Sosa, Customary International Law, and the Continuing Relevance of Erie

Ten years ago, the conventional wisdom among international law academics was that customary international law (CIL) had the status of self-executing federal common law to be applied by courts without any need for political branch authorization. This modern position came under attack by so-called revisionist critics who argued that CIL had the status of federal common law only in the relatively rare situations in which the Constitution or political branches authorized courts to treat it as such. Modern position proponents are now claiming that the Supreme Court\u27s 2004 decision in Sosa v. Alvarez-Machain confirms that CIL has the status of self-executing federal common law. As this Article explains, the decision in Sosa did not in fact embrace the modern position, and, indeed, is best read as rejecting it. Commentators who construe Sosa as embracing the modern position have confounded the automatic incorporation of CIL as domestic federal law in the absence of political branch authorization (i.e., the modern position) with the entirely different issue of whether and to what extent a particular statute, the Alien Tort Statute ( ATS ), authorizes courts to apply CIL as domestic federal law. The Article also explains how CIL continues to be relevant to domestic federal common law despite Sosa\u27s rejection of the modern position. The fundamental flaw of the modern position is that it ignores the justifications for, and limitations on, post-Erie federal common law. As the Article shows, however, there are a number of contexts in addition to the ATS in which it is appropriate for courts to develop federal common law by reference to CIL, including certain jurisdictional contexts not amenable to state regulation (namely admiralty and interstate disputes), and gap-filling and interpretation of foreign affairs statutes and treaties. The Article concludes by considering several areas of likely debate during the next decade concerning the domestic status of CIL: corporate aiding and abetting liability under the ATS; application of CIL to the war on terrorism; and the use of foreign and international materials in constitutional interpretation

Exploring the role of the patient–physician relationship on insulin adherence and clinical outcomes in type 2 diabetes: Insights from the MOSAIc study

BackgroundThe 2‐year prospective MOSAIc (Multinational Observational Study assessing Insulin use: understanding the challenges associated with progression of therapy) study is investigating whether patient‐, physician‐, and health system‐related factors affect outcomes in patients with type 2 diabetes (T2D). This baseline subanalysis investigated how aspects of the patient–physician relationship are associated with diabetes‐related distress, insulin adherence, and glycemic control.MethodsPatients with T2D taking insulin for ≥3 months were recruited at primary care and specialty practice sites in 18 countries. Physicians provided usual care. Clinical history and most recent HbA1c values were collected; patients were surveyed regarding their perception of physician interactions, diabetes‐related distress level, and insulin adherence.ResultsThe analysis population comprised 4341 patients. Four (of six) domains showed a significant relationship with total diabetes‐related distress (P < 0.01). Poor insulin adherence was associated with greater diabetes‐related distress (adjusted odds ratio [aOR] 1.14; 95% confidence interval [CI] 1.06–1.22), higher Discrimination (aOR 1.13; 95% CI 1.02–1.27) and Hurried Communication (aOR 1.35; 95% CI 1.20–1.53) scores, and a lower Explained Results score (aOR 0.86; 95% CI 0.77–0.97). Poor insulin adherence was associated with a 0.43% increase in HbA1c, whereas a 1‐unit increase in total diabetes‐related distress and Hurried Communication scores was associated with a 0.171% and 0.145% increase in HbA1c, respectively.ConclusionsPatients distressed about living with T2D, and dissatisfied with aspects of their interactions with physicians, exhibited poor insulin adherence. Perceived physician inattention and lack of engagement (and diabetes‐related distress) directly affect insulin adherence and glycemic control.背景为期2年的前瞻性MOSAIc(Multinational Observational Study assessing Insulin use: understanding the challenges associated with progression of therapy,评估胰岛素使用情况的多国观察性研究:了解治疗进展带来的挑战)研究调查了患者‐、医生‐、医疗卫生系统‐相关因素是否会对2型糖尿病患者的临床结局产生影响。这项基线亚组分析调查了患者‐医生关系对糖尿病相关的不适、胰岛素依从性以及血糖控制可造成何种影响。方法在18个国家的初级保健以及专业医疗机构中招募胰岛素使用时间≥ 3个月的2型糖尿病患者。医生提供了常规的医疗护理。收集临床病史以及最近的HbA1c值;调查患者对医患之间关系的看法、与糖尿病相关的不适程度以及胰岛素依从性。结果分析人群包含了4341名患者。(在6个领域中)有4个方面与总的糖尿病相关不适之间具有显著的相关性(P < 0.01)。胰岛素依从性差与较高的糖尿病相关不适(校正过的优势比[aOR]为1.14;95%置信区间[CI]为1.06‐1.22)、较高的歧视(aOR为1.13;95% CI为1.02‐1.27)和仓促沟通(aOR为1.35;95% CI为1.20‐1.53)得分以及更低的解释病情得分(aOR为0.86;95% CI为0.77‐0.97)相关。胰岛素依从性差可导致HbA1c升高0.43%,然而总的糖尿病相关不适以及仓促沟通得分每增加1个单位就可以导致HbA1c分别升高0.171%与0.145%。结论患者感到苦恼的是2型糖尿病影响到了他们的生活,对于与医生的交流感到不够满意,而且表现为胰岛素依从性差。患者觉得医生不关心自己、缺乏交流(以及糖尿病本身造成的相关痛苦)会直接影响到胰岛素依从性以及血糖控制。HighlightsPatient perceptions of the quality of their interactions with their physicians have a significant association with total diabetes‐related distress. Diabetes‐related distress and patient–physician interactions have a significant independent association with insulin adherence and HbA1c level.This study delineates specific aspects of the patient–physician interaction that are linked to diabetes‐related distress, insulin adherence behavior, and glycemic control.Path analysis showing associations between patient–physician interactions, diabetes‐related distress, insulin adherence, and HbA1c level. The model is not adjusted for baseline covariates and shows only those factors with at least one significant interaction. Parameter coefficients in the path analysis are shown.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137500/1/jdb12443.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137500/2/jdb12443_am.pd

Evaluation of Corn Distillers Solubles on Finishing Steer Performance

A finishing study was conducted to evaluate the effects of feeding 0, 8, 16, or 20% corn distillers solubles (CDS), as well as the effects of feeding a combination of 16% CDS and 20% wet distillers grains plus solubles (WDGS) to replace a blend of dry-rolled and high-moisture corn on finishing steer performance. As inclusions of CDS increased, ADG linearly increased and F:G linearly decreased. Feeding value of CDS at 20% inclusion was determined to be 147% compared to the corn blend. The addition of WDGS resulted in a decrease in DMI with similar ADG, resulting in a decrease in F:G. Feeding a combination of CDS and WDGS resulted in a feeding value of 161% compared to corn. Feeding CDS up to 20% or in combination with WDGS displaces corn in finishing diets and improves ADG and F:G

Long‐Term Outcomes Among Elderly Survivors of Out‐of‐Hospital Cardiac Arrest

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139093/1/jah31396_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139093/2/jah31396.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139093/3/jah31396-sup-0001-SupInfo.pd

Differences in health care use and outcomes by the timing of in-hospital worsening heart failure

BACKGROUND: Patients hospitalized with acute heart failure may experience worsening symptoms requiring escalation of therapy. In-hospital worsening heart failure is associated with worse in-hospital and postdischarge outcomes, but associations between the timing of worsening heart failure and outcomes are unknown. METHODS: Using data from a large clinical registry linked to Medicare claims, we examined characteristics, outcomes, and costs of patients hospitalized for acute heart failure. We defined in-hospital worsening heart failure by the use of inotropes or intravenous vasodilators or initiation of mechanical circulatory support, hemodialysis, or ventilation. The study groups were early worsening heart failure (n = 1,990), late worsening heart failure (n = 4,223), complicated presentation (n = 15,361), and uncomplicated hospital course (n = 41,334). RESULTS: Among 62,908 patients, those with late in-hospital worsening heart failure had higher in-hospital and postdischarge mortality than patients with early worsening heart failure or complicated presentation. Those with early or late worsening heart failure had more frequent all-cause and heart failure readmissions at 30 days and 1 year, with resultant higher costs, compared with patients with an uncomplicated hospital course. CONCLUSION: Although late worsening heart failure was associated with the highest mortality, both early and late worsening heart failures were associated with more frequent readmissions and higher health care costs compared to uncomplicated hospital course. Prevention of worsening heart failure may be an important focus in the care of hospitalized patients with acute heart failure

Users' Guides to the Medical Literature: How to Use an Article About Mortality in a Humanitarian Emergency

The accurate interpretation of mortality surveys in humanitarian crises is useful for both public health responses and security responses. Recent examples suggest that few medical personnel and researchers can accurately interpret the validity of a mortality survey in these settings. Using an example of a mortality survey from the Democratic Republic of Congo (DRC), we demonstrate important methodological considerations that readers should keep in mind when reading a mortality survey to determine the validity of the study and the applicability of the findings to their settings

Timing of CGM initiation in pediatric diabetes: The CGM TIME Trial.

OBJECTIVE: To determine whether timing of CGM initiation offering low glucose suspend (LGS) affects CGM adherence in children and youth starting insulin pump therapy. METHODS: A 5-site RCT of pump-naïve subjects (aged 5-18 years) with type 1 diabetes (T1D) for at least 1 year compared simultaneous pump and CGM initiation offering LGS vs standard pump therapy with CGM initiation delayed for 6 months. Primary outcome was CGM adherence (hours per 28 days) (MiniMed™ Paradigm™ Veo™ system; CareLink Pro™ software) over 6 months after CGM initiation. Secondary outcome HbA1c was measured centrally. Linear mixed-models and ordinary least squares models were fitted to estimate effect of intervention, and covariates baseline age, T1D duration, HbA1c, gender, ethnicity, hypoglycemia history, clinical site, and association between CGM adherence and HbA1c. RESULTS: The trial randomized 144/152 (95%) eligible subjects. Baseline mean age was 11.5 ± 3.3(SD) years, T1D duration 3.4 ± 3.1 years, and HbA1c 7.9 ± 0.9%. Six months after CGM initiation, adjusted mean difference in CGM adherence was 62.4 hours per 28 days greater in the Simultaneous Group compared to Delayed Group (P = .007). There was no difference in mean HbA1c at 6 months. However, for each 100 hours of CGM use per 28-day period, HbA1c was 0.39% (95% CI 0.10%-0.69%) lower. Higher CGM adherence was associated with reduced time with glucose \u3e10 mmol/L (P \u3c .001). CONCLUSION: CGM adherence was higher after 6 months when initiated at same time as pump therapy compared to starting CGM 6 months after pump therapy. Greater CGM adherence was associated with improved HbA1c

Standard‐space atlas of the viscoelastic properties of the human brain

Standard anatomical atlases are common in neuroimaging because they facilitate data analyses and comparisons across subjects and studies. The purpose of this study was to develop a standardized human brain atlas based on the physical mechanical properties (i.e., tissue viscoelasticity) of brain tissue using magnetic resonance elastography (MRE). MRE is a phase contrast-based MRI method that quantifies tissue viscoelasticity noninvasively and in vivo thus providing a macroscopic representation of the microstructural constituents of soft biological tissue. The development of standardized brain MRE atlases are therefore beneficial for comparing neural tissue integrity across populations. Data from a large number of healthy, young adults from multiple studies collected using common MRE acquisition and analysis protocols were assembled (N = 134; 78F/ 56 M; 18–35 years). Nonlinear image registration methods were applied to normalize viscoelastic property maps (shear stiffness, μ, and damping ratio, ξ) to the MNI152 standard structural template within the spatial coordinates of the ICBM-152. We find that average MRE brain templates contain emerging and symmetrized anatomical detail. Leveraging the substantial amount of data assembled, we illustrate that subcortical gray matter structures, white matter tracts, and regions of the cerebral cortex exhibit differing mechanical characteristics. Moreover, we report sex differences in viscoelasticity for specific neuroanatomical structures, which has implications for understanding patterns of individual differences in health and disease. These atlases provide reference values for clinical investigations as well as novel biophysical signatures of neuroanatomy. The templates are made openly available (github.com/mechneurolab/mre134) to foster collaboration across research institutions and to support robust cross-center comparisons

Discovery of bright z ~ 7 galaxies in the UltraVISTA survey

We have exploited the new, deep, near-infrared UltraVISTA imaging of the COSMOS field, in tandem with deep optical and mid-infrared imaging, to conduct a new search for luminous galaxies at redshifts z ~ 7. The unique multi-wavelength dataset provided by VISTA, CFHT, Subaru, HST and Spitzer over a common area of 1 deg^2 has allowed us to select galaxy candidates at z > 6.5 by searching first for Y+J-detected (< 25 AB mag) objects which are undetected in the CFHT+HST optical data. This sample was then refined using a photometric redshift fitting code, enabling the rejection of lower-redshift galaxy contaminants and cool galactic M,L,T dwarf stars.The final result of this process is a small sample of (at most) ten credible galaxy candidates at z > 6.5 which we present in this paper. The first four of these appear to be robust galaxies at z > 6.5, and fitting to their stacked SED yields z = 6.98+-0.05 with a stellar mass M* = 5x10^9 Msun, and rest-frame UV spectral slope beta = -2.0+-0.2. The next three are also good candidates for z > 6.5 galaxies, but the possibility that they are low-redshift galaxies or dwarf stars cannot be excluded. Our final subset of three additional candidates is afflicted not only by potential dwarf-star contamination, but also contains objects likely to lie at redshifts just below z = 6.5. We show that the three even-brighter z > 7 galaxy candidates reported in the COSMOS field by Capak et al. (2011) in fact all lie at z ~ 1.5-3.5. Consequently the new z ~ 7 galaxies reported here are the first credible z ~ 7 Lyman-break galaxies discovered in the COSMOS field and, as the most UV-luminous discovered to date at these redshifts, are prime targets for deep follow-up spectroscopy. We explore their physical properties, and briefly consider the implications of their inferred number density for the form of the galaxy luminosity function at z = 7.Comment: Updated to accepted version, MNRAS. 18 pages, 9 figures, 3 table