When Insiders Become Outsiders: Parental Objections to Public School Sex Education Programs

This Note argues that parents\u27 fundamental right to direct their children\u27s moral and educational upbringing includes the right to exempt their children from objectionable sex education programs in public schools. Schools usurp parents\u27 fundamental rights when they unilaterally introduce children to topics of human sexuality without parental notice or permission. Alleged violations of these rights merit strict scrutiny review from courts. When parents\u27 objections are confined to discrete, tangible events, parents are constitutionally entitled to exempt their children from objectionable activities. The efficacy of this constitutional relief is more limited, however, when parental objections are pervasive and unassociated with a particular aspect of the school\u27s program or curriculum

Large Scale Analysis of Pit Fire Geometry

Research and small-scale tests have indicated that combustion of trash fires can be improved through burning the trash in pits with optimized geometry. In order to investigate the potential to create a cleaner way to burn trash, these small-scale tests must be scaled up. Potential benefits to burning trash in a pit instead of on open ground include reductions of burn injuries, increased rate of burning which would lead to less exposure to harmful smoke, and an increase in burn efficiency which would reduce the amount of harmful particulates in the smoke. Our project created a large-scale experimental set-up to effectively investigate the effect of pit geometry on the combustion of trash

How medical students screen for HIV with standardized patients establishing care.

How Medical Students Screen for HIV with Standardized Patients Establishing Care AUTHORS Christopher J. Brown, B.S., B.A. Candidate; Emily J Noonan, PhD, MA; Laura A. Weingartner, PhD, MS BACKGROUND Approximately 1.1 million people in the U.S. are living with HIV. The US Preventive Services Task Force (USPSTF) recommends HIV testing for everyone 15-65 years old at least once regardless of sexual activity, with more frequent testing for those considered at risk. METHODS Rising third-year medical students were recorded taking health histories from standardized patients. These recordings were coded for HIV screening, including: risk factors such as unprotected sex, intravenous drug usage, multiple partners, patient/partner HIV status; contextualization by student as to how screening questions related to HIV; and discussion tone (accusatory, informative, or non-judgmental). RESULTS Of the 71 sampled encounters, students identified whether the patient knew their STI status without mentioning HIV status, and 10 students explicitly identified whether the patient knew their HIV status. Similarly, 13 students discussed the STI status of the patient’s partner(s) without mentioning HIV, while only 4 students discussed the HIV status of the patient’s partner(s). In total, only 7 out of 71 students recommended HIV testing to their patient. When discussing patient status, most students (34) were non-judgmental, but one used an accusatory tone while eight were informative. DISCUSSION The results show a lack of explicit HIV discussions and testing recommendations to patients despite USPSTF recommendations that all patients be tested. This study highlights that even when STI status is discussed, many students do not specify HIV status, an important distinction when providing preventive care. Future studies should address how perceived patient risk for HIV and patient identity impact HIV testing recommendations

Driving human motor cortical oscillations leads to behaviorally relevant changes in local GABAA inhibition: a tACS-TMS study

Beta and gamma oscillations are the dominant oscillatory activity in the human motor cortex (M1). However, their physiological basis and precise functional significance remain poorly understood. Here, we used transcranial magnetic stimulation (TMS) to examine the physiological basis and behavioral relevance of driving beta and gamma oscillatory activity in the human M1 using transcranial alternating current stimulation (tACS). tACS was applied using a sham-controlled crossover design at individualized intensity for 20 min and TMS was performed at rest (before, during, and after tACS) and during movement preparation (before and after tACS). We demonstrated that driving gamma frequency oscillations using tACS led to a significant, duration-dependent decrease in local resting-state GABAA inhibition, as quantified by short interval intracortical inhibition. The magnitude of this effect was positively correlated with the magnitude of GABAA decrease during movement preparation, when gamma activity in motor circuitry is known to increase. In addition, gamma tACS-induced change in GABAA inhibition was closely related to performance in a motor learning task such that subjects who demonstrated a greater increase in GABAA inhibition also showed faster short-term learning. The findings presented here contribute to our understanding of the neurophysiological basis of motor rhythms and suggest that tACS may have similar physiological effects to endogenously driven local oscillatory activity. Moreover, the ability to modulate local interneuronal circuits by tACS in a behaviorally relevant manner provides a basis for tACS as a putative therapeutic intervention.SIGNIFICANCE STATEMENT Gamma oscillations have a vital role in motor control. Using a combined tACS-TMS approach, we demonstrate that driving gamma frequency oscillations modulates GABAA inhibition in the human motor cortex. Moreover, there is a clear relationship between the change in magnitude of GABAA inhibition induced by tACS and the magnitude of GABAA inhibition observed during task-related synchronization of oscillations in inhibitory interneuronal circuits, supporting the hypothesis that tACS engages endogenous oscillatory circuits. We also show that an individual's physiological response to tACS is closely related to their ability to learn a motor task. These findings contribute to our understanding of the neurophysiological basis of motor rhythms and their behavioral relevance and offer the possibility of developing tACS as a therapeutic tool

Whole genome sequence analysis reveals the broad distribution of the RtxA type 1 secretion system and four novel putative type 1 secretion systems throughout the Legionella genus.

Type 1 secretion systems (T1SSs) are broadly distributed among bacteria and translocate effectors with diverse function across the bacterial cell membrane. Legionella pneumophila, the species most commonly associated with Legionellosis, encodes a T1SS at the lssXYZABD locus which is responsible for the secretion of the virulence factor RtxA. Many investigations have failed to detect lssD, the gene encoding the membrane fusion protein of the RtxA T1SS, in non-pneumophila Legionella, which has led to the assumption that this system is a virulence factor exclusively possessed by L. pneumophila. Here we discovered RtxA and its associated T1SS in a novel Legionella taurinensis strain, leading us to question whether this system may be more widespread than previously thought. Through a bioinformatic analysis of publicly available data, we classified and determined the distribution of four T1SSs including the RtxA T1SS and four novel T1SSs among diverse Legionella spp. The ABC transporter of the novel Legionella T1SS Legionella repeat protein secretion system shares structural similarity to those of diverse T1SS families, including the alkaline protease T1SS in Pseudomonas aeruginosa. The Legionella bacteriocin (1-3) secretion systems T1SSs are novel putative bacteriocin transporting T1SSs as their ABC transporters include C-39 peptidase domains in their N-terminal regions, with LB2SS and LB3SS likely constituting a nitrile hydratase leader peptide transport T1SSs. The LB1SS is more closely related to the colicin V T1SS in Escherichia coli. Of 45 Legionella spp. whole genomes examined, 19 (42%) were determined to possess lssB and lssD homologs. Of these 19, only 7 (37%) are known pathogens. There was no difference in the proportions of disease associated and non-disease associated species that possessed the RtxA T1SS (p = 0.4), contrary to the current consensus regarding the RtxA T1SS. These results draw into question the nature of RtxA and its T1SS as a singular virulence factor. Future studies should investigate mechanistic explanations for the association of RtxA with virulence

Effects of cochlear implantation on binaural hearing in adults with unilateral hearing loss

A FDA clinical trial was carried out to evaluate the potential benefit of cochlear implant (CI) use for adults with unilateral moderate-to-profound sensorineural hearing loss. Subjects were 20 adults with moderate-to-profound unilateral sensorineural hearing loss and normal or near-normal hearing on the other side. A MED-EL standard electrode was implanted in the impaired ear. Outcome measures included: (a) sound localization on the horizontal plane (11 positions, −90° to 90°), (b) word recognition in quiet with the CI alone, and (c) masked sentence recognition with the target at 0° and the masker at −90°, 0°, or 90°. This battery was completed preoperatively and at 1, 3, 6, 9, and 12 months after CI activation. Normative data were also collected for 20 age-matched control subjects with normal or near-normal hearing bilaterally. The CI improved localization accuracy and reduced side bias. Word recognition with the CI alone was similar to performance of traditional CI recipients. The CI improved masked sentence recognition when the masker was presented from the front or from the side of normal or near-normal hearing. The binaural benefits observed with the CI increased between the 1- and 3-month intervals but appeared stable thereafter. In contrast to previous reports on localization and speech perception in patients with unilateral sensorineural hearing loss, CI benefits were consistently observed across individual subjects, and performance was at asymptote by the 3-month test interval. Cochlear implant settings, consistent CI use, and short duration of deafness could play a role in this result

The Platform Press: How Silicon Valley Reengineered Journalism

The influence of social media platforms and technology companies is having a greater effect on American journalism than even the shift from print to digital. There is a rapid takeover of traditional publishers’ roles by companies including Facebook, Snapchat, Google, and Twitter that shows no sign of slowing, and which raises serious questions over how the costs of journalism will be supported. These companies have evolved beyond their role as distribution channels, and now control what audiences see and who gets paid for their attention, and even what format and type of journalism flourishes. Publishers are continuing to push more of their journalism to third-party platforms despite no guarantee of consistent return on investment. Publishing is no longer the core activity of certain journalism organizations. This trend will continue as news companies give up more of the traditional functions of publishers. This report, part of an ongoing study by the Tow Center for Digital Journalism at Columbia Journalism School, charts the convergence between journalism and platform companies. In the span of 20 years, journalism has experienced three significant changes in business and distribution models: the switch from analog to digital, the rise of the social web, and now the dominance of mobile. This last phase has seen large technology companies dominate the markets for attention and advertising and has forced news organizations to rethink their processes and structures

Hospital Mortality in the United States following Acute Kidney Injury

Acute kidney injury (AKI) is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths increased almost twofold from 147,943 to 285,768 deaths. We discuss the importance of the 71% reduction in AKI-related mortality among hospitalized patients in the United States and draw on the discussion of whether or not this is a phenomenon of hospital billing (coding) or improvements to the management of AKI

Platforms and Publishers: The End of an Era

Since our last report was published in June 2018, the shift in the journalism landscape has been seismic. Advertising revenues have continued to plummet and newsrooms across the country have experienced mass layoffs. In turn, publishers have scrambled to adapt their business models and priorities in an ever-changing and volatile media ecosystem—one still dominated by platforms despite the large-scale public reckoning with their effects on society and democracy. There is no telling how publishers will fare in the coming years as platforms undergo perhaps their most dramatic transformations since their foray into publishing products in 2015. However, one thing is certain: Despite facing increasing antitrust scrutiny and calls for regulation, platforms are more powerful than ever. Over time, they have come to control the online information ecosystem and, increasingly, in the case of Facebook and Google, are among the news industry’s top funders. It is in this context that many of the publishing executives and employees we interviewed described the “end of an era.” But as is clear in the report, this does not mean the end of their cooperation with platforms. It refers, rather, to the end of optimism that scale and ad-based platform products will bring about meaningful revenue and audience growth. From the rise of paywalls and reader revenue initiatives to the diversification of revenue streams through live events and podcasts, publishers are attempting to regain control over the future of their businesses

FGF4 retrogene on CFA12 is responsible for chondrodystrophy and intervertebral disc disease in dogs.

Chondrodystrophy in dogs is defined by dysplastic, shortened long bones and premature degeneration and calcification of intervertebral discs. Independent genome-wide association analyses for skeletal dysplasia (short limbs) within a single breed (PBonferroni = 0.01) and intervertebral disc disease (IVDD) across breeds (PBonferroni = 4.0 × 10-10) both identified a significant association to the same region on CFA12. Whole genome sequencing identified a highly expressed FGF4 retrogene within this shared region. The FGF4 retrogene segregated with limb length and had an odds ratio of 51.23 (95% CI = 46.69, 56.20) for IVDD. Long bone length in dogs is a unique example of multiple disease-causing retrocopies of the same parental gene in a mammalian species. FGF signaling abnormalities have been associated with skeletal dysplasia in humans, and our findings present opportunities for both selective elimination of a medically and financially devastating disease in dogs and further understanding of the ever-growing complexity of retrogene biology