Virginia Mason Federal Way Medical Center

BACKGROUND: Approximately two hundred human burials were discovered on the edge of a paleolake in Niger that provide a uniquely preserved record of human occupation in the Sahara during the Holocene ( approximately 8000 B.C.E. to the present). Called Gobero, this suite of closely spaced sites chronicles the rapid pace of biosocial change in the southern Sahara in response to severe climatic fluctuation. METHODOLOGY/PRINCIPAL FINDINGS: Two main occupational phases are identified that correspond with humid intervals in the early and mid-Holocene, based on 78 direct AMS radiocarbon dates on human remains, fauna and artifacts, as well as 9 OSL dates on paleodune sand. The older occupants have craniofacial dimensions that demonstrate similarities with mid-Holocene occupants of the southern Sahara and Late Pleistocene to early Holocene inhabitants of the Maghreb. Their hyperflexed burials compose the earliest cemetery in the Sahara dating to approximately 7500 B.C.E. These early occupants abandon the area under arid conditions and, when humid conditions return approximately 4600 B.C.E., are replaced by a more gracile people with elaborated grave goods including animal bone and ivory ornaments. CONCLUSIONS/SIGNIFICANCE: The principal significance of Gobero lies in its extraordinary human, faunal, and archaeological record, from which we conclude the following: The early Holocene occupants at Gobero (7700-6200 B.C.E.) were largely sedentary hunter-fisher-gatherers with lakeside funerary sites that include the earliest recorded cemetery in the Sahara.Principal components analysis of craniometric variables closely allies the early Holocene occupants at Gobero with a skeletally robust, trans-Saharan assemblage of Late Pleistocene to mid-Holocene human populations from the Maghreb and southern Sahara.Gobero was abandoned during a period of severe aridification possibly as long as one millennium (6200-5200 B.C.E).More gracile humans arrived in the mid-Holocene (5200-2500 B.C.E.) employing a diversified subsistence economy based on clams, fish, and savanna vertebrates as well as some cattle husbandry.Population replacement after a harsh arid hiatus is the most likely explanation for the occupational sequence at Gobero.We are just beginning to understand the anatomical and cultural diversity that existed within the Sahara during the Holocene.

OBJECTIVE: We studied whether polyunsaturated fatty acids (PUFAs) can protect rat insulinoma (RIN5F) cells against alloxan-induced apoptosis in vitro and type 1 diabetes mellitus (type 1 DM) in vivo and if so, mechanism of this beneficial action. MATERIAL AND METHODS: In vitro study was conducted using RIN5F cells while in vivo study was performed in Wistar rats. The effect of PUFAs, cyclo-oxygenase and lipoxygenase inhibitors, various eicosanoids and PUFAs metabolites: lipoxin A4 (LXA4), resolvin D2 and protectin against alloxan-induced cytotoxicity to RIN5F cells and type 1 DM was studied. Expression of PDX1, P65 NF-kB and IKB in RIN5F cells and Nrf2, GLUT2, COX2, iNOS protein levels in the pancreatic tissue and plasma glucose, insulin and tumor necrosis factor-α and antioxidants, lipid peroxides and nitric oxide were measured. RESULTS: Of all, arachidonic acid (AA) was found to be the most effective against alloxan-induced cytotoxicity to RIN5F cells and preventing type 1 DM. Both cyclo-oxygenase and lipoxygenase inhibitors did not block the beneficial actions of AA in vitro and in vivo. Alloxan inhibited LXA4 production by RIN5F cells and in alloxan-induced type 1 DM Wistar rats. AA-treatment restored LXA4 levels to normal both in vitro and in vivo. LXA4 protected RIN5F cells against alloxan-induced cytotoxicity and prevented type 1 DM and restored expression of Nrf2, Glut2, COX2, and iNOS genes and abnormal antioxidants to near normal. DISCUSSION: AA seems to bring about its beneficial actions against alloxan-induced cytotoxicity and type 1 DM by enhancing the production of LXA4. © 2016 BioFactors, 43(2):251-271, 2017.

The purpose of this single subject research study was to examine the effects of a once weekly, 10-week hippotherapy program for three children, ages 27-54 months, with cerebral palsy. Participants were rated as Level V on the Gross Motor Function Classification System. The Sitting Dimension of the Gross Motor Function Measure was used to establish a baseline of sitting abilities, and was administered every 2 weeks during intervention. The Sitting Assessment Scale and the Gross Motor Function Measure were administered before, after, and 4 weeks postintervention. Parental perceptions of the hippotherapy intervention were assessed using questionnaires. None of the children made gains on any of the standardized outcome measures. Parental perceptions were very positive, with reported improvements in range of motion and head control.

In a five-year longitudinal study of typical literacy development (grades 1 to 5 or 3 to 7) relationships were examined between (a) parental responses to questionnaires about home literacy activities and ratings of children's self-regulation at home, both completed annually by the same parent, and (b) children's reading and writing achievement assessed annually at the university. Higher reading and writing achievement correlated with engaging in more home literacy activities. Parental help or monitoring of home literacy activities was greater for low achieving than high achieving readers or writers. Children engaged more minutes per week in reading than writing activities at home, but parents provided more help with writing and reported computers were used more for homework than school literacy instruction. Parental ratings of self-regulation of attention remained stable but executive functions-goal-setting, hyperactivity and impulsivity tended to improve. Results are translated into consultation tips for literacy learning and best professional practices.

A new genus and species of Fagaceae are established for compressed leaves and attached fruits which represent one of the dominant taxa in the rich Miocene Clarkia flora of northern Idaho. The leaf and fruit morphology, cuticular and pericarp anatomy, and leaf phytoliths fall within the range of variation of the subfamily Fagoideae. The unique fruit consists of a large, exposed, distinctly keeled, trigonous nut and a diminutive basal cupule. The cupule has an apical frill of free, petiolate, leaflike appendages but lacks other ornamentation, and there is no evidence of a distinct Valvation. As no other genus of the Fagaceae has fruits with this combination of characters, a new genus is established and is referred to the subfamily Fagoideae. The Miocene genus seems most closely related to the extant genus Fagus.

Abstract Randomized controlled clinical trials, the gold standard to determine treatment efficacy against control, have demonstrated advantages of skin substitutes for the treatment of chronic diabetic foot ulcers in comparison to standard of care. However, randomized controlled clinical trials comparing efficacy between two or more skin substitutes are very limited. With growing numbers of new skin substitutes, such studies are essential for treatment and policy‐making decisions by wound care providers and payers. In this study, we analyzed clinical outcomes and product cost between a viable cryopreserved placental membrane (vCPM) and a human fibroblast‐derived dermal substitute (hFDS) for the treatment of chronic diabetic foot ulcers in a prospective, multicenter, single‐blind study. The outcomes of 62 patients were analyzed: 31 patients in the vCPM treatment group and 31 patients in the hFDS treatment group. Utilizing a non‐inferiority trial design and the established treatment regimen of 8 applications for hFDS, we demonstrated that vCPM was not inferior to hFDS for the proportion of patients achieving complete wound closure (9.68, 90% CI: [10.67, 28.94]). However, preliminary findings show that vCPM may have better outcomes for wounds ≤ 5 cm 2 : 81.3% (13/16) of wounds in the vCPM group vs. 37.5% (6/16) of wounds in the hFDS group reached complete closure at the end of treatment ( p = 0.0118). A preliminary product cost analysis for wounds ≤ 5 cm 2 may show significant savings for patients treated with vCPM. Average per‐patient costs during the course of treatment were $3,846 and $7,968 ( p < 0.0001) for vCPM and hFDS patients, respectively. These results may be used as guidance to wound care providers and payers.

The bird cherry-oat aphid (Rhopalosiphum padi L.) is a global pest of wheat and vectors some of the most damaging strains of barley yellow dwarf virus (BYDV). In years of heavy R. padi infestation, R. padi and BYDV together reduce wheat yields by 30-40% in Kansas and other states of the U.S. Great Plains wheat production area. Cultivation of wheat cultivars resistant to R. padi can greatly reduce production costs and mitigate R. padi-BYDV yield losses, and increase producer profits. This study identified cultivars of hard red and soft white winter wheat with R. padi resistance that suppress R. padi populations or tolerate the effects of R. padi feeding damage. 'Pioneer (S) 25R40,' 'MFA (S) 2248,' 'Pioneer (S) 25R77,' and 'Limagrain LCS Mint' significantly reduced R. padi populations. MFA (S) 2248, Pioneer (S) 25R40, and 'Limagrain LS Wizard' exhibited tolerance expressed as significantly greater aboveground biomass. These findings are significant in that they have identified wheat cultivars currently available to producers, enabling the immediate improvement of tactics to manage R. padi and BYDV in heavily infested areas. Secondarily, these results identify cultivars that are good candidates for use in breeding and genetic analyses of arthropod resistance genes in wheat.

This article examines research methodologies for classroom-based research in light of the complementary ideas of Freire and Habermas. After reflecting on classroom-based participatory action research in a secondary mathematics classroom, I discuss the suitability of critical participatory action research in critical mathematics education. Critical participatory action research resonates with central concerns of critical mathematics education as it allows researchers to consider emancipatory alternatives to existing situations.

A new genus and species of Fagaceae are established for compressed leaves and attached fruits which represent one of the dominant taxa in the rich Miocene Clarkia flora of northern Idaho. The leaf and fruit morphology, cuticular and pericarp anatomy, and leaf phytoliths fall within the range of variation of the subfamily Fagoideae. The unique fruit consists of a large, exposed, distinctly keeled, trigonous nut and a diminutive basal cupule. The cupule has an apical frill of free, petiolate, leaflike appendages but lacks other ornamentation, and there is no evidence of a distinct Valvation. As no other genus of the Fagaceae has fruits with this combination of characters, a new genus is established and is referred to the subfamily Fagoideae. The Miocene genus seems most closely related to the extant genus Fagus.

Many who have served in a war zone carry deep emotional wounds that go beyond the typical symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal that comprise a diagnosis of posttraumatic stress disorder (PTSD). Specifically, many combatants experience unresolved grief, guilt, and shame caused by losses and traumatic experiences suffered in war, called "moral injury" by some clinicians and researchers (e.g., Litz et al., 2009; Shay, 1994). We describe the aspects of human attachment that set the stage for grief, guilt, and shame, and outline the 3-phase group therapy model we have implemented in a clinical setting to foster the reconnection of severed human bonds. Special attention is paid to killing and related phenomena that are unique to combat PTSD. The program phases include psychoeducation, trauma-focused therapy, and aftercare, which focuses on assisting the veterans in reconnecting with their families and communities. The use of letter writing as an intervention is illustrated through case examples, and clinical outcomes are anecdotally described.

Under most circumstances, plumb pile systems are more economical and are usually the system of choice for piers and wharves subject to seismic loading. However, there are situations where batter piles are desirable, such as under high service-level lateral loading conditions or where the new structure has to be compatible with an existing batter pile structure. For these situations, using displacement design with carefully-detailed batter piles may result in a significant project savings compared to a force-based seismic design method. This paper reviews the basic concepts of displacement design. Insight is offered on the behavior of batter piles using a simplified displacement method to show why batter pile structures are vulnerable to seismic loading if designed using a force-based method. Sample details and a design procedure for a proposed system are presented.

This research examined the validity of the theoretical model of reading outlined by the Simple View of Reading when measuring reading ability with a performance-based reading test. Participants were 95 fourth-grade, students randomly sampled from four schools in an urban district. The test we studied employed a mixture of traditional (multiple-choice) and performance assessment approaches (constructed-response items that required written responses). Our findings indicated that writing ability emerged as an important source of individual differences in explaining overall reading ability, even when we deconstructed the test into a multiple-choice-only score.

The purpose of this single subject research study was to examine the effects of a once weekly, 10-week hippotherapy program for three children, ages 27–54 months, with cerebral palsy. Participants were rated as Level V on the Gross Motor Function Classification System. The Sitting Dimension of the Gross Motor Function Measure was used to establish a baseline of sitting abilities, and was administered every 2 weeks during intervention. The Sitting Assessment Scale and the Gross Motor Function Measure were administered before, after, and 4 weeks post-intervention. Parental perceptions of the hippotherapy intervention were assessed using questionnaires. None of the children made gains on any of the standardized outcome measures. Parental perceptions were very positive, with reported improvements in range of motion and head control.

Several aphid species transmit barley yellow dwarf, a globally destructive disease caused by viruses that infect cereal grain crops. Data from >400 samples collected across Kansas wheat fields in 2014 and 2015 were used to develop spatiotemporal models predicting the extent to which landcover, temperature and precipitation affect spring aphid vector abundance and presence of individuals carrying Barley yellow dwarf virus (BYDV). The distribution of Rhopalosiphum padi abundance was not correlated with climate or landcover, but Sitobion avenae abundance was positively correlated with fall temperature and negatively correlated to spring temperature and precipitation. The abundance of Schizaphis graminum was negatively correlated with fall precipitation and winter temperature. The incidence of viruliferous (+BYDV) R. padi was positively correlated with fall precipitation but negatively correlated with winter precipitation. In contrast, the probability of +BYDV S. avenae was unaffected by precipitation but was positively correlated with fall temperatures and distance to forest or shrubland. R. padi and S. avenae were more prevalent at eastern sample sites where ground cover is more grassland than cropland, suggesting that grassland may provide over-summering sites for vectors and pose a risk as potential BYDV reservoirs. Nevertheless, land cover patterns were not strongly associated with differences in abundance or the probability that viruliferous aphids were present.

ABSTRACT The 24th World Congress of Dermatology was held in Milan, Italy, on June 11–15, 2019, under the auspices of the International League of Dermatological Societies. The Dermatology Nurses' Association and the British Dermatological Nursing Group, both sister societies of the International League of Dermatological Societies, coordinated a nursing scientific program and a half-day leadership meeting held during the World Congress. Overview of the nursing scientific program and outcomes of the half-day leadership meeting are described.

BACKGROUND: Asian American (AA) community leaders, Native Hawaiian/Pacific Islander (NH/PI) community leaders, and allies in the United States Pacific Northwest expressed concern that there are families and children from AA communities and NH/PI communities who experience and witness acts of xenophobia and racism. This can cause racial trauma. The long-time practice of aggregating AA and NH/PI data contributes to erasure and makes it challenging to advance health equity, such as allocating resources. According to AAPI Data's long-awaited report in June 2022, there are over 24 million AAs and 1.6 million NHs/PIs in the United States, growing by 40% and 30%, respectively, between 2010 and 2020. Philanthropic investments have not kept up with this substantive increase. The National Academies of Sciences, Engineering, and Medicine emphasized the need for effective partnerships to advance the health and well-being of individuals and communities in antiracism and system-level research. OBJECTIVE: The aim of this community-based participatory research qualitative description study was to identify perceptions and experiences regarding racial discrimination, race-based stress, and racial trauma; intergenerational healing and resiliency; and sharing the body with science from key informants of an academic and community partnership to inform antiracism coalition work. This partnership includes academic researchers and community leaders from community-based organizations and a health care organization serving immigrant and marginalized communities, including AAs and NHs/PIs in the United States Pacific Northwest. METHODS: In total, 10 key informants joined 1 of 2 participatory group discussions via videoconference for 2 hours in 2022. We used a semistructured and open-ended group interview guide. A qualitative participatory group-level assessment was conducted with the key informants and transcribed. Interpretations and meanings of the main points and the main themes were reflected upon, clarified, and verified with the key informants in real time. The field note-based data transcripts were manually coded using conventional content analysis. Reflexivity was used. RESULTS: There were 6 main themes: prejudice plus power in racism definition and working in solidarity to counter lateral oppression/false sense of security, microaggression as multilayers, "not assimilationist by nature" and responding differently to white superiority, intergenerational- and identity-related trauma, what is healing among People of Color and through a lens of resiliency and intergenerational connection and knowledge, and mistrust and fear in the research and health care systems surrounding intentions of the body. CONCLUSIONS: The themes highlight the importance of internal and intergenerational healing from racial trauma and the need for solidarity among communities of color to combat white supremacy and colonization. This work was foundational in an ongoing effort to dismantle racism and uplift the community voice through a cross-sector academic and community partnership to inform antiracism coalition work.

This comprehensive study of the place of oral communication in the English language arts curriculum of K‐72 schools was based on a telephone survey of all 50 states and an examination of the curriculum frameworks of the 38 states that publish them. We analyzed the major conceptual bases and organizational patterns, integration of listening and speaking with the other language arts, resources offered, classroom assessment, and extent to which the oral communication content reflects current thinking in communication education. Over 60 percent of the frameworks give extensive treatment to oral communication, but there is great variability in approaches. Thirty‐four of the frameworks use five organizational patterns, two use mixed models, and two states are in transition. The most specificity is found where listening and speaking are treated as separate strands or analyzed by grade levels; the most superficial treatments of oral communication are in common core and completely integrated models. We recommend that communication education scholars and teachers take a more active role to ensure adequate treatment of oral communication in the English language arts curriculum.

PRIMARY STUDY OBJECTIVE: To evaluate the economic utility of a fecal biomarker panel structured to suggest alternative, treatable diagnoses in patients with symptoms of irritable bowel syndrome (IBS) by quantifying, comparing, and contrasting health service costs between tested and non-tested patients. STUDY DESIGN: Retrospective, matched cohort study comparing direct medical costs for IBS patients undergoing fecal biomarker testing with those of matched control subjects. METHODS: We examined de-identified medical and pharmacy claims of a large American pharmacy benefit manager to identify plan members who underwent panel testing, were eligible for covered benefits for at least 180 days prior to the test date, and had data available for 30, 90, and 365 days after that date. We used propensity score matching to develop population-based control cohorts for each tested cohort, comprised of records with IBS-related diagnoses but for which panel testing was not performed. Primary outcome measures were diagnostic and medical services costs as determined from claims data. RESULTS: Two hundred nine records from tested subjects met inclusion criteria. The only significant baseline differences between groups were laboratory costs, which were significantly higher in each tested cohort. At each follow-up time point, total medical and gastrointestinal procedural costs were significantly higher in non-tested cohorts. Within tested cohorts, costs declined significantly from baseline, while costs rose significantly in non-tested control cohorts; these differences were also significant between groups at each time point. CONCLUSIONS: Structured fecal biomarker panel testing was associated with significantly lower medical and gastrointestinal procedural costs in this study of patients with IBS symptoms.

Even as the Paris climate accords were signed in 2015, climate scientists warned that just eliminating further addition of CO2 to the atmosphere might not be enough to forestall the worst of global...

Aging | doi:10.18632/aging.204197. Kara N. Fitzgerald, Romilly Hodges, Douglas Hanes, Emily Stack, David Cheishvili, Moshe Szyf, Janine Henkel, Melissa W. Twedt, Despina Giannopoulou, Josette Herdell, Sally Logan, Ryan Bradley