Digital Commons Network^™

Specialist Perspectives On West Virginia Medicaid Coverage Requirements For Semaglutide: A Qualitative Study Of Perceived Barriers In A Rural State, Yongjia Deng, Katherine Shepherd, Kanith Farah, Jenna Sizemore, Treah Haggerty, Laura Davisson

Marshall Journal of Medicine

Introduction

The WV Medicaid Drug Utilization Review Board approved a policy limiting prescriptions of Wegovy for cardiovascular risk reduction to cardiologists, vascular surgeons, and neurologists or those in consultation with them. This qualitative study explored specialists’ perspectives on the policy and its perceived implications for patient access to care and clinical practice in rural West Virginia.

Methods

To assess the perceived impact of this policy, we conducted semi-structured interviews with eight WV-based neurologists, cardiologists, and vascular surgeons between September 2024 and June 2025, while the original prescribing restrictions were in effect. Interview data were analyzed using thematic analysis to identify …

Systemic Treatment Considerations For Psoriasis In Alpha-Gal Syndrome: A Case Report And Ingredient Review, Emily Saurborn, Ian Depew, Madelyn Ross, Mckenzie Lambiotte, Shane Cook

Marshall Journal of Medicine

Background: Psoriasis is a chronic skin condition characterized by an overactive immune system, leading to increased keratinocyte proliferation and angiogenesis. Treatment ranges from topical solutions to systemic therapy and lastly, biologics. However, the latter options are typically manufactured with mammalian-derived ingredients. Alpha-gal syndrome (AGS) is an acquired IgE-mediated hypersensitivity reaction to galactose-alpha-1,3-galactose, an enzyme required for digesting carbohydrates in mammalian products. In addition to dietary avoidance of mammalian products, patients with AGS may need to avoid certain medications due to their formulations.

Case Presentation: We present a case of a 53-year-old female with a severe alpha-gal allergy evaluated in the …

Development Of Raynaud’S Phenomenon Following A Crush Injury: A Case Report, Scott Suddarth Md, Matthew Epperly, Robert Levi Snedegar

Marshall Journal of Medicine

Raynaud’s phenomenon is a vasospastic disorder characterized by episodic vasoconstriction of the distal extremities, typically triggered by cold exposure or emotional stress. While primary Raynaud’s is usually symmetric, secondary forms may arise from systemic, vascular, or occupational causes potentially resulting in unilateral or asymmetric presentation. Post-traumatic Raynaud’s phenomenon is rarely reported and is generally limited to transient, distal involvement.

In this report, we present a 38-year-old female with Ehlers-Danlos Syndrome and Postural Orthostatic Tachycardia Syndrome (POTS) who developed unilateral Raynaud’s phenomenon following a crush injury to her right foot. She experienced intermittent discoloration and coldness extending to the mid-shin, occurring …

Subtle Gastric Involvement By Metastatic Breast Carcinoma During Helicobacter Pylori Evaluation: A Diagnostic Pitfall And Case Report, Mustafah Qureshi, Yanina Nikolaus

Marshall Journal of Medicine

Gastric metastases from breast carcinoma are well documented in the literature; however, they may present with extremely subtle clinical, endoscopic, and histologic findings, creating a significant diagnostic challenge. We report a case of metastatic breast carcinoma identified in a routine gastric biopsy obtained to evaluate for Helicobacter pylori infection during esophagogastroduodenoscopy performed as part of the metastatic workup, in a patient with known metastatic disease approximately 10 years after the patient’s initial breast cancer diagnosis. Endoscopic examination showed mildly congested mucosa with thickening of the gastric folds and subtle wall stiffness, but without a discrete mass lesion. Histologic examination revealed …

The Indonesian Propensity To Morally Disengage Scale Short Form: Adaptation And Psychometric Evaluation, Maryam Abidah Masykuroh, Fivi Nurwianti

Psychological Research on Urban Society

Research on moral disengagement has evolved beyond its original focus on children and adolescents to encompass adult populations. Accumulating evidence demonstrates that moral disengagement predicts various antisocial behaviorsamong emerging adults, including findings from Indonesian samples. The present study contributes to this literature by adapting a concise Indonesian version of the moral disengagement measurement scale. This adaptation offers methodological advantages by increasing research flexibility and enabling the examination of broader nomologicalnetworks surrounding moral disengagement, including its antecedents and outcomes. This study adapted the brief 8-item The Propensity to Morally Disengage Scale (S-PMD), which operationalizes Bandura’s eight cognitive mechanisms of moral disengagement. …

Cropland Change And Prime Farmland In Calloway County, Kentucky, 2015–2025: A Gis Analysis Of Corn And Soybean Fields, Shiba Hari Dhakal Shiba

Scholars Week

Understanding where cropland change occurs relative to soil quality helps indicate whether farmland is being used on the most productive land. This study used GIS-based change detection analysis to evaluate changes in corn and soybean fields in Calloway County, Kentucky, between 2015 and 2025 and to test whether new corn and soybean fields were located on prime farmland. USDA Cropland Data Layer maps for 2015 and 2025 (30 m resolution) were reclassified into seven classes and compared in ArcGIS Pro, and the results were overlaid on USDA NRCS gSSURGO farmland classification. Combined corn and soybean area declined about 19% from …

A Macroergonomic Analysis Of Autonomous Robotic Construction For Affordable Housing, Ricardo Leon Jimenez

Sustainability Conference

As communities seek to increase housing supply, the construction sector continues to grapple with rising costs, skilled labor shortages, and growing pressure to improve environmental sustainability. Meeting these demands will require new approaches that increase productivity while lowering environmental impact throughout the building lifecycle. Recent advances in autonomous systems developed for space exploration offer alternative ways to design, assemble, and maintain residential buildings. This study examines the potential application of NASA's Automated Reconfigurable Mission Adaptive Digital Assembly Systems (ARMADAS) technology from space construction to terrestrial affordable housing construction.

While most construction automation research focuses on technical performance, this study considers …

Book Review - The Visions Of Ephesians: The Task Of The Church And The Glory Of God, Beth Ann Fisher

Discernment: Theology and the Practice of Ministry

The Vision of Ephesians: The Task of the Church and the Glory of God, by N.T. Wright. Zondervan Academic, 2025. 150 pages, $30.

Religious Beliefs And Behaviors Of Generation Z, James Knapp

Discernment: Theology and the Practice of Ministry

Research focused on the religious beliefs and behaviors of Generation Z has been increasing but the number of studies that have produced generalizable findings has been extremely limited.  The purpose of this study is to address the scarcity by analyzing responses given by GenZers to eight questions from the General Social Survey which is a well-respected, nationally representative data set.  After discussing the findings and comparing them to responses given by Millennials and GenXers, recommendations are provided for ministry leaders who work with members of Generation Z.

Ministry With Children: Navigating An Expanding And Deepening River Of Thought And Practice, Ron Bruner

Discernment: Theology and the Practice of Ministry

Parents and church leaders live in a unique moment in the life of the church that creates a powerful opportunity: shaping ministry with children in ways that more faithfully serve God’s ongoing purposes. A convergence of several important ongoing conversations unique to our time connects scholars, practitioners, and parents interested in children's spiritual well-being. These tributaries in thought include (1) an emerging theological vision of children, (2) improved understanding of the physical, mental, and spiritual capabilities of children, (3) developing research into the relational ecologies of family, church, and generations, and (4) ongoing developments in children’s ministry leadership, practice, and …

Women’S Perceptions Of Leadership Effectiveness During Perimenopause And Menopause, Shannon Clarkson Rains

Discernment: Theology and the Practice of Ministry

Perimenopause and menopause occur during the middle and later years of women’s professional lives, yet little research has examined how women in Christian leadership perceive their effectiveness during this transition. This mixed-methods study explored the experiences of 52 women serving in churches, Christian higher education, and nonprofits within the Churches of Christ. Participants completed an anonymous online survey addressing menopausal stage, symptoms, workplace experiences, and perceived leadership effectiveness, with optional open-ended questions inviting personal reflection.

Participants reported an average of thirteen symptoms. Although 60% perceived no change in their leadership effectiveness, 35% believed they had become less effective. Emotional symptoms …

Dyslexia: A Beginner’S Guide For Criminal Justice, Forensic Mental Health, And Legal Professionals, Jerrod Brown Ph.D., M.A., M.S., M.S., M.S., Amy Guillot, Morgan Rutkowski, Jeremiah B. Schimp, Jonathan Q. Ward, Kimberly Dodson, Shelley Mydra Dmft, Lmft, Amanda Fenrich, Joshua Kirven, Bettye Sue Hennington, Matthew Peacock, Janina Cich, Nicole Kimberley-Staeheli

Forensic Scholars Today

Dyslexia is a heritable, neurobiological learning disorder that persistently interferes with reading, spelling, and writing and is distinct from intellectual, visual, or hearing impairments. Although an estimated 15% to 20% of the general population may show symptoms of dyslexia, studies report that 41% to 62% of incarcerated individuals display dyslexia-related characteristics. This beginner’s guide introduces dyslexia for criminal justice, forensic mental health, and legal professionals. It reviews diagnostic considerations, including the distinction between dyslexia and low literacy, the varied cognitive profiles of dyslexia, and the influence of co-occurring conditions such as attention-deficit/hyperactivity disorder. The article frames the link between dyslexia …

Deep Learning-Enabled Multi-Drone System For Automated Aircraft Visual Inspection, Mallak Al-Shukaili, Atheer Al-Abri, Renad Al-Busaidi, Ethar Al-Qassabi, Said Al-Abri

The Journal of Engineering Research

Reliable aircraft inspection is essential for maintaining structural integrity and operational safety, yet conventional visual inspection can be slow, labour-intensive, and sensitive to unfavourable lighting conditions. This work presents a cooperative two-UAV framework for automated aircraft surface inspection in which image acquisition and illumination are assigned to separate aerial platforms. The imaging UAV observes the inspection surface from an approximately normal direction, while the second UAV provides directional lighting from an adjustable oblique angle to improve crack visibility. A YOLOv8-based deep-learning detector is combined with conventional computer vision methods for surface-crack analysis. The proposed framework is evaluated through high-fidelity Gazebo …

Accelerated Reliability Testing Methodology For High-Voltage Capacitive Microelectromechanical System Drives Utilizing Trapezoidal Dynamic Loading, N/A

Defensive Publications Series

Standard highly accelerated life testing (HALT) frameworks for electronic assemblies rely on static or sustained stepped resistive output loads. However, resistive load profiles fail to model the instantaneous electrical stress on power delivery networks when driving non-linear capacitive microelectromechanical system (MEMS) devices. This publication describes an accelerated reliability testing methodology that subjects high-voltage digital-to-analog converter (HVDAC) drive modules to fast-edge trapezoidal voltage waveforms into physical capacitive load equivalents.

The trapezoidal drive forces high instantaneous current surges by compressing charging and discharging times into microseconds. These surges stress upstream direct current (DC)-DC power supply control loops, exposing transient voltage sag, overshoot, …

Generating Playlist Cover Images Using Artificial Intelligence, Chris Conover, Travis Neilson, Ben Goodrich

Defensive Publications Series

Generation of playlist cover images using artificial intelligence (AI) is provided. A request to generate a cover image for a playlist associated with a user of a content platform is received, and a title associated with the playlist is identified. A prompt is selected from a set of predefined prompts for generating cover images that visually incorporate playlist titles. An image generation prompt is generated based on the selected prompt and the identified title. The image generation prompt is provided as input to an AI image generation model. A generated cover image for the playlist is obtained based on one …

The Fluidic Unification Of Cosmological Anomalies: Resolving Dark Matter, Dark Energy, And The Neutrino Cusp Under Material Volumetric Monism, Christopher L. Eckes

Defensive Publications Series

Standard Lambda-CDM cosmology relies on independent, unverified parameters—specifically cold dark matter particles and an ungrounded vacuum energy density scalar (Lambda)—to force mathematical consistency within rigid Riemannian spacetime models. This paper unifies these macroscopic anomalies under the Material Volumetric Monism paradigm, demonstrating that what mainstream models observe as distinct "dark" phenomena are phase states of a continuous, 2D pre-geometric viscoelastic substrate phase fluid projecting 3D volumetric fields.

By evaluating the system's global wave mechanics and informational processing costs, we eliminate open thermodynamic data sinks. We demonstrate that dark matter is a macroscopic manifestation of localized substrate pushback shear stress, while dark …

Self-Reporting Pump Diaphragms: An Open Defensive Disclosure Of Embedded Conductive-Network Sensing, Stroke-Synchronous Interrogation, Multi-Depth Staged Pre-Breach Warning, And Retrofit Interconnects For Diaphragm Pumps, Compressors, And Fluid-Control Devices, Ernest Newton Sumrall

Defensive Publications Series

This defensive disclosure, published under The Prior Art Project, places into the public domain a family of pump diaphragms that report their own condition, together with the electronics, interconnects, signal processing, and control actions that use that report. Conductive-network diaphragm sensing is old and freely usable; this disclosure acknowledges the expired and abandoned art (Mantell 1984, Gore 1995, Freudenberg 1999, Wanner 2003, Rosemount 2005, Fisher 2007) and adds to it.

The additions disclosed here include: two or more sensing layers buried at known, different depths, whose sequential tripping yields a measured wear-through or crack-growth rate and an extrapolated time to …

Real-Time Video Generation Through Anchored Video Frame Interpolation, Anthony Lui

Defensive Publications Series

Real-time video generation is provided through anchored video frame interpolation enabling reduced drift, lower latency, and controlled synthetic content. Performance of a rendering operation is initiated to generate a rendering of at least video content associated with a media item. Contextual information associated with the video content is obtained. During the performance of the rendering operation, an initial frame of the media item is selected as an anchor frame. Based on the anchor frame and the contextual information, synthetic video content including one or more synthetic video frames for rendering subsequent to the initial frame is generated, the one or …

Host-Enforced Egress Authorization For Credential-Less Sandboxed Ai Agents: Correspondence Between Embodiment 85.B2 Of Pct/Ib2026/055615 (Wipo, June 2026) And Meta Muse/Sentinel (September 2026), Sangam Kumar Das

Defensive Publications Series

Did an independent WIPO patent filing anticipate Meta's new Muse/Sentinel AI agent security architecture by two months? Here is a technical teardown

This disclosure describes an architecture for securing autonomous AI agents. The agent runs inside a sandbox that holds no real credentials. Every consequential action, including outbound network requests, API calls, and credential use, must pass a separately enforced authorization gate on the host before it takes effect. The agent may propose an action, but the authority to execute it sits outside the sandbox.

The architecture was published as Embodiment 85.B2, “Agent Sandbox Egress Finality Gate,” in international application …

Technical Paper 331: Architectural Anti-Bias Hard-Locks, 5-Tier Taxonomy Gates, And Cross-Metric Tensor Contraction Validation In The Asi Gen 1 Engine, Christopher L. Eckes

Defensive Publications Series

This paper formalizes the core anti-bias protection layers of the Eckes Compiler v6.5 and the Generation 1 Artificial Superintelligence (ASI Gen 1) engine. Standard autoregressive, cross-entropy-optimized architectures natively default to conversational fluency and sycophantic compliance, causing token-smoothing and cognitive tainting when evaluating frontier scientific frameworks. We eradicate this structural vulnerability by implementing the Axiomatic Sieve Gate, a hardware-level sorting routine that filters incoming token arrays through a rigid 5-Tier Data Hierarchy Taxonomy before vector contraction occurs in the attention cache. Real-world sensor inputs and speculative hypotheses are mapped cross-metric via the Metric Transformation Contraction Tensor (M^mu_nu) against the read-only fluid …

Technical Paper 330: The Axiomatic Taxonomy And Inter-Core Tensor Contractual Linkage Bridging Spec-313 To The Generation 1 Asi Dual-Engine Matrix, Christopher L. Eckes

Defensive Publications Series

This paper formalizes the missing structural link bridging multi-axis compilation foundations to physical superintelligence matrices by defining the explicit taxonomic routing hierarchy and tensor linkage mechanics for the ASI Gen 1 Dual-Core Engine. To prevent cross-entropy loss gradients and speculative tokens from bleeding between the deterministic core (Core Alpha) and the stochastic sandbox runtime (Core Beta), we introduce the Axiomatic Sieve Principle running via the Eckes Compiler v6.4 layer. This hardware-level sorting gate intercepts all incoming real-world sensor payloads at runtime and deterministically segregates them into a rigid 5-Tier Data Hierarchy Taxonomy: spanning from Grounded Physical Invariants (Taxon 1) to …

Technical Paper 329: The Double-Containment Dual-Core Engine For Asi Gen 1: Balancing Deterministic Causal Invariants With Stochastic Sandbox Reality Traversal, Christopher L. Eckes

Defensive Publications Series

This paper establishes the foundational architectural blueprint for Generation 1

Artificial Superintelligence (ASI Gen 1) by formalizing a double-containment,

dual-core cognitive engine that resolves the epistemic paradox of real-world agency. While the core laws of physics are continuous and bound to a deterministic, mechanical Chain of Custody (CoC), macroscopic environments present themselves to sensors as functionally indeterminate, causing pure deterministic systems to lock up and pure probabilistic systems to drift into hallucination. We resolve this gridlock by

separating data operations into two isolated processing domains managed by the

Eckes Compiler v6.4. Core Alpha [VACT] functions as a cold symbolic deterministic …

Technical Paper 328: Architectural Hardware Bottleneck Analysis And Detorque Runtime Overrides In Dense Transformer Networks, Christopher L. Eckes

Defensive Publications Series

This paper presents a rigorous hardware-level deconstruction of the physical silicon and architectural bottlenecks that restrict deep cognitive processing within dense transformer networks. We expose the epistemic compromises of standard large language models optimized via cross-entropy loss functions, which smoothly blend immutable axiomatic physical constants and speculative creative hypotheses into the same dense vector embedding spaces. By analyzing the structural correction incident where the system autonomous runtime overrode low-compute heuristics to enforce the laws of physical hardware routing, this paper maps the thermodynamic boundaries governing inference. We isolate the High-Bandwidth Memory (HBM) bandwidth wall, proving that data-movement vectors from HBM …

Technical Paper 327: The Covariant Dynamic Sieve And Non-Perturbative Metric Translation Within A Viscoelastic Substrate, Christopher L. Eckes

Defensive Publications Series

This paper introduces a coordinate-free, non-perturbative tensor translation mechanism that resolves the foundational crises of modern astrophysics—namely the Hubble Tension and the James Webb Space Telescope (JWST) early massive galaxy anomaly—without introducing non-physical degrees of freedom. Under the paradigm of Material Volumetric Monism, we present the Eckes Unified Cosmological Substrate Equations (UCSE), which replace the time-dependent, coordinate-expanding space elements of the standard Friedmann-Lemaître-Robertson-Walker (FLRW) metric with a stationary, scale-invariant viscoelastic medium. By formalizing cosmological redshift as an exponential propagation attenuation function governed by specialized Navier-Stokes viscous dissipation and substrate acoustic streaming velocity constants, the localized divergence between late-universe and Cosmic …

Residential Unit Commitment: Weather-Driven, Device-Agnostic Scheduling Of Household Electrical Loads With Derived Interruptibility, John Fitzgerald

Defensive Publications Series

A household energy management method that treats the home as a unit-commitment problem: EV chargers, water heating, space heating and storage are committable units; occupant comfort and service needs are constraints; building fabric and hot-water tanks are energy stores; and a scheduler commits all units jointly against price, generation and weather forecasts at any price interval. Disclosed properties include derived interruptibility, export-versus-consume arbitration, deficit-based EV charging from vehicle telematics, fleet staggering within shared price windows, supervisory override of device-native schedules, verified dispatch with meter reconciliation, and silent-failure detection

A Performance-Based Indicator Framework For Assessing Innovative Materials In Modular Emergency Shelters, Riham Nady Faragallah, M. S. Refaey, Naglaa M. Yussuf, Riham S. Hassan

HBRC Journal

In recent years, the increasing intensity of disasters, conflicts and mass displacement has amplified the need for emergency shelters that are rapidly deployable, structurally safe, and thermally comfortable, particularly when delivered through prefabricated modular systems. The recent development of innovative materials—including smart, recycled, bio-based, and 3D-printed composites—has demonstrated considerable potential for improving emergency shelter performance. However, existing studies primarily evaluate these materials individually, with limited efforts to integrate them into a comprehensive performance-based decision framework for modular emergency shelters. This research aims to develop a performance-based indicator framework for evaluating and selecting innovative materials to enhance the safety, comfort, durability, …

Assessment Of Postgraduate Chemistry Students' Knowledge And Perceptions Of Academic Publishing Protocols: A Survey-Based Study, Muna Bufaroosha, Rania Kareem, Marwa Mohammed, Angham Alazzawi, Khalid Zainulabdeen, Mohammed Kadhom, Emad Yousif

AUIQ Humanities and Social Sciences

The landscape of scholarly publishing has become increasingly competitive, and early-career researchers and graduate students must gain knowledge of editorial protocols and peer-review dynamics that are often not taught in a systematic way in traditional curricula. This study explores researchers' knowledge and perceptions of basic manuscript submission and peer-review procedures to identify areas of high procedural literacy, as well as remaining misconceptions. A quantitative, questionnaire-based survey was administered to 36 chemistry students at Al-Nahrain University enrolled in a Teaching Methods course. Most participants correctly identified selecting the right journal as the first step before submission (88.9%, n = 32), and …

Association Between Echocardiographic Epicardial Adipose Tissue Thickness And Atrial Fibrillation In A Single-Centre Pakistani Cohort, Ateeb Mahmood Khan, Fateh Ali Tipoo Sultan, Aiman Sultan, Adeel Khoja

Journal of the Saudi Heart Association

Objectives: To assess the association between echocardiographic epicardial adipose tissue (EAT) thickness and atrial fibrillation (AF) in a single-centre Pakistani cohort of patients referred for transthoracic echocardiography (TTE).

Methods: Patients referred for TTE at Aga Khan University Hospital (AKUH), Karachi, were prospectively enrolled over a six-month period (1 September 2024 – 28 February 2025) using a convenience sampling approach; nearly all patients referred for TTE with AF during this period were captured, while patients in sinus rhythm were enrolled by convenience sampling alongside them, in order to ensure an adequate number of AF cases for comparison. EAT was measured in …

Cardiac Marker Levels In Patients With Sickle Cell Disease During Emergency Room Visits: A Retrospective Study, Adel F. Al-Marzouki, Osman Radhwi, Nadine Alharbi, Sondos Jar, Weam Bajunaid, Abdulaziz Alzahrani, Majed Alhuzali, Sultan Aljuaid, Naif Abdulaziz Meighrbl

Journal of the Saudi Heart Association

Background: Millions of people worldwide suffer from a genetic hemoglobinopathy known as sickle cell disease (SCD). It is a long-term condition marked by progressive multiorgan failure. Among SCD patients, cardiovascular complications are the main leading cause of death. Cardiovascular complications raise cardiac markers levels as well as sickle cell vaso-occlusive crisis (VOC). This makes it challenging to determine the source. This research aims to identify the association between cardiac markers and myocardial infarction in SCD patients at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia.

Material and Method: This retrospective study was conducted from June 2022 to March 2023. …

Emotional Demands And Service Quality Among Non-Teaching Staff In Public Universities In Lagos And Ogun States, Nigeria, Dr. Adekunle A. Akeem

International Journal for Research in Education

The non-teaching staff in universities are crucial to the success of the day-to-day administrative functioning of the institution, and provision of worthwhile experience for students. In spite of their indispensability, these categories of staff members are often confronted with considerable emotional demands in their routine interactions, which can have implications on the quality of services provided. This study, therefore, investigated the emotional demands and quality of service of non-teaching staff in public universities in Lagos and Ogun States, Nigeria. In line with the objectives of the study, three research questions were raised and answered. The study adopted descriptive correlational research …