319 research outputs found

    Fighting For Equal Protection Under The Fourth Amendment: Why Knock-And-Talks Should Be Reviewed Under The Same Constitutional Standard As Stop-And-Frisks

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    A knock-and-talk, like a stop-and-frisk, is a flexible investigatory tool that is used by law enforcement officials to subvert the Fourth Amendment\u27s warrant requirement

    Unequal Racial Access to Kidney Transplantation

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    Access to medical care is an issue of acute and increasing importance in the United States, a country in which the most promising of ground-breaking technologies may be available to only the privileged few. Although debate about the problem of unequal access to medical care typically centers on financial obstacles to advanced therapies and the obvious inequity of allowing patients\u27 ability to pay to drive treatment decisions, issues of equitable access for patients of both genders and all racial and ethnic backgrounds increasingly have come into focus. These concerns about equitable access animate the ongoing debate about how government should regulate the transplantation of kidneys. More than 100,000 people in the United States suffer from kidney failure-what doctors call end-stage renal disease (ESRD). While kidney failure may be treated with dialysis,\u27 kidney transplantation is the preferred treatment: studies show that transplant recipients are more likely to return to work, avoid hospitalization, and enjoy a greater sense of well-being than patients on dialysis. Kidney transplants constitute more than three-fourths of the solid organ transplants performed in this country and have success rates routinely as high as eighty percent. A severe shortage of transplantable kidneys, however, limits the availability of this preferred treatment.\u27 For example, in 1990, while more than 18,000 Americans were registered on waiting lists, fewer than 8200 received renal transplants. Federal regulations control the allocation of scarce donated kidneys among prospective recipients. Since 1972, Medicare has covered the costs of virtually all kidney transplants. To qualify for Medicare reimbursement, transplanting hospitals must abide by rules promulgated by the federal Organ Procurement and Transplantation Network (OPTN). Current OPTN policies for cadaveric kidney allocation give strong preference to potential recipients who are genetically similar to the donor as determined by the identification of antigens located on the surface of cells. For example, if a harvested kidney has all the same antigens as a potential recipient on the waiting list, then that patient will receive the kidney-even if other dialysis patients have waited longer for a transplant

    Unequal Racial Access to Kidney Transplantation

    Get PDF
    Access to medical care is an issue of acute and increasing importance in the United States, a country in which the most promising of ground-breaking technologies may be available to only the privileged few. Although debate about the problem of unequal access to medical care typically centers on financial obstacles to advanced therapies and the obvious inequity of allowing patients\u27 ability to pay to drive treatment decisions, issues of equitable access for patients of both genders and all racial and ethnic backgrounds increasingly have come into focus. These concerns about equitable access animate the ongoing debate about how government should regulate the transplantation of kidneys. More than 100,000 people in the United States suffer from kidney failure-what doctors call end-stage renal disease (ESRD). While kidney failure may be treated with dialysis,\u27 kidney transplantation is the preferred treatment: studies show that transplant recipients are more likely to return to work, avoid hospitalization, and enjoy a greater sense of well-being than patients on dialysis. Kidney transplants constitute more than three-fourths of the solid organ transplants performed in this country and have success rates routinely as high as eighty percent. A severe shortage of transplantable kidneys, however, limits the availability of this preferred treatment.\u27 For example, in 1990, while more than 18,000 Americans were registered on waiting lists, fewer than 8200 received renal transplants. Federal regulations control the allocation of scarce donated kidneys among prospective recipients. Since 1972, Medicare has covered the costs of virtually all kidney transplants. To qualify for Medicare reimbursement, transplanting hospitals must abide by rules promulgated by the federal Organ Procurement and Transplantation Network (OPTN). Current OPTN policies for cadaveric kidney allocation give strong preference to potential recipients who are genetically similar to the donor as determined by the identification of antigens located on the surface of cells. For example, if a harvested kidney has all the same antigens as a potential recipient on the waiting list, then that patient will receive the kidney-even if other dialysis patients have waited longer for a transplant

    Introduction of a Toric Intraocular Lens to a Non-Refractive Cataract Practice: Challenges and Outcomes

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    AIM: To identify challenges inherent in introducing a toric intraocular lens (IOL) to a non-refractive cataract practice, and evaluate residual astigmatism achieved and its impact on patient satisfaction. METHODS: Following introduction of a toric IOL to a cataract practice with all procedures undertaken by a single, non-refractive, surgeon (SB), pre-operative, intra-operative and post-operative data was analysed. Attenuation of anticipated post-operative astigmatism was examined, and subjectively perceived visual functioning was assessed using validated questionnaires. RESULTS: Median difference vector (DV, the induced astigmatic change [by magnitude and axis] that would enable the initial surgery to achieve intended target) was 0.93D; median anticipated DV with a non-toric IOL was 2.38D. One eye exhibited 0.75D residual astigmatism, compared to 3.8D anticipated residual astigmatism with a non-toric IOL. 100% of respondents reported satisfaction of ≥ 6/10, with 37.84% of respondents entirely satisfied (10/10). 17 patients (38.63%) reported no symptoms of dysphotopsia (dysphoptosia score 0/10), only 3 respondents (6.8%) reported a clinically meaningful level of dysphotopsia (≥ 4/10). Mean post-operative NEI VF-11 score was 0.54 (+/-0.83; scale 0 – 4). CONCLUSION: Use of a toric IOL to manage astigmatism during cataract surgery results in less post-operative astigmatism than a non-toric IOL, resulting in avoidance of unacceptable post-operative astigmatism

    Revision more of the same, or is there greater merit in a different approach?

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    In the period prior to examinations students commonly spend hours revising, in an attempt to improve their knowledge and memory of the course work. This is certainly true in physics, hence research on the subject of revision could be deemed relevant and useful. In certain contexts there are two or more quite different approaches by which the material may be taught. The question arises: is it better, in terms of the understanding and retention of concepts, to revise the material using the same way it was initially taught, hoping to increase retention by repetition, or to use a different approach, hoping to improve understanding by parallel reinforcement? In the physics of elementary magneto-dynamics there is a "standard" approach to understanding why a current-carrying coil in a magnetic field experiences torque, in which the force on each side of a square loop is analysed separately. There is also a non-standard approach that considers the current-carrying loop to be a magnetic dipole between two magnetic poles, enabling students to predict whether or not torque is applied on a coil, and if so, the direction it would rotate. The teachers of 78 students in five classrooms trialled the non-standard approach. The control had 72 students in five classrooms revising the same syllabus material, their teachers re-using the traditional method. A pre-test was compiled based on a mixture of seven multiple-choice questions, together with free response questions from previous high school public examinations. The efficacy of the revision methods was assessed in four different ways. Initially the pre-test results were mapped against those of an identical post-test, and the improvement analysed. Later one of the free response questions was assessed using a five-level SOLO-style taxonomy. Qualitative data analysis also demonstrated where several participants were successfully using their revision method. Moreover, students assessed the novelty and perceived effectiveness of the revision method they employed using a selfrating questionnaire. The results were uniformly promising

    Crowdsourcing and COVID-19: a case study of Cochrane Crowd

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    Cochrane has used crowdsourcing effectively to identify health evidence since 2014. To date, over 175,000 trialshave been identified for Cochrane’s Central Register of Controlled Trials via Cochrane Crowd (https://crowd.cochrane.org), Cochrane’s citizen science platform, engaging a Crowd of over 20,000 people from 166 countries. The COVID-19 pandemic presented the evidence synthesis community with the enormous challenge of keeping up with the exponential output of COVID-19 research. This case study will detail the new tasks we developed to aid the production of COVID-19 rapid reviews and supply the Cochrane COVID-19 study register. The pandemic initially looked set to disrupt the Crowd team’s plans for 2020 but has in fact served to further our understanding of the potential role crowdsourcing can play in the health evidence ecosystem

    The gene regulatory basis of genetic compensation during neural crest induction.

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    The neural crest (NC) is a vertebrate-specific cell type that contributes to a wide range of different tissues across all three germ layers. The gene regulatory network (GRN) responsible for the formation of neural crest is conserved across vertebrates. Central to the induction of the NC GRN are AP-2 and SoxE transcription factors. NC induction robustness is ensured through the ability of some of these transcription factors to compensate loss of function of gene family members. However the gene regulatory events underlying compensation are poorly understood. We have used gene knockout and RNA sequencing strategies to dissect NC induction and compensation in zebrafish. We genetically ablate the NC using double mutants of tfap2a;tfap2c or remove specific subsets of the NC with sox10 and mitfa knockouts and characterise genome-wide gene expression levels across multiple time points. We find that compensation through a single wild-type allele of tfap2c is capable of maintaining early NC induction and differentiation in the absence of tfap2a function, but many target genes have abnormal expression levels and therefore show sensitivity to the reduced tfap2 dosage. This separation of morphological and molecular phenotypes identifies a core set of genes required for early NC development. We also identify the 15 somites stage as the peak of the molecular phenotype which strongly diminishes at 24 hpf even as the morphological phenotype becomes more apparent. Using gene knockouts, we associate previously uncharacterised genes with pigment cell development and establish a role for maternal Hippo signalling in melanocyte differentiation. This work extends and refines the NC GRN while also uncovering the transcriptional basis of genetic compensation via paralogues

    Titania-doped tantala/silica coatings for gravitational-wave detection

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    Reducing thermal noise from optical coatings is crucial to reaching the required sensitivity in next generation interferometric gravitational-wave detectors. Here we show that adding TiO2 to Ta2O5 in Ta2O5/SiO2 coatings reduces the internal friction and in addition present data confirming it reduces thermal noise. We also show that TiO2-doped Ta2O5/SiO2 coatings are close to satisfying the optical absorption requirements of second generation gravitational-wave detectors

    Outbreak of Sporotrichosis, Western Australia

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    A cluster of sporotrichosis cases occurred in the Busselton-Margaret River region of Western Australia from 2000 to 2003. Epidemiologic investigation and mycologic culture for Sporothrix schenckii implicated hay initially distributed through a commercial hay supplier as the source of the outbreak. Declining infection rates have occurred after various community measures were instigated

    Functional Outcomes Among Young People With Trajectories of Persistent Childhood Psychopathology

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    IMPORTANCE Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies. OBJECTIVE To investigate the odds of poor outcomes in emerging adulthood (ages 17 to 20 years) for children with different mental health trajectories at ages 9 to 13 years. DESIGN, SETTING, AND PARTICIPANTS Growing Up in Ireland is a longitudinal, nationally representative population-based cohort study. Data collection began in August 2007 and was repeated most recently in September 2018. All results were weighted to account for sampling bias and attrition and were adjusted for socioeconomic factors. Data analysis took place from October 2022 to April 2023. EXPOSURE Four latent classes captured variation in mental health in children aged 9 and 13 years, based on the parent-completed Strengths and Difficulties Questionnaire. Classes included no psychopathology, internalizing, externalizing, and high (comorbid) psychopathology. Those who remained in the same class from ages 9 to 13 years were included. MAIN OUTCOMES AND MEASURES Poor functional outcomes in emerging adulthood were measured at approximate ages 17 years (range, 16 to 18 years) and 20 years (range, 19 to 21 years). Outcomes included poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective well-being, and adverse educational/economic outcomes. RESULTS Of 5141 included participants, 2618 (50.9%) were male. A total of 3726 (72.5%) were classed as having no childhood psychopathology, 1025 (19.9%) as having persistent externalizing psychopathology, 243 (4.7%) as having persistent internalizing psychopathology, and 147 (2.9%) as having persistent high psychopathology. Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalizing group had elevated odds of most outcomes except for heavy substance use (range of odds ratios [ORs]: 1.38 [95% CI, 1.05-1.81] for frequent health service use to 3.08 [95% CI, 2.33-4.08] for poor mental health). The externalizing group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (range of ORs: 1.38 [95% CI, 1.19-1.60] for frequent health service use to 1.98 [95% CI, 1.67-2.35] for adverse educational/economic outcomes). The high psychopathology group had elevated odds of all outcomes (nonsignificantly for frequent health service use), though with wide confidence intervals (range of ORs: 1.53 [95% CI, 1.06-2.21] for poor physical health to 2.91 [95% CI, 2.05-4.12] for poor mental health). Female participants with any psychopathology had significantly higher odds of poor physical health and frequent health service use compared with male participants with any psychopathology
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