Digital Commons Network^™

Failure Rates And Patient-Reported Outcomes Are Similar Across 5 Arthroscopic, Suprapectoral Bicepts Tenodesis Fixation Techniques, Senah E. Stephens, Samantha M. Strohm, Rachael M. Shaughnessy, Katherine S. Worcester, Kevin F. Bonner

Department of Medicine Faculty Publications

Purpose

To compare failure rates and patient‐reported outcome measures (PROMs) across 5 arthroscopic, suprapectoral biceps tenodesis fixation techniques: tenodesis screw, tenodesis anchor, expanding tenodesis anchor, onlay with single all‐suture anchor, and soft tissue tenodesis in the bicipital groove with suture.

Methods

This was a retrospective cohort study approved by the Institutional Review Board, including patients age 18 years or older who underwent arthroscopic, suprapectoral biceps tenodesis between 2014 and 2024 with a minimum of 6 months of clinical follow‐up. Exclusion criteria included cervical pathology, chronic pain syndromes, revisions, and workers' compensation cases. Patients completed PROMs including pain Visual Analog Scale …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Glucagon-Like Peptide Receptor Agonists (Glp-1ras) As Cardiovascular Risk Modifiers In Obstructive Sleep Apnea And Obesity: A Real-World Study, Jaeun Ahn, Junmin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Nathaniel T. Gordon, Joshua M. Sill

Department of Medicine Faculty Publications

Introduction

Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients.

Methods

We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching …

Educational Case: Hidradenitis Suppurativa, Ryan C. Saal, Linnea Lackstrom Westerkam, Cristo A. Carrasco Mendoza, Paul B. George, Christopher J. Sayed

Department of Medicine Faculty Publications

[Introduction] The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see https://doi.org/10.1016/j.acpath.2023.100086.1¹

Objective SK1.1: Pathophysiology of changes in the skin. Describe the pathophysiologic basis for changes in the color, surface texture, swelling, temperature, and sensitivity of skin.

Competency 2: Organ system pathology, Topic: Skin (SK); Learning Goal 1: …

Constructing Effectiveness: Culture, Legitimacy, And Strategic Planning In Zoos And Aquariums, Robin Keith

Dissertations

Zoos and aquariums are complex organizations operating with multiple mandates—saving species, providing exceptional care to animals, connecting communities with nature, and inspiring environmental action—making “effectiveness” difficult to define. What counts as success depends on who is asked and which goals are foregrounded. This study investigated how stakeholders in Association of Zoos and Aquariums (AZA)–accredited organizations conceptualize and operationalize effectiveness within strategic planning processes. Prior research on nonprofit and mission-driven organizations has shown effectiveness is multidimensional and often defined differently by various stakeholders. However, little has been known about how these definitions are negotiated through the practice of strategic planning, …

The Impact Of Rurality On Durable Medical Equipment Access And Discharge Planning For Tracheostomy And Ventilation Care In Nebraska, Karissa Nichols, Kayley Anderson, Morgan Bintner, Teresa Rodriguez, Jana L. Wardian, Jayme Dowdall

Journal Articles: Hospital Medicine

OBJECTIVES: Recognize how rurality impacts safe discharge planning and home management for complex airway patients. This study explores the distribution of durable medical equipment (DME) companies for patients with tracheostomies and/or ventilators, aiming to identify patterns in service access statewide.

METHODS: Key informant phone surveys assessed active DME companies statewide. DME companies were identified through hospital referral lists, discharge directories, and online searches. Data collected included service radius, respiratory supplies, and ventilation types. Geographic information system (GIS) mapping visualized coverage. Rural-urban status was classified using rural-urban commuting area (RUCA) codes.

RESULTS: Of 16 companies identified, 6 were closed, leaving 50 …

Real-Time Electronic Drug Monitoring: Experiences From A Multinational Phase 3 Clinical Trial To Prevent Multidrug-Resistant Tb, T. Jimah, J.E. Haberer, K.R. Amico, J. Tinkamanyire, M.A. Kendall, S. Moonsamy, R.T. Khan, K.B.F. Fetalvero, N. Suryavanshi, A. Gupta, A.C. Hesseling, Susan Swindells, G. Churchyard

Journal Articles: Infectious Diseases

OBJECTIVE: We describe the experience of implementing real-time electronic drug monitoring (EDM) within a clinical trial to prevent multidrug-resistant TB (MDR-TB) among high-risk household contacts.

METHODS: The Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients (PHOENIx) trial is a phase 3, open-label, cluster-randomised clinical trial conducted in 31 sites in Africa, Asia, and Latin America. Household contacts of adults with MDR-TB were enrolled from June 2019 to January 2025, each receiving an EDM device to monitor adherence to TB preventive therapy. Here, we review selection of the adherence monitoring approach and key procedures implemented to support EDM …

At A Crossroads: Crisis, Vulnerability, And The Possibility Of Transformation Of Nature-Based Tourism In Canada, Brooklyn Rushton

Theses and Dissertations (Comprehensive)

We live in an era shaped by a global polycrisis, where climate change, pandemics, economic shocks, geopolitical tensions, and social inequities are converging to create complex, cascading, and compounding risks. For Canada’s nature-based tourism sector, situated at the nexus of social and ecological systems, the polycrisis both amplifies the vulnerabilities of tourism and highlights tourism’s role in perpetuating global risks. Recognizing this duality, this dissertation examines how crises amplify systemic vulnerabilities while also acting as leverage points for transformative change in Canada’s nature-based tourism sector, drawing on geography, systems thinking, resilience theory, regenerative tourism, and futures thinking scholarship.

The three …

Geovig And Purevig: Geometry-Aware Architectures For Efficient Computer Vision, Omar Ismail

Theses and Dissertations (Comprehensive)

Deploying deep learning models for medical image analysis on mobile devices requires a balance between inference latency, memory footprint, and delineating anatomical boundaries with high accuracy. While Convolutional Neural Networks (CNNs) and mobile Vision Transformers (ViTs) offer efficiency, they often struggle to model the irregular, non-local geometric structures inherent in biological tissues without incurring prohibitive computational costs. In this thesis, we introduce GeoViG (Geometric Vision Graph), an architecture that bridges the gap between efficient grid-based processing and explicit Geometric Deep Learning. GeoViG introduces a novel transition from high-resolution pixel grids to low-resolution dynamic graphs via a SpreadEdgePool operator, a geometry-aware …

What Church Planters Need : How Community, Training, & Intentional Relationships Fuel Church Growth, Carolina G. Miller

Academic Books

No abstract provided.

Judgement Morning: Studies In Holiness Radicalism, William Kostlevy

Academic Books

No abstract provided.

Social Health Programming During Adolescence Is Associated With Increased Serum Levels Of Carotenoids, Vitamin A, And Vitamin E In Young Women: An Observational Cohort Study, Rebecca Drakowski, Matthew Vanormer, Laura Ebers, Katie Mayhan, Anum Akbar, Colman Freel, Taija Hahka, Rebekah Rapoza, Corrine K. Hanson, Keyonna King, Aaryn Mustoe, Melissa K. Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

Over 85% of young women in the United States do not meet fruit and vegetable intake recommendations, placing them at risk for low antioxidant nutrient intake. Social health programming (SHP) can improve dietary intake of fruits and vegetables, but it is not known how SHP impacts serum levels of specific antioxidant nutrients. This observational cohort study assessed the effect of participation in SHP through Girls Inc., Omaha, on serum carotenoid, retinol, and tocopherol levels for 12–29-year-old women. Serum nutrient levels were measured using high-performance liquid chromatography and nutrient intake from diet was measured using three 24 h dietary recalls (ASA24 …

Application Of Current Enteral Nutrition Support Recommendations To Infants Born Less Than 750 Grams Or Less Than 25 Weeks' Gestation: A Critical Review, Mar Romero-Lopez, Mamta Naik, Teresa Hartman, Ann Anderson-Berry, Melissa Thoene

Journal Articles: Pediatrics

Clinicians face a paucity of evidence-based recommendations for provision of enteral nutrition in infants born < 750 g or < 25 weeks' gestation, termed "nano-preterm." Current enteral nutrition recommendations for extremely low birth weight infants may not be broadly applicable to nano-preterm infants due to physiological and developmental differences, while others may be appropriate. Key enteral nutrition-related considerations include: the unique anatomy and physiology of the gastrointestinal tract, altered metabolic capacity, availability of maternal milk and use of alternative substrates, detailed methods of initiation and advancement of enteral feeding, methods of human milk fortification, targeted requirements for macronutrient and micronutrients, and the safety and efficacy of enteral nutrition support management to optimize the growth and development of the nano-preterm infant. This comprehensive review focused on enteral nutrition provision in nano-preterm infants, thoroughly evaluating available literature and identifying knowledge gaps about the unique physiology and metabolism of the nano-preterm infant as it pertains to enteral nutrition. Ultimately, prospective multicenter research is needed to establish evidence-based guidelines to promote optimal growth and development while minimizing complications of extreme prematurity.

Robust Lc–Ms/Ms Method For Quantification Of Ascorbic Acid In Infant Formula And Heat-Processed Donor Human Milk: A Stabilization And Matrix Effects Mitigation Approach, Omar M. Al Kilani, Lee C. Winchester, Melissa Thoene, Colman Freel, Christopher Lee Shaffer, Anthony T. Podany

Journal Articles: Pediatrics

Ascorbic acid is an essential antioxidant for infant health; however, its quantification in infant formula and human milk is challenging due to matrix complexity, analyte instability, and lack of blank matrix equivalents. This study presents a simple and robust LC-MS/MS method that bypasses the need for standard addition using only 20 µL sample. The method showed excellent linearity (R² > 0.99), precision (CV < 15%), accuracy (±10%), and sensitivity (LOD < 0.0375 µg/mL). Stock and working solutions remained stable for months at −20 and −80 °C, respectively, avoiding daily preparation. Optimized extraction substantially reduced matrix effects. The method was externally validated using certified infant formula reference material and successfully applied to commercial samples, with incurred sample reanalysis showing <  20% variation. This validated method offers a practical tool for the routine quantification of ascorbic acid in heat-processed donor human milk and infant formula, with the potential for application to other matrices.

Ash/Isth 2026 Guidelines For Anticoagulant Prophylaxis In Pediatric Patients At Risk Of Venous Thromboembolism, Marisol Betensky, Muayad Azzam, Rachel Bercovitz, Rukhmi V. Bhat, Tina Biss, Brian Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Qais Hamarsha, Julie Jaffray, Sophie Jones, Hassan Kawtharany, Bryce A. Kerlin, Jana Khawandi, Grace Krider, Nicole Kucine, Riten Kumar, Christoph Male, Paul Monagle, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sarak Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Reem A. Mustafa

Journal Articles: Pediatrics

High-quality data on anticoagulant prophylaxis for pediatric VTE prevention are scarce. Key research priorities include the development and validation of subgroups-specific VTE risk assessment models, and evaluation of the safety and efficacy of risk-stratified anticoagulant prophylaxis strategies across different pediatric subgroups.

BACKGROUND: Venous thromboembolism (VTE) is a significant cause of morbidity in children, particularly among hospitalized patients and those with chronic medical conditions. There is a lack of consensus on anticoagulant prophylaxis strategies.

OBJECTIVE: These evidence-based guidelines from the American Society of Hematology (ASH) and the International Society on Thrombosis and Haemostasis (ISTH) are intended to support patients and health …

Multiparametric Flow Cytometry Immune Profiling Of Pulmonary And Extra-Pulmonary Tuberculosis Reveals Distinct Blood-Based Biomarker Signatures, Kalaiarasan Ellappan, Prakash Babu Narasimhan, Harriet N. Garlant, Seshadri Vasan, Komal Jain, Saka Vinod Kumar, Vishnukanth Govindaraj, Vir Singh Negi, Karen E. Kempsell

Research outputs 2022 to 2026

This study investigated immune cell distributions, cell-specific immune markers, and selected biomarker targets in pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) using multiparametric flow cytometry (MFC). Whole blood was collected from 45 individuals, including healthy controls (HC), EPTB, and PTB patients (n = 15/group). Peripheral blood leukocytes were analysed by MFC to characterize CD4+ and CD8+ T cells, natural killer (NK), invariant NKT (iNKT) and NKT cells, classical (CM), intermediate (IM) and non-classical monocytes (NCM), and activated monocytes (AM). Expression of GBP1, CALCOCO2, IFIT3, SNX10, ARG1, PD-1, and PD-L1 was assessed across these immune subsets. Increased frequencies of NK, NKT, …

Emotional Expression For Community Healing: A Study Of Restorative Justice Circle Discussions Addressing Social Harm, Hannah Darnell

FCRH Honors Program Theses

Restorative justice (RJ) programs have increasingly been used to respond to social harm, and at times have been employed as alternatives to some of the United States’ traditional criminal court procedures. Studies suggest that these restorative programs find success in repairing relationships and reintegrating individuals back into their communities, tend to be perceived as positive by participants, and have the potential to reduce recidivism rates. This study explores how and why these restorative justice meetings work through an examination of the presence and evolution of participant emotional expression, as well as the role that outward communication of emotion has in …

Risquer La Résistance: La Réponse Surréaliste À L’Exposition Coloniale Internationale De 1931, Milla Ben-Ezra , '26

Senior Theses, Projects, and Awards

No abstract provided.

A Quest For Food In Bedford-Stuyvesant And Brooklyn Heights: Residential Interactions With Neighborhood Food Resources, Aidan Carroll , ‘26

Senior Theses, Projects, and Awards

This thesis examines urban inequalities situated across Brooklyn, New York by speculating residential interactions with food resources in their neighborhood such as gardens, grocery stores, restaurants, and food pantries. With a specific focus on the areas Bedford-Stuyvesant and Brooklyn Heights of Brooklyn, New York, the study utilized qualitative data such as interviews and dietary food logs during ethnographic fieldwork in order to assess the ways in which experiences with accessing food can reveal a deeper message about systemic inequalities along the lines of racism and class if we are to consider food apartheid. That said, I found that food apartheid …

When The Internet Attacks, Craig Cowie

Cardozo Law Review

Courts have struggled with applying personal jurisdiction in cases involving intentional torts where the defendants act outside the forum, and the problem is particularly apparent and acute when the defendants use the internet to commit the tort. For example, is there jurisdiction when a defendant doxxes someone and calls for violence? What if they leave a bad Yelp review? Or tweet a defamatory statement? Courts have used many tests for determining whether personal jurisdiction is appropriate in these situations, but there has been relatively little recent scholarship on whether these tests are appropriate for analyzing personal jurisdiction in these contexts. …

Undermining Discretion: The Selective Attacks On Progressive Prosecutors, Angela J. Davis

Cardozo Law Review

Prosecutors are the most powerful officials in the criminal legal system. They decide whether to bring criminal charges and what those criminal charges should be. These decisions are totally within their discretion. The U.S. Supreme Court has consistently protected the power and discretion of prosecutors in making these decisions, and legal challenges to the exercise of prosecutorial discretion have been largely unsuccessful.

In recent years, a growing number of individuals have successfully run for chief prosecutor on platforms of reducing the prison and jail populations, consistent with public safety. They pledged to use their power and discretion to implement policies …

Rivers Of Sovereignty: The Epa’S New Water Quality Standards Rule As A Potential Channel For Revitalizing Tribal Reserved Water Rights, Mostyn Josty

Cardozo Law Review

This Note explores the federal government’s evolving approach to its obligation to protect tribal reserved water rights through a case study of the Environmental Protection Agency’s (EPA) 2024 Water Quality Standards Regulatory Revisions to Protect Tribal Reserved Rights rule (the “WQS Rule”). It argues that while the WQS Rule represents a step forward in safeguarding tribal water rights, the legal challenge it faces underscores broader issues of federalism, administrative authority, and the country’s fluctuating commitment to tribal sovereignty. The Note examines the WQS Rule’s legal foundation, its potential challenges, and the implications for tribal self-determination, emphasizing the need for a …

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 …

Data Rights For Workers, Pauline Kim, Rachel Leavitt

Scholarship@WashULaw

Workers are subject to immense amounts of data collection on the job, and the algorithmic management tools built with that data can produce negative effects, including deskilling jobs, unstable work hours, reduced wages, and dangerous and degrading working conditions. Workers thus have significant interests how their data are collected and used, and yet they have been excluded from nearly all the recently enacted or proposed data protection laws. Their exclusion stems from data protection’s roots in privacy law and theory, which primarily focused on consumers as data subjects. Current data protection laws, even if expanded to cover workers, would provide …

Primer On Financing Commercial Real Property, Judge John M. Tyson

Campbell Law Review

No abstract provided.

Some Caution About Novel State Constitutional Rights, Nick Brod

Campbell Law Review

No abstract provided.

One Post Too Few: Doxing As A True Threat And North Carolina's Repeated Action Requirement, Abigail C. Akins

Campbell Law Review

The purpose of this Comment is to argue for the removal of the repeated action and direct targeting requirements for cyberstalking crimes under N.C. Gen. Stat. § 14-196.3. The recent influx of “doxing”1 behavior on the internet has necessitated statutory change for the protection of North Carolinians. This Comment describes the origins and different types of doxing on the internet, as well as the potential mental and physical impacts that doxing has on individuals who have been doxed. Further, this Comment analyzes the legal doctrines at work with doxing, specifically the First Amendment’s free speech protections and the right to …

Beyond Digital Pessimism: How A Focus On Trust Can Enhance Eu Digital Law, Neil M. Richards, Woodrow Hartzog, Claire Boine, Lea Despotis

Scholarship@WashULaw

Lawmakers looking to foster technological innovation on the European market are adopting laws they hope will promote consumer trust in digital products. Their strategy can be broken down into three components. First, they aim to empower consumers to choose how much data they want to share with companies through an express consent framework. Second, they seek to avoid harms from digital products through product safety law such as adapting the Product Safety Regulation to digital products or adopting the AI Act. Third, they endeavor to prevent manipulation of consumers through digital means.

In this essay, we argue that while laudable, …

Apportioned Direct Taxes, Conor Clarke, Ari Glogower

Scholarship@WashULaw

The Constitution requires that Congress apportion any “direct” tax among the states by population. This once-dormant provision is now the most important constitutional limitation on Congress’s taxing power. Last year, in Moore v. United States, the Supreme Court seriously considered, for the first time in decades, whether to invalidate an Act of Congress as an unapportioned direct tax. While the law survived, Moore has opened a new era in which scholars and policymakers must again take apportionment seriously. Yet the apportionment requirement remains poorly understood.

This Article provides a new perspective on apportionment by examining how Congress and Treasury …

How International Organizations Regulate Lobbyist Access, Melissa (M.J.) Durkee

Scholarship@WashULaw

This chapter explores how international organizations (IOs) regulate lobbyist access through participation frameworks rather than traditional lobbying laws. While no unified international lobbying regime exists, IOs use rules on NGO 'consultation' and 'engagement' to structure access. These rules, rooted in historical practices like the UN's Economic and Social Council (ECOSOC) accreditation system, prioritize representativeness and legitimacy over transparency and accountability. As lobbying increasingly targets international forums, concerns about undue influence (the 'lobbying critique') and insufficient stakeholder inclusion (the 'access critique') have driven divergent reforms: some IOs, like the World Health Organization, have adopted stricter controls; others, such as the GAVI …