Brief of Amici Curiae Scholars of The Constitutional Rights and Interests Of Children in Support of Respondents in Masterpiece Cakeshop LTD, et al v. Colorado Civil Rights Commission

Masterpiece Cakeshop LTD, et al v. Colorado Civil Rights Commission is about much more than a wedding cake. It is about the rightful place of LGBT people and their families in the commercial and public sphere. In fact, children are already bearing the brunt of exclusionary practices in the public marketplace because of their relationship to or association with their LGBT parents. In Michigan, a pediatrician refused to treat an infant based solely on the fact that the child had lesbian mothers. In Kentucky, a judge refused to hear adoption cases of children involving LGBT adoptive-parents-to-be. In Tennessee, a nondenominational private school rejected enrollment for a pre-kindergartener and his 8-month-old sister after discovering that the children had two dads. In this brief, we argue that an expressive or religious exemption to sexual orientation discrimination prohibitions will deny children of LGBT parents equal access to the public sphere, inflict upon them psychological harm, and interfere with the “integrity and closeness” of their families — contrary to the aims of public accommodation and anti-discrimination law, and LGBT equality principles advanced in United States v. Windsor and Obergefell v. Hodges

The psychological impact of prostate cancer after treatment: a critical review of the literature

Aim: This critical review of the literature seeks to understand the psychological impact that treatment interventions may have on prostate cancer (PC) survivors. Materials and Methods: A literature search was conducted using databases of peer-reviewed literature. The search terms used were devised using the building-blocks technique to divide the query into facets. The articles were manually assessed for relevance and appraised using the relevant Critical Appraisal Skills Programme (CASP) tool. Government guidelines and regulations were also used following a manual search on the National Institute for Health and Care Excellence (NICE) website. This process resulted in a total of 12 sources being included in the critical review. Results: The key themes that arose from the review were masculinity, depression, anxiety and psychological implications related to sexual functioning. Psychological impact varies on an individual basis and is influenced by the quality of a patient's experience during and after treatment in relation to sufficient information giving and support. Findings: Open communication should be encouraged by healthcare professionals to assess patient mental wellbeing. The extent of psychological impact varies on an individual basis; however, there are predictive factors that can make an individual more at risk of being affected psychologically post-PC treatment

Cervical screening attendance and cervical cancer risk among women who have sex with women

Objectives: To describe cervical cancer screening participation among women who have sex exclusively with women (WSEW) and women who have sex with women and men (WSWM) compared with women who have sex exclusively with men (WSEM), and women who have never had sex and compare this with bowel (colorectal) and breast screening participation. To explore whether there is evidence of differential stage 3 cervical intraepithelial neoplasia (CIN3) or cervical cancer risk. Methods: We describe cervical, bowel and breast cancer screening uptake in age groups eligible for the national screening programmes, prevalent CIN3 and cervical cancer at baseline, and incident CIN3 and cervical cancer at five years follow-up, among 218,674 women in UK Biobank, a cohort of healthy volunteers from the UK. Results: Compared with WSEM, in adjusted analysis [odds ratio (95% confidence interval)], WSEW 0.10 (0.08–0.13), WSWM 0.73 (0.58–0.91), and women who have never had sex 0.02 (0.01–0.02) were less likely to report ever having attended cervical screening. There were no differences when considering bowel cancer screening uptake (p = 0.61). For breast cancer screening, attendance was lower among WSWM 0.79 (0.68 to 0.91) and women who have never had sex 0.47 (0.29–0.58), compared with WSEM. There were incident and prevalent cases of both CIN3 and cervical cancer among WSEW and WSWM. Compared with WSEM with a single male partner, among WSEW there was a twofold increase in CIN3 1.91 (1.01 to 3.59); among WSWM with only one male partner, this was 2.25 (1.19 to 4.24). Conclusions: These findings highlight the importance of improving uptake of cervical screening among all women who have sex with women and breast screening among WSWM and women who have never had sex

Reviews

The Collected Poems of C.S. Lewis: A Critical Edition. Edited by Don W. King. Reviewed by Joe R. Christopher. Tree of Salvation: Yggdrasil and the Cross in the North. G. Ronald Murphy. Reviewed by Jon Garrad. Anglo-Saxon Community in J.R.R. Tolkien\u27s The Lord of the Rings. Deborah A. Higgins. Reviewed by Yvette Kisor. Surprised by the Feminine: A Rereading of C.S. Lewis and Gender. Monika B. Hilder. Reviewed by Laura Lee Smith. Arda Inhabited: Environmental Relationships in The Lord of The Rings. Susan Jeffers. Reviewed by Jeremy Larson. Joy: Poet, Seeker, and the Woman Who Captivated C.S. Lewis. Abigail Santamaria. Reviewed by Crystal Hurd. A Naked Tree: Love Sonnets to C.S. Lewis and Other Poems. Joy Davidman. Ed. Don W. King. Reviewed by Joe R. Christopher. The Hero Enkidu. Lewis Turco. Reviewed by Nicholas Birns. Encyclopedia of Goddesses & Heroines. Patricia Monaghan. Reviewed by Cait Coker. The Oxford Inklings. Colin Duriez. Reviewed by Crystal Hurd. The Fellowship: The Literary Lives of the Inklings. Philip Zaleski and Carol Zaleski. Reviewed by Crystal Hurd. The Pilgrim\u27s Regress: Wade Annotated Edition. C.S. Lewis. Edited and introduced by David C. Downing. Reviewed by Mike Foster. North Wind: A Journal of George MacDonald Studies. Editors John Pennington and Fernando Soto. Reviewed by Janet Brennan Croft. Supernatural Studies. Special Issue: Television and the Supernatural. Editor Leah Richards; Guest editor Marisa C. Hayes. Reviewed by Janet Brennan Croft. Journal of Inklings Studies: Theology, Philosophy, Literature. Special Issue: Inklings and the Bible. Executive editor Judith Wolfe. Reviewed by Janet Brennan Croft

The impact of cancer and quality of life for post-treatment non-Hodgkin lymphoma survivors

Recent work suggests that perceptions of the impact of cancer on survivors’ lives are associated with physical and mental health and quality of life (QOL) outcomes. This study examines the association between the Impact of Cancer version 2 scales (IOCv2) and these outcomes in a large sample of survivors of adult non-Hodgkin lymphoma (NHL)

A mechanistically and operationally simple route to metal-N-heterocyclic carbene (NHC) Complexes

We gratefully acknowledge VLAIO (SBO project CO2PERATE), King Saud University (Distinguished Scientist Fellowship Program) and King Abdullah University of Science and Technology for support. The Special Research Fund (BOF) of Ghent University is also acknowledged (Doctoral Scholarship to N.V.T.). COST action (CA15106-CHAOS) is thanked for mobility support to N.V.T. Umicore AG is acknowledged for generous gifts of materials.We have been puzzled by the involvement of weak organic and inorganic bases in the synthesis of metal‐N‐heterocyclic carbene (NHC) complexes. Such bases are insufficiently strong to permit the presumed required deprotonation of the azolium salt (the carbene precursor) prior to metal binding. Experimental and computational studies provide support for a base‐assisted concerted process that does not require free NHC formation. The synthetic protocol was found applicable to a number of Transition Metal‐ and Main Group‐centered NHC compounds and could become the synthetic route of choice to form M‐NHC bonds.PostprintPeer reviewe

Role of MALDI-MSI in combination with 3D tissue models for early stage efficacy and safety testing of drugs and toxicants

Introduction: Three-dimensional (3D) cell cultures have become increasingly important materials to investigate biological processes and drug efficacy and toxicity. The ability of 3D cultures to mimic the physiology of primary tissues and organs in the human body enables further insight into cellular behavior and is hence highly desirable in early-stage drug development. Analyzing the spatial distribution of drug compounds and endogenous molecules provides an insight into the efficacy of a drug whilst simultaneously giving information on biological responses. Areas Covered: In this review we will examine the main 3D cell culture systems employed and applications, which describe their integration with mass spectrometry imaging (MSI). Expert Opinion: MSI is a powerful technique that can map a vast range of molecules simultaneously in tissues without the addition of labels that can provide insights into the efficacy and safety of a new drug. The combination of MSI and 3D cell cultures has emerged as a promising tool in early-stage drug analysis. However, the most common administration route for pharmaceutical drugs is via oral delivery. The use of MSI in combination with models of the GI tract is an area that has been little explored to date, the reasons for this are discussed

Protocolised non-invasive compared with invasive weaning from mechanical ventilation for adults in intensive care : the Breathe RCT

Background: Invasive mechanical ventilation (IMV) is a life-saving intervention. Following resolution of the condition that necessitated IMV, a spontaneous breathing trial (SBT) is used to determine patient readiness for IMV discontinuation. In patients who fail one or more SBTs, there is uncertainty as to the optimum management strategy. Objective: To evaluate the clinical effectiveness and cost-effectiveness of using non-invasive ventilation (NIV) as an intermediate step in the protocolised weaning of patients from IMV. Design: Pragmatic, open-label, parallel-group randomised controlled trial, with cost-effectiveness analysis. Setting: A total of 51 critical care units across the UK. Participants: Adult intensive care patients who had received IMV for at least 48 hours, who were categorised as ready to wean from ventilation, and who failed a SBT. Interventions: Control group (invasive weaning): patients continued to receive IMV with daily SBTs. A weaning protocol was used to wean pressure support based on the patient’s condition. Intervention group (non-invasive weaning): patients were extubated to NIV. A weaning protocol was used to wean inspiratory positive airway pressure, based on the patient’s condition. Main outcome measures: The primary outcome measure was time to liberation from ventilation. Secondary outcome measures included mortality, duration of IMV, proportion of patients receiving antibiotics for a presumed respiratory infection and health-related quality of life. Results: A total of 364 patients (invasive weaning, n = 182; non-invasive weaning, n = 182) were randomised. Groups were well matched at baseline. There was no difference between the invasive weaning and non-invasive weaning groups in median time to liberation from ventilation {invasive weaning 108 hours [interquartile range (IQR) 57–351 hours] vs. non-invasive weaning 104.3 hours [IQR 34.5–297 hours]; hazard ratio 1.1, 95% confidence interval [CI] 0.89 to 1.39; p = 0.352}. There was also no difference in mortality between groups at any time point. Patients in the non-invasive weaning group had fewer IMV days [invasive weaning 4 days (IQR 2–11 days) vs. non-invasive weaning 1 day (IQR 0–7 days); adjusted mean difference –3.1 days, 95% CI –5.75 to –0.51 days]. In addition, fewer non-invasive weaning patients required antibiotics for a respiratory infection [odds ratio (OR) 0.60, 95% CI 0.41 to 1.00; p = 0.048]. A higher proportion of non-invasive weaning patients required reintubation than those in the invasive weaning group (OR 2.00, 95% CI 1.27 to 3.24). The within-trial economic evaluation showed that NIV was associated with a lower net cost and a higher net effect, and was dominant in health economic terms. The probability that NIV was cost-effective was estimated at 0.58 at a cost-effectiveness threshold of £20,000 per quality-adjusted life-year. Conclusions: A protocolised non-invasive weaning strategy did not reduce time to liberation from ventilation. However, patients who underwent non-invasive weaning had fewer days requiring IMV and required fewer antibiotics for respiratory infections. Future work: In patients who fail a SBT, which factors predict an adverse outcome (reintubation, tracheostomy, death) if extubated and weaned using NIV? Trial registration: Current Controlled Trials ISRCTN15635197. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 48. See the NIHR Journals Library website for further project information