Dartmouth Institute for Health Policy and Clinical Practice
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The Hemi-Hand
No full textCurrent rehabilitation devices, such as splints and therapeutic gloves, aid spastic hemiparetic patients but are often impractical to don independently due to constant muscle contraction. Therefore, hemiparetic patients need a user-friendly method of extension in their affected hand to improve motor coordination, prevent contracture, and maintain muscle balance. The purpose of the device is to make hand expansion technology available to a wider range of individuals. We achieve this by creating a customizable device which both simplifies the donning process, and effectively expands the customers contracted hand. The device uses a base for stabilization, and a detachable cone. The cone gradually expands the hand to the width of the main component, while simultaneously guiding the fingers and thumb to their desired position. This system allows the customer to have full control and don the device fully independently. As the customer slides their hand onto the main component, their thumb is caught by an adjustable thumb anchor which keeps the thumb extended by the desired amount. Once the customer has successfully donned the main body, the cone can be quickly removed. Subsequently, the device is secured in place using a custom easy-on, easy-off strap. The strap is further secured by an end cap which provides additional stabilization and support. Once the device is donned, an adjustable hinge can be used to further expand the hand using a series of adjustable wedges. The overall design consists of streamlined and durable parts, providing the customer with a solution which is built to last
Exploration of inhibition and modulation of an epoxide hydrolase by nanobodies.
No full textNanobodies are immune fragments derived from heavy-chain only antibodies and are attractive tools for biomedical research due to their ease of production, small size, stability, and facile functionalization. Nanobodies have also garnered attention for their ability to modulate enzymatic activities through competitive and allosteric mechanisms. In the context of microbial virulence factors and toxins, these attributes give nanobodies therapeutic and diagnostic potential while simultaneously providing new opportunities to explore fundamental principles pertaining to protein function. For these reasons, a nanobody library was constructed for Cif, an epoxide hydrolase with virulence properties produced by Pseudomonas aeruginosa that has implications for people with Cystic Fibrosis.
Preliminary data indicated that a subset of nanobodies showed inhibitory potential against Cif and were selected for further characterization using a combination of structural and biochemical techniques. The co-crystal structures of several Cif:nanobody complexes revealed CDR3-centric and CDR2-centric mechanisms for direct steric competitive inhibition. In both cases, a conserved pentad motif in the nanobodies position a hydrophobic, often aromatic, side chain into the active-site entrance of Cif. Nanobodies in both classes also utilize highly similar stereochemistries for antigen recognition despite low sequence identity.
Allosteric nanobody modulators of Cif were also identified and described for the first time. The first is nanobody VHH108, which exerts substrate-dependent enhancement of Cif. Co-crystal structures of the Cif:VHH108 complex reveal subtle structural changes at the binding interface that are accompanied with global changes to protein dynamics, as inferred by an analysis of normalized ADPs. In contrast, the second allosteric nanobody, VHH116, functions as an allosteric inhibitor of Cif, and ongoing work to uncover the structural details governing the interaction is underway.
Collectively, these allosteric nanobodies add to a growing network of long-range communications previously identified in Cif. More generally, the detailed understanding of these Cif:nanobody interactions serves as a primer for the development of research tools that will aid in clarifying the clinical impact Cif has in the scope of Cystic Fibrosis lung infections. The inhibitory nanobodies also have potential for immediate therapeutic applications
Investigation of Molten Salt Electrolysis for Scalable Lunar Mining Applications
No full textPermanent lunar habitation faces considerable challenges, including the availability of consumable resources for fuel and construction. Sourcing these raw materials from Earth represents a significant cost to future missions, reducing the capacity for equipment and personnel. Toward the goal of permanent settlements on the Moon, it is not enough to simply produce materials from lunar regolith. We must achieve industrial-scale production of oxygen, iron, silicates, and other materials on the lunar surface, comparable to the terrestrial extraction industries. Molten Salt Electrolysis (MSE) has the potential to extract oxygen from lunar regolith at scale. The process of MSE has been experimentally proven to have a 96% oxygen yield in lab testing in conditions that are reproducible within Dartmouth facilities.1 We developed an experimentation environment and investigated the scalability of the different components in this process, from the recyclability of the molten salts to the life expectancy of crucibles and the efficiency of the anodes. For an industrial-scale process on the Moon, minimizing resupply missions will be explored by reusing salt, crucibles, anodes, and cathodes. This contribution includes our experimental setup, results, and scalability analysis. Our results demonstrate a successful removal of oxygen from the lunar regolith simulant, however, they also highlight some shortcomings of MSE as a scalable option. In addition, we share our decision-making process that led to our pursuit of MSE over other proven extraction methods of oxygen from lunar regolith
Adoption, Friendships, and Social Skills
No full textAdoption functions as both an identity status and a source of unique social benefits and challenges for teenagers, informing their experience of friendship. While prior research primarily focuses on individual outcomes and difficulties that adoptees face, such as trauma-related disorders and social skill deficits, it often overlooks how adoptees and their parents perceive these impacts on peer relationships. This study draws on twenty-one in-depth interviews with adoptees ages thirteen to twenty-one and their adoptive parents to explore the role that adoption and adverse childhood experiences have on an adopted teen’s experience of friendships. Findings reveal that despite facing significant social and emotional challenges stemming from trust and attachment issues, neglect, and early trauma, many adoptees demonstrate immense resilience.
Friendships offer adopted teens emotional support, motivation, and the opportunity to celebrate their identity as an adoptee. Adoption can also serve as a point of connection, helping adolescents form bonds with other adoptees or relate more deeply to non-adopted peers through shared vulnerability. Ultimately, this study underscores the complex relationship between adoption, identity, and adolescent peer relationships, advocating for a more holistic approach and view of adoptees’ social development and experience of friendship that highlights their struggles and strengths
Flight Lessons: Drones Find Their Way as Search-and-Rescue Tools
Full text linkSince 2018, New Hampshire Fish & Game has begun using drones to search for lost and injured hikers in the White Mountains, complementing ground searches, trained dogs, and helicopters
Return to the Cuyahoga Valley: From Toxic Dump to National Park
Full text linkOnce known as the place where a river caught fire, today’s Cuyahoga Valley National Park in Ohio attracts boaters and hikers
Accidents
Full text linkReports of rescues and accidents in the White Mountains of New Hampshire from the cold season of 2023-24. Thoughts on the Pemi Loop, the 31-mile passage around the Pemigewassett Wilderness. Hikers call for help but then hike out another way while rescuers search along Signal Ridge Trail. Chris Roma perishes while attempting a solo Pemi Loop in January. Skiers trigger an avalanche in the Great Gulf. Hypothermia puts one of a threesome in grave danger on Mount Monadnock. An ill-prepared hiker becomes dangerously cold after heading into frigid snow-blowing conditions on the Ammonoosuc Ravine Trail. Sledding down Mount Avalon ends with a crash into a tree and an injury requiring a carryout. A hiker falls on the Falling Waters Trail. A trail runner encounters deep spring snow. A missing solo hiker’s body is found on the Dry River a month after he must have set out
Insanity as an American Empire: The Canton Insane Asylum for American Indians, 1902-1934
Full text linkThis graduate thesis involves a retelling of the history of the now defunct Canton Insane Asylum, built in the early 20th century located in Canton, South Dakota. It was America’s first federal psychiatric facility dedicated exclusively for American Indians. The Canton Insane Asylum for American Indians is a touchstone whose microhistory reflects larger political and economic sentiments in both the state of South Dakota and in the United States writ large. Conceiving South Dakota, as first and foremost a white settler society erected on land forcibly wrested from American Indian people, the asylum played an important economic development role and helped transform Canton, South Dakota. All of this was accomplished through physical and medical violence and exploitation of vulnerable American Indians. The Canton Insane Asylum for American Indians was aided and abetted by cheerleading state officials and callously managed by various colonial superintendents of whom one is particularly noteworthy—Dr. Harry Reid Hummer. Methodologically, this thesis leverages archival records (housed and littered across three national archives: Kansas City, Dallas, Texas, and Washington, D.C. as well as state archives) consisting of governmental reports, the insane asylum’s financial records, oral testimonies, and patient case files. Where primary sources are lacking, secondary sources are used. More specifically, the thesis highlights the brutal scientific management and medical practices as carried out by the insane asylum executives and staff members; the inherent capitalistic ethos propelling the insane asylum, the business of confinement, and the manner in which pseudoscience and epidemiology data were contorted to justify the confinement of American Indians. The first patient arrived in 1902, and the facility permanently closed in 1934 due to dehumanizing conditions. Over its lifetime, it warehoused more than three-hundred and seventy American Indians
