Digital Commons Network^™

Donor-Derived Cell-Free Dna As A Prognostic Biomarker After Heart Transplantation: The Define-Ht Study, Palak Shah, Paul J. Kim, Kelly H. Schlendorf, David A. Baran, Monica M. Colvin, Adam D. Devore, Howard Eisen, Kambiz Ghafourian, Michael M. Givertz, Eileen Hsich, Jaime L. W. Kennedy, Evan P. Kransdorf, Jose N. Nativi-Nicolau, Jignesh Patel, Eleni Tseliou, Omar Wever-Pinzon, Andrew Doud, Michelle S. Bloom, Sandra A. Carey, Navchetan Kaur, D Giovanni Biagini, Kyle E. Marshall, Michael Olympios, Mandeep R. Mehra, Josef Stehlik

Department of Medicine Faculty Papers

BACKGROUND: Measurement of donor-derived cell-free DNA fraction (dd-cfDNA%) and donor quantity score (DQS) is a noninvasive biomarker of acute rejection in heart transplantation (HT). Its prognostic value beyond histopathology remains uncertain.

OBJECTIVES: This study sought to evaluate associations between donor-derived cell-free DNA (dd-cfDNA) and clinically meaningful outcomes using a composite endpoint of treated rejection, graft dysfunction, retransplantation, or death within 1 year post-HT.

METHODS: The DEFINE-HT (Development of Noninvasive Cell-free DNA to Supplant Invasive Biopsy in Heart Transplantation) was a prospective, observational study following adult HT recipients at 10 U.S. centers for 1-year post-HT; blood was collected for dd-cfDNA testing …

Fluoroquinolone Use And Risk Of Pneumothorax In Adults Hospitalized With Community Acquired Pneumonia: A Retrospective Cohort Study, Steven Yi B. S., Saurav Sumughan B.S., Jessica Cobb M. D., Erika J. Yoo

Department of Medicine Faculty Papers

Objectives: The objective of this study is to examine the relationship between fluoroquinolone exposure and pneumothorax risk in patients hospitalized with pneumonia.

Methods: This retrospective cohort study used the TriNetX US Collaborative Network. We defined two mutually exclusive cohorts of hospitalized adults based on exposure to antibiotic classes commonly used to treat community acquired pneumonia: fluoroquinolone (ciprofloxacin, moxifloxacin, levofloxacin, and ofloxacin) versus nonfluoroquinolone (amoxicillin, azithromycin, ceftriaxone, and doxycycline). Patients with connective tissue disorders were excluded. The primary outcome was the occurrence of pneumothorax within 60 days. We used Cox proportional hazards regression to estimate hazard ratios (HRs) adjusted for demographics, …

Pearson Syndrome: Expanding The Clinical Spectrum Of A Mitochondrial Cytopathy-A Case Report, Alizah Faisal, Hooria Waqas, Hania Masood, Armeen Butt, Saad Rahman, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Pearson syndrome (PS) is a rare multisystem mitochondrial disorder characterized by single large-scale mitochondrial DNA deletions (SLSMDs). It typically presents in infancy with refractory sideroblastic anemia, exocrine pancreatic insufficiency, and failure to thrive. Due to its heterogeneous manifestations and resemblance to other hematological conditions, early diagnosis remains a clinical challenge.

CASE PRESENTATION: A south asian male infant presented with persistent pancytopenia, severe anemia unresponsive to intravenous and oral iron and multivitamin supplements, exocrine pancreatic insufficiency, failure to thrive, and metabolic acidosis. Born to consanguineous parents, the child had a significant family history of early infant deaths and hematological abnormalities. …

Cultivating Narratives: A Critical Discourse Analysis Of Higher Education Student-Led Farms And Gardens, Maximilan Sherard, Marc T. Sager

Publications

Despite extensive research on community agriculture, little attention has been paid to student-led farms or gardens (SFGs) in higher education contexts. SFGs represent a unique site for community agriculture due to their diverse stakeholders, academic affiliations, and the institutional policies they navigate. This study examines online promotional materials from 42 SFGs located on land-grant higher education campuses across the United States. Using critical discourse analysis, we (1) map these organizations’ practices and (2) identify competing discourses about community and agriculture within their promotional narratives. We identify and explain four core practices (membership, growing, distribution, and purpose) and connect these practices …

Mapping Dna Methylation Signatures To Identify Epigenetic Variation Across Subcortical Regions Of The Human Posttraumatic Stress Disorder Brain, Hongyu Li, Yujing Liu, Yiming Shi, Jiawei Wang, Tuan P Nguyen, Yuhan Xie, Wangjie Zheng, Youshu Cheng, Dianne A Cruz, Jennifer L Modliszewski, Rosemarie Terwilliger, Alexa-Nicole Sliby, José Jaime Martínez-Magaña, Janitza L Montalvo-Ortiz, John D Roache, Lynnette A Averill, Stacey Young-Mccaughan, Paulo R Shiroma, Bertrand R Huber, David A Lewis, Jill Glausier, Paul Holtzheimer, Matthew J Friedman, Jing Zhang, Alan L Peterson, Chadi G Abdallah, Amir Valizadeh, Xinyu Zhang, Ke Xu, John H Krystal, Ronald S Duman, Hongyu Zhao, David L Corcoran, Douglas E Williamson, Matthew J Girgenti

Staff and Researcher Publications

Background: Posttraumatic stress disorder (PTSD) is a mental disorder that may occur in the aftermath of severe psychological trauma. Epigenetic changes in the brain may play a critical role in understanding the neurobiology of PTSD by linking environmental traumatic stress exposure to lasting alterations in gene expression that shape neuronal function.

Methods: We examined 1,065,750 DNA methylation (DNAm) sites from 171 donors including neurotypical controls and PTSD and major depressive disorder (MDD) cases across 6 regions implicated in the fear circuitry of the brain. We performed RNA sequencing (RNA-seq) to examine changes in gene expression and linked these changes to …

The Coming Privatization Of Corporate Law, Dorothy S. Lund, Eric L. Talley

Faculty Scholarship

For more than a century, American corporate law has revolved around a simple competitive premise: State governments supply corporate law while companies choose their state of incorporation, and the market rewards the state offering the best corporate law product. Delaware’s longstanding market dominance (especially for public companies) is often explained through the confluence of its unusually attractive institutional package: expert judges, extensive precedent, a specialized bar, an enabling statute, and a legislature that — at least traditionally — treats corporate law as something to be calibrated technocratically rather than politicized.

There Is No Free Benchmark: An Institutional View Of Legal Ai Benchmarking, Neel Guha, Andy K. Zhang, Christine Tsang, Christopher D. Manning, Julian Nyarko, Daniel E. Ho

Faculty Scholarship

Despite substantial excitement around the use of AI in law, little information exists on the performance and associated risks of the domain’s widely marketed tools. Recent work, for instance, has demonstrated the significant potential for “hallucinations” — wherein models make up facts, law, and precedent — leading Chief Justice Roberts to spotlight this risk in his annual report on the judiciary. We argue that there is a need for public AI benchmarking in law. First, relative to other AI application domains, the legal AI ecosystem lacks legibility — there is little information about the design and performance of many commercial …

Presidential Immunity: Before And After Trump, Thomas P. Schmidt

Faculty Scholarship

“All the officers of government,” the Supreme Court said long ago, “from the highest to the lowest, are creatures of the law, and are bound to obey it.” Despite that ringing and categorical language, however, the Court has held that the President — the “highest” and most powerful of all government officers — is “immune” from judicial oversight in several respects. Indeed, when the Court held last Term that former presidents are presumptively immune from criminal prosecution for officials acts, the dissenters warned: “In every use of official power, the President is now a king above the law.”

This Article …

What Is To Be Done About The Radical Far-Right?, Bernard E. Harcourt

Faculty Scholarship

The far Right in America has become radical. In the process, it has outmaneuvered the progressives. In the first months of his second mandate, President Trump has mounted a revolution (or counterrevolution) against the liberal democratic state. Steve Bannon said he was Leninist and wanted to “smash the state.” President Trump has done just that. In this essay, I explore the far Right’s embrace of Lenin. I return to the Hegelian roots of Lenin’s politics to explain what he meant by “smashing the state machine.” I then argue that the Left should reclaim Lenin’s dialectics and his call, in the …

The Contested Contingent Constitution: Plutocrats, Right-Wing Populists, And Labor Rights In The U.S., Kate Andrias

Faculty Scholarship

Constitutional labor rights have long been negligible in the United States. Now, with the ascendance of Donald Trump’s right-wing authoritarianism, even statutory labor rights are under threat. Yet there is an apparent paradox: While the Trump Administration seeks to declare the NLRB unconstitutional and has decimated federal workers’ rights, Trump’s “Make America Great Again” (MAGA) movement rose to power in part by invoking the plight of the American worker. The more populist wing of the American Right does not expressly challenge the constitutionality of labor law. Indeed, some right-wing populists urge an expansion of labor rights, emphasizing such goals as …

Evaluating The Use Of Artificial Intelligence To Enhance Pediatric Simulation Among Associate Degree Nursing Students, Kaitlyn Price

Theses

Abstract

Background: Simulation has long been used to prepare pre-licensure nursing students for clinical practice. Traditional written pre-simulation assignments have been the assignment of choice for many years. However, artificial intelligence (AI) guided preparatory tools may offer students a more interactive, personalized way to enhance their simulation experience.

Purpose: The purpose of this project was to utilize AI technology in pre-simulation preparatory work to enhance learning in second-semester associate degree nursing students. 

Methods: The study consisted of randomized traditional and AI-guided preparatory groups among consenting participants. The sample consisted of 23 participants. Both sets of students completed the same simulation. …

Genetics Of Cerebrotendinous Xanthomatosis

Faculty, Staff and Students Publications

Cerebrotendinous xanthomatosis (CTX) is rare, autosomal recessive inborn error of metabolism caused by biallelic pathogenic variants in CYP27A1, which encodes sterile 27 hydroxylase, a key enzyme in bile acid biosynthesis. Enzyme deficiency results in reduced cholic and chenodeoxycholic acid synthesis with accumulation of cholestanol, bile acid intermediates, and bile alcohols, producing a progressive multisystem disorder characterized by chronic diarrhea, juvenile-onset cataracts, tendons xanthomas, and neurological dysfunction. Although CTX typically begins in childhood, diagnosis is frequently delayed until adulthood, limiting the benefit of effective disease modifying therapy with chenodeoxycholic acid. Since the identification of CYP27A1, more than 200 pathogenic variants have …

From Theory To Practice Implementing A Mission, Vision, And Values Statement To Support Change In An Academic Library Liaison Program, Patricia Fiorillo, Kristy Padron

Faculty Scholarship

Academic library liaison programs historically varied in their functions and adapted to their organizational needs and priorities. This case study examines the integration of a mission, vision, and values statement into the liaison program at Florida Atlantic University Libraries. Originating from business and organizational theories, these statements have been adopted by nonprofit organizations, including academic libraries, to guide administrative processes and services. The study highlights a re-visioning of an established liaison program during a period of transition. This fostered a shared understanding of the library’s priorities and documented its goals and objectives. This alignment was particularly crucial as Florida Atlantic …

Herbaceous Plants In Forest Ecosystems: One Hundred Fundamental And Applied Questions, Harikrishnan Venugopalan Nair Radhamoni, Michelle Elise Spicer, Marlyse C. Duguid, Liza S. Comita, Emilio Bruna, Andrew J. Andrade, Julia I. Burton

Michigan Tech Publications

Aims: Herbaceous plants (herbs) found in the understory of forests contribute substantially to the biodiversity of these ecosystems, as well as being important socio-culturally, economically, and for advancing ecological theory. However, the ecology of herbs is less well understood compared with woody plants, despite evidence that herbs are physiologically and ecologically different. Similarly, herb research has focused on north temperate forests, with less information from forests in the tropics and Global South. Understanding this knowledge gap, and recognizing the critical importance of expanding and streamlining the scope of research on forest herbs, we set out to identify 100 fundamental and …

Evaluating Acoustic Deterrents For Reducing Migratory Bird Collisions With Buildings, Jenna Brewer, Shane Oberloier, Annette Prince, David B. Stone, Jared Wolfe

Michigan Tech Publications

Migratory songbird populations are declining across North America, and collisions with glass-fronted buildings have become one of their leading causes of mortality. Finding practical ways to curb these collisions is a key conservation priority, but large-scale solutions remain elusive because retrofitting glass façades and enforcing lights-out policies are often prohibitively costly and logistically difficult. In this study, we focused on developing low-cost alternative deterrents that redirect migrants away from high-risk areas. We tested two acoustic deterrents: a broadband synthetic signal designed to mask nocturnal flight calls, which are important social cues for migrants, and a “predator” track featuring alarm calls …

Current Adoption Of The Prosthodontic Diagnostic Index For Clinical Care-A Cross-Sectional Survey Study

Faculty, Staff and Student Publications

Purpose: To assess current utilization of the Prosthodontic Diagnostic Index (PDI), identify perceived benefits and limitations, and evaluate support for future updates.

Materials and methods: A survey regarding the use of the PDI was made available through email invitations to 68 US dental school prosthodontic/restorative department chairs (PD), 48 graduate prosthodontic program directors (GP), and 1834 private practice prosthodontists (PP) from the American College of Prosthodontists (ACP) member database. The results of this initial survey were inconclusive due to low response rates. The survey was also administered during the 2024 ACP Annual Session with an improved response rate for educators. …

Quantitative Analysis Of Peri-Implant Collagen Fiber Orientation Around External Hexagon And Morse Taper Implant Connections: A Dog Model Study

Faculty, Staff and Student Publications

Background: Peri-implant soft tissue stability depends on the implant-abutment interface and collagen fiber organization. Unlike natural teeth, peri-implant fibers exhibit a less favorable orientation, potentially weakening the biological seal. Implant connection design may influence this collagen arrangement and tissue integrity.

Materials and methods: Eighteen immediately loaded implants (n = 9 per group) were placed in nine mongrel dogs. Group I received external hexagon implants, while Group II received Morse taper implants. After a 4-month healing period, animals were euthanized and specimens were processed for histological evaluation. Collagen fiber orientation was analyzed using polarized light microscopy and quantified with ImageJ software. …

Kras G12c And Kras G12d Respond To Lipid Metabolism In An Allele-Specific Manner

Faculty, Staff and Student Publications

KRAS mutated at hotspots G12, G13, and Q61 possess profound allele-specific oncogenesis. Signaling of KRAS mutants is mostly compartmentalized to the proteolipid nanoclusters on the plasma membrane (PM), illustrating critical roles of spatiotemporal organization in KRAS cancer signaling. The activated GTP-bound KRAS molecules, including the wild type and mutants, have been traditionally thought to favor similar lipids. We recently reported distinct lipid sensing capabilities of different KRAS mutants, especially with KRASG12D favoring unsaturated lipids and KRASG12C gaining additional enrichment of saturated lipids. As such, KRAS mutants may respond to lipid acyl chain remodeling in an allele-specific manner. Lysophosphatidylcholine acyltransferase 1 …

Erk-Mediated Phosphorylation Of Yap Defines A Noncanonical Fgf Signaling Mechanism In Stem Cells, James F Martin, Jun Wang

Faculty, Staff and Student Publications

While Fgf and Hippo-Yap signaling are fundamental for proper development, homeostasis, and disease, their crosstalk remains largely unknown. Here, we identified that Yap and Taz, canonical Hippo effectors, function as noncanonical effectors of Fgf signaling to maintain the proper function of neural crest (NC) lineages. NC cells are a multipotent stem cell population during vertebrate embryogenesis that contribute to numerous structures and diverse cell lineages, including craniofacial and cardiac tissues, neurons, and suture mesenchymal cells (SMCs), a specified cell population required for cranial bone growth and repair. We observed that activation of Fgf signaling in NC cells and NC-derived SMCs …

Seabed Wide-Angle Reflection Coefficient And Source Radiation Pattern Measurements From A Low-Frequency Multibeam Sonar, Charles W. Holland, Cody R. Henderson, Tim Sonnemann, Bjørnar Langli, Daniel L. Orange

Electrical and Computer Engineering Faculty Publications and Presentations

In acoustic remote sensing, the seabed frequency-domain reflection coefficient contains significant geoacoustic information, namely the depth and frequency dependence of sediment sound speed, density, and attenuation. Typical reflection measurements are performed with a towed source and/or receivers to obtain a range of seabed reflected angles. It is shown here that the measurements can be performed using a hull-mounted low-frequency multibeam sonar with an offboard fixed or drifting hydrophone. To obtain the reflection coefficient (as well as scattering strength and other quantities of potential interest), the multibeam sonar radiation pattern must be known. Radiation patterns and absolute levels of the Kongsberg …

Medadl: High-Throughput Information Extraction Of Functional Status From Electronic Health Records To Advance Frailty Assessment In Older Adults, Jaerong Ahn, Vanessa Ramirez, Jude Des Bordes, Hongfang Liu, Min Ji Kwak, Nahid J Rianon

Faculty, Staff and Student Publications

Background: Functional status is essential for assessing frailty and planning care in older adults but is often under-documented in the structured fields of electronic health records. Manual chart review can capture functional status information but is labor-intensive and time-consuming. In this study, we developed and validated a scalable natural language processing (NLP) model to extract functional status information from unstructured electronic health record (EHR) notes.

Methods: This retrospective cohort study included 110 older adults seen at a geriatric osteoporosis clinic. A large language model-augmented symbolic NLP pipeline (MedADL) was developed to extract activities of daily living (ADL) and instrumental activities …

Implementation And Evaluation Of The Owll Intervention To Improve The Quality And Safety Of Pediatric Dental Sedation: A Mixed-Methods Approach, Janelle Urata, Alfa-Ibrahim Yansane, Jungsoo Kim, Emily Sedlock, Krishna K Kookal, Yan Xiao, Oluwabunmi Tokede, Heiko Spallek, Amy Franklin, Gregory Olson, Joel White, Elsbeth Kalenderian, Muhammad F Walji

Faculty, Staff and Student Publications

Background: The OWLL (Open-Wide Learning Lab) intervention was developed using Human-Centered Design to improve the quality and safety of pediatric dental sedation. The intervention includes a patient-facing informational sedation brochure and video, and an enhanced set of clinical sedation records. Here, we report on the process evaluation 6 months after implementation in daily clinical practice.

Methods: This study was conducted at the outpatient pediatric dental clinics of 2 large US academic dental institutions. We used a mixed-methods design to assess the fidelity, acceptability, appropriateness, and feasibility of the OWLL intervention. Quantitative data were gathered through chart reviews, while qualitative data …

Clinical Document Metadata Extraction: A Scoping Review, Steven Bedrick, Andrew Wen, Hongfang Liu

Faculty, Staff and Student Publications

Objectives: Clinical document metadata, such as document type, structure, author role, medical specialty, and encounter setting, is essential for accurate interpretation of information captured in clinical documents. However, vast documentation heterogeneity and drift over time challenge harmonization of document metadata. Automated extraction methods have emerged to coalesce metadata from disparate practices into target schema. This scoping review aims to catalog research on clinical document metadata extraction, identify methodological trends and applications, and highlight gaps warranting further investigation.

Methods: We followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to identify articles from Ovid …

2026 July, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for July of 2026.

Influence Of Self-Reported Maternal Mental Health Diagnosis And Parenting Practice On Child Externalizing Behavior, Caitlin E. Smith

All-Inclusive List of Electronic Theses and Dissertations

Maternal psychopathology generally has been associated with greater likelihood of childhood pathology (e.g., Bellina et al., 2020) which is likely due to both genetic (e.g. heritability of mental health diagnoses) and environmental (e.g., parenting) influences. ADHD, in particular, is a disorder with a high heritability rate (Kuja-Halkola et al., 2015). Other parent mental health difficulties, such as anxiety or depression, can also influence parenting behavior as well as child behavior. Broadly, maternal psychiatric history is related to child ADHD symptom severity (López Seco et al., 2015). Positive parenting may be especially important when parenting a child with ADHD as positive …

How Cultural Homogeneity Couples With Organizational Climate In Public School Environments, Steven R. Peterson

All-Inclusive List of Electronic Theses and Dissertations

This quantitative study examines how cultural homogeneity influences teachers’ perceptions of school climate in Indiana public schools. Grounded in systems thinking and organizational theory, the study analyzes how shared values and norms shape teachers’ responses to leadership practices and stakeholder demands. Data were collected from educators using the School Culture Survey and a custom scenario-based climate instrument capturing reactions to organizational challenges. Statistical analyses explored relationships between cultural homogeneity and teachers’ perceptions of stability, workload, and adaptive capacity. Results indicate that alignment in key cultural dimensions—particularly Collaborative Leadership—significantly shapes climate experiences, while overall homogeneity alone does not predict workload pressures. …

Global, Regional, And National Burden Of Tuberculosis And Multidrug-Resistant Tuberculosis By Hiv Status, 1990–2023: A Systematic Analysis For The Global Burden Of Disease Study 2023, Gbd 2023 Tb Hiv Collaborators, Kathryn H. Jacobsen

Health Studies Faculty Publications

Summary

Background

Coupled Effects Of Sub-Atmospheric Pressure And Surface Structures On Pool Boiling Performance And Hysteresis Pathways, Mohammad Ishraq Hossain

Graduate Theses and Dissertations

The increasing power density of microelectronics has created a need for cooling technologies capable of maintaining low operating temperatures. Sub-atmospheric pool boiling of water is promising because reducing saturation pressure lowers the boiling temperature, enabling two phase cooling within electronics-relevant temperature limits. However, reduced pressure also affects CHF, HTC, and post-CHF recovery. In this work, pool boiling experiments were conducted on flat copper, microchannel copper, and micro-pin-fin copper surfaces over 10–100 kPa to examine the coupled effects of pressure and surface structure. CHF and HTC increased with pressure, while structured surfaces enhanced both relative to flat copper. Surface structure dominated …

Fugue State: The Body Politic Of Identity Theatre, Sean Patrick Ryan

Graduate Theses and Dissertations

This paper will cover my approach as an actor and a creator in two separate productions during my time at the University of Arkansas. The first is a solo theatre piece that I devised under the tutelage of Michael Landman. This work, Half Brother, is a piece of theatre that takes an abstract approach to exploring the familial and psychological ripples that can occur in the life of a queer person when a parental unit takes on a political and religious identity that is oppositional to the LGBTQ community. It exposes the effect this transformation has on the child, their …

Dragging The Self: Manifesting Genderqueer Identity As A Drag King Performer And Teacher, Jasmine Mcmasters

Graduate Theses and Dissertations

This thesis investigates drag performance as a site of gender identity formation, pedagogical practice, and arts-based inquiry through a critical autoethnographic methodology. Drawing on my lived experience as the drag king, Jas Mania, I investigate how drag functions as a dialogical relationship between performance and self, facilitating an ongoing exploration of my identity as a queer, non-binary artist and educator. Situated within theories of gender performativity, queer phenomenology, queer temporality, and performative pedagogy, this research considers how embodied performance generates knowledge that extends beyond the stage and into everyday life. Using improvisatory arts-based methods of reflective journaling and performance production, …