James Spratt White, Sr. Papers - Accession 547

This collection consists of the papers of Reverend James Spratt White, Sr. (1841-1891) who was a Presbyterian minister who served in Americus, Georgia, and Chester County, South Carolina. The collection consists of White’s Civil War amnesty oath, sermons, newspaper clippings, view books, and photographs from Le Bosphore (Bosporus), France, Greece, Jerusalem, London, Venice, Washington (D.C.), Constantinople, Damascus, the Holy Land, Paris, and North Carolina.https://digitalcommons.winthrop.edu/manuscriptcollection_findingaids/2642/thumbnail.jp

Title VII - Seniority - The Relevant Scope of Inquiry for Determining the Legality of a Seniority System

Title VII of the Civil Rights Act of 1964, which became effective on July 2, 1965, was enacted to eliminate artificial barriers to employment that historically have deprived minorities and women of employment opportunities. Section 703 of the Act thus makes discrimination on the basis of race, color, religion, sex, or national origin an unlawful employment practice. In order to obtain relief from a discriminatory employment practice, an aggrieved party must demonstrate that the defendant intentionally engaged in the unlawful practice. Because the broad language of sections 703(a), 703(c), and 706(g) fails to define the terms discriminate and intentionally, the effectiveness of title VII in eliminating artificial employment barriers depends upon the interpretation of these terms by the federal courts.\u27 In its first major title VII case, Griggs v. Duke Power Co., the United States Supreme Court rejected the argument that a redressable violation of title VII requires a demonstration that the defendant had a subjective intent to discriminate, thereby establishing the effect of an employment practice on the employment opportunities of minorities and women as the important inquiry. The Court held that a facially neutral employment practice depriving minorities and women of employment opportunities at a rate higher than the rate at which it deprives other employees constitutes a redressable violation of title VII. A seniority system, although neutral in its operation and in its intent, can have the effect of depriving minorities and women of employment opportunities at a rate higher than the rate at which it deprives other individuals.\u27 A seniority system with such effect would be unlawful according to Griggs. Section 703(h) of title VII,however, immunizes bona fide seniority systems from illegality.Because neither the language nor legislative history of title VII defines the term bona fide, its definition has depended upon federal court interpretation. The District Court for the Eastern District of Virginia in Quarles v. Phillip Morris, Inc. suggested that section 703(h) did not protect a seniority system that perpetuated the effects of past discrimination. Other federal courts adopted Quarles\u27 theory of discrimination to invalidate facially neutral seniority systems. Two recent United States Supreme Court decisions,International Brotherhood of Teamsters v. United States and United Air Lines, Inc. v. Evans, undermine the theory of discrimination enunciated in Quarles and followed by courts in other circuits. The purpose of this Recent Development is to examine the impact of these two decisions on the meaning of the term bona fide and to reassess the relevant scope of inquiry for determining the legality of a seniority system

Eating Disorders in Men: A Comprehensive Summary

Eating disorders (EDs) have detrimental effects on an individual’s physical and mental health, along with significant interpersonal, social and economic effects. Furthermore, men who are suffering with an ED face unique challenges with this. Men suffering with EDs have historically received little attention within ED research, diagnosis and intervention. However, the number of men suffering with these issues is significant and growing. Understanding of EDs tend to ignore male experiences, meaning many are left to suffer in silence until the ED has developed to a critical point. However, many now recognize the need to understand the issues facing men suffering with an ED. By improving our understanding, we can better improve early detection, diagnosis and treatment for those who are suffering. This paper aims to provide a comprehensive general introduction to this growing area of research and it is hoped that it will be of good use to interested researchers, students and the general public. Prevalence, presentation, history, diagnosis and more will be covered in order to provide a well-rounded understanding of EDs in men

Appropriate inclusion of interactions was needed to avoid bias in multiple imputation

OBJECTIVE: Missing data are a pervasive problem, often leading to bias in complete records analysis (CRA). Multiple imputation (MI) via chained equations is one solution, but its use in the presence of interactions is not straightforward. STUDY DESIGN AND SETTING: We simulated data with outcome Y dependent on binary explanatory variables X and Z and their interaction XZ. Six scenarios were simulated (Y continuous and binary, each with no interaction, a weak and a strong interaction), under five missing data mechanisms. We use directed acyclic graphs to identify when CRA and MI would each be unbiased. We evaluate the performance of CRA, MI without interactions, MI including all interactions, and stratified imputation. We also illustrated these methods using a simple example from the National Child Development Study (NCDS). RESULTS: MI excluding interactions is invalid and resulted in biased estimates and low coverage. When XZ was zero, MI excluding interactions gave unbiased estimates but overcoverage. MI including interactions and stratified MI gave equivalent, valid inference in all cases. In the NCDS example, MI excluding interactions incorrectly concluded there was no evidence for an important interaction. CONCLUSIONS: Epidemiologists carrying out MI should ensure that their imputation model(s) are compatible with their analysis model

Multidetector CT improving surgical outcomes in breast cancer (MISO-BC) : a randomised controlled trial

Background: Early diagnosis of malignant axillary nodes in breast cancer guides the extent of axillary surgery: patients with known axillary malignancy receive a more extensive single operation at the same time as surgery to their breast. A multicentre randomised controlled trial assessed whether a Computed Tomography (CT) scan of the axilla could more accurately diagnose malignant axillary lymph node involvement in patients with newly diagnosed breast cancer when compared to usual care. Methods: Patients with newly diagnosed breast cancer (identified via screening and symptomatic pathways) at two NHS Trusts in the North East of England were recruited and randomised in equal numbers. Both groups received routine diagnostic and surgical care. In addition, one group received a CT scan of their axilla on the same side as the breast cancer. The primary endpoint was the need to undergo a second axillary surgical procedure. Findings: The trial recruited 297 patients of whom 291 contributed to findings. The proportion of patients undergoing a second operation was similar (CT vs UC: 19.4% vs. 19.7%; CT-UC: −0.3%, 95%CI: = −9.5% to 8.9%, χ2 [1]: p = 1.00). Patients in the two groups were similar before treatment, had similar types and grade of cancer, experienced similar patterns of post-operative complications and reported similar experiences of care. Interpretation: CT scan-guided care did not result in a change in the number of patients requiring a second operation; similar numbers of patients needed further axillary surgery in both groups. New diagnostic imaging technologies regularly enter NHS centres. It is important these are evaluated rigorously before becoming routine care

Impact of prophylactic and 'rescue pack' antibiotics on the airway microbiome in chronic lung disease

The management of many chronic lung diseases involves multiple antibiotic prescriptions either to treat acute exacerbations or as prophylactic therapy to reduce the frequency of exacerbations and improve patients’ quality of life. AIM: To investigate the effects of antibiotics on the homeostasis of bacterial communities in the airways, and how this may contribute to antimicrobial resistance (AMR) among respiratory pathogens and microbiota. METHODS: Within an observational cohort study, sputum was collected from 84 patients with chronic obstructive pulmonary disease and/or bronchiectasis at stable state: 47 were receiving antibiotic prophylaxis therapy. V3-V4 16S-rRNA sequencing on Illumina MiSeq, quantitative PCR for typical respiratory pathogens, bacteriology cultures and antimicrobial susceptibility testing of sputum isolates, resistome analysis on a subset of 17 sputum samples using MinION metagenomics sequencing were performed. FINDINGS: The phylogenetic α-diversity and the total bacterial density in sputum were significantly lower in patients receiving prophylactic antibiotics (p=0.014 and 0.029, respectively). Antibiotic prophylaxis was associated with significantly lower relative abundance of respiratory pathogens such as Pseudomonas aeruginosa, Moraxella catarrhalis and members of family Enterobacteriaceae in the airway microbiome, but not Haemophilus influenzae and Streptococcus pneumoniae. No major definite directional shifts in the microbiota composition were identified with prophylactic antibiotic use at the cohort level. Surveillance of AMR and resistome analysis revealed a high frequency of resistance to macrolide and tetracycline in the cohort. AMR expressed by pathogenic bacterial isolates was associated with antibiotics prescribed as ‘rescue packs’ for prompt initiation of self-treatment of exacerbations (Spearman’s rho=0.408, p=0.02). CONCLUSIONS: Antibiotic prophylactic therapy suppresses recognised pathogenic bacteria in the sputum of patients with chronic lung disease. The use of antibiotic rescue packs may be driving AMR in this cohort rather than prophylactic antibiotics

Justice Stevens: The First Three Terms

This Special Project undertakes an examination of Justice Stevens\u27 Supreme Court opinions in an effort to identify his philosophical orientations, to evaluate the consistency of his views, and to determine the extent to which he has developed workable analytical methods. To achieve these goals, Justice Stevens\u27 opinions are examined in three contexts: first, the area of federal-state relations,including commerce clause and supremacy clause questions; second, the individual rights area, emphasizing criminal constitutional and first amendment issues, and problems of fifth and fourteenth amendment analysis; and third, questions concerning the proper role of the Supreme Court in the constitutional scheme. Even though any vote cast by a Supreme Court Justice may illustrate a significant aspect of his ideology, this Special Project limits attention to opinions authored by Justice Stevens on the assumption that they most accurately represent his views.\u2

In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis.

OBJECTIVES: Intraplaque angiogenesis and inflammation are key promoters of atherosclerosis and are mediated by the alpha-V beta-3 (αvβ3) integrin pathway. We investigated the applicability of the αvβ3-integrin receptor-selective positron emission tomography (PET) radiotracer 18F-fluciclatide in assessing human aortic atherosclerosis. METHODS: Vascular 18F-fluciclatide binding was evaluated using ex vivo analysis of carotid endarterectomy samples with autoradiography and immunohistochemistry, and in vivo kinetic modelling following radiotracer administration. Forty-six subjects with a spectrum of atherosclerotic disease categorised as stable (n=27) or unstable (n=19; recent myocardial infarction) underwent PET and CT imaging of the thorax after administration of 229 (IQR 217-237) MBq 18F-fluciclatide. Thoracic aortic 18F-fluciclatide uptake was quantified on fused PET-CT images and corrected for blood-pool activity using the maximum tissue-to-background ratio (TBRmax). Aortic atherosclerotic burden was quantified by CT wall thickness, plaque volume and calcium scoring. RESULTS: 18F-Fluciclatide uptake co-localised with regions of increased αvβ3 integrin expression, and markers of inflammation and angiogenesis. 18F-Fluciclatide vascular uptake was confirmed in vivo using kinetic modelling, and on static imaging correlated with measures of aortic atherosclerotic burden: wall thickness (r=0.57, p=0.001), total plaque volume (r=0.56, p=0.001) and aortic CT calcium score (r=0.37, p=0.01). Patients with recent myocardial infarction had greater aortic 18F-fluciclatide uptake than those with stable disease (TBRmax 1.29 vs 1.21, p=0.02). CONCLUSIONS: In vivo expression of αvβ3 integrin in human aortic atheroma is associated with plaque burden and is increased in patients with recent myocardial infarction. Quantification of αvβ3 integrin expression with 18F-fluciclatide PET has potential to assess plaque vulnerability and disease activity in atherosclerosis