The Impact of Bostock v. Clayton County on Access to Health Care for LGBTQ Persons

LGBTQ individuals face countless acts of discrimination in health care insurance and delivery. In spite of this inequality, there are zero LGBTQ-inclusive health insurance protections in over half of the United States. Title VII of the Civil Rights Act (Title VII) and Section 1557 of the Patient Protection and Affordable Care Act (ACA) are two federal statutes that prohibit discrimination, in relevant part, on the basis of sex. Both federal statutes have been greatly impacted by the Supreme Court decision in Bostock v. Clayton County, which interpreted “sex” in Title VII to include gender identity and sexual orientation. This Article explains how Bostock protects LGBTQ persons from discrimination in employer-provided health insurance under Title VII. Bostock’s scope extends beyond health insurance and into health care delivery, as demonstrated by its applicability to Section 1557 of the ACA (Section 1557). This Article demonstrates how Section 1557—where its enabling statutes do not include Title VII—should prohibit discrimination regardless of sexual orientation and gender identity. Lastly, this Article emphasizes the importance of state action, for example in public accommodations laws, in the absence of clear and explicit federal LGBTQ protections

Comparative Study between Neopterin and Alvarado Score in the Diagnosis of Acute Appendicitis and Its Severity

BACKGROUND: Acute appendicitis (AA) remains a complex case even for experienced surgeons. Rate of negative appendectomy is 5–40% and delayed intervention result in perforated appendicitis in 5–30% of cases. AIM: The aim of the study was to evaluate NPT as a marker for the diagnosis of AA concerning its severity. And compare the diagnostic value of it with the ALV scoring system. METHODS: One hundred twenty patients presented with signs and symptoms of AA and underwent appendectomy, only 84 patients proved to be AA by histopathological examination, were included in the study. Blood samples for neopterin (NPT) estimation and Alvarado (ALV) score was calculated. Control group consists of 45 healthy individual. RESULTS: NPT levels were significantly higher in patients’ group than control with p = 0.001 at a cutoff point 5.3 nmol/L. The diagnostic accuracy of NPT was higher than ALV score. NPT sensitivity, specificity, positive predictive value, and negative predictive value were 85.4%, 76.9%, 89%, and 70%, respectively. CONCLUSION: NPT significantly elevated in patient with AA and has a high diagnostic accuracy, with correlation to clinical features and severity of the inflammation

Simultaneous segmentation of the left and right heart ventricles in 3D cine MR images of small animals

New high resolution image techniques allow to capture the anatomy and movement of the heart of small animals. The availability of these in vivo images can be very useful for medical research, however the amount of generated data for large animal studies makes manual analysis a very tedious task. To cope with the problem of automatic analysis of these images, we propose the use of the Deformable Elastic Template method to perform automatic segmentation of the ventricles. To adapt the method to the specificities of high-resolution MRI, several improvements are presented, including an image-context dependent scheme for more robust segmentation. Qualitative results show that our method is able to correctly retrieve the heart’s contours in 3D. 1

Formulation and In Vitro Evaluation of Taste- Masked Prednisolone Orodispersible Tablets

Background: prednisolone is a corticosteroid with a very bitter taste acts as anti- anti-inflammatory and immune suppressant drug and it is used at any age. Objective: To improve patient compliance by masking the bitter taste of the drug to be delivered as an orodispersible tablet. Methods: External ionic gelation using sodium alginate (0.5%w/v) and calcium chloride (1% w/v) in presence of 0.5% w/v carbopol 940 was used to prepare taste masked beads loaded with prednisolone to be compressed as orodispersible tablets.   Results:  The bitter taste of was masked by preparing beads composed of 1:1:1 (sodium alginate: Carbopol 940: prednisolone) which released only 0.77 % of the drug in pH 6.8 (pH of oral cavity). The ODT prepared by direct compression using taste masked beads equivalent to 5 mg PRD, 3% crospovidone, 2% PVP, 1% talc, 1% magnesium stearate and combination of Avcil® PH 102 and mannitol at (1:1) ratio was the optimum formula  (T6) with hardness of 3.9± 0.32 kg, , friability 0.45%, thickness 2.5 ± 0.05 mm, % drug content  98.2% ± 1.8, wetting time 18.7 ± 1.3 sec, water absorption 41 ± 2.1%, disintegration time 15.3 ± 0.5 sec. and released only 0.75% ± 0.01 of PRD in an oral pH of 6.8 within one minute (indicating good taste masking). Its release in the stomach (pH 0.1N HCl) and intestine (pH 6.8) was continued for up to two hours.    Conclusion: it can be concluded that the external ionic gelation method successfully masked the bitter taste of prednisolone and can also be formulated as taste-masked orodispersible tablets by the direct compression method.     Received: Jan. 2023 Accepted: May 2023 Published: Oct.2023

Design of a fuzzy distance relay taking into consideration the impact of using a unified power flow controller

The compact design of a fuzzy distance relay, which includes its impact on using a unified power flow controller in a power system, has been adopted as the object of the study. Traditional power system grids have increasingly widely used flexible alternating current transmission system devices in recent years to increase power system stability when faults, unbalance, and sudden changes in load occur. This plays a role in improving power quality, power factor corrections, and power flow control. A unified power flow controller is one of these devices that is most used, popular and meets these benefits, but it simultaneously gives a different change in the apparent impedance of the protection system due to its design. To overcome these issues, the proposed novel design of a fuzzy distance relay is made with the assistance of MATLAB® Simulink and Neuro-Fuzzy Designer. The proposed design work was divided into three parts, the first without fault and the second one including four scenarios without using and using a unified power flow controller in different transmission line locations. The design was carried out in the third part after collecting all input-output data sets. This paper offers an efficient design method, which depends on the input value of the observed apparent impedance, also known as resistance (R), and reactance (X). The output is a trip signal to the circuit breaker when a fault occurs. The advantages of the proposed design are a fast-clearing time of 1.42 ms, and working when utilizing a unified power flow controller in different locations; the results show a fast clearing although the long impedance trajectory for some cases. The fast fault clearing will make the system more stable and overcome the maloperation of the distance rela

Direct differentiation of adult ocular progenitors into striatal dopaminergic neurons.

Parkinson\u27s disease, characterized by motor dysfunction due to the loss of nigrostriatal dopaminergic neurons, is one of the most prevalent age-related neurodegenerative disorders. Given there is no current cure, the stem cell approach has emerged as a viable therapeutic option to replace the dopaminergic neurons that are progressively lost to the disease. The success of the approach is likely to depend upon accessible, renewable, immune compatible, and non-tumorigenic sources of neural progenitors from which stable dopaminergic neurons can be generated efficaciously. Here, we demonstrate that neural progenitors derived from limbus, a regenerative and accessible ocular tissue, represent a safe source of dopaminergic neurons. When the limbus-derived neural progenitors were subjected to a well-established protocol of directed differentiation under the influence of Shh and FGF8, they acquired the biochemical and functional phenotype of dopaminergic neurons that included the ability to synthesize dopamine. Their intrastriatal transplantation in the rat model of hemi-Parkinsonism was associated with a reduction in the amphetamine-induced rotation. No tumor formation was observed 6 weeks post-transplantation. Together, these observations posit limbus-derived neural progenitors as an accessible and safe source of dopaminergic neurons for a potential autologous ex-vivo stem cell approach to Parkinson\u27s disease