Digital Commons Network^™

“If Rules They Can Be Called”, Amy J. Griffin

Georgetown Law Faculty Publications and Other Works

Who gets to decide what counts as law? The weight of authority in the U.S. legal system is governed almost entirely by unwritten rules—social norms that establish which sources have weight (and how much weight they have). In 2016, Bryan A. Garner and twelve judges published a treatise essentially codifying unwritten rules related to the operation of precedent. That book, The Law of Judicial Precedent, has itself become a source of authority (on legal authority), cited by judges across jurisdictions. In this essay, I question whether the judicial norms governing the operation of precedent are appropriately presented as definitive blackletter …

Toward A Fully Implantable Ecosystem For Adaptive Neuromodulation In Humans: Preliminary Experience With The Cortec Braininterchange Device In A Canine Model, Gerwin Schalk, Samuel Worrell, Filip Mivalt, Alexander Belsten, Inyong Kim, Jonathan M Morris, Dora Hermes, Bryan T Klassen, Nathan P Staff, Steven Messina, Timothy Kaufmann, Jörn Rickert, Peter Brunner, Gregory A Worrell, Kai J Miller

2020-Current year OA Pubs

This article describes initial work toward an ecosystem for adaptive neuromodulation in humans by documenting the experience of implanting CorTec's BrainInterchange (BIC) device in a beagle canine and using the BCI2000 environment to interact with the BIC device. It begins with laying out the substantial opportunity presented by a useful, easy-to-use, and widely available hardware/software ecosystem in the current landscape of the field of adaptive neuromodulation, and then describes experience with implantation, software integration, and post-surgical validation of recording of brain signals and implant parameters. Initial experience suggests that the hardware capabilities of the BIC device are fully supported by …

A Process For Politics, Anna Gelpern

Georgetown Law Faculty Publications and Other Works

I argue that consistent and public process observance has a distinctly valuable function in sovereign debt restructuring, with no precise equivalent in national insolvency regimes. National regimes reflect the distribution bargains of their enactment, presumptively legitimate and binding. Debtors and creditors allocate insolvency losses in their shadow, with liquidation as a backstop and politics just outside the frame. All else equal, the restructuring process has a harder job with sovereign debt. There is no liquidation backstop and no default distribution scenario. Each crisis resolution episode must allocate losses from scratch among the country’s citizens, foreign and domestic creditors, and other …

The International Database Of Central Arterial Properties For Risk Stratification: Research Objectives And Baseline Characteristics Of Participants, Lucas S. Aparicio, Qi-Fang Huang, Jesus D. Melgarejo, Dong-Mei Wei, Lutgarde Thijs, Fang-Fei Wei, Natasza Gilis-Malinowska, Chang-Sheng Sheng, José Boggia, Teemu J. Niiranen

School of Medicine Publications

OBJECTIVE

To address to what extent central hemodynamic measurements, improve risk stratification, and determine outcome-based diagnostic thresholds, we constructed the International Database of Central Arterial Properties for Risk Stratification (IDCARS), allowing a participant-level meta-analysis. The purpose of this article was to describe the characteristics of IDCARS participants and to highlight research perspectives.

METHODS

Longitudinal or cross-sectional cohort studies with central blood pressure measured with the SphygmoCor devices and software were included.

RESULTS

The database included 10,930 subjects (54.8% women; median age 46.0 years) from 13 studies in Europe, Africa, Asia, and South America. The prevalence of office hypertension was 4,446 …

Hydroxychloroquine/Chloroquine For The Treatment Of Hospitalized Patients With Covid-19: An Individual Participant Data Meta-Analysis, Leon Di Stefano, Jane A. O'Halloran, Adriana M. Rauseo, Et Al

2020-Current year OA Pubs

BACKGROUND: Results from observational studies and randomized clinical trials (RCTs) have led to the consensus that hydroxychloroquine (HCQ) and chloroquine (CQ) are not effective for COVID-19 prevention or treatment. Pooling individual participant data, including unanalyzed data from trials terminated early, enables more detailed investigation of the efficacy and safety of HCQ/CQ among subgroups of hospitalized patients.

METHODS: We searched ClinicalTrials.gov in May and June 2020 for US-based RCTs evaluating HCQ/CQ in hospitalized COVID-19 patients in which the outcomes defined in this study were recorded or could be extrapolated. The primary outcome was a 7-point ordinal scale measured between day 28 …

Comprehensive Onboarding And Orientation To Support Newly Hired Faculty In A Nursing Program, Kylateia Farrar-Stern, Michele Sheridan Malin, Amber Young-Brice

College of Nursing Faculty Research and Publications

Background:

Nursing programs are challenged with retaining nurse faculty due to many complex factors, one being the problem of suboptimal transition to the role.

Purpose:

The purpose of this project was to assess the impact of an onboarding and orientation program, the Teaching Excellence Program (TEP), on the transition of newly hired nurse faculty.

Methods:

Program assessment data, including quantitative and qualitative measures of 14 participants' needs and experiences, were collected over one academic year.

Results:

A Wilcoxon signed-rank test found no discernible difference between the preprogram and postprogram survey responses. Qualitatively, participants reported positive experiences with the TEP, highlighting …

Mega‐Analysis Methods In Enigma: The Experience Of The Generalized Anxiety Disorder Working Group, André Zugman, Anita Harrewijn, Elise M. Cardinale, Hannah Zwiebel, Gabrielle F. Freitag, Katy E. Werwath, Janna Marie Bas-Hoogendam, Nynke A. Groenewold, Moji Aghajani, Anderson M. Winkler

School of Medicine Publications

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as …

Loss Of Function Of Wfs1 Causes Er Stress-Mediated Inflammation In Pancreatic Β-Cells, Shuntaro Morikawa, Lindsey Blacher, Chinyere Onwumere, Fumihiko Urano

2020-Current year OA Pubs

Wolfram syndrome is a rare genetic disorder characterized by juvenile-onset diabetes mellitus, optic nerve atrophy, hearing loss, diabetes insipidus, and progressive neurodegeneration. Pathogenic variants in the

Analysis Of Variation In Pre-Procedural Fasting Duration For Common Inpatient Gastrointestinal Procedures, Vorada Sakulsaengprapha, Michael Daniel, Jiarui Cai, Diego A. Martinez, Simon C. Mathews

2020-Current year OA Pubs

BACKGROUND: Gastrointestinal procedures generally require pre-procedural fasting to optimize sedation safety. While the American Society of Anesthesiologists (ASA) recommends no intake of clear liquids and solid food 2-4 and 6-8 hours respectively prior to endoscopic procedures, the actual nil per os (NPO) duration for these procedures in practice is unknown. Our objective was to analyze NPO duration for patients undergoing these procedures and to determine its association with clinical and administrative variables.

METHODS: Inpatient data from 2016-2018 for the three procedures was extracted from electronic medical records and administrative data at a single-center tertiary academic medical center. Various statistical tests …

Coronavirus Disease 2019 (Covid-19) Vaccine Breakthrough Infections Among Healthcare Personnel, December 2020-April 2021, Katelin B Nickel, Victoria J Fraser, Hilary M Babcock, Jennie H Kwon, Cdc Prevention Epicenters Program

2020-Current year OA Pubs

Coronavirus disease 2019 (COVID-19) vaccine effectiveness in the early months of vaccine availability was high among healthcare personnel (HCP) at 88.3% for 2-doses. Among those testing positive for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), those with breakthrough infection after vaccination were more likely to have had a non-work-related SARS-CoV-2 exposure compared to unvaccinated HCP.

Monosynaptic Targets Of Utricular Afferents In The Larval Zebrafish, Yizhen Jia, Martha W Bagnall

2020-Current year OA Pubs

The larval zebrafish acquires a repertoire of vestibular-driven behaviors that aid survival early in development. These behaviors rely mostly on the utricular otolith, which senses inertial (tilt and translational) head movements. We previously characterized the known central brainstem targets of utricular afferents using serial-section electron microscopy of a larval zebrafish brain. Here we describe the rest of the central targets of utricular afferents, focusing on the neurons whose identities are less certain in our dataset. We find that central neurons with commissural projections have a wide range of predicted directional tuning, just as in other vertebrates. In addition, somata of …

Academic Medical Center Clinical Research Professional Workforce: Part 2 - Issues In Staff Onboarding And Professional Development, Jacqueline M Knapke, Michelle Jenkerson, Peg Tsao, Stephanie Freel, Jessica Fritter, Shirley L Helm, Penelope Jester, H Robert Kolb, Angela Mendell, Megan Petty, Carolynn T Jones

2020-Current year OA Pubs

Background: Defining key barriers to the development of a well-trained clinical research professional (CRP) workforce is an essential first step in identifying solutions for successful CRP onboarding, training, and competency development, which will enhance quality across the clinical and translational research enterprise. This study aimed to summarize barriers and best practices at academic medical centers related to effective CRP onboarding, training, professional development, identify challenges with the assessment of and mentoring for CRP competency growth, and describe opportunities to improve training and professionalization for the CRP career pathway.

Materials/Methods: Qualitative data from a series of Un-Meeting breakout sessions and open-text …

Virtual Adaptation Of An International Exchange Program In Medical Education, Celia Fung, Nicholas Maxwell, Stephen Powell, Michelle Benassai, Natalia Chunga, Jennifer Corcoran, William Barbosa, Marisabel Lopez, Betsy Hanampa, Melissa Llaiqui-Condori, Victor Delgado-Lazo, Karina Mendoza, Yanet Astete, Martin Flor, Sheyla Palacios, Blanca Valdovinos, Jorge Risco, Isabel Camargo, Ralph Jozefowicz, Karlo J Lizárraga

2020-Current year OA Pubs

Medical education has drastically transformed during the COVID-19 pandemic. Measures such as adopting telemedicine visits, minimizing the number of trainees on service, discontinuing external rotations, and converting in-person to online didactics have been broadly and swiftly implemented. While these innovations have promoted greater interconnectivity amongst institutions and made continuing medical education possible, international exchange programs in medical education are still largely disrupted. In response to the changing guidelines and restrictions necessitated by the COVID-19 pandemic, the authors used Kern's six-step approach to design and implement a virtual curriculum to replace the in-person activities of the 2020-2021 Neurology Peru-Rochester exchange program …

Risk Based Day-Ahead Energy Resource Management With Renewables Via Computational Intelligence, Pratik Mochi, Kartik S. Pandya, Dharmesh Dabhi, Vipul N. Rajput

Research Outputs: 2025-Present

An indeterminate and variable nature of renewable energy sources like solar photovoltaic, wind power, load consumption, electric vehicles trips and market spot prices, make the operation and control of energy management system quite complex. Also, it is expected that the system should be consistent and resilient in case of extreme events like faults, hurricanes etc. This paper has used the risk based optimization strategies considering uncertainty of aforementioned parameters to minimize the operational cost of the aggregator. A 13-bus practical distribution system with 15-scenarios (03-scenarios as extreme events with high impact) are considered as a test system. WCCI-2018 award winning, …

China's Approach To Central Bank Digital Currency: Selectively Reshaping International Financial Order?, Heng Wang

Research Collection Yong Pung How School Of Law

China is likely to be the first major economy to issue central bank digital currency (CBDC), the digital version of sovereign currency. China’s CBDC is also known as e-CNY, DC/EP, or digital yuan. ECNY has the potential to profoundly affect the international financial system and order. This article explores the following crucial issues from an international perspective: what are the core features of e-CNY? What is China’s approach to CBDC? What is the long-term sustainability of China’s CBDC approach? This article argues that the role of the state, the potential cross-border use of e-CNY, and China’s proactiveness in international governance …

The Problems With Trade Secret Protection/Overprotection In Asia, Kung-Chung Liu

Research Collection Yong Pung How School Of Law

Trade secret protection law has been an important complement to patent law and has gained increasing importance over the last three decades, not least in Asia. Major Asian countries are now at a crossroads, as some (Japan, Korea, Thailand, Taiwan, and China) are following the US approach to criminalizing trade secret infringement and imposing harsher penalties on economic espionage (Japan, Korea, Taiwan, and China). This paper identifies many of the problems associated with trade secret protection, provides indicators of the overprotection of trade secrets, and warns against its many side effects. It then points out the crossroads that Asian economies …

Contractual Depth, Matthew C. Jennejohn, Cathy Hwang

Faculty Scholarship

Who is the intended audience of a contract? A court, who may be called upon to resolve a dispute, is one audience. Another is commercial communities, who punish breach with reputational sanctions, per the longstanding literature on informal enforcement. This article shows how modern contracts have more intended audiences than courts and communities—instead, they are drafted with many third parties in mind, including regulators. When contracts speak to many audiences, they gain multiple layers of meaning, giving them “contractual depth.” This article draws upon a series of novel interviews with dealmakers—law firm partners, general counsel, and executives—in a wide range …

Doctoral Physical Therapy Students' Increased Confidence Following Exploration Of Active Video Gaming Systems In A Problem-Based Learning Curriculum In The United States: A Pre-And Post-Intervention Study, Michelle E. Wormley, Wendy Romney, Diana Veneri, Andrea Oberlander

Physical Therapy Faculty Publications

Purpose: Active video gaming (AVG) is used in physical therapy (PT) to treat individuals with a variety of diagnoses across the lifespan. The literature supports improvements in balance, cardiovascular endurance, and motor control; however, evidence is lacking regarding the implementation of AVG in PT education. This study investigated doctoral physical therapy (DPT) students' confidence following active exploration of AVG systems as a PT intervention in the United States.

Methods: This pretest-posttest study included 60 DPT students in 2017 (Cohort 1) and 55 students in 2018 (Cohort 2) enrolled in a problem-based learning curriculum. AVG systems were embedded into patient cases …

Supported Decision-Making: Potential And Challenges For Older Persons, Morgan K. Whitlatch, Rebekah Diller

Articles

In recent years, supported decision-making (SDM) has gained traction as a recognized alternative to guardianship for persons with disabilities in the United States. To date, SDM has not been as widely recognized as an alternative for older people, particularly those struggling with cognitive decline. This paper explores some of the obstacles that have prevented SDM from being used more broadly by older people, identifies ways of surmounting some of those obstacles, and makes recommendations for ways that SDM can be used in the aging context.

Remote Justice & Domestic Violence: Process Pluralism Lessons From The Pandemic, Andrea K. Schneider, Heather Hlavka, Sameena Mulla, Erin Schubert, Aleksandra J. Snowden

Articles

Domestic violence procedures, like so many court processes around the world, were forced to go online and remote during the pandemic. The impact was dramatic—there were fewer restraining order petitions filed in the first place and an even lower amount granted. In short, domestic violence survivors, among the most vulnerable in our court system, were even more challenged in the last two years. Like many court systems, Milwaukee will never go back to being fully in-person for all procedures in conjunction with domestic violence. The evolving hybrid choices could provide additional access to justice, or these processes could create additional …

Dynamic Pricing Algorithms, Consumer Harm, And Regulatory Response, Alexander Mackay, Samuel Weinstein

Articles

Pricing algorithms are rapidly transforming markets, from ride-sharing, to air travel, to online retail. Regulators and scholars have watched this development with a wary eye. Their focus so far has been on the potential for pricing algorithms to facilitate explicit and tacit collusion. This Article argues that the policy challenges pricing algorithms pose are far broader than collusive conduct. It demonstrates that algorithmic pricing can lead to higher prices for consumers in competitive markets and even in the absence of collusion. This consumer harm can be initiated by a single firm employing a superior pricing algorithm. Higher prices arise from …

“A Force Created”: The U.S. Chamber Of Commerce And The Politics Of Corporate Immunity, Myriam E. Gilles

Articles

Upon its founding in 1912, the U.S. Chamber of Commerce was conceived as a “force created” to exert “a beneficent influence upon our national life” by integrating the views of the business community into governmental policies and regulations. That a force was created is beyond question. Beneficence is a separate issue.

Marian Fernandez Hernandez, Nadia Abulbaki

Latinx Civil Rights

Marian touches on cultural topics like the stereotypes or expectations descendants of a Hispanic American origin are placed under concerning social skills, education, occupation, etc. In addition, Marian discusses her family origins and education levels. The interview concludes with a comparison of Marian's views and experience of learning about Hispanic American history in Honduras to traditional American school learning.

Yoga Therapy During Chemotherapy For Early-Stage And Locally Advanced Breast Cancer, Samantha K Greaney, Neha Amin, Bethany C Prudner, Maggie Compernolle, Linda J Sandell, Susan C Tebb, Katherine N Weilbaecher, Peri Abeln, Jingqin Luo, Yu Tao, Angela C Hirbe, Lindsay L Peterson

2020-Current year OA Pubs

BACKGROUND: Chemotherapy is associated with decreased quality of life (QOL), fatigue, depression, and weight gain in patients with breast cancer. Weight gain is associated with poorer prognosis. Yoga improves QOL, fatigue, and mood in women with breast cancer but its effect on treatment-related weight gain has not been studied. The aim of this trial was to determine the feasibility of personalized yoga therapy in women receiving treatment for early-stage or locally advanced breast cancer and assess its impact on weight gain.

METHODS: Thirty women were randomized 1:1 to receive yoga therapy by a certified yoga therapist during treatment or a …

Evaluating The Implementation Of A Multi-Level Mhealth Study To Improve Hydroxyurea Utilization In Sickle Cell Disease, J S Hankins, A A King, A A Baumann, L M. Klesges, Et Al.

2020-Current year OA Pubs

BACKGROUND: Sickle Cell Disease (SCD) is a progressive genetic disease that causes organ damage and reduces longevity. Hydroxyurea is an underutilized evidence-based medication that reduces complications and improves survival in SCD. In a multi-site clinical trial, part of the NIH-funded Sickle Cell Disease Implementation Consortium (SCDIC), we evaluate the implementation of a multi-level and multi-component mobile health (mHealth) patient and provider intervention to target the determinants and context of low hydroxyurea use. Given the complexity of the intervention and contextual variability in its implementation, we combined different behavioral and implementation theories, models, and frameworks to facilitate the evaluation of the …

Psychiatric Diagnoses And Medications In Wolfram Syndrome, Angela M Reiersen, Jacob S Noel, Tasha Doty, Richa A Sinkre, Anagha Narayanan, Tamara Hershey

2020-Current year OA Pubs

BACKGROUND: Wolfram Syndrome is a rare genetic disorder usually resulting from pathogenic variation in the

OBJECTIVE: To examine lifetime psychiatric diagnoses and medication history in Wolfram Syndrome.

METHOD: Child, adolescent, and young adult Wolfram Syndrome participants (n=39) were assessed by a child & adolescent psychiatrist to determine best estimate DSM-5 lifetime psychiatric diagnoses as well as psychoactive medication history. In addition, the Child & Adolescent Symptom Inventory-5 (CASI-5) Parent Checklist was used to determine likely psychiatric diagnoses based on symptom counts in Wolfram Syndrome patients (n=33), type 1 diabetes (n=15), and healthy comparison (n=18) groups.

RESULTS: Study participants with Wolfram …

Assessing The Sustainability Capacity Of Evidence-Based Programs In Community And Health Settings, Caren Bacon, Sara Malone, Kim Prewitt, Rachel Hackett, Molly Hastings, Sarah Dexter, Douglas A Luke

2020-Current year OA Pubs

BACKGROUND: Within many public health settings, there remain large challenges to sustaining evidence-based practices. The Program Sustainability Assessment Tool has been developed and validated to measure sustainability capacity of public health, social service, and educational programs. This paper describes how this tool was utilized between January 2014 and January 2019. We describe characteristics of programs that are associated with increased capacity for sustainability and ultimately describe the utility of the PSAT in sustainability research and practice.

METHODS: The PSAT is comprised of 8 subscales, measuring sustainability capacity in eight distinct conceptual domains. Each subscale is made up of five items, …

Fentanyl Exposure In Preterm Infants: Five-Year Neurodevelopmental And Socioemotional Assessment, Kimberly P Mills, Rachel E Lean, Christopher D Smyser, Terrie Inder, Cynthia Rogers, Christopher C Mcpherson

2020-Current year OA Pubs

OBJECTIVE: To evaluate the association between cumulative fentanyl dose during neonatal intensive care and 5-year neurodevelopmental and socioemotional outcomes in very preterm infants.

MATERIALS AND METHODS: Patient demographics and clinical factors during the perinatal and neonatal course were collected in 84 patients born between 23- and 30-weeks gestational age (GA). Cumulative fentanyl dose during neonatal intensive care was calculated. Developmental testing at age 5 years included the Wechsler Preschool and Primary Scale of Intelligence Full-Scale Intelligence Quotient, Third Edition, Clinical Evaluation of Language Fundamentals-Preschool, Second Edition, Movement Assessment Battery for Children, Second Edition (MABC-2), and Shape School Assessment. Socioemotional outcomes …

The Human Myocardium Harbors A Population Of Naive B-Cells With A Distinctive Gene Expression Signature Conserved Across Species, Kevin C Bermea, Nicolas Kostelecky, Sylvie T Rousseau, Chieh-Yu Lin, Luigi Adamo

2020-Current year OA Pubs

INTRODUCTION: Cardiac immunology studies in murine models have identified a sizeable population of myocardial B-cells and have shown that its modulation represents a promising strategy to develop novel therapies for heart failure. However, scarce data on B-cells in the human heart leaves unclear whether findings in rodents are relevant to human biology.

METHODS: We performed immunohistochemical stains to characterize the amount and distribution of B-cells in human hearts, analyzing both fresh and post-mortem tissue. To gain insight into the biology of human myocardial B-cells we analyzed publicly-available spatial transcriptomics and single-cell sequencing datasets of myocardial and peripheral blood mononuclear cells …

Sustainability Of Breastfeeding Interventions To Reduce Child Mortality Rates In Low, Middle-Income Countries: A Systematic Review Of Randomized Controlled Trials, Alexis Engelhart, Stacey Mason, Ucheoma Nwaozuru, Chisom Obiezu-Umeh, Victoria Carter, Thembekile Shato, Titilola Gbaja-Biamila, David Oladele, Juliet Iwelunmor

2020-Current year OA Pubs

Child mortality is the lowest it has ever been, but the burden of death in low- and middle-income countries (LMICs) is still prevalent, and the numbers average above the global mean. Breastfeeding contributes to the reduction of child mortality by improving chance of survival beyond childhood. Therefore, it is essential to examine how evidence-based breastfeeding interventions are being maintained in resource-constrained settings. Guided by Scheirer and Dearing's sustainability framework, the aim of this systematic review was to explore how evidence-based breastfeeding interventions implemented to address child mortality in LMICs are sustained. The literature search included randomized controlled trials (RCTs) of …