Digital Commons Network^™

Clinical And Demographic Characteristics Of Hospitalized Patients With Xylazine-Related Wounds, Elizabeth Novick, Nikhil Seval, Dagan Coppock, Mollie Tucker, Daniel Taupin, John Zurlo, Carolyn Kramer

Department of Medicine Faculty Papers

OBJECTIVES: Little is known about the demographic and clinical features of patients with xylazine-related wounds. We sought to characterize hospitalized patients with substance use disorder (SUD) and xylazine-related wounds seen for infectious diseases consultation.

METHODS: We retrospectively reviewed the medical records of 193 patients diagnosed with SUD at 3 Philadelphia hospitals between October 2023 and January 2024. Patients were identified as either being diagnosed with (n=73) or without (n=120) xylazine-related wounds. We compared the demographic and clinical features between the 2 groups.

RESULTS: Patients diagnosed with wounds were younger ( P < 0.001), more likely to be White or Hispanic and less likely to be Black/AA ( P < 0.001), more likely to have tested positive for fentanyl ( P < 0.001), amphetamines ( P < 0.001), and cocaine ( P 0.001), more likely to acknowledge injection ( P < 0.001), and more likely to leave the hospital by patient-directed discharge (PDD) ( P < 0.001). Most patients had multiple wounds (75%), and more than half (53%) had at least one wound greater than 10 cm at its widest dimension. Although most patients diagnosed with wounds received antibiotics, many did not have symptoms or signs of infection.

CONCLUSIONS: Xylazine-related wounds are highly associated with illicitly manufactured …

Durable, Distributed Llm Inference On Cots Devices, Brycen E. Dunn

Electronic Theses and Dissertations

The advancement of Large Language Models (LLMs) has fundamentally changed the nature of natural language processing. The substantial memory requirements of frontier models creates a significant barrier to entry, centralizing inference. This thesis presents the design and implementation of a distributed inference framework designed to democratize LLMs by leveraging commodity devices. The framework combines the resources of heterogeneous COTS devices into a unified compute pool, enabling the inference of models exceeding a single device's memory capacity. A novel Task Partitioning Engine (TPE) analyzes model architectures, profiles node capabilities, and supports pipeline and expert parallelism strategies. The primary contribution is a …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

“The Distance And Time Difference Aren’T Helping”: Family Communication Practices Of African Graduate Students Adapting To A New Country, Hummuh Abubakar

Electronic Theses and Dissertations

This qualitative study examined how international graduate students maintained long-distance communication with family members while adapting to life in the United States. Drawing on semi-structured interviews with seven international students, the research explored how participants sustained emotional closeness, manage disclosure, and select communication media across geographic distance. Guided by Communication Privacy Management Theory and Media Richness Theory, the study analyzed how students regulated private information and strategically used video calls, voice calls, and messaging platforms to meet relational and emotional needs. Findings revealed four primary themes: reliance on digital communication technologies; the emotional and psychological functions of family communication; structural …

I’Ll Have A Who Christmas Without You: A Case Study On The One-Person Show Through Who’S Holiday, Caitlyn Turner

Theses & ETDs

This thesis discusses the experience and history of the one-person show, or monodrama, through a performance of Who’s Holiday by Matthew Lombardo. Who’s Holiday was first performed in November 2017 at the Westside Theatre Off-Broadway. This thesis is in three parts: History & Theory, Analysis of the Play, and a Reflection of the performance. My professor Tim O’Donnell directed my performance of the play, which was performed in December 2025.

Interventional Approach To Intermediate-High-Risk Pe: Catheter-Directed Mechanical Thrombectomy, Shreya Agarwal, Kirill Ruban, Ishan Kirti, Karina Ruban, Fadi Saab, Sujata Kambhatla, Pranay Gupta

Conference Presentation Abstracts

Acute pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. The clinical outcomes are largely determined by thrombus burden and its hemodynamic impact on the right ventricle (RV). Over the past decade, catheter-directed mechanical thrombectomy has emerged as a promising alternative for systemic thrombolysis for PE management, particularly in patients at high risk for major bleeding. This approach provides rapid mechanical debulking of thrombus without exposure to thrombolytics and has been associated with significant improvements in RV function and pulmonary artery pressures. We present a case of extensive bilateral PE successfully treated with mechanical thrombectomy, highlighting the …

Acute Myocardial Injury And Vasospastic Stunning Following A Grand Mal Seizure, Aaron Goyal, Kirill Ruban, Ishan Kirti, Karina Ruban, Fadi Saab, Pranay Gupta, Sujata Kambhatla

Conference Presentation Abstracts

Acute non-ischemic myocardial injury results from myocardial oxygen supply-demand mismatch in the absence of critical coronary stenosis or atherothrombotic plaque rupture, and may be precipitated by acute physiologic stress, including sustained sympathetic overactivity. Troponin elevation may occur in 6.7-10.9% of post-seizure cases, with higher incidence among the elderly and individuals with cardiovascular risk factors. We present the case of a 55-year-old woman with long-standing epilepsy, dyslipidemia, multiple sclerosis treated with ocrelizumab, and significant cardiovascular risk factors (20 pack-year smoking history, occasional alcohol use, family history of early myocardial infarction) who presented to the emergency room after a witnessed generalized tonic-clonic …

Right Ventricular Involvement In Stress Cardiomyopathy: A Case Of Biventricular Takotsubo With Cardiogenic Shock, Ahmad Muhammad, Yazan Alkehef, Theodore Schreiber

Conference Presentation Abstracts

Introduction Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular (LV) dysfunction following a stressor in the absence of obstructive coronary artery disease. We present a case of a less common variant with right ventricular involvement. Hospital course A 45-year-old woman with sickle cell disease and asthma presented with nausea, vomiting, abdominal pain, and fevers, one week after the death of her father. Examination revealed an irregular tachycardia. Labs demonstrated leukocytosis, elevated lactate, and markedly increased troponin. Chest imaging showed bilateral basilar opacities. ECG demonstrated atrial flutter with rapid ventricular response. She developed progressive respiratory failure requiring intubation. Repeat ECG …

Look, I Finished My Pem Sticker Chart!, Kimberly L. Fugok Do, Sarah Fish Do, Kira Galeano, Kyle S Wilson Md, Dawn M. Yenser, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Plasma Metabolites After 10-Weeks Of Glucose Vs Fructose-Sweetened Beverages In Subjects With Overweight/Obesity, Peter J Havel, Kimber L Stanhope, Olga Ilkayeva, Christopher B Newgard, Nicola M Mckeown, Mark A Herman

Faculty, Staff and Students Publications

To identify metabolites as potential biomarkers of fructose vs glucose consumption and related metabolic changes, we conducted exploratory metabolomic profiling of fasting blood samples from participants in a double-blind, parallel-arm trial involving 31 male and female adults with overweight or obesity, both before and after supplementation with glucose- or fructose-sweetened beverages. Orthogonal Partial Least Square Discriminatory Analysis (OPLS-DA) was used to identify metabolites that could discriminate between the 2 intervention groups. Changes in 16 metabolites (5 of which are branched-chain amino acid catabolic pathway metabolites) and the branched chain keto acid (BCKA) composite score showed nominal (FDR adjusted P-value …

Single-Nuclei Transcriptomic Profiling Of Human Myocardium In Long-Chain 3-Hydroxyacyl-Coenzyme A Dehydrogenase Deficiency, Chang-Ru Tsai, Lalita Wadhwa, Debra L Kearney, Iki Adachi, Xiao Li, James F Martin

Faculty, Staff and Students Publications

No abstract provided.

Improving Dimensional Stability Of Irreversible Hydrocolloid By Condensation Silicone Incorporation

Faculty, Staff and Student Publications

Background: Irreversible hydrocolloid (alginate) is widely used for dental impressions, but its poor dimensional stability over time limits accuracy when delays in pouring occur. Enhancing its stability through material modification, such as incorporating condensation silicone, may improve clinical outcomes.

Materials and methods: Three groups (n = 10) were evaluated: Group I (conventional alginate, Avagel), Group II (extended-pour alginate, Hydrogum 5), and Group III (alginate modified with condensation silicone). Specimens were fabricated using standardized molds and stored under controlled humidity. Dimensional stability was assessed at five time points (immediate, 24, 48, 72, and 120 h) by measuring mass and linear dimensions. …

Ultrasonic Cavity Preparation With Cvd Diamond Tips: A Scanning Electron Microscopy Study Of Dentin Surface Morphology And Smear Layer Formation

Faculty, Staff and Student Publications

Background: Minimally invasive dentistry has driven the development of alternative cavity preparation techniques aimed at preserving tooth structure and improving biological outcomes. Ultrasonic systems associated with chemical vapor deposition (CVD) diamond tips have emerged as a potential alternative to conventional rotary instruments; however, evidence regarding their effects on dentin surface morphology and smear layer characteristics under SEM remains limited. This study aimed to evaluate the morphological characteristics of dentin surfaces after cavity preparation using ultrasonic and conventional rotary techniques.

Materials and methods: Twenty extracted human teeth were sectioned longitudinally to obtain standardized specimens. Samples were assigned to ultrasonic preparation using …

The Current Status Of Infant Oral Health Instruction Within Predoctoral Dental Education

Faculty, Staff and Student Publications

A pediatric dental home is a patient-provider relationship that establishes compassionate, comprehensive care that is continually accessible. For more than two decades, professional organizations have recommended children establish a dental home by their first birthday. In 2024, the American Academy of Pediatric Dentistry (AAPD) Council on Pre-Doctoral Education had a governance charge approved by the AAPD Board of Trustees to evaluate the status of infant oral health (IOH) instruction in pre-doctoral dental education. This study was designed to describe the current state of didactic and clinical clock hours dedicated to IOH in U.S. pre-doctoral curricula. Following IRB approval, a 25-item …

Long Covid Persistence And Surveillance Gaps Across 58 Us Hospitals, Jonas Hügel, Michele Morris, Jingya Cheng, Pedram Fard, Ingrid V Bassett, Douglas S Bell, Elmer V Bernstam, Shyam Visweswaran, Jeffrey G Klann, Shawn N Murphy, Hossein Estiri

Faculty, Staff and Student Publications

Importance: Surveillance of postacute sequelae of SARS-CoV-2 infection (PASC) depends on diagnostic coding systems that capture fewer than one-half of affected individuals, rendering millions invisible to health systems and policymakers.

Objective: To quantify the gap between true PASC burden and diagnostic code-based estimates, determine the proportion representing chronic disease, and characterize organ system heterogeneity and temporal trends across diverse populations.

Design, setting, and participants: This retrospective cohort study used electronic health record data from 58 hospitals and affiliated clinics in 4 US regions, from 2017 to 2025. Adults (aged ≥18 years) with laboratory-confirmed SARS-CoV-2 infection or a COVID-19 diagnosis code …

Ucva Ontology: Standardizing Local Context Factors To Support The Analysis Of Unwarranted Clinical Variation, Cui Tao, Susan Fenton

Faculty, Staff and Student Publications

Objectives: Unwarranted clinical variation (UCV), defined as care provided to a patient that is not proportional to the patient's needs, clinical characteristics, or preferences, results in negative patient outcomes. UCV detection is performed to compare healthcare outcomes across regions or organizations and reduce UCV incidences. However, the lack of standardized UCV concepts and the local context factors hinder the interoperability of UCV analyses between organizations. Currently, UCV analysis relies on centralized analysis, posing challenges due to the proprietary nature of an organization's healthcare and operational data. Standardizing analysis factors enables interoperable analyses by establishing a common context between organizations. This …

Segmental Trans-Endplate Pedicle Screws Do Not Induce Spinal Deformity In A Porcine Model, Jonathan H Wen, Austin J Stoner, Arianne Salunga, Vivian Ho, Miranda Guzman, David Berry, Vidyadhar Upasani, John S Vorhies

Faculty, Staff and Student Publications

Purpose: Growth modulation is an established technique for limb deformity correction and is increasingly applied to spinal deformities. While distraction-based posterior and anterior compressive methods have been explored, spinal growth modulation through fixation across vertebral growth centers remains unstudied. We hypothesized that unilateral trans-endplate screws-spinal epiphysiodesis trajectory (SET) screws-could induce partial anterior growth arrest and promote scoliotic deformity in a porcine model.

Methods: Four male piglets (two experimental, two control) underwent unilateral posterior spinal instrumentation at four lower thoracic levels at eight weeks of age. Experimental animals received trans-endplate SET screws; controls received pedicle screws. Radiographs obtained three months postoperatively …

Exploring Culturally Responsive Practices At A Community-Based Organization Serving Incarcerated Men Of Color And Their Families: A Leadership Case Study, Franchesca M. Capellan

Education Doctoral

The purpose of this qualitative phenomenological study was to explore the perceptions of New York City community-based organization (CBO) executive leaders regarding how they support families affected by paternal incarceration through culturally responsive leadership practices and the navigation of systemic barriers. Six executive leaders from a multi-site CBO participated in virtual semi-structured interviews designed to examine leadership approaches, family engagement strategies, and organizational responses to structural inequities affecting justiceimpacted families. Using Saldaña’s hybrid deductive–inductive coding process, seven superordinate themes emerged from the data analysis. Findings revealed that the leaders supported caregivers, youth, and incarcerated fathers through trust-based, trauma-informed programming, crisis …

Teacher Perceptions In Early Childhood Classrooms: Understanding The Disproportionate Suspension Of Black Girls In Preschool, Lachelle Dionne Walker

Education Doctoral

The purpose of this interpretive qualitative study was to examine eight preschool lead teachers’ perceptions of the behaviors of Black girls, with a specific focus on those leading instruction in classrooms of 3- and 4-year-old learners, to assess if their perceptions of the behaviors of Black preschool-aged girls influenced their discipline practices and behavior management. The findings of this study revealed that preschool lead teachers held positive perceptions and early adultified views, also known as adultification bias, of Black girls in preschool settings. Furthermore, early adultified views of preschool lead teachers toward Black preschool-aged girls did not correlate with discriminatory …

Targeted Therapy With Braf/Mek Inhibitors And Immune Check Point Inhibitors In Anaplastic Thyroid Cancer - A Case Report, Yagnapriya Ammakola, Muhammad Ibrahim Majeed, Ishmael Jaiyesimi

Conference Presentation Abstracts

Introduction- Anaplastic thyroid carcinoma (ATC) is a highly aggressive malignancy constituting about 1% of all the thyroid neoplasms. It has poor prognosis with median survival of around 3 to 6 months. Recent advancements with targeted therapies have improved the survival outcome in these patients. We report a case of anaplastic transformation of papillary thyroid cancer with BRAF V600E mutation who responded to targeted therapy. Case presentation- A 54 year old male presented with a palpable left sided mass. Labs were unremarkable but imaging with contrast enhanced CT scan showed a 3 cm left thyroid nodule with bilateral cervical lymphadenopathy. Biopsy …

Severe Transvalvular And Paravalvular Aortic Regurgitation As Late Tavr Failure Successfully Treated With Percutaneous Therapy, Ashley Armstrong, Luca Halalau, Ivan Hanson

Conference Presentation Abstracts

BACKGROUND - Transcatheter aortic valve replacement (TAVR) is an established therapy for severe aortic stenosis. With improving long-term survival, late prosthetic valve–related complications are increasingly recognized. CASE SUMMARY - We report a 74-year-old man who presented eight years after TAVR with progressive dyspnea, orthopnea, and bilateral lower extremity edema, identified to be acute decompensated heart failure with a new diastolic murmur. Transthoracic echocardiography demonstrated severe aortic regurgitation. Subsequent transesophageal echocardiography identified concomitant severe paravalvular and severe transvalvular regurgitation of the bioprosthetic valve. Invasive hemodynamic assessment revealed acute volume overload with markedly elevated filling pressures, secondary pulmonary hypertension, and right ventricular …

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

Morehead State Press Release Archive, 1961 to the Present

Press releases for May of 2026.

Growing Your Oer Program, Nataly Blas, Jonah Dees, Theresa Huff, Jessea Young, Karna Younger

Librarian Publications & Presentations

OER work can stall not because OER advocates lack commitment, but because they lack reusable tools that help connect advocacy, faculty storytelling, student engagement, and institutional support. This session gives a sneak peak of the Growing Your OER Program: A Marketing and Advocacy Toolkit, an openly licensed resource developed to help campuses sustainably expand the reach of open education with adaptable material. The interinstitutional team of librarians, an instructional designer, and student graphic designer will share how they are developing marketing tools, like posters and social media posts to shine a light on OER programs.

Long Run Effect Of Industrial Place-Based Policy On County Level Complexity, An Investigation Of The Tennessee Valley Authority, Anita Ifeyinwa Umunnah

Master's Theses

This paper studies the long-term effects of large federal investments in place-based industrial policies on regional economic development, contributing new evidence on how industrial policies shape regional local productive capabilities over time. While extensive research show that industrial policies impact regional development by advancing productive technology (capabilities), the fundamental question remains how to measure this technological transformation. The study employs the use of Economic Complexity Index (ECI) as a measure of “technological advancements” resulting from large federal investments in place-based industrial policies. Previous evaluations of such investment were based on livelihood, employment and income outcomes, with productive capability of receiving …

Digital Ischemia, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Resilience, Stress, And Emotion Regulation In College Students: A Moderated Mediation Model Of Tiktok Engagement, Samuel Bibat, Jon Thang, Hui Zhang, Hannah Carrie, Jessica Golden

Journal of Social, Behavioral, and Health Sciences

This study examined associations between stress, resilience, emotion regulation (ER), and TikTok use. Data were collected from 101 undergraduate students (M_age = 20.04, SD_age = 4.02) at a Midwestern private university. Participants completed self-report measures of TikTok use and intensity (i.e., emotional attachment), resilience, perceived stress, and intrapersonal and interpersonal ER. Mediation and moderated mediation analyses were conducted using PROCESS macro models. Stress mediated the relationship between resilience and TikTok use but not intensity. Interpersonal ER moderated the resilience–stress link, with higher interpersonal ER amplifying the negative association between resilience and stress, which in turn was linked …

The Quality Assurance Machine – A Software Quality Assurance Architecture For Ml-Enabled Systems, Shane E. Downing

All-Inclusive List of Electronic Theses and Dissertations

This dissertation evaluates whether a reusable assurance architecture, the Quality Assurance Machine (QAM), can provide effective product and process quality assurance for ML-enabled software platforms. The QAM is a system-level SQA architecture that turns plans and policies into versioned configurations, executes them in controlled environments, and produces preserved run evidence that supports traceability, auditability, and controlled change. The study follows Design Science Research and evaluates the instantiated artifact using eight assurance requirements (AR1–AR8) synthesized from standards-based guidance, including IEEE 730 and ISO/IEC/IEEE 15026. A four-year longitudinal evaluation combines two methods. First, operational evidence from routine regression and release-validation runs, defect …

Analysis Of Volumetric Reconstruction Methods In Archaeology, Cade O'Fallon

All-Inclusive List of Electronic Theses and Dissertations

The use of Structure from Motion (SfM) photogrammetry in archaeological projects is entering a period of transition; a method of producing 3D data that is traditionally embraced as tool for documentation is being explored for its analytic potential. One such way SfM photogrammetry can be used analytically is through the calculation of volumes using photogrammetric data. The tools exist for archaeologists to be able to create and quantify volumetric models; however, the discourse on these methods is still so new there is no consensus on the best method for conducting volumetric work. Different methods of creating and isolating volumetric space …

Microplastic Composition And Exposure Pathways In Freshwater Systems: A Multi-Matrix Comparison Between Streams And Retention Ponds In Hamilton County, In, Mya Whaley

All-Inclusive List of Electronic Theses and Dissertations

Since the early 1900s, the use of plastics has increased exponentially. The breakdown of plastic materials has exposed all ecosystems to microplastics (small particles of plastic < 5 mm), which are now ubiquitous in natural settings. Microplastics have a relatively large surface area, and many chemicals adsorb to these small particles, impacting their fate and transport of pollution. While microplastics have been found in virtually every setting on Earth, research is necessary to understand their impact on freshwater ecosystems and biogeochemical cycles. The focus of this research was to investigate microplastic compositions in crayfish, sediments, and water samples collected in streams and retention ponds. We analyzed trends in microplastic counts across different land-cover classes, waterbody types, and species, and compared concentrations among matrices to improve our understanding of microplastic exposure pathways in freshwater ecosystems. As a secondary objective, lead and arsenic concentrations were analyzed from sediment samples to investigate metal burdens and compare them to microplastic concentrations. Our findings revealed that, in general, urban streams had the highest microplastic concentrations within land cover categories, and retention ponds had higher microplastic counts than streams. Crayfish, such as F. rusticus had higher microplastic concentrations than F. virilis and F. propinquus, although these results may be influenced by study design. The most common microplastic type was fibers, and most common color was transparent. There was no significant correlation between microplastic and metal concentrations in sediments. We found crayfish to be adequate bioindicators of microplastic pollution, because they were less impacted by environmental variability than sediment and water samples. This research presents the first evidence of microplastics in our study species, F. propinquus, F. rusticus, and F. virlis. This work presents new evidence of microplastic accumulation in crayfish, sediments, and water from freshwater systems in the Midwestern United States. Microplastics were found in every sample type—crayfish, water, and sediment—across urban, rural, and forested landscapes, highlighting their pervasive distribution. The findings provide foundational data for assessing emerging ecological and human-health risks and emphasize the importance of sustained monitoring and research on MP contamination in freshwater environments.

Personality Characteristics Of Emergency Nurses And Their Subjective Fit In The Emergency Department, Jose Michael Maria

Theses & Dissertations

Nursing workforce challenges in the United States persist despite widespread recruitment and retention efforts, and the COVID-19 pandemic has further exacerbated shortages, turnover, and workforce instability. Despite interventions such as residency programs, financial incentives, and organizational initiatives, long-term retention remains inconsistent, particularly in high-demand settings like emergency departments. Ongoing issues such as overcrowding, rising patient acuity, and workforce attrition contribute to burnout, compassion fatigue, and compromised patient outcomes, perpetuating a cycle of staffing strain. Grounded in Person–Environment Fit theory, this research proposes that aligning emergency nurses’ personality traits with the specialty practice environment, the emergency department, may offer a more …