Digital Commons Network^™

Effect Of A Pressure Injury Prevention Bundle On Compliance And Staff Attitudes In A Medical Icu, Elizabeth L. Woods

International Nursing Research Congress (INRC)

Background: Hospital-acquired pressure injuries (HAPIs) are considered preventable yet remain prevalent in intensive care units (ICUs), where critically ill patients face increased risk due to immobility, hemodynamic instability, and complex care needs. This quality improvement (QI) project aimed to evaluate whether implementing a pressure injury prevention bundle (TEAMS) would improve compliance with preventive measures and staff attitudes toward HAPI prevention in a medical ICU.

Methods: A pre-post intervention design was conducted in a 17-bed medical ICU at a tertiary academic hospital. The TEAMS bundle included five components: Turn teams, Education, daily Assessments, a multidisciplinary approach, and daily Skin care. The …

Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …

Strategic Planned Preventive Maintenance To Promote Sustainability In Acute Care Hospitals, Samuel Ngounou

Walden Dissertations and Doctoral Studies

Despite advances in healthcare delivery, acute care hospitals often lack standardized strategic planned preventive maintenance (SPPM) protocols, resulting in equipment failures, higher costs, and disruptions to patient care. The purpose of this integrative review was to identify evidence-based best practices for implementing SPPM programs in acute care hospitals. The review question concerned the organizational practices and strategic approaches most effective for implementing an SPPM program. The Donabedian structure–process–outcome model represented the foundational framework for this review. The initial literature search yielded 110 articles. After further assessment, 27 studies were appraised using the Johns Hopkins Nursing evidence-based practice tools. Three low-quality …

A List Of The Vascular Plants Of Iowa, James P. Smith Jr

Botanical Studies

No abstract provided.

Patronage Pardons, Lee Kovarsky

Duke Law Journal

Abuse of presidential pardon power is taking a new and frightening turn. The Donald Trump administration is using clemency, including pardons, to signal impunity to regime allies contemplating misconduct. Such clemency has a predictable effect: it induces loyalist crime by reducing the expected penalty. "Patronage pardoning" refers to the clemency practices that power this loyalty-for-protection exchange. Those practices pose a grave threat to the rules-based constitutional order, and they are the subject of this Article.

Some historical observations predicate the diagnostic and prescriptive arguments that come later. Most importantly, the Framers concentrated federal pardon power in the president because they …

Ensuring "The Right To Live In The World": The Right To Repair Powered Wheelchairs, Maximillian J. Grahl

Duke Law Journal

Twenty-seven years ago, in Olmstead v. L.C., the Supreme Court held that improperly institutionalizing people with disabilities is a form of unlawful discrimination. In doing so, the Court acknowledged that people with disabilities have a right to live free from confinement. Yet today, repair restrictions and outdated Medicare standards combine to threaten powered-wheelchair users' ability to live out in the world. Some states have responded by passing right-to-repair laws, which require powered-wheelchair manufacturers and suppliers to provide the resources necessary for more accessible and more timely repairs. This Note analyzes these state laws in the context of previous right-to …

Private Equity For All: The Paradoxical Push To Democratize Private Markets, William W. Clayton, Elisabeth De Fontenay

Duke Law Journal

The recent push to open private equity and other private assets to retail investors represents one of the most profound changes to U.S. capital markets in decades. This "retailization" effort is often framed as an overdue democratization of superior investment opportunities. Indeed, private equity has long been viewed as special, both for its market-beating returns and its success in making companies more profitable. Yet it has historically been off-limits to retail investors.

This Article argues that the push to democratize private equity is subject to a glaring paradox: Expanding access to private equity undermines the very benefits that access aims …

Pyrolysis Of Biomass Feedstocks For Hydrogen-Enriched Syngas Production: Cold Gas Efficiency Modelling, Latin Hypercube Uncertainty Analysis, And Parametric Stress Analysis, Hadi Taghavifar, Thomas Allison, Hao Chen, Dibyendu Roy, Abdullah Malik, Yaodong Wang, Anthony Paul Roskilly, K.V. Shivaprasad

School of Engineering, Computing and Mathematics

Biomass-derived syngas offers a viable pathway for producing renewable, hydrogen-rich fuel gas. However, its conversion performance is influenced by feedstock type, temperature, feed rate, and moisture content. This study develops a Cold Gas Efficiency (CGE) model for four agricultural feedstocks: wheat, barley, oilseed rape, and beans. Temperature-dependent regression correlations are developed for the main syngas components and gas flow rate using experimental data. Results show that CGE is highly sensitive to temperature, with low-temperature stress (0–5th percentile) reducing mean CGE by up to 22%. High-moisture stress (95–100th percentile) produced an even larger decline, lowering mean CGE from ∼44% to ∼35% …

2026 Final Bpsou Backfill And Cover Material Quality Assurance Project Plan (Qapp), Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Powers' Conjecture On The Third Largest Eigenvalue Of A Graph, Kevin Schmidt

Master's Theses

In 1989, David Powers conjectured that for any connected graph G on n vertices, the k-th largest eigenvalue of the adjacency matrix satisfies λk(G) ≤ ⌊n/k⌋ for every 1 ≤ k ≤ n/2. The conjecture has since been resolved case by case, in the sharper form λk(G) ≤ n/k − 1: the case k = 1 is classical, k = 2 was settled independently by Hong and by Powers in 1988, and k ≥ 4 was shown to fail by Nikiforov and Linz. This thesis surveys the resolution of the remaining case, k = 3, achieved in March 2026 by …

Cognitive Impairment In Idiopathic Intracranial Hypertension: A Conceptual Framework And Therapeutic Implications, Brandon Shin, Vishnu Achyuth Suresh, Nicholas Borg

Student Publications

Background: Cognitive impairment is an increasingly recognized but poorly understood manifestation of idiopathic intracranial hypertension (IIH). Although deficits in attention, executive functioning, memory, processing speed, and reaction time have been reported, the characteristics, trajectory, and underlying mechanisms of cognitive dysfunction remain incompletely defined. Interpretation of the literature is limited by heterogeneity in study design, variability in neurocognitive assessment methods, and the absence of standardized cognitive outcome measures. Consequently, cognitive morbidity is overlooked in clinical practice and is not incorporated into treatment decision-making, which remains centered around visual outcomes and papilledema.

Methods: In this narrative review, we synthesize evidence from IIH …

Using Digital Engagement Methods To Balance Democracy And Efficiency In Public Decision Making, Catherine Zietse

PNHA Review

At the bedrock of our democratic society is the active participation of everyday people in shaping public affairs. Local governments seek to build inclusive and democratic processes for decision making, while at the same time being good stewards of scarce resources to efficiently address immediate needs of the community. This paper explores the role of digital engagement in balancing democracy and efficiency in public decision-making by looking at both theory and practice. Academic literature and case studies from the field show that technology and digital engagement platforms do not circumvent the risks of traditional engagement methods but provide both opportunities …

A New Age Of Leaders: Examining The Empowering Effect Of Collaborative Leadership In Nonprofit Organizations, Colton C. Hyble

PNHA Review

In the changing environment in the nonprofit sector, leaders are under increasing pressure to satisfy stakeholders and bring change to their communities. The collaborative leadership style, proposed and built upon by various authors in the twentieth century, is one potential solution. A theoretical analysis was conducted to understand the collaborative style, its strengths and weaknesses, and its applicability to the nonprofit sector. Results showed overwhelmingly positive findings in the impact on the organization, highlighted by increased organizational performance, a positive workplace environment, and superb employee job satisfaction. Few drawbacks and potential pitfalls exist in slowness, the possibility of a narrow …

Mental Health Standards In Michigan Juvenile Detention Facilities: At Odds With Best Practice And State’S Own Public Health Code, Jessica M. Montgomery

PNHA Review

This paper details the current standards and qualifications established for mental health providers in Michigan juvenile justice system (JJS) detention facilities. The state policies regulating JJS detention facilities are compared with Michigan’s Public Health Code Act (1978) and best-practice recommendations published by national mental health and juvenile justice authorities. This paper finds that Michigan policies regulating JJS detention facilities fall below both national best-practice recommendations and the state Public Health Code (1978), and effectively establish a standard of mental health care for youth in JJS detention facilities that is below what is established for youth in the general public. It …

Transforming Healthcare With Ai: The Illusion Of Control, Garrett L. Heaney

PNHA Review

Artificial intelligence is a new technology that has paved a path into the future for our healthcare sectors. This technology uses machine learning methods and big data to conduct its intended purpose within its designated parameters; however, researchers and consumers have experienced unintended outcomes. Artificial intelligence is deployed throughout our daily lives, so our society looks at this immense responsibility superficially. As organizational leaders experience short-sighted tunnel vision and push for innovative artificially intelligent programs, they do not realize the potential severe dangers.

This paper argues for a graded approach to studying and implementing artificially intelligent machines in healthcare. Our …

High Times Or Hazy Horizons? Michigan’S Cannabis Market As A Rural Economic Development Tool, Jakob L. Bigard

PNHA Review

Since legalizing cannabis for adult use in 2018, Michigan’s (recreational) cannabis market has become the second largest in the nation. As the state’s market sees rapid maturity, it serves as a model for other states with ongoing legalization efforts. Michigan’s actions, and others like it, have begun to impact movement at the federal level, with multiple cannabis-related bills being introduced in Congress to President Biden signing the first standalone marijuana reform bill earlier this month. As Michigan’s cannabis market continues to mature and grow, it deserves attention from economists and academics alike. Using traditional economic development metrics, this paper evaluates …

Adaptive, Complexity-Gated Prompt Optimization For Reducing Token Consumption In Large Language Model Agents, Saket Jain

Defensive Publications Series

A prompt pre-processing layer for large language model agents conditionally rewrites user prompts to reduce token consumption. For each prompt, a complexity score is computed from textual features such as the presence of file paths, the density of vague language, and the number of bundled tasks. The score is compared to a threshold: specific prompts are forwarded unchanged, while vague or multi-task prompts are transformed into a focused, scoped instruction before dispatch. Because rewriting is a low-cost text transformation gated on expected net savings, the system eliminates costly exploration and retry cycles for vague prompts without imposing any rewriting overhead …

Business Writing Performance And Instructional Practices Under English Medium Instruction: A Multisite Mixed-Methods Study Of Diploma Students In Saudi Arabia, Shaykhah Saeed Raffaa

UB Journal for Humanities

Saudi Arabia’s Vision 2030 treats English Medium Instruction (EMI) as a central instrument in vocational colleges, on the assumption that delivering content in English develops the professional literacies, business writing among them, that the labour market demands. This study examined business writing performance and the instructional practices associated with it among diploma students in Marketing and Business Administration at five Saudi public applied colleges, using a convergent mixed-methods design that combined a writing performance task (N = 130), a perceptions and affective-beliefs questionnaire (N = 130), semi-structured instructor interviews (N = 18), and structured classroom observations (N = 10). Because …

Expression Of Follicle Stimulating And Luteinizing Hormone Receptors In Porcine Testes After Timing The First Vaccination For Immunocastration, Sayamon Srisuwatanasagul, Rungrueang Yodsheewan, Amornthep Archawakulathep, Suvaluk Seesupa, Kongkiat Srisuwatanasagul, Atthaporn Roongsitthichai, Siriluck Juntautsa

The Thai Journal of Veterinary Medicine

This study aimed to examine the expression of follicle stimulating hormone receptor (FSHR) and luteinizing hormone receptor (LHR) in the testes of male fattening pigs based on the timing of the first immunocastration dose. A total of 24 male pigs were randomly assigned to 3 groups: C (n=8) consisted of only intact pigs, T1 (n=8) contained those immunocastrated at 15 and 19 weeks of age, and T2 (n=8) was composed of those immunocastrated at 9 and 19 weeks of age. The expression of FSHR and LHR was evaluated using H-score from immunohistochemistry and protein band intensity from Western blotting. Immunohistochemistry …

The Thank-All-Nearby Primitive: One-Tap Anonymous Gratitude Transfer To Everyone Nearby Over Bluetooth Low Energy Proximity, Thon Ly

Defensive Publications Series

We specify a one-tap broadcast operation for anonymous peer-to-peer value transfer to every co-present, human-verified recipient within Bluetooth Low Energy (BLE) proximity, optionally carrying money or time, in which each recipient receives a verifiable receipt and the sender receives no exportable record. The recipient set is resolved by physical co-presence rather than account lookup: devices advertise rotating, unlinkable proximity beacons, with ultra-wideband ranging and peer-to-peer nearby-connection APIs as optional substrates, and the platform learns only that two devices were in range, never absolute location. Components: (1) sender authentication by a per-action passkey signature, within a proof-of-humanity layer attesting a distinct …

Respiratory Biofeedback Coupled To Ai-Mediated Contemplative Guidance: A Wearable Closed-Loop Breathing Sensor With Adaptive Audio Meditation Guidance, Thon Ly

Defensive Publications Series

This disclosure specifies a closed-loop respiratory biofeedback system: a chest-worn wearable respiration sensor (respiratory inductance plethysmography, with inertial and acoustic alternatives) streams breathing rate, depth and rhythm, in privacy-preserving form, to an AI meditation-guidance agent, which returns adaptive audio guidance to the wearer in real time. The device also renders the breath visibly, as ambient light modulated to the breathing cycle, so the practitioner receives continuous external feedback and the guidance agent receives a live physiological signal rather than self-report.

Three aspects are disclosed as prior art: (I) the integrated closed loop — sensor, on-device processing, guidance agent grounded in …

Aura-Gated Anonymous Mate-Selection: Online Dating Matching Gated On A Verified Record Of Prosocial Giving, With Mutual Anonymous Opt-In, Thon Ly

Defensive Publications Series

We specify an online dating matching system in which discovery is gated on a reputation built from anonymous gratitude records instead of photographs, and a match fires only on mutual anonymous interest between users verified as real humans. The reputation (termed "aura") aggregates thank-you acknowledgments a user has received from many nearby verified strangers over a long period; no individual acknowledgment is read, and it changes only a user's ordering in a local anonymous pool, never anyone's obligation to respond. No photographs appear in discovery. The match trigger requires each of two users to independently and anonymously give time to …

The Time-Locked Gift Tag: Qr- And Nfc-Addressed Gift Labels With Scheduled Reveal Of The Message, The Sender And A Pledge Of Time, Thon Ly

Defensive Publications Series

We specify a QR- or NFC-addressed physical gift label that replaces a handwritten gift tag with a scanned, time-locked reveal: the sender, recipient and message fields are each independently sealed and released at a chosen date or occasion. Scanned before that moment, a web page shows the structure of the gift (which sealed fields exist, with a countdown) but not their content; re-scanning the label at or after the moment unlocks the fields without an app install. Beside the message, the label carries a pledge of the giver's own time to the recipient, rendered as an offer of presence with …

Decided By No One: Publicly Verifiable Random Selection And Round-Robin Rotation From A Committed Roster And A Public Randomness Beacon, With A Time-Locked Sealed Regime, Thon Ly

Defensive Publications Series

This disclosure specifies a publicly verifiable random selection method for allocating turns and oversubscribed admissions. The output is a pure function of inputs committed before the seed can be known (a frozen roster, a salt and the algorithm version, bound into a hash commitment on an append-only, externally timestamped log) and of a seed taken from a named future round of a threshold public randomness beacon, so anyone holding the disclosed inputs can recompute the result.

Two forms share one keyed shuffle. The turn form deals every roster member exactly once per round in an unpredictable order, records an absence …

Provenance-Carrying Retrieval: Hash, Timestamp And Source Binding For Retrieval-Augmented Generation, Thon Ly

Defensive Publications Series

We specify a retrieval-augmented generation (RAG) response format in which every document a retrieval server returns to a language model carries a provenance envelope binding the served text to a cryptographic hash of a named, fetchable source file, at least one timestamp independent of the server (an RFC 3161 time-stamp authority, an OpenTimestamps Bitcoin anchor, or a transparency log), and, where available, a persistent identifier (DOI). The envelope also carries a scope statement declaring what the hash covers relative to the served text (whole source, excerpt, or derived rendering), an explicit "no anchor" statement rather than silence when none exists, …

The Reciters' Protocol: Content Integrity Verification, Completeness Manifests And Variant-Preserving Text Retrieval Transposed From Oral Canon Transmission, Thon Ly

Defensive Publications Series

This disclosure specifies content integrity verification and provenance mechanisms for text retrieval systems that serve quoted passages to machine readers, transposed from a multi-recension oral canon transmitted for roughly two millennia without an authoritative copy (the Pāli Buddhist canon).

A conformance endpoint accepts a claimed quotation, compares it with the served multi-recension corpus, and returns one of a closed set of dispositions on the claim, including a conforming variant with its witness, each paired with a prescribed next action and by construction none on the claimant; closed disposition sets are anticipated by OCSP; the composition is disclosed. A separated completeness …

Whose Turn, Not Who's Best: Round-Robin Rotation Over A Boolean Liveness Predicate For Unranked Local Business Discovery, Thon Ly

Defensive Publications Series

We specify an unranked local-business discovery system in which candidates are ordered by a publicly verifiable round-robin rotation (algorithm, per-cycle seed and recomputation tool published) and admitted by a boolean activity predicate instead of a ranking score. Admission asks only whether a participant's account balance has returned to zero within one published, global time window; amplitude and volume are excluded, so admission is a rate that cannot be accumulated or purchased. The discovery turn belongs to the payer, not the merchant: candidates are presented when a user spends from a forward-only, locality-restricted gratuity account, so the system has no merchant-facing …

Offshore Ai Data Center Platform — Version 2.0 (Oadc-P V2.0) Self-Sustaining Marine Compute Infrastructure With Closed-Loop Resource Recovery, Ocean Plastic Feedstock, And Maritime Ai Revenue, Michael Victor Caldwell Mr.

Defensive Publications Series

OADC-P v2.0 is an offshore platform hosting 10–100 MW of AI compute that:

• Generates its own power from proven offshore wind + wave + solar

• Cools chips directly with seawater via vortex-enhanced TPMS cores

• Produces fresh water as a marketable revenue product (RO + condensation)

• Collects and converts ocean plastic debris into backup fuel (CIMFR-1.0)

• Processes brine concentrate into mineral products (near-zero discharge)

• Is future-proofed for quantum AI compute via deep cold seawater precooling

• Serves maritime AI inference to the shipping industry at 1–5 ms latency

The result is a platform whose non-compute revenue streams (water + ocean plastic fuel …

Timing-Aware Path Computation And Clock Selection For Ptp In Sr-Mpls And Srv6 Based Networks Using Flex-Algo, Anonymous

Defensive Publications Series

Disclosed is a framework for timing-aware path computation and clock source selection for Precision Time Protocol transport in Segment Routing networks. New IS-IS node and link sub-TLVs advertise timing quality into the routing control plane, the node sub-TLV carrying constant time error, telecom clock type, and clock class, and the link sub-TLV carrying packet delay variation. A dedicated Flexible Algorithm instance for PTP backhaul uses cumulative constant time error as its optimization metric and excludes any link whose packet delay variation exceeds a configured threshold. A prefix segment identifier or SRv6 locator mapped to that algorithm, anchored on the grandmaster …

System And Method For Asynchronous Network Simulation Telemetry, Topological Environment Remediation, And Generative State-Machine Security, N/A

Defensive Publications Series

An automated, state-aware network orchestration and evaluation platform provides asynchronous security exercise assessment and environment management. The platform initializes isolated virtual guest environments by executing guest agent software that dynamically generates unique boot-time cryptographic artifacts and sends them to a centralized evaluation engine to dynamically compile a grading rubric. User submissions are evaluated using a dual-pipeline generative language model configured with a strict schema contract that concurrently determines semantic equivalence and detects structural anomalies or prompt injection attempts. Trainee progression across simulation objectives is tracked using a topological directed acyclic graph that triggers automated hypervisor commands to mutate guest environment …