Digital Commons Network^™

The Ai-Native Health Science Institution Innovation Theater Vs. Structural Redesign, Jiajie Zhang, Martin J Citardi, Xiaoqian Jiang, Sean Savitz

Faculty, Staff and Student Publications

Academic health institutions face a new constraint: cognitive labor. Many adopt AI through additive initiatives that risk becoming "innovation theater"-visible activity without structural change. We argue this reflects a mismatch between rapid AI advances and slower institutional evolution. AI-native institutions treat AI as infrastructure, requiring governance, shared platforms, and workforce readiness. The challenge is not adoption but redesign; those that fail risk widening gaps and accelerating irrelevance.

Genetic Variants Associated With Sjögren’S Disease Subtypes Stratified By Clinical Feature, Nitesh Enduru, Chihiro Iwaya, Akiko Suzuki, Zhongming Zhao, Junichi Iwata

Faculty, Staff and Student Publications

Introduction: Sjögren's disease (SjD) is a chronic autoimmune disorder characterized by dry mouth (xerostomia) and dry eyes (xerophthalmia) due to inflammation in exocrine glands, particularly the salivary and lacrimal glands. The condition presents a wide variety of clinical features, suggesting that it may involve heterogeneous conditions without a clear boundary. Although genome-wide association studies (GWAS) have identified several genetic variants associated with SjD, their roles in SjD pathogenesis remain unclear.

Methods: In this study, we aimed to identify single-nucleotide polymorphisms (SNPs) associated with SjD by categorizing patients based on four diagnostic markers: anti-Ro/SSA and anti-La/SSB antibodies, IgG levels, and lymphocyte …

Modeling Hepa Filter Media Performance And Evaluation Of Filtration Leak Test Success, Daniel M. Abraham, Steven J. Eckels, Shahin N. Amiri

Civil & Environmental Engineering Faculty Publications

This research presents a cost-effective microscale modeling analysis of high-efficiency particulate air (HEPA) filter media. We analyzed leak-free and leaking media with known leak sizes. A three-dimensional fibrous model with non-homogeneous fiber diameters (0.2–2 µm) and a packing density of 7.5% was developed to replicate a HEPA filter sheet (H14) microstructure. The objective was to simulate and analyze the pressure drop and collection efficiency of nanofibrous media for aerosol particles with a diameter of d_p ≤ 0.5 µm. The results were compared to prior experimental and theoretical models, exhibiting a high level of agreement with pressure drop and efficiency …

Religious Norms In The Mechanisms Of Legal Regulation Of Freedom Of Conscience In Modern States, Mykola Lahodych

Occasional Papers on Religion in Eastern Europe

This article is devoted to role of religious norms in the legal regulation of freedom of conscience, with a special focus on the institutional interaction in modern democratic societies between religious organizations and the state, particularly in Central and Eastern Europe. The extant scholarly literature has addressed first and foremost the constitutional guarantees of religious freedom and church autonomy. However, less attention has been devoted to the institutional mechanisms through which religious norms operate within public administration. The study utilizes comparative legal analysis, institutional analysis, discourse analysis of official church documents and qualitative analysis of 28 judicial and institutional cases …

Good Forestry In The Granite State - 3rd Edition, Cooperative Extension

UNH Cooperative Extension

No abstract provided.

Lung Inflammation From Daily Exposure To Airborne Particulate Matter In A Trade School, Kynda Tinawi, Céline Plante, Alan Da Silveira Fleck, Édith Giasson, Isabelle Valois, Caroline Couture, Eva Suarthana, Maximilien Debia, Audrey Smargiassi

Études primaires

Background Workers are exposed daily to various airborne chemical agents, however, associations between daily exposures to particulate matter and lung inflammation in occupational settings have been little explored. Objective To estimate the association between daily occupational exposure to respirable (PM4 and PM2.5), ultrafine particles, their oxidative potential, and fractional exhaled nitric oxide within apprentices in a school of construction trades. Methods We used a repeated measures design over 5 consecutive days in 56 apprentices from 3 construction trade sectors (bricklaying, welding, and carpentry). Fractional exhaled nitric oxide was measured each day post-work. Personal and work area daily PM4 were collected …

Early Drowsiness Detection Via Second-Order Derivative Analysis Of Heart Rate Variability: A Non-Contact Ecg Approach With Machine Learning, Fabrice Vaussenat, Abhiroop Bhattacharya, Julie Payette, Alireza Saidi, Victor Bellemin, Geordi-Gabriel Renaud-Dumoulin, Sylvain G. Cloutier, Ghislain Gagnon

Études primaires

Drowsy driving contributes to roughly 20% of traffic fatalities, yet most detection systems rely on behavioral cues that appear only after impairment has set in. Here we ask whether first and second derivatives of heart rate variability (HRV) can detect pre-crash states earlier than conventional approaches. Twenty-five participants completed 49 driving simulator sessions while we recorded cardiac activity through capacitive ECG electrodes embedded in the seat backrest—a non-contact method that avoids the privacy concerns of camera-based monitoring. To prevent circular evaluation, ground truth labels were based solely on crash proximity rather than HRV-derived scores. The combined HRV feature set (conventional …

If Only Pickups And Vans Could Fly: Vehicle Maintenance And The Challenge Of Safely Lifting Large Vehicles On A Two-Post Lift, Damien Burlet-Vienney, Sylvie Beaugrand, Maud Gonella, Bertrand Galy, Élise Ledoux

Études primaires

The use of automotive lifts requires mechanics to work under or near a multi-ton load. Based on consultation with stakeholders, pickups and vans appear to pose problems when raised using two-post above-ground lifts (2PAG lifts), the most common type of automotive lift in garages. The aim of this study is therefore to highlight the work activity performed by mechanics when raising pickups and vans on 2PAG lifts and to describe the factors they take into account to ensure vehicle stability. Data collection took place under actual conditions in five garages. A total of 108 lifting situations were filmed and analyzed, …

Managing Complexity: Manager-Stakeholder Communication, Relational Dynamics, And The Dual Nature Of Rtw Communication, H. Bertolini, Marc Corbière, Alessia Negrini, Nadine Larivière, Patrizia Villotti, Dominic Prévost, Meryl Caiada, Jason Amorim, Fergal O'Hagan

Études primaires

Purpose

The return to work (RTW) process of worker absent due to common mental disorders (CMD) or musculoskeletal disorders (MSD) represents a complex challenge that involves multiple stakeholders. The aim of this study was to examine how managers perceive the factors that facilitate or hinder communication with other stakeholders during the RTW process.

This qualitative study was based on four focus groups conducted in Canada (Quebec and Ontario) with 18 managers.

Thematic analysis identified five themes related to facilitators and seven themes related to communication obstacles. Among the main facilitators, trust, clarity, and collaboration emerged as key elements …

Le Parcours Des Travailleurs Immigrants Blessés Et Son Incidence Sur L’Alliance Thérapeutique : Une Étude De Cas Longitudinale En Contexte De Réadaptation Au Travail Au Québec, Maude Arsenault, Jessica Dubé, Daniel Côté

Études primaires

Cette étude explore l’incidence du parcours prélésionnel des travailleuses et travailleurs immigrants (TI) blessés sur l’alliance thérapeutique (AT) en réadaptation au travail. À partir d’une ethnographie longitudinale menée dans une clinique québécoise, sept trajectoires ont été analysées selon leurs dimensions migratoires, socioprofessionnelles et linguistiques. Les résultats montrent que le déclassement professionnel, la précarité de l’emploi, les barrières linguistiques et les expériences de racisme fragilisent la construction du lien de confiance et la définition partagée des objectifs de retour au travail. Lorsque l’emploi prélésionnel est perçu comme transitoire ou inadéquat, l’obligation institutionnelle d’y retourner crée une rupture symbolique qui entre en …

Occupational Exposure To Pesticides Increases The Risk Of Amyotrophyc Lateral Sclerosis: A Systematic Review And Meta-Analysis, France Labrèche, Pamela Prudhomme, Maryse Gagnon, Nicolas Dupré, Sabrina Gravel

Études primaires

Objective To systematically review the evidence on the association between occupational exposure to pesticides and the risk of amyotrophic lateral sclerosis (ALS).

Methods A systematic search, conducted in eight bibliographic databases for publications between 1990 and 2025, identified observational studies estimating the risk of ALS after occupational pesticide exposure. Study quality was assessed using the WHO Risk of Bias (RoB) assessment instrument for systematic reviews, with the ROBINS-E (RoB in non-randomised studies of exposure) tool domains of bias. Pooled risk estimates were produced using random-effects models with restricted maximum likelihood, heterogeneity was assessed with I² statistics, and meta-regressions and publication …

On The Use Of Hearing Aid Algorithms In Industrial Noise: Balancing Speech Intelligibility And Hearing Protection, Solenn Ollivier, Fabien Bonnet, Alexis Pinsonnault-Skvarenina, Christian Giguère, Jérémie Voix, Hugues Nélisse

Études primaires

Hearing protection devices (HPDs) are widely used to mitigate the risks of noise-induced hearing loss in industrial environments. However, conventional HPDs can often hinder communication for workers with hearing loss. While those workers may rely on hearing aids in their daily lives, the potential benefits and associated risks of using such devices in noisy workplaces remain unexplored. This study evaluated the effects of different hearing aid signal processing algorithms on speech intelligibility and estimated noise exposure under industrial noise conditions to characterize the balance between communication and protection needed to develop solutions for workers with hearing loss. A digital hearing …

Tracking Vigilance While Driving: Pilot Study Of Heart Rate Variability Classification Under A Controlled Sleep-Deprivation Protocol, James Elber Duverger, Eli Moser, Philippe Boudreau, Marie Claude Ouimet, Diane B. Boivin, Alireza Saidi

Études primaires

Decreased vigilance associated with drowsiness is a major cause of motor vehicle crashes, but its physiological characterization and detection remain difficult due to behavioral and environmental confounding factors. This study presents an original experimental framework combining a highly controlled sleep-deprivation protocol, repeated driving simulations, and a machine-learning-based heart rate variability (HRV) analysis to study the physiological and behavioral changes in vigilance during a prolonged period of wakefulness while driving. Twelve healthy young adults participated in a 30-h sleep-deprivation constant routine protocol that included driving simulations every two hours, with data collection: electrocardiography (ECG), subjective ratings of drowsiness, psychomotor vigilance test, …

Computer Vision-Based Collision Prevention In Construction: Bridging Academic Advances And Industrial Requirements, Marwa Ziadia, François Gauthier, Damien Burlet-Vienney

Études primaires

Computer vision (CV) technologies have emerged as promising tools for real-time collision risk management. This paper examines CV-based collision-prevention systems from academic and industrial perspectives with a focus on identifying technical and implementation challenges affecting their deployment on construction sites. A scoping review of 158 publications was conducted, alongside an assessment of commercial CV-based collision-prevention systems currently used in construction. The analysis focused on five key functions: object detection, distance measurement and proximity estimation, tracking, worker re-identification (ReID), and deployment robustness. Academic studies demonstrate substantial progress in detection accuracy, real-time processing, trajectory tracking, and predictive risk assessment through deep learning …

Partnerships To Advance Patient Safety And Address Preventable Harm: Case Studies From International Health Care Leaders, Rachel Bonesteel, Robert Saunders, Tilithia Mcbride, Susan Sheridan, David W Bates, Mark Mcclellan, Charles H Kahn, Eyal Zimlichman

Faculty, Staff and Students Publications

There have been notable improvements in patient safety in recent years; however, significant challenges remain in reducing the incidence of preventable patient harm. Supporting patient safety efforts is increasingly important given increasing complexity of care and changing health needs, especially with aging populations. Emerging technologies and capabilities open new possibilities to address longstanding patient safety problems. For example, predictive analytics to support provider decision-making, increased patient interest in engagement in their care, and artificial intelligence provide opportunities to further reduce harm. Many of these examples support a more proactive approach to patient safety by focusing on anticipating, predicting, and preventing …

External Validation Of A Machine Learning Model To Predict Postpartum Hemorrhage In A Us Northeastern Healthcare System, Vesela P Kovacheva, Ricardo Kleinlein, Nolan Wheeler, Kartik K Venkatesh, Eric Jelovsek, David W Bates, Kathryn J Gray

Faculty, Staff and Students Publications

Introduction: Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Timely prediction may prevent adverse maternal outcomes, and efforts are needed to develop accurate predictive tools. A high-performing machine learning model to predict PPH using data from the US Consortium for Safe Labor (CSL) remains to be widely validated in contemporary clinical settings using electronic health record (EHR) data. Our goal was to evaluate the performance of the CSL PPH predictive model using EHR data across a large healthcare system in the Northeastern United States.

Methods: We conducted a retrospective cohort study across eight hospitals in the …

Exposing The Work Of The Market Through The Case Of Alternative Provision For English School Students, Nick Pratt, Elizabeth Done, Sam Morahan

School of Law, Humanities and Social Sciences

Pupils in England who for some reason are not able to attend school often find themselves in Alternative Provision (AP). These are special arrangements designed to address their specific needs and help them return to mainstream schooling. AP involves a financial agreement between the provider and the organisation that commissions the provision and thus operates as an explicit form of education market in which educational services are traded directly for financial recompense. We report on a case study of one AP provider in the South-West of England undertaken over a one-year period which generated data through individual, semi-structured interviews and …

The Career Choices Of Final Year Nursing Students In The United Kingdom: A Qualitative Study., Kevin Hambridge, Frazer Underwood, Gosia Bettache, Matt Carey, Halil Kaya, Lisa Burrows, Rachel Tims, Christian Brailsford

School of Nursing and Midwifery

Aim: The aim of this study is to explore the career choices of final year under-graduate nursing students in the United Kingdom. Background: Worldwide there is a decreasing number of nurses and in the United Kingdom there is a decreasing amount of nursing students. There is sparce evidence relating to the career's choices of nursing students and reasons for those choices. Obtaining a deeper comprehension of these choices may aid healthcare employers, in partnership with universities, to design the future nursing workforce. Design: A qualitative design was used. Methods: Twenty-one final year under-graduate nursing students from across a range of …

An Evidence Review Of Technology Enabled Social Care In The Uk: Report For Cornwall Health Determinants Research Collaboration, Sheena Asthana, Michael Loizou, Marius Varga, Oliver Beer, Rory Baxter, Kieran Green

School of Nursing and Midwifery

The Urgent Need for a Shift from Crisis Intervention to Prevention. As highlighted by the Chief Medical Officer, demographic ageing—particularly acute in coastal areas like Cornwall—necessitates a fundamental shift in care models to allow individuals to live as independently as possible. Currently, the potential of digital technologies to support this aim is not being realised. To maintain wellbeing and reduce demand on statutory services, the system must pivot from reactive crisis management to a greater focus on prevention. While technology can play a pivotal role, it will only succeed if integrated into interoperable, data-driven systems that facilitate early intervention and …

How Does Pre-Registration Child Specific Education Prepare Newly Qualified Nurses’ To Care For Children, Young People, And Their Families? An Empty Narrative Review, Matt Carey, Danielle Edge, Julie Blamires, Mandie Foster, Sarah Neill

School of Nursing and Midwifery

This narrative review investigates the influence of child-specific content within pre-registration nursing programs on newly qualified nurses’ perceptions of preparedness to care for children, young people, and their families. Despite international recognition of the specialised competencies required for pediatric nursing, the proportion and quality of child-focused education across Higher Education Institutions is not clear. The Population, Exposure, Outcome framework provided a comprehensive search strategy applied across eight databases to identify relevant studies that met the inclusion and exclusion criteria. Of 663 records identified, 451 were screened and 25 full texts wereassessed for eligibility by two reviewers. No studies met the …

Exploring The Views Of Children With Cerebral Palsy, Their Parents And Physiotherapists On Participating In A Feasibility Randomised Controlled Trial Testing An Exergaming Device: A Qualitative Study, Rachel Rapson, Jos M. Latour, Jonathan Marsden, Bernie Carter

School of Nursing and Midwifery

Background: This study aimed to understand the experiences and views of children with cerebral palsy, their parents and physiotherapists participating in the ACCEPT feasibility randomised controlled trial, which explored a 10-week physiotherapy intervention using an interactive gaming training device. Design: Qualitative methods included semi-structured interviews, e-diary and photographs. Nine parent–child dyads and three physiotherapists participated. Children were aged between 7 and 16 years; four had co-existing additional needs. Interviews were transcribed. Reflexive thematic analysis was used. Results: Five themes covered the breadth of participants’ experiences: (1) Fitting in therapy; (2) Motivation; (3) New opportunities; (4) Physiotherapists out of their comfort …

Who Seeks Help? Characteristics Of Doctors Accessing Mental Health Support In England: 4-Year National Review, Rohit Shankar

Peninsula Medical School

BackgroundMental health difficulties affect the well-being of doctors and compromise the delivery of healthcare. However, large-scale data on doctors’ mental health needs are limited.AimsDescribe patterns of self-referrals for mental health support among doctors in England and explore associations with demographic factors, speciality, neurodevelopmental and mental health indicators.MethodObservational study using data from doctors who self-referred for mental health difficulties to a national service in England over a 4-year period. Logistic regression was used to explore associations between speciality and mental health indicators.ResultsOf the 16 815 doctors who self-referred during the study period, 80% were under the age of 49 and 70.6% …

Does In-Bed Cycling Delivered Within 48 Hours Of Mechanical Ventilation, Reduce The Occurrence Of Delirium In Critically Ill Patients: A Mixed-Methods Feasibility Randomised Controlled Trial Protocol, Jacqueline Bennion, Mark Hudson, Mary Hickson, Victoria Allgar, Bridie Kent, David Mcwilliams, Daniel Martin

Peninsula Medical School

Background: Delirium is a severe neuropsychiatric clinical state presenting as an acute onset of cognitive deficits. Patients receiving invasive mechanical ventilation (IMV), have the highest incidence (50%–80%) of delirium amongst patients admitted to intensive care units. Preliminary data indicates that early mobilisation is associated with reduced delirium in critically ill patients. However, definitive evidence is lacking. Current practice varies due to many barriers to patients, who require IMV, receiving early mobilisation interventions. In-bed cycling may address some of these barriers. This research aims to evaluate the feasibility and acceptability of early in-bed cycling to reduce delirium in critically ill patients. …

The Effectiveness Of Digital Therapeutics Intervention In Oral Anticoagulation Management: A Systematic Review And Meta-Analysis, Jiayue Guo, Lili You, Lu Liu, Xitong Jiao, Debasish Kar, Jitendra Jonnagaddala

Peninsula Medical School

Objective: To summarize the key intervention characteristics and evaluate the effectivenessand safety of digital therapeutics (DTx) in patients receiving oral anticoagulation, witheffectiveness evaluated using time in therapeutic range (TTR), thromboembolic events (TEE),and mortality, and safety evaluated based on bleeding events.Patients and Methods: We searched PubMed, Embase, Web of Science, and the CochraneLibrary from inception to June 20, 2025, and identified ten randomized controlled trialsinvolving 7,237 patients. The criteria required studies to assess software-based DTxsupporting anticoagulation management and report effectiveness or safety outcomes. Studyquality was evaluated using the Grading of Recommendations, Assessment, Development,and Evaluation (GRADE) framework, and random-effects models were applied.Results: …

Microbial Collagenase Activity Is Linked To Oral–Gut Translocation In Advanced Chronic Liver Disease, Shen Jin, Aurelie Cenier, Daniela Wetzel, Bethlehem Arefaine, Mar Moreno-Gonzalez, Marilena Stamouli, Merianne Mohamad, Mariia Lupatsii, Emilio Ríos, Sunjae Lee, Ane Zamalloa, Shilpa Chokshi, Adil Mardinoglu, Saeed Shoaie, Naiara Beraza, Vishal C. Patel, Melanie Schirmer

Peninsula Medical School

Microbiome perturbations are associated with advanced chronic liver disease (ACLD), but how microorganisms contribute to disease mechanisms is unclear. Here we analysed metagenomes of paired saliva and faecal samples from an ACLD cohort of 86 individuals, plus 2 control groups of 52 healthy individuals and 14 patients with sepsis. We identified highly similar oral and gut bacterial strains, including Veillonella and Streptococcus spp., which increased in absolute abundance in the gut of patients with ACLD compared with controls. These microbial translocators uniquely share a prtC gene encoding a collagenase-like proteinase, and its faecal abundance was a robust ACLD biomarker (area …

Involving Parents In Prevention: A Case Example Of Research And Intervention Development To Improve Financial Well-Being Support, Nick Axford, Gisella Hanley, Rebecca Summers, Kristin Liabo, Amy Bond, Eleanor Bryant, Georgia Smith, Rachel Silcock, Vashti Berry

Peninsula Medical School

The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children’s …

Investigating The Impact Of Carboxylated Polystyrene Nanoplastics In The Liver Using Cell Lines And Precision-Cut Liver Slices, Namrata Pandey, Paula Boeira, Nathaniel J. Clark, Eleanor T. Walker, Somaiah Aroori, Jemimah Denson, Richard C. Thompson, Matthew E. Cramp, Shilpa Chokshi, Ashwin Dhanda

Peninsula Medical School

Background and Aims: Increasing reports of plastic accumulation in human tissue have raised concerns about potential adverse health outcomes. Evidence of negative effects of nanoplastics is heterogeneous and provides limited insights into the underlying pathogenic toxicity mechanisms in humans. Methods: In the present study, carboxylate-modified fluorescently labelled polystyrene nanoparticles (PS NPs) were used to investigate uptake and cytotoxicity in three different hepatic models of varying complexity, including HepG2 cells, IHH cells, and human precision-cut liver slices (hPCLS). Results: The results show model- and dose-dependent effects on hepatocytes. 74.2% ± 13.4% of the IHH cells showed PS NPs uptake at 0.1 …

Psychotropic Medication Prescribing To Children And Young People Mental Health Inpatient Services: An English National Study, David Branford, Anne Webster, Marinos Kyriakopoulos, Shermin Imran, Prathiba Chitsabesan, Tina Irani, Teresa Randon, Kirsten Peebles, Rohit Shankar

Peninsula Medical School

Background:Mental disorders frequently begin in childhood or adolescence. Worldwide, psychotropics are commonly prescribed for under-18s to stabilise behaviour, mood or thoughts. Psychotropics could cause long-term effects on children and young people (CYP) health, growth and development. There is a knowledge gap about psychotropic prescribing in CYP mental health inpatient units.Aims:To understand and compare psychotropic prescribing patterns in England mental health inpatient units for CYPs and to solicit CYP and their parents’ and carers’ views of it.Method:A national Quality Improvement programme authorised by National Health Service (NHS) England invited all English CYP mental health inpatient units to participate. The programme included …

Microplastics, Nanoplastics And Liver Disease: An Emerging Health Concern?, Shilpa Chokshi, Ashwin Dhanda, Matthew E. Cramp, Richard Thompson

Peninsula Medical School

Human liver tissue has been found to contain microplastics and nanoplastics (MNPs), with evidence that hepatic MNP accumulation has markedly increased over the past 10 years, prompting critical questions regarding their potential causal role in liver disease. In cell-based and murine models, MNP exposure can trigger oxidative stress, fibrogenesis and inflammation, pathological features that resemble those of advanced liver disease, suggesting shared mechanistic pathways. Furthermore, the capacity for MNPs to act as vectors for microbial pathogens, antimicrobial resistance, endocrine-disrupting chemicals and carcinogenic additives might have important implications for liver pathology. This Perspective examines emerging evidence on the consequences of MNPs …

Designing A Mobile App For Post Traumatic Stress Disorder: Insights From Lived Experience And Clinical Practice, Rohit Shankar, Richard Laugharne, Michael Loizou, Marius Varga, Sivia Lin, Bojana Daw Srdanovic, Roger Farrell

Peninsula Medical School

Post-traumatic stress disorder (PTSD) is a disabling anxiety disorder precipitated by severe trauma. Many people with this condition have little access to clinical interventions, especially in low-middle-income countries. For the development of any digital health intervention, it is vital to know the opinions of PLE and clinicians to guide the developers. We conducted two focus groups, one with clinicians (n = 5) and one with people with lived experience (PLE) (n = 11), to gain knowledge of their views on the development of a PTSD App. Transcripts of both focus groups were coded and thematically analysed. The key themes that …