Digital Commons Network^™

Platypnea-Orthodeoxia Syndrome Caused By A Patent Foramen Ovale And Interatrial Septal Aneurysm: A Case Report, Abes A. Bautista Neughebauer, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by positional hypoxemia, often due to right-to-left shunting across a patent foramen ovale (PFO) despite normal right-sided pressures. Early recognition is essential as symptoms may be subtle and imaging is often unrevealing. A 78-year-old female patient with a known PFO presented with one week of lower abdominal pain and mild exertional dyspnea without chest pain. She was profoundly hypoxic to 76% on room air, with improvement when supine and worsening when upright. Initial labs were unremarkable, and arterial blood gas revealed primary respiratory alkalosis with severe hypoxemia. Despite unremarkable chest radiography, CT …

Association Of Valvular Disease Progression Using Echocardiographic Findings In A Large U.S. Cohort, Abes A. Bautista Neughebauer, Amin Yehya, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Background

The prevalence of valvular disease in the US is approximately 2.5%. Given that over 5 million Americans are affected, it is crucial to find those at higher risk of progression. The goal of this paper is to uncover which patients are more likely to have valvular disease progression using demographic factors, EKG and echocardiogram (ECHO) findings.

Methods

This paper utilized the EchoNext Database, which pairs 100,000 electrocardiograms and echocardiograms based on specific structural heart disease labels. Univariate and multivariate logistic regression were used to find risk factors for progression for aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Examining The Association Of Maternal Oral Health Experiences With Adverse Birth Outcomes: Findings From Virginia's Prams Survey, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Li-Wu Chen, Anwar T. Merchant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Preterm birth (PTB) and low birth weight (LBW) are significant public health challenges globally, contributing to neonatal morbidity, mortality, and long-term complications. Maternal oral health has been increasingly recognized as a potential contributor to PTB and LBW, yet there is inconclusive evidence about the effectiveness of dental cleaning in preventing PTB and LBW. This study examined the association between dental cleaning during pregnancy and the prevalence of PTB and LBW using data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods

We analyzed data from Virginia PRAMS Phases 7 and 8, spanning a 10-year period from 2012 to …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …

The Impact Of True Crime Podcasts On Cold Case Investigations And Victims' Advocacy, Kyle Gamache, Karlie Rice, Ashley Allen, Willem Pontbriand

Arts & Sciences Faculty Publications

True crime has long captivated public interest, evolving from sensationalized accounts in the Middle Ages to the widespread popularity of modern podcasts. This qualitative study explores the ethical complexities of true crime media by examining how it intersects with criminal investigations, public perception, and victim advocacy. Through in-depth interviews with law enforcement officers, victim advocates, and true crime content creators, the study investigates differing attitudes toward the role of podcasts in active and cold cases. Using Colaizzi’s (1978) phenomenological method, data were analyzed to uncover shared and divergent themes across professional roles. Law enforcement participants voiced concerns over web- sleuthing …

Updates To Version 1.0 Of The Four‐Dimensional Ecology Education Framework Create Version 1.1., Christopher W. Beck, Loren B. Byrne, Jennifer Doherty, Amanda E. Sorensen, Et Al.

Arts & Sciences Faculty Publications

Since its introduction in 2018, the Four-Dimensional Ecology Education (4DEE) Framework has advanced ecology education. Yet, ecology educators have had different understandings of aspects of the Framework. Here, we describe the updates to the original Framework that aim to provide more clarity. Specifically, we describe higher-level changes in how the Framework is presented on the 4DEE website, changes to some of the elements within the dimensions, mostly in the Human–Environment Interactions dimension, and perhaps most substantively, replacing the lists of subelements with more descriptive paragraphs that explain the intent of the elements. We hope that these updates will promote the …

On The Multicolor Ramsey Numbers Of Balanced Double Stars, Deepak Bal, Louis Debiasio, Ella Oren-Dahan

Department of Mathematics Faculty Scholarship and Creative Works

The balanced double star on 2n+2 vertices, denoted Sn,n, is the tree obtained by joining the centers of two disjoint stars each having n leaves. Let Rr(G) be the smallest integer N such that in every r-coloring of the edges of KN there is a monochromatic copy of G, and let Rr^bip(G) be the smallest integer N such that in every r-coloring of the edges of KN,N there is a monochromatic copy of G. It is known that R2(Sn,n)=3n+2 [8] and R2^bip(Sn,n)=2n+1 [14], but very little is known about Rr(Sn,n) and Rr^bip(Sn,n) when r≥3 …

Advancing Cybersecurity Through Userland Memory Forensics: From Runtime Analysis To Security Applications, Hala Ali

Theses and Dissertations

Memory forensics has become a crucial component of digital investigations, particularly for detecting malware operating solely in system memory. As operating system vendors implemented kernel access restrictions, malware authors shifted to userland malware. However, existing memory forensics techniques have largely focused on kernel-level analysis, leaving userland runtimes insufficiently covered. This dissertation addresses this gap by expanding memory analysis capabilities across two distinct paradigms: interpreted and compiled runtimes. The first phase targets the Python runtime, developing automated recovery techniques that enable several security applications. For malware detection, these techniques extract critical forensic artifacts such as encryption keys and command-and-control configurations. For …

Language Acquisition And Emergent Literacy In The 21st Century, Albert H. White Jr.

Open Touro Created

2026

Grounded in contemporary scholarship and pedagogical research, this work employs an integrated, multidisciplinary approach to 21st-century literacy instruction while prioritizing diversity, equity, and inclusion. Through its multimodal, universally accessible design—featuring interactive components, multimedia elements, and curated links to the New York State Department of Education Standards and Instruction Website—the resource facilitates critical engagement with content and alignment with state-mandated learning standards. Supplementary materials for pre-service teacher preparation and professional development are embedded throughout, enabling educators to customize and repurpose content for their specific contexts. Developed in partnership with Touro University and Colleges, this OER supports the continuous professional development …

From Germination To Transformation: Policy Studies In China Over The Past Half-Century (1970s–2020s), Shuai Cao, Ping Xu, Hongtao Yi, Ling Zhu

Political Science Faculty Publications

Over the past half-century, policy studies in China have undergone a remarkable evolution. This paper seeks to provide a comprehensive analysis of the field's development by tracing its origins and transformations over time. We introduce a time-based and multifaceted framework that delineates the evolution of policy studies in China into four distinct phases: germination (1978 to mid-1990s), burgeoning (late 1990s to 2012), normalization (2013 to 2022), and transformation (2023 to present). We first analyze the evolution of each phase in terms of historical contexts, disciplinary development, policy research (including policy domains, theoretical advancements, and methodological approaches), and intellectual engagement with …

Location, Location, Reaction: How Mandatory Ip Disclosure Silences Critics And Sparks Backlash, Sirui Li, Ping Xu, Yue Guo

Political Science Faculty Publications

Previous research has identified two competing outcomes of regulatory disclosure for negative online sentiment: chilling effects, which suppress negative online sentiment, and reactance effects, which intensify it. In this study, we apply these theories to examine the impact of mandatory IP location disclosure on citizens' negative online sentiment expressed on Sina Weibo, a leading Chinese social media platform. We argue that the mandatory IP location disclosure can have opposite effects on negative online sentiment depending on the type of social media context. To test this, we use a quasi-natural experiment and analyze more than 160,000 comments posted before and after …

The Permanent Bar(S): The Unprincipled Cage Of Retribution For Immigrant Youth, Dianara Ramirez Ibarra

Cardozo Law Review

This Note argues that a minor’s diminished decisional capacity should be recognized as an affirmative defense when a permanent bar that is triggered during minority strips away a noncitizen’s opportunity to gain lawful status in the United States. Dreamers and Deferred Action for Childhood Arrivals (DACA) recipients, individuals who arrived in the United States as children, are victims of punitive immigration laws that have extinguished any possibility of securing lawful residency in the United States. Even more egregiously, Dreamers and DACA recipients are subject to these permanent bars despite lacking the intent and capacity to fully understand the long-term consequences …

Browser-Based Phishing Detection System Using Modern Web Technologies, Muhammad Arshad, Beena Sherin Kuriakose, Choo Wou Onn, Farhan Ahmad Siddiqui, Mohammad Shahid Kamal

Research Outputs: 2025-Present

Phishing remains one of the most persistent cybersecurity threats, exploiting human trust to steal sensitive information through deceptive websites. Traditional detection methods, reliant on blacklists and reactive reporting, offer limited protection against rapidly evolving zero-day attacks. To address these challenges, this study proposes and evaluates a hybrid browser-resident phishing detection framework that combines three complementary detection mechanisms: a locally executed Random Forest model using URL lexical features, lightweight real-time DOM structure analysis, and VirusTotal’s multi-engine reputation service. Communication between the client and server is optimised using gRPC over the QUIC protocol, ensuring secure, high-performance data exchange with built-in retry mechanisms …

Playing It Safe Or Playing Favorites? Miller Act Bonds And The Cost Of Exclusion Of Women- And Minority Owned Businesses, Fernando Mendoza López

American University Law Review

As federal contracting policy has moved away from race- and gender-conscious contracting initiatives, the need to identify and remove facially neutral requirements that create disparate impacts has assumed heightened significance in shaping access to government contracting law. In construction projects, the federal government has long required contractors to purchase surety bonds under the Miller Act to protect subcontractors and the government in cases of prime contractor default. While that original purpose remains valid today, bonding requirements are widely believed to unnecessarily limit participation by women- and minority-owned businesses.

Federal, state, and local governments have tacitly accepted the claim that bonding …

Ticking Toward Reform: Rethinking The Material Difference Exception In The Luxury Watch Resale Market And Beyond, Mallory K. Hogan

American University Law Review

The rapid growth of the luxury resale market has heightened tension between trademark holders and secondary-market sellers. Courts are increasingly left to apply the material difference exception to first sale doctrine defenses, to find trademark infringement when resold goods differ from the original product, even in de minimis ways. Originally designed to protect consumers from confusion where post-sale modifications affected product quality or safety, the exception has evolved into a broad enforcement tool that luxury brands leverage to challenge resellers over minor or cosmetic alterations. In the luxury watch and accessories markets in particular, courts have deemed even minimal differences …

The Lawyer Of The Future: Ethics And Identity In The Age Of Ai, David Yosifon, Michael Santoro, Isaac Nikssarian

American University Law Review

The dawn of artificial intelligence (AI) poses a fundamental challenge to the legal profession’s practical function and social identity. We argue that this challenge should be met as an opportunity to reclaim the profession’s core ethical intentions. We approach the emergence of AI as an occasion to define and safeguard what is irreducibly human in legal work. We ground our approach in the ethical imperatives set out in the American Bar Association’s Model Rules of Professional Conduct, while extending them into an invigorated framework for the AI era.

We survey the uses and ethical challenges associated with cutting-edge deployment of …

Truth And Consequences: What Catastrophe Teaches Us About Homeownership And Underinsurance, Kenneth S. Klein

Faculty Scholarship

The firestorms enveloping Los Angeles in January 2025 made yet more inescapable the reality of the increasingly overwhelming impacts that climate change is having on communities. Many thousands of owner-occupied homes were destroyed. Most homes will have insurance, but many homeowners will be surprised to find themselves underinsured, meaning their insurance proceeds will be materially less than the insurer-reported, incurred cost of rebuilding their destroyed home. The human consequences on these homeowners, each of whom has lost everything in a single week, are a now sadly all too imaginable tragedy in real time.

How underinsurance happened and what could have …

Healthcare Provider Perspectives On A Clinical Decision Tool To Support Individualized Exercise Prescriptions And Discussions For Breast Cancer Survivors, Jinani Jayasekera, Oliver W. A. Wilson, Kaitlyn M. Wojcik, Eleanor M. Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K. Parson, Padma Sheila Rajagopal, Richard L. Street Jr.

Department of Medicine Faculty Publications

Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.

Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged >= 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.

Results: The sample consisted of …

By Design, Roger Allan Ford

American University Law Review

In recent years, scholars and policymakers have increasingly embraced regulation “by design” to address new problems, especially those caused by new technologies. These approaches go by various names, like privacy by design, security by design, even the rule of law by design. Despite the popularity of these approaches, though, describing what goes into regulation “by design” is surprisingly challenging. Different speakers use the term in strikingly different ways, with little consensus about why design is important, how design and new technologies interact, or how design can be harnessed to deliver policy results.

Design exists along multiple dimensions: process versus result, …

The Painted Ones’ Fine Line: Batok As A Protectable Form Of Traditional Knowledge Under Trade Secret Jurisprudence, Kathleen M. Dinoso

American University Law Review

For centuries, the ancestral tattooing practice of batok has served not as mere ornamentation but as a visual archive of Indigenous Filipinos’ history and identity. In 2021, a digital creator invited the public to learn batok online for merely fifteen dollars. Soon after, many discovered that the renown instructor, Apo Whang-Od, may not have agreed to take part. The resulting discourse exposed a broader issue: Indigenous customs and creations become increasingly vulnerable to misappropriation and improper commodification as they enter global markets and multimedia platforms. Though this event occurred abroad, it highlights how U.S. law is poorly designed to protect …

The Trademark Bargain: Registration As Disclosure, Dustin Marlan

American University Law Review

This Article highlights the central—and under-theorized—role that disclosure plays within trademark law. By loose analogy, the patent disclosure requirement is a cornerstone of patent law, embodying the “patent bargain” where an inventor must disclose their invention in exchange for a twenty-year monopoly. This quid pro quo is believed to stimulate the progress of science and technology, making patent disclosure the very pulse of the patent regime. However, the fundamental importance of disclosure in trademark law remains underexplored. Like patents, trademark law imposes a rigorous bargain—to obtain the enhanced rights granted by federal registration, trademark owners must first make significant disclosures …

A Quantitative Analysis Of Barriers To College Students’ Seasonal Vaccination Intentions And Behaviors, Kelly S. Clemens, John Matkovic

Faculty Publications – Health Sciences

Objective
Vaccination is crucial to college student health, but quantitative analyses of barriers in this population are limited. The present study expands the work of Su and Chen to determine the relative influence of structural, psychological, and social vaccination barriers.

Participants
Participants were 650 students from a large, midwestern university during the 2024 vaccination season.

Methods
Participants were recruited from a college campus and randomized to respond to items assessing their barriers to, intentions to receive, and uptake of the COVID-19 or influenza vaccination.

Results
Structural, psychological, and social barriers were differentially important to vaccinations and to intentions vs. uptake …

Shades Of Stress: Colorism As Minority Stress For Women Of Color, Caitlin M. Mercier, Brea M. Banks, Lourdes D. Concepción Cabán, Michelle Duong

Faculty Publications – Psychology

Women of color often endure indignities shaped by colorism and skin tone discrimination, pressuring them to adhere to racialized beauty ideals (i.e., lighter skin). In response, some women of color may internalize these standards (i.e., through internalized coping and racial self-hatred) which can foster psychological distress. Yet, these associations remain underexplored. Using minority stress theory, in our cross-sectional study we collected online survey data to examine whether internalization and racial self-hatred explained the indirect link between colorist microaggressions and psychological distress among 121 women of color at a Midwestern US historically white institution. Using path analysis, we found support for …

Fishing For Father Relationships: Motivations, Successes, And Barriers To Participating In A Community-Based Program, Jordan A. Arellanes, Kyle Miller, Travis Hicks, Ryan J.S. Liew, Earl Kloppmann

Faculty Publications – Psychology

Fathers who participate in community programs experience a range of positive outcomes, including improved relationships with their children. However, many community programs struggle to gain fathers’ attendance at local events. To counteract this, we utilized Community-Based Action Research in collaboration with local and state agencies to develop a father-specific community program that capitalized on the traditionally masculine parenting activity of fishing. The program educated families on the basics of fishing and then provided them with all the necessary materials. Over the course of three years of data collection, 48 fathers participated in interviews, designed to gain a deeper understanding of …

“I Know How To Identify And Communicate My Needs”: A Qualitative Study Of The Self-Perceived Strengths Of People In Polyamorous Relationships, Alexander K. Tatum, Sharon M. Flicker, Nawar Albarak, Jessi M. Schroeder, Ash Moomaw, Idil Ugurluoglu, Alex Whitman, Alysse Wiggins, Danielle Davis, Robyn Fisher

Faculty Publications – Psychology

Little empirical research has adopted a strength-based approach to examine strategies that help offset challenges (e.g., discrimination, internalized stigma) faced by people in polyamorous relationships. The current qualitative study assessed the self-perceived strengths of 63 US-based, adult participants who reported present or former engagement in at least one polyamorous relationship. Participants' responded to the open-ended question, “What particular characteristics do you have that help you navigate the challenges of polyamory?” A thematic analysis identified strengths across eight broad themes: personality traits, a willingness to challenge mononormative socialization, ability to manage difficult emotions, experiencing compersion and/or low levels of/well-managed jealousy, strong …

Daily Fluctuations In Adolescents’ Political Stress, Jacqueline Cerda-Smith, Sholeh Najafian, Shevaun Neupert, Kelly Lynn Mulvey

Faculty Publications – Psychology

This study explored adolescents' daily political stress during the 2024 US election and how proximal and distal factors shaped stress. Participants completed surveys for 20 consecutive days before, during, and after the election. At baseline, they reported perceptions of peer and family election-related experiences and anticipated election impact. Daily surveys captured their daily political stress and election-related exposure. The final sample included 445 daily observations reported by 36 adolescents (aged 13–18, M = 15.61, SD = 1.23) who were mostly white, female, and Democrats. Participants reported significant daily fluctuations in political stress and greater political stress on days when they …

School Psychologists As Advocates: Addressing Microaggressions Targeting Students In Schools, Brea M. Banks, Lourdes D. Concepcion-Cabas, Farhia A. Osman, Kendell Kelly

Faculty Publications – Psychology

The aim of this conceptual paper surrounds a discussion of school psychologists’ role as advocates who can combat the prevalence of microaggressions in schools. The authors first define microaggressions in the context of Critical Race Theory and discuss the negative impact these transgressions have on students. Advocacy is a foundational role of school psychologists, and combatting microaggressions is one way school psychologists can engage in such efforts. Given the goal of this special issues is to highlight how social justice advocacy can address critical issues in school psychology, we use the NASP Practice Model as a framework to describe how …

Ex Vivo Assessment Of Keratinocytic Carcinomas Using A Fast Mid-Infrared Probe., Maria G Vazquez De Vasquez, Rebecca C Bradley, Charles L Hitchcock, Angela S Casey, Austin Cusick, James V Coe, Ronald Siegle

Ambulatory and Primary Care Articles

A fast mid-infrared spectral probe was used to record infrared (IR) spectra of fresh skin tissue removed from patients with biopsy-proven keratinocytic cancer (KC) during Mohs surgery. A 150-patient library of IR spectral data was obtained to see if KC on the epidermal side (outside) of tissue samples can be differentiated from adjacent nonmalignant tissue and normal skin. A linear support vector machine model minimized overtraining predicting the contributions to decisions at each step in the spectrum. Training with an equal cost for KC and nontumor cases samples demonstrated a KC sensitivity of 93% ± 5% and specificity 82% ± …