Digital Commons Network^™

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 …

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 …

Royal College Of Psychiatrists College Report 244: Optimising Psychotropic Medication Prescribing For People With Intellectual Disability, Rohit Shankar

Peninsula Medical School

No abstract provided.

Frontline Aspiration Versus Stent Retriever Thrombectomy For M2 Occlusions: Insights From The Star Registry, Michael Gaub, Joshua Osbun, Et Al.

2020-Current year OA Pubs

BACKGROUND: Recent trials have furthered uncertainty regarding the endovascular benefit for medium vessel occlusions (MeVO). Stent retrievers (SR) were employed in the first attempt in most interventional arm participants. We sought to compare outcomes in acute MCA M2 occlusions between frontline aspiration and SR, and to delineate procedural and anatomical covariates associated with differential treatment effect.

METHODS: Retrospective analysis of a multicenter stroke thrombectomy cohort identified cases of MT for M2 occlusions. Unmatched and propensity score-matched (PSM) cohorts were generated comparing frontline aspiration to standalone and combined SR. The primary outcome was functional independence (mRS 0-2) at 90 days. Recanalization, …

Cutting The Gordian Knot Of Civil Liability: Cross-Deputization Agreements As A Remedy To Jurisdiction And Liability Concerns For Indian Country In Oklahoma, K. Mekko Factor

American Indian Law Review

No abstract provided.

Unethical Business Practices Plague Native American Cultures And Economies – Solutions To The Ineffectiveness Of The Indian Arts And Crafts Act, Benjamin Amoroso Sinder

American Indian Law Review

No abstract provided.

A Survivor's Tale: How The Northern And Eastern Districts Of Oklahoma Survived The Tidal Wave Collision Of Mcgirt V. Oklahoma, Darbi E. Robertson

American Indian Law Review

No abstract provided.

Winner, Best Appellate Brief In The 2024 Native American Law Student Association Moot Court Competition, Molly Gunther, Kevin Burdet

American Indian Law Review

No abstract provided.

Front Pages

American Indian Law Review

No abstract provided.

The Bad Man’S Hourglass: Extending The Clock On Justice, Liv G. Cummins

American Indian Law Review

No abstract provided.

With Religious Freedom Came Religious Authority: Apache Stronghold V. United States And The Exclusion Of Native American Religion Within The Legal Understanding Of Religious Freedom, Cassidy Beck

American Indian Law Review

No abstract provided.

“Discovered!”: Plaintiff’S Brief To The United States Supreme Court In Johnson & Graham’S Lessee V. M‘Intosh (1823), Mark Savage

American Indian Law Review

No abstract provided.

Abrogation Without Mention: A Note On Lac Du Flambeau Band Of Lake Superior Chippewa Indians V. Coughlin, Taya Maxson

American Indian Law Review

No abstract provided.

Tulsa V. O’Brien: A City Adds To The Battle Over Jurisdiction In Indian Country, Fatima D. Jaime

American Indian Law Review

No abstract provided.

Winner, Best Appellate Brief In The 2025 Native American Law Student Association Moot Court Competition, Baylee Ogle, Madison Bailey

American Indian Law Review

No abstract provided.

Front Pages

American Indian Law Review

No abstract provided.

When Tribal Sovereign Immunity And The Americans With Disabilities Act Collide, Who Wins?, Baylee M. Ogle

American Indian Law Review

No abstract provided.

Native Gifts In An Electric Universe: Exploring Tribal Sovereignty Through Digital Data, Spectrum, And Technological Imaginings, Michael Johnson

American Indian Law Review

No abstract provided.

In Pursuit Of Federal Recognition: A Legal And Historical Analysis Of The Duwamish Tribe’S Fight For Federal Tribal Recognition, Gabrielle Gollihar

American Indian Law Review

No abstract provided.

Becerra V. San Carlos Apache Tribe And The Indian Self Determination & Education Assistance Act: Keeping Indian Health Services Responsible In The Wake Of Forced Sterilizations, Alexis K. O’Brien

American Indian Law Review

No abstract provided.

Tribal Civil Jurisdiction: Lexington V. Smith And The Evolution Of The Montana Framework, Will Speed

American Indian Law Review

No abstract provided.

Enhancing Offshore Wind Resource Assessment Through Neural Network-Based Hf Radar Data Analysis, Nikolas Martzikos, Matthew Craven, David Walker, Daniel Conley

School of Engineering, Computing and Mathematics

The increasing demand for offshore wind energy underscores the need for accurate wind speed estimation to support the design and operation of offshore wind farms. High-Frequency Radar (HFR), a widely used remote sensing technology in oceanographic research, offers promising potential for wind resource assessment, particularly in areas where conventional measurements are limited. This study explores the application of artificial neural networks (ANNs) for offshore wind speed prediction using HFR-derived data, addressing key challenges in model development and training. A key feature of this approach is the use of a decade-long dataset from the Celtic Sea, off the southwest UK coast, …

Next-Generation Virtual Environment Training For Cybersecurity In The Maritime Logistics Industry: A Position Paper, Tyler Cheng, Rory Hopcraft, Kimberly Tam, Ji-Jian Chin

School of Engineering, Computing and Mathematics

The maritime logistics industry is the most dependent on it in the modern world, yet it is not well protected against cyber risks. Recently, the maritime industry has been transitioning into industry-specific tech, and threats of cyberattacks are increasing as the adoption of technology and automation continues. One of the most effective methods to protect industries and ships from such security incidents, is to train seafarers to mitigate and handle such incidents. However, to the best of our knowledge, we did not find anything that addresses this gap. This article will present the idea and benefits of using virtual environments …

Fault Tolerant Adaptive Control Under Actuator Saturation For Robot Manipulators, D. J. López-Araujo, N. Alvarez-Jarquin, P. Borja, A. T. Becker

School of Engineering, Computing and Mathematics

In practice, actuators inherently have natural limitations that are often overlooked by theoretical control strategies, such as bounded output and discrepancies between calculated and actual responses. Consequently, reliable control techniques must be employed to ensure safe and dependable operation. We propose an adaptive control law for global regulation in the case of partial loss of effectiveness due to input faults. The proposed control strategy maintains the system at the desired configuration while accounting for the physical limitations of the actuators. Additionally, it is suitable for dealing with unknown parameters in the vector of gravitational forces, making it robust to these …

Scope 3 Carbon Emissions Assessment For Manufacturing Smes, Kourosh Halat, Stephen Childe, Nick Golding, John Summerscales

School of Engineering, Computing and Mathematics

This paper addresses the challenges facing managers of Small-andMedium-Size Enterprises (SMEs) when conducting environmental sustainability assessment at the value chain level, particularly Scope 3 Greenhouse Gases GHG) emissions. The paper investigates issues related to data availability and data quality for Scope 3 assessment and identifies dimensions of Scope 3 reliability.Utilising a series of in-depth case study analyses with SMEs in the south-west of England, UK, the paper fills a gap in supply chain sustainability research by identifying practical challenges. The findings show that SMEs encounter persistent difficulties in assessing emissions associated with purchased goods and services and downstream activities linked …

Usable Authentication: Are We There Yet?, Nathan Clarke, Steven Furnell

School of Engineering, Computing and Mathematics

With technology increasingly embedded in everyday life, the demand for secure and usable authentication methods has never been greater. Traditional password-based systems continue to dominate, despite well-known usability and security challenges. This paper explores the evolution of user authentication technologies, from secret knowledge and tokens to biometrics and emerging approaches such as Passkeys. It critically evaluates the extent to which usability has been achieved, identifying both successes—such as biometrics integrated into smartphones—and persistent issues, including inconsistent guidance, ecosystem dependence, and accessibility barriers. Drawing on academic and commercial developments, the discussion highlights the growing burden on users who must authenticate across …