Digital Commons Network^™

The Spectrum Of Pneumonia Among Intubated Neonates In The Neonatal Intensive Care Unit, Dayle J. Bondarev, Rita M. Ryan, Devashis Mukherjee

Faculty Scholarship

We review the pathophysiology, epidemiology, diagnosis, treatment, and prevention of ventilator-associated pneumonia (VAP) in neonates. VAP has been studied primarily in adult ICU patients, although there has been more focus on pediatric and neonatal VAP (neo-VAP) in the last decade. The definition as well as diagnosis of VAP in neonates remains a challenge to date. The neonatal intensivist needs to be familiar with the current diagnostic tools and prevention strategies available to treat and reduce VAP to reduce neonatal morbidity and the emergence of antibiotic resistance. This review also highlights preventive strategies and old and emerging treatments available.

Simulacra And Historical Fidelity In Digital Recreation Of Lost Cultural Heritage: Reconstituting Period Materialities For The Period Eye, Trent Olsen, James Hutson, Charles O'Brien, Jeremiah Ratican

Faculty Scholarship

The advancement of digital technologies in art history has opened avenues for reconstructing lost or damaged cultural heritage, a need highlighted by the deteriorated state of many artworks from the 1785 Salon. Grounded in the concept of the “Period Eye” by art historian Michael Baxandall, which emphasizes understanding artworks within their original historical and cultural contexts, this study proposes a subfield focused on Reconstituting Period Materialities for the Period Eye. This methodology bridges comprehensive historical research with generative visual artificial intelligence (AI) technologies, facilitating the creation and immersive virtual reality viewing of artworks. Beyond mere visual replication, the approach aims …

Advancing Sentiment Analysis Through Emotionally-Agnostic Text Mining In Large Language Models (Llms), Jay Ratican, James Hutson

Faculty Scholarship

The conventional methodology for sentiment analysis within large language models (LLMs) has predominantly drawn upon human emotional frameworks, incorporating physiological cues that are inherently absent in text-only communication. This research proposes a paradigm shift towards an emotionallyagnostic approach to sentiment analysis in LLMs, which concentrates on purely textual expressions of sentiment, circumventing the confounding effects of human physiological responses. The aim is to refine sentiment analysis algorithms to discern and generate emotionally congruent responses strictly from text-based cues. This study presents a comprehensive framework for an emotionally-agnostic sentiment analysis model that systematically excludes physiological indicators whilst maintaining the analytical depth …

Resonant Perceptions: Exploring Autistic Aesthetics Through Embodied Cognition, James Hutson, Piper Hutson

Faculty Scholarship

No abstract provided.

The Submerged Administrative State, Gabriel Scheffler, Daniel E. Walters

Faculty Scholarship

The United States government is experiencing a reputation crisis: after decades of declining public trust, many Americans have lost confidence in the government’s capacity to perform its basic functions. While various explanations have been offered for this worrying trend, these existing accounts overlook a key factor: people are unfamiliar with the institutions that actually do most of the governing—administrative agencies—and they devalue what they cannot easily observe. The “submerged” nature of the administrative state is, we argue, a central reason for declining trust in government.

This Article shows that the administrative state is systematically submerged in two ways. First, administrative …

Constitutional Rights And Remedial Consistency, Katherine Mims Crocker

Faculty Scholarship

When the Supreme Court declined definitively to block Texas’s S.B. 8, which effectively eliminated pre-enforcement federal remedies for what was then a plainly unconstitutional restriction on abortion rights, a prominent criticism was that the majority would have never tolerated the similar treatment of preferred legal protections—like gun rights. This refrain reemerged when California enacted a copycat regime for firearms regulation. This theme sounds in the deep-rooted idea that judge-made law should adhere to generality and neutrality values requiring doctrines to derive justification from controlling a meaningful class of cases ascertained by objective legal criteria.

This Article is about consistency, and …

Inmate Assistance Programs: Toward A Less Punitive And More Effective Criminal Justice System, Erkmen G. Aslim, Yijia Lu, Murat C. Mungan

Faculty Scholarship

High recidivism rates in the United States are a well-known and disturbing problem. In this article, we explain how this problem can be mitigated in a cost-effective manner through reforms that make greater use of humane methods that help inmates rather than using more punitive measures.

We focus on Inmate Assistance Programs (IAPs) adopted by many states. Some of these programs provide inmates with valuable skill sets to utilize upon their release while others are geared towards treating mental health and substance use disorder problems. IAPs are likely to reduce recidivism by lowering ex-convicts’ need to resort to crime for …

The Rise, Fall, And Rise Of Cyber Civil Libertarianism, Hannah Bloch-Wehba

Faculty Scholarship

Using sexual speech as its focal point, this essay explores the ambiguous legacy of cyber civil liberties and the ascent of alternative paradigms for digital freedom. From its inception, cyberlaw was characterized by a moral panic over sexual speech, pornography, and the protection of children familiar to First Amendment scholars. Important civil libertarian victories recognized that sexual speech and pornography were constitutionally protected from state intervention. The civil libertarian paradigm saw government regulation as the primary threat to free speech online, the marketplace as the more appropriate mechanism for regulating expression, and courts as the rightful arbiters of these disputes. …

Bail At The Founding, Kellen R. Funk, Sandra G. Mayson

Faculty Scholarship

How did criminal bail work in the Founding era? This question has become pressing as bail, and bail reform, have attracted increasing attention, in part because history is thought to bear on the meaning of bail-related constitutional provisions. To date, however, there has been no thorough account of bail at the Founding. This Article begins to correct the deficit in our collective memory by describing bail law and practice in the Founding era, from approximately 1790 to 1810. In order to give a full account, we surveyed a wide range of materials, including Founding-era statutes, case law, legal treatises, and …

The Remedial Rationale After Sffa, Olatunde C.A. Johnson

Faculty Scholarship

After the Supreme Court’s ruling in Students for Fair Admissions, Inc. v. President & Fellows of Harvard College (SFFA) limiting the ability of higher education institutions to use race as a factor to advance diversity in the student body, at least one prominent commentator suggested that universities should now justify their affirmative action policies based not on diversity but on the need to remedy discrimination. Chief Justice John Roberts’s majority opinion deems diversity — the rationale established in Regents of the University of California v. Bakke and affirmed in Grutter v. Bollinger — a “commendable” goal. But the …

Distinguishing Family Poverty From Child Neglect, Joshua Gupta-Kagan

Faculty Scholarship

Family courts and child protective services (“CPS”) agencies surveil, regulate, and separate hundreds of thousands of families for neglect annually. These families are overwhelmingly poor, and the history of this legal system reveals an expectation, if not an intention, to intervene in poor families. This raises the question whether family courts and CPS agencies are “confusing poverty and neglect” or if they intervene for more than “just poverty,” as a raging debate in the field is framed.

The law fails to help resolve this debate. Instead of distinguishing poverty from neglect, or providing nuanced examinations of what social science has …

Government Misinformation Platforms, Janet Freilich

Faculty Scholarship

There is a harmful mismatch between how information published by the government is perceived-as highly trustworthy-and the reality that it is often not. This Article shows that the government frequently collects information from third party private entities and publishes it with no review or vetting. Although this information is riddled with errors and inaccuracies, scholars, policymakers, and the public treat the information with unwarranted confidence because it derives from the government. Further, institutional imprimatur (and consequent trust) attaches to information even tangentially associated with the government and to information where the government explicitly disclaims review.

This Article highlights the ubiquity …

Optimizing Adult Learner Success: Applying Random Forest Classifier In Higher Education Predictive Analytics, Emily Barnes, James Hutson, Karriem Perry

Faculty Scholarship

This study examines the application of the Random Forest Classifier (RF) model in predicting academic success among adult learners in higher education. It focuses on evaluating the model's effectiveness using key statistical measures like accuracy, precision, recall, and F1 score across a comprehensive dataset from 2013–14 to 2021–22, which includes variables such as age, ethnicity, gender, Pell Grant eligibility, and academic performance metrics. The research highlights the RF model's capability to handle large datasets with varying data types and demonstrates its superiority over traditional regression models in predictive accuracy. Through an iterative process, the study refines the RF model to …

The Anti-Innovation Supreme Court: Major Questions, Delegation, Chevron And More, Jack M. Beermann

Faculty Scholarship

The Supreme Court of the United States has generally been a very aggressive enforcer of legal limitations on governmental power. In various periods in its history, the Court has gone far beyond enforcing clearly expressed and easily ascertainable constitutional and statutory provisions and has suppressed innovation by the other branches that do not necessarily transgress widely held social norms. Novel assertions of legislative power, novel interpretations of federal statutes, statutes that are in tension with well-established common law rules and state laws adopted by only a few states are suspect simply because they are novel or rub up against tradition. …

A New Approach To Patent Reform, Janet Freilich, Michael J. Meurer, Mark Schankerman, Florian Schuett

Faculty Scholarship

Scholars and policy makers have tried for years to solve the tenacious and harmful crisis of low quality, erroneously granted patents. Far from resolving the problem, these determined efforts have resulted in hundreds of conflicting policy proposals, failed Congressional bills, and no way to evaluate the policies’ value or impact or to decide between the overwhelming multiplicity of policies.

This Article provides not only new solutions, but a new approach for designing and assessing policies both in patent law and legal systems more generally. We introduce a formal economic model of the patent system that differs from existing scholarship because …

The Post-Pandemic Job Market For Academic Librarians In The Southeast United States, Louise Lowe, J.B. Hill, Jenna Eastwood Hill, Claresta Icasia

Faculty Scholarship

This study examines the state of the post-pandemic academic library job market in the Southeastern region of the United States. This analysis of academic librarian job advertisements collected from 2022 and 2023 reveals that while some new jobs have emerged there is a continued demand for traditional roles, prior work experience and the ALA-accredited master’s degree. Diversity, equity, and inclusion are prominent in job advertisements despite some regional political opposition. Remote work options are limited, signaling a nuanced approach to work modality post-pandemic.

Reply To: On The Statistical Foundation Of A Recent Single Molecule Fret Benchmark, Dorothy A. Erie, Lydia Kisley, Dushani Dunukara

Faculty Scholarship

In their ‘Matters Arising’ manuscript, Saurabh et al. discuss two issues related to single-molecule Förster resonance energy transfer (smFRET) experiments: the use of the Gaussian noise approximation and spectral crosstalk. Their arguments are based on simulations obtained with parameters that differ significantly from the typical conditions measured experimentally, and, thus, from the regime included in the original study (Götz et al.1). In addition, they make claims about our multi-lab blind study that we would like to rectify. In Table 1, we provide a list of specific statements made by Saurabh et al. with our respective explanations.

Self-Reported Determinants Of Covid-19 Vaccine Acceptance Among Persons With And Without Autoimmune Disease, Jenny D. Gong, Maya Mattar, Donald D. Anthony, Adam T. Perzynski, Nora G. Singer

Faculty Scholarship

Objective: Patients with autoimmune disease (AD) are at increased risk for complications from COVID-19 infection, so, optimizing vaccine utilization in this population is of particular importance. We compared COVID-19 vaccination perspectives among persons with and without AD. Methods: 471 patients in the MetroHealth System and Cleveland Veteran Affairs Medical Center completed a 38-item questionnaire between August 2021 and February 2022. This survey containing questions regarding COVID-19 vaccine perceptions and demographics was administered both to unvaccinated individuals and individuals who delayed vaccination for at least 2 months. Multivariable ordinary least squares regression models were created to assess factors associated with vaccination …

The Efficacy Of High-Fidelity Simulation On Knowledge And Performance In Undergraduate Nursing Students: An Umbrella Review Of Systematic Reviews And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objectives: This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. Design: Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. Data sources: Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. Review methods: The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). …

Association Of School Instructional Mode With Community Covid-19 Incidence During August–December 2020 In Cuyahoga County, Ohio, Pauline D. Terebuh, Jeffrey M. Albert, Jacqueline W. Curtis, Kurt C. Stange, Jill E. Miracle, Wail Yar, Prakash R. Ganesh, Heidi L. Gullett, Johnie Rose

Faculty Scholarship

Remote and hybrid modes of instruction were employed as alternatives to in-person instruction as part of early mitigation efforts in response to the COVID-19 pandemic. We investigated the impact of a public school district’s instructional mode on cumulative incidence and transmission in the surrounding community by employing a generalized estimating equations approach to estimate the association with weekly COVID-19 case counts by zip code in Cuyahoga County, Ohio, from August to December 2020. Remote instruction only (RI) was employed by 7 of 20 school districts; 13 used some non-remote instruction (NRI) (2–15 weeks). Weekly incidence increased in all zip codes …

Aso Author Reflections: Outcomes Of Hepatic Artery-Based Therapies And Systemic Multiagent Chemotherapy In Unresectable Colorectal Liver Metastases: A Systematic Review And Meta-Analysis, Lee M. Ocuin

Faculty Scholarship

No abstract provided.

Continuous Glucose Monitoring For Glycaemic Control And Cardiovascular Risk Reduction In Patients With Type 2 Diabetes Not On Insulin Therapy: A Clinical Trial, Joseph Reed, Tony Dong, Sanjay Rajagopalan, Ian J. Neeland

Faculty Scholarship

Aim: To evaluate the impact of the Dexcom G6 continuous glucose monitoring (CGM) device on glycaemic control and cardiometabolic risk in patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk who are not on insulin therapy. Materials and Methods: Adults with T2DM with glycated haemoglobin (HbA1c) >7% and body mass index (BMI) ≥30 kg/m2 not using insulin were enrolled in a two-phase cross-over study. In phase 1, CGM data were blinded, and participants performed standard glucose self-monitoring. In phase 2, the CGM data were unblinded, and CGM, demographic and cardiovascular risk factor data were collected through 90 days …

Approach To Simple Kidney Cysts In Children, Katherine M. Dell

Faculty Scholarship

The finding of a simple kidney cyst in a child can pose a diagnostic and management challenge for pediatric nephrologists, urologists, and primary care providers. The reported prevalence varies from 0.22 to 1% in large ultrasonography-based series of more than 10,000 children each. The true prevalence, however, may be higher or lower, as factors such as variations in referral patterns, indications for ultrasonography, or technical considerations could impact prevalence rates. For many patients, simple kidney cysts may be found incidentally when imaging is performed for another indication. Although simple cysts can occur in children, they may also represent the first …

Amplon: Amplifying Dna With Multiarm Priming And Looping Optimization Of Nucleic Acid, Mert Tunca Doganay, Ethan Roman, Andrea M. Hujer, Robert A. Bonomo, Mohamed S. Draz

Faculty Scholarship

Nucleic acid amplification, the bedrock of biotechnology and molecular diagnostics, surges in applications—especially isothermal approaches—heightening the demand for advanced and precisely engineered methods. Here, a novel approach for amplifying DNA with multiarm priming and looping optimization of nucleic acid (AMPLON) is presented. AMPLON relies on a novel polymeric material with unique set of multiarm polyethylene glycol–DNA primers for efficient DNA amplification under isothermal conditions. Each arm carries single-stranded DNA complementing the sense or antisense sequence of the target DNA. The amplification reaction begins with antisense arms binding to the target DNA, forming a template for sense-carrying arms to direct multiarm …

Emergency Department Imaging Utilization Post-Transcatheter Aortic Valve Replacement: Single Institution 7-Year Experience, Andy Mew, Kaustav Bera, Sirui Jiang, Nikhil Ramaiya, Robert Gilkeson

Faculty Scholarship

Purpose: This study aims to highlight presentations, acute findings and imaging phenotypes of patients presenting to the emergency department (ED) within 30 days of a transcatheter aortic valve replacement (TAVR). Methods: A retrospective review of patients diagnosed with aortic valve disease who underwent a TAVR between Jan 2015 and Nov 2021 at a large academic medical center was completed. From an initial 1271 patients, 146 were included based on their presentation to the ED within 30 days post-TAVR procedure. Patient data, including ED presentation details and imaging results, were recorded and de-identified. Results: Of the 146 post-TAVR patients, there were …

Barriers To Dental Utilization Among Medicaid-Enrolled Young Children From Primary Care Practices In Northeast Ohio, David Selvaraj, Neel Agarwal, Jeffrey M. Albert, Suchitra Nelson

Faculty Scholarship

Objectives: To evaluate the individual and community factors that contribute to dental utilization among young children on Medicaid utilizing the Anderson Model and the Socio-Ecological Framework. Methods: This observational cross-sectional study was conducted using baseline data (socio-demographics, clinical dental need) from a cluster-randomized hybrid effectiveness-implementation trial among 1021 child–parent dyads recruited from primary care practices across northeast Ohio. The baseline data were then linked to dental Medicaid claims data (categorized as any dental visit, volume, and type in the past 12 months) and ICD-10 codes from the child's EHR data (individual-level) together with Dental Health Provider Shortage Area (HPSA) status …

Auditory Feedback Decreases Timing Variability For Discontinuous And Continuous Motor Tasks In Autistic Adults, Nicole M. Richard Williams, Luc Tremblay, Corene Hurt-Thaut, Jessica Brian, Julia Kowaleski, Kathrin Mertel, Sebastian Schlüter, Michael Thaut

Faculty Scholarship

Introduction: Autistic individuals demonstrate greater variability and timing error in their motor performance than neurotypical individuals, likely due at least in part to atypical cerebellar characteristics and connectivity. These motor difficulties may differentially affect discrete as opposed to continuous movements in autistic individuals. Augmented auditory feedback has the potential to aid motor timing and variability due to intact auditory-motor pathways in autism and high sensitivity in autistic individuals to auditory stimuli. Methods: This experiment investigated whether there were differences in timing accuracy and variability in autistic adults as a function of task (discontinuous vs. continuous movements) and condition (augmented auditory …

Common Questions And Misconceptions About Protein Supplementation: What Does The Scientific Evidence Really Show?, Jose Antonio, Cassandra Evans, Arny A. Ferrando, Jeffrey R. Stout, Brandi Antonio, Harry P. Cintineo, Patrick Harty, Shwn M. Arent, Darren G. Candow, Scott C. Forbes, Chad M. Kerksick, Flavia Pereira, Drew Gonzalez, Richard B. Kreider

Faculty Scholarship

Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their protein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of “protein and exercise performance” reveals thousands of publications. Despite the considerable volume of evidence, it is …

The Pml1-Wdr5 Axis Regulates H3k4me3 Marks And Promotes Stemness Of Estrogen Receptor-Positive Breast Cancer, Chun-Peng Pai, Han Wang, Darcie D. Seachrist, Neel Agarwal, Joshua A. Adams, Zhenghao Liu, Ruth A. Keri, Kaixiang Cao, William P. Schiemann, Hung-Ying Kao

Faculty Scholarship

The alternative splicing of PML precursor mRNA gives rise to various PML isoforms, yet their expression profile in breast cancer cells remains uncharted. We discovered that PML1 is the most abundant isoform in all breast cancer subtypes, and its expression is associated with unfavorable prognosis in estrogen receptor-positive (ER+) breast cancers. PML depletion reduces cell proliferation, invasion, and stemness, while heterologous PML1 expression augments these processes and fuels tumor growth and resistance to fulvestrant, an FDA-approved drug for ER+ breast cancer, in a mouse model. Moreover, PML1, rather than the well-known tumor suppressor isoform PML4, rescues the proliferation of PML …

Teaching "Is This Case Rightly Decided?", Steven Arrigg Koh

Faculty Scholarship

“Is this case rightly decided?” From the first week of law school, every law student must grapple with this classroom question. This Essay argues that this vital question is problematically under-specified, creating imprecision in thinking about law. This Essay thus advocates that law professors should present students with a three-part framework: whether a case is rightly decided legally, morally, or sociologically.

Additionally, this Essay argues that disaggregating the question exposes deeper deficiencies in legal education. Many law professors do not provide students with serious grounding to engage in rigorous thinking about the relationship between law, morality, and justice, not to …