A Case of Protein Losing Enteropathy after Fontan Operation

Protein Losing Enteropathy (PLE) is a condition in which an excessive amount of proteins are lost through the gastrointestinal tract leading to hypoproteinemia and manifesting as edema, ascites, and diarrhea. While in most cases PLE is a treatable disorder with good outcomes, the morbidity and mortality of the disorder is significantly elevated in patients with a history of Fontan surgery–an operation used to palliate patients born with a single ventricle by rerouting venous blood return directly to pulmonary circulation. After failure of first-line therapeutics of diuretics and steroids, this case study explores the successful treatment of a 5-year-old patient with PLE after fontan operation through lymphatic imaging and intervention

Exercise-Induced Adult Neruogenesis and the Seizure Threshold: the Role of COX-2

Neurogenesis, the generation of new neurons, is most prevalent when the brain is being formed during pre-natal development. However, this process continues in select areas in the brain during adult life as well. One such area in the brain is the dentate gyrus (DG) of the hippocampus, an area known to be associated with learning and memory. In this region, neurogenesis is believed to contribute to neuroplasticity as well as improving its functions in learning and memory. Interestingly, this synthesis of neurons is increased by physical activity—predominantly running—and by seizures originating in the limbic system. The increased excitatory neuronal activity that occurs during a seizure leads to an increase in an enzyme called cyclooxygenase-2 (COX-2), the initial enzyme in the production of prostaglandins from arachidonic acid. COX-2 is usually expressed in certain neurons of the brain including the CA3 subregion of the hippocampus, and its level of expression is linked to increased excitatory neuronal activity. In other words, COX-2 is up-regulated by seizure activity; therefore, during seizures there is an increase in COX-2 activity and expression. Because new neurons exhibit increased excitatory responsiveness, the goal of this research is to test the possibility that exercise-induced new neurons of the DG will exhibit increased COX-2 levels following acute seizure activity. It is predicted that it will, and amplified COX-2 levels will be found in subjects that have access to physical exercise, particularly in the new neurons generated by running. An experimental group of mice were supplied with running wheels and allowed to run for roughly one month. Bromodeoxyuridine (BrdU) was injected one week after the start of running in order to label the newly generated neurons in the hippocampus. After running, animals were subjected to acute seizures through pentylenetetrazol (PTZ) injections, and the subsequent seizures were scored based on severity. Cardiac perfusions were then performed to collect brain tissue that was then coronally sectioned using the cryostat and mounted on microscope slides, in order to stain for COX-2 and BrdU. Running mice exhibited lower seizure scores than control mice implying that the neurogenesis induced by physical activity increased the COX-2 levels, thus raising the seizure threshold in exercised mice

The Impermissibility of Police Deception in Juvenile Interrogations

Although perjury is a criminal offense in all states and a felony in many, law enforcement may routinely lie to suspects during interrogations. This widespread, judicially authorized practice consists of interrogators making false promises of leniency that the suspect will receive a lighter sentence in exchange for a confession, and making misrepresentations about the evidence against the suspect. Police deception in interrogations becomes even more problematic when used against juvenile suspects because the psychological vulnerability of minors may lead them to succumb to deceptive pressures and even to falsely confess. This Note explores the debate surrounding the use of police deception tactics in interrogations and suggests that, for juvenile suspects, the practice should be categorically barred through state legislation. The suggestibility and susceptibility of youth render them more likely to falsely confess than adults are. This Note argues that deceptive interrogation tactics inherently violate due process rights by allowing law enforcement to lie to youth who are more likely to believe them than adult suspects are. Because of these concerns, deception in juvenile interrogations should be prohibited per se through state legislation. Such legislation should categorically prohibit law enforcement from intentionally misrepresenting the evidence available against the juvenile suspect or from intentionally engaging in other deceptive practices that are fundamentally unfair and unjust

Studies toward the syntheses of tetrahydroswertianolin and puniceaside B

Tetrahydroxanthones are a family of natural products with chemically interesting functional groups and a diverse array of reported biological activities. The dissertation research described herein has been focused on the synthesis of tetrahydroswertianolin, a glycosylated tetrahydroxanthone, and puniceaside B, a heterodimeric, glycosylated tetrahydroxanthone. To the best of our knowledge, there have been no published reports on the total synthesis of either natural product. We have targeted tetrahydroswertianolin and puniceaside B in hopes of developing a divergent method to easily access a variety of tetrahydroxanthone cores for natural product and analogue synthesis. Our efforts to develop a cascade reaction toward the tetrahydroxanthone core and the stepwise route that we simultaneously pursued will be presented. A scalable synthetic route to the tetrahydroxanthone core of tetrahydroswertianolin and the aromatic xanthone core of puniceaside B was accomplished. An asymmetric route to the tetrahydroxanthone precursor was also developed.2019-02-14T00:00:00

Occupational Therapists’ Evaluation and Treatment of Everyday Technology with Adult Patients with Traumatic Brain Injury

Everyday technology (ET), which includes devices such as smartphones and tablets, is dynamic, complex, and interactive and may be difficult for an adult with a traumatic brain injury (TBI) to use due to cognitive deficits, including executive dysfunction. Executive dysfunction leads to difficulty with higher level thinking, including planning, organizing, and problem solving, skills which are used in instrumental activities of daily living (IADL), work, leisure, and social participation. The purpose of this study was to examine how occupational therapists use ET in assessment and treatment of adults with TBI to regain or increase independence in IADL, work, leisure, and social participation. The researchers used a qualitative descriptive approach using semi-structured interviews with two occupational therapists who use ET with adults with TBI. Three themes emerged after reviewing the data: (1) Fit Between Person, Task, and ET, (2) Making it Work, and (3) Barriers to ET. Occupational therapists can use a holistic perspective and activity analysis in order to utilize ET as occupation-as-means or as occupation-as-ends to increase occupational performance for adults with TBI

Additional Powers of Search and Seizure at and near the Border

In normal practice, the Fourth Amendment of the U.S. Constitution requires individualized suspicion together with procurement of a warrant prior to a government search and/or seizure. Federal courts have recognized some exceptions, however, with the most common one pertaining at the nation’s borders, where most stops and searches are exempt from the usual requirements. That exception is justified by the understanding that a sovereign nation has the power to control who and what comes within its borders. This article describes practices related to searches and seizures at and near the border. A lengthy discussion of U.S. practices is followed by a brief discussion of Canadian practices

State-by-State Abolition of Juvenile Life without Parole Sentences in the United States since Miller v. Alabama (2012)

Since Miller v. Alabama (2012), 18 states and the District of Columbia abolished juvenile life without parole sentences. This thesis examines the arguments, norms, logic, and messages utilized at each state since Miller to support the elimination of juvenile life without parole sentences. The arguments either stem from the nature of children or the nature of the sentence itself. Scientific studies that confirm the distinctive psychological attributes of youth has been adduced to argue for the diminished culpability of children, the inability of the sentence to serve its penological goals, children’s capacity of change, and the fallacy of the predictive enterprise to determine the incorrigibility of a juvenile offender. The harshness of the sentence itself, domestic and foreign practice, the prohibition of the sentence under international human rights law, the fiscal and behavioral benefits of offering the possibility of parole, and the racial disparities of the sentence have also been argued at the state-level. The effectiveness of the arguments above may be enhanced when they are delivered by formerly incarcerated youth or victims of violence or when they are reframed as a religious ideal to a more conservative, religious audience

What Counts as Common Core Aligned? An Examination of a Reading Program\u27s Agreement with the Common Core State Standards

Passage and implementation of the Common Core State Standards (CCSS) created numerous difficulties for educational stakeholders. One such difficulty, determining the alignment of previously utilized curricula to the CCSS, forced many states, districts, and schools into purchasing “new” curricular resources marketed as “Common Core Aligned” without any available auditing process to validate the claims made by publishers. Since initial implementation of CCSS, measures for determining alignment have been developed. This study examined the alignment of a widely used reading program, Adventures Common Core (pseudonym), to the Common Core State Standards using a modified version of the Educators Evaluating the Quality of Instructional Products (EQuIP) Rubric for Lessons and Units: ELA/Literacy. The following research questions guided this study: (1) To what extent does the Adventures Common Core reading program effectively address all components of literacy as defined by the Common Core State Standards? (2) To what extent does the Adventures Common Core reading program accurately assess student literacy in alignment with the Common Core State Standards? Findings, which are significant for future research, show that even intentionally aligned curricula can fall short of addressing standards to the depth and rigor intended