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Two Stories, One Site: The Case of Fort Snelling
Get PDFThe revitalization of Fort Snelling, a site of immense historical and cultural significance located in the heart of the Twin Cities in Minnesota, has sparked ongoing debates about representation, reconciliation, and historical memory. For the Dakota people, this land is sacred, marking their ancestral origins and the site of profound suffering during the U.S.-Dakota War of 1862. Simultaneously, the fort is a cornerstone of Minnesota’s military history, reflecting broader narratives of westward expansion and national development. With over $200 million invested in revitalization efforts, the challenge remains: Can Fort Snelling equitably represent these layered histories without diminishing one perspective in favor of the other?
This paper examines the complexities of Fort Snelling’s revitalization by analyzing historical context, site redevelopment projects, and the tensions surrounding historical interpretation. Key concerns include the perceived inadequacy of Dakota representation, economic exclusion from housing initiatives on historically Dakota land, and growing calls for land return or stewardship. Drawing on case studies of inclusive historic preservation and Indigenous-led land trusts, this study explores pathways for integrating Dakota voices into site management and interpretation.
Ultimately, this paper argues that Fort Snelling’s future as a model for reconciliation depends on its ability to center Dakota perspectives in meaningful ways. Recommendations include enhanced collaboration with Dakota communities, more inclusive housing policies, and potential mechanisms for shared cultural stewardship. By acknowledging the full scope of Fort Snelling’s history, the site has the potential to serve not only as a place of education but as a space for healing, dialogue, and shared historical responsibility.Master of City and Regional Plannin
Enhancing Behavioral Health Access for Veterans: A Policy Proposal For a Statewide Peer Support Program
Get PDFVeterans face higher rates of behavioral health disorders and suicide than the general population, often stemming from combat exposure, separation from family, and experiences of trauma. Untreated conditions such as post-traumatic stress disorder, depression, and substance use disorder can lead to unemployment, homelessness, and family instability. Many veterans now rely on community-based care due to limited access to VA services, but provider shortages hinder treatment. To address this, our team recommends a statewide Veteran Peer Support Specialist program to expand access to behavioral healthcare. The policy would enhance North Carolina’s Certified Peer Support Specialist Program to better support and train veterans as peer specialists. Similar efforts in other conservative states have seen bipartisan success. While some grant support is expected, we estimate $15 million in state funding will be needed over the program’s first three years.Master of Public Healt
The Functions of Neighborhood Schools
Get PDFThis project consists of guided readings, slides, and assignments, formatted as a college-level course. It moves through three units, which focus respectively on academic, neighborhood, and political aspects of schools. The course challenges would-be students to ask: What and whom are schools for? What are their manifest effects and how do these match up with their intentions? And who makes the decisions that affect this?Master of City and Regional Plannin
Initial Experience with Single-Session Resin-Based Transarterial Radioembolization Mapping and Treatment of Small Hepatocellular Carcinomas
Get PDFBackground/Objectives: Studies have indicated that forgoing lung shunt fraction measurement in select patients undergoing Yttrium 90 (Y90) transarterial radioembolization (TARE) may be safe without sacrificing efficacy. This study evaluated the safety and efficacy of a streamlined treatment in patients with small hepatocellular carcinoma (HCC) receiving resin-based TARE. Methods: Patients who received single-session Y90 TARE between September 2023 and May 2024 were retrospectively evaluated. Treatment response was evaluated at the 3-month follow-up using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Adverse events (AEs) ≥ Grade 3 were recorded post-procedurally at 3 months. The time from the interventional radiology clinic visit to the procedure date was compared to patients receiving the conventional TARE treatment. Results: Ten consecutive patients were treated with 12 treatments. Each treatment targeted an isolated lesion with median size of 2.5 cm (IQR: 2.1, 2.9). Two patients received two treatments (one for treatment of a separate lesion and the other for the initial incomplete targeting of the tumor). The median delivered tumor dose was 377.7 Gy (IQR: 246.5, 570.1). No patients developed ≥ Grade 3 AEs post-TARE. Complete response was achieved in 11/12 patients (92%). The conventional cohort consisted of 60 patients, all OPTN T2 treated with radiation segmentectomy with glass microspheres. Patients undergoing SSMT had a median time from clinic visit to treatment of 26.5 days (IQR: 15.3, 39) vs. 61 days (IQR: 48, 88.8) in the conventional TARE group (p < 0.001). Conclusions: Streamlined single-session resin-based Y90-TARE in patients with OPTN T2 stage HCC is feasible, efficacious, safe, and associated with reduced time to treatment
Integrator complex subunit 12 knockout overcomes a transcriptional block to HIV latency reversal
Get PDFThe latent HIV reservoir is a major barrier to HIV cure. Combining latency reversal agents (LRAs) with differing mechanisms of action such as AZD5582, a non-canonical NF-kB activator, and I-BET151, a bromodomain inhibitor is appealing toward inducing HIV-1 reactivation. However, even this LRA combination needs improvement as it is inefficient at activating proviruses in cells of people living with HIV (PLWH). We performed a CRISPR screen in conjunction with AZD5582 & I-BET151 and identified a member of the Integrator complex as a target to improve this LRA combination, specifically Integrator complex subunit 12 (INTS12). Integrator functions as a genome-wide attenuator of transcription that acts on elongation through its RNA cleavage and phosphatase modules. Knockout of INTS12 improved latency reactivation at the transcriptional level and is more specific to the HIV-1 provirus than AZD5582 & I-BET151 treatment alone. We found that INTS12 is present on chromatin at the promoter of HIV and therefore its effect on HIV may be direct. Additionally, we observed more RNAPII in the gene body of HIV only with the combination of INTS12 knockout with AZD5582 & I-BET151, indicating that INTS12 induces a transcriptional elongation block to viral reactivation. Moreover, knockout of INTS12 increased HIV-1 reactivation in CD4 T cells from virally suppressed PLWH ex vivo, and we detected viral RNA in the supernatant from CD4 T cells of all three virally suppressed PLWH tested upon INTS12 knockout, suggesting that INTS12 prevents full-length HIV RNA production in primary T cells. Finally, we found that INTS12 more generally limits the efficacy of a variety of LRAs with different mechanisms of action
Editorial: Clinical uses and alternative approaches of frailty determination
Get PDFFrailty represents a greater vulnerability to stressors that increases an individual’s susceptibility to adverse health outcomes, such as disability, loss of independence, and death. As one ages, the prevalence of frailty increases and affects up to 50% of those aged 85 and older (Clegg et al., 2013). Efforts to characterize and quantify states of frailty took a substantial leap forward with the emergence of frailty assessment frameworks based on physical frailty and deficit accumulation in the early 2000s (Fried et al., 2001; Rockwood and Mitnitski, 2007; Searle et al., 2008). Since then, frailty tools have been correlated with important health outcomes relevant to aging, have been used to evaluate therapeutic benefit, and are now being explored to help scientists understand the underlying biology of frailty (Fried et al., 2001; Rockwood and Mitnitski, 2007; Brivio et al., 2019; Kwak et al., 2020; Ota and Kodama, 2022). Importantly, frailty tools have also found utility in predicting outcomes of medical and surgical interventions and continue to be refined to improve prognosis in older individuals (Ko, 2019; Nidadavolu et al., 2020; Rabelo et al., 2023)
Preclinical usability evaluation of the Liveborn app: A mobile health application that provides feedback for neonatal resuscitation
Get PDFNeonatal mortality, particularly due to failure to breathe at birth, remains a significant challenge in low- and middle-income countries (LMICs). Effective neonatal resuscitation is essential to improving survival, but is challenging to implement consistently at the bedside. The Liveborn mobile health application for newborn resuscitation was developed to provide real-time guidance and support debriefing for healthcare workers in LMICs. Liveborn allows an observer to document the timing of key actions during a resuscitation; it then compares the observer data to recommended care and provides data-driven feedback. This study aimed to evaluate the usability of Liveborn in simulated resuscitations. We conducted two rounds of simulated resuscitations using Liveborn with midwives at one health facility in the Democratic Republic of Congo. Each round included ten simulations, with half testing real-time guidance and half focusing on debriefing. Between rounds, Liveborn was iteratively refined based on analysis of video-recordings of the simulations and participant surveys. Midwives' perceptions of usability and feasibility were assessed using previously validated survey tools including the System Usability Scale (SUS) with a score >68 considered above average, and the Feasibility of Intervention Measure (FIM) with a score >12 considered above neutral. Round 1 of testing identified several key usability issues including difficulty accurately recording events, poor adherence to audio guidance that was insufficiently specific, and poor flow of debriefing for intrapartum stillbirth cases. The Liveborn app, after iterative refinement, demonstrated excellent usability (median SUS score of 90 [Q1, Q3: 85, 95]) and excellent feasibility (median FIM score of 19 [16, 20]). Further research is needed to assess Liveborn's effectiveness in real clinical settings and its impact on neonatal outcomes in LMICs
Mixed-method longitudinal investigation of sexual and gender-based violence following COVID-19 in South Africa
Get PDFBACKGROUND: Throughout the COVID-19 pandemic, concerns were raised about unintended effects of measures taken to prevent its spread, on sexual and gender-based violence (SGBV). The United Nations called for understanding how national lockdowns put young people at risk of SGBV. This research is particularly needed in contexts such as South Africa, where pre-existing levels of SGBV are high and limited data has been released. METHODS: This mixed-method longitudinal study characterised trajectories of household-level and partner-level SGBV exposure over 6 months, approximately 1 year after the initial COVID-19 lockdown. Utilising group-based trajectory modelling, survey data from 535 male and female participants, ages 13-24 and qualitative insights from 20 in-depth interviews were analysed. RESULTS: Two trajectory groups emerged for both household-level and partner-level SGBV: (1) groups of participants with consistently low SGBV levels (household: 77.5%; partner: 89.4%) and (2) groups with high baseline levels of SGBV, followed by decreases to moderate levels (household: 22.5%; partner: 10.8%). Characteristics significantly associated with the latter groups included being female, not employed or in school, food insecurity and symptoms of probable common mental disorders. Qualitative data supported these findings and revealed the mitigating role of positive household communication skills, along with potentially unmeasured levels of technology-facilitated partner violence, occurring over phones and social media during lockdown. CONCLUSIONS: Findings should inform the targeting of financial, food and mental health support to those at higher risk of ongoing violence during future times of crises. Further research on technology-facilitated violence should be conducted to better understand its prevalence
[OSAN] Trends Related to Overdose Deaths
No full textPresentation to Opioid State Action Network of the National Governors Association. Covers current drug supply landscape and overview of overdose trends nationally.
Sharing allowed: Licensed for slides to be reused without needing further permission
Awareness and perceptions related to self-managed abortion in Ohio after Dobbs
Get PDFOBJECTIVE: To analyze awareness and perceptions related to self-managed abortion in Ohio after Dobbs and subsequent changes in Ohio abortion law. STUDY DESIGN: We analyzed data from the most recent wave (September 2022 to August 2023) of the Ohio Survey of Women, a cross-sectional survey of a population-representative sample of women aged 18-44 years in Ohio (full sample N=2,473). Our variables of interest were awareness of self-managed medication abortion (SMMA) and perceptions of self-managed abortion (SMA). Respondents were considered to have awareness of SMMA if they reported having heard of pills they can buy and use at home to conduct an abortion without going to a clinic or consulting a doctor. All respondents were also asked to indicate methods that they understand to mean SMA. RESULTS: A plurality (41.6%) of respondents were aware of SMMA. Non-Hispanic Black and non-Hispanic Asian women had less awareness of SMMA compared to non-Hispanic White women (prevalence ratio PR=0.72, 95% confidence interval CI [0.54-0.95] and PR=0.45, 95% CI [0.26-0.77] respectively). When compared with women who hold a bachelor's degree or higher educational level, women with less than a high school education, those with a high school degree, and those with only some college had less awareness of SMMA (respectively, PR=0.58, 95% CI [0.36-0.94]; PR=0.71, 95% CI [0.58-0.86]; PR=0.78, 95% CI [0.68-0.88]). About 30.3% of women identified Plan B and 24.4% indicated herbs as methods of SMA. CONCLUSIONS: Findings highlight disparities in awareness of SMMA abortion in adult, reproductive-age women in Ohio