Digital Commons Network^™

Dwelling / Knowing / Loving: Imaging The Immanent Present, Joel Pasquarelli

All Theses

This thesis serves as an attempt to articulate, understand, and testify to my experiences within the immanent present. Defined as moments where the world impresses itself upon my awareness with such a force that it eclipses all else, the experience of immanence is necessarily undeniable and ephemeral. These moments are accompanied by a combined sense of exultation in the world’s existence and poignant longing for something beyond. I feel as though I am embedded within something great and meaningful, as the material world acts upon me, yet I remain ever unsatiated by this experience as the world inevitably returns once …

Predicting Long-Term Creep Behavior Using Short-Term Stress Relaxation Data In Expanded Polyethylene Foam, Andrew M. Seelig

All Theses

Closed cell expanded polyethylene (EPE) foams are widely used for protective packaging due to their high energy absorption properties and recyclability. However, these foams can be subjected to sustained compressive stresses (13.78 - 36.20 kPa), depending on density and application, leading to time-dependent deformation (creep). Creep reduces cushioning performance, making its understanding critical for effective protective packaging. Two standards, ASTM D3575 and ASTM D2221, define methods for conducting compressive creep tests on foam materials, with test durations extending up to 1000 hours. Accelerated methods such as Time Temperature Superposition (TTS) and the Stepped Isostress Method (SSM) have been explored for …

Understanding Policy Transfer Under Decomposition And Coordination: Sequential Reinforcement Learning With Relaxation-Based Feasibility Control, Aannand Lal

All Theses

This thesis investigates how decomposition and coordination (D&C) choices influence exploration, learning, and transfer in reinforcement learning (RL) based design frameworks. A unified methodology is developed to evaluate generality under decomposition and to demonstrate sequential coordination on a representative physical task. The generality study holds the underlying physics constant while varying problem presentation - specifically scalarization weights, objective orientations, and feasibility handling. A train-evaluate matrix is constructed in which each trained policy is assessed across all alternative decompositions. Set-based diagnostics quantify generality through exact-match identity, Jaccard similarity of distinct feasible states, total feasible coverage, and Pareto-front quality. Results show that …

Learning To Be Trauma-Informed: An Examination Of Individual-Level Factors Predicting Perceptions Of And Response To Trauma-Informed Practice Trainings, Kelly Daniel

Electronic Theses and Dissertations

Trauma is a substantial threat to public health. As such, significant effort has been exerted into developing interventions which mitigate the consequences of trauma. Trauma-informed practice (TIP) aims to alleviate the effects of trauma by building policies and practices focused on safety, trust, transparency, support, collaboration, and empowerment. This study investigated how individual-level factors, including readiness for organizational change, perceived benefit of TIP training, and personal trauma history affect one’s ability to apply a TIP lens in a sample (n =100) of members of a graduate-level college. Further, it explored if one’s perceptions of and response to trauma-informed practice training …

The People’S Medicine: Modern Perspectives On Folk Medicine In South Central Appalachia, Stacey M. Horton

Electronic Theses and Dissertations

The study addresses the critical need to document Appalachian folk medicine conventions and cultural practices from a modern perspective. In so doing, it addresses folk medicine research gaps in understudied places in South Central Appalachia, particularly in Southwestern Virginia and Northeast Tennessee. This research utilizes participant observation and oral history interviews to research modern Appalachian folk medicine practices among a select group of practitioners. Interviews focused on individuals who center their professional careers and subsequent lifestyles around herbalism, foraging, folk medicine, ethnobotany, and botanicals. By utilizing a critical praxis framework, the study seeks to move beyond lists of symptoms and …

Learning To Think, Thinking To Learn: A Qualitative Investigation Of Inquiry-Based Learning And Metacognition In Preschools, Jessica Carter

Electronic Theses and Dissertations

In response to an increased focus in the field of early childhood on inquiry-based practices and metacognition, this qualitative study was designed to investigate a variety of approaches to planning and facilitating classroom inquiry. Additionally, this research was designed to discover the ways in which metacognitive strategies are used in preschool classrooms to foster the learning process. Using teacher interviews, classroom observation, and analyses of teachers’ planning documents in a multiple case study design, this study focused on five Reggio-inspired classrooms to investigate the planning and teaching practices of preschool teachers related to inquiry-based learning. Of importance was their use …

Tennessee Reconnect And Adult Learner Retention, Brandon R. Dotson

Electronic Theses and Dissertations

This study examined the relationship between participation in the Tennessee Reconnect (TNReconnect) program and the retention of adult learners at two community colleges in northeast Tennessee. Grounded in Astin’s (1993) Input–Environment–Outcome (I-E-O) model, the study employed quantitative methods to investigate whether program duration, demographic characteristics, academic performance, and financial aid status predicted the likelihood of retention among adult learners.

Using institutional records of 2,355 students, binary logistic regression analyses were conducted across three models. The first model tested whether the duration of TNReconnect participation predicted retention. Results indicated that both program duration and GPA were significant predictors. Each additional semester …

Branding The Divide: Political Ideology And The Strategic Challenges Of Higher Education Marketing, Oscar J. Early Mr

Electronic Theses and Dissertations

The purpose of this qualitative study was to explore how first-year students experience and interpret institutional branding within the context of their personal and social identities, with particular attention to the role of political ideology. While previous research had examined general branding strategies and declining public trust in higher education, scholars have given little attention to the ways in which prospective students make meaning from institutional messaging during one of the most significant transitions of their lives.

I conducted interviews with 12 first-year students from four-year colleges and universities across South-Central Appalachia. The phenomenological analysis revealed that students’ interpretation of …

Behavioral Manifestations Of Childhood Abandonment: African-American Men's Reflections And Strategies To Support Teenage Boys In K-12 Education, Jarmel Bell

Electronic Theses and Dissertations

The purpose of this study was to explore the behavioral manifestations of childhood abandonment as reflected in the lived experiences of African-American men and to identify strategies that may support African-American boys in K–12 educational settings. Although there has been limited documentation regarding the direct connection between childhood abandonment and behavioral challenges in school environments, this study seeks to address that gap by capturing the reflections of African-American men who experienced abandonment during their formative years. These reflections provide insight into how abandonment may shape behavior in educational spaces and what types of interventions or supports might have made a …

Assessing Post-Pandemic Engagement In The Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Northeast Tennessee, Christen Minnick

Electronic Theses and Dissertations

Since 1974, the federal Supplemental Nutrition Program for Women, Infants, and Children (WIC) has provided healthy food resources, nutrition education, and provider referrals for families at risk for poor nutrition. Public health professionals have consistently presented evidence that WIC engagement reduces premature births and infant mortality, improves child health and development, and increases specialized care access for participants. While average monthly participation in WIC has increased since the program’s inception, trends indicate that only around half of eligible families have consistently engaged with the program since 2011. Research has linked declining WIC participation to administrative burden, citing learning, psychological, compliance, …

Educator Perceptions Of Mindfulness Education In Rural Elementary Schools In Tennessee, Mary C. Shepherd-Mcgown

Electronic Theses and Dissertations

The purpose of this phenomenological study was to examine educator perceptions of mindfulness instruction and the alignment of school policies in rural elementary schools in Tennessee. Despite growing interest in mindfulness in education, few studies have investigated how these practices are experienced and implemented within under-resourced, rural contexts.

Guided by Bandura’s Social Learning Theory (SLT) and framed conceptually by the Whole-School Mindfulness (WSM) model, the study explored how social, organizational, and policy factors influence the adoption of mindfulness practices. SLT provided a theoretical lens for understanding how educator behaviors are shaped through observation, modeling, and reinforcement, while the WSM framework …

A Comparative-Correlational Study On The Mental Health And Well-Being Of First-Generation Students At A Historically Black College And University, Shedred Jackson

Electronic Theses and Dissertations

The purpose of this study was to investigate the mental health and well-being of first-generation college students (FGCS) in comparison to non-first-generation college students (NFGCS) at a private Historically Black College and University (HBCU) in the Southeast. This study was undertaken to investigate students' mental health and well-being, as well as their use of, access to, and the availability of mental health services. A comparative-correlational research design was employed to collect and analyze the data. The study used a sample size of 388 responses from undergraduate college students enrolled at the private HBCU. Of the 388 students in the sample, …

Teacher Perceptions Of The Effectiveness Of Voluntary Pre-Kindergarten Attendance, Kimberly Taylor

Electronic Theses and Dissertations

The purpose of this study was to identify the perceptions of educators with respect to student enrollment in voluntary pre-kindergarten classes provided through the Tennessee Department of Education in public schools. The data collection strategy used to gain teacher perspectives was through conducting one-on-one interviews with 15 educators in three Tennessee school districts. To qualify for the study, teachers must have been teaching in kindergarten classrooms that receive students who had previously been enrolled in the school’s pre-kindergarten program. Data collection and analysis were based on the Grounded Theory approach which uses data that is systematically gained and analyzed to …

Bud On The Ballot: A County-Level Analysis Of Citizen Support For Cannabis Legalization, Amelia G. Jennings

Electronic Theses and Dissertations

Cannabis research has often emphasized usage rates among certain groups of citizens, focusing mostly on demographic factors. A less studied topic within the cannabis literature pertains to the predictors of voting patterns of legalization referendums. Past research on this topic has examined states with similar characteristics, which calls into question the generalizability of results. The current study attempts to broaden the scope of knowledge in this area by partially replicating a previous study that explored county-level voting patterns, while also exploring the potential influence of the declining agricultural industry in predicting support for cannabis legalization. This was accomplished by analyzing …

Bias And The Writing Process In Adaptations And Retellings Of Mythology, Haley Sanderson

Electronic Theses and Dissertations

My thesis is an examination of how adaptations and retellings of mythology are written and affected by readership and reception of mythology. I compare American Gods by Neil Gaiman and The Penelopiad by Margaret Atwood and how they are written as adaptations and retellings of mythology. As seen in both novels, the presence of the mythological source material in adaptations and retellings of mythology is equally influenced by authors’ perception and the influence of readership. Approaching the ideological positions of Atwood and Gaiman through the similarities and differences of The Penelopiad and American Gods provides a deeper insight on the …

Undergraduate Students' Perceptions Of Sense Of Belonging And Engagement Opportunities In The Campus Community, Shelby Jo Akers

Electronic Theses and Dissertations

This non-experimental, correlational, quantitative study examined the relationship between undergraduate students’ perceptions of sense of belonging and their participation in university programming and engagement opportunities at a medium-sized public institution in the Southeastern United States. Guided by the Integrative Framework for Belonging (Allen et al., 2021), the study explored how specific student factors including academic major, campus residency status, class standing, primary mode of instruction, and employment status intersect with engagement to shape students’ sense of belonging. Engagement opportunities that were measured included dimensions of campus facility use and participation in clubs and organizations. Questions related to perceptions of the …

"That Was Something I Had To Get Used To”: Communication Challenges Of African Graduate Teaching Assistants, Mohammed Hafiz Nabila

Electronic Theses and Dissertations

This qualitative study examined the communication challenges and adaptive strategies of African Graduate Teaching Assistants (AGTAs) in U.S. higher education, focusing on East Tennessee State University. The study aimed to understand how AGTAs navigate linguistic, cultural, and institutional barriers in their teaching roles. Using semi-structured interviews with seven participants, data were analyzed through thematic analysis to identify key patterns and meanings. Findings revealed challenges related to accents, cultural adjustment, and limited institutional preparation. Faculty mentorship played a vital role in shaping AGTAs’ confidence, interpretation of challenges, and professional growth. However, lack of support often led to isolation and self-doubt. The …

A Leslie System For A Demographic Simulation: From An Actuarial Point Of View, David Kings

Electronic Theses and Dissertations

This thesis develops a discrete stochastic linear systems interpretation of age–stage demographic evolution grounded in Leslie operators and realized in a discrete-event simulation implemented with salabim. The central claim is that one annual cycle of the simulation constitutes a cone-preserving, stochastic affine transformation on a high- dimensional population state vector indexed by age, sex, marital status, household type, employment, and education, and that the composition of yearly operators yields a random matrix product whose top Lyapunov exponent is the stochastic counterpart of the Perron–Frobenius growth rate (Caswell, 2001; Tuljapurkar, 1997)[1, 2]. The actuarial bridge is constructed by mapping simulated survival …

Perceptions Of Choral Teachers On The Characteristics Of A Secondary Choral Program, Nathan Dale Rhea

Electronic Theses and Dissertations

The purpose of this study was to examine the perceptions of choral teachers on the characteristics of a successful secondary choral program. The study focused on the main characteristics of excellence, success, and sustainability. The literature showed that there was a significant amount of research on the music curriculum, standards, and various assessment strategies but minimal research on perceptions on the characteristics of excellence, success, and sustainability of a choral music program at the secondary level.

Data collection strategies included individual interviews of eight participants who were choral music educators. The analysis of data occurred through the lens of the …

Isolation, Chemical Characterization, And In-Vitro Cytotoxic Evaluation Of Novel Polar Flavonoids From Chromolaena Leivensis, Matthew Tohatsu Tetteh

Electronic Theses and Dissertations

This study focuses on isolation, chemical characterization, and in-vitro cytotoxic evaluation of novel polar flavonoids from chromolaena leivensis. A 95% ethanolic extract of c. leivensis shipped by Prof. Ruben Torrenegra from University of Applied and Environmental Sciences, Bogota, Colombia, was dissolved in 1:1 methanol/chloroform mixture and its purity analyzed by TLC. The sample was eluted with toluene/methanol in an increasing order of polarity on silica gel, resulting in 49 fractions labelled CLA1 to CLA49. Among these fractions, CLA10 (1) and CLA19 (2) obtained yellow and white crystals. They were analyzed by GCMS, IR, and …

Comparative Value Of Echocardiography Vs. Right Heart Catheterization In Heart Failure With Preserved Ejection Fraction, Nathanael Tran, Mohammad Shaar, Hussein Al-Sudani, Ramy Sedhom, Hamza Akhtar, Kevin Bryan Lo, Gregg S. Pressman

Einstein Health Papers

BACKGROUND: Echocardiography and right heart catheterization (RHC) are useful in the evaluation of heart failure with preserved ejection fraction (HFpEF). We compared the two among decompensated HFpEF patients to determine their relative value in predicting all-cause mortality and a composite of cardiovascular (CV) death and heart failure (HF) readmission at 1 year.

METHODS: One hundred seventy-eight decompensated HFpEF patients who underwent both procedures and survived to hospital discharge were retrospectively identified. Hospital records and the National Death Index were queried to determine outcomes. Echocardiographic and invasive parameters were tested for significant associations with each outcome. Additionally, three predictive models were …

Large Language Models As End-To-End Combinatorial Optimization Solvers, Xia Jiang, Yaoxin Wu, Minshuo Li, Zhiguang Cao, Yingqian Zhang

Research Collection School Of Computing and Information Systems

Combinatorial optimization (CO) problems, central to decision-making scenarios like logistics and manufacturing, are traditionally solved using problem-specific algorithms requiring significant domain expertise. While large language models (LLMs) have shown promise in automating CO problem solving, existing approaches rely on intermediate steps such as code generation or solver invocation, limiting their generality and accessibility. This paper introduces a novel framework that empowers LLMs to serve as end-to-end CO solvers by directly mapping natural language problem descriptions to solutions. We propose a two-stage training strategy: supervised fine-tuning (SFT) imparts LLMs with solution generation patterns from domain-specific solvers, while a feasibility-and-optimality-aware reinforcement learning …

Agentguard: An Active Threat Discovery System For Package Confusion Using Multi-Agent Collaboration, Wei Ma, Yu Li, Zhi Chen, Ye Liu, Lingxiao Jiang, Qiang Hu, Junyi Tao

Research Collection School Of Computing and Information Systems

The proliferation of open-source software (OSS) has made software supply chains prime targets for attacks like Package Confusion, where adversaries publish malicious packages with names deceptively similar to legitimate ones. Existing detection methods often rely on simple lexical similarity or passive analysis of known package pairs, struggle with high false positive rates (FPR), fail to proactively identify emerging threats, and are vulnerable to adversarial evasion. To overcome these limitations, we introduce AgentGuard, a novel framework for proactive, single-input package confusion detection. AgentGuard employs a multi-agent architecture that autonomously discovers potential confusion targets using fine-tuned word embedding model to hybird semantic …

Kpiroot+: An Efficient Integrated Framework For Anomaly Detection And Root Cause Analysis In Large-Scale Cloud Systems, Wenwei Gu, Renyi Zhong, Guangba Yu, Xinying Sun, Jinyang Liu, Yintong Huo, Zhuangbin Chen, Jianping Zhang, Jiazhen Gu, Yongqiang Yang, Michael R. Lyu

Research Collection School Of Computing and Information Systems

To ensure the reliability of cloud systems, their runtime status reflecting the service quality is periodically monitored with monitoring metrics, i.e., KPIs (key performance indicators). When performance issues happen, root cause localization pinpoints the specific KPIs that are responsible for the degradation of overall service quality, facilitating prompt problem diagnosis and resolution. To this end, existing methods generally locate root-cause KPIs by identifying the KPIs that exhibit a similar anomalous trend to the overall service performance. While straightforward, solely relying on the similarity calculation may be ineffective when dealing with cloud systems with complicated interdependent services. Recent deep learning-based methods …

In This Issueclinical Practice Guidelinesreview Articleoriginal Articles

Saudi Medical Journal

No abstract provided.

Navigating Challenges In Management Of Difficult-To-Treat Chronic Rhinosinusitis With Nasal Polyps In The Greater Gulf, Osama A. Marglani, Abdul Razzak Juratli, Athari Maatouq Alwael, Ghassan Hussain Alokby

Saudi Medical Journal

ABSTRACT Chronic rhinosinusitis with nasal polyps (CRSwNP) poses significant management challenges, particularly in treatment-resistant cases, greatly affecting patients’ quality of life. This paper provides consensus-based recommendations to guide clinicians in managing difficult-to-treat CRSwNP in the Gulf Cooperation Council (GCC) region. A modified Delphi method was used to gather expert opinions from GCC specialists through surveys and discussions, achieving consensus on 14 key statements for CRSwNP management. Key criteria identified for difficult-to-treat CRSwNP included early recurrence after surgery, comorbid atopic diseases, and frequent need for oral steroids. The importance of structured histopathology reporting and understanding inflammatory characteristics to differentiate patients with …

Interventional Study Of The Iselfie Heart Health Tool For Assessment Of Vital Signs (Heart Rate, Blood Pressure, And Oxygen Saturation) In The Kingdom Of Saudi Arabia, Abdulaziz S. Alhomod, Demah Abdulaziz Almowanes, Robert Scooter Plowman, Azhar Quddus, Hassan Mohamed, Mahmut Karakaya, Ahmed Elgebaly, Jamilah Alrahimi, Raed Alkutshan, Adel Tash

Saudi Medical Journal

ABSTRACT Objectives: To validate the diagnostic performance of the iSelfie Heart Health tool compared to standard-of-care devices, focusing on accuracy, reliability, and classification capabilities. Methods: Vital sign measurements from 579 participants were analyzed using the iSelfie tool in calibrated and non-calibrated modes. Further analyses applied the Association for the Advancement of Medical Instrumentation (AAMI) standards and criteria for cuff-based blood pressure (BP) devices. Primary endpoints included mean absolute error (MAE) and cumulative error percentages for all vital parameters. Binary and multi-class classification analyses evaluated the device’s performance to categorize hypertension grades. Results: In calibrated mode, the iSelfie tool demonstrated high …

Prevalence Of Respiratory Distress Syndrome Among Late Preterm Infants Admitted To A Neonatal Intensive Care Unit In Saudi Arabia: A Retrospective Study, Abdulmohsen K. Alswayed, Kamal Ali, Amjad O. Alharbi, Ghadah K. Alnami, Haifa M. Bindokhi

Saudi Medical Journal

ABSTRACT Objectives: The objective of this research was to identify how common Respiratory distress syndrome (RDS) is and explore related factors in late preterm infants admitted to the neonatal intensive care unit (NICU) at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Methods: A retrospective cross-sectional study was conducted over 1 year (2021). Infants with a gestational age of 34 to 36 weeks were selected using a consecutive, non-probability sampling method. Clinical, neonatal, and maternal factors were analyzed to assess their impact on the prevalence of RDS in this gestational age group. Results: The majority of infants in the …

Satisfaction With The Saudi Healthcare System: Findings From The 2019 Kingdom Of Saudi Arabia World Health Survey, Ali M. Alzahrani, Holly C. Felix

Saudi Medical Journal

ABSTRACT Objectives: To provide details on patient satisfaction with the Saudi healthcare system and patient characteristics associated with satisfaction levels using nationally representative survey data. Methods: A cross-sectional secondary analysis was conducted using the Kingdom of Saudi Arabia World Health Survey (KSAWHS 2019) data, which collected information on demographics, health status, chronic conditions, and access to and use of healthcare services among Saudi adults aged ≥15 years. Descriptive statistics and logistics regression analyses were performed to identify significant predictors of satisfaction with Saudi healthcare services. Results: Between April and July 2019, 8,912 individuals completed the KSAWHS 2019 individual questionnaire. Out …

Discharge Against Medical Advice Among Pediatric Patients: A Retrospective Study From A Saudi Tertiary Emergency Department, Elaf A. Alshammari, Atheer M. Aljeraibah, Haya M. Aldabas, Saad M. Alqahtani, Raseel S. Alghamdi, Abdulrahman M. Alsharif, Yahya K. Alyahya, Abdullah I. Almojali

Saudi Medical Journal

ABSTRACT Objectives: To investigate the incidence, parental reasons, and predictors of emergency room (ER) revisits following discharge against medical advice (DAMA) in a pediatric center in Saudi Arabia. Methods: This retrospective cohort study was conducted between January 2020 and December 2024 at a tertiary care hospital. Pediatric patients aged 0-14 years who signed the DAMA during ER visits were included. Medical records of patients with DAMA were reviewed to collect demographic data, diagnoses, reasons for DAMA, and outcomes. Results: Among 446,251 ER visits, 2,336 (0.52%, 95% CI: 0.50%–0.55%) involved caregiver-signed DAMA. These rates ranged from 0.45% (2020) to 0.69% (2023). …