Digital Commons Network^™

Overbreadth In Medical Practice Acts: A Threat To Preventive Speech, Barbara Zabawa

Faculty Works

Many Americans consult unlicensed wellness coaches for scientifically-valid advice on diet, exercise, and lifestyle interventions. Yet state medical practice acts and ambiguous government line drawing between wellness and medical care chill the speech of these coaches as it relates to disease prevention, even though conventional medicine systematically fails to deliver the speech-heavy preventive care consumers need and want. This Article argues that medical practice acts, particularly the sixteen state statutes that include "prevention" in their definition of medical practice, are constitutionally overbroad restrictions on protected speech. Despite judicial and scholarly assumptions to the contrary, not all those working in wellness …

Agriculture And Commodities: Commodities Outside The Jurisdiction And Expertise Of The House And Senate Agriculture Committees, Helena Rowe

Student Works

No abstract provided.

Kingsley And The Deliberate Indifference Circuit Split, Kevin Scanlon

Student Works

No abstract provided.

Moving Forward Together For Cancer Recovery: Collaborative Guide For Researchers And Cancer Care Organizations, M. Madison Kindred, Karen E. Wickersham, Daneille E. Ostendorf, Bernardine M. Pinto

Faculty Publications

No abstract provided.

Built Different: Place, Identity, And The Holistic Well-Being Of Female Student Athletes, Jaye Mack

Theses and Dissertations

This research furthers the conversation surrounding holistic female student-athlete wellness, recognizing that their experiences can be inequitable – influenced by the intersectionality of race, gender, and athletic identity (Armstrong et al., 2018; Druckman et al., 2018; Neeley et al., 2021). This research accredits the physical environments where athletes train, recover, and connect as an underexplored factor in holistic well-being.

The Indivisible Self Model of Wellness (IS-WEL) was used to (1) explore the influence of physical design features on female student athletes' holistic well-being and (2) understand how their identity shapes how they experience and attach meaning to their team environments. …

Production Of Fungal Biomass And Crude Chitin From Cheese Whey: Effects Of Whey Type And Lactose Hydrolysis On Aspergillus Niger And Trichoderma Reesei, Anye Catharine Nora Drum

Electronic Theses and Dissertations

Chitin is a biodegradable and biocompatible biopolymer with broad applications in the food, biomedical, pharmaceutical, and packaging industries. Conventional chitin production from crustacean shells is associated with seasonal availability, intensive chemical processing, and environmental concerns, creating interest in more sustainable alternatives. Filamentous fungi represent a promising source of chitin because of their rapid growth and ability to utilize low cost agro-industrial residues. This study evaluated the feasibility of producing fungal biomass and crude chitin from cheese whey through submerged fermentation while investigating the effects of whey type and enzymatic lactose hydrolysis on fungal growth, substrate utilization, and wastewater remediation. Aspergillus …

A Narrative Review Of The High-Carbohydrate Fueling Revolution (≥100 G/H) In The Professional Peloton, Patrick B. Wilson

Exercise Science Faculty Publications

High-carbohydrate fueling in cycling (defined as ≥ 100 g/h for this paper) has received significant media attention in recent years. Whether this practice improves performance, however, remains an unresolved issue in the scientific literature. The purpose of this narrative review is to provide an up-to-date analysis of the practice of high-carbohydrate fueling, with a specific focus on potential performance implications in professional cycling. Topics covered include historical carbohydrate intake guidelines, research directly comparing high-carbohydrate fueling with traditional fueling guidelines, theorized benefits of high-carbohydrate fueling specific to cycling, potential risks associated with high-carbohydrate fueling, and personalizing carbohydrate intakes. Among a small …

Physical Activity Among Active-Duty Us Military Servicemembers With Overweight And Obesity, Natalie M. Yarish, Jessica L. Morse, Jennalee S. Wooldridge, Erin E. Dooley, Niloofar Afari

Exercise Science Faculty Publications

Background

To examine physical activity (PA) among US military servicemembers (SM) with overweight and obesity (OW/OB) and if they meet Physical Activity Guidelines (PAG). To assess differences in PA by sex and associations between PA and body composition.

Methods

PA duration and intensity were objectively collected via accelerometers and self-reported daily average via self-report International Physical Activity Questionnaire (IPAQ) among US active-duty SM (n=113, 58% female, Mean BMI = 33.3 ± 3.9 kg/m2). Sex, body mass index (BMI), and body fat % (BF% via circumference and an equation) were measured. Accelerometer PA and sedentary time were computed for IPAQ categories …

From Couriers To City Dwellers: The Changing Human-Pigeon Relationship, Mallory C. Peterson

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Their coos echo off the walls of skyscrapers and their wings beat faster than the cadence of footsteps. Whether dodging cars or pecking at food scraps, pigeons are a constant character of urban environments. Their unique history has allowed them to raise their young under bridges and on windowsills. Pigeons and humans are inextricably intertwined, to the joy and dismay of many. Once celebrated as couriers, pigeons carried messages of war, love, and survival across vast distances, shaping human connection and history. Today, they are more often dismissed as pests, their presence flattened into the city noise.

This narrative piece …

Rebalancing The Milk Market: A Shared-Burden Framework For Dairy And Plant-Based Producers, Isabelle Ulrich

Mitchell Hamline Law Review

This Note examines the structural and regulatory differences between traditional dairy products and the rapidly expanding plant-based milk products in the United States. Through analysis of historical Federal Milk Marketing Order policies, mandatory checkoff programs, and contrasting labeling standards in the United States and European Union, this Note reveals how plant-based milk producers enjoy competitive advantages without sharing the financial or regulatory burden that traditional dairy producers face. This Note argues for a shared-burden policy requiring all entities marketing “milk,” whether dairy or plant-based, to contribute to promotional and regulatory funds. This framework will restore market fairness, preserve consumer choice, …

Cultivating Holistic And Mindful Rest Practices: A Workbook, Cecelia V. Murray

Mindfulness Theses

In a cultural moment that conflates productivity with self-worth, rest is often undervalued or seen as indulgent. This thesis explores mindfulness as a means of reframing rest as an essential human right and a cornerstone of holistic wellness. Drawing on Bill Hettler’s Six Dimensions of Wellness (i.e. physical, intellectual, emotional, social, spiritual, and occupational wellness), this project situates mindful rest as a multidimensional practice that supports balance across body, mind, and spirit. This work also highlights the social, structural, and psychological barriers that affect individuals’ access to rest. It argues that while mindfulness alone cannot resolve systemic inequities, it can …

What Truly Drives Graduate Earnings?, Aiden Akbarov

High Impact Practices Student Showcase Spring 2026

The goal of my project, Predicting the Paycheck: What Factors Truly Influence Graduate Earnings?, was to see if we could actually predict a college graduate's starting salary using data instead of just guessing. I used a dataset of 172 majors from the American Community Survey to look at how a student's field of study, the gender balance of their major, and the current job market all impact their first paycheck. I wanted to create a tool that helps students understand the financial reality of their degree before they even graduate.

To get my results, I used a Multiple Linear Regression …

Comparison Of Clinical Outcomes By Tube Type And Size Following Percutaneous Radiologic Gastrostomy: A 10-Year Retrospective Study, Diane Zhao

Yale Medicine Thesis Digital Library

PurposeTo compare the complication rate and time to the first reintervention of pull-type and push-type gastrostomy tubes placed under radiologic fluoroscopy guidance in adults. Materials and Methods During a 10-year period (2012-2022), 2341 adult patients underwent percutaneous radiological gastrostomy at our institution, and their charts were reviewed. 896 (39%) procedures were done with the push method, and 1393 (61%) were done with the pull method. Results Rates of significant hemorrhage at the surgical site, leakage at the site, and malplacement of the g-tube were not found to be statistically different between the two groups. However, push g-tubes were significantly more …

Epidermal Differentiation Disorders Across The Lifespan: Growth, Ophthalmologic, And Perinatal Manifestations, Caroline Echeandia-Francis

Yale Medicine Thesis Digital Library

Epidermal differentiation disorders (EDDs) are a heterogeneous group of inherited skin diseases characterized by impaired epidermal barrier function, scaling, and erythema. Although substantial progress has been made in identifying the genetic causes of EDD, long-standing clinical observations—including impaired growth, ectropion, and increased rates of preterm birth—remain poorly characterized across genotypes. The prevalence, severity, and clinical significance of these manifestations have not been systematically evaluated in large, genotype-stratified cohorts, limiting the ability to provide anticipatory guidance and tailored clinical care. This thesis seeks to (1) characterize growth trajectories in children with EDD and determine genotype-specific patterns of growth impairment; (2) assess …

Influence Of Demographics On Research Participation In Female Patients Undergoing Ambulatory Surgery, Tiana Fernandez

Yale Medicine Thesis Digital Library

Background: Historically, research on women and minorities has consisted of unethical experimentation, human rights violations, and crimes against humanity. Numerous examples can be found throughout the past two centuries, including the exposure of pregnant women to radioactive iron in the Tennessee-Vanderbilt Nutrition Project (TVNP), failure to treat cervical carcinoma in situ in the Unfortunate Experiment, surgical experimentation on female slaves by Dr. J. Marion Sims, failure to treat syphilis in the Tuskegee Syphilis Study, intentional exposure to and subsequent failure to treat sexually transmitted diseases in Guatemala, collection of biospecimens from Henrietta Lacks, and nontherapeutic experimentation on minority children in …

Prevalence, Predictors, And Consequences Of Postoperative Dysphagia After Aortic Surgery, Andrew Joseph Johnson

Yale Medicine Thesis Digital Library

Prevalence, Predictors, and Consequences of Postoperative Dysphagia After Aortic SurgeryAndrew Johnson and Ronny Munoz-Acuna, M.D., Department of Anesthesiology, Yale School of Medicine, New Haven, CT 06510. Abstract Background: Postoperative dysphagia is an underrecognized complication following cardiothoracic surgery and is associated with aspiration, prolonged hospitalization, and adverse clinical outcomes. Patients undergoing complex aortic surgery may be at particularly high risk due to prolonged mechanical ventilation, extensive airway instrumentation, and neurologic vulnerability. Data describing the prevalence, predictors, and clinical consequences of postoperative dysphagia in this population remain limited. Research Aim: This study consisted of three aims: first, to determine the prevalence and …

Frailty And Functional Decline After Elective Endovascular Abdominal Aortic Aneurysm Repair, Judy Li

Yale Medicine Thesis Digital Library

Background: Frailty can be used to estimate perioperative and long-term mortality risk in octogenarians undergoing elective endovascular abdominal aortic aneurysm repair (EVAR). Its association with functional decline, an important surrogate of quality of life in older adults, has not been well studied in this population. We aimed to evaluate whether preoperative factors such as frailty are associated with one-year functional decline after elective EVAR in octogenarians and to compare the performance of three different frailty assessments.

Methods: The Vascular Quality Initiative (VQI) database was queried for octogenarians who underwent elective EVAR for an asymptomatic infrarenal abdominal aortic aneurysm (AAA) (2014 …

Chapter 6 - Interviewing The Client, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The first interview with a criminal client is probably the most important exchange that counsel will have with the client. It largely shapes the client’s judgment of the lawyer. Any initial impressions counsel makes may be indelible. At the least, this interview will strongly affect all future dealings between the two. The lawyer’s primary objective in the initial interview is to establish an attorney-client relationship grounded on mutual confidence, trust, and respect.

Public Utilities Commission, Azad Hassan Khanzadeh Faal, Kelly Downes, Annika Kjos, Marcus Friedman

California Regulatory Law Reporter

No abstract provided.

Improving Early Detection And Response To Clinical Deterioration Among Nurses Through Competency-Based Interventions, Courtney E. Miller

Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Clinical deterioration among hospitalized patients remained a significant contributor to preventable morbidity and mortality, often due to delayed recognition and response in general care settings (Choi et al., 2025; Chung & Jung, 2024).

PICOTS: For registered nurses working on a general level of care inpatient hospital unit (P), how did a competency-based training program bundle incorporating didactic educational intervention of learning how to use technology, machine learning (ML) based early warning system (EWS) of trends and patterns to identify at risk patients, and low-fidelity simulation-based education (SBE) (clinical readiness to improve confidence with education and coaching) (I), …

The Role Of Parenting In Mitigating Epigenetic Cardiometabolic Risk In Predominantly Latino Preschoolers, Adamari López

Open Access Master's Theses

Background: Childhood obesity is a highly prevalent public health concern with significant consequences for health and development across the lifespan. Risk is disproportionately elevated among children from marginalized racial and ethnic groups and socioeconomically disadvantaged backgrounds, highlighting persistent disparities in long-term health outcomes. Epigenomic mechanisms, including DNA methylation (DNAm), have emerged as a promising approach for understanding the biological embedding of metabolic risk; however, prior research has largely emphasized deficit-based models, with limited attention to protective family-level factors. The present study examined whether participation in a positive parenting intervention was associated with epigenetic cardiometabolic risk among preschool-aged children. Methods …

In The Flesh, Isabella Mason

Theses and Dissertations--English

IN THE FLESH is a nonfiction collection by Bell McEntire Mason, in which she illustrates a life dominated by the corporeal, embodied, and incarnate experience of physicality. Consisting primarily of personal essay, lyric essay, and flash nonfiction, the collection follows a journey of bodily understanding and acceptance that braids itself with the author’s life experiences, ranging from battles with mental health and physical illness to tender and painful relationships with family to looming acknowledgement of a body’s temporary status.

Role Of Estrogen Receptor Alpha In Modulating The Circadian System In Female Mice, Victoria Alvord

Theses and Dissertations--Biology

Circadian rhythms are approximately 24-hour cycles of physiology and behavior. Circadian rhythms of eating, or meal timing, are linked to cardiometabolic dysfunction in humans. Mistimed eating, such as breakfast skipping and eating late at night, increases the risk of obesity, diabetes, and cardiovascular disease in humans. Likewise, disrupted eating rhythms cause obesity in mice. This dissertation investigates how estrogens regulate eating behavior rhythms and tissue clock timing in female mice. Chapter 1 reviews three key components critical to this work. The first is an overview of the field of chronobiology and the function of the circadian system. The second is …

The Rhesus Macaque Model Of Mycobacterium Avium Infection Reveals That Age-Related Disease Is Due In Part To Chronic Inflammation And Lung Microbial Dysbiosis, Ethan G. Napier

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Aging is associated with dysregulated immunity and increased susceptibility to infection, a phenomenon dubbed as immunosenescence and characterized by reduced naïve T and B cell pools, altered innate immune function, and chronic low-grade inflammation. Nontuberculous mycobacterial (NTM) pulmonary disease (NTMPD) is an increasingly relevant chronic lung infection that disproportionately affects older adults (65+ years) and immunocompromised individuals. However, the host factors underlying increased disease severity in aged patients remain poorly defined. Literature suggests that effective control of NTM relies on coordinated innate and adaptive immune responses, particularly macrophage activation and Th1 cytokine signaling. Using a rhesus macaque model that closely …

Metabolism As A Regulator Of Sleep And Cortical Activity In Health And Alzheimer’S Disease, Nicholas J. Constantino

Theses and Dissertations--Neuroscience

Metabolic flexibility is essential for maintaining normal physiological function, enabling an organism to sense, flux, utilize, and switch fuel sources in response to changing energetic availability, demand, and cellular needs. Energetic demands are state-dependent, with wake and sleep exhibiting distinct metabolic profiles. Sleep is highly sensitive to changes in metabolism and requires metabolic flexibility to both transition into and maintain sleep stability. Alzheimer’s disease (AD) is increasingly recognized as a disease of altered metabolism yet is often framed as a disease of energetic failure. We instead define AD as a disease of metabolic inflexibility, characterized not by insufficient energy availability, …

Validation Of Final And Dynamic Subsidence Prediction Models Using The Influence Function Method, Carlos M. Hernandez Garcia

Theses and Dissertations--Mining Engineering

This study evaluates the Surface Deformation Prediction System (SDPS Version 7) for predicting final and dynamic subsidence in longwall mining. Using the influence function method, SDPS 7 was calibrated using data from the Quarto 7 Mine (Ohio, USA) and two panels in Anhui Province, China, to test the reliability of the method under varying geological and operational conditions, particularly low advance rates.

For the Quarto 7 Mine, monument line C provided the optimal set of subsidence parameters: SSF of 78%, tanβ of 2.97, edge‑effect offset of 160 ft, with an RMSE of 0.108 ft. These values aligned with estimates obtained …

Improving Evaluation Practices Of Community Arts Extension Agents: A Mixed-Methods Study Leveraging Theory Of Change And Open Systems Theory, Melissa G. Bond

Theses and Dissertations--Arts Administration

This dissertation examines how a structured evaluation training and subject-based evaluation tool can strengthen evaluation practices among Community Arts Extension professionals in Kentucky. Community Arts programs often support outcomes such as belonging, connection, skill development, and cultural engagement, yet those outcomes can be difficult to document within standardized public reporting systems. Guided by Theory of Change and Open Systems Theory, this mixed-methods study combines an environmental scan of FY2020–FY2025 Community Arts indicator records and agent-authored Success Stories with three survey waves administered before training, immediately after training, and approximately 60 days later.

Findings show that routine reporting captured substantial activity …

A Tale Of Two Serpins: Pathologic And Protective Roles Of Agt And Pai-1 In Metabolic And Cardiovascular Disease, Alex C. Pettey

Theses and Dissertations--Physiology

Metabolic and cardiovascular diseases are leading causes of morbidity and mortality worldwide. Conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), aortic aneurysm, and cardiac fibrosis have limited pharmacological therapies, underscoring the need for deeper mechanistic investigations. Serine protease inhibitors (serpins) have been implicated in these pathologies and represent potential therapeutic targets. Despite structural homology, serpins regulate diverse physiological processes through both protease inhibition and non-inhibitory mechanisms. This dissertation examines the roles of two serpins, angiotensinogen (AGT) and plasminogen activator inhibitor-1 (PAI-1), in preclinical models of metabolic and cardiovascular disease to identify novel mechanisms that may inform future therapeutic strategies. …

Seasonal Population Dynamics And Interspecific Interactions Of Drosophila Suzukii, Eleanor Mccabe

Theses and Dissertations--Entomology

Invasive species are a growing problem, and it is important to investigate how invasives interact with novel ecosystems, which are characterized by distinct abiotic and biotic factors. In this dissertation, I investigate abiotic and biotic factors affecting two invasive pests in central Kentucky, Drosophila suzukii and Zaprionus indianus. In Kentucky, seasonality, and landscape features on population dynamics and fitness are unknown. I found that D. suzukii overwinters in Kentucky and that wild berry species improve winter survival. I used local weather data to identify meteorological variables that best predict D. suzukii populations. I tested the extent to which D. suzukii …

Fusarium Head Blight Of Hemp: A Destructive Disease Emerges On A New Host, Henry Smith

Theses and Dissertations--Plant Pathology

Hemp was reintroduced as a commercial crop in 2018 after a near 50-year production ban under the Controlled Substances Act. Since reintroduction, Kentucky has consistently ranked among the top five hemp producing states in the US. Surveys have shown that hemp is susceptible to a multitude of diseases that impact production. Among the most concerning diseases in Kentucky is Fusarium head blight (FHB). FHB is a major disease of cereals that is caused by various Fusarium species, predominately F. graminearum. FHB of hemp caused by F. graminearum was first reported in Kentucky in 2020. A survey of 25 different …