Digital Commons Network^™

Genome-Wide Gene By Sleepiness Interaction Analysis For Sleep Apnea, Pavithra Nagarajan, Nuzulul Kurniansyah, Jiwon Lee, Sina A Gharib, Yushan Xu, Yiyan Zhang, Brian Spitzer, Tariq Faquih, Hufeng Zhou, Eric Boerwinkle, Han Chen, Daniel J Gottlieb, Xiuqing Guo, Nancy L Heard-Costa, Bertha A Hidalgo, Daniel Levy, Peter Y Liu, Hao Mei, Rebecca Montalvan, Sutapa Mukherjee, Kari E North, George T O'Connor, Lyle J Palmer, Sanjay R Patel, Bruce M Psaty, Shaun M Purcell, Laura M Raffield, Stephen S Rich, Jerome I Rotter, Richa Saxena, Albert V Smith, Katie L Stone, Xiaofeng Zhu, Topmed Sleep Trait Working Group, Brian E Cade, Tamar Sofer, Susan Redline, Heming Wang

Faculty, Staff and Student Publications

Study objectives: Excessive daytime sleepiness (EDS), influenced by environmental and social-behavioral factors, is reported by a subset of patients with sleep apnea-a group that may be at elevated cardiovascular risk. However, it is unclear whether sleep apnea with and without EDS have distinct genetic underpinnings. In this study, we perform gene-by-EDS interaction analyses for apnea hypopnea index, a diagnostic marker of sleep apnea severity, to understand EDS's influence on its underlying genetic risk.

Methods: Discovery interaction analyses for common variants and gene-based rare variants were conducted respectively using multi-ethnic Trans-Omics for Precision Medicine (N = 11 619) data, followed by …

No More “Vague Handwaving”: Applying The Overlooked “Person Aggrieved” Provision Of The North Carolina Administrative Procedure Act To Election Litigation, William Allred

Duke Law Journal

The North Carolina Administrative Procedure Act requires claimants against state agencies to be “persons aggrieved,” meaning they have been “affected substantially” in their “person, property, or employment” by the challenged agency action. But in the 2024 general election, North Carolina state courts largely ignored this requirement, permitting plaintiffs to sue based on allegations of harm that some considered to reflect no more than “vague handwaving about election integrity.” This fact-light litigation strained state resources and reduced ballot access. But the solution is not so simple as just reminding courts that a statute exists. State appellate courts have never explained how …

Insights On Global Rangeland Ecosystem Services Shaped By Grazing And Fertilization, Laura Yahdjian, Sofía Campana, Pedro M. Tognetti, Juan Alberti, Pamela Graff, Cecilia Molina, Elizabeth T. Borer, Eric W. Seabloom, Suzanne M. Prober, Andrew S. Macdougall, Anita C. Risch, Jodi N. Price, Sally A. Power, Isabel C. Barrio, Erika Hersch-Green, Philip A. Fay, Sumanta Bagchi, Jonathan D. Bakker, Dana Blumenthal, Elizabeth H. Boughton, Cynthia S. Brown, Miguel N. Bugalho, Marc Cadotte, Maria C. Caldeira, Jane A. Catford, Clinton Carbutt, Qingqing Chen, Scott L. Collins, Thomas W. Crowther, Carla D’Antonio, Christopher R. Dickman

Michigan Tech Publications

Rangelands are crucial to human well-being, but their ability to provide ecosystem services is threatened. We (1) quantified key ecosystem services provided by rangelands, (2) assessed short- and long-term impacts of fertilization (nutrient addition) and the exclusion of large grazing herbivores with fences (herbivore exclusion) on services, and (3) identified synergies and trade-offs among services. We measured indicators of ecosystem services and plant diversity at 79 sites across six continents in the global Nutrient Network. Short-term herbivore exclusion increased forage quantity and soil fertility, but longer-term herbivore exclusion decreased both along with plant richness and pollination. Nutrient addition improved forage …

Prevalence Of And Factors Associated With Nurse Burnout In The Us, Megha K. Shah, Nikhila Gandrakota, Jeannie P. Cimiotti, Neena Ghose, Miranda Moore, Mohammed K. Ali

Individual Open Access Articles

IMPORTANCE Clinician burnout is a major risk to the health of the US. Nurses make up most of the health care workforce, and estimating nursing burnout and associated factors is vital for addressing the causes of burnout.

OBJECTIVE To measure rates of nurse burnout and examine factors associated with leaving or considering leaving employment owing to burnout. DESIGN,

SETTING, AND PARTICIPANTS This secondary analysis used cross-sectional survey data collected from April 30 to October 12, 2018, in the National Sample Survey of Registered Nurses in the US. All nurses who responded were included (N = 50 273). Data were analyzed …

Ai-Assisted Tailored Intervention For Nurse Burnout: A Three-Group Randomized Controlled Trial, Gumhee Baek, Chiyoung Cha

Individual Open Access Articles

Background: High-stress environments, heavy workloads, and the emotional demands of patient care, which are common challenges faced by nurses, are factors that can lead to burnout. Shift work can make traditional burnout interventions costly and difficult to implement. Artificial intelligence (AI) could offer solutions that are less constrained by time, resources, and labor.

Aim: To investigate the effectiveness of an AI-assisted intervention in reducing nurse burnout.

Methods: A single-blind, three-group, randomized controlled trial of 120 nurses (40 per group) was conducted from June 2023 to July 2023. The AI-assisted tailored intervention included two 2-week programs, delivering one of four programs …

Mediating Role Of Lifestyle Factors In The Resilience–Job Satisfaction Relationship Among Nurses: A Descriptive Correlational Study, Lena I. Serafin, Katarzyna Wesołowska-Gorniak, Angeli Malewska, Karolina Kruszewska, Justyna Kujawa, Bozena Czarkowska-Pączek

Individual Open Access Articles

Given the global nursing shortage and the increasing prevalence of workplace stressors, resilience has emerged as a crucial factor influencing job satisfaction, preventing burnout, and ensuring high-quality patient care. While previous research has established a connection between resilience and various occupational outcomes, the mediating effect of health-promoting behaviors—such as physical activity, diet, and sleep—remains largely unexplored, underscoring the need for further investigation in this area. Therefore, the objective of this study is to examine the effect of chosen lifestyle aspects on the connection between resilience and job satisfaction among nurses.

Personal And Work-Related Factors Associated With Nurse Resilience: An Updated Systematic Review Using Meta-Analysis And Narrative Synthesis, Fiona Yu, Deborah Raphael, Lisa Mackay, Melody Smith, Ritin Fernandez

Individual Open Access Articles

Background: Nursing shortages and increased workforce turnover have significantly increased nurses’ workloads, thus increasing the risk of burnout and stress, particularly during the COVID-19 pandemic. A systematic review published in 2019 suggested that resilience could act as a buffer to adversity; however, the factors associated with resilience during and after this global pandemic have not been identified.

Objectives: To identify personal and work-related factors associated with nurse resilience, including the period during and after the COVID-19 pandemic.

Design: Systematic review.

Data Sources: The search was conducted between January and February 2024 in the following databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, …

Advanced Practice Registered Nurse Burnout In Magnet Hospitals: Opportunities For Organizational Intervention, Lori Kennedy, Heather Brom, Karen B. Lasater, Nancy M. Albert, Barbara Holmes Gobel, Christi Delemos, Lisa M. Williams, Linda H. Williams, Linda H. Aiken

Individual Open Access Articles

OBJECTIVE: To determine modifiable organizational factors associated with advanced practice RN (APRN) burnout in Magnet®-designated hospitals to guide organizational interventions to improve APRN well-being and retention.

METHODS: Cross-sectional study of work environments of 50 US Magnet hospitals and the associated well-being of 21 855 of their clinicians (APRNs, physician assistants, physicians [MDs], RNs).

RESULTS: Overall, 37%of APRNs experienced high burnout compared with 34% of MDs (P < 0.05) and 49% of RNs (P < 0.001); additionally, 32%of APRNs intended to leave their jobs. APRN burnout was significantly lower in organizations that minimized chaotic working conditions, provided APRNs more control over their workloads, involved APRNs in shared governance, improved clinician and management relations, and improved interprofessional teamwork.

CONCLUSIONS:Well-being and retention of APRNs in Magnet hospitals require their greater engagement in organization processes and systems that improve work environments.

Evidence-Based Practice Improves Patient Outcomes And Healthcare System Return On Investment: Findings From A Scoping Review, Linda Connor, Jennifer Dean, Molly Mcnett, Donna M. Tydings, Amanda Shrout, Penelope F. Gorsuch, Ashley Hole, Laura Moore, Roy Brown, Bernadette Mazurek Melnyk, Lynn Gallagher-Ford

Individual Open Access Articles

Background: Evidence-based practice and decision-making have been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes in isolated reports throughout the literature. However, a comprehensive summary and review of the extent and type of evidence-based practices (EBPs) and their associated outcomes across clinical settings are lacking.

Aims: The purpose of this scoping review was to provide a thorough summary of published literature on the implementation of EBPs on patient outcomes in healthcare settings.

Methods: A comprehensive librarian-assisted search was done with three databases, and two reviewers independently performed title/abstract and full-text reviews within a systematic …

The Relationship Between Cadet Strength And Musculoskeletal Injury During Basic Training And Physical Program Requirements, Gregory Hess

Doctorate in Kinesiology

Musculoskeletal injuries (MSKIs) are a leading cause of lost training time and reduced readiness in military populations. This study examined the relationship between muscular strength and MSKI prevalence among New Cadets (NCs) at the U.S. Military Academy during six weeks of Cadet Basic Training (CBT). Using self-reported survey data, muscular strength was assessed via the Army Fitness Test (AFT) three-repetition maximum deadlift (MDL), and injury status was determined from reported bone, muscle, joint, or tendon injuries. Analyses included paired t tests comparing pre- and during-CBT MDL performance, Welch’s t tests by injury status, and Spearman correlations with training behaviors and …

Intelligent Prediction Model For Icing Of Asphalt Pavements In Cold Regions Oriented To Geothermal Deicing Systems, Junming Mo, Ke Wu, Jiading Jiang, Lei Qu, Wenbin Wei, Jinfu Zhu

Faculty Research, Scholarly, and Creative Activity

To address traffic safety hazards from asphalt pavement icing in Xinjiang’s cold regions and inefficiencies of conventional deicing and imprecise geothermal deicing systems, this study focused on local asphalt surfaces. Using “outdoor qualitative screening and indoor quantitative verification”, key variables were identified via controlled tests and their coupling effects on the time to complete icing were quantified through an L16(4⁴) orthogonal test (a 4-factor, 4-level design encompassing 16 test groups). A Backpropagation (BP) neural network model (3 inputs, 5 hidden neurons, and a learning rate of 0.7) optimized with 64 datasets was established to predict the time to …

Effect Of Microwave Treatment On Structure , Physicochemical Properties , And Digestibility Of Oat Starch, Sun Huijun, Xu Yixuan, Wang Jiameng, Zhou Yibin, Yu Zhenyu

Food and Machinery

[Objective] To investigate the effect of microwave treatment on the structure, physicochemical, and digestibility of oat starch. [Methods] Oat starch (OAT) is taken as the research object to analyze the effects of different microwave treatment times on the particle size distribution, microstructure, crystalline structure, short-range ordered structure, thermodynamics, rheology, and digestibility of OAT. [Results] With the prolongation of microwave treatment time, OAT granules are expanded, and the particle size is significantly increased. Additionally, the crystallinity is decreased from 12.32% to 5.33%, the infrared absorption ratio R1 047 cm-1/1 022 cm-1 is decreased from 0.73 to 0.62, and the half width …

Research Progress Of Non-Thermal Food Processing Technologies, Wei Wenqiang, Bi Hanqing, Xiao Zhaoyin, Pang Guibing, Li Mingying, Zhang Hui

Food and Machinery

Non-thermal food processing technology, as an emerging technology in the food industry, has increasingly attracted attention and plays an important role in improving food nutrition, safety, and quality. This paper focuses on the working principles, mechanisms of action, and applications of non-thermal food processing technologies, including six mainstream methods, i.e., high-voltage electric field, magnetic field, ultra-high pressure, plasma, ultrasound, and radiation. It also discusses the current difficulties and challenges faced by non-thermal food processing technologies and analyzes their future development trends.

Molecular Survival Strategies Against Kidney Filtration: Implications For Therapeutic Protein Engineering, William Heaps, Anna Elise Packard, Kristina M. Mccammon, Tyler P. Green, Joseph P. Talley, Bradley C. Bundy, Dennis Della Corte

Faculty Publications

The glomerular filtration barrier poses a significant challenge for circulating proteins, with molecules below ~60–70 kDa facing rapid renal clearance. Endogenous proteins have evolved sophisticated evasion mechanisms including oligomerization, carrier binding, electrostatic repulsion, and FcRn-mediated recycling. Understanding these natural strategies provides blueprints for engineering therapeutic proteins with improved pharmacokinetics. This review examines how endogenous proteins resist filtration, evaluates their application in protein engineering, and discusses clinical translation including established technologies (PEGylation, Fc-fusion) and emerging strategies (albumin-binding domains, glycoengineering). We address critical challenges of balancing half-life extension with tissue penetration, biological activity, and immunogenicity—essential considerations for the rational design of next-generation …

Method And System For Secure Re-Registration Of Unified Payments Interface Accounts, Alok Roy

Defensive Publications Series

The present disclosure relates to a secure method and system for re-registration of a Unified Payments Interface (UPI) account, which employs a Cloud-Backed Device Continuity Token (CDCT). The method includes generating the CDCT during initial user registration using a one-way hash function based on a random number, a mobile number, and a timestamp. The CDCT is securely stored in both a backend server of a UPI payment application provider and in a user cloud identity vault. During a re-registration attempt on a new device, the presence and authenticity of the CDCT are validated. If the token matches, re-registration is allowed, …

Delta-Driven Data Rebuilding System With Integrity Verification Via Layered Checksum, Alok Roy

Defensive Publications Series

A system and method for reconstructing and validating versions of a data record. The system continuously monitors and stores data records, data changes and checksums of a plurality of versions of each data record after every operation. Upon receiving a request from a user device to roll back to a target version of the data record the system determines proximity of the target version to first and last versions of the data record and determines traversal direction based on the proximity of the target version. The system generates target version of the data record by traversing through data changes in …

Assessment Of Engine Performance And Characteristics Of Soot And NoX Emissions In The Vcr Engine Fuelled With Different Sustainable Fuel Blends, Mohammed A. Fayad, M. A. I. Al-Hamid, Shaimaa B. Al-Baghdadi, Suha A. Mohammed, Amani Ahmed, Hind A. Al Salihi, Hussain Ali Hussain, Salman Hussien Omran, Francisco J. Martos

Terra Joule Journal

In last few decades, many researchers working on the alternative fuel such as biodiesel that used in CI engine. It is proposed that the biodiesel can be good replace to the diesel due to the lower exhaust emissions, agricultural origin and improve the combustion process and engine performance. Rapeseed methyl ester (RME) blended with diesel fuel as sutainable fuel by 10% R10D, 20% R20D and 30% R30D in this study. Various compression ratio (CR) of 15 and 18 and different engine loads (25%, 50%, 75% and 100%) with keep engine speed constant. The results showed that the BTE increased with …

Hydrogen Energy As Sustainable Energy: A Comprehensive Review, Talal Yusaf, Kumaran Kadirgama, Hayder A. Dhahad, Abd Rahim Abu Talib, L. Samylingam, Navid Aslfattahi, Maryam Sadat Kiai, Chee Kuang Kok

Terra Joule Journal

Hydrogen is increasingly recognized as a cornerstone of the global transition toward a low-carbon and sustainable energy system. This review synthesizes recent advances across the hydrogen value chain—from production and storage to utilization and policy—while highlighting the opportunities and challenges shaping its large-scale deployment. We compare the main production routes, including reforming, gasification, and electrolysis, with particular attention to green hydrogen derived from renewable energy. Advances in storage technologies, such as compressed, liquid, and solid-state systems, are critically assessed in terms of efficiency, safety, and scalability. The analysis extends to hydrogen’s emerging roles in hard-to-abate sectors including industry, heavy transport, …

Confluence, Vol. 4, Iss. 2, Full Issue

The Confluence

No abstract provided.

A Comparative Analysis Of Eyewitness Testimony Accuracy: Victims Versus Bystanders, Allyson Phillips

The Confluence

Eyewitness testimony is a vital yet fallible component of the criminal justice system. This study investigates differences in eyewitness testimony accuracy between two witness types: victims and bystanders, adding to the scarce literature regarding the subject. Participants were assigned to either the Victim or Bystander Group and participated in a memory test. During the memory test, a staged intruder entered the room and stole either a gift card belonging to the participant (Victim Group) or me (Bystander Group). Following the theft, participants were given an eyewitness testimony survey and photo lineup to assess their memory of the theft and intruder. …

Evaluating Lunch Plan Data In The St. Charles School District (Scsd), Maddy Alexander, Guillermo Bilbao Olarreaga, Duncan Krige, Alyssa Schreiber, Nick Wintz, Wojciech Golik

The Confluence

The SCSD is a public school district in St. Charles, with, on average, 4500 students a year. The SCSD is subdivided into an early childhood center, six elementary schools, two intermediate (5-6,7-8) schools, and two high schools. Vocational schools are also within this district but were not included in this report. The SCSD is concerned with the impact of the Covid-19 pandemic on their district’s population and on the number of students that needed assistance with lunch. They have asked Lindenwood’s 2024-25 PIC Math group to analyze their data from the years 2020-25 and identify any trends. Identifying these trends …

A Tiny Battle: Conflict, Structure, And Satire In "The Rape Of The Lock", Helen R. Ball

The Confluence

Writing in London during the eighteenth-century, the poet Alexander Pope earned an enduring reputation in literary canon as a master of satire. His well-loved poem The Rape of the Lock exemplifies his biting wit and characteristically satirical heroic rhyme couplets. In my article, I use a formalist literary approach to examine Pope's stylistic, literary, and rhetorical strategies throughout the climactic third canto of the poem. Performing a close reading, this essay analyzes the intricacies of the poem through its use of diction, rhyme, and dramatic subject matter, ultimately arguing that Pope achieves a complex balance of satirizing and sympathizing with …

Lucy Wortham James And The Gospel Of Wealth: A Case Study Of Female Philanthropy In Rural Missouri During The Progressive Era, Jacob F. Rinehart

The Confluence

Various historical scholars have examined the role of Andrew Carnegie's Gospel of Wealth on philanthropic attitudes and endeavors of affluent Americans during the Progressive Era. Modern developments, driven by post-structural feminist theory, have shown that rural-born Missouri women, exemplified by Phoebe Apperson Hearst, acted as complementary equals to Carnegie through their humanitarian efforts by uniquely interpreting and implementing his social doctrines. However, the existing scholarship has focused substantially on coastal developments, neglecting the role of this benevolence in rural Missouri communities. By examining the philanthropic endeavors of Lucy Wortham James, both during her life and post-mortem through her endowment of …

Mindful Libraries: Integrating Well-Being Into Library Strategy And Culture, Lauren Fralinger, Jose Rodriguez, Adrian Legaspi, Nyabi Benjamin

Navigating the Future Together: Student Success Symposium

Abstract:

Academic libraries are uniquely positioned to support holistic student success by fostering environments that promote well-being, belonging, and resilience. This presentation highlights how our university library integrates wellness into its strategic planning, services, and physical spaces. Through initiatives such as a dedicated meditation room, guided mindfulness sessions, and stress-relief activities, the library creates inclusive spaces for reflection and restoration. A curated Mindfulness Collection—featuring digital and physical resources on mental health, spirituality, and contemplative practices—empowers students to explore wellness on their own terms. These efforts are complemented by Earth Month programming that connects personal well-being with environmental stewardship.

Library leadership …

Working With What We've Got: Small-Scale Assessment Of Library Impact On Student Success, Gina Calia, Amna Zigic

Navigating the Future Together: Student Success Symposium

Harford Community College Library has been working on illustrating the impact the Library has on student success. Working in a community college library, librarians often have to wear many hats, helping patrons with everything from printing and finding their way around campus to troubleshooting devices and navigating their courses in the LMS, in addition to our primary duties of helping students with research, teaching information literacy sessions, creating online guides and tutorials, maintaining our print collection, participating in outreach activities, and much more. It can often be challenging to find time to synthesize the various data and statistics we collect, …

Interprofessional Collaboration In Inpatient Rehabilitation For Patient With Thiamine Deficiency-Related Sensorimotor And Cognitive Deficits – Case Report, Christina Thomas, Tahreem Hashmi, Joanne Delgado-Lebron, Rania Massad

Journal of Interprofessional Practice and Collaboration

Purpose: We aim to describe the clinical presentation, interprofessional management, and functional outcomes of a patient with thiamine deficiency. Problem: Thiamine deficiency can result in peripheral polyneuropathy and cognitive deficits that limit function and participation. Despite deficits that warrant interprofessional neurorehabilitation, previous reports focus narrowly on medical management. Case: A 36-year-old female was admitted to inpatient rehabilitation with a diagnosis of Guillain Barre. She underwent evaluation by the interprofessional team that revealed cognitive deficits inconsistent with Guillain Barre. Further medical workup identified a thiamine deficiency. Comprehensive treatment included supplementation managed by the physiatrist; promotion of motor learning and neuroplasticity to …

Co-Designing Health Education: A Mixed-Methods Study Of Interdisciplinary Collaboration Between Dpt Faculty And Interactive Media Students, Francois A. Prizinski, Charles Palmer, Jacki Kopack, Caitlin Mcgee

Journal of Interprofessional Practice and Collaboration

Purpose: This study explored the impact of an interdisciplinary collaboration between Doctor of Physical Therapy (DPT) faculty and Interactive Media (IMED) students to co-design a gamified training module on Personal Protective Equipment (PPE).

Problem: While interprofessional education (IPE) traditionally focuses on clinical disciplines, healthcare's increasing reliance on digital tools demands collaboration with non-clinical fields. Limited research exists on incorporating design and technology students into healthcare education to co-create meaningful instructional content.

Significance: The study applied the Double Diamond design model and Design Thinking pedagogy to guide a 6-week collaboration between DPT faculty and IMED students. A mixed-methods …

Fear Of Falling: A Collaborative Approach To Treatment, Alexandra Uhren, Celeste Delap, Kate Jansen

Journal of Interprofessional Practice and Collaboration

Purpose: Physical Therapy (PT) and Behavioral Health (BH) often overlap in patient care; however, collaborative treatment is always not utilized by providers. This case study details the interdisciplinary treatment of a 69-year-old female with a fear of falling; emphasizing the importance of interprofessional collaborative care in treating Fear of Falling (FOF) in individuals at risk for fall-related injury with Cognitive Behavioral Therapy (CBT) and PT interventions.

Problem: FOF is common among older adults and can result in physical, psychological, and social consequences (Lee & Tak, 2023; MacKay et al., 2021). Patients at risk of fall-related injury experience decreased self-confidence in …

Treatment For Women With Mental Health Disorders Associated With Reproductive Health: An Opportunity For Interprofessional Collaboration, Ellen Modlin Phd, Otr/L, Bcp, Caps, Deana Goldin Phd, Dnp, Arnp, Fnp-Bc, Pmhnp-Bc

Journal of Interprofessional Practice and Collaboration

Abstract

Purpose: This article proposes an opportunity for interprofessional collaboration between mental health practitioners (MHPs) and occupational therapy practitioners (OTPs) for the treatment of women experiencing mental health disorders (MHDs) associated with reproductive health (RH) changes throughout the lifespan. This collaborative approach have the potential to optimize women’s health care and mitigate the risk of fragmented care, as these conditions are highly complex.

Method: Peer- reviewed literature from mental health and occupational therapy (OT) research was reviewed and summarized. The search focused on the barriers and potential opportunities for collaboration between MHPs and OTPs in women affected with MHDs associated …

A Phenomenological Exploration Into The Interpersonal Relationships And Mental Health Impacts Of Physical Activity, Movement, And Play On The Lived Experiences Of Caribbean Mothers, Janelle Chase-Mayers, Theresa D. Thomas

Journal of Interprofessional Practice and Collaboration

Purpose: To explore the impact of wellness strategies incorporating movement, physical activity, and play on the mental health and interpersonal relationships of Caribbean mothers aged 25 and older.

Methods: A phenomenological study was conducted in 2021 to delve into the lived experiences of seven Caribbean mothers. Semi-structured interviews were employed to gather rich, qualitative data on their perceptions of wellness, motherhood, and the role of movement and physical activity in their lives.

Results: Over 700 codes resulted in 6 themes and 100 subthemes. Thematic analysis revealed six key themes: 1. Family of Origin Influences: Participants discussed how …