Digital Commons Network^™

An Agent-Based System For Optimizing Webpage Content For Automated Information Retrieval, Lenord Melvix

Defensive Publications Series

A challenge may arise for automated information retrieval systems, such as generative artificial intelligence applications, when parsing webpages designed primarily for human visual consumption, potentially leading to incomplete or inaccurate responses to user queries. To address this, systems and methods can employ a multi-agent framework to optimize webpage content. The system can parse a webpage, generate a set of potential user queries, and identify informational gaps by determining which queries are not answered by the page's existing content. A business representative can then provide verified answers for these gaps, which an agent can programmatically embed into the webpage's source code …

Steroid-Responsive Encephalopathy Associated With Autoimmune Thyroiditis: A Case Fulfilling Definite Graus Criteria, Stephanie Ammari, Nawras Ibrahim, Sravani Karuchola, Samir Ouais

Journal of Community Hospital Internal Medicine Perspectives

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto encephalopathy, is a rare immune-mediated neurological syndrome with an incidence of 2.1 per 100,000 and a 4:1 female predominance. Neurological manifestations are independent of thyroid status, occurring in 30–40% of euthyroid patients, and include cognitive impairment, confusion, seizures, and psychiatric symptoms. Diagnosis is challenging in the elderly, where symptoms overlap with dementia or delirium, with only 51 reported cases in patients aged ≥65 years. We describe a 70-year-old woman with autoimmune hypothyroidism and levothyroxine nonadherence who presented with progressive weakness, melena, dyspnea, and altered mental status complicated by obstructive …

Prognostic Utility Of Delta -Procalcitonin And Modified Shock Index For Risk Stratification Of Sepsis In Acute Care Settings, Sanveer Singh, Neeraj Singla, Navneet Sharma, Mandip Bhatia, Saurabh C Sharda

Journal of Community Hospital Internal Medicine Perspectives

Background: Risk stratification in sepsis remains challenging, and while several scoring systems exist, there is a need for simple tools that can reliably predict outcomes.

Aims: To study the role of Delta -Procalcitonin and Modified Shock Index (MSI) in predicting the severity of Multiple Organ Dysfunction Syndrome (MODS)like acute kidney injury, vasopressor requirement, need for mechanical ventilation, coagulopathy and 28 day mortality in sepsis

Methods: This prospective observational study recruited 122 patients with suspected sepsis. Delta- Procalcitonin was calculated by measuring the difference in procalcitonin values at the time of admission and after 48 hours. Modified Shock Index (MSI) is …

Evolving Trends And Racial Disparities In Alcohol Associated Liver Disease (Ald), Metabolic Dysfunction Associated Steatohepatitis (Mash) And Hepatitis C Viral Infection (Hcv) As Etiology Of Liver Transplantation: Past, Present, And Future Projections, Boniface Mensah, Albert E. Orhin, Natalie A. Y. Akoto, Seunghee Han, Rachel A Boateng, Ramya Varesiddy, Joseph Atarere, Simardeep Singh, Terrylyna Baffoe-Bonnie, Haider Naqvi, Christopher J. Haas

Journal of Community Hospital Internal Medicine Perspectives

Background

Liver transplantation remains the definitive treatment for end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC). While hepatitis C virus (HCV) was historically the leading indication for liver transplant, the introduction of direct-acting antivirals (DAAs) has drastically reduced HCV-related ESLD. In contrast, metabolic dysfunction-associated steatohepatitis (MASH) and alcohol-associated liver disease (ALD) have emerged as predominant causes of liver transplantation. This study evaluates racial and ethnic disparities in liver transplantation indications from 2004 to 2023 and projects future trends through to 2040.

Methods

De-identified data from the Standard Transplant Analysis and Research (STAR) files of the United Network for Organ Sharing …

Three-Dimensional Surgical Orthodontic Management Of Pruzansky Iia Craniofacial Microsomia With Severe Facial Asymmetry And Obstructive Sleep Apnea, Hung-Wen Chiu, Cheng-Hui Lin, Yi-Hsuan Carol Chen

Taiwanese Journal of Orthodontics

Background: Craniofacial microsomia (CFM) is the second most common craniofacial anomaly with asymmetrical, congenital malformation. Treatment is challenging and requires interdisciplinary cooperation to restore function and facial esthetics. Objective: A CFM patient suffered from facial asymmetry, occlusal plane cant, malocclusion and severe obstructive sleep apnea, and a 3D surgical orthodontic treatment was planned. Case report: A 37-year-old male patient complained of small chin with deviation. Craniofacial microsomia grade IIa by Pruzansky system and S2A1T1 by SAT system was diagnosed. Clinical examination showed severe facial asymmetry, right microtia, chin deviation to right side 7.0 mm, occlusal plane cant, right Class …

Management Of Skeletal Class Iii Malocclusion With Deep Bite And Moderate Overjet Using Improved Super-Elastic Ti-Ni Alloy Wire (Isw), Wen-Hsuan Lin, Ching-Yu Yang, Yuan-Hou Chen, Jian-Hong Yu

Taiwanese Journal of Orthodontics

A 20-year-old female presented with concerns about poor dental alignment and a tendency to bite on her lip easily. Clinical examination revealed a concave and brachy facial profile, accompanied by a deep overbite and a moderate overjet. Radiographic examination showed skeletal Class III with a low mandibular plane angle. Correction of the deep bite was achieved by using the Improved Super-elastic Ti-Ni alloy Wire (ISW) and Intermaxillary elastics (IMEs). To correct the moderate overjet, interproximal reduction (IPR), the Multi-bend Edgewise Archwire (MEAW) technique, and arch lengthening of the lower arch were applied. The active treatment duration took approximately 54 months, …

Improved Super-Elastic Ti-Ni Alloy Wire For The Treatment Of Skeletal Class Iii Malocclusion With Anterior Crossbite And Missing Lower Molar, De-Lun Zhuang, Yuan-Hou Chen, Jian-Hong Yu

Taiwanese Journal of Orthodontics

This case report describes the use of Improved Super-elastic Ti-Ni alloy wire (ISW), developed by Tokyo Medical and Dental University, in managing a skeletal Class III malocclusion with anterior crossbite and a missing lower molar. A 26-year-old female presented with a chief complaint of poor dental alignment. Clinical and radiographic evaluation revealed Angle Class III malocclusion, anterior crossbite, a missing mandibular first molar (36), and a centric occlusion–centric relation (CO–CR) functional shift, consistent with a skeletal Class III pattern. Treatment involved the use of ISW for leveling and alignment of both arches and correction of the anterior crossbite, while maintaining …

Inferior Alveolar Nerve Proximity In Mandibular Molar Distalization: Implications For Orthodontic Treatment Planning, Samantha Hsien-Chu Mao, Chia-Hsuan Chan, Yu-Jen Chang, Shiu-Shiung Lin, Chen-Feng Cheng, Te-Ju Wu

Taiwanese Journal of Orthodontics

Purpose: This study aimed to clarify the anatomical boundaries of mandibular molar distalization, emphasizing the risk of inferior alveolar nerve (IAN) contact. Patients and Methods: In total, 30 skeletal Class III patients undergoing orthognathic surgery (59 mandibular hemi-arches) were analyzed using pretreatment three-dimensional (3D) computed tomography scans. The shortest horizontal distance between the mandibular second molar and the inferior alveolar canal (M2-IAC) was measured at multiple depths below the cementoenamel junction, along with the distance to the lingual cortical plate (M2-MLC). Samples were categorized by vertical facial pattern (low-, normal-, and high-angle case). Simulated distalization cases predicting IAN contact were …

A Holistic Perspective On (In)Formal English Learning Through Mobile Apps, Gamification, And Virtual And Augmented Reality, Ahmed Abdullah Ahmed Alshehri

UB Journal for Humanities

Using digital tools such as Computer-Assisted Language Learning (CALL), Mobile-Assisted Language Learning (MALL), Virtual Reality (VR), Augmented Reality (AR), and gamification has remodeled language learning. Despite their advances and integration into language programs, gaps remain in personalization, accessibility, and skill development. This study aims to explore the impact of such tools on language learning outcomes in formal and informal settings, with a focus on mobile Apps, VR/AR, and gamification. A mixed-method approach was employed, interconnecting quantitative surveys with 150 participants and qualitative interviews. The former was used to assess tool usage, motivation, and proficiency, and the latter (qualitative data dealt …

Profiling Students’ Academic Language Readiness For English‑Medium Instruction In Saudi Higher Education, Hanan Sarhan Alsubaiai

UB Journal for Humanities

Saudi universities have been rolling out English‑Medium Instruction (EMI) at a fast pace. But no standardized and validated instrument currently exists to assess students’ readiness. The present study developed the Academic Language Readiness Test (ALRT), administered it to undergraduate students, and determined the score cut-offs distinguishing those who are Ready, Borderline, and those who are Not Ready. A crosssectional, multisite quantitative design was employed with 712 undergraduate students from seven colleges at Bisha University. The ALRT measured four subskills: academic listening, academic reading, academic vocabulary and grammar, and academic study skills (notetaking and visual data interpretation). Psychometric analysis combined Classical …

Grit And Psychological Well-Being As Predictors Of Job Persistence Among K–12 Teachers In The United States, Tina Marie Sheppard

Walden Dissertations and Doctoral Studies

Throughout the United States, K–12 public school teachers are leaving the profession, contributing to teacher shortages and instability in classrooms and schools. Teacher persistence is critical to student success, yet little was known about the nature of the predictive relationship between grit and psychological well-being on job persistence among K–12 public school teachers in the United States. Guided by the framework of positive psychology, the purpose of this quantitative nonexperimental correlational study was to investigate the nature of the predictive relationship between the independent variables grit, as measured by the 12-Item Grit Scale, and psychological well-being, as measured by the …

The Lived Experiences Of The Flint Water Crisis And Its Psychological Effects, Joe W. Glenn

Walden Dissertations and Doctoral Studies

The Flint, Michigan, water crisis of 2014, with lead contamination of drinking water, adversely affected predominantly Black, socioeconomically disadvantaged residents. However, no research has investigated residents’ experiences, especially their trust in local and state government leaders. The purpose of this study was to explore the lived experiences of the Flint water crisis and its psychological effects. Rawls’s theory of justice provided the framework for the study. Three research questions guided this qualitative descriptive phenomenological study. Information from eight Flint residents was collected through semi-structured interviews. Data analysis followed Giorgi’s descriptive phenomenological steps. Five strong themes emerged: understanding individual perceptions, views …

General And Special Education Teachers’ Experiences With The Implementation Of Inclusive Education, Katie Chardoussin

Walden Dissertations and Doctoral Studies

Some elementary special education and general education teachers in New Jersey struggle to implement inclusion programs. The purpose of this study was to explore special and general education teachers’ experiences with the challenges they encountered teaching in inclusion classrooms. The conceptual framework for this study was Anderson’s ecology of inclusive education, which highlighted the importance of students having meaningful relationships with their peers. For this basic qualitative design, semistructured interviews were conducted with 19 participants, of whom eight were special education teachers, and 11 were general education teachers. Through inductive coding, the following three themes emerged: Special education and general …

Higher Education Faculty’S Perceptions On Generative Artificial Intelligence Use In Teaching And Learning Practices, Inez Mitchell

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study is that higher education (HE) faculty are challenged to integrate generative artificial intelligence (GenAI) in their teaching and learning practices. Grounded in Mishra and Koehler’s technological, pedagogical and content knowledge framework and Knowles’ theory of andragogy, the purpose of this study was to explore HE faculty’s perceptions on their content, andragogical, and technological knowledge and their instructional strategies used in integrating GenAI. For this basic qualitative design, semistructured interviews were conducted with nine HE faculty who self-identified as having at least 3 years of teaching and GenAI usage experience from across the …

Overcoming Igf1r-Mediated Resistance To Oncolytic Hsv1 And Radiotherapy Via Triple Combination Therapy, Alexandra A Miller, Min-Hye Noh, Jin Muk Kang, Jiyeon Kim, Lily Nguyen, Amanda S Kouaho, Grace Nguyen, Minxin Huang, Stephanie M Bean, Joshua Davis, Matthew P Mullarkey, Sunil Krishnan, Zhongming Zhao, E Antonio Chiocca, Tae Jin Lee, Ji Young Yoo

The Brown Foundation: Institute of Molecular Medicine

FDA-approved oncolytic herpes simplex virus-1 (oHSV) therapy has emerged as a promising viro-immunotherapy for solid tumors. However, tumor- and tumor microenvironment (TME)-associated adaptations following viral treatment, such as feedback immune suppression, neoangiogenesis, and enhanced tumor aggressiveness, often hinder complete tumor eradication. A deeper understanding of the molecular mechanisms underlying resistance to oHSV is crucial to enhancing its clinical impact. We recently discovered that oHSV induces Insulin-like growth factor 2 (IGF2) secretion, shaping an immunosuppressive TME. Similarly, radiotherapy (RTx) activates the IGF1/IGF1R and YAP1 signaling pathways, further promoting therapeutic resistance. In this study, we investigated how oHSV-induced Insulin-like growth factor 1 …

Who Pays Dividend? Statistical Explanation And Machine Learning Prediction: Evidence From Pakistan, Zohaib Aziz, Javed Iqbal

The Indonesian Capital Market Review

This study explains and predicts the firm’s dividend payment decision using an unbalanced panel dataset of non-financial firms listed on the Pakistan Stock Exchange covering the period 2009-2020. Several traditional statistical models and modern machine learning algorithms are applied to examine the firm-specific and macroeconomic determinants of dividend decision. Logistic regression and dynamic panel probit models indicate that lagged dividend, firm efficiency and firm size positively influence the firm’s dividend decision whereas leverage and sales growth show negative effects. Lagged dividend is found to be the most influential variable in explaining and predicting the dividend decision while the role of …

Impact Of Trade And Financial Openness On The Efficiency Of The Nigerian Stock Market, Damian Chidozie Uzoma-Nwosu Dr, Samuel Orekoya Dr, Oluwatosin Adeniyi

The Indonesian Capital Market Review

The study investigates the impact of Financial Openness (FOp) or/and Trade Openness (TOp) on the efficiency of the Nigerian Stock Market (NSM). Applying auto-regressive distributed lag model on stock market data, the result revealed that either in individual models or when in one model, an increase in TOp significantly increased the efficiency of the NSM in both the short and long-run, while the contrary holds for a percentage increase in FOp over 2010-2020. This suggests that TOp rather than FOp, significantly contributed to the efficiency of the NSM. Thus, TOp and FOp have differentiated impacts on stock market efficiency. Policymakers …

100-Day Analysis Of Usd/Idr Exchange Rate Dynamics Around The 2025 U.S. Presidential Inauguration, Sandy Hs Herho, Siti N. Kaban, Cahya Nugraha

The Indonesian Capital Market Review

Using a 100-day symmetric window around the January 2025 U.S. presidential inauguration, non-parametric statistical methods with bootstrap resampling (10,000 iterations) analyze distributional properties and anomalies. Results indicate a statistically significant 3.61% Indonesian rupiah depreciation post-inauguration, with a large effect size (Cliff's Delta =-0.9224, CI: [-0.9727, -0.8571]). Central tendency shifted markedly, yet volatility remained stable (variance ratio = 0.9061, p=0.504). Four significant anomalies exhibiting temporal clustering are detected. These findings provide quantitative evidence of political transition effects on emerging market currencies, highlighting implications for monetary policy and currency risk management.

Principals' Perceived Leadership Training For Inclusive K-12 Education, Lettie E. Webster

Walden Dissertations and Doctoral Studies

Adequate training and professional development enhance school principals’ effectiveness in leading inclusive K-12 schools. The problem addressed in this study was the gap in the literature on K-12 principals’ perceptions of the essential elements of preparation and ongoing professional development needed for effective leadership in inclusive educational settings. The purpose of this qualitative study was to explore K-12 school principals’ perceptions of essential components of preparation for effective leadership and the role of ongoing professional development in enhancing their effectiveness as leaders in inclusive educational settings. Beard’s engaged school leadership theory served as the conceptual framework. For this basic qualitative …

Mechanistic Basis Of Bifunctional Oxidation By A Non-Heme Fe(Ii)/2-Oxoglutarate-Dependent Enzyme Cctet Toward N6-Methyladenine And 5-Methylcytosine In Double-Stranded Dna, Bhargav Varada, Simahudeen Bathir Jaber Sathik Rifayee, Midhun George Thomas, Ethan Sommer, Carter Davis, Sodiq Waheed, Sudheesh Devadas, Surajit Kalita, Sreerag Melayikandy, Tatyana Karabencheva-Christova, Christo Christov

Michigan Tech Publications

CcTET (Coprinopsis cinerea ten-eleven translocation) is a non-heme Fe(II)/2-oxoglutarate (2OG)-dependent oxygenase that catalyzes the oxidative demethylation of both N⁶-methyladenine (6mA) and 5-methylcytosine (5mC) in double-stranded DNA, distinguishing it from other TET enzymes that act exclusively on 5mC. Despite this bifunctional activity, the molecular origins of its substrate selectivity and catalytic mechanism remain poorly understood. Here, we employed a multiscale computational approach combining classical molecular dynamics simulations and hybrid quantum mechanics/molecular mechanics calculations to characterize the conformational dynamics and reaction pathways of CcTET. Our results show that CcTET follows the canonical Fe(IV)=O-mediated mechanism, in which hydrogen atom transfer (HAT) …

The Role Of Rhyme In Children’S Word Learning, Tengwen Fan

LSU Doctoral Dissertations

Rhyme increases the phonological similarity of phrases individuals hear and enhances recall from working memory. The present study explores whether rhyme aids word learning in children and examines the underlying neural mechanisms through which rhyme facilitates word learning. Thirty-four children between 6 and 8 years old completed a word learning task where they were exposed to 15 nonwords (NWs), four times each, in the sentence-final position as their EEG was recorded. Participants were randomly assigned to either a Rhyme or No-Rhyme group, where the NWs rhymed or did not rhyme with a prime real word in the sentence, respectively, during …

Kinds Of Evidence Cited By Councilors In Municipal Council Sessions: The Case Of Santa Fe, Cebu, Philippines, Junald D. Ango

Journal of Public Affairs and Development

This paper explores the practice of evidence-based policymaking (EBPM) in the municipal council of Santa Fe, Cebu, Philippines. Data for this study is based on a content analysis of the minutes of council sessions and committee meetings from July 2022 to August 2024. The use of evidence in policymaking has caught on among policymakers in the Philippines, at both the national and local levels. However, few studies have examined policymakers' use of evidence in municipal governments, especially those in smaller, less urbanized towns. In the case of the Municipality of Santa Fe, at least 13 kinds of evidence were cited …

Interstitial Fluid N-Glycans Serve As A Proxy For Serum Biomarker Discovery In A Pilot Study, Radka Saldova, Talus K. Gaymore, Caitriona Walsh, Eder Zavala, Paula M. Mendes

Student Papers, Posters & Projects

Protein glycosylation is the most prevalent post-translational modification and is known to undergo profound alterations in disease. While serum N-glycosylation has been extensively studied, interstitial fluid is gaining prominence as a minimally invasive biomarker source, underscored by the widespread clinical adoption of wearable glucose monitors in diabetic patients. However, the glycomic landscape of interstitial fluid remains largely unexplored. Here, we have performed a comparative analysis of the N-glycome from interstitial fluid and matched plasma from five healthy volunteers using liquid chromatography, mass spectrometry and exoglycosidase digestions. Strikingly, the interstitial fluid N-glycome closely shows overlapping profiles with the plasma of each …

Transcriptomic And Genomic Insights Into Nutrient Stress Responses And Subgenome Evolution In Chenopodium, Ashley Kathleen Marcheschi

Theses and Dissertations

Chenopodium is a diverse genus of nutritionally and ecologically important species in the Amaranthaceae family. This thesis investigates two outstanding questions in the genus: how Chenopodium quinoa responds transcriptionally to nutrient deficiency and how Australian Chenopodium species are related through their subgenomic ancestry and evolutionary history. First, we characterized transcriptomic responses of C. quinoa to deficiencies of twelve essential macro- and micronutrients across leaf and root tissues using RNA sequencing. Leaves showed the strongest responses under nitrogen, potassium, magnesium, and zinc deficiency, while roots responded more evenly across conditions. Recurring responses included suppression of photosynthesis, remodeling of translational machinery, reactive …

Food And Drug Administration Audit Outcomes And Their Association With Class I And Class Ii Food Recalls, Mark Baker

Walden Dissertations and Doctoral Studies

Foodborne illness and food recalls remain major public health concerns in the United States. Guided by the Theory of Planned Behavior, the purpose of this quantitative secondary analysis was to examine whether Food and Drug Administration (FDA) inspection classifications, warning letters, and prior 24-month inspection frequency were associated with facility involvement in a subsequent Class I or Class II food recall. Question-specific analytic files were created from publicly available FDA administrative records. Eligible records included FDA-regulated food facilities with qualifying inspection or warning letter events and sufficient data to assess recall involvement within a 12-month follow-up period. The final analytic …

Neurofilament Light Chain (Nfl) As A Surrogate Outcome Measure For Gm2 Gangliosidoses., Kyriakos Martakis, Nicolas J. Abreu, Joshua J. Baker, Peter R. Baker Ii, Ian Billington, T Andrew Burrow, Mallory Factor, Taylor Fields, Cassandra Fields, Jennifer L. Gannon, Megan Grosso, Jorgji Kerthi, Marc C. Patterson, Brian J. Shayota, Michael Strupp, Lennard Strupp, Tatiana Bremova-Ert

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The GM2 gangliosidoses (GM2) are ultra-rare neurodegenerative disorders caused by deficient hexosaminidase A and/or B activity, leading to lysosomal GM2 ganglioside accumulation. Disease onset ranges from infancy to adulthood, with earlier onset associated with more rapid progression. Neurofilament light chain (NfL), a sensitive marker of axonal injury, has been extensively investigated as a biomarker for neurodegenerative disorders, including GM2.

METHODS: To evaluate its clinical utility as a biomarker for GM2, NfL was measured in patients with GM2 enrolled in a Phase 2b, multinational, rater-blinded study of levacetylleucine [NCT03759665], and in its open-label Extension Phase (EP).

RESULTS: Nineteen participants had …

Continuous 1:1 Sitter Observation Versus Standard Safety Interventions To Reduce Falls In Hospitalized Adults At Risk, Zainab Williams

Student Scholarly Projects

Practice Problem: Patient falls remain a significant patient safety concern among hospitalized adults, particularly those at high risk. Traditional fall-prevention strategies, including continuous 1:1 sitter observation, require evaluation to determine their effectiveness in reducing falls and fall-related injuries.

PICOT: In hospitalized adult patients at high risk for falls (P), does continuous 1:1 sitter observation (I), compared to standard safety interventions (C), reduce fall rates (O) as measured by reported falls per 1,000 patient days during hospitalization over 12 weeks (T)?

Evidence: Current evidence supports multifactorial fall-prevention programs that combine patient assessment, staff engagement, and proactive nursing interventions through intentional rounding. …

In Re: City Of Chester Pennsylvania

2026 Decisions

USDC for the Eastern District of Pennsylvania

Usa V. Alan Dorsey

2026 Decisions

USDC for the Middle District of Pennsylvania

In Re: Boy Scouts Of America And Delaware Bsa Llc

2026 Decisions

USDC for the District of Delaware