Digital Commons Network^™

Ddor: Delta Debugging For Explainable Overrefusal Testing And Repair, Qinyan Zhou, Peixin Zhang, Jun Sun, Haonan Zhang, Dongxia Wang

Research Collection School Of Computing and Information Systems

While safety alignment and guardrails help large language models (LLMs) avoid harmful outputs, they can also induce overrefusal, i.e., unwarranted rejection of benign queries that merely appear risky. We present DDOR (Delta Debugging for OverRefusal), a fully automated and explainable framework for overrefusal testing and repair in a black-box setting, where only model inputs and outputs are accessible and internal safety mechanisms remain opaque. DDOR applies delta debugging to localize minimal refusal-triggering fragments (mRTFs) that provide phrase-level, explainable evidence for why a refusal occurs. Conditioned on these mRTFs, DDOR generates diverse, context-rich prompts and performs multi-oracle validation to filter intrinsically …

Primary Total Hip Arthroplasty For A Displaced Femoral Neck Fracture In An Above-The-Knee Amputee: A Case Report., Nathaniel J Starcher, Jignesh Patel, Andrew R Golden, Cameron A Kirk

Surgery Articles

Introduction: Femoral neck fractures in patients with ipsilateral above-knee amputations are uncommon and present unique diagnostic, biomechanical, and surgical challenges. The absence of a distal limb limits fracture reduction, intraoperative manipulation, and implant positioning, making standard treatment techniques difficult to perform. Although several fixation and arthroplasty strategies have been described for lower-extremity amputees, reports detailing primary total hip arthroplasty (THA) for displaced femoral neck fractures in young above-knee amputees remain scarce. This case highlights a practical surgical technique utilizing a temporary Steinmann pin as a lever arm to facilitate femoral control during arthroplasty and contributes to the limited orthopedic literature …

Enhancing Collaboration Through Post-Round Huddles, Kristen Ramirez

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: On a 16-bed medically supervised detoxification unit at a northeast Ohio community hospital, the interprofessional team had no consistent, structured way to communicate after physician rounds, fragmenting coordination and threatening patient safety for a complex, co-occurring population. Organizational HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) communication scores fell below the 80% national benchmark, confirming a modifiable, systems-level concern.

Aim of the Project: The quality improvement (QI) project aimed to enhance care quality and coordination by standardizing a shared plan of care across the interprofessional team.

Review of the Evidence: A systematic search retained 12 …

Arcadia Magazine

Alumni Magazine

No abstract provided.

Barriers To Veterans Affairs (Va) Healthcare Utilization: Exploring The Underutilization Of Va Healthcare Services Among Rural, West Texas Veterans, Adam G. Rodgers

Electronic Theses and Dissertations

Rural veterans forgo Department of Veterans Affairs (VA) healthcare at disproportionate rates, and this study found that the primary barrier is not enrollment but utilization. Seven of the eight participants were already enrolled yet remained functionally outside the system. The purpose of this qualitative single-case study was to explore why rural West Texas veterans forgo and underutilize Veterans Health Administration (VHA) healthcare. Two research questions examined the perceptions contributing to that decision and the barriers preventing access. Andersen’s behavioral model of health services use provided the framework. Semistructured virtual interviews with eight rural West Texas veterans were analyzed using Braun …

Organizational Systems, Support Structures, And Principal Retention In Urban Secondary Schools: A Job Demands And Resources Analysis Of Belonging And Isolation, Meredith L. Perry

Electronic Theses and Dissertations

Principal turnover remains a challenge in high-poverty secondary schools, where leadership stability is critical to school improvement and student success. Although factors associated with principal attrition have been studied, less is known about how district-level systems and support structures shape principals’ experiences of connection, belonging, and professional isolation. This qualitative multiple-case study was conducted within a program evaluation context to examine how district policies, processes, and support structures functioned as job demands and job resources influencing principals’ experiences and retention decisions within a large urban school district. Guided by the job demands–resources (JD-R) framework, the study included four secondary principals …

Cultural Humility In The Workplace: A Causal-Comparative Study Of Foreign And Local Hire Employees In International Education, Natalie A. Ortiz

Electronic Theses and Dissertations

Cultural humility is recognized as a framework for fostering respectful relationships in culturally diverse workplaces. However, limited research has examined cultural humility within international education in regard to workplace dynamics and power imbalances that may exist between foreign and local hire educators. The purpose of this quantitative causal-comparative study was to examine differences in perceived cultural humility levels between foreign and local hire employees in PreK-12^th grade private international schools in Central Asia and Eastern Europe. The study also examined whether years of international educational experience and the number of international educational assignments influenced perceived cultural humility levels. Data …

Navigating Leadership Transitions In Academic Affairs At Small Historically Black Colleges And Universities In The Southern United States: A Qualitative Study, Marquita Renee Mitchell

Electronic Theses and Dissertations

This study explored the specific problem that necessitates the functionality of departmental leadership, its outcomes, and emphasized leadership transitions. Researching leadership transitions can potentially enhance our understanding of how small HBCUs, particularly HBCUs with a student population of fewer than 5,000, can effectively navigate, ensuring the continuity and sustained success of the academic affairs department within the Southern U.S. region. To address this gap, this study engaged narrative methods while employing transformational leadership theory as a theoretical lens to explore the immediate and long-term impacts of leadership transitioning on strategic initiatives, staff morale, and outcomes within the academic affairs department, …

The Role Of Hardiness On Leadership In Big-Box Retail Managers, Cari Alvarez

Electronic Theses and Dissertations

Retail managers face constant customer demands, unpredictable staffing, and high-pressure performance expectations, yet little research has examined how these leaders sustain effectiveness under such conditions. This qualitative descriptive study explored how big-box retail managers in the United States described their development and use of hardiness across the constructs of control, commitment, and challenge to lead in a complex retail environment, an area not previously examined in the literature. Hardiness theory served as the theoretical framework for the study. Data were collected through 12 semistructured interviews with retail managers and an online questionnaire completed by 45 qualifying respondents. Interview data were …

Navigating The Political Waters Of Rural Superintendency In Texas, Brian D. Aiken

Electronic Theses and Dissertations

Superintendents frequently report job-related stress and politics as primary reasons for early resignations. Rural superintendents and school boards engage extensively with community stakeholders, intensifying the impact of local political influence on decision-making. The purpose of this study was to describe how five rural superintendents in Texas experience the influence of political will on decision-making and, subsequently, on their well-being. Perceptions of sources of political influence and the strategies used by superintendents to navigate political influence were investigated. Participant data were gathered through district documents and semistructured interviews. The research captured the challenges the rural superintendents face. The participants in this …

Quantum Mechanics, Non-Locality, And The Space Discreteness Hypothesis, Wilson A. Zuniga-Galindo

School of Mathematical & Statistical Sciences Faculty Publications

The space discreteness hypothesis asserts that the nature of space at short distances is radically different from that at large distances. Based on the Bronstein inequality, here, we use a totally disconnected topological space X as a model for the physical space at short distances. However, we consider the time as a real variable. In this framework, the Dirac–von Neumann formalism can be used. This discreteness hypothesis implies that given two different points in space, there is no continuous curve (a world line) joining them. Consequently, this hypothesis is not compatible with the theory of relativity. We propose R×(R×X)3 as …

Using Electronic Health Record Audit Logs To Identify Pediatric Intensive Care Unit Teams, Liem M Nguyen, Stefanie S Sebok-Syer, Dane Jacobson, Karley Mariano, John Grunyk, Shelby Burk, Yasaman Nourkhalaj, Kimberley Kirk, Jochen Profit, Christian Rose, A Jay Holmgren, Thomas Kannampallil, Daniel Tawfik

2020-Current year OA Pubs

BACKGROUND: Teamwork influences patient outcomes, but electronic health records (EHRs) do not reliably capture patient care team members, limiting its study. EHR audit logs provide insights into healthcare workers' workflows and may help identify patients' care team members.

OBJECTIVE: To develop, validate, and compare algorithms utilizing EHR audit logs to identify patient-centric primary teams (bedside nurse, frontline clinician, and attending physician) in pediatric intensive care units (ICUs).

METHODS: We observed rounds for 1931 patient days (development = 678; validation = 1253) across pediatric (PICU), neonatal (NICU) and cardiovascular (CVICU) ICUs at a quaternary children's hospital and documented each patient's daytime …

Risks Of Mercury Release From Disturbance Of Blue Carbon Ecosystems, Fan Zhang, Jingrou Hu, Ana Carolina Ruiz-Fernández, Christian J. Sanders, Xinxin Li, Ruotong Chen, Kunshan Bao, Bigyan Neupane, Aidah Baloch, Yanhui Zheng, Oscar Serrano

Research outputs 2022 to 2026

Blue carbon ecosystems (BCEs) function as dual repositories of organic carbon and legacy contaminants. While BCEs are recognized carbon sinks, their role as mercury (Hg) sinks and the risk of their conversion into sources due to human and climatic disturbances remain unexplored. This review synthesizes current knowledge on the drivers and risks of contaminant remobilization from threatened BCEs, with a primary focus on mercury. We explore how natural and human disturbances influence Hg storage, release, and bioavailability, while evaluating the risks posed to ecosystems and human health. Through a three-level meta-analysis, we show that physical disturbance remobilizes approximately 54% (95% …

A Geometric Framework For Modeling Real-World Experience, Knowledge, Learning, And Memory, Paxton C. Fitzpatrick

Dartmouth College Ph.D Dissertations

A growing body of recent work highlights the importance of studying learning and memory in “naturalistic” contexts that reflect how these processes function in our day-to-day lives. Yet the incredible complexity of the world around us, and of the idiosyncratic ways we learn from and remember it, make characterizing the dynamics of learning and memory for real-world experiences challenging. I present a computational framework that leverages the embedding representations of language models to cast experiences and memories as high-dimensional trajectories unfolding through a common representation space, enabling them to be directly related and compared via their latent semantic geometries. I …

Streamlining Diagnosis Of Bardet-Biedl Syndrome: New Diagnostic Algorithm With Updated Criteria., Jeremy J. Pomeroy, Jesse Richards, Brooke Sweeney, Seema Kumar, Katie E. Queen, Joshua Zaritsky, Carl H. Cramer, Elias I. Traboulsi, Brittni A. Scruggs, Erica E. Davis, Ekaterina Keifer, Emma Mcgibbon, Timothy Ogden, Bendert De Graaf, Tonia Hymers, Elizabeth Forsythe, Philip Beales

Manuscripts, Articles, Book Chapters and Other Papers

Considerable advances have been made in our understanding of Bardet-Biedl syndrome (BBS), particularly in its core clinical features and molecular genetics, warranting an update to the existing diagnostic criteria framework. Using a rigorous, evidence-based, and consensus-driven process, a multidisciplinary group of international experts and patient-led organizations developed an updated diagnostic algorithm. This algorithm provides practical, updated guidance for clinicians, including a pathway for accurately incorporating genetic findings into the diagnostic process. We recommend that a clinical diagnosis requires either 4 major criteria or 3 major and 2 minor criteria. Revised major criteria are retinal dystrophy, obesity (or overweight in individuals <  2 years old), congenital anomalies of the kidney and urinary tract or chronic kidney disease, hypogonadism/genital anomalies, neurodevelopmental/neurocognitive manifestations, and postaxial polydactyly. The diagnosis can also be established with a positive genetic testing result in patients exhibiting ≥ 1 major criterion, provided that genetic findings should be interpreted in the context of the patient's clinical presentation, age, family history, and overlap with related ciliopathies. These consensus criteria offer a simple algorithm incorporating updated definitions for major and minor criteria and genetic testing to support a timely and accurate diagnosis of patients with BBS, inform genetic counseling, and potentially facilitate earlier access to treatment. Trial Registration: CRIBBS Registry; ClinicalTrials.gov: NCT02329210.

Intelligence Report On Quantum Diplomacy In Action 2026-2027, Alex Bernasconi, Andrea Boggio, Audrey Himmer, Marieke Hood, Catherine Lefebvre, Tim Smith, Daria Robinson, Francesca Schiavello, Mira Wolf-Bauwens

Politics, Law, and Society Faculty Journal Articles

This report draws on the discussions of the 2026 Quantum Diplomacy in Action Conference, organised by GESDA and the Open Quantum Institute in May 2026 in Geneva. The conference brought together over 60 participants from diplomacy, government, international organisations, academia and industry, and was held under the Chatham House Rule. GESDA and the OQI are grateful to all participants for their candour and expertise. In line with the Rule, no statement in this report is attributed to any individual or institution. This report includes a series of standalone reports describing the national quantum strategies of various nations or blocs. Lack …

Empire By Gaslight, Christina D. Ponsa-Kraus

Faculty Scholarship

This Article argues that the constitutional law of U.S. colonialism as it applies to Puerto Rico should be understood as a form of collective gaslighting. The United States has been gaslighting Puerto Ricans for a century-and-a-quarter. By defining their constitutional status as a series of contradictions — starting with defining Puerto Rico as “foreign,” but only in a “domestic sense” — the federal government has caused Puerto Ricans to question their capacity to judge their own reality, thereby solidifying U.S. power over the island and undermining Puerto Rican resistance.

Not only has the United States been gaslighting Puerto Ricans since …

Measuring The Effectiveness Of Social Work Practice In Health Care Settings: An Annotated Bibliography, Uab Social Work Partnership, Lana Turner Msw, Laurel Iverson Hitchcock Phd Mph Licsw-S

College of Arts & Sciences Professional Work

This annotated bibliography brings together recent research on how the effectiveness of social work practice is measured in medical and health care settings. It examines outcomes linked to social work interventions, including hospital readmissions, length of stay, treatment engagement, equity of access, and team collaboration, as well as the tools and frameworks used to evaluate them. The collection is organized around five themes: social work interventions improve patient outcomes; social workers enhance interdisciplinary team effectiveness; structured assessment tools improve care planning; social workers promote equity and patient advocacy; and social work supports hospital efficiency and resource optimization. It helps students, …

Ai/Human Companionship In Literature: An Investigation Of Klara And The Sun And Neuromancer, Matthew Hale

Tredway Library Prize for First-Year Research

Our honorable mention essay, “AI/Human Companionship in Literature: An Investigation of Klara and the Sun and Neuromancer,” presents a complicated argument about the role of fiction in relation to technological advances in a passionate and accessible voice. Its willingness to interrogate its primary sources, to accept nothing at face value and to critically evaluate narrative choices and their implications, is especially admirable. Written in Dr. Elizabeth Lawrence’s APEP section of FYI 101, the essay is notable for its prose and for its originality. By discussing the consequences of its two sources’ differing treatments of technology, the paper points out the …

Implementing A Fall-Prevention Bundle To Reduce Falls In A Skilled Nursing Facility, Ginette Lubin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are a persistent patient-safety concern in skilled nursing facilities (SNFs), contributing to injury, functional decline, reduced quality of life, healthcare utilization, and costs. At the project site, a short-term rehabilitation unit in an urban SNF, 13 resident falls occurred during the baseline period, with 23% resulting in injury, and prevention relied on routine risk assessments, environmental checks, and post-fall reporting rather than proactive strategies.

Aim: To decrease the overall fall rate by 20%, reduce fall-associated injuries from 23% to 15% or less, and raise staff adherence to evidence-based fall-prevention interventions to 90% or higher within 12 weeks.

Evidence: …

Strengthening Post-Fall Huddle Practices In Long-Term Care, Janette Perry

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: High resident fall rates and repeat falls caused by an unreliable nurse-only post-fall huddle (PFH) process that lacked structure, interdisciplinary participation, and timely root-cause analysis.

Aim of the Project: To reduce falls and fall-related injuries in long-term care units by implementing a standardized, evidence-based PFH workflow that strengthens root-cause analysis, improves interdisciplinary communication, and increases PFH reliability.

Review of the Evidence: Evidence from fourteen high-quality, peer-reviewed studies demonstrates that structured, interdisciplinary post-fall huddles are more effective than informal, nurse-only approaches in improving fall analysis and reducing repeat falls in long-term care settings. Structured PFHs strengthen root-cause analysis; interdisciplinary participation …

Implementing A Risk-Stratified Fall Prevention Bundle To Reduce Inpatient Falls,, Nana A. Tabiri

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Step-Down Unit (SDU) had a high fall rate of 4.8 falls/ 1,000 patient days, falling short of the 3.0 falls/1,000 patient days organizational target. Despite the high fall rate, the unit used a one-size-fits-all approach, which was ineffective. Also, nursing practices in the unit were unevenly adopted.

Project Objective: The project aimed to lower the fall rate in SDU by 10% and increase compliance with risk-stratified documentation to at least 90%.

Evidence Review: A huge pool of evidence supported the adoption of a multifactorial, person-centered fall prevention approach as opposed to universal precautions. The AHRQ …

Baby-Friendly Implementation For Decreased Skin-To-Skin Care Initiation Delays, Brianna Grace

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Immediate skin-to-skin care (SSC) remains inconsistently implemented, despite evidence linking it to improved neonatal outcomes. At the project site, baseline SSC rates were 64% for vaginal births and 19% for Cesarean births, below the 80% standard established by the Baby-Friendly Hospital Initiative.

Aim of the Project: This QI project aimed to improve outcomes by implementing evidence-based SSC practice and first-hour breastfeeding initiation to align with Baby-Friendly standards.

Review of the Evidence: The applied interventions align with the seminal guidance from the World Health Organization and the United Nations Children’s Fund, which represents the global standard for maternity and newborn …

Rapid Environmental Health Impact Assessment: A Practical Methods Guide For Graduate Students With Alaska Examples, Eduardo Piqueiras, Britteny M. Howell

Educational Resources

Developed through graduate instruction in environmental and occupational health at the University of Alaska Anchorage, this guide provides a practical framework for conducting rapid environmental health impact assessments. It combines established assessment methods with applied Alaska examples, structured worksheets, and guidance for evaluating evidence, characterizing health impacts, and developing recommendations. The methods apply broadly; the examples are drawn from Alaska.

How The Spiritan Mission And Spirituality Can Bring Hope Today, Igono Abel Raphael Cssp

Spiritan Horizons

No abstract provided.

Visit To A Place Of Worship, Emma Mindach

Spiritan Horizons

No abstract provided.

Enhancement In Surface Finish Of Additively Manufactured 17-4ph Stainless Steel Using A Hybrid Chemical Machining–Magnetic Abrasive Finishing Approach, Harish Kumar, Gurpreet Singh, Anil K. Srivastava, Majid Hosseini

Manufacturing & Industrial Engineering Faculty Publications

Additive Manufacturing (AM) is a cutting-edge technique utilized for the precise manufacturing of complex components made from a variety of material compositions. Although AM, generally, produces a better surface finish than traditional subtractive methods, additional post-processing is required to attain the desired surface characteristics. One commonly used AM material is 17-4PH stainless steel, which is majorly employed in modern industries like aerospace, marine, petroleum, chemical, medical, and firearms due to its superior physical and chemical properties compared to other stainless steels. Surface finish of additively fabricated 17-4PH stainless steel can be further improved using various finishing techniques. This study presents …

Burden Of Disease In Us Patients With Skeletal Versus Muscular Or Pain Manifestations Of Hypophosphatasia: An Analysis From The Global Hpp Registry., Priya S. Kishnani, Steven Ing, Julie Hoover-Fong, J Carl Pallais, Angie Voskopoja, Shona Fang, William R Mowrey, Eric Rush, Kathryn Dahir

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Hypophosphatasia (HPP) is a metabolic disorder characterized by deficient alkaline phosphatase (ALP) activity, defective mineralization of bones and teeth, and non-skeletal manifestations. We compared disease burden between patients with skeletal and non-skeletal manifestations.

METHODS: Data from US adults enrolled in the Global HPP Registry through July 2024 were analyzed to compare baseline characteristics, genetic testing results, functional outcomes, and patient-reported outcomes between participants with and without overt skeletal manifestations. Patients who had only dental manifestations were excluded.

RESULTS: Of 283 participants, 234 (82.7%) had skeletal manifestations (79.1% female; 89.3% White; median age 48.7 years) and 49 (17.3%) had only …

Clinical Presentations, Treatments, And Outcomes Of Pediatric Lupus Nephritis: A Prospective Cohort Study From The Pediatric Nephrology Research Consortium., Melonie Phillips, Mahmoud Kallash, Chloe Tang, Steve Rust, Kia Jubert-Bacon, Scott Wenderfer, Smriti Mohan, Neal Blatt, Don Batisky, Alejandro Quiroga, Tetyana L. Vasylyeva, Nilka Dejesus, Jerome C. Lane

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There are few prospective studies of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) for pediatric lupus nephritis (pLN) and none evaluating rituximab (RTX).

METHODS: The Prospective Pediatric Lupus Nephritis Registry (ProPeL-R) enrolled patients <  21 years within 4 weeks of an initial kidney biopsy diagnostic of pLN. Demographic, clinical, and laboratory data were collected prospectively at enrollment, 3 months, 6 months, and then every 6 months thereafter for up to 5 years of follow-up. For this study, we compared patients receiving initial therapy with corticosteroids (CS) and either MMF (n = 33) vs. CYC (n = 18), and those treated with CS, either MMF or CYC, with RTX (n = 20) vs. without RTX (n = 51).

RESULTS: Histology consisted of 18% class III; 35% class IV; 25% mixed class; and 22% pure class V. Eighty-two percent were female. No significant differences in response or infection rates were identified between those receiving MMF or CYC. There was a significant increase in combined complete (CR) and partial response (PR) at 24 months with RTX use. Overall CR rates at 6 and 24 months were 35% …

Ceftaroline Pharmacokinetics On Ecmo, A Pediatric Case Report., Kathryn Pavia, Ashton Bellamy, Alaina Burns, Allison Scott, Ethan A. Poweleit

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: In-vitro studies suggest that patients on extracorporeal membrane oxygenation (ECMO) may struggle to achieve therapeutic ceftaroline exposure to treat infections due to antibiotic sequestration within the ECMO oxygenator; however, there are no published data regarding ceftaroline concentrations from patients supported by ECMO.

PATIENT PRESENTATION: Here we present an analysis of ceftaroline pharmacokinetics in a 5-y-old patient supported on ECMO due to influenza-associated necrotizing pneumonia.

RESULTS: A total of nine concentrations were analyzed, including three concentrations prior to cannulation and six on ECMO. ECMO cannulation was associated with a relatively small change in the volume of distribution (0.17 L/kg to …