Digital Commons Network^™

Uncovering The Interhospital Price Variations For Vasectomies In The United States, Sherry Mortach, Nicholas Sellke, Stephen Rhodes, Helen H. Sun, Kimberly Tay, Ramy Abou Ghayda, Aram Loeb, Nannan Thirumavalavan

Faculty Scholarship

Due to the historic lack of transparency in healthcare pricing in the United States, the degree of price variation for vasectomy is largely unknown. Our study aims to assess characteristics of hospitals reporting prices for vasectomy as well as price variation associated with hospital factors and insurance status. A cross-sectional analysis was performed in October, 2022 using the Turquoise Database which compiles publicly available hospital pricing data. The database was queried for vasectomy prices to identify the cash (paid by patients not using insurance), commercial (negotiated by private insurers) and Medicare and Medicaid prices for vasectomies. Hospital characteristics of those …

3.0-T Mr-Guided Transgluteal In-Bore-Targeted Prostate Biopsy Under Local Anesthesia In Patients Without Rectal Access: A Single-Institute Experience And Review Of Literature, Kaustav Bera, Nikhil Ramaiya, Dean Nakamoto, Sree Harsha Tirumani

Faculty Scholarship

Purpose: To describe the technique and evaluate the performance of MRI-guided transgluteal in-bore-targeted biopsy of the prostate gland under local anesthesia in patients without rectal access. Methods: Ten men (mean age, 69 (range 57–86) years) without rectal access underwent 13 MRI-guided transgluteal in-bore-targeted biopsy of the prostate gland under local anesthesia. All patients underwent mp-MRI at our institute prior to biopsy. Three patients had prior US-guided transperineal biopsy which was unsuccessful in one, negative in one, and yielded GG1 (GS6) PCa in one. Procedure time, complications, histopathology result, and subsequent management were recorded. Results: Median interval between rectal surgery and …

Structural Insights Into Peptidoglycan Glycosidase Etga Binding To The Inner Rod Protein Esci Of The Type Iii Secretion System Via A Designed Esci-Etga Fusion Protein, Jacob Boorman, Focco Van Den Akker

Faculty Scholarship

Bacteria express lytic enzymes such as glycosidases, which have potentially self-destructive peptidoglycan (PG)-degrading activity and, therefore, require careful regulation in bacteria. The PG glycosidase EtgA is regulated by localization to the assembling type III secretion system (T3SS), generating a hole in the PG layer for the T3SS to reach the outer membrane. The EtgA localization was found to be mediated via EtgA interacting with the T3SS inner rod protein EscI. To gain structural insights into the EtgA recognition of EscI, we determined the 2.01 Å resolution structure of an EscI (51–87)-linker-EtgA fusion protein designed based on AlphaFold2 predictions. The structure …

Factors Influencing Music Therapists’ Retention Of Clinical Hours With Autistic Clients Over Telehealth During The Covid-19 Pandemic, Nicole M. Richard Williams

Faculty Scholarship

The COVID-19 pandemic influenced music therapists to migrate services to online platforms, though some lost clinical hours during the pandemic when telehealth was not a viable option. This survey study aimed to ascertain factors that helped music-based therapists to continue serving autistic clients over telehealth during the pandemic. We surveyed 193 accredited music therapists located mainly in Canada and the United States. In addition to gathering data on general perceptions of telehealth music therapy and Neurologic Music Therapy® (NMT), one-way ANOVAs were applied to determine differences in percent-change loss of clinical hours for music therapists: 1) working in different employment …

In Vivo Characterization Of Intracortical Probes With Focused Ion Beam-Etched Nanopatterned Topographies, Jonathan L. Duncan, Jaime J. Wang, Gabriele Glusauskas, Yue Gao, George F. Hoeferlin, Allison E. Hess-Dunning, Jeffrey R. Capadona

Faculty Scholarship

(1) Background: Intracortical microelectrodes (IMEs) are an important part of interfacing with the central nervous system (CNS) and recording neural signals. However, recording electrodes have shown a characteristic steady decline in recording performance owing to chronic neuroinflammation. The topography of implanted devices has been explored to mimic the nanoscale three-dimensional architecture of the extracellular matrix. Our previous work used histology to study the implant sites of non-recording probes and showed that a nanoscale topography at the probe surface mitigated the neuroinflammatory response compared to probes with smooth surfaces. Here, we hypothesized that the improvement in the neuroinflammatory response for probes …

Integrating Multiscale Geospatial Analysis For Monitoring Crop Growth, Nutrient Distribution, And Hydrological Dynamics In Large-Scale Agricultural Systems, Olatunde D. Akanbi, Deepa C. Bhuvanagiri, Erika I. Barcelos, Arafath Nihar, Brian Gonzalez Hernandez, Jeffrey M. Yarus, Roger H. French

Faculty Scholarship

Monitoring crop growth, soil conditions, and hydrological dynamics are imperative for sustainable agriculture and reduced environmental impacts. This interdisciplinary study integrates remote sensing, digital soil mapping, and hydrological data to elucidate intricate connections between these factors in the state of Ohio, USA. Advanced spatiotemporal analysis techniques were applied to key datasets, including the MODIS sensor satellite imagery, USDA crop data, soil datasets, Aster GDEM, and USGS stream gauge measurements. Vegetation indices derived from MODIS characterized crop-specific phenology and productivity patterns. Exploratory spatial data analysis show relationships of vegetation dynamics and soil properties, uncovering links between plant vigor, edaphic fertility, and …

Integrating Multiscale Geospatial Analysis For Monitoring Crop Growth, Nutrient Distribution, And Hydrological Dynamics In Large-Scale Agricultural Systems, Olatunde D. Akanbi, Deepa C. Bhuvanagiri, Erika I. Barcelos, Arafath Nihar, Brian Gonzalez Hernandez, Jeffrey M. Yarus, Roger H. French

Faculty Scholarship

Monitoring crop growth, soil conditions, and hydrological dynamics are imperative for sustainable agriculture and reduced environmental impacts. This interdisciplinary study integrates remote sensing, digital soil mapping, and hydrological data to elucidate intricate connections between these factors in the state of Ohio, USA. Advanced spatiotemporal analysis techniques were applied to key datasets, including the MODIS sensor satellite imagery, USDA crop data, soil datasets, Aster GDEM, and USGS stream gauge measurements. Vegetation indices derived from MODIS characterized crop-specific phenology and productivity patterns. Exploratory spatial data analysis show relationships of vegetation dynamics and soil properties, uncovering links between plant vigor, edaphic fertility, and …

Using Spatio-Temporal Graph Neural Networks To Estimate Fleet-Wide Photovoltaic Performance Degradation Patterns, Yangxin Fan, Raymond Wieser, Xuanji Yu, Yinghui Wu, Laura S. Bruckman, Roger H. French

Faculty Scholarship

Accurate estimation of photovoltaic (PV) system performance is crucial for determining its feasibility as a power generation technology and financial asset. PV-based energy solutions offer a viable alternative to traditional energy resources due to their superior Levelized Cost of Energy (LCOE). A significant challenge in assessing the LCOE of PV systems lies in understanding the Performance Loss Rate (PLR) for large fleets of PV systems. Estimating the PLR of PV systems becomes increasingly important in the rapidly growing PV industry. Precise PLR estimation benefits PV users by providing real-time monitoring of PV module performance, while explainable PLR estimation assists PV …

Using Spatio-Temporal Graph Neural Networks To Estimate Fleet-Wide Photovoltaic Performance Degradation Patterns, Yangxin Fan, Raymond Wieser, Xuanji Yu, Yinghui Wu, Laura S. Bruckman, Roger H. French

Faculty Scholarship

Accurate estimation of photovoltaic (PV) system performance is crucial for determining its feasibility as a power generation technology and financial asset. PV-based energy solutions offer a viable alternative to traditional energy resources due to their superior Levelized Cost of Energy (LCOE). A significant challenge in assessing the LCOE of PV systems lies in understanding the Performance Loss Rate (PLR) for large fleets of PV systems. Estimating the PLR of PV systems becomes increasingly important in the rapidly growing PV industry. Precise PLR estimation benefits PV users by providing real-time monitoring of PV module performance, while explainable PLR estimation assists PV …

Real-Time Assessment Of Rodent Engagement Using Aruco Markers: A Scalable And Accessible Approach For Scoring Behavior In A Nose-Poking Go/No-Go Task, Jeffrey R. Capadona

Faculty Scholarship

In the field of behavioral neuroscience, the classification and scoring of animal behavior play pivotal roles in the quantification and interpretation of complex behaviors displayed by animals. Traditional methods have relied on video examination by investigators, which is labor-intensive and susceptible to bias. To address these challenges, research efforts have focused on computational methods and image-processing algorithms for automated behavioral classification. Two primary approaches have emerged: marker-and markerless-based tracking systems. In this study, we showcase the utility of “Augmented Reality University of Cordoba” (ArUco) markers as a marker-based tracking approach for assessing rat engagement during a nose-poking go/no-go behavioral task. …

Definitions Of Recovery And Reintegration Across The First Year: A Qualitative Study Of Perspectives Of Persons With Spinal Cord Injury And Caregivers, Kim D. Anderson, Anne M. Bryden, Brian Gran, Susan W. Hinze

Faculty Scholarship

Study Design: Longitudinal, qualitative cohort study. Objectives: To understand how people with newly acquired spinal cord injury (PWS) and their support person (SP) define recovery and successful community reintegration (CR) across the first 12 months post-injury (mpi) and their satisfaction with the rate of recovery and reintegration experienced. Setting: Academic and Veterans hospitals in Midwest USA. Methods: In-depth, semi-structured interviews were conducted in two cohorts of PWS and SP during the initial inpatient rehabilitation stay, at 6 mpi, and at 12 mpi. Recordings were transcribed; four authors independently undertook line-by-line coding. The team discussed codes to reach consensus and synthesize …

Flow Cytometry Of Dnmt1 As A Biomarker Of Hypomethylating Therapies, Philip G. Woost, Basem M. William, Brenda W. Cooper, Masumi Ueda Oshima, Folashade Otegbeye, Marcos J. De Lima, David Wald, Reda Z. Mahfouz, Yogen Saunthararajah, Tammy Stefan, James W. Jacobberger

Faculty Scholarship

The 5-azacytidine (AZA) and decitabine (DEC) are noncytotoxic, differentiation-inducing therapies approved for treatment of myelodysplastic syndrome, acute myeloid leukemias (AML), and under evaluation as maintenance therapy for AML postallogeneic hematopoietic stem cell transplant and to treat hemoglobinapathies. Malignant cell cytoreduction is thought to occur by S-phase specific depletion of the key epigenetic regulator, DNA methyltransferase 1 (DNMT1) that, in the case of cancers, thereby releases terminal-differentiation programs. DNMT1-targeting can also elevate expression of immune function genes (HLA-DR, MICA, MICB) to stimulate graft versus leukemia effects. In vivo, there is a large inter-individual variability in DEC and 5-AZA activity because of …

Dose Tapering And Discontinuation Of Biologic Dmards In Axial Spondyloarthritis: A Narrative Review (2023 Spartan Annual Meeting Proceedings), Haseeb Chaudhary, Ansaam Daoud, Marina Magrey

Faculty Scholarship

Purpose of Review: Limited data is available for tapering or discontinuation of biologic therapy in patients with axSpA who are in disease remission. The current review concentrates on published studies regarding dose tapering or withdrawal of biologics in axSpA. Recent Findings: Recent evidence in light of randomized controlled trials suggests that tapering of b-DMARDs is a feasible strategy to maintain remission or low disease activity in axSpA patients. TNF inhibitors were the studied biologics in most of these trials. The disease flare rates were comparable to those maintained on standard dose in most of these studies, although with variable tapering …

Intracellular Neural Control Of An Active Feeding Structure In Aplysia Using A Carbon Fiber Electrode Array, Yu Huan, Benjamin N. Tibbetts, Hillel J. Chiel

Faculty Scholarship

Background: To study neural control of behavior, intracellular recording and stimulation of many neurons in freely moving animals would be ideal. However, current technologies limit the number of neurons that can be monitored and manipulated. A new technology has become available for intracellular recording and stimulation which we demonstrate in the tractable nervous system of Aplysia. New method: Carbon fiber electrode arrays (whose tips are coated with platinum-iridium) were used with an in vitro feeding preparation to intracellularly record from and to control the activity of multiple neurons during feeding movements. Results: In an in vitro feeding preparation, the carbon …

Nurse Practitioners In Critical Care Transport, David M. Kaniecki, Robert L. Grabowski, David Holloway

Faculty Scholarship

The inclusion of nurse practitioners (NPs) in critical care transport teams has the potential to enhance patient care and improve team operations. NPs can manage complex clinical situations during transport and excel in various roles such as leadership, education, mentoring, research, quality improvement, and clinical expertise. As we navigate the evolving landscape of critical care transport, it is crucial to explore the potential benefits offered by NPs. Their distinct skills and experiences effectively position them to improve patient outcomes, enhance team performance, and contribute to health care's financial sustainability. This article discusses the role of NPs in critical care transport, …

Point-Of-Care Diagnostic Test For Beta-Thalassemia, Ran An, Umut A. Gurkan

Faculty Scholarship

Hemoglobin (Hb) disorders are among the most common monogenic diseases affecting nearly 7% of the world population. Among various Hb disorders, approximately 1.5% of the world population carries β-thalassemia (β-Thal), affecting 40,000 newborns every year. Early screening and a timely diagnosis are essential for β-thalassemia patients for the prevention and management of later clinical complications. However, in Africa, Southern Europe, the Middle East, and Southeast Asia, where β-thalassemia is most prevalent, the diagnosis and screening for β-thalassemia are still challenging due to the cost and logistical burden of laboratory diagnostic tests. Here, we present Gazelle, which is a paper-based microchip …

Enhancing Workplace Neuro Health And Productivity: The Synergy Of Wearable Technology With Biophilic And Oxygenation Strategies, Piper Hutson, James Hutson

Faculty Scholarship

In the contemporary workplace, where a staggering 62% of employees reported experiencing burnout in 2023 according to a Medium article, the integration of wearable technology with biophilic and oxygenation strategies emerges as a vital Neurohemal initiative. This approach is particularly relevant for supporting neurodivergent individuals, as well as those recovering from stroke and long-COVID, in the context of return-to-office mandates. The article underscores the significance of research on increased hydrostatic pressure in circulation, particularly its impact on spinal and spinal cord blood flow during water immersion. This insight lays the groundwork for innovations like non-wet water massage devices, which could …

The Wages Of Crying Roe: Some Realism About Dobbs V. Jackson Women’S Health Organization, Neil S. Siegel

Faculty Scholarship

The U.S. Supreme Court’s reasoning in Dobbs v. Jackson Women’s Health Organizationcannot be taken seriously. The Court’s stated rationale for rejecting continued protection of the abortion right—that abortion is not deeply rooted in nineteenth century history and tradition—applies with equal force to other substantive due process rights that the DobbsCourt repeatedly insisted were not under threat even without considering stare decisis, including contraception, sexual intimacy between consenting adults, and same-sex marriage. One should add inter-racial marriage and protection from involuntary sterilization to that list. Rather than applying its draconian version of the “history and tradition” test in a …

The Physical-Emotional Distinction In Tort, Philip Petrov

Faculty Scholarship

Several legal scholars have recently argued that U.S. tort law’s physical-emotional distinction commits tort to the objectionable position of mind-body dualism, but they have not considered the distinction’s role as an aid to judicial cognition and decision-making. Drawing primarily on the law of negligent infliction of emotional distress, this essay argues that tort’s physical-emotional distinction is not a relic of mind-body dualism but a heuristic that judges have used to structure and simplify the difficult but unavoidable task of drawing lines between legally cognizable and non-cognizable harm. The analysis has at least three normative implications: (1) users of tort’s physical-emotional …

The Administrative State, Financial Regulation, And The Case For Commissions, Kathryn Judge, Dan Awrey

Faculty Scholarship

Administrative law is under attack, with the Supreme Court reviving, expanding, and creating doctrines that limit the authority and autonomy wielded by regulatory agencies. This anti-administrative turn is particularly alarming for financial regulation, which already faces enormous challenges stemming from the dynamism of modern finance, its growing complexity, and fundamental contestability. Yet that does not mean that defending the current regime is the optimal response. The complexity and dynamism of modern finance also undercut the efficacy of established administrative procedures. And the panoply of financial regulators with unclear and overlapping jurisdictional bounds only adds to the challenge. Both these procedural …

Time To Blood Pressure Control And Predictors Among Patients Receiving Integrated Treatment For Hypertension And Hiv Based On An Adapted Who Hearts Implementation Strategy At A Large Urban Hiv Clinic In Uganda, Willington Amutuhaire, Lewis S. Musoke, George A. Yendewa, Lewis S. Musoke, George A. Yendewa

Faculty Scholarship

In this cohort study, we determined time to blood pressure (BP) control and its predictors among hypertensive PLHIV enrolled in integrated hypertension-HIV care based on the World Health Organization (WHO) HEARTS strategy at Mulago Immunosuppression Clinic in Uganda. From August 2019 to March 2020, we enrolled hypertensive PLHIV aged ≥18 years and initiated Amlodipine 5 mg mono-therapy for BP (140–159)/(90–99) mmHg or Amlodipine 5 mg/Valsartan 80 mg duo-therapy for BP ≥ 160/90 mmHg. Patients were followed with a treatment escalation plan until BP control, defined as BP < 140/90 mmHg. We used Cox proportional hazards models to identify predictors of time to BP control. Of 877 PLHIV enrolled (mean age 50.4 years, 62.1% female), 30% received mono-therapy and 70% received duo-therapy. In the monotherapy group, 66%, 88% and 96% attained BP control in the first, second and third months, respectively. For patients on duo-therapy, 56%, 83%, 88% and 90% achieved BP control in the first, second, third, and fourth months, respectively. In adjusted Cox proportional hazard analysis, higher systolic BP (aHR 0.995, 95% CI 0.989-0.999) and baseline ART tenofovir/lamivudine/efavirenz (aHR 0.764, 95% CI 0.637–0.917) were associated with longer time to BP control, while being on ART for >10 years was associated with a shorter time to BP control (aHR 1.456, …

Major Questions About Presidentialism: Untangling The “Chain Of Dependence” Across Administrative Law, Jodi L. Short, Jed Handelsman Shugerman

Faculty Scholarship

A contradiction about the role of the president has emerged between the Roberts Court’s Article II jurisprudence and its Major Questions Doctrine jurisprudence. In its appointment and removal decisions, the Roberts Court claims that the president is the “most democratic and politically accountable official in Government” because the president is “directly accountable to the people through regular elections,” an audacious new interpretation of Article II; and it argues that tight presidential control of agency officials lends democratic legitimacy to the administrative state. We identify these twin arguments about the “directly accountable president” and the “chain of dependence” as the foundation …

Sports Participation By Athletes With Cardiovascular Disease, Matthew W. Martinez, Michael J. Ackerman, George J. Annas, Aaron L. Baggish, Sharlene M. Day, Kimberly G. Harmon, Jonathan H. Kim, Benjamin D. Levine, Margot Putukian, Rachel Lampert

Faculty Scholarship

Millions of young people participate in competitive sports, with well-documented physical and psychological benefits.1 Athletes may be diagnosed with cardiovascular disease (CVD) during evaluation of symptoms, routine preparticipation screening, or clinically indicated family screening. When this occurs, decisions about return-to-play (RTP) are difficult, especially in circumstances when risk may exist or be unknown. Historically, expert consensus documents such as the Bethesda Conference Proceedings,2 provided a “yes/no” approach to RTP after a diagnosis of a CVD such as hypertrophic cardiomyopathy (HCM) or long QT syndrome (LQTS). These recommendations were made with a paucity of data, and were predicated on a zero-risk …

A Conversation On The Carceral Home, Ngozi Okidegbe, Kate Weisburd, Emmett Sanders, James Kilgore

Faculty Scholarship

On February 8, 2024, scholars Ngozi Okidegbe, Kate Weisburd, Emmett Sanders, and James Kilgore met virtually at the Boston University School of Law to hold a conversation on Professor Weisburd’s article, The Carceral Home, 103 B.U. L. Rev. 1879 (2023).

Abortion Politics And The Rise Of Movement Jurists, Robert L. Tsai, Mary Ziegler

Faculty Scholarship

This Article employs the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization and litigation in its wake as the jumping off point to reconsider the connections between judges, the Constitution, and social movements. That movements influence constitutional law, and that judicial pronouncements in turn are reshaped by politics, is well-established. But, while these accounts of legal change depend upon judges to embrace movement ideas, less has been written about the conditions under which judicial entrenchment can be expected to take place. There may, in fact, be different types of judicial dispositions towards external political phenomena.

In this Article, …

Reactive Amine Functionalized Microelectrode Arrays Provide Short-Term Benefit But Long-Term Detriment To In Vivo Recording Performance, Lindsey N. Druschel, Pierce E. Boucher, George F. Hoeferlin, Dhariyat M. Menendez, Jonathan L. Duncan, Jeffrey R. Capadona

Faculty Scholarship

Intracortical microelectrode arrays (MEAs) are used for recording neural signals. However, indwelling devices result in chronic neuroinflammation, which leads to decreased recording performance through degradation of the device and surrounding tissue. Coating the MEAs with bioactive molecules is being explored to mitigate neuroinflammation. Such approaches often require an intermediate functionalization step such as (3-aminopropyl)triethoxysilane (APTES), which serves as a linker. However, the standalone effect of this intermediate step has not been previously characterized. Here, we investigated the effect of coating MEAs with APTES by comparing APTES-coated to uncoated controls in vivo and ex vivo. First, we measured water contact angles …

Selective Neural Inhibition Via Photobiomodulation Alleviates Behavioral Hypersensitivity Associated With Small Sensory Fiber Activation, Andrew Buzza, Kalista Tapas, Junqi Zhuo, Stephen J. Lewis, Michael W. Jenkins, Michael Moffitt

Faculty Scholarship

Objective: Photobiomodulation at higher irradiances has great potential as a pain-alleviating method that selectively inhibits small diameter nerve fibers and corresponding sensory experiences, such as nociception and heat sensation. The longevity and magnitude of these effects as a function of laser irradiation parameters at the nerve was explored. Methods: In a rodent chronic pain model (spared nerve injury—SNI), light was applied directly at the sural nerve with four delivery schemes: two irradiance levels (7.64 and 2.55 W/cm2) for two durations each, corresponding to either 4.8 or 14.4 J total energy, and the effect on sensory hypersensitivities was evaluated. Results: At …

Anatomy Camp: A Medical Student-Run Outreach Program, Ethan P. Winter, Josika Sammarco, Vivian Hua, Orlando M. Martinez, Tianqi Xiao, Susanne Wish-Baratz

Faculty Scholarship

Anatomy Camp is a medical student-run program for underserved youth from communities near the university. Middle and high school students are invited to visit the medical school for an afternoon of interacting with medical students, informal learning of anatomy and wellness, and becoming inspired to consider medical and STEM professions.

Pathogenicity Prediction Of Gabaa Receptor Missense Variants, Ya-Juan Wang, Giang H. Vu, Ting-Wei Mu

Faculty Scholarship

Variants in the genes encoding gamma-aminobutyric acid type A (GABAA) receptor subunits are associated with epilepsy. To date, over 1000 clinical variants have been identified in these genes. However, the majority of these variants lack functional studies and their clinical significance is uncertain although accumulating evidence indicates that proteostasis deficiency is the major disease-causing mechanism. Here, we apply two state-of-the-art modeling tools, namely AlphaMissense and Rhapsody to predict the pathogenicity of saturating missense variants in genes that encode the major subunits of GABAA receptors in the central nervous system, including GABRA1, GABRB2, GABRB3, and GABRG2. We demonstrate that the predicted …

Bacterial Contamination Of Platelet Products, Michael R. Jacobs `, Bowen Zhou, Robert W. Maitta

Faculty Scholarship

Transfusion of bacterially contaminated platelets, although rare, is still a major cause of mortality and morbidity despite the introduction of many methods to limit this over the past 20 years. The methods used include improved donor skin disinfection, diversion of the first part of donations, use of apheresis platelet units rather than whole-blood derived pools, primary and secondary testing by culture or rapid test, and use of pathogen reduction. Primary culture has been in use the US since 2004, using culture 24 h after collection of volumes of 4–8 mL from apheresis collections and whole-blood derived pools inoculated into aerobic …