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Background: Larsucosterol is a DNA methyltransferase inhibitor in development for alcohol-associated hepatitis (AH), a disease for which there is no approved therapy. Methods: In this phase 2b trial, patients with severe AH were randomly assigned 1:1:1 to receive 30 mg or 90 mg of larsucosterol or placebo; a second dose was administered after 72 hours if the patient remained hospitalized. All patients received supportive care as determined by investigators. Patients in the placebo group, if prescribed, received 32 mg of methylprednisolone, while patients in the larsucosterol groups received matching placebo capsules. The primary end point was 90-day mortality or liver transplant (LT) rate. The key secondary end point was 90-day mortality. We prespecified the reporting of U.S. results separately. Results: Among 307 enrolled patients, 301 received at least one treatment dose. The difference in 90-day mortality or LT between the 30-mg or 90-mg larsucosterol and placebo groups did not reach statistical significance. Ninety-day mortality in the placebo and the 30-mg and 90-mg groups was 25 out of 103, 15 out of 102, and 17 out of 102, respectively. Among U.S. patients (76% of all enrolled patients), there were 21 deaths and 4 LTs among 77 patients in the placebo group, 8 deaths and 5 LTs among 73 patients in the 30-mg larsucosterol group, and 10 deaths and 8 LTs among 77 patients in the 90-mg larsucosterol group. In patients who were treated within less than 10 days of hospitalization (75%), mortality in the placebo group was 20 out of 79 (U.S. patients 17/57), mortality in the 30-mg larsucosterol group was 7 out of 74 (U.S. patients 4/57), and mortality in the 90-mg larsucosterol group was 13 out of 77 (U.S. patients 9/66). Most adverse events arising during treatment were attributable to hepatic disease, and there was no imbalance in adverse events that could not be ascribed to liver disease. Conclusions: The trial did not meet the primary end point of showing a beneficial effect of larsucosterol on 90-day mortality or LT in patients with severe AH. Equipoise has been established for a further trial of larsucosterol on AH survival. (The trial was funded by the DURECT Corporation; its ClinicalTrials.gov number is NCT04563026.) [ABSTRACT FROM AUTHOR]

College classrooms are changing from the traditional classroom of the past. Professors are greeted with a more diverse population of students and are seeing many different types of learners. Recent census data confirm that the United States population is becoming more multicultural and that this diversity will continue to increase. As the world is becoming more diverse, students in all domains of university study can benefit from developing an appreciation and understanding of issues of diversity. In this article, the author discusses the need for professors to address issues of diversity and different perspectives, not only as part of the content of teacher education, but also to help their students become a community of learners.

The article explains the differences among the U.S. states with respect to their treatment of putative spouses, with topics that include sincerity of belief, presumptions of good faith, and how the non-putative spouse should be treated.

The article discusses the court case Obergefell v. Hodges which focuses on the bans on same-sex marriage. It reports that the Court of Obergefell which is a Supreme court focuses on the equal protection analysis, non-marital relationships, and due process guarantees in order to explain the fundamental right to marry.

The article focuses on the wavering approaches of the U.S. Supreme Court to free exercise guarantees as the Court has affirmed and rejected that religious practices are afforded special protection under free exercise guarantees under the U.S. First Amendment.

This paper examines the life and career of the prominent sociologist Werner Stark (1909–1985), born and raised in Marienbad, Bohemia, and after 1918 in the multi-ethnic state of Czechoslovakia. As a prolific and wide-ranging scholar whose many works failed to find an enduring place in American sociology, Stark is a prime example of academic marginalisation. The authors analyse Stark’s major contributions from the standpoint of the sociology of knowledge. They argue that his ideas regarding human nature, the need for social discipline, and the desirability of community were rooted in a pervasive biographical marginality that found resolution in his conversion to Catholicism. In turn, these ideas reinforced the marginality from which they emerged. The reception of Stark’s work in the United States was governed by a perceived incompatibility of his outlook with the assumptions and goals of his American audience. In particular, Stark offered an explicitly value-directed sociology, one which asserted the importance of social order, individual discipline, and universal community, at a time (the 1960s and 1970s) when the field sought to maintain its credibility as an objective scientific discipline in the face of growing challenges from sociologists and non-sociologists alike. Stark’s American colleagues focused on aspects of his work that were incompatible with their own cultural and disciplinary orientations and this obscured the full range of his achievements, especially his analyses which anticipated contemporary sociological work. [ABSTRACT FROM AUTHOR]

The article focuses on the rulings of the U.S. Congress in regulating the matters associated with use of treaty powers in reference to the court case Bond v. United States and further discusses the powers of federal government in overreaching the international covenants.

The article explores the constitutionality of same-sex marriage bans and the analysis on equal protection guarantees based on the Fourteenth Amendment of the U.S. Constitution. It discusses the jurisprudence of federal equal protection despite the differing scrutiny. It explores the attempts to analyze same-sex marriage bans whether it violates equal protection guarantees and doctrines. The Supreme Court determines whether a certain equal protection jurisprudence is deemed as inconsistent.

The article explores the possible effects of U.S. Defense of Marriage Act (DOMA) repeal, over the decision on which state have the power to refuse or give marriages the validity to be celebrated in other states. It is not to be presumed that the repeal of DOMA will relieve same-sex families over its rights and protection. It discusses the grounds stipulated within the Full Faith and Credit Provision wherein states are required to recognize any marriages validly celebrated in another state.

The article focuses on the impact of invalidation of the two U.S. Defense of Marriage Act (DOMA) provisions on same sex couples, and on some DOMAs passed earlier. It states that one provision of the DOMA will affect the full faith and credit guarantees and other will affect the definition of same sex marriage. It concludes, while several claims by the members of U.S. congress about the need for DOMA will be laid as groundless, the invalidation of its provisions will benefit same sex families.

The article examines several cases in which the Court addressed direct public funding of religiously affiliated colleges and universities in the U.S. In the case Tilton v. Richardson, the Court examined a provision of the Higher Education Facilities Act providing funds for the construction of academic facilities at institutions of higher learning. In the case Lemon v. Kurtzman, the Court discussed some of the dangers that arise in the context of secondary religious education.

The article discusses how several marriage amendments might affect particular groups as well as highlights the federal constitutional implications of broadly interpreting these amendments in the U.S. In addition, it asserts that courts should interpret these amendments narrowly to mitigate the harm they will cause. The author believes that the amendments conflict with the principles of fairness, statutory construction, and good public policy. He then suggests that judges must do their best to reduce the harm enforced by these amendments for the sake of the society as a whole and the affected individuals themselves.

Background: Contraception care is essential to providing comprehensive healthcare; however, little is known nationally about the contraception workforce. Previous research has examined the supply, distribution, and adequacy of the health workforce providing contraception services, but this research has faced a series of data limitations, relying on surveys or focusing on a subset of practitioners and resulting in an incomplete picture of contraception practitioners in the United States.Objective: This study aimed to construct a comprehensive database of the contraceptive workforce in the United States that provides the following 6 types of highly effective contraception: intrauterine device, implant, shot (depot medroxyprogesterone acetate), oral contraception, hormonal patch, and vaginal ring. In addition, we aimed to examine the difference in supply, distribution, the types of contraception services offered, and Medicaid participation.Study Design: We constructed a national database of contraceptive service providers using multiple data sets: IQVIA prescription claims, preadjudicated medical claims, and the OneKey healthcare provider data set; the National Plan and Provider Enumeration System data set; and the Census Bureau's American Community Survey data on population demographics. All statistical analyses were descriptive, including chi-squared tests for groupwise differences and pairwise post hoc tests with Bonferroni corrections for multiple comparisons.Results: Although 73.1% of obstetrician-gynecologists and 72.6% of nurse-midwives prescribed the pill, patch, or ring, only 51.4% of family medicine physicians, 32.4% of pediatricians, and 19.8% of internal medicine physicians do so. The ratio of all primary care providers prescribing contraception to the female population of reproductive age (ages, 15-44 years) varied substantially across states, with a range of 27.9 providers per 10,000 population in New Jersey to 74.2 providers per 10,000 population in Maine. In addition, there are substantial differences across states for Medicaid acceptance. Of the obstetrician-gynecologists providing contraception, the percentage of providers who prescribe contraception to Medicaid patients ranged from 83.9% (District of Columbia) to 100% (North Dakota); for family medicine physicians, it ranged from 49.7% (Florida) to 91.1% (Massachusetts); and for internal medicine physicians, it ranged from 25.0% (Texas) to 75.9% (Delaware). For in-person contraception, there were large differences in the proportion of providers offering the 3 different contraceptive method types (intrauterine device, implant, and shot) by provider specialty.Conclusion: This study found a significant difference in the distribution, types of contraception, and Medicaid participation of the contraception workforce. In addition to obstetrician-gynecologists and nurse-midwives, family medicine physicians, internal medicine physicians, pediatricians, advanced practice nurses, and physician assistants are important contraception providers. However, large gaps remain in the provision of highly effective services such as intrauterine devices and implants. Future research should examine provider characteristics, programs, and policies associated with the provision of different contraception services. [ABSTRACT FROM AUTHOR]

Given the current high incidence of depression, occupational health nurses in all work settings are likely to encounter many employees who suffer from some form of depression. Depression has the highest medical benefit costs for all behavioral conditions and results in more days of disability than chronic medical conditions such as heart disease, hypertension, diabetes, and lower back pain. Advances in understanding the physiologic changes in the brain which cause depression have lead to development of effective psychopharmacologic agents for treatment. Depressed individuals have the most positive responses with a combination of medication and psychotherapy. Nurses need to assist affected employees to obtain optimal mental health care so they may remain as functional as possible, thereby diminishing the detrimental effects of the illness.