Digital Commons Network^™

Tiny Homes: A Big Solution To American Housing Insecurity, Lisa T. Alexander

Faculty Scholarship

“There’s no place like home,” said Dorothy. Yet, millions of people in the United States may face eviction, foreclosure, or homelessness in 2021 and beyond. America is on the brink of an unprecedented housing crisis in the wake of Covid-19. The federal government, and various states and localities, have taken actions to avert a housing crisis in the aftermath of Covid 19. While these actions have undeniably helped mitigate widespread foreclosure and eviction crises, they do not fully address the more fundamental American housing challenge—an inadequate supply of affordable housing at all income levels, a longstanding problem that Covid-19 has …

The Place Of The Prosecutor In Abolitionist Praxis, Cynthia Godsoe

Faculty Scholarship

No abstract provided.

Long-Term Safety And Efficacy Of Deutetrabenazine In Younger And Older Patients With Tardive Dyskinesia, Martha Sajatovic

Faculty Scholarship

Objectives: To assess long-term safety and efficacy of deutetrabenazine in younger (<55 years) and older (≥55 years) adult participants with tardive dyskinesia (TD). Design: Three-year, single-arm, open-label extension (OLE) study enrolling participants who completed the 12-week, pivotal ARM-TD or AIM-TD studies. Setting: Seventy-six centers in the United States and Europe. Participants: A total of 337 participants with TD (119 younger and 218 older). Intervention: Deutetrabenazine was initiated at 12 mg/day and titrated once weekly by 6 mg/day using a response-driven dosing regimen until adequate dyskinesia control was reached or a clinically significant adverse event occurred. Measurements: This post hoc analysis assessed change and percent change from baseline in total motor Abnormal Involuntary Movement Scale (AIMS) score, response rates for ≥50% AIMS improvement, Clinical Global Impression of Change (CGIC), Patient Global Impression of Change (PGIC), and safety in younger and older participants with TD. Results: After 3 years of open-label treatment, mean deutetrabenazine dose was ∼39.5 mg/day in both groups. Mean±SE changes from baseline in total motor AIMS score were –6.7 ± 0.62 and –6.5 ± 0.47 in younger and older participants, respectively (percent changes: –61.4% ± 4.10% and –54.6% ± 3.01%); 76% of younger and 62% of older participants achieved ≥50% AIMS response. Most younger and older participants achieved treatment success per CGIC (67% and 76%) and PGIC (64% and 63%). Deutetrabenazine was generally well tolerated in both groups. Conclusions: Deutetrabenazine treatment was associated with sustained improvements in total motor AIMS score, treatment success, and improved quality of life, and was well tolerated in younger and older adults with TD in this 3-year OLE study.

Stress Testing Governance, Rory Van Loo

Faculty Scholarship

In their efforts to guard against the world’s greatest threats, administrative agencies and businesses have in recent years increasingly used stress tests. Stress tests simulate doomsday scenarios to ensure that the organization is prepared to respond. For example, agencies role-played a deadly pandemic spreading from China to the United States the year before COVID-19, acted out responses to a hypothetical hurricane striking New Orleans months before Hurricane Katrina devastated the city, and required banks to model their ability to withstand a recession prior to the economic downturn of 2020. But too often these exercises have failed to significantly improve readiness …

Regulating Natural Gas Venting And Flaring As Waste: A Review Of The New Mexico Approach, Joseph A. Schremmer

Faculty Scholarship

Special issue: Law and Policy for Gas Flaring in a Low-Carbon Economy.

This essay interrogates the regulation of routine venting and flaring of natural gas as a source of prohibited “waste,” using New Mexico’s recently adopted Waste Rule as an example. It begins with a survey of both the environmental and economic benefits to be achieved by limiting or eliminating venting and flaring and the direct and indirect costs of doing so, including the forgone opportunity to produce crude oil. Then the essay explains the common law and statutory definitions of “waste” to demonstrate that the concept implicates a balancing …

The Epistemology Of Second Best, Gary S. Lawson

Faculty Scholarship

Second best theory “holds that where it is not possible to satisfy all the conditions necessary for a[] . . . system to reach an overall optimum, it is not generally desirable to satisfy as many of those conditions as possible.” Adrian Vermeule, Foreword: System Effects and the Constitution, 123 HARV. L. REV. 4, 17 (2009). In other words, if you are not moving all the way to the ideal state of affairs, it is unclear whether partial moves that seem to go in the direction of the ideal make the world “better” or “worse” – with “better” or “worse” …

You Can’T Betray A Fish: One Reason Eating Fish May Cause Less Harm Than Eating Cows, Ronald G. Oldfield

Faculty Scholarship

In The Ultimate Betrayal: Is There Happy Meat?, Bohanec (2013) proposed that farmed animals raised humanely may experience betrayal when slaughtered. I argue based on personal experience that humans often betray trust relationships with farmed animals. Using published scientific literature, I find that typical farmed animals (mammals) and farmed fishes are both cognitively capable of a rudimentary experience of betrayal. However, the manner in which fishes are typically maintained does not present opportunities for human-fish trust relationships to develop. Eating farmed fishes presents fewer ethical implications than eating cows, at least in some cases.

This article was featured in …

Implementation Of An Antibiotic Stewardship Program In Long-Term Care Facilities Across The Us, Robin L.P. Jump

Faculty Scholarship

Importance: Antibiotic overuse in long-term care (LTC) is common, prompting calls for antibiotic stewardship programs (ASPs) designed for specific use in these settings. The optimal approach to establish robust, sustainable ASPs in LTC facilities is unknown. Objectives: To determine if the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use, an educational initiative to establish ASPs focusing on patient safety, is associated with reductions in antibiotic use in LTC settings. Design, Setting, and Participants: This quality improvement study including 439 LTC facilities in the US assessed antibiotic therapy data following a pragmatic quality-improvement program, which was …

Back To The Basics: A Covid-19 Surveillance Program Within A Local School District, Prakash R. Ganesh, Johnie Rose, Heidi Gullett, Kurt C. Stange

Faculty Scholarship

BACKGROUND: A school district in Northern Ohio implemented a COVID-19 surveillance program from January 4 to May 21, 2021, as in-person school and extracurricular activities resumed. METHODS: Among 560 staff members and >6300 students, random weekly testing was performed on 563 students and weekly for 204 students participating in extracurricular activities, and 553 staff. RESULTS: Cases of COVID-19 were identified among 26 staff members and 23 students. Most of those infected were participating in extracurricular activities (14/23) and in the age range of 14-18. Percent positivity was low (range 0.2-2.4%) throughout the school surveillance program despite significant changes in positivity …

Investigation Of A Cluster Of Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Infections In A Hospital Administration Building, Lucas D. Jones, Ernest R. Chan, Sarah N. Redmond, Jeffrey D. Kovach, Marlin Linger, Peter A. Zimmerman, Curtis J. Donskey

Faculty Scholarship

Objective: To investigate a cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in employees working on 1 floor of a hospital administration building. Methods: Contact tracing was performed to identify potential exposures and all employees were tested for SARS-CoV-2. Whole-genome sequencing was performed to determine the relatedness of SARS-CoV-2 samples from infected personnel and from control cases in the health-care system with coronavirus disease 2019 (COVID-19) during the same period. Carbon dioxide levels were measured during a workday to assess adequacy of ventilation; readings >800 parts per million (ppm) were considered an indication of suboptimal ventilation. To assess …

Environmental Effects Of Stratospheric Ozone Depletion, Uv Radiation, And Interactions With Climate Change: Unep Environmental Effects Assessment Panel, Update 2021, Laura S. Bruckman

Faculty Scholarship

The Environmental Effects Assessment Panel of the Montreal Protocol under the United Nations Environment Programme evaluates effects on the environment and human health that arise from changes in the stratospheric ozone layer and concomitant variations in ultraviolet (UV) radiation at the Earth’s surface. The current update is based on scientific advances that have accumulated since our last assessment (Photochem and Photobiol Sci 20(1):1–67, 2021). We also discuss how climate change affects stratospheric ozone depletion and ultraviolet radiation, and how stratospheric ozone depletion affects climate change. The resulting interlinking effects of stratospheric ozone depletion, UV radiation, and climate change are assessed …

Functional Maintenance Of Differentiated Embryoid Bodies In Microfluidic Systems: A Platform For Personalized Medicine, Umut A. Gurkan

Faculty Scholarship

Hormone replacement therapies have become important for treating diseases such as premature ovarian failure or menopausal complications. The clinical use of bioidentical hormones might significantly reduce some of the potential risks reportedly associated with the use of synthetic hormones. In the present study, we demonstrate the utility and advantage of a microfluidic chip culture system to enhance the development of personalized, on-demand, treatment modules using embryoid bodies (EBs). Functional EBs cultured on microfluidic chips represent a platform for personalized, patient-specific treatment cassettes that can be cryopreserved until required for treatment. We assessed the viability, differentiation, and functionality of EBs cultured …

Regional Cooperative Federalism And The Us Electric Grid, Hannah Jacobs Wiseman

Faculty Scholarship

The U.S. Constitution makes no direct mention of regional governing entities, yet they are an entrenched part of our federalist system. In the area of electric grid governance, the federal government enlists independent, private entities called regional transmission organizations (RTOs) to implement federal policy and achieve state energy goals. RTOs are the most prominent form of regional cooperative federalism, yet other policy spheres, such as opioid control, encompass a similar approach. This is a twist on the classic form of cooperative federalism, in which the federal government relies upon individual states to achieve federal mandates.

The regionally governed electric grid …

Similar Mortality Among United States Veterans With Invasive And Noninvasive Pneumonia Due To Group B Streptococcus, Brigid M. Wilson, Sunah Song, Robin L.P. Jump, Federico Perez

Faculty Scholarship

Background: The nosology of noninvasive pneumonia due to group B Streptococcus (GBS) is not well defined. This study compared clinical characteristics and outcomes of patients with invasive pneumonia and noninvasive pneumonia caused by GBS. Methods: We conducted a retrospective cohort study among Veterans Affairs (VA) healthcare users between 2008 and 2017. Using data from electronic health records, we identified patients who had blood or respiratory cultures that grew GBS and had invasive pneumonia or noninvasive pneumonia. We analyzed patient and infection characteristics associated with all-cause mortality, including among the subset of patients with cultures that were monomicrobial for GBS. Results: …

Asian Americans, Racial Stereotypes, And Elite University Admissions, Vinay Harpalani

Faculty Scholarship

Asian Americans have long occupied a precarious position in America’s racial landscape, exemplified by controversies over elite university admissions. Recently, this has culminated with the Students for Fair Admissions, Inc. v. President & Fellows of Harvard College case. In January 2022, the Supreme Court granted certiorari in this case, and it will hear arguments and make a ruling in the next year or so. Students for Fair Admissions (“SFFA”) has attempted to link “negative action,” or discrimination against Asian Americans in admissions in favor of White Americans, with “affirmative action,” or race-conscious admissions policies intended to increase the enrollment of …

Statues Of Fraud : Confederate Monuments As Public Nuisances, Emily T. Behzadi

Faculty Scholarship

The deaths of George Floyd, Breonna Taylor, and countless other African Americans have capitulated a new wave of social activism throughout the United States. Notwithstanding the existence of one of the most infectious diseases of the 21st century, racist and unrestrained police violence continues to plague American society. The unprecedented national uprisings resulting from the brutal killings of African Americans have positioned the U.S. on the precipice of immense social and political change. This transitory period is marked by an amalgamation of social, political, and cultural influences. However, the continued exhibition of Confederate monuments inexorably stymies the ability to remedy …

Decoding Nondelegation After Gundy: What The Experience In State Courts Tells Us About What To Expect When We're Expecting, Daniel E. Walters

Faculty Scholarship

The nondelegation doctrine theoretically limits Congress’s ability to delegate legislative powers to the executive agencies that make up the modern administrative state. Yet, in practice, the U.S. Supreme Court has, since the New Deal, shied away from enforcing any limits on congressional delegation. That may change in the near future. In Gundy v. United States, the Court narrowly upheld a delegation, and a dissent signaled deep doubts about the Court’s longstanding “intelligible principle” standard and offered a new framework to replace it. Subsequent events strongly suggest that the Court is poised to move in the direction contemplated by the dissent …

The Second Transformation Of The International Intellectual Property Regime, Peter K. Yu

Faculty Scholarship

This chapter focuses on the structural changes that international investment norms have posed to the international intellectual property regime. It begins by documenting the regime’s first transformation by the adoption of the TRIPS Agreement and the marriage of intellectual property and trade through the World Trade Organization. The chapter then explores the regime’s potential second transformation when bilateral, regional, and plurilateral agreements and new investor-state disputes have caused international investment norms to intrude into the intellectual property domain. It continues to identify three sets of problems that have emerged from such intrusion. The chapter concludes by proposing three solutions to …

Contributing Factors To Low Energy Availability In Female Athletes: A Narrative Review Of Energy Availability, Training Demands, Nutrition Barriers, Body Image, And Disordered Eating, Andrew R. Jagim, Jennifer Fields, Meghan K. Magee, Chad M. Kerksick, Margaret T. Jones

Faculty Scholarship

Relative Energy Deficiency in sport is experiencing remarkable popularity of late, particularly among female athletes. This condition is underpinned by low energy availability, which is a byproduct of high energy expenditure, inadequate energy intake, or a combination of the two. Several contributing factors exist that may predispose an athlete to low energy availability, and therefore a holistic and comprehensive assessment may be required to identify the root causes. The focus of the current narrative review is to discuss the primary contributing factors as well as known risk factors for low energy availability among female athletes to help practitioners increase awareness …

Predictors Of Persistence, Retention & Completion For First-Generation Graduate Students, James Hutson, Susan Edele, Roger Mitch Nasser Jr., Gillian Parrish, Christie Rodgers, Scott Richmond, Michael Marzano, Ryan Curtis

Faculty Scholarship

Postsecondary education is still considered key for achieving upward mobility and economic success. While access to higher education has over the past three decades, students whose parents did not complete at least a bachelor’s degree continue to be at a distinct disadvantage. Given that most first-generation college students are from low-income and minority backgrounds, this population faces challenges distinct to them-1) insufficient academic preparation, 2) inadequate financial resources, and 3) deficient support from family members and/or peers that attended college. Yet, while first-generation undergraduate students have been extensively studied with regard to their motivations, challenges, and unique needs for persistence, …

Threat And Emotions: Mobilizing And Attitudinal Outcomes Of A Ballistic Missile Scare, Kelly Bergstrand, Christopher Robertson

Faculty Scholarship

This study examines the false ballistic missile alert that occurred in Hawaii in 2018, which presented a unique opportunity for assessing the civic and mobilizing outcomes of a threat. In the days that followed the scare, we conducted an online experiment to investigate its effects on willingness to engage in activism and concerns about broader issues. Our results show that emotions serve as an important mechanism for channeling threat experiences into concern about specific causes. Those most emotionally affected by the missile scare in Hawaii thought it more important to engage in activities to control the spread of nuclear weapons, …

Andragogy: The Common Thread In The Teaching Of Adults In Colleges Of Education, Criminal Justice, And Health Management, Grant J. Shostak, Larry Acker, Vanessa Vandergraaf

Faculty Scholarship

The Covid-19 pandemic has brought dramatic changes to higher education. Students and educators face challenges never anticipated, including switching classes from on-ground to online and back again, mental fatigue, stress, and burnout. Faculty across disciplines may turn to Andragogy to best teach college students to inform their teaching practices. This paper demonstrates how professors from education, criminal justice, and healthcare management have used andragogical techniques in their classrooms.

An Interventional Pilot Of Customized Adherence Enhancement Combined With Long-Acting Injectable Antipsychotic Medication (Cae-L) For Poorly Adherent Patients With Chronic Psychotic Disorder In Tanzania, Christopher J. Burant, Carol E. Blixen, Kristin A. Cassidy, Jennifer B. Levin, Martha Sajatovic

Faculty Scholarship

Background: Chronic psychotic disorders (CPD) impose a particularly significant burden in resource-limited settings. Combining long-acting antipsychotic medication (LAI) with a customized adherence enhancement intervention (CAE-L) has potential to advance care. Methods: Nineteen adults ≥ age 18 with CPD who self-reported missing ≥20% of antipsychotic medication within the last month were stabilized on oral haloperidol prior to transitioning to monthly haloperidol decanote for 25 weeks. Outcome evaluations were conducted at baseline and Week 25. Primary outcomes were oral medication adherence assessed via the Tablet Routines Questionnaire (TRQ) and LAI injection frequency. Secondary outcomes included CPD symptoms measured by the Brief Psychiatric …

Directly Observed Weekly Fluoxetine For Major Depressive Disorder Among Hemodialysis Patients: A Single-Arm Feasibility Trial, Kelley M. Kauffman, Jacqueline Dolata, Maria Figueroa, Douglas Gunzler, Anne Huml, Julie Pencak, Martha Sajatovic, Ashwini R. Sehgal

Faculty Scholarship

Rationale & Objective: Major depressive disorder (MDD) is common among hemodialysis patients, but treatment can add to their pill burden and may be limited by nonadherence. We sought to investigate the value of directly observed, once-weekly fluoxetine dosing in MDD. Study Design: Feasibility trial of adult hemodialysis patients with untreated MDD. The diagnosis of MDD was determined using the Mini International Neuropsychiatric Interview. Setting & Participants: 16 patients at 15 hemodialysis facilities in Northeast Ohio. Intervention: Patients were initially prescribed 20 mg of fluoxetine once daily for 2 weeks to assess their tolerance. The patients took this daily fluoxetine unobserved …

Global News Toronto Interviews Joshua Kastenberg: U.S. Supreme Court Blocks Biden Vaccine Mandate, Joshua Kastenberg, Miranda Anthistle

Faculty Scholarship

The Supreme Court rejected the Biden Administration’s workplace vaccine mandate which would require employees at large businesses to be vaccinated or undergo weekly testing.

Constitutional law expert Joshua Kastenberg shares that this decision is not quite as bleak as one might think. He even has some advice for POTUS.

Prevalence And Amounts Of Common Ingredients Found In Energy Drinks And Shots, Andrew R. Jagim, Patrick S. Harty, Abdelrahman R. Barakat, Jacob L. Erickson, Victoria Carvalho, Chinguun Khurelbaatar, Clayton L. Camic, Chad M. Kerksick

Faculty Scholarship

Background: Energy drinks are one of the most popular packaged beverage products consumed within the United States (US). Energy drinks are considered a functional beverage, a category that also includes sports drinks and nutraceutical beverages. Purpose: The focus of the current study was to examine the nutrition fact panels of the top selling commercially available energy drink and energy shot products within the US to characterize common ingredient profiles to help establish a standard definition and ingredient profile of energy drinks and energy shots for consumers, health care practitioners, and researchers. Methods: The top 75 commercially available energy drinks and …

Antibiotic Exposure And Acquisition Of Antibiotic-Resistant Gram-Negative Bacteria Among Outpatients At A Us Veterans Affairs Medical Center, Brigid M. Wilson, Sunah Song, Federico Perez, Robin L.P. Jump

Faculty Scholarship

Objectives: To assess the prevalence of antibiotic-resistant gram-negative bacteria (R-GNB) among patients without recent hospitalization and to examine the influence of outpatient antibiotic exposure on the risk of acquiring R-GNB in this population. Design: 2-year retrospective cohort study. Setting: Regional Veterans Affairs healthcare system. Patients: Outpatients at 13 community-based clinics. Methods: We examined the rate of acquisition of R-GNB within 90 days following an outpatient visit from 2018 to 2019. We used clinical and administrative databases to determine and summarize prescriptions for systemic antibiotics, associated infectious diagnoses, and subsequent R-GNB acquisition among patients without recent hospitalizations. We also calculated the …

Optimizing Biomedical Discoveries As An Engine Of Culture Change In An Academic Medical Center, Anne K. Dechant, Stephen Fening, Michael Haag, William Harte, Mark R. Chance

Faculty Scholarship

Academic discovery in biomedicine is a growing enterprise with tens of billions of dollars in research funding available to universities and hospitals. Protecting and optimizing the resultant intellectual property is required in order for the discoveries to have an impact on society. To achieve that, institutions must create a multidisciplinary, collaborative system of review and support, and utilize connections to industry partners. In this study, we outline the efforts of Case Western Reserve University, coordinated through its Clinical and Translational Science Collaborative (CTSC), to promote entrepreneurial culture, and achieve goals of product development and startup formation for biomedical and population …

Beyond Bake Sales: Environmental Justice Through Superfund Removal Actions, Clifford Villa

Faculty Scholarship

Few people outside of EPA seem to be aware of the existence of the Superfund removal program, a program through which millions of dollars are allocated through EPA’s ten regional offices each year for cleaning up contaminated sites that are not designated 'Superfund' sites. This essay will provide a basic introduction to the Superfund removal program and particularly encourage consideration of Superfund removals to address growing concerns for environmental justice. Part II examines the legal authorities and limitations of the Superfund removal program. Part III provides examples of removal actions in environmental justice communities across the country. Part IV considers …

A History Of The West Nutshells, Robert M. Jarvis

Faculty Scholarship

No single source provides a detailed history of the West Nutshell Series. This is rather surprising, given that the books are routinely relied on by both law students and lawyers and have been cited in multiple court opinions. Accordingly, this article provides the first detailed look at the series’ birth, evolution, and present status.