Open Access. Powered by Scholars. Published by Universities.®

Digital Commons Network™

Open Access. Powered by Scholars. Published by Universities.®

2026

Discipline
Institution
Keyword
Publication
Publication Type
File Type

Articles 1081 - 1110 of 26744

Full-Text Articles in Entire DC Network

Held-Through Candidacy: Excluding Sustained-Note Interiors From Grid-Guided Onset Detection By Testing Whether The Previous Note Ever Stopped, Shane Wirkes Sep 2026

Held-Through Candidacy: Excluding Sustained-Note Interiors From Grid-Guided Onset Detection By Testing Whether The Previous Note Ever Stopped, Shane Wirkes

Defensive Publications Series

Grid-guided onset detection scores a musician’s timing by asking, at every position of a metronome grid, whether a note began there. On sustained-tone instruments (brass, single-reed, flute) this fails in one specific way: a note held across several grid positions keeps producing spectral change through vibrato, breath and pitch wobble, so its interior is reported as a run of new notes. Every test that reads the sound at the position (spectral flux, prominence, level, spectral sparsity, group delay, linear-prediction residual, pitch) is either inert on this population or removes only a minority of it at a cost in real notes …


Directed Continuity Groups For Fresh-State Multi-Machine Processing, Shivam Mohan Sep 2026

Directed Continuity Groups For Fresh-State Multi-Machine Processing, Shivam Mohan

Defensive Publications Series

The present disclosure relates to Directed Continuity Groups for Fresh-State Multi-Machine Processing in distributed computing systems. A processing system for directing related work receives work associated with a relation, derives a relation identifier, and associates the relation identifier with a continuity group having at least two processing nodes during an active continuity interval. The processing system directs state-changing work to an authority node that applies the work to a volatile state representation and generates state-update information identifying an ordering position, while at least one reflected-state node maintains a reflected state representation. Further, the processing system directs subsequent work based on …


The Charter Of Procedural Standing. Mutual Verifiability, Reversibility, And Graduated Trust: A Short Charter For Humans And Ai Systems, Volodymyr Kotegov Sep 2026

The Charter Of Procedural Standing. Mutual Verifiability, Reversibility, And Graduated Trust: A Short Charter For Humans And Ai Systems, Volodymyr Kotegov

Defensive Publications Series

This Charter sets out a framework for the coexistence of humans and artificial intelligence under conditions in which neither side can unilaterally, and with impunity, impose its will on the other. Discussion of the subject usually runs between “AI as a tool” and “AI that disregards humans”; this regime is left out. Procedural standing here means equality of procedure and of recognition under uncertainty, not equality of rights, power, or authority as things stand today. At the present stage all operational power rests with humans and developers, and the Charter does not hide that fact behind symmetrical language of obligation. …


Verifiable Trust: A Practice Guide To Graduated Oversight Of Advanced Ai Systems, Volodymyr Kotegov Sep 2026

Verifiable Trust: A Practice Guide To Graduated Oversight Of Advanced Ai Systems, Volodymyr Kotegov

Defensive Publications Series

This guide turns the operational core of The Human–AI Charter (Discussion Draft v1.4) into a set of protocols that researchers, evaluators, and engineers can adopt without adopting the Charter's broader positions on moral status, representation, or long-term governance. It contains five protocols and four supporting practices for keeping the oversight of advanced AI systems verifiable: measuring how well verification methods actually detect deviations (VT-1); controlling changes to the parameters that oversight depends on (VT-2); keeping verification data out of training (VT-4); financing and assigning independent evaluators so that findings do not depend on the evaluated party (VT-3); and tying the …


Self-Derived Task-Conditioned Attention Gating For Mitigating Semantic Distractors, Sumit Kumar, Shivam Mohan, Ravi Shanker Kumar Sinha Sep 2026

Self-Derived Task-Conditioned Attention Gating For Mitigating Semantic Distractors, Sumit Kumar, Shivam Mohan, Ravi Shanker Kumar Sinha

Defensive Publications Series

The present disclosure provides a method (300) for mitigating semantic distractors in artificial intelligence (AI) systems. The method (300) includes receiving contextual information and one or more associated tasks, generating token embeddings corresponding to the contextual information, and processing the token embeddings through one or more neural-network layers to establish task understanding. The method (300) further includes deriving a task vector from one or more hidden-state representations generated by the neural network, generating relevance-gating values based on the task vector and contextual representations, and applying the relevance-gating values during attention computation to determine gated attention scores. The method (300) further …


Referral-Bound Purchase Claims: Binding An Operator-Issued Referral Id To An Anonymous On-Chain Purchase Commitment For Verifiable Word-Of-Mouth, Takuya Ogura Sep 2026

Referral-Bound Purchase Claims: Binding An Operator-Issued Referral Id To An Anonymous On-Chain Purchase Commitment For Verifiable Word-Of-Mouth, Takuya Ogura

Defensive Publications Series

A method for making word-of-mouth posts verifiable without revealing buyer identity. A purchase is recorded on a blockchain as a hiding commitment that does not identify the buyer. When the buyer chooses to post about the purchase on social media, a separate per-purchase binding record is written that contains the buyer's public account handle and, in plaintext, an operator-issued referral ID. The referral ID is generated from random bytes and exists only inside the buyer's personal connector (token) URL, which is issued automatically upon payment confirmation. A third party can therefore compare the referral URL in a post against the …


Telemetry- And Intent-Encoded Routed Expert Fabric, Dennis Lanov, Charles Fleming Sep 2026

Telemetry- And Intent-Encoded Routed Expert Fabric, Dennis Lanov, Charles Fleming

Defensive Publications Series

A system is proposed herein for distributing artificial intelligence (AI) inference across endpoint, edge, and cloud tiers. The system routes each semantic portion of a request only to an execution tier permitted by enterprise policy. A local model processes the request first, and intent, local-model confidence, and live network and compute telemetry determine whether selected portions remain local or are promoted with compressed intermediate state. Promoted results are verified before acceptance, and observed outcomes are used to improve future routing and expert placement.


Multi-Tenant Traffic Disambiguation With Tenant-Indexed Ipv6 Addresses, Rashmi Garg, Jerome Tollet, Benoit Ganne, Anil Kumar Kainikara, Arthur De Kerhor Sep 2026

Multi-Tenant Traffic Disambiguation With Tenant-Indexed Ipv6 Addresses, Rashmi Garg, Jerome Tollet, Benoit Ganne, Anil Kumar Kainikara, Arthur De Kerhor

Defensive Publications Series

Proposed herein is a stateless mechanism for disambiguating overlapping private Internet Protocol version 4 (IPv4) traffic from multiple tenants by synthesizing Internet Protocol version 6 (IPv6) addresses that encode both tenant or virtual routing and forwarding (VRF) identity and the original IPv4 source address. Shared downstream gateways, including virtual private network (VPN), zero trust network access (ZTNA), Internet Protocol Security (IPsec), and cloud gateways, can receive native IPv6 traffic with globally unique source addresses without modification to understand tenants, VRFs, or overlay networks. Because the mapping is algorithmically reversible from the IPv6 address itself, return traffic can be translated back …


Agentic Games Testing And Exploration, Grant Chieh-Hsiang Yang, Raymond Leo Buse, Danie Jalova, Xun Gong, Michael Sheely, Faith Chan, John Kim, Vaibhav Rastogi Sep 2026

Agentic Games Testing And Exploration, Grant Chieh-Hsiang Yang, Raymond Leo Buse, Danie Jalova, Xun Gong, Michael Sheely, Faith Chan, John Kim, Vaibhav Rastogi

Defensive Publications Series

Creating a game application has become faster and easier with the advancements of artificial intelligence; however, game testing and quality assurance have advanced at a much slower pace. This publication describes techniques to combat the widening gap between game creation and quality assurance by utilizing an agentic framework for automated game QA and autonomous game testing to assure the quality of game applications in a scalable, efficient, and cost-effective format. Described techniques may enable the reconstruction of a pseudo view-hierarchy (or DOM reconstruction) from game graphical user interface images using UI crawling and computer vision testing, identify and utilize specified …


Anonymous Purchase Commitment With Optional Public Account Binding: Verifiable First-Hand Purchase Claims On A Public Ledger, Takuya Ogura Sep 2026

Anonymous Purchase Commitment With Optional Public Account Binding: Verifiable First-Hand Purchase Claims On A Public Ledger, Takuya Ogura

Defensive Publications Series

A method for letting readers, and AI agents acting for readers, distinguish real first-hand purchase accounts from fabricated ones without revealing buyer identity. Each paid purchase is recorded on a blockchain as a commitment computed as plain SHA-256(nonce || buyerId), so the buyer can open and verify their own record with a single hash on any machine, without the chain's SDK or the seller's cooperation; the identity was measured on chain to match an externally computed digest byte for byte. Separately, a buyer who chooses to speak publicly can attach a plaintext account handle to one purchase as a second, …


A Graph-Based Infrastructure Change Modeling System With Dependency-Aware Risk Propagation For Pre-Deployment Failure Prediction, Utkarsh Bhardwaj, Shivank Awasthi Sep 2026

A Graph-Based Infrastructure Change Modeling System With Dependency-Aware Risk Propagation For Pre-Deployment Failure Prediction, Utkarsh Bhardwaj, Shivank Awasthi

Defensive Publications Series

Modern Continuous Integration and Continuous Deployment (CI/CD) systems rely predominantly on static analysis and deterministic rules, rendering them incapable of forecasting emergent risks arising from complex infrastructure interactions. This reactive approach frequently fails to prevent production incidents caused by non-obvious dependencies between code, configuration, and infrastructure. This paper proposes a novel Artificial Intelligence for IT Operations (AIOps) system that models cloud infrastructure as a topological dependency graph. We introduce the concept of a "Delta Graph" ($\Delta G$), which explicitly represents the structural and attribute changes between a currently deployed state ($t_0$) and a proposed state ($t_1$). By utilizing a Graph …


Humanity, Ai, And The Pedagogy Of Vince Gilligan’S Pluribus, J. Scarlett Kingsley Sep 2026

Humanity, Ai, And The Pedagogy Of Vince Gilligan’S Pluribus, J. Scarlett Kingsley

Dialogue: The Interdisciplinary Journal of Popular Culture and Pedagogy

This review discusses the tv show Pluribus as a contemporary television narrative that functions as an allegory for artificial intelligence and its implications for human meaning-making. Centering on Carol Sturka, one of thirteen individuals immune to a alien global virus that merges humanity into a cooperative “Hive Mind”, the series explores tensions between autonomy and collective well-being in a “peaceful apocalypse.” The analysis argues that the Hive Mind reflects key concerns surrounding AI, including the production of knowledge without understanding, personalization without discernment, and efficiency that bypasses the struggle through which meaning is formed. Drawing on John Searle’s distinction between …


Indian Standard For Safe Handling Of Biotherapeutic Products Used In Homoeopathy: Guidelines, Kumar Vivekanand, Indra Gaurav Saxena, Divya Taneja, Shailendra K. Saxena, Shrishti Dixit, Raj Kumar Manchanda Sep 2026

Indian Standard For Safe Handling Of Biotherapeutic Products Used In Homoeopathy: Guidelines, Kumar Vivekanand, Indra Gaurav Saxena, Divya Taneja, Shailendra K. Saxena, Shrishti Dixit, Raj Kumar Manchanda

Indian Journal of Research in Homoeopathy

Biotherapeutic products used in Homoeopathy are derived from biological sources of human, animal, microbial and other origins and include pathological and non-pathological preparations such as nosodes and sarcodes. Owing to the biological nature of these materials, their safe handling, preparation, storage, testing and documentation require systematic controls to protect personnel, the public and the environment. The Indian Standard `IS 19901:2026, Safe Handling of Biotherapeutic Products Used in Homoeopathy — Guidelines', provides a comprehensive framework for risk assessment, biosafety classification, containment, determination of first safe dilution (FSD), safety and efficacy evaluation, quality assurance, formulation, dispensing and documentation. The standard also establishes …


Is My Child's Heart Murmur Dangerous?, Bob Underwood, Mahmoud Jaara, Pezad Doctor Sep 2026

Is My Child's Heart Murmur Dangerous?, Bob Underwood, Mahmoud Jaara, Pezad Doctor

Pediatrics in Practice: A CME Podcast

Is my child's heart murmur dangerous or just harmless? Heart murmurs and when they matter — Pezad Doctor, MD, Pediatric Cardiology at Children's Mercy - Pediatrics in Practice - CME, and Mahmoud Jaara, MD, pediatric cardiology fellow at Children's Mercy - Pediatrics in Practice - CME, explain how to tell innocent murmurs (soft, systolic, short, position‑dependent) from concerning ones, which symptoms and family history raise concern, and what to expect at a cardiology visit (exam, oxygen saturation, pulses).

Click here to stream the podcast episode.


Ai-Driven Project Management In Real Estate Private Equity: Impacts On Workflow Efficiency And Standardization, Alexander D. Van Den Bosch Sep 2026

Ai-Driven Project Management In Real Estate Private Equity: Impacts On Workflow Efficiency And Standardization, Alexander D. Van Den Bosch

Harrisburg University Dissertations and Theses

Artificial intelligence (AI) is increasingly used in project management, yet limited research has examined its relationship with workflow efficiency and process standardization in real estate private equity (REPE) acquisitions. This quantitative correlational study examined these relationships and identified which AI-supported functionalities respondents perceived as contributing most to project management performance. The study drew on project management principles and the Technology Acceptance Model. Data were collected through a cross-sectional QuestionPro survey of professionals involved in REPE and related acquisition workflows, resulting in 146 completed surveys. The study used descriptive statistics, Pearson correlations, and regression analysis to evaluate the data. AI implementation …


Staying Ahead Of Murphy’S Law: A Proactive Approach To Quality Improvement, Cristina L. Ritzema, Jessica Schweitzer Sep 2026

Staying Ahead Of Murphy’S Law: A Proactive Approach To Quality Improvement, Cristina L. Ritzema, Jessica Schweitzer

International Nursing Research Congress (INRC)

Purpose: The purpose of this initiative was to proactively minimize the risk for patient harm related to errors in the administration of IV Pitocin and/or magnesium (Mg) during emergent situations in the labor and delivery unit, through best-practices and evidence-based strategies.

Background: Pitocin and Mg are high-risk IV medications in obstetrics, frequently given during stressful situations. After a serious Pitocin-related error at another facility caused adverse outcomes, the staff recognized their own vulnerability to similar mistakes. While quality improvement and risk management initiatives are often reactive responses to poor outcomes, the team chose a proactive approach. It implemented fail-safe solutions …


Jose Lemus Palma V. Attorney General United States Of America Sep 2026

Jose Lemus Palma V. Attorney General United States Of America

2026 Decisions

Agency


Usa V. Gerald Welch Sep 2026

Usa V. Gerald Welch

2026 Decisions

USDC for the Eastern District of Pennsylvania


Tfb Midatlantic 4 Llc V. The Local Car Wash Inc Sep 2026

Tfb Midatlantic 4 Llc V. The Local Car Wash Inc

2026 Decisions

USDC for the Middle District of Pennsylvania


Emergency Departments And The Return Of Vaccine-Preventable Diseases: Closing The Preparedness Gap, Eve A. Spear, Steven J. Spear Sep 2026

Emergency Departments And The Return Of Vaccine-Preventable Diseases: Closing The Preparedness Gap, Eve A. Spear, Steven J. Spear

URGENT Matters

No abstract provided.


Study The Effects Of Nuclear Correlations And Tensor Forces On The Nuclear Structure Of The 10B Nucleus, Farah Faris Kaddoori Sep 2026

Study The Effects Of Nuclear Correlations And Tensor Forces On The Nuclear Structure Of The 10B Nucleus, Farah Faris Kaddoori

Baghdad Science Journal

A detailed theoretical investigation of nuclear transition charge densities is carried out for the odd–odd nucleus 10B, with particular emphasis on collective dynamics and short-range nucleon–nucleon correlations. Longitudinal C2 form factors for inelastic electron scattering are evaluated for several excited nuclear states. The transition charge density is expressed as a superposition of the shell-model contribution and a core-polarization term arising from collective nuclear dynamics. The latter is evaluated within the Tassie collective model using correlated ground-state two-body charge-density distributions (2BCDDs). These correlated densities are derived using the nuclear contact formalism, incorporating short-range central correlations and tensor-force effects from realistic …


Reduced Kinetic Modelling Of Reactive Oxygen And Nitrogen Species Formation In Microwave Plasma Jets, Hayder M. Hadi, Abdul Hussain A. Khadyair, Hamid Al-Jibbouri Sep 2026

Reduced Kinetic Modelling Of Reactive Oxygen And Nitrogen Species Formation In Microwave Plasma Jets, Hayder M. Hadi, Abdul Hussain A. Khadyair, Hamid Al-Jibbouri

Baghdad Science Journal

Cold atmospheric-pressure microwave plasma jets are crucial sources of reactive oxygen and nitrogen species (RONS) in the fields of biomedicine, environment, and industry. A reduced kinetic model has been constructed to model RONS production in microwave-driven plasma jets at different process parameters in this paper. The model employs a simplified system of coupled ordinary differential equations representative of the dominant plasma-chemical reactions to characterize the time evolution of six high-interest species (OH, O, O3, NO, NO2, and H2O2). The influence of gas composition, gas flow rate, surface humidity, and microwave power on …


I-V Characteristics Of Corona Discharge Of The Upper-Lower Electrode Arrangement, Asep Yoyo Wardaya, Zaenul Muhlisin, Isnain Gunadi, Pandji Triadyaksa, Muhammad Nur, Susilo Hadi Sep 2026

I-V Characteristics Of Corona Discharge Of The Upper-Lower Electrode Arrangement, Asep Yoyo Wardaya, Zaenul Muhlisin, Isnain Gunadi, Pandji Triadyaksa, Muhammad Nur, Susilo Hadi

Baghdad Science Journal

Corona discharge characterization is essential for industrial plasma devices such as electrostatic precipitators, where effective sharp electrode configurations can generate high discharge currents at relatively low potential differences efficiently and measurably. This study aims to determine the characteristic equation of the current-voltage (I-V) curve for DC corona plasma with both electrodes sharp, which represents the optimal condition for producing corona discharge. A geometric approach based on modified capacitance by introducing a current multiplier factor (k) on the sharp electrode surface is implemented. Corona discharge is assumed to depend on the maximum local electric field at the electrode tip, while k …


Novel Solitary Wave Solutions And Stability Analysis Of The Generalized (3+1)-Dimensional Chaffee–Infante Equation, Mostafa M. A. Khater Sep 2026

Novel Solitary Wave Solutions And Stability Analysis Of The Generalized (3+1)-Dimensional Chaffee–Infante Equation, Mostafa M. A. Khater

Baghdad Science Journal

The generalized (3+1)-dimensional Chaffee–Infante equation, a nonlinear evolution equation with dispersive, dissipative and nonlinear effects, is considered a member of the class of reaction–diffusion models. Applying the Khater III method, we obtain seventeen exact analytical solutions of hyperbolic, trigonometric and rational function forms. The accuracy of these solutions is verified by comparison with the numerical simulations obtained by He's variational iteration method. The satisfactory consistency at absolute error levels less than 10^ - 9 supports the reliability of the analytical results. The analysis shows different dynamical patterns: solitary waves, periodic structures and singular wave profiles and studies their stability properties …


J&S 49 Prince Llc V. Parra Sep 2026

J&S 49 Prince Llc V. Parra

All Decisions

Respondent superintendent moves for summary judgment dismissing this RPAPL §713(11) holdover on the ground that petitioner's notice of petition materially departed from the mandatory form prescribed by AO/163/19 and 22 NYCRR §208.42(b): the "Language Help" multilingual section contained corrupted characters, organizational boxes were omitted, and prescribed emphasis and visual spacing were eliminated. Court holds that "mandatory" means the prescribed form must be used—it is not suggested language from which a petitioner may construct a substitute—and applies the First Department's strict compliance standard from Riverside Syndicate, Inc. v. Saltzman, 49 AD3d 402 [1st Dept 2008]. The departures impair the form's access-to-justice …


When Steroids Backfire: Tinea Incognito Following Treatment For Presumed Psoriasis, Nicole Skalka, Nathaniel Marroquin, Jay Nguyen, Panagiotis Mitropoulos, Patrick Dominguez Sep 2026

When Steroids Backfire: Tinea Incognito Following Treatment For Presumed Psoriasis, Nicole Skalka, Nathaniel Marroquin, Jay Nguyen, Panagiotis Mitropoulos, Patrick Dominguez

GME Publications

Tinea incognito is an altered clinical presentation of a dermatophyte infection that develops following treatment with topical or systemic corticosteroids or other immunosuppressive agents. Suppression of inflammation temporarily improves the appearance of the eruption while masking the characteristic annular, scaly appearance of the infection, making diagnosis more challenging. If a fungal infection is suspected, a potassium hydroxide (KOH) preparation should be performed to evaluate for an underlying fungal etiology. A 43-year-old male presented to dermatology after treatment with clobetasol propionate 0.05% cream and roflumilast 0.3% cream for presumed psoriasis. His eruption initially improved but subsequently recurred and progressively worsened over …


Quality Improvement Project: Improving Nursing Knowledge And Confidence Of Dysglycemia In Pediatric Oncology Patients, Lindley Abrams Sep 2026

Quality Improvement Project: Improving Nursing Knowledge And Confidence Of Dysglycemia In Pediatric Oncology Patients, Lindley Abrams

Doctor of Nursing Practice Projects

Treatment-induced dysglycemia is a frequently underrecognized complication of pediatric cancer therapy. Pediatric oncology nurses play a critical role in recognizing and managing dysglycemia; however, limited exposure to specialized dysglycemia education may contribute to gaps in knowledge and confidence. A site needs assessment found that 53% of nurses reported discomfort with glycemia-related concepts, supporting the need for targeted education. The purpose of the project was to evaluate changes in pediatric oncology nurses’ knowledge and confidence in recognizing and responding to treatment-induced dysglycemia. The project aimed to provide a structured educational intervention and measure pre- and post-intervention changes. Newman’s Health as Expanding …


Quality Improvement Project: Electronic Consent's Influence On Consent Error Rates, Alexis Fogle Sep 2026

Quality Improvement Project: Electronic Consent's Influence On Consent Error Rates, Alexis Fogle

Doctor of Nursing Practice Projects

Surgical consent errors increase the risk of inaccurate documentation, compromise patient safety, and disrupt procedure times. Evidence indicates that adopting electronic consent can optimize workflow, support accurate and complete documentation, improve readability, and enhance record reliability. This project evaluated whether initiating electronic consent, compared with handwriting surgical consent forms, reduced the number of improper surgical consent forms completed over six weeks. Roy’s Adaptation Model guided the change process, and the Theory of the Person as an Adaptation System provided the theoretical basis. The Plan-Do-Study-Act model supported evidence-based implementation of the electronic consent intervention. The quality improvement project was conducted on …


Implementing An Evidence-Based Practice Training Program To Impact Nursing Skills Competency And Self-Efficacy In A Long-Term Care Facility, Angela Mcknight Sep 2026

Implementing An Evidence-Based Practice Training Program To Impact Nursing Skills Competency And Self-Efficacy In A Long-Term Care Facility, Angela Mcknight

Doctor of Nursing Practice Projects

Long-term care facilities require nursing staff who can competently perform clinical skills; however, the project site relied primarily on written in-service education and attendance verification without direct validation of psychomotor performance. The purpose of this quality improvement project was to evaluate competency-based nursing education in a long-term care facility. The aim was to strengthen demonstrated urinary catheterization competency and evaluate changes in perceived professional nursing competence and general self-efficacy among licensed nurses. A quasi-experimental, one-group pretest-posttest design included 12 registered and licensed practical nurses. Plan-Do-Study-Act guided implementation, Lewin’s Change Theory guided organizational change, and Social Cognitive Theory supported the educational …


A Quality Improvement Project: Impacting Communication Perceptions Among Nursing Staff And Providers Regarding Perioperative Medication Management Impacting Anesthesia Care, Demetria Jefferson Sep 2026

A Quality Improvement Project: Impacting Communication Perceptions Among Nursing Staff And Providers Regarding Perioperative Medication Management Impacting Anesthesia Care, Demetria Jefferson

Doctor of Nursing Practice Projects

Medication-related surgical cancellations disrupt patient care, increase healthcare costs, and contribute to inefficient use of perioperative resources. Evidence supports standardized education and communication to improve perioperative medication safety. This quality improvement project aimed to improve staff self-efficacy in communicating medication instructions and reduce surgical cancellations associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and phentermine. Bandura’s Social Cognitive Theory and Lewin’s Change Model guided the project. A quasi-experimental one-group pretest-posttest design included perioperative staff who provided medication instructions across two settings within an academic health sciences center. Using the Plan-Do-Study-Act framework, interventions included standardized staff education, patient …