COVID-19 and Public Accommodations Under the Americans with Disabilities Act: Getting Americans Safely Back to Restaurants, Theaters, Gyms, and “Normal”

THIS IS A PRELIMINARY EXPEDITED VERSION OF THE OFFICIAL ARTICLE TO BE ORIGINALLY PUBLISHED IN SAINT LOUIS UNIVERSITY LAW JOURNAL VOLUME 65 NUMBER 2 COVID-19 permanently changed the way places of public accommodation like restaurants, theaters, medical facilities, arenas, gyms, and many other proprietors of mainstream American activities must operate in order to accommodate people with newly-defined, COVID-19-related disabilities under Title III of the Americans with Disabilities Act (ADA). The required modifications will affect all patrons and employees of these establishments. Under the ADA, places of public accommodation are barred from discriminating against people with disabilities in the full and equal enjoyment of goods, services, and facilities. Infectious diseases like tuberculosis and HIV have been categorized as disabilities under the ADA, and COVID-19 is defining new categories of individuals with disabilities (including individuals vulnerable to COVID-19 complications) as revealed in this paper. Places of public accommodation will be required to establish non-discriminatory methods to identify “direct threats,” to modify policies and procedures for COVID-19-related disability groups identified here, and remove structural barriers that discriminate against those same groups. Controversial measures like fever checkpoints, mandatory face masking, and required social distancing are discussed in depth and analyzed in light of the ADA’s requirements.https://scholarship.law.slu.edu/lawjournalonline/1000/thumbnail.jp

States’ Rights to Protect Gun-Owning Patients from Politicized Physician Speech

The article examines the U.S. states\u27 obligations to protect patients\u27 best interests and evaluates physicians\u27 free speech rights in the patient-physician relationship

Significant Concern about Climate and Health Among Montana Public and Environmental Health Professionals

A survey of Montana public and environmental health professionals conducted during September and October 2019 revealed that these health professionals not only largely accept climate change but also have significant concerns about climate and health. Eighty-nine percent accepted that global warming is occurring and 69% accepted human causation. They expressed much stronger climate change risk perceptions compared to the general public in recent surveys and in most surveys of health professionals, and similar perceptions to vulnerable health care providers working with vulnerable populations. In addition, most felt that their own health was already being affected by climate. Most felt that mental health effects from climate change would be a concern in the future (89%). Political ideology was found to be the demographic most highly correlated with acceptance of global warming’s occurrence, human causation, and risk perception. Three-fourths of respondents felt that health departments should be preparing to deal with the public and environmental health effects of climate change. Almost all felt that multiple entities in Montana, including public and environmental health professionals, should be working to address climate change. Environmental health and public health professionals did not differ significantly in their acceptance of global warming and human causation and risk perception. Compared to a separate cohort of students, professionals were less likely to accept global warming and had lower risk perceptions, but acceptance of human causation did not differ between the two groups. Very few studies have looked at these populations with these questions

Structured illumination microscopy using micro-pixellated light-emitting diodes

Structured illumination is a flexible and economical method of obtaining optical sectioning in wide-field microscopy [1]. In this technique the illumination system is modified to project a single-spatial frequency grid pattern onto the sample [2, 3]. The pattern can only be resolved in the focal plane and by recording images for different transverse grid positions (or phases) an image of the in-focus parts of the object can be calculated. Light emitting diodes (LEDs) are becoming increasingly popular for lighting and illumination systems due to their low cost, small dimensions, low coherence, uniform illumination, high efficiency and long lifetime. These properties, together with recent developments in high brightness, ultraviolet operation and microstructured emitter design offer great potential for LEDs as light sources for microscopy. In this paper we demonstrate a novel structured illumination microscope using a blue micro-structured light emitting diode as the illumination source. The system is potentially very compact and has no-moving-parts

An Entomopathogenic Nematode Extends Its Niche by Associating with Different Symbionts

Bacterial symbionts are increasingly recognised as mediators of ecologically important traits of their animal hosts, with acquisition of new traits possible by uptake of novel symbionts. The entomopathogenic nematode Heterorhabditis downesi associates with two bacterial symbionts, Photorhabdus temperata subsp. temperata and P. temperata subsp. cinerea. At one intensively studied coastal dune site, P. temperata subsp. cinerea is consistently more frequently isolated than P. temperata subsp. temperata in H. downesi recovered from under the bare sand/Ammophila arrenaria of the front dunes (where harsh conditions, including drought, prevail). This is not the case in the more permissive closed dune grassland further from the sea. No differences were detected in ITS1 (internal transcribed spacer) sequence between nematode lines carrying either of the two symbiont subspecies, nor did they differ in their ability to utilise insects from three orders. The two symbionts could be readily swapped between lines, and both were carried in equal numbers within infective juveniles. In laboratory experiments, we tested whether the symbionts differentially affected nematode survival in insect cadavers that were allowed to dry. We assessed numbers of nematode infective juveniles emerging from insects that had been infected with H. downesi carrying either symbiont subspecies and then allowed to desiccate for up to 62 days. In moist conditions, cadavers produced similar numbers of nematodes, irrespective of the symbiont subspecies present, while under desiccating conditions, P. temperata subsp. cinerea cadavers yielded more nematode progeny than P. temperata subsp. temperata cadavers. Desiccating cadavers with the same nematode isolates, carrying either one or the other symbiont subspecies, confirmed that the symbiont was responsible for differences in nematode survival. Moreover, cadavers harbouring P. temperata subsp. cinerea had a reduced rate of drying relative to cadavers harbouring P. temperata subsp. temperata. Our experiments support the hypothesis that H. downesi can extend its niche into harsher conditions by associating with P. temperata subsp. cinerea

Quality of Life and Clinical Outcomes in Elderly Patients Treated with Ventricular Pacing as Compared with Dual-Chamber Pacing

ABSTRACT Background Standard clinical practice permits the use of either single-chamber ventricular pacemakers or dual-chamber pacemakers for most patients who require cardiac pacing. Ventricular pacemakers are less expensive, but dual-chamber pacemakers are believed to be more physiologic. However, it is not known whether either type of pacemaker results in superior clinical outcomes. Methods The Pacemaker Selection in the Elderly study was a 30-month, single-blind, randomized, controlled comparison of ventricular pacing and dualchamber pacing in 407 patients 65 years of age or older in 29 centers. Patients received a dual-chamber pacemaker that had been randomly programmed to either ventricular pacing or dual-chamber pacing. The primary end point was health-related quality of life as measured by the 36-item Medical Outcomes Study Short-Form General Health Survey. Results The average age of the patients was 76 years (range, 65 to 96), and 60 percent were men. Quality of life improved significantly after pacemaker implantation (P0.001), but there were no differences between the two pacing modes in either the quality of life or prespecified clinical outcomes (including cardiovascular events or death). However, 53 patients assigned to ventricular pacing (26 percent) were crossed over to dual-chamber pacing because of symptoms related to the pacemaker syndrome. Patients with sinus-node dysfunction, but not those with atrioventricular block, had moderately better quality of life and cardiovascular functional status with dual-chamber pacing than with ventricular pacing. Trends of borderline statistical significance in clinical end points favoring dual-chamber pacing were observed in patients with sinus-node dysfunction, but not in those with atrioventricular block. Conclusions The implantation of a permanent pacemaker improves health-related quality of life. The quality-of-life benefits associated with dualchamber pacing as compared with ventricular pacing are observed principally in the subgroup of patients with sinus-node dysfunction. (N Engl J Med 1998;338:1097-104.

Beam divergence measurements of InGaN/GaN micro-array light-emitting diodes using confocal microscopy

The recent development of high-density, two-dimensional arrays of micrometer-sized InGaN/GaN light-emitting diodes (micro-LEDs) with potential applications from scientific instrumentation to microdisplays has created an urgent need for controlled manipulation of the light output from these devices. With directed light output these devices can be used in situations where collimated beams or light focused onto several thousand matrix points is desired. In order to do this effectively, the emission characteristics of the devices must be fully understood and characterized. Here we utilize confocal microscopy to directly determine the emission characteristics and angular beam divergences from the individual micro-LED elements. The technique is applied to both top (into air) and bottom (through substrate) emission in arrays of green (540 nm), blue (470 nm), and UV (370 nm) micro-LED devices, at distances of up to 50 µm from the emission plane. The results are consistent with simple optical modeling of the expected beam profiles

Legal Rights and Issues Surrounding Conception, Pregnancy, and Birth

Advances in medicine are reported almost daily in the media. Medical researchers have developed and are continuing to develop new methods of creating, saving, and prolonging life. This Special Project examines the impact that rapidly advancing medical technology has on the law governing conception, pregnancy, and birth. Although medical techniques have advanced rapidly during the past decades, state and federal legislatures have responded in-adequately to the legal consequences of these new birth technologies. The resulting lag between technology and the law has forced courts to confront new situations that do not fit neatly into the statutory framework created to deal with past fact situations. For example, courts have applied statutes prohibiting child bartering to surrogate parenting cases and statutes prohibiting fetal experimentation to artificial insemination cases although it is clear that the legislators never considered such fact patterns when passing the statutes. A lag is inevitable because the law can only respond to, rather than predict, emerging medical developments. Nonetheless, legislators must respond promptly by confronting the new legal issues that result from new medical technologies. One impediment to prompt legislative response to the lag between medical technology and the law is the controversial nature of the legal problems posed. Abortion continues to be an extremely controversial issue thirteen years after the Supreme Court legalized it in the landmark decision Roe v. Wade. The Baby Doe issue of whether to force hospitals and parents of severely deformed newborns to provide medical care is another extremely controversial issue. Baby Doe has become highly politicized as the Reagan administration, Congress, right-to-life groups, disability groups, medical professionals, and other groups have taken stances. Surrogate parenting also has produced controversial situations. In one incident, a New York couple contracted with a California surrogate mother. When the surrogate mother breached the agreement, the couple brought suit. The court discovered that the couple consisted of a man and a transsexual, thus raising the issue of whether transsexuals or homosexuals should be allowed to adopt children by contracting with surrogate mothers

The stellar mass ratio of GK Persei

We study the absorption lines present in the spectra of the long-period cataclysmic variable GK Per during its quiescent state, which are associated with the secondary star. By comparing quiescent data with outburst spectra we infer that the donor star appears identical during the two states and the inner face of the secondary star is not noticeably irradiated by flux from the accreting regions. We obtain new values for the radial velocity semi-amplitude of the secondary star, Kk = 120.5 +- 0.7 km/s, a projected rotational velocity, Vksin i = 61.5 +- 11.8 km/s and consequently a measurement of the stellar mass ratio of GK Per, q = Mk/Mwd = 0.55 +- 0.21. The inferred white dwarf radial velocities are greater than those measured traditionally using the wings of Doppler-broadened emission lines suspected to originate in an accretion disk, highlighting the unsuitability of emission lines for mass determinations in cataclysmic variables. We determine mass limits for both components in the binary, Mk >= 0.48 +- 0.32 Msolar and Mwd >= 0.87 +- 0.24 Msolar.Comment: 8 pages, 8 figures, accepted by MNRA