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The Effect Of Parental Behavior On The Ontogeny Of The Immune System In The Eastern Bluebird (Sialia Sialis), Wyatt Boehm, William Kirkpatrick, Sarah E. Durant Jan 2025

The Effect Of Parental Behavior On The Ontogeny Of The Immune System In The Eastern Bluebird (Sialia Sialis), Wyatt Boehm, William Kirkpatrick, Sarah E. Durant

2025 Research Poster Competition

Previous research has explored the trade-offs between growth and immune endpoints in offspring since early development is critical in shaping adult responses to disease. However, an unexplored aspect of immune development is the influence of parental behavior on immune outcomes. I observed parental behavior during early development and its influence on offspring immune condition. To analyze parental behavior during incubation in the Eastern Bluebird, I quantified incubation constancy (percentage of time spent on the nest) and its impact on white blood cell ratios throughout development. Incubation constancy is useful in defining general trends in adult incubation behavior. Here, I have …


Nests With Higher Thermal Variation Produce Fewer Fledglings With Larger Bills Than Higher Temperature Nests, Salvador Barraza-Del Barco, William Kirckpatrick, Sarah Heissenberger, Sarah Durant Jan 2025

Nests With Higher Thermal Variation Produce Fewer Fledglings With Larger Bills Than Higher Temperature Nests, Salvador Barraza-Del Barco, William Kirckpatrick, Sarah Heissenberger, Sarah Durant

2025 Research Poster Competition

Warmer temperatures and increased temperature variability are predicted in the future due to climate change. Phenotypic outcomes of avian nestlings are heavily impacted by nest temperature. We examined metabolic rates and growth of Eastern Bluebird nestlings subjected to increased mean temperature and increased temperature variability within the nest during development.


Effect Of Vibration Isolation During Transportation On Beef Sirloin Subprimal And Steak Quality, Kylie Nevada Krueger Jan 2025

Effect Of Vibration Isolation During Transportation On Beef Sirloin Subprimal And Steak Quality, Kylie Nevada Krueger

Electronic Theses and Dissertations

The objective of this study was to determine the influence of vibration during transportation on beef sirloin water holding capacity, color, and tenderness. USDA Choice center-cut sirloin top butts (n = 45 cases) were collected at a commercial processing facility and randomly allocated to one of three treatments 1) regular pallet driven 241 km (Reg241), 2) regular pallet driven 644 km (Reg644), and 3) vibration isolation pallet driven 644 km (Iso644). All subprimals were transported at -2.2 °C (d0) and stored for 10 days to mimic industry practices for product aging. Following storage (d11), one subprimal per case was evaluated …


Polarimetric Capture And Differentiable Rendering, Katherine Anne Salesin Jan 2025

Polarimetric Capture And Differentiable Rendering, Katherine Anne Salesin

Dartmouth College Ph.D Dissertations

Many scientific fields rely on the capture and modeling of light to extract underlying information about the world. Often, more information can be extracted by capturing more about the nature of the light, such as its spectral shape or polarization state. While polarization is a relatively unexplored topic in computer graphics, when used in tandem with other recent advancements in the field it has enormous potential to improve both forward and inverse models in other scientific disciplines. We demonstrate this potential in two distinct settings in this thesis.

First, we apply the capture of polarized light to an inverse problem …


Sentence Determination As A Function Of Sex Offender Gender, Kyle Gamache, Matt Zaitchik, Judith Platania, Willem Pontbriand Jan 2025

Sentence Determination As A Function Of Sex Offender Gender, Kyle Gamache, Matt Zaitchik, Judith Platania, Willem Pontbriand

Arts & Sciences Faculty Publications

The current study examines perceptions of dangerousness and sentencing recommendations for female sex offenders (FSOs) compared to male sex offenders (MSOs). Participants (N = 82) were randomly assigned to read one of three vignettes depicting a sexual offense committed by a male, female, or male-female co defendant pair. Key individual difference variables—Need for Cognition (NFC) and Gender Role Beliefs (GRB)—were assessed to examine their influence on sentencing and attributional judgments. NFC emerged as a significant moderator: participants with low NFC assigned longer sentences to FSOs, whereas high NFC participants gave longer sentences to MSOs. Participants endorsing traditional gender role beliefs …


Diversifying Ecology Education For Everyone Through More Inclusive, Interdisciplinary, And Accessible Teaching, Loren B. Byrne, Emily S. J. Rauschert, Vikki L. Rodgers, Gillian Bowser, Et Al. Jan 2025

Diversifying Ecology Education For Everyone Through More Inclusive, Interdisciplinary, And Accessible Teaching, Loren B. Byrne, Emily S. J. Rauschert, Vikki L. Rodgers, Gillian Bowser, Et Al.

Arts & Sciences Faculty Publications

Educating more students about ecology and its beneficial applications to societal issues is urgent yet challenging. To address this challenge, diversifying ecology education is a key way to make ecology more inclusive, accessible, and interdisciplinary for more people than ever. Advancing this goal requires ecology educators to develop a more expansive view of (1) how to engage more diverse undergraduate students in ecology courses, especially those from historically underrepresented groups and non-majors, (2) the interdisciplinarity of content in those courses, and (3) the learner-centered pedagogies used to engage students. We suggest ways that ecologists can advance “ecology education for everyone” …


Rightly Dividing Jus Ad Bellum And Jus In Bello In The Israel/Hamas War, Jeffrey F. Addicott Jan 2025

Rightly Dividing Jus Ad Bellum And Jus In Bello In The Israel/Hamas War, Jeffrey F. Addicott

Faculty Articles

The purpose of this paper is to: (1) review the applicable rule of law as it relates to both the initiation of warfare and the use of armed force in the execution of that warfare; and (2) apply those legal standards to the facts associated with the Israel/Hamas conflict. While this may seem an easy task – to set out unanimity in the international community – it is not. The inability to set bright lines of distinction between aggressors and those acting in self-defense is not just a failure in definition or even understanding, it is a failure to legitimize …


The Research Examining Factors Associated With The Opioid Crisis Among Urban Adults (Refocus), Mona K.M. Goggins, Paige Orphé, Jovonna Atkinson, Brittany Miller-Roenigk, Kaylee A. Palomino, Danelle Stevens-Watkins Jan 2025

The Research Examining Factors Associated With The Opioid Crisis Among Urban Adults (Refocus), Mona K.M. Goggins, Paige Orphé, Jovonna Atkinson, Brittany Miller-Roenigk, Kaylee A. Palomino, Danelle Stevens-Watkins

Educational, School, and Counseling Psychology Faculty Publications

Introduction: Deaths due to opioid-related overdoses have increased across the United States. Specifically in the state of Kentucky, African Americans are the only population that continues to experience an increase in opioid-related deaths. Previous literature highlights African Americans having unique drug use patterns due to systematic barriers and how these barriers limit access to protective factors and substance use treatment. The current study aims to specify patterns of African American non-medical prescription opioid use (NMPOU) and how these patterns may differ based on biological sex and generational cohort. Also, this study plans on using this data on patterns to inform …


Commencement Program, 2025, Cuny John Jay College Of Criminal Justice Jan 2025

Commencement Program, 2025, Cuny John Jay College Of Criminal Justice

Reports and Publications from John Jay College

Commencement Programs are handed out at each graduation. They include information on honorary degrees, awards and prizes and candidates for degree. However, they cannot be considered an official record of conferring of degrees.


Impact Of Substrates And Deposition Time On Bacteria Associated With Saliva Samples And Its Implication On A Bacterial Signature-Based Body Fluid Identification Method, Olisdey Galano Cruz Jan 2025

Impact Of Substrates And Deposition Time On Bacteria Associated With Saliva Samples And Its Implication On A Bacterial Signature-Based Body Fluid Identification Method, Olisdey Galano Cruz

Master of Science in Forensic Science Directed Research Projects

Traditional serological methods for body fluid detection are limited by poor specificity and sensitivity, lacking confirmatory capability and thereby increasing the risk of false positives that may compromise the integrity of forensic investigations. While molecular methods such as mRNA, miRNA, and DNA methylation offer improved specificity, they are often hindered by marker instability and operational complexity in routine forensic workflows. Bacterial signature profiling has emerged as a promising alternative, offering enhanced stability, abundance, and compatibility with existing DNA workflows. However, its forensic implementation requires further validation. This study evaluated the effects of substrate type and storage time on the salivary …


Qualitative Method Validation Of Acid/Neutral Drugs Carisoprodol, Meprobamate, And Naproxen Using Liquid Chromatography-Tandem Mass Spectrometry, Kate O. Martin Jan 2025

Qualitative Method Validation Of Acid/Neutral Drugs Carisoprodol, Meprobamate, And Naproxen Using Liquid Chromatography-Tandem Mass Spectrometry, Kate O. Martin

Master of Science in Forensic Science Directed Research Projects

Meprobamate, carisoprodol, and naproxen are acidic/neutral drugs widely prescribed for muscle relaxation and inflammatory conditions, with frequent detection in forensic toxicology casework due to extensive clinical use. A method to qualitatively evaluate these compounds was developed to unify acid/neutral drug screening. This study incorporated blank blood, antemortem blood, postmortem blood, urine, and liver homogenate as representative biological matrices. Method validation was conducted in accordance with ANSI/ASB Standard 036 for Forensic Toxicology, encompassing key parameters including limit of detection (LOD), endogenous interferences, potential interferences, carryover, processed sample stability, and ionization suppression/enhancement. The validation was performed using the internal standards carisoprodol-D7, meprobamate-D7, …


Novel Time-Since-Deposition Signatures For Canine Blood; Implications For Animal Cruelty Investigations, Alysia M. Townsley Jan 2025

Novel Time-Since-Deposition Signatures For Canine Blood; Implications For Animal Cruelty Investigations, Alysia M. Townsley

Master of Science in Forensic Science Directed Research Projects

Dogfighting is a felony in all 50 states and is often tied to other organized crime activities including gambling, narcotics, and weapons trafficking. Because of the clandestine nature of dogfighting crimes, it may be necessary to determine the age of blood samples from suspected events, not just the source. In this study, flow cytometry was used to identify cellular autofluorescence signatures for estimating TSD (time-since-deposition) in canine blood deposits up to 6 months old. To accomplish this, blood was taken from canines of various chronological ages and breeds, then deposited to create TSD samples ranging between 1 day and 180 …


Development Of Novel Signatures For Determination Of Cell Types In Blood And Saliva Mixtures, Caitlin Lydon Jan 2025

Development Of Novel Signatures For Determination Of Cell Types In Blood And Saliva Mixtures, Caitlin Lydon

Master of Science in Forensic Science Directed Research Projects

Determination of tissue source and the time at which a biological material is transferred from its source to another surface, known as the time-since-deposition (TSD), would assist forensic analysts by providing crucial context for DNA profiles generated from biological evidence. Many methods for cell identification have been explored using biomolecule markers such as mRNA, miRNA, and differential DNA methylation. Forensic laboratories have also developed methods for TSD estimation that focus on degradation of biomolecules. Biomolecules such as mRNA or miRNA degrade at different rates due to some being more stable than others. The ratio of stable degrading biomolecules, therefore, can …


History In The Making (Volume 18), Csusb - Alpha Delta Nu Chapter Of The Phi Alpha Theta National History Honor Society Jan 2025

History In The Making (Volume 18), Csusb - Alpha Delta Nu Chapter Of The Phi Alpha Theta National History Honor Society

History in the Making

No abstract provided.


Who Grows There? Rethinking Forest Types Beyond Biomass And Composition In Coastal Ecuador, Evelyn Kent Jan 2025

Who Grows There? Rethinking Forest Types Beyond Biomass And Composition In Coastal Ecuador, Evelyn Kent

Geography Honors Projects

Tropical Dry Forests (TDFs) are among the world’s most threatened ecosystems. Many are biodiversity hotspots, and most are fragmented and vulnerable to deforestation, wildfires and climate change. TDFs also receive less conservation attention compared to other tropical forest types. To provide critical baseline information for their conservation, this research defines and quantifies the extent of different forest types and their respective aboveground biomass (AGB) in a fragmented TDF landscape in Manabí, Ecuador. Focusing on two forest reserves and their adjacent areas, we used tree plot inventories (N=16) and community composition analyses to define forest types based on tree community composition. …


Master Of Social Work Portfolio: Rooted In Community, Whitney Wb Pratt Jan 2025

Master Of Social Work Portfolio: Rooted In Community, Whitney Wb Pratt

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.


Exploring The Stem Career Identity Development Of Black Women Across Their Lifespan, Veronica Hurd Jan 2025

Exploring The Stem Career Identity Development Of Black Women Across Their Lifespan, Veronica Hurd

Theses and Dissertations

Although STEM is the fastest-growing career sector, Black women are grossly underrepresented as they account for 2.5% of the workforce. Research highlights that this underrepresentation is due to racialized structures in K-12, postsecondary, and career settings that restrict Black girls’ and women’s STEM opportunities. While macrosystems such as hegemonic ideologies, attitudes, and social conditions shape Black girls’ and women’s opportunities in STEM, they continue to persist and achieve their career goals. To explore these barriers and Black women’s persistence in this industry, this study draws from the autobiographical memories of 10 Black women in the field or formerly in the …


Expanding The Performance And Functionality Of Air-Jet Dry Powder Inhalers Across Multiple Applications, Ghali H. Aladwani Jan 2025

Expanding The Performance And Functionality Of Air-Jet Dry Powder Inhalers Across Multiple Applications, Ghali H. Aladwani

Theses and Dissertations

This dissertation aims to expand the performance and functionality of air-jet dry powder inhaler (DPI) applications through the development of a next-generation, mesh-nebulizer-based, and scalable spray dryer for the production of pharmaceutical aerosols, along with new spray-dried formulation production methods, novel formulations, and new air-jet DPI components for aerosol delivery to both infants and adults. The first aim focused on the development of a custom small-particle spray drying system capable of integrating vibrating mesh nebulizer technologies in various configurations for the production of excipient enhanced growth (EEG) formulations. This flexible system enabled efficient production of both small- and large-particle powders …


The Ecoformative And Transformative Issues Of Nature In The Schoolyard: An Exploration Of The Relationship Between Everyday Experiences Of Nature And Well-Being At School, Alix Cosquer, Olivier Gimenez, Arnaud Gregoire, Vincent Girard, Thierry Noell, Tatiana Wasella Jan 2025

The Ecoformative And Transformative Issues Of Nature In The Schoolyard: An Exploration Of The Relationship Between Everyday Experiences Of Nature And Well-Being At School, Alix Cosquer, Olivier Gimenez, Arnaud Gregoire, Vincent Girard, Thierry Noell, Tatiana Wasella

Cities and the Environment (CATE)

In urban areas, the implementation of schoolyard facilities (especially through the greening of these spaces) aims to promote children's contact with nature to improve well-being and increase their awareness of environmental preservation. In this study, we use the prospect of schoolyard landscaping in two French schools to conduct research on pupils’ relationship with nature and well-being at school. We explore cognitive and social mechanisms that affect children's perceptions and behaviour in their relationships with nature on a daily basis and in the school context, with a view toward implementing schoolyard designs.

The research aims are (i) to gain a better …


Examining The Biotic And Abiotic Degradation Of Simple Phenols, Madeline Gruenberg Jan 2025

Examining The Biotic And Abiotic Degradation Of Simple Phenols, Madeline Gruenberg

Browse all Theses and Dissertations

Plant secondary metabolites are a diverse class of compounds that encompass small phenols to large polymeric structures such as tannins. Smaller compounds such as phenolic acids can serve as substrates for soil microbes and enzymes. We monitored the degradation of three small phenols pyrogallol, gallic acid, and benzoic acid in biotic and abiotic conditions. They were chosen to observe the impacts of specific functional groups on both degradation processes and act as model compounds to mimic larger tannin reactivity. Both abiotic and biotic degradation of pyrogallol resulted in the formation of a stable quinone, while abiotic degradation of gallic acid …


The Circadian Modulating Drug Sr8278 Slows Cell Proliferation Independent Of Rev-Erbs, Ushaswini Atluri Jan 2025

The Circadian Modulating Drug Sr8278 Slows Cell Proliferation Independent Of Rev-Erbs, Ushaswini Atluri

Browse all Theses and Dissertations

The small molecule compound SR8278 was initially identified as an antagonist of the REV-ERB proteins, which play an important role in regulating circadian rhythms. Furthermore, the use of SR8278 in preclinical models has been demonstrated to ameliorate a variety of different pathologies. Using RNA-seq analysis of HaCaT keratinocytes treated with SR8278, our laboratory found that SR8278 induces a down regulation of genes involved in the G1/S phase transition of the cell cycle and an up regulation of genes involved in cholesterol biosynthesis. RT-qPCR and western blot analyses confirmed that SR8278 treatment led to lower expression of several factors involved in …


The Role Of Rad51 And Its Paralogs In Dna Damage Response In Quiescent Cells Exposed To Solar Simulating Uv Radiation, Angitha Radhakrishnan Nair Jan 2025

The Role Of Rad51 And Its Paralogs In Dna Damage Response In Quiescent Cells Exposed To Solar Simulating Uv Radiation, Angitha Radhakrishnan Nair

Browse all Theses and Dissertations

Rad51, and its five paralog proteins Rad51B, Rad51C, Rad51D, XRCC2, and XRCC3, are crucial in homologous recombination (HR) repair of DNA double-strand breaks. Prior studies have extensively shown the roles of Rad51 in the S/G2 phase, but its role in the G0/G1 phase is still unclear. Our lab focuses on studying the role of Rad51 and its paralogs in quiescent cells. RT-qPCR and western blots helped us understand the expression of Rad51 paralogs in proliferating and quiescent keratinocyte cells. Using a pharmacological inhibitor of Rad51, we found that Rad51 promotes quiescent cell survival after exposure to UV radiation. Like Rad51, …


Determinants Of Bat Activity And Habitat-Use At Runkle Woods And Huffman Metropark, Ohio, Heidi E. Orloff Jan 2025

Determinants Of Bat Activity And Habitat-Use At Runkle Woods And Huffman Metropark, Ohio, Heidi E. Orloff

Browse all Theses and Dissertations

North American bats are an excellent control of pests as most are insectivorous feeders. They face numerous threats including habitat loss, anthropogenic development, disease (White-nose Syndrome), and potentially artificial light at night (ALAN). It is important to track species populations and habitat-use to determine the magnitude of effects from these threats. Acoustic monitoring has proven a useful and non-invasive method for tracking bat populations. In my research, I conducted stationary acoustic surveys of bat activity at Wright State University’s Runkle Woods and nearby Huffman MetroPark during the summers of 2023 and 2024. I recorded bat calls in three different habitats …


Burning Up And Burned Out: Examining Burnout In Human Services Employees, Chloe A. Bell Jan 2025

Burning Up And Burned Out: Examining Burnout In Human Services Employees, Chloe A. Bell

Browse all Theses and Dissertations

Burnout is a prevalent and critical condition experienced among human services employees. This study examined the roles of gender, parental status, and perceived organizational support (POS) as moderating factors in the relationship between stress and burnout in human services employees. A sample of full-time human services employees (N = 303) completed a survey containing assessments measuring burnout, stress, POS, and neuroticism. The results of this study indicated that POS significantly moderated the stressburnout relationship, such that greater reported levels of POS weakened the relationship between stress and burnout. However, neither gender nor parental status was found to significantly moderate the …


Comparative Impact Of Canagliflozin Versus Pioglitazone On Biomarkers Of Diabetic Kidney Disease In Db/Db Mice, Siri Chandana Minikuri Jan 2025

Comparative Impact Of Canagliflozin Versus Pioglitazone On Biomarkers Of Diabetic Kidney Disease In Db/Db Mice, Siri Chandana Minikuri

Browse all Theses and Dissertations

Diabetes mellitus is a leading cause of chronic kidney disease (CKD), primarily through dysregulation of the renin-angiotensin system (RAS), characterized by elevated Ang II which promotes vasoconstriction, oxidative stress, and renal fibrosis, along with increased urinary shedding of angiotensin converting enzyme 2 (ACE2), which can exacerbate the imbalance of RAS and tubular injury. Previous studies demonstrated that rosiglitazone, a PPAR-γ agonist, attenuated hyperglycemia, glycosuria, albuminuria, and decreased urinary ACE2 shedding in db/db mice, suggesting a RAS-mediated renoprotective mechanism. Building on this evidence, the current study compared the renal effects of pioglitazone (a PPAR-γ agonist) and canagliflozin (an SGLT2 inhibitor) in …


The Role Of Fbxl16 In Regulating Erk3 Stability And Cell Migration, Seth Charles Murdock Jan 2025

The Role Of Fbxl16 In Regulating Erk3 Stability And Cell Migration, Seth Charles Murdock

Browse all Theses and Dissertations

Extracellular signal-regulated kinase 3 (ERK3) is a member of the atypical mitogen-activated protein kinase (MAPK) family. While ERK3’s role in promoting cell migration and invasion in multiple types of cancer has been well-documented, its activation and regulation remain poorly understood. Unlike other typical MAPK proteins, whose activation is regulated via the phosphorylation of an upstream kinase, ERK3 is regulated through its abundance, as it is constitutively phosphorylated when present in the cell. While USP20 has been established as a deubiquitinating protein that stabilizes ERK3 by preventing its degradation, both TRIM21 and FBXW7 have been identified as E3 ligases that target …


The Role Of Base Excision Repair In Dna Damage Responses In Human Keratinocytes Exposed To Solar Simulating Uv Radiation, Mobolaji Eniola Alabi Jan 2025

The Role Of Base Excision Repair In Dna Damage Responses In Human Keratinocytes Exposed To Solar Simulating Uv Radiation, Mobolaji Eniola Alabi

Browse all Theses and Dissertations

Ultraviolet (UV) radiation from the sun is the most prominent source of exogenous UV damage to DNA. UV directly causes damage by forming UV photoproducts, including pyrimidine-pyrimidone (6-4) photoproducts ((6-4) PPs), which significantly distort the helical structure of DNA and interfere with transcription and replication processes. The only known repair process of these photoproducts in human cells is nucleotide excision repair (NER). However, a recent study reported an APE1-dependent base excision repair (BER) of a subset of UV photoproducts. The study showed that deletion or inhibition of APE1, PARP1, NTH1, XRCC1, and FEN1 led to a 2-fold increase in sensitivity …


Characterization Of Atr Kinase Function In Quiescent Keratinocytes Exposed To Solar Simulating Uv Radiation, Mohamed Sameer Cholakkathody Jan 2025

Characterization Of Atr Kinase Function In Quiescent Keratinocytes Exposed To Solar Simulating Uv Radiation, Mohamed Sameer Cholakkathody

Browse all Theses and Dissertations

This study examines the role of Ataxia Telangiectasia and Rad3-related kinase in quiescent human keratinocytes exposed to solar-simulated UV radiation (SSL). The ATR inhibitor VE-822 did not significantly affect cell viability in the absence of UV exposure, showing that ATR kinase activity is not essential for quiescent cell survival in the absence of additional genotoxic stress. After SSL exposure, ATR inhibition did not impact acute cell viability but reduced the cells’ long-term ability to proliferate. Western blot analysis demonstrated that VE-822 potently suppressed phosphorylation of ATR target proteins KAP1 and CHK2 in a dose-dependent manner after SSL exposure, confirming strong …


Impacts Of Salinity And Drought On Growth And Carbon Sequestration In Acorus Americanus And Carex Scoparia, Eleora L. Mantle Jan 2025

Impacts Of Salinity And Drought On Growth And Carbon Sequestration In Acorus Americanus And Carex Scoparia, Eleora L. Mantle

Browse all Theses and Dissertations

From the late 18th century until the 1980s, Ohio lost close to 90% of its wetlands. Despite increased efforts to maintain what is left, many freshwater marshes are still being degraded due to pollutants, such as road salt, and the impacts of climate change. This study sought to understand how both road salt and drought could impact the health and carbon sequestration of two wetland species, Acorus americana and Carex scoparia, to better understand tolerance. To do this, both species were separated into groups and subjected to varying salt concentrations and drought conditions. After 9 weeks of treatment, plants were …


Patient Subset Classification Using Encoded Embeddings And Knowledge Graph Retrieval-Augmented Generation, Benjamin A. Holmes Jan 2025

Patient Subset Classification Using Encoded Embeddings And Knowledge Graph Retrieval-Augmented Generation, Benjamin A. Holmes

Browse all Theses and Dissertations

The widespread adoption of electronic medical records has created a vast reservoir of clinical data that can be leveraged to better understand how interventions relate to patient outcomes. Much of this information, however, exists as unstructured free-text, posing significant challenges for traditional statistical and machine-learning methods. Solving these challenges would allow the extraction of specific patient subpopulations (clinically relevant cohorts of individuals who share overlapping symptoms, risk factors, or diagnostic criteria), which could be used in precision medicine. Despite this promise, extracting these subpopulations from unstructured medical notes is an ongoing challenge due to the variability of clinical language and …