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Respiratory Morbidity and Neurodevelopmental Outcomes in Infants Born Preterm: A Complex Web
Get PDFThis commentary is on the original article by Yu et al. on pages 1246–1253 of this issue
North American Genetic Counselors\u27 Approach to Collecting and Using Ancestry in Clinical Practice
Get PDFCurrent guidelines from the National Society of Genetic Counselors (NSGC) recommend that patients\u27 ancestry be obtained when taking a family history. However, no study has explored how consistently genetic counselors obtain or utilize this information. The goals of this study included assessing how genetic counselors collect their patients\u27 ancestry, what factors influence this decision, and how they view the utility of this information. Genetic counselors working in a direct patient care setting in the US or Canada were recruited to participate in an anonymous survey via an NSGC email blast. Most participants (n = 115) obtain information about their patients\u27 ancestry (96.5%), with the most common methods being directly asking the patient (91%) and utilizing intake forms (43.2%). Of participants who ask about ancestry directly, 50.5% always ask about the presence of Ashkenazi Jewish ancestry and 70.3% always ask about additional ancestries, suggesting that for most genetic counselors’ collection of ancestry is standard practice. However, the clinical utility of ancestry information is highly variable, with the impact on genetic testing choice being particularly low. A slight majority of participants support a reevaluation of current ancestry guidelines (51.3%), with many participants suggesting that the varying utility of ancestry in different clinical indications/specialties should be incorporated into guidelines. Despite being standard practice for most genetic counselors, no unified approach or standard for how ancestral information should be used in genetic counseling practice was identified
Training the Next Generation of Translational Scientists: The Case Western Reserve University Translational Fellows Program
Get PDFBackground: An important part of biomedical research is the translation of discoveries into clinical or community applications that impact patient health. For a vast majority of clinical applications and sustainable community interventions, a time-tested way to get innovations to patients is through licensing of the technology and commercial development, often through startups. While biomedical scientists and trainees are schooled in discovery research, the processes of commercialization are foreign or intimidating. Further, many trainees will not aspire to a faculty position, and other avenues of advancement are desirable. Methods: At Case Western Reserve University, we developed and launched a Translational Fellows Program to provide such training for the community, focusing specifically on graduate students and postdoctoral fellows. The goals of this program include familiarizing our trainees with the principles of entrepreneurship, product development, and startups. This is accomplished through study of their laboratory\u27s technology to identify points of translational focus and to increase awareness to potentially move ideas and products toward societal impact. This program leverages much of our existing infrastructure and provides a mechanism for the prioritization of the translation of the technology as well as release-time to promote effort. Results: Launched in summer 2020, our first cohort had 3 of the 12 fellows launching startups based on their technology and submitting an National Institutes of Health Small Business Innovation Research (SBIR) proposal. At least 80% reported increased knowledge and confidence in five of six key translational competencies. Conclusion: We are now continuing and improving the program and searching for sustainable support to stabilize the program for a long-term productive future
You Can’t Betray a Fish: One Reason Eating Fish may Cause Less Harm than Eating Cows
Get PDFIn The Ultimate Betrayal: Is There Happy Meat?, Bohanec (2013) proposed that farmed animals raised humanely may experience betrayal when slaughtered. I argue based on personal experience that humans often betray trust relationships with farmed animals. Using published scientific literature, I find that typical farmed animals (mammals) and farmed fishes are both cognitively capable of a rudimentary experience of betrayal. However, the manner in which fishes are typically maintained does not present opportunities for human-fish trust relationships to develop. Eating farmed fishes presents fewer ethical implications than eating cows, at least in some cases.
This article was featured in The Case Daily [archived link]
A Randomized Controlled Trial of Customized Adherence Enhancement (CAE-E): Study Protocol for a Hybrid Effectiveness-Implementation Project
No full textBackground: Mood-stabilizing medications are a cornerstone of treatment for people with bipolar disorder, though approximately half of these individuals are poorly adherent with their medication, leading to negative and even severe health consequences. While a variety of approaches can lead to some improvement in medication adherence, there is no single approach that has superior adherence enhancement and limited data on how these approaches can be implemented in clinical settings. Existing data have shown an increasing need for virtual delivery of care and interactive telemedicine interventions may be effective in improving adherence to long-term medication. Methods: Customized adherence enhancement (CAE) is a brief, practical bipolar-specific approach that identifies and targets individual patient adherence barriers for intervention using a flexibly administered modular format that can be delivered via telehealth communications. CAE is comprised of up to four standard treatment modules including Psychoeducation, Communication with Providers, Medication Routines, and Modified Motivational Interviewing. Participants will attend assigned module sessions with an interventionist based on their reasons for non-adherence and will be assessed for adherence, functioning, bipolar symptoms, and health resource use across a 12-month period. Qualitative and quantitative data will also be collected to assess barriers and facilitators to CAE implementation and reach and adoption of CAE among clinicians in the community. Discussion: The proposed study addresses the need for practical adherence interventions that are effective, flexible, and designed to adapt to different settings and patients. By focusing on a high-risk, vulnerable group of people with bipolar disorder, and refining an evidence-based approach that will integrate into workflow of public-sector care and community mental health clinics, there is substantial potential for improving bipolar medication adherence and overall health outcomes on a broad level. Trial registration: The study was registered on ClinicalTrials.gov NCT04622150 on November 9, 2020
Resolving Ultrafast Photoinitiated Dynamics of the Hachimoji 5-Aza-7-Deazaguanine Nucleobase: Impact of Synthetically Expanding the Genetic Alphabet
Get PDFThe guanine derivative, 5-aza-7-deazaguanine (5N7CG) has recently been proposed as one of four unnatural bases, termed Hachimoji (8-letter) to expand the genetic code. We apply steady-state and time-resolved spectroscopy to investigate its electronic relaxation mechanism and probe the effect of atom substitution on the relaxation mechanism in polar protic and polar aprotic solvents. Mapping of the excited state potential energy surfaces is performed, from which the critical points are optimized by using the state-of-art extended multi-state complete active space second-order perturbation theory. It is demonstrated that excitation to the lowest energy 1ππ* state of 5N7CG results in complex dynamics leading to ca. 10- to 30-fold slower relaxation (depending on solvent) compared with guanine. A significant conformational change occurs at the S1 minimum, resulting in a 10-fold greater fluorescence quantum yield compared with guanine. The fluorescence quantum yield and S1 decay lifetime increase going from water to acetonitrile to propanol. The solvent-dependent results are supported by the quantum chemical calculations showing an increase in the energy barrier between the S1 minimum and the S1/S0 conical intersection going from water to propanol. The longer lifetimes might make 5N7CG more photochemically active to adjacent nucleobases than guanine or other nucleobases within DNA
Numerical Investigation on Blast Response of Cold-Formed Steel Framing Protected with Functionally Graded Composite Material
Get PDFThis paper presents a numerical simulation on the blast response of cold-formed steel (CFS) structural framing system protected with a functionally graded composite material (FGM) panel. The steel frame consists of four CFS studs, which were protected by 12.5 mm thick gypsum, aluminum composite, and FGM composite materials on both sides. The numerical simulation was performed using ABAQUS on a 1.8 m × 2.4 m, overall wall panel exposed to air blast on one side. A 1.0 kg TNT explosive charge placed at four standoff distances (R) of 1.0 m, 1.5 m, 2.0 m, and 2.5 m from the framing were investigated. The FGM board was modeled using a stepwise material variation using the power-law material function. Deformation and failure modes of the studs, as well as the protective materials, were compared to the same framing system but with different protective materials, including conventional gypsum boards and aluminum composite panels. Based on the observation from the analysis and computational simulation, the proposed protective composite material (FGM) resulted in a smaller deformation at peak overpressure at a given standoff distance (R) and local failure modes on studs. The same frame system with gypsum and aluminum panel exhibited excessive deformation as well as an early collapse of the CFS studs. This observation can lead to an alternative material solution in blast-resistant design
Antithrombin-III Mitigates Thrombin-Mediated Endothelial Cell Contraction and Sickle Red Blood Cell Adhesion in Microscale Flow
Get PDFIndividuals with sickle cell disease (SCD) have persistently elevated thrombin generation that results in a state of systemic hypercoagulability. Antithrombin-III (ATIII), an endogenous serine protease inhibitor, inhibits several enzymes in the coagulation cascade, including thrombin. Here, we utilize a biomimetic microfluidic device to model the morphology and adhesive properties of endothelial cells (ECs) activated by thrombin and examine the efficacy of ATIII in mitigating the adhesion of SCD patient-derived red blood cells (RBCs) and EC retraction. Microfluidic devices were fabricated, seeded with ECs, and incubated under physiological shear stress. Cells were then activated with thrombin with or without an ATIII pretreatment. Blood samples from subjects with normal haemoglobin (HbAA) and subjects with homozygous SCD (HbSS) were used to examine RBC adhesion to ECs. Endothelial cell surface adhesion molecule expression and confluency in response to thrombin and ATIII treatments were also evaluated. We found that ATIII pretreatment of ECs reduced HbSS RBC adhesion to thrombin-activated endothelium. Furthermore, ATIII mitigated cellular contraction and reduced surface expression of von Willebrand factor and vascular cell adhesion molecule-1 (VCAM-1) mediated by thrombin. Our findings suggest that, by attenuating thrombin-mediated EC damage and RBC adhesion to endothelium, ATIII may alleviate the thromboinflammatory manifestations of SCD
The Potentials and Challenges of Zoom Live Theatre during Coronavirus Lockdown: Pandemic Therapy and Corona Chicken (Part Two)
Get PDFThis study discusses the potentials and challenges of Zoom theatre performances during the lockdown caused by the Covid-19 pandemic. It examines the utilization and applicability of videoconferencing software Zoom, and other streaming software compatible with it, in creating a viable performance option for theatre practitioners and audiences during mandatory social distancing. Such software can be a strategy for social inclusion, alleviating the adverse effects of extended quarantine. The article also discusses the technical and performative aspects of Zoom theatre, pointing out its pros and cons. It uses a critical and analytical approach to performances of two Zoom plays, Pandemic Therapy and Corona Chicken (Part Two), revealing how the playwright, dramaturg, and actors manage to present a live theatrical experience capable of engaging audiences and promoting social interaction. Khaled Mostafa Karam is an Assistant Professor of English Literature at the Suez University in Egypt and a Postdoctoral Fellow in the Department of Cognitive Science, Case Western Reserve University, USA. He has published eleven articles on the interdisciplinary field of cognitive science and drama. Galal Mohamed Naguib is an Assistant Professor of Sociology at Suez University and author of several articles in the fields of demographic analysis and the sociology of art
It\u27s About Time: Emphasizing Temporal Dynamics in Dynamic Personality Regulation
Get PDFPeople change over time. These changes are thought to represent some self-regulatory, dynamic processes. However, dynamic processes need to be distinguished from mere stochastic variation. Just as the Brownian motion of a dust mote does not help us understand the basic principles of classical physics, neither does random variation within an individual describe the complexity of self-regulatory processes. This regulation implies solving the problem of competing goals and desires within the constraints of situational presses. And what people feel, think, and do at one moment affects what they feel, think and do in the next moment. Thus, describing and explaining change over time must focus on dynamics in response to environmental cues and competing internal states. That is, we must include time and change over time in our models. We will outline the constructs needed to examine time explicitly in models of personality regulation, distinguishing between those that are not inherently temporal from those that are. We will discuss how computational modeling approaches may be used to study temporal dynamics and explain personality consistency and change. We will consider different time scales and discuss how an information processing perspective may inform choices regarding time scale and corresponding contexts for empirical studies
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