Digital Commons Network^™

Why Mlp Legal Care Should Be Financed As Health Care, William M. Sage, Keegan D. Warren

Faculty Scholarship

Medical-legal partnership (MLP) integrates the unique expertise of lawyers into collaborative clinical environments. MLP teams meet the needs of individual patients while also detecting structural problems at the root of health inequities and advancing solutions at the institutional, community, and system levels. Yet MLPs today operate in limited settings and survive on scant budgets. Expanding their impact requires secure funding. Financing MLPs as health care can do the following: (1) help address inequity at the point of care; (2) enable expert diagnosis and treatment of nonmedical drivers of health; (3) enhance team-based practice in health care organizations; (4) offer another …

A Framework For The Foundation Of The Philosophy Of Artificial Intelligence, Emily Barnes, James Hutson

Faculty Scholarship

In recent years, the rapid advancement of artificial intelligence (AI) technology has sparked profound questions about the nature of machine intelligence and the possibility of AI consciousness. As AI systems become increasingly sophisticated, examining their philosophical foundations has become imperative. This article investigates the intricate relationship between AI and existential thought, aiming to establish a comprehensive framework for understanding AI's philosophical underpinnings. The historical development of AI, from symbolic AI to contemporary machine learning paradigms, highlights the increasing complexity and sophistication of AI systems, prompting significant philosophical debates about machine consciousness. Theoretical models such as the Independent Core Observer Model …

Materials Data Science Using Cradle: A Distributed, Data-Centric Approach, Thomas G. Ciardi, Arafath Nihar, Rounak Chawla, Olatunde Akanbi, Pawan K. Tripathi, Yinghui Wu, Vipin Chaudhary, Roger H. French

Faculty Scholarship

There is a paradigm shift towards data-centric AI, where model efficacy relies on quality, unified data. The common research analytics and data lifecycle environment (CRADLE™) is an infrastructure and framework that supports a data-centric paradigm and materials data science at scale through heterogeneous data management, elastic scaling, and accessible interfaces. We demonstrate CRADLE’s capabilities through five materials science studies: phase identification in X-ray diffraction, defect segmentation in X-ray computed tomography, polymer crystallization analysis in atomic force microscopy, feature extraction from additive manufacturing, and geospatial data fusion. CRADLE catalyzes scalable, reproducible insights to transform how data is captured, stored, and analyzed. …

Changes In Revenues Associated With Antimicrobial Reimbursement Reforms In Germany, Matt Mcenany, Kevin Outterson

Faculty Scholarship

Policy declarations from the G7 and other high-level meetings call for increased incentives for antimicrobial research and development (R&D). Governments fund push incentives like CARB-X and GARDP, and G7 countries are now designing pull incentives—financial rewards given to manufacturers post-market authorization that are intended to encourage the creation and introduction of novel antimicrobials. Germany has declared previously at the G7 that it has developed a pull incentive that will increase revenues from sales of important new antimicrobials, principally by exempting them from some aspects of health technology benefit assessments and reference pricing, which should result in higher prices. This policy …

Bridging The Gap: Ai And The Hidden Structure Of Consciousness, Emily Barnes, James Hutson

Faculty Scholarship

The quest to develop Artificial Intelligence (AI) systems that possess human-like consciousness necessitates a deep dive into both theoretical and practical aspects underpinning this ambitious goal. This article builds on initial philosophical explorations of AI consciousness by examining the intricate and often hidden structures that may facilitate conscious experiences in AI. Drawing from concepts in cognitive science and neuroscience, the article elucidates how AI systems can be designed to replicate the structural and functional aspects of human consciousness. The discussion includes the Hierarchy of Spatial Belongings proposed by Forti (2024), frameworks like the Integrated Information Theory (IIT), and models linking …

Using Latent Variables To Improve The Management Of Depression Among Hemodialysis Patients, Douglas D. Gunzler, Martha Sajatovic, Ashwini R. Sehgal

Faculty Scholarship

Background: Screening for depression can be challenging among hemodialysis patients due to the overlap of depressive symptoms with dialysis or kidney disease related symptoms. The aim of this study was to understand these overlapping symptoms and develop a depression screening tool for better clinical assessment of depressive symptoms in dialysis patients. Methods: We surveyed 1,085 dialysis patients between March 1, 2018 and February 28, 2023 at 15 dialysis facilities in Northeast Ohio with the 9-item patient health questionnaire (PHQ-9) and kidney disease quality of life (KDQOL) instrument. To evaluate overlap across questionnaire items, we used structural equation modeling (SEM). We …

Diagnosis And Management Of Hypertension In Adolescents With Obesity, Shradha M. Chhabria, Sarah D. Ronis, Courtney E. Batt

Faculty Scholarship

Purpose of Review: Hypertension (HTN) and obesity are increasing in prevalence and severity in adolescents and have significant implications for long term morbidity and mortality. This review focuses on the diagnosis and management of HTN in adolescents with obesity with an emphasis on co-management of the two conditions. Recent Findings: Recent studies affirm the increasing prevalence of abnormal blood pressures and diagnoses of HTN associated with increased adiposity. Current guidelines recommend routine screening with proper technique for HTN in patients with obesity. Additionally, obesity and HTN related co-occurring medical conditions should be evaluated as there is frequently a bidirectional impact …

Materials Data Science Using Cradle: A Distributed, Data-Centric Approach, Thomas G. Ciardi, Arafath Nihar, Rounak Chawla, Olatunde Akanbi, Pawan K. Tripathi, Yinghui Wu, Vipin Chaudhary, Roger H. French

Faculty Scholarship

There is a paradigm shift towards data-centric AI, where model efficacy relies on quality, unified data. The common research analytics and data lifecycle environment (CRADLE™) is an infrastructure and framework that supports a data-centric paradigm and materials data science at scale through heterogeneous data management, elastic scaling, and accessible interfaces. We demonstrate CRADLE’s capabilities through five materials science studies: phase identification in X-ray diffraction, defect segmentation in X-ray computed tomography, polymer crystallization analysis in atomic force microscopy, feature extraction from additive manufacturing, and geospatial data fusion. CRADLE catalyzes scalable, reproducible insights to transform how data is captured, stored, and analyzed.

Aso Author Reflections: The Association Between Sentinel Lymph Node Biopsy And Melanoma-Specific Survival In The Elderly, Luke D. Rothermel

Faculty Scholarship

No abstract provided.

Alpha Angle And Anterior Femoral Neck Offset Identify Different Cohorts Of Cam Morphology: An Osteologic Study, Grigory A. Manyak

Faculty Scholarship

Purpose: To explore differences in cam morphology defined by alpha angle (AA) and anterior femoral neck offset (AFNO) in the context of other anthropometric parameters in an osteologic collection to further elucidate whether each measurement tool is identifying the same underlying pathology. Methods: Anthropometric measurements of 992 cadaveric hips from the Hamann-Todd Osteological Collection were analyzed. Femurs with cam morphology were identified by AA >55° or AFNO <7 mm. Anthropometric parameters stratified by cam morphology were assessed with Wilcoxon rank-sum and Pearson χ2 tests. Multivariate logistic regressions were performed on significant variables in univariate analysis to examine the predictive ability of anthropometric variables to cam morphology. Results: Cam morphology was identified in 242 hips via AA, 344 hips via AFNO, and 123 hips via both measures. Multivariate logarithmic regression analysis demonstrated that sex negatively predicted AA (females with less pathology, β = –0.14, P = .04), race negatively predicted AA (Blacks with less pathology, β = –0.21, P < .01), and proximal femoral osteoarthritis was positively associated with AA (β = 0.16, P = .02), while none of these were associated with AFNO. On the other hand, right-side specimens were associated with AA (β = 0.15, P = .02) and AFNO (β = 0.25, P < .01), whereas the combined version was unassociated with both measures. Conclusions: In conclusion, cam morphology was identified in a modest percentage of osteologic specimens by both AA and AFNO in our study. Further, associations of multiple demographic, anthropometric, and anatomical parameters to AA and AFNO suggest they may identify different subsets of cam morphology. Clinical Relevance: Cam morphology identified by AA versus AFNO may represent 2 different pathologic entities. Future studies should assess differences between these measures in a clinical cohort and determine whether these 2 definitions of cam morphology identify different clinical populations.

Nocturnal Paroxysmal Dystonia To Sleep-Related Hypermotor Epilepsy: A Critical Review, Neel Fotedar, Hans O. Lüders

Faculty Scholarship

Sleep-related paroxysmal motor episodes (SPMEs) have been described by various names, including nocturnal paroxysmal dystonia, nocturnal frontal lobe epilepsy (NFLE), and sleep-related hypermotor epilepsy. The underlying pathophysiology has been debated over the years, with these episodes assumed to be a form of paroxysmal dystonia or parasomnia versus a form of epilepsy. In most studies published on SPMEs and their variants (paroxysmal arousals, nocturnal paroxysmal dystonia, and episodic nocturnal wanderings) in the early 1990s, the authors speculated on the pathophysiology but did not commit to one idea. It was not until the mid-1990s that epilepsy became the leading prospect. We performed …

The Utility Of Sentinel Lymph Node Biopsy In Elderly Patients With Melanoma, Carmen A. Jung, Kathleen M. Mulligan, Iris Sheng, John B. Ammori, Ankit Mangla, Richard S. Hoehn, Luke D. Rothermel

Faculty Scholarship

Background: Sentinel lymph node biopsy (SLNB) is performed less often for older patients with melanoma. We investigated the association of SLNB and melanoma-specific survival (MSS) in the elderly. Methods: We retrospectively reviewed the Surveillance, Epidemiology, and End Results (SEER: 2010–2019) for patients ≥ 70 years with cT2-4N0M0 melanoma. We used multivariable Cox proportional hazard models to evaluate the impact of SLNB performance and SLN status on MSS at increasing age cutoffs. In addition, we evaluated the association of different factors with SLNB performance using multivariable logistic regression. Results: We identified 11,548 patients. Sentinel lymph node biopsy occurred in 6754 (58.5%) …

L-Pbf High-Throughput Data Pipeline Approach For Multi-Modal Integration, Kristen J. Hernandez, Thomas G. Ciardi, Rachel Yamamoto, Mingjian Lu, Arafath Nihar, Jayvic Cristian Jimenez, Pawan K. Tripathi, John J. Lewandowski, Roger H. French, Laura S. Bruckman

Faculty Scholarship

Metal-based additive manufacturing requires active monitoring solutions for assessing part quality. Multiple sensors and data streams, however, generate large heterogeneous data sets that are impractical for manual assessment and characterization. In this work, an automated pipeline is developed that enables feature extraction from high-speed camera video and multi-modal data analysis. The framework removes the need for manual assessment through the utilization of deep learning techniques and training models in a weakly supervised paradigm. We demonstrate this pipeline’s capability over 700,000 high-speed camera frames. The pipeline successfully extracts melt pool and spatter geometries and links them to corresponding pyrometry, radiography, and …

A Qualitative Study On The Integration Of Artificial Intelligence In Cultural Heritage Conservation, Kholoud Ghaith, James Hutson

Faculty Scholarship

The widespread adoption of generative artificial intelligence (GAI) technologies heralds an era of expanding possibilities in the domain of cultural heritage conservation. This paradigm shift is marked by a confluence of innovative methodologies, including digital twin mapping, digital archiving, and enhanced preservation strategies, aimed at safeguarding the vestiges of our shared past. The application of AI within this field represents a frontier where technology and tradition intersect, offering new vistas for the preservation of historical structures and artifacts that are at risk of deterioration or oblivion. This article endeavors to elucidate the perspectives of professionals within the conservation domain on …

Single-Fly Genome Assemblies Fill Major Phylogenomic Gaps Across The Drosophilidae Tree Of Life, K. Nicole Crown, Sarah E. Diamond, Ryan A. Martin

Faculty Scholarship

AU Long-read: Pleaseconfirmthatallheadinglevelsarerepresentedcorrectly sequencing is driving rapid progress in genome assembly : across all major groups of life, including species of the family Drosophilidae, a longtime model system for genetics, genomics, and evolution. We previously developed a cost-effective hybrid Oxford Nanopore (ONT) long-read and Illumina short-read sequencing approach and used it to assemble 101 drosophilid genomes from laboratory cultures, greatly increasing the number of genome assemblies for this taxonomic group. The next major challenge is to address the laboratory culture bias in taxon sampling by sequencing genomes of species that cannot easily be reared in the lab. Here, we build …

Three-Year Outcomes Of 6-Month Paliperidone Palmitate In Adults With Schizophrenia: An Open-Label Extension Study Of A Randomized Clinical Trial, Martha Sajatovic

Faculty Scholarship

Importance: Long-acting injectable (LAI) antipsychotics have the potential to improve adherence and symptom control in patients with schizophrenia, promoting long-term recovery. Paliperidone palmitate (PP) once every 6 months is the first and currently only LAI antipsychotic with an extended dosing interval of 6 months. Objective: To assess long-term outcomes of PP received once every 6 months in adults with schizophrenia. Design, Setting, and Participants: In a 2-year open-label extension (OLE) study of a 1-year randomized clinical trial (RCT), eligible adults with schizophrenia could choose to continue PP every 6 months if they had not experienced relapse after receiving PP once …

Elevating Black Fathers' Experiences In The National Fatherhood Initiative: Strengths And Areas For Improvement Of 24/7 Dad® Curriculum And Case Management Services, Laura A. Voith, Katie N. Russell, Ashley Withrow, Tian Xia, Darrell Coleman

Faculty Scholarship

The Healthy Marriage and Responsible Fatherhood grant program is one of the most robust mechanisms supporting fatherhood programming in the United States, with the gold standard of care including fatherhood curriculum (e.g., 24/7 Dad®) and case management services. Despite the fact that fatherhood in the United States is not a monolith and Black fathers make up over 40% of those served through Responsible Fatherhood (RF) program, little research explicitly centers the lived experiences of low-income Black fathers. The current study used focus groups with fathers (n = 23) and staff (n = 8) enrolled in a RF grantee program. Thematic …

Psychedelic Experiences And Long-Term Spiritual Growth: A Systematic Review, William A. Schutt, Julie J. Exline, Kathleen C. Pait, Joshua A. Wilt

Faculty Scholarship

Psychedelic substances, which can occasion mystical experiences, are sometimes used for religious and spiritual reasons. Despite strong links between psychedelics and spirituality, no previous systematic review has investigated connections between psychedelics and indicators of long-term spiritual growth. Thus, 34 empirical studies were analyzed with 19,724 total participants from 32 independent samples. A variety of methodologies were used among the reviewed studies, and some studies included international samples. Results showed that psychedelics—especially classic psychedelics (e.g., psilocybin, LSD, and DMT)—have been studied more often in this context than other substances. Findings indicate that psychedelic use is linked with a variety of subjective …

The History Of Diapers And Their Environmental Impact, Cansu Tokat, Nicholas C. Rickman, Cynthia F. Bearer

Faculty Scholarship

Impact: This article examines diaper practices around the world throughout history. This article reviews the innovation of the modern diaper and the environmental effects of disposable diapers.

Spinal Movement Disorders In Nmosd, Mogad, And Idiopathic Transverse Myelitis: A Prospective Observational Study, Hesham Abboud, Rongyi Sun, Nikhil Modak, Mohamed Elkasaby, Alexander Wang

Faculty Scholarship

Background: Retrospective studies suggest that spinal movement disorders, especially tonic spasms, are prevalent in NMOSD. However, there have been no prospective studies evaluating spinal movement disorders in NMOSD, MOGAD, and idiopathic transverse myelitis (ITM). Methods: Patients referred to a tertiary neuroimmunology clinic for spinal cord demyelination (excluding MS) were evaluated. All patients answered a movement disorders survey and underwent a movement disorder-focused exam. Movement disorders were compared among patients with NMOSD with and without AQP4-IgG, MOGAD, and ITM. Patients with and without involuntary movements were also compared to identify predictors of spinal movement disorders. Results: Sixty-three patients were evaluated from …

A Sequential, Multiple Assignment, Randomized Trial Design With A Tailoring Function, Holly Hartman

Faculty Scholarship

We present a trial design for sequential multiple assignment randomized trials (SMARTs) that use a tailoring function instead of a binary tailoring variable allowing for simultaneous development of the tailoring variable and estimation of dynamic treatment regimens (DTRs). We apply methods for developing DTRs from observational data: tree-based regression learning and Q-learning. We compare this to a balanced randomized SMART with equal re-randomization probabilities and a typical SMART design where re-randomization depends on a binary tailoring variable and DTRs are analyzed with weighted and replicated regression. This project addresses a gap in clinical trial methodology by presenting SMARTs where second …

Kinetics Of Selenate Reduction Mediated By Underpotentially Deposited Cu On Polycrystalline Au Electrodes In Aqueous Perchloric Acid, Jonathan Strobl, Saurabh Pathak, Daniel Scherson

Faculty Scholarship

The reduction of selenate, SeO²₄⁻(aq),in 0.1 M HClO₄ solutions, induced by underpotential deposition, UPD, of Cu on polycrystalline Au electrodes was investigated using the rotating ring-disk electrode, RRDE, technique. Design and implementation of electrode potential-rotation rate protocols made it possible to determine the rates of SeO²₄⁻(aq)reduction as a function of Cu coverage, θCu, as determined by the Bruckenstein method (Swathirajan et al. J. Phys. Chem. 1982, 86, 2480–2485). In agreement with the results reported recently for Au(111) film electrodes (Strobl et al. Electrochimica Acta 2024, 493, 144,298), the reaction was found to proceed only for θCu above a critical value, …

Mitigating Algorithmic Bias: Strategies For Addressing Discrimination In Data, Sonia Gipson Rankin

Faculty Scholarship

This article examines the pervasive issue of algorithmic bias, particularly within large language models (LLMs) and the legal system. It argues that unlike simple programming bugs, these biases are deeply ingrained in the design and training data of artificial intelligence (AI) systems. By understanding the historical roots of bias and its realworld consequence across various sectors, we can develop effective strategies to mitigate its impact and ensure AI serves as a tool for progress. Weaving together historical insights, case studies, and forward-looking recommendations, the article aims to equip legal professionals with the knowledge and tools necessary to lead the charge …

False Start On Nil: Public And Private Law Should Treat College Athletes Like Any Other Student, Jodi Balsam

Faculty Scholarship

No abstract provided.

Enhancing Adult Learner Success In Higher Education Through Decision Tree Models: A Machine Learning Approach, Emily Barnes, James Hutson, Karriem Perry

Faculty Scholarship

This article explores the use of machine learning, specifically Classification and Regression Trees (CART), to address the unique challenges faced by adult learners in higher education. These learners confront socio-cultural, economic, and institutional hurdles, such as stereotypes, financial constraints, and systemic inefficiencies. The study utilizes decision tree models to evaluate their effectiveness in predicting graduation outcomes, which helps in formulating tailored educational strategies. The research analyzed a comprehensive dataset spanning the academic years 2013–2014 to 2021–2022, evaluating the predictive accuracy of CART models using precision, recall, and F1 score. Findings indicate that attendance, age, and Pell Grant eligibility are key …

Do Private Actors Have Rights Under The Wto? The Motivation For And (Inadequate) Implementation Of Gatt Article X, Adeet Dobhal, Petros C. Mavroidis, Lucas Moreira Jiminez, Sunayana Sasmal, Robert Wolfe

Faculty Scholarship

General Agreement on Tariffs and Trade (GATT) Article X has been consistently overlooked in literature even though it is a unique provision in the GATT-regime: it acknowledges standing for private actors who can challenge trade-related administrative action by World Trade Organization (WTO) members. This provision is an unusual instantiation of the need to provide transparency for private actors about state policy. It is equally eccentric in seeming to provide a right for private actors to challenge governments, albeit only before domestic fora. How did the GATT end up with this provision? And are these apparent private rights meaningful in practice? …

Fund Kinship Caregivers To Help Keep Families Together, Not Separate Them, Joshua Gupta-Kagan

Faculty Scholarship

Money impacts relationships. And when the money involved is a foster care subsidy to kinship caregivers, it can drive a wedge in relationships between parents and kinship caregivers that should be strengthened, not strained. Unfortunately, foster care funding incentivizes the “relational disruption”1 endemic to foster care, when it should instead support family members coming together to support each other and their children.

In contrast, Medicaid funding has increasingly supported family members taking care of each other and can provide child welfare with a model for funding family caregiving without disrupting relationships and without even requiring a family court or foster …

Negotiating Police Reform, Cynthia Alkon

Faculty Scholarship

In the summer of 2020, after the murder of George Floyd, the national conversation around police reform intensified and was part of a conversation with students at Texas A&M University School of Law. Students wanted more discussion and teaching about police, police misconduct, police reform, and defunding the police. Following those discussions, I created a simulation on local level police reform that, as of this writing, I have used twice in my negotiation class. Simulations are helpful teaching tools in a variety of settings, including law schools. Simulations can be particularly useful to help students discuss difficult topics in different …

Whistle-Blowing And The Incentive To Hire, Jef De Mot, Murat C. Mungan

Faculty Scholarship

We consider a previously neglected cost of whistle-blower awards: employers may base their hiring decisions, on the margin, not on the productivity of an employee but rather on the probability that the employee will become a whistle-blower. We develop a three-stage model to examine how productivity losses due to distortions at the hiring stage influence optimal whistle-blower rewards. We characterize optimal rewards for whistle-blowing, and show that when rewards can be chosen according to either the benefits of the employer from offending or the productivity of the worker being hired, productivity-based rewards are superior to benefit-based rewards.

Parental Political Engagement And Self-Efficacy: An Exploratory Study, Christina Randolph, Robert Needlman, Ellen Hutchinson

Faculty Scholarship

Political engagement (PE) is associated with a sense of empowerment. PE by parents affects children's lives. This study explored parents' attitudes about inclusion of political engagement discussion in well-child care. Because voting is an expression of empowerment, we hypothesized that voting would be related to higher parenting self-efficacy. We administered a brief questionnaire to a convenience sample of parents/guardians at well-child visits at an urban hospital. The questionnaire included 10 Likert scale questions touching on parenting efficacy; beliefs about political engagement; voting behaviors; and demographics. Analysis included descriptive statistics, correlations, and factor analysis. Among the 70 respondents 84% were mothers; …