Digital Commons Network^™

Hope In The Holler: How Eminent Domain Can Bring Economic Justice To Central Appalachia, Matthew B. Chaney

Kentucky Law Journal

No abstract provided.

History And Tradition Of Inequality, Advocacy, And Progress, Teri Dobbins Baxter

Kentucky Law Journal

No abstract provided.

States Strip Local Governments Of Authority To Govern Causing Some Rural Communities To Suffer, Terence J. Centner

Kentucky Law Journal

No abstract provided.

Arbitration Clause Expansion, Hossein Fazilatfar

Kentucky Law Journal

No abstract provided.

The New Parens Patriae, Meredith Johnson Harbach

Kentucky Law Journal

No abstract provided.

Unified Authentication And Intelligent Orchestration Of Remote Sessions For Continuous Access In Failure Scenarios, Hp Inc

Defensive Publications Series

This disclosure describes a unified authentication system for single sign-on (SSO) and an orchestration component that maintains continuous remote access to a compute device across system states, including pre-boot, boot, and post-boot. A user authenticates once via a centralized identity service, and the resulting authentication artifact (e.g., token, assertion, certificate, or derived session credential) is consumed by both a hardware-based out-of-band (OOB) remoting path and a software-based in-band remoting path. An orchestration agent brokers session establishment and performs a controlled handoff between remoting paths without requiring the user to reauthenticate, enabling smooth transitions during operating system failures, reboots, and recovery.

Time-Travel Replay Tokens Using Consistent Cross-Domain Snapshots, Dennis Lanov

Defensive Publications Series

Time-travel replay tokens using consistent cross-domain snapshots provide a control-plane system and technique for making multi-domain network changes repeatable. The system captures a consistent snapshot boundary across participating controllers and mints a signed token that binds an intent to the previews, rollback handles, and state references used to plan the change. Before execution, each domain must prove that the domain still conforms to the token boundary. If any required domain has drifted, the token is rejected and the system re-snapshots and re-plans instead of applying a stale decision. As a differentiator from ordinary snapshots, rollback, or audit logging, the token …

Anatomy Of Success: Unveiling Key Resources For A Stand-Alone Occupational Therapy Anatomy Course, Annika Knuth, Sophia Wilkes, Julia Huber, Graci Leineberg, Rebecca Ozelie

Student Journal of Occupational Therapy

Anatomy is a complex curriculum involved in occupational therapy education. This study aimed to investigate occupational therapy (OT) students’ perceived usefulness of resources offered in a stand-alone anatomy course within their program. A survey was administered to 284 OT students enrolled in accredited programs who had completed a stand-alone anatomy course. The survey assessed the resources available, their usage, and the perceived benefit to students' learning. Results indicated that open labs and teaching assistants were perceived as the most valuable resources for student success, while print/electronic textbooks and office hours were perceived as the least beneficial. These findings suggest that …

Artificial Neural Network-Based Diagnosis Of Wind Turbine Blade Faults Using Vibration Analysis At Constant Operational Speed, Zeashan Hameed Khan, Shabbir Ahmad, Ali Habeeb Askar

Terra Joule Journal

Wind turbine blade faults, such as surface erosion, cracks, mass imbalance, and twist deformation, significantly compromise operational efficiency and reliability, thereby increasing maintenance costs. This research presents an artificial neural network (ANN)-based diagnostic approach for identifying five distinct fault states in wind turbine blades using vibration signal data collected at a constant operational speed of 1.3 m/s. The dataset, which encapsulates real-world vibration responses under varying fault conditions, was analyzed to extract amplitude features for classification. A balanced dataset of 500 samples per class was used to ensure robust training and evaluation. The ANN model achieved highly reliable performance, with …

Transcriptomic Profiling Of The Donkey Endometrium Reveals Dynamic Molecular Transitions Across The Estrous Cycle, Limeng Shi, Shuaishuai Wu, Mingyue Zhao, Wenhao Zhou, Abd Ullah, Muhammmad F. Akhtar, Changfa Wang, Muhammad Z. Khan, Ying Han

The Thai Journal of Veterinary Medicine

The endometrium undergoes extensive cyclical remodeling essential for reproductive success; however, the molecular mechanisms governing these processes in donkeys (Equus asinus) remain poorly characterized. To address this gap, we performed high-throughput RNA sequencing on endometrial tissues collected from Dezhou donkeys (n = 16) at four post-ovulation stages: Day 0 (ovulation), Day 3 (early luteal), Day 7 (mid-luteal), and Day 18 (late luteal/pre-luteolysis). Differential gene expression analysis, Gene Ontology enrichment, and KEGG pathway mapping were conducted to characterize temporal transcriptomic dynamics. We identified 2,474, 6,548, and 1,288 differentially expressed genes in Day 0 versus Day 3, Day 0 versus …

Ai-Enhanced Fluorescein Angiography Detection Of Diabetes-Induced Silent Retinal Capillary Dropout And Rna-Seq Identification Of Pre-Symptomatic Biomarkers, Yiyan Peng, Huishi Toh, Dennis Clegg, Peng Jiiang

Biological, Geological, and Environmental Faculty Publications

Objective: Retinal capillary dropout, characterized by acellular capillaries or "ghost vessels," is an early pathological sign of diabetic retinopathy (DR) that remains undetectable through standard clinical imaging techniques until visible morphological changes, such as microaneurysms or hemorrhages, occur. This study aims to develop a non-destructive artificial intelligence (AI)-based method using fluorescein angiography (FA) images to detect early-stage, silent retinal capillary dropout.

Methods: We utilized 94 FA images and corresponding destructive retinal capillary density measurements obtained through retinal trypsin digestion from 51 Nile rats. Early capillary dropout was defined as having an acellular capillary density of >= 18 counts per mm2. …

Implementation Of A Cognitive Aide To Guide The Use Of Non-Invasive Hemodynamic Monitoring For Goal-Directed Fluid Therapy During Cesarean Deliveries, Ashley George, Ashley Walbert

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, with delayed recognition contributing to adverse outcomes during cesarean delivery. In cesarean deliveries, traditional intermittent non-invasive blood pressure monitoring may not detect early hemodynamic instability, creating a need for more structured interpretation of continuous hemodynamic data. This Doctor of Nurse Anesthesia Practice quality improvement project implemented a cognitive aid to support anesthesia providers using the Edwards EV1000/ClearSight platform during goal-directed fluid therapy. A pre–post implementation design using provider surveys evaluated feasibility, usability, confidence, and perceived impact. By organizing continuous values such as stroke volume, cardiac output, and systemic …

A Staff Nurse-Led Clinical Instructional Competency Program To Improve Clinical Judgement In Undergraduate Nursing Students: A Quality Improvement Initiative, Shana Skeffrey

Doctor of Nursing Practice (DNP) Manuscripts

There is increasing concern that new graduate nurses are leaving bedside roles early in favor of less stressful positions due to rising patient acuity and heightened organizational expectations, increasing the effects of the nursing shortage (McClosky et al., 2022; AACN, 2024). A standardized clinical experience, combined with fair and consistent access to skill application in the hospital setting can support a collaborative approach for undergraduate nursing students. This quality improvement project is aimed to implement a Staff Nurse-Led Clinical Instructional Competency Program that will provide a structured opportunity for clinical instructors to help fill the gap in preparing undergraduate nurses …

Feasibility And Acceptability Of A Home-Health Aide-Delivered Loneliness Reduction Program In A Small Home Care Agency: The Caring Connections Quality Improvement Project, Tontalayia L. Robinson

Doctor of Nursing Practice (DNP) Manuscripts

Loneliness is a significant public health concern that adversely affects mental, cognitive, and physical health, with consequences comparable to smoking 15 cigarettes per day. Home care recipients experience loneliness at rates of 15.9% to 24.2%, yet home-health aides (HHAs), who often have the most consistent contact with homebound clients, lack structured tools for recognizing and responding to loneliness. This gap highlights the need for practical, evidence-based strategies that can be integrated into routine home care practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the feasibility, acceptability, and appropriateness of a home-health aide–delivered loneliness …

A Quality Improvement Initiative Utilizing Help To Reduce Delirium, Improve Patient Outcomes, And Provide Age Friendly Care For Patients 65 Years Of Age Or Older With Modifiable Delirium Risk Factors., Maggie Blake

Doctor of Nursing Practice (DNP) Manuscripts

Background: Delirium, an acute change in cognition, occurs in 21% of hospitalized patients and is linked to increased length of stay, readmissions, and increased mortality (Shen et al., 2024). In older adults, delirium prevalence increases and is linked to poor outcomes that inhibit patients' health care goals (Shen et al., 2024). Despite the well-published harms of delirium and standardized prevention measures, delirium prevention is not prioritized. Methods: HELP, originally the Hospital Elder Life Program, now preferred to be known as HELP, is a standardized delirium prevention model specifically designed to address the unique needs of hospitalized older adult patients. HELP …

Improving Chlamydia Testing For Females Through Universal Screening In Outpatient Pediatric Primary Care: An Adolescent Quality Improvement Initiative, Christina Howard

Doctor of Nursing Practice (DNP) Manuscripts

Chlamydia is the most common sexually transmitted infection in the United States in adolescents and young adults (Dutra & Lazenby, 2023). Per Smith, Reirden, and Nyquist (2022), adolescents and young adults between the ages of 15 and 24 account for more than 60% of new chlamydia infections each year. Testing for chlamydia is not standardized, and it is estimated that only 50% of those who qualify receive a yearly screening American Sexual Health Association. (2021). If outpatient testing and treatment is not improved these asymptomatic cases will be missed, infections in general will increase, and reinfections may occur leading to …

Enhancing New Graduate Nurse Confidence And Patient Safety Through Clinical Development Coach Integration, Megan T. Kramer

Doctor of Nursing Practice (DNP) Manuscripts

The transition from student to professional nurse is a critical developmental stage often marked by heightened stress, emotional exhaustion, and uncertainty in clinical judgment. These challenges frequently contribute to lower confidence levels, increased anxiety, and higher risks for patient safety events among new graduate nurses. This program evaluation project aims to assess the effectiveness of integrating a Clinical Development Coach (CDC) role to enhance new graduate nurse’s confidence, comfort, and overall competence while reducing patient safety incidents on a trauma/surgical inpatient unit in a medical center on the East coast. The CDC role is a structured mentorship and resource position, …

Implementation Of A Deteriorating Patient Simulation For New Graduate Nurses To Improve Clinical Judgment: A Quality Improvement Project, Kasey Mundell

Doctor of Nursing Practice (DNP) Manuscripts

New graduate nurses (NGNs) often have trouble recognizing and responding to patient deterioration because of limited clinical judgment and confidence during the transition to practice. This quality improvement project evaluated the implementation of a high-fidelity deteriorating patient simulation within a new graduate nurse orientation program at a Level I trauma center. Guided by the Plan-Do-Study-Act framework and the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice, the simulation focused on the assessment and management of a patient experiencing pulmonary embolism. Eight NGNs participated in the simulation and completed the Attitudes Toward Recognizing Early and Noticeable …

Evaluating The Implementation And Progress Of A Bereavement Care Program In An Acute Care Adult Hospital, Nancy Abraham

Doctor of Nursing Practice (DNP) Manuscripts

Bereavement care is a significant component of patient and family centered care; however, it remains inconsistently addressed in acute adult hospital settings. Families of patients who die in hospitals frequently experience grief, anxiety, and emotional distress, which may be exacerbated by fragmented or inadequate bereavement support (Kustanti et al., 2021). Evidence supports the use of structured, interdisciplinary approaches to bereavement care to ensure timely, consistent, and compassionate support for families. To address this gap, a Bereavement Committee was established at a Level I trauma center in eastern Pennsylvania to implement a standardized Bereavement Care Program aimed at improving bereavement practices …

From Novice To Competent: Enhancing Orientation And Readiness For Post-Anesthesia Care Nurses, Gerri Y. Young

Doctor of Nursing Practice (DNP) Manuscripts

Post-anesthesia care unit (PACU) nurses are responsible for managing complex postoperative patients requiring advanced clinical judgment, airway management, hemodynamic monitoring, and rapid recognition of complications. Many nurses transition into the PACU without formal perianesthesia education, resulting in variability in orientation practices, competency validation, and preparedness for independent practice. At a military treatment facility (MTF) in Mississippi, 78% of newly assigned PACU nurses had only one to two years of medical-surgical experience, and a standardized orientation program was not available.

This quality improvement project aimed to implement and evaluate a standardized, evidence-based PACU orientation program designed to improve nurse knowledge, confidence, …

Maternal Microchimerism As A Mechanism Of Developmental Origins Of Health And Disease, Amy M. Boddy, Kristine J. Chua

Human Biology Open Access Pre-Prints

The in utero environment is now widely recognized as a critical determinant of health across the entire lifespan. The developmental origins of health and disease (DOHaD) framework has established that prenatal exposures, including maternal stress, infection, nutrition, and environmental toxins, can impact fetal development in profound ways associated with disease risk from infancy to old age. Yet a fundamental aspect of pregnancy, the bidirectional exchange of maternal and fetal cells, DNA, and other biological material, a phenomenon known as microchimerism, has received little attention in this context. Maternal cells and genomic material transfer to the developing fetus early in utero …

Terrain Characterization And Spot Traversability In Mining Environments, Gordon Oti

Honors Theses

Hazardous mining environments, including abandoned underground workings and disturbed surface areas, remain difficult to explore safely because of unstable ground conditions, limited accessibility, and unknown terrain characteristics. The Boston Dynamics SPOT quadruped platform supports remote exploration and data collection in these environments; however, effective operation requires a better understanding of how measurable terrain characteristics relate to SPOT traversability performance.

This study combined terrestrial laser scanning (TLS)-based terrain characterization with field-based SPOT testing to evaluate traversability performance in representative mining environments. High-resolution TLS data acquired using a Maptek laser scanner were processed to quantify terrain slope and rock fragmentation, while field …

Pcom Doctor Of Osteopathic Medicine Class Of 2030 White Coat Ceremony, Philadelphia College Of Osteopathic Medicine

White Coat Ceremony

Program of PCOM Philadelphia Campus 2026 White Coat Ceremony Program for the Class of 2030.

Guest Speaker: Michael A. Becker, DO '87, Senior Associate Dean of Clinical Education, Professor, Department of Family Medicine.

Wip: Developing A Generative Ai Autoethnography Assistant, Jyoti Suhag, Jennifer Drewyor, Kathryn Bugbee, Michelle Jarvie-Eggart, Lynn Albers, Leo Ureel

Michigan Tech Publications

Background: Generative AI (genAI) is transforming educational research, offering new possi-bilities for conducting interviews while local sandboxing minimizes data privacy risks and hallucinations. Purpose: This work-in-progress presents the AI Autoethnography Assistant, a project investigating how large language models (LLMs) can support autoethnographic interview design and execution. Approach: Using prompt engineering grounded in Interpretative Phenomenological Anal-ysis, paraphrasing techniques, and structured follow-up questions, we developed protocols that incorporate po-sitionality and prompt reflection on origin stories and pivotal life moments. Outcomes: Conversations conclude at the user’s discretion, with the AI generating a thematic summary. We tested refined prompts across four platforms (Gemini, Claude, …

Fast Mr Imaging: Reducing Sedation And Improving Patient Experience, Hajir Aljumaily

Radiologic Sciences

Purpose To examine the impact of fast magnetic resonance (MR) protocols on sedation requirements, patient tolerance, workflow efficiency, and diagnostic accuracy in musculoskeletal and brain imaging.

Method An integrative literature review was conducted using PubMed, CINAHL, and Google Scholar to identify peer-reviewed, original research articles published between 2019 and 2026. Studies were selected for relevance, human subjects, and outcomes related to sedation, patient experience, or diagnostic effectiveness.

Results Fast MR protocols were consistently associated with reduced sedation use, improved patient comfort, and increased exam completion rates. Workflow efficiency improved due to shorter scan times. Although minor reductions in image quality …

Ai Integration In Radiotherapy Workflows: Emerging Trends And Best Practices, Vi T. Dinh

Radiologic Sciences

Purpose To synthesize current evidence on artificial intelligence (AI) integration in radiotherapy workflows, identify emerging application trends, and examine best practices for clinical implementation.

Method A structured literature review was conducted using PubMed, Scopus, and Google Scholar to identify peer-reviewed studies published between 2015 and 2025. Eligible studies evaluated AI applications in radiotherapy workflows, including segmentation, treatment planning, and clinical decision-making. Findings were synthesized using thematic analysis.

Results Three primary themes emerged: (a) AI-based segmentation improved contouring efficiency and reduced interobserver variability; (b) AI-assisted treatment planning enhanced dose prediction consistency and workflow reproducibility; and (c) workflow integration supported clinical decision-making …

Disengagement And Reconnection: Investigating The Role Of Purpose And Identity Seeking Across Career Stages In Healthcare, Charmel Renee Jeffery

Radiologic Sciences

Purpose To examine the generational purpose gap in healthcare by identifying the psychological and environmental factors underlying early-career disengagement and late-career reconnection.

Method An integrative literature review was conducted using four academic databases. An artificial intelligence (AI)-assisted thematic synthesis was applied to extract and organize findings within a standardized analytic matrix. To ensure accuracy and rigor, all AI-generated outputs were validated against the original source data.

Results Two primary themes emerged. Early-career healthcare workers commonly experienced disengagement associated with destiny beliefs, while later-career professionals demonstrated renewed purpose and resilience despite ongoing stressors.

Discussion The findings revealed a pronounced generational divide …

Ai-Driven Multi-Modal Mr For Precision Oncology, Maneet K. Marwaha

Radiologic Sciences

Purpose To examine the role of artificial intelligence (AI) in multiparametric magnetic resonance (MR) imaging for precision oncology, with a focus on automated tumor segmentation, treatment response prediction, and workflow efficiency.

Method A literature review was conducted to examine current evidence on AI applications in multiparametric MR imaging for oncology. Studies evaluating deep learning models for tumor segmentation, longitudinal imaging analysis, and treatment response prediction were synthesized using a thematic analysis approach.

Results Three primary themes emerged: (a) AI-driven tumor segmentation improved accuracy, reproducibility, and efficiency across multiparametric MR sequences; (b) deep learning models enhanced prediction of treatment response through …

Mr-Linac Technology, Katherine Orellana

Radiologic Sciences

Purpose To examine the clinical advantages of magnetic resonance-guided linear accelerator (MR-Linac) technology in radiation therapy, with a focus on treatment accuracy, adaptive planning, and patient outcomes.

Method A literature review was conducted using peer-reviewed articles identified through The University of Texas MD Anderson Cancer Center Research Medical Library. Studies published between 2022 and 2026 were included if they addressed the clinical advantages of MR-Linac technology. Findings were synthesized using thematic analysis.

Results Three primary themes emerged: (a) superior soft-tissue visualization improved tumor delineation and treatment accuracy; (b) daily adaptive treatment planning and real-time tumor tracking enhanced precision by accounting …

Impact Of Music On Patient Comfort During Mr Scans: A Literature Review, He Yan

Radiologic Sciences

Purpose To investigate the influence of auditory stimuli on patient comfort levels during magnetic resonance (MR) imaging, with particular emphasis on indicators of distress, duration of patient positioning, and utilization of emergency signaling devices.

Method An integrative literature review was undertaken utilizing peer-reviewed research articles sourced from journals within the fields of radiology, music therapy, and clinical practice. A comprehensive search was conducted across databases such as PubMed, ScienceDirect, SpringerLink, and Oxford Academic employing keywords including MR anxiety, music therapy, and patient comfort.

Results The body of literature consistently indicated that auditory stimuli significantly mitigate patient anxiety and distress in …