335 research outputs found
An Idea Whose Time Has Come: Certified Legal Interns as Oral Advocates in the Pennsylvania Appellate Courts
Affirmative Action: Are the Equal Protection and Title VII Tests Synonymous?
Over the past decade, the United States Supreme Court has debated the extent to which employment decisions can be based on race or sex. As yet, the Court has not articulated a controlling test to evaluate the legality of all types of affirmative action plans. A review of the relevant cases, however, reveals that the Court uses the same standards to test the validity of both voluntary and court ordered affirmative action plans regardless of whether the challenge is brought under Title VII or the equal protection clauses
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An adolescent girl with signs and symptoms of anaphylaxis and negative immunologic workup: a case report.
BackgroundThe increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed history and supportive testing. However, there are cases where the underlying factors are more complex and difficult to identify.Case presentationHere we present the case report of a 14-year-old Caucasian girl with weight loss and a 3-year history of reported angioedema culminating in five intensive care unit admissions over the course of 2.5 months. Her initial clinical presentation included hypotension, dyspnea, and reported facial edema, but allergy and immunological workup were negative. A psychiatric workup identified an eating disorder with food restriction, comorbid major depression, obsessive compulsive disorder, and posttraumatic stress disorder. A close collaboration between Adolescent Medicine, Allergy and Immunology, and Psychiatry helped disentangle medical from psychiatric problems, including fluoxetine medication effects, as well as develop a treatment plan that was acceptable to the family. The angioedema was ultimately diagnosed as factitious disorder.ConclusionsThis patient's treatment highlights the importance of a multidisciplinary team approach, a multifactorial etiology that needed to be addressed by multiple specialists, and the importance of long-term treatment and support
Systems Biology and Mechanistic Explanation
We address the question of whether and to what extent explanatory and modelling strategies in systems biology are mechanistic. After showing how dynamic mathematical models are actually required for mechanistic explanations of complex systems, we caution readers against expecting all systems biology to be about mechanistic explanations. Instead, the aim may be to generate topological explanations that are not standardly mechanistic, or to arrive at design principles that explain system organization and behaviour in general, but not specific mechanisms. These abstraction strategies serve various aims, including prediction and control, that are central to understanding the epistemic diversity of systems biology
The European Union: Where Is It Now?
In four decades, western Europe has, by the force of economics, not blood and iron, united along economic, social and political venues. The western European marketplaces emerging from the devastation of World War II began to integrate with the concomitant benefit of a standard of economic well-being theretofore unknown. The unifying theme underlying the cooperation of the nations of western Europe in the European Economic Community has been that economic union quite necessarily leads to political union and both work in unison to preserve peace. This is the first of two articles on the European Union. The purpose of this article is to help educate the reader generally about the historical development and the law of the European Union, including its sources of law and its institutions
Systematic Review of the Addition of Hip Strengthening Exercises for Adults with Patellofemoral Pain Syndrome
Patellofemoral Pain Syndrome (PFPS) is a common musculoskeletal disorder typically occurring in physically active people aged 40 years and younger, causing pain, functional deficits and lower limb weakness. Traditional treatment has been aimed at strengthening the knee, however recent research suggests the muscles around the hip also play an important role in the development and continuity of Patellofemoral Pain Syndrome.
Purpose: To investigate the effectiveness of the addition of hip strengthening exercises to standard physiotherapy treatment (knee strengthening and stretching exercises) on reducing pain, and enhancing strength and function when compared to standard physiotherapy treatment alone in adults with Patellofemoral Pain Syndrome.
Method: A systematic search of Cochrane, CINAHL, Embase, MEDLINE®, PEDro and SportDiscus was conducted. Studies of participants aged 18 to 44, diagnosed with Patellofemoral Pain Syndrome by a healthcare practitioner, or reporting peripatellar or retropatellar pain with common functional tasks, were included. A critical appraisal, using the Critical Appraisal Skills Program for Randomised Controlled Trials (CASP) was used to assess methodological quality.
Results: Five randomised controlled trials of varying methodological quality met the inclusion criteria. The participants in these studies were aged between 18 to 40 years of age. The duration of the intervention ranged from four to six weeks consisting of 12 to 30 supervised exercise sessions. Studies used varying outcome measures for each of the three outcomes. Overall, the studies demonstrated that the addition of hip strengthening exercises to standard physiotherapy care consistently improved pain and function, but the impact on strength was variable.
Conclusion: Previously, only a small number of studies have looked at the addition of hip exercises to standard physiotherapy care for treatment of Patellofemoral Pain Syndrome. While there is a growing body of evidence for the efficacy of hip strengthening exercises for Patellofemoral Pain Syndrome, this is constrained by bias towards female participants, lack of true controls in most studies, and low methodological quality of studies overall. Hip exercises added to standard physiotherapy care shows potential as a treatment method for improving outcomes of pain and function in adults with Patellofemoral Pain Syndrome
The use of multiple-criteria decision-making theory to measure students’ perceptions of high-fidelity simulation
Background
High fidelity simulation (HFS) has great potential to improve decision-making in clinical practice. Previous studies have found HFS promotes self-confidence, but its effectiveness in clinical practice has not been established. The aim of this research is to establish if HFS facilitates learning that informs decision-making skills in clinical practice using Multiple-Criteria Decision Making Theory (MCDMT).
Method
The sample were 2nd year undergraduate pre-registration adult nursing students. MCDMT was used to measure the students’ experience of HFS and how it developed their clinical decision-making skills. MCDMT requires characteristic measurements which for the learning experience were based on five factors that underpin successful learning and for clinical decision making an analytical framework was used. The study utilised a repeated-measures design to take two measurements: the first one after the first simulation experience and the second one after clinical placement. Baseline measurements were obtained from academics. Data were analysed utilising the MCDMT tool.
Results
After their initial exposure to simulation learning students reported that HFS provides a high quality learning experience (87%) and supports all aspects of clinical decision-making (85%). Following clinical practice the level of support for clinical decision-making remained at 85% suggesting that students believe HFS promotes transferability of knowledge to the practice setting.
Conclusion
Overall, students report a high level of support for learning and developing clinical decision-making skills from HFS. However, there are no comparative data available from classroom teaching of similar content so it cannot be established if these results are due to HFS alone
A multicopper oxidase-related protein is essential for insect viability, longevity and ovary development
Citation: Peng Z, Green PG, Arakane Y, Kanost MR, Gorman MJ (2014) A Multicopper Oxidase-Related Protein Is Essential for Insect Viability, Longevity and Ovary Development. PLOS ONE 9(10): e111344. https://doi.org/10.1371/journal.pone.0111344Typical multicopper oxidases (MCOs) have ten conserved histidines and one conserved cysteine that coordinate four copper atoms. These copper ions are required for oxidase activity. During our studies of insect MCOs, we discovered a gene that we named multicopper oxidase-related protein (MCORP). MCORPs share sequence similarity with MCOs, but lack many of the copper-coordinating residues. We identified MCORP orthologs in many insect species, but not in other invertebrates or vertebrates. We predicted that MCORPs would lack oxidase activity due to the absence of copper-coordinating residues. To test this prediction, we purified recombinant Tribolium castaneum (red flour beetle) MCORP and analyzed its enzymatic activity using a variety of substrates. As expected, no oxidase activity was detected. To study MCORP function in vivo, we analyzed expression profiles of TcMCORP and Anopheles gambiae (African malaria mosquito) MCORP, and assessed RNAi-mediated knockdown phenotypes. We found that both MCORPs are constitutively expressed at a low level in all of the tissues we analyzed. Injection of TcMCORP dsRNA into larvae resulted in 100% mortality prior to adult eclosion, with death occurring mainly during the pharate pupal stage or late pharate adult stage. Injection of TcMCORP dsRNA into pharate pupae resulted in the death of approximately 20% of the treated insects during the pupal to adult transition and a greatly shortened life span for the remaining insects. In addition, knockdown of TcMCORP in females prevented oocyte maturation and, thus, greatly decreased the number of eggs laid. These results indicate that TcMCORP is an essential gene and that its function is required for reproduction. An understanding of the role MCORP plays in insect physiology may help to develop new strategies for controlling insect pests
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