Digital Commons Network^™

Impact Of Age And Rurality On Colorectal Cancer Outcomes In The United States, Caitlyn Grunert, Meng Han Tsai, Charles R. Rogers, Sydney Howard, Rachel Hogg-Graham, Courtney Martin, Darwin Conwell, Adetunji T. Toriola, Avinash Bhakta, Justin Moore

Surgery Faculty Publications

Background: While overall colorectal cancer (CRC) rates have declined in the United States (U.S.), early-onset CRC (EO-CRC), diagnosed before age 50, has increased. Rural U.S. residents face higher CRC incidence than non-rural counterparts. We aimed to examine the relationship between age at diagnosis and EO-CRC outcomes and whether rurality modify these associations. Methods: We analyzed data from 835,907 patients aged 20–79 years in the 2006–2020 SEER Program. Rurality was defined using U.S. Department of Agriculture Rural–Urban Commuting Area (RUCA) codes. Multivariable logistic regression models were used to examine associations between age, rurality, and late-stage CRC diagnosis. Competing-risk regression models were …

Surgical Nodal Sampling Established By Commission On Cancer Standard 5.8 Is Essential For Accurate Lung Cancer Staging, Raheem Bell, Amanda B. Francescatti, Daniel Boffa, Timothy W. Mullett, Matthew A. Facktor, Nirmal K. Veeramachaneni, Ryan C. Jacobs, Frank Schneider, Tina J. Hieken, David D. Odell, Ronald J. Weigel

Surgery Faculty Publications

Objective Accurate mediastinal staging is critical for the effective treatment of non–small cell lung cancer because lymph node involvement significantly influences prognosis and therapeutic decisions. We sought to evaluate the diagnostic accuracy, limitations, and complementary roles of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), cervical mediastinoscopy, and surgical lymph node sampling in mediastinal staging of non–small cell lung cancer. Methods A systematized literature review was performed using PubMed and national guideline repositories. Studies were included if they reported or provided sufficient data to calculate the negative predictive value (NPV) for EBUS-TBNA, mediastinoscopy, or surgical lymph node sampling. Data were synthesized qualitatively …

Validating Ai Through Evaluation, Keith Porcaro, Carmela D'Antuno, Wilson Jeter, Bridgett Kohno, Alexander Mcelya, Nicolas Osorio, Melinda Xiaong, Demi Yang

Duke Center on Law & Technology

Stewards of legal information sites are facing enormous funder and partner pressure to "do AI" — but validating the quality of AI implementations remains a critical challenge, especially for client-facing applications. In the spring of 2026, the Duke AI Audits practicum worked with Scale Justice to help articulate the true foundational costs of scoping and building a generative AI application on a statewide LawHelp site.

Imaging Performance Analysis Of Euv Mask Stacks For Sub-24 Nm Features At High And Hyper Numerical Aperture, Abdusame Omran N. Berish

Theses

As extreme ultraviolet (EUV) lithography advances toward high numerical apertures (NAs) of 0.55 and 0.75, mask-3D effects degrade image fidelity, limiting resolution and the process window. This work investigates the performance of alternative EUV absorber materials for sub-12 nm half-pitch patterning under high-NA and hyper-NA conditions. The lithographic simulations were conducted using the PROLITH Maxwell rigorous model under dipole illumination optimized for sub-24 nm resolution dense line/space features. The EUV mask stacks were derived from five fabricated and tested absorbers: TaBN, Ru/Ta, Pt2W, Ni/CrN, and TaSi2.  The absorber thickness was recalibrated to an optimal value, ensuring a maximum normalized image …

Building Qualitative Research Capacity In The Global Health Workforce And Developing A Community Of Practice In Parts Of Sub-Saharan Africa: A Case Study, Jack Lumsdon, Catherine Dotchin, Albert Akpalu, Benedict Calys-Tagoe, Dilraj Sokhi, Momodou Cham, Njideka Okubadejo, Richard Morton, Violet Naanyu, Richard Walker

Internal Medicine, East Africa

Background Qualitative research offers unique insights into the lived experience of individuals with chronic conditions which can tie directly into public health priorities and identifying the need for additional support. More participatory approaches and qualitative data surrounding chronic diseases are needed in sub-Saharan Africa (SSA). Valuable “insider” insights are often missing as the conceptualisation of research often overlooks the value of such interactions. For successful and meaningful global health research, it is imperative to involve in-country experts and strengthen the capacity of research teams with qualitative skills.

Methods To address this, two hybrid qualitative research skills workshops were conducted in …

Renal Adverse Effects Of Antiangiogenic Agents In A Tertiary Hospital In Kenya, Joan Wambugu, Joyce Bwombengi, Jasmit Shah, Manel Haj Mansour

Internal Medicine, East Africa

Introduction Anti-angiogenic therapies, including vascular endothelial growth factor (VEGF) inhibitors and tyrosine kinase inhibitors (TKIs), have transformed cancer management by targeting tumor vasculature and suppressing metastasis. However, these agents can induce renal toxicities such as hypertension, proteinuria, and acute kidney injury (AKI), which may affect treatment continuity and outcomes. Data from sub-Saharan Africa on these adverse effects remains scarce.

Methods This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Nairobi, oncology clinic. Medical records of adult patients receiving anti-angiogenic therapy between January 2020 and December 2024 were reviewed. Demographic data, comorbidities, treatment regimens, renal parameters, and …

Evolution Of Antibiotic Responses During Chronic P. Aeruginosa Infections In The Human Lung, David Frank Ritz

Dartmouth College Ph.D Dissertations

Typical antibiotic susceptibility testing (AST) of microbial samples is performed in homogeneous cultures in batch environments, which does not account for the highly heterogeneous and dynamic nature of antibiotic responses. The most common mutation found in P. aeruginosa lineages evolved during chronic cystic fibrosis infections in the human lung, a loss of function of repressor MexZ, increases basal levels of multidrug efflux MexXY, but does not increase resistance by traditional minimal inhibitory concentration (MIC) assays. Here, we use single cell microfluidics to show that P. aeruginosa’s response to aminoglycosides is highly heterogeneous, with only a subpopulation of cells surviving exposure. …

Transfusion In Transit: A Decade Of Prehospital Blood Transfusion In Pediatric Trauma, Krysta M Sutyak, Eunise C Chen, Lea Mock, Rudolfo Cabrera, Jeannette M Joly, Kuojen Tsao, Bryan A Cotton, David E Meyer, Charles S Cox, Kevin P Lally, Natalie A Drucker

The Brown Foundation: Institute of Molecular Medicine

Background: Prehospital blood transfusion improves mortality in adults, with limited evidence in children. This study describes prehospital blood transfusion in pediatric trauma patients and the impact on shock index, pediatric adjusted (SIPA).

Methods: This study is a retrospective cohort study of trauma patients younger than 18 years who received blood transfusions during helicopter transport to a Level 1 pediatric trauma center from 2011 to 2023. Primary outcome was change in SIPA at time of emergency department (ED) arrival with prehospital transfusion. Secondary subgroup analysis was performed based on transport origin.

Results: Of 137 patients, 58% (80 of 137 patients) were …

Affinity-Optimized Trop2 Antibodies Support Potent Antitumor Activity In Antibody-Drug Conjugates, Aiko Yamaguchi, Junping Hong, Leike Li, Kiyotaka Kobayashi, Chisato M Yamazaki, Summer Y Y Ha, Yasuaki Anami, Wei Xiong, Junquan Liu, Zhiqiang An, Ningyan Zhang, Kyoji Tsuchikama

The Brown Foundation: Institute of Molecular Medicine

Background: Trophoblast cell surface antigen 2 (TROP2) is frequently overexpressed in epithelial tumors and is associated with poor prognosis, making it an attractive therapeutic target. Antibody-drug conjugates (ADCs) directed against TROP2 show clinical benefit, but expression in normal tissues such as skin raises concerns about on-target, off-tumor toxicity. Strategies that improve antitumor efficacy without increasing toxicity are needed.

Methods: Using an in-house phage library, we identified and characterized a novel fully human monoclonal antibody recognizing a unique conformational epitope of TROP2 with reduced binding affinity. This antibody was engineered into homogeneous ADCs carrying auristatin and/or duocarmycin payloads. Comparative studies with …

Telomerase Knockout In Myeloid Cells Predisposes Mice To Foam Cell Formation, Dyslipidemia, Lung Fibrosis, And Cardiac Dysfunction, Zhanguo Gao, Yongmei Yu, David Wiggins, Eva M Sevick-Muraca, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

Aging-associated changes in myeloid cells are incompletely understood. One of the culprits of aging is the downregulation of the Tert gene coding for the catalytic subunit of telomerase. Studies of mouse models with Tert knockout (KO) in specific cells have revealed the importance of the telomere-independent noncanonical function of TERT in supporting mitochondrial metabolism and protection from cell senescence. To investigate the role of TERT in myeloid cells (MCs), we analyzed mice with Tert KO in the LysM+ lineage, indelibly labeled with membrane green fluorescent protein (mG). Macrophage numbers and properties in various organs were compared. Changes in the vasculature, …

Describing Psychosocial Risk In The Mexican Working Population By Sex, Generation, And Industry: A Cross-Sectional Study, Courtney Blondino, Karla M. Téllez, Noémie Le Pertel, Ariel Joab Almazan, Lorna Friedman

Health Studies Faculty Publications

Objectives

Methods

Results

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Dark Wave - Comics And Transgender Studies In Practice, Mieke Vanderveen

Dartmouth College Master’s Theses

This is a thesis in two parts. Its goal is to provoke the intersection of superhero comics and transgender studies in order to interrogate the parallels between those two identities and explore ways in which pairing them together can strengthen each other narratively and academically. Rather than seeking an answer to a question, the project as a whole serves as a way of communicating trans internalities from a transfeminine perspective in a format that brings the issues to the forefront of the narrative in an in-depth and entertaining way. The result is hopefully a coherent artistic work that achieves those …

Active Measures, Jacob Campbell

Dartmouth College Master’s Theses

            Active Measures is a Cold War era espionage drama, written for television. In the story, two mid-level agents in a centrally located, yet functionally unimportant CIA station are scapegoated after a high-level defection is sabotaged by an unknown mole, resulting in the defector’s death. Having found intelligence sewn into the defector’s jacket, the agents, John O’Neil and Sam Rosen, attempt to pursue his lead and clear their names while under internal investigation.

The story is influenced by the moral ambiguity of espionage novels by Alan Furst and John le Carre, and the television series The Americans. Like these predecessors, …

Getting Across That Stage: Identifying And Addressing Barriers To Degree Completion For Undergraduates At A Selective Four-Year Institution, Karen G. Afre

Dartmouth College Master’s Theses

Selective institutions, like Dartmouth College, offer students extensive academic opportunities and institutional support. Despite large endowments and strong alumni networks that provide holistic support for students, selective institutions still experience student drop-out and extended time-to-degree. For Dartmouth undergraduate students who matriculated in Fall 2018, the six‑year graduation rate was 96%, while only 75% graduated within four years. This gap indicates that 25% of students took longer than four years to complete their degrees and 4% had not graduated within six years. 

This thesis examines barriers to college completion at selective institutions to inform retention efforts and institutional initiatives. I use …

2026 April, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for April of 2026.

Evaluating The Environmental Parameters Impacting Spawning Movement Of Gulf Sturgeon (Acipenser Desotoi) In The Bouie River System., Olivia St. Germain

Honors Theses

The anadromous Gulf Sturgeon (Acipenser desotoi) is federally listed as “threatened” and is natal to seven rivers from Louisiana to Florida. Only one spawning reach for Gulf Sturgeon natal to the Pascagoula River has been verified via the collection of eggs and larvae; a reach of the lower Bouie River. This reach is anthropogenically modified by four gravel mining formations, hereafter referred to as pits. The greater depths associated with this area have prompted previous researchers to suggest that Gulf Sturgeon may over-summer in pit formations instead of migrating to downstream holding areas in the Pascagoula River after spawning. The …

Generative Artificial Intelligence With A Human Touch: Building Hana, Conrad Johnson

Faculty Scholarship

This Essay examines how generative artificial intelligence (GenAI) can be integrated into legal education and public interest law practice in a way that meaningfully enhances — rather than diminishes — human judgment, professional responsibility, and access to justice. Drawing on the experience of Columbia Law School’s Lawyering in the Digital Age Clinic, the Essay situates GenAI within an experiential pedagogy that emphasizes competence, ethical awareness, and collaborative problem-solving. It argues that law students and lawyers must move beyond a passive or uncritical use of GenAI tools; toward a deeper understanding of how these systems operate, the risks they pose, and …

False Conflict: Colorblindness And Section 2 Of The Voting Rights Act, W. Kerrel Murray

Faculty Scholarship

If friends and foes of section 2 of the Voting Rights Act of 1965 agree on one thing, it is the irrepressible conflict between section 2’s attention to race and constitutional colorblindness.  They’re wrong.  Rightly understood, section 2’s design is remarkably compatible with colorblind constitutionalism’s letter and spirit.

To show how, this Article first returns to section 2’s origins and the preexisting approach its text codifies.  That approach had an underappreciated ethos:  When intentional discrimination’s effects sufficiently distort a political system, an electoral rule’s results might impugn its unconstitutionality, even if the rule had been adopted without discriminatory purpose.  Drawing …

How To Transform Capitalism Through Law, Katharina Pistor

Faculty Scholarship

This essay is based on the presentation of my book, The Law of Capitalism and How to Transform It, at the University of Miami Law School on October 14, 2025. I am grateful for the opportunity to share a summary of this work in the University of Miami Law Review and to my colleagues Ingo Venzke and Martijn Hesselink, who were kind enough to offer their thoughts on it for this mini symposium.

Agenda Control And Precedent, Thomas P. Schmidt

Faculty Scholarship

The U.S. Supreme Court now has vast control over its agenda: It has the power to pick and choose not only what cases it will hear through writs of certiorari, but also what specific legal questions within those cases it will consider. As a result, the Court never revisits a precedent unless it has made a prior, discretionary choice to put the viability of a precedent on its agenda. For that reason, the Court’s powers of agenda control play a significant and underappreciated role in maintaining the continuity of the legal order. Indeed, it is no surprise that the formal …

Bad Faith Disregard Of Benefits And Science In Federal Environmental Deregulation, Michael B. Gerrard

Faculty Scholarship

Since the beginning of the Reagan administration in 1981, federal agencies have used cost-benefit analysis when making important policy decisions, especially when issuing regulations. In the years since then the methodologies have been refined and enshrined in White House guidance. The second Trump administration has upended these practices by often ignoring the benefits of regulations and only considering the costs. In doing so it often claims that there are such uncertainties about the benefits that they should be disregarded. It uses these claims in support of repealing or softening regulations that prior administrations found would save thousands of human lives.

Thinking Constructively About International Law, Monica Hakimi

Faculty Scholarship

The international order that has defined the post-World War II period is being radically transformed, presenting a once-in-a-generation opportunity to reconstitute its basic foundations. The pressing questions for international lawyers are about the roles their enterprise can and should play going forward. I argue in this Article that most lack the analytic framework they need even to begin tackling these questions. Worse, most seem mired in an old theory about law that corrupts how they approach their enterprise. My goals in the Article are to expose the prevalence of this bad theory and to present the grounds for discarding it, …

Uncomfortably Reminiscent: Odonnell V. Harris County In History And Memory, Kellen R. Funk

Faculty Scholarship

In ODonnell v. Harris County, a federal trial court enjoined the misdemeanor bail system of Houston, Texas, freeing approximately 20,000 indigent defendants annually. To do this, the trial court drew upon Reconstruction era precedents establishing intensive federal oversight of state criminal proceedings. The court explicitly invoked the Civil War and Reconstruction transformation of the federal judiciary, comparing the County’s defenses to slavery era arguments. Conversely, when the en banc Fifth Circuit reviewed a similar order in Dallas, Texas, six years later, it rejected this historical framework, condemning such litigation as an impermissible “ongoing federal audit of state criminal proceedings.” …

Tfeb Degradation Is Regulated By An Ikk/Β-Trcp2 Phosphorylation-Ubiquitination Cascade, Yan Xiong, Jaiprakash Sharma, Meggie N Young, Wen Xiong, Ali Jazayeri, Karl F Poncha, Ma Xenia G Ilagan, Qing Wang, Bei Gao, Hui Zheng, Nicolas L Young, Marco Sardiello

Center on Aging Staff Publications

Transcription factor EB (TFEB) is a master regulator of lysosomal biogenesis and cellular clearance pathways. TFEB activity is tightly controlled by multiple post-translational mechanisms, but the exact molecular mechanism controlling its stability has remained elusive. Here, we identify the IκB kinase (IKK) complex as a key regulator of TFEB protein stability through a phosphorylation-ubiquitination cascade. A high-content kinase inhibitor screen reveals that IKK inhibition increases TFEB protein levels, and genetic ablation of IKK components increases TFEB stability, upregulates lysosomal genes, and enhances lysosomal biogenesis and degradative capacity. Mechanistically, we show that IKK phosphorylates TFEB on a cluster of serine residues …

Leveraging Wearables And Vehicle Technologies To Automate Injury Severity Detection, Alexander Macgregor

Honors Capstone Projects and Theses

No abstract provided.

Bodies As Vessels: (Re)Production, Consumption, And Female Identity In The Handmaid’S Tale And Dawn, Shelby Clark

Honors Theses

This honors thesis examines how reproduction and food are used to signify power and impact female identity in Margaret Atwood’s The Handmaid's Tale and Octavia Butler’s Dawn. Both feminist dystopian novels portray societies that secure futurity through the commodification and management of women's domestic labor. The protagonist of each novel, Offred in The Handmaid's Tale and Lilith in Dawn, is responsible for ensuring the survival of humanity through forced reproduction and is additionally expected to produce or manage food. In this thesis, I argue that in both novels, female identity is reclaimed and affirmed as separate from a commodified state …

Natural Language Generation In Healthcare: A Review Of Methods And Applications, Mengxian Lyu, Xiaohan Li, Ziyi Chen, Jinqian Pan, Cheng Peng, Sankalp Talankar, Yonghui Wu

Faculty, Staff and Student Publications

Objective: This study presents a systematic review of natural language generation (NLG) methods and applications in the medical domain, providing quantitative and qualitative analyses to answer four key research questions regarding methods, evaluation, applications, and challenges of NLG in healthcare.

Methods: We searched PubMed, ACM Digital Library, Web of Science, Science Direct, Scopus, Embase, and ACL Anthology for NLG-related studies in healthcare from 2018 to 2024. Out of 3,988 research articles, 113 met the inclusion criteria and were analyzed across data modality, model architecture, evaluation metrics, and application domain.

Results and conclusion: NLG in healthcare has grown substantially, with annual …

A New Standard: Default Inclusion Of Children In Clinical Trials, Megyn Gordon

Colorado Law Student Scholars

No abstract provided.