Third Session: Freedom of Religion and Expression

This panel will explore the implications of various cases on the freedom of expression and religion. Professor Ravitch’s article goes in depth on religious freedom claims and, focusing on government employees, he will explain when accommodation for specific religious freedoms are appropriate and when they conflict with the rights of others. Professor Katz’s article discusses the connection between the Supreme Court’s decision on same-sex marriage and the religious freedoms of individuals and entities who oppose same-sex marriage and same-sex relations on religious grounds. In Asma T. Uddin’s article, she examines the Charlie Hebdo attacks in Paris and focuses on the distinction between provocation and incitement to imminent violence for line drawing between protected and unprotected speech. Professor SpearIt’s article explores Muslims in America and their use of hip hop culture to voice a long list of radical critiques of the criminal justice system

Partisipasi Masyarakat Dalam Pengelolaan Dan Pemanfaatan Dana Desa Di Desa Keji Kabupaten Semarang

IntisariArtikel ini bertujuan untuk menjelaskan partisipasi masyarakat dalam pengelolaan dan pemanfaatan Dana Desa. Penelitian ini berlokasi di Desa Keji Kecamatan Ungaran Barat Kabupaten Semarang dengan subyek penelitiannya adalah masyarakat Desa Keji dan informan utamanya tokoh masyarakat, BPD dan perangkat desa. Jenis penelitian yang digunakan adalah penelitian kualitatif yang mendasarkan penelitiannya pada deskripsi dari data lapangan. Data diperoleh melalui observasi, wawancara, FGD, dan studi dokumentasi. Hasil penelitian menunjukkan, pengetahuan masyarakat terhadap dana desa masih terbatas. Informasi tentang pengelolaan dana desa mereka dapatkan dari aparat desa dan warga masyarakat lain melalui gethok tular. Dana desa di Desa Keji yang berjumlah Rp 608.057.000 diorientasikan pada pembangunan infrastruktur, seperti jalan paving, talud, dan jembatan sederhana. Dalam pemanfaatan dana desa ini, masyarakat dilibatkan dalam seluruh prosesnya mulai dari perencanaan, pelaksanaan, hingga monitoring dan evaluasi kegiatan. Penelitian ini juga menyoroti tentang partispasi masyarakat di Desa Keji dalam pengelolaan dana desa masih sebatas aktifitas berperan serta yang yang formal, berpusat dari aparat desa, dan tertib administrasi

Design of a Novel Low Cost Point of Care Tampon (POCkeT) Colposcope for Use in Resource Limited Settings

Introduction: Current guidelines by WHO for cervical cancer screening in low- and middle-income countries involves visual inspection with acetic acid (VIA) of the cervix, followed by treatment during the same visit or a subsequent visit with cryotherapy if a suspicious lesion is found. Implementation of these guidelines is hampered by a lack of: trained health workers, reliable technology, and access to screening facilities. A low cost ultra-portable Point of Care Tampon based digital colposcope (POCkeT Colposcope) for use at the community level setting, which has the unique form factor of a tampon, can be inserted into the vagina to capture images of the cervix, which are on par with that of a state of the art colposcope, at a fraction of the cost. A repository of images to be compiled that can be used to empower front line workers to become more effective through virtual dynamic training. By task shifting to the community setting, this technology could potentially provide significantly greater cervical screening access to where the most vulnerable women live. The POCkeT Colposcope’s concentric LED ring provides comparable white and green field illumination at a fraction of the electrical power required in commercial colposcopes. Evaluation with standard optical imaging targets to assess the POCkeT Colposcope against the state of the art digital colposcope and other VIAM technologies. Results: Our POCkeT Colposcope has comparable resolving power, color reproduction accuracy, minimal lens distortion, and illumination when compared to commercially available colposcopes. In vitro and pilot in vivo imaging results are promising with our POCkeT Colposcope capturing comparable quality images to commercial systems. Methods: Rapid 3D printing, consumer grade light sources, and cameras were used to construct the TVDC. The TVDC’s concentric LED ring provides comparable white and green field illumination at a fraction of the electrical power required in commercial colposcopes, and crossed polarizers provide a reduction in glare. Evaluation was performed using standard optical imaging targets to assess the TVDC against the state of the art digital colposcope and other VIA technologies. Results: Our TVDC has comparable resolving power, color reproduction accuracy, minimal lens distortion, and illumination when compared to commercially available colposcopes. In vitro and pilot in vivo imaging results are promising with our TVDC capturing images of comparable quality to commercial systems. Conclusion: The TVDC is capable of capturing images suitable for cervical lesion analysis. Our portable low cost system will be useful for increasing access to cervical cancer screening and diagnostics in resource-limited settings by providing a more readily portable and easy to use device for medical personnel.The image data and support information that is published in the article "Design of a Novel Low Cost Trans-Vaginal Digital Colposcope for use in Resource Limited Settings" are available at: http://dukespace.lib.duke.edu/dspace/handle/10161/8357.National Institutes of Health (US) 5R21CA162747-0

The Dynamic Effect of Pile Installation in Sand on Nearby Piles

Driven piles have often been used in many civil structures to provide structural loading support. However, the unavoidable vibrations induced by pile driving processes may cause varying degrees of damage to adjacent structures. This research presents experimental studies to investigate the transmitted vibrations induced by impact of pile driving on vicinity piles. In the experimental work, a small scale model was tested in a sand box (steel container 1 × 1.5 × 0.8 m)  with pile driving hammer device to install the impact pile in sand soil by dropping weights (1, 2, 3, 4 and 5 kg) for different heights of falling (4, 8, 12, 16 and 20 cm). The peak particle velocity was measured at a head of the vicinity piles by vibration meter device. In this study, several piles on different distances away from the vibration source were studied. The experimental results indicate that the peak particle velocity for vibrations emitted with impact pile driving is increased with increasing the energy and the penetration depth of pile driving for all vicinity piles and it can be decreased without change in the driving energy by decreasing the weight of hammer and increasing the height of falling hammer. Vibration intensities are attenuated with increasing surface distance from the pile driving and the peak particle velocity decreased uniformly with surface distance from the pile driving for piles. Also, through laboratory model representation and evaluation of the results obtained in the laboratory, the empirical relations which were determined based on the scaled-distance concept, are appropriate and give results very close and can be relied upon to represent the transmission of vibration resulting from the impact of pile driving to nearby piles

Assessment of Sodium Knowledge and Urinary Sodium Excretion among Regions of the United Arab Emirates: A Cross-Sectional Study

Non-communicable diseases (NCDs) such as cardiovascular disease, cancer and diabetes, are increasing worldwide and cause 65% to 78% of deaths in the Gulf Cooperation Council (GCC). A random sample of 477 healthy adults were recruited in the United Arab Emirates (UAE) in the period March-June 2015. Demographic, lifestyle, medical, anthropometric and sodium excretion data were collected. A questionnaire was used to measure knowledge, attitude and practice regarding salt. Mean sodium and potassium excretion were 2713.4 ± 713 mg/day and 1803 ± 618 mg/day, respectively, significantly higher than the World Health Organization (WHO) recommendations for sodium (2300 mg/day) and lower for potassium (3150 mg/day). Two-thirds (67.4%) exceeded sodium guidelines, with males 2.6 times more likely to consume excessively. The majority of the participants add salt during cooking (82.5%) and whilst eating (66%), and 75% identified processed food as high source of salt. Most (69.1%) were aware that excessive salt could cause disease. Most of the UAE population consumes excess sodium and insufficient potassium, likely increasing the risk of NCDs. Despite most participants being aware that high salt intake is associated with adverse health outcomes, this did not translate into salt reduction action. Low-sodium, high-potassium dietary interventions such as the Mediterranean diet are vital in reducing the impact of NCDs in the UAE

The collateral damage of COVID-19 to cardiovascular services. A meta-Analysis

Aims: The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-Analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic. Methods and results: From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66-0.94) and revascularisation (RR 0.73, 95% CI 0.62-0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10-1.37) and heart failure (RR 1.08, 95% CI 1.04-1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave. Conclusions: There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification

The association between prenatal atrioventricular septal defects and chromosomal abnormalities

Objective Atrioventricular septal defect is associated with a high risk of a chromosomal abnormality, particularly trisomy 21. The aim of this study is to assess the rate of trisomy 21 in fetuses diagnosed with an atrioventricular septal defect and to examine the influence of prior screening on the rate of trisomy 21. Methods Electronic ultrasound database was searched to identify fetuses diagnoses with an atrioventricular septal defect from 2002 to 2014. Rate of trisomy 21 and other aneuploidies was calculated among fetuses with normal situs. The prevalence of trisomy 21 and other aneuploidies was assessed in women with low and high first trimester risk for trisomy 21, using a cut-off value of 1:150 and 1:250. Results A total 110 fetuses with a diagnosis of atrioventricular septal defect were identified. Among the 98 fetuses with normal situs, the prevalence of trisomy 21 was 46% (95%CI: 36-56%). Using a 1:150 threshold, the rate of trisomy 21 within the low-risk group was 41% (95%CI: 27-57%) while in the high-risk group it was 70% (95% CI: 52-83%), significantly higher than in the low risk group (p = 0.028). Similar results were obtained when the 1:250 threshold was applied (66% versus 41%, p = 0.055). Conclusions The rate of trisomy 21 among fetuses identified with an atrioventricular septal defect in the second trimester is high even in those that undergo first trimester combined screening. Some fetuses with a high-risk screening result show a normal karyotype. Therefore, an offer of an invasive procedure to check fetal karyotyping is indicated. Knowledge of these rates may be helpful for parents in the decision making process

Advantages and Disadvantages of Using St. John\u27s Wort as a Treatment for Depression

BACKGROUND AND OBJECTIVES: St. John\u27s wort (SJW) extracts are currently being used to treat depression of various degrees of severity. While many studies have shown it to be superior to placebo, data regarding the effectiveness of using SJW as a stand-alone treatment compared with standard antidepressants has yet to be proven conclusively. This study aims to understand the advantages and disadvantages of SJW as a treatment modality for depression. METHODS: The authors searched PubMed, JAMA network, Springer Link, Elsevier, Google Scholar, and Scientific Progress databases, from 2011 through August 2021, using the following keywords: St John\u27s wort, Hypericum perforatum, depression, antidepressant, complementary alternative medicine, economic evaluation depression St. wort, St John\u27s wort and depression, antidepressant interactions. This yielded a total of 27 papers following a thorough removal of irrelevant content and dissemination in languages other than English. RESULTS: In patients with mild and moderate depression, SJW proved superior to placebo. Certain studies comparing the efficacy of SJW versus selective serotonin reuptake inhibitors (SSRIs), especially fluoxetine, reported SJW to be more efficacious, while the majority reported no significant difference. Tricyclic antidepressants were also found to have similar efficacy as SJW. Moreover, treatment with SJW was also found to reduce postmenopausal depression. Regarding the safety profile, although SJW is better tolerated with fewer adverse effects when compared to standardized antidepressants, its predisposition to causing fatal serotonin syndrome, when used in conjunction with other serotonergic agents and drug interactions noted with CYP 450 drugs, raises a question in the safety profile. CONCLUSION: It is essential to acknowledge that SJW has been used as a treatment measure in Germany. Despite being only listed as a dietary supplement by the FDA and not a drug, SJW has shown to be comparable, if not more efficacious, than most standard treatment options for depression. SJW does prove to be an exciting piece of pharmacotherapy in the realm of mental health and post-menopausal treatment. More prospective studies will help us better understand its efficacy in mild and moderate depression and its ability to serve as a long-term agent. Considering its mechanism of action, its role in relieving patients suffering from an anxiety disorder is also worth considering

Deregulation of the endometrial stromal cell secretome precedes embryo implantation failure

STUDY QUESTION Is implantation failure following ART associated with a perturbed decidual response in endometrial stromal cells (EnSCs)? SUMMARY ANSWER Dynamic changes in the secretome of decidualizing EnSCs underpin the transition of a hostile to a supportive endometrial microenvironment for embryo implantation; perturbation in this transitional pathway prior to ART is associated with implantation failure. WHAT IS KNOWN ALREADY Implantation is the rate-limiting step in ART, although the contribution of an aberrant endometrial microenvironment in IVF failure remains ill defined. STUDY DESIGN, SIZE, DURATION In vitro characterization of the temporal changes in the decidual response of primary EnSCs isolated prior to a successful or failed ART cycle. An analysis of embryo responses to secreted cues from undifferentiated and decidualizing EnSCs was performed. The primary clinical outcome of the study was a positive urinary pregnancy test 14 days after embryo transfer. PARTICIPANTS/MATERIALS, SETTING, METHODS Primary EnSCs were isolated from endometrial biopsies obtained prior to IVF treatment and cryopreserved. EnSCs from 10 pregnant and 10 non-pregnant patients were then thawed, expanded in culture, subjected to clonogenic assays, and decidualized for either 2 or 8 days. Transcript levels of decidual marker gene [prolactin (PRL), insulin-like growth factor binding protein 1 (IGFBP1) and 11β-hydroxysteroid dehydrogenase (HSD11B1)] were analysed using real-time quantitative PCR and temporal secretome changes of 45 cytokines, chemokines and growth factors were measured by multiplex suspension bead immunoassay. The impact of the EnSC secretome on human blastocyst development was scored morphologically; and embryo secretions in response to EnSC cues analyzed by multiplex suspension bead immunoassay. MAIN RESULTS AND THE ROLE OF CHANCE Clonogenicity and induction of decidual marker genes were comparable between EnSC cultures from pregnant and non-pregnant group groups (P > 0.05). Analysis of 23 secreted factors revealed that successful implantation was associated with co-ordinated secretome changes in decidualizing EnSCs, which were most pronounced on Day 2 of differentiation: 17 differentially secreted proteins on Day 2 of decidualization relative to undifferentiated (Day 0) EnSCs (P 0.05)