Digital Commons Network^™

Medadl: High-Throughput Information Extraction Of Functional Status From Electronic Health Records To Advance Frailty Assessment In Older Adults, Sunyang Fu, Zhiyi Yue, Jennyly T Nguyen, Huipeng Liu, Jaerong Ahn, Vanessa Ramirez, Jude Des Bordes, Hongfang Liu, Min Ji Kwak, Nahid J Rianon

Faculty, Staff and Student Publications

Background: Functional status is essential for assessing frailty and planning care in older adults but is often under-documented in the structured fields of electronic health records. Manual chart review can capture functional status information but is labor-intensive and time-consuming. In this study, we developed and validated a scalable natural language processing (NLP) model to extract functional status information from unstructured electronic health record (EHR) notes.

Methods: This retrospective cohort study included 110 older adults seen at a geriatric osteoporosis clinic. A large language model-augmented symbolic NLP pipeline (MedADL) was developed to extract activities of daily living (ADL) and instrumental activities …

Association Of Ultra-Processed Food Intake With Insulin Secretion And Sensitivity In Mexican American Children: Results From The Safari Study, Hemant Kulkarni, Rector Arya, Srinivas Mummidi, Sharon P. Fowler, Roy G. Resendez, Juan C. Lopez-Alvarenga, Vidya Farook, John Blangero

Human Genetics Publications

Background/Objectives: There is increasing interest in and evidence for the role of ultra-processed foods (UPFs) in cardiometabolic risk. We tested the hypothesis that UPF intake score derived from dietary history is associated with measures of insulin secretion and sensitivity in a family setting even when the process of type 2 diabetes is still to ensue. Methods: We used data from our well-characterized San Antonio Family Assessment of Metabolic Risk Indicators in Youth (SAFARI) study cohort of nondiabetic children (aged 6–17 years). Dietary history was assessed using the Block Food Frequency Questionnaire. Outcomes of interest were 19 clinically useful indexes of …

Supported Decision-Making And The Inclusion Of People Who Lack Decisional Capacity In Greater Than Minimal Risk Research, Aaron Eli Segal, David Wendler, Dana Howard

Faculty and Staff Publications

In recent years, some have argued that supported decision-making can be ethically superior to surrogate decision-making with respect to decisions involving adults with cognitive and intellectual impairments or disabilities. In this paper, we argue that supported decision-making could also be ethically superior to surrogate decision-making in the context of clinical research that involves greater than minimal net risks. In current practice, adults who lack decisional capacity are often excluded from research that involves greater than minimal net risks (call this the minimal risk requirement). While this approach is intended to protect them, it can be ethically problematic, in part because …

2026 Summer - Friendly Correspondence Newsletter, Courtright Memorial Library

Friends of the Library

In This Issue:

• Class of '75 Feature
• Fundraising Updates
• Student Appreciation Awards
• Yearly Program Review
• BLISS
• FOL Bookmark
• Library Staff Update
• In Memoriam

Fall Tailoring Interventions For Patient Safety: A Program Evaluation, Shirley Morrison

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls with injury rates had increased for over two years at the project hospital until nurse leaders implemented a new fall-prevention intervention. Patient falls are the most common preventable adverse event in acute care hospitals, with approximately 700,000 to 1 million occurring annually in the United States. Before implementing the Fall Tailoring Interventions for Patient Safety (TIPS) toolkit, the hospital’s program lacked an evidence-based approach and a fall communication board to alert staff, patients, and families about the individual fall risk status, leaving a significant gap in patient-centered care.

Aim of the Project: The aim of the project was …

Tailoring Interventions For Patient Safety Protocol: A Strategy To Prevent Inpatient Falls, Yashu Adhikari

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Inpatient falls were a significant safety issue at the project site, substantially affecting patient outcomes and organizational resources. The identified gap was the lack of individualized, patient-centered fall-prevention strategies despite the presence of standard fall-prevention bundles. The baseline fall rate of 6.04 was 20% higher than the national benchmark of three to five falls per 1,000 patient days, indicating a clear need for improvement.

Aim of the Project: The quality improvement (QI) project aimed to improve patient safety by reducing inpatient falls through implementation of the AHRQ Fall Tailoring Interventions for Patient Safety (TIPS) protocol on a …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …

Utilizing A Multidisciplinary Team Approach To Opioid Stewardship In A Long-Term Acute Care Hospital, Lesley Moore

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

The opioid crisis continues to negatively affect patient safety and healthcare outcomes across the United States. Long-term acute care hospitals (LTACHs) care for medically complex patients who often require prolonged pain management and are at increased risk for opioid-related adverse events. At the project site, a 32-bed LTACH, 72% of reviewed patient charts included an opioid prescription upon admission, exceeding recommended prescribing benchmarks and identifying a gap in opioid stewardship practices. The absence of a standardized opioid stewardship program (OSP) and opioid risk screening process increased the risk of opioid misuse, dependency, and adverse patient outcomes.

Aim of the …

Comprehensive Assessment Of Direct And Passive Smoking Across The Pancreatitis Spectrum, Samuel Han, Dhiraj Yadav, Jun Xu, Melena D Bellin, William E Fisher, Evan L Fogel, Chris Forsmark, Phil A Hart, Liang Li, Stephen J Pandol, Walter G Park, Guru Trikudanathan, Stephen K Van Den Eeden, Santhi Swaroop Vege, Darwin L Conwell, Christie Y Jeon, Consortium For The Study Of Chronic Pancreatitis, Diabetes, And Pancreatic Cancer (Cpdpc)

Faculty, Staff and Students Publications

Objectives: Smoking is a key risk factor for pancreatitis, contributing to pathogenesis and disease progression. Data regarding second-hand smoking, or passive smoking (PS) exposure, are lacking. We therefore aimed to assess the impact of PS exposure across the pancreatitis spectrum.

Methods: We analyzed baseline data from the PROCEED study, a multicenter study in the United States including patients with acute (AP), recurrent acute (RAP), and chronic (CP) pancreatitis. Participants detailed their individual smoking history and PS exposure, which was compared between AP, RAP, and CP subgroups. Participant factors and clinical characteristics were compared by level of individual and PS exposure. …

The Effect Of Cyp1a2 Gene Polymorphisms On Caffeine Pharmacokinetics And Exercise Performance In Male Recreational Athletes, Chloe Masters, Ajmol Ali, Claire Badenhorst, Martin Dickens, Kay Rutherfurd-Markwick

Research outputs 2022 to 2026

This study examined the effects of caffeine consumption on endurance exercise performance, and the influence of CYP1A2 gene polymorphisms in caffeine pharmacokinetics and exercise performance. The data sets of two randomised, double blind, placebo-controlled crossover study design experiments have been merged. Thirty-eight recreationally active male participants provided saliva samples for CYP1A2 genotyping (AA homozygotes n = 19; AC heterozygotes n = 19) and completed either a 10-km run or 40-km cycling time trial of 60-min following a single dose of 6 mg·kg⁻¹ caffeine (CAF) or placebo (maltodextrin; PLA) throughout which heart rate (HR) and time to completion (TTC) were …

Muscle–Tumor Crosstalk In Exercise Oncology: Exercise-Induced Myokines And Cancer Cachexia, Amirhossein Ahmadi Hekmatikar, Francesco Bettariga, Álvaro López Llorente, Diego Fernández-Lázaro, Katsuhiko Suzuki, D. Maryama Awang Daud

Research outputs 2022 to 2026

Exercise-induced myokines, such as IL-6, irisin, and myostatin, play crucial roles in mediating systemic adaptations and modulating tumor progression. This narrative review synthesizes evidence on how regular moderate-intensity exercise affects the myokine network within the tumor microenvironment (TME) of solid tumors. Results from the 86 included studies indicate that structured training (aerobic: 45–65% VO2 max; resistance: 45–70% 1RM) enhances the expression of beneficial myokines that support immune surveillance, reduce inflammation, and improve muscle–tumor cross-talk. IL-6 demonstrates a dual modulatory effect on inflammation and immunity; irisin contributes to tumor apoptosis, while myostatin downregulation supports muscle integrity and metabolic balance. Evidence suggests …

The Moderating Effect Of Dietary Fiber And Protein On The Relationship Between Symptoms Of Depression And Anxiety And Cognitive Decline, Samantha L. Gardener, Hilal Salim Said Al Shamsi, Stephanie R. Rainey-Smith, Hamid R. Sohrabi, Kevin Taddei, Colin L. Masters, Ralph N. Martins, W. M.A.D. Binosha Fernando

Research outputs 2022 to 2026

Introduction: Depression and anxiety often co-occur with Alzheimer's disease, exacerbating the associated cognitive impairment. This study examined moderating effects of dietary protein and fiber intake on relationships between depressive and anxiety symptoms, and cognitive decline.

Methods: Cognitively unimpaired (n = 553; 39.4% male, 70.6 ± 9.6 years) provided baseline fiber and protein intake, and had repeated cognitive testing and symptoms of depression/anxiety measured (baseline and up to eight follow-ups over 144 months). Moderation and simple slope analyses were employed in the cohort as a whole and following stratification by sex.

Results: Fiber intake moderated the relationship between change in depressive …

Advancing Dimensional Models Of Psychopathology In Cancer: Insights From Applying The Hierarchical Taxonomy Of Psychopathology (Hitop), Darren Haywood, Jai Carmichael, Miriam K. Forbes, Roman Kotov, Robert F. Krueger, Aidan G.C. Wright, Susan L. Rossell, David Castle, Wendy Lam, Maryam Lustberg, Colin E. Vize, Anna Ugalde, Phyllis Butow, Nicolas H. Hart

Research outputs 2022 to 2026

Objective: Cancer survivors, defined as those living with or beyond a cancer diagnosis, experience more than double the prevalence of psychopathology when compared to the general population. Categorical diagnostic systems, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), remain dominant in psycho-oncology despite concerns about reliability, validity, and clinical utility for this population. Dimensional frameworks, such as the Hierarchical Taxonomy of Psychopathology (HiTOP), offer a more precise alternative; however, they have not yet been widely applied in cancer survivors. Accordingly, the objective of this research was to examine the applicability of HiTOP to cancer survivors. Methods: Data …

Does Poor Regulation Lead To Pollution? Key Takeaways From A Systematic Review, Vincent Emenyonu, Kat O. Mara, Mark Lund

Research outputs 2022 to 2026

Formal recycling of used lead acid batteries (ULAB) is a multibillion-dollar industry, valued at US$12.12 billion in 2024, and expected to grow to more than $26 billion within eight years. Demand for recycled lead (Pb) for new batteries grows in developing countries where costs limit the uptake of lithium-ion batteries. ULAB recycling in these regions poses significant danger to human health and the environment. Stringent regulatory approaches for ULAB recycling in developing countries, intended to reduce pollution, have thus far been ineffective as they typically do not adequately cover small-scale informal recycling in rural and remote communities. We examine what …

Integrative Oncology For Prostate Cancer: A Narrative Review, Kevin T. Liou, Nicole A. Metri, Robert U. Newton, Divya Ajay, Eleanor M. Walker, Channing J. Paller

Research outputs 2022 to 2026

Prostate cancer is most common malignancy among men in the United States. As men are now living longer with prostate cancer due to advances in treatment, there exists a growing need to manage the long-term physical and psychological sequelae of this disease, which range from genitourinary dysfunction to cardiometabolic and psychosocial consequences. Over half of men with prostate cancer report unmet needs in symptom management. Integrative oncology, a patient-centered, evidence-informed field combining lifestyle, natural product, and mind–body interventions with conventional treatments, offers a promising approach to prostate cancer symptom management. This review summarizes the current landscape of integrative oncology research …

Semantic Context Improvisational Retrieval-Augmented Generation For Empathic Conversational Ai, Sharjeel Tahir, Judith Johnson, Jumana Abu-Khalaf, Syed Afaq Ali Shah

Research outputs 2022 to 2026

A fundamental limitation of modern conversational AI is its limited capacity to demonstrate sustained empathy in long-form interactions. We propose SCIRAG (Semantic Context Improvisational Retrieval-Augmented Generation), a feedback-driven retrieval framework for adaptive empathic dialogue. It employs a dual-loop retrieval framework, iteratively optimizing a static counseling dataset through user metadata and feedback memory refinement. To enhance contextual alignment, we deploy retrieval adaptation, enabling the model to retain and leverage past conversational cues based on user preferences. When integrated with Mixtral-8x7B, SCIRAG improves human-rated empathic understanding by +1.26 points and empathic response by +1.00 point on the RoPE scale, while increasing acceptability …

A Remarkable Diversity Of Syngnathid Fishes In A Highly Modified Large Coastal Embayment In The Southeastern Indian Ocean, Glenn I. Moore, Jenelle A. Ritchie, Georgia M. Nester, Glenn A. Hyndes, Alan J. Kendrick

Research outputs 2022 to 2026

Southern Australia supports a high diversity of fishes in the family Syngnathidae, which is recognised as globally threatened, facing threats from coastal development, over-exploitation and bycatch. In southwestern Australia, Cockburn Sound houses a large industrial port and naval defence assets with plans to substantially expand the port facilities but also sits within a recognised syngnathid ‘hotspot’. Using a broad array of data sources, including historical museum vouchers, published records, historical and contemporary observations from notebooks and diving surveys, historical and contemporary trawl surveys, citizen science observations and environmental DNA, we compiled 4839 records of syngnathid fishes from the embayment. Twenty-one …

Dasyurus Hallucatus Movement Response To Fire In A Complex, Resource Rich Tropical Savanna, Ian J. Radford, Annette Cook, Natasha Harrison, Ben Corey, Roberta Bencini, Harriet R. Mills

Research outputs 2022 to 2026

The northern quoll, Dasyurus hallucatus, is part of a suite of threatened native northern Australian mammals that have inappropriate fire regimes listed as a threatening process. However, fire responses reported for D. hallucatus are inconsistent among different studies. Based on the theory that the fire response of D. hallucatus will depend partially on habitat quality, we postulate that home range in high quality savannas of the north Kimberley will be small, post-breeding male mortality low and prey resources little affected by fire. Based on previous research we hypothesised that male D. hallucatus would respond to fire more than females. By …

Forecast: An Exhibition Inviting Slow Feeling Through Participation In Unstable Weather States, Jo Pollitt, Helena Grehan, Lilly Blue, Peggy Attkinson, Justine Dandy, Naomi Joy Godden, Leanda Mason, Renee Esther Newman, Alexa Taylor, Danielle Gilson

Research outputs 2022 to 2026

This paper presents a series of responses from Western Australian based artists and scholars from a range of disciplines including: meteorology, science, education, social work, psychology, art and performance studies, to a year-long exhibition titled Forecast in Gallery 09 at The Art Gallery of Western Australia (AGWA). Forecast is a collaboration between AGWA's Head of Learning and Creativity Research, Lilly Blue, Edith Cowan University's Centre for People, Place and Planet artist-scholar, Jo Pollitt, together with artists Dianne Jones and Eva Fernández. The exhibition invites audiences to contribute to two participatory works: Weather Patterns, a daily changing installation that makes room …

Healthcare Professionals’ Experiences And Perspectives On Self-Management Education For Breast Cancer Survivors In Australian Primary Care: A Qualitative Study, Meng Yuan Li, Tao Wang, Daniel Terry, Haiying Wang, Isabella Zhao, Jing Yu Tan

Research outputs 2022 to 2026

Purpose: Breast cancer has been recognised as a chronic condition, with survivors experiencing long-term physical and psychosocial effects following treatment. Supporting breast cancer survivors to self-manage their health can optimise health-related quality of life and reduce symptom burden. Self-management education (SME) has been advocated at the policy and programme level in Australian primary care, but its uptake is often limited. This study explores healthcare professionals’ (HCPs) experiences and perceptions of SME in primary care, aiming to identify factors influencing its implementation and to support survivorship care for breast cancer survivors in Australia.

Methods: A qualitative descriptive approach was adopted involving …

Rhetorical Physics And The Laws Of Language: A Comparative Analysis Of President Trump And President Macron At The United Nations 2025, David Edmund Allen

Research outputs 2022 to 2026

The paper features a textual analysis of the UN speeches made by the US President Donald Trump and by France’s President Macron. President Trump’s speech was made in the absence of a teleprompter and lasted almost an hour. President Macron’s speech was representative of a more standard diplomatic speech. Both speeches are analyzed using a variety of models and techniques. The analysis incorporates an exploration of Manin’s link of Zipf’s law to concepts from information theory and algorithmic complexity, Tao’s concepts applied to power laws, ‘E pluribus unum’, out of many, one, plus a completely new application of Villermaux’s universal …

Weathering In-Beyond Hydro(S)Cenes, Bronwyn Bailey-Charteris, Kathryn Mcmahon, Mary Christina Rapp, Natalie Davey

Research outputs 2022 to 2026

This paper examines the cultural, ecological and political dimensions of the contemporary water crisis through a curatorial and environmental humanities lens. Through the watery conceptual epoch of the Hydrocene, it highlights the work of artists and interdisciplinary practitioners whose hydro-Artistic methods propose ways to realign human-water relations. Central to this analysis is the role of curatorial care, here understood as a practice of convening, holding and enabling reciprocal encounters between bodies of water, artists and communities. Bringing these diverse practices into dialogue, the paper proposes water not only as subject matter but as a potential collaborator and leaky agent. It …

Sachi Prasad Ray-Chaudhuri: Drosophila Genetics And Mutagenesis In Indian Science, Rajiva Raman, Awadhesh Jha

School of Biological and Marine Sciences

This article summarizes the scientific contributions of Professor Sachi Prasad Ray-Chaudhuri and his unwavering commitment to advancing research and teaching in mutagenesis and genetics in post-independence India, following his postgraduate training in the United Kingdom under the mentorship of Professor H. J. Muller. His contributions in basic mutagenesis, radiation protection, animal cytogenetics, and population genetics using a range of model and native species laid the foundation of scientific research in India in these contemporary fields. This played a pivotal role in advancing genetics and biological sciences in India at a time when scientific infrastructure and resources were limited. He also …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …

System For Privacy-Preserving Cryptographic Auditing Using Zero-Knowledge Proofs, N/A

Defensive Publications Series

Systems for enterprise security may rely on high (fidelity) logging, which can involve collecting and storing large volumes of sensitive event metadata, creating security and privacy liabilities. A cryptographic auditing framework may be utilized where, instead of storing raw event data, a system can generate and store a succinct cryptographic proof, such as a zero-knowledge proof. This proof can serve as a mathematical attestation that a permitted action occurred in compliance with a governing policy, potentially without revealing the specific details of the user or the action. This approach can be used to generate a tamper-evident, privacy-preserving, and space-efficient audit …

Autonomous Stress Testing In A Network Digital Twin For Predictive Remediation, Mohit Chandra, Amrita Mukherjee

Defensive Publications Series

The management of complex telecommunications networks can be challenged by difficulties in predicting the impact of component failures and the risks of testing automations on a live system. Systems and methods are described that can address these challenges by creating and maintaining a graph-based digital representation, such as a digital twin, of an operational network that can be synchronized with real-time data. Within this digital twin, for example, an autonomous agent can perform synthetic fault injections to simulate a wide range of potential failures and stressors. The system can analyze the effects of these simulated faults to predict potential service-level …

Product Ownership Inference From Conversion Signals For Advertising Optimization, Anonymous

Defensive Publications Series

A digital advertising platform constructs a per-user product ownership graph by ingesting third-party conversion signals from multiple advertisers, including purchase events and registration-related events, and resolving each signal to a canonical product entity using catalog matching, fuzzy attribute matching, and cross-merchant deduplication. The platform assigns an ownership confidence score and stores owned product nodes with acquisition metadata, taxonomy, attributes, lifecycle state, and relationship edges such as complementary, successor, substitute, and sequence relationships. During ad selection and auction, the platform suppresses ads for owned products and for satisfied categories, and adjusts ranking to promote complementary products, timed replacements, version upgrades, similarity-based …

If It Quacks Like A Duck, Brendan Hurley

Graduate Medical Education Research Journal

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A Purulent Surprise, Brendan Hurley

Graduate Medical Education Research Journal

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