Digital Commons Network^™

Identifying The Best Cutoff Value Of The Fecal Occult Blood Immunochemical Test In The Detection Of Advanced And Neoplastic Colorectal Lesions [Identificación Del Mejor Punto De Corte De La Prueba Inmunoquímica De Sangre Oculta En Heces En La Detección De Lesiones Colorrectales Avanzadas Y Neoplásicas], Patricia Gaggero, Eduardo Fenocchi, Cecilia Silva, Juan C. Lopez-Alvarenga, Natalia Lambert, Fabian Batista, Sergio Sobrino-Cossio, Jonathan R. White, Adolfo Parra-Blanco

School of Medicine Publications

Objective: Screening is an effective tool for detecting colorectal lesions in asymptomatic subjects. There is a positive correlation between fecal immunochemical test (FIT) values and the size of tumors. Despite the efficacy of screening, the detection of colorectal cancer (CRC) remains low. The primary objective was to evaluate the best FIT cutoff value for detecting advanced adenomas and CRC among individuals at average risk in a country with a high incidence and morbidity from CRC.

Methods: This observational and prospective study analyzed consecutive cases in 1461 asymptomatic subjects with a positive FIT (≥ 100 ng hemoglobin [Hb]/ mL) referred for …

Dissolution Or Restructuring? Fiscal Implications For Taxpayers In Special Tax Districts: A Case Study Of The Reedy Creek Improvement District, Tasha Huber

MPA/MPP/MPFM Capstone Projects

Although extensive research has examined the creation and function of special tax districts in the U.S., little research has been done regarding the fiscal and governance implications of dissolution of these entities. This study examines the fiscal outcomes of dissolution versus restructuring special districts, using the former Reedy Creek Improvement District as the primary case study. Using a qualitative approach, the analysis compares restructuring and dissolution cases in California, Vermont, and Tennessee. Drawing on publicly available material such as financial documents, media coverage, and legislative records, this research evaluates impacts on taxpayer burden. Findings suggest that dissolving large, active special …

Expenditure Management Strategies For Long-Term Fiscal Sustainability In South Korea, Jaehyun Ryu

MPA/MPP/MPFM Capstone Projects

This capstone examines strategies for managing government expenditures to secure long-term fiscal sustainability in South Korea. Although South Korea currently maintains a relatively low public debt-to-GDP ratio compared with other OECD countries, rapid population aging, slowing economic growth, and the continued expansion of mandatory expenditures pose significant long-term fiscal risks. Given the political and economic constraints associated with tax increases and growth-led debt management, this study focuses on expenditure management as a primary and feasible policy instrument for sustaining fiscal soundness.

The research combines empirical analysis with comparative case studies. First, the study examines the relationship between government debt and …

A Comparative Policy Analysis Of Lung Cancer, Maternal Mortality, And Obesity, Destiny M. Rucker, Rhonda M. Lawson, Trinity Olmstead

MPA/MPP/MPFM Capstone Projects

Kentucky has significantly poorer outcomes than peer states across key women's health indicators. This capstone focuses on lung cancer, maternal mortality, and obesity to evaluate the structural and policy factors behind these disparities. Using a quantitative comparative research design, the study analyzes secondary data from sources including CDC WONDER, the Behavioral Risk Factor Surveillance System (BRFSS), America’s Health Rankings, and the March of Dimes. Data were analyzed in Excel to create comparative figures, benchmarking Kentucky’s outcomes against the U.S. average and four regional peer states: Tennessee, Indiana, Illinois, and Virginia. These states were chosen for their demographic and geographic similarities …

Ai Data Center Boom: An Analysis Of Economic And Legislative Impacts, Shelby Jackson

MPA/MPP/MPFM Capstone Projects

The United States is currently experiencing an Artificial Intelligence (AI) data center boom due to increased demand for generative AI following the launch of models such as ChatGPT. Data centers, particularly hyperscale data centers, have become a flashpoint due to environmental and public health concerns, along with rising utility costs. Although more than 70% of Americans do not want data centers in their community, state and local governments often offer tax incentives to attract data center development with the aim of job creation and tax revenue.

This study assessed whether the financial benefits that AI data centers may offer state …

A Comparative Analysis Of Governance And Financial Frameworks In Public Transit Systems: A Case Study Of Lextran And Peer Transit Agencies, Kelin E. Beattie

MPA/MPP/MPFM Capstone Projects

Public transportation serves as a vital community "lifeline," providing essential mobility for the 45% of Americans without private vehicle access and generating a 5-to-1 economic return on investment. This research investigates a critical fiscal paradox within Lextran, the transit authority for Lexington, Kentucky: despite achieving a cost per passenger trip 22% lower than the national peer average, the agency faces a $25.95 million unfunded capital gap over the current five-year planning horizon. Utilizing a comparative case study methodology, this paper evaluates the "rules of the game"—the hybrid governance and fiscal frameworks—that influence long-term financial sustainability.

The study benchmarks Lextran against …

Balancing Accountability And Efficiency: A Policy Review Of The City Of Toledo's Purchasing Contract Threshold, Jennifer L. Baskey

MPA/MPP/MPFM Capstone Projects

Municipal procurement policies are intended to balance fiscal accountability with the efficient acquisition of goods and services necessary to support public operations. One of the primary mechanisms used to achieve this balance is the establishment of purchasing thresholds that determine when formal contracts are required. While these controls are essential for protecting public resources, procurement policies should also evolve to reflect changing economic conditions and contemporary public-sector management practices.

The City of Toledo currently requires formal contracts and legislative approval for purchases exceeding $10,000 pursuant to Toledo Municipal Code, Chapter 13, Section 228 (City of Toledo Municipal Code, 2026). This …

Allocation And Governance Of Opioid Response Funding In Rural Kentucky: A Case Study Of The Big Sandy Area Development District, Hayley M. Mccarty

MPA/MPP/MPFM Capstone Projects

The opioid epidemic continues to present significant public health, economic, and administrative challenges throughout the United States, with rural Kentucky experiencing some of the nation's highest rates of opioid-related morbidity and mortality.

Effectively responding to this crisis requires not only adequate financial resources but also transparent governance, coordinated implementation, and accountability for how public funds are distributed.

This study examines the allocation, governance, and implementation of opioid response funding within the Big Sandy Area Development District (BSADD), a rural multi-county region in eastern Kentucky. Using a qualitative case study and policy analysis approach, the research evaluates four primary funding sources: …

Best Practices For Budgeting In Small Non-Profit Organizations: The Arts Commission Of Danville/Boyle County, Esther Rugerio

MPA/MPP/MPFM Capstone Projects

Nonprofit arts organizations face unique financial management challenges due to limited staffing, restricted funding sources, and fluctuating revenue streams. This thesis examines the Arts Commission of Danville/Boyle County located in Danville, KY. It identifies opportunities to strengthen financial oversight, accountability, and long-term sustainability. Using a qualitative research approach and document-based analysis, the study evaluated organizational budgets, governance documents, and nonprofit financial management best practices.

The findings revealed several areas for improvement, including reliance on line-item budgeting, recurring use of carry-forward funds, limited board financial oversight, fiscal sponsorship complexities, and a lack of formal financial policies. Recommendations include adopting a program-informed …

Should Kentucky Adopt A Formal Statewide Framework To Address The Local Fiscal Effects Of Tax-Exempt Public Universities On Host Communities?, Trina Shields, Catie Baumstark

MPA/MPP/MPFM Capstone Projects

Kentucky’s public universities provide significant educational, economic, and workforce development benefits to the Commonwealth. However, because these institutions are exempt from local property taxes, questions arise about the fiscal effects on the communities that host them. While the benefits generated by universities extend beyond municipal boundaries, the fiscal effects of tax-exempt property are often concentrated within host communities. As universities expand their campuses and acquire additional property, local governments may face increased demands for public services without a corresponding increase in property tax revenue.

This study examines whether Kentucky should adopt a formal statewide framework to address the local fiscal …

Defamation, Privacy, And The First Amendment: Cases & Problems (3rd Ed.), George Biashvili

Books

I created this resource in anticipation of teaching my Torts II class, which will primarily explore defamation and privacy torts. Though I searched for a suitable coursebook, I found that none contained all of the opinions I consider essential for teaching the nuances and complexities of these subjects. Additionally, I wanted to spare my students the exorbitant price tags associated with traditional law school texts. Hence, I assembled a collection of relevant privacy and defamation cases that align with the objectives of my course. Each case is accompanied by a set of questions to further stimulate class discussion. Where I …

Schelling & Spinoza, Michael Vater

Philosophy Faculty Research and Publications

Schelling is notorious for having a fluid vision of systematic philosophy and its methods. In an age where philosophy is expected to result in one or two books, not years of discussions with students and colleagues--and certainly not a distillation of one’s way of life--Schelling’s thought has been called protean or restless, or in Hegel’s snarky verdict “an education pursued in public.” The same could be said of Socrates. But there is a truth in these comments; it is difficult to find in fifty-six years of publications, addresses and abandoned manuscripts the single argument that is Schelling’s philosophy. What provokes …

Calculus In Context: The Five College Calculus Project, James Callahan, Kenneth Hoffman, David Cox, Donal O'Shea, Harriet Pollatsek, Lester Senechal

Open Educational Resources: Textbooks

Calculus in Context: The Five College Calculus Project is a thorough reframing of what it means to learn calculus. It starts with a “clean slate;” there is no presumptive commitment to any aspect of the traditional course. Instead, the curriculum is guided by the following principles:

• Calculus is fundamentally a way of dealing with functional relationships that occur in scientific and mathematical contexts. The techniques of calculus must be subordinate to an overall view of the underlying questions.
• Technology radically enlarges the range of questions we can explore and the ways we can answer them. Computers can be engaged as …

Metadata Extraction From Satellite Data Using Small Language Models, Ram Sharan Rimal

Theses

NASA’s GHG Center and VEDA platforms publish satellite Earth observation datasets through STAC catalogs. Publishing a new dataset requires a subject-matter expert to author the discovery configuration and catalog collection for the data, a task that takes three to five hours per dataset to complete. This work contributes a metadata curation pipeline that turns granules, the documentation, and usage examples into both files.Fields readable directly from the files, such as spatial and temporal extent, are extracted deterministically. Fields that require language understanding are sent to a locally hosted small language model. The small model infers the structure of the asset …

Limits On Damages For Breach Of A Forum Selection Clause, Coyle, John, Monestier, Tanya

Santa Clara Law Review

When a plaintiff sues in a court other than the one designated in a forum selection clause, the defendant’s remedial options are limited. It can ask the court to dismiss the case outright. Or it can ask the court to transfer the case to the designated forum. The defendant typically cannot, however, recover money damages—in the form of attorneys’ fees and related expenses—that it incurs in the course of persuading the court that transfer or dismissal is appropriate. This is because the conventional wisdom among judges has long been that damages are not available for breach of a forum selection …

Formal Neutrality And Unequal Liability: How Algorithmic Aversion Distorts Liability For Algorithmic Torts, Gao, Jingkang

Santa Clara Law Review

The shift in the cause of machine-induced harm from mechanical failures to algorithmic decision- making is challenging the applicability of products liability. Because algorithms now operate machines analogously to humans, a doctrinally coherent response is to subject algorithmic torts to a negligence framework that evaluates the reasonableness of decisions rather than the content of algorithms. This approach offers a theoretically grounded, formally neutral, and normatively appealing solution. In practice, however, it may result in unequal liability. Even under a negligence regime, algorithmic decision- makers may face systematically greater liability if injured parties are more inclined to pursue litigation against algorithmic …

Inexcusable? Building An Artificial Intelligence Micro- Expert On Contract Excuse Doctrine, Burge, Mark Edwin

Santa Clara Law Review

This Article details and advocates for a general methodology for creating a “microexpert” grounded in a user-defined set of legal sources and widely-accessible tools for integrating generative artificial intelligence (AI) into legal analysis. The study focuses particularly on background contract excuse doctrines of impossibility, impracticability, and frustration of purpose, which are collectively a methodologically challenging area of law to rationalize due to fact-intensive variables that undermine their predictability. Particular challenges include assessing the foreseeability of the event that led to the contract’s non-performance, the extent of the hardship or burden on the party seeking excuse, and the purpose of the …

An Elective Wealth Tax, Reis, Eric

Santa Clara Law Review

Foes of wealth inequality face a basic dilemma. Economic restraints make it impractical to tax income at the very high rates needed to address inequality, while constitutional restraints likely make it impossible to tax principal (wealth) directly.

This problem can be solved by marrying the two approaches. The wealthiest taxpayers would be put to a choice: Pay very high income tax rates, or pay more typical income tax rates along with a wealth tax. Because the proposed wealth tax would be voluntary, it should avoid the constitutional difficulties that bedevil a conventional wealth tax. And because the increase in income …

Constitutional Structures In Private Law And The Example Of Waste Law, Fraley, Jill M.

Santa Clara Law Review

This Article proposes three criteria for when a private law mechanism performs a structural constitutional function: when it constrains present authority in the name of future stability, when it disperses enforcement to avoid centralized authority, and when it has structural entrenchment to avoid ordinary displacement. While many private law doctrines contain constitutional resonances or echo rights, the core of constitutional law is the power structure—a precondition for the protection of those rights. Constitutional structures have three key components: self-binding through time, separation and diffusion of power, and entrenchment beyond ordinary politics. For a private law doctrine to do more than …

What Ai Can’T Say: Oral Competence In Legal Education, Ho, Cynthia M.

Santa Clara Law Review

This Article brings together two critical conversations rarely considered in tandem – the impact of generative AI (GenAI) on legal education and the need for more practical skills – and argues for a shared solution centered on oral communication skills. Law schools have historically devoted substantial attention to teaching students how to write like lawyers, but not how to speak like one. Although a long-standing imbalance, the widespread use of GenAI in written work provides an additional urgent reason to place more emphasis on oral assignments.

This Article argues that doctrinal classes offer an underused, scalable opportunity to develop oral …

Don’T Breathe In: The Dangers Of Ssm Events And Why Repealing Affirmative Defenses Falls Short, Spring, Gillian

Santa Clara Law Review

From the Louisiana and Texas Gulf coasts to Wilmington, California, communities face disproportionately high cancer risks linked to excess hazardous emissions. This article examines the longstanding regulatory gaps that allow industrial facilities to emit excess levels of hazardous air pollution during startup, shutdown, and malfunction (SSM) events. Despite the Clean Air Act’s enacted framework for controlling emissions, the EPA has created exemptions and affirmative defenses that shield polluters from civil penalties even when emissions exceed legal limits. Excess pollution emissions occur when air pollution levels exceed what is considered safe for human ingestion. When communities are subjected to certain pollutants, …

The Constitutional Ramifications Of Grants Pass, Galdamez, Alanis, Conway, Nicholas D., Slatkin, Ellen M.

Santa Clara Law Review

The brief and ambiguous wording of the Eighth Amendment has permitted courts to adopt a variety of interpretations. These interpretations have been applied inconsistently through different periods of the Amendment’s history, but the U.S. Supreme Court has never established a singular, definitive method for interpreting the Amendment. That is, until the 2024 decision in City of Grants Pass, Oregon v. Johnson, where the Court rejects any interpretation of the Eighth Amendment that is not strictly originalist in nature. This article analyzes the Court’s reasoning in Grants Pass and explores the potential consequences of adopting such a narrow interpretation of the …

Criminalizing Survival: How The Grants Pass Decision Is Intensifying The Homelessness Crisis In California And Beyond, Riley, Laura

Santa Clara Law Review

This article examines the intensifying criminalization of homelessness in the United States since the Supreme Court’s 2024 decision in Grants Pass v. Johnson, which removed the ability of people to challenge laws under the Eighth Amendment’s Cruel and Unusual Punishment Clause that prohibit survival behaviors in public places like sitting, sleeping, or lying down. The article explores the legal and practical challenges in documenting criminalization of homelessness, analyzes national and California-specific legislative trends and enforcement practices, and assesses the impacts on unhoused populations. The article concludes with policy recommendations to shift the state of homelessness criminalization from one of punitive …

The Rna-Binding Protein Hur Modulates The Expression Of The Disease-Linked Ccl2 Rs1024611g-Rs13900t Haplotype, Feroz Akhtar, Joselin Hernandez-Ruiz, Ya-Guang Liu, Roy G. Resendez, Denis Feliers, Liza D. Morales, Alvaro Diaz-Badillo, Donna M. Lehman, Rector Arya, Juan Carlos Lopez-Alvarenga, John Blangero, Ravi Duggirala, Srinivas Mummidi

School of Medicine Publications

CC-chemokine ligand 2 (CCL2) is involved in the pathogenesis of several diseases associated with monocyte/macrophage recruitment, such as HIV-associated neurocognitive disorder (HAND), tuberculosis, and atherosclerosis. The rs1024611 (alleles: A>G; G is the risk allele) polymorphism in the CCL2 cis-regulatory region is associated with increased CCL2 expression in vitro and ex vivo, leukocyte mobilization in vivo, and deleterious disease outcomes. However, the molecular basis for the rs1024611-associated differential CCL2 expression remains poorly characterized. It is conceivable that genetic variant(s) in linkage disequilibrium (LD) with rs1024611 could mediate such effects. Previously, we used rs13900 (alleles: C>T) in the CCL2 …

Associations Of Blood Pressure Level And Variability With Cortical Thickness: A Cross-Sectional Analysis From The Maracaibo Aging Study, Romeo De Leon, Shana Garza, Silvia Mejia-Arango, Kristina Vatcheva, Sokratis Charisis, Claudia L. Satizabal, Luis J. Mena, Joseph H. Lee, Joseph D. Terwilliger, Eron Manusov

School of Medicine Publications

Background: Although high blood pressure (BP) level and variability are associated with Alzheimer's Disease (AD), their relationship with cortical thickness in brain regions that are associated with AD is unclear. Furthermore, the role of 24-hour BP has not been examined. We investigated the associations of office and ambulatory BP measures with cortical thickness in brain regions implicated in AD.

Methods: We performed a cross sectional analysis of 304 participants without dementia from a population-based study with office and 24-hour BP and magnetic resonance imaging (MRI) data. We considered cortical thickness values derived from 10 regions throughout the frontal, parietal, and …

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 …

Spinning-Induced Exertional Rhabdomyolysis Without Acute Kidney Injury, Yolanda V. Gutierrez, Ronald Shaju, Alyssa L. Sepulveda, Joaquin Rivera, Aamir Ahmad

School of Medicine Publications

Rhabdomyolysis is a condition with a myriad of causes, including both traumatic and non-traumatic. Traumatic conditions are observed in crush injuries, compartment syndrome, and fractures, while non-traumatic rhabdomyolysis is commonly seen due to exertional heat stroke, extreme physical exercise, and dehydration. This case report explores two cases of extreme non-traumatic rhabdomyolysis caused by indoor cycling, also known as spinning. A common complication of severe rhabdomyolysis is acute kidney injury (AKI), which increases the risk of renal failure. Rapid interventions such as aggressive intravenous fluids are necessary to prevent kidney function loss. In this case report, two sisters, on two separate …

Breaking The Resistance: A Narrative Review Of The Evolution From Traditional Drugs To Precision Therapies In Epilepsy, Tirath Patel, Fathimathul Henna, Ashfaq Ahmed, Ayesha Ahmad, Noor Ul Huda, Syed Aaraiz Ul Hassan, Aiman Muhammad, Amna Javed, Maryem Filal, Nikhilesh Anand

School of Medicine Publications

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, affecting approximately 50 million individuals globally. While conventional antiseizure medications (ASMs) control seizures in 70-80% of patients, about 30% experience drug resistance or intolerable side effects, necessitating alternative approaches.

Objective: To critically compare the efficacy, safety, and accessibility of conventional and emerging therapies for epilepsy, particularly in the context of treatment-resistant cases and global disparities in care.

Methods: This narrative review synthesized evidence from 120 peer-reviewed articles published between 2015 and 2025. Literature was retrieved from PubMed, Embase, Cochrane Library, and Scopus using predefined search terms related to epilepsy …

Early Detection In Oral Cancer: Are We Prepared For Artificial Intelligence-Driven Precision Medicine?, Nikil Kumar, Sinnha Kumari, Sadia Sultana, Muhammad Saad Khan, Tirath Patel, Nikhilesh Anand

School of Medicine Publications

Oral cancer, particularly oral squamous cell carcinoma, remains a serious health concern, with a poor prognosis and a late diagnosis. Leukoplakia, erythroplakia, lichen planus, and submucous fibrosis are examples of oral potentially malignant disorders that must be detected early but are not always so by traditional, laborious, and subjective diagnostic techniques. In oral cancer, artificial intelligence (AI) and precision medicine are becoming game-changing technologies that enhance individualized care, treatment planning, and diagnostic precision. Complex imaging and histopathology data may be analyzed using machine learning and deep learning algorithms, particularly convolutional neural networks, which can identify patterns that are invisible to …

Hall Current And Nth Order Chemical Reaction Effects On Unsteady 3d Mhd Williamson Nanofluid Flow With Thermophoresis And Brownian Motion Over An Inclined Stretching Sheet, Polavarapu Sudheer, Ramachandra Reddy Vaddemani, Raghunath Kodi

Mansoura Engineering Journal

This study examines the influence of Hall current and nth-order chemical reaction on unsteady three-dimensional magnetohydrodynamic (MHD) Williamson nanofluid flow over an inclined stretching sheet. The model incorporates thermal radiation, heat source, Brownian motion, and thermophoresis effects. The governing nonlinear partial differential equations are transformed into a system of ordinary differential equations using similarity transformations and solved numerically using the shooting method with a fourth-order Runge–Kutta scheme. The results indicate that an increase in the magnetic parameter significantly reduces velocity profiles while enhancing temperature and concentration distributions. The Hall parameter reduces surface drag and improves heat transfer, while decreasing mass …