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The Indirect Taxes, Conor Clarke, Ari Glogower Jan 2027

The Indirect Taxes, Conor Clarke, Ari Glogower

Scholarship@WashULaw

Article I of the Constitution empowers Congress to “lay and collect Taxes, Duties, Imposts and Excises.” It is arguably Congress’s most important power. A government’s first task is to fund itself, and the absence of an enforceable funding mechanism under the Articles of Confederation was a primary reason for the Constitution in the first place. Yet scholarly and judicial attention has focused mostly on the term “taxes” (and specifically what constitutes a “direct tax” that must be apportioned) while largely overlooking the three terms that follow—the duties, imposts, and excises that are collectively known as the “indirect taxes.” 

While poorly …


Study On The Concept And Framework Of Synergy Between Mitigation And Adaptation, Xianchun Tan Dec 2026

Study On The Concept And Framework Of Synergy Between Mitigation And Adaptation, Xianchun Tan

Double Helix Methodology

Carbon neutrality and the Global Goal on Adaptation jointly drive the integration of mitigation and adaptation; however, a clear conceptual and analytical framework for their synergy remains absent. This study first examines the components of mitigation and adaptation, and analyzes the mechanisms through which they interact. It then explores the fundamental principles underlying the synergy between mitigation and adaptation, and construct a corresponding analytical framework. It emphasizes that mitigation and adaptation are mutually influential, providing a foundation for achieving synergy. Furthermore, synergy should be promoted in the five aspects of objectives, regions, sectors, pathways, and policies—and follows the logic of …


When Probiotics Guidelines Differ: A Practical Guide For Clinicians And Researchers, Geoffrey A Preidis, Hania Szajewska, Marla Cunningham, Howard Bauchner, Daniel J Merenstein Dec 2026

When Probiotics Guidelines Differ: A Practical Guide For Clinicians And Researchers, Geoffrey A Preidis, Hania Szajewska, Marla Cunningham, Howard Bauchner, Daniel J Merenstein

Faculty, Staff and Students Publications

Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations …


Sar Ship Detection Based On Shallow Feature Guidance, Chenxu Xia, Peng Chen, Ya Zhang, Ying Li Dec 2026

Sar Ship Detection Based On Shallow Feature Guidance, Chenxu Xia, Peng Chen, Ya Zhang, Ying Li

Journal of Marine Science and Technology–Taiwan

Maritime ship detection is of great significance for both military security and civilian applications. Synthetic Aperture Radar (SAR), with its all-weather and all-day imaging capability, plays a vital role in maritime surveillance. Nevertheless, SAR ship targets typically appear small in scale, embedded in complex backgrounds, blurred at boundaries, and easily confused with near-shore features, which pose substantial challenges for accurate detection. To address these issues, we propose a SAR ship detection network that integrates dual enhancements of small-object representation and edge information. The network introduces two key components: the Small Target Refine Pyramid (STRP) to strengthen shallow feature representation for …


Does The Court Follow The Election Returns?, Thomas Keck Dec 2026

Does The Court Follow The Election Returns?, Thomas Keck

Political Science - All Scholarship

No abstract provided.


Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo Dec 2026

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.


The People, The Branches, And The Pearl Of Independence, Brian C. Murchison Dec 2026

The People, The Branches, And The Pearl Of Independence, Brian C. Murchison

Hofstra Law Review

What will be the fate of the independent agencies? Since 1887, Congress has seen fit to address an array of contemporary issues by creating expert federal agencies, such as the Interstate Commerce Commission, the Federal Trade Commission, the National Labor Relations Board, and others. The principal officers of these agencies are appointed by the President on advice and consent of the Senate, serve limited staggered terms, are bipartisan in the sense that only a bare majority of the agency’s officers can be members of the same political party, and are “independent” in the sense that the officers are removable only …


Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina Dec 2026

Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina

Faculty, Staff and Student Publications

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known.

Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e'/a'), and …


A Projector-Rank Partition Theorem For Exact Degrees Of Freedom In Experimental Design, K. G. Nagananda Dec 2026

A Projector-Rank Partition Theorem For Exact Degrees Of Freedom In Experimental Design, K. G. Nagananda

Mathematics and Statistics Faculty Publications and Presentations

In many experimental designs—split-plots, blocked or nested layouts, fractional factorials, and studies with missing or unequal replication—standard ANOVA procedures no longer tell us exactly how many independent pieces of information each effect truly contributes. We provide a general degrees of freedom (df) partition theorem that resolves this ambiguity. For N observations, we show that the total information in the data (i.e., N −1 df) can be split exactly across experimental effects and randomization strata by projecting the data onto each stratum and counting the df each effect contributes there. This yields integer df—not approximations—for any mix of fixed and random …


Pieces Solving A Puzzle: Emerging Roles And Cross-Field Analogies During A Distributed Epistemic Game, Jenna Matthews Dec 2026

Pieces Solving A Puzzle: Emerging Roles And Cross-Field Analogies During A Distributed Epistemic Game, Jenna Matthews

All Graduate Theses and Dissertations, Fall 2023 to Present

In an effort to describe why some problems can’t be solved, a character compared them to a cubic meter of platinum - a block so dense that all the people who could squeeze around it still couldn’t lift it off the ground. In the same way, these problems simply can’t have enough people gathered around and communicating about them - and so they remain unsolved.

This research looks at the first Polymath Project (2009) as an example of a distributed epistemic game to examine how groups engage with complex problems. and without a locally omniscient individual. In this setting of …


Depression, Psychological Distress, And Coping Strategies Among African Migrants In Australia: A Cross-Sectional Web-Based Study, Uchechukwu Levi Osuagwu, Lillian Mwanri, Edith N. Botchway-Commey, David Chisanga, Agness Tembo, Nnaemeka Meribe, Kathomi Gatwiri, Obed Adonteng-Kissi, Kerrie P. Doyle, Frank Darkwa Baffour, Ahmed A. Moustafa Dec 2026

Depression, Psychological Distress, And Coping Strategies Among African Migrants In Australia: A Cross-Sectional Web-Based Study, Uchechukwu Levi Osuagwu, Lillian Mwanri, Edith N. Botchway-Commey, David Chisanga, Agness Tembo, Nnaemeka Meribe, Kathomi Gatwiri, Obed Adonteng-Kissi, Kerrie P. Doyle, Frank Darkwa Baffour, Ahmed A. Moustafa

Research outputs 2022 to 2026

Background: African migrants constitute a significant proportion of the Australian population. While migration and resettlement offer opportunities, the associated stressors may adversely affect the mental health and well-being of African migrants. This study explored, for the first time, the prevalence of depression and psychological distress among African migrants in Australia and the relationship between coping mechanisms and mental health outcomes. Methods: A web-based cross-sectional survey of adult African migrants in Australia was conducted between February and May 2022. Participants (N = 167) who did not have a refugee status who resided in Australia for at least 12 months were recruited …


Smart Service Experience And Consumer Loyalty In Saudi Arabian Smart Hotels: The Mediating Roles Of Tourist Happiness And Value Co-Creation, Fahad M. Alhuqbani Dec 2026

Smart Service Experience And Consumer Loyalty In Saudi Arabian Smart Hotels: The Mediating Roles Of Tourist Happiness And Value Co-Creation, Fahad M. Alhuqbani

Journal of Global Business Insights

Drawing on Cognitive-Affective System Theory (CAST), this study investigates the mediating roles of tourist happiness and willingness to co-create value in the relationship between Smart Service Experience (SSE) and loyalty among consumers of smart hotels in Saudi Arabia. Data were collected from 367 guests who had stayed in a smart hotel in Saudi Arabia within the past year and analyzed using Partial Least Squares Structural Equation Modeling. The findings reveal that SSE positively influences both tourist happiness and co-creation willingness, which in turn drive guest loyalty. Notably, the affective pathway through tourist happiness exerts a stronger effect on loyalty than …


When Lawyers Attack The Rule Of Law: The Rise Of Autocracy In America, Scott L. Cummings Dec 2026

When Lawyers Attack The Rule Of Law: The Rise Of Autocracy In America, Scott L. Cummings

Hofstra Law Review

No abstract provided.


"None Of This Is Normal": The Golden Age Of Legal Bribery, James J. Sample Dec 2026

"None Of This Is Normal": The Golden Age Of Legal Bribery, James J. Sample

Hofstra Law Review

No abstract provided.


The Morality Of Legality, Cass R. Sunstein Dec 2026

The Morality Of Legality, Cass R. Sunstein

Hofstra Law Review

The Morality of Legality holds that it is a moral wrong, and essentially taboo, for those who work in the executive branch to act unlawfully, even if high-level officials much want to act unlawfully, even if circumstances clearly call for the action in question, and even if there is a strong public demand for the unlawful action. The Morality of Legality is less innocuous and more directive than it might seem. It is a red light; it is a conversation-stopper; it empowers law and lawyers. Those who are committed to it will not engage in unlawful action even if no …


Legislation Is Hot: Reforming The Troubled Teen Industry In California, Jaclyn Ragusa Dec 2026

Legislation Is Hot: Reforming The Troubled Teen Industry In California, Jaclyn Ragusa

Hofstra Law Review

No abstract provided.


Reasserting Congressional Authority In National Security In The Post-Chadha Era, Jacob Shaffer Dec 2026

Reasserting Congressional Authority In National Security In The Post-Chadha Era, Jacob Shaffer

Hofstra Law Review

No abstract provided.


Providing Effective Student Feedback: Effects Of Sociotropy, Student-Teacher Connectedness, And Expressed Disappointment And Praise On Students' Self-Esteem And Motivation, Emily Davied Dec 2026

Providing Effective Student Feedback: Effects Of Sociotropy, Student-Teacher Connectedness, And Expressed Disappointment And Praise On Students' Self-Esteem And Motivation, Emily Davied

All Graduate Theses and Dissertations, Fall 2023 to Present

This study examined how different types of teacher feedback (i.e., expressed pride, expressed disappointment, and near-neutral feedback) impact students’ motivation to learn and self-esteem. It also explored whether such effects vary depending on students' personality and how connected they feel to their teacher. Undergraduate students (N = 221) imagined receiving feedback from a teacher and completed surveys assessing their motivation, self-esteem, sociotropy, and connectedness with the teacher. The results showed that feedback expressing disappointment lowered students' self esteem compared to expressing pride and lowered students' motivation compared to near neutral feedback. Although sociotropy (i.e., dependence on others' approval) and teacher …


The Willing And The Compelled: How Power And Place Shape Human-Bison Coexistence In Poland And The United States, Patrick Orville Kelly Dec 2026

The Willing And The Compelled: How Power And Place Shape Human-Bison Coexistence In Poland And The United States, Patrick Orville Kelly

All Graduate Theses and Dissertations, Fall 2023 to Present

Wildlife recovery programs depend not just on animals, but on how people feel about living with them. The degree to which people accept the disruptions wildlife brings to their lives, known as social tolerance, can determine whether a recovery program succeeds or fails, yet it remains understudied and underapplied in management plans. This dissertation studies how people in Poland and the western United States feel about living with the two living species of bison, the largest land animals in Europe and North America. In Poland, we surveyed 242 residents living at different distances from European bison habitat. Surprisingly, the most …


Extending Geometric Acoustic Ray Tracing To Multi-Room Environments: A Case Study On Gunshot Sound Transmission Between Adjacent Rooms, Tyler Ton Dec 2026

Extending Geometric Acoustic Ray Tracing To Multi-Room Environments: A Case Study On Gunshot Sound Transmission Between Adjacent Rooms, Tyler Ton

Theses and Dissertations

Accurate localization of gunshots in multi-room building environments remains a challenging problem in acoustic forensics and public safety applications. Existing approaches model sound propagation within a single room, neglecting the transmission of acoustic energy through walls and other building materials. This thesis presents a study on modeling multi-room gunshot acoustic transmission, combining geometric ray tracing with structural acoustic transmission-loss modeling to generate impulse responses for two horizontally adjacent rooms separated by a shared wall, providing a foundation for future inter-room gunshot localization work. The proposed system uses GSound-SIR, a geometric acoustics engine, to simulate sound propagation in both of the …


Harnessing Digital Twin (Dt) Technology For Food Security And Climate Resilience In Sub-Saharan Africa (Ssa), Henri E.Z. Tonnang, Francis Chianu, Siyabusa Mkuhlani, Francis Muthoni, John Michael Humphries Choptiany, Franck B.N. Tonle, Bonoukpoe M. Sokame, Mercy Lung’Aho Dec 2026

Harnessing Digital Twin (Dt) Technology For Food Security And Climate Resilience In Sub-Saharan Africa (Ssa), Henri E.Z. Tonnang, Francis Chianu, Siyabusa Mkuhlani, Francis Muthoni, John Michael Humphries Choptiany, Franck B.N. Tonle, Bonoukpoe M. Sokame, Mercy Lung’Aho

All Peer-Reviewed Publications

Sub-Saharan Africa (SSA) faces chronic food insecurity despite possessing approximately 60% of the world’s uncultivated arable land. Field trials generate evidence but are costly and insufficiently scaled to address accelerating climate and demographic pressures. Digital twin (DT) technology, defined as the continuous, bidirectional virtual replication of physical systems using real-time data, supports monitoring, modelling, and optimisation of agrifood systems. To our knowledge, however, no published synthesis has examined DT agriculture research through the lens of SSA food systems or smallholder farming realities. A PRISMA-compliant systematic review was conducted across bibliographic databases using a pre-defined Boolean search and adapted PICOS eligibility …


The Roddey Mcmillan Record - November 25, 2025, Winthrop University Nov 2026

The Roddey Mcmillan Record - November 25, 2025, Winthrop University

The RMR 2020-2029

The Roddey McMillan Record (RMR) is Winthrop’s monthly multicultural student publication. The RMR has been a significant voice of the minority population of the Winthrop community since its creation by Gail Harris in April 1986. It promotes awareness and understanding of issues concerning minorities for the prosperity of the entire Winthrop community. The purpose of the RMR is to shine light on the many diverse cultures at Winthrop, focusing on issues, concerns and happenings of those who represent the multicultural community on campus. The Roddey McMillan Record is named after Dr. Cynthia Roddey and Atty, Sheila McMillan. Cynthia Roddey was …


Lost In Chaos: The Battle Between Selfcare And Motherhood, Sarah Shahzad Nov 2026

Lost In Chaos: The Battle Between Selfcare And Motherhood, Sarah Shahzad

MS Marketing Research Projects/Theses

Motherhood in collectivist societies such as Pakistan is deeply intertwined with caregiving, leaving limited space for women’s self-care or personal well-being. This study explores how young Pakistani mothers negotiate self-care within competing expectations of maternal sacrifice, cultural morality, and structural constraints. Guided by the Institutional Logics Perspective (ILP), it examines how familial norms, religious values, and market forces collectively shape women’s self-care practices, framing self-care not as an autonomous act but as a negotiated process embedded within social and institutional boundaries. This study adopts an interpretive phenomenological approach to explore how Pakistani mothers experience and negotiate self-care within cultural and …


A Finite Element Model For Thermomechanical Stress-Strain Fields In Transversely Isotropic Strain-Limiting Materials, Saugata Ghosh, Dambaru Bhatta, S. M. Mallikarjunaiah Nov 2026

A Finite Element Model For Thermomechanical Stress-Strain Fields In Transversely Isotropic Strain-Limiting Materials, Saugata Ghosh, Dambaru Bhatta, S. M. Mallikarjunaiah

School of Mathematical & Statistical Sciences Faculty Publications

This paper presents a comprehensive computational framework for investigating thermo-elastic fracture in transversely isotropic materials, where classical linear elasticity fails to predict physically realistic behavior near stress concentrations. We address the challenge of unphysical strain singularities at crack tips by employing a strain-limiting theory of elasticity. This theory is characterized by an algebraically nonlinear constitutive relationship between stress and strain, which intrinsically enforces a limit on the norm of the strain tensor. This approach allows the development of very large stresses, as expected near a crack tip, while ensuring that the corresponding strains remain physically bounded. A loosely coupled system …


Lrq-Solver: A Transformer-Based Neural Operator For Fast And Accurate Solving Of Large-Scale 3d Pdes, Peijian Zeng, Guan Wang, Haohao Gu, Xiaoguang Hu, Tiezhu Gao, Zhuowei Wang, Aimin Yang, Xiaoyu Song Nov 2026

Lrq-Solver: A Transformer-Based Neural Operator For Fast And Accurate Solving Of Large-Scale 3d Pdes, Peijian Zeng, Guan Wang, Haohao Gu, Xiaoguang Hu, Tiezhu Gao, Zhuowei Wang, Aimin Yang, Xiaoyu Song

Electrical and Computer Engineering Faculty Publications and Presentations

Solving large-scale PDEs on complex three-dimensional geometries remains a central challenge in scientific and engineering computing, often due to expensive pre-processing stages and high computational overhead. We present Low-Rank Query-based PDE Solver (LRQ-Solver), a physics-integrated deep learning framework for efficient CAE simulations of complex three-dimensional geometries in CAD-driven design analysis. Built upon the Parameter-Conditioned Lagrangian Modeling (PCLM) that embeds physical consistency into the learning process and the Low-Rank Query Attention (LR-QA) module that reduces attention complexity from O(N2) to O(NC2+C3) via covariance decomposition, LRQ-Solver supports multi-configuration analysis within iterative design workflows. On two benchmark datasets, it achieves a 28.6% error …


Assessing Awareness And Use Of Artificial Intelligence Tools Among Library Personnel In Public And Private Institutions In Ekiti State, Nigeria, Thomas Aanu Ojo Oct 2026

Assessing Awareness And Use Of Artificial Intelligence Tools Among Library Personnel In Public And Private Institutions In Ekiti State, Nigeria, Thomas Aanu Ojo

Library Philosophy and Practice (e-journal)

Artificial Intelligence is a technology integrated into libraries as a tool to help eliminate tedious and repetitive tasks. However, its awareness and use in libraries are still in the early stages. Therefore, this study investigated the awareness and use of AI tools among library personnel in public and private institutions in Ekiti State, Nigeria. The study population comprised 107 library personnel in Ekiti State. The questionnaire was used to elicit data. Descriptive statistics of frequency count, percentage, mean and standard deviation were used to analyse the data. The findings revealed that the level of awareness of AI tools among library …


Voucher Reliance And Tuition Determination In Private K-12 Schools: A Quantitative Analysis Of Florida Schools Under 500 Students, Rebekah A. Kogelschatz Oct 2026

Voucher Reliance And Tuition Determination In Private K-12 Schools: A Quantitative Analysis Of Florida Schools Under 500 Students, Rebekah A. Kogelschatz

PhD in Education

The purpose of this quantitative survey study was to investigate the relationship between voucher dependency and tuition-setting practices among leaders of private K-12 schools in Florida with fewer than 500 students. Guided by resource dependence theory, the study examined school leaders’ perceptions of scholarship funding, tuition income, affordability, sustainability, timing, and flexibility in tuition-setting decisions, as well as the adequacy of current scholarship amounts. A quantitative, non-experimental survey design was used. The sample included 85 decision-making school leaders from private K-12 schools in Florida whose roles involved financial or tuition-setting decisions. Data were analyzed using descriptive statistics, reliability analysis, confirmatory …


Engl 426: Editing And Production Workshop (Syllabus), Lytton Smith Ph.D. Oct 2026

Engl 426: Editing And Production Workshop (Syllabus), Lytton Smith Ph.D.

School of Arts & Sciences

This syllabus was developed by SUNY Geneseo Professor Lytton Smith for the fall 2026 semester.

Course Learning Outcomes

  1. Students will demonstrate knowledge of editing practices, including manuscript review and selection, and correspondence with contributors.
  2. Students will show proficiency at a variety of practical aspects of publishing such as copyediting, proofreading, layout, creating advertising, and soliciting work from SUNY writers and artists.
  3. Students will demonstrate knowledge of contemporary literary journals.
  4. Students will show ability to work collaboratively.


Sanctified Rhythms Of Rest: Reclaiming Sabbath And Spiritual Retreat For Pastoral Renewal And Burnout Mitigation In The Georgia Assemblies Of God, Philip Sosebee Oct 2026

Sanctified Rhythms Of Rest: Reclaiming Sabbath And Spiritual Retreat For Pastoral Renewal And Burnout Mitigation In The Georgia Assemblies Of God, Philip Sosebee

Doctor of Ministry (DMin)

“Sanctified Rhythms of Rest: Reclaiming Sabbath and Spiritual Retreat for Pastoral Renewal and Burnout Mitigation in the Georgia Assemblies of God” explored how intentional rhythms of Sabbath observance, solitude and silence, and spiritual retreat shaped the lived experiences of credentialed ministers within the Georgia District of the Assemblies of God. Pastoral burnout, emotional exhaustion, and unsustainable ministry expectations continue to affect ministers across denominational contexts, raising questions regarding the role of biblically grounded rhythms of rest in fostering pastoral renewal and sustainability. Using a six-month longitudinal hermeneutic phenomenological design, twenty-nine credentialed ministers participated in the intentional practice of weekly Sabbath …


Burden Of Disease In Us Patients With Skeletal Versus Muscular Or Pain Manifestations Of Hypophosphatasia: An Analysis From The Global Hpp Registry., Priya S. Kishnani, Steven Ing, Julie Hoover-Fong, J Carl Pallais, Angie Voskopoja, Shona Fang, William R Mowrey, Eric Rush, Kathryn Dahir Oct 2026

Burden Of Disease In Us Patients With Skeletal Versus Muscular Or Pain Manifestations Of Hypophosphatasia: An Analysis From The Global Hpp Registry., Priya S. Kishnani, Steven Ing, Julie Hoover-Fong, J Carl Pallais, Angie Voskopoja, Shona Fang, William R Mowrey, Eric Rush, Kathryn Dahir

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Hypophosphatasia (HPP) is a metabolic disorder characterized by deficient alkaline phosphatase (ALP) activity, defective mineralization of bones and teeth, and non-skeletal manifestations. We compared disease burden between patients with skeletal and non-skeletal manifestations.

METHODS: Data from US adults enrolled in the Global HPP Registry through July 2024 were analyzed to compare baseline characteristics, genetic testing results, functional outcomes, and patient-reported outcomes between participants with and without overt skeletal manifestations. Patients who had only dental manifestations were excluded.

RESULTS: Of 283 participants, 234 (82.7%) had skeletal manifestations (79.1% female; 89.3% White; median age 48.7 years) and 49 (17.3%) had only …