Digital Commons Network^™

Disparities In Dysphagia Care Among Head And Neck Cancer Patients: A Retrospective Cohort Study, Gillian Michaelson, Claudia I. Cabrera, Alexis Nahra, Nina W. Zhao

Faculty Scholarship

Objective: To investigate the incidence of dysphagia among head and neck cancer (HNC) patients and assess disparities in utilization of speech-language pathology (SLP) services across different demographic groups. Study Design: Retrospective cohort study. Setting: Analysis of data from the TriNetX global health network, comprising over 125 million deidentified electronic health records worldwide. Methods: HNC patients diagnosed with oral, oropharyngeal, laryngeal, or nasopharyngeal cancer with and without dysphagia between January 1, 2004 and October 30, 2024 were identified. Patients were divided into two cohorts for comparison: those who received SLP services after dysphagia diagnosis and those who did not. The association …

Phosphotungstic Acid Staining To Visualize The Vagus Nerve Perineurium Using Micro-Ct, Aniruddha R. Upadhye, Jennifer Coleman, Michael W. Jenkins, David Wilson, Andrew J. Shoffstall

Faculty Scholarship

Background and Purpose: Peripheral nerve stimulation is approved by the US Food and Drug Administration for treating various disorders, but it is often limited by side effects, highlighting the need for a clear understanding of fascicular and fiber organization to design selective therapies. Micro-CT imaging of contrast-stained nerves enables the visualization of tissue microstructures, such as the fascicular perineurium and vasculature. In this work, we evaluated phosphotungstic acid (PTA) as a contrast agent and assessed its compatibility with downstream histology. Methods: Human vagus nerve samples were collected from three embalmed cadavers and subjected to three different staining methods, followed by …

The Interchangeable-Part Structure Of Food And Drug Law, Adam I. Muchmore

Faculty Scholarship

This Article demonstrates that nested tiers of interchangeable parts serve as the foundation for the regulatory programs administered by the U.S. Food and Drug Administration. Core interchangeable parts used in FDA-administered programs include product categories, prohibitions on adulteration and misbranding, agency-registration requirements, current good manufacturing practices, product standards, marketing authorization requirements, postmarket requirements, and user fees. In each of these areas, Congress or the FDA has engaged in interchangeable-part lawmaking (IPL). IPL occurs when a government takes a portion of its law in one subject area and uses it as a model for its own law in another subject area. …

Sustained Release Of Antifibrotic Nintedanib From Polymer Microparticles Reduces Dosing Frequency While Reducing Inflammation In Murine Idiopathic Pulmonary Fibrosis, Emmanuel Einyat Opolot, Filip Goshevski, Rahul Chaudhary, Horst A. Von Recum, Amar B. Desai

Faculty Scholarship

Purpose: Idiopathic pulmonary fibrosis (IPF) is a life-threatening, progressive lung disease with limited therapeutic options, often resulting in poor patient outcomes. Current treatments, such as Nintedanib (NTB) and Pirfenidone (PFD), require frequent administration, leading to adverse effects and low patient adherence. The purpose of this study was to investigate a sustained-release drug delivery system utilizing microparticles (MPs) composed of insoluble beta-cyclodextrin (β-CD) polymers to enhance the bioavailability and extend the release of NTB and PFD. Methods: A multidisciplinary approach, including in silico modeling, in vitro assays, and in vivo studies, was employed to assess the efficacy of β-CD-polymer MPs as …

Living Nondirected Kidney Donation: A Psychoanalytic Case-Based Investigation Of Altruism And Its Implications For Psychosocial Evaluation Guidelines, Robert M. Guerin

Faculty Scholarship

Why donate a kidney to a stranger? The history of living nondirected kidney donation, so-called altruistic or Good Samaritan donation, is notable for its associated skepticism if not outright rejection. Since its possibility, transplantation institutes have been concerned over the motives of individuals who present to their clinics with the wish to donate a kidney to a stranger. Are these motives pure? Might there be ulterior motives or secondary gain? Or might these motives be pathological, derivative from a psychiatric disease or syndrome? Although attitudes toward the nondirected donor have improved, skepticism remains: Why, after all, benefit another in this …

Teaching Interprofessional Collaborative Skills In Primary Care Using Team-Based Learning With Simulation: A Pilot Study, Elaine B. Cruz, Mamta K. Singh

Faculty Scholarship

No abstract provided.

Characterizing Stroke Presenting To A Regional Referral Hospital Before And During The Covid-19 Pandemic In Uganda: A Retrospective Analysis, Christopher Burant, Shirley Moore, Martha Sajatovic

Faculty Scholarship

Introduction: Stroke, a leading cause of global morbidity and mortality, disproportionately impacts low and middle-income countries, particularly in sub-Saharan Africa (SSA) which reports the highest stroke burden. The COVID-19 pandemic further complicated this situation, emerging as a significant stroke risk factor. The pandemic also disrupted healthcare systems worldwide, affecting stroke management and care accessibility, and leading to deteriorated conditions in stroke patients upon hospital admission. In this pre/during COVID-19 pandemic analysis of acute stroke cases presenting to a Ugandan hospital, we investigated the relationship between stroke admissions, management and treatment outcomes. Methods: This was a retrospective medical record review in …

Scoping Review Of Socio-Ecological Factors Contributing To Sleep Health Disparities In Children With Autism Spectrum Disorder, Megan L. Wenzell, Carolyn E. Ievers-Landis, Sehyun Kim, Samantha Desimio, Siobhan Aaron, Meng Miao

Faculty Scholarship

Given the high prevalence of sleep problems in children with autism spectrum disorder (ASD), there is a critical need to examine how sleep problems may be exacerbated for children exposed to social and environmental adversity. Guided by the socio-ecological model, this review aimed to evaluate factors linked to sleep health disparities (SHDs) in children with ASD, determine possible gaps/limitations in existing literature, and identify possible solutions. A scoping review was selected to ascertain what is known about SHDs in ASD. Four databases identified articles from 2004 to 2023. Included articles were those conducted in children with ASD that focused on …

Addressing Hiv And Substance Use Health Disparities Among Racial/Ethnic Minority Individuals, Jamie V. Saunt, David L. Hussey

Faculty Scholarship

Purpose of Review: Advances in HIV testing, prevention, and treatment, alongside increased awareness and harm reduction efforts for substance use disorder (SUD) have improved care and treatment access over the past decade. However, racial and ethnic minorities with SUD and HIV or at risk for HIV still face disproportionately high health disparities. Understanding and addressing the reasons behind these disparities is crucial. Recent Findings: Structural and systemic barriers continue to negatively impact minoritized communities, due to lack of access to care, mistrust, and feelings of ostracization. Disconnected systems for HIV and SUD treatment complicate combined care. Delays in HIV diagnosis …

Computed Microtomographic Imaging Of Revascularization During Healing Of Achilles Tendon Injury, Seher Yilmaz, Ozan Akkus

Faculty Scholarship

Angiogenesis in injured tendons may contribute to regeneration, but quantifying it post-injury has been mostly limited to 2D semi-quantitative histology. This study aimed to develop micro-CT as a 3D tool to quantitatively assess tendon blood vessels in an experimental animal model. Adult male Wistar rats (N = 36) had injuries induced in their Achilles tendons by needle insertion. The study included three post-injury groups: 12 hours post-injury (12H), 3 weeks post-injury (3W), and 8 weeks post-injury (8W). The uninjured left Achilles tendon served as the control for each group. Intravital cardiac perfusion with barium sulfate enhanced contrast between tendon and …

Enhancing Metacognitive Competencies Through Human-Centered Ai: The Role Of Custom-Trained Intelligent Agents In Workforce Upskilling, James Hutson

Faculty Scholarship

This editorial examines the integration of human-computer intelligent interaction (HCII), specifically through human-centered artificial intelligence (AI) and custom-trained intelligent agents, to foster metacognitive competencies critical for workforce upskilling. With 59% of the workforce projected to require substantial upskilling by 2030, developing personalized AI models tailored to individual cognitive and learning profiles presents an innovative pathway. These custom-trained agents leverage human-computer interaction (HCI) technologies and machine learning methodologies to enhance understanding of one’s own learning processes-metacognition-thus empowering individuals to optimize their future learning and adaptability. This approach not only enhances the individual’s ability to engage effectively with complex tasks in the …

Legal Market Decartelization, Milan Markovic, Nuno Garoupa

Faculty Scholarship

American lawyers’ grip on the legal market is receding. Scholars and policymakers increasingly agree that the public has little to lose and potentially much to gain from legal market decartelization - the weakening of the lawyers’ monopoly over the legal services market. Harkening to deregulatory initiatives abroad and in Arizona and Utah, reformers contend that removing restrictions on the corporate delivery of legal services and unauthorized practice of law will slash costs and expand access to justice.

Drawing on economic theory and recent market developments, this Article offers a cautionary rejoinder. Understandable concerns about cartelization and lawyer rent-seeking have led …

Artificial Intelligence, Autonomous Creation, And The Future Path Of Copyright Law, Peter K. Yu

Faculty Scholarship

Most literature at the intersection of copyright and AI has focused primarily on what copyright law is or ought to be. Frequently overlooked is the question of what copyright law will be in the AI space. Understanding this question is crucial because the path of copyright law chosen by the United States will have a major impact on the country's economic and technological future.

This article begins by scrutinizing two lines of arguments that have been advanced to deny copyright protection to AI-generated works: constitutional and incentive-based. The article then discusses a third line of arguments—harmonization-based arguments—and identifies select instances …

Wildfire Smoke And U.S. Law, Michael B. Gerrard

Faculty Scholarship

Many of the most wicked feedback effects of climate change relate to wildfire smoke. In some places the greenhouse gases poured into the atmosphere by wildfires exceed the reductions achieved by all efforts to fight climate change. At the same time, climate change is a major reason why wildfires are becoming more frequent and intense. Climate change and wildfires feed each other. However, environmental law and climate policy have paid relatively little attention to wildfires. The smoke from these fires — a major cause of illness and death, even thousands of miles from the blazes — is mostly unregulated. Efforts …

The Limits And Promise Of Global Antitrust Law, Anu Bradford, Adam S. Chilton, Katerina Linos

Faculty Scholarship

A large body of evidence suggests that open, competitive markets are a key driver of economic development. In recognition of this fact, many of the world’s leading economies not only adopted their own antitrust laws to promote competition, but they also urged developing countries around the world to do the same. This resulted in a remarkable proliferation of global antitrust law over the last several decades. Many studies have empirically examined the effect of this development, and, consistent with the hopes of policymakers, they have largely found that adopting antitrust laws produces positive economic outcomes.

In this Article, we reassess …

Property And Prejudice, Fatma E. Marouf, Vanessa Casado Pérez

Faculty Scholarship

“Alien land laws”—laws restricting noncitizens from owning real property—are back. A dozen states have enacted such laws during the past year, and over thirty states have considered such bills. These new bills are rooted in xenophobia, much like their predecessors, but they also have unique characteristics. They single out governments, citizens, and corporations of specific countries perceived to pose a threat; they impose ownership restrictions based on arbitrary distances to U.S. military bases and critical infrastructure; they inflict particularly harsh penalties; and they try to ferret out foreign control in complex corporate structures. The purported justifications are national defense, food …

Understanding Processes That Produce Racial Disparities In California Death Sentences: A Review Of The Literature, Catherine M. Grosso, Michael Laurence, Jeffrey A. Fagan

Faculty Scholarship

A robust and extensive body of empirical research, and a rich historical record, documents a recurring and pervasive influence of race in the application of California’s death penalty. This article reviews the legal and social science research to document multiple paths through which institutions and processes produce these racial disparities over many decisions in many cases across four decades. The article reviews relevant literature by decision, institution, or actor and presents key findings. This includes documenting the history of the broad statutory design of the California capital punishment statue. The review also considers research on policing, including the influence of …

Humanist Copyright, Jane C. Ginsburg

Faculty Scholarship

This exploration of the role of authorship in copyright law proceeds in three parts: historical, doctrinal, and predictive. First, I will review the development of author-focused property rights in the pre-copyright regimes of printing privileges and in early Anglo-American copyright law through the 1909 U.S. Copyright Act. Second, I will analyze the extent to which the present U.S. copyright law does (and does not) honor human authorship. Finally, I will consider the potential responses of copyright law to the claims of proprietary rights in AI-generated outputs. I will explain why the humanist orientation of U.S. copyright law validates the position …

Experimental Investigation Of External Flow Condensation Heat Transfer In Horizontal Tube-In-Tube Configuration, Jiayuan Li, Jayachandran K. Narayanan, Chirag R. Kharangate

Faculty Scholarship

Flow condensation is an important process used to achieve heat rejection across thermal power and energy systems. Studies on tube condensation have concentrated on the condensing fluid flowing in the inner tube. However, common heat exchanger configurations like the shell-and-tube types see the condensing fluid on the outer surface of the tubes. To address this gap, in this study, we investigate the local and channel-averaged heat transfer characteristics of flow condensation happening on the exterior of a horizontal tube in the tube-in-tube configuration. An external flow condensation module is developed and tested to obtain heat transfer and flow visualization data, …

Redefining Cancer Photodynamic Therapy With Gold Nanoparticles, Zoey A. Lockwood, Michael R. Jirousek, James P. Basilion, Clemens Burda

Faculty Scholarship

Despite advancements made in treatment options, cancer continues to be one of the leading causes of death worldwide. Photodynamic therapy (PDT) has gained attention as a minimally invasive and highly selective treatment option for cancer. However, challenges due to the hydrophobicity of photosensitizers and their poor tumor selectivity have limited their use in cancer therapy. Recent developments in nanotechnology, particularly the use of gold nanoparticles (AuNPs), help overcome these challenges. AuNPs provide a stable and biocompatible platform to deliver photosensitizers, improving their solubility, stability, and ability to target tumors while reducing side effects. Functionalized AuNPs take advantage of mechanisms like …

Development Of A Self-Management Tool For Individuals With Seizure Clusters: Trial Design And Methodological Report, Molly Mcvoy, Eytan Hirsch, Luisa Londono, Kari Colón-Zimmermann, Jin Seok Cho, Martha Sajatovic

Faculty Scholarship

Background: Despite advances in anti-seizure medications (ASMs) for people with epilepsy (PWE), adverse outcomes, negative health events (NHEs), and breakthrough seizures remain common. Rescue medication (RM) can better manage repetitive seizures, but barriers to RM use persist. Self-management for PWE and a history of NHEs (SMART) is an evidence-based epilepsy self-management program aimed at reducing barriers and maximizing facilitators to self-care in high-risk PWE. Methods: This 2-phase, ongoing clinical trial adapts SMART to integrate RM support for PWE with repetitive seizures. Phase 1, now completed, used input from an advisory board (AB) of PWE, caregivers, and clinicians to adapt the …

Promises, Promises: Understanding Claims Made In Social Robot Consumer Experiences, Johanna Gunawan, Sarah Elizabeth Gillespie, David Choffnes, Woodrow Hartzog, Christo Wilson

Faculty Scholarship

Social robots are a class of emerging smart consumer electronics devices that promise sophisticated experiences featuring emotive capabilities, artificial intelligence, conversational interaction, and more. With unique risk factors like emotional attachment, little is known on how social robots communicate these promises to consumers and whether they adequately deliver upon them within their overall product experiences prior to and during user interaction.

Animated by a consumer protection lens, this paper systematically investigates manufacturer claims made for four commercially available social robots, evaluating these claims against the provided user experience and consumer reviews. We find that social robots vary widely in the …

U.S. Territories And The Criminal Law Curriculum, Emmanuel Hiram Arnaud

Faculty Scholarship

In this Article, I make a case for why issues concerning the territories should be taught in law school courses and suggest a few ways in which federal criminal adjudication in the territories can and should be incorporated into the criminal law and procedure curriculum.¹⁰ As I advance elsewhere,¹¹ criminal adjudication in the territories functions differently than in the mainland United States.¹² Using the framework of what I call the “territorial criminal legal system,” I have begun mapping the contours of the unique prosecutorial ecosystem produced by the territorial condition.¹³ Chief among the characteristics is the …

The Lost English Roots Of Notice-And-Comment Rulemaking, Rephael G. Stern

Faculty Scholarship

Notice-and-comment rulemaking is arguably the most important procedure in the modern administrative state. Influential accounts even frame it as the 1946 Administrative Procedure Act’s “most important idea.” But its historical origins are obscure. Scholars have variously suggested that it grew out of the constitutionally sanctioned practice of congressional petitioning, organically developed from the practices of nineteenth-century agencies, or was influenced by German conceptions of administrative rulemaking. These histories, however, are incomplete. Using original archival research, this Article demonstrates that notice-and-comment rulemaking was the product of a series of American transplantations of English rulemaking procedures that developed in the late nineteenth …

The Misuse Of Ratification-Era Sources By Unitary Executive Theorists, Jed Handelsman Shugerman

Faculty Scholarship

This symposium essay suggests that, given an ostensibly originalist Supreme Court, the future depends on getting the past right. The unitary executive theory is approaching its political and doctrinal zenith in 2025, at the very moment it is approaching an evidentiary crisis. This essay details that crisis: a subset of misuses and misrepresentations of sources in the unitary executive scholarship. This subset focuses on serious misrepresentations of the Ratifications debates.

The Ratification debates appropriately have become the primary source of evidence for original public meaning, the dominant theory of originalism. The Ratification debates have always been a significant problem for …

Memgb-Diff: Memory-Efficient Multivariate Gaussian Bias Diffusion Model For 3d Bias Field Correction, Shuo Li

Faculty Scholarship

Bias fields inevitably degrade MRI that seriously interferes the diagnosis of physicians for accurate analysis, and removing it is a crucial image analysis task. Generative models (such as GANs) are used for bias field correction, and outperform traditional methods, however are hindered by the high cost of data annotation and instability during training. Recently, the diffusion-based methods have excelled over GANs in many applications, and they are powerful in removing noise from images, while the bias field can be regarded as a smooth noise. However, it is a challenge to directly apply to 3D bias field correction due to sampling …

Stable Heteroclinic Channels As A Decision-Making Model: Overcoming Low Signal-To-Noise Ratio With Mutual Inhibition, Natasha A. Rouse

Faculty Scholarship

Bio-inspired robot controllers are becoming more complex as we strive to make them more robust to, and flexible in, noisy, real-world environments. A stable heteroclinic network (SHN) is a dynamical system that produces cyclical state transitions using noisy input. SHN-based robot controllers enable sensory input to be integrated at the phase-space level of the controller, thus simplifying sensor-integrated, robot control methods. In this work, we investigate the mechanism that drives branching state trajectories in SHNs. We liken the branching state trajectories to decision-splits imposed into the system, which opens the door for more sophisticated controls-all driven by sensory input. This …

Nerve Transfers For Median Nerve Injury, Corinne Wee

Faculty Scholarship

Due to its role in hand function, median nerve injuries can have a significant impact on patients’ lives. Nerve transfers can be performed alone or in conjunction with tendon transfers to restore critical functions supplied by the median nerve, with a particular emphasis on restoring grasp, pinch, and sensation. Continued study into possible nerve transfers for median nerve injury has led to multiple options that can be tailored to the patient's demands, deficits, and injury pattern.

Soft Robotic Brittle Star Shows The Influence Of Mass Distribution On Underwater Walking, Zach J. Patterson

Faculty Scholarship

Most walking organisms tend to have relatively light limbs and heavy bodies in order to facilitate rapid limb motion. However, the limbs of brittle stars (Class Ophiuroidea) are primarily comprised of dense skeletal elements, with potentially much higher mass and density compared to the body disk. To date, little is understood about how the relatively unique distribution of mass in these animals influences their locomotion. In this work, we use a brittle star inspired soft robot and computational modeling to examine how the distribution of mass and density in brittle stars affects their movement. The soft robot is fully untethered, …

Thermodynamic Water Activity Explains The Unusual Electrochemical Stability Of Aqueous Deep Eutectic Solvents, Desiree Mae Prado, Aaron Niño Gonzaga, Clemens Burda

Faculty Scholarship

The presence of water in nonaqueous deep eutectic solvent (DES) electrolytes has been debated in recent years, with efforts ranging from its complete removal to willful addition. It was shown that controlled amounts of water can be beneficial, as it not only enhances the physicochemical properties of these electrolytes but also has no significant detrimental effects on their electrochemical stability. Despite these advantages, there is still limited understanding of how water interacts with DES systems at the molecular level. This study examines the water activity in ethylene glycol and glycerol, as well as their binary mixtures with choline chloride to …