Digital Commons Network^™

Understanding Perceptions And Other Barriers To The Utilization Of Guideline-Directed Medical Therapy In Patients With Heart Failure With Reduced Ejection Fraction: A Provider Needs Assessment, Jessica Cox, Joseph Pfeifer

Doctor of Nursing Practice Projects

Background. Guideline-directed medical therapy (GDMT) is fundamental to the management of heart failure with reduced ejection fraction (HFrEF), yet its utilization remains suboptimal in clinical practice. Despite strong evidence supporting GDMT’s ability to improve survival and reduce hospitalizations, significant underutilization of these medications persist due to patient, provider, and system-level barriers.

Purpose. This project aimed to assess provider knowledge, perceptions, and barriers to prescribing GDMT for HFrEF within a single regional healthcare system. Data from this project will be used to inform targeted quality improvement strategies to enhance GDMT utilization and, ultimately, patient outcomes.

Methods. A cross-sectional survey was distributed …

Undergraduate Nursing Students’ Perceptions, Knowledge, And Barriers To Accessing Student Mental Health Services, Margot Sprague

Doctor of Nursing Practice Projects

Background: While improving the mental health of college students is a worldwide goal of the World Health Organization, programs to address student needs in the United States are underresourced, complex to access, and frequently confusing. In 2024, the National College Health Assessment found that 21% of college students scored high in severe psychological distress, 50% were positive for loneliness, 11% reported self-injury over the previous 12 months, and 28% scored positive on suicidal screening. Nursing students have increased levels of depression, anxiety, sleep disturbances, stress-related illness, and suicide. Aim: The first aim of this project was to identify perceptions, knowledge, …

Neurotensin Regulates Primate Ovulation Via Multiple Neurotensin Receptors, Andrew C. Pearson, Jessica S. Miller, Hannah J. Jensen, Ketan Shrestha, Thomas E. Curry Jr., Diane M. Duffy

Department of Biomedical and Translational Sciences Faculty Publications

Neurotensin (NTS), a small neuropeptide, was recently established as a key paracrine mediator of ovulation. NTS mRNA is highly expressed by granulosa cells in response to the luteinizing hormone (LH) surge, and multiple NTS receptors are expressed by cells of the ovulatory follicle. To identify the role of NTS receptors NTSR1 and SORT1 in ovulation in vivo, the dominant follicle of cynomolgus macaques (Macaca fascicularis) was injected with either vehicle control, the general NTS receptor antagonist SR142948, the NTSR1-selective antagonist SR48692, or the SORT1-selective antagonist AF38469. Human chorionic gonadotropin (hCG) was then administered to initiate ovulatory events. …

Mind The Gap: Supporting Freshmen Voice Students Transitioning To Higher Education Through Coaching Conversations, Erica L. Gabriel

Theses and Dissertations--Music

The experiences one may encounter while matriculating through the K-12 system of education are vastly different from the world of higher education. While one feeds directly into the other, the transition can be a difficult one for young singers also navigating the developmental leap from adolescence to adulthood. This is due to several systematic and instructional differences, compounded with unique challenges encountered by freshman voice students in the first year. Gaps in support systems compiled with new and increasing financial, social, and academic demands can lead to a decline in overall student well-being and an increase in stress.

This increase …

Enhancing Trust In Ai For Healthcare: A Quantative Evaluation Of Explainable Methods In Clinical Decision Support Systems, Abdul Aziz Noor

Masters

The integration of Artificial Intelligence (AI) into healthcare has revolutionized Clinical Decision Support Systems (CDSS) by enabling sophisticated predictive capabilities. However, the opaque nature of many machine learning models, commonly referred to as "black-box" systems, poses significant challenges to their adoption in critical clinical settings where transparency, interpretability, and trust are paramount. This thesis addresses these challenges by developing a rigorous, mathematically grounded framework to evaluate Explainable AI (XAI) methods and enhance their integration into CDSS.

Assessment Of Bifidobacterium Longum Itt 13 As A Probiotic Candidate, Eleana Keatley

Masters

Probiotics are live microorganisms that when administered in adequate amounts confer a health benefit on the host. Beneficial microbes are found in several sites throughout the body such as the oral cavity, skin, respiratory tract, vagina, urinary tract, breast tissue and the gut. In this research, the culture Bifidobacterium longum ITT 13, which was previously isolated from a neonatal faecal sample, was examined for its potential as a probiotic candidate. Probiotics can have numerous desirable characteristics. The pertinent ones to this research are being of human or animal origin, not prone to antibiotic resistance, demonstration of antagonistic activity towards pathogens, …

Treating Social Media Addiction In Adolescents: A Scoping Review With Implications For Music Therapy Practice, Roman D. Swain

Theses and Dissertations--Music

With the rapid expansion of online connectivity, concerns have emerged regarding the influence of digital interactions on adolescents’ real-world relationships and mental health. Social media use can expose adolescents to harmful content and disrupt the brain’s pleasure centers, increasing the risk of developing addictive patterns of use. Such disruptions may interfere with daily functioning and contribute to negative mental health outcomes. Given the impact of music on the brain’s reward system, music therapy may offer a beneficial approach for helping adolescents develop mindfulness of social media use and strengthen offline social connections. This thesis presents a scoping review of current …

Statistical Approaches In Evolutionary Biology: Using Threespine Stickleback Fish To Test Fisher's Geometric Model And Evaluate Methods For Handling Missing Data, Aaron Mathew Myrold

Dissertations

This thesis explores two distinct yet complementary aspects of evolutionary biology. The first chapter tests predictions from Fisher's geometric model of adaptation using a finely resolved fossil sequence of Gasterosteus doryssus spanning approximately 21,250 years. I analyze phenotypic changes in three armor traits during adaptation to a new environment and find that while step sizes follow the predicted exponential distribution—with many small steps and few large ones—they do not adhere to the model's temporal prediction that large-effect mutations should fix early in the adaptive walk. This discrepancy likely reflects adaptation from standing genetic variation rather than de novo mutation. The …

Genetic Architecture Of Complex Traits In African Ancestries Across Diverse Environments, Isadore Gregga

Dissertations

Given genetic and environmental diversity, genetic prediction based on African- ancestries individuals in the US or UK may not transfer well to other African diaspora regions. The Modeling the Epidemiological Transition Study (METS) is a longitudinal study of cardiometabolic health in five African-ancestry populations. We performed genome-wide genotyping in METS participants from the US, Jamaica, South Africa, and Ghana. We aimed to explore how genetic models for the transcriptome and body mass index (BMI) built using US- based African-ancestries populations perform in these four diverse populations. A subset of METS participants also had whole blood RNA-Seq data. For these, we …

Characterizing Niche Specialization In Staphylococcus Epidermidis, Sandra Jablonsk

Dissertations

This thesis investigates the microbial diversity of Staphylococcus epidermidis (S. epidermidis) across various anatomical sites in the human body. While traditionally viewed as a benign skin microbe, S. epidermidis also inhabits the urinary, gastrointestinal, and respiratory tracts, raising questions about its genetic variation and adaptability in different environments. The research aims to compare strains of S. epidermidis isolated from the oral cavity, nostrils, urinary tract, and skin of healthy individuals to determine if they share a common ancestor or if they evolved independently in response to specific environmental factors. The study comprises three main aims. Aim 1 focuses on assessing …

Insights On The Cranial Anatomy And Osteohistology Of Cyonosaurus, Alexander Acker

Dissertations

This study investigates the cranial anatomy and life history of the small-bodied gorgonopsian Cyonosaurus. Previous research on gorgonopsians has disproportionately focused on larger members of the clade, leaving smaller forms relatively understudied. This gap has led to several unresolved questions, the most pressing of which concerns gorgonopsian ontogeny. Specifically, it remains unclear whether small-bodied gorgonopsians represent genuinely diminutive adult individuals or juveniles of larger species. The specimen NHCC LB1087 presents an ideal opportunity to address this issue and gain new insights into the biology of small-bodied gorgonopsians. The first chapter focuses on cranial anatomy. Due to the specimen’s preservation, many …

Appendix: Selected Quotes From Prosecutors' Interview Responses, Anna Arons

Faculty Publications

No abstract provided.

Sffa V. Harvard: Racial Triangulation And The Invidious Myth Of Colorblindness, Philip Lee

Faculty Publications

(Excerpt)

In Students for Fair Admissions, Inc. (SFFA) v. President and Fellows of Harvard College, a case in which the Supreme Court ended the longstanding practice of race-conscious admissions in higher education, Asian Americans were used as a wedge between White people and non-Asian minorities to eradicate a mechanism that fostered greater racial diversity in student bodies in many highly selective institutions across the country. A majority of Supreme Court justices justified their decision in the name of “colorblindness.” However, the way the justices positioned Asian Americans against other people of color was not colorblind. It was consistent with …

The Criminal System Under Racial Capitalism, Sandeep Singh Dhaliwal

Faculty Publications

In 2021, major segments of the business lobby converged around a consensus for criminal system reform. As the United States experienced historic levels of labor market tightness, business groups argued for removing “barriers” to employment that system-involved people face. Just a few months later, the orientation of business to the criminal system was decidedly more mixed. By March 2022, the U.S. Chamber of Commerce, the country’s most powerful business lobby, had stepped to the forefront of the national moral panic around retail theft, launching a vigorous campaign to defend and even strengthen criminal punishment across the country.

Anchoring its analysis …

Queers, Closets, And Corporate Governance, Darren Rosenblum

Faculty Publications

The past few years have seen several corporate diversity initiatives that include Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) people. In 2020, Nasdaq, the world’s second-largest stock exchange, and California, the largest state, both adopted rules to encourage board diversity for underrepresented groups, including LGBTQ+ people. Since that time, the Los Angeles Superior Court struck down California’s law, the Fifth Circuit invalidated Nasdaq’s rule, and the Trump administration initiated a slew of anti-Diversity Equity and Inclusion (DEI) and anti-LGBTQ+ measures. In the context of this sharp ideological turn, this Article attempts to step back and tackle a larger question: how can …

The Model Minority Victim, Elaine M. Chiu

Faculty Publications

The rise in xenophobia, hate and violence against AAPI Americans inspired by the COVID-19 pandemic was an opportunity to assess the effectiveness of the criminal legal system as a tool of anti-racism. This Article traces the legal aftermath when Asian New Yorkers reported 276 possible hate crimes to the police in 2021. The analysis takes an empirical approach and a narrative approach. It relies on a unique database that followed what happened to civilian complaints of anti-Asian crimes from beginning to end. Using metrics such as arrest rates and conviction rates, the Article draws initial conclusions about the systemic legal …

Legal Academia's White Gaze, Renee Nicole Allen

Faculty Publications

For Black law faculty, Blackness, the Black experience, and Black legal and social identity are not trends. Yet, there are inflection points where legal scholarship about race, particularly Blackness, is in vogue. The most recent rise in such legal scholarship came in the aftermath of George Floyd’s murder and the worldwide Black Lives Matter protests in 2020. When antiracist sentiment is high, the regard for scholarship central to the personhood of Black legal scholars is high. Even then, there is an expectation that Black authors write in ways that conform to the White norms of legal scholarship. Though central to …

What’S Left Of The New Deal State?, Sandeep Singh Dhaliwal

Faculty Publications

(Excerpt)

A vast body of scholarship situates itself in the New Deal era. Another extensive collection explores the history of criminal justice in the United States. To date, however, there has been little effort to bring these conversations together. New Deal Law and Order, written by legal historian Anthony Gregory, fills this conspicuous gap. Gregory remarkably narrates the New Deal era through the lens of President Franklin Roosevelt’s “war on crime” (p. 1), challenging how we think about both the New Deal’s legacy and the foundations of the modern security state.

In recent years, scholars have called on their …

Family Regulation's Consent Problem, Anna Arons

Faculty Publications

The home is the most protected space in constitutional law. But family regulation investigators conduct millions of home searches a year. Under pressure, parents nearly always consent to these state agents’ entry into the most private areas of their lives.

This Article identifies the coercive forces—not least the threat of family separation—that drive parents to consent to home searches. Drawing on primary sources and case law examining consent in criminal cases, it shows that common family regulation investigation tactics render consent involuntary and the ensuing searches unconstitutional. And yet, it argues, the Constitution is not enough. Though constitutional litigation could …

Getting The Reader To Say “Yes”: Applying Negotiation Principles From The Books Getting To Yes And Getting Past No To Achieve Effective And Persuasive Legal Writing, Patricia G. Montana

Faculty Publications

This Article explores the relationship between the strategies of principled negotiation and effective persuasive legal writing as articulated in the best-selling books, Getting to Yes and Getting Past No. Though there is substantial scholarship advocating adding a negotiation component to legal writing instruction, there is little scholarship addressing how to apply the concepts of principled negotiation to persuasive writing itself. In this Article, the Author explains the foundational concepts of principled negotiation and then shows how they relate and apply to drafting an effective piece of persuasive legal writing. Looking at written advocacy through a negotiation lens reinforces good …

Student Protests And “Fighting Words”: Critical Race Theory And The Evolution Of Hate Speech Codes On College Campuses, Mark C. Niles

Faculty Publications

Devastating Hamas attacks on Israeli civilians and military personnel in October 2023, and the Israeli military response to those attacks in Gaza, have given rise to protests around the world, notably on college campuses in the United States. These protests (on more than fifty campuses in all parts of the country) have in turn generated multiple allegations of antisemitic statements and conduct by protestors. Many high-profile university donors and board members, portions of the media, and some elected officials responded to these allegations by identifying perceived deficiencies in campus administrative responses to these complaints and to calls for more robust …

Developing A Gpt-Based Virtual Training System For Medical Undergraduates' History Taking In Stroke Rehabilitation, Chao-Yu Hsu, Ching-Lin Hsieh, Jeng-Cheng Wu, Wen-Hsuan Hou

Rehabilitation Practice and Science

Background: Effective history taking in stroke rehabilitation requires comprehensive assessment skills, yet opportunities for medical undergraduates to practice such skills remain limited. Virtual patients (VPs), especially those powered by large language models (LLMs), offer a promising solution. This study aimed to develop and evaluate a GPT-based virtual training system for functional assessments in stroke rehabilitation history taking.

Methods: A mixed-methods design was employed in which VPs were modeled on a clinical stroke case and 10 core domains of functional assessments in stroke rehabilitation were integrated. A virtual examiner (VE) module provided automated scoring and feedback. Phase 1 evaluated the reliability …

Examining Pyroptosis In Neutrophil-Like Differentiated Hl-60 Cells, Jared Long

Dissertations

The innate immune system is the first line of defense against pathogens. Innate immune cells, such as macrophages and neutrophils, recognize pathogens through the recognition of pathogen associated molecular patterns or damage associated molecular patterns (PAMPS & DAMPS). When a pathogen is recognized, innate immune cells will start clearing the pathogen and secreting pro-inflammatory cytokines, such as interleukin-1β (IL-1β) to initiate the innate immune response. Release of IL-1β occurs through an unconventional secretory pathway triggered by inflammasome activation. Activation of the NLR family pyrin domain containing 3 (NLRP3) inflammasome cleaves both pro-IL-1β into mature IL-1β, and full length gasdermin-D (GSDMD) …

Interactions Between Microplastics, Biofilms, And Antimicrobials In Freshwater Streams, Ryan Thomas Krantz

Dissertations

Microplastics (MPs) are ubiquitous contaminants in freshwater ecosystems that could be hotspots for the interaction of antimicrobial compounds and surface-attached microbial biofilm communities. MPs and antimicrobials are both common in wastewater and urban freshwaters and MPs can adsorb contaminants like antimicrobials to their surface. Within aquatic habitats, MPs also support colonization by microbial biofilms. Therefore, we hypothesized that the adsorption of antimicrobials to MP surfaces would affect microbial communities colonizing MPs, altering their diversity, composition, and antimicrobial resistance. We investigated the effects of these interactions across two studies. The first study, discussed in Chapter 2, used a microcosm approach to …

Examining The Adjustment, Acculturation, And Well-Being Of International Arab Students In The United States: Implications For Policy And Practice, Hassan A A Kh A A Arab

Wayne State University Dissertations

This paper explored Arab international students studying in the United States to see whether they face acculturation stress, adjustment, or well-being issues. I found that my sample (N=95) experienced moderately high well-being distress and acculturative stress. However, the sample showed resilience and positive adjustment in all aspects, psychological (M=34.7), social (M=38.5), and academic (M=37.4). Moreover, well-being score from a modified GHQ survey came with high SD, indicating some students were dealing with serious mental issues, while others were doing well (M=42.92, SD=5.52). The majority of my participants were males (74.7%), single (75.8%), and graduate students (50.5%). Chi-square analysis found a …

Soil Phosphorus Retention In A Palustrine Wetland Chronosequence Of The Northern Mississippi Embayment, Cora Lee Aossey

Theses and Dissertations--Plant and Soil Sciences

The USDA NRCS Agricultural Conservation Easement Program Wetland Reserve Easements is focused on converting marginal agricultural lands to wetlands to restore hydrologic function and enhance wetland habitat. There is a gap in knowledge of how phosphorus (P) dynamics develop as these wetlands are converted from row crops to wetland vegetation over time. Recently converted wetlands have the potential to develop into P sinks. In this study, a chronosequence of former farmlands converted to forested palustrine wetlands in the northern Mississippi Embayment was used to evaluate the potential mobility of P post-conversion. Three soil depth intervals were analyzed for water-soluble P, …

Management Adaptations To Sustainably Increase Soybean Yield And Water Productivity Through Field Studies And Crop Modeling, Mounica Talasila

Theses and Dissertations--Plant and Soil Sciences

Soybean (Glycine max [L.] Merr.), a major crop in the upper U.S. Mid-South, is predominantly cultivated under rainfed conditions, where variable precipitation frequently induces water stress and limits yield potential. Consequently, irrigation adoption has been increasing across this region. Determining the optimal cultivar maturity group (MG) and planting date (PD) for both rainfed and irrigated systems is essential for maximizing yield and improving water use metrics. Evaluating crop water use efficiency (WUE; yield per unit of seasonal evapotranspiration) and total water productivity (WP; yield per unit of total water input from precipitation and irrigation) is critical to developing such …

Pan-Caribbean Airlines: Unlocking Regional Aviation Potential, Dimitrios V. Siskos, Alexander Maravas, Jordan Karatzas

Publications

The Caribbean's air transport system is facing significant challenges, including operational fragmentation, excessive costs, and inadequate inter-island connectivity. These challenges limit its ability to support the region’s heavily tourism-dependent economies. This research evaluates whether consolidating small Caribbean airlines into a single or virtual Pan-Caribbean carrier could transform regional air travel. Based on financial analysis, historical traffic data, and case comparisons with airline mergers in South America and the US, the paper simulates the anticipated efficiencies resulting from route consolidation, fleet standardization, and common operational services. The research concludes that consolidation may create a regional GDP impact of up to $3.3 …

A Time-Dependent Spectral Analysis Of Γ Cassiopeiae, Sean J. Gunderson, David P. Huenemoerder, José M. Torrejón, Dustin K. Swarm, Joy S. Nichols, Pragati Pradhan, Richard Ignace, Hans Moritz Guenther, A.M.T. Pollock, Norbert S. Schulz

Publications

We investigated the temporal and spectral features of γ Cassiopeiae’s X-ray emission within the context of the white dwarf (WD) accretion hypothesis. We find that the variabilities present in the X-ray data show two different signals, one primarily due to absorption and the other due to flickering like in nonmagnetic cataclysmic variables. We then use this two-component insight to investigate previously unreported simultaneous XMM and NuSTAR data. The results of model fitting find WD properties consistent with optical studies alongside a significant secondary, thermal source. We propose a secondary shock between the Be decretion disk and WD accretion disk as …

January 2025 Library News, University Libraries

Library News

No abstract provided.