Digital Commons Network^™

Pharmacogenetics In Pediatric Cardiology., Adenike Adenikinju, Jonathan B. Wagner, Mollie Walton

Manuscripts, Articles, Book Chapters and Other Papers

Children with congenital and acquired heart disease frequently require complex and prolonged pharmacotherapy, often involving off-label cardiovascular medications with narrow therapeutic ranges. Consequently, variability in drug response and medication-related adverse events remains a significant clinical challenge in pediatric cardiology. Pharmacogenetics provides a framework to individualize drug selection and dosing by incorporating genetic variability alongside established clinical and developmental factors. This review outlines the current clinical utility and emerging role of pharmacogenetics in pediatric cardiology, emphasizing applications most relevant to day-to-day patient care. Established pharmacogenetic associations with direct implications for pediatric cardiac practice include gene-drug pairs involving tacrolimus (CYP3A5), …

Preface. Neutrosophic Decision-Making, Artificial Intelligence And Large Language Models: Applications In Engineering, Education And Public Policy In Latin America. Special Issue Of The International Academic Meeting At Universidad Bernardo O'Higgins, Santiago, Chile (2026), Maikel Yelandi Leyva Vazquez, Alexis Matheu Perez, Florentin Smarandache

Neutrosophic Sets and Systems

This special issue collects the papers presented at, and derived from, the international academic meeting held at Universidad Bernardo O'Higgins (UBO) in Santiago, Chile, over two days: Tuesday, June 30 and Wednesday, July 1, 2026. The meeting, organized by Professors Maikel Yelandi Leyva Vazquez and Alexis Matheu Perez, was honored by the presence of Professor Florentin Smarandache, founder of neutrosophy. Sessions covered the foundations of neutrosophic logic, NeutroAlgebra and AntiAlgebra, plithogenic statistics and probability, the epistemic auditing of large language models, and their applications to higher education, institutional evaluation, and public policy, in connection with the FONDECYT Regular 2026 project …

Internal Verdicts Track Evidence: A Template-Controlled Neutrosophic Reading Of Epistemic States In Large Language Models Via The Jacobian Lens, Maikel Leyva, Alexis Matheu Perez, Florentin Smarandache

Neutrosophic Sets and Systems

For twenty-five years, neutrosophic logic has assigned independent degrees of truth (T), indeterminacy (I), and falsity (F) to model epistemic states that classical and fuzzy semantics cannot express. All previous applications, however, measured these components on outputs: answers, judgments, expert evaluations. This paper reports, to our knowledge, the first neutrosophic reading of components inside the internal representations of a large language model. Using the recently released Jacobian lens on Qwen3.5-4B, we project intermediate-layer readouts onto lexicons of support, refutation, and hedging, obtaining layer-wise (T, I, F) profiles under three epistemic conditions (conflicting evidence, first-person false belief, factual control; n = …

Sexual Education And Sti Prevention In High School: A Neutrosophic Analysis Of The Opportunities And Risks Of Generative Artificial Intelligence, Antonio Pioquinto Rivera, Gregorio Nunez Hernandez, Rosalinda Villa Juarez

Neutrosophic Sets and Systems

Sexually transmitted infections (STIs) remain a critical challenge during adolescence. Given the limitations of traditional sex education, generative artificial intelligence (GAI) has emerged as a personalized and anonymous consultation alternative. This study analyzes, from a neutrosophic perspective, the scientific evidence published between 2019 and 2026 on the use of GAI to strengthen STI prevention among high school students. Through a critical integrative review of thirteen reference studies, a matrix was built that classifies the findings across four dimensions (AI-mediated learning, sexual education, STI prevention, and educational equity) according to their truth (T), falsity (F), and indeterminacy (I) components. The results …

Beyond National Accuracy: A Neutrosophic Geographic Evidence Audit Of Preschool-Attendance Prediction In Ecuador (Ensanut 2018), Cindy Patricia Campoverde Vera

Neutrosophic Sets and Systems

Predictive models built on national surveys are usually summarized by one aggregate performance figure, yet a national metric may conceal large differences in how the model behaves across territories. We examined this problem with the 2018 Ecuadorian National Health and Nutrition Survey (ENSANUT 2018). A conventional Random Forest trained on five child and household variables reached a national accuracy of 64.83% against a majority-class baseline of 54.40%. This aggregate concealed substantial geographic heterogeneity: provincial accuracy ranged from 56.1% (Bolivar) to 78.0% (Canar). To represent this evidence without collapsing it into one number we formalize a Neutrosophic Geographic Evidence Audit (NGEA), …

Project-Based Learning And Mathematical Competencies In Primary Education: A Neutrosophic Cognitive Map Reading Of A Critical Integrative Review, Uriostegui Adan Yurithzi Majogani

Neutrosophic Sets and Systems

Developing mathematical competencies in primary school is essential for interacting with the environment. Faced with the limitations of traditional direct instruction, project-based learning (PBL) has emerged as an active alternative. This study analyzes, through a critical integrative review of ten reference studies (2016-2026), whether PBL determines the development of basic mathematical competencies in primary school students, and formalizes the resulting conceptual system as a neutrosophic cognitive map (NCM) with eight concepts and nine causal connections classified as positive, negative, or indeterminate. The static analysis of the map identifies PBL as the most central concept and makes explicit that the direct …

Verified, Unsupported, Or Contradicted? A Neutrosophic Evidence Audit Of Public-Security Dashboard Indicators: Citizen-Security Incidents Reported To Ecuador's Ecu911, July 2026, Jhon Jairo Tuz Chamorro

Neutrosophic Sets and Systems

Administrative dashboards display values whose evidential support is rarely audited. This study characterised the open file of incidents reported during July 2026 to Ecuador's Integrated Security Service ECU911. The analysis demonstrated that population normalisation substantially changed the territorial ranking. Three dashboard indicators that failed evidential review were used as validation cases for the proposed Neutrosophic Dashboard Indicator Audit (NDIA), under which each indicator is treated as a proposition whose numerical value and interpretation must be adequately supported by the underlying data and computational procedure. The audit distinguished between different forms of evidential failure, including a computational contradiction, a claim unsupported …

Beyond Scalar Uncertainty: Independent Neutrosophic Evidence Coordinates For Conflict-Aware Retrieval-Augmented Generation, Florentin Smarandache, Maikel Yelandi Leyva Vazquez

Neutrosophic Sets and Systems

Retrieval-augmented generation (RAG) pipelines reduce the quality of retrieved evidence to one number, and common scalar uncertainty summaries conflate evidential distinctions that a three-coordinate representation keeps apart: insufficient, contradictory and explicitly indeterminate evidence. We use the non-normalized neutrosophic triple (T, I, F) as a testable multidimensional evidence representation, with independent channels for support, explicit indeterminacy and opposition, and subject its defining design principle to a controlled empirical test on a pre-specified battery built on Climate-FEVER, validated externally on ConfRAG. The independent triple gives the best five-way behaviour with the LLM evaluator; normalization deletes the magnitude that signals insufficiency. The benefit …

Generative Artificial Intelligence As A Formative Mediator In Mathematical Task Design: An Ontosemiotic-Neutrosophic Analysis Of Didactical Suitability In Teacher Education, Arian Vazquez Alvarez

Neutrosophic Sets and Systems

The transformation of mathematics teaching in the digital society demands the integration of emerging technologies with solid pedagogical foundations. This study analyses the mediation of generative artificial intelligence (GAI) in the design of mathematical tasks from the Ontosemiotic Approach (OSA). A neutrosophic reading is introduced to preserve, rather than collapse, the evidential structure of GAI-mediated tasks, annotating each facet with independent degrees of truth (T), indeterminacy (I), and falsity (F) and modelling the teacher's critical mediation as an operator of evidence refinement. GAI does not replace the teacher but strengthens their role as epistemological mediator and fosters critical didactic thinking.

Generative Ai For Curriculum And Assessment Design In Competency-Based Tvet: An Exploratory Evidence Map With Neutrosophic Annotations, Maria Del Refugio Patino Cayetano, Blanca Estela Calderon Munoz

Neutrosophic Sets and Systems

Technological and polytechnic universities in Mexico revise their competency-based study plans on a multi-year cycle, and generative AI (GAI) tools are increasingly used informally by faculty to draft curriculum documents and evaluation instruments, without a published evidence base for the practice. This paper reports an exploratory, non-registered scoping search of the OpenAlex database for evidence on GAI use in curriculum and assessment design, read against four explicit propositions. What remains undocumented is narrower: authoring of curriculum or evaluation documents by GAI inside a multi-year, institutional, competency-based TVET/polytechnic revision cycle, specifically within the Textile Design and Fashion Engineering discipline.

Field-Deployable Pose Estimation For Youth Athlete Screening: A Reproducible Protocol And Its Sensitivity Limits In A Genetically Controlled Case Series, Darvin Manuel Ramirez Guerra, Christian Edison De La Torre Choque, Jorge Guiseppe Herrera Chamorro, Jordi Kevin Flores Zabaleta

Neutrosophic Sets and Systems

Smartphone pose-estimation applications promise laboratory-grade biomechanical screening at negligible cost, an attractive prospect for youth sport programmes in low-resource settings. This paper contributes a reproducible field protocol for smartphone-based postural and jump screening, and reports its behaviour on a deliberately adversarial test case: a set of sex-discordant triplets (n = 3, age 13 years) who share prenatal environment, socioeconomic context and training history. The contribution is the protocol, the fully reported case data, and an explicit statement of what a criterion-validation study against force platforms and open pose estimators would need to establish before field screening claims can be sustained.

How Much Of A Multicriteria Ranking Is The Data And How Much Is The Arithmetic? A Neutrosophic Stress Test On Stakeholder Perception Data, Leili Genoveva Lopezdominguez Rivas, Sol David Lopezdominguez Rivas, Dixie Marisol Lopezdominguez Rivas, Franklin Parrales-Bravo

Neutrosophic Sets and Systems

Multicriteria rankings computed on aggregated survey means are routinely used to allocate improvement budgets in higher education, and they are read as if the closeness coefficients were ratios of need. This paper shows, on real data, that a large part of what such a ranking reports is arithmetic rather than evidence. Using doctoral survey data on university-society engagement from two state universities in Guayaquil, Ecuador, we compare a crisp entropy-TOPSIS treatment with a single-valued neutrosophic treatment in which the indeterminacy component is measured from inter-stakeholder dissent. We report that the fine order of the ranking is not identifiable from these …

Ahp-Topsis-Based Cybersecurity Control Prioritization For Local E-Government: Integrating Cobit 2019 And Iso/Iec 27001:2022 In Ecuador, Gabriel Neptali Bailon Arcentales, Jair Andres Semblantes Pinto, Noel Batista Hernandez

Neutrosophic Sets and Systems

Local governments in Ecuador manage critical citizen services yet operate with limited cybersecurity maturity. This paper presents MPEC-GAD, a cybersecurity governance model integrating COBIT 2019 strategic alignment with ISO/IEC 27001:2022 technical controls, using AHP-TOPSIS multi-criteria prioritization. Applied to GAD Jaramijo (Manabi, Ecuador), the four decision criteria weight risk reduction, implementation cost, deployment time, and technical complexity (AHP Consistency Ratio CR = 0.0054 < 0.10). The TOPSIS ranking directs scarce resources toward the 47 mandatory EGSI controls with highest risk-reduction per investment unit. A single-round structured review by seven experts rated pertinence, viability and completeness with mean scores >=4.0/5.0.

Multi-Criteria Credit Risk Prioritization In Cooperative Smes Using Ahp-Topsis: A Reproducible Pilot With Pseudonymized Data, Ramiro Javier Castillo Herrera, Dayron Rumbaut Rangel

Neutrosophic Sets and Systems

Credit risk assessment in small and medium-sized enterprises (SMEs) within savings and credit cooperatives presents persistent challenges due to incomplete, heterogeneous, and dispersed information. This paper reports and audits a pilot AHP-TOPSIS multi-criteria model for relative credit risk prioritization using a pseudonymized pilot dataset of seven SMEs (n=7) with active loans, implemented as a fully Excel-reproducible framework without proprietary software. AHP pairwise comparisons yield validated criterion weights (CR=0.0440 < 0.10). Results demonstrate the model's interpretability, traceability, and operational applicability for credit portfolio management in resource-constrained cooperative financial environments.

How Certain Is An Institutional Research Profile? Three Undeclared Decisions, And A Neutrosophic Reading Of What They Cost, Alexis Matheu Perez, Bastian Gutierrez

Neutrosophic Sets and Systems

Institutional bibliometric profiles report Lotka's exponent, a Bradford core and a Price ratio as if they were properties of the institution. They are properties of the institution together with three decisions that the reporting almost never states: which source defines the corpus, which document types are compared, and which population of authors the laws are fitted on. This article measures what each decision is worth, using Universidad Bernardo O'Higgins (UBO, Santiago, Chile) as the case and Universidad Bolivariana del Ecuador as a control. Since the resulting uncertainty is not sampling error, we give it a place to be reported: a …

Typed Abstention For Llm-Elicited Fuzzy Criteria In Multicriteria Transportation Decisions, Maikel Maikel Leyva-Vazquez, Nezir Aydin

Neutrosophic Sets and Systems

Fuzzy multicriteria decision-making (MCDM) increasingly draws its criterion evaluations from large language models (LLMs), but the aggregation step typically treats these elicited judgments as interchangeable with expert opinion, with no mechanism to flag disagreement, insufficiency, or unreliable sources. We port a source-preserving, typed-abstention decision policy into fuzzy-MCDM pipelines, instantiated on a four-alternative sustainable-transportation case, and report two live pilots. Pilot 1 returns all-coherent; Pilot 2, redesigned with criteria of greater normative dependence, shows the gate firing on real disagreement. We report both pilots candidly and verify the gate's logic with synthetic unit tests.

Neutrosophic Sets And Systems, Vol. 101, 2026, Proceedings Of The International Conference On Artificial Intelligence, Indeterminacy, And Education, University O'Higgns, Santiago, Chile, Florentin Smarandache

Neutrosophic Sets and Systems

No abstract provided.

More Than A Free Snack: Benefits Of Mobilized Resources And Socialization For Pediatric Healthcare Workers., Thomas Ayres, Kristin Ray, Aimee M. Hoflander, Angela Myers

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Addressing the burnout epidemic in the healthcare workforce is a primary concern of the modern healthcare organization and recognized across researchers and leaders of nations. This study aims to test whether a mobilized micro-break intervention, the Wellbeing on Wheels (WOW) Cart, improved health care worker (HCW) energy perceived organizational support and work engagement.

METHODOLOGY: This study was conducted at an independent children's hospital in the midwestern United States. Between August and September 2024. A total of 367 pediatric HCWs completed our survey. IBM's SPSS was used to analyze the data using t-tests, ANOVAs, linear regression, and polynomial regression …

Efficient Dynamic Mechanism Design Without A Common Prior, Dirk Bergemann, Marek Bojko

Cowles Foundation Discussion Papers

No abstract provided.

Relationships Between Psychosocial Aspects Of Stuttering And Self-Disclosure Of Stuttering In A Japanese Sample, Daichi Iimura, Saburo Takahashi, Mizuki Aoki, Kentaro Yoshizawa, Kota Yanai, Shoko Miyamoto, Michael P. Boyle

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Purpose We aimed to psychometrically evaluate a Japanese version of the Disclosure of Stuttering Scale, from Boyle et al. (2018), and identify the psychosocial factors associated with level of stuttering self-disclosure among adults who stutter.

Methods: Adults who stutter were recruited via stuttering self-help groups in Japan and the authors’ contacts. Participants completed their demographics, the Disclosure of Stuttering Scale and other psychological scales assessing affective, cognitive, and social aspects of stuttering via an online survey. We analyzed 180 participants after those with unreliable or duplicate responses were excluded. The scale’s reliability and validity were confirmed, and multiple linear regression …

Relationships Between Psychosocial Aspects Of Stuttering And Self-Disclosure Of Stuttering In A Japanese Sample, D Iimura, S Takahashi, M Aoki, K Yoshizawa, K Yanai, S Miyamoto, Michael P Boyle

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Purpose: We aimed to psychometrically evaluate a Japanese version of the Disclosure of Stuttering Scale, from Boyle et al. (2018), and identify the psychosocial factors associated with level of stuttering self-disclosure among adults who stutter. Methods: Adults who stutter were recruited via stuttering self-help groups in Japan and the authors' contacts. Participants completed their demographics, the Disclosure of Stuttering Scale and other psychological scales assessing affective, cognitive, and social aspects of stuttering via an online survey. We analyzed 180 participants after those with unreliable or duplicate responses were excluded. The scale's reliability and validity were confirmed, and multiple linear regression …

Dancing In Circles: Bon Dance As Performance Of The Past, Travis Robb Kim

Dissertations, Theses, and Capstone Projects

This capstone project traces the contours of the Japanese folk dance tradition of Bon Dance in Hawaiʻi through the nuances of public scholarship, diaspora, and racial capitalism by producing an original play which aims to perform the knowledge and praxis which the performance ritual puts forward. Treating Bon Dance as muse, the original play examines the necessity of turning to the past in order to disrupt a future made inevitable by oppressive systems; a fiction that comments on and critiques the predictive and generative technologies that have embedded themselves into society at large. Through intertwining conversations that explore prophecy and …

Sedentary Behaviors And Functional Disability Among Chinese Older Adults (2008–2018): Evidence Including Mahjong, Yen-Han Lee, Yen-Chang Chang, Minzhi Ye, Cai Xu

School of Social Work Faculty Publications

Purpose: This study examined how different types of sedentary behavior relate to changes in functional disability, measured by activities of daily living (ADL) and instrumental activities of daily living (IADL), among Chinese older adults.

Major findings: Using data from 17,939 participants in four waves (2008–2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), sedentary behavior was categorized into four types: none, playing mahjong only, combining these with other sedentary activities, and other activities alone (e.g., reading and watching TV). Cox two-state regression models estimated the hazard of transitioning in ADL and IADL disability. Engaging in sedentary behaviors was generally …

Impact Of Exercise On Mental Health In Inpatient Settings, Samuel Blake Rn, Nathaniel Clark Rn

Nurse Residency

In adult psychiatric inpatients with mental illness, how does participation in a structured exercise program compared with standard inpatient care affect depression, anxiety, and overall mental health outcomes during hospitalization?

Night Shift-Specific Training & Engagement, Keith Procell Rn, Kyleigh Keitel Rn

Nurse Residency

In night shift hospital workers (P) does mandatory daytime attendance for required education (I), compared to shift-aligned, asynchronous, or flexible scheduling of education (C), increase health risks associated with circadian disruption (O), as supported by current research?

Algorithm Aversion In Academic Libraries: User Resistance To Ai-Enabled Discovery And Search Services, Fenfang Cao, Lvting Bu, Yi Huang, Yu Chi, Hengyi Fu

Faculty Research, Scholarly, and Creative Activity

Academic libraries increasingly deploy AI-enabled services such as intelligent search, recommendation systems, and chat-based assistance to support scholarly resource discovery. However, some users remain reluctant to rely on these tools. This phenomenon, often described as algorithm aversion, has been widely examined in healthcare and finance but remains underexplored in library contexts. This study investigates the factors associated with algorithm aversion in academic digital libraries and examines how these factors relate to one another. A two-phase mixed-method design was adopted. First, 41 semi-structured interviews with users from Chinese university libraries were analyzed using grounded theory. This stage produced 58 initial concepts, …

Abundance And Balance Of Circulating Leukocyte Subsets And Colorectal Cancer Survival, Alicia R Richards, Maria F Gomez, Bianca I Dowling, Catherine M Bulka, Biljana Gigic, Jane C Figueiredo, Christopher I Li, David Shibata, Adetunji T Toriola, Doratha A Byrd, Cornelia M Ulrich, Mingxiang Teng, Paul A Stewart, Erin M Siegel, Jacob K Kresovich

2020-Current year OA Pubs

BACKGROUND: Cancer immunology research has traditionally focused on tumor-infiltrating leukocytes, but the role of the peripheral leukocytes remains understudied. Since tumor-infiltrating leukocytes are recruited from the blood, circulating immune profiles may provide prognostic insights obtainable before surgery, reflecting overall immune competence.

METHODS: We analyzed treatment-naïve blood samples from 134 stage I-III colorectal cancer (CRC) patients using a nested case-control design (33 recurrences, 45 deaths; median follow-up: 7.4 years). Circulating leukocyte subsets were estimated using methylation cytometry applied to genome-wide methylation profiles. Cox regression models estimated associations between leukocyte metrics and disease-free and overall survival, adjusting for clinical factors.

RESULTS: Higher …

Identifying Influential Drivers To The Utilization Of Prefabrication On Student Housing At Cal Poly: A Case Study On The Delivery Method, Dominique Giang

Construction Management

As universities experience increasing enrollment and housing shortages, student housing projects require efficient delivery methods capable of meeting strict occupancy deadlines while minimizing disruption to active campus environments. This research investigates the influential drivers behind the utilization of prefabrication on an ongoing student housing project at California Polytechnic State University, San Luis Obispo. The seven-story project consists of 417 student beds and incorporates repetitive layouts and prefabricated building components. Through qualitative interviews with key project stakeholders involved in early decision-making and field execution, the study examines how project objectives, construction constraints, and delivery considerations influenced the decision to implement prefabrication. …

Whose Job Is It To Care For The Poor? Public Support, Private Charity, And Crowding Out In Canada Since 1960, Sandra J. Peart

Jepson School of Leadership Studies articles, book chapters and other publications

Executive Summary 

• This study explores whether increased public spending has “crowded out” private donations to charitable organizations. 
• Private charities emerged during industrialization to provide mutually beneficial services to individuals in need. 
• In Canada, government social spending increased both on a per capita basis and as a percentage of GDP after 1961. The percentage of GDP allotted to social spending rose and fell from then until the late 1990s, but rose thereafter, with a spike during the COVID years. It has fallen and risen gradually since 2022. 
• All in all, social benefit spending as a percentage of GDP has roughly doubled, …

Heroclix®: A Multiplayer Chess Game For Teaching The Fundamentals Of Human Capital Management, Chin Heng Low, Jiunwen Wang, Paul Lim, Bernie Koh

Research Collection Lee Kong Chian School Of Business

This article describes the adaptation and use of the HeroClix® board game to teach critical real-world principles for effective human capital management within teams. In a HeroClix® game, players pit their team of miniature figurines against other players’ miniatures in combat. This is akin to organizations striving in the business environment today, with well-structured human capital within their teams as a key competitive advantage. In this article, we suggest how the game can be applied in the classroom for undergraduate students to experience, reflect on, and learn more about the prerequisite considerations in proficient people management, the dynamic nature of …