Digital Commons Network^™

Reduced Threat-Related Neural Efficiency: A Possible Biomarker For Pediatric Anxiety Disorders, Julia O. Linke, Reut Naim, Simona P. Haller, Parmis Khosravi, Beck Scheinberg, Meghan E. Byrne, Anita Harrewijn, Ellen Leibenluft, Melissa A. Brotman, Anderson M. Winkler, Daniel Samuel Pine

School of Medicine Publications

Objective: Pediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as cognitive-behavioral therapy (CBT), produce lasting remission in less than 50% of affected youths. To support the search for improved, mechanistically grounded interventions, this study evaluated neural efficiency, defined as similarity in functional connectivity between a threat task and rest, as a potential biomarker. The study evaluated neural efficiency in relation to anxiety diagnosis and treatment response.

Methods: The authors compared 103 youths with an anxiety disorder diagnosis (mean age, 12.5 years [SD=2.91], 62% female) to 103 youths with no psychiatric diagnosis (mean age, 13.4 years …

The End Of Territoriality?, Reuven S. Avi-Yonah

Articles

The One Big Beautiful Big Act (OBBBA) of 2025 is generally consideredto be a continuation of the Tax Cuts and Jobs Act (TCJA) of 2017.1Thatis definitely true as far as the individual tax provisions are concerned, be-cause the OBBBA merely made permanent the TCJA provisions with minorchanges, such as increasing the cap on the state and local tax deduction from$10,000 to $40,000. For the corporate tax, the OBBBA continued some of thechanges in the TCJA (such as expensing) while relaxing others (such as amorti-zation of research and experimentation (R&E) expenditures and a stricter limiton interest deductions) without changing the overall …

Liability For Non-Disclosure In Ipos, Albert H. Choi, Kathryn E. Spier

Articles

A privately-informed entrepreneur may withhold material information from prospective investors who may sue the firm ex post for (alleged) non-disclosure. Absent liability, the entrepreneur has an excessive incentive to withhold bad news and pursue socially-wasteful projects. Liability deters inefficient non- disclosure and prevents capital misallocation. Any damage award received by investors is partially offset by a reduction in equity value. Depending on the likelihood of court error and litigation cost, the socially-optimal damage award may be either zero or the minimum necessary for full deterrence. The private incentive to waive liability may be socially excessive or insufficient. Positive and normative …

States As Gatekeepers In Global Governance, Kristina Daugirdas

Articles

Over the last several decades, private actors—corporations, philanthropic foundations, and non-governmental organizations—have increasingly contributed to the development and implementation of public international law. In some cases, private actors are developing standards that serve as substitutes for public regulation. In other cases, private actors have been “invited in” to public international organizations as funders, accredited observers and consultants, and even representatives of member states. According to one estimate, 56 percent of international organizations offered some form of access to private actors in 1990; two decades later, more than 90 percent did.

What we are witnessing, in other words, is the growing …

State Climate Superfunds, Rachel Rothschild

Articles

The harmful effects of climate change have already arrived in cities and states across America, with disasters increasing markedly in recent years along with more gradual environmental changes like sea-level rise and drought. To protect populations and natural resources, significant funding will be necessary for preventative measures as well as disaster response.

At present, it is states and ordinary taxpayers who must shoulder the enormous costs and planning for climate adaptation. A number of state legislators, however, have recently proposed enacting new laws that would require the companies who have most profited from fossil fuel usage to assist in funding …

Ai-Powered Lawyering: Ai Reasoning Models, Retrieval Augmented Generation, And The Future Of Legal Practice, Daniel Schwarcz, Sam Manning, J. J. Prescott, Patrick Barry, David R. Cleveland, Beverly Rich

Articles

Generative AI is set to transform the legal profession, though its most promising uses and ultimate effects are still unclear. While AI models like GPT-4 improve efficiency, they can also “hallucinate” and may undermine legal judgment, particularly in complex tasks typically handled by skilled lawyers. This article examines two emerging AI innovations that may mitigate these concerns: Retrieval Augmented Generation (RAG), which grounds AI-powered analysis in legal sources, and AI reasoning models, which structure complex reasoning before generating output. We conduct the first randomized controlled trial assessing these technologies, assigning upper-level law students to complete legal tasks using a RAG-powered …

Authorship Nonsense, Jessica Litman

Articles

Copyright law’s primary device for promoting progress is to bestow rights on the authors of works. Rights vest automatically and last for a very long time. Authors’ choices to retain, license, or transfer those rights fuel opportunities to communicate the works to their audiences. The copyright system’s mechanisms for determining who authored works (and therefore automatically obtained copyright rights) should be both accurate and reliable, since misidentifications will undermine the law’s working as intended.

This article examines authors’ creation of works and copyright law’s handling of authorship disputes. Many works result from creative collaboration. Although the copyright statute incorporates mechanisms …

Monitoring, Oversight, And Learning In Medical Ai, W. Nicholson Price Ii

Articles

When medical AI errs, it often goes unnoticed. If there’s a specific patient injury, and the link to AI is obvious, that problem might be reported to the Food and Drug Administration (FDA), but not always. And many other types of problems, like worse performance on specific groups or ineffective integration into health system workflows, simply don’t fall within the contours of regularized reporting. Even if they are noticed by the health system—far from a given—there’s no obvious way to share that information more broadly. Against this backdrop, there are justified calls for better oversight and reporting. But there’s the …

The Basis Of The Labor Exemption Reconsidered, Sanjukta Paul

Articles

Broadly speaking, this symposium queries the question of expanding some actors’ coordination rights under antitrust law as a way of effectuating legal goals relating to “power relations.” I commend the organizers of the symposium for opening this conversation, for asking about the use of “collective bargaining” beyond the traditional labor domain, and for taking on the question in a creative way. These broader questions are essential, and yet my own article will (paradoxically, perhaps) try to contribute to this effort by going back to the core domain of the labor exemption itself—where, it turns

How The U.S. Constitution Shapes International Tax Law: Instrument Choice In Tax Agreements, Noam Noked, Young Ran (Christine) Kim, Reuven Avi-Yonah

Articles

The U.S. Constitution’s Treaty Clause, which requires Senate approval by a two-thirds vote for treaties, has significantly influenced the development of international tax law. This Article examines the implications of Senate supermajority requirements on bilateral and multilateral tax treaties and agreements, alternative instruments, relevant international tax standards, and global tax governance.

Historically, tax treaties have been approved exclusively as Article II treaties requiring Senate approval. The difficulty of entering into treaties with the United States has influenced the instrument choice and design of U.S. and international tax standards. To address this challenge, several U.S. and international tax reforms have employed …

Covid And The Great Retrenchment, Samuel R. Bagenstos

Articles

The past six years have seen two dramatic shifts in federal health and benefits policy. First, during the COVID pandemic, the government dramatically expanded public benefits. These expansions had incredibly positive effects, and recipients were largely satisfied with them. But after a relatively short time, Congress rolled back nearly all of the expansion. Worse, the immediate pullback set the stage for even more significant retrenchments in the second Trump Administration. Where in 2023 the United States came closest to universal health care in its history—with a record low uninsured rate of 7.7%—the Trump Administration’s Medicaid cuts and failure to extend …

Useful Noise: Understanding Dicta And Knowing What To Do With It, Len Niehoff, Tucker Gribble

Articles

Sometimes we approach the idea of obiter dictum as if it were Latin for “Here the court says something I wish it didn’t.” When a judicial opinion includes a statement that hurts our case, we labor to cast it as dicta and we give it the first name “mere.” If the opposing party quotes the statement, we huff about its irrelevance and dismissively proclaim that it can, indeed must, be ignored. We treat dicta as background noise, and we encourage the court to plug its ears and hum.

Noneconomic Tort Damages And Biased Beliefs About Vulnerability To Harm, Roseanna Sommers

Articles

The American tort system aspires to provide fair compensation to injured plaintiffs, regardless of socioeconomic status, race, religion, or gender. Recent experimental evidence from psychology suggests, however, that factfinders consistently judge identical harms as less severe when experienced by individuals of lower socioeconomic status (SES). People presume, for instance, that a paper cut hurts a wealthy person more than a less well-off person, that domestic violence inflicts greater suffering on a high-SES woman than a lower-SES woman, and that bullying harms a fiveyear- old from a high-SES family more severely than one from a low- SES family. This Essay examines …

Junior Public Health Service Officer Mentor Program: Developing New Leaders In The United States Public Health Service Commissioned Corps For Workforce Retention, Felecia Annetta Bailey

Yale School of Nursing Digital Theses

Junior Public Health Service Officer Mentor Program: Developing New Leaders in the United States Public Health Service Commissioned Corps for Workforce Retention

Mentorship is a critical tool for preparing junior personnel for senior roles, professional development and retention within organizations; however, formal mentorship is often lacking or insufficiently tailored to the needs of diverse workforces, particularly in organizations comprising uniformed service members and civilian employees. This project was designed to provide targeted mentorship for Public Health Service (PHS) Commissioned Corps junior officers and to modify an existing mentoring program that primarily served civilian personnel.

The project aimed to modify the …

Optimization Of Social Determinants Of Health Data With Z Code Utilization In Inpatient Care, Felicia Cordia Alleyne

Yale School of Nursing Digital Theses

The U.S. healthcare system is characterized as being costly, wasteful, and fraught with inequity, due to historical disparities and contemporary challenges such as the aftermath of the COVID 19 pandemic and recent international policy changes that raise the costs of materials and imports. There is evidence to support that with the use of social determinants of health screening tools that are associated with a standardized data capture approach can contribute to value-added clinical and financial changes, resulting in improve care, reduce healthcare disparities, and reduce healthcare costs. This DNP project piloted the implementation of a training protocol for a social …

Nursing Primary Care To Better Health, Kristen Dulling

Yale School of Nursing Digital Theses

The national nursing shortage and the rising cost of nursing is threatening sustainability of

the RN role on the care team in ambulatory care settings. There is a critical need to develop a

care model that defines the value of RNs on the primary care team by improving access and

effectively reducing cost by mitigating turnover and role dissatisfaction. This DNP project

developed and implemented a care model across four primary care settings that shifted

workflows for vaccine administration, prior authorizations, and emergency department follow up

calls from RNs to other roles on the care team. Capacity created allowed the …

Addressing Social Determinants Of Health To Reduce Missed Appointments In Primary Care Setting., Omolara Goyea

Yale School of Nursing Digital Theses

Background: Missed appointments impose a significant financial burden on the U.S. healthcaresystem, costing over $150 billion annually, with individual physicians losing an average of $200 per unused time slot (Gier, 2017). Unmet Social Determinants of Health (SDOH), such as transportation barriers, negatively impact primary care services and contribute to missed appointments (Brown et al., 2020; Fiori et al). The missed appointment rate in the United States ranges from 12% to 50% of scheduled appointments (Boone et al., 2023). Objective: This quality improvement project aimed to develop, implement, and evaluate a telehealth protocol specifically tailored for patients who identified transportation as …

The Effect Of Polypharmacy On Nurse’S Workflow And Healthcare Expenditure In Post-Acute Care, Rachel Hudec

Yale School of Nursing Digital Theses

This DNP project modified a deprescribing initiative to engage frontline nursing staff. The intervention included a comprehensive educational curriculum, clinical guidelines, and a system to track nurse workflow and financial metrics. Guided by Donabedian’s conceptual model, the project was piloted in a large municipal PAC facility. Methods included twelve in-person training sessions for 93 nurses, pre- and post-knowledge tests, a program evaluation, medication pass times, and tracked the costs deprescribed medications over six months.Nursing knowledge significantly improved, with mean test scores rising from 41.39 to 90.64 (p < .001). Medication pass decreased by 18%, reducing the time per resident from 7 to 5.7 minutes. Financially, the initiative saved over $21,000 in six months, with a projected annual savings exceeding $42,000. Integrating nurses as leaders in deprescribing enhances clinical competency and operational efficiency. These findings provide a compelling case for standardizing an interdisciplinary deprescribing program to improve financial sustainability, nursing efficiency and resident safety in the PAC setting.

Implementing Hepatitis C Screening And Treatment In Primary Care, Michele Castellano Wetmore

Yale School of Nursing Digital Theses

AbstractHepatitis C (HCV) is a curable hepatic disease. With direct-acting antivirals, it can be treated in 95% of cases. When left untreated, it can cause severe liver disease, including hepatocellular carcinoma and even death. The World Health Organization’s (WHO) goal is to eliminate HCV by 2030. This Quality Improvement (QI) project, conducted at a Federally Qualified Health Center (FQHC) from 8/4/2025 to 11/4/2025, will address the barriers to elimination and show that providing local services closes gaps. Screening and treating HCV within primary care has become a strategic approach to enhance access to treatment. This involves developing and utilizing a …

The Effect Of Verbal De-Escalation Simulation Training Using Artificial Intelligence On Nurse Leader’S Self-Efficacy, Mary Vitullo

Yale School of Nursing Digital Theses

Per year, rates of verbal workplace violence (V-WPV) are estimated to occur in 38.8 per 100 nurses, which is decreasing leader retention (NIOSH, 2020, Chang, Hsu, & Ouyang, 2022). Increasing the confidence of nurses in handling V-WPV through simulated training programs increases their intent to stay (Ming et al., 2019).

A two-pronged training program allowed nurse leaders to learn de-escalation techniques and then apply that knowledge in a life-like simulated environment. The education included a pre-work module on V-WPV de-escalation and a simulated scenario using an artificial intelligence conversational agent.

The aims of the project were: to develop a model, …

Exploring Parent-Child Reminiscing Style And Internal-State Talk When Discussing Positive And Negative Shared Events, Komal Verma Miss.

Theses and Dissertations (Comprehensive)

Conversations between parents and children about past events play a critical role in children’s social, emotional, and cognitive development. Parents scaffold their children in learning to recount details of their autobiographical memories by creating a space to reflect on internal states, specifically emotions and cognitions. Parents with an ‘elaborative’ reminiscing style are responsive to children’s utterances and ask open-ended questions (e.g., What do you remember about...?). Parents who are less ‘elaborative’ typically ask narrow questions like Did you like it?” that do not encourage conversation. Children whose parents use an elaborative reminiscing style have children who produce the most detailed …

Exploring Engagement With The Ecoschools Platform: An Interactive Display Board Exploratory Evaluation, Kaitlyn E. Ashmore

Theses and Dissertations (Comprehensive)

This study explores strategies to enhance engagement with EcoSchools Canada, an online sustainability platform used across Canada. Through an exploratory case study involving two Waterloo Region District School Board (WRDSB) schools, the research evaluates the effectiveness of interactive tools such as an Interactive Display Board (IDB) and action cards in fostering student engagement, self-efficacy, and action competence in sustainability initiatives. Through examining user experiences and feedback from Eco-teams and staff, the findings aim to identify if and how these interventions serve as valuable complements to EcoSchools activities. Although not a standalone solution, these tools facilitate deeper involvement when integrated within …

Nanoparticle Carriers Enhance The Prophylactic Antiviral Effects Of Dsrna In Vitro And Ex Vivo, Shayne Oberhoffner, Stephanie Dewitte-Orr, Starla Richardson, Leah Haile, Dominique Daniels, Erin Cooper, Aizah Ijaz, Janet Velasquez Perez, Mathilde Peruzzi, Bertrand Collet, Paul Craig, Kristof Jenik

Theses and Dissertations (Comprehensive)

Aquaculture now outpaces traditional capture fisheries as the world population and demand for sustainable protein sources increases. Wild and farmed species are increasingly susceptible to pathogen spread as global temperatures rise and stocking densities increase. Despite the devastating losses experienced by aquaculture due to viral infections, there remain few effective prophylactic antiviral therapeutics. Long double-stranded (ds)RNA is a uniquely viral molecule produced by nearly all viruses during their replication cycle, and its detection by salmonids like rainbow trout (Oncorhynchus mykiss) and chinook salmon (Oncorhynchus tshawytsha) leads to the establishment of a defensive antiviral state. Previous in vitro studies demonstrated a …

Adapting To Uncertainty: Effects Of Environmental Instability On Zebrafish Behaviour, Britney Sekulovski

Theses and Dissertations (Comprehensive)

This thesis addresses how animals cope with unpredictability by testing how environmental stability changes the behaviour of zebrafish (Danio rerio) in two complementary experiments. In Experiment 1, fish lived for three months in either a Dynamic environment (water temperature, feeding times, habitat complexity, group size, and membership fluctuated) or a Stable environment (all factors constant). Across seven behavioural assays, measuring individual behavioural differences, collective movement, social memory, and information use, Dynamic condition fish were found to be more sensitive to social cues and more likely to conform to recent social information, independent of the quality of the information …

Minority Stress And Drug Use Among 2slgbtq+ Canadians, Robert Chin-See, Todd Coleman

Theses and Dissertations (Comprehensive)

Background: Several social and environmental factors influence drug use behaviors and contribute to frequent drug use among Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, and other (2SLGBTQ+) individuals. The purpose of the current study was to examine the relationship between the minority stress, drug use, and other socio-ecological factors.

Methods: This study employed structural equation modelling on data (2021—2022) from a nationally representative pan-Canadian survey (N = 1542) on 2SLGBTQ+ health to examine the association between minority stress, drug use, and relevant socio-ecological predictors. A separate mediation analysis was conducted and controlled for socio-demographic characteristics.

Results: SEM results showed parsimonious fit …

Envisioning The Role Of Community-Owned Stores & Aligning Federal Food Policies: A Participatory Approach To Food Security And Food Sovereignty In Sambaa K’E, Denendeh (Northwest Territories, Canada), Narayan Subramoniam

Theses and Dissertations (Comprehensive)

Northern Indigenous communities have relied on traditional food systems for meaningful, nutritious diets since time immemorial. But many Indigenous communities in remote northern regions of Canada still face disproportionately elevated levels of food insecurity due to climate change radically altering the availability for traditional foods, colonial food policies imposing Western diets, and the high costs of transporting store-bought foods. Extreme weather events such as wildfires further isolate fly-in remote communities increasing both the costs of transporting store-bought foods and the difficulties of harvesting traditional foods. There are many examples of community-based initiatives for supporting traditional and locally grown foods, however, …

Investigating The Impact Of Winter Exposure To Natural Environments On Perceived Health And Well-Being Using Geographic Ecological Momentary Assessment: A Case Study At Arrowhead Provincial Park, Faith M. Laing

Theses and Dissertations (Comprehensive)

This study examined how winter exposure to specific natural environments influenced perceived health and well-being outcomes using Geographic Ecological Momentary Assessment (GEMA) in Arrowhead Provincial Park. Studies performed in the wintertime are limited, as is our understanding of how specific park features and/or activities impact health and well-being. To address this, GEMA was used with a video component to capture participants’ real-time experience and emotional responses in specific park locations defined by polygon boundaries. Two surveys were administered through participants mobile devices, one being an in-situ engagement survey triggered by entering a bounded location, which included a video and …

Injury To Insight: Exploring The Influence Of Media On Acl Rehabilitation Experiences Of Female Soccer Players, Chynna Ho-Young Cadogan, Jill Tracey

Theses and Dissertations (Comprehensive)

Participation in soccer inherently carries a risk of injury, with female athletes facing a significantly higher susceptibility to anterior cruciate ligament (ACL) injuries (Campbell et al., 2014; Le et al., 2025; Silvers-Granelli, 2021). The increasing participation in women’s soccer, coupled with the growing demand for its consumption through spectatorship, has contributed to a rise in ACL injuries, and increase in media coverage on this phenomenon (Parsons et al., 2021). Understanding how media narratives surrounding ACL injuries and recovery may influence rehabilitation experiences can educate coaches, mental performance consultants, athletic therapists, and female soccer players to better understand and navigate ACL …

Autism And Homelessness: An Intersectional Case Study In Kitchener-Waterloo, Ontario, Nicole J. Mcdonald

Theses and Dissertations (Comprehensive)

Homelessness is a growing crisis in Canada, with literature suggesting autistic traits as over-represented within this population. Literature addressing intersectional experiences of autism is emerging, however there are gaps in the research surrounding intersectional experiences of autism and homelessness. Research suggests that autistic individuals may be more vulnerable to experiencing homelessness and face difficulties in exiting homelessness. This qualitative case study utilizes a Disability Justice framework to explore intersectional autistic experiences of homelessness, social service usage, and suggests recommendations on improving support for autistic individuals at risk of and experiencing homelessness. Four autistic participants with experience of homelessness and accessing …

The Phone Eats First: Reconfiguring Cultural Capital And Performing Taste On Tiktok’S #Torontoeats, Annie M. Willick

Theses and Dissertations (Comprehensive)

This study investigates how TikTok reconfigures cultural capital through the visual commodification and performative display of Toronto’s food culture using the hashtag “#TorontoEats”. Through a digital ethnographic multimodal critical discourse analysis, my research considers Bourdieu’s (1984) definition of cultural capital as the guiding definition of distinction, status, and personal taste. This analysis considers how cultural capital manifests through algorithmic engagement, adherence to platform norms, and TikTok’s multimodal format that blends video, sound, text, and gesture to entice audiences. Findings suggest that mundane food practices and activities are transformed into conspicuous commodities on TikTok, where creators position themselves as tastemakers and …