Symposium: The Least Understood Branch: The Demands and Challenges of the State Judiciary

On March 31, 2017, the Vanderbilt Law Review, in conjunction with the American Constitution Society, hosted a Symposium at Vanderbilt Law School entitled The Least Understood Branch: The Demands and Challenges of the State Judiciary. This Symposium began five months earlier at Emory University School of Law, where the Symposium\u27s contributors gathered to discuss the importance and difficulties of studying state courts. This theme is reflected in the articles published in this Symposium issue. The importance of state courts to the American system of justice can hardly be overstated. As Professors Tracey George and Albert Yoon recognize, The work of courts in America is the work of state courts. \u27 Still, given federal court dominance in both legal scholarship and law school curricula, it seems appropriate to preface this Symposium on state courts with a reminder of their critical role in the American system of justice. By almost any measure, state courts wield greater influence over the way Americans interact with the judicial system than do federal courts. Consider the raw number of cases filed in state and federal courts annually. In 2015, 86.2 million cases were filed in state courts. 2 Compare this to the 361,689 cases filed in federal court that same year.3 State courts heard over 54 times more civil cases than federal courts 4 and over 226 times more criminal cases.5 Consider also the number of state and federal judgeships: there are approximately 30,000 state judges in America, compared to only 1,700 federal judges.6 When individuals interact with the judicial system, it is overwhelmingly through state courts

Object Repetition Leads to Local Increases in the Temporal Coordination of Neural Responses

Experience with visual objects leads to later improvements in identification speed and accuracy (“repetition priming”), but generally leads to reductions in neural activity in single-cell recording studies in animals and fMRI studies in humans. Here we use event-related, source-localized MEG (ER-SAM) to evaluate the possibility that neural activity changes related to priming in occipital, temporal, and prefrontal cortex correspond to more temporally coordinated and synchronized activity, reflected in local increases in the amplitude of low-frequency activity fluctuations (i.e. evoked power) that are time-locked to stimulus onset. Subjects (N = 17) identified pictures of objects that were either novel or repeated during the session. Tests in two separate low-frequency bands (theta/alpha: 5–15 Hz; beta: 15–35 Hz) revealed increases in evoked power (5–15 Hz) for repeated stimuli in the right fusiform gyrus, with the earliest significant increases observed 100–200 ms after stimulus onset. Increases with stimulus repetition were also observed in striate/extrastriate cortex (15–35 Hz) by 200–300 ms post-stimulus, along with a trend for a similar pattern in right lateral prefrontal cortex (5–15 Hz). Our results suggest that experience-dependent reductions in neural activity may affect improved behavioral identification through more coordinated, synchronized activity at low frequencies, constituting a mechanism for more efficient neural processing with experience

Incorporating Alternative Polygenic Risk Scores into the BOADICEA Breast Cancer Risk Prediction Model

Polygenic risk; Prediction; Breast cancerRiesgo poligénico; Predicción; Cáncer de mamaRisc poligènic; Predicció; Càncer de mamaBackground: The multifactorial risk prediction model BOADICEA enables identification of women at higher or lower risk of developing breast cancer. BOADICEA models genetic susceptibility in terms of the effects of rare variants in breast cancer susceptibility genes and a polygenic component, decomposed into an unmeasured and a measured component - the polygenic risk score (PRS). The current version was developed using a 313 SNP PRS. Here, we evaluated approaches to incorporating this PRS and alternative PRS in BOADICEA. Methods: The mean, SD, and proportion of the overall polygenic component explained by the PRS (α2) need to be estimated. α was estimated using logistic regression, where the age-specific log-OR is constrained to be a function of the age-dependent polygenic relative risk in BOADICEA; and using a retrospective likelihood (RL) approach that models, in addition, the unmeasured polygenic component. Results: Parameters were computed for 11 PRS, including 6 variations of the 313 SNP PRS used in clinical trials and implementation studies. The logistic regression approach underestimates α⁠, as compared with the RL estimates. The RL α estimates were very close to those obtained by assuming proportionality to the OR per 1 SD, with the constant of proportionality estimated using the 313 SNP PRS. Small variations in the SNPs included in the PRS can lead to large differences in the mean. Conclusions: BOADICEA can be readily adapted to different PRS in a manner that maintains consistency of the model.This work has been supported by grants from Cancer Research UK (PPRPGM-Nov20\100002); the European Union's Horizon 2020 Research and Innovation Programme under grant agreement numbers 633784 (B-CAST) and 634935 (BRIDGES); the PERSPECTIVE I&I project which is funded by the Government of Canada through Genome Canada (#13529) and the Canadian Institutes of Health Research (#155865), the Ministère de l’Économie et de l'Innovation du Québec through Genome Québec, the Quebec Breast Cancer Foundation, the CHU de Quebec Foundation and the Ontario Research Fund; and by the NIHR Cambridge Biomedical Research Centre (BRC-1215–20014). BCAC is funded by the European Union's Horizon 2020 Research and Innovation Programme (grant numbers 634935 and 633784 for BRIDGES and B-CAST respectively), and the PERSPECTIVE I&I project. Additional funding for BCAC is provided via the Confluence project which is funded with intramural funds from the NCI Intramural Research Program, NIH. Genotyping of the OncoArray was funded by the NIH Grant U19 CA148065, and Cancer Research UK Grant C1287/A16563 and the PERSPECTIVE project supported by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research (grant GPH-129344) and, the Ministère de l’Économie, Science et Innovation du Québec through Genome Québec and the PSRSIIRI-701 grant, and the Quebec Breast Cancer Foundation. MT was supported by the NIHR Cambridge Biomedical Research Centre (BRC-1215–20014) and Cancer Research UK C22770/A31523 (International Alliance for Cancer Early Detection programme). The PRISMA study has been funded by Instituto de Salud Carlos III through the project " PI19/01195″ (Co-funded by European Regional Development Fund "A way to make Europe") and it received the institutional support of CERCA Program (Generalitat de Catalunya). The publication costs of this article were defrayed in part by the payment of publication fees. Therefore, and solely to indicate this fact, this article is hereby marked “advertisement” in accordance with 18 USC section 1734

The position of authenticity within extant models of personality.

The aim of the current study was to explore where authenticity, derived from the humanistic tradition of psychology, was positioned within a number of extant models of personality. Exploratory and Confirmatory Factor Analysis of data from four samples (total N = 1286) suggested that authenticity can be considered as loading on the Honesty–Humility factor of personality. These findings are discussed in terms of the wider theoretical overlaps between Honesty–Humility and psychological functioning as emphasised by the humanistic tradition of psychology

“PPI? That sounds like Payment Protection Insurance”: Reflections and learning from a substance use and homelessness study Experts by Experience group

BackgroundPatient and Public Involvement in research is important for citizenship, accountability and transparency, and has the practical benefit of helping to ensure its quality and applicability. Involving members of the public in research is becoming increasingly commonplace, in the UK and internationally. It is essential that public involvement is inclusive of individuals and their diverse life experiences, including challenging experiences that may be associated with stigma and social exclusion. The involvement of people with lived/living experience of substance use and homelessness in research is increasing in response to increased recognition of the importance of inclusion and the benefits conferred to research.Main bodyIn this commentary, we share our own experiences of being part of a Patient and Public Involvement group that was convened during a feasibility study of a peer-delivered harm reduction intervention. We are a diverse group but share experience of the field of substance use/homelessness, as people with lived/living experience, and as researchers and practitioners. We share our reflections and learning, as well as offer recommendations for researchers working in our field. Our group worked together to make a positive and deliberate contribution to the study. This did not happen by chance but required the development of mutual trust and respect, with each member having a commitment to support the group for its two-year duration.Short conclusionIt is important for researchers to appreciate that meaningful Patient and Public Involvement is very valuable but requires a commitment from all involved. Regarding our field of substance use and homelessness specifically, it is essential that people with these experiences have opportunities to contribute to research and can do so in a meaningful way. People with lived/living experience are able to bring to life the rich tapestry of others’ experiences. However, the involvement must be neither tokenistic nor indifferent to the wider challenges common to these experiences.---Plain English SummaryThis article describes the activities and lessons learned from the involvement of an Experts by Experience group in a National Institute for Health Research (NIHR) study. The study was about peer support for people experiencing homelessness and substance use challenges. The Experts by Experience group was made up of research team members, and a range of individuals from across the UK who had experienced homelessness and/or drug use and/or alcohol use, and who were recruited from a range of services who currently worked with people experiencing homelessness and/or substance use. The purpose of the group was to ‘sense check’ the study throughout. The group was a requirement from NIHR who funded the project. These groups are usually known as PPI groups (Patient and Public Involvement), but members of the group felt that ‘Experts by Experience’ was a more accurate term to describe the membership. The lived/living experience members’ knowledge of the topic, and experience of using the types of services and interventions involved in the study, helped to guide the study team. Study team members facilitated Experts by Experience group meetings, but everyone was equal. The group gelled and worked well together to oversee the study. This article describes the benefits of having Experts by Experience members as part of the project from the inception through to the end. Ensuring the group had autonomy enhanced the study and was a powerful and empowering experience for the lived/living experience members

Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: A multi-methods study.

BACKGROUND:There is a growing focus on the development of multi-factorial cancer risk prediction algorithms alongside tools that operationalise them for clinical use. BOADICEA is a breast and ovarian cancer risk prediction model incorporating genetic and other risk factors. A new user-friendly Web-based tool (CanRisk.org) has been developed to apply BOADICEA. This study aimed to explore the acceptability of the prototype CanRisk tool among two healthcare professional groups to inform further development, evaluation and implementation. METHOD:A multi-methods approach was used. Clinicians from primary care and specialist genetics clinics in England, France and Germany were invited to use the CanRisk prototype with two test cases (either face-to-face with a simulated patient or via a written vignette). Their views about the tool were examined via a semi-structured interview or equivalent open-ended questionnaire. Qualitative data were subjected to thematic analysis and organised around Sekhon's Theoretical Framework of Acceptability. RESULTS:Seventy-five clinicians participated, 21 from primary care and 54 from specialist genetics clinics. Participants were from England (n = 37), France (n = 23) and Germany (n = 15). The prototype CanRisk tool was generally acceptable to most participants due to its intuitive design. Primary care clinicians were concerned about the amount of time needed to complete, interpret and communicate risk information. Clinicians from both settings were apprehensive about the impact of the CanRisk tool on their consultations and lack of opportunities to interpret risk scores before sharing them with their patients. CONCLUSIONS:The findings highlight the challenges associated with developing a complex tool for use in different clinical settings; they also helped refine the tool. This prototype may not have been versatile enough for clinical use in both primary care and specialist genetics clinics where the needs of clinicians are different, emphasising the importance of understanding the clinical context when developing cancer risk assessment tools

Taking on a Community Solutions Process (Co-Solve) to the Pain and Opioid Epidemic: A Multi-disciplinary and Multi-institute Pain Panel and Community Response in Sacramento, California

America’s healthcare providers and patients are challenged by an overwhelming high prevalence of chronic pain and opioid misuse. Approximately 23.4 million adults suffer from daily pain and in 2014, nearly 61% of Americans who died from drug overdoses used an opioid analgesic. Unrecognized addiction, untreated psychiatric comorbidity, and lack of training/education for providers and patients are factors associated with chronic pain and opioid misuse. Communication strategies and structures are required to enhance collaboration between multidisciplinary providers and institutions. On September 28, 2017, an open panel discussion with pain specialists from three major academic and medical institutes in Sacramento, California initiated an integrative community solutions process to optimize pain education best practices and to protect public health. The attendees represented a wide range of healthcare disciplines. This commentary describes ideas derived from dialogue between community attendees and panelists, which considers both healthcare provider characteristics and patients’ cultural backgrounds. Providers of most disciplines underscored the need to share information and institute cross-disciplinary training on pain and behavioral health treatments. In conclusion, we outline an integrative community-based framework, namely the Community Solutions Process (Co-Solve), to help other communities to implement and derive their own action-oriented solutions unique to their population

Deception in context: coding nonverbal cues, situational variables and risk of detection

There are many situations in which deception may arise and understanding the behaviors associated with it are compounded by various contexts in which it may occur. This paper sets out a coding protocol for identifying cues to deception and reports on three studies, in which deception was studied in different contexts. The contexts involved manipulating risks (i.e., probability) of being detected and reconnaissance, both of which are related to terrorist activities. Two of the studies examined the impact of changing the risks of deception detection, whilst the third investigated increased cognitive demand of duplex deception tasks including reconnaissance and deception. In all three studies, cues to deception were analyzed in relation to observable body movements and subjective impressions given by participants. In general, the results indicate a pattern of hand movement reduction by deceivers, and suggest the notion that raising the risk of detection influences deceivers? behaviors. Participants in the higher risk condition displayed increased negative affect (found in deceivers) and tension (found in both deceivers and truth-tellers) than those in lower risk conditions

pedigreejs: a web-based graphical pedigree editor.

MOTIVATION: The collection, management and visualization of clinical pedigree (family history) data is a core activity in clinical genetics centres. However, clinical pedigree datasets can be difficult to manage, as they are time consuming to capture, and can be difficult to build, manipulate and visualize graphically. Several standalone graphical pedigree editors and drawing applications exist but there are no freely available lightweight graphical pedigree editors that can be easily configured and incorporated into web applications. RESULTS: We developed 'pedigreejs', an interactive graphical pedigree editor written in JavaScript, which uses standard pedigree nomenclature. Pedigreejs provides an easily configurable, extensible and lightweight pedigree editor. It makes use of an open-source Javascript library to define a hierarchical layout and to produce images in scalable vector graphics (SVG) format that can be viewed and edited in web browsers. AVAILABILITY AND IMPLEMENTATION: The software is freely available under GPL licence (https://ccge-boadicea.github.io/pedigreejs/). CONTACT: [email protected]. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online

Incorporating Alternative Polygenic Risk Scores into the BOADICEA Breast Cancer Risk Prediction Model

Background: The multifactorial risk prediction model BOADI-CEA enables identification of women at higher or lower risk of developing breast cancer. BOADICEA models genetic susceptibility in terms of the effects of rare variants in breast cancer susceptibility genes and a polygenic component, decomposed into an unmeasured and a measured component -the polygenic risk score (PRS). The current version was developed using a 313 SNP PRS. Here, we evaluated approaches to incorporating this PRS and alternative PRS in BOADICEA.Methods: The mean, SD, and proportion of the overall polygenic component explained by the PRS (a2) need to be estimated. a was estimated using logistic regression, where the age-specific log-OR is constrained to be a function of the age-dependent polygenic relative risk in BOADICEA; and using a retrospective likelihood (RL) approach that models, in addition, the unmeasured polygenic component.Results: Parameters were computed for 11 PRS, including 6 variations of the 313 SNP PRS used in clinical trials and imple-mentation studies. The logistic regression approach underestimates a, as compared with the RL estimates. The RL a estimates were very close to those obtained by assuming proportionality to the OR per 1 SD, with the constant of proportionality estimated using the 313 SNP PRS. Small variations in the SNPs included in the PRS can lead to large differences in the mean.Conclusions: BOADICEA can be readily adapted to different PRS in a manner that maintains consistency of the model.Impact : The methods described facilitate comprehensive breast cancer risk assessment