Digital Commons Network^™

Mediating Role Of Self-Efficacy In The Association Between Fatigue And Depressive Symptoms In Females With Rheumatoid Arthritis, I-Yu Hsiao, Hanoch Livneh, Chieh-Tsung Yen, Ming-Chi Lu, Wei-Jen Chen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background and Objectives: Extant research on the relationship between fatigue and depression in people with rheumatic diseases portrays a divergent picture. While caring for persons with this medical condition, one issue that represents individual confidence in carrying out specific tasks, namely self-efficacy level, has attracted significant attention. Yet, the information regarding whether self-efficacy may pose a clue linking these two major symptoms is still unknown. The aim of this study, therefore, is to examine whether self-efficacy mediates the association between fatigue and depressive symptoms among persons with rheumatoid arthritis (RA). Materials and Method: A cross-sectional study of 224 …

The Impact Of Artificial Intelligence On Ecojustice And Ethics, Vishnu S. Pendyala

Faculty Research, Scholarly, and Creative Activity

Artificial Intelligence (AI) has attained human-level performance in tasks like text summarization, machine translation, and code generation while handling multimodal data. Despite these advances, AI poses challenges such as generating false or biased outputs, causing discrimination, and exhibiting opaque decision-making processes that hinder bias mitigation. Additionally, training large language models (LLMs) for AI consumes substantial energy and can enable autonomous warfare, posing a threat to eco-justice, and raising sustainability concerns. Their ability to create realistic content poses the risk of misuse and perpetuating misinformation. This article addresses these ethical issues and presents solutions through regulation and technology, with examples of …

Exploring The Translation Lookaside Buffer (Tlb) For Low-Level Task Differentiation And Classification, Cristian Agredo, Daniel F. Koranek, Christine M. Schubert, Jose A. Gutierrez Del Arroyo, Tor J. Langehaug, Scott R. Graham

Faculty Publications

The primary focus of modern Central Processing Unit (CPU) technologies is performance improvement, with security often considered a secondary concern. As a result, vulnerabilities within the system are overlooked. While significant research, both offensive and defensive, has been conducted on CPU caches, relatively little attention has been given to the Translation Lookaside Buffer (TLB) due to its perceived lack of data granularity. Prior studies have typically combined multiple Hardware Performance Counters (HPCs) or relied on timing analysis to extract meaningful insights. In contrast, this study introduces a novel methodology that leverages only TLB related HPCs for multi-task classification, without incorporating …

Impact Of Antimicrobial-Impregnated Dressings On The Rate Of Periprosthetic Joint Infections In Primary Joint Arthroplasty Surgeries Of The Hip And Knee, Michael Critelli, Janae Rasmussen, Sydney Shindler, Collin Reasch, Aaditya Patel, Mihir Patel, Jesua Law

Student Publications

Periprosthetic joint infections (PJIs), are a serious complication following total joint arthroplasty (TJA) of the hip and knee. Antimicrobialimpregnated dressings (AMIDs) are emerging as an adjunct measure to reduce microbial growth at the surgical site. This literature review examines the evidence regarding iodine and silver AMIDs in primary TJA of the hip and knee. Evidence indicates that use of AMIDs can be highly beneficial in high-risk infection patients, especially silver-based AMIDs to reduce the incidence of PJIs. Studies showed silver- and iodine-based AMIDs have comparable effects on healing wounds colonized by Staphylococcus aureus. There remains debate regarding the appropriate clinical …

The Parthenon, June 25, 2025, Baylee Parsons, Kaitlyn Fleming, Ashton Pack, Nate Harrah, Soleil Woolard

The Parthenon

No abstract provided.

Standing Up For Medical Microbiology, L.T. Joshi, Timothy J.J. Inglis

Peninsula Dental School

No abstract provided.

Cannabis Use In Women And Sexual Dysfunction, Becky K. Lynn, Julia D. López, Morgan E. Link, E C. Campian

2020-Current year OA Pubs

No abstract provided.

What Drives Clinic Follow-Up After Traumatic Spinal Injury? An Observational Cohort Study From Tanzania, Chibuikem A Ikwuegbuenyi, Julie Woodfield, Romani Roman Sabas, Sean Inzerillo, Noah Willett, Magalie Cadieux, Scott L Zuckerman, Francois Waterkeyn, Halinder S Mangat, Hamisi K Shabani, Roger Härtl

2020-Current year OA Pubs

OBJECTIVES: To evaluate factors associated with clinic follow-up after traumatic spinal injury (TSI) in Tanzania, focusing on demographic, injury-related and hospital variables. We hypothesised that socioeconomic and injury-specific factors would predict follow-up adherence.

DESIGN: Retrospective observational cohort study.

SETTING: Tertiary government referral centre for neurosurgery and orthopaedics in Dar es Salaam, Tanzania.

PARTICIPANTS: 443 adults with TSI admitted between September 2016 and October 2021. Inclusion criteria included survival to discharge and availability of the discharge date. Patients with missing data were excluded.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were any clinic follow-up and 1-year follow-up post-discharge. Secondary outcome was …

Low Frequency, High Complexity: Assessing Skill Decay In Transesophageal Echocardiography Post-Simulation Training, Enyo Ablordeppey, Emily Terian, Collyn T Murray, Laura Wallace, Wendy Huang, Erica Blustein, Alexander Croft, Ernesto Romo, Mansi Agarwal, Daniel Theodoro

2020-Current year OA Pubs

INTRODUCTION: Resuscitative transesophageal echo (rTEE) is a promising adjunct to cardiac arrest resuscitation. However, it is a high-acuity diagnostic tool that is rarely used in this setting and its safety establishment is limited because of low occurrence. High-acuity, low occurrence skills such as rTEE during cardiac arrest inevitably decay. In this study we examined the content and percentage of rTEE skill decay following simulation-based education (SBE).

METHODS: Resuscitative TEE-naïve emergency physicians (EP) were trained using a combination of clinical exposure, web-based didactics, and monthly hands-on sessions with a high-fidelity rTEE simulator for four months. The COVID-19 pandemic created a natural …

Integrated Proteomic And Targeted Next Generation Sequencing Reveal Relevant Heterogeneity In Lower-Grade Meningioma And Anxa3 As A New Target In Nf2 Mutated Meningiomas, Maryam Shah, Yeasmin Akther, Claire Adams, Matt Banton, Vikram Sharma, Emanuela Ercolano, David A Hilton, Kathreena M. Kurian, Liyam Laraba, Waldemar Woznica, David Parkinson, Leandro Jose De Assis, Oliver Hanemann

Peninsula Medical School

Background: Meningiomas, the most common primary brain tumours, are classified by the World Health Organization (WHO) into grades 1, 2, and 3. Some grade 1 tumours exhibit increased clinical aggressiveness, with the biallelic mutation of NF2 being the most frequently reported. Methods: In our study, we analysed the most common driver mutations (NF2, AKT1, KLF4, and TRAF7) in meningioma by genomics describing co-occurrences and new mutations. Furthermore, tumour tissue bearing the driver mutations was analysed by proteomics. The relevance of the specific target found in the most common driver mutation in meningiomas (NF2) was validated in vitro using both lower …

Strategies To Improve Nurse Staffing And Workforce Management In Home Health Agencies, Kelechi Lillian Wabeke

Walden Dissertations and Doctoral Studies

Home health agencies continue to grapple with challenges in nurse staffing and workforce management. This integrative review explored effective strategies to address these challenges and improve operational efficiency. The review focused on identifying best practices for enhancing nurse recruitment, retention, and scheduling processes within home health settings. Guided by the transformational leadership framework, the study examined 30 empirical and theoretical articles published over the past 5 years. The selected articles were further assessed for relevance and quality using the Johns Hopkins evidence-based practice model. Through an in-depth thematic analysis, five primary themes and 10 supporting subthemes emerged. The key themes …

Law Enforcement Officers’ Perceptions About Antipolice Sentiment And Social Media As A Force Multiplier, Edward Peter Pope

Walden Dissertations and Doctoral Studies

As a newly emergent form of mass communication, social media platforms can act as a force multiplier in fomenting negative and critical attitudes or viewpoints toward law enforcement officers and agencies. The purpose of this qualitative study was to examine the perceptions and lived experiences of law enforcement officers about antipolice sentiment and social media as a force multiplier. Amid growing concerns regarding public opinion and the impact of social media on law enforcement practices, more research was needed on how officers navigate and interpret these challenges. Data from in-depth interviews with 10 law enforcement officers were thematically analyzed to …

Effective Strategies To Leverage Organizational Culture To Enhance Employee Retention, Tavares E. Scott

Walden Dissertations and Doctoral Studies

Employee retention is a critical issue for healthcare organizations, with the average tenure in the U.S. being only 3.8 years. High turnover contributes to staffing shortages, increased costs, and compromised patient care. Hospital administrators and healthcare leaders are particularly concerned, as sustained turnover threatens organizational sustainability, care quality, and long-term profitability. Identifying strategies to retain employees is essential to improving workforce stability, maintaining service excellence, and securing financial viability. Grounded in Herzberg’s motivation-hygiene theory, the purpose of this qualitative pragmatic inquiry was to explore strategies healthcare managers in private medical healthcare systems used to leverage organizational culture to enhance employee …

Pengaruh Asset Life Cycle Management Terhadap Performa Aset Negara, Budi Susanto, Muhammad Halley Yudhistira

Jurnal Kebijakan Ekonomi

This study examines the impact of government intervention in asset management systems on the performance of state-owned assets. Using Asset Life Cycle Management (ALCM) indicators and binary logistic regression, the findings reveal that three key aspects of ALCM—strategy and planning, acquisition, and operation and maintenance—significantly influence asset performance. The impact of ALCM policies varies by asset location, categorized into five major regions: Sumatra, Java, Kalimantan, Bali-Nusa Tenggara, and Papua. These results provide empirical evidence that effective asset management policies positively contribute to optimizing the performance of state assets.

Carbon Capture Storage Sand Control Injection Sleeve, Baker Hughes Company

Defensive Publications Series

This solution is to address carbon capture storage wells that are required to have re-close/re-open sand control injection sleeve across wells' injection lifecycle. This Sand Control Injection Sleeve’s novelty comes from the design features addressing excessive injection rate while ensuring re-close/re-open feature, the design features also address sand screen erosion prevention.

Self-Adaptive Curvature Screen For Dynamic User Position, Hp Inc

Defensive Publications Series

Maintaining the same visual distance and making the picture more realistic as it appears in the real world is an important factor that deepens immersion. Generally, the edge of the screen of a flat display often causes deformation and distortion due to the viewing angle.

The purpose of the curved display is trying to maintain the same viewing distance when viewing images from different angles, which not only reduces the distortion of the edge of the screen. It also improves visual comfort and allows people to enter an immersive state through virtual scenes.

In this disclosure, the proposed is an …

Ai Assisted Pen Drop Detection, Hp Inc

Defensive Publications Series

Active pens have been a tool to enhance productivity in office environments and in school class. This publication proposed a method to enable active pen drop detection by utilizing IMU/Gyro sensor with AI assisted algorithm to detect active pen dropping events and implement buzzer, haptic module, or Bluetooth communication to host computer system to alert end users that their active pen is lost. This function can prevent end users losing their active pens causing productivity loss in the office or in the school.

The Gift Shop - Celebrates (A Journey Just Begun)

University anniversary celebration materials

No abstract provided.

Sustainable Tourism Behaviour Through Walking Tour: A Qualitative Study To Walking Tour Participants In Jakarta, Melisa Bunga Altamira, Khairunnisa Devani Aqtus Permana Putri

Journal of Indonesian Tourism and Policy Studies

As urban tourism continues to rise, walking tours have emerged as a low-impact, environmentally friendly, and culturally immersive form of tourism. This study explores the relationship between walking tours and the development of sustainable tourism behaviour among participants in Jakarta, Indonesia. Using a qualitative research approach, this study elaborates the motivations, perceptions, and behavioural changes of individuals who have participated in walking tours across Jakarta’s historical and cultural sites. Data were collected through in-depth interviews and participant observations, focusing on themes such as environmental awareness, appreciation of local culture, and reduced dependency on motorized transport. The findings suggest that walking …

Director, Military Cyber Institute, Joseph Schafer

Military Cyber Affairs

No abstract provided.

Throughput Of Ascon Compared With Popular Iot Encryption Algorithms, Mitchel R. Harvey (Ryan), Andrew M. Kaiser, Garrett W. Hoiness

Military Cyber Affairs

No abstract provided.

Characterizing Caldera’S Cyber Attack Emulation Capabilities, Caleb Chang, Matthew Cao, Kenyou Teoh, Ekzhin Ear, Shouhuai Xu

Military Cyber Affairs

Autonomous cyber attack emulation can aid cyber defenders to identify and remediate cyber risks. MITRE’s Caldera software is the state-of-the-practice for automated attack emulation. Yet, it has not been systematically analyzed, putting its performance and effectiveness into question. This paper systematically characterizes Caldera’s architecture, abilities and use cases, and assesses its strengths and weaknesses. It draws useful insights, such as: Caldera excels in stealthy access and execution tactics to pilfer data against Windows operating systems. It also discusses two directions for Caldera improvement: module-level automation and end-to-end attack emulation.

Using Blockchain Technology To Help Secure America's Defense Critical Infrastructure, Vimal Buck, Aerin Krebs, Brynn Hillard, Jakob Gerha, Joseph Lutma, Srikar Maduposu, Ted Allen

Military Cyber Affairs

Critical water infrastructure in the United States faces increasing cybersecurity threats from state-sponsored actors, with potentially devastating consequences for national security, economic stability, and public health. (Cybersecurity and Infrastructure Security Agency, 2025). This infrastructure supports defense critical assets and is actively being targeted by various state-sponsored hacking groups, which poses a major concern for civilians and military alike. K. Herath (personal communication, February 24, 2025) reported being aware of two attacks on Ohio water systems during his tenure as Cybersecurity Strategic Advisor to Ohio Governor Mike DeWine.

Water is essential to everyday life and defense and presents as a high-value …

Network And Multipath Traceroute Visualization, Cameron Makowski

Military Cyber Affairs

TraceCam introduces a new paradigm in network path analysis, leveraging GPU-accelerated WebGL visualization, advanced traceroute integrations, and AI-driven insights to transform complex routing data into actionable intelligence. Early prototypes have demonstrated significant improvements in performance, clarity, and multi-path discovery, overcoming traditional limitations in traceroute analysis. By incorporating retrieval-augmented language models and enriched metadata sources like IPinfo.io, TraceCam enables automated anomaly detection, contextual explanations, and rapid root-cause analysis, enhancing operational efficiency. The platform’s architecture ensures scalability and adaptability, supporting deeper investigations and real-time situational awareness. Future development will focus on clustering-based anomaly detection, expanded geographic visualizations, and enhanced AI-generated analysis to …

Quantifying Adversary Military Forces’ Susceptibility To Cognitive Attacks, Bonnie Rushing, Cole Nelson, Shouhuai Xu, Christofer “Raven” O’Keefe, Olga Karpoyan

Military Cyber Affairs

This paper introduces a method to quantify international populations’ susceptibility to cyber cognitive attacks using press freedom and media trust metrics. We present the Cognitive Influence Calculator, a tool that estimates susceptibility (𝑆) based on Press Freedom Scores (PFS) and media trust levels. Findings show that while authoritarian regimes are harder to reach, successful cognitive attacks have greater impacts due to higher trust in state-controlled narratives. Using U.S. wargaming data and international trust metrics, we compute susceptibility scores for the U.S., Russia, China, Iran, and North Korea. Results show an inverse relationship between PFS and media susceptibility, with local/allied …

Forward, Amy Hamilton

Military Cyber Affairs

No abstract provided.

Understanding Russia’S Cyber Policies, Strategies, And Doctrines, Bryan Hancock, Hanh Nguyen, Olga Karpoyan, Ekzhin Ear, Shouhuai Xu

Military Cyber Affairs

This study analyzes the strengths and weaknesses of Russia’s cyber policies, strategies, and doctrines through a systematic set of attributes, leading to key insights: (i) Russia has proactively adapted its cyber policies, strategies, and doctrines to its evolving environment; (ii) Russia actively conducts cognitive warfare, but remains equally vulnerable to it; and (iii) Russia’s cyber posture faces significant challenges, including a limited technological base, shortage of skilled personnel, and restrictive approach to information control, all of which undermine the effectiveness of its strategies. These insights offer valuable implications for US Cyber Command and the Department of Defense.

Full Issue: Volume 20, Number 3 - Spring 2025

Jefferson Surgical Solutions

A publication for friends and colleagues of Jefferson’s Department of Surgery

In This Issue

Cover Story Toll Institute Integrates Cardiac and Vascular Services Across Jefferson Health - Page 1

Overview Surgery: Exciting Times at Jefferson Health - Page 2

On the Job Lauren Meloni, MHA, PTA - Page 2

Education Combating Limb Loss: Coalition Brings Life-Saving Screenings to Underserved Communities - Page 2

Changing Lives Through Research Department Pilot Grants Enable Continued Scientific, Clinical Advances - Page 3

Please Welcome New Faculty - Page 3

Those Who Give Grateful Mother Honors Merli: ‘Great Doctor, Even Better Human Being’ - Page …

Toll Institute Integrates Cardiac And Vascular Services Across Jefferson Health

Jefferson Surgical Solutions

Through a transformational gift from the Bruce and Robbi Toll Foundation, Jefferson Health established the Bruce & Robbi Toll Heart and Vascular Institute in June 2024. This comprehensive program is designed to bring high-quality cardiovascular care directly to patients and communities in Jefferson’s vast and expanding service area. Led by Joseph Bavaria, MD, FACS, FRCS (Edin) ad hom, the Toll Institute is integrating cardiac and vascular services across the Jefferson enterprise – including Cardiology, Cardiac Surgery, Vascular Medicine and Vascular Surgery.

The unified structure will significantly enhance collaboration among care teams, streamline patient experience and increase access to promising clinical …

Characterizing Cyberattacks Against Operational Technology Infrastructures Through The Lens Of Attack Flows, Sherman Kettner, Caleb Chang, Ekzhin Ear, Shouhuai Xu

Military Cyber Affairs

Operational Technology (OT) infrastructures play a critical role in modern society and economy. However, their increasing connectivity with public networks such as the Internet has made them vulnerable to cyberattacks, much like traditional Information Technology (IT) systems. In particular, cyberattacks against OT infrastructures remain relatively underexplored and little understood. In this paper, we aim to deepen our understanding of cyberattacks against OT infrastructures. For this purpose, we propose a methodology, including novel cybersecurity metrics to analyze the attack flows of these attacks in an end-to-end fashion, which allows us to draw useful insights. We demonstrate the utility of the methodology …