Digital Commons Network^™

Knowledge, Attitude, And Practices Of Nurses Providing End-Of-Life Care At Aga Khan University Hospital, Nairobi County, Eunice Wanjiku Kariuki

MSc in Advanced Practice Nursing

Introduction: End-of-life care is an essential aspect of healthcare, and nurses play a vital role in its provision. Due to the growing population, there has been an increase in the number of people in need of End-of-life care, and nurses must be adequately prepared to meet the complex and diverse needs of patients and their families. However, many studies suggest that many nurses feel unprepared to provide quality end-of-life care, and there is a need for further investigation of the factors that contribute to their preparedness.

Methods:The study was conducted at a level 6 teaching and referral hospital, in …

Breaking Up Bottlenecks In Big Tech And Everywhere Else: Two Remedies That Keep Your Packages Arriving In Two Days, Peter Carstensen, Darren Bush

UC Law Journal

This article addresses the colossal problem of remedy in antitrust and regulatory cases combatting monopoly “bottlenecks.” A bottleneck monopoly lies somewhere along the chain of production and distribution of goods or services. Often both before and after the monopoly, the markets are workably competitive. When a bottleneck owner also participates in those workably competitive markets, the bottleneck owner has the incentive and ability to self-preference, discriminating against other competing products in the markets. As a monopolist, a bottleneck owner will also seek to constrain access to the bottleneck, assuring that the use of the bottleneck is not optimized. Traditional remedies …

A Computational Analysis Of The Effect Of Hard Choices On The Individuation Of Values, Norberto M. Grzywacz

Psychology: Faculty Publications and Other Works

Background/Objectives: Experimental studies show that when an individual makes choices, they affect future decisions. Future choices tend to be consistent with past ones. This tendency matters in the context of ambivalent situations because they may not lead to clear choices, often leading people to make “arbitrary” decisions. Thus, because of choice consistency with the past, people’s decision-making values diverge. Thus, hard choices may contribute to the individuation of values. Methods: Here, we develop a Bayesian framework for the effects of cognitive choice consistency on decision-making. This framework thus extends earlier cognitive-science Bayesian theories, which focus on other tasks, such as …

Perceptual Complexity As Normalized Shannon Entropy, Norberto M. Grzywacz

Psychology: Faculty Publications and Other Works

Complexity is one of the most important variables in how the brain performs decision making based on esthetic values. Multiple definitions of perceptual complexity have been proposed, with one of the most fruitful being the Normalized Shannon Entropy one. However, the Normalized Shannon Entropy definition has theoretical gaps that we address in this article. Focusing on visual perception, we first address whether normalization fully corrects for the effects of measurement resolution on entropy. The answer is negative, but the remaining effects are minor, and we propose alternate definitions of complexity, correcting this problem. Related to resolution, we discuss the ideal …

Strategically Restated Defaults, Wendy Gerwick Couture

William & Mary Business Law Review

Business and commercial statutes are composed almost entirely of default rules, which parties may override via agreement or adopt via silence. Drafters of these statutes, and theories about the substance of default rules, assume that parties indeed adopt statutory default rules via silence.

Against this backdrop, this Article examines unexpected behavior by parties to business and commercial agreements: parties often restate statutory default rules in their agreements rather than adopting those rules via silence. Based on a review of actual limited partnership agreements and security agreements, this Article identifies five unique species of restatement—bald, tweak, refill, baseline, and context restatements—and …

Beyond Water Surface Profiles: A New Iterative Methodology For 2d Model Calibration In Rivers Using Velocity Data From Multiple Cross-Sections, Fabian Rivera-Trejo, Gabriel Soto-Cortes, Kory M. Konsoer, Eddy J. Langendoen, Gaston Priego-Hernandez

Faculty Publications

Observed longitudinal water-surface profiles are commonly used to calibrate river hydrodynamic models, relying on assumptions of lateral uniformity in water surface elevation and velocity distribution. While suitable for 1D models, this approach has limitations in regard to 2D model calibration. When 2D flow measurements are available, a more robust quantitative evaluation is necessary to assess model accuracy. This study introduces a novel methodology to improve 2D model calibration and evaluate performance. High-resolution bathymetric and hydrodynamic data collected with a multibeam echosounder (MBES) and acoustic Doppler current profiler (ADCP) were aligned to compare observed and simulated flow velocities at matching spatial …

Childhood Religious Participation As Mediator For Posttraumatic Symptoms And A Joyful Disposition In Adulthood, Kara S. Mccoy

Walden Dissertations and Doctoral Studies

Individuals who have experienced trauma may have varying life experience outcomes based on trauma histories and other factors. Little to no study has been done to determine whether childhood religious involvement can be a mediating factor. The purpose of this quantitative study was to test if any potential mediating effects exist between childhood religious attendance, the presence of joyfulness in life, and adult posttraumatic symptoms. The theoretical framework utilized in this study was Kenneth Pargament’s theory of religious coping. Data were collected in a secure fashion utilizing Survey Monkey, and all participants voluntarily answered questions that utilized the short posttraumatic …

Childhood Religious Participation As Mediator For Posttraumatic Symptoms And A Joyful Disposition In Adulthood, Kara S. Mccoy

Walden Dissertations and Doctoral Studies

Individuals who have experienced trauma may have varying life experience outcomes based on trauma histories and other factors. Little to no study has been done to determine whether childhood religious involvement can be a mediating factor. The purpose of this quantitative study was to test if any potential mediating effects exist between childhood religious attendance, the presence of joyfulness in life, and adult posttraumatic symptoms. The theoretical framework utilized in this study was Kenneth Pargament’s theory of religious coping. Data were collected in a secure fashion utilizing Survey Monkey, and all participants voluntarily answered questions that utilized the short posttraumatic …

Risk Factors For Peripheral Artery Disease-Related Amputations Among Black Americans, Darnell L. Blake

Walden Dissertations and Doctoral Studies

Evidence suggests that Black Americans (BAs) are at a significantly higher risk of peripheral artery disease (PAD)-related amputations. This study aimed to examine risk factors for non-traumatic lower extremity amputation (NTLEA) among BAs with PAD addressing a significant knowledge gap regarding racial disparities in PAD outcomes. Grounded in Bandura's social cognitive theory, which posits the interplay among personal factors, environmental influences, and behavior, this study examines how age, gender, income, and comorbidities like cardiovascular disease, kidney disease, and diabetes influence NTLEA across various insurance types (private, Medicaid, Medicare, self-pay). This quantitative cross-sectional study used the 2020 National Inpatient Sample, 1% …

Proactive Conversational Ai: A Comprehensive Survey Of Advancements And Opportunities, Yang Deng, Lizi Liao, Wenqiang Lei, Grace Hui Yang, Wai Lam, Tat-Seng Chua

Research Collection School Of Computing and Information Systems

Dialogue systems are designed to offer human users social support or functional services through natural language interactions. Traditional conversation research has put significant emphasis on a system's response-ability, including its capacity to understand dialogue context and generate appropriate responses. However, the key element of proactive behavior-a crucial aspect of intelligent conversations-is often overlooked in these studies. Proactivity empowers conversational agents to lead conversations towards achieving pre-defined targets or fulfilling specific goals on the system side. Proactive dialogue systems are equipped with advanced techniques to handle complex tasks, requiring strategic and motivational interactions, thus representing a significant step towards artificial general …

Qultsf: Long-Term Time Series Forecasting With Quantum Machine Learning, Hari Hara Suthan Chittoor, Paul Robert Griffin, Ariel Neufeld, Jayne Thompson, Mile Gu

Research Collection School Of Computing and Information Systems

Long-term time series forecasting (LTSF) involves predicting a large number of future values of a time series based on the past values. This is an essential task in a wide range of domains including weather forecasting, stock market analysis and disease outbreak prediction. Over the decades LTSF algorithms have transitioned from statistical models to deep learning models like transformer models. Despite the complex architecture of transformer based LTSF models ‘Are Transformers Effective for Time Series Forecasting? (Zeng et al., 2023)’ showed that simple linear models can outperform the state-of-the-art transformer based LTSF models. Recently, quantum machine learning (QML) is evolving …

Student-Conscious Practice And Pathways For Student Success, Anthony Walker, Sara Mata

Journal of Research Initiatives

This paper shares evidence of how four programs enhanced students' pathways from high school through bachelor's degrees. Each program expanded students' networks, fostered a sense of belonging, and developed critical thinking skills. Ten years after participation, we looked back to gain insights into key elements that impacted students' learning experience. Data from student voices highlighted the importance of inclusiveness in action, institutional responsibility, and culturally relevant pedagogy in student success and program impact.

May Federal Courts Answer Questions When Not Deciding Cases?, Benjamin B. Johnson

Notre Dame Law Review

Conventional wisdom says that Article III’s case-or-controversy requirement prevents federal courts from answering legal questions when they are not deciding cases. This is only partially correct. This Article shows conditions under which a federal court may answer questions even when not deciding a case. To do so, it traces the appellate power back to its origins in English common law courts and through the early American judiciary. For centuries, common law judges have answered questions sent to them by lower courts when doing so would help those lower courts to decide pending cases. In England, the “case stated” procedure facilitated …

Immunity For Imaginary Policy In Tort Claims Against The Federal Government, Gregory C. Sisk

Notre Dame Law Review

Fictional policy justifications for official negligence are regularly accepted by the federal courts to shield the federal government from liability for ordinary tortious wrongdoing. The lower federal courts have adopted an extravagant interpretation of the discretionary function exception to the Federal Tort Claims Act that applies whenever a policy implication can be theorized. Under this “susceptible to policy analysis” approach, the United States government escapes accountability through after-the-fact speculation regarding policy factors that could have played a role (but actually did not) in the harmful government conduct.

By textual command, the exception shields only government decisions “based on,” that is, …

Dimensions Volume 60 - Full Issue, Editors, Dimensions

Dimensions

SCOLT Dimensions Volume 60

Economic Inequality And Political Participation In East Asian Democracies: The Role Of Perceived Income Inequality And Intergenerational Mobility, Mi-Son Kim, Dongkyu Kim, Sang-Jic Lee

Political Science Faculty Publications

This study examines how perceptions of economic inequality affect political participation focusing on East Asian democracies. It develops nuanced predictions on how perceptions of income inequality and social mobility and their interplay affect individuals’ engagement in various types of political activities in six East Asian democracies. Using the fourth wave of the Asian Barometer Survey, we examine novel arguments built upon the existing inequality-participation nexus. Our analysis suggests that inequality is a multifaceted concept, and the mechanisms of the inequality-participation nexus could vary depending on the regional, socioeconomic, and political context.

Phase Of The Seabed Frequency-Domain Reflection Coefficient: Measurements And Modeling, Charles W. Holland

Electrical and Computer Engineering Faculty Publications and Presentations

The phase of the seabed frequency-domain reflection coefficient potentially contains valuable information on the geoacoustic properties in a layered/refracting seabed. However, heretofore, the phase has not been exploited. Measurements of phase are presented in an area of thick mud at the New England Mud Patch. In addition, a model is presented along with the modeling results. While this is only a first step towards understanding the potential value of exploiting the phase, it seems clear that in some instances, the phase not only contains valuable geoacoustic information, but carries a higher information content than the magnitude.

J Mich Dent Assoc February 2025

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It is the primary publication reaching Michigan dentists. The February issue sets the tone for the MDA’s Annual Meeting, Revving Up Dentistry, this April in Detroit.

A detailed Annual Session Preview is included within the Journal with course listings and activities planned for the four-day event. Regular Departments: News You Need, New Dentist Column, MDA Insurance, Dentistry and the Law, Staff Matters, MDA at your Service, Governmental Affairs, and a Michigan Dental …

Our Classrooms, Our Curriculum, Our Expertise: Crafting A Future Through Credit Teaching, Angie Cox, Amandajean F. Nolte

LOEX Quarterly

No abstract provided.

Hospital Commitments To Address Diagnostic Errors: An Assessment Of 95 Us Hospitals, Alexandra Campione Russo, Jean-Luc Tilly, Leah Kaufman, Melissa Danforth, Mark L Graber, J Matthew Austin, Hardeep Singh

Faculty, Staff and Students Publications

Background: Diagnostic errors are a leading cause of patient harm. In 2022, the Leapfrog Group published a report containing 29 evidence-based practices that hospitals can adopt to reduce diagnostic errors.

Objectives: To understand the extent to which US hospitals have already implemented these practices, we conducted a national pilot survey of Leapfrog-participating hospitals.

Methods: To reduce respondent burden, we divided the 29 practices across two surveys: one focused on organizational culture and structure (Domain 1), and the second focused on the diagnostic process itself (Domain 2).

Results: A total of 95 hospitals from 23 states responded to one or both …

Multi-Modal Prediction Of Extracorporeal Support-A Resource Intensive Therapy, Utilizing A Large National Database, Daoyi Zhu, Bing Xue, Neel Shah, Philip Richard Orrin Payne, Chenyang Lu, Ahmed Sameh Said

2020-Current year OA Pubs

OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is among the most resource-intensive therapies in critical care. The COVID-19 pandemic highlighted the lack of ECMO resource allocation tools. We aimed to develop a continuous ECMO risk prediction model to enhance patient triage and resource allocation.

MATERIAL AND METHODS: We leveraged multimodal data from the National COVID Cohort Collaborative (N3C) to develop a hierarchical deep learning model, labeled "PreEMPT-ECMO" (Prediction, Early Monitoring, and Proactive Triage for ECMO) which integrates static and multi-granularity time series features to generate continuous predictions of ECMO utilization. Model performance was assessed across time points ranging from 0 to 96 …

Analysis Of Predefined Safety Events Across Spesolimab Trials In Dermatological And Non-Dermatological Conditions, Kenneth B Gordon, Yayoi Tada, Milan J Anadkat, Siew Eng Choon, Boni Elewski, Jonathan N Barker, Arash Mostaghimi, Kilian Eyerich, Ming Tang, Thomas Haeufel, Christian Thoma, Diamant Thaçi

2020-Current year OA Pubs

INTRODUCTION: Spesolimab, a selective, humanised monoclonal antibody targeting the interleukin-36 receptor, is approved for the treatment of generalised pustular psoriasis (GPP). As a result of the limited patient numbers in GPP trials of spesolimab, analysing safety events across dermatological and non-dermatological diseases helps to further characterise the known safety profile of spesolimab. Here, we analyse predefined safety events from nine randomised, placebo-controlled spesolimab trials across dermatological (including GPP) and gastrointestinal conditions.

METHODS: Predefined safety events were based on the known safety profile of spesolimab across all diseases investigated to date and potential risks of biological therapeutics, and included serious/severe/opportunistic infections, …

Prospective Observational Study Of Fkrp-Related Limb-Girdle Muscular Dystrophy R9: A Grasp Consortium Study, Lindsay N Alfano, Stephanie Hunn, Conrad C Weihl, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Limb-girdle muscular dystrophy R9 (LGMDR9, formerly known as LGMD2I), caused by variants in the fukutin-related protein (FKRP) gene leads to progressive muscle weakness of the shoulder and pelvic limb-girdles and loss of motor function over time. Clinical management and future trial design are improved by determining which standardized clinical outcome assessments (COA) of function are most appropriate to capture disease presentation and progression, informing endpoint selection and enrollment criteria. The purpose of our study was to evaluate the cross-sectional validity and reliability of clinical outcome assessments in patients with FKRP-related LGMDR9 participating in the Genetic Resolution and Assessments Solving …

Dubai’S Future Mobility: Systems Thinking & Scenarios, Mohammed Mazloum Hanafy

Theses

Transportation is one of the essential pillars of any smart city. The future of transportation in Dubai faces enormous hurdles in urban mobility, including a growing population density, congestion, and environmental issues. Without careful planning and policy actions, these problems would certainly worsen in the future. Thus, the purpose of this thesis is to investigate the future of urban mobility in Dubai and to suggest solutions for constructing a sustainable, efficient, and equitable transportation system by employing future foresight tools. Dubai has emerged in recent years as a global center for technological innovation, altering its built environment and reevaluating its …

Cross-Sectional Comparison Of Structural Mri Markers Of Impairment In A Diverse Cohort Of Older Adults, Julie K Wisch, Kalen Petersen, Peter R Millar, Omar Abdelmoity, Ganesh M Babulal, Karin L Meeker, Meredith N Braskie, Kristine Yaffe, Arthur W Toga, Sid O'Bryant, Beau M Ances, Habs‐Hd Study Team

2020-Current year OA Pubs

Neurodegeneration is presumed to be the pathological process measure most proximal to clinical symptom onset in Alzheimer Disease (AD). Structural MRI is routinely collected in research and clinical trial settings. Several quantitative MRI-based measures of atrophy have been proposed, but their low correspondence with each other has been previously documented. The purpose of this study was to identify which commonly used structural MRI measure (hippocampal volume, cortical thickness in AD signature regions, or brain age gap [BAG]) had the best correspondence with the Clinical Dementia Rating (CDR) in an ethno-racially diverse sample. 2870 individuals recruited by the Healthy and Aging …

Tuning A Secondary Dose Verification Software For A Ct-Guided Online Adaptive Delivery System, Xiaodong Zhao, Markus Baur, Phillip D H Wall, Eric Laugeman

2020-Current year OA Pubs

BACKGROUND: Quality assurance (QA) remains unstandardized for CT-guided online adaptive radiotherapy (CTgART) platforms (Ethos, Varian Medical Systems, Inc., Palo Alto, CA), as they become more clinically prevalent. A secondary dose calculation software (Mobius3D, Varian Medical Systems, Inc., Palo Alto, CA) is provided for this closed CTgART system. However, the clinical impact of tuning dosimetric leaf gap (DLG) correction values for specific delivery techniques for CTgART secondary dose calculations remains uninvestigated.

PURPOSE: Tuning the DLG correction value for different delivery techniques of the independent secondary dose verification software for adaptive online QA.

METHODS: A total of 31 volumetric arc therapy (VMAT) …

Gestational Weight Gain And Increased Risk Of Cesarean Delivery Across Body Mass Index Categories., Pearl A Mcelfish, Britni L Ayers, Nicola L Hawley, Aaron Caldwell, Austin Porter, Michael D Macechko, Donya Watson, Jennifer A Callaghan-Koru, James P Selig, Jennifer A Andersen, Nirvana Manning, Lanita White, Enrique Gomez-Pomar, Clare C Brown

Pediatrics Faculty Publications

BACKGROUND: Unnecessary cesarean delivery can have negative implications for both mothers and infants. In the United States, the proportion of women undergoing cesarean delivery exceeds the acceptable World Health Organization proportion. Reducing cesarean deliveries is a national goal of Centers for Disease Control and Prevention Healthy People 2030, the American College of Obstetricians and Gynecologists, and the Alliance for Innovation on Maternal Health.

OBJECTIVE: This study aimed to examine if excessive gestational weight gain is associated with increased risk of cesarean delivery across multiple body mass index categories.

STUDY DESIGN: Analysis was conducted using vital records data from the National …

February 2025, Pacific Alumni Association

Alumni News & Events

No abstract provided.

Industrial Policy In The Competition Between An Existing Hegemon And A Rising Superpower: The Case Of The Us And China, Kevin Honglin Zhang

Faculty Publications – Economics

Central to the current US-China geopolitical rivalry is the strategic use of industrial policy (IP) by both countries, which is an unexpected reverse of view on IP. This paper examines the role of IP in the economic competition between the US, the incumbent global hegemon, and China, the rising superpower. Both countries increasingly view IP as essential to winning the rivalry. While the methods differ –more market-driven in the US and more state-led in China - their IP reflects shared goals: securing technological leadership and strengthening national security through self-reliance. China’s IP works well in achieving scale, coordination, and technological …

Analyzing The Use Of The (Patrol) Early Warning Model In Assessing The Financial Performance Of The Banking Sector In Iraq, Haider Ali Saif-Allah, Salah Mahdi Abbas

Journal of Economics and Administrative Sciences

This paper describes the financial performance of the banking sector in Iraq using the PATROL early warning model. The research found the strengths and weaknesses in bank operations and forecasted the financial crises using data from 2018 to 2022 to enhance performance. The indicators included capital adequacy, credit risk, profitability, organizational efficiency, and liquidity, with performance rated on a scale from "very good" to "poor." Related findings proved that the Iraqi banks would be entirely successful in financial performance regarding most indicators and scaling-high in capital adequacy, profitability, organization, and liquidity, in accordance with sound management and robust operations. However, …