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Indirect vs. Direct Assessment of Cold Induced Vasodilation
No full textCold-induced vasodilation (CIVD) is a phenomenon involving a counterintuitive increase in skin blood flow during cold exposure. Although CIVD was first described in 1930, CIVD mechanisms remain unknown. CIVD research has assessed vasodilation via skin temperature rather than direct assessment of skin blood flow. The study objective was to determine if laser-Doppler flux, cutaneous vascular conductance (CVC), or skin erythrocyte concentration provides better assessment of CIVD. Twelve (8 men and 4 women) healthy (via health history and vital signs) subjects’, laser- Doppler flux, erythrocyte concentration, and skin-surface temperature were measured in the index and middle finger of the left hand and index finger of the right hand, while arterial blood pressure (ABP) on a beat-by-beat basis was measured in the right ring finger. The left hand was exposed to: baseline (10 min 22-23°C air), warming (10 min 35°C water), cooling (30 min 8°C water), and recovery (15 min 22-23°C air) and the right hand to 22-23°C air throughout. Temperature CIVD was observed in all participants, with an average of 2.33±0.98 occurrences. Flux and concentration CIVDs were observed in 11 and 9 subjects with an average occurrence rate of 1.67±1.37 and 0.92±1.16, respectively. CVC increased during warming +38.1±11.8% (P=0.006), then decreased during the first 5 min of cooling -54.1±8.4% (P\u3c0.001) but was not different by the end of cooling (P=0.143). Right hand, CVC was not initially altered, but decreased by the end of opposite hand cooling (p=0.008). Left hand index and middle finger values and responses were congruent. Cooling increased ABP by an average of 17.3±0.08% (P\u3c0.001). These data indicate sympatholysis in immersed hand during CIVD that is not observed in the non-immersed hand. Direct measures of skin blood flow and erythrocyte concentration appear to add different aspects to the traditional indirect assessment of CIVD and allow new investigations into CIVD mechanisms
Abstract
No full textUnemployment is a substantial problem amongst veterans with mental illness. This pervasive vocational dysfunction results in poor financial, clinical, quality of life, and psychosocial outcomes. The Cognitive Behavioral Therapy for Work Success (CBTw) intervention was developed through previous studies to address this issue and improve employment outcomes in this population. Design: This ongoing pilot study is using a within groups, pre-post design investigating the effects of the CBTw intervention in veterans with mental health disorders who are enrolled in VA vocational services. Setting: The study is taking place at the Roudebush Veteran Affairs Medical Center, a federal acute care facility providing comprehensive medical and rehabilitation services for veterans. Participants: Participants are veterans with a diagnosis of a mental illness who are currently enrolled in VA vocational services and have a competitive work goal in the community. To date, a total of 36 veterans have been consented to participate in the study and 26 have completed the CBTw intervention. Methods: CBTw is a manualized, group-based, 12 session program that addresses problematic thoughts, feelings, behavioral patterns, and deficits in sense of self as a worker that act as barriers to achieving work success in the community. Work and psychosocial outcomes are assessed before participation in the CBTw intervention, after the conclusion of the intervention, and again at a six month follow-up. Results: To date, findings demonstrate that 65% of unemployed participants at baseline had acquired a paid job at the 12-week follow-up. All employed participants at baseline maintained their jobs over the 12-week intervention period. In the total sample, there was also a significant pre to post increase in total hours worked in competitive jobs, t(25)= -2.4, p=.02, d=.47. Conclusion: Preliminary findings suggest that the CBTw program is an effective complement to existing VA vocational services, assisting veterans to reach their community employment goals
Cryoglobulinemic Vasculitis in a Patient with Trismus Pseudocamptodactyly
Get PDFCryoglobulinemia is a condition where immunoglobulins precipitate at temperatures \u3c 37°C causing damage to blood vessels of the skin, joints, peripheral nervous system, and kidneys. Diagnosis is difficult due to various etiologies and clinical manifestations. We present a challenging case of idiopathic type III cryoglobulinemia. A 33-year-old man with a history of trismus pseudocamptodactyly syndrome (TPS), chronic pain, and polysubstance abuse presented with several days of worsening rash on both feet. The patient noted more restriction in his joints, increased from his baseline restriction due to TPS. Physical exam revealed palpable purpura on the dorsum of both feet. Extensive tests were performed (CBC, CMP, PT and INR, Lupus Anticoagulant (LA), Hepatitis B and C serology, HIV antibody, ANA panel, ANCA panel, serum complement) which were unremarkable. A punch biopsy of the right foot demonstrated epidermal necrosis with vascular thrombosis. The patient was discharged due to improvement of his condition. Two weeks later, the patient was readmitted for worsening pain in his feet. The purpuric lesions were more necrotic compared to his last visit. New petechiae appeared on the ventral forearms. Work-up for lupus, infectious etiologies, and malignancy were negative; however, a cryoglobulin test was positive. A follow-up SPEP revealed elevated polyclonal IgM of 622 mg/dL. A punch biopsy of the new lesions revealed leukocytoclastic vasculitis (LCV), which can be caused by mixed cryoglobulinemia (MC), further supporting the diagnosis. This case highlights the difficulty in making the diagnosis of cryoglobulinemia in a patient with a history of drug abuse and TPS. His clinical presentation was confounded by his inability to localize any particular joint involvement due to chronic pain, his history of polysubstance abuse raising concerns for drugseeking behavior, and his negative hepatitis panel making the diagnosis of MC less likely. Despite this, the patient did meet several classification criteria for cryoglobulinemia, which include: the presence of cryoglobulins, elevated monoclonal IgM, constitutional symptoms, and articular and vascular involvement
Amyloid-beta Alzheimer targets - protein processing, lipid rafts, and amyloid-beta pores.
Get PDFAmyloid beta (Aβ), the hallmark of Alzheimer\u27s Disease (AD), now appears to be deleterious in its low number aggregate form as opposed to the macroscopic Aβ fibers historically seen postmortem. While Alzheimer targets, such as the tau protein, amyloid precursor protein (APP) processing, and immune system activation continue to be investigated, the recent discovery that amyloid beta aggregates at lipid rafts and likely forms neurotoxic pores has led to a new paradigm regarding why past therapeutics may have failed and how to design the next round of compounds for clinical trials. An atomic resolution understanding of Aβ aggregates, which appear to exist in multiple conformations, is most desirable for future therapeutic development. The investigative difficulties, structures of these small Aβ aggregates, and current therapeutics are summarized in this review
Sr. Evelyn Lindenmaier
Get PDFIn this segment Sr. Evelyn Lindenmaier reflects on her decision to follow her twin sister, Rachel Lindenmaier, and her aunt, Sr. Leona, into the convent of the Sisters of Saint Francis, Oldenburg. Sr. Evelyn discusses her love of working with her hands and how her skills enabled her to expand her vocation to such jobs as a copy repair person, painter, and carpenter—creating gifts for her fellow Sisters, her family, and the local community. She highlights her life in formation as a young novice and her mission work with the poor of Cincinnati, teaching elementary school and building Christmas trees for those who could not afford them. Sr. Evelyn also describes her changing prayer life and her unique role as a twin caring for a twin, and vice versa, in times of failing health. She underscores how being twin Sisters helped Rachel and her impact others often simply by being present to those in need. With candor and gleefulness, Sr. Evelyn ends her interview by reflecting on the time elementary students mistook her for her “older Sister.https://mushare.marian.edu/wrp/1018/thumbnail.jp
Sr. Angela Betsch
Get PDFIn her oral history, Sister Angela Betsch reflects on her experience growing up in White Oak, Cincinnati and her path to becoming a Sister of Saint Francis, Oldenburg. Sr. Angela highlights her decision to follow her older sister into the convent, her missionary work as a teacher and principal in Missouri, Indianapolis, and Papua New Guinea, as well as her time as a caretaker for her eight-year-old nephew after her sister\u27s untimely death. With kindness and heartfelt joy, Sister Angela describes her blessed life as a Sister of Saint Francis, Oldenburg.https://mushare.marian.edu/wrp/1016/thumbnail.jp
Safety and Efficacy of Fecal Microbiota Transplantation in Patients with a History of Solid Organ Transplant and C. Difficile Infection
No full textClostridium difficile infection is particularly common in SOT patients and the consequences are severe. Fecal microbiota transplantation is an emerging, highly efficacious therapeutic modality for CDI but data on FMT success in SOT patients is scarce. This study is a retrospective, observational study, collecting a large number of cases to assess the safety and efficacy of FMT in the SOT population from our FMT database. The specific aims of the proposal are 1. To identify SOT recipients prior to undergoing FMT (organ type, antirejection medications used) 2. To characterize CDI by severity, number of recurrences, antibiotic therapies 3. To characterize FMT for efficacy and safety 4. To characterize SOT course following FMT Inclusion criteria: 1. Established solid organ transplant (SOT) recipient prior to first Fecal Microbiota transplantation. 2. Clostridium difficile infection (CDI) treated with fecal microbiota transplantation (FMT) 3. No Exclusion criteria were present. Study Procedures: This study is a retrospective and observational study of patients with SOT treated with FMT for CDI since 2012. Outside institutions will be asked to participate. Data will be extracted from FMT research databases and from review of electronic medical records. Data points that will be collected include basic demographic information, SOT characteristics, CDI severity prior and following FMT procedure, details of treatments used for CDI and SOT, documented comorbidities, and success of FMT at 1 month and 3 month following procedure through PCR testing. (Appendix A: data collection sheet). Other institutions will use the data collection sheet in the appendix. All of the information will be de-identified when it is sent to us. The patient # is NOT the MRN, but only a number assigned to each subject to keep track of entries. We will not be sent any identifiable information from other institutions. Data collection sheets from our site will also be de-identified. Statistical Considerations: Data interpretation will be performed using descriptive statistical methods. Conclusion: The project is currently being finalized and will be formally submitted to the American College of Gastroenterology by the end of this month
Early Expression of D-Pax2 in Drosophila Sense Organs is Controlled by a 700 Base Pair Cis-Regulatory Region
Get PDFBristles are mechanosensory organs in the Drosophila peripheral nervous system composed of four cells that adopt different fates and differentiate. These four cells (neuron, shaft, sheath, and socket) arise from a sensory organ precursor (SOP). D-Pax2 is a transcription factor necessary for the development of functional bristle cells, particularly in the differentiation of the sheath and shaft cells. This transcription factor is expressed in all four bristle cells during mitotic phases, but is then restricted to the sheath and the shaft cells during differentiation. D-Pax2 is controlled by a 3.1 KB upstream enhancer region, which can be further divided into two segments that drive early and late expression of D-Pax2 separately. The purpose of the research was to try to find the minimal regions of these enhancer segments that control D-Pax2 expression. Understanding control of D-Pax2 expression may help elucidate the mechanism of control of the mammalian homolog Pax2, which has a role in the urogenital tract, eyes, and possibly in kidney cell differentiation. This research was accomplished by cloning truncated fragments of the enhancer regions into the green fluorescent protein (GFP) reporter plasmid pH-Stinger to create transgenic flies that could be dissected and examined for GFP expression, which could be used as a readout for D-Pax2 expression. Drosophila nota were then stained with an anti-D-Pax2 primary antibody, which was detected with a secondary red fluorescence antibody. A fluorescence microscope was used to examine the occurrence of GFP in relation to D-Pax2 protein, and images were taken. Expression of GFP in fly lines bearing proximal, early enhancer fragments and distal, late enhancer fragments was greatly reduced as compared to the controls. The distal, early enhancer fragment showed a similar expression pattern to the control. It was found that this 700 BP segment was sufficient in driving early expression of D-Pax2
Constructing and Enforcing the Medicine Line : A Comparative Analysis of Indian Policy on the North American Frontier
No full textThe national self-images of the United States and Canada have been shaped, in part, by their contrasting histories and mythologies of westward expansion and nation-building. Those narratives are most distinct with regard to government policies toward aboriginal peoples on either side of the 49th parallel, what Indians called the medicine line. The purpose of this article is two fold: (1) to specify and develop a three-part conceptual framework (consisting of the Turnerian discourse, the Lipset Thesis, and Borderlands Studies) for examining the history of the North American frontier and (2) utilizing a wide range of scholarly literature, to apply that framework in a comparative analysis of national policies toward Indians and First Nations in the post-Civil War/post-Confederation period on the Great Plains and Prairies. Several explanatory factors for cross-national difference will be identified and examined, including variance in geography and geology; demography, demographic trends, and political pressures in each country; the types of national political institutions and their impact on policymaking; and the types of forces deployed in the West (the Mounties and the US Army)
They Might Pop-In: Instruction and Workshops for Faculty Only
Get PDFDuring the spring semester, we designed faculty-only workshops each week that they could pop-in for instruction on library resources, research or citation support, and at least one freebie resource. These included infographic and media creation, copyright-free images, video design, and apps they could use in teaching, assessment, or marketing. Through these sessions, we built relationships with faculty that transferred to additional requests for instruction, materials, and research support, and building their own information literacy skills