrochemical impedance spectroscopy (EIS), potential axes to identify spontaneous reactions, and select examples from organic and biological electrochemistry. Explained is the rationale behind certain Go To molecules used in electrochemical experiments such as ferrocene, ferricyanide, and other inorganic and organic electroactive molecules. Finally, more than sigmoidal curves are needed to confirm electrocatalysis. The domain of …

Entendre L’Inouï: Resonance, Volume, And Transduction In Gilbert Gatore’S Le Passé Devant Soi, Rebecca Saunders

Faculty Publications – English

This paper analyses three features of sound – resonance, volume, and transduction – in Gilbert Gatore’s novel of memory and the Rwandan genocide, Le passé devant soi [The Past Before Us]. Theorising two modes of resonance in Gatore’s novel – thematic and semiotic – I demonstrate how the novel is structured by semantic forms of resonance, how those resonances incite significance, and how they are augmented by a semiotic resonance that produces “vibratory meanings”. I subsequently examine the novel’s depiction of shatteringly loud volume, its ability to obliterate thought, and to cause physical harm. Elaborating reasons why the …