VTechWorks
VTechWorks provides global access to Virginia Tech scholarship, including journal articles, books, theses, dissertations, conference papers, slide presentations, technical reports, working papers, administrative documents, videos, images, and more by faculty, students, and staff. Faculty can deposit items to VTechWorks from Elements, including journal articles covered by the University open access policy. Email vtechworks@vt.edu for help.
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Virginia Tech's open access policy enables researchers to deposit the accepted version of scholarly articles with no embargo.
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Virginia Tech was first in the world to require ETDs in 1997, and continues to add scans of older theses and dissertations.
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More than 50 freely available and openly licensed textbooks are among our most downloaded items.
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Recent Submissions
Thalamo-hippocampal pathway determines aggression and self-harm
Jung, Jane; You, In-Jee; Shin, Sora (American Association for the Advancement of Science, 2025-11-05)
Aggression and self-harm are maladaptive coping strategies that often occur in individuals with a history of early life trauma (ELT), yet their underlying neural mechanisms remain unclear. Here, we identify L-type calcium channel (LTCC)–expressing thalamic nucleus reuniens (RE) as a critical component regulating both behaviors. ELT-induced excessive LTCC activity in vesicular glutamate transporter 2 (vGlut2) RE neurons and its corresponding effects on persistent neuronal activation contribute to increasing susceptibility to aggression and self-harm. Activation of vGlut2 RE neurons projecting to ventral hippocampus (vCA1), but not medial prefrontal cortex, promotes these behaviors in control mice. Furthermore, we found that RE neurons modulate two distinct subsets of vCA1 neurons, with one projecting to the hypothalamus to drive aggression and another to the basal amygdala to mediate self-harm. Our findings uncover how LTCC functions in the RE-to- vCA1 neural pathway increase the risk of aggression and self-harm, highlighting potential therapeutic targets for mitigating destructive behaviors following early adversity.
Redefining Perceived Boundaries: Insights into the Audit Committee's Evolving Responsibilities
Cunningham, Lauren M.; Stein, Sarah E.; Walker, Kimberly; Wolfe, Karneisha (American Accounting Association, 2025-07)
Oversight responsibilities for many audit committees (ACs) are evolving to include some of the hottest topics in the boardroom: enterprise risk management, cybersecurity, and environmental, social, and governance reporting. However, certain ACs avoid overseeing these evolving areas, creating significant variation across boards in the assignment of responsibilities. In this study, we seek to understand how ACs respond when environmental changes create new evolving risks that may extend the boundary of their traditional domain. To do so, we interview a diverse set of 29 AC members from U.S. publicly traded companies. We analyze our data through the theoretical lens of collaborative boundary work to identify how ACs respond by extending, blurring, or maintaining their perceived oversight boundaries, the related implications of these decisions, and their key tactics employed to manage AC workload. Our findings should be of interest to boards, investors, and regulators tasked with monitoring AC effectiveness.
Imitation without Intention: A Qualitative Analysis of Isomorphic Audit Committee Disclosures
Cunningham, Lauren M.; Stein, Sarah E.; Walker, Kimberly; Wolfe, Karneisha (2025-04-29)
Audit committee (AC) oversight is critical for maintaining investors’ confidence in financial reporting as well as other areas of expanded AC responsibility. However, it is unclear to what extent investors can meaningfully evaluate AC oversight quality based on public disclosures. We observe that some companies stay firmly rooted in disclosures that comply with minimal regulatory standards, while others voluntarily expand disclosures to discuss industry-recommended information primarily related to financial reporting and audit oversight. Rarely do we observe companies expanding their disclosures past industry recommendations to provide company-specific context that outlines AC member qualifications, training, and temporal changes in risk oversight. To explore how companies decide on the extent of AC disclosures and how well they address investor needs, we conduct semi-structured interviews with 30 AC members, five disclosure preparers, and 14 members of the investment community. We find the current disclosure process creates a disproportionate focus on standardized language—aligning with coercive and mimetic isomorphism—that fails to provide investors with sufficient information to distinguish AC oversight quality across companies. We further observe that ACs may be willing to expand disclosures to signal their oversight activities if they receive direct investor feedback about the usefulness of such disclosures. However, limited channels for direct investor-to-company feedback, combined with investors’ perception that current disclosures do not provide enough information to engage, often result in investors’ silence. This silence leads companies to incorrectly assume that investors are satisfied with current disclosures. We conclude with suggestions for closing this legitimacy gap, along with examples of potential disclosure enhancements.
A Broken Heart: Grief-Associated Left Ventricular Rupture with Non-Occlusive Coronary Arteries
Ward, Maxwell; Wu, K.; Ayzenbart, Vira I.; Mirza, Mohd A.; Kietrsunthorn, Patrick S. (2025-09-05)
Ischemic Events Occur Early in Patients Undergoing Percutaneous Coronary Intervention and Are Reduced With Cangrelor: Findings From CHAMPION PHOENIX
Cavender, Matthew A.; Harrington, Robert A.; Stone, Gregg W.; Steg, Gabriel; Gibson, C. Michael; Hamm, Christian W.; Price, Matthew J.; Lopes, Renato D.; Leonardi, Sergio; Deliargyris, Efthymios N.; Prats, Jayne; Mahaffey, Kenneth W.; White, Harvey D.; Bhatt, Deepak L.; CHAMPION PHOENIX Investigators (Wolters Kluwer Health, 2022-01)
Background: Thrombotic events are reduced with cangrelor, an intravenous P2Y12 inhibitor. We sought to characterize the timing, number, and type of early events (within 2 hours of randomization) in CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard of Care Therapy in Subjects Who Require Percutaneous Coronary Intervention).
Methods: CHAMPION PHOENIX was a double-blind, placebo-controlled trial that randomized patients undergoing percutaneous coronary intervention to cangrelor or clopidogrel. For this analysis, we evaluated the efficacy of cangrelor in the first 2 hours postrandomization with regards to the primary end point (death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis). Sensitivity analyses were performed evaluating a secondary, post hoc end point (death, Society of Coronary Angiography and Intervention myocardial infarction, ischemia-driven revascularization, or Academic Research Consortium definite stent thrombosis).
Results: The majority of events (63%) that occurred in the trial occurred within 2 hours of randomization. The most common early event was myocardial infarction; next were stent thrombosis, ischemia driven revascularization, and death. In the first 2 hours after randomization, cangrelor significantly decreased the primary composite end point compared with clopidogrel (4.1% versus 5.4%; hazard ratio, 0.76 [95% CI, 0.64-0.90], P=0.002). Similar findings were seen for the composite end point of death, Society of Coronary Angiography and Intervention myocardial infarction, ischemia-driven revascularization, or Academic Research Consortium stent thrombosis at 2 hours (0.9% versus 1.6%; hazard ratio, 0.57 [95% CI, 0.40-0.80], P=0.001). Between 2 and 48 hours, there was no difference in the primary composite end point (0.6% versus 0.5%; odds ratio, 1.17 [95% CI, 0.71-1.93]; P=0.53). Early (≤2 hours of randomization) GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) moderate or severe bleeding events were infrequent, and there was no significant difference with cangrelor compared with clopidogrel (0.2% [n=10] versus 0.1% [n=4]; adjusted odds ratio, 1.41 [95% CI, 0.37-5.40]; P=0.62).
Conclusions: The reductions in ischemic events and overall efficacy seen with cangrelor in CHAMPION PHOENIX occurred early and during the period of time in which patients were being actively treated with cangrelor. These findings provide evidence that supports the importance of potent platelet inhibition during percutaneous coronary intervention.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01156571.