bluuebunny/crossref_metadata_2025 huggingface dataset:
Preconception Tort Liability: Recognizing a Strict Liability Cause of Action for DES Grandchildren
Authors: Mascaro Marisa L.
Published: February 2021

Over the past decade more than 1,000 "DES daughters" have filed lawsuits against the manufacturers of DES, alleging that their in utero exposure to the drug caused various reproductive tract abnormalities, including cancer. Plaintiffs now allege that their grandmothers' use of DES during pregnancy caused genetic damage leading to cancer in third generations. This Note addresses the validity of preconception tort liability in the context of third-generation DES cases. Plaintiffs in preconception tort liability cases have sought recovery under both negligence and strict liability causes of action. Courts should recognize the validity of preconception tort liability and allow a strict liability cause of action in third-generation cases.
An Ethical Perspective on Health Care Insurance Reform
Authors: Brennan Troyen A.
Published: February 2021

Much recent analysis of health care insurance reform emphasizes economic and policy issues. In contrast, this Article examines health policy issues from the viewpoint of medical ethics. The critical ethical “problem” in health care today is that ability to pay determines the availability and quality of care. This Article discusses three types of proposed solutions: health care insurance reform, health care financing reform, and health care cost reform. It sketches an ethical framework for evaluating health policy and presents seven specific propositions that an ethical analysis of health care reform proposals raises. This Article concludes that remedying the unethical treatment of certain classes of patients requires both health care financing reform and health care cost reform; health care insurance reform will not suffice.
Home HIV Testing and Conflicts with State HIV Testing Regulations
Authors: Fabbri William O.
Published: February 2021

Currently the number of AIDS-related deaths in the United States has reached 311,000 and at least one million more Americans are infected with HIV. Of those one million or more infected, many spread the virus unknowingly as approximately forty percent of those infected have never been tested. More than eighty-five percent of the U.S. population has never been tested for HIV. No cure or vaccine for HIV currently exists.

The federal and state governments have set up a patchwork of free and confidential HIV testing at local clinics. States have enacted a variety of legislation concerning HIV testing and test results. Most states have enacted statutes that require informed consent for an HIV test to be conducted. All states require the reporting of AIDS cases, and many also require the reporting of HIV-positive status to state public health departments. Furthermore, many states mandate certain requirements for HIV counseling.
Advocacy for The Mentally Impaired Elderly: A Case Study Analysis
Authors: Kayser-Jones Jeanie , Kapp Marshall B.
Published: February 2021

The authors present a case study to illustrate how a mentally impaired but socially intact nursing home resident, who had no one to act as an advocate for her, was denied appropriate treatment for an acute illness which ultimately resulted in her death. The case raises important questions about advocacy for the mentally-impaired, acutely-ill institutionalized patient. This Article explores the role of the advocate, how advocates are selected, what qualities and talents they should possess, and what responsibilities should be assigned to them. The authors suggest that nursing home residents should be encouraged to engage in self-advocacy to the greatest extent possible. The competent elderly should be urged to name their preferred advocates. Individuals who serve in advocacy roles should be advised to seek information regarding the patient's wishes from those who know the patient well. Furthermore, there is a need for quality education and training of those who serve in advocacy roles on behalf of nursing home residents, and state laws need to specify the responsibilities of persons who serve as advocates.
Provider Sponsored Organizations and Provider Service Networks—Rationale and Regulation
Authors: Hirshfeld Edward B.
Published: February 2021

When a provider accepts capitation from a health plan for a pool of patients, it assumes risk from the plan. The risk is that the cost of furnishing health care needed by the patients may exceed the funds paid to the provider by the health plan. There are several levels of risk. The first level is capitation arrangements for services rendered by the provider. The next level is capitation arrangements where the provider assumes risk not only for its own services, but also the services of other providers. As the number of services of other providers for which risk is assumed increases, the risk-taking provider comes closer and closer to assuming risk for the entire benefits package. At some point, it makes sense for the risk-taking provider to become a licensed health plan. As providers become more capable in managing large amounts of risk, they become more interested in organizing health plans.
Legal Consequences of Disposable Dialyzer Reuse
Authors: Hallquist Scott G.
Published: February 2021

This Article discusses potential legal liability for adverse effects resulting from reuse of disposable hemodialysis equipment. After explaining the dialysis process and the health risks involved with the reuse of dialyzers, the Article outlines possible theories of recovery for injured dialysis patients. The Article describes the possibility of recovery under a negligence theory against either the treating physician or the institutional provider, and includes a discussion of applicable statutory law. The remainder of the Article discusses possible recovery under the theory of strict liability.
Subjecting Hospitals to Truth in Lending Disclosure Requirements: Bright v. Ball Memorial Hospital
Authors: Galler Linda
Published: February 2021

The federal Truth in Lending Act requires creditors to comply with complex disclosure requirements whenever they engage in consumer credit transactions. In light of procedures adopted by hospitals and health care professionals which permit payment for services over time, there is some question as to whether these groups may be considered creditors within the meaning of the Act and therefore subject to the Act’s disclosure requirements. In Bright v. Ball Memorial Hospital, the Court of Appeals for the Seventh Circuit concluded that a hospital can be a creditor with respect to certain hospital-patient transactions. However, the court found that the defendant had not consummated consumer credit transactions with the plaintiffs and consequently had not violated the Act by failing to make disclosures.

This Case Comment contends that although the court correctly determined that a hospital, in certain circumstances, may be subject to the Act, it incorrectly held that Ball Memorial failed to consummate consumer credit transactions with the plaintiffs. This Case Comment also discusses the circumstances under which a hospital should be considered a creditor for purposes of the Truth in Lending Act and recommends that hospitals offering installment payment plans routinely comply with disclosure requirements of the Act.
The Health Care Quality Improvement Act of 1986: Its History, Provisions, Applications and Implications
Authors: Horner Susan L.
Published: February 2021

Congress granted qualified immunity from liability for peer review participation to physicians, osteopaths and dentists, created a national practitioner data bank to track inept, incompetent or unprofessional physicians, and enacted procedural rules for due process, privilege restrictions, and reporting and disbursement of information. The Health Care Quality Improvement Act of 1986 is now in full force, and peer review participants are anxious to cloak themselves with immunity from actions brought by health care professionals. Although its goals are worthy, HCQIA's effects remain to be seen. Serious loopholes appear to exist, warranting close monitoring and possibly early amendment of the Act. Cautious judicial assessment is needed, in order to prevent not only circumvention of the Act's requirements by artful litigants, but also use of the national data bank by health care entities as a pretext for denying privileges and escaping antitrust liability.
Severely Handicapped Infants with Life-Threatening Conditions: Federal Intrusions Into the Decision Not To Treat
Authors: Huefner Dixie Snow
Published: February 2021

In recent years the federal government has attempted to intervene in certain family-medical decisions to withhold treatment from seriously handicapped newborns with life-threatening conditions. Invoking section 504 of the Rehabilitation Act of 1973, which prohibits discrimination against “otherwise qualified handicapped” individuals, the Reagan Administration promulgated regulations allowing federal government investigations of such decisions. Recently, the U.S. Supreme Court upheld lower court decisions invalidating these “Baby Doe” regulations. The federal government's fall-back position is reflected in the Child Abuse Prevention and Treatment Amendments of 1984, requiring states accepting funds under the Child Abuse Prevention and Treatment Act to establish and maintain procedures to assure that cases of medical neglect of handicapped infants are investigated by the states. Although the primary oversight of parental decision-making has been returned to the states where it has traditionally belonged, the federal government's definition of medical neglect of handicapped infants with life-threatening conditions is an ethically inadequate response to the complex needs of the handicapped child, the family, the medical profession, and society as a whole. After examining the relevance of Kantian, utilitarian, and Rawlsian ethical positions, the author contends that an effective governmental policy, capable of enforcement and acceptance by the public, must utilize the strengths of each philosophy and reflect the pragmatism of American society.
U.S.Industries v. Director:“Claim” Versus “Condition” in the Analysis of Workers' Compensation Cases
Authors: Yospe Jordan
Published: February 2021

Under most workers' compensation statutes, an injury must “arise out of” and “in the course of” employment in order to qualify as a compensable disability. InU.S. Industries v. Director, the Supreme Court held that the Longshoremen's and Harbor Workers' Compensation Act must be strictly construed to avoid transforming the compensation system into a form of social insurance. InU.S. Industries, the Court denied a disability claim based on an arthritic condition which was manifested while the worker was at home in bed. This Note contends that the Supreme Court neglected to consider pertinent medical realities when analyzing the causation question. Thus, the decision undermines the overall rationale behind workers' compensation legislation. Nonetheless, the Note argues that the case does not relax the requirement of adequately scrutinizing the causative elements underlying any reasonable claim for disability benefits. An analysis adequately accommodating both medical and legal facts, instead of relying upon the vagaries of statutory interpretation, is necessary to improve the efficiency and fairness of workers' compensation disability determinations.
The Fetus as a Patient: Emerging Rights as a Person?
Authors: Lenow Jeffrey L.
Published: February 2021

Dramatic scientific breakthroughs in medical technology have revolutionized the physician’s diagnostic prowess in the art of obstetrics. Scientific procedures now reveal previously undetectable secrets about the womb’s tiny inhabitants. In the last few years, perinatologists have not only demonstrated the ability to discern fetal abnormalities of an extraordinary variety, but also have become increasingly successful in correcting many of these defects in utero. This article identifies the potential medicolegal conflicts that may arise as fetal surgery becomes an accepted medical practice. It begins by surveying the legal rights of unborn persons with a particular emphasis on the role of viability in determining those rights. The article will then examine the concept of viability as developed by the Supreme Court inRoe v. Wadeand later abortion decisions and concludes that the current judicial deference to the medical community in determining viability is adequate for balancing rights in the abortion context. However, conflicts among physicians and between the mother and her unborn child that may arise in the fetal surgery context suggest that viability may be an inadequate benchmark for resolving such conflicts. The article concludes with a recommendation to reform the current method of resolving the critical question of when a fetus becomes viable.
Examining Exclusionary Conduct of HMOs and PPOs: A Case Comment on Northwest Medical Laboratories v. Blue Cross and Blue Shield of Oregon
Authors: Levitt Debra M.
Published: February 2021

As the climate of the health care industry has changed to one of cost-containment and competition through the growth of HMOs and PPOs, health care providers have become the subjects of antitrust litigation. One such case, Northwest Medical Laboratories v. Blue Cross and Blue Shield of Oregon, involved a medical laboratory and a radiology center who claimed that they were victims of an illegal group boycott after defendant's pre-paid health plan denied them preferred provider status. The Oregon Court of Appeals, using the traditional antitrust analysis applied to other industries for decades, failed to consider the intricacies that exist within the health care industry. This result led to an inaccurate market share computation and an inadequate rule of reason analysis. This Comment examines the shortcomings of the Northwest Medical opinion and argues that, in applying the antitrust laws to the health care industry, courts in future cases must recognize and respect the unique features of the business of providing health care.
Infanticide, Physicians, and the Law: The “Baby Doe” Amendments to the Child Abuse Prevention and Treatment Act
Authors: Lund Nelson
Published: February 2021

Infanticide, like most other species of homicide, is probably coeval with the human race itself. In modern Western civilization, what were formerly the most powerful incentives to infanticide have virtually disappeared. As with other social problems that affluence has seemed to solve, however, infanticide has reappeared in a new form that seems to have been made possible by affluence itself. This "new infanticide" occurs in a place whose very existence is the result of a tremendously wealthy society's devotion to its most vulnerable and least “useful” members. The modern neonatal intensive care unit, which treats, and often saves, extremely ill newborn children, who during most of history would surely have died, has proven to be a setting where many of the age-old incentives for infanticide have begun to operate again. The “new infanticide” consists of withholding food or needed medical treatment from selected infants who suffer from one or more serious, though treatable, medical problems. The national government has now enacted legislation designed to curtail the practice of infanticide by the medical profession. This paper traces the genesis of that legislation, explores the problem to which it is addressed, and evaluates its prospects for success.
The Insanity Defense: Effects of Abolition Unsupported by a Moral Consensus
Authors: Cobun Lynnette S.
Published: February 2021

The insanity defense reflects the moral judgment that some criminal defendants do not deserve criminal sanctions because of mental incapacity. This Note examines the alternative formulations, such as guilty but mentally ill and diminished responsibility, that some states have enacted in the face of growing controversy over the insanity defense. It observes that the alternatives, if used in lieu of the insanity defense, distort the criminal law and do not comport with the legal doctrine of responsibility, which eschews punishing mentally ill defendants. The Note concludes that the insanity defense should not be abolished unless the moral consensus changes regarding the criminal responsibility of mentally ill defendants.
Products Liability Issues in School Asbestos Litigation
Authors: Zelen Melissa
Published: February 2021

The hazards posed by deteriorating friable asbestos in the nation’s schools are causing serious concerns for public health officials, school boards, parents and school employees. Reports by both the Environmental Protection Agency and the U.S. Attorney General’s Office agree that both school children and school employees stand a substantially increased risk of contracting some form of asbestos-related disease as a result of exposure to deteriorating asbestos materials in school buildings.

School systems plagued by die asbestos hazards are now filing suits against asbestos manufacturers alleging causes of action in breach of warranty, negligence and strict products liability in tort. Some plaintiffs in school asbestos litigation seek to recover die costs of EPA-mandated asbestos inspection and abatement programs which have already been completed. Still others request injunctions to compel the manufacturers themselves to conduct inspections and finance abatement.

This Note examines the school asbestos situation from a legal perspective and focuses primarily on whether die schools’ claims should be considered as economic losses or as property damage. It examines die impact of statutes of limitations on these cases under both contract and tort theories. The Note argues diat school asbestos claims should be decided under a strict products liability standard.
Orphan Drugs: The Question of Products Liability
Authors: Scharf Susan F.
Published: February 2021

Orphan drugs, essential for die treatment of persons widi rare diseases, generally are unprofitable for manufacturers to develop and market. While congressional and administrative efforts to promote die development of orphan drugs have met widi modest success, application of products liability doctrine to orphan drug sponsors could subvert those efforts. This Note describes die provisions of die Orphan Drug Act and analyzes products liability law with respect to orphan drug litigation. It argues that die goals of tort law support the imposition of liability for design defect, failure to warn and negligence in testing. Finally, die Note acknowledges diat liability costs create disincentives for orphan drug development and suggests mechanisms for reducing manufacturers’ liability concerns.
Direct-to-Consumer Prescription Drug Advertising
Authors: Terzian Tamar V.
Published: February 2021

The Food and Drug Administration (FDA) regulates the promotion of pharmaceutical products. The FDA's regulations issued under the Food, Drug and Cosmetic Act (FDCA) require that prescription drug broadcast advertisements include the following: (1) a major statement of the product's risks in at least the audio part of the advertisement; and (2) that an adequate provision for the dissemination of the approved package labeling be made “in connection with the broadcast presentation,” if the brief summary is not also part of the advertisement. Under the FDCA, the brief summary provides information concerning the major risks of the drug.
Introduction: Did the Amicus Effort Make a Difference?
Authors: Kolbert Kathryn
Published: February 2021

With the opening of the new Supreme Court term and three new cases, each with the potential of eroding or overruling Roe v. Wade, discussions of Webster v. Reproductive Health Services, the most anticipated case of the 1989 term, are seemingly out of fashion. But Webster is significant and noteworthy as the first case of this decade which directly presented the high Court an opportunity to overrule Roe, the 1973 landmark case which afforded women the right to make intimate decisions about abortion free of governmental interference. The Court, flooded with amici curiae on both sides of the issue and an avalanche of political activism unparalleled in this decade, left Roe intact, albeit slightly modified. Because there are no longer five solid votes on the Court to uphold Roe, Webster has left its mark on American politics and has radically changed the tenor of the abortion debate for years to come.
The Case for Patenting Medical Procedures
Authors: Garris Joel J.
Published: February 2021

In contrast to the few medical procedure patents granted in the three decades following the 1950s, patent attorneys now estimate that the Patent and Trademark Office (PTO) grants at least a dozen medical procedure patents each week. This growing trend heightened the medical community’s concerns that such patents may adversely affect the cost, quality, and patient accessibility of medical care. Additionally, attempts by physicians to enforce medical procedure patents against other physicians further increased these concerns. One of the more widely publicized patented medical procedure cases involves an infringement suit over a patent for a method of making self-sealing episcleral incisions during cataract operations. On July 6, 1993, Dr. Samuel Pallin filed a lawsuit against fellow opthalmologist Dr. Jack Singer, accusing Dr. Singer and his clinic of performing hundreds of cataract operations using the patented procedure. The medical community views this case as an illustration of the problems that may arise in patenting medical procedures because Dr. Pallin’s suit restricts Dr. Singer’s use of a procedure that benefits patients.
The Omnibus Reconciliation Act of 1990: Redefining Pharmacists’ Legal Responsibilities
Authors: Huang Steven W.
Published: February 2021

Henry Fan, owner of T.I. Drugstores, one of the city's largest pharmacies, just walked into your office for legal advice. He sits down across from your desk and holds his head in his hands. With a worried look on his face, he tells you that his pharmacy has just been sued by one of its customers, Elaine Jones. A year ago, T.I. Drugstores received a prescription for Jones from Dr. Kenneth Brown for Bendectin, a prescription drug used for the treatment of nausea and vomiting during the early stages of pregnancy. After reviewing the prescription for errors, the pharmacist filled the prescription according to its directions and sold it to Jones.

Approximately eight months later, Jones gave birth to a baby girl with severe deformities as a result of the ingested Bendectin. Sadly, her child will never be able to sit or walk properly. Jones is suing T.I. Drugstores for negligently failing to advise her of the potential hazards associated with ingesting Bendectin. Additionally, Jones claims that T.I. Drugstores is strictly liable for failing to warn her of the fact that ingesting Bendectin causes birth defects in children.

Fan informs you that the pharmacist assumed that Brown had forewarned Jones of the risks associated with Bendectin. Outraged, Fan insists that neither his drugstore nor his pharmacist acted incorrectly. They simply did what they were supposed to do: fill the prescription according to its specifications.
The U.S. Health Delivery System: Inefficient and Unfair to Children
Authors: Kopelman Loretta M. , Palumbo Michael G.
Published: February 2021

What proportion of health care resources should go to programs likely to benefit older citizens, such as treatments for Alzheimer’s disease and hip replacements, and what share should be given to programs likely to benefit the young, such as prenatal and neonatal care? What portion should go to rare but severe diseases that plague the few, or to common, easily correctable illnesses that afflict the many? What percentage of funds should go to research, rehabilitation or to intensive care? Many nations have made such hard choices about how to use their limited funds for health care by explicitly setting priorities based on their social commitments. In the United States, however, allocation of health care resources has largely been left to personal choice and market forces. Although the United States spends around 14% of its gross national product (GNP) on health care, the United States and South Africa are the only two industrialized countries that fail to provide citizens with universal access.
Ensuring the Safety of Genotech Drugs Through Implied Warranty Theory
Authors: Serra Wayne M.
Published: February 2021

Genotechnology (genotech) is the subset of biotechnology (biotech) dealing with human genetics. Even as a subset, however, genotechnology has a significant effect within the U.S. economy. This impact is partly attributable to the federal government’s efforts to nurture the industry. Although these efforts have contributed to the American genotech industry’s rapid growth, the federal government has not kept pace in the legal and regulatory areas necessary to ensure that genotech drugs are marketed responsibly. In fact, current federal policy has been characterized as “grossly short-sighted.”

The Food and Drug Administration (FDA) presently has approved more than thirty genotech drugs for general use. Over 450 more products are currently under development, with at least 120 of those in final testing awaiting FDA approval. Cancer treatment products comprise the largest segment with 114 drugs either under development, pending approval, or finally approved for sale.

As sales figures indicate, genotech drugs have already firmly entrenched themselves in the marketplace.
The Patients’ Bill of Rights: Women’s Rights Under Managed Care and ERISA Preemption
Authors: Theodos Tiffany F.
Published: February 2021

Public concern over the perceived failure of managed care has led many to call for the increased accountability of managed care organizations (MCOs). In response, during his January 1998, State of the Union address, President Clinton outlined a Patients’ Bill of Rights that would guarantee patients certain protections against abuses by their health plans. Since January 1998, the Patients’ Bill of Rights has been entrenched in partisan politics. Consequently, the 105th Congress failed to enact a Patients’ Bill of Rights and the 106th Congress has passed two opposing versions of the Bill. At the time of publication, the two bills sat in a joint House Senate conference committee awaiting reconciliation.

Although both sides support legislation increasing patient protections, Democrats and Republicans are divided over the issue of remedies for patients who have had their rights violated.
Reflective Choice in Health Care: Using Information Technology to Present Allocation Options
Authors: Rai Arti K.
Published: February 2021

Over the last few decades, the U.S. health care system has been the beneficiary of tremendous growth in the power and sheer quantity of useful medical technology. As a consequence, our society has, for some time, had to make cost-benefit tradeoffs in health care. The alternative—funding all health care interventions that would produce some health benefit for some patient—is not feasible, because it would effectively consume all of our resources.
The Siren Song of the Elderly: Florida's Nursing Homes and the Dark Side of Chapter 400
Authors: Williamson Jennifer L.
Published: February 2021

Nursing homes perform a vital function in the long-term care continuum by providing nursing care around the clock to the elderly and disabled. By entrusting these institutions with society's frailest members, the general population relies on government agencies and their regulations to ensure that the elderly receive quality care. States expect quality care, but providers often lack the financial support and regulatory guidance.

Recently, the conflict between reimbursement and quality care received national attention. Vencor, the U.S.'s second largest nursing home chain, attempted to terminate its Medicaid contracts and evict all its Medicaid residents. Executives explained that the contract terminations and resident evictions were strategies to make room for higher paying private pay residents. Faced with state, and potentially federal, fines, as well as a district court injunction and public outrage over the patient dumping, the company quickly abandoned its policy and apologized.
A Prescription for Mental Distress: The Principles of Psychosomatic Medicine with the Physical Manifestation Requirement in N.I.E.D. Cases
Authors: Bagdasarian Narbeh
Published: February 2021

In March of 1998, a Connecticut jury awarded $400,000 under a claim for Negligent Infliction of Emotional Distress (“N.I.E.D”) to an employee who had only lost his job. The employee had been subject to unnecessary internal investigation, and his employment was terminated as a result of this investigation. In December of 1992, a North Carolina jury awarded only $100,000 for N.I.E.D. damages to parents who had lost their nine month-old infant. The parents actually witnessed the death of their infant, who died from swelling of the brain caused by improper administration of intravenous fluids. Both of these awards were meant to compensate plaintiffs for the mental distress caused by the defendants' negligent conduct. Yet considering the circumstances of these two cases, one wonders whether the jurors were really able to evaluate the nature and extent of the plaintiffs' mental distress and, more importantly, what kind of evidence the jurors considered to make their determination.
Emerging Parallels in the American Health Care and Legal-Judicial Systems
Authors: Hadorn David C.
Published: February 2021

The structure and principal decision-making processes of the American health care system have, in recent years, evolved to closely resemble those of the legal-judicial system. This transformation reflects important common values that underlie both systems, including the values of life and liberty. This Article analyzes quasi-legal features of the health care system and draws conclusions about how those features might be used to address the problem of health care rationing. It concludes that coverage rules, if properly developed, can provide the sort of objective framework necessary to evaluate claims of health care needs. This Article also demonstrates that by defining legitimate health care needs, society can thereby potentially eliminate or forestall the need to ration necessary care. This can be achieved by using carefully developed coverage rules, rather than the informal rules currently in place, in conjunction with already existing due process methods for interpreting and implementing those rules.
Case Comment: Moore v. Regents of the University of California
Authors: Bergman Helen R.
Published: February 2021

The increasing use of human tissues in medical research has spawned a host of ethical and legal debates. Legal analysis in this area has almost exclusively focused on the question of property rights in both the tissues used in research and in the resulting products. One illustrative case isMoore v. Regents of the Unversity of California,in which a patient sued his doctor for conversion of his spleen which had been removed for therapeutic purposes. The doctor later used the spleen to develop a patented and profitable cellline. This Comment examines and rejects the property law approach to this issue. Instead, this Comment proposes two legislative changes which would 1) eliminate any trade in human tissues and 2) require doctors to inform their patients of any research interest in proposed medical procedures. These proposals resolve the problem presented inMoore,and avoid the misleading, and inevitably unanswerable, question of property rights.
Race, Ethnicity and Quality Of Care: Inequalities and Incentives
Authors: Watson Sidney D.
Published: February 2021

As was my custom, I moved from one exam room to the next with a fluidity that comes from years of practice, yet I was stopped in my tracks when Mr. North rose to his feet to greet me. His deep ebony, six foot-three-inch frame dwarfed my pale, five-foot-three presence. The tremendous hands on his 260 pound body grabbed my own outstretched right hand and shook it…. I glanced at his face, trying to see through my initial discomfort, only to be greeted by my own face staring back at me from the silver, reflective sunglasses he wore beneath a baseball cap that covered his head and any hair that might have been growing on it. His huge chest was tightly wrapped in a black T-shirt that, even in its largest version, couldn't stretch comfortably to encompass his pectoral girth….

Mr. North became one of my favorite patients….I like him because I realize how hard I have had to work all of my life to overcome the racist feelings that made me fear him when we first met and that never allow me to act completely naturally in his presence.
Ashes to Ashes: Why FDA Regulation of Tobacco Advertising May Mark the End of the Road for the Marlboro Man
Authors: Paralusz Kathleen M.
Published: February 2021

Despite education campaigns about the health hazards associated with smoking and the use of smokeless tobacco, teenage use of tobacco products has reached epidemic proportions. Recent studies indicate that adolescent smoking is on the rise, and that children are beginning to smoke at progressively earlier ages. “Nearly 3,000 young people start smoking each day,” accounting for more than one million new smokers each year. In addition, ninety percent of all new smokers are under the age of eighteen.

Although young people are generally aware of the serious, long-term health risks associated with tobacco use, studies suggest that those who smoke do not usually view those risks as applying to them personally. Furthermore, evidence shows that young people who begin to smoke know about the addictive properties of nicotine, but do not believe that they will become addicted. For these reasons, in August 1995, the Food and Drug Administration (FDA) proposed strict regulations aimed at reducing the number of children and adolescents who smoke. Several of these provisions target cigarette advertisements aimed at minors.
Unresolved Issues in Controlling the Tuberculosis Epidemic Among the Foreign-Born in the United States
Authors: Weber Guido S.
Published: February 2021

Tuberculosis (TB), “the world’s most neglected health crisis,” has returned after decades of decline, but has only gradually caught the attention of governments as a formidable threat to public health. By 1984, when TB cases hit an all-time low, federal and state governments stopped supporting the medical infrastructure that once served to contain the disease. State officials around the nation began dismantling laboratory research programs and closing TB clinics and sanitoria. Since 1985, however, TB rates have steadily increased to 26,673 reported cases in 1992, and some have estimated that by the year 2000, there could be a twenty percent increase. By 1993, Congress, realizing that TB could pose a major public health threat, allocated over $100 million to the Department of Health and Human Services for TB prevention and treatment programs. Those funds, however, were sorely needed years before and amounted to only a fraction of what public health officials believe necessary to control TB today.
Brief for 885 Law Professors in Support of Maintaining Adherence to the Roe Decision
Authors: Michelman Frank I. , Redlich Norman , Neuwirth Stephen R. , Carty-Bennia Denise
Published: February 2021

The mission of this brief was not only to oppose the outright over-ruling of Roe v. Wade. It was further to resist any weakening of the protective doctrine surrounding Roe's central holding that would allow states to eviscerate the right that Roe recognized. Because the brief was written on behalf of nearly 900 law professors, we consulted widely among our constituency, drawing heavily on the scholarship developed since Roe. We relied on extensive work by our colleagues supporting Roe's holding, reasoning and legitimate place in constitutional jurisprudence.
Roe v. Wade and the History of Abortion Regulation
Authors: Linton Paul Benjamin
Published: February 2021

In Roe v. Wade, the Supreme Court held that “[the] right of privacy … founded in the Fourteenth Amendment's concept of personal liberty … is broad enough to encompass a woman's decision whether or not to terminate her pregnancy.” The Court acknowledged that “[t]he Constitution does not explicitly mention any right of privacy.” Nevertheless, the Court held that a “right of personal privacy, or a guarantee of certain areas or zones of privacy, does exist under the Constitution.” However, “only personal rights that can be deemed ‘fundamental’ or ‘implicit in the concept of ordered liberty,’ … are included in this guarantee of personal privacy.”
A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?
Authors: Benbow Susan Mary , Eost-Telling Charlotte , Kingston Paul
Published: February 2021

We carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.
Hybrid IWD-GA: An Approach for Path Optimization and Control of Multiple Mobile Robot in Obscure Static and Dynamic Environments
Authors: Kumar Saroj , Parhi Dayal Ramakrushna , Pandey Krishna Kant , Muni Manoj Kumar
Published: February 2021

In this article, hybridization of IWD (intelligent water drop) and GA (genetic algorithm) technique is developed and executed in order to obtain global optimal path by replacing local optimal points. Sensors of mobile robots are used for mapping and detecting the environment and obstacles present. The developed technique is tested in MATLAB simulation platform, and experimental analysis is performed in real-time environments to observe the effectiveness of IWD-GA technique. Furthermore, statistical analysis of obtained results is also performed for testing their linearity and normality. A significant improvement of about 13.14% in terms of path length is reported when the proposed technique is tested against other existing techniques.
Social choice problems with public reason proceduralism
Authors: Kugelberg Henrik D.
Published: February 2021

Most political liberals argue that only rules, policies and institutions that are part of society’s basic structure need to be justified with so-called public reasons. Laws enacted outside this set are legitimate if and when public reasons can justify the procedure that selects them. I argue that this view is susceptible to known problems from social choice theory. However, there are resources within political liberalism that could address them. If the scope of public reason is extended beyond the basic structure it could order people’s preferences in a way that circumvents the identified issues.
Early economic evaluation to guide the development of a spectroscopic liquid biopsy for the detection of brain cancer
Authors: Gray Ewan , Cameron James M. , Butler Holly J. , Jenkinson Michael D. , Hegarty Mark G. , Palmer David S. , Brennan Paul M. , Baker Matthew J.
Published: February 2021

Objectives

An early economic evaluation to inform the translation into clinical practice of a spectroscopic liquid biopsy for the detection of brain cancer. Two specific aims are (1) to update an existing economic model with results from a prospective study of diagnostic accuracy and (2) to explore the potential of brain tumor-type predictions to affect patient outcomes and healthcare costs.

Methods

A cost-effectiveness analysis from a UK NHS perspective of the use of spectroscopic liquid biopsy in primary and secondary care settings, as well as a cost–consequence analysis of the addition of tumor-type predictions was conducted. Decision tree models were constructed to represent simplified diagnostic pathways. Test diagnostic accuracy parameters were based on a prospective validation study. Four price points (GBP 50-200, EUR 57-228) for the test were considered.

Results

In both settings, the use of liquid biopsy produced QALY gains. In primary care, at test costs below GBP 100 (EUR 114), testing was cost saving. At GBP 100 (EUR 114) per test, the ICER was GBP 13,279 (EUR 15,145), whereas at GBP 200 (EUR 228), the ICER was GBP 78,300 (EUR 89,301). In secondary care, the ICER ranged from GBP 11,360 (EUR 12,956) to GBP 43,870 (EUR 50,034) across the range of test costs.

Conclusions

The results demonstrate the potential for the technology to be cost-effective in both primary and secondary care settings. Additional studies of test use in routine primary care practice are needed to resolve the remaining issues of uncertainty—prevalence in this patient population and referral behavior.
Minimising CM degree and slope stability of projective varieties
Authors: OHNO KENTARO
Published: February 2021

We discuss a minimisation problem of the degree of the Chow–Mumford (CM) line bundle among all possible fillings of a polarised family with fixed general fibers, motivated by the study of the moduli space of K-stable Fano varieties. We show that such minimisation implies the slope semistability of the fiber if the central fiber is smooth.
A lower bound for Cusick’s conjecture on the digits of n + t
Authors: SPIEGELHOFER LUKAS
Published: February 2021

Let S be the sum-of-digits function in base 2, which returns the number of 1s in the base-2 expansion of a nonnegative integer. For a nonnegative integer t, define the asymptotic density
$${c_t} = \mathop {\lim }\limits_{N \to \infty } {1 \over N}|\{ 0 \le n < N:s(n + t) \ge s(n)\} |.$$
T. W. Cusick conjectured that ct > 1/2. We have the elementary bound 0 < ct < 1; however, no bound of the form 0 < α ≤ ct or ct ≤ β < 1, valid for all t, is known. In this paper, we prove that ct > 1/2 – ε as soon as t contains sufficiently many blocks of 1s in its binary expansion. In the proof, we provide estimates for the moments of an associated probability distribution; this extends the study initiated by Emme and Prikhod’ko (2017) and pursued by Emme and Hubert (2018).
Diet quality and all-cause mortality among US adults, estimated from National Health and Nutrition Examination Survey (NHANES), 2003–2008
Authors: Gicevic Selma , Tahirovic Emin , Bromage Sabri , Willett Walter
Published: February 2021

Objective:

We assessed the ability of the Prime Diet Quality Score (PDQS) to predict mortality in the US population and compared its predictiveness with that of the Healthy Eating Index-2015 (HEI-2015).

Design:

PDQS and HEI-2015 scores were derived using two 24-h recalls and converted to quintiles. Mortality data were obtained from the 2015 Public-Use Linked Mortality File. Associations between diet quality and all-cause mortality were evaluated using multivariable Cox proportional hazards models, and predictive performance of the two metrics was compared using a Wald test of equality of coefficients with both scores in a single model. Finally, we evaluated associations between individual metric components and mortality.

Setting:

A prospective analysis of the US National Health and Nutrition Examination Survey (NHANES) data.

Participants:

Five-thousand five hundred and twenty-five participants from three survey cycles (2003–2008) in the NHANES aged 40 years and over.

Results:

Over the 51 248 person-years of follow-up (mean: 9·2 years), 767 deaths were recorded. In multivariable models, hazard ratios between the highest and lowest quintiles of diet quality scores were 0·70 (95 % CI 0·51, 0·96, Ptrend = 0·03) for the PDQS and 0·77 (95 % CI 0·57, 1·03, Ptrend = 0·20) for the HEI-2015. The PDQS and HEI-2015 were similarly good predictors of total mortality (Pdifference = 0·88).

Conclusion:

Among US adults, better diet quality measured by the PDQS was associated with reduced risk of all-cause mortality. Given that the PDQS is simpler to calculate than the HEI-2015, it should be evaluated further for use as a diet quality metric globally.
Kant’s Enlightenment and Women’s Peculiar Immaturity
Authors: Sabourin Charlotte
Published: February 2021

In ‘What is Enlightenment?’, Kant claims that no women are currently enlightened. Here I argue that this exclusion is due to certain legal restrictions guiding Kant’s conception of enlightenment. As enlightenment is intended to take place in society, it appears that Kant has a specific legal context in mind that affects its enactment. His twofold conception of citizenship and the dimension of subordination he puts forward by restricting the private use of reason will prove useful in clarifying those legal restrictions. It thus seems unlikely that Kant intended women to take an active part in enlightenment.
Comparison of multiplex PCR kits for SCoT and SRAP genotyping in plants
Authors: Sathapondecha Ponsit , Boonsermsukchareon Lathapol , Whankeaw Sukhuman
Published: February 2021

Taq polymerase system is one of the key success factors for genotyping by using semi-random marker types. Start codon targeted (SCoT) and sequence-related amplified polymorphism (SRAP) are semi-random markers that amplify more than one target at a time, like in multiplex PCR. Here, we compared the performance of five multiplex PCR kits (QIAGEN®, Thermo Scientific™, New England Biolabs, KAPA Biosystem and iNtRON Biotechnology) and Taq DNA polymerase from Vivantis as a representative common Taq polymerase. The PCR using three SCoT and three SRAP markers was performed in six plants, which were different in genome size, including three monocotyledons (rice, oil palm and onion) and three dicotyledons (holy basil, chilli pepper and eggplant). The overall results demonstrated consistent high performance of the Taq polymerase system with the multiplex PCR kit from KAPA Biosystem. Considered by plant, the multiplex PCR kit from KAPA Biosystem showed the best performance in holy basil, eggplant, oil palm and chilli pepper, whereas in rice, the Taq DNA polymerase from Vivantis generated better results than the KAPA Biosystem. In onion, multiplex PCR kit from Thermo Scientific™ showed the best performance among those tested, even if it did not perform well in the other plans. Different Taq polymerase systems might generate different band patterns, therefore using the same Taq polymerase system within one experimental dataset is recommended. The multiplex PCR kit from KAPA Biosystem is the best starting choice.