Digital Commons Network^™

Colour Changes In The Feet: A Sign Of Autonomic Symptoms In Systemic Sclerosis, Brittany L Adler, Kamini Kuchinad, Seeun Judy Jeong, Lauren E Stiles, Ami A Shah, Tae Chung, Zsuzsanna H Mcmahan

Faculty, Staff and Student Publications

Objectives: Patients with autonomic dysfunction, or dysautonomia, often report discolouration of their dependent extremities, which is thought to be from venous pooling or acrocyanosis. A subset of patients with SSc are affected by dysautonomia but may be challenging to identify. We sought to determine whether patients with SSc who report discolouration in their feet have a higher burden of autonomic symptoms, including orthostatic, gastrointestinal (GI), urinary, secretomotor and pupillomotor.

Methods: 167 patients with SSc completed the Composite Autonomic Symptom Score (COMPASS)-31 survey, which queries whether the patient experiences discolouration of the feet or hands. We compared the COMPASS-31 subdomain scores …

Evidence For Biomolecular Condensates Formed By The Escherichia Coli Matp Protein In Spatiotemporal Regulation Of The Bacterial Cell Division Cycle, Inés Barros-Medina, Miguel Ángel Robles-Ramos, Marta Sobrinos-Sanguino, Juan Román Luque-Ortega, Carlos Alfonso, William Margolin, Germán Rivas, Begoña Monterroso, Silvia Zorrilla

Faculty, Staff and Student Publications

An increasing number of proteins involved in bacterial cell cycle events have been recently shown to form biomolecular condensates important for their functions that may play a role in development of antibiotic-tolerant persister cells. Here we report that the E. coli chromosomal Ter macrodomain organizer MatP, a division site selection protein coordinating chromosome segregation with cell division, formed biomolecular condensates in crowding cytomimetic systems preferentially localized at the membrane of microfluidics droplets. Condensates were antagonized and partially dislodged from the membrane by DNA sequences recognized by MatP (matS), which partitioned into them. FtsZ, a core component of the division machinery …

Sustained Improvement In Health-Related Quality Of Life In Transplant-Ineligible Newly Diagnosed Multiple Myeloma Treated With Daratumumab, Lenalidomide, And Dexamethasone: Maia Final Analysis Of Patient-Reported Outcomes, Aurore Perrot, Thierry Facon, Torben Plesner, Saad Z Usmani, Shaji Kumar, Nizar J Bahlis, Cyrille Hulin, Robert Z Orlowski, Hareth Nahi, Peter Mollee, Karthik Ramasamy, Murielle Roussel, Arnaud Jaccard, Michel Delforge, Lionel Karlin, Bertrand Arnulf, Ajai Chari, George Wang, Niodita Gupta-Werner, Shuchita Kaila, Huiling Pei, Kathryn Matt, Katharine S Gries, Robin Carson, Fredrik Borgsten, Katja Weisel

Faculty, Staff and Student Publications

Objectives: This final post hoc analysis evaluated patient-reported outcomes from the Phase 3 MAIA study of daratumumab, lenalidomide, and dexamethasone (D-Rd) versus lenalidomide and dexamethasone (Rd) after median 64.5-month follow-up in transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM), including patient subgroups.

Methods: Key scales from the EORTC QLQ-C30 (global health status [GHS], physical functioning, pain, and fatigue) were assessed. Scores were evaluated every 3 months for 1 year, then every 6 months until disease progression.

Results: The intent-to-treat population (n = 737) included 46.3% frail, 35.4% 70 to < 75 years old, and 43.6% ≥ 75 years old. D-Rd-treated patients showed improvements from baseline that were sustained over 5 years in the intent-to-treat population and across subgroups by age, frailty, and bone lesions. Greater proportions of patients treated with D-Rd versus Rd achieved minimally important changes for improvement at cycle 36 (year ~3) in GHS (odds ratio, 1.84 [95% CI, 1.16-2.91]), physical functioning (1.93 [1.18-3.14]), pain (1.41 [0.90-2.22]), and fatigue (2.00 [1.24-3.23]). Greater proportions of patients with bone lesions improved with D-Rd versus Rd on GHS and physical functioning.

Conclusions: In transplant-ineligible patients with NDMM, D-Rd improved health-related quality of …

T2-Weighted Imaging Of Rectal Cancer Using A 3d Fast Spin Echo Sequence With And Without Deep Learning Reconstruction: A Reader Study, Dan Nguyen, Sarah Palmquist, Ken-Pin Hwang, Jingfei Ma, Usama Salem, Jia Sun, Xinzeng Wang, Jong Bum Son, Randy Ernst, Peng Wei, Harmeet Kaur, Nir Stanietzky

Faculty, Staff and Student Publications

Purpose: To compare image quality and clinical utility of a T2-weighted (T2W) 3-dimensional (3D) fast spin echo (FSE) sequence using deep learning reconstruction (DLR) versus conventional reconstruction for rectal magnetic resonance imaging (MRI).

Methods: The study included 50 patients with rectal cancer who underwent rectal MRI consecutively between July 7, 2020 and January 20, 2021 using a T2W 3D FSE sequence with DLR and conventional reconstruction. Three radiologists reviewed the two sets of images, scoring overall SNR, motion artifacts, and overall image quality on a 3-point scale and indicating clinical preference for DLR or conventional reconstruction based on those three …

Multiparametric Mri Scoring System Of The Pancreas For The Diagnosis Of Chronic Pancreatitis, Temel Tirkes, Dhiraj Yadav, Darwin L Conwell, Xuandong Zhao, Anil K Dasyam, Vivek Gowdra Halappa, Aashish Patel, Zarine K Shah, Jordan Swensson, Naoki Takahashi, Sudhakar Venkatesh, Ashley Wachsman, Liang Li, Kristofer Jennings, Yunlong Yang, Phil A Hart, Stephen J Pandol, Walter G Park, Santhi Swaroop Vege, Mark Topazian, Paul R Territo, Scott A Persohn, Dana K Andersen, Evan L Fogel, Consortium For The Study Of Chronic Pancreatitis, Diabetes, And Pancreatic Cancer (Cpdpc)

Faculty, Staff and Student Publications

Background: Ductal features alone may not offer high diagnostic sensitivity or most accurate disease severity of chronic pancreatitis (CP).

Purpose: Diagnose CP based on multiparametric MRI and MRCP features.

Study type: Prospective.

Population: Between February 2019 and May 2021, 46 control (23 males, 49.3 ± 14.1 years), 45 suspected (20 males, 48.7 ± 12.5 years), and 46 definite (20 males, 53.7 ± 14.6 years) CP patients were enrolled at seven hospitals enrolled in the MINIMAP study. CP classification was based on imaging findings and clinical presentation.

Field strength and sequences: 1.5 T. T1-weighted (T1W) spoiled gradient echo, T1 map with …

2025-05-00 Newsletter, Morehead State University. Staff Congress.

Staff Congress Records

Staff Congress newsletter from May of 2025.

Data-Driven Audits: Audit Analytic Platforms And General Ledger Analytic Tools, Daniel E. O'Leary, Vernon J. Richardson, Marcia Weidenmier Watson

Accounting Faculty Publications and Presentations

The future of auditing is a data-driven audit, which extracts and analyzes digital data stored in client accounting systems. To help conduct data-driven audits, audit firms are developing audit analytic platforms (AAPs). This paper focuses on one key application tool of AAPs that analyzes the entire population of general ledger transactions. These general ledger analytics tools (GLATs) use assessment routines to assign a risk score to each transaction, helping guide the auditor’s planning, risk assessment, and selection of high-risk transactions for substantive procedures. GLATs help support audit quality and provide valuable new insights about client operations. We discuss the analytics …

Quantitative Ablation Confirmation Methods In Percutaneous Thermal Ablation Of Malignant Liver Tumors: Technical Insights, Clinical Evidence, And Future Outlook, Iwan Paolucci, Jessica Albuquerque Marques Silva, Yuan-Mao Lin, Alexander Shieh, Anna Maria Ierardi, Gianpaolo Caraffiello, Carlo Gazzera, Kyle A Jones, Paolo Fonio, Reto Bale, Kristy K Brock, Marco Calandri, Bruno C Odisio

Faculty, Staff and Student Publications

Percutaneous image-guided thermal ablation is an established local curative-intent treatment technique for the treatment of primary and secondary malignant liver tumors. Whereas margin assessment after surgical resection can be accomplished with microscopic examination of the resected specimen, margin assessment after percutaneous thermal ablation relies on cross-sectional imaging. The critical measure of technical success is the minimal ablative margin (MAM), defined as the minimum distance between the tumor and the edge of the ablation zone. Traditionally, the MAM has been assessed qualitatively using anatomic landmarks, which has suboptimal accuracy and reproducibility and is prone to operator bias. Consequently, specialized software-based methods …

Imaging In Pelvic Exenteration-A Multidisciplinary Practice Guide From The Esgar-Sar-Esur-Pelvex Collaborative Group, Stephanie Nougaret, Doenja M J Lambregts, Geerard L Beets, Regina G H Beets-Tan, Lennart Blomqvist, David Burling, Quentin Denost, Maria A Gambacorta, Benedetta Gui, Ann Klopp, Yulia Lakhman, Kate E Maturen, Riccardo Manfredi, Iva Petkovska, Luca Russo, Atul B Shinagare, James A Stephenson, Damian Tolan, Aradhana M Venkatesan, Aaron J Quyn, Rosemarie Forstner

Faculty, Staff and Student Publications

Pelvic exenteration (PE) is a radical surgical approach designed for the curative treatment of advanced pelvic malignancies, requiring en-bloc resection of multiple pelvic organs. While the procedure is radical, it has shown promise in enhancing long-term survival and is now comparable in surgical mortality to elective resections for primary pelvic cancers. Imaging plays a crucial role in preoperative planning, with MRI, CT, and PET/CT being pivotal in assessing the extent of cancer and formulating a surgical roadmap. This paper presents clinical practice guidelines for imaging in the context of PE, developed jointly by ESGAR, SAR, ESUR, and the PelvEx Collaborative. …

In Vivo Assessment Of Cardiac Radiofrequency Ablation In A Large-Animal Model Using Photoacoustic-Ultrasound Imaging, Nilesh Mathuria, Krithik Vishwanath, Blake C Fallon, Antonio Martino, Giorgio Brero, Richard C Willson, Miguel Valderrabano, Carly S Filgueira, Richard R Bouchard

Faculty, Staff and Student Publications

Despite advancements in catheter technology, intraoperative assessment of radiofrequency ablation (RFA) lesions remains elusive. Prior ex vivo data suggest photoacoustic imaging (PAI) can provide RFA lesion characteristics, but in vivo data are lacking. PAI involves delivering near-infrared light to tissue, leading to transient acoustic waves that can be detected by clinically available ultrasound transducers, providing optically based tissue characterization at depth. Three epicardial RFA lesions were delivered in an open-chest porcine model. In vivo PAI-based measurements of RFA lesion dimensions matched (< 0.7-mm error) gross pathologic assessment, yielding in vivo feasibility data of PAI to provide intraoperative RFA lesion dimensions.

Quantifying Photon Counting Detector (Pcd) Performance Using Pcd-Ct Images, Linying Zhan, Guang-Hong Chen, Ke Li

Faculty, Staff and Student Publications

Background: Photon counting detector CTs (PCD-CTs) have recently been introduced to clinical imaging. This development creates a new need for end-users to quantify and monitor the physical performance of PCDs. Traditionally, the characterization of PCD performance relied on detector counts, which are typically accessible to the manufacturer but are not usually available to clinical end-users.

Purpose: The goal of this work was to develop a new method for quantifying PCD performance using reconstructed PCD-CT images, without requiring access to the PCD counts.

Methods: The proposed method is based on a set of closed-form relationships that connect PCD-CT image noise, the …

Temporal Trends Of Subsequent Central Nervous System Malignancies Among Survivors Of Childhood Cancer, Robert T Galvin, Yan Chen, Yan Yuan, Tabitha Cooney, Rebecca Howell, Susan Smith, Michael A Arnold, Miriam Conces, Wendy Leisenring, Gregory T Armstrong, Joseph P Neglia, Lucie M Turcotte

Faculty, Staff and Student Publications

Background: It is not known whether temporal changes in childhood cancer therapy have reduced risk of subsequent malignant neoplasms of the central nervous system (CNS), a frequently fatal late effect of cancer therapy.

Methods: Five-year survivors of primary childhood cancers diagnosed between 1970 and 1999 in the Childhood Cancer Survivor Study with CNS subsequent malignant neoplasms were identified. Cumulative incidence rates and standardized incidence ratios were compared among survivors diagnosed between 1970-1979 (n = 6223), 1980-1989 (n = 9680), and 1990-1999 (n = 8999). Multivariable models assessed risk factors for CNS subsequent malignant neoplasms.

Results: A total of 157 CNS …

Overlapping Clinical Phenotypes In Patients With Primary Ciliary Dyskinesia Or Activated Phosphoinositide 3-Kinase Delta Syndrome, Adam J Shapiro, Eveline Y Wu, Deborah J Morris-Rosendahl, Kenneth N Olivier, Sharon D Dell, Scott D Sagel, Cullen M Dutmer, Ricardo A Mosquera, Markus Rose, Michael G O'Connor, Chi A Ma, Gulbu Uzel, Timothy J Vece, Maimoona A Zariwala, Michael R Knowles, Margaret W Leigh, Stephanie D Davis, Thomas W Ferkol

Faculty, Staff and Student Publications

Primary ciliary dyskinesia and activated phosphoinositide 3-kinase delta syndrome type 1 present similarly, with recurrent respiratory infections and reduced nasal nitric oxide levels. When diagnostic confirmation of primary ciliary dyskinesia with genetic testing and/or ciliary electron microscopy is inconclusive, activated phosphoinositide 3-kinase delta syndrome type 1 and other inborn errors of immunity must be investigated.

Understand The Power Of Resilient Adult Survivors Of Childhood Neglect, Sheena Smith

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study was to explore the lived experiences of adults from New York (NY) and New Jersey (NJ) who have overcome adverse childhood experiences and describe their experiences in becoming resilient. Adverse childhood experiences have been linked to various health disparities, including depression, anxiety, substance misuse, and physical health concerns. However, limited research focuses specifically on resilience among survivors of childhood neglect and adversity. The study investigated the subjective experiences of adults residing in New York and New Jersey who have experienced high levels of ACEs, including neglect and abandonment. The study answered the following …

Shame, Identity And Reconciliation With Christ, Michele D. Corgiat

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the impact of reconciliation with Christ on shame narratives and identity. Although shame and identity has been extensively researched, the added theological construct of reconciliation with Christ makes this research unique. This phenomenological study explored the impact of reconciliation with Christ on shame narratives and identity. Sixteen participants, ages 20 to 75 years, who professed to have reconciled with Christ through faith and repentance, were selected and interviewed. Each participant was interviewed three times over a four-week period using a transcendental phenomenological method. Data were collected and analyzed using reflexive thematic …

Using Technology Responsibly To Align Church Ministry With God's Plan, Sandra Rolon-Rodriguez

Doctoral Dissertations and Projects

The proliferation of digital technologies, including live-streaming services, online community platforms, and virtual events, is revolutionizing the operational dynamics of church ministries. Churches of all sizes are embracing these changes to expand their influence, engage with members in new ways, and enhance the impact of digital technology on their ministry. Implementing digital transformation has led to innovative approaches in worship services, outreach programs, and community engagement, enabling churches to meet the evolving needs of their congregation and the broader community.

This dissertation-in-praxis explores the broader biblical and theological significance to gain a deeper understanding and demonstrate the practical application of …

The Effects Of Hyper-Communication: A Quantitative Study On Workplace Productivity, David J. Olson

Doctoral Dissertations and Projects

Today's workforce is overwhelmed with information delivered by tools designed to make them more productive. In a milieu of distraction and overload, employees are disadvantaged in processing the tremendous volumes of information they receive. This is called hyper-communication, which is associated with stress, overload, communication misalignment, and, ultimately, distractedness that impairs an employee’s work efficiency. This quantitative study presents research conducted through surveys examining hyper-communication's effects on workplace productivity. A sample of 631 respondents, solicited through social media, participated in this study. The participants came from diverse occupational backgrounds, providing cross-sectional insights into how factors like employees' titles, roles, gender, …

A Holistic Case Study On Leaders In The Division Of Enrollment Services’ Experiences Implementing Interdepartmental Partnerships In Higher Education, Christopher A. Almond

Doctoral Dissertations and Projects

The purpose of this holistic case study was to understand the experiences of higher education leaders in the division of enrollment services at a public research university who experienced departmental realignments or mergers because of performance-based funding initiatives. The study addresses the gap in the literature on the effect of change on interpersonal relationships in higher education. The theory guiding the study is Tierney’s theory on organizational behavior among college employees. The research methodology consisted of three phases. I conducted focus groups, individual interviews, and document analyses. The setting was a large research university in an urban city. There were …

Positive And Negative Religious Coping As A Moderator Of The Relationship Between Covid-19 Stressors And Employee Burnout Among Vocational Rehabilitation Counselors, Kristen M. Lewis

Doctoral Dissertations and Projects

During the investigation of this study, no study was located that explores the moderating effects of both positive religious coping (PRC) and negative religious coping (NRC) on the COVID-19 stressor-employee burnout relationship within the vocational rehabilitation counseling (VRCs) profession. Therefore, this study sought out to examine just that. Recruitment emails were sent out to VRCs to obtain 79 participants who were at least 18 years old, have worked at least 6 months as a VRC during the COVID-19 pandemic, and worked an average of 20 hrs/week. Each participant completed a 20-minute online survey containing CIS, PSS, MBI-HSS, Brief RCOPE scales. …

A Descriptive, Comparative Study Of Preexisting Leadership Qualities And Leadership Effectiveness Of Theologically Conservative United States Army Battalion-Level Chaplains, Aaron Jonathan Fabian

Doctoral Dissertations and Projects

This immediate demand for spiritual and professional leadership can be overwhelming for a new battalion-level chaplain (Blackaby 2001; Howell 2003). They perform or provide religious service for Soldiers who have volunteered to serve their country. By going through the same military training in conjunction with their religious education and experience, chaplains are able to integrate with Soldiers where traditional clergy cannot. There is additional pressure to perform because chaplains, as commissioned officers, are evaluated immediately through an annual Officer Evaluation Report (OER hereafter, DA Form 67-9). With no time to acquire new skills, battalion-level chaplains are forced to rely on …

A Trauma-Informed Study Of Combat-Related Loss: Sibling Descriptions Of Traumatic Grief And Bereavement Support, Ashleigh Carlin

Doctoral Dissertations and Projects

The purpose of this qualitative descriptive study was to explore how individuals in the United States describe their grief and the bereavement support they have received after experiencing the traumatic loss of a military sibling(s) due to hostile action while engaged in combat operations. Cohen and Wills' social support model, which demonstrates how social connections buffer the effects of stress and loss, guided this study to explain how the role of bereavement support, or lack thereof, influenced how surviving military siblings process their grief. The study sought to elicit in-depth responses that provided rich insights and descriptions. Data collection involved …

Christian Nationalism: Comparing Sociological Critiques To Christian Political Theologies, Daniel Christopher Samms

Doctoral Dissertations and Projects

The definition of Christian Nationalism which attempts to link White Nationalism to Christian appeals to God as the basis for justice is not reflective of any prominent, contemporary version of Christian political theology. This is demonstrated through an analysis of the prominent definition of Christian Nationalism used by sociologists such as Samuel L. Perry, Andrew L. Whitehead, and Joshua B. Grubbs as well as an analysis of three prominent Christian approaches to Christian Nationalism and their respective approaches to the basis for civil law in the public square.

The Messages Of James To The Rich: Warnings Rather Than Exclusions, Joseph Daniel Peters

Doctoral Dissertations and Projects

James frequently references or alludes to the poor and the rich throughout his epistle (1:9–11; 2:1–10, 14–20; 4:13–17; 5:1–6). Even though most scholars throughout church history have accepted that the poor are Christians among the churches James is writing to, it has been debated on whether he is presenting the rich as Christians or as outsiders. If the wealthy are outsiders to the churches, then his messages about them would serve to encourage the recipients by assuring them that their rich oppressors will be punished, which would also discourage any imitation of their oppressive practices. However, if the wealthy are …

Engaging Church Teams To Support Youths Aging Out Of Care, John Alan Honeycutt

Doctoral Dissertations and Projects

Emerging Adults (EAs) in out-of-home care (OHC) face significant challenges when aging out of the foster care system, including histories of traumatic experiences. Approximately 30,000 exit Child Protective Services (CPS) annually, with 4,000 becoming instantly homeless. This study used a facilitated grounded theory approach, engaging 14 participants representing two churches. The aim was to identify the topmost factors for gaining interest, commitment, and action from a Volunteer Church Team Volunteer Team to assist one EA in their transition to independent living (IL). Primarily, non-Hispanic White and Native American Indian participants aged 35–65 contributed insights during three hours of brainstorming and …

A Qualitative Phenomenological Exploration Of The Experience Menopausal African American Women Have With Their Health Care Providers And Accessing Treatment For Menopausal Symptoms, Michelle Way-Houser

Doctoral Dissertations and Projects

This phenomenological qualitative case study delved into the underexplored area of menopausal research as it pertains to African American women. This study aimed to identify the existing gap in literature, through examining the factors contributing to the disparity, and proposed potential solutions. By conducting a thorough review of the available evidence, this study sheds light on the unique challenges faced by African American women during menopause and advocates for more inclusive and diverse research approaches in this field. Semi-structured interviews were conducted with ten participants and thematic analysis was used to identify key themes related to symptom management, healthcare access, …

A Weapon In One Hand And A Bible In The Other: Places Of Worship Are Under Attack, Edmond J. Bergeron

Doctoral Dissertations and Projects

This qualitative descriptive study aims to ascertain the degree of preparedness for reducing and preventing extreme violence and the countermeasures that are in place (or lack thereof) at houses of worship. All places of worship in this study are considered soft targets and not “holy ground” as traditionally referenced. The terms “places of worship” and “church” will be used interchangeably in this study. A place of refuge for both the physical and spiritual is now considered vulnerable as the congregants are focused on worship rather than protection from an attack. Violence against places of worship will be described at this …

On A Wing And A Prayer: A Phenomenological Study Of High School Teachers' Experiences Teaching Ell Students, Malerie Rene Huguley

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to understand the self-efficacy of high school ELL teachers at a large private high school in central Virginia. The theory guiding this study was Bandura’s self-efficacy theory and how it related to high school teachers’ preparation and confidence in teaching ELL students. The central research question for this study was: What are the experiences of high school general education teachers who teach ELL students in a private school setting? This study was a qualitative transcendental phenomenological study that included the lived experiences of 13 high school teachers. Data were collected from participants using …

A Qualitative Study Of The Lived Experiences Of Individuals Whose Parents Or Grandparents Had/Have Substance Abuse Issues In The Midwest, Brandie Lee Gaudet

Doctoral Dissertations and Projects

This study focused on the lived experiences of individuals being raised by individuals who had/have substance abuse issues in the Midwest region of the United States of America. A closer look at this topic offered new insight into treatment and resources for adult children raised by parents/grandparents (collectively “parents”) with substance abuse issues (“SAI”) and how the parents’ substance abuse issues compromised the behavioral health outcomes of the adult children and affected the parents’ parenting outcomes. Understanding the role of family systems theory in adaptive and maladaptive behaviors is essential when formulating a plan to help individuals’ negatively impacted by …

Lived Experiences Of Older Adults After Involuntary Work Separation, Mark Mallock Rose

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study was to describe the lived experiences of those subjected to involuntary work separation at age 50+ in the United States. The literature concerning involuntary job loss is lacking in research pertaining to the 50+ age demographic. This research is important in the aspect that older workers face specific challenges that their younger counterparts may not after involuntary work separation. Understanding the psychological responses, positive aspects, and negative aspects of involuntary job separation in older adults added to the literature for those aged 50+. The research design was qualitative inquiry using virtual recorded interviewing …

The Relationship Of Proximate-Peer Characteristics Of Seed Accelerator Participants To Member Firm Survival Outcomes, Matthew David Crowley

Doctoral Dissertations and Projects

This study examined how composite gender and ethnic heterogeneity present at three levels of proximate-peer groups of accelerators—firms, cohorts, and alumni—relate to firm survival within five years after program graduation. This research addresses the problem that accelerator membership alone does not guarantee firm success by examining the factor of heterogeneity on survival using a fixed-design, quantitative, correlational approach via a Cox proportional hazards model. Using archival data from Crunchbase on Y Combinator cohorts running from 2013 to 2017 augmented with demographic output from NamSor, the study investigated whether diversity at various levels of proximate-peer interactions related to the hazard of …