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The purpose of this study was to assess sociodemographic and behavioral risk factors associated with driving after marijuana use (DAMU) among West Virginia college students. Participants were recruited from West Virginia University between September and November 2022. The study sample was restricted to students who were ≥18 years of age; reported recently driving; possessed a current, valid driver's license from any US state; and were enrolled for at least one credit hour in the Fall 2022 semester. Among respondents (N = 772), 28.9% reported DAMU. Students who had a GPA of B (adjusted odds ratio [AOR]: 2.17, 95% confidence interval [CI]: 1.06–4.42), smoked or ingested marijuana in the past year (AOR: 26.51, 95% CI: 10.27–68.39), drove after drinking (AOR: 2.38, 95% CI: 1.18–4.79), and used both marijuana and alcohol concurrently and then drove (AOR: 10.39, 95% CI: 2.32–46.54) associated with DAMU. Individuals who felt the behavior was somewhat dangerous or not dangerous or thought their peers approved of DAMU showed significant associations with DAMU. As DAMU was prevalent, future interventions that raise awareness of the danger and potential consequences of DAMU may be needed to reduce this risky behavior on college campuses. [ABSTRACT FROM AUTHOR]

Purpose: Mutations in Topoisomerase I–binding RS protein (TOPORS) have been previously documented and have been described to result in pathological autosomal dominant retinitis pigmentosa (adRP). In our study, we describe the various genotypes and clinical/phenotypic manifestations of TOPORS-related mutations of our unique patient population in Rural Appalachia. Methods: The medical records of 416 patients with inherited retinal disease at the West Virginia University Eye Institute who had undergone genetic testing between the years of 2015–2022 were reviewed. Patients found to have pathologic RP and mutations related to TOPORS were then analyzed. Results: In total, 7 patients (ages 12–70) were identified amongst three unique families. All patients were female in our study. The average follow-up period was 7.7 years. A mother (70 yr) and daughter (51 yr) had a novel heterozygous nonsense point mutation in TOPORS c.2431C > T, p.Gln811X (Exon 3) that led to premature termination of the desired protein resulting in early onset vision loss, cataract formation, and visual field restriction. The mother developed a full-thickness macular hole which was successfully repaired. Five other patients were found to have previously described TOPORS mutations. Visual field loss was progressive with age in both cohorts. Conclusions: Seven patients at our institution were identified to have mutations in TOPORS resulting in autosomal dominant retinitis pigmentosa. Two patients were found to have novel truncating mutations in the TOPORS gene resulting in profound night blindness and visual field loss, recurrent macular edema, and in one individual, epiretinal membrane formation leading to a macular hole which was able to be successfully repaired. [ABSTRACT FROM AUTHOR]

Recessive Protein O-linked-mannose beta-1,2-N-acetylglucosaminyltransferase 1 (POMGNT1) mutations can cause early onset muscle–eye–brain disease but have also more recently been associated with non-syndromic Retinitis Pigmentosa. In this case series, we describe three sisters affected by non-syndromic autosomal recessive POMGNT1 retinopathy with a report of a new variant. The three patients received care at West Virginia University Eye Institute, including full ophthalmic examination with additional fundus imaging, optical coherence tomography (OCT), electroretinogram (ERG), and visual field testing. Diagnostic panel testing of 330 genes was also obtained. The proband was seen for cataract evaluation at age 42, and her fundus examination was suggestive of retinitis pigmentosa. Her oldest sister had been treated for acute anterior uveitis with retinal vasculitis. Another sister was diagnosed with multiple sclerosis (MS) and peripheral retinal degeneration. Posterior subcapsular cataracts were diagnosed between age 42 and 55 in all three sisters, each with constricted fields with preserved central vision. We identified one pathogenic POMGNT1 variant (c.751 + 1G > A) and one likely pathogenic variant (c.1010T > C p.Ile337Thr) in all three sisters. A thorough family history and examination of the siblings with genotyping might have led to an earlier diagnosis of retinal inherited disease and avoidance of immunomodulatory treatment in the oldest sibling. [ABSTRACT FROM AUTHOR]

Introduction Service members and veterans applying to medical schools can be a challenging experience. Often, the applicants have difficulty providing descriptions of their experiences. Additionally, their pathway to medical school is significantly different compared to traditional applicants. We sought to determine if there were statistically significant factors within a cohort of U.S. military medical school applications to a U.S.-based allopathic medical school to provide recommendations on how to best advise military applicants. Methods Data about social, academic, and military factors were collected and analyzed from the American College Application Service (AMCAS) applications to the West Virginia University School of Medicine (WVU SoM) from the 2017 to 2021 cycles. Eligibility criteria included the applications that indicated that the applicant listed any type of military experience. Results In the 5-year study period, there were 25,514 applicants to the WVU SoM, and 1.6% (n  = 414) self-identified as military applicants. Of the military applicants, 28 (7%) were accepted to the WVU SoM. Statistically significant differences were found in several factors, including but not limited to academic performance, number of total experiences (14.5 vs. 12, P  = .01), and number of military experiences (4 vs. 2, P  = .003) listed on the AMCAS applications. In the accepted group, 88% of the applications included information about military experiences, which was understandable to the nonmilitary researchers compared to 79% in the nonaccepted group (P  = .24). Conclusions Premedical advisors can share statistically significant findings with military applicants, so they are informed about the academic and experiential factors associated with medical school acceptance. Applicants should also be advised to provide clear explanations of any military lexicon used in their applications. Although not statistically significant, there were a higher percentage of applications that contained descriptions of military language that was understandable to the civilian researchers in the accepted group vs. the nonaccepted group. [ABSTRACT FROM AUTHOR]

Water-in-diesel emulsion fuel has become a popular alternative fuel for diesel engines. The main limitation is related to its stability, whereby it relies heavily on surfactants to remain homogeneous, therefore causing production costs to rise. This paper highlights the application of real-time non-surfactant emulsion fuel supply system (RTES), a water/diesel emulsifying device without surfactants, to produce water-in-diesel emulsion fuel in a common rail direct injection diesel engine powered vehicle. In this study, RTES was installed near to the diesel fuel pump to ensure water-in-diesel emulsions were continuously fed to the engine. The test vehicle was set up on a roller dynamometer and operated following a modified West Virginia University (WVU) 5-Peak cycle. Fuel consumption and exhaust emissions were measured to determine the optimum water percentage of emulsion fuel and suitable timing for emulsion fuel to be introduced into the fuelling system based on the vehicle speed. The results revealed that the optimum water percentage of the emulsion fuel for the test vehicle is 10 wt%, as it was capable to reduce fuel consumption as well as nitrogen oxides and smoke emissions of a common rail direct injection diesel engine powered vehicle. [ABSTRACT FROM AUTHOR]

Background and Aim: Sars‐CoV‐19 pandemic necessitated a transition to telemedicine for many healthcare encounters. The environmental impact of this transition in gastroenterology (GI) combined with user experience has not been studied. Methods: We conducted a retrospective cohort study of patients who underwent telemedicine visits (telephone and video) at a GI clinic at West Virginia University. Distance of patients' residence from clinic × 2 was calculated, and Environmental Protection Agency calculators utilized to calculate greenhouse gas (GHG) emissions that were avoided from tele‐visits. Patients were reached by telephone and were asked questions to fill in a validated Telehealth Usability Questionnaire with Likert scales (1–7). Variables were also collected via chart review. Results: A total of 81 video and 89 telephone visits were conducted for gastroesophageal reflux disease (GERD) between March 2020 and March 2021. A total of 111 patients were enrolled, with a response rate of 65.29%. Mean age was lower in the video visit cohort compared with the telephone visit cohort (43.45 ± 14.32 years vs 52.34 ± 17.46 years). Most patients had medications prescribed during the visit (79.3%), and a majority had laboratory testing orders placed (57.7%). We calculated a total distance of 8732 miles that the patients would have traveled if they were to present for in‐person visits (including return trips). A total of 393.3 gallons of gasoline would have been required to transport these patients to and from the healthcare facility to their residence. A total of 3.5 metric tons of GHG's were saved by avoiding 393.3 gallons of gasoline for travel. In relatable terms, this is equivalent to burning more than 3500 pounds of coal. This averages to 31.5‐kg GHG emissions and 3.54 gallons of gasoline saved per patient. Conclusion: Telemedicine for GERD resulted in significant environmental savings and was rated highly for access, satisfaction, and usability by patients. Telemedicine for GERD can be an excellent alternative to in‐person visits. [ABSTRACT FROM AUTHOR]

Objective: To report the incidence of postoperative epiretinal membrane (ERM) formation after primary pars plana vitrectomy (PPV) for giant retinal tear associated retinal detachment (GRT-RD) repair as well as its clinical characteristics and visual outcomes at a level one trauma and tertiary referral academic center. Patients and Methods: Patients with primary RD repair for GRT-RD at West Virginia University from September 2010 to July 2021 were identified using the ICD-10 codes (H33.031, H33.032, H33.033 and H33.039). Imaging studies including optical coherence tomography (OCT) were manually reviewed pre- and post-operatively for ERM formation after PPV for GRT-RD repair in patients who underwent PPV or combined PPV and scleral buckle (SB). Univariate analysis was performed to analyze clinical factors for ERM formation. Results: The study included 17 eyes of 16 patients who underwent PPV for GRT-RD. Postoperative ERM was observed in 70.6% (13 of 17 eyes) of the patients. Anatomic success was achieved in all patients. The mean (range) preoperative and final best corrected visual acuity (BCVA) in logMAR units by macula status was 0.19 (0– 0.5) and 0.28 (0– 0.5) for macula-on and 1.7 (0.5– 2.3) and 0.7 (0.2– 1.9) for macular-off GRT-RDs. Clinical variables including use of medium-term tamponade with perfluorocarbon liquid (PFCL), cryopexy, endodiathermy, number of tears or total clock hours of tears did not correlate with an increased risk of ERM formation. Conclusion: Post-vitrectomized eyes for GRT-RD repair have a significantly higher incidence of ERM formation, nearing 70% in our study. Surgeons may consider prophylactic ILM peel at the time of removal of tamponade agents or weigh in ILM peel at the time of primary repair, a more challenging surgical technique in our opinion. [ABSTRACT FROM AUTHOR]

Objectives: To assess the incidence of barotrauma and its impact on mortality in COVID-19 patients admitted to ICU. Design: Single-center retrospective study of consecutive COVID-19 patients admitted to a rural tertiary-care ICU. The primary outcomes were incidence of barotrauma in COVID-19 patients and all-cause 30-day mortality. Secondary outcomes were the length of stay (LOS) in the hospital and ICU. Kaplan-Meier method and log-rank test were used in the survival data analysis. Setting: Medical ICU, West Virginia University Hospital (WVUH), USA. Patients: All adult patients were admitted to the ICU for acute hypoxic respiratory failure due to coronavirus disease 2019 between September 1, 2020, and December 31, 2020. Historical controls were ARDS patients admitted pre-COVID. Intervention: Not applicable. Measurements and main results: One hundred and sixty-five consecutive patients with COVID-19 were admitted to the ICU during the defined period, compared to 39 historical non-COVID controls. The overall incidence of barotrauma in COVID-19 patients was 37/165 (22.4%) compared to 4/39 (10.3%) in the control group. Patients with COVID-19 and barotrauma had a significantly worse survival (HR = 1.56, p = 0.047) compared to controls. In those requiring invasive mechanical ventilation, the COVID group also had significantly higher rates of barotrauma (OR 3.1, p = 0.03) and worse all-cause mortality (OR 2.21, p = 0.018). COVID-19 with barotrauma had significantly higher LOS in the ICU and the hospital. Conclusions: Our data on critically ill COVID-19 patients admitted to the ICU shows a high incidence of barotrauma and mortality compared to the controls. Additionally, we report a high incidence of barotrauma even in non-ventilated ICU patients. [ABSTRACT FROM AUTHOR]

Background: The prevalence of diabetes in the state of West Virginia (WV) is amongst the highest in the United States, making diabetic retinopathy (DR) and diabetic macular edema (DME) a major epidemiological concern within the state. Several challenges exist regarding access to eye care specialists for DR screening in this rural population. A statewide teleophthalmology program has been implemented. We analyzed real-world data acquired via these systems to explore the concordance between image findings and subsequent comprehensive eye exams and explore the impact of age on image gradeability and patient distance from the West Virginia University (WVU) Eye Institute on follow-up. Methods: Nonmydriatic fundus images of diabetic eyes acquired at primary care clinics throughout WV were reviewed by retina specialists at the WVU Eye Institute. Analysis included the concordance between image interpretations and dilated examination findings, hemoglobin A1c (HbA1c) levels and DR presence, image gradeability and patient age, and distance from the WVU Eye Institute and follow-up compliance. Results: From the 5,512 fundus images attempted, we found that 4,267 (77.41%) were deemed gradable. Out of the 289 patients whose image results suggested DR, 152 patients (52.6%) followed up with comprehensive eye exams—finding 101 of these patients to truly have DR/DME and allowing us to determine a positive predictive value of 66.4%. Patients within the HbA1c range of 9.1-14.0% demonstrated significantly greater prevalence of DR/DME (p < 0.01). We also found a statistically significant decrease in image gradeability with increased age. When considering distance from the WVU Eye Institute, it was found that patients who resided within 25 miles demonstrated significantly greater compliance to follow-up (60% versus 43%, p < 0.01). Conclusions: The statewide implementation of a telemedicine program intended to tackle the growing burden of DR in WV appears to successfully bring concerning patient cases to the forefront of provider attention. Teleophthalmology addresses the unique rural challenges of WV, but there is suboptimal compliance to essential follow-up with comprehensive eye exams. Obstacles remain to be addressed if these systems are to effectively improve outcomes in DR/DME patients and diabetic patients at risk of developing these sight-threatening pathologies. [ABSTRACT FROM AUTHOR]

Stacey Balkan's I Rogues in the Postcolony: Narrating Extraction and Itinerancy in India i is a valuable study that cuts across fields such as postcolonial studies, South Asian studies, Global South studies, environmental humanities, and disaster studies. In this light, Balkan interprets Ghosh's novels as a rich archive that gives us a palimpsestic account of subaltern agency, suffering, and resistance and serves as a counter to the hegemonic colonial archive. Balkan's interpretation of Animal's roguery offers us new perspectives on postcolonial pessimism and neoliberal dehumanization. [Extracted from the article]

The article titled "Defining Public Goods: An Institutional Approach to Community-Building and Negotiating Inter-Community Conflict" by David J. O'Brien explores the challenges faced by communities due to increased globalization and polarization between rural and urban areas. O'Brien argues that these challenges can be addressed through a public goods framework and the implementation of formal institutions. The book examines the origins of these issues, their connection to populist movements, and proposes solutions through the reestablishment of connectivity within and between communities. While the book provides valuable insights, it may be overwhelming at times and leaves some questions about the effectiveness of formal institution initiatives. [Extracted from the article]

The article focuses on the steps taken by the West Virginia University to enhance higher education and offers suggestions for school leaders to maintain and enhance the value of higher education. It advises to change old patterns, reduce bureaucracy and convey their objectives to their students, the broader public, and the taxpayers. It describes the West Virginia University's Public Education Collaborative implemented to promote optimal practices at various educational levels in the state.

Background: Dedicated, breast‐specific positron emission tomography (BPET)–cone‐beam computed tomography (BPET/CT) systems have been developed to improve detection and diagnosis of cancer in women with indeterminate mammograms caused by radiodense breasts. The absorption of X‐rays that often vexes mammography in this subset of women does not affect the detection of the high energy annihilation photons used in PET. PET imaging of the breast, however, is subject to limitations caused by their comparatively low spatial resolution (∼2 mm) and often moderate radiotracer uptake in lesions. Purpose: The purpose of this investigation is to explore the PET‐based lesion detection capabilities of a BPET/CT scanner developed by the Department of Radiology Instrumentation group at West Virginia University. Methods: The PET component of the system consists of a rotating pair of 96 × 72 arrays of 2 × 2 × 15 mm3 LYSO scintillator elements. The cone‐beam‐CT component utilized a pulsed X‐ray source and flat panel detector operated in portrait orientation. The density maps created by the CT scanner were used to correct the BPET data for photon attenuation and Compton scattering. The nonuniform uptake of 18F‐fluorodeoxyglucose (FDG) in normal breast tissue was emulated in a specially designed phantom consisting of an acrylic cylinder filled with a mixture of acrylic beads and liquid containing FDG. FDG‐avid lesions were simulated with agar spheres (3, 4, 6, 8, and 10 mm diameters) containing vary amounts of FDG to produce target‐to‐background ratios (TBR) of 6:1, 8:1, and 10:1. The spheres also contained X‐ray contrast agent to make even the smallest ones readily visible in CT images. Positions of all the lesions were identified in the CT images. These positions were used to extract signal present and signal absent sub‐images from the PET images. The sub‐images were then input to software that calculated areas‐under‐the‐curve for two numerical model observers (Laguerre–Gauss channelized Hotelling observer and non‐prewhitening matched filter). Results: The results showed that the smallest detectable lesion with this system is no smaller than ∼3 mm in diameter with a TBR of 6:1. Simulated lesions with diameters of 4 mm and greater were calculated to have good to excellent likelihood of detection for all TBRs tested. Conclusion: The results from this investigation identified the detectability capabilities and limitations for a dedicated breast‐PET/CT scanner. Its ability to detect relatively small simulated FDG‐avid breast lesions for a range of TBRs indicates its potential for clinical application. Finally, the study used methodologies that could be applied to a detectability assessment of other PET/CT scanners. [ABSTRACT FROM AUTHOR]

To comprehensively model the macroeconomic impacts that result from changes in long-term energy-economy forecasts, the United States (U.S.) Department of Energy's National Energy Technology Laboratory (NETL) partnered with West Virginia University (WVU)'s Regional Research Institute to develop the NETL/WVU econometric input-output (ECIO) model. The NETL/WVU ECIO model is an impacts forecasting model that functions as an extension of the U.S. energy-economic models available from the U.S. Energy Information Administration's National Energy Modeling System (NEMS) and the U.S. Environmental Protection Agency's Market Allocation (MARKAL) model. The ECIO model integrates a macroeconomic econometric forecasting model and an input-output accounting framework along derived forecast scenarios detailing a baseline of the U.S. energy-economy and an alternative forecast on how power generation resources can meet future levels of energy demand to generate estimates of the impacts to gross domestic product, employment, and labor income. This manuscript provides an overview of the model design, assumptions, and standard outputs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine students' perceived confidence in mechanics skills increases through exploration and enlargement of the college education experience. This paper describes the relationship between West Virginia University first-semester agricultural education pre-service teachers' perception of their confidence in specific woodworking skills and who the student considered to be their primary instructor of woodworking-based skills, (university faculty, schoolteachers, family/friends, the student themselves) as they entered the teacher preparation program. Bandura's theory of self-efficacy and social learning was adopted as the theoretical framework for this study. This study utilized a quantitative non-experimental survey research design. Quantitative methods and correlational analysis were employed to provide clarity. The homogeneous nature of the population provided no demographic variables of significance. The results of data analysis found that all participating students (n = 11) reported a higher level of self-confidence in selected woodworking skills after a sixteen-week-long course of agricultural mechanics education. Results of the Spearman's (rs) correlation indicated that a highly significant relationship existed between students' perception of self-confidence in woodworking (wood testing, identifying, measuring) and who the students perceived to be their primary teachers of woodworking as they finished the semester. No significant correlations existed at the beginning of the semester. By learning more about agricultural education students' perception of learned woodworking skills, stakeholders will be better equipped to make up-to-date programming pronouncements about the long-term assessment of agricultural mechanics courses, and their relevance to the agricultural education curriculum. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a leading cause of disease morbidity. Combined treatment with antidepressant medication (ADM) plus psychotherapy yields a much higher MDD remission rate than ADM only. But 77% of US MDD patients are nonetheless treated with ADM only despite strong patient preferences for psychotherapy. This mismatch is due at least in part to a combination of cost considerations and limited availability of psychotherapists, although stigma and reluctance of PCPs to refer patients for psychotherapy are also involved. Internet-based cognitive behaviorial therapy (i-CBT) addresses all of these problems.Methods: Enrolled patients (n = 3360) will be those who are beginning ADM-only treatment of MDD in primary care facilities throughout West Virginia, one of the poorest and most rural states in the country. Participating treatment providers and study staff at West Virginia University School of Medicine (WVU) will recruit patients and, after obtaining informed consent, administer a baseline self-report questionnaire (SRQ) and then randomize patients to 1 of 3 treatment arms with equal allocation: ADM only, ADM + self-guided i-CBT, and ADM + guided i-CBT. Follow-up SRQs will be administered 2, 4, 8, 13, 16, 26, 39, and 52 weeks after randomization. The trial has two primary objectives: to evaluate aggregate comparative treatment effects across the 3 arms and to estimate heterogeneity of treatment effects (HTE). The primary outcome will be episode remission based on a modified version of the patient-centered Remission from Depression Questionnaire (RDQ). The sample was powered to detect predictors of HTE that would increase the proportional remission rate by 20% by optimally assigning individuals as opposed to randomly assigning them into three treatment groups of equal size. Aggregate comparative treatment effects will be estimated using intent-to-treat analysis methods. Cumulative inverse probability weights will be used to deal with loss to follow-up. A wide range of self-report predictors of MDD heterogeneity of treatment effects based on previous studies will be included in the baseline SRQ. A state-of-the-art ensemble machine learning method will be used to estimate HTE.Discussion: The study is innovative in using a rich baseline assessment and in having a sample large enough to carry out a well-powered analysis of heterogeneity of treatment effects. We anticipate finding that self-guided and guided i-CBT will both improve outcomes compared to ADM only. We also anticipate finding that the comparative advantages of adding i-CBT to ADM will vary significantly across patients. We hope to develop a stable individualized treatment rule that will allow patients and treatment providers to improve aggregate treatment outcomes by deciding collaboratively when ADM treatment should be augmented with i-CBT.Trial Registration: ClinicalTrials.gov NCT04120285 . Registered on October 19, 2019. [ABSTRACT FROM AUTHOR]

Background: Analysis of the biomedical workforce and graduate education have produced recommendations for modifications of pre-doctoral training to broadly prepare trainees for wider ranging scientific careers. Development of training in professional skills is widely recommended, but details of implementation are not widely available. In alignment with these recommendations, we have incorporated professional skills training into the biomedical science graduate curriculum at West Virginia University. An important component of the training is developing conflict resolution and negotiation skills. This training will provide useful skills for academic careers, non-academic careers and life situations outside of the workplace. Conflict resolution/negotiation skills are also relevant in managing issues in diversity, equity and inclusivity. We report our experience in developing this component of the training program, provide an overview of the approach to delivery and practice of skills, and provide an analysis of the reception and effectiveness of the training. Methods: Evaluation of effectiveness of training used the principals of the Kirkpatrick Four Level Model of Evaluation. At the end of the course, students completed a questionnaire about their perceptions of training and were asked how they would respond to different scenarios requiring conflict resolution/negotiation skills. Several months later, students were surveyed to determine if they used some of these skills and/or witnessed situations where these skills would be useful. Results: We report our experience in developing conflict resolution/negotiation training in our graduate curriculum, provide an overview of the approach to delivery and practice of skills, and provide an analysis of the reception and effectiveness of the training. The results suggest this training meets a need and is effective. Importantly, these materials provide a template for others wishing to implement similar training in their curricula. Conclusions: Conflict resolution and negotiation training meets a need in graduate education. A mixed approach using didactic and interactive components spaced out over time appears to be an effective method of training. [ABSTRACT FROM AUTHOR]

Hayne Waring Reese was born on January 14, 1931 and died on March 17, 2022. Between 1958 and his retirement in 2000, he held faculty positions at SUNY-Buffalo, the University of Kansas, and West Virginia University. At the latter institution he held a prestigious Centennial Professorship for the last 30 years of his academic career. Although his primary professional identity was as an experimental child psychologist and a life-span developmental psychologist, he made distinguished contributions to many other areas of psychology including philosophical psychology and behavior analysis. He is remembered by his colleagues for his exceptional scholarship, incisive analyses of both theoretical and practical matters, and fine personal qualities that made him a role model for those who knew him. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lumbar puncture procedures with intrathecal chemotherapy are part of the backbone of treatment for pediatric leukemia and lymphoma. Pain and anxiety are the top stressors associated with these procedures. A topical eutectic mixture of local anesthetics (a 1:1 mixture of lidocaine and prilocaine) has been beneficial in reducing pain in these procedures. OBJECTIVE: To compare the efficacy of propofol and a lidocaine plus tetracaine patch versus propofol and a placebo patch in controlling pain during lumbar puncture in pediatric patients with blood cancer. METHOD: We conducted a randomized, controlled, double-blind crossover study from June 2016 to June 2018 in patients aged 3 to 21 years with acute leukemia or lymphoma at West Virginia University Medicine Children's Hospital. Patients were divided into 2 groups based on their use of propofol and a lidocaine plus tetracaine patch or propofol and a placebo patch for sedation during a lumbar puncture procedure in the postinduction phase of treatment. Patients were evaluated during 2 study periods: the first period began the day the patient had the first lumbar puncture procedure and the second period began the day the patient had the second procedure. RESULTS: The study included a total of 20 patients who were randomized in a 1:1 ratio to the lidocaine plus tetracaine patch or the placebo patch. The total propofol dose was not decreased in the lidocaine plus tetracaine group versus the placebo group; however, the mean pain score (0.2 vs 0.8, respectively) and the heart rates were higher in the placebo group than in the active patch group, although the difference was not statistically significant. CONCLUSION: These results show that topical anesthesia with the lidocaine plus tetracaine patch did not decrease the propofol sedation dose requirement, and is not more effective in reducing pain in deeply sedated pediatric patients with cancer during lumbar puncture procedures compared with propofol plus placebo. [ABSTRACT FROM AUTHOR]

Objectives: Recruiting/retaining healthcare professionals within rural and underserved communities in the United States remains a challenge. The West Virginia University Institute for Community and Rural Health implemented a service scholarship program in 2011 to address a lack of dental and primary care.Methods: Dental and medical students commit to practice 12-months full time following graduation in a Health Profession Shortage Area (HPSA) or Rural Urban Commuting Area (RUCA) in West Virginia for each $25,000 received.Results: Since inception of the program, 20 of 23 (87 percent) dental recipients had completed their service commitment, 17 (85 percent) are still practicing in WV, and 3 (13 percent) are fulfilling their commitment. Four of 20 medical recipients have repaid (2) or fulfilled (2) program commitments and 16 are completing commitments or deferred during training. Retention rate is 82 percent for both dental and medical professionals following program completion.Conclusions: Service scholarships effectively engage students to provide care in rural/underserved areas and remain there after program completion. [ABSTRACT FROM AUTHOR]

Background: In this study, we aim to compare outcomes after cystotomy repair between standard sutures (910 polyglactin, poliglecaprone) versus barbed (V-LocTM 90) suture. As a secondary outcome, we analyzed factors for suture preference between the two groups. Methods: A retrospective chart review was undertaken for surgeries complicated by cystotomy, identified by ICD-9/10 codes from 2016 to 2019 at West Virginia University (WVU) Hospital. Comparisons were made between cystotomy repair using barbed suture versus standard braided suture. Injuries were categorized by procedure, surgical route, type of suture used in repair, and subsequent complications related to repair. Primary endpoints were examined by Pearson's Chi-square test and interval data by t-test. A p < 0.05 was significant. Results: Sixty-eight patients were identified with iatrogenic cystotomy at WVU. Barbed suture was used for cystotomy repair in 11/68 (16.2%) patients. No significant difference was seen in postoperative outcomes between patients repaired with barbed suture versus standard braided suture. Barbed suture was significantly more likely to be used for cystotomy repair in minimally invasive surgery (p = 0.001). It was most often utilized in a robotic approach 7/11 (63.6%) followed by laparoscopic 3/11 (27.3%). Body mass index (BMI) was significantly higher in patients receiving a barbed suture repair (p = 0.005). Conclusion: Barbed suture may be comparable to standard braided suture for cystotomy repair. Barbed suture may offer a practical alternative to facilitate cystotomy repair in minimally invasive surgery, especially in patients with a high BMI. [ABSTRACT FROM AUTHOR]

Background: We sought to determine if participating in a surgical training session using perfused fresh human cadavers (PFHC) had a positive effect on urology residents' confidence in performing open and endoscopic procedures.Methods: Urology residents at our institution participated in a surgical training session in the West Virginia University Fresh Tissue Training Program, which utilized fresh cadavers with vascular perfusion. The session consisted of performing different urologic procedures (open and endoscopic) on the perfused fresh human cadavers (PFHC). Residents were given a survey to rate their confidence in different urologic procedures before, after, and 6 months after the session. Each procedure on the survey had 3-6 questions associated with it, with scores ranging from 0 (no confidence) to 4 (great confidence). Scores for each procedure before and after the session were compared.Results: Six residents participated in the session. There was an increase in the score for every procedure performed after the session. Scores at 6 month follow up remained higher than the pre-session scores.Conclusion: PFHCs offer an excellent opportunity to teach a wide variety of urologic procedures to residents. Incorporation of PFHCs may be very useful in urologic training, and further studies on its use are warranted. [ABSTRACT FROM AUTHOR]

This promising practice describes an innovative collaboration between West Virginia University, a land grant institution situated in the middle of rural Appalachia, and Kanawha County Schools, located in Charleston, WV. The partnership aimed to assist the rural school district by supporting children in three elementary schools and by providing the university's school counseling students an immersion experience in rural schools, with the hope of retaining them in the school district following graduation. The collaboration fulfilled the original mission of the program in two ways; first, the school district retained one-third of the school counseling students who participated. Secondly, the collaboration was met with overwhelming support by district leadership, resulting in an increase in school counseling students entering the program in the next academic year. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that autoimmune disorders and their immunomodulating medications may increase the risk of rhinosinusitis. The goal of this study is to determine if autoimmune and autoinflammatory diseases are associated with increased risk of chronic rhinosinusitis (CRS) in children. A retrospective case-control study of pediatric patients (age 2–18 years) seen in the West Virginia University Hospitals System in the past 10 years was performed. Cases were children with autoimmune or autoinflammatory diseases. Controls were children without any autoimmune or autoinflammatory disorders. Query of our electronic medical record (Epic) was performed using ICD-10 codes. Univariate (unadjusted) and multivariate (adjusted) logistic regression were used to calculate the strength of association of autoimmune or autoinflammatory disorders with CRS and the other airway disorders while adjusting for age, sex, and race. 420582 pediatric patients were queried with mean age of 10.8 years (SD of 4.8, range of 2–18 years), and 47.9% being female. 1956 (0.5%) had autoimmune disorders and 293 (0.07%) had autoinflammatory disorders. Both autoimmune and autoinflammatory disorders increase the odds of having CRS in the unadjusted [OR = 3.36, p < 0.001 and 5.69, p < 0.001 for the respectively] and the adjusted [OR = 2.90, p < 0.001 and OR = 5.07, p < 0.001 respectively after adjusting for age, sex, and race] models. Autoimmune and autoinflammatory disorders increase the risk of CRS and chronic rhinitis in children. [ABSTRACT FROM AUTHOR]

The West Virginia University Libraries migrated to OCLC's Hosted EZproxy service in 2020. The Libraries' main goals with the migration were to reduce staff time spent on proxy maintenance, customize user access to resources, and increase analytics about resource usage. The migration process involved sending configuration and user data to OCLC, updating vendors with a new IP address and proxy URL, and creating specialized user groups. The following details the Libraries' experience during this project. [ABSTRACT FROM AUTHOR]

Objective  This study aims to report the prevalence of obesity and overlapping comorbidities in a rural population of children and adolescents with migraine. Design and Methods  A cross-sectional, descriptive, secondary data analysis using a comprehensive patient database from the West Virginia University (WVU) Medicine Epic Clarity system will be reported. A review of electronic medical records of 990 children and adolescents, ages 7 to 17 years, evaluated for headache at a rural clinic from December 1, 2009 to December 31, 2017 was completed. The Chi-square test was used to identify any differences in demographic characteristics (age, gender, and race) and distribution of comorbidities (obstructive sleep apnea syndrome [OSAS], depression, and anxiety) among obese versus nonobese adolescents with migraine. Student's t -test was used to identify any differences in the number of comorbidities between the two groups. Results  A total of 648 children and adolescents with a diagnosis of migraine were identified. Approximately 26.4% of the children and adolescents diagnosed with migraine (n = 648) met the criteria for being obese with a mean body mass index (BMI) of 30.6 kg/m 2 (standard deviation [SD] = 6.5), ranging from 20.0 to 58.5 kg/m 2. There were no significant differences between migraineurs who were categorized as obese versus nonobese in terms of gender (p = 0.8587), age (p = 0.1703), race (p = 0.7655), anxiety (p = 0.1841), or depression (p = 0.2793). Obese individuals have more comorbidities than nonobese individuals (p = 0.015). Additionally, the prevalence of OSAS was significantly higher among obese versus nonobese migraineurs (20 vs. 9.9%, p = 0.0007). Conclusion  Given the prevalence of obesity in rural pediatric populations and the reported neurobiological links between migraine and obesity, BMI needs to be monitored and weight management interventions included in plans of care for rural children and adolescents with migraine. [ABSTRACT FROM AUTHOR]

Background: Approximately 85% of melanoma patients who undergo a sentinel lymph node biopsy (SLNB) are node‐negative. Melanoma incidence is highest in patients ≥65 years, but their SLNB positivity rate is lower than in younger patients. CP‐GEP, a model combining clinicopathologic and gene expression variables, identifies primary cutaneous melanoma (CM) patients who may safely forgo SLNB due to their low risk for nodal metastasis. Here, we validate CP‐GEP in a U.S. melanoma patient cohort. Methods: A cohort of 208 adult patients with primary CM from the Mayo Clinic and West Virginia University was used. Patients were stratified according to their risk for nodal metastasis: CP‐GEP High Risk and CP‐GEP Low Risk. The main performance measures were SLNB reduction rate (RR) and negative predictive value (NPV). Results: SLNB positivity rate for the entire cohort was 21%. Most patients had a T1b (34%) or T2a (31%) melanoma. In the T1‐T2 group (153 patients), CP‐GEP achieved an SLNB RR of 41.8% (95% CI: 33.9‐50.1) at an NPV of 93.8% (95% CI: 84.8‐98.3). Subgroup analysis showed similar performance in T1‐T2 patients ≥65 years of age (51 patients; SLNB positivity rate, 9.8%): SLNB RR of 43.1% (95% CI: 29.3‐57.8) at an NPV of 95.5% (95% CI: 77.2‐99.9). Conclusion: We confirmed the potential of CP‐GEP to reduce negative SLNB in all relevant age groups. Our findings are especially relevant to patients ≥65 years, where surgery is often elective. CP‐GEP may guide SLNB decision‐making in clinical practice. [ABSTRACT FROM AUTHOR]

Forensic activities related to footwear evidence may be broadly classified into the following two categories: (1) intelligence gathering and (2) evidential value assessment. Intelligence gathering provides additional leads for investigators. Assessment of evidential value, as practiced in the United States, involves a trained footwear examiner evaluating the degree of similarity between a known shoe of interest (together with its test impressions) and footwear impressions obtained from a crime scene, by performing side‐by‐side visual comparisons. However, the need for developing quantitative approaches for expressing similarities during such comparisons is being increasingly recognized by the forensic science community. In this paper, we explore the ability of similarity metrics to discriminate between impressions made by a shoe of interest and impressions made by close non‐matching shoes. Close non‐matching shoes largely share the same design and size. Therefore, the ability to effectively discriminate between them requires considering, either explicitly or implicitly, not only design and size, but also wear patterns and, to some extent, individual characteristics. This type of discrimination is necessary for assessment of evidential value. The similarity metrics examined in this paper are correlation‐based metrics, including normalized cross‐correlation, phase‐only correlation, AvNCC, and AvPOC. The latter two metrics are based on features obtained from a convolutional neural network. Experiments are performed using Everspry impressions, FBI boot impressions, and the West Virginia University footwear impression collection. The results show that phase‐only correlation performs as well as or better than the other metrics in all cases for the datasets we considered. [ABSTRACT FROM AUTHOR]

This article discusses various concerns and challenges in the current educational climate, including a teacher shortage, anti-intellectualism, and economic impacts on schools. It highlights examples such as program cuts at West Virginia University and the Department of Education's new Financial Transparency Employment rule. The article also addresses issues such as accountability measures for educator preparation programs and the limitations on compensation for advanced degrees. It emphasizes the importance of supporting educators and advocating for a free and equitable public education for all. Additionally, the article includes several research articles that focus on diverse and inclusive pedagogical approaches, supporting LGBTQIA+ students, serving students with disabilities, and engaging in critical reflections on race and racism. [Extracted from the article]

A previous study showed that residents felt a universal well-being visit to a Faculty Staff Assistance Program (FSAP) would increase self-initiated visits. It is unknown whether such program is associated with more self-initiated visits, improved professionalism, or positive well-being measures. We measured internal medicine (IM) resident-initiated visits before and after the universal well-being FSAP intervention to assess for increased utilization of FSAP services and effect on professionalism and well-being measures. Universally scheduled, resident-initiated, program-mandated FSAP visits for IM residents at West Virginia University were counted for years 2014–2019. Professionalism reports of all residents and IM residents were tallied. A Mann-Kendall trend test was used to estimate slope of trends. Burnout and compassion satisfaction (CS) scores were assessed from 2017–2020. Residents opted-out of 8 of 239 (3.3%) universally scheduled FSAP visits. Resident-initiated visits significantly increased from 0 in 2014–2015 to 23 in 2018–2019 (slope = 6.5; P =.027; 95% CI [1.0, 8.0]). Program-mandated visits significantly decreased from 12 in 2014–2015 to 3 in 2018–2019 (slope = -2.4; P =.027; 95% CI [-3.0, -1.0]). IM-attributed professionalism reports significantly decreased from 17 of 62 (31%) in 2014 to 1 of 62 (1.6%) in 2019 (slope = -5.7%; P =.024; 95% CI [-11.6%, -0.6%]). Burnout scores remained in the low range (≤ 22) and CS scores in the average-high range (38.7–42) from 2017–2020. A universal well-being FSAP program increased resident utilization of mental health resources and was associated with fewer professionalism breaches. [ABSTRACT FROM AUTHOR]

As part of the National Collegiate Honors Council's (2022) collection of essays about the value of honors to its graduates (1967-2019), the author reflects on the personal and professional impacts of the honors experience. [ABSTRACT FROM AUTHOR]

Between February 2017 and August 2018, West Virginia University conducted a reliability study to determine expert performance among forensic footwear examiners in the United States. Throughout the study's duration, 70 examiners each performed 12 comparisons and reported a total of 840 conclusions. In order to assess the accuracy of conclusions, the similarities and differences between mated and nonmated pairs were evaluated according to three criteria: (i) inherent agreement/disagreement in class, wear, and randomly acquired features, (ii) limitations as a function of questioned impression quality, clarity, and totality, and (iii) adherence to the Scientific Working Group for Shoeprint and Tire Tread Evidence (SWGTREAD) 2013 conclusion standard. Using these criteria, acceptable/expected categorical conclusions were defined. Preliminary results from this study are divided into a series of three summaries. This manuscript (Part II) reports accuracy and reproducibility. For mated pairs, accuracy equals 76.3% ± 13.0% (median of 78.6% and a 90% confidence interval between 72.2% and 80.0%). For nonmated pairs, accuracy equals 87.4% ± 9.24% (median of 91.4% and a 90% confidence interval between 84.7% and 89.8%). In addition, the community assessed agreement (denoted by IQR) of reported results equals the research team's accepted/expected conclusions for 10 out of 12 comparisons. In terms of reproducibility, the 90% confidence interval for consensus was computed and found to equal 0.71–0.86 (median of 0.77) for the combined dataset. Although based on a limited sample size, these results provide a baseline estimate of accuracy and consensus/reproducibility as a function of the existing seven‐point SWGTREAD 2013 conclusion standard. [ABSTRACT FROM AUTHOR]

In order to assess the extent of agreement between forensic footwear examiners in the United States, a reliability study was performed by West Virginia University between February 2017 and August 2018. Over the span of 19 months, 70 examiners each performed 12 comparisons and reported a total of 840 conclusions. For each comparison, participants were queried on a number of factors in order to determine the degree to which different types of features were identified, evaluated, and weighted, before arriving at a final decision regarding the strength of the association or disassociation between questioned and test impressions. Preliminary results from this study are divided into a series of three summaries. This manuscript (Part I) describes participant demographics as well as community agreement in both feature identification/annotation, and final reporting. Results indicate considerable variation in feature identification/annotation (as low as 66.5% agreement), but higher consistency in the reporting of overall conclusions. For mated pairs, this agreement was 79.7% ± 14.1% (median of 85.7% and a 90% confidence interval between 75.9% and 83.2%). For nonmated pairs, the equivalent overall agreement was 89.8% ± 6.69% (median of 91.4% and a 90% confidence interval between 87.4% and 92.1%). These estimates of agreement are further compared with previous published findings, and collectively, the work extends the body of knowledge concerning reliability in forensic footwear comparisons and conclusions. [ABSTRACT FROM AUTHOR]

Over the course of 19 months, West Virginia University collected reports from 70 footwear experts, each performing 12 questioned‐test comparisons, resulting in a dataset that includes more than 1000 examiner attributes (education, training, certification status, etc.), 3500 impression features identified and evaluated (clarity, totality, and similarity), and 840 source conclusions. The results were used to estimate the performance of forensic footwear examiners in the United States, including error rates, predictive value (PV), and measures of inter‐rater reliability (IRR). For the dataset and mate‐prevalence (31.5%) used in this study, results indicate correct predictive value varies from 94.5% for exclusions, 85.0% for identifications, and between 70.1% and 65.2% for limited associations and association of class, respectively (with all other conclusions producing PVs between these extremes). After data transformation based on ground truth, the case study materials show a false‐positive rate of 0.48%, a false‐negative rate of 15.6%, a (correct) positive predictive value of 98.8%, and a (correct) negative predictive value of 93.3%. In addition to error rates and PVs, inter‐rater reliability was likewise computed to describe examiner reproducibility; results indicate a Gwet AC2 agreement coefficient of 0.751–0.692 when using a six‐ and four‐level reporting structure, respectively, which translates into "substantial" and "moderate agreement" for a benchmarked verbal equivalent scale. The reported performance metrics are further compared against past forensic footwear reliability studies, including a discussion of how the use of a six‐level reporting structure impacts results. [ABSTRACT FROM AUTHOR]

Objective: We evaluate the extent to which Coca-Cola tried to influence research in the Global Energy Balance Network, as revealed by correspondence between the company and leading public health academics obtained through Freedom-of-Information (FOI) requests.Design: US state FOI requests were made in the years 2015-2016 by US Right to Know, a non-profit consumer and public health group, obtaining 18 030 pages of emails covering correspondence between The Coca-Cola Company and public health academics at West Virginia University and University of Colorado, leading institutions of the Global Energy Balance Network. We performed a narrative, thematic content analysis of 18 036 pages of Coca-Cola Company's emails, coded between May and December 2016, against a taxonomy of political influence strategies.Results: Emails identified two main strategies, regarding information and messaging and constituency building, associated with a series of practices and mechanisms that could influence public health nutrition. Despite publications claiming independence, we found evidence that Coca-Cola made significant efforts to divert attention from its role as a funding source through diversifying funding partners and, in some cases, withholding information on the funding involved. We also found documentation that Coca-Cola supported a network of academics, as an 'email family' that promoted messages associated with its public relations strategy, and sought to support those academics in advancing their careers and building their affiliated public health and medical institutions.Conclusions: Coca-Cola sought to obscure its relationship with researchers, minimise the public perception of its role and use these researchers to promote industry-friendly messaging. More robust approaches for managing conflicts of interest are needed to address diffuse and obscured patterns of industry influence. [ABSTRACT FROM AUTHOR]

Background: The state of West Virginia (WV) is often seen as a health care desert with a scarcity of hospitals and resources. The prevalence of cerebrovascular disease and associated comorbidities are also some of the highest in the nation. Introduction: Ischemic stroke is a time-sensitive diagnosis. Prompt treatment in WV is difficult due to limited and isolated stroke-ready hospitals. Adoption of telestroke has helped to bypass these obstacles and improve access to care. Materials and Methods: Retrospective analyses; using data from the American Heart Association's Get With The Guidelines Stroke Data Registry, and other statewide agencies, we looked for trends in the volume of patients treated with intravenous-tissue plasminogen activator (tPA) in WV. We also reviewed data from West Virginia University's (WVU) telestroke database to assess trends in consult volumes and quality metrics. Results: Since the establishment of WVU telestroke, the total number of stroke patients receiving tPA across the state increased by 173% from 2015 (259 patients) to 2018 (448 patients) (p < 0.0001). Telestroke consults made up 24% (107/448) of total statewide tPA administrations for 2018. Between 2016 and 2018, the total symptomatic hemorrhage rate for tPA treated patients through telestroke was 1% (3/292). Telestroke also facilitated local care by avoiding patient transfer on average 65% of the time. Conclusion: Not only has telestroke increased the quantity of treated acute ischemic strokes, but it has also done so safely and effectively even in resource-poor areas. These findings demonstrate that telestroke is a useful tool for treating strokes, particularly those that happen far from stroke centers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to expand the domain of experiential learning by sharing the experiences of establishing and developing student managed investment fund (SMIF) at West Virginia University (WVU). Design/methodology/approach: This paper discusses the structure and performance of the SMIF at WVU within the context of experiential learning literature in financial education. Findings: The adopted structure and coordination of SMIF appears to be effective in bridging the gap between classroom and the professional world, while significantly enhancing student experiential learning opportunities, engagement and professional preparedness. Originality/value: The paper presents experience of launching and operating a SMIF at WVU, which has recently joined the ranks of R1 research universities. While the importance of research productivity has been on the rise, the significance of strengthening student experiences has also been growing and maintaining the balanced approach can be challenging. Enrollment in WVUs undergraduate finance program grew 33 percent over the past three years. With growing enrollment and competitiveness of finance degree programs, experiential learning opportunities like WVU's SMIF are an essential for an evolving curriculum. [ABSTRACT FROM AUTHOR]

Background: One of the most feared complications of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence of 3.5 to 15%, is post ERCP pancreatitis (PEP). Given the role of statins in the reduction of systemic and pancreatic intraluminal inflammation, we hypothesized that the use of statins may lower the risk of PEP.Methods: A retrospective cohort study of all patients undergoing ERCP at West Virginia University during the years 2016 and 2017 was performed. Possible association of collected variables with PEP was assessed with Univariate tests and multivariable logistic regression analyses.Results: A total of 1162 ERCPs were included. Mean age was 60.12 years (SD: 17.5). 51.3% of the participants were female. Two hundred and sixty-three participants underwent more than one ERCP during the study period. Seven hundred and ninety-nine ERCPs (78.8%) were conducted in participants who were not taking a statin medication at the time of ERCP, while 363 participants were on statin medications at the time of ERCP; 118 and 245 participants were taking high dose statins (atorvastatin 40-80 mg or rosuvastatin 20 mg), and low/medium dose statins (all other statin regimens) at the time of the procedure, respectively. The overall incidence of PEP in the cohort was 7.3%. In the non-statin and statin groups, 9.5 and 3.4% of participants developed PEP, respectively. On univariate analysis, young age, no statin use, history of PEP, and endoscopic sphincterotomy were found to be significantly associated with the development of PEP. In a binary logistic regression model, young age (P = 0.033), history of PEP (P = 0.0001, OR 2.41, 95% CI: 1.05-5.51) and endoscopic sphincterotomy (P = 0.038, OR 2.85, 95% CI: 1.7-4.78) were found to be associated with increased risk of PEP. Statin usage was found to be protective against PEP, (OR 0.35, 95% CI: 0.18-0.69).Conclusion: Chronic statin usage is protective against post ERCP pancreatitis, and our findings suggest a potential role of these drugs as prophylactic agents. Randomized controlled trials are needed to establish any potential clinical application. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe the transdisciplinary, multiphase, mixed methods, generative design research, participatory planning and social design activities developed and implemented by the West Virginia University Rural Tourism Design Team and associated outcomes. Design/methodology/approach: The multiphase methodology included quantitative and qualitative research in initial stages of the study (key informant interviews, resident attitudes toward tourism survey, visitor preferences survey, economic impact analysis) which informed social design activities at latter stages (asset mapping, landscape design/visualization of opportunities and sites targeted for development and cultural identity design) using generative design tools facilitating co-design with the communities and helping the destination take sequential steps toward achieving their goals and objectives. Findings: Opportunities and challenges identified through multiple methods were triangulated and pointed to the same conclusions including the need for long term planning and managed growth; protecting community values; underutilized natural, cultural and historic assets; the opportunity to develop nature-based, cultural and historical attractions; and the need for a common vision and collective identity. Research limitations/implications: This study makes a unique contribution to literature on sustainable tourism planning by incorporating social design activities to visualize findings of more traditional planning methods and provide tangible, visible outcomes of planning activities which can guide local stakeholders in rural destinations more directly to funding for planning recommendations and project implementation. Practical implications: The transdisciplinary and social/generative/participatory approach provided a scaffolding of outputs to the community with citizen control and active involvement throughout the planning and design process. The incorporation of social design provided tangible outcomes including site designs and a cultural identity. Generative design research gives people a language with which they can imagine and express their ideas and dreams for future experiences. Originality/value: This paper investigates the role of social design in a transdisciplinary, multiphase project to support sustainable tourism planning. [ABSTRACT FROM AUTHOR]

Background/Objectives: Social media use has been suggested to worsen psychiatric health among adolescents, especially those with visible skin lesions including acne. However, little is known about social media's impact on acne treatment. The purpose of the study sought to characterize the influence of social media use on acne treatment. Methods: We conducted a cross‐sectional survey of West Virginia University ambulatory patients whose chief complaint was acne was conducted. The survey collected sociodemographics and queried whether individuals accessed social media for acne treatment advice or not, whether changes to acne care were made based on social media, and whether these changes aligned with the American Academy of Dermatology (AAD) clinical guidelines for acne management. Results: Of 130 respondents, 45% consulted social media for acne treatment advice (54% of women vs 31% of men). 41% of adolescents and 51% of adults consulted social media. The most used platforms were YouTube and Instagram (58% each). Social media users often tried an OTC treatment (81%) or dietary modification (40%). However, only 31% of participants consulting social media made changes fully aligned with AAD clinical guidelines. Conclusions: Social media‐influenced acne treatment advice is prevalent, especially among women, adolescents, and young adults. This treatment advice frequently does not align with AAD guidelines, with notably 40% of respondents choosing dietary modification for acne management. These results suggest that dermatologists should inquire about social media acne treatment advice and directly address misinformation. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Ureteral injuries are a source of morbidity, and delays in diagnosis can increase the risk for long-term sequelae. Our aim was to quantify and describe iatrogenic ureteral injuries in a rural tertiary care center. Our secondary goal was to evaluate the impact of delayed diagnosis of ureteral injury on patient outcomes and whether cystoscopy had any influence on these outcomes. Methods: A retrospective chart review was undertaken for ureteral injuries, identified by the ICD-9 code from 1997 to 2017 at West Virginia University (WVU) Hospital. Injuries were categorized by procedure, surgeon specialty, location (WVU versus community hospital), and intraoperative cystoscopy. A delay in diagnosis was defined as a ureteral injury sustained during surgery not diagnosed intraoperatively. Results: Forty-six patients were identified with iatrogenic ureteral injury at WVU. Twenty-seven occurred during gynecologic procedures (59%). Fourteen ureteral injuries were sustained at community hospitals and transferred to WVU for evaluation and treatment. Fifty percent of those had a known delay in diagnosis. The average delay in diagnosis for transferred patients was 6.5 days vs. 3.6 days for patients with ureteral injury sustained at WVU. Cystoscopy was only utilized in 37% (10/27) of gynecologic cases involving a ureteral injury. When cystoscopy was utilized, it was 80% (8/10) effective in helping to identify ureteral injury. Conclusions: Within a rural population, approximately half of patients with ureteral injuries were transferred to a tertiary care center for evaluation and treatment. Transferred patients were more likely to have a delay to diagnosis than patients who had injuries sustained at WVU. The delayed diagnosis patients had comparatively worse outcomes. Gynecologic surgeons working in rural hospitals should be adequately trained to perform diagnostic cystoscopy. [ABSTRACT FROM AUTHOR]

Known disparities exist amongst HPV-related cancer outcomes in urban versus;rural populations, including squamous cell carcinoma (SCC) of the penis.; Appalachia as a whole, and West Virginia specifically, present a unique opportunity for analysis of penile cancer in underserved areas with few tertiary care centers and large distances and travel time;between centers.; The majority of patients in the state seek urologic oncology care at two tertiary centers.; This study seeks;to examine;differences in penile cancer presentation (including TNM stage,;grade, pertinent risk factors,;presenting symptoms and duration), treatment, and outcomes;between rural and urban populations in West Virginia.; Identification of disparities is crucial in detecting disease;to provide earlier intervention and improve outcomes in a traditionally underserved population. Following approval from institutional review boards, 89;patients with biopsy-proven SCC of the penis treated at Charleston Area Medical Center (CAMC) and West Virginia University over a fourteen-year period (2007-2022) were studied via retrospective chart review.; Distance and travel time from the respective tertiary care centers were collected based on zip code, and patients were stratified into urban and rural groups according to county based on the US Census Burea defition of Census Places >10,000.; T-stage, clinical node positivity, grade, risk factors (circumcision, smoking), primary tumor size and location, and treatment modality (chemotherapy, radiation, local therapy vs. partial penectomy vs. radical penectomy) and timing (symptom duration and time from presentation to surgery);were analyzed.; Patients were also followed post-operatively to assess the endpoints of death from penile cancer and local/nodal/distant recurrence.; Appropriate statistical tests were performed using SPSS. Patients;further from;tertiary care centers;(travel time) were more likely to undergo radical penectomy as primary therapy;(p=0.03), although advanced stage;(pT2 or greater) and clinical nodal status at diagnosis;did not increase;with travel time.; Those living;in counties classified as "urban";had higher BMI on average (p=0.004) and were more likely to present with a lesion on the penile shaft (p=0.06).; No significant;difference exists in stage or grade at diagnosis, other risk factors;(smoking status, circumcision), primary tumor size,;clinically palpable lymph nodes, radiation and chemotherapy use, symptom duration, or timing of therapy based on distance or travel time or when stratified based on rural/urban county of residence.; Patients were followed for a mean 32.8 months post-operatively and 30% exhibited local/nodal recurrence and 42% mortality.; Disease burden and stage appears greater in West Virginia when compared nationally. Penile cancer patients in West Virginia fare poorly when compared to allcomers in the US in terms of both disease at presentation, recurrence, and mortality.; Patients further from tertiary care center (travel time) are more likely to undergo radical penectomy as definitive therapy. This did not occur due to higher risk disease based on pT stage statistically, although anecdotally there does appear to be more disease >pT1b in rural populations. When stratified based on census definitions, rural patients had lower BMI and presented less often with disease of the penile shaft, suggesting they may opt for a definitive radical penectomy due to difficulties with healthcare access. [ABSTRACT FROM AUTHOR]

Building on calls for "slow scholarship," we highlight the importance of time and care in producing rigorous, ethical research through our advising practices. We describe how feminist ethics and epistemologies shape each of our research clusters: the Hydro-Feminist Lab at West Virginia University and the Feminist Geography Collective at the University of Texas at Austin. We show a couple of ways that feminist geographers can adopt the "lab model" and use it to build meaningful mentoring networks, fostered through time and care, and in a way that both meets and transgresses the demands of academic neoliberalism. We then show how this approach extends into our fieldwork, recounting instances where the importance of mentoring through a caring ethic emerged. Unfolding over weeks, months, and years we show the value of time and care, both in deepening the quality of advising relationships and in creating mentoring relationships of trust and support. We contend that this better prepares students for the intellectual and emotional challenges of feminist research and, in turn, strengthens that research. In the face of neoliberalism's quickening drives, we highlight the benefits and the contradictions of this kind of slow and caring "lab-field" feminist mentoring for geographic research. [ABSTRACT FROM AUTHOR]

The Pulsar Search Collaboratory (PSC) is a collaboration between the Green Bank Observatory and West Virginia University, funded by the National Science Foundation. The PSC program is currently expanding nationwide and engages high school students, teachers, and undergraduate mentors in real-world research by searching for pulsars in data collected with the 100-m Green Bank Telescope. In the process, students learn about observational radio astronomy, radio frequency interference, pulsar timing, and data analysis procedures. The primary goals of the PSC are to stimulate student interest in Science, Technology, Engineering, and Mathematics (STEM) careers, to prepare teachers in implementing authentic research with students by training them within a professional scientific community, and to promote student use of information technologies through online activities and workshops. In this paper, we provide an overview of pulsar science and the data analysis students undertake, as well as a general overview of the program. We then discuss evaluation data collected from participants through a series of survey questions to determine if the program's initial goals were met. The program had a positive impact on the students according to multiple measures, in particular, on their understanding of the nature of scientific inquiry and motivation to pursue STEM career paths. [ABSTRACT FROM AUTHOR]

This paper uses daily hotel occupancy data for the Greater Morgantown area to estimate the effect of West Virginia University football and basketball games on hotel demand. Hotel demand is an important part of the economic activity generated by sporting events because hotel rooms are largely occupied by out-of-town guests. Their expenditures, therefore, are likely to represent new local economic activity. We look at the effect of Mountaineer football and basketball games on average daily room rates, revenue per room, demand, occupancy, and total revenue. We find large and statistically significant effects of Mountaineer football on hotel demand with very little evidence of crowding out. Our estimates for basketball, while statistically significant in a positive direction, are considerably smaller. WVU football games bring in approximately $360,000 in additional hotel revenue from each football home game, while WVU basketball games generate about $20,000 in additional hotel revenue. [ABSTRACT FROM AUTHOR]

A framework based on the artificial immune system (AIS) paradigm is proposed in this paper for correcting position and velocity estimations for autonomous flight vehicles in environments where global navigation satellite systems (GNSS) are not available. The AIS consists of sets of memory cells built under normal conditions when all sensor systems function properly. The memory cells mimic the functionality of memory T-cells and B-cell capable of encoding and storing information about the invading antigens and the needed antibodies. This information is used to enhance the response of the innate immune system with an adaptive component that is expected to accelerate and intensify the immune response when subsequent infections with the same antigen are experienced. The artificial memory cells are constructed with two parts. One represents the antigen and is a collection of instantaneous measurements of relevant features that characterize the dynamics of the system and are the basis of the position and velocity estimation. The other represents the antibodies and is a set of instantaneous estimation errors that are viewed as necessary corrections for the estimation. During GNSS-denied operation, the current measured features are matched against the AIS antigens and the corresponding corrections are extracted and used to tune the outputs of the position and velocity estimation algorithm for feedback control. The functionality of the proposed methodology and its promising potential is successfully illustrated using the West Virginia University unmanned aerial system simulation environment. [ABSTRACT FROM AUTHOR]

Periorbital cellulitis in children are commonly caused by acute rhinosinusitis (ARS). This study investigated the association of ARS and the severity of periorbital cellulitis in children. Retrospective case-control study of children with periorbital cellulitis with ARS versus periorbital cellulitis without ARS. Patients were seen at West Virginia University Children's Hospitals between August 2011 to August 2022. Patients were divided into cases and controls based on presence or absence of ARS. ARS was defined based on clinical symptoms with objective presence of disease on CT scan. Patients' characteristics, treatment, hospital length of stay, and readmission were collected. The sample consisted of 118 pediatric patients with orbital cellulitis. Patients with ARS were younger than patients without ARS (6.3 vs 8.5, p = 0.025), however there were no sex differences between two groups (p = 0.540). The ARS group had higher incidence of postseptal cellulitis (51.5% vs 9.6%, p < 0.001). As compared to patients without ARS, patients with ARS were more likely to be admitted (p < 0.001), have a longer length of stay (median of 3.5 days vs 0.5 days, p < 0.001), require IV antibiotics (95.3% vs 54.9%, p < 0.001), and require surgical intervention (23.1% vs 5.8%, p < 0.001). Readmission rate was similar between the two groups. Children presenting with acute periorbital cellulitis who have ARS tend to have more severe infection requiring higher level of care. ARS should be assessed and incorporated into the plan of care of pediatric patients with periorbital infections. [ABSTRACT FROM AUTHOR]