Religious Liberty for a Select Few

This report discusses how the Department of Justice’s guidance opens the door to an extreme rewriting of the concept of religious liberty. The guidance — and the numerous agency rules, enforcement actions, and policies that it is influencing — will shift the balance of individual religious protections across the federal government toward a new framing that allows religious beliefs to be used as a weapon against minority groups

An evaluation of the integration of non-traditional learning tools into a community based breast and cervical cancer education program: The witness project of Buffalo

BACKGROUND: Breast and cervical cancer continue to represent major health challenges for African American women. among Caucasian women. The underlying reasons for this disparity are multifactorial and include lack of education and awareness of screening and early detection. Traditional educational methods have enjoyed varied success in the African American community and spawned development of novel educational approaches. Community based education programs employing a variety of educational models have been introduced. Successful programs must train and provide lay community members with the tools necessary to deliver strong educational programs. METHODS: The Witness Project is a theory-based, breast and cervical cancer educational program, delivered by African American women, that stresses the importance of early detection and screening to improve survival and teaches women how to perform breast self examination. Implementing this program in the Buffalo Witness Project of Buffalo required several modifications in the curriculum, integration of non-traditional learning tools and focused training in clinical study participation. The educational approaches utilized included repetition, modeling, building comprehension, reinforcement, hands on learning, a social story on breast health for African American women, and role play conversations about breast and cervical health and support. RESULTS: Incorporating non-traditional educational approaches into the Witness Project training resulted in a 79% improvement in the number of women who mastered the didactic information. A seventy-two percent study participation rate was achieved by educating the community organizations that hosted Witness Project programs about the informed consent process and study participation. CONCLUSION: Incorporating non-traditional educational approaches into community outreach programs increases training success as well as community participation

Pathogenic variants in glutamyl-tRNAGln amidotransferase subunits cause a lethal mitochondrial cardiomyopathy disorder.

Mitochondrial protein synthesis requires charging mt-tRNAs with their cognate amino acids by mitochondrial aminoacyl-tRNA synthetases, with the exception of glutaminyl mt-tRNA (mt-tRNAGln). mt-tRNAGln is indirectly charged by a transamidation reaction involving the GatCAB aminoacyl-tRNA amidotransferase complex. Defects involving the mitochondrial protein synthesis machinery cause a broad spectrum of disorders, with often fatal outcome. Here, we describe nine patients from five families with genetic defects in a GatCAB complex subunit, including QRSL1, GATB, and GATC, each showing a lethal metabolic cardiomyopathy syndrome. Functional studies reveal combined respiratory chain enzyme deficiencies and mitochondrial dysfunction. Aminoacylation of mt-tRNAGln and mitochondrial protein translation are deficient in patients' fibroblasts cultured in the absence of glutamine but restore in high glutamine. Lentiviral rescue experiments and modeling in S. cerevisiae homologs confirm pathogenicity. Our study completes a decade of investigations on mitochondrial aminoacylation disorders, starting with DARS2 and ending with the GatCAB complex

Risk factors for Coronavirus disease 2019 (Covid-19) death in a population cohort study from the Western Cape province, South Africa

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1)

Religious Liberty for a Select Few

This report discusses how the Department of Justice’s guidance opens the door to an extreme rewriting of the concept of religious liberty. The guidance — and the numerous agency rules, enforcement actions, and policies that it is influencing — will shift the balance of individual religious protections across the federal government toward a new framing that allows religious beliefs to be used as a weapon against minority groups

Mutations in the V-ATPase Assembly Factor VMA21 Cause a Congenital Disorder of Glycosylation With Autophagic Liver Disease

Background and Aims Vacuolar H+-ATP complex (V-ATPase) is a multisubunit protein complex required for acidification of intracellular compartments. At least five different factors are known to be essential for its assembly in the endoplasmic reticulum (ER). Genetic defects in four of these V-ATPase assembly factors show overlapping clinical features, including steatotic liver disease and mild hypercholesterolemia. An exception is the assembly factor vacuolar ATPase assembly integral membrane protein (VMA21), whose X-linked mutations lead to autophagic myopathy. Approach and Results Here, we report pathogenic variants in VMA21 in male patients with abnormal protein glycosylation that result in mild cholestasis, chronic elevation of aminotransferases, elevation of (low-density lipoprotein) cholesterol and steatosis in hepatocytes. We also show that the VMA21 variants lead to V-ATPase misassembly and dysfunction. As a consequence, lysosomal acidification and degradation of phagocytosed materials are impaired, causing lipid droplet (LD) accumulation in autolysosomes. Moreover, VMA21 deficiency triggers ER stress and sequestration of unesterified cholesterol in lysosomes, thereby activating the sterol response element-binding protein-mediated cholesterol synthesis pathways. Conclusions Together, our data suggest that impaired lipophagy, ER stress, and increased cholesterol synthesis lead to LD accumulation and hepatic steatosis. V-ATPase assembly defects are thus a form of hereditary liver disease with implications for the pathogenesis of nonalcoholic fatty liver disease.Peer reviewe

Emerging Best Practices for the Management and Treatment of Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex Youth in Juvenile Justice Settings

In 2016 according to the U.S. Department of Justice, 856,130 youth were arrested and 45,567 juveniles were held in 1,772 residential juvenile facilities across the country. Detained and confined youth share many characteristics: most are from poor communities and lack access to quality health care. Mental illness and sexually transmitted infections are prevalent. Compared to their non-confined counterparts, incarcerated youth also experience higher rates of substance abuse and homelessness, are educationally behind their peers, are disproportionately identified as needing special education services, and are more likely to have had traumatic experiences (including sexual and emotional abuse) and injuries including traumatic brain injury, among other health issues. Increasingly, youth-serving justice professionals believe that community-based alternatives to incarceration are preferable. Incarceration should be used only as a last resort. To the extent that youth are incarcerated, this resource provides best practices for making juvenile justice facilities as safe and affirming as possible for lesbian, gay, bisexual, transgender, queer, questioning, and intersex youth. Traditionally, many juvenile justice professionals have had a strong commitment to the rehabilitation and treatment needs of youth in their care. In fact, most youth are held in facilities that screen for educational needs, substance abuse, and mental health needs. Many strive to create a therapeutic environment for adolescents. Actually achieving that goal is a challenge for many institutions, one that this paper strives to highlight and address. Juvenile justice administrators and staff must create a professional, non-discriminatory environment where all youth in their charge are physically and emotionally safe and treated respectfully. To meet this professional goal, including the mandates of the Prison Rape Elimination Act of 2003, administrators and staff need to understand how to create and maintain a safe and secure environment within the juvenile justice system for a particularly vulnerable population that is at disproportionate risk for both confinement and sexual abuse: lesbian, gay, bisexual, transgender, questioning, and intersex youth (collectively, LGBTQI youth). Youth, regardless of whether or not they are in custody and/ or identify as LGBTQI, experience developmental and social challenges during adolescence. LGBTQI youth not only face the changes and challenges of adolescence, but also the stress of developing and living with a stigmatized identity including—too often—family and societal rejection. Juvenile justice facilities should offer mental health and other support services to all youth in their care to aid them in the process of maturation. These services should always be offered and tailored to the unique needs of each individual. This in turn will allow facility staff to create a safer, more secure facility for all youth in their care and custody, along with a supportive rehabilitative environment. We have created this informational guide to offer important background about LGBTQI youth in confinement, along with promising practices for their proper and effective management and treatment. We trust it will be a useful resource to better equip all juvenile justice administrators and staff with needed and more precise tools to better address the particular needs and vulnerabilities of this population. This, in turn, will allow correctional staff to execute their jobs more effectively and create a safer, more secure facility for all youth in their care and custody, along with a supportive rehabilitative environment