Protecting the Least of These: A New Approach to Child Pornography Pandering Provisions

The pandering of child pornography - selling, distributing, or conveying the impression that one possesses sexually graphic images of children for sale or distribution - facilitates actual harm to children, such as molestation. Yet legislative attempts to curb pandering inevitably implicate concerns about panderers\u27 First Amendment rights. This Note argues that in balancing the vulnerability of children against the power of the First Amendment, the law must shift to focus more on the subject of this grievous harm - children. This approach will appropriately extend protection to a subset of the population that is least able to protect itself

First Steps Toward Change in Teacher Preparation for Elementary Science

Unless introductory undergraduate science classes for prospective elementary teachers actively incorporate the philosophy of inquiry-based learning called for in K-l2 science education refom little will change in elementary science education. Thus, at James Madison University, we have developed a new integrated science core curriculum called Understanding our World [1]. This course sequence was not only designed to fulfill general education science requirements. but also to focus on content areas our students will need to know as teachers. The objectives of these courses are based on the National Science Education Standards and Virginia’s Science Standards of Learning, including earth and space science, chemistry, physics, life sciences, and environmental science [2,3]. As an integrated package, this course sequence addresses basic science content, calculation skills, the philosophy and history of science, the process of how science is done, the role of science in society, and applications of computers and technology in science. Keeping in mind that students tend to teach in the same way they were taught, Understanding our World core classes embrace the concepts associated with reform in elementary math and science

Interrater Reliability in Toxicity Identification: Limitations of Current Standards.

PurposeThe National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v5.0 is the standard for oncology toxicity encoding and grading, despite limited validation. We assessed interrater reliability (IRR) in multireviewer toxicity identification.Methods and materialsTwo reviewers independently reviewed 100 randomly selected notes for weekly on-treatment visits during radiation therapy from the electronic health record. Discrepancies were adjudicated by a third reviewer for consensus. Term harmonization was performed to account for overlapping symptoms in CTCAE. IRR was assessed based on unweighted and weighted Cohen's kappa coefficients.ResultsBetween reviewers, the unweighted kappa was 0.68 (95% confidence interval, 0.65-0.71) and the weighted kappa was 0.59 (0.22-1.00). IRR was consistent between symptoms noted as present or absent with a kappa of 0.6 (0.66-0.71) and 0.6 (0.65-0.69), respectively.ConclusionsSignificant discordance suggests toxicity identification, particularly retrospectively, is a complex and error-prone task. Strategies to minimize IRR, including training and simplification of the CTCAE criteria, should be considered in trial design and future terminologies

Preferential mobilization and egress of Type 1 and Type 3 innate lymphocytes in response to exercise and hypoxia

The study examined the effect of exercise and hypoxia on the mobilization and egress of innate lymphocytes (ILCs) and adaptive T cell populations in the blood. The ILCs have emerged as a critical population of cells in immune regulation at mucosal surfaces in animals and humans. Eleven healthy male subjects performed (i) 45 min of exercise at 50% VO2 peak on a cycle ergometer under normoxia and (ii) hypoxia, or (iii) while resting in hypoxia. Blood samples were obtained pre-exercise, immediately post-exercise and 60 min post-exercise and were analyzed by flow cytometry to examine the type 1 and type 3 ILCs and CD4+ and CD8+ naive and memory cell populations. There was a significant increase in the number of type 1 (NK cells) and type 3 ILC22 cells in the blood in response to exercise under normal oxygen conditions followed by a significant egress of these cells following the cessation of exercise. Exercise performed under hypoxic conditions abrogated the mobilization response of NK cells and ILC22 cells. Type 3 LTi cells were mobilized into the blood only under hypoxic rest conditions. No significant changes were observed when we analysed total CD4+ and CD8+T cell populations or the naive and memory subsets. This study highlights that distinct innate populations are mobilised under different environmental conditions and types of stress

The Talin Head Domain Reinforces Integrin-Mediated Adhesion by Promoting Adhesion Complex Stability and Clustering

Talin serves an essential function during integrin-mediated adhesion in linking integrins to actin via the intracellular adhesion complex. In addition, the N-terminal head domain of talin regulates the affinity of integrins for their ECM-ligands, a process known as inside-out activation. We previously showed that in Drosophila, mutating the integrin binding site in the talin head domain resulted in weakened adhesion to the ECM. Intriguingly, subsequent studies showed that canonical inside-out activation of integrin might not take place in flies. Consistent with this, a mutation in talin that specifically blocks its ability to activate mammalian integrins does not significantly impinge on talin function during fly development. Here, we describe results suggesting that the talin head domain reinforces and stabilizes the integrin adhesion complex by promoting integrin clustering distinct from its ability to support inside-out activation. Specifically, we show that an allele of talin containing a mutation that disrupts intramolecular interactions within the talin head attenuates the assembly and reinforcement of the integrin adhesion complex. Importantly, we provide evidence that this mutation blocks integrin clustering in vivo. We propose that the talin head domain is essential for regulating integrin avidity in Drosophila and that this is crucial for integrin-mediated adhesion during animal development

Bilingualism Is Associated with a Delayed Onset of Dementia but Not with a Lower Risk of Developing it: a Systematic Review with Meta-Analyses.

Some studies have linked bilingualism with a later onset of dementia, Alzheimer's disease (AD), and mild cognitive impairment (MCI). Not all studies have observed such relationships, however. Differences in study outcomes may be due to methodological limitations and the presence of confounding factors within studies such as immigration status and level of education. We conducted the first systematic review with meta-analysis combining cross-sectional studies to explore if bilingualism might delay symptom onset and diagnosis of dementia, AD, and MCI. Primary outcomes included the age of symptom onset, the age at diagnosis of MCI or dementia, and the risk of developing MCI or dementia. A secondary outcome included the degree of disease severity at dementia diagnosis. There was no difference in the age of MCI diagnosis between monolinguals and bilinguals [mean difference: 3.2; 95% confidence intervals (CI): -3.4, 9.7]. Bilinguals vs. monolinguals reported experiencing AD symptoms 4.7 years (95% CI: 3.3, 6.1) later. Bilinguals vs. monolinguals were diagnosed with dementia 3.3 years (95% CI: 1.7, 4.9) later. Here, 95% prediction intervals showed a large dispersion of effect sizes (-1.9 to 8.5). We investigated this dispersion with a subgroup meta-analysis comparing studies that had recruited participants with dementia to studies that had recruited participants with AD on the age of dementia and AD diagnosis between mono- and bilinguals. Results showed that bilinguals vs. monolinguals were 1.9 years (95% CI: -0.9, 4.7) and 4.2 (95% CI: 2.0, 6.4) older than monolinguals at the time of dementia and AD diagnosis, respectively. The mean difference between the two subgroups was not significant. There was no significant risk reduction (odds ratio: 0.89; 95% CI: 0.68-1.16) in developing dementia among bilinguals vs. monolinguals. Also, there was no significant difference (Hedges' g = 0.05; 95% CI: -0.13, 0.24) in disease severity at dementia diagnosis between bilinguals and monolinguals, despite bilinguals being significantly older. The majority of studies had adjusted for level of education suggesting that education might not have played a role in the observed delay in dementia among bilinguals vs. monolinguals. Although findings indicated that bilingualism was on average related to a delayed onset of dementia, the magnitude of this relationship varied across different settings. This variation may be due to unexplained heterogeneity and different sources of bias in the included studies. Registration: PROSPERO CRD42015019100

Changing Behaviour towards Aerobic and Strength Exercise (BASE): Design of a randomised, phase I study determining the safety, feasibility and consumer-evaluation of a remotely-delivered exercise programme in persons with multiple sclerosis

Background Multiple sclerosis is a chronic progressive neurological disease. Evidence attests to the benefits of exercise, guidelines for exercise in multiple sclerosis are available. Remote-delivery of exercise adherence programmes based on the exercise guidelines require urgent testing. Aims The design, and outcomes of Behaviour towards Aerobic and Strength Exercise in MS (BASE-MS), a remotely-delivered exercise training study based principles of behaviour change, will further evaluate the remote-delivery of the current exercise guidelines. Methods BASE is a 4-month clinically relevant randomised controlled trial to explore the delivery of a remotely supervised, guidelines-based exercise programme for persons with multiple sclerosis, underpinned by principles of health behaviour change. Initially, 72 persons with mild to moderate multiple sclerosis will be randomised in a 1:1:1 allocation to receive the BASE programme, or act as controls continuing usual care. On programme completion, exercise participants will be further randomised to an optimised adherence treatment or usual adherence. Our online survey assesses the primary outcome of exercise participation, and secondary outcomes of symptoms, and correlates of behaviour change at baseline, month four, month five and month eleven. Online surveys will capture coach and participant feedback to identify the contexts, mechanisms and outcomes of BASE implementation. Conclusions The research and clinical landscape for MS management must remain in-step with public health and health communication. BASE tests the remote-delivery of the current exercise guidelines for exercise in persons with MS. Safety, feasibility and evaluative outcomes will provide rich data for future remote-delivery of exercise in neurological conditions