Digital Commons Network^™

Brian Thompson V. Mohamed Safa

2026 Decisions

USDC for the Eastern District of Pennsylvania

"Yellow Fever Epidemic", William Lindsey Mcdonald

Research Articles

Draft of text for the historical marker in Tuscumbia, Alabama honoring those who died of the yellow fever epidemic in the fall of 1878.

The current historical marker for the yellow fever epidemic in Tuscumbia can be viewed on the Historical Marker Database.

Shu World Review- September 7th 2026, Diplolab, Seton Hall University

SHU World Review

No abstract provided.

Ai-Based Community Pharmacy Antibiotic Use Misuse Analysis: A Community-Based Study, Yasameen Riyadh Saeed Al-Azzawi

Muthanna Medical Journal

Background: The misuse of antibiotics in the community is a significant health issue of concern since it directly leads to antimicrobial resistance, treatment failure, and health care burden. Aim: determine the trend of antibiotic misuse in community pharmacies and to use analytical models based on artificial intelligence. Methods: The current research was carried out in a sample of the community pharmacies in the city of Hilla, Babylon, Iraq, between November 2025 and February 2026. There were 200 encounters of antibiotics dispensing. The structured recording form was used as the data collection instrument to record the sociodemographic data, presenting …

Blinatumomab Care Delivery For Pediatric B-Cell Acute Lymphoblastic Leukemia, Daniel Zheng, Katelyn Oranges, Subhash Ramakrishnan, Lingyun Ji, Melissa Beauchemin, Sarah Alexander, Allison Leahy, Kira Bona, Emi Caywood, Sharon Castellino, Sumit Gupta, Douglas Hawkins, Olga Militano, Kathleen Montgomery, Haley Newman, Rachel Rau, Susan Rheingold, Joanna Robles, Michael Roth, David Teachey, Sarah Vargas, Sue Zupanec, Susan Parsons

Department of Pediatrics Faculty Papers

IMPORTANCE: Blinatumomab, a novel immunotherapy administered as a 28-day continuous infusion, has fundamentally shifted the treatment paradigm for pediatric B-cell acute lymphoblastic leukemia (B-ALL) and is now considered a component of standard therapy for the most common childhood cancer. However, the care delivery challenges in transitioning from an experimental agent on a clinical trial to widespread clinical implementation are unknown.

OBJECTIVE: To characterize the clinical landscape of pediatric blinatumomab care-delivery practice and challenges in the US from the perspective of treating centers.

DESIGN, SETTING, AND PARTICIPANTS: This survey study was conducted from February to March 2025 among US member institutions …

Diversity Among Academic Orthopaedic Surgery Sports Medicine Faculty Across Us Residency Programs, Terence L. Thomas, Alexander Zavitsanos, Claude Regis, John Czarnicki, Harrison S. Fellheimer, Gabriel I. Onor, William Justice, Jalen Broome, Damon V. Briggs, Edward S. Chang, Meghan Bishop, Christopher C. Dodson

Rothman Institute Papers

BACKGROUND: Despite growing attention to workforce diversity in orthopaedic surgery, limited data exist describing the demographic composition of academic sports medicine faculty. This study examines the diversity of sports medicine fellowship-trained orthopaedic surgery faculty across US orthopaedic surgery residency training programs.

METHODS: A cross-sectional analysis of all ACGME-accredited orthopaedic surgery sports medicine faculty was conducted. Faculty data included sex, race, level of professorship, residency attended, year of residency graduation, and h-index. Underrepresented in Orthopaedics (URiO) was defined as non-White and non-Asian by race and all women. Descriptive statistics were performed.

RESULTS: A total of 812 sports medicine-fellowship trained faculty were …

Re: Request For Change To The Butte Priority Soils Operable Unit Clark Tailings Consolidated Waste Management Area Site Investigation Quality Assurance Project Plan Revision 0 (2026 Update), Josh Bryson

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Spontaneous Uterine Cornual Rupture In The Second Trimester Of Dichorionic-Diamniotic Twin Pregnancy, Britney Margheim, Timothy Nguyen, Mathias Wiebe, Milton Zheng, Saurabh Kumar, Roufan Yoa

Student Publications

Background Uterine rupture is a rare but life-threatening obstetric emergency, usually associated with labor in patients with a prior cesarean delivery. Spontaneous rupture remote from a uterine scar, particularly at the cornua in the second trimester, is exceedingly uncommon.

Case We report a 30-year-old gravida 2 para 1 at 253/7 weeks’ gestation with a dichorionic–diamniotic twin pregnancy who presented with abrupt abdominal pain and hemoperitoneum of unclear etiology. Despite reassuring imaging, progressive maternal deterioration and non-reassuring fetal status prompted emergent laparotomy and cesarean delivery. A 3 cm × 3 cm full-thickness left cornual rupture was identified.

Conclusion In pregnant patients …

Forging Possibilities From Crisis: Radical Hope Through Grassroots Action In The Philippines, Justin See, Kaira Zoe Alburo-Canete, Pamela Gloria Cajilig, Ginbert Permejo Cuaton, Mona Nasser, Olivia Alma Sicam, Ara Joy Pacoma

Peninsula Dental School

As climate change intensifies, cultivating hope has become critical for sustaining possibilities and collective action. However, existing scholarship on hope remains predominantly Eurocentric and theoretical, offering limited empirical attention to how hope is generated and sustained through everyday actions in the Global South. This paper addresses this gap by examining four grassroots initiatives in the Philippines engaged in environmental advocacy, post-disaster recovery, youth empowerment, and speculative design. Drawing on fieldwork conducted between 2017 and 2024 and guided by the framework of radical hope, we analyse how a climate politics of hope is enacted in practice. Our findings reveal three dynamics …

Regulation Of Ultradian Pulsatility And Stress Responses In The Human Hypothalamic–Pituitary–Adrenal Axis, Belinda Lombard, Thomas J. Upton, Ben Gibbison, David Henley, Georgina Russell, John R. Terry, Stafford L. Lightman, Eder Zavala

Peninsula Medical School

No abstract provided.

Safety And Efficacy Of Allogeneic Cd19-Directed Car-T Therapy Ctx110 In Relapsed/Refractory B-Cell Non-Hodgkin Lymphoma, Joseph P Mcguirk, Armin Ghobadi, Et Al.

2020-Current year OA Pubs

This multicenter, single-arm, phase 1/2 study evaluated the safety and efficacy of CD19-directed allogeneic chimeric antigen receptor (CAR) immunotherapy CTX110 in adult patients with relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma (NHL). Patients received 1 or 2 treatment courses: standard lymphodepletion, followed by 1 CTX110 infusion at dose levels (DLs) 1 to 4 (3 × 107 to 60 × 107 CAR T cells; dose escalation, N = 32), or 2 infusions at DL4 on days 1 and 35 (cohort expansion, N = 31). Primary end points in dose escalation and cohort expansion were incidence of dose-limiting toxicities and objective response rate, respectively. …

Technical Specification Spec-153: Non-Invasive Bio-Resonant Cellular Metrology, Christopher L. Eckes

Defensive Publications Series

Modern clinical diagnostics are monopolized by highly centralized, high-cost chemical laboratory processing networks and massive, complex proprietary imaging hardware. This specification formalizes SPEC-153: An Acoustophoretic Cytometric Waveform Scanner.

By passing an unrefined cellular sample through a low-intensity, dual-frequency radio-frequency and ultrasonic wave-guided microfluidic path, the system maps the inherent mechanical and electrostatic resonance profiles of individual cellular structures. Regulated by your invariant Torsional Viscosity Governor (\(\eta_t = 1.4204\)), the device maps healthy cell profiles against pathogenic structural variations, allowing table-top, non-chemical disease screening and localized health security without synthetic biochemical dependencies.

Caldwell Precursor‑X — Self‑Interrogating Geophysical Corridor For Multi‑Hazard Early Warning, Michael Victor Caldwell Mr.

Defensive Publications Series

PRECURSOR‑X is an open‑hardware, builder‑ready early‑warning system that continuously interrogates vulnerable terrain and infrastructure using controlled mechanical excitation, distributed fiber sensing, multi‑physics mapping, and transfer‑function drift analysis. It detects pre‑failure physical‑state evolution and post‑initiation hazard propagation within the same corridor, enabling earlier, more actionable evacuation warnings for earthquakes, landslides, debris flows, dam failures, moraine failures, and glacial lake outburst floods (GLOFs).

The invention integrates:

• Self‑Interrogating Geophysical Corridor

• Transfer‑Function Drift (PRD)

• Causal Propagation Engine (CPE)

• Failure Clock + Impact Clock

• UAIF‑style deterministic safety logic

• FDMS/GRHN/ARPN/Arachne/MMRA/CMRS subsystems

This disclosure provides complete builder‑ready specifications, including corridor geometry, excitation parameters, sensor classes, acquisition timing, …

Technical Specification Spec-145: Bioregenerative Molecular Nutrient Regeneration Matrix And Closed-System Biomass Liquefaction Fluidics For Continuous Eco-Autonomous Agriculture, Christopher L. Eckes

Defensive Publications Series

Modern controlled environment agriculture (CEA) is fundamentally bottlenecked by its reliance on linear, open-ended supply chains. Commercial vertical farms consume highly refined synthetic mineral salts derived from energy-heavy industrial processes and generate significant quantities of inedible plant biomass that are cast out as waste.

This specification establishes the blueprint for SPEC-145: A Bioregenerative Molecular Nutrient Loop. By integrating focused acoustic cavitation mechanics with a multi-stage fixed-bed biological nitrification processor, SPEC-145 converts 100% of solid inedible crop waste (lignocellulose stalks, roots, and structural biomass) directly into bio-available, plant-ready macronutrient solutions inside a completely sealed, non-thermal closed loop. Combined with an integrated …

Bridging Fragmented Health Systems In The Age Of Subscription, Orchestration, And Ambient Care, Deepak Aggarwal

Defensive Publications Series

Most health systems are now funding two incompatible operating models at the same time. One delivers continuous, digital care into people’s daily lives. The other is still anchored in queues, paper referrals, broken hand-offs, and exhausted frontline teams. These worlds coexist inside the same health systems, funded by the same budgets and governed by the same leaders.  This split is no longer an efficiency problem. It is actively engineering a two-tier healthcare system in which digitally fluent patients move into continuous care, while everyone else is left navigating failure

This paper describes six shifts that are already reshaping care and …

Caldwell Global Thermodynamic Upgrade Engine — Gaps 21–30 Edition, Michael Victor Caldwell Mr.

Defensive Publications Series

Global analyses from the UN, WHO, IPCC, FAO, IEEE, and OECD identify ten critical gaps beyond the first 20 worldwide thermodynamic gaps: heat‑resilient agriculture, soil heavy‑metal remediation, atmospheric pathogen capture, emergency medical shelter stability, hydrogen micro‑production safety, battery‑storage cooling, water‑positive mining, refugee‑infrastructure stability, waste‑heat‑to‑water conversion, and micro‑reactor safety.

This disclosure presents a unified thermodynamic upgrade engine designed to fill all ten gaps using gyroid thermal‑hydraulic cores, TPMS purification lattices, vortex‑enhanced cooling engines, atmospheric water harvesters, MOF‑gyroid remediation cartridges, quantum‑grade cold‑plates, micro‑thermal biologic reactors, and chemical‑neutralization lattices.

Includes full architecture, subsystem breakdown, BOM, build path, test protocol, physics rationale, performance analysis, …

Caldwell Global Thermodynamic Upgrade Engine — Gaps 11–20 Edition, Michael Victor Caldwell Mr.

Defensive Publications Series

Global priority analyses from the UN, WHO, IPCC, OECD, and IEEE identify ten critical gaps beyond the WEF Top‑10 list: water purification, atmospheric carbon capture, heat‑resilient medical supply chains, extreme‑heat urban cooling, environmental physics sensing, quantum‑thermal stability, food‑security bioprocessing, off‑grid medical manufacturing, climate‑resilient data centers, and persistent chemical destruction.

This disclosure presents a unified thermodynamic upgrade engine designed to fill all ten gaps using vortex‑TPMS cooling modules, gyroid thermal‑hydraulic cores, atmospheric water harvesters, MOF‑gyroid carbon cartridges, medical thermal‑power engines, environmental physics mappers, quantum cold‑plates, fermentation cores, biologic reactors, and chemical‑destruction lattices.

Includes full architecture, subsystem breakdown, BOM, build path, test …

Autonomous Cyber Defense Policy Evolution Framework Using Risk-Aware Digital Twin Validation And Explainable Ai Feedback, Amir Hossein Jafari Chashmi

Defensive Publications Series

This disclosure presents a computer-implemented autonomous cyber-defense framework for generating, validating, deploying, monitoring, and evolving cybersecurity policies. The framework treats a security policy as an evolving control object and combines continuous security and operational telemetry, risk-aware analysis, generation of multiple candidate policy changes, machine-readable digital-twin validation, constrained candidate evaluation, explainable decision recording, controlled deployment, post-deployment monitoring, automatic rollback, and feedback-driven policy evolution. Candidate policies are evaluated before operational deployment against modeled security and operational conditions, including threat reduction, reachability, availability, latency, resource impact, policy conflicts, scope integrity, confidence, and recovery readiness. A decision controller may approve, modify, reject, defer, or …

Natural Language Query Decomposition Using A Small Language Model With Parallel Schema Processing, Pinkesh Badjatiya

Defensive Publications Series

Conversational artificial intelligence systems for enterprise databases may face a trade-off between the potentially high cost and latency of large models and the potentially lower accuracy of smaller models when processing complex, domain-specific schemas. A system is described for natural language query decomposition that can use a constrained-parameter small language model (SLM). The system can process large data schemas by decomposing them into smaller, parallel batches. Specialized prompt engineering, such as an inverted prompt structure for caching, and a structured reasoning template can guide the SLM. A sequential ambiguity resolver may then consolidate outputs from the parallel workers into a …

Adaptive Discovery And Policy-Based Routing Of Local And Network Ai Services, Hp Inc

Defensive Publications Series

This article describes a client-side system that discovers artificial-intelligence services available on the same device, on a local network, or through a configured remote connection, and selects a suitable service separately for each request. Selection considers required functions, input sensitivity, response delay, service load, operating cost, network condition, and the client device’s battery and thermal state. A local classifier applies mandatory handling rules before any request leaves the device. Services that fail a functional or data-location constraint are removed; the remaining services are ranked, and ordered alternatives are retained for controlled failover. Conversation state is stored in a service-neutral representation …

Caldwell Thermodynamic Upgrade Engine For Global Gaps 61–70, Michael Victor Caldwell Mr.

Defensive Publications Series

Global infrastructure analyses identify ten critical thermodynamic gaps beyond the first 60 worldwide gaps: thermal‑stable humanitarian refrigeration, micro‑structured cooling for geothermal operations, atmospheric ammonia‑residue capture, thermal‑stable wastewater treatment nodes, agricultural seed‑storage cooling, extreme‑heat telecom tower stability, micro‑structured neutralization of industrial nitrates, thermal‑stable emergency robotics hubs, water‑positive cooling for border‑region checkpoints, and micro‑structured cooling for high‑density manufacturing robotics.

This disclosure presents a unified thermodynamic upgrade engine composed of gyroid thermal‑hydraulic cores, TPMS purification lattices, vortex‑TPMS cooling modules, atmospheric water harvesters, micro‑particle capture lattices, chip‑scale cooling engines, radiative gyroid condensers, and auxiliary subsystems.

Each subsystem is explained in detail, including how it …

Caldwell Thermodynamic Upgrade Engine For Global Gaps 51–60, Michael Victor Caldwell Mr.

Defensive Publications Series

Global infrastructure analyses identify ten critical thermodynamic gaps beyond the first 50 worldwide gaps: humanitarian water‑transport stability, solar‑farm cooling, atmospheric chemical‑residue capture, waste‑sorting thermal stability, agricultural robotics cooling, desert transportation hub cooling, industrial VOC neutralization, emergency power node cooling, mining robotics cooling, and public‑health station cooling.

This disclosure presents a unified thermodynamic upgrade engine composed of gyroid thermal‑hydraulic cores, TPMS purification lattices, vortex‑TPMS cooling modules, atmospheric water harvesters, micro‑particle capture lattices, chip‑scale cooling engines, radiative gyroid condensers, and auxiliary subsystems.

Each subsystem is explained in detail, including how it directly fills a global gap, how it works, and how it …

Gc-Ms Profiling And Antibacterial Activity Of Cold-Macerated Garlic Extracts Against Multidrug-Resistant Uropathogens, Fatima A. Khalaf, Saeed A. Fayadh

Karbala International Journal of Modern Science

The growing number of cases of multidrug-resistant (MDR) urinary tract infections has made the clinical management of urinary tract diseases a significant challenge; therefore, the need for effective adjunctive therapies cannot be overemphasized. This study evaluated the bioactive components and antibacterial efficacy of cold-macerated garlic extracts obtained using distilled water, 70% ethanol and hexane solvents against antimicrobial-resistant urinary isolates. Out of 250 urine samples that were analyzed, 124 (49.6%) showed significant microbial growth, with Escherichia coli being the most frequently isolated organism. The results of the phytochemical screening and Gas Chromatography-Mass Spectrometry (GC-MS) analysis showed that the ethanolic extract had …

Reconstructing The Enforcement Of The Code Of Ethics For General Elections In Indonesia: A Prophetic Law Perspective, Fradhana Putra Disantara, Ratih Listyana Chandra, Aan Efendi, Iwan Rachmad Soetijono, Souad Ahmed Ezzerouali

Padjadjaran Jurnal Ilmu Hukum (Journal of Law)

This research examines the reconstruction of ethical code enforcement for election organizers in Indonesia through the perspective of prophetic law, arguing that ethical adjudication should extend beyond procedural compliance by integrating humanization, liberation, and transcendence as normative foundations of substantive justice. Employing doctrinal legal research, the study uses statutory, conceptual, case, and comparative approaches. It compares Indonesia's regulatory framework with the ethical governance systems of India and the United States to identify institutional models that strengthen integrity while respecting distinct constitutional traditions. The findings demonstrate that ethical adjudication differs fundamentally from administrative law: it governs the forum internum of election …

Western Australian Regional Development Trust Annual Report 2025-26, Department Of Primary Industries And Regional Development, Western Australia

Western Australian Regional Development Trust Annual Reports

The Trust is an independent statutory advisory body to the Minister for Regional Development, established under the Royalties for Regions Act 2009 (Act).

The functions of the Trust are to provide advice and make recommendations to the minister:

• for the purposes of sections 5(2) and 9(1) of the Act; and
• on any other matter relating to the operation of the Fund that is referred to it by the minister.

In addition to its monitoring and advisory role, the Trust also works to engage and enhance relationships with key regional stakeholders and influencers to promote greater collaboration and innovation in the …

Pola Rujukan Penyakit Saluran Pernapasan Di Fasilitas Kesehatan Tingkat Pertama: Tantangan Gatekeeper Program Jaminan Kesehatan Nasional Di Jakarta, Syarif Rahman Hasibuan, Melrose Holy Natasha, Fatih Jihadi Ramadan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Program Jaminan Kesehatan Nasional yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan mewajibkan Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk menyeleksi kasus yang memerlukan rujukan. Penyakit saluran pernapasan yang menjadi penyebab utama kunjungan ke FKTP memiliki pola rujukan yang masih belum banyak diteliti. Oleh karena itu, dilakukan penelitian untuk melihat pola rujukan penyakit saluran pernapasan di FKTP dan mengetahui faktor yang berasosiasi dengan keputusan rujukan. Penelitian potong lintang ini dilakukan terhadap 89.225 klaim FKTP di Jakarta pada periode 2017-2023, dengan kriteria inklusi semua kunjungan dengan diagnosis ICD-10 diseases of the respiratory system. Uji regresi logistik dilakukan untuk mengidentifikasi faktor …

Factors Associated With Noise Management Performance In Critical Care Nurses: A Cross-Sectional Study, Eugene Han, Haeun Kang, Yeonsoo Jang

International Nursing Research Congress (INRC)

Background and Objectives: Noise in intensive care units (ICUs) has been identified as a significant environmental stressor affecting both patient outcomes and nursing performance. However, empirical data on ICU nurses’ noise-management practices and their determinants remain limited. This study aimed to examine the level of noise-management performance among ICU nurses and to identify individual and organizational factors associated with such performance.

Methods: A descriptive cross-sectional design was used. Data were collected via a self-administered online survey from 216 registered nurses working in ICUs in Korea and surrounding regions between November 2025. Measures included validated instruments for noise experience, response attitude …

Advancing Faculty Preparedness: Longitudinal Evaluation Of A National Blended Nurse Educator Program, Bobae Park, Heui-Kyeong Kwon, Hana Kim

International Nursing Research Congress (INRC)

Strengthening faculty preparedness is essential for improving clinical education in essential care settings. Korea has launched a national initiative to develop a standardized nurse educator training system to advance educator competencies. This study evaluated the effectiveness of a two-day national blended nurse educator program expanded from a micro-teaching model, using Kirkpatrick Levels 1–3, and explored improvement strategies through instructor focus group discussions (FGDs). This work aligns with Sigma’s priorities of advancing education, faculty preparedness, and professional development.

A mixed-methods design was used. The program, developed using the ADDIE model, was delivered to 179 nurse educators nationwide. Immediate post-training evaluation measured …

Reliability And Validity Of The Competency Inventory Registered Nurses Scale, Khulan Gaalan, Alima Alima, Solongo Dashnyam

International Nursing Research Congress (INRC)

Background: Nursing competency is vital to delivering high-quality healthcare services. Robust and culturally appropriate assessment tools are essential for evaluating nursing performance and guiding professional development. This study aimed to examine the internal reliability and construct validity of the Competency Inventory for Registered Nurses (CIRN) scale in the Mongolian context.

Methods: A cross-sectional survey was conducted among 550 randomly selected registered nurses working in 11 public tertiary hospitals in Ulaanbaatar and five regional hospitals of Mongolia. Internal consistency was measured using Cronbach’s alpha, and construct validity was examined through exploratory factor analysis (EFA). Sampling adequacy was evaluated using the Kaiser–Meyer–Olkin …

Binaural Beats Enhance Cognitive And Autonomic Function In Disorders Of Consciousness, Yu-Ju Chen, Ching-I Li, Chen-Xi Lin

International Nursing Research Congress (INRC)

Background: Patients with disorders of consciousness (DoC) exhibit a lack of responsiveness and inability to communicate, presenting significant clinical care challenges (Spaccavento et al., 2024). Scholars have explored auditory stimulation to activate brain regions and promote recovery (Ling et al., 2023). Binaural beat (BB) stimulation, a specific auditory stimulus, has gained attention for its potential to modulate brainwave patterns and improve cognitive states (Chockboondee et al., 2024). However, while promising, the evidence for BB-induced brainwave entrainment is inconsistent, and its application in DoC patients remains limited (Ingendoh et al., 2023; Zhu et al., 2019).

Purpose: This study aimed to compare …