Digital Commons Network^™

Quality Improvement Project: The Impact Of Staff Education On Utilization Of The Phq-9 Tool And Follow-Up Management Protocol, Shuntak Jerideau

Doctor of Nursing Practice Projects

Depression is a prevalent mental health disorder that affects daily functioning. Timely screening enables the identification of symptoms, monitoring treatment efficacy, and informs additional treatment such as referrals. The practice site reported low screening rates of patient’s post-psychiatric hospitalization, which was attributed to inadequate knowledge of the PHQ-9 tool. The purpose of this quality improvement project was to evaluate the impact of staff education on the utilization of the PHQ-9 tool and follow-up management protocol in a mental health clinic. A quasi-experimental design method was used in an outpatient mental health clinic. Pretest knowledge of the PHQ-9 was obtained from …

Benchmarking Dna Foundation Models For Genomic And Genetic Tasks, Haonan Feng, Lang Wu, Bingxin Zhao, Chad Huff, Jianjun Zhang, Jia Wu, Lifeng Lin, Peng Wei, Chong Wu

Faculty, Staff and Student Publications

The rapid evolution of DNA foundation models promises to revolutionize genomics, yet comprehensive evaluations are lacking. Here, we present a comprehensive, unbiased benchmark of five models (DNABERT-2, Nucleotide Transformer V2, HyenaDNA, Caduceus-Ph, and GROVER) across diverse genomic and genetic tasks including sequence classification, gene expression prediction, variant effect quantification, and topologically associating domain (TAD) region recognition, using zero-shot embeddings. Our analysis reveals that mean token embedding consistently and significantly improves sequence classification performance, outperforming other pooling strategies. Model performance varies among tasks and datasets; while general purpose DNA foundation models showed competitive performance in pathogenic variant identification, they were less …

Retrieval Augmented Framework For Deepfake Audio Detection, Avinash Saxena

Master's Theses

The widespread use of AI-based audio deepfakes threatens severely to undermine media integrity and public trust. Speech synthesis techniques have improved dramatically in voice conversion (VC) and text-to-speech (TTS) in recent years, making forgeries sound highly realistic, and concerns are raised about possible malevolent uses. Existing state-of-the-art techniques for identifying fake speech have proven to be effective in some cases but are still limited in application and robustness when faced with novel attacking strategies, different acoustic conditions, or alternative linguistic domains. To address some of these limitations, the current research presents a novel deepfake audio detection system based on personalized …

General Practitioners' Perspectives On Identifying Early Symptoms For Breast Cancer Detection In The Primary Care Facilities: A Case Study, Bob Andinata

Kesmas

In primary care settings, general practitioners (GPs) frequently face challenges in identifying the early symptoms of breast cancer. This study aimed to explore, in depth, the perspectives of GPs regarding the identification and interpretation of early-stage breast cancer symptoms during the early detection process in primary care facilities. This study used a qualitative approach based on a case study. Data were collected through in-depth interviews with GPs at primary health care and private clinics in Depok City, Indonesia, complemented by observations and documentation. The data was analyzed using the Miles and Huberman method. The questionnaire assessment and focus group discussion …

Burnout Assessment Tool Development And Validation For Healthcare Workers: A Psychometric Approach Using Rasch Modelling And Exploratory Factor Analysis, Rosnah Ismail, Suriya Kumareswaran Vallasamy

Kesmas

Burnout remains a significant occupational threat to healthcare workers (HCWs). Existing instruments, e.g., the Maslach Burnout Inventory, have limited applicability in healthcare-specific contexts. This study aimed to develop and validate the Burnout Scale for Assessing Stress in Healthcare Workers (BSAS-HCW), designed to measure cognitive and emotional exhaustion. A cross-sectional survey was conducted among 245 Malaysian HCWs representing diverse roles, including staff nurses (57.7%), house officers (14.3%), medical officers (13.5%), specialists (5.7%), pharmacists (4.5%), and other HCWs. Exploratory factor analysis revealed a two-factor structure with strong internal consistency (Cronbach's alpha: cognitive = 0.95; emotional = 0.97), and all items loaded above …

Analysis Of Public Knowledge, Attitudes, And Practices In Food And Drug Selection In Indonesia, Tina Wikara, Sri Astuti, Sri Nurhayati, Rotua Uli Carolina, Evi Ratna Sari

Kesmas

As consumers, the public plays a vital role in ensuring the safe and appropriate use of products. This study aimed to assess awareness of food and drug safety and quality among the Indonesian population. Using a cross-sectional survey, the authors measured public awareness across three key dimensions: knowledge, attitudes, and practices. Data were collected from 20,610 respondents aged 17–65 years from 34 provinces in Indonesia. The survey approach employed a three-stage stratified sampling design. Data were collected through structured face-to-face interviews, and the results were presented as an index ranging from 0 to 100 (low to high awareness). The respondents …

Improving Glycemic Control Among Indonesian Urban Adults: A Digital And Behavioral Extension Of The Information–Motivation–Behavioral Skills Model, Imelda Appulembang

Kesmas

Management of type 2 diabetes mellitus (T2DM) in Indonesia continues to face challenges due to behavioral, informational, and technological gaps among patients. This study analyzed the influence of self-regulatory competence and information, motivation, family support, and digital health literacy on glycemic control behavior. A cross-sectional survey was conducted from February to April 2025 among 587 adults aged >30 years with T2DM enrolled in the Chronic Disease Management Program at primary health care in six major cities: Jakarta, Surabaya, Yogyakarta, Medan, Makassar, and Banjarmasin. Data were collected through structured questionnaires and analyzed using partial least squares structural equation modeling. The findings …

Post-Release Health Insurance Utilization Among Ex-Prisoners: A Scoping Review, Icha Khaerunnisa, Megah Andriany, Luky Dwiantoro

Kesmas

The lack of health insurance coverage after prison release significantly reduces access to essential healthcare services, hindering the continuity of care during community reintegration. The evidence on studies of health insurance use following prison release is limited. This scoping review aimed to summarize research on health insurance utilization after release from prison. Literature searches were conducted across databases including ScienceDirect, PubMed, and Scopus. Relevant articles were selected through a two-stage screening process. Data were extracted from the included studies and presented in tabular and descriptive formats. The keywords used were "health insurance AND post-release" and "inmates OR prisoners." This scoping …

Structure Of An Lgr Dimer, An Evolutionary Predecessor Of Glycoprotein Hormone Receptors, Zhen Gong, Shuobing Chen, Ziao Fu, Brian Kloss, Chi Wang, Jonathan Kim, Oliver B Clarke, Qing R Fan, Wayne A Hendrickson

2020-Current year OA Pubs

Glycoprotein hormones (GpHs) produced in the human pituitary act through receptors (GpHRs) in the gonads to support reproduction and in the thyroid for metabolism. GpHs are heterodimeric cystine-knot proteins; their receptors bind cognate hormones at an extracellular domain and signal through a transmembrane domain to heterotrimeric G proteins. GpHs and GpHRs have co-evolved from invertebrate counterparts. Structures of the human receptors as isolated for cryogenic electron microscopy (cryo-EM) are all monomeric despite compelling evidence for their functioning as dimers. Here we characterize the homologous receptor from Caenorhabditis elegans. Its biochemical properties are notably similar to those of the thyroid stimulating …

Impact Of Common Variants On Brain Gene Expression From Rna To Protein To Schizophrenia Risk, Qiuman Liang, Yi Jiang, Annie W. Shieh, Dan Zhou, Rui Chen, Feiran Wang, Meng Xu, Mingming Niu, Xusheng Wang, Ramu Vadukapuram

School of Medicine Publications

Genetic variants influencing gene expression have been extensively studied at the transcriptional level. How these variants affect downstream processes remains unclear. We quantitated ribosome occupancy in prefrontal cortex samples from the BrainGVEX cohort and integrated these data with transcriptomic and proteomic profiles from the same individuals. Through cis-QTL mapping, we identified genetic variants associated with transcript level (eQTLs), ribosome occupancy (rQTLs), and protein level (pQTLs). Notably, only 34% of eQTLs have their effects propagated to the protein levels, suggesting widespread post-transcriptional attenuation. Using both a gene-based approach and a variant-based approach we identified omics-specific QTLs that associated with brain disorder …

Peer Connect: An Embedded Qualitative Study Of The Experiences Of A Peer Well-Being Coaching Intervention For People Living With A Long-Term Health Condition, Rachel Dennett, Julian Elston, Tom P. Thompson, Wendy Clyne, Joanne Hosking, Krystina Bones, Helen Davies-Cox, Agne Straukiene

Peninsula Medical School

Introduction Many people with long-term conditions such as pain and arthritis struggle with their health and well-being. To support better self-management, a new peer-delivered coaching intervention (Health Connect Coaching) was set up at a National Health Service integrated care organisation in Southwest England. Based on principles of personalised care and supported goal setting, the one-to-one coaching programme, targeting patients with low activation, delivered coaching sessions in a step-down approach over 6 months. A randomised controlled feasibility trial (fRCT) of Health Connect Coaching was conducted to inform the design of a definitive randomised controlled trial. This article reports the embedded qualitative …

Risk Exposure And Stakeholder Oversight In College Sports: Lessons From A Lightning Incident, John J. Miller Dr., Jason W. Lee Dr., Elizabeth A. Gregg, Jeffrey F. Levine

The COSMA Journal

The management of collegiate athletic events increasingly demands systematic approaches to risk identification, assessment, and mitigation, yet risk management education within athletics remains inconsistent. As a result, athletic directors, coaches, and facility managers frequently lack the formal preparation necessary to design and implement effective risk management policies, thereby exposing institutions to operational disruption and legal liability. Severe weather events, particularly lightning storms, underscore the importance of integrating legal principles such as duty of care, premises liability, and foreseeability into institutional planning. This case study, based on a real-life incident, shows that athletic administrators, often with limited formal training in risk …

Automated Segmentation Of Impersonators (Fake Participants) In Virtual Meetings Using Quarantine Breakrooms, Bhavik Pradeep Shah, Chidambaram Arunachalam

Defensive Publications Series

This submission proposes novel techniques to automatically segment impersonators (fake users) detected in virtual collaboration meetings by dynamically moving them to a quarantine virtual room. Security administrators of an organization can be notified about segmentation events and may have the ability to join a quarantine room, observe the activities of impersonated users, assess potential business impacts of such users, and use the learning to further enhance impersonator detection techniques. A virtual meeting controller that orchestrates a virtual meeting can dynamically inform network controller and management systems in collaboration cloud networks to automatically apply network policies to block new sessions or …

The Great Divide – A New Leader, A New Identity? Examining A Mascot Controversy And The Role Of The New Coach In School Rebranding, Jason W. Lee, Elizabeth A. Gregg, John J. Miller

The COSMA Journal

Divisive school imagery can significantly impact academic branding while raising ethical concerns. In the presented case study, issues such as those encountered by Marty Lundy, a newly hired head football coach, are addressed as he faces divisive imagery at his new school. As Marty is aware of the divisive nature of his school's imagery, he must navigate the challenge of balancing the school's tradition and community heritage with the need to promote a welcoming environment and address the potential impact on the school's reputation. Consequently, this case study encourages examining various brand communication and ethical strategies necessary for addressing such …

Subject Index, 12 Months Ended March 1974, American Institute Of Certified Public Accountants

Tax Adviser

No abstract provided.

Professions At Work: Separating The Wheat From The Chaff In 1974, Joel M. Forster

Tax Adviser

No abstract provided.

Index: Subject Index—12 Months Ended February 1974, American Institute Of Certified Public Accountants

Tax Adviser

No abstract provided.

Index: Subject Index—12 Months Ended January 1974, American Institute Of Certified Public Accountants

Tax Adviser

No abstract provided.

Index: Subject Index—12 Months Ended December 1973, American Institute Of Certified Public Accountants

Tax Adviser

No abstract provided.

Automated Execution Of Manufacturing Flowcharts Using Genai, Marcus T. Heron

Defensive Publications Series

This invention is the process of taking any image of a flowchart and using multiple GenAI Agents to execute the depicted process. In manufacturing flowcharts are used prolifically to describe multiple business practices and workflows, therefore this invention has wide applicability across a range of use cases. Enabling full automation of the depicted process in a reliable and repeatable fashion without the risk of human error and in a much faster time.

Scan To Email Summary, Hp Inc

Defensive Publications Series

This innovation focuses on the automated use of imaging technologies to simplify a well-known user experience that is frustrating to many customers today - the ability to scan to email, and then easily retrieve the scanned content. Providing an automated, simplified experience that results in significantly improved customer satisfaction, being able to search and retrieve emails that they have scanned on a multi-function device through their regular email client. The system leverages Large Language Models (LLMs) with engineered prompts to generate contextually relevant filenames, titles, and summaries for scanned documents.

The Master Engineering Compliance Atlas: A Unified Architecture For Automating Global Regulatory Governance, Ai Safety, And Cyber Risk, Ramkumar Bharathan

Defensive Publications Series

This technical disclosure presents the "Master Engineering Compliance Atlas," a comprehensive framework designed to bridge the gap between complex global regulations and modern software engineering practices. As regulatory landscapes fragment across jurisdictions, this document provides a unified methodology for harmonizing requirements from major frameworks, including Sarbanes-Oxley (SOX), GDPR, the EU Digital Markets Act (DMA), the Digital Services Act (DSA), the EU AI Act, NIST SP 800-53, and ISO 27001.

Unlike traditional legal summaries, this framework focuses on technical implementation, offering specific architectural patterns, "L7" control designs, and automation strategies to achieve "Compliance as Code." It introduces a "Mega-Matrix" that maps …

Exploring Communication Strategies With Esports Fans: Signaling Physical Location And Popularity, Gavin Nolin, Ismail Karabas, Skylar King

Faculty & Staff Research and Creative Activity

Purpose

Using signaling theory as a theoretical foundation, this study aims to investigate how consumers respond to message framing emphasizing physical location and popularity of an esports team. Additionally, this research looks at how power distance belief, need for uniqueness, sense of power and pride in community are associated with consumer intentions (e.g. support likelihood, watch likelihood, follow on social media likelihood) as a function of physical location versus popularity-signaling in team communication with prospective fans. Design/methodology/approach

This research uses an experiment to test the effects of physical location and popularity-signaling on consumer intentions toward an esports team, as well …

How Experiencing Eudaimonic Emotions Through Music Shapes Prosocial And Altruistic Behavior: Introducing A Unified Model Of Music-Listening-Induced Eudaimonia (Ummie), Rebecca Tukachinsky Forster, Daniel H. Spitz, Tal-Chen Rabinowitch, Roni Granot

Communication Faculty Articles and Research

This paper introduces the Unified Model of Music-Listening Induced Eudaimonia (UMMIE), which offers an integrated novel theoretical framework to explain how music listening promotes prosocial and altruistic outcomes. Drawing on communication and psychology research, UMMIE maintains that elicitation of eudaimonic emotions can be appraised inwards, towards oneself, and thus contribute to the individual's personal growth, wellbeing, and development, or outwards, by connecting to something bigger than oneself, to humanity in general, which could possibly then lead to enhanced prosocial and altruistic attitudes and behaviors. The model specifies musical, situational, and individual variables that serve as moderators and increase the likelihood …

“I Missed My Other Oncologist”: Established Relationships As Barriers And Facilitators To Accessing Car-T And Autologous Transplantation, Zachary A. K. Frosch, Clark Meshack, Caitlin Meeker, Asya Varshavsky-Yanovsky, Rashmi Khanal, Michael Bromberg, Ashwin Chandar, Emmanuel Quien, Jordan Carter, Shazia K. Nakhoda, Marcus Messmer, Charissa Montgomery, Jason A. Incorvati, Nadia D. Ali, Michael J. Styler, Carolyn Y. Fang

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Autologous stem cell transplantation (ASCT) and chimeric antigen receptor T-cell therapy (CAR-T) can provide significant clinical benefit, but are not equally available to all patients. Oncologist continuity and trust are important to patients, and may act as barriers to receipt of therapy. However, detailed data are lacking on the mechanism by which these might affect receipt of therapy, or how this barrier may be overcome.

METHODS: We conducted a qualitative interview study with patients with non-Hodgkin lymphoma (NHL), classic Hodgkin lymphoma (cHL) or multiple myeloma (MM) eligible for or treated with ASCT/CAR-T. Participants were recruited from a multi-site academic …

Digital Neuropsychology And Social Anxiety: The Effect Of Observer Presence And Personality On Stress And Cognition, Ava M. Dixon

Master's Theses

This study examined how observer presence and social anxiety influence stress and cognitive performance during neuropsychological assessments, focusing on the potential benefits of unsupervised digital testing environments. Eighty university students were randomly assigned to observed or unobserved digital neuropsychological conditions and completed assessments of social cognition and executive functioning and questionnaires of social anxiety and personality. Participants also completed measures of state anxiety and heart rate variability at baseline and after cognitive tests. The findings indicated that observation led to higher subjective anxiety, but it did not produce significant interactions with social anxiety on stress or cognitive performance. Post-hoc analyses …

Non-Invasive Ultrasonic Neuromodulation Of The Human Nucleus Accumbens Impacts Reward Sensitivity, Siti N Yaakub, John Eraifej, Nadège Bault, Mathilde Lojkiewiez, Elouan Bellec, Jamie Roberts, Noah S Philip, Amir Puyan Divanbeighi Zand, Alexander L Green, Matthew F S Rushworth, Elsa F Fouragnan

School of Psychology

Precisely neuromodulating deep brain regions could bring transformative advancements in both neuroscience and treatment. We demonstrate that non-invasive transcranial ultrasound stimulation (TUS) can selectively modulate deep brain activity and affect learning and decision making, comparable to deep brain stimulation (DBS). We tested whether TUS could causally influence neural and behavioural responses by targeting the nucleus accumbens (NAcc) using a reinforcement learning task. Twenty-six healthy adults completed a within-subject TUS-fMRI experiment with three conditions: TUS to the NAcc, dorsal anterior cingulate cortex (dACC), or Sham. After TUS, participants performed a probabilistic learning task during fMRI. TUS-NAcc altered BOLD responses to reward …

Perceived Parental Relationship Quality And Adolescent Conscious Bias: Important Links Between Affect, Agency, Gender, And Race/Ethnicity, Amanda Terrall, Michael J. Merten, Thulitha Wickrama

General Human Environmental Sciences Faculty Publications and Presentations

Introduction Guided by attachment, social cognitive, and ecological systems theories, this study examined the direct and indirect effects of perceived parent-adolescent relationship quality on youths' conscious bias toward individuals facing socioeconomic or minority-related challenges.Methods Data were collected from 702 U.S. 18-year-olds via Qualtrics online panels. Measures included parent relationship quality, negative affect, human agency, and conscious bias (disregard for minority experiences and blaming attitudes).Results The findings revealed that strong parent-teen bonds indirectly influenced conscious bias through psychosocial wellbeing. However, while negative emotions were universally influential, the impact of human agency varied depending on gender and race/ethnicity.Discussion Study findings underscore the …

Creative Evaluators: When Machines Evaluate Us, Kuakou Bossou, Margareta Ackerman

Computer Science and Engineering

The Computational Creativity literature stresses the importance of evaluation in computational creativity systems in addition to generative capabilities. But, what about machines that only evaluate? When it comes to co-creative systems, humans often take on the primary evaluative role, while machines assist with the generation of creative artifacts. In this paper, we propose flipping the paradigm, envisioning machines that (only) evaluate humans in the creative space. We call such machines Creative Evaluators whose end goal is to evaluate human-made artifacts and provides feedback to aid humans in the creative process, while the machine itself refrains from directly generating any content. …

How Human Personality Will Change With The Use Of Artificial Intelligence, John Mayer

UNH Personality Lab

INTRODUCTION: Human personality changes in response to new habits, situations, and maturation, among other causes. As people interact with artificial intelligence (AI), their personalities are likely to change, from their emotional responses to their self-concept.

METHODOLOGY: This theoretical account draws together empirical studies of how personality changed in response to past technological innovations, changes in personal interactions observed in people’s AI usage, changes that arise from the use and disuse of cognitive skills, and works on the self-concept. Research reports in the review were selected according to their relevance and quality.

THEORETICAL STATEMENT: While AI becomes increasingly human-like, humans increasingly …