A Quantitative Methodology for Determining the Need for Exposure-Prompted Medical Monitoring

Some toxic exposures to drugs or other environmental chemicals may create an increased risk of future disease for which periodic preventive medical screening might be desirable. However, many of these risks, even if unacceptable as a matter of public health policy, might still not be significant enough for medical monitoring (periodic diagnostic screening for latent illnesses or medical conditions) to be an appropriate medical intervention. This somewhat unintuitive, but statistically certain, conclusion can be demonstrated in relatively simple mathematical terms. Accordingly, we introduce Bayes\u27s Rule and decision analysis, a quantitative methodology commonly employed by medical practitioners. A review of current medical practices indicates that physicians decide whether to recommend monitoring for a particular exposed population by knowing the natural history of the disease and by first calculating the predictive value of a positive test ( PPV ), which will be one to five percent or greater for an endorsable monitoring exercise, absent exceptional circumstances. Rather than simply relying on the opinions of retained medical experts, this accessible quantitative method permits judges, jurists, and policymakers to more confidently and objectively decide whether medical monitoring is appropriate and necessary as a result of a specific chemical exposure

A Quantitative Methodology for Determining the Need for Exposure-Prompted Medical Monitoring

Some toxic exposures to drugs or other environmental chemicals may create an increased risk of future disease for which periodic preventive medical screening might be desirable. However, many of these risks, even if unacceptable as a matter of public health policy, might still not be significant enough for medical monitoring (periodic diagnostic screening for latent illnesses or medical conditions) to be an appropriate medical intervention. This somewhat unintuitive, but statistically certain, conclusion can be demonstrated in relatively simple mathematical terms. Accordingly, we introduce Bayes\u27s Rule and decision analysis, a quantitative methodology commonly employed by medical practitioners. A review of current medical practices indicates that physicians decide whether to recommend monitoring for a particular exposed population by knowing the natural history of the disease and by first calculating the predictive value of a positive test ( PPV ), which will be one to five percent or greater for an endorsable monitoring exercise, absent exceptional circumstances. Rather than simply relying on the opinions of retained medical experts, this accessible quantitative method permits judges, jurists, and policymakers to more confidently and objectively decide whether medical monitoring is appropriate and necessary as a result of a specific chemical exposure

Credit scores, lending, and psychosocial disability

Credit scores have become a near-universal financial passport for Americans to meet common personal needs including employment, loans, insurance, and home and car purchases or leases. At the same time, Elizabeth Warren and others have documented the horrific economic, emotional, and health consequences of low creditworthiness for score-bearers and their families. Individuals with psychosocial disabilities (previously called mental disabilities or mental illnesses) can make disastrously poor financial decisions during the active phases of their conditions; during inactive phases they are as capable as others of making sound or poor financial decisions. Yet, in computing credit scores and selling credit reports, national and transnational credit-reporting agencies (like Equifax) do not account for the implications of psychosocial disability. Worse, evidence shows that businesses rely on these reports to predatorily target borrowers with psychosocial disabilities—and especially those who are also women and racial minorities—in deciding terms of lending, employment, and housing. In theory but not in practice, the Americans with Disabilities Act and the Fair Housing Act each prohibit discriminatory financial decisions arising from disability status, while also requiring reasonable accommodations to equalize opportunities for disabled persons. The United Nations Convention on the Rights of Persons with Disabilities (which the United States has signed) further mandates enabling the financial decision making of these individuals, but does not provide guidance on achieving this obligation. Further, despite the crucial and direct implications this situation also raises for vast numbers of Americans without psychosocial disabilities who likewise make poor credit decisions, it has not undergone legal analysis. We engage this significant gap by suggesting schemes drawn from historical and comparative contexts that could enable the creditworthiness of persons with psychosocial disabilities, and then critiquing the costs and benefits of each. In doing so, we proffer the first analysis of this issue in the legal literature and seek to stimulate future dialogue among academics and policymakers. The Article concludes with thoughts on the implications of its analyses for the broader issue of credit scoring.http://www.bu.edu/bulawreviewam2016Centre for Human Right

Evolution of the electronic structure with size in II-VI semiconductor nanocrystals

In order to provide a quantitatively accurate description of the band gap variation with sizes in various II-VI semiconductor nanocrystals, we make use of the recently reported tight-binding parametrization of the corresponding bulk systems. Using the same tight-binding scheme and parameters, we calculate the electronic structure of II-VI nanocrystals in real space with sizes ranging between 5 and 80 {\AA} in diameter. A comparison with available experimental results from the literature shows an excellent agreement over the entire range of sizes.Comment: 17 pages, 4 figures, accepted in Phys. Rev.

Multiband tight-binding theory of disordered ABC semiconductor quantum dots: Application to the optical properties of alloyed CdZnSe nanocrystals

Zero-dimensional nanocrystals, as obtained by chemical synthesis, offer a broad range of applications, as their spectrum and thus their excitation gap can be tailored by variation of their size. Additionally, nanocrystals of the type ABC can be realized by alloying of two pure compound semiconductor materials AC and BC, which allows for a continuous tuning of their absorption and emission spectrum with the concentration x. We use the single-particle energies and wave functions calculated from a multiband sp^3 empirical tight-binding model in combination with the configuration interaction scheme to calculate the optical properties of CdZnSe nanocrystals with a spherical shape. In contrast to common mean-field approaches like the virtual crystal approximation (VCA), we treat the disorder on a microscopic level by taking into account a finite number of realizations for each size and concentration. We then compare the results for the optical properties with recent experimental data and calculate the optical bowing coefficient for further sizes