Digital Commons Network^™

Agency Protocol: A Decentralized Trust-Building System Using Domain-Specific Merit And Economic Stakes To Incentivize Promise-Keeping In Agent-To-Agent Interactions, David Joseph

Defensive Publications Series

The Agency Protocol defines a decentralized trust infrastructure in which autonomous agents cooperate by issuing cryptographically‑signed, domain‑scoped promises and verifiable assessments. Each promise carries a dual‑component stake—an at‑risk credit deposit and a non‑refundable operational‑cost fee—that is locked in content‑addressed storage and returned or slashed according to assessment consensus. Assessments are merit‑weighted; an agent’s merit is a non‑transferable, domain‑specific reputation score updated by matrix‑factorized aggregation of historical outcomes, while credits form a fully transferable internal currency. Merit discounts future stake requirements, creating a positive feedback loop that makes honest behaviour utility‑maximising.

External facts enter the system through a decentralised oracle …

“Try, Start, Do It”: Phil Zimbardo And The Heroes’ Square Foundation, Györgyi Orosz

Heroism Science

This article pays tribute to the life and legacy of Philip Zimbardo, emphasizing his transformative influence in Hungary through education, social engagement, and the science of heroism. The journey began with a 2012 invitation that brought Zimbardo to Budapest, ultimately leading to the foundation of the Heroes’ Square (Hősök Tere) initiative. His message—that heroism is not reserved for the exceptional but is accessible and teachable—became the core of nationwide programs focused on mindset, intervention behavior, and social responsibility. Zimbardo’s influence went beyond academia; he inspired personal and institutional change. The foundation’s programs, such as teacher trainings, the Hero School, and …

Enterobacter Cloacae As A Rare Cause Of Cerebral Abscesses In A Neonatal Late-Onset Sepsis – A Case Report And Literature Review With Focus On Risk Factors, Diagnostics And Treatment, Yıldız Yıldırım, Ruy Perez, Rüdiger Wentzell, Clemens Andrée, Martin Weinzierl, Norbert Utz, Tim Niehues

Journal of Pediatric Infectious Diseases

Late-onset sepsis (LOS; sepsis occurring after the first 72 hours of life) increases the morbidity and mortality of premature neonates, especially those with very-low-birth weight (≤1500g). In LOS, Enterobacter cloacae has been rarely described as a cause of secondary brain abscesses. Our case report summarizes important aspects of cerebral abscesses due to an E. cloacae sepsis in a preterm neonate. Our patient received surgical abscess drainage and rational antibiotic treatment employing prolonged meropenem infusions plus fosfomycin and subsequent treatment with oral trimethoprim/sulfamethoxazole. Furthermore, we present a review of the current literature from 2009-2022, comparing cases similar to our case.

Modulation Of Dendritic Cell Phenotypes By Cd4+ Effector Memory T Cell Via Ikzf1-Regulated Il16/Cd4 Signaling In Covid-19 And Kawasaki Disease, Seyan Yan, Kaiming Zheng, Zicheng Zhen, Tianfu Xu

Journal of Pediatric Infectious Diseases

Objective: Kawasaki Disease (KD) is the primary cause of acquired heart disease among children in developed countries and is identified by systemic vasculitis of unknown origin. This research explores the possible common pathogenesis between KD and coronavirus disease 2019 (COVID-19), focusing on the roles of peripheral blood mononuclear cell (PBMC) subpopulations. Methods: We utilized single-cell and bulk RNA sequencing data from COVID-19 and KD patients, as well as healthy controls. Our comprehensive analysis included cell-type identification, pseudotime analysis, cell-cell communication, and transcription factor analysis. Results: Our results show the critical role of CD4+ effector memory T cells and dendritic cells …

Magnitude And Factors Associated With Mortality Of Neonates Admitted To Intensive Care Unit In Northern Ethiopia: Hospital-Based Cross-Sectional Study, Gebrhud Berihu Haile, Tensay Kahsay Weldegebreal, Desta Hailu Aregawi, Daniel Birhane Berhe, Tomas Amare Abraha

Journal of Pediatric Infectious Diseases

Objectives: Neonatal mortality is a global burden both in developed and developing countries. Marked disparities exist across countries. In Ethiopia, the neonatal mortality rate is unacceptably high. Even though some published research exists, there is a lack of data regarding the magnitude and factors associated with mortality in neonates. The aim of this study was to assess the magnitude and factors associated with mortality in neonates admitted to intensive care units in northern Ethiopia. Methods: A cross-sectional study was employed among 325 neonates admitted to intensive care units in public hospitals from October 2021 to May 2022. Systematic random sampling …

Investigating Respiratory Viral Pathogens In Pediatric Age Groups, Yaser Ali Hussein Musawa, Fatma Esenkaya Taşbent, Mehmet Özdemir

Journal of Pediatric Infectious Diseases

Objective: Respiratory viral infections are the leading causes of morbidity and mortality in children. Acute respiratory infections account for approximately 20% of childhood fatalities. This study aimed to retrospectively investigate the respiratory viral agents and epidemiological characteristics, in pediatric patients. Methods: The study included pediatric patients, aged 0-18 years. A retrospective analysis was conducted on 5,253 samples sent to the microbiology laboratory with suspected respiratory tract infection between January 1, 2020 and December 31, 2023. Sixteen different viral agents were investigated in samples using multiplex PCR. The enrolled patients were divided into three groups. Positive results were examined in terms …

The Role Of Hematological Parameters In The Differential Diagnosis Of Testicular Torsion And Epididymo-Orchitis In Children, Mehmet Sarikaya, Fatma Ozcan Siki, Metin Gunduz, Tamer Sekmenli, Muslu Kazım Korez, Ilhan Ciftci

Journal of Pediatric Infectious Diseases

Objective: This study uses various hematological inflammatory parameters to evaluate the diagnostic distinction between testicular torsion (TT) and epididymo-orchitis (EO). These include the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, systemic inflammation response index, panimmune inflammation value, derived neutrophil-to-lymphocyte ratio, and neutrophil-lymphocyte-platelet ratio. Methods: The demographic data and hemogram parameters of TT and EO cases treated in the pediatric surgery clinic between January 2010 and January 2023 were retrospectively examined. The hematological inflammatory parameters were statistically compared across the groups. Results: The study included 181 patients, categorized into control (n = 60), TT (n = 64), and EO …

Epidemiological Characteristics Of Mycoplasma Pneumoniae Epidemic Among Children In Ningbo, China, 2022-2023, Fei Xu, Yefang Ke, Fei Li, Wenbo Lu, Junhua Wu, Wenyuan Liu

Journal of Pediatric Infectious Diseases

Objective Following the full relaxation of COVID-19 control measures in China at the end of 2022, there was a resurgence of pediatric Mycoplasma pneumoniae pneumonia (MMP) outbreaks. Methods We performed a retrospective study of children with M. pneumoniae pneumonia who were admitted to the Women and Children's Hospital of Ningbo University between January 2022 and December 2023. Demographic and clinical characteristics and proportion of A2063G/A2064G mutant train were compared between 2022 and 2023. Results Among the 13013 children hospitalized with pneumonia in 2022 and 2023, M. pneumoniae infections were identified in 4889 cases (37.57%). Notably, the positive rate of M. …

Dynamics Of Human Adenovirus In Hospitalized Children With Acute Respiratory Tract Infection During 2014-2022 In Hubei Province, China, Song Yi, Juan Du, Wan-Xue Zhang, Xin-Rui Wang, Yi-Guo Zhou, Xing-Wen Hu, Qing-Bin Lu

Journal of Pediatric Infectious Diseases

Objective: The study mainly aimed to explore the impact of Human adenovirus (HAdV) detection by two-child policy and coronavirus disease 2019 (COVID-19) epidemic in China. Methods: Hospitalized children with ARTI were enrolled in Maternal and Child Health Hospital of Hubei Province from January 2014 to June 2022, whose clinical data were collected retrospectively. The effects of two-child policy and COVID-19 pandemic on the detection of HAdV were analyzed. Results: Among 100215 hospitalized children with ARTI, the positive rate of HAdV was 1.93% with the peak in 2019. After the implementation of two-child policy, the positive rate of HAdV during 2017-2019 …

Prognostic Nutritional Index For Predicting Late-Onset Sepsis And Mortality In Late Preterm Infants: A Retrospective Study, Nurdan Dinlen Fettah, Nihan Yıldırım Yıldız, Seda Aydoğan, Meltem Aksu, Ferit Kulalı, Nur Aycan

Journal of Pediatric Infectious Diseases

Objective: Neonatal sepsis is a critical condition with considerable mortality and morbidity. The prognostic nutritional index (PNI), calculated from serum albumin level and lymphocyte count, is a marker for assessing nutritional and inflammatory states. This study evaluates the clinical value of PNIs in predicting late-onset sepsis and mortality in late-preterm neonates. Methods: This retrospective single-center study included 210 neonates with suspected sepsis. Clinical and laboratory data were collected, and PNI was calculated using the formula: serum albumin (g/L) + 5 × total lymphocyte count (10^9/L). Of the total cohort, 130 neonates with confirmed sepsis were assigned to the sepsis group, …

Association Of Respiratory Viruses With Febrile Seizures: A Two-Year Observational Study, Ivana Clara Trittler-Ugidos, Fernando Paredes-Carmona, Núria Visa-Reñé

Journal of Pediatric Infectious Diseases

Objective: This study aims to explore the association between respiratory viruses and febrile seizures (FS), and to analyze the impact of these viruses on the type and management of FS. Methods: We conducted a retrospective, single-center study of 49,445 emergency cases from September 2021 to December 2023. Among these, 266 patients with FS were identified. Nasopharyngeal swabs were performed to detect respiratory viruses. We categorized FS into simple febrile seizures (SFS) and complex febrile seizures (CFS) based on established criteria. Results: Of the 266 FS cases, 150 had a nasopharyngeal swab and 76.6% were positive for respiratory viruses. The most …

Prognostic Value And Clinical Influence Of Long Non-Coding Rna Small Nucleolar Rna Host Gene 1 Expression In Pediatric Pneumonia, Xin Wang, Jiajia Xu, Jingjing Han

Journal of Pediatric Infectious Diseases

Objective: Severe pediatric pneumonia is characterized by acute onset and rapid progression, posing a serious threat to patients' lives. Accurate assessment of the severity of pneumonia is essential for clinical decision-making and prognostication. Studies of acute lung injury and lung cancer have revealed a significant increase in the expression of the long non-coding RNA (lncRNA) small nucleolar RNA host gene 1 (SNHG1) in cells, suggesting that SNHG1 is likely to play an important role in the progression of lung disease. Methods: 72 children with mild pneumonia, 58 children with severe pneumonia and 135 healthy children were selected as study subjects. …

A Decade Of Pediatric Intensive Care Outreach And The Deteriorating Child—The Relationship Between Dose And Outcomes In A Tertiary Children's Hospital, Lynette Kirby, Jayshan Chagan, Catherine Adams, Natalie Duns, Michael Haddad, Sarah Pearson, Oliver Tegg, Chong Tien Goh

Journal of Pediatric Intensive Care

Objectives: The aim of this study is to evaluate the amalgamation and maturation of a Paediatric Intensive Care Outreach Service (PICOS) with a Rapid Response System (RRS) and associated outcomes over a ten year period. Methods: Single centre retrospective study analysing patient outcomes within the context of significant organisational changes introducing a track & trigger RRS called Between the Flags (BTF), and evolution of this system to electronic observation charting and alerts (eBTF) in a tertiary metropolitan children’s hospital. Children on inpatient wards who required urgent activation of the RRS and admission to the Paediatric Intensive Care Unit (PICU) between …

Utility And Impact Analysis Of Inpatient Pediatric Physiologic Monitoring, Anand Gourishankar, Monaliza Evangelista, Misti Ellsworth, Jean Hsu

Journal of Pediatric Intensive Care

Objective: This study aimed to study the practice and effect of monitoring pediatric patients in the length of stay (LOS). Methods: We performed a prospective, observational study of pediatric patients in the general ward from October to December 2016. We have recorded the use of cardiac, pulse-oximeter, or both, and as per physician order at time of patient admission. We have studied the proportions of monitoring at different patient groups. We have applied linear regression model to investigate the relationship between LOS and cardiopulmonary monitoring, orders, and medical complexity. Results: Among 399 patients, patients with cardiac and pulse oximeter monitoring …

Incidence And Risk Factors For Hyponatremia In Hospitalized Children With Lower Respiratory Tract Infections, Anshul Bhargava, Vikram Patra, Priyanka Amonkar, Jeetendra Gavhane

Journal of Pediatric Intensive Care

Objectives: Lower respiratory tract infection (LRTI) is an important cause of hospitalization in pediatric population. Hyponatremia is frequently present in children hospitalized with pneumonia and bronchiolitis and is associated with poorer outcomes. We conducted a study to identify the risk factors for hyponatremia in hospitalized children with LRTI and to evaluate the relationship between serum sodium levels and severity of respiratory distress. Methods: 147 patients between 2 months – 12 years of age, admitted with the diagnosis of LRTI at Mahatma Gandhi Mission’s Hospital & Medical College, a tertiary hospital in Navi Mumbai, India, between December 2017 to November 2019 …

Use Of Continuous Eeg Monitoring And Short-Term Outcomes In Critically Ill Children, Xiuhua Liang Bozarth, Pin-Yi Ko, Hao Bao, Nicholas S. Abend, R. Scott Watson, Pingping Qu, Leslie A. Dervan, Lindsey A. Morgan, Mark Wainwright, John K. Mcguire, Edward Novotny

Journal of Pediatric Intensive Care

Objectives: This study aimed to compare short-term outcomes at pediatric intensive care unit (PICU) discharge in critically ill children with and without continuous EEG (cEEG) monitoring. Methods: We retrospectively compared 234 patients who underwent cEEG with 2294 patients without cEEG. Propensity score matching was used to compare patients with seizures and status epilepticus between cEEG cohort and historical cohort. Results: The EEG cohort had higher in-hospital mortality, worse Pediatric Cerebral Performance Category (PCPC) scores, and greater PCPC decline at discharge. In patients with status epilepticus, PCPC decline was higher in the cEEG cohort. Conclusions: PCPC decline at PICU discharge was …

Multisystem Inflammatory Syndrome In Children Associated With Covid-19 Infection: A Comprehensive Review, Alejandra Isabel Meza-Contreras, Marcelo Nicolas Galdos-Bejar, Raffo Escalante-Kanashiro

Journal of Pediatric Intensive Care

Objectives: The Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious syndrome associated with COVID-19 disease in children. The aim of this study is to conduct a thorough review to assist healthcare professionals in diagnosis and management of this complication of COVID-19 disease in children Material and Methods: A thorough systematic review was conducted through an on-line search based on MIS-C with the primary focus on epidemiology, clinical characteristics, diagnosis, pathophysiology, management and long-term follow-up. Results: This syndrome is characterized by an exaggerated and uncontrolled release of pro-inflammatory cytokines involving dysfunction of both innate and adaptive immunity. In this review, …

Post-Intensive Care Syndrome In A Cohort Of School-Aged Children And Adolescent Icu Survivors: The Importance Of Follow-Up In The Acute Recovery Phase, Trevor A. Hall, Rachel K. Greene, Justin B. Lee, Skyler Leonard, Kathryn R. Bradbury, Kurt Drury, Grace Recht, Julie Randall, Megan E. Norr, Cydni N. Williams

Journal of Pediatric Intensive Care

Objectives: Pediatric ICU survivors experience a collection of physical, cognitive, emotional, and social symptoms named post-intensive care syndrome (PICS). We aimed to quantify PICS morbidities from multiple stakeholder perspectives across domains. Methods: Using physician, neuropsychologist, and parent/caregiver completed outcome measures across domains in a cross-sectional analysis of 186 children between the ages of 8 and 19 years with data from a PICU follow-up clinic 1-3 months after PICU discharge, we quantified PICS morbidities and used Spearman correlation to evaluate interdependence of PICS domains. Results: Compared to pre-hospitalization functioning, new PICS related morbidities were observed and significant correlations were identified between …

Impact Of The Covid-19 Pandemic On Children And Families In Picu Follow-Up Clinic, Lucile Barcat, Genevieve Du Pont-Thibodeau, Camille Jutras, Karen Harrington, Simon Macdonald, Laurence Ducharme-Crevier

Journal of Pediatric Intensive Care

Objective: The novel coronavirus disease 2019 (COVID-19) pandemic disrupted the lives of many families, especially those of children with chronic health problems. Little is known about the impact of this pandemic on the health and well-being of critically ill children and their families after their discharge from pediatric intensive care unit (PICU) hospitalization. This study describes the repercussions of the COVID-19 related lockdown on the physical and psychological wellbeing, quality of life, and access to resources of PICU survivors and their families. Method: Prospective cohort study. Telephone encounter. Children and families followed at the Centre Hospitalier Universitaire Ste- Justine PICU …

Randomized Trial To Compare Nasoduodenal Tube And Nasogastric Tube Feeding In Infants With Bronchiolitis On High-Flow Nasal Cannula, Raymond L. Parlar- Chun, Meaghan Lafferty-Prather, Veronica M. Gonzalez, Hanna S. Huh, Guenet H. Degaffe, Monaliza S. Evangelista, Sheela Gavvala, Sofia Khera, Anand Gourishankar

Journal of Pediatric Intensive Care

Objectives: We aim to determine if there is a difference in length of respiratory support between nasoduodenal (NDT) and nasogastric tube (NGT) feedings in patients with bronchiolitis on high flow nasal cannula (HFNC). Methods: A single-center non-blinded parallel randomized control trial at a tertiary care hospital was designed. Pediatric patients ≤ 12 months old with bronchiolitis, on HFNC, requiring nutrition via a feeding tube were eligible. Patients were randomized to NGT or NDT and stratified into low- and high-risk groups. Length of respiratory support was the primary outcome. Secondary outcomes included length of stay, number of emesis events, maximum level …

Adult Admissions To A Canadian Picu During The Covid-19 Pandemic, Tanya Holt, Leanne Smith, Gregory Hansen

Journal of Pediatric Intensive Care

Introduction: In response to the burden of COVID-19 and overwhelmed ICU resources, some PICUs have had to adapt. The purpose of this study was to assess criticality, scope of diagnosis and outcomes of an adult cohort admitted to a Canadian PICU. Methods: A retrospective chart review was completed on all patients between 17-50 years admitted to the PICU between June 2020 and December 2021. Admission data included body mass index, admission Sequential Organ Failure Assessment score (SOFA), COVID-19 status, diagnosis and comorbidities. The duration of ventilatory support, PICU and hospital admission, mortality and discharge disposition were assessed. Discrete variables were …

Correlation Of Ultrasound-Based Hydration Assessment Measures With Cvp And Clinical Hydration Status Among Children Admitted To The Picu: A Prospective Observational Study, Sandeep Tripathi, Tara Osman, Mina Hafzallah, Kejin Lee, Drew A. Whalen

Journal of Pediatric Intensive Care

Purpose: To assess the correlation of respiratory variation in IVC with CVP in children. Secondary objective was to evaluate IVC variability with clinical hydration status. Methods: IVC variability assessed at the subcostal (SC), and right lateral (RL) region and collapsibility index (CI) (spontaneously breathing) and distensibility index (DI) (positive pressure) and IVC/Aortic ratio calculated. Partial correlations calculated between CI/DI with CVP adjusting for BMI & age. Sensitivity of CI & DI to predict clinical dehydration calculated using ROC curves. Results: 145 ultrasounds on 72 patients (41% positive pressure). Only RL CI in spontaneously breathing patients strongly correlated with CVP (r …

Impact Of Extended Reality On Robot-Assisted Surgery Training: A Systematic Review And Meta-Analysis, Michael Bickford, Fayez Alruwaili, Sara Ragab, Hanna Rothenberg, Mohammad Abedin-Nasab

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Robot-assisted surgeries (RAS) have an extremely steep learning curve. Because of this, surgeons have created many methods to practice RAS outside the operating room. These training models usually include animal or plastic models; however, extended reality simulators have recently been introduced into surgical training programs. This systematic review and meta-analysis was conducted to determine if extended reality simulators can improve the performance of robotic novices and how their performance compares to the conventional training of surgeons on surgical robots. Using the PRISMA 2020 guidelines, a systematic review was performed searching PubMed, Embase, Web of Science, and Cochrane library for studies …

Some Properties Of Rescaled Sasaki Type Metric On The Coframe Bundle, Habil Fattayev, Arif Salimov

Turkish Journal of Mathematics

In this paper we introduce the rescaled Sasaki type metric on the coframe bundle of a Riemannian manifold and investigate the Levi-Civita connection, curvature tensor, paracomplex structures of coframe bundle with this metric

Janowski Close-To-Convexity Harmonic Mappings, Bushra Arif, Jacek Dziok, Wasim Ul Haq, Mohsan Raza

Turkish Journal of Mathematics

In the present work we introduce harmonic univalent functions related to Janowski close-to-convexity and we provide their necessary and sufficient criteria. The extreme points and topological features of such harmonic mappings will also be investigated. By applying extreme points theory, we obtain integral mean inequalities, distortion theorems, and coefficient estimates for families of harmonic functions.

Script To Sans: The Shift Toward Minimalist Branding, Angela Brayton, Abigail Derouard

Arts & Sciences Undergraduate Showcase

It has become common for companies to do rebrands from more detailed, complex branding to simple and bold branding. With lettering, there has been a trend of companies shifting from script to sans serif typefaces. This pattern brought us to the question, why? It’s important to understand trends in graphic design like this one to get a better grasp of marketing strategies and consumer preferences. It’s also good practice as graphic designers to stay up to date with social and cultural shifts, so we can apply that knowledge and make smart design choices. While there isn’t much research on this …

Cover And Contents

Turkish Journal of Mathematics

No abstract provided.

Approximate Controllability Of Fractional Backward Stochastic Differential Inclusions With Order 1/2 < P < 1, Müberaa Selah

Turkish Journal of Mathematics

In this paper, fractional backward stochastic differential equations are extended to multivalued forms. Since the problem of approximate controllability of the obtained fractional backward stochastic differential inclusions has not yet been addressed in the literature, we focus on the approximate controllability of these systems. The study’s main results, such as existence of the mild solution and approximate controllability for fractional backward stochastic differential inclusions, have been proven through fractional calculus, Bohnenblust-Karlin Theorem, and appropriate conditions.

The Circular Sum Of Points Of An Affine Segment, Mircea Crasmareanu, Marius Munteanu

Turkish Journal of Mathematics

This note introduces a sum for two interior points of an affine segment [AB] based on a trigonometric approach. Some properties of this operation, along with general examples (including squares of endpoints, the midpoint, and the centroid), are discussed. A main result is that the midpoint of a segment is the circular sum of the points dividing the segment with the ratios 4 and 9. In addition, we completely solve a Diophantine equation associated with the circular sum in order to identify all points with integer ratio whose circular sum is a point with integer ratio.

Weighted Inequalities For Discrete Bilinear Hardy-Type Operator With A Matrix, Nazerke Zhangabergenova, Ainur Temirkhanova

Turkish Journal of Mathematics

In this paper, we consider a new discrete bilinear inequality of Hardy-type involving a matrix operator. We establish weight characterizations of this inequality under some conditions on the matrix entries.