Digital Commons Network^™

Race-Associated Egfr And Kras Mutation Profiles In Lung Adenocarcinoma, Lovyanne Vergel De Dios, Catherine Wu, Salique Hassan Shaham, Manish K. Tripathi

School of Medicine Publications

Background: Lung adenocarcinoma (LUAD) is the most prevalent histologic subtype of non-small cell lung cancer (NSCLC) and exhibits considerable molecular heterogeneity. Among the most clinically significant driver alterations are mutations in EGFR and KRAS, both of which influence treatment selection and oncologic outcomes. The prevalence of these mutations varies by race, yet racial minority populations remain underrepresented in genomic studies. EGFR alterations are more frequently observed in Asian patients, while KRAS mutations predominate in non-Asian cohorts. This study aimed to characterize race-associated differences in driver mutation prevalence among Asian, Black, and White patients with LUAD. Methods: A retrospective secondary cohort …

Engagement Of Understudied Populations As Community Change: The South Texas Adrc Model, Gladys E. Maestre, Neela K. Patel, Rosa V. Pirela, Robin C. Hilsabeck, Kendra Stine, Neyra García, Roberto Reyes, Omar Oropeza, Cristian Maestre, Jesus D. Melgarejo, Sarah Williams-Blangero, Ney Alliey Rodriguez, Sylvia A. Robles

School of Medicine Publications

Many populations experiencing the highest burdens of Alzheimer's disease and related dementias remain understudied, in part because traditional recruitment and retention models are insufficient to support sustained engagement. The Outreach, Recruitment, and Engagement Core (OREC) of the South Texas Alzheimer's Disease Research Center reconceptualized participant recruitment as a long-term system change in a Hispanic-majority, urban–rural region. OREC institutionalizes shared power through community advisory governance, aligns research protocols with local lived realities (through patient navigators, community health workers/promotores, and decentralized access points), and employs a data-driven feedback loop for continuous improvement. In 1 year, 46 outreach events touched 10,134 individuals (71% …

Timing Of Middle Meningeal Artery Embolization And Surgery: Analysis Of The Embolise Trial, Maxim Mokin, Jared Knopman, Jason M. Davies, Ameer E. Hassan, Robert E. Harbaugh, Alexander Khalessi, Jens Fiehler, Elad I. Levy

School of Medicine Publications

Background: The EMBOLISE trial (The Embolization of the Middle Meningeal Artery With Onyx Liquid Embolic System in the Treatment of Subacute and Chronic Subdural Hematoma) demonstrated that middle meningeal artery embolization as an adjunct to surgical drainage reduces recurrence of symptomatic subacute and chronic subdural hematomas. We performed a subgroup analysis of the EMBOLISE surgical cohort to determine how the timing of embolization relative to surgery impacted various outcomes.

Methods: We performed a post hoc subgroup analysis to examine the association of the timing of embolization relative to surgery with the primary end point (hematoma reoperation within 90 days), secondary …

The Reverse Insert: Inverting The Traditional Vocal Signal Processing Chain As A Dancehall Production Method, Benson Madzivire

Postgraduate

Standard vocal production practice places reverberation at the end of the signal chain, after corrective processes such as equalisation, compression, de-essing, and pitch correction, so the effect functions as a spatial finish rather than a formative stage of the sound. This exegesis reports on the Reverse Insert, a technique first discovered through a deliberate rule-breaking exercise in an earlier Masters of Creative Industries production unit, in which a reverb plugin, FabFilter Pro-R 2 (FabFilter, 2023), is placed as the very first insert on the vocal channel, ahead of pitch correction, de-essing, and dynamic compression. The research question asks how this …

Understanding What Works In Disseminating Clinical Practice Guidelines: A Qualitative Evidence Synthesis, Sumanth Kumbargere Nagraj, Tandekile Lubelwana Hafver, Valerie Reinthaler, Stijn Van De Velde, Carlos Zaror, Yan Jiao Shen, Susan Banda, Talitha Mpando, Gertrude Kunje, Suzgika Lakudzala, Ameer Hohlfeld, Emmanuel Effa, Denny Mabetha, Thomas Agoritsas, Per Olav Vandvik, Nicolas Delvaux

Peninsula Dental School

Objective To identify the barriers and facilitators that influence the dissemination of clinical practice guidelines (CPGs) and to explore the perceived usefulness, practical utility, expectations, and unmet needs of end users in relation to current dissemination strategies. Methods This qualitative evidence synthesis (QES) is a part of mixed-methods evidence synthesis. We searched literature from MEDLINE, Embase, CINAHL, Web of Science, Scopus, Epistemonikos, and Agency for Healthcare Research and Quality and Medical Guidelines Clearing house on January 30, 2025. Screening, data extraction and quality appraisal of the included studies were done by at least two authors independently and in duplicate. We …

Geodesic Completeness And The Hopf-Rinow Theorem, Christopher Farias

Electronic Theses, Projects, and Dissertations

Differential geometry is concerned with the properties of calculus and geometry on curved n-dimensional manifolds. As a result, thinking about such a space often runs counter to the Euclidean geometer's intuition of distances, angles, and transformations. This thesis aims to build up to proving an important result in the study of Riemannian manifolds: the Hopf-Rinow theorem.

In Chapter 2, we begin by defining what a manifold is and showing that the collection of directional derivatives at a point on the manifold spans a tangent vector space. After defining a basis and a metric for this space, in Chapter 3, we …

From Genes To Streams: Mitochondrial Approaches To Population Monitoring Of The Santa Ana Sucker Catostomus Santaanae, Mariana Antonio

Electronic Theses, Projects, and Dissertations

This study was developed to use aquatic environmental DNA (eDNA) as a tool to detect the presence of the Santa Ana sucker (Catostomus santaanae), a federally threatened fish species, across the Santa Ana River in Southern California. Environmental DNA is any genetic material that an organism sheds into the environment. We can get an idea of what aquatic species are present when sampling water at a given site. We sequenced the complete mitochondrial genome (mitogenome) of the Santa Ana sucker and designed custom DNA primers to improve eDNA detection accuracy. These primers were selected based on high genetic …

Advantages Of Dynamic Representation For Related Rates Problems In Calculus, Eri Osuna

Electronic Theses, Projects, and Dissertations

Related-rates problems are a standard yet persistently difficult topic in first-semester calculus. Research increasingly recommends dynamic visualization tools such as GeoGebra, but direct comparisons of static and dynamic representations in related-rates settings remain scarce. This qualitative study examines how representation type shapes the quality of students' reasoning and their perceived experience during related-rates problem solving. Six mathematics students who had completed Calculus —a group of four undergraduates and a pair of graduate students—completed a static sliding-ladder task and a dynamic airplane-and-camera task supported by an interactive GeoGebra applet, followed by an interview. Findings indicate that the two representations supported reasoning …

The Effect Of Telehealth Expansion On The Health Equity Of Underserved Populations, Mansi B. Satani

Electronic Theses, Projects, and Dissertations

The rapid expansion of telehealth, during and after the COVID-19 pandemic, has changed healthcare delivery in the United States. The use of telehealth can potentially decrease disparities related to isolation, shortage of providers and barriers to transportation, however, its impact on health equity in underserved populations is unknown. This paper explores how telehealth expansion impacts rural populations' access to healthcare, health outcomes, and equity. It also examines its impact on populations with low income, racial, ethnic minorities, and Medicaid recipients who frequently encounter obstacles to healthcare and digital access (Nouri et al., 2020; Shah et al., 2024). A mixed-method design …

Student Attitudes And Perceptions Of Proof In Mathematics, Emelin G. Sibrian Marquez

Electronic Theses, Projects, and Dissertations

Traditionally, mathematical proof is viewed primarily as a tool for validation or verification. However, proof holds many other important roles such as discovery, reasoning, explanation, and justification. For many students, these other roles are not always obvious. Those encountering rigorous proof for the first time often find the process abstract, intimidating or disconnected from their previous learning. This disconnect can lead to negative attitudes as students transition from computational mathematics to advanced proof-based mathematics. Utilizing a mixed-methods approach, this study examined undergraduate and graduate mathematics students at a Hispanic-Serving Institution (HSI) in Southern California. We investigated what students perceive the …

How Recent Medicaid Defunding Has Impacted San Bernardino County Residents Access To Health Care Services, Samantha I. Rios

Electronic Theses, Projects, and Dissertations

Background: Medicaid is a critical source of health insurance for low-income populations in the United States, providing access to essential preventative, primary, and reproductive health care services (Donohue et al., 2022). The Medicaid defunding of 2025 and policy changes that follow have raised concerns regarding increased barriers to care, particularly among low-income and vulnerable populations who rely on safety-net providers such as Planned Parenthood (Planned Parenthood, 2025). The purpose of this study was to examine how the 2025 Medicaid defunding has impacted access to general and reproductive health care services among residents of San Bernardino County, California.

Conclusion: The research …

Effects Of Photosynthetic Mode On Growth In Closely Related Tillandsia Species, Jeremy L. Read

Electronic Theses, Projects, and Dissertations

To examine the effects of photosynthetic mode (C3 vs CAM) on plant productivity, subjects of the sister taxa Tillandsia confertiflora (a C3 species) and Tillandsia latifolia (a CAM species) were grown under controlled conditions via growth chamber over 30 weeks. These subjects were divided into non-stressed and drought stress groups. Subjects were compared for total biomass gained or lost over the time period as well as physiological stress measures and CAM activity. The primary conclusion is that usage of CAM does not show major differences or tradeoffs for overall productivity. Future work is needed to clarify if this holds true …

From Margins To Center: Los Deslenguados In The Borderlands, Brissa S. Porras Villalobos

Electronic Theses, Projects, and Dissertations

Borderland literature is a subgenre that often includes narratives of migration, tribulations, identity development, and resilience. It foregrounds the collaboration of vulnerability, isolation, connection, and power, showing that hybridity is a source of cultural energy. Acknowledging the borderland and its culture is crucial because it challenges stereotypes, validates marginalized voices, and celebrates heritage in all its complexity. By centering these experiences, borderland literature affirms the potential of living between cultures, prioritizing the recognition of the in-between, valuing and celebrating the space where identities are continually reshaped, histories are reclaimed, and resilience is nurtured rather than neglected. Using Gloria Anzaldúa's theory …

Navigating Undone Science: The Search For Adequate Endometriosis Care, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Endometriosis is an estrogen-dependent disease in which tissue similar to the lining of the uterus grows elsewhere in the body leading to a variety of symptoms including heavy and prolonged menstruation, chronic pain, cysts, infertility, and gastrointestinal issues. Despite being one of the most common gynecologic conditions, much remains unknown about potential risk factors for endometriosis, its etiology, and treatment options. First and second-line biomedical treatment options, complementary and alternative medicine, and lifestyle changes are all treatment options that people living with endometriosis (PLE) leverage to manage their symptoms. This article draws on in-depth interviews with 52 people living with …

Extending Genome-Wide Association Studies To Admixed Cohorts With High Degrees Of Relatedness, Taotao Tan, Alejandra Vergara-Lope, José Jaime Martínez-Magaña, Nirav N Shah, Yi-Sian Lin, Kai Yuan, Jaime Berumen, Jesus Alegre-Díaz, Pablo Kuri-Morales, Roberto Tapia-Conyer, Joel Gelenter, Janitza L Montalvo-Ortiz, Wei Zhou, Jason M Torres, Elizabeth G Atkinson

Duncan NRI Faculty and Staff Publications

Admixed populations comprise a large portion of the human population worldwide, but are often excluded from genome-wide association studies (GWASs) due to analytic challenges. Our group developed Tractor, a local-ancestry-informed GWAS tool designed for admixed samples that produces accurate ancestry-specific effect sizes and boosts the discovery power to identify ancestry-enriched loci. However, Tractor operates under an assumption of unrelated samples. Here, to address this gap, we propose Tractor-Mix, which allows for well-calibrated association studies in datasets containing admixed samples with relatedness. Extensive simulations show that this method is competitive with other state-of-the-art approaches that do not produce ancestry-specific results. Empirical …

A Blended Genome And Exome Sequencing Method Captures Genetic Variation In An Unbiased And Cost-Effective Manner, Toni A Boltz, Benjamin B Chu, Matthew Defelice, Calwing Liao, Julia M Sealock, Robert Ye, Jacqueline I Goldstein, Lerato Majara, Jack M Fu, Susan K Service, Lingyu Zhan, Sarah E Medland, Sinéad B Chapman, Simone Rubinacci, Jonna L Grimsby, Tamrat Abebe, Melkam Alemayehu, Fred K Ashaba, Elizabeth G Atkinson, Tim B Bigdeli, Amanda B Bradway, Harrison Brand, Lori B Chibnik, Samuel Deluca, Ana M Diaz-Zuluaga, Abebaw Fekadu, Michael Gatzen, Bizu Gelaye, Stella Gichuru, Marissa L Gildea, Toni C Hill, Hailiang Huang, Kalyn M Hubbard, Wilfred E Injera, Roxanne James, Moses Joloba, Christopher Kachulis, Phillip R Kalmbach, Rogers Kamulegeya, Gabriel Kigen, Soyeon Kim, Nastassja Koen, Edith K Kwobah, Joseph Kyebuzibwa, Seungmo Lee, Niall J Lennon, Penelope A Lind, Esteban A Lopera-Maya, Johnstone Makale, Serghei Mangul, Justin Mcmahon, Pierre Mowlem, Henry Musinguzi, Rehema M Mwema, Noeline Nakasujja, Carter P Newman, Lethukuthula L Nkambule, Conor R O'Neil, Ana Maria Olivares, Catherine M Olsen, Linnet Ongeri, Sophie J Parsa, Adele Pretorius, Shengying Qin, Raj Ramesar, Faye L Reagan, Chiara Sabatti, Jacquelyn A Schneider, Welelta Shiferaw, Christine Stevens, Anne Stevenson, Erik Stricker, Rocky E Stroud, Jessie Tang, Megan Townsend, David Whiteman, Mary T Yohannes, Mingrui Yu, Kai Yuan, Dickens Akena, Lukoye Atwoli, Symon M Kariuki, Karestan C Koenen, Charles R J C Newton, Dan J Stein, Solomon Teferra, Zukiswa Zingela, Carlos N Pato, Michele T Pato, Carlos Lopez-Jaramillo, Nelson B Freimer, Roel A Ophoff, Loes M Olde Loohuis, Michael E Talkowski, Benjamin M Neale, Daniel P Howrigan, Alicia R Martin

Duncan NRI Faculty and Staff Publications

Here we developed and deployed the blended genome exome (BGE) method, a DNA library approach that generates low-pass whole-genome (1–4× mean depth) and deep whole-exome (30–40× mean depth) data in a single sequencing run. BGE is cost-effective, empowers most genomic discoveries possible with deep whole-genome sequencing and captures global common single-nucleotide polymorphism diversity. We applied BGE to sequence >53,000 samples from the PUMAS Project (Populations Underrepresented in Mental Illness Associations Studies), including African, African American and Latin American populations. Imputed genotypes showed high concordance with Illumina Global Screening Array calls (R2 ≥ 95% for minor allele frequency ≥1%; …

Hippo Signaling Regulates Cuticle Pigmentation And Dopamine Metabolism In Drosophila, Shelley B Gibson, Samantha L Deal, Ye-Jin Park, Bo Sun, Yanyan Qi, Jung-Wan Mok, Hyung-Lok Chung, Hongjie Li, Shinya Yamamoto

Duncan NRI Faculty and Staff Publications

Pigmentation plays multiple important roles in development, physiology and evolution. Melanization of the insect cuticle requires dopamine as a precursor of melanin and involves key enzymes in dopamine biosynthesis including Tyrosine hydroxylase (TH) and Dopa decarboxylase (Ddc). Some studies have hinted that disruption of the evolutionarily conserved Hippo signaling pathway, which has been primarily studied in the context of tissue growth, may lead to changes in cuticle pigmentation in the fruit fly Drosophila melanogaster. However, to our knowledge, there have not been any systematic investigations into their potential mechanistic links. In this study, we identified that all genes that comprise …

Borderplex Business Barometer, Volume 10, Number 8, Thomas M. Fullerton, Steven L. Fullerton

Border Region Modeling Project

No abstract provided.

Tribal Reciprocity In Action: Good Medicine For Community & Academia, Keona Marie Manuelito

Theses and Dissertations

The practice of good medicine should be universal and accessible to all; however, for many Indigenous communities, equitable healthcare remains elusive. The historical trauma experienced by Indigenous peoples continues to shape health disparities and institutional mistrust, yet Indigenous communities persist through strength, resilience, sovereignty, and Indigenous knowledge systems. The products that follow embody strengths-based approaches that elevate and support Indigenous science, health, and self-determination. The manuscript identifies key elements necessary to establish the feasibility and institutional support for a peer-reviewed journal centered on Indigenous Health within the United States. A qualitative descriptive study was conducted using semi-structured interviews with journal …

Qualitative Exploration Of Understanding Gluten Intolerance: Knowledge, Experiences, And Perceptions Among American Indian Adults Living On The Mandan, Hidatsa, And Arikara Nation, Roselle M. Martin

Theses and Dissertations

Background: This dissertation examines gluten intolerance, particularly celiac disease (CD), within American Indian communities. Although CD has been traditionally considered more common among people of European descent, emerging evidence suggests increasing rates among American Indian populations as dietary patterns have shifted from traditional, naturally gluten-free foods to diets containing higher levels of gluten. These dietary changes, along with possible genetic factors and historical underdiagnosis, highlight the importance of understanding how gluten-related health concerns are recognized and discussed within American Indian communities. Lower rates of diagnosis may reflect limited awareness of symptoms and challenges in communicating gluten-related health experiences rather than …

The Centers For Disease Control And Prevention's Healthy Tribes Program: Uncertainty Around Executive Orders During 2025 - A Qualitative Study, Gem Wilson

Theses and Dissertations

Programs that center culture as prevention are required for promoting holistic health and well-being in American Indian and Alaska Native communities, however limited research demonstrates how these programs are affected by federal policy instability. Securing and sustaining funding for culturally centered initiatives is essential not only for reducing health inequities, but also for upholding Tribal self-determination and the federal government’s trust and treaty obligations.

This qualitative study examines the impact of federal funding uncertainty related to executive orders issued in 2025 on the Centers for Disease Control and Prevention’s Healthy Tribes program.

This Tribally driven study employed Knowledge Sharing Sessions, …

Cultivating Kalo In Diaspora: A Qualitative Exploration Of Growing And Harvesting Kalo And Its Connection To Health Among Native Hawaiian Adults In The United States, Nicole Lee Kamakahiolani Ellison

Theses and Dissertations

For Native Hawaiians, kalo, known in English as taro, is more than a traditional food; it is an ancestor. As Hāloa, kalo embodies genealogy, cultural identity, and foundational relationships with ʻāina. Today, the majority of Native Hawaiians live outside of Hawaiʻi, yet little research has explored the experiences of Native Hawaiians cultivating kalo while living in the continental United States. Understanding these experiences shows how Native Hawaiians in diaspora sustain cultural practices, identity, and relationships with Hāloa and ʻāina. This descriptive qualitative study explored the experiences and perceptions of growing and harvesting kalo among Native Hawaiian adults living in the …

Public Good, Politics, And Public Goods: The Social Construction Of Educators In Progressive Era North Dakota, Kevin Joel Read

Theses and Dissertations

This dissertation examines education reforms in North Dakota’s early Nonpartisan League period (circa 1916-1920) by focusing on three policy vignettes located in the local, state, and higher education domains. Together, this dissertation investigates the tensions and nuances of modernizing education in the state including the conditions which created a moment for rapid policy implementation, and the factors which led to that moment ending. The local vignette focuses on housing policy for educators, and the state’s consolidation of education governance into a Board of Administration is explored in the state and higher education chapters. Additionally, the role educators in the state …

Cultural Identification And Preferences In Treatment For American Indian Adults With Substance Use Disorder, Megan Kay Saboo

Theses and Dissertations

Substance use disorders occur at a disproportionately higher rate for American Indian adults in the United States, yet there is a limited understanding of how those in the recovery process perceive their American Indian culture as a meaningful component of their treatment. This study intended to address this gap in the research and to assist with tribal efforts in treating substance use disorder among a small sample of American Indian adults enrolled in a Northern Plains tribe by assessing cultural identification and the importance, contribution, and incorporation of cultural traditions, practices, and ways of living into the recovery process. Results …

Strengthening Teacher Development Through School-University Partnerships: A Document Analysis Informed By Improvement Science, Holly Ripley

Theses and Dissertations

Teacher shortages have become a persistent challenge across the United States, particularly following the COVID-19 pandemic. Although alternative certification pathways have helped fill vacancies, many have also resulted in underprepared teachers entering the profession. This Dissertation in Practice addresses the need for sustainable solutions that strengthen teacher preparation while supporting school districts facing workforce shortages. Guided by improvement science and the Plan-Do-Study-Act cycle, this study investigates school-university partnerships as a strategy for addressing both teacher shortages and teacher preparedness. A qualitative document analysis was conducted to examine funded school-university partnerships and state policies that support their implementation. The study explored …

A Mixed Methods Study: Exploring The Concept Of Rematriation Through The Work Of Indigenous Doulas In New Mexico, Michelle Gutiérrez

Theses and Dissertations

Both the United States and New Mexico are facing a maternal health crisis. Despite significant resources and medical advances, Indigenous mothers continue to be impacted by health disparities. This research study explored the concept of Rematriation, most simply defined, as a return to a traditional and spiritual way of life with respect to Mother Earth or the Land, through the work of certified Indigenous birth doulas in New Mexico. Using a mixed methods approach that integrated a survey, body mapping, and interviews with 10 self-identified Indigenous doulas, this research sought insights and knowledge on their experiences and practices in birthwork, …

Gender Perceptions Of Occupational Therapy Students And The Impact On Academic Experience, John Brian Leclerc

Theses and Dissertations

Since its inception in 1917, the field of occupational therapy has maintained a pronounced gender imbalance, with females comprising the vast majority of practitioners despite major historical shifts in healthcare delivery. This dissertation examines how occupational therapist (OT) and occupational therapy assistant (OTA) students perceive gender and how these perceptions influence their academic experiences and future professional roles.

Using a multi-study design, this dissertation integrates qualitative and quantitative approaches across three articles. In article 1, focus groups were employed with doctoral OT students (N=30) and revealed five central themes: the value of gender diversity for learning, a nurturing and supportive …

Pezuta: Ceremony Assisted Treatment To Promote Recovery Among American Indians, Diana Blossom Hawkins

Theses and Dissertations

This study aimed to understand and describe the role of traditional ceremonies and its impact on American Indian adults’ ongoing sobriety and recovery from substance misuse. The research focuses on the perspective of those American Indian adults seeking services from a partnering Tribal-serving organization in South Dakota. A qualitative study design was applied through semi-structured focus groups to better understand relatives’ experiences of participation in ceremony and how it contributed to their recovery. Findings indicate that ceremony fostered healing and strengthened cultural resilience. This lead to recovery-oriented changes that work across cultural, relational, and individual dimensions to support recovery. Furthermore, …

Hidden In Plain Sight: A Single-Case Study Analysis Of An Established Employee Well-Being Department In Higher Education, Andria Spaeth

Theses and Dissertations

This study addresses the perceptions and experiences of student-facing staff within the Divisionof Student Affairs at the University of North Dakota to understand how they currently have their holistic well-being needs met through the Work Well department and the support they receive from the senior administration. A detailed review of the relevant literature is included. A qualitative single-case study research methodology is used alongside the Social Cognitive Theory framework to examine the current perceived support student-facing staff have.

The case study follows a bounded system approach with the Work Well department serving as the site selection as the worksite wellness …

Improving Health Literacy In Diagnostic Imaging For Indigenous Populations: Evaluating Practices, Integrating Policy, And Bridging Gaps, Kimberly Harn

Theses and Dissertations

Indigenous populations in the United States and internationally experience persistent disparities in healthcare access, patient communication, and health outcomes, including disproportionate cancer mortality rates and inequitable engagement with diagnostic imaging services. Communication barriers, limited health literacy, historical trauma, cultural incongruence, and structural inequities reduce meaningful participation in imaging-related care and contribute to delayed diagnosis and poorer outcomes. Despite the critical role of diagnostic imaging in disease detection and clinical management, the intersection of Indigenous health, health literacy, patient communication, and cultural safety within diagnostic imaging contexts remains substantially understudied.

This applied dissertation addresses that gap through three integrated scholarly products …