Procedural Architecture Matters: Innovation Policy at the Federal Communications Commission

This Article examines the puzzle of whether today\u27s Federal Communications Commission ( FCC or the Agency ) is institutionally suited to craft telecommunications innovation policy and, if not, what changes are needed to better equip the Agency to respond to twenty-first century realities. Evaluation of FCC innovation policy performance is stubbornly difficult. Some criticize the FCC as a brake on innovation yet, under the FCC\u27s oversight, the United States\u27 communications industry has become an innovative engine propelling the overall economy more than ever before. It is difficult to untangle whether the FCC deserves credit for helping usher in today\u27s communications age, whether the FCC deserves blame for hamstringing innovation, or both. New tools are needed to address this puzzle. This Article develops such a tool, the procedural architecture analysis. A detail-rich examination of the FCC\u27s procedural architecture-viz., the Agency\u27s formal and informal procedures, resources, and institutional norms-reveals systemic FCC leanings that are in tension with oft-stated innovation objectives. The Article cracks the black box problem, whereby much Agency decision-making is not readily observable, by studying a key yet understudied input: the advocacy of those who practice in front of the FCC. Procedural architecture analysis reveals surprising gaps between administrative process theory\u27s ideals and FCC realities. Moreover, it underscores crucial reforms needed to enable the FCC to act faster, marshal independent expert resources that it conspicuously lacks, and broadly fulfill its twenty-first century imperative to facilitate telecommunications innovation

The Evolution of Entrepreneurial Finance: A New Typology

There has been an explosion in new types of startup finance instruments. Whereas twenty years ago preferred stock dominated the field, startup companies and investors now use at least eight different instruments—six of which have only become widely used in the last decade. Legal scholars have yet to reflect upon the proliferation of instrument types in the aggregate. Notably missing is a way to organize instruments into a common framework that highlights their similarities and differences. This Article makes four contributions. First, it catalogues the variety of startup investment forms. I describe novel instruments, such as revenue-based financing, which remain understudied within law and entrepreneurship. Second, this Article shows the limitations of the debt vs. equity distinction as a classification method for startup financial contracts. Reliance on this traditional distinction obscures understanding of how instruments function. Third, the Article proposes a “new typology” to classify investment instruments based upon their economic, control, time, and regulatory dimensions. Three new broad categories— Payouts, Lock-in, and Park-n-ride—provide an insightful way to group these contracts. And fourth, the new typology explains how an expansion in instrument types creates complex capital structures which increase horizontal conflicts among startup investors. Further, new instruments increasingly place investors into a non-shareholder role that is outside the boundaries of corporate law’s protections. As early-stage investors increasingly fall outside the protections of corporate law, a greater burden shifts to contract law to resolve disputes arising from divergent investor interests

The Evolution of Entrepreneurial Finance: A New Typology

There has been an explosion in new types of startup finance instruments. Whereas twenty years ago preferred stock dominated the field, startup companies and investors now use at least eight different instruments—six of which have only become widely used in the last decade. Legal scholars have yet to reflect upon the proliferation of instrument types in the aggregate. Notably missing is a way to organize instruments into a common framework that highlights their similarities and differences. This Article makes four contributions. First, it catalogues the variety of startup investment forms. I describe novel instruments, such as revenue-based financing, which remain understudied within law and entrepreneurship. Second, this Article shows the limitations of the debt vs. equity distinction as a classification method for startup financial contracts. Reliance on this traditional distinction obscures understanding of how instruments function. Third, the Article proposes a “new typology” to classify investment instruments based upon their economic, control, time, and regulatory dimensions. Three new broad categories— Payouts, Lock-in, and Park-n-ride—provide an insightful way to group these contracts. And fourth, the new typology explains how an expansion in instrument types creates complex capital structures which increase horizontal conflicts among startup investors. Further, new instruments increasingly place investors into a non-shareholder role that is outside the boundaries of corporate law’s protections. As early-stage investors increasingly fall outside the protections of corporate law, a greater burden shifts to contract law to resolve disputes arising from divergent investor interests

The Future of 9-1-1: New Technologies and the Need for Reform

Our nation\u27s 9-1-1 system\u27s success to date belies the fact that its core premises will not continue to serve it effectively and it has come to a critical juncture. In particular, the balkanized nature of 9-1-1 operations that differ across jurisdictions and are supported by Byzantine funding mechanisms obscure a simple but profound development: our nation\u27s emergency system is not keeping up with or taking advantage of technological change. Because the system continues to work and policymakers largely do not appreciate the system\u27s technological limitations, decision makers not only fail to focus on this challenge but instead are all too willing to raid 9-1-1 funds to put them to other uses. Accordingly, our emergency communications networks are unable to accommodate what is increasingly viewed as basic functionality inherent in many of today\u27s advanced technologies. This Article sets forth a coherent vision concerning the opportunity to transition to a next generation 9-1-1 network. To be sure, the United States\u27 9-1-1 system is hardly a monolith and prescriptions for its evolution cannot be reduced to simple one size fits all solutions. In practice, the system is comprised of numerous jurisdictions (including over 6000 Public Safety Answering Points); myriad governance structures and controls which vary across jurisdictions; a ballooning number of service providers; and a diversity of funding amounts and models that differ across jurisdictional boundaries. The result, not surprisingly, is a fractured and complicated system where policy is highly contingent on parochial and often political perspectives. To reform today\u27s balkanized 9-1-1 landscape, we recommend that: (1) clear leadership and vision embrace the need to transition the 9-1-1 system to a next generation architecture; (2) more effective state oversight provide both the funding and logistical support necessary to make this happen; and (3) localities should remain responsible for providing access to 9-1-1, but that they must be supported from higher levels of government as well as industry to exercise that responsibility. In short, there is an important opportunity for thoughtful leadership and vigilant policy reform that will serve the goals of 9-1-1 emergency response far more effectively than the policies currently in place

Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model.

Introduction:Treatment of open fractures routinely involves multiple surgeries and delayed definitive fracture fixation because of concern for infection. If implants were made less susceptible to infection, a one-stage procedure with intramedullary nailing would be more feasible, which would reduce morbidity and improve outcomes. Methods:In this study, a novel open fracture mouse model was developed using Staphylococcus aureus (S. aureus) and single-stage intramedullary fixation. The model was used to evaluate whether implants coated with a novel "smart" polymer coating containing vancomycin or tigecycline would be colonized by bacteria in an open fracture model infected with S. aureus. In vivo bioluminescence, ex vivo CFUs, and X-ray images were evaluated over a 42-day postoperative period. Results:We found evidence of a markedly decreased bacterial burden with the local release of vancomycin and tigecycline from the PEG-PPS polymer compared to polymer alone. Vancomycin was released in a controlled fashion and maintained local drug concentrations above the minimum inhibition concentration for S. aureus for greater than 7 days postoperatively. Bacteria were reduced 139-fold from implants containing vancomycin and undetected from the bone and soft tissue. Tigecycline coatings led to a 5991-fold reduction in bacteria isolated from bone and soft tissue and 15-fold reduction on the implants compared to polymer alone. Antibiotic coatings also prevented osteomyelitis and implant loosening as observed on X-ray. Conclusion:Vancomycin and tigecycline can be encapsulated in a polymer coating and released over time to maintain therapeutic levels during the perioperative period. Our results suggest that antibiotic coatings can be used to prevent implant infection and osteomyelitis in the setting of open fracture. This novel open fracture mouse model can be used as a powerful in vivo preclinical tool to evaluate and optimize the treatment of open fractures before further studies in humans

The Future of 9-1-1: New Technologies and the Need for Reform

Our nation\u27s 9-1-1 system\u27s success to date belies the fact that its core premises will not continue to serve it effectively and it has come to a critical juncture. In particular, the balkanized nature of 9-1-1 operations that differ across jurisdictions and are supported by Byzantine funding mechanisms obscure a simple but profound development: our nation\u27s emergency system is not keeping up with or taking advantage of technological change. Because the system continues to work and policymakers largely do not appreciate the system\u27s technological limitations, decision makers not only fail to focus on this challenge but instead are all too willing to raid 9-1-1 funds to put them to other uses. Accordingly, our emergency communications networks are unable to accommodate what is increasingly viewed as basic functionality inherent in many of today\u27s advanced technologies. This Article sets forth a coherent vision concerning the opportunity to transition to a next generation 9-1-1 network. To be sure, the United States\u27 9-1-1 system is hardly a monolith and prescriptions for its evolution cannot be reduced to simple one size fits all solutions. In practice, the system is comprised of numerous jurisdictions (including over 6000 Public Safety Answering Points); myriad governance structures and controls which vary across jurisdictions; a ballooning number of service providers; and a diversity of funding amounts and models that differ across jurisdictional boundaries. The result, not surprisingly, is a fractured and complicated system where policy is highly contingent on parochial and often political perspectives. To reform today\u27s balkanized 9-1-1 landscape, we recommend that: (1) clear leadership and vision embrace the need to transition the 9-1-1 system to a next generation architecture; (2) more effective state oversight provide both the funding and logistical support necessary to make this happen; and (3) localities should remain responsible for providing access to 9-1-1, but that they must be supported from higher levels of government as well as industry to exercise that responsibility. In short, there is an important opportunity for thoughtful leadership and vigilant policy reform that will serve the goals of 9-1-1 emergency response far more effectively than the policies currently in place

Credit Cards as Lifestyle Facilitators

Credit cards are an increasingly essential technology, but they carry with them the paradoxical capacity to propel consumers along lifestyle trajectories of marketplace freedom or constraint. We analyze accounts provided by consumers, credit counselors, and participants in a credit counseling seminar in order to develop a differentiated theory of lifestyle facilitation through credit card practice. The skills and tastes expressed by credit card practice help distinguish between the lifestyles of those with higher cultural capital relative to those with lower cultural capital. Differences in lifestyle regulation practice are posited to originate in cultural discourses related to entitlement and frugality

How Long Do Endoprosthetic Reconstructions for Proximal Femoral Tumors Last?

As the life expectancy of patients with musculoskeletal tumors improves, long-term studies of endoprosthetic reconstructions are necessary to establish realistic expectations for the implants and compare them to other reconstruction approaches. (1) What is the long-term survival of cemented bipolar proximal femoral replacements? (2) How does prosthesis survival compare to patient survival among patients with Stage I, II, and III disease? (3) Do modular implants outperform custom-built prostheses? (4) Do some proximal femoral replacements require conversion to THA? We retrospectively reviewed all 86 proximal femoral replacements used for tumor reconstruction from 1982 to 2008. Primary diagnoses were 43 high-grade tumors (IIA/IIB), 20 low-grade tumors (IA/IB or benign), and 23 with metastatic disease. We reviewed prosthesis survival, patient survival, complication rates, functional outcomes, and rates of conversion to THA. Five of 86 patients (5.8%) required revision of the femoral component. Five-, 10-and 20-year implant survivorships were 93%, 84%, and 56%, respectively. All patients with low-grade disease survived; the 5-year survival rate for patients with metastatic disease was 16%; the 5-, 10-, and 20-year survival for IIA/IIB patients was 54%, 50%, and 44%, respectively. Five of 86 patients (5.8%) underwent conversion to THA for groin pain. Cemented bipolar proximal femoral replacements after tumor resection proved a durable reconstruction technique. The implants outlived patients with metastatic disease and high-grade localized disease while patients with low-grade disease outlived their implants. The survival of modular prostheses was comparable to that of older, one-piece custom designs. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence

Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology

Recerca col·laborativa; Grup focal; Oncologia ortopèdicaCollaborative research; Focus group; Orthopaedic oncologyInvestigación colaborativa; Grupo focal; Oncología ortopédicaObjectives As tumours of bone and soft tissue are rare, multicentre prospective collaboration is essential for meaningful research and evidence-based advances in patient care. The aim of this study was to identify barriers and facilitators encountered in large-scale collaborative research by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. Methods All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss their experiences with collaborative research in this area. The discussion was digitally recorded, transcribed and anonymised. The transcript was analysed qualitatively, using an analytic approach which aims to organise the data in the language of the participants with little theoretical interpretation. Results The 13 surgeons who participated in the discussion represented orthopaedic oncology practices from seven countries (Argentina, Brazil, Italy, Spain, Denmark, United States and Canada). Four categories and associated themes emerged from the discussion: the need for collaboration in the field of orthopaedic oncology due to the rarity of the tumours and the need for high level evidence to guide treatment; motivational factors for participating in collaborative research including establishing proof of principle, learning opportunity, answering a relevant research question and being part of a collaborative research community; barriers to participation including funding, personal barriers, institutional barriers, trial barriers, and administrative barriers and facilitators for participation including institutional facilitators, leadership, authorship, trial set-up, and the support of centralised study coordination. Conclusions Orthopaedic surgeons involved in an ongoing international randomised controlled trial (RCT) were motivated by many factors to participate. There were a number of barriers to and facilitators for their participation. There was a collective sense of fatigue experienced in overcoming these barriers, which was mirrored by a strong collective sense of the importance of, and need for, collaborative research in this field. The experiences were described as essential educational first steps to advance collaborative studies in this area. Knowledge gained from this study will inform the development of future large-scale collaborative research projects in orthopaedic oncology