• A Rare Case of Aortoatrial Fistula from Streptococcal Endocarditis

      Arshad, Hammad; Young, Meilin; Rali, Parth (2017-07-05)
      We represent an unfortunate case of postinfluenza streptococcal endocarditis in a 34-year-old healthy male. He presented with hypoxic respiratory failure and was found to have mitral and aortic valve vegetation. Hospital course was complicated by the presence of an aortoatrial fistula from an aortic root abscess, persistent septic shock, and multiorgan failure.
    • Addressing the Housing Crisis: Challenges and Innovations

      Levine, Judith A.; Hammar, Colin J.; Public Policy Lab (Temple University) (Temple University. Public Policy Lab, 2021)
    • Assessing Legal Responses to COVID-19

      Burris, Scott; de Guia, Sarah; Gable, Lance; Levin, Donna E.; Parmet, Wendy E.; Terry, Nicolas P.; Center for Public Health Law Research (Temple University); ChangeLab Solutions; Wayne State University; The Network for Public Health Law; et al. (2020-08)
      In August 2020, as the nation continued to address the ongoing COVID-19 pandemic, which had resulted in hundreds of thousands of deaths and a severe economic recession, 50 top national experts offered an assessment of the U.S. policy response to the crisis. The research details the widespread failure of the country’s leadership in planning and executing a cohesive, national response, and how the crisis exposed weaknesses in the nation’s health care and public health systems. In Assessing Legal Responses to COVID-19, the authors also offer recommendations on how federal, state and local leaders can better respond to COVID-19 and future pandemics.
    • Assuring Access to Abortion

      Center for Public Health Law Research (Temple University) (2021)
      Over the spring of 2020, numerous states announced measures suspending abortions in response to COVID-19. Banning abortion during the pandemic is counterproductive. Impeding access to abortion will not help preserve healthcare resources. Moreover, prohibiting access to abortion care exacerbates the strain on the healthcare system. People who lack access to abortions will travel to neighboring states, induce their own abortions, or carry pregnancies to term, which will require prenatal care and assistance in childbirth. Perhaps more importantly, the people hit hardest by suspending abortion care are those for whom the pandemic already has had devastating effects. Lifting restrictions on medication abortion and expanding telehealth abortion services will conserve healthcare resources and improve public health. Recognizing the advantages of telemedicine, some states, as well as the federal government, have relaxed restrictions on remote diagnosis and treatment. However, many of those same states have carved out exceptions for abortion in their telemedicine policies. In addition, people seeking medication abortions still face unnecessary restrictions on access, none of which are applied to comparable office-based procedures. Policymakers can eliminate barriers to safe abortion services now and in the future. “No-touch” terminations, in which all medical supervision happens over the telephone or online, can better accomplish the goals that the present abortion suspensions cannot. Telehealth for medical abortion can ease the burdens on pregnant people, healthcare workers, and health systems in light of the unprecedented challenges presented by COVID-19.
    • COVID-19 Policy Playbook II: Legal Recommendations for a Safer, More Equitable Future

      Burris, Scott; de Guia, Sarah; Gable, Lance; Levin, Donna E.; Parmet, Wendy E.; Terry, Nicolas P.; Center for Public Health Law Research (Temple University); ChangeLab Solutions; Wayne State University; The Network for Public Health Law; et al. (2021-03)
      The United States continues to address and recover from the year-old COVID-19 pandemic, which has resulted in more than 500,000 deaths so far and a historic economic recession. Fifty top legal experts convene to offer a new assessment of the U.S. policy response to the crisis, COVID-19 Policy Playbook: Legal Recommendations for a Safer, More Equitable Future, and recommend policy solutions at all levels of government, as the nation works to quell the current crisis and carry out plans to rebuild.
    • COVID-19: Challenges for Higher Education

      Public Policy Lab (Temple University) (Temple University. Public Policy Lab, 2020-08-18)
    • Embracing the TBOR

      Abreu, Alice G.; Greenstein, Richard K. (2017-11-27)
      When Congress codified the Taxpayer Bill of Rights (the “TBOR”) in 2015 the tax bar largely shrugged, but that is a mistake. Section 7803(a)(3) is not just another iteration of the phrase Congress used to christen legislation designed to reign in perceived IRS abuses in the 80’s and 90’s, when Congress enacted three different pieces of legislation that bore the name “Taxpayer Bill of Rights.” Despite their lofty titles, none of those enactments contained a single amendment to the Internal Revenue Code that used the word “right,” or employed the language of rights. By contrast, section 7803(a)(3) actually refers to “taxpayer rights” and lists ten items. Therefore, despite the claims of its promoters that the 2015 legislation simply restates rights already provided by the Code, the codification of the TBOR has the power to transform the tax practice and the relationship between taxpayers and the IRS. In this Article we explain why. Specifically, we make three arguments. First, construing the 2015 codification of the TBOR as a meaningless gesture ignores the well-established canon of statutory construction against surplusage, as well as its important corollary: when Congress amends a statute it intends to change something. Second, the TBOR significantly enhances taxpayers’ normative basis for demanding legal remedies for violations of their rights because it invokes procedural justice, using the language of rights where only government duties existed before. Third, the TBOR may have actually created taxpayer rights. We do not argue that all taxpayer rights should be enforced either all the time or to the same extent, as that could be disruptive or even catastrophic for tax administration and may not be necessary to allow the TBOR to achieve its goals. But we do maintain that the codification of the TBOR can transform the legal environment so that demands for enforcement can be weighed by the courts on a case by case basis, in light of all the facts and circumstances, which include the identity and attributes of the taxpayer. Recent events confirm the importance of the TBOR and suggest that the tide of taxpayer indifference has begun to turn. On November 8, 2017, Facebook filed a complaint against the IRS, citing the TBOR’s “right to appeal a decision of the Internal Revenue Service in an independent forum,” section 7803(a)(3)(E)), as the basis for its request that the court “[i]ssue an injunction or mandamus-like relief ordering Defendants to provide Facebook access to IRS Appeals.” We believe that Facebook is just the first of many taxpayers who will formally embrace the TBOR as a source of rights and as the basis for crafting remedies to enforce those rights.
    • Is non-invasive indocyanine-green angiography a useful adjunct for the debridement of infected sternal wounds?

      Tyrell, Richard O.; Kilmartin, Catherine; Acevedo, Edwin; Keshavamurthy, Suresh; Gassman, Andrew; 0000-0002-5578-1911 (2018-05-01)
      Laser-assisted indocyanine-green imaging (ICG) has a wide range of surgical applications, and has been used in reconstructive surgery to aid in assessing the viability of free tissue transfers and to help predict poor tissue perfusion. However, its indications for use is limited to assessing free flap tissue perfusion, coronary artery perfusion during coronary artery bypass (CABG), and tissue perfusion in diabetic foot ulcers, to name a few. This system has been proven to be a safe, reliable adjunctive modality to assess microvascular compromise or poor perfusion peri-operatively, which could minimize skin necrosis and other post-operative complications (Further et al., 2013).1 The ability to objectively assess tissue perfusion has led to improved post-operative outcomes in breast, abdominal wall, colorectal, and cardiac surgery. To date, no studies have reviewed the use of ICG in delineating devitalized bone during sternal wound debridement after cardiac surgery. At our institution, we have encountered a cohort of patients with post-cardiac surgery sternal wound infections who have required debridement of infected and devitalized bone. We propose that SPY technology aids in delineating this devitalized bone, and may aid in the timing muscle flap coverage. In this paper, we will demonstrate two cases of patients who had post-operative sternal wound infections after undergoing cardiac surgery for which ICG was used to demarcate debridement zones and subsequent flap coverage. In these cases, ICG allowed for efficient and reliable intraoperative evaluation of bony perfusion and has aided in early adequate debridement and flap coverage.
    • Latent Print Examination and Human Factors: Improving the Practice through a Systems Approach

      Expert Working Group on Human Factors in Latent Print Analysis (2012)
    • Missing Voters Project: United States 2016

      Pathak, Elizabeth; Menard, Janelle; Ward, Beverly G.; Margolis, Ellie (2018)
      Missing voters are voting age citizens who did not vote in November 2016. Missing voters reflect the diversity of the United States as a whole. They are of all ages and races, of all educational backgrounds, and they live in every state across our nation. Yet, voting participation rates vary considerably across specific population groups. The purpose of this report is to provide a detailed description of the social and demographic characteristics of America’s missing voters, to inform the widespread grassroots efforts to increase voter participation in the 2018 mid-term elections and the 2020 presidential election.
    • Missing Voters Project: Young Adults 2016

      Pathak, Elizabeth; Margolis, Ellie; Ward, Beverly G.; Menard, Janelle (2018)
      Missing voters are voting age citizens who did not vote in November 2016. Missing young adult voters reflect the diversity of the United States as a whole. They are women and men of all races and educational backgrounds, and they live in every state across our nation. Yet, voting participation rates vary considerably across specific groups of young adults. The purpose of this report is to provide a detailed description of the social and demographic characteristics of America’s young adult missing voters. Our goal is to inform the widespread grassroots efforts to increase young adult voter participation in the 2018 mid-term and 2020 presidential elections.
    • Overworked and Underpaid: H-2A Herders in Colorado

      Migrant Farm Worker Division of Colorado Legal Services (2010-01-14)
      "Throughout much of rural western Colorado, a virtually unknown and unrecognized workforce toils alone in extreme cold or heat, making approximately $2 per hour. These workers are migrants, legally employed by Colorado ranchers to herd their livestock. They are in the United States as part of a program for temporary foreign labor called the H-2A program, which allows U.S. employers to bring in foreign farm workers if there are insufficient U.S. workers to meet the employers’ needs. Herders work for pay that on a per-hour basis is closer to volunteering than it is to earning minimum wage. They are required to be on-call 24 hours per day, 7 days per week, living in small campers without electricity, running water or a bathroom. Colorado’s migrant herders are a crucial part of the ranching industry. Most frequently coming from Peru, Chile and Mexico, herders, who rarely speak English, come to Colorado and other Western states searching for better employment opportunities. In some cases they find these opportunities; in the majority of cases they do not. Colorado Legal Services’ Migrant Farm Worker Division (CLS), with Professor Thomas Acker of Mesa State College, surveyed 93 herders over a two-year period to document a variety of issues, including their pay, their employers’ control over their lives, their living and working conditions, their work contracts and their general opinions about their work situation." -- quoted from Executive Summary
    • Primary extranodal jejunal diffuse large B cell lymphoma as a diagnostic challenge for intractable emesis: a case report and review of literature

      Vien, Linda; Bains, Ashish; Yeung, Ho-Man; 0000-0001-9257-0200 (2019-12-14)
      Introduction: The gastrointestinal tract is the most common extranodal site for non-Hodgkin’s lymphoma, with the most common being diffuse large B cell lymphoma. Unlike the stomach or the ileum, the jejunum is a rare site for primary extranodal lymphomas, given the scarcity of lymphoid tissue. Due to its location, inflammation in the jejunum may not be visualized on routine imaging or endoscopy, making jejunal lymphoma difficult to diagnose. Case Description: We present a case of a 90-year-old male with 1 week of intractable emesis, initially thought to be due to viral gastroenteritis. His symptoms never improved and he underwent serial CT imagings in addition to esophagogastroduodenoscopy. A stomach biopsy and a diagnostic paracentesis did not reveal any malignant cells, but a CT enterography revealed significant jejunal inflammation with obstruction. After a month of hospitalization, a jejunal biopsy was obtained, which showed proliferation of neoplastic B cells. He was ultimately diagnosed with primary jejunal diffuse large B cell lymphoma. Discussion: Chemotherapy and surgical resection are typically the definitive treatment for extranodal lymphoma. Clinicians, however, must carefully consider the patient’s functional and nutritional statuses before offering such interventions. This case was a diagnostic challenge and demonstrated a rare GI malignancy’s convoluted mimicking nature.
    • Reducing Wound Hemorrhage: Use of Bilayer Collagen Matrix in Chronic Myelogenous Leukemia

      Lo, Alexis L.; Tyrell, Richard O.; Golarz, Scott R.; Jones, Christine M. (2019-11-27)
      Summary: Donor site preparation is a critical step before the application of an autologous split-thickness skin graft (STSG). Comorbidities can lead to complications and graft loss, including that due to hematoma. In this case, a bilayer collagen matrix was used as a temporary wound dressing in a 25-year-old woman with active chronic myelogenous leukemia. She presented with a bleeding diathesis and spontaneous intramuscular and intracompartmental hematomas of the right leg. She experienced ongoing high-volume blood loss from her fasciotomy wounds, requiring wound care to be performed in the operating room under general anesthesia, and requiring multiple blood and platelet transfusions. Instead of immediate STSG, a bilayer collagen matrix was placed to reduce the bleeding and further prepare the wound bed over a 9-week period while she underwent medical optimization. Once stabilized from a hematologic standpoint, STSG was performed with total graft take. Both uncontrolled chronic myelogenous leukemia and its therapy, tyrosine kinase inhibitors, have a risk of hemorrhagic and thrombotic complications. Bilayer collagen matrix serves as an adjunct in the limb salvage algorithm that can reduce transfusion needs whereas a temporary bleeding diathesis is medically corrected before the application of an autologous skin graft.
    • Spine-to-Dendrite Calcium Modeling Discloses Relevance for Precise Positioning of Ryanodine Receptor-Containing Spine Endoplasmic Reticulum

      Breit, Markus; Kessler, Marcus; Stepniewski, Martin; Vlachos, Andreas; Queisser, Gillian (2018-10-23)
      The endoplasmic reticulum (ER) forms a complex endomembrane network that reaches into the cellular compartments of a neuron, including dendritic spines. Recent work discloses that the spine ER is a dynamic structure that enters and leaves spines. While evidence exists that ER Ca2+ release is involved in synaptic plasticity, the role of spine ER morphology remains unknown. Combining a new 3D spine generator with 3D Ca2+ modeling, we addressed the relevance of ER positioning on spine-to-dendrite Ca2+ signaling. Our simulations, which account for Ca2+ exchange on the plasma membrane and ER, show that spine ER needs to be present in distinct morphological conformations in order to overcome a barrier between the spine and dendritic shaft. We demonstrate that RyR-carrying spine ER promotes spine-to-dendrite Ca2+ signals in a position-dependent manner. Our simulations indicate that RyR-carrying ER can initiate time-delayed Ca2+ reverberation, depending on the precise position of the spine ER. Upon spine growth, structural reorganization of the ER restores spine-to-dendrite Ca2+communication, while maintaining aspects of Ca2+ homeostasis in the spine head. Our work emphasizes the relevance of precise positioning of RyR-containing spine ER in regulating the strength and timing of spine Ca2+ signaling, which could play an important role in tuning spine-to-dendrite Ca2+ communication and homeostasis.
    • The Convergence of the COVID-19 and Opioid Health Crises in the US

      Public Policy Lab (Temple University) (Temple University. Public Policy Lab, 2020-08-18)
    • The Hardest Hit: Post-COVID Unemployment in Immigrant-Dense Industries

      Public Policy Lab (Temple University) (Temple University. Public Policy Lab, 2020-08-18)
    • Trump's New 'Regulatory Czar': Poised to Lead the Assault on Our Safeguards

      The Center for Progressive Reform (2017-04)
      The White House Office of Information and Regulatory Affairs (OIRA) sits at a critical juncture in the path of regulatory safeguards for health, safety, and the environment. It has a long history of using the lever of cost-benefit analysis to dilute and block safeguards unpopular with industry, and in a variety of ways, politicizing the regulatory process. According to an April 2017 report from CPR, the nomination of George Mason University law professor Neomi Rao to serve as its administrator signals the Trump administration’s determination to buttress OIRA’s role as an impediment to sensible safeguards. The report by CPR Member Scholars Thomas McGarity, Amy Sinden, Rena Steinzor, and Robert Verchick, and CPR Senior Policy Analyst James Goodwin, examines Rao’s background and concludes the her modest record of “scholarship and other public statements reflect a deep distrust of federal agencies and their role as policymaking institutions within our constitutional system of government.” The authors note, Rao “has called for more constraints on regulatory agencies – including enhanced centralized presidential control over both executive branch and independent agencies – that would inhibit their ability to carry out their respective missions by instituting new public safeguards and enforcing existing ones. In addition, she has staked out an extremely narrow conception of some human rights, which could lead to a low-balling of rules intended to protect those rights.” Since the early days of the Reagan administration, OIRA has required regulatory agencies like the Environmental Protection Agency, Food and Drug Administration, Occupational Safety and Health Administration, and others to seek its approval before issuing protective rules — thus giving political appointees in the White House great influence over the rules designed to enforce landmark laws like the Clean Air Act, Clean Water Act, Occupational Safety and Health Act, and more. OIRA rides herd over agencies’ cost-benefit analyses for rules and uses that authority to block or weaken them, often after inviting industry lobbyists to weigh in, repeating objections they’ve voiced to agencies during the development of the rules. Two key factors are likely to distinguish the Trump administration’s regulatory process from his predecessors’, according to the report: “The first is Trump’s’ selection of individuals – such as EPA Administrator Scott Pruitt – who are actively hostile to the missions of the agencies they will be running. The other is Trump’s two new anti-regulatory executive orders, which together make deregulation a top policy priority for the administration and a shared commitment among Trump-appointed officials to comply with those orders.” Rao and OIRA are poised to oversee implementation of Trump’s assault on our safeguards, working to assist and direct agencies in dismantling crucial public protections, and perhaps helping them devise ways to insulate the repeal of duly enacted rules from subsequent legal challenge.