LOW VITAMIN B12: THE NEED FOR UPDATED PROVIDER EDUCATION

Vitamin B12 deficiency is a notable clinical problem with multi-factorial risk factors and a multitude of clinical manifestations. It is associated with polyglandular autoimmune syndromes, some familiar and some lesser well known. The specific aim of this scholarly project was to evaluate whether education aimed at providers such as nurse practitioners, nurse practitioner students, physician assistants, and physicians regarding updated diagnostic criteria for vitamin B12 deficiencies as well as associated diseases, specifically autoimmune gastritis, and pernicious anemia, increased their knowledge and ultimately improved clinical practice. The project utilized a pre-test/post-test design with education provided in between. There was an improvement in all five of the post-scores when compared to the pre-test scores. In addition, 94.1% of respondents thought the education provided would lead to an improvement in their clinical practice

Writing in the Margins: Brennan, Marshall, and the Inherent Weaknesses of Liberal Judicial Decision-Making (essay)

From 1967, when Thurgood Marshall took his seat as Supreme Court Justice, until 1990, when William Brennan, Jr. vacated his seat, the two Justices formed one of the most consistent liberal voting blocs in the history of the Court. Both Justices were judicial activists who labored in the tradition of Legal Realism. Although both Brennan and Marshall recognized the interpretation and application of the law as purposeful exercises, they differed in their approach to the task. Marshall, for instance, appealed to social consensus stating that his views were supported by society. Furthermore, Marshall strongly believed that the Constitution is a living document which evolves and can bring about future change. Brennan, on the other hand, was a strong believer of natural law. Brennan supported the widely accepted position that a judge cannot solely rely on his or her personal views when making judicial decisions. Marshall, however, showed little sign of utilizing any version of natural law interpretation or reliance on transcendent values. Justice Brennan and Justice Marshall knew well that what is moderate, centrist, or in the best interest of the majority changes, and a society comes to demand different protections from its government and its founding document. Following Brennan and Marshall’s retirement, an increasingly conservative population elected conservative presidents who, in turn, placed more conservative Justices on the Court. By the early 1980s, the more liberal justices found themselves in the minority. Nonetheless, when society once again catches up, the jurisprudence of Brennan and Marshall will be there, waiting

The Effect of 8 U. S. C. 1324(d) in Transporting Prosecutions: Does the Confrontation Clause Still Apply to Alien Defendants

Cases prosecuted under 8 U.S.C. §1324 present special challenges for the Government and for defendants. Under §1324, it is a crime to transport or smuggle aliens into the United States. Prosecuting transporters or smugglers may present a challenge if a witness is unavailable. Even though transporting or smuggling always has witnesses—the alien(s) who hired the smuggler or transporter—not all witnesses have prolonged detentions, and some are returned to their native country. The transporter or smuggler may then assert their Sixth Amendment right. The Sixth Amendment’s Confrontation Clause requires that in all criminal prosecutions, the accused shall enjoy the right to be confronted with the witnesses against him. Whether, and under what conditions, the absent witnesses’ hearsay deposition testimony is admissible in a §1324 defendant’s trial has courts divided. Because of the obligations placed on the government by the Confrontation Clause, §1324(d) cannot, by itself, resolve the tension between a defendant’s right to confrontation and the need to address both the logistical and human rights implications of detaining material witnesses. While Congress cannot abrogate the requirements of the Constitution, it can, and should, draft legislation that makes it easier for the government to comply with the requirements of the Constitution. Congress has the authority to expand the government’s options for detaining witnesses who can be persuaded to stay and authorize the government to take measures to bring witnesses back to the United States. Therefore, Congress should make it easier for the government to make any necessary efforts without unduly burdening the witnesses whose testimony it seeks

Speaking the Language of Exclusion: How Equal Protection and Fundamental Rights Analyses Permit Language Discrimination (comment)

In the summer of 1995, the en banc Texas Court of Criminal Appeals in Flores v. State upheld a lower court’s ruling to give a drunk-driving (DWI) offender a year in prison as opposed to probation. The trial judge denied the defendant probation due to his inability to speak English. The county in which the defendant was arrested and convicted did not provide a DWI rehabilitation program in Spanish, leading the judge to determine the defendant would not benefit from probation. In his appeal, Mr. Flores claimed the lower court violated his equal protection and due process rights under the Fourteenth Amendment of the United States Constitution, and his equality rights and due course of law rights under the Texas Constitution. The case invited the court to resolve federal and state confusion over the issue of language and to find constitutional protection for those unable to speak English. The court declined this invitation, instead applying the rigid classification scheme for assessing equal protection claims. Those like Mr. Flores face a combination of difficulties, as they are members of a group which cannot be identical to one based on race or national origin; furthermore, judges can deny state privileges rather than fundamental rights without violating due process theory. Had it accepted the case, the Court could have demonstrated the Fourteenth Amendment analysis can be more flexible than the formulaic one the Texas Court of Criminal Appeals applied. The Court could have reached this result by declaring language-based discrimination as suspect, either because language is presumptively related to national origin or because it is the basis of invidious discrimination. Alternatively, the Court could have taken seriously the rational-basis test, as even minimal scrutiny merited an examination of the fit between denying a probation request and the stated goal of meaningful rehabilitation

Story of Your Lazy Function’s Life: A Bidirectional Demand Semantics for Mechanized Cost Analysis of Lazy Programs

Lazy evaluation is a powerful tool that enables better compositionality and potentially better performance in functional programming, but it is challenging to analyze its computation cost. Existing works either require manually annotating sharing, or rely on separation logic to reason about heaps of mutable cells. In this paper, we propose a bidirectional demand semantics that allows for reasoning about the computation cost of lazy programs without relying on special program logics. To show the effectiveness of our approach, we apply the demand semantics to a variety of case studies including insertion sort, selection sort, Okasaki\u27s banker\u27s queue, and the push function of the implicit queue. We formally prove that the banker\u27s queue and the push function of the implicit queue are both amortized and persistent using the Rocq Prover (formerly known as Coq). We also propose the reverse physicist\u27s method, a novel variant of the classical physicist\u27s method, which enables mechanized, modular and compositional reasoning about amortization and persistence with the demand semantics

eta-prime photoproduction on the proton for photon energies from 1.527 to 2.227 GeV

Differential cross sections for the reaction gamma p -> eta-prime p have been measured with the CLAS spectrometer and a tagged photon beam with energies from 1.527 to 2.227 GeV. The results reported here possess much greater accuracy than previous measurements. Analyses of these data indicate for the first time the coupling of the etaprime N channel to both the S_11(1535) and P_11(1710) resonances, known to couple strongly to the eta N channel in photoproduction on the proton, and the importance of j=3/2 resonances in the process.Comment: 6 pages, 3 figure

A Bayesian analysis of pentaquark signals from CLAS data

We examine the results of two measurements by the CLAS collaboration, one of which claimed evidence for a $\Theta^{+}$ pentaquark, whilst the other found no such evidence. The unique feature of these two experiments was that they were performed with the same experimental setup. Using a Bayesian analysis we find that the results of the two experiments are in fact compatible with each other, but that the first measurement did not contain sufficient information to determine unambiguously the existence of a $\Theta^{+}$. Further, we suggest a means by which the existence of a new candidate particle can be tested in a rigorous manner.Comment: 5 pages, 3 figure