Autoimmune destruction of pericytes as the cause of diabetic retinopathy

In diabetic retinopathy, collapse of the retinal vasculature is associated with loss of the pericytes. These are contractile cells that together with endothelial cells form the terminal arterioles of the retina. The cause of the loss of pericytes is not known. Recently, it has been discovered that type 1 diabetes is caused by forbidden clones of cytotoxic T lymphocytes, which destroy the insulin-making cells with exquisite specificity. In the light of this, I postulate that an antigenically-related forbidden clone of cytotoxic T lymphocytes selectively destroys the pericytes and that this is the cause of the vascular collapse of diabetic retinopathy. If this is so, the therapeutic implications are immense, involving a switch from ineffectual tight glycemic control to immunotherapy. This is already used as immunosuppression to prevent organ transplant rejection, and as the immune ablation and autologous bone marrow cell reconstitution that has saved the lives of patients with lethally-severe scleroderma. Once the pericyte surface auto-antigen for the T lymphocytes has been isolated, selective destruction of the pathogenic T lymphocytes would be possible by manufacture and use of cytotoxic auto-antigen complexes, which arrests progression of the retinopathy

Doctor of Philosophy

dissertationThe focus of this dissertation is threefold: conduct a systematic review to identify literature regarding the use of malaria control methods, identify rates of control method use, and identify predictors associated with the combined use of control methods among African children under age five through Demographic and Health Surveys (DHS). A systematic review identified literature regarding malaria control methods utilizing DHS surveys. Sixtyfive articles met the review criteria and were evaluated for insecticide treated nets (ITN) use, indoor residual spray (IRS), and prompt/appropriate treatment. While DHS datasets are a rich source to identify malaria practices in African children, additional research considering the combined use of malaria control methods is needed. DHS surveys from three countries at two separate time points were then analyzed to identify rates of children under five who reported fever and utilized one or more malaria control methods (ITNs, IRS, and/or prompt/appropriate treatment). Independent use of ITNs ranged from 30% to 75%, IRS from 1% to 18%, and prompt/appropriate treatment from 3% to 25%. Combined use of all control methods ranged between <1% to 3%. Within this descriptive analysis, while some improvements to using control methods were noted over time, independent and combined use of these methods are inadequate. Within the predictor analysis, using univariate, multivariate, and multinomial regression analysis, variables such as child age, maternal education, wealth index, and residence location were evaluated as possible predictors of the independent or combined use of these control methods. Higher maternal education and iv wealth were found to be significant predictors of using one malaria control method among some of the populations. The sample sizes for using two and three methods were extremely small and significant associations among the variables were few and sporadic. In summary, there were no predictors that remained consistent across all surveys. This final analysis demonstrates the necessity for further evaluation of availability, access, and effective dissemination of these control methods both singularly and in combination to improve the transmission and impact of malaria in these endemic populations

The Effects of Various Levels of Counselor-Offered Empathy on Client Anxiety in the Initial Counseling Session

The purpose of the present study was two-fold: (1) to investigate various degrees of counselor-offered empathy in initial interviews, in order to determine whether consistently high levels of counselor-- offered empathy in the initial therapy interview causes high levels of client anxiety, and (2) to determine whether increased client anxiety or the levels of counselor-offered empathy that the client receives in the initial counseling interview affects the client\u27s likelihood to continue in counseling following one session. To accomplish the purpose of the study 27 high-anxiety and 27 low-anxiety undergraduate, incentive volunteers were seen in an initial counseling session by one of three psychology, graduate-student counselors. During the interview the counselor offered the clients one of three predetermined levels of empathy (high, medium, or low). The subject\u27s state-anxiety level was measured prior to the interview and during the interview by two paper and pencil, self-report measures, and also by heart rate. The likelihood to continue in counseling following the initial interview was also measured by a specially designed questionnaire. Results revealed that there were no differences between the anxiety scores of the subjects receiving high, medium, or low counselor-offered empathy. No relationship was found to exist between the subjects\u27 anxiety scores and their choice to terminate or continue counseling after the initial interview. However, an interaction effect upon the subjects\u27 likelihood to continue in counseling was found to exist between their trait anxiety level and the level of counselor-offered empathy which they received

Periprosthetic Knee Infection after tumor excision complicated by Carbapenem Resistant Enterobacteriaceae

Case: A 65 year old Caucasian man presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem. Conclusion: CRE is a relatively uncommon cause of PJI that will infect patients who are immunosuppressed or have specific risk factors. This case demonstrates the importance of early diagnosis and treatment of CRE joint infections and the need for a multidisciplinary approach that includes aggressive surgical intervention and tailored antimicrobial therapy

Periprosthetic knee infection after benign tumor excision complicated by carbapenem resistant Enterobacteriaceae: A case report

Introduction Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI. Case presentation We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem. Discussion CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE PJI, we suggest further workup for other systemic disease. Conclusion This case demonstrates the importance of early diagnosis and treatment of CRE joint infections and the need for a multidisciplinary approach that includes aggressive surgical intervention and tailored antimicrobial therapy

Transverse Momentum Correlations in Relativistic Nuclear Collisions

From the correlation structure of transverse momentum $p_t$ in relativistic nuclear collisions we observe for the first time temperature/velocity structure resulting from low-$Q^2$ partons. Our novel analysis technique does not invoke an {\em a priori} jet hypothesis. $p_t$ autocorrelations derived from the scale dependence of $$ fluctuations reveal a complex parton dissipation process in RHIC heavy ion collisions. We also observe structure which may result from collective bulk-medium recoil in response to parton stopping.Comment: 10 pages, 10 figures, proceedings, MIT workshop on fluctuations and correlations in relativistic nuclear collision

Public geographies II: being organic

This second report on ‘public geographies' considers the diverse, emergent and shifting spaces of engaging with and in public/s. Taking as its focus the more ‘organic’ rather than ‘traditional’ approach to doing public geography, as discussed in the first report, it explores the multiple and unorthodox ways in which engagements across academic-public spheres play out, and what such engagements may mean for geography/ers. The report first explores the role of the internet in ‘enabling conversations', generating a range of opportunities for public geography through websites, wikis, blogs, file-sharing sites, discussion forums and more, thinking critically about how technologies may enable/disable certain kinds of publically engaged activities. It then considers issues of process and praxis: how collaborations with groups/communities/organizations beyond academia are often unplanned, serendipitous encounters that evolve organically into research/learning/teaching endeavours; but also that personal politics/positionality bring an agency to bear upon whether we, as academics, follow the leads we may stumble upon. The report concludes with a provocative question – given that many non-academics appear to be doing some amazing and inspiring projects and activities, thoughtful, critical and (arguably) examples of organic public geographies, what then is academia’s role

A Validation Study of the Adolescent Behavior Checklist Using Clinical and Non-Clinical Samples.

The purpose of this study was to evaluate the discriminant validity of scores from the Adolescent Behavior Checklist (ABC), an adolescent self-report measure of ADHD symptomatology for adolescents ages 11-17 years (n = 60). Validity was assessed through correlational, univariate, and discriminant function analyses using three groups: (1) adolescents diagnosed with ADHD; (2) adolescents currently experiencing a mood and/or anxiety disorder; and (3) adolescents with no major psychological disorder. Convergent and divergent validity of the ABC factor scores was demonstrated through correlational results with: (1) parent- and adolescent-report of ADHD symptoms during structured psychiatric interviews; and, (2) scores on questionnaires measuring related and non-related constructs. Univariate analyses indicated that the ADHD group obtained significantly higher scores than did the normal adolescents across all ABC factors. Additionally, the ADHD group scored significantly higher than did the psychiatric controls on the following ABC factors: Conduct Problems, Impulsivity/Hyperactivity, and Social Problems. Results from discriminant analyses supported the reliability of ABC scores in correctly classifying subjects into groups. When compared to the Youth Self-Report, the ABC was found to be somewhat better at classifying subjects, especially when used in a multi-informant discriminant analysis. Therefore, overall results from the current study suggest that the ABC is a valid and useful self-report screening measure for ADHD symptoms and related difficulties

Development and Validation of a Modified Multiple Errands Test for Adults with Intellectual Disabilities

Background: The aims of the current study were to adapt a version of the MET for people with intellectual disabilities (IDs) and assess its ecological and construct validity. Material and Methods: Using a correlational design, 40 participants with IDs were invited to complete a battery of neuropsychological assessments and the modified Multiple Errands Test for Intellectual Disabilities (mMET-IDs). Results: The ability to successfully complete tasks on the mMET-IDs correlated significantly with measures of the Supervisory Attentional System, namely, the Tower of London Test and the Six Parts Test. However, performance on the mMET-IDs and the Six Parts Test could be accounted for by Verbal IQ and receptive vocabulary. The mMET-IDs failed to correlate with the DEX-IR. Conclusions: The mMET-IDs can be successfully used to assess some aspects of the Supervisory Attentional System in people with IDs. Further development is needed, however, to improve the ecological validity of the mMET-IDs