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Using Visual Prompts to Analyze Ejection Fraction in Echocardiograms
No full textLeft ventricular ejection fraction (LVEF) is a critical biomarker for heart failure, but manual estimation from echocardiograms is time-consuming. Artificial intelligence can be used to accelerate this process, allowing clinicians to focus on other critical tasks. Current methods typically train models from scratch on echocardiogram datasets; however, this approach is limited by the scarcity of large medical imaging datasets, which are expensive and difficult to acquire. We present a transfer learning approach that leverages pretrained models from massive datasets, enabling continuous improvement as foundation models advance. Our method employs visual prompting to generate trainable masks for echocardiogram videos, transforming the input data into representations compatible with the backbone model’s classification space. When evaluated on the EchoNet Dynamic dataset using CLIP as the backbone model, our framework achieves an AUROC of 0.89. This lightweight solution provides reliable LVEF prediction while avoiding expensive retraining, demonstrating the potential of adapting general-purpose vision models for specialized medical applications through innovative prompting techniques
The Effects of Brand Activism on Brand Performance
No full textBrand activism—the explicit demonstration of a brand’s sociopolitical beliefs—has become increasingly prevalent and consequential. Concurrently, consumers now hold higher expectations for firms to engage in sociopolitical conversations, driven by the rise of belief-drive purchase in consumers’ decision-making and the growing ideological polarization worldwide. The interaction of brand activism and consumer behavior presents unique potential for brands to gain competitive advantages while contributing to social welfare. This dissertation comprises three essays that examine the effects of brand activism through multiple understudied yet compelling perspectives.
Essay One investigates how brand activism influences consumer-brand relationships through both transactional and relational lenses. This research identifies consumer-brand values deviation as a key predictor of purchase intention and brand loyalty. Notably, the impacts of brand activism are contingent on the sociopolitical cause concerned and consumers’ consumption goal. Specifically, consumer-brand values deviation has a more salient impact on consumer-brand identification when the cause is highly controversial or when consumers hold a hedonic consumption goal. This paper underscores the importance of considering both cause-level and consumer-level factors to develop a more nuanced understanding of brand activism.
Essay Two explores a critical challenge that multinational firms face when engaging in brand activism across global markets. Due to potential conflicting sociopolitical norms between the home country and the foreign country, multinational firms are motivated to conform to local norms and silent their sociopolitical values when they do not align with those of the foreign country. However, this research reveals that brand activism inconsistency leads to more negative brand evaluations, as consumers tend to perceive such inconsistencies as opportunistic. Furthermore, the impact of brand activism inconsistency on perceived opportunism is amplified when the consumer is highly allocentric or when a firm sends additional signals to indicate a responsible brand image. This work thus offers valuable insights into how multinational corporations effectively communicate their sociopolitical opinions across diverse cultural contexts.
Finally, Essay Three studies two strategic considerations in brand activism for small and medium enterprises (SMEs), namely breadth and depth of brand activism engagement. This research uncovers that the depth-oriented (vs. breadth-oriented) strategy is more effective at encouraging positive consumer word-of-mouth (WOM). This happens because consumers tend to perceive the brand that adopts the depth-oriented strategy as more charismatic. However, the relative effectiveness of depth-oriented strategy is dependent on consumer-brand identification. In other words, high consumer-brand identification can help increase perceived brand charisma when SMEs employ the breadth-oriented strategy, but the same effect does not occur when the depth-oriented strategy is utilized. This essay provides guidance for SMEs to leverage limited resources to achieve optimal potential outcomes through engaging in sociopolitical activism.
Collectively, this dissertation investigates several crucial aspects of brand activism and examines strategic considerations for firms engaging in sociopolitical activities. The findings not only contribute to a deeper understanding of brand activism but also highlight its complexity due to its social-laden nature. Given the significance of brand activism in shaping consumer behavior, designing marketing strategy, and influencing social welfare, the novel insights presented in this dissertation offer valuable implications for both scholars and practitioners
Prioritizing AMD Impaired Watersheds for Watershed-scale Restoration Using Multi-criteria Decision Analysis
No full textAcid Mine Drainage (AMD) remains a significant environmental challenge in coal-mining and hard rock regions like West Virginia, degrading water quality and ecosystem health. Traditional site-specific remediation efforts often prove inefficient in addressing AMD at large scale. This study explores watershed-scale restoration as a more effective solution, leveraging centralized treatment facilities and multi-source pollution management. This study will follow Multi-criteria Decision Analysis (MCDA), specifically the Analytical Hierarchy Process (AHP), to develop a structured rubric for grading watersheds. The process involves identifying critical criteria, organizing them into a hierarchy, and generating weights for clusters of criteria through collaboration with decision makers. An intensity of importance scale will be developed for each criterion, followed by scoring and finalizing the watershed’s suitability score (Al-Bayati and Al-Zubaidy, 2020).
The rubric will be applied to two watersheds in Preston County, WV: Muddy Creek and Greens Run. In 2017, West Virginia Department of Environmental Protection (WVDEP) consolidated West Virginia Department of Environmental Protection – Abandoned Mine Lands (WVDEP-AM) and West Virginia Department of Environmental Protection – Office of Special Reclamation (WVDEP-OSR) pollutant sources from Muddy Creek to a centralized treatment facility, marking the first instance of watershed-scale restoration. A retroactive analysis of Muddy Creek will thus provide a valuable baseline for comparison with future projects. In contrast, Greens Run was selected as a high-priority watershed with significant potential for future restoration efforts. By applying the rubric to both a past project and a future project, this study will both validate the tool and identify areas for refinement when dealing with less known information about the watershed.
The rubric evaluates critical factors such as water chemistry, hydrology, topography, land use, and long-term treatment feasibility. As more watershed assessments are conducted, the rubric undergoes iterative refinement to improve its applicability and effectiveness. Findings highlight the importance of scale adjustments, criterion weighting, and real-world implementation feedback in optimizing the rubric for practical decision-making. This research aims to provide policymakers and environmental agencies with a structured tool for prioritizing watershed restoration efforts, ultimately improving AMD mitigation strategies across affected landscapes.
The application of the rubric to Muddy Creek and Greens Run revealed several key insights: Scoring Outcomes: Greens Run received a higher score (0.713) compared to Muddy Creek (0.622), indicating greater suitability for watershed-scale restoration under the current rubric. Key Influencing Factors: While both watersheds exhibited similar levels of impairment and restoration potential, watershed size and pollutant distribution played a decisive role. Greens Run’s smaller watershed area and closely clustered pollutant sources reduced cost and logistical complexity, making it a more viable candidate for centralized treatment. Data Availability and Learning Curve: Scoring Greens Run was more efficient due to experience gained from evaluating Muddy Creek, highlighting the potential for increased efficiency as the rubric is applied to more watersheds. Challenges in Scoring Certain Criteria: Some criteria, such as long-term treatment cost and biological restoration, could not be fully assessed due to data limitations. Leaving these criteria blank was determined to be the best approach to maintain conservative estimations
Community Belonging: Experiences of Outsiderness in Appalachia
No full textThis study demonstrates the potential long standing social impacts of extractive industries in Appalachia, supported by historical data and literature that defines the region as a sacrifice zone or as resource cursed. As represented by key informants and the communities under observational study, West Virginia communities can exhibit dynamics indicative of collective trauma that is emplaced and complex in nature, given a historical high level of industrial intervention and social control that induced precarious economic, environmental, and social circumstances. Some of the main “symptoms” of this collective trauma are an aversion to outsider intervention and nostalgia about the past that necessitate certain strategies, like extreme deference to current resident needs and ideas, when working toward communal change. Variation in these dynamics seem to be determined by community narrative identity and past experiences with community outsiders that outline conditions of communal belonging. Additionally, this collective trauma has led to some “strange dichotomies” that often complicate experiences of community belonging and strategies for economic and community development
An Investigation into How the Prostate and Androgens Mediate Greater Levels of Uric Acid in Males Compared to Females
No full textChronic elevated circulating uric acid (UA) levels (hyperuricemia) are associated with gout as well as cardiovascular, metabolic, and renal dysfunction. Men have greater mean circulating UA levels than women and are more likely to exhibit hyperuricemia. This may be partly driven by the hormonal regulation of renal UA transporters; however, a direct link between hormones and UA production has not been established. Production of UA is catalyzed by xanthine oxidoreductase (XOR / XDH), which is ubiquitously expressed but has the greatest specific activity in the liver. Interestingly, an extensive gout genome-wide association study (GWAS) recently revealed a robust genetic association between sequence variants via single-nucleotide polymorphism (SNPs) at the XDH locus and gout in men versus women. Surprisingly, these SNPs were associated with elevated mRNA expression of XDH and UA transporters in the prostate and not the liver. In addition, reports demonstrate potential hormonal (testosterone/estrogen) regulation of urate transporters, XOR expression, and UA production. When taken together, these observations incentivized our hypothesis that the prostate, in conjunction with hormonal input, may contribute to the greater levels of circulating UA in men versus women. To test this hypothesis, we used a preclinical murine model and revealed that the prostate contains similar levels of XOR and UA as the liver (XOR or UA/mg protein). In addition, when castrated, male mice demonstrate diminution in both XOR and UA levels by 4 weeks, which is recovered by 8 weeks, indicating compensation by alternative tissue(s). Furthermore, genetic ablation (50%) of XOR in prostate epithelial cells did not alter circulating UA levels. In the aggregate, these data do not support our hypothesis; however, they do not discount the possibility that both prostate-specific UA production and hormonal regulation of XOR may synergize to impact overall plasma UA levels in men and serve to incentivize future work in that direction
Native Mass Spectrometry using Capillary Vibrating Sharp-Edge Spray Ionization and Surface Analysis on Thin Films used in Superconducting Detectors
No full textAbstract
Native Mass Spectrometry using Capillary Vibrating Sharp-Edge Spray Ionization and Surface Analysis on Thin Films used in Superconducting Detectors
Vikum Kanishka Dewasurendra
My thesis is made up of two projects. The main project involves using a novel native mass spectrometry (MS) source to investigate biomacromolecules, including proteins and DNA. A smaller project involves x-ray photoelectron spectroscopy (XPS) to analyze superconducting thin films in NASA’s microwave kinetic inductance detectors (MKID) used for far infrared imaging.
In native mass spectrometry, a gentle ion source takes large biomacromolecules in solution and transfers them to the gas phase, preserving their native state. Once in the gas phase, such large molecules can be mass analyzed using MS-based techniques to characterize conformational features and even break apart the biomacromolecule to determine its underlying structure. We collaborated with Profs. Valentine and Li (Chemistry, WVU) to better understand their novel capillary Vibrating Sharp-edge Spray Ionization (cVSSI) source. These sources use an ultrasonically vibrating capillary tip to directly nebulize a solution into a cloud of droplets. This work began by measuring droplet diameters from cVSSI sources, including under conditions where a bias voltage was applied between the solution in the capillary and the MS inlet. We measured droplet diameters in the range of 25 µm that decreased slightly with increased bias voltage and even more so by increasing the capillary vibration amplitude. Through measurements of the electric current carried by the nebulized droplets, we found that the droplet current at high +ve bias voltage was +ve, as expected, but surprisingly at low +ve bias it was –ve. Based on this unexpected result, we were able to propose different pathways from initial (large) droplets, final progeny droplets to charged gas-phase macromolecules. Applying this to MS studies of the protein ubiquitin under +ve applied bias voltage, we were able to understand why we observe bimodal charge state distributions (CSDs), especially at low voltage and identify low charge states (2+ to 6+) as native-like conformer and high charge states \u3e6+ as extended conformer ensembles. Our studies show that cVSSI can maintain native conformers and due to its tunability, we can reproducibly access multiple conformations. For our work on Triplex DNA, we started by optimizing the cVSSI source parameters (bias voltage and inlet temperature) to maximize the Triplex ion current. Then we developed tools to identify fragmentation patterns associated with the Triplex, and Triplex Forming Oligonucleotide (TFO) to better understand the fragmentation processes.
The NASA collaboration involves using XPS to investigate surface and buried interface oxide layers associated with the superconductor thin films used in MKIDs for far-infrared detectors. XPS, with its chemical sensitivity, is well suited to investigating surface oxides, however, for buried interfaces, sputter depth profiling is required, and sputtering alters chemistry so that firm conclusions are difficult. In this thesis, I present challenges and strategies developed to overcome them
An Epidemiological Study of Finger, Hand, and Wrist Injuries in the Department of Air Force and US workers
No full textABSTRACT
An Epidemiological Study of Finger, Hand, and Wrist Injuries in the Department of Air Force and US workers
Melody Gwilliam
Background and Objectives: Fingers, hands, and wrists (FHW) are the leading injured body parts in work-related injuries in the United States (U.S.) and in the U.S. Department of the Air Force (DAF). There has been limited research on risk factors for FHW injuries. Workers across all industries are at risk for these injuries. The objectives of these studies are to 1) describe and compare FHW injuries among enlisted, officer, and civilian U.S. Department of the Air Force (DAF) personnel to those in the U.S. workforce, 2) examine epidemiologic characteristics and outcomes of FHW injuries by severity in the DAF workers and provide prevention recommendations, and 3) analyze national estimates and rates of work-related FHW ED-treated injuries by industry, source of injury, diagnosis, demographics, and severity.
Methods: Study 1. All work-related, noncombat FHW injuries (≥1 lost workday) and demographics among DAF personnel and U.S. workforce (2008–2018) were included using Air Force Safety Automated System (AFSAS) and the US Survey of Occupational Injuries and Illnesses (SOII). The AFSAS data captures both DAF military and civilian employees’-work related injury events, reported by local safety professionals. The SOII data is based on employer reported injuries and illnesses. The DAF FHW injury rates were age adjusted to the US employed population and compared by sex, source, event, and nature of the injuries. Study 2. This study evaluated general characteristics, injury details, and injury severity among all DAF personnel with work-related, noncombat FHW injuries between 2008 to 2018 using the Air Force Safety Automated System (AFSAS). Injury rates were calculated, patterns of injury severity were determined, and at-risk populations were identified within the DAF. Study 3. The National Electronic Injury Surveillance System - Occupational Supplement (NEISS-Work), a national estimate of emergency department (ED) injuries, was used to analyze FHW injuries between 2015 and 2022. National estimates and rates per 10,000 full-time equivalent (FTE) workers were calculated using employment labor force estimates (denominator) from the Current Population Survey.
Results: Study 1. Finger, hand, and wrist injuries were significantly lower among the DAF (3.30 per 10,000 workers) compared to all US workers (15.71 per 10,000 workers) by estimates and among females. In both populations, FHW injuries from falls were higher and increased with age group among females. Males had higher overall FHW injuries from contact with objects and equipment. Study 2. Nearly a quarter of injuries in the DAF during 2008 to 2018 were from FHW related injuries, with an overall injury rate of 27.9 per 10,000 workers. The highest rates of FHW injuries in the DAF were non-severe (24.6 per 10,000 workers), among males (29 per 10,000 workers), those 30 and younger (38.9 per 10,000 workers), and enlisted workers (31.8 per 10,000 workers). Among the severe FHW injuries, the majority occurred among those who were male (3.5 per 10,000 workers), 30 and younger (4.5 per 10,000 worker), 60 and older (3.7 per 10,000 worker), and enlisted (3.8 per 10,000 worker). There were significantly increasing odds of older age groups (40-49: aOR 1.32, 50-59: aOR: 1.45, 60 and older years: aOR 2.01) of having a severe injury compared to workers aged 30 and younger after adjusting for demographic factors (sex, age, occupational group, and DAF group). Male had significantly higher likelihood (uOR: 1.22) of severe FHW injury compared to females on crude analysis but after adjusting for sex, age, occupational group, and DAF group there was no significant difference (aOR: 0.96). Open wounds accounted for more than half of all FHW injuries, however fractures accounted for the largest percentage (37%)of severe injuries. Among all and severe FHW injuries, aircraft maintenance workers had the highest number of injuries and metal workers had the highest rates of injuries. After adjusting for demographic factors, the highest likelihood of severe injury appears significantly elevated in equipment, facilities, and services workers, while the lowest likelihood to have a severe injury was among medical sciences when compared to maintenance workers. Severe FHW injuries were significantly more likely to be related to vehicles, chemical/toxic substances, vehicles, and heat compared to aircrafts and tools/machinery after adjusting for all demographic factors. There was a significant decrease among FHW injuries in the DAF from 2011 to 2018. Study 3. There were approximately five million FHW ED-treated injuries between 2015 and 2022 and 2% were severe. More than half of the injuries were to fingers (58%). Approximately two-thirds (67%) of work-related ED-treated FHW injuries were among males, however females had higher odds of severe ED-treated work-related FHW injuries than male when adjusting for industry. The rate of injury decreased with the increasing age; however, there was a higher likelihood of severe ED-treated work-related FHW injuries among older age groups after adjusting for industry. Lacerations accounted for more than a third (36%) of these FHW injuries. Health care and social assistance workers experienced the highest number of FHW injuries (814,100 injuries), however, accommodation and food service workers had the highest rate of injury (81 per 10,000 FTE). The leading source of injury and diagnosis, respectively, for severe ED-treated FHW injuries were machinery-related (31%) and fractures (27%). Construction (24%) and manufacturing (23%) workers each experienced nearly a quarter of the severe FHW injuries. However, the leading industries for severe FHW injury rates were agriculture, forestry, fishing, and hunting (35.3 per 100,000 FTE workers) and construction (23.4 per 100,000 FTE workers).
Conclusions: Examining three separate work-related datasets provides a valuable way to improve understanding of FHW injuries and adds strength to the common findings in the datasets. The findings address the dearth of information on these common work-related injuries and the largely descriptive nature of previous studies compared to the more analytic methods used in this study. Future research should examine tailored prevention strategies for high-risk groups, including males, females (with an emphasis on severe injuries by industry/occupation), younger and older workers, and workers in high-risk industries and occupations such as aircraft maintenance, metalworking, construction, and manufacturing. Linkage of acute injury reports to other databases on longer-term medical outcomes such as time off work or permanent disability would also provide valuable information to better target specific causes of the more disabling injuries. There is a need for industry specific surveillance and targeted interventions for high-risk occupations, including examining severe injuries investigation text records using machine learning to gain more detailed information regarding specific circumstances and causes of injuries. There is also a need to review and update training programs, implement engineering modifications, updating operating procedures, and policies to improve worker safety. Also, there is a need to evaluate successful injury prevention programs to share this information across industries for prevention efforts to better understanding of common risk factors and sharing of effective prevention strategies. Investigations of injury prevention programs and examination of workplace safety climates can also benefit future intervention efforts
Supporting the Social Emotional Needs of Preschoolers
No full textSocial-emotional competence is a prerequisite to school performance and participation in daily tasks. Children in West Virginia face social and emotional barriers including the effects of the opioid epidemic leading to children placed in foster care, born with neonatal abstinence syndrome, and being exposed to toxic stress in the home environment. Additionally, the COVID-19 pandemic has impacted children\u27s social-emotional functioning due to isolation periods. Social-emotional programming can improve children\u27s well-being, school performance, relationships, and outcomes later in life. Occupational therapy practitioners can use data-driven decision-making and relationship-centered practice to develop group-based, health-promotion social-emotional programming in the preschool setting. The purpose of the study is to add social-emotional support to the preschool curriculum to support preschoolers’ social-emotional needs. This study included three preschoolers and 20 teachers. A mixed methods approach was utilized to assess social-emotional competence, feasibility, and effectiveness of a social-emotional program delivered to preschool students. The findings suggested that children improved in social-emotional competence and teachers believed the program was feasible and effective. This study can inform occupational therapists, early childhood educators, and stakeholders on holistic, collaborative ways to support preschoolers’ social-emotional needs
Providing Health Providers Best Practice Strategies when Working with the Deaf and Hard of Hearing Population: A Continuing Education
No full textBackground: Healthcare training has improved over the years. However, many healthcare providers are having a difficult time understanding the culture and the needs of the Deaf and Hard of Hearing (HOH) community. Continuing Education (CE) programs can be designed to improve cultural awareness to help close the gap by educating healthcare providers on the community’s culture, effective communication strategies, use of assistive technology, American Sign Language (ASL), and accommodations such as interpreters.
Purpose: The project aimed to develop a CE program that helped healthcare providers learn effective communication strategies, assistive devices, and accommodations for the Deaf and HOH community. Additionally, the program aimed to improve healthcare providers\u27 awareness of this community. The program aimed to improve healthcare providers’ communication, build trust, improve the overall care for this community, and help provide equitable care for all patients.
Methods: The CE program offers a developed CE program that improves healthcare providers’ cultural understanding of this community, effective communication methods, use of assistive technology, and accommodations to improve their healthcare services. The CE program used educational modules with videos, real-life experiences, and quizzes to educate healthcare providers about the community’s communication needs, culture, assistive devices, and accommodations to improve their services. The CE program has 5 modules, and it is delivered asynchronous and online.
Results: These results suggest that the CE program improved the healthcare providers\u27 knowledge and confidence when working with the Deaf and HOH population.
Conclusion: The development of these modules presents a positive step towards having a CE program that can help improve healthcare services for the Deaf and HOH population. Overall, the data shows improvements in the participants’ cultural knowledge, highlighting that the CE program was valuable and effective
Thermal Inactivation of E. Faecium on Ground Poultry
No full textChicken products in grocery stores are contaminated with Salmonella that is ranked number one as a foodborne pathogen, and causes about 1.35 million cases of foodborne illness, 26,500 hospitalizations, and 420 deaths annually. The objective of this study is to determine thermal kinetic parameters of Salmonella surrogate bacteria E. faecium in ground poultry as affected by different temperatures and salt concentrations. The raw chicken was sliced up into a 500 g batch with a total of 6 batches per replicate, ground up in the meat grinder followed by inoculation with E. faecium resistant to 200 ppm Nalidixic Acid. NaCl (0, 1.0, 3.0, and 5.0%) plus Na-tripolyphosphate (0.5%) solution to achieve a pump rate of 8% was added. The lab scale circulated water bath was set and pre-heated at 62, 66, 70, and 74°C followed by submerging 10 g samples of inoculated ground poultry into the water bath for 0, 15, 30, 45, 60, 70, 80, 90, 100, 110, 120, 140, 180, or 240 s. Enumeration of E. faecium was determined via plate counting after homogenized sample was diluted, and then plated on BEA agar containing 200 ppm Nalidixic Acid. Agars were incubated at 35°C for 48 hours followed by manually counting the colonies recorded as colony forming unit (CFU). At 62°C with an initial E. faecium count of 4.85-6.58 log10CFU/g and heated for 240 seconds, surrogate cell counts decreased to a range of 2.72-5.55 log10CFU/g. D-values and Z-values were calculated using the Weibull model. Survival curves suggest chicken samples containing no salt were least heat susceptible when compared to samples containing higher salt concentrations