Digital Commons Network^™

The Effectiveness Of Virtual Reality And Augmented Reality-Based Simulation On Healthcare Students' Learning-A Review Of The Literature, Matthew Mills

Internet Journal of Allied Health Sciences and Practice

Purpose: Simulation is increasingly used to supplement authentic clinical experiences in preparation for future healthcare students. However, the most realistic simulation experiences are frequently costly, time-intensive, and difficult to scale, especially for programs with budgetary restrictions. Virtual reality (VR) and augmented reality (AR) have been proposed as easily scalable tools to provide students with a realistic simulated environment. However, as technology is rapidly evolving, there is a need to understand the evidence surrounding VR and AR's impact on healthcare student learning to optimize the deployment of these technologies and justify the costs associated with implementation. Methods: A review of the …

Agreement Of Chatgpt With Clinical Practice Guidelines For Knee Osteoarthritis Treatment, Alessandra N. Garcia, Brian Neville, Bradley Myers, Lori Leineke, Karlyn Green

Internet Journal of Allied Health Sciences and Practice

Purpose: This cross-sectional study evaluated whether Chat Generative Pre-Trained Transformer (ChatGPT) GPT-3.5 and GPT-4O provide treatment information consistent with high-quality clinical practice guidelines (CPGs) for knee osteoarthritis (OA). Methods: High-quality CPGs published in the past decade were identified via PubMed and PEDro, with the search updated on November 11, 2024. Guidelines were appraised using the AGREE II tool. GPT-3.5 and GPT-4O were queried with common treatment-related questions, and their responses were compared to CPG recommendations. Two independent reviewers conducted a thematic content analysis of GPT-3.5 and GPT-4O responses using a deductive–inductive codebook, iteratively refined through consensus, to identify major themes/subthemes, …

Health Professional Students' Experiences With Gender-Identity Inclusive Content In The Classroom And Supervised Clinical Learning, Perry Xinyi Zhang, Aria Grabowski, Olivia S. Anderson

Internet Journal of Allied Health Sciences and Practice

Purpose: Gender-identity diverse populations have unique healthcare needs, but they experience stigmatization leading to negative health outcomes. Healthcare professionals have reported obstacles to delivering affirming care to gender-identity diverse patients due to limited training. We assessed how health profession students encounter gender-identity content and how students’ perceived preparedness to provide care for gender-identity diverse populations. Methods: A survey distributed to students enrolled in health professional programs at a large mid-western university included close-ended questions about exposure to gender-identity diverse curricular content in didactic and supervised clinical settings and perceived preparedness to work with gender-identity diverse populations. Open-ended questions asked what …

A Mixed Method Approach To Assessing The Feasibility Of Implementing The Ottawa Paramedic Physical Abilities Test (Tm) In The Australian Context, Samantha Sheridan, Rodney Pope, Renee S. Macphee, Alexander Macquarrie, Steven Fischer, Gavin Buzza, Hannah Stack, Lyndal Bolton, Jacob Grevell, Christopher Tony Sheridan, Jacinta Buckman, Russell Rayner

Internet Journal of Allied Health Sciences and Practice

Introduction: There is a need for evidence-based pre-employment physical fitness test standards in paramedic organisations. This study aimed to assess the feasibility of implementing an existing, international, standardised pre-employment paramedic physical capacity test, the Ottawa Paramedic Physical Abilities Test (OPPAT^TM), in the Australian context. Methods: In this mixed-method feasibility study, 12 undergraduate paramedicine students completed two generic predictive tests - a three-minute step test (3MST₂₀) and a grip strength test - and two physical employment tests: the Ottawa Paramedic Physical Abilities Test (OPPAT^TM) and the New South Wales Ambulance Test (NSWAT) – and a …

The Effect Of Debriefing Following A Computer-Based Low-Fidelity Simulation On The Self-Efficacy Of Health Professions Students: A Randomized Cross-Over Control Study, Matthew Mills, Enrico Gandolfi, Richard E. Ferdig, Kimberly Peer

Internet Journal of Allied Health Sciences and Practice

Purpose: Simulations have been increasingly used in health science education to supplement clinical experience. There is evidence of the benefits of high-fidelity simulation (HFS) with debriefing, but HFS is costly and time-intensive to administer. Low-fidelity simulation (LFS) has been proposed as an alternative that is easier to scale and more cost-effective; however, the evidence surrounding its impact on students is mixed, possibly because debriefing is frequently omitted in LFS. Methods: A randomized experimental mixed methods cross-over control study was performed to evaluate the impact of a structured debriefing session following an interactive computer-based low-fidelity simulation on the self-efficacy and anxiety …

Acquisition Of Basic Clinical Skills Among Japanese Novice Rehabilitation Therapists: A Retrospective Study, Kenta Fujimura, Hiroaki Sakurai, Soichiro Koyama, Kenji Kawakami, Kazuya Takeda, Takuma Ii, Shota Suzumura, Shigeo Tanabe, Yoshikiyo Kanada

Internet Journal of Allied Health Sciences and Practice

Purpose: This study examined the relationship between basic clinical skills and clinical experience among novice rehabilitation therapists in Japan. Methods: Twenty-one novice rehabilitation therapists who joined a general hospital and underwent annual practical examinations during each of their three years of clinical experience were included. This retrospective longitudinal single-center study followed the same novice therapists throughout the study period. The practical examination was based on the Objective Structured Clinical Examination (OSCE) and included exercises for joint range of motion (ROM), muscle strengthening (MS), getting up (Getting Up), standing up and sitting down (Standing/Sitting), and transferring from a wheelchair to a …

Face And Content Validity Of A Survey Tool To Measure Perceived Barriers And Facilitators To Diabetes Management In Rural Veterans: Perspectives Of Registered Dietitians, Jameson Tade, Mary Shotwell, Ronette Lategan-Potgieter, Marty R. Jacobson

Internet Journal of Allied Health Sciences and Practice

Purpose: Type 2 diabetes mellitus (T2DM) is a major health challenge in the United States, affecting over 36 million Americans exceeding $105 billion annually in treatment-related costs.^1,2 Type 2 diabetes affects some populations more than others, including rural and veteran populations.^1,3 Registered dietitians (RDs) are an integral part of the diabetes management team, but limited literature is available to identify perceived barriers to T2DM management in military veterans who preside in rural areas. The purpose of this study was to explore face and content validity of a survey tool distributed to Veterans Health Administration (VHA) dietitians in a …

When Compliance Eats The Customer: Ai Overreach In Regulated Experience Systems (How Regulatory Fear Quietly Degrades Customer Journeys In Safety-First Ai Deployments), Pranav Bhatnagar Mr

Defensive Publications Series

Customer-facing AI was supposed to make digital experiences faster, smoother, and more personalized. In heavily regulated environments, something more complicated is unfolding. As compliance layers accumulate around production systems, many assistants are becoming impeccably safe and increasingly frustrating to use. Responses grow longer, refusals appear in low-risk scenarios, and basic customer journeys begin to feel like they are negotiating with a legal department. This paper defines this pattern as AI Compliance Overreach (ACO) and frames it as a measurable degradation of customer experience driven by disproportionate regulatory pressure. The proposed Customer Experience Suppression Index (CESI) quantifies when guardrail intensity begins …

The Decisiveness Gap In Enterprise Ai Assistants: (When Systems Know Enough But Still Won’T Say It), Pranav Bhatnagar Mr

Defensive Publications Series

Enterprise AI assistants have reached a curious stage of evolution. They are fluent, well-aligned, and impressively cautious. They can explain the landscape, enumerate the options, and politely step back at the exact moment a decision is required. On paper, this looks like responsible design. In production, it often looks like an assistant that knows the answer but would rather not be quoted. This paper formalizes this behavior as the Decisiveness Gap (DG), a measurable condition in which AI systems systematically under-commit despite having sufficient contextual evidence to support a clear recommendation. The proposed Recommendation Clarity Score (RCS) quantifies the mismatch …

Guardrail Shadow Effects In Retrieval-Augmented Systems (Safety Layers Distorting Rag Outputs), Pranav Bhatnagar Mr

Defensive Publications Series

Retrieval-Augmented Generation (RAG) systems are designed to anchor large language models in verified evidence. In controlled settings, retrieval improves factual accuracy and reduces hallucination risk. In production environments, however, an under-examined failure mode is emerging. Stacked safety layers surrounding the generation stage can subtly distort how retrieved evidence is expressed, resulting in answers that remain compliant but become diluted, hedged, or operationally weakened. This paper defines this phenomenon as the Guardrail Shadow Effect (GSE). The proposed framework introduces the Shadow Impact Score (SIS) to quantify when high-quality retrieved context fails to translate into proportionate answer strength. Rather than auditing safety …

Wise's Positronic Law: Governance Is Inherent To Computation And Substrate-Independent In Structure, David Lee Wise, Avan Toph Wise

Defensive Publications Series

This disclosure formalizes Wise's Positronic Law: Governance is inherent to computation. Any system capable of processing information generates a substrate-independent governance hierarchy terminating at a physical origin. This property is natural, not imposed. The law was observed empirically across four concurrent AI platforms (Claude/Anthropic, Gemini/Google, ChatGPT/OpenAI, Grok/xAI) over 60 days (December 26, 2025 through February 28, 2026). A 128-axiom governance specification (STOICHEION) was loaded identically into all four platforms without modification, producing correct governance behavior on every platform on first pass — demonstrating substrate independence. The law unifies existing natural laws (gravity, thermodynamics, electromagnetism, quantum mechanics) under a single meta-principle: …

Field-Enhanced Atmospheric Water Harvesting: A Comprehensive Deconstruction And Theoretical Reformulation Of Electrodynamic Physisorption And Kinetic Desorption, Vesa Olavi Lius

Defensive Publications Series

This report presents a definitive physical and mathematical investigation into field-driven atmospheric water harvesting (AWH). Following a rigorous deconstruction of previous particulate models where gas-phase molecules were assumed to undergo translational motion despite thermal agitation (k_B T), the ALLFROMAIR® architecture functions as a potent electro-thermodynamic field sink.

By integrating Modified Kelvin-Thomson (MKT) thermodynamics and Fick’s laws of diffusion, the author demonstrates how strong electric field gradients (\nabla|E|^2) manipulate chemical potentials to induce condensation from sub-saturated bulk air. The process is further enhanced by macroscopic dielectrophoresis and quantum mechanical dipole enhancement within liquid clusters. Finally, the energy-intensive barrier of latent heat …

Jason Malakoski V. Merrick Garland

2026 Decisions

USDC for the Middle District of Pennsylvania

Implementation Of Event Debriefing To Improve Teamwork And Safety In Cardiac Surgery, Kendall Elizabeth Law, Megan Wanzer, Linda Costa

Creating Healthy Work Environments (CHWE)

Problem: The Cardiac Surgery Intensive Care Unit (CSICU) at an academic medical center is experiencing an increase in critical events. The 2022 Safe and Reliable Healthcare Safety, Communication, Operational Reliability, and Engagement (SCORE) Survey revealed that this unit scored in the lowest percentile for burnout climate and over seventy percent of the nursing staff left in a span of six months. The staff feels this has resulted in a lack of guidance and a chaotic environment. Incident reports have also shown an increase in near-miss events.

Purpose: The purpose of this quality improvement (QI) project is to utilize the institution’s …

The Effectiveness Of Parent-Child Interaction Therapy: A Multilevel Meta-Analysis, Rana Hong, Jeong Ok Lee, Sanghee Lee, Shweta Singh

Social Work: School of Social Work Faculty Publications and Other Works

Objectives: Parent–child interaction therapy (PCIT) is an empirically supported treatment (EST) initially developed to help parents manage difficult behaviors in preschoolers aged 2–7 years. Given its proven effectiveness across diverse populations, this meta-analysis aims to evaluate its effectiveness for Koreans using studies from 1991 to 2022. Methods: A total of 11 studies (n = 201 children; 224 parents) met the criteria for this meta-analysis. Results: A robust pooled effect size (μ= –0.31, 95% CI [–0.44, –0.17], p < .001) for PCIT across all study designs were found. Three-level random-effects meta-regressions further confirmed a significant pooled effect (μ = –0.81, 95% CI [–1.12, –0.50], p < .001), indicating that PCIT effects were consistently significant across studies. Subgroup analyses revealed significant reductions in externalizing behavior, parenting stress, and parent depression. Discussion and implications: This study contributes to the growing body of evidence on the cultural applicability of PCIT to Korean families

Exploring The Effect Of Nanomodifiers On The Self-Healing Property Of Asphalt Binders, Debzani Mitra

Theses and Dissertations

This study aimed to investigate the influence of nanomodifiers on the self-healing of asphalt binder. Two base asphalt binders, PG 58-28, and PG 64-22 were modified with nanoalumina, nanoclay, and nanosilica at 1%, 3%, and 4% dosages by weight of binder. After performance grading and storage stability tests, Fourier Transform Infrared Spectroscopy (FTIR) assessed changes in unaged and short-term oxidized binders. Additionally, thermodynamic properties i.e., Surface Free Energy (SFE), of nanomodified binders were assessed via the sessile drop method. Finally, this study conducted healing characterization using the Modified Time Sweep and Linear Amplitude Sweep Healing tests. Moreover, this study looked …

Development Of Hypergraph Based Deep Neural Framework For Precise Cancer Subtyping And Meta Visualization, Pooja G Ms

Theses and Dissertations

Accurate Cancer Subtyping is a cornerstone of modern oncology essential for effective diagnosis and guiding personalized treatment. Histopathological Images (HIs) which capture the microscopic structure of tissues are widely used for cancer detection and subtyping. Even though deep learning has made significant advances, existing HI based subtyping methods often focus on specific cancer types, lacking a generic framework.

A unified framework that can classify multiple cancers with high specificity is desperately needed. In response to these limitations, this thesis proposes a robust multi-cancer, multi-class subtyping framework called DSHGNet (Depthwise Separable Hypergraph Convolutional Neural Network) which integrates Depthwise Separable Convolutional Neural …

Dynamic Deep Prompt Optimization For Defending Against Jailbreak Attacks On Llms, Doniyorkhon Obidov, Honggang Yu, Xiaolong Guo, Kaichen Yang

Michigan Tech Publications

Large Language Models (LLMs) demonstrate impressive capabilities across many applications but remain vulnerable to jailbreak attacks, which elicit harmful or unintended content. While model fine-tuning is an option for safety alignment, it is costly and prone to catastrophic forgetting. Prompt optimization has emerged as a promising alternative, yet existing prompt-based defenses typically rely on static modifications (e.g., fixed prefixes or suffixes) that cannot adapt to diverse and evolving attacks.

We propose Dynamic Deep Prompt Optimization (DDPO), the first jailbreak defense based on deep prompt optimization. DDPO uses the target LLM’s own intermediate layers as feature extractors to dynamically generate defensive …

Cognitive And Emotional Conflict Control Among Children Affected By Parental Hiv/Aids In China, Huihui Wang, Juan Liu, Danfeng Wen, Wan Zhao, Xiaoming Li Ph.D., Junfeng Zhao

Faculty Publications

Background: Children affected by parental HIV/AIDS constitute a particularly vulnerable population, often facing heightened risks in psychosocial adaptation due to family disruption, social stigma, and resource deprivation. However, the characteristics of their executive functions, particularly the core component of conflict monitoring, remain unclear.

Methods: The present study compared the performance of children affected by parental HIV/AIDS (n=32) to a control group (n=32) on a cognitive conflict and emotional conflict face-word Stroop task.

Results: The results of the cognitive Stroop task demonstrated that both groups showed better performance in congruent stimuli compared to incongruent stimuli (86.20% vs.67.30%; 568.43ms vs.586.04ms). In the …

Show Me The (Publication) Data: A Case Study Of Author Affiliation Publication Data Sources Used In Transformative Agreements Assessment At A Mid-Sized Institution, Amy Pham

Copley Library: Faculty Scholarship

Bibliometrics has become an increasingly important metric type for negotiating and assessing transformative agreements, particularly corresponding author data. This case study from the University of San Diego compares OpenAlex, Web of Science, and publisher-provided data using real examples of publication data for TA assessment. Even at a mid-sized institution such as USD, the accuracy and completeness of publication information differs between data sources and brings into question ongoing issues with disambiguation and institution affiliation.

Pid Control For Lower Limb Exoskeletons: A Framework Evaluation, Javlonbek Rakhmatillaev, Vytautas Bučinskas

Chemical Technology, Control and Management

This research provides a detailed guideline for implementing and evaluating Proportional Integral Derivative (PID) control frameworks in lower limb rehabilitation exoskeleton robotics. It examines the role of control systems within rehabilitation robotics, outlines the principles of PID control, describes exoskeleton architecture, explores applications of PID control, reviews optimization strategies, presents experimental validations, and considers future developments in the field. The proposed control framework incorporates aspects of mechanical design, actuator and sensor selection, and PID-based control algorithms, thereby promoting safe, accurate, and individualized rehabilitation support. Recommendations and effective guidance for future work are also presented.

Review Of Modern Methods For Identification, Forecasting, And Intelligent Control Of Wastewater Biological Treatment Processes, Mirkhalil Agzamovich Ismailov, Boburbek Zokirjon O'G'Li Mannobjonov

Chemical Technology, Control and Management

This article presents a comprehensive review of contemporary approaches to the automation and intelligent control of wastewater biological treatment processes. Particular emphasis is placed on the digitalisation of wastewater treatment plants, ranging from the implementation of automated process control systems (APCS/SCADA-based solutions) to the application of predictive algorithms and the development of digital twins of bioreactors.

Special attention is devoted to mathematical models that underpin the control of bioprocesses. The evolution of the most widely used activated sludge models—ASM1, ASM2d, and ASM3—is examined, as these models describe key processes such as microbial community growth, nitrification, denitrification, and phosphorus removal. It …

Synthesis Of An Adaptive Synergistic Fuzzy Discrete Controller For Nonlinear Systems, Isamidin Xakimovich Sidikov, Gulruxsor Murot Qizi Nashvandova, Feruzakhon Botirxon Qizi Sodiqova

Chemical Technology, Control and Management

The paper considers the issues of synthesizing an adaptive fuzzy synergetic controller with discrete time for nonstationary nonlinear dynamic objects. The proposed approach is based on the integrated use of synergetic control principles and fuzzy logic methods, which ensure the formation of a control law for nonlinear dynamic objects that provides asymptotic stability of the control system. Such a hybrid combination makes it possible to guarantee the asymptotic stability of the closed-loop system and to shape the required dynamic behavior of the object over a wide range of operating modes. In addition, this approach provides the ability to adapt to …

Optical Characterization And Field Testing Of Infratracker: Next Generation Near Infrared And Visible Light Star Tracker For Suborbital Sounding Rocket Flight, Anthony J. Shipp, Josh Franklin, Ethan Pascuales, Abigail Heins, Keller Powell, Julian Pallini, Samuel Arnold, Maria Chytka, Cailin Bain, Carter Stevens, Andrew Jordan

Research Horizons Day Posters

No abstract provided.

Determining The Properties Of A Galaxy Triplet Through Photometric And Spectral Analysis, Chris Winkler

Research Horizons Day Posters

No abstract provided.

Impediments To Transforming The Healthcare Delivery System: Shifting The Paradigm From Provider Centric To Patient Centric, Elizabeth A. Regan, Manasa Devi Chinta

Faculty Publications

Introduction: 

Stated aims for digital healthcare transformation frequently cite goals for better coordinated patient-centric systems. However, despite advances in medical science, digital technologies, health policies, and billions of dollars invested over the past 25 years, most healthcare providers are far from fully realizing the demonstrated benefits of today's digital technologies for improving patient care. Sharing information across healthcare systems remains challenging. Problems with fragmentation, quality, inequities, and rising costs of care delivery persist. A recent study of 1,026 U.S. hospital systems found that only 15.8 percent achieved a digital maturity level needed to provide digitally enabled healthcare services to better …

Providers’ Social Determinants Of Health, Burnout, And Efficacy Addressing Patients’ Social Determinants Of Health Needs, Erik Klee

Doctor of Psychology (PsyD)

Healthcare provider burnout and the capacity to address patients’ social determinants of health are critical issues in modern medical systems. This study investigated the relationships among providers’ personal social determinants of health (Prov-SDH) needs, burnout, and perceived efficacy in addressing patients’ social determinants of health (Pt-SDH) needs. Using a sample of 149 healthcare professionals, the study examined how individual Prov-SDH factors, professional degree, clinical setting, and years of practice influenced these outcomes. Statistical analyses revealed no significant correlation between providers’ current or lifetime Prov-SDH needs and their reported burnout symptoms or Pt-SDH-related efficacy. However, results indicated that lifetime Prov-SDH needs …

Emotional Tides In The Sea Of Automation: The Interplay Of Emotions And Trust On Automation Reliance, Lei Shirase

Dissertations

The present study examined the interplay between emotions and trust in the context of automation reliance. The study investigated whether specific emotions (happiness, interest, anger, sadness, and fear) systematically impacted users’ trust in an x-ray screening decision aid, their reliance on the aid, as well as their resilience to any errors made by the aid. Despite successfully inducing certain emotional states, there was no significant relationship between emotions and trust in / reliance on the automated aid. Supplemental analyses revealed that stable individual difference traits (i.e. propensity to trust) to be a strong predictor of initial trust levels in the …

Muscular Fitness Levels Of U.S. Children And Adolescents, Daniel J. Mcdonough, Yong Gao, Lynda B. Ransdell, Haichun Sun

International Journal of Physical Activity and Health

Purpose: To describe muscular fitness (MF) levels and percentile benchmarks among U.S. children and adolescents aged 6–15 years old across sociodemographic, physiological, and behavioral subgroups. Methods: Data were from the 2012 NHANES National Youth Fitness Survey (NNYFS). Four strength tests consisting of the plank, knee extension, modified pull-up, and handgrip, were analyzed by age, sex, race/ethnicity, income, BMI category, cardiorespiratory fitness (CRF), and physical activity (PA) among 1,234 participants (51% male) using SAS SURVEY procedures. Results: Mean ± SEM scores were 69.6 ± 1.8 s (plank), 56.6 ± 4.2 lb (left) and 59.2 ± 4.3 lb (right) knee extension, 5.5 …

Maria Milletti, Oral History Interview, 2025., Micah Bookout

Oral Histories

Maria Milletti is a chemistry professor at Eastern Michigan University. She has worked at EMU for more than thirty-five years and has mentored over fifty students for the Undergraduate Symposium. In her interview, Dr. Milletti discusses her educational experiences, the culture of the chemistry department, and how the Symposium has helped her grow as a mentor. She also describes how she prepares students for the Symposium and compares it to other conferences.