The Implications of Inequality for Fiscal Federalism (or Why the Federal Government Should Pay for Local Public Schools)

In designing public policy, a question of first principle is the degree to which government services—and the mechanisms of collecting revenue to finance those services—should be centralized within and across political systems. To inform their assessments of where redistribution should properly occur, public finance researchers have, to date, worked backwards from different assumptions about the mobility of residents within the political community. Scholars have disagreed about the viability of local governments’ efforts to redistribute wealth—with traditionalists arguing that these efforts are made impossible by residential mobility, and recent reformists countering that limitations on mobility indeed allow for limited redistribution at the local level. But these arguments have largely sidestepped questions about what level of centralization is theoretically optimal for redistributive programs. And by focusing on the empirical question of residential mobility, they have ignored a variable that—I seek to demonstrate—is at least as important. In this Essay, I argue that those two deficiencies in the literature are connected. I introduce a simple model to show that economic redistribution becomes more difficult—indeed, approaches impossibility—as economic inequality increases, regardless of one’s assumptions about levels of mobility (by the rich or poor). That is because economic inequality has an inherent spatial dimension: so long as citizens exhibit anything short of perfect mobility (and perfect responsiveness to redistributive policy), its rise will result in an increasing geographic concentration of fiscal resources available to governments. For this reason, higher levels of economic inequality strengthen the case for centralizing the financing of any public good or program with redistributive goals—including the great bulk of what contemporary governments aim to do. I introduce the concept of a “fiscal unit” to refer to the geographic scope of public financing—which might be, depending on the program, a school district boundary, a county, a state, or the entire country. In order to achieve an equitable allocation of public goods, policymakers should respond to rising income inequality by shifting the site of revenue collection to occur at widely drawn “fiscal units”. This can take two forms. It can be done by expanding the scope of fiscal boundaries—for example, by funding locally-administered programs at the state or federal level. Alternatively, policymakers could respond to inequality by increasing fiscal transfers from higher levels of government (wider fiscal units) to lower, geographically smaller governments. Rather than an afterthought, the existing level of economic inequality within a political community may be the single most important question for this aspect of policy design. Where wealth is unequally distributed, the primary responsibility of assessing the revenues used to finance public goods should be assumed by levels of government representing the greatest number of people. This paper thus suggests that policymakers should respond to rising income inequality by shifting not only the burden but also the site of redistributive taxation

Effectiveness of an Adapted Virtual Medication Reconciliation OSCE Compared with In Person OSCE

Introduction: The objective of this study was to measure virtually-based objective structured clinical exam (OSCE) pass rates of student pharmacists who received remote, synchronous instruction on medication reconciliation compared with OSCE pass rates from the previous class, who received face to face synchronous instruction and OSCEs. The secondary objective was to measure student perceptions of remote instruction and OSCE preparation. Materials and Methods: Second year student pharmacists attended four online preparatory labs to learn and practice the process of performing a medication reconciliation. A virtually-based OSCE was used to assess student competency of identifying the primary or life-threatening medication related problem (MRP). Failing to identify the MRP represented a “kill point” and an automatic failing grade. A brief 10-item survey designed to measure student perceptions was sent to all participants post OSCE. Results: Seventy-seven students completed the OSCE and the overall pass rates were similar between the 2020 and 2019 class years (97% vs 94%, respectively; p = 0.24). Survey responses showed students lacked confidence, preferred face-to-face learning rather than online and most described their remote environments as not conducive to learning. Conclusion: Online instruction and assessment was at least as effective as traditional face-to-face methods. however the virtual-based platform was not preferred by learners

BHLHE40 regulates the T-cell effector function required for tumor microenvironment remodeling and immune checkpoint therapy efficacy

Immune checkpoint therapy (ICT) using antibody blockade of programmed cell death protein 1 (PD-1) or cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) can provoke T cell-dependent antitumor activity that generates durable clinical responses in some patients. The epigenetic and transcriptional features that T cells require for efficacious ICT remain to be fully elucidated. Herein, we report that anti-PD-1 and anti-CTLA-4 ICT induce upregulation of the transcription factor BHLHE40 in tumor antigen-specific CD8+ and CD4+ T cells and that T cells require BHLHE40 for effective ICT in mice bearing immune-edited tumors. Single-cell RNA sequencing of intratumoral immune cells in BHLHE40-deficient mice revealed differential ICT-induced immune cell remodeling. The BHLHE40-dependent gene expression changes indicated dysregulated metabolism, NF-κB signaling, and IFNγ response within certain subpopulations of CD4+ and CD8+ T cells. Intratumoral CD4+ and CD8+ T cells from BHLHE40-deficient mice exhibited higher expression of the inhibitory receptor gene Tigit and displayed alterations in expression of genes encoding chemokines/chemokine receptors and granzyme family members. Mice lacking BHLHE40 had reduced ICT-driven IFNγ production by CD4+ and CD8+ T cells and defects in ICT-induced remodeling of macrophages from a CX3CR1+CD206+ subpopulation to an iNOS+ subpopulation that is typically observed during effective ICT. Although both anti-PD-1 and anti-CTLA-4 ICT in BHLHE40-deficient mice led to the same outcome-tumor outgrowth-several BHLHE40-dependent alterations were specific to the ICT that was used. Our results reveal a crucial role for BHLHE40 in effective ICT and suggest that BHLHE40 may be a predictive or prognostic biomarker for ICT efficacy and a potential therapeutic target

Early Navigation Performance of the OSIRIS-REx Approach to Bennu

The New Frontiers-class OSIRIS-REx (Origins, Spectral Interpretation, Resource Identification, Security-Regolith Explorer) mission is the first American endeavor to return a sample from an asteroid. In preparation for retrieving the sample, OSIRIS-REx is conducting a campaign of challenging proximity-operations maneuvers and scientific observations, bringing the spacecraft closer and closer to the surface of near-Earth asteroid (101955) Bennu. Ultimately, the spacecraft will enter a 900-meter-radius orbit about Bennu and conduct a series of reconnaissance flybys of candidate sample sites before being guided into contact with the surface for the Touch and Go sample collection event. Between August and December 2018, the OSIRIS-REx team acquired the first optical observations of Bennu and used them for navigation. We conducted a series of maneuvers with the main engine, Trajectory Correction Maneuver, and Attitude Control System thruster sets to slow the OSIRIS-REx approach to Bennu and achieve rendezvous on December 3, 2018. This paper describes the trajectory design, navigation conops, and key navigation results from the Approach phase of the OSIRIS-REx mission

Pilot study of sources and concentrations of size-resolved airborne particles in a neonatal intensive care unit

Infants in neonatal intensive care units (NICUs) are vulnerable to environmental stressors. Few studies have reported on airborne particles in the NICU environment. During a four-day pilot study in a private-style NICU, we measured size-resolved particle number (PN) concentrations with 1-min resolution. The investigation included simultaneous sampling in an unoccupied baby room and in an incubator of an otherwise normally functioning NICU. Background submicron (0.3-1 µm) particle levels in the room were 3-4 orders of magnitude lower than outdoors, owing to high-efficiency particulate filtration of supply air. Airborne supermicron particles were detected in the room; their presence was attributed primarily to emissions from occupant movements. The fraction of in-room PN detected within an infant incubator ranged from 0.2 for particles >10 µm to 0.6 for particles with diameter 0.3-0.5 µm. The incubator humidifier was a strong additional source of particles smaller than 5 µm. Activities by researchers, designed to simulate caregiver visits, were associated with elevated particle concentrations across all measured size ranges, and were particularly discernible among larger particles. Concentrations increased with the number of occupants and with the duration and vigor of activities. The highest levels were observed when fabrics were handled. Against the low background in this environment, even small occupancy-associated perturbations – such as from a brief entry – were discernible. Measurements from a second NICU in a different US region were found to be broadly similar. A notable difference was higher submicron particle levels in the second NICU, attributed to elevated outdoor pollution

Preserving and Using Germplasm and Dissociated Embryonic Cells for Conserving Caribbean and Pacific Coral

Coral reefs are experiencing unprecedented degradation due to human activities, and protecting specific reef habitats may not stop this decline, because the most serious threats are global (i.e., climate change), not local. However, ex situ preservation practices can provide safeguards for coral reef conservation. Specifically, modern advances in cryobiology and genome banking could secure existing species and genetic diversity until genotypes can be introduced into rehabilitated habitats. We assessed the feasibility of recovering viable sperm and embryonic cells post-thaw from two coral species, Acropora palmata and Fungia scutaria that have diffferent evolutionary histories, ecological niches and reproductive strategies. In vitro fertilization (IVF) of conspecific eggs using fresh (control) spermatozoa revealed high levels of fertilization (>90% in A. palmata; >84% in F. scutaria; P>0.05) that were unaffected by tested sperm concentrations. A solution of 10% dimethyl sulfoxide (DMSO) at cooling rates of 20 to 30°C/min most successfully cryopreserved both A. palmata and F. scutaria spermatozoa and allowed producing developing larvae in vitro. IVF success under these conditions was 65% in A. palmata and 53% in F. scutaria on particular nights; however, on subsequent nights, the same process resulted in little or no IVF success. Thus, the window for optimal freezing of high quality spermatozoa was short (∼5 h for one night each spawning cycle). Additionally, cryopreserved F. scutaria embryonic cells had∼50% post-thaw viability as measured by intact membranes. Thus, despite some differences between species, coral spermatozoa and embryonic cells are viable after low temperature (−196°C) storage, preservation and thawing. Based on these results, we have begun systematically banking coral spermatozoa and embryonic cells on a large-scale as a support approach for preserving existing bio- and genetic diversity found in reef systems

The Implications of Inequality for Fiscal Federalism (or Why the Federal Government Should Pay for Local Public Schools)

In designing public policy, a question of first principle is the degree to which government services—and the mechanisms of collecting revenue to finance those services—should be centralized within and across political systems. To inform their assessments of where redistribution should properly occur, public finance researchers have, to date, worked backwards from different assumptions about the mobility of residents within the political community. Scholars have disagreed about the viability of local governments’ efforts to redistribute wealth—with traditionalists arguing that these efforts are made impossible by residential mobility, and recent reformists countering that limitations on mobility indeed allow for limited redistribution at the local level. But these arguments have largely sidestepped questions about what level of centralization is theoretically optimal for redistributive programs. And by focusing on the empirical question of residential mobility, they have ignored a variable that—I seek to demonstrate—is at least as important. In this Essay, I argue that those two deficiencies in the literature are connected. I introduce a simple model to show that economic redistribution becomes more difficult—indeed, approaches impossibility—as economic inequality increases, regardless of one’s assumptions about levels of mobility (by the rich or poor). That is because economic inequality has an inherent spatial dimension: so long as citizens exhibit anything short of perfect mobility (and perfect responsiveness to redistributive policy), its rise will result in an increasing geographic concentration of fiscal resources available to governments. For this reason, higher levels of economic inequality strengthen the case for centralizing the financing of any public good or program with redistributive goals—including the great bulk of what contemporary governments aim to do. I introduce the concept of a “fiscal unit” to refer to the geographic scope of public financing—which might be, depending on the program, a school district boundary, a county, a state, or the entire country. In order to achieve an equitable allocation of public goods, policymakers should respond to rising income inequality by shifting the site of revenue collection to occur at widely drawn “fiscal units”. This can take two forms. It can be done by expanding the scope of fiscal boundaries—for example, by funding locally-administered programs at the state or federal level. Alternatively, policymakers could respond to inequality by increasing fiscal transfers from higher levels of government (wider fiscal units) to lower, geographically smaller governments. Rather than an afterthought, the existing level of economic inequality within a political community may be the single most important question for this aspect of policy design. Where wealth is unequally distributed, the primary responsibility of assessing the revenues used to finance public goods should be assumed by levels of government representing the greatest number of people. This paper thus suggests that policymakers should respond to rising income inequality by shifting not only the burden but also the site of redistributive taxation