Digital Commons Network^™

Leveraging Machine Learning Models To Explore Disparities In Prostate Cancer Diagnosis, Treatment, And Survival, Reuben Adatorwovor, Rasaq Oladapo, Parisa Ghasemi, Gaurav Kumar, Daniel J. Morton, Motolani E. Ogunsanya, Olufunmilola Abraham

Biostatistics Faculty Publications

Introduction: Prostate cancer (CaP) is the second most common cancer in men globally and a leading cause of cancer-related mortality, particularly among older men. In the United States, disparities in incidence, stage at diagnosis, and outcomes persist across racial, socioeconomic, and geographic lines. Men in medically underserved regions like Appalachia experience higher mortality due to limited access to timely screening and treatment. Given the complex interplay of clinical, behavioral, and sociodemographic factors, machine learning (ML) offers promise in identifying survival predictors that traditional models may overlook. This study applies ML models to assess the impact of age at diagnosis, treatment …

Outcomes Of A Pilot Randomized Clinical Trial Testing Brief Interventions To Increase Hiv Pre-Exposure Prophylaxis Uptake Among Rural People Who Inject Drugs Attending Syringe Services Programs, Hilary L. Surratt, Sarah Brown, Abby L. Burton, Will Cranford, Laura C. Fanucchi, Christie Green, Stephanie M. Mersch, Rebecca Rains, Philip M. Westgate

Biostatistics Faculty Publications

Background: Kentucky is one of seven states with high, sustained rural HIV transmission tied to injection drug use. Expanding access to pre-exposure prophylaxis (PrEP) has been endorsed as a key HIV prevention strategy; however, uptake among people who inject drugs (PWID) has been negligible in rural areas. Syringe services programs (SSPs) have been implemented throughout Kentucky’s Appalachian region, providing an important opportunity to integrate PrEP services. Objectives: The primary objective was to examine preliminary efficacy and effect sizes of the study interventions on PrEP initiation among HIV-negative PWID. Design: Parallel group randomized controlled trial. Methods: Eighty participants were enrolled from …

Clinical Criteria For Limbic-Predominant Age-Related Tdp-43 Encephalopathy, David A. Wolk, Peter T. Nelson, Liana Apostolova, Konstantinos Arfanakis, Patricia A. Boyle, Cynthia M. Carlsson, Nick Corriveau-Lecavalier, Penny Dacks, Bradford C. Dickerson, Kimiko Domoto-Reilly, Brittany N. Dugger, Rebecca Edelmayer, David W. Fardo, Michel J. Grothe, Timothy J. Hohman, David J. Irwin, Gregory A. Jicha, David T. Jones, Claudia H. Kawas, Edward B. Lee, Karen Lincoln, Gladys E. Maestre, Elizabeth C. Mormino, Chiadi U. Onyike, Ronald C. Petersen, Gil D. Rabinovici, Rosa Rademakers, Rema Raman

Biostatistics Faculty Publications

Limbic predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is highly prevalent in late life and a common co-pathology with Alzheimer's disease neuropathologic change (ADNC). LATE-NC is a slowly progressive, amnestic clinical syndrome. Alternatively, when present with ADNC, LATE-NC is associated with a more rapid course. With the emergence of anti-amyloid therapeutics, discrimination of LATE-NC from ADNC is critical and will lead to greater clinical recognition of amnestic patients without ADNC. Furthermore, co-pathology with LATE-NC may influence outcomes of these therapeutics. Thus there is a need to identify patients during life with likely LATE-NC. We propose criteria for clinical diagnosis of …

Code Status Discussions, Hunter Bechtold, Reagan T. Smith, Peter Wallenhorst, Kaylee Gouge, Sarah Schaefer, Kelsey Karnik, Kristen Mcquerry, Kristen E. Fletcher

Biostatistics Faculty Publications

Introduction: Residents frequently conduct code status discussions (CSDs) with patients, but many report not receiving formal training in this skill. While institutions have attempted to address this, there remains a need for a curriculum that uses standardized patients (SPs), is generalizable to students interested in different medical specialties, and has been tested on a large sample of students. Methods: We trained 192 fourth-year medical students across four different campuses in how to conduct CSDs during one 2-hour workshop as part of their Transition to Residency course in April 2024. Students worked with SPs as part of this workshop. Students at …

How Patient, Infection, And Cysticercus Characteristics Impact The Evolution Of Taenia Solium Larva In The Human Brain, Hongbin Zhang, Meghana G. Shamsunder, Pryanka Bawa, Arturo Carpio, W. Allen Hauser, Karina Quinde-Herrera, Alex Jaramillo, Elizabeth A. Kelvin

Biostatistics Faculty Publications

Neurocysticercosis is a poorly understood infection of the central nervous system with Taenia solium larva and treatment often fails to kill all the parasitic larva. Most research on this infection has used patient-level data, looking at summaries of the encysted parasitic cysticercus burden. Cyst-level analysis is needed to identify factors that impact individual cyst trajectories and how that may vary based on characteristics of the patient, infection, and cyst being followed. We disaggregated data on 221 cysts from 117 patients who participated in a trial evaluating the impact of albendazole treatment to identify factors that impact cyst evolution over time …

A Myostatin Inhibitory Antibody Combined With Insulin, Partially Rescues The Musculoskeletal Phenotype Of Female Insulin-Deficient Diabetic Mice, R. Clay Bunn, Reuben Adatorwovor, Philip D. Ray, Alexander R. Keeble, Christopher S. Fry, Sasidhar Uppuganti, Jeffry S. Nyman, John L. Fowlkes, Evangelia Kalaitzoglou

Biostatistics Faculty Publications

Introduction: Type 1 diabetes is associated with deficits in both skeletal muscle and bone. Inhibition of myostatin, a negative regulator of muscle mass, was explored as a druggable target to improve the musculoskeletal phenotype associated with insulin-deficient diabetes in female mice. Methods: We investigated whether administration of an inhibitory myostatin antibody (MyoAb) in streptozotocin-induced diabetes in female mice is protective for skeletal muscle and bone. DBA/2J female mice were injected with low-dose streptozotocin or with citrate buffer (vehicle). Subsequently, mice were implanted with insulin-containing or vehicle pellets, with groups being randomized to myostatin or control antibody for 8 weeks. At …

Diagnosing Statistical Education Needs Of Health Science Learners, Amy S. Nowacki, Ann M. Brearley, Robert A. Oster, Emily Slade, Katrina L. Devick, Matthew J. Hayat, Sally W. Thurston

Biostatistics Faculty Publications

Many types of health science learners, including clinical and translational scientists, students, researchers, and clinicians, seek to increase their knowledge of biostatistics. These learners are heterogeneous in their field, career stage and career focus. Based on the collective experience of an expert panel with over 115 years teaching statistics to health science learners, we propose a framework for considering the needs of health science learners motivated by their career goals. This framework defines four types of health science learners seeking statistical training: (a) consumers, (b) “milestone makers”, (c) biomedical researchers with statistical support, and (d) biomedical researchers without statistical support. …

Pecto-Intercostal Fascial Plane Block With Or Without Rectus Sheath Block In Cardiac Surgery, Anne L. Castro, Hemanckur Makker, Laura S. Gonzalez, Audrey Jensen, Sergey S. Tarima, Adam Pagryzinski, Rozalin Thapa, Ali Qureshi, Christopher Fadumiye, Krystal Weierstahl, Paul Pearson, Julie K. Freed

Biostatistics Faculty Publications

Background Median sternotomy and chest tube sites drive pain following cardiac surgery. Prior research has demonstrated that pecto-intercostal fascial plane blocks (PIFBs) reduce median sternotomy pain after cardiac surgery. Prior studies examining the addition of a rectus sheath block (RSB) to localize the insertion site of subxiphoid chest tubes have had mixed results. Methods In this single-center, randomized, double-blind, placebo-controlled trial, 62 patients undergoing cardiac surgery with median sternotomy and subxiphoid chest tubes were randomized to receive PIFB and RSB with local anesthetic versus PIFB with local anesthetic and RSB with saline placebo. The primary outcome was pain at rest …

Exploring Creative Processes In Elementary Art Education: Memory, Observation, And Imagination, Angela Steuer

Graduate Research Papers

This study explores the factors influencing idea generation and creativity in young students, focusing on 4th graders' engagement using comics as a motivational tool. It examines the roles of memory, observation, and imagination in shaping artistic choices, as well as the impact of teaching strategies, such as structured challenges and personal storytelling, in fostering creativity. This research offers insights into how tailored instructional practices and cognitive processes support the artistic development of elementary students, empowering them to generate original ideas and create meaningful artwork.

Intergenerational Arts In The Classroom: A Win-Win, Audrey Klunenberg

Graduate Research Papers

This paper suggests that intergenerational arts programs, particularly those conducted in public schools, can help participants build empathy, a sense of community and belonging. Evidence of these changes was collected through informal observations during three intergenerational art classes in a first grade classroom, as well as through discussions with participants before and after their participation in the intergenerational arts programming. Empathy and community can be built through carefully planned collaborative art-making opportunities and the effect can be evidenced in the forming of relationships, the absence of behavioral problems, and the building of the facilitator’s personal network. The paper concludes that …

Motivations And Challenges For African International Students In Choosing On-Campus Housing And Transitioning Off-Campus, Francis Dugbartey

Graduate Research Papers

The findings of this qualitative phenomenological study explained the motives and challenges faced by African international students (n = 10) who initially chose to live on-campus and subsequently transitioned to off-campus accommodations. The research was conducted through semistructured interviews with African international students who were currently enrolled at a predominantly White institution in the Midwestern United States, discussing their experiences with housing, cultural adjustment, and financial constraints. Although the initial choices to stay on-campus stem from convenience and institutional support, various challenges pushed the students toward going off-campus. To begin with, the costliness of staying in an institution may be …

Spring 2025 Graduate Portfolio, Alex Billman

Graduate Research Papers

History is more than a mere chronicle of events; it is a dynamic tapestry woven from a multitude of experiences, cultures, and narratives that shape our collective past. My philosophy of history is rooted in the belief that understanding history is essential for comprehending the present and envisioning the future. As a passionate historian with a focus on Iowa's rich and diverse history, I am driven by a commitment to uncovering the stories that have shaped this region and its people. My approach to history is both analytical and empathetic, aiming to bring to light the voices and perspectives that …

Graduate Portfolio, Amber Ellen Hoodjer

Graduate Research Papers

No abstract provided.

Graduate Portfolio, Cody Miller

Graduate Research Papers

No abstract provided.

Adverse Childhood Experiences And Healthcare Access, Kyla M. Frost

Graduate Research Papers

The purpose of this study was to examine the relationship between adverse childhood experiences (ACEs) and healthcare access, and ACEs and healthcare access among people of color. The current study is a secondary data analysis of the 2023 Behavioral Risk Factor Surveillance System (BRFSS) data collected by the Centers for Disease Control and Prevention. A disproportionate stratified sample (DSS) design and a simple random sample design were used to collect data. The current study examined 48,865 participants who completed ACEs through telephone surveys. The results showed a statistically significant negative relationship between ACEs and healthcare access. The results also showed …

Intellectual And Developmental Disabilities As A Risk For Child Maltreatment, Maddie Hawley

Graduate Research Papers

The purpose of this study is to examine the relationship between intellectual and developmental disabilities (IDDs) and child maltreatment. Data from the 2022 National Child Abuse and Neglect Data System (NCANDS) from the state of Minnesota was analyzed. The sample was made up of 38,083 reports of child maltreatment, where the average age of the child was 7.66 years. 51.2% of the children in the sample were female, and White children comprised the largest portion of the sample at 39.6%. Results of this study showed that children with IDDs are at an elevated risk of child maltreatment compared to typically …

Impacts Of Sexual Assault On Mental Health In Adolescents, Nicole Trip

Graduate Research Papers

The current study focuses on the impacts of forced sexual activity on mental health among high school students. This study is a secondary data analysis, using the 2023 Youth Risk Behavior Surveillance System (YRBSS), which is nationally representative data collected by the Centers for Disease Control and Prevention (CDC). A total of 19,945 high school students with an average age of 15.89 years, and about half of the students were White and male. This study found that experiences of sexual assault are associated with increased depression and suicidal ideation. This study also found that female youth experienced a higher level …

Adverse Childhood Experiences And Chronic Health Conditions In Black Individuals, Emily K. Etringer

Graduate Research Papers

The purpose of this study is to examine the relationship between Adverse Childhood Experiences (ACE) and chronic health conditions among Black individuals of different genders. The study employs quantitative research methods and utilizes secondary data analysis on the 2023 Behavioral Risk Factor Surveillance System (BRFSS) collected by the Centers for Disease Control and Prevention. Data was analyzed using descriptive statistics, including frequency, percent, mean, standard deviation, range, and inferential statistics, such as correlation analyses, independent groups t-tests, ANOVA, and Chi-square tests. This research revealed a statistically significant finding that Black individuals with an ACE score of 4+ have more chronic …

Survivors Of Childhood Sexual Abuse: The Impact Of Social Support, Cultural Background, And Early Interventions, Alysha Haaland

Graduate Research Papers

Childhood sexual abuse (CSA) is a critical public health issue that leaves enduring psychological, emotional, and social impacts on survivors. This paper examines the interrelated roles of social support, cultural background, and early interventions in promoting long-term resilience and recovery, with a particular focus on male and culturally diverse survivors. Grounded in Trauma and Resiliency Theory, this literature review highlights key protective factors—including emotional, informational, and instrumental support—while exploring how cultural norms, religious beliefs, and systemic stigma shape survivors’ coping strategies and access to care. The paper also evaluates the effectiveness of early interventions such as trauma-focused cognitive behavioral therapy, …

Black Girls In School: The Harmful Effects Of Dehumanization And Disciplinary Inequities, Annika Peterson

Graduate Research Papers

Black girls in the U.S. experience dehumanization through adultification and sexual objectification that impact disciplinary practices in the education system. Adultification stereotypes Black girls as more mature, less innocent, and less in need of protection, which results in harsher disciplinary actions and limited empathy from educators. At the same time, sexual objectification reinforces harmful perceptions of Black girls' sexuality and culpability in their sexual violence victimization. The “Jezebel” and “Angry Black Woman” stereotypes continue to influence how Black girls are perceived as either hypersexual or aggressive. These biases and stereotypes contribute to disproportionate disciplinary measures, particularly subjective infractions like “defiance” …

Police Interactions On Adverse Mental Health Outcomes Within Black Communities, Anessa Smith

Graduate Research Papers

This study examines the relationship between police interactions and psychological distress among Black adults, contributing to existing research on systemic racism and mental health disparities. Utilizing secondary data analysis, the 2023 California Health Interview Survey (CHIS), this study focuses on the analysis of a nationally representative, address-based sample of non-institutionalized Black adults residing in California, with a sample size of 1,009. The study examines associations between the number of police stops over a three-year period and psychological distress by gender. Findings indicate that a higher frequency of police stops is significantly associated with increased psychological distress. However, no statistically significant …

Sexual And Bystander Sexual Harassment Experiences Among Part-Time Female Employees: Testing An Interactive Model, Erin Powers

Graduate Research Papers

The current research investigated the impact of sexual and bystander harassment on work-related attitudes, work behaviors, and psychological health. Participants included 314 females who worked part-time at their organization. All participants individually completed a computer administered Workplace Experiences Survey assessing various aspects of their work environment including personal and bystander harassment experiences, work-related attitudes (supervisor, coworker, and work satisfaction), work behaviors (work and job withdrawal), and psychological well-being. It was predicted that both direct sexual harassment and bystander harassment experiences would be associated with more negative work attitudes, greater withdrawal behaviors, and poorer psychological health, with bystander harassment moderating the …

Using Analysis Of Teaching And Assessment Practices To Revise Implementation Of A Force Unit In An 8th Grade Science Course, Caleb Christine

Graduate Research Papers

One thing I have noticed from my fellow teachers is a desire to improve how we teach and to engage our students in active learning. As a new teacher I have that same desire. Accomplishing my goal of being an effective teacher while also improving how the material is presented requires an approach that includes evaluating not only how the students are performing, but also how they are responding to my instruction.

I used self reflection journals to keep track of how I was presenting material in my classroom. I also collected information from completion of ungraded assignments and investigations. …

Research Portfolio, Kezia Mariam Abraham

Graduate Research Papers

No abstract provided.

The Effect Of Mitochondrial Disease On The Eyes And Possible Treatments With An Emphasis On Leber Hereditary Optic Neuropathy, Olivia Chambers

Honors Program Theses

Mitochondrial diseases are a diverse group of genetic disorders that impair cellular energy production, often leading to multisystem complications, including vision loss. This thesis explores how mitochondrial dysfunction impacts ocular health, with an emphasis on Leber Hereditary Optic Neuropathy (LHON), a disorder caused by point mutations in mitochondrial DNA affecting Complex I of the oxidative phosphorylation pathway. Through an extensive literature review, this research examines the mechanisms by which mitochondrial mutations damage retinal ganglion cells and evaluates current and emerging treatment approaches. Pharmacological therapies, such as idebenone and other quinone analogs, demonstrate limited but promising results in stabilizing early-stage vision …

Citizen-Centric Building Energy Retrofits: Understanding And Supporting Citizens As Occupants, Participants, Decision-Makers, And Learners In Home Energy Retrofits, Nikhil Singh Yaduvanshi

Civil Engineering Dissertations - Archive

Residential building retrofits remain significantly under-adopted despite substantial technological advances, economic incentives, and policy efforts, creating a critical gap between technical potential and actual implementation in achieving climate goals. Assessment of citizen involvement in building retrofit processes plays a critical role in formulating effective home retrofit program designs to ensure maximum adoption rates and avoid energy waste. Although, existing retrofit programs and decision-making models recognize the importance of citizen involvement, the extent of citizen capabilities and the effects of citizen-centered approaches on retrofit adoption and building performance has not been comprehensively examined. The adoption and success of retrofit programs depends …

Transforming Lives For Eternity: 2024-2025 Year End Summary, Southern Adventist University

Strategic Plans

Southern Adventist University's Strategic Plan Year End Summary for the year 2024-2025.

De La Alfabetización Digital A La Analfabetización: El Impacto De La Posverdad Y Las Redes Sociales En Eduación, Sonia Rodríguez-Fernández, Diego Fraile Gómez

Capítulos de libros

La alfabetización digital es un concepto clave en la sociedad contemporánea debido al crecimiento exponencial de la tecnología y su influencia en la vida cotidiana. Desde la llegada de internet y las redes sociales, el acceso a la información se ha democratizado, permitiendo que millones de personas interactúen, aprendan y participen activamente en entornos digitales. No obstante, esta accesibilidad sin precedentes también ha traído consigo nuevos desafíos, entre ellos la desinformación, la intoxicación y la propagación de narrativas sesgadas que afectan a la construcción del conocimiento y la toma de decisiones informadas. En estos últimos tiempos, se puede observar un …

Simulación Clínica En La Formación De Psicólogos Organizaciones: Burnout Y Acoso Laboral, Patricia Vizuete Escobar, Sara Uceda Gutiérrez, Esther Martínez Miguel, Irene Morueco Moreno

Capítulos de libros

No abstract provided.

Credit Card Fraud Detection., Sonia Ndonga

ICT

This capstone project applies machine learning to detect credit card fraud, addressing a critical financial threat to banks and payment providers. Using an anonymised dataset of 284,807 transactions, which is highly imbalanced with only 0.172% fraudulent cases, three models—Logistic Regression, Random Forest, and Gradient Boosting—were developed and evaluated. The pipeline incorporates data preprocessing, feature engineering, hyperparameter tuning, cross-validation, and interpretability analysis using SHAP values, SHAPASH, and permutation importance. Random Forest achieved the highest performance with an ROC AUC of 0.97 and Average Precision of 0.66. The study also considers fairness, threshold optimisation, and practical deployment strategies, providing a robust automated …