Digital Commons Network^™

Medical Debt Among Low-Wage Workers In The United States: Reason To Worry And Reason To Hope, Mathieu Despard, Stephen Roll, Eva Stahl, Camila Salvagno

Center for Social Development Research

With one in five low-wage workers reporting medical or dental debt they cannot afford to pay, financial assistance programs (also known as charity care) are an important resource. Federal law requires nonprofit hospitals to offer such programs, but evidence suggests that workers experience administrative burdens in learning about and applying for the assistance. Drawing upon data from the Workforce Economic Inclusion and Mobility (WEIM) survey, this brief presents findings on associations between the characteristics of low-wage workers and their experiences with financial assistance programs. The brief also shares examples of how hospital policies and patients’ needs may not align, presenting …

A New Kind Of Faith That Makes Jesus Stop!, Joseph Khabbaz

The Main Thing Devotional

Jesus stopped and said, “Call him.” So they called to the blind man, “Cheer up! On your feet! He’s calling you.” Mark 10:49

Effects Of The “Chai For 2” Pilot Intervention Among Asian Indian Immigrants, Maya Joseph, Anju Wadhawan, Shailja Mathur, Haiqun Lin, Karen T. D'Alonzo

International Nursing Research Congress (INRC)

Asian Indian (AI) immigrants, the second largest immigrant group in the US, have a high prevalence of abdominal obesity and premature cardiovascular disease (CVD).^1,2,3 Despite ample epidemiological evidence of the need to reduce CVD risk in AIs, few published interventions have addressed this population, primarily focusing on dietary measures and promotion of physical activity, and none of these address immigrant AIs.^4,5

This study was built upon the results of our prior work to 1) Implement and pilot test a peer leader-facilitated 10-week dyadic intervention (Community Health among Asian Indian immigrants (CHAI) Dyad study) using a cluster randomization design, …

Leadership In Action: Building A Research Community Of Practice Through The Np-Clinician Scientist, Sarah Jayne Colgan, Breanna Lloy, Melanie Dunlop

International Nursing Research Congress (INRC)

Purpose Statement: To describe the formation of an Advanced Practice Nursing (APN) Research Community of Practice (CoP) led by an NP Clinician Scientist, aimed at fostering research capacity, partnerships, mentorship, scholarly engagement, and knowledge translation among NPs and Clinical Nurse Specialists (CNSs) in two provincial healthcare organizations.

Background: The Nova Scotia Health (NSH) NP Interprofessional Practice and Learning (IPP&L) team observed ongoing challenges with NP recruitment and retention highlighted by feelings of undervaluation among NPs in clinical practice. Concurrently, changes to NP entry-level competencies and increasing NP inquiries regarding research, demonstrated a growing appetite for scholarly engagement.

Methods: Through innovation …

How To Promote Community Engaged Research (In Less Than 7 Minutes…), Karen T. D'Alonzo, Shailja Mathur, Maya E. Joseph, Anju Wadhawan

International Nursing Research Congress (INRC)

The phrase “community-engaged research” (CER) has become popularized over the past decade to describe attempts to promote community involvement in the research process.¹ Historically, the term CER referred to scientific researchers and community members who work together to develop community academic partnerships (CAPs), improve research, and create better outcomes in communities, particularly for marginalized populations.² The aim of CER is for the people most directly impacted by the research topic to become active participants in the research process.³ Many forms of CER are guided by the formation of CAPs.⁴ But this process can be daunting, due …

Paul Pieczynski V. Brian Szumski

2026 Decisions

USDC for the Middle District of Pennsylvania

Usa V. Charles Sechler

2026 Decisions

USDC for the Middle District of Pennsylvania

Investigation Of Masseter Muscle Thickness In Individuals With And Without Bruxism: An Ultrasonographic Study, Thalib R. Attamimi, Acing H. Mude, Eri H. Jubhari, Ike D. Habar, Yukinori Maruo, Muthia M. Bachtiar, Ian A. Sudarman

Journal of Dentomaxillofacial Science

Objective: This study aimed to evaluate the relationship between bruxism and masseter muscle thickness, as measured by ultrasonography, in university students.
Materials and Methods: This analytical observational case-control study included 48 students (mean age, 21.19 ± 0.61 years). Participants were classified into two groups based on a validated questionnaire and clinical examination: 24 with bruxism and 24 without bruxism. Bruxism was assessed using the Winocour questionnaire, while masseter muscle thickness was measured by ultrasonography under both relaxation and contraction conditions. Differences between the groups were analyzed using an independent t-test.
Results: Individuals with bruxism exhibited significantly greater masseter muscle thickness …

Evaluation Of Gingival Crevicular Fluid Macrophage Migration Inhibitory Factor In Various Periodontal Conditions With Their Diagnostic Ability, Suzan A. Salman, Lubaba A. Abdulameer, Nadia M. Kadhim, Zainab J. Raheem, Hadeel M. Akram, Raghad F. Abbass

Journal of Dentomaxillofacial Science

Objectives: To profile the concentration of macrophage migration inhibitory factor (MIF) in gingival crevicular fluid (GCF) in periodontal health, biofilm-induced gingivitis, and periodontitis, and to evaluate its ability to discriminate between these periodontal conditions.
Materials and Methods: This was a case-control study in which GCF samples were collected from three groups: gingivitis, periodontitis, and periodontal health (control). Plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss were measured as full-mouth clinical periodontal parameters. Gingival crevicular fluid macrophage migration inhibitory factor was evaluated using an enzyme-linked immunosorbent assay.
Results: The concentration of (MIF) in the …

Association Of Frenal Attachment Morphology With Orthodontic And Esthetic Outcomes: A Systematic Review, Mohan Kumar Pasupuleti, Radhika Thakkar, Vijaya Lakshmi Pavani Molli, Digvijaysinh Parmar, Abhishek Jahagirdar, Subramanya Shetty M

Journal of Dentomaxillofacial Science

Background: Although individual studies have investigated the clinical significance of frenal attachments, no recent systematic review has comprehensively synthesized the evidence regarding the association between frenal attachment morphology, orthodontic treatment considerations, and esthetic outcomes. Therefore, this systematic review was conducted to address this knowledge gap.
Methods: Electronic database searches were conducted through December 31, 2025, and studies published between January 2014 and December 2025 were eligible for inclusion.Eligible observational and clinical studies reporting orthodontic or esthetic outcomes associated with frenal attachment morphology were included. Study selection, data extraction, and CASP-based quality assessments were performed independently by two reviewers. Twelve studies …

Discovering Secondhand Smoke Exposure Impact On Mental Illness: A Systematic Review & Meta-Analysis, Pooja Bhattarai, Bassema Abufarsakh, Chizimuzo T. C. Okoli

International Nursing Research Congress (INRC)

Background: SHSe remains a major global public health concern and contributes to preventable morbidity and mortality across populations (World Health Organization 2021). While SHSe is well recognized as a risk factor for cardiovascular and respiratory illness, emerging evidence suggests an association with MI and Substance use disorders (SUDs) (Carreras et al., 2019; Nadhiroh et al., 2020; U.S. Department of Health and Human Services, 2024; Van der Eijk & Woh 2023, Lee et al., 2025). Addressing SHSe requires acknowledging its impact and transforming new discovery about the complex factors contributing to MI into action that shapes the future of nursing research. …

Preview; Johnson V. Spire Home Inspection: A Debate On Judicial Resources Through Manufactured Finality, Madison Blank-Plautz

Montana Law Review Online

No abstract provided.

Low-Income, Minority-Serving Public Schools In Southern California Have Disproportionately High Surface Temperatures, Joaquin Murillo, Gabriella R. Dauber, Joshua B. Fisher, Gregory R. Goldsmith

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Extensive evidence demonstrates that people from minority backgrounds often face unequal exposure to extreme heat and have less access to green space that can provide cooling relief. What is less clear is whether these inequities extend to students on school playgrounds, where high temperatures can affect physical health, social and emotional well-being, and learning. We paired high resolution, satellite remote sensing surface temperature data for all 615 of the public schools in Orange County, California (serving ca. 450,000 students) with data on neighborhood household income, race/ethnicity of school enrollment, distance from the coast, and Normalized Difference Vegetation Index as a …

Cultivating A Culture Of Belonging: Elementary Principal Practices, Sara Macneil

Educational Studies Dissertations

A sense of belonging is a fundamental human need that influences students’ experiences, relationships, and engagement within their school context. It is shaped through intentional actions and everyday experiences. Understanding how school leaders intentionally shape conditions that foster students’ sense of belonging requires further exploration. This study focused on an elementary school principal and sought to identify specific leadership practices that strengthen the sense of belonging for elementary students. Using a mixed-methods approach, data were collected through a sense of belonging survey and small group interviews. The survey data provided a measure of students’ sense of belonging and were used …

The Implementation Of Sel-Based Interactive E-Modules To Enhance Mental Health Literacy, Muhammad Arif Budiman Sucipto, Mulyani Mulyani

Jurnal Kajian Bimbingan dan Konseling

The mental health crisis among Generation Alpha students is concerning, marked by stagnating life purpose and digital academic pressure. This study aims to examine the effectiveness of an interactive SEL-based E-Module in enhancing students' mental health literacy, offering an innovative solution responsive to the digital era. Employing a Classroom Action Research design integrated with ADDIE. Thirty-two tenth-grade students with low initial literacy scores (mean pre-test = 42.3) participated through purposive sampling. The two-cycle intervention utilized a digital module featuring Private Mode (encrypted emotional journal) and Emergency Button (direct link to counselors). Data were collected through literacy scales, observations, interviews, and …

Evaluation Of Deep Learning Techniques For Intrusion Detection In Cybersecurity, Doaa El-Shahat, Mohamed Mahmoud Abdelaziz, Waseem Akram, Muhammad Jabir Khan

Sustainable Machine Intelligence Journal

The increasing prevalence of Internet of Things (IoT) technology is also leading to a rise in potential cybersecurity risks. Therefore, it has become crucial to develop effective solutions using deep learning to enable us to discover the various vulnerabilities that may arise from continuous technological advancements, and to defend against the different types of attacks that fraudsters might use to exploit system weaknesses, such as Distributed Denial of Service (DDoS) attacks, web attacks, and spoofing. Most model failures stem from their reliance solely on detecting spatial patterns and their failure to focus on detecting temporal patterns, resulting in poor performance …

Haf-Bitrans: A Heterogeneity-Aware Federated Bilstm-Transformer Framework For Privacy-Preserving Detection Of Multi-Stage Apt Behaviors In Iot Networks, Tareef S Alkellezli, Nariman A. Khalil

Sustainable Machine Intelligence Journal

Advanced persistent threats (APTs) are difficult to detect in heterogeneous Internet of Things (IoT) environments because malicious behavior can unfold across reconnaissance, scanning, command-and-control, denial-of-service, and exfiltration stages. Centralized intrusion-detection pipelines also create privacy, communication, and latency concerns when traffic originates at distributed edge devices. This study presents HAF-BiTrans, a heterogeneity-aware federated BiLSTM-Transformer framework for privacy-preserving detection of multi-stage APT-like behavior. At each client, a bidirectional long short-term memory encoder captures temporal dependencies, a lightweight Transformer models broader contextual relationships, and a class-balanced focal objective addresses class imbalance. At the server, Heterogeneity-Aware Contribution-Trust Aggregation (HACTA) weights client updates using sample …

Comparative Evaluation Of Robusta Coffee Fruit Skin And Bean Skin Nanoparticle Edible Films: Physicochemical, Antibacterial, Mucoadhesive, And Immunomodulatory Properties, I Dar. Dewanti, I Da. Susilawati, Didin E. Indahyani, Eri H. Jubhari

Journal of Dentomaxillofacial Science

Objective: This study aimed to compare the physicochemical characteristics, antibacterial activity, mucoadhesive strength, and immunomodulatory properties of edible films containing Robusta coffee fruit skin or bean skin nanoparticles for oral wound therapy.
Materials and Methods: Edible films containing 2% Robusta coffee fruit skin or bean skin nanoparticles were prepared using carbomer, kappa carrageenan, glycerin, stevia, and sodium benzoate. The physicochemical properties of the samples were evaluated by measuring pH, scanning electron microscopy, and organoleptic assessment. The antibacterial activity against Streptococcus mutans was determined using the colony-forming unit method. Mucoadhesive strength was measured using a texture analyzer, and immunomodulatory activity was …

Spatial Markov Equilibrium Models For Taxi Services: Driver Decision, Search Friction, And Locational Pricing, Yanchao Liu

Industrial and Systems Engineering Faculty Research Publications

This paper develops a modeling framework for stochastic multi-agent systems and applies it to equilibrium and pricing analysis in urban taxi markets. Travel demand is represented as a trip network and embedded in a Markov chain that captures both locational and in transit taxi states, with transition dynamics reflecting trip durations, search frictions, spatial competition, and drivers’ perceptions of long-term value. The framework features a parametric Markov chain with endogenous transition probabilities and a behavioral model in which agents’ decisions depend on anticipated long-term rewards. We establish equilibrium existence and examine two locational pricing schemes that align individual incentives with …

Spatiotemporal Variations Of Tidal Asymmetry Along The Coast Of Taiwan: Characteristics And Implications, Ting-Chieh Lin, Tai-Wen Hsu, Tzu-Chun Huang, Chun-Yuan Lin

Journal of Marine Science and Technology–Taiwan

This study presents the first systematic investigation into the spatiotemporal characteristics and evolutionary trends of tidal asymmetry along the coast of Taiwan from 2003 to 2022, employing a moving window method combined with the S_TIDE toolbox.  By quantifying the skewness of the Main Tidal Asymmetry Combinations (MTAC) and their temporal variations, the study reveals significant regional disparities between the eastern and western coasts.  The western coast is primarily dominated by the M2-M4 combination, with the northwestern region exhibiting a flood dominance pattern and the southwestern region characterized by ebb dominance.  Conversely, the eastern coast, attributed to its open topography and …

Evaluating The Readability Of Online Patient Education Materials For Avascular Necrosis, Gabriella B. Smith, Grady H. Hofmann, Anna V. Gussner, Nicole S. Pham, Nneoma O. Duru, Kevin G. Shea

Journal of Patient-Centered Research and Reviews

Purpose: Avascular necrosis (AVN) is a progressive pathology affecting pediatric and adult patients. Given the risks of joint collapse and surgery, patients frequently research their condition online. The average reading level in the United States is approximately the eighth-grade level. The National Institutes of Health (NIH) recommend that patient materials be written at or below a sixth-grade level. This study aimed to assess the readability and quality of online AVN resources.

Methods: A Google search using the terms “avascular necrosis” and “osteonecrosis” was conducted, and firstpage results were aggregated. Flesch-Kincaid Grade Level, Gunning Fog Index, and Flesch Reading Ease tests …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Under Pressure And Underrecognized: The Role Of Social Workers And Case Managers In Screening For Social Determinants Of Health In The United States, Melissa L. Habrat, Lindsay D. Nelson, David A. Nelson

Journal of Patient-Centered Research and Reviews

Social determinants of health (SDOH) screening is increasingly embedded in clinical care, yet the work of asking, documenting, and responding to social needs often falls to social workers and nurses or professional case managers who operate under significant time, staffing, and system constraints. We conducted a narrative review to examine how SDOH influence outcomes, identify systemic and emotional barriers to effective screening, and synthesize evidence-informed strategies that support implementation. Across included sources, findings clustered into three domains: challenges in integrating screening (policy and accreditation pressure, staffing and resource constraints, EHR documentation and interoperability limits, closed-loop referral and cross-sector partnership gaps, …

Reliable Performance Analysis Of Polyurea Coatings Used In Offshore Wind Turbines, Yu-Chang Lin, Yen-Fu Liu, I-Ming Pan, Ming-Yuan Lin, Kang-Yu Liao, Hung-Hua Sheu, Hung-Bin Lee

Journal of Marine Science and Technology–Taiwan

This study explores the weather resistance, mechanical properties and corrosion resistance of polyurea coatings in marine environments. The relevant analysis results can be used as a reliability assessment of offshore wind turbine structural coatings during their service life under the influence of marine environments. The long-term experiment uses seawater and 70°C thermal aging conditions as coating reliability assessment items. The microstructure of the samples that have been immersed in seawater for a long time and thermally aged is observed using a scanning electron microscope (SEM). The results show that the surface of the 100 and 125 series polyurea coatings is …

Identifying The Causality And Criticality Of Factors Influencing The Promotion Of Asian Island-Hopping Cruise Tourism In Taiwan, Hsiao-Chuan Liu, Gin-Shuh Liang, Feng-Ming Tsai, Yu-Ling Lien

Journal of Marine Science and Technology–Taiwan

Following the COVID-19 pandemic, the global tourism industry has steadily recovered since 2022. Island-hopping cruises have gained increasing attention for enhancing regional connectivity and diversifying marine travel experiences; however, their development in Asia remains limited compared with that in Europe and the Caribbean due to fragmented policy coordination, inadequate port infrastructure, and uneven technological readiness. Although Taiwan possesses a geographic advantage and can serve as a strategic hub linking Asian island destinations, systematic planning and stakeholder coordination remain insufficient, resulting in unclear mechanisms that drive or constrain island-hopping cruise tourism. Existing studies mainly focus on market demand or passenger behavior, …

Enhancing The Bearing Capacity And Settlement Performance Of Soft Clay Using Geocell Reinforcement: A 3d Numerical Parametric Study, Alaa Ata, Engy E. Elbasuny, Ayman Metodiev El-Zohairy, Marwa Nabil

Faculty Publications

Problematic soils pose a risk to structures due to excessive or uneven settlement, swelling, and limited bearing capacity. To address some of these issues, mechanical reinforcement using geosynthetic products such as geocells can be employed, given their ease and speed of implementation. The purpose of this study was to assess the impact of geocells on the behavior of soft clay soil in Port Said, Egypt, using a three-dimensional finite element model, namely, the PLAXIS 3D software. The results show that replacing the top 1.5 m of the soft clay with sand significantly reduced settlement. This improvement was further enhanced by …

A Reflection On Growing Up With Hyperacusis, Jemma-Tiffany Rosewater, Katherine Melton

Journal of Patient-Centered Research and Reviews

I, the first author, explore here my personal experiences growing up with severe hyperacusis pain, a rare condition that significantly affected my childhood but also gave me a deeper understanding of how medical professionals interact with children. I discuss the many ways my condition was dismissed or misunderstood by doctors, and I examine the broader negative implications that this dismissal had on both my physical health and day-to-day life. This article also emphasizes the power and sway that the words of medical professionals hold compared to the voices of children. I reflect on how outdated yet common misconceptions about hyperacusis, …

White Shark Occurrence In Flower Garden Banks National Marine Sanctuary Revealed From Acoustic Telemetry In An Offshore Mpa, Michael A. Dance, Jay R. Rooker, R. J. David Wells, Megan V. Winton, Landes L. Randall, Marissa F. Nuttall, Brondum M. Krebs, Creed C. Branham, Brett B. Sweezey, Richard J. Kline

School of Earth, Environmental, & Marine Sciences Faculty Publications

The outer continental shelf of the Gulf of Mexico (Gulf) is characterized by unique bathymetric features that provide critical habitat for marine fauna. Here, we demonstrate the utility of large-scale acoustic telemetry for monitoring an oceanic marine protected area (MPA) and document the first known occurrences of white sharks (Carcharodon carcharias) within Flower Garden Banks National Marine Sanctuary (FGBNMS). White sharks were tagged with acoustic transmitters in the western North Atlantic Ocean off the east coast of the United States and Canada. Nine white sharks were detected along the outer shelf ecosystem associated with FGBNMS over a three-year …

Lin V. Genis-Perez

All Decisions

After trial in this GCEL lease expiration holdover, court takes up two questions: whether small landlord ownership disclosures must appear in the predicate notice, and whether landlord may add them to the petition post-trial. On the first, a plain reading of the statutes places those disclosures in the petition — not the termination notice. On the second, with no showing of prejudice by tenant, court allows the amendment under CPLR § 3025 and reopens the trial record so tenant may contest whether landlord qualifies for the exemption.

Ivory Towers Have Glass Ceilings: Institutional Responsibility In Promotion To Full Professor, Chardie L. Baird, Mangala Subramaniam

Navigating Careers in Higher Education Series

A must-read for higher education leaders committed to equity, Ivory Towers Have Glass Ceilings examines faculty members’ experiences in promotion to full professorship. This volume discusses how structures, practices, processes, and policies pertaining to promotion from associate professor to full professor both presume and reproduce racialized and gendered inequity.

Women’s teaching and service loads are often quantitatively and qualitatively different from white and some Asian men’s experiences, which only serves to reinforce the status quo. This also extends beyond teaching and service to the types of intellectual contributions that are considered important, which often excludes the hands-on, engaged work that …