Digital Commons Network^™

North Country Career Expo Student Brochure, Cooperative Extension, Coos County, Ray Berthiaume

UNH Cooperative Extension

No abstract provided.

Beyond The Checklist: Just-In-Time Education For Multi-Component Fall Risk Reduction, Kyle Knight

Master's Projects and Capstones

Objective On a Telemetry unit at a level 1 trauma center public safety net hospital in the Bay Area, a review was conducted of 45 reported falls over the past year. The analysis uncovered inconsistencies in fall-risk assessment techniques, underuse of continuous observation among high-risk patients, and an absence of standardized purposeful rounding. These data points suggest existing tools were not being applied consistently, and need reinforcement and updating.

Aim This project aimed to reduce inpatient fall rates to the national benchmark by strengthening staff's consistent use of existing fall-prevention practices and infrastructure, including multifactorial risk assessment, purposeful rounding, and …

Determinants Of Antenatal Care Utilization: A Community-Based, Cross-Sectional Study In Morang And Sunsari Districts, Eastern Nepal, Sunil Shah, Chandra Jha

Journal of Social, Behavioral, and Health Sciences

This study examined the factors influencing antenatal care (ANC) utilization in the eastern region of Nepal, focusing on the Morang and Sunsari districts, with the aim of identifying key determinants affecting ANC uptake and assessing the extent of ANC service utilization among mothers. Using lot quality assurance sampling, a community-based, descriptive, cross-sectional design was employed, surveying 164 mothers who had given birth within the previous 12 months; data were collected from June through November 2023. Data were collected through a semi-structured questionnaire and analyzed using SPSS, with descriptive statistics, chi-square tests, and logistic regression. Findings revealed that 80.5% of respondents …

Comparison Of Basketball-Related Injuries At Us Emergency Departments Between High School-Aged And College-Aged Athletes: A 10-Year Neiss Analysis, 2015-2024, John R. Tyler, Mark Gamadia, Nata Parnes, Hunter Czajkowski, Mitchell J. Christiansen, Mary K. Mulcahey

Student Publications

Background: Basketball is widely played in the United States, yet contemporary comparisons of basketball-related injuries between high school- and college-aged athletes using nationally representative emergency department (ED) data remain limited.

Purpose: To compare basketball-related injury epidemiology between high school- and college-aged athletes and characterize the burden of these injuries on US EDs.

Study design: Descriptive epidemiological study.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for basketball-related injuries in athletes aged 14 to 23 years from 2015 to 2024. Patients aged 14 to 18 years were categorized as high school-aged and those aged 19 to 23 years as …

Mechanism Of Injury And Fracture Status Influence Outcomes After Central Cord Injury, Karlo M. Pedro, Mohammed Ali Alvi, Kathleen Zang, Christopher Lozano, Jetan H. Badhiwala, Jefferson R. Wilson, James Harrop, James D. Guest, Bizhan Aarabi, Christopher I. Shaffrey, Michael G. Fehlings

Department of Neurosurgery Faculty Papers

Central cord syndrome (CCS) is the most common form of incomplete cervical spinal cord injury (SCI), yet its optimal management remains controversial. We examined whether stratifying CCS by injury stability improves treatment assessment. CCS was defined as an American Spinal Injury Association Impairment Scale (AIS) C/D cervical SCI with a ≥5-point lower-upper extremity motor score difference and classified as CCS-stable (CCS-S) or -unstable (CCS-U) based on the absence or presence of fracture/dislocation. Functional recovery at 1 year was assessed using the functional independence measure (FIM) motor score. Among 291 patients, 131 (45%) had CCS-S. These patients were older and more …

Brief Amici Curiae Of New Ways Ministry, Et Al., St. Mary Catholic Parish V. Roy, Leslie C. Griffin, Marci A. Hamilton

Court Briefs

No abstract provided.

Panitumumab-Based Egfr Blockade In Smarcb1-Deficient Renal Medullary Carcinoma: Preclinical Basis And Prospective Clinical Activity, Niki M Zacharias, Eric S Rupe, Xinyue Chen, Ritesh R Kotecha, Damian T Rieke, Bradley A Mcgregor, Pedro Pesquera, Zhiyuan Yu, Abha Grover, Najat C Daw, Emily Wang, Sze Wah Samuel Chan, Dorothea Douglas-Lindsay, Alice C Fan, Eric M Knoche, Christos E Kyriakopoulos, Aly-Khan A Lalani, Charlene M Mantia, Amartej Merla, Martin H Voss, Nicklas Pfanzelter, Sneha Ramakrishna, Neil M Reaume, Tianyi Tang, Davis R Ingram, Diana Shamsutdinova, Khalida M Wani, Wei-Lien Wang, Alexander J Lazar, Rahul A Sheth, Priya Rao, Sandra L Grimm, Cristian Coarfa, Rong He, Jing Qian, Fei Duan, Deepa Bisht, Pankaj K Chauhan, Luigi Perelli, Giannicola Genovese, Liuqing Yang, Chunru Lin, Jose A Karam, Ludovica La Posta, Eleonora Dondossola, Rafet Basar, Nadima Uprety, Katayoun Rezvani, Jianjun Gao, Linghua Wang, Luisa M Solis Soto, Bora Lim, Nizar M Tannir, Menuka Karki, Pavlos Msaouel

Faculty, Staff and Students Publications

Purpose: SMARCB1-deficient renal medullary carcinoma (RMC) is an ultra-rare, lethal malignancy refractory to therapies approved for other renal cell carcinomas, and its rarity makes randomized trials logistically unfeasible. We investigated whether wild-type epidermal growth factor receptor (EGFR) is a therapeutically actionable dependency in RMC and translated this insight into a deployable clinical regimen.

Experimental design: EGFR expression was assessed by CLIA-certified immunohistochemistry in RMC tumors and by integrated RNA- and chromatin immunoprecipitation-sequencing of primary tumors and adjacent kidney. Panitumumab was compared with erlotinib in patient- and cell line-derived xenografts, and its mechanism defined by immunoblotting, confocal colocalization, cell-cycle and apoptosis …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

Minimally Invasive Percutaneous Endoscopic Foraminotomy And Discectomy In A French Bulldog With Intervertebral Disc Extrusion, Tanhatai Krajarngjang, Luksamee Limpongsai, Panutda Darapong, Woraphanit Sonbanpai, Mataya Taweechart

The Thai Journal of Veterinary Medicine

A six-year-old female French Bulldog was referred for neurological diagnostic tests and treatment for progressive paraparesis over an 8-day period. The dog had a history of intervertebral disc extrusion (IVDE) surgical correction two years prior. Neurological examination revealed T3–L3 myelopathy. Magnetic resonance imaging of the thoracolumbar spine confirmed IVDE with spinal cord compression at T13–L1. A minimally invasive percutaneous endoscopic foraminotomy and discectomy (PEFD) was performed to remove the extruded disc material. The patient regained the ability to stand and showed voluntary limb movement 48 hours post-surgery. At the 4-week follow-up, the patient showed a complete recovery to her baseline …

Sporicidal Activity Mechanism Of Lactic Acid And Peracetic Acid On Bovine Pathogenic Bacillus Cereus Spores, Xin Zhang, Yunjiao Chen, Jingjing Zhao, Haiying Zheng, Lanlan Liu, Wei Liu, Mingshan Fu, Weijuan Jia, Zelin Jia, Jiayu Cui, Yuhang Zhang, Huisheng Xiong, Yujie Ma, Xueli Wang, Haifeng Wang

The Thai Journal of Veterinary Medicine

In recent years, the pathogenicity of Bacillus cereus (B. cereus) has increased significantly, its host adaptability has continued to expand, and the infection spectrum has also expanded. At the same time, food contamination by B. cereus is also common. Therefore, it is of practical significance to select green, safe and effective inhibitors. Lactic acid (LA) and peroxyacetic acid (PAA) possess good antibacterial properties, making them environmentally friendly, safe, and non-toxic. The purpose of this experiment was to preliminarily explore the inhibition mechanism of LA and PAA on B. cereus spores. The effects of LA and PAA on B. …

Novel Uncrewed Aircraft Water Sampling Device, Justin Fratto, Avinash Muthu Krishnan, Kayla D. Taylor, David Zink, Marc Compere, Kevin Adkins

Discovery Day - Daytona Beach

Supported by the Environmental Protection Agency (EPA), this project’s objective is to create a novel simultaneous surface and discrete depth water sampler for use with an uncrewed aircraft, something which has not been done before. The device will be used to improve the spatiotemporal resolution of harmful algal bloom (HAB) monitoring on Lake Okeechobee in South Florida to provide timely and precise information on water quality and HABs. HABs are characterized by the EPA as certain species of algae that can produce harmful toxins and produce excessive blooms or growth in certain conditions. Often occurring in warmer months due to …

Leadership Style And Employee Outcomes In Private Practice Outpatient Physical Therapy Clinics, Catherine Beuerle Martin, Debra Ann Beazley

Lynchburg Journal of Medical Science

Background: Workforce retention, employee engagement, and job satisfaction are ongoing challenges in outpatient physical therapy practice. Leadership style has been identified as a potentially modifiable organizational factor that may influence clinician experience and workplace outcomes. Despite extensive leadership research in other health professions, evidence specific to outpatient physical therapy settings remains limited. 

Purpose: To examine the relationships between private practice outpatient physical therapy clinic directors’ perceived leadership styles and staff physical therapists' work engagement, job satisfaction, turnover intention, leadership effectiveness, satisfaction with leadership, and willingness to exert extra effort.

Methods: This cross-sectional correlational study surveyed licensed staff physical …

From “Fixer” To “Facilitator”: A Clinical Review Of Shared Medical Appointments As A Strategy For Workforce Sustainability, Barbara A. Slusher

Lynchburg Journal of Medical Science

Clinician burnout remains a significant threat to workforce sustainability, particularly in resource-constrained settings managing complex chronic diseases. While shared medical appointments (SMAs) have demonstrated clear benefits in patient satisfaction and access, their impact on clinician well-being and professional fulfillment is less clearly defined. This review evaluates whether participation in SMAs improves clinician satisfaction and mitigates burnout by facilitating a conceptual transition from isolated “Fixer” to collaborative “Facilitator.”

A targeted literature search of PubMed, the Cochrane Library, and Google Scholar identified peer-reviewed publications examining shared medical appointments and clinician-centered outcomes, including burnout, clinician satisfaction, and workforce sustainability. …

Umbilical Artery Doppler In Fetal Growth Restriction, Britanie Dollard

Lynchburg Journal of Medical Science

Umbilical artery (UA) Doppler velocimetry is a noninvasive tool used to assess placental vascular resistance and improve risk stratification in pregnancies complicated by suspected fetal growth restriction (FGR). Placental insufficiency remains a leading cause of stillbirth and neonatal morbidity, making early identification critical for optimizing perinatal outcomes. This clinical review synthesizes current evidence regarding the role of UA Doppler in identifying placental insufficiency, outlines key waveform interpretations, and evaluates how Doppler findings guide clinical management and delivery planning. Evidence and major society guidelines support UA Doppler as a targeted surveillance tool in high-risk pregnancies complicated by suspected FGR. Progressive abnormalities, …

Hidden Infarctions: Understanding And Managing Myocardial Infarction With Non-Obstructive Coronary Arteries Through A Multimodal Lens, Catalina Esquivel

Lynchburg Journal of Medical Science

Myocardial infarction with non-obstructive coronary arteries (MINOCA) accounts for 5–15% of myocardial infarctions and disproportionately affects women and minority populations. It is defined by clinical evidence of myocardial ischemia with

The Use Of Psilocybin For Managing Refractory Behavioral Health Conditions: A Narrative Review, Rachel N. Clark

Lynchburg Journal of Medical Science

The purpose of this review is to evaluate the possible benefits of using psilocybin (C₁₂H₁₇N₂O₄P), a naturally occurring psychoactive compound found in certain species of mushrooms, in the treatment of multiple forms of mental illness and substance use disorders, either as monotherapy or in conjunction with traditional psychiatric medications. The compound has high affinity for several serotonin receptors, including 5-HT_1A, 5-HT_2A, and 5-HT_2C, which are located throughout the cerebral cortex and thalamus. A comprehensive search of electronic databases was conducted, identifying studies that assessed pharmacokinetics, therapeutic …

Countering Hpv Vaccine Misinformation On Social Media: Practical Strategies For Healthcare Providers, David Baldwin

Lynchburg Journal of Medical Science

Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical and other HPV-related cancers; however, vaccine hesitancy remains a significant barrier to optimal vaccination rates. Social media has become a major source of health information while simultaneously amplifying misinformation that influences parental attitudes toward HPV vaccination. This narrative literature review examined the relationship between social media misinformation and HPV vaccine hesitancy and identified evidence-based strategies healthcare providers can use to improve vaccine confidence.

A literature search of PubMed and Google Scholar identified 31 articles published between 2016 and 2025, of which 19 met inclusion criteria. The literature demonstrates …

Professional Values And Workplace Alignment In Dpt Alumni: A Quantitative Cohort Analysis, Debra Ann Beazley, Stephen Elam, Penny S. Elam, Lawrence S. Ramiscal, Pt, Dpt, Ph.D.

Lynchburg Journal of Medical Science

Background: Professional values are foundational to physical therapy practice and are emphasized throughout Doctor of Physical Therapy (DPT) education. Although identity formation literature suggests that core values may persist after graduation, less is known about how workplace context, career stage, and clinical performance relate to the long-term enactment of values among practicing clinicians.

Purpose: To examine whether professional values among DPT alumni differ across demographic groups, career stages, and outpatient settings, and to explore associations among organizational support, workplace value alignment, and historical educational performance.

Methods: A cross-sectional survey study was conducted among University of Lynchburg DPT alumni …

Effects Of Intensive Exercise On The Blood Chemistry Of Fighting Bulls In Southern Thailand, Siriwat Wasiksiri, Pratthana Yongsakulchai, Wichaya Thongtako, Paradorn Muangnil, Teepakorn Adulkasem

The Thai Journal of Veterinary Medicine

Bullfighting is a cultural activity in southern Thailand. Bulls walk and undergo intensive exercise before competition. In the arena, winners are determined by their opponents' surrender, so bulls do not die after fighting. However, there are very few studies on organ injuries in living bulls during these activities. This study compared the effects of walking and intensive exercise on complete blood count (CBC) and blood chemistry. Blood parameters of 14 Thai fighting bulls aged over 6 years, regularly trained for walking and intensive exercise, were measured and analyzed using a paired t-test or Wilcoxon signed-rank test. Eosinophils decreased significantly after …

Multi-Domain Federated Agentic Operations, Akhil Raja Pappu, Martin Espinosa, Rajneesh Gupta

Defensive Publications Series

To manage operational tasks and production environments  in large-scale computing environments, a system and method can utilize a federated swarm of specialized software agents. Each agent may have a specific domain persona, such as an incident investigator or a mitigation specialist, an operational workflow specialist for Method of Procedure (MOP) execution, a release engineering specialist for software development lifecycle (SDLC) release health, or a third-party (3P) SaaS governance/operational specialist . These agent swarms can be running headless and/or they could also be instantiated on a per-event basis and can operate within a context defined by a component-specific harness, which may …

Caldwell Planetary Nexus Habitat — Minimum Build V3.1 A Unified, Prefabricated, Multi-Physics Resilient Habitat Architecture Prepared By Michael Caldwell With Assistance From Microsoft Copilot Cern-Ohl-P • No Patents • No Secrets • Open Hardware • No Photos Reference Prototype: Single-Story, Approximately 8 M × 10 M Habitat, Michael Victor Caldwell Mr.

Defensive Publications Series

The Caldwell Planetary Nexus Habitat — Minimum Build v3.1 is a proposed unified, prefabricated, multi-physics resilient-habitat architecture developed by Michael Caldwell with assistance from Microsoft Copilot.

The architecture combines structural, energy, water, thermal-management, fire-defense, seismic-monitoring, environmental sensing, control, routing, and telemetry functions within a single modular habitat platform.

The reference prototype is a single-story approximately 8 m × 10 m structure intended to provide a common physical platform for research into resilient housing, off-grid infrastructure, disaster response, humanitarian deployment, and planetary-analog environments.

The minimum architecture integrates:

• SBMS-1.0 / Sanitized Block-2.0 gyroid structural-panel architecture

• URES resonant/environmental energy-harvesting architecture

• Mechanic's Battery mechanical-flow …

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Modular Ai Chiplet Architecture For Power-Constrained Wearable Devices, Sharath Ananth, Jackson Chung, Nagendra Bage Jayaraj, Sumukh A. Shevde, Triton Hurd

Defensive Publications Series

This publication describes a flexible, modular hardware system for running artificial intelligence (AI) and machine learning on battery-powered devices like smartwatches, fitness trackers, smart TVs, and Internet of Things (IoT) devices. Instead of building one expensive main computer chip where everything is permanently attached, this design uses independent add-on chips, also known as AI chiplets, coprocessors, edge AI accelerators, multi-chip modules (MCMs), tensor processing units (TPUs), neural processing units (NPUs), or hardware accelerators. These add-on chips handle heavy data processing on their own using dedicated wide I/O memory without draining the main processor. A software manager automatically detects how many …

Firebreaker-2.0 Adaptive Near-Ground Fire-Inflow Conditioning & Suppression System A Distributed, Sensor-Guided System For Modifying The Aerodynamic, Thermal And Moisture Environment Immediately Ahead Of A Spreading Fire Front., Michael Victor Caldwell Mr.

Defensive Publications Series

FIREBREAKER-2.0 is an experimental wildfire-suppression platform designed to investigate whether actively controlled near-ground airflow, combined with spatially controlled water delivery, can modify the environment through which a spreading fire advances.

Rather than relying exclusively on direct flame attack, FIREBREAKER establishes a controlled conditioning field between the suppression system and the advancing fire.

Each mobile module combines:

• high-volume directional airflow,

• controlled water delivery,

• interchangeable spray characteristics,

• thermal imaging,

• airflow measurement,

• temperature and humidity sensing,

• heat-flux measurement,

• fuel-temperature measurement,

• water-flow measurement,

• synchronized data acquisition,

• and adaptive control.

Multiple modules operate as a coordinated array.

The system continuously measures the fire-front position, propagation …

The Dream Itself Was Home”: Imaginary Homelands As A Model For Analyzing Contemporary African Return Narratives, Renee King

Masters Theses

Although contemporary African return narratives featuring female protagonists explore a wide range of themes, they consistently portray women who struggle to situate themselves within an increasingly globalized world. In these narratives, the homeland initially functions as a stabilizing anchor that emboldens the protagonist to pursue education or employment abroad, yet works such as Doreen Baingana’s Tropical Fish and Chimamanda Adichie’s Americanah reveal that the homeland the protagonists once treated as immutable ultimately exposes itself as a dream. This destabilization unsettles the notion of an unshakeable cultural identity and demonstrates how migration reshapes both the self and the meaning of home. …

Lucas Guggenheimer V. Wellpath Llc

2026 Decisions

USDC for the Middle District of Pennsylvania

Understanding The Lived Experiences Of Autistic Students As They Navigate Nutrition In Higher Education: A Hermeneutic Study, Amanda Beeman

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study is to interpret how adult students with ASD in higher education navigate nutritional choices. This study was guided by Bronfenbrenner’s ecological systems theory, which explains the relationship between environmental factors and individual health and well-being. A hermeneutic phenomenological approach was used to examine how students with ASD experienced nutrition within the higher education environment. The central research question asked how adult higher education students with ASD experienced and navigated nutrition in the context of college life. The sample included 10 adult participants with ASD enrolled in a higher education institution. Data were collected …

Spn 313: Advanced Communication Skills, Aleksin Ortega, Aleksín H. Ortega

Open Educational Resources

This syllabus for SPN 313 (Advanced Communication Skills) at the College of Staten Island, CUNY, presents a zero-textbook-cost, OER-based course in advanced academic writing in Spanish designed for a mixed population of heritage speakers and advanced second-language learners. The course follows a genre-based progression through four textual forms — description, narration, exposition, and argumentation — organized around a recursive writing process of drafting, instructor feedback, and revision. Its signature assignment, the Autobiografía lingüística (Linguistic Autobiography), serves as the Spanish program's ACTFL-aligned assessment artifact and is supported by a structured independent-inquiry project on dialectal variation. The syllabus foregrounds the dialectal diversity …

From Relicensing To Revalidation: Strengthening Nursing And Midwifery Regulation In Ghana, Bibha Simkhada, Philomina Woolley, Ransford Akrong, Padam Simkhada, Charles Adjei, Ampem Darko Oklodu-Abbey, Susan Jones, Osei Agyei Duodu, Dennis Ekow Addai, Manish Parajuli, Hari Krishna Neupane, Precious Adade Duodu

International Nursing Research Congress (INRC)

Background: Nurses and midwives play a vital role in achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) (WHO, 2025). Strengthening regulatory systems is crucial to produce competent nurses and midwives, maintain professional and public confidence (WHO, 2021). The Nursing and Midwifery Council (N&MC) of Ghana sought to strengthen its regulatory framework by introducing revalidation and improve its Management Information System (MIS). Recognising reflective practice in nursing, the Council incorporated it into pre-registration curricula (N&MC Ghana, 2021a & N&MC Ghana 2021b). To address gaps in post-registration practice, a 12-month project was launched to strengthen licensing regulation and prepare …

The Nurses’ Perceptions Of Shared Governance, Psychological Empowerment, And Turnover Intention, Emma Maniago Aquino-Maneja, Linda Searle Leach, Hong Li, Juli Mcginnis

International Nursing Research Congress (INRC)

Background: A major challenge in healthcare is the significant shortage of experienced nurses. Although evidence shows that shared governance (SG) is a key strategy for retaining nurses, gaps remain in understanding its relationship and predictive pathways to psychological empowerment (PE) and turnover intention (TI).

Purpose: The study explored the relationships and predictive pathways among nurses' perceptions of SG, PE, and TI in acute care hospitals. It also aimed to compare how nurse leaders (NLs) and clinical nurses (CNs) perceive these factors, and to examine the influence of their socio-demographic characteristics on these perceptions.

Method: The study employed a descriptive, correlational, …

Diagnostic Accuracy Of A Single-Item Happiness Index For Screening Mild Depressive Symptoms, Shun Chan, Aderonke Odetayo, Jasmine Cheung, Anson Chui Yan Tang, Lorna Kawi Ping Suen, Simon Ching Lam

International Nursing Research Congress (INRC)

Background: Depression symptoms are a mental health problem with rising prevalence globally. To enhance the estimation of depressive symptoms in epidemiological studies, a 9-item Patient Health Questionnaire (PHQ-9) has been widely used. Some local research found that a single-item General Happiness Index (GHI) highly correlated with the scales used for screening the depressive symptoms. This study hence aimed to explore the sensitivity and specificity of GHI for screening mild or more severe depressive symptoms based on the secondary data analysis in the Chinese population.

Methods: This methodological study used the data collected in the General Happiness Survey 2024 and 2025 …