Clearing the Mixed-Motive Smokescreen: An Approach to Disparate Treatment Under Title VII

Part I of this Note describes the indirect-evidence inquiry of McDonnell Douglas and its basis in the policies underlying Title VII. Part II presents the various judicial treatments of cases where direct evidence is presented. These three major approaches reflect varying views of the burdens of proof regarding Title VII causation, and assume that the plaintiff has already shown some palpable level of discrimination. Part III describes Mt. Healthy City School District Board of Education v. Doyle, in which the Supreme Court first devised an approach to mixed motives. Although the Mt. Healthy analysis was developed for first amendment purposes, the Court has extended it to a number of different areas, such as equal protection and labor-management relations. The analysis also has provided a model for lower courts in Title VII cases because the Court has never ruled on the mixed-motive issue under Title VII, and because Mt. Healthy involved an employment dispute, like Title VII cases. Part IV explains the indeterminacy and unhelpfulness of the mixed-motive characterization, arguing that it obfuscates the critical inquiry into whether the employer intentionally discriminated against the plaintiff. The label ignores the fact that nearly every Title VII case is potentially a mixed-motive case, and that cases so labeled are simply those with facts that are not compelling in favor of either party. Finally, Part V proposes that the direct/indirect evidence approach is a superior method of analyzing the distinction between single- and mixed-motive cases, and suggests abandoning mixed-motive terminology altogether

Redefining the Supreme Court\u27s Role: A Theory of Managing the Federal Judicial Process

A Review of Redefining the Supreme Court\u27s Role: A Theory of Managing the Federal Judicial Process by Samuel Estreicher and John Sexto

Recommended Priorities for Research on Ecological Impacts of Ocean and Coastal Acidification in the U.S. Mid-Atlantic

The estuaries and continental shelf system of the United States Mid-Atlantic are subject to ocean acidification driven by atmospheric CO2, and coastal acidification caused by nearshore and land-sea interactions that include biological, chemical, and physical processes. These processes include freshwater and nutrient input from rivers and groundwater; tidally-driven outwelling of nutrients, inorganic carbon, alkalinity; high productivity and respiration; and hypoxia. Hence, these complex dynamic systems exhibit substantial daily, seasonal, and interannual variability that is not well captured by current acidification research on Mid-Atlantic organisms and ecosystems. We present recommendations for research priorities that target better understanding of the ecological impacts of acidification in the U. S. Mid-Atlantic region. Suggested priorities are: 1) Determining the impact of multiple stressors on our resource species as well as the magnitude of acidification; 2) Filling information gaps on major taxa and regionally important species in different life stages to improve understanding of their response to variable temporal scales and sources of acidification; 3) Improving experimental approaches to incorporate realistic environmental variability and gradients, include interactions with other environmental stressors, increase transferability to other systems or organisms, and evaluate community and ecosystem response; 4) Determining the capacity of important species to acclimate or adapt to changing ocean conditions; 5) Considering multi-disciplinary, ecosystem-level research that examines acidification impacts on biodiversity and biotic interactions; and 6) Connecting potential acidification-induced ecological impacts to ecosystem services and the economy. These recommendations, while developed for the Mid-Atlantic, can be applicable to other regions will help align research towards knowledge of potential larger-scale ecological and economic impacts

A Comparison of Embedded and Nonembedded Print Coverage of the U.S. Invasion and Occupation of Iraq

This study examines the impact of embedded versus nonembedded (unilateral) news coverage during the U.S. invasion and occupation of Iraq. A content analysis was conduycted of the Washington Post, New York Times, Los Angeles Times, and Chicago Tribune news coverage of the invasion and occupation examining whether embedded and nonembedded new reports were different and, if so, how. News reports were examined for differences in tone toward the military, trust in the military, framing, and authoritativeness. The results of the study revealed significant differences in overall tone toward the military, trust in military personnel, framing, and authoritativeness between embedded and nonembedded articles.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Hemorrhage and thrombosis in COVID-19-patients supported with extracorporeal membrane oxygenation: an international study based on the COVID-19 critical care consortium

Background: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy in patients with severe acute respiratory distress syndrome (ARDS) secondary to COVID-19. While bleeding and thrombosis complicate ECMO, these events may also occur secondary to COVID-19. Data regarding bleeding and thrombotic events in COVID-19 patients on ECMO are sparse. Methods: Using the COVID-19 Critical Care Consortium database, we conducted a retrospective analysis on adult patients with severe COVID-19 requiring ECMO, including centers globally from 01/2020 to 06/2022, to determine the risk of ICU mortality associated with the occurrence of bleeding and clotting disorders. Results: Among 1,248 COVID-19 patients receiving ECMO support in the registry, coagulation complications were reported in 469 cases (38%), among whom 252 (54%) experienced hemorrhagic complications, 165 (35%) thrombotic complications, and 52 (11%) both. The hazard ratio (HR) for Intensive Care Unit mortality was higher in those with hemorrhagic-only complications than those with neither complication (adjusted HR = 1.60, 95% CI 1.28–1.99, p < 0.001). Death was reported in 617 of the 1248 (49.4%) with multiorgan failure (n = 257 of 617 [42%]), followed by respiratory failure (n = 130 of 617 [21%]) and septic shock [n = 55 of 617 (8.9%)] the leading causes. Conclusions: Coagulation disorders are frequent in COVID-19 ARDS patients receiving ECMO. Bleeding events contribute substantially to mortality in this cohort. However, this risk may be lower than previously reported in single-nation studies or early case reports. Trial registration ACTRN12620000421932 (https://covid19.cochrane.org/studies/crs-13513201)

Pennsylvania Folklife Vol. 20, No. 4

• Flight of the Distelfink • The Newswangers, Interpreters of Amish Life • The Sorrow Song of Susanna Cox • Country Butcher: An Interview with Newton Bachman • Swing Your Partner : Folk Dancing at the Festival • Festival Highlights • Folk Festival Program • Leaving the Festival with Thoughts of Food • Spindrift: The Old Dog Churn • Candy Making in the Dutch Country • Gee, Haw and Geehaw • The Evil Eye in Philadelphia • The Country School: Folk-Cultural Questionnaire No. 20https://digitalcommons.ursinus.edu/pafolklifemag/1044/thumbnail.jp

Direct evidence for cancer-cell-autonomous extracellular protein catabolism in pancreatic tumors

Mammalian tissues rely on a variety of nutrients to support their physiological functions. It is known that altered metabolism is involved in the pathogenesis of cancer, but which nutrients support the inappropriate growth of intact malignant tumors is incompletely understood. Amino acids are essential nutrients for many cancer cells that can be obtained through the scavenging and catabolism of extracellular protein via macropinocytosis. In particular, macropinocytosis can be a nutrient source for pancreatic cancer cells, but it is not fully understood how the tumor environment influences metabolic phenotypes and whether macropinocytosis supports the maintenance of amino acid levels within pancreatic tumors. Here we utilize miniaturized plasma exchange to deliver labeled albumin to tissues in live mice, and we demonstrate that breakdown of albumin contributes to the supply of free amino acids in pancreatic tumors. We also deliver albumin directly into tumors using an implantable microdevice, which was adapted and modified from ref. 9. Following implantation, we directly observe protein catabolism and macropinocytosis in situ by pancreatic cancer cells, but not by adjacent, non-cancerous pancreatic tissue. In addition, we find that intratumoral inhibition of macropinocytosis decreases amino acid levels. Taken together, these data suggest that pancreatic cancer cells consume extracellular protein, including albumin, and that this consumption serves as an important source of amino acids for pancreatic cancer cells in vivo.National Science Foundation (U.S.) (Grant T32GM007287)National Cancer Institute (U.S.) (Grant F30CA183474)National Institute of General Medical Sciences (U.S.) (Award T32GM007753)National Institutes of Health (U.S.) (Grant P30CA1405141)National Institutes of Health (U.S.) (Grant R01CA168653

It could be a ‘Golden Goose’: a qualitative study of views in primary care on an emergency admission risk prediction tool prior to implementation

BACKGROUND: Rising demand for health care has prompted interest in new technologies to support a shift of care from hospital to community and primary care, which may require clinicians to undertake new working practices. A predictive risk stratification tool (Prism) was developed for use in primary care to estimate patients’ risk of an emergency hospital admission. As part of an evaluation of Prism, we aimed to understand what might be needed to bring Prism into effective use by exploring clinicians and practice managers’ attitudes and expectations about using it. We were informed by Normalisation Process Theory (NPT) which examines the work needed to bring an innovation into use. METHODS: We conducted 4 focus groups and 10 interviews with a total of 43 primary care doctors and colleagues from 32 general practices. All were recorded and transcribed. Analysis focussed in particular on the construct of ‘coherence’ within NPT, which examines how people understand an innovation and its purpose. RESULTS: Respondents were in agreement that Prism was a technological formalisation of existing practice, and that it would function as a support to clinical judgment, rather than replacing it. There was broad consensus about the role it might have in delivering new models of care based on active management, but there were doubts about the scope for making a difference to some patients and about whether Prism could identify at-risk patients not already known to the clinical team. Respondents did not expect using the tool to be onerous, but were concerned about the work which might follow in delivering care. Any potential value would not be of the tool in isolation, but would depend on the availability of support services. CONCLUSIONS: Policy imperatives and the pressure of rising demand meant respondents were open to trying out Prism, despite underlying uncertainty about what difference it could make. TRIAL REGISTRATION: Controlled Clinical Trials no. ISRCTN55538212