The rush to save the ill

David W. Levy Prize finalist, Fall 2017Benjamin Rush is not to be dismissed as history has shown-his extensive medical training and experience, when contextualized within his own time, was highly beneficial to the people of Philadelphia during the summer 1793 yellow fever outbreak. In the late summer months, a lethal fever swept its way from the docks of America's capital to the heart of the city. From the beginning of August until November, four thousand and forty-four individuals died from the outbreak. This killed a tenth of Philadelphia's 50,000 citizens with half of that population escaping to the countryside. Among those who stayed behind, many encompassed the city's physicians including Dr. Benjamin Rush-signer of the Declaration of Independence, surgeon general of the Continental Army, and chair of the Institutes of Medicine and Clinical Practice at the University of Philadelphia.undergraduat

Religion and Language: The Two Tactics Used by the British to Colonize Kenya

Second-place winner in the Academic Category of the 2019 Emerging Writers Contest. The essay examines how religion and language were used as colonial practices by the British empire broadly in Africa and specifically in Kenya

Rationalizing the Pediatric Emergency Department Workload: An Epidemiological Profile of Presentations Before and During the COVID-19 Pandemic

Background: Infectious respiratory disease in children provides a significant seasonal workload burden to pediatric emergency departments. Studies from the Southern hemisphere during the first wave of coronavirus (COVID-19) had shown a decrease in seasonal pediatric respiratory infections. During the COVID-19 pandemic, predicted drops in infectious disease circulating in children led to redeployment of junior doctors in pediatric services to adult services. Methods: We extracted data on children presenting to a tertiary emergency department with a respiratory illness, comparing winter 2019-2020 (pre-COVID-19) to winter 2020-2021 (post-COVID-19). We compiled demographic and epidemiological data and compared the two groups with regards to number and type of infectious respiratory presentations, admissions, days spent in hospital, and whether intensive or high dependency support was required. Results: We have found a reduction in respiratory disease presentations post-COVID-19 compared to pre-COVID-19. These patients were more likely to be admitted but their stay was reduced, and there was a trend towards a reduction in requirement for intensive or high dependency support during their admission. Conclusion: This work supports the redeployment of junior doctors in pediatric departments to adult departments given increased demand in other areas of medical care at that time. In view of the changing landscape, we suggest the introduction of a flexible staffing format to ensure adequate support to areas with higher demand

A global transcriptional network connecting noncoding mutations to changes in tumor gene expression.

Although cancer genomes are replete with noncoding mutations, the effects of these mutations remain poorly characterized. Here we perform an integrative analysis of 930 tumor whole genomes and matched transcriptomes, identifying a network of 193 noncoding loci in which mutations disrupt target gene expression. These 'somatic eQTLs' (expression quantitative trait loci) are frequently mutated in specific cancer tissues, and the majority can be validated in an independent cohort of 3,382 tumors. Among these, we find that the effects of noncoding mutations on DAAM1, MTG2 and HYI transcription are recapitulated in multiple cancer cell lines and that increasing DAAM1 expression leads to invasive cell migration. Collectively, the noncoding loci converge on a set of core pathways, permitting a classification of tumors into pathway-based subtypes. The somatic eQTL network is disrupted in 88% of tumors, suggesting widespread impact of noncoding mutations in cancer

Safe Care for Seizure Patients on an Epilepsy Monitoring Unit

Seizure patients admitted to an Epilepsy Monitoring Unit located within an academic tertiary medical center have a high potential to impact patient safety. As a result, a unit based team identified a need for a higher level of training for both their staff and float companions to ensure safe and standardized care for this group of patients. The goal of this quality improvement project was to create an educational tool that would assist 100% of staff in better recognizing and responding to seizures. Baseline metrics and root cause analysis demonstrated a lack of consistent information being taught, a poorly identified target audience as well as educators. Several countermeasures were instituted to include an educational video that standardized seizure and response education. Data collected post rollout demonstrated several positive outcomes to include zero safety events involving this patient population, meeting the goal of 100% of staff educated, and education being mandatory for new staff. Some of the next steps include expanding training to staff caring for pediatric epilepsy patients as well as a tele-sitters video monitoring system request for FY20 budget year

A.R.G. [curated by Farkas, Rozsa and Clark, Tom]

Charlotte Wainwright, David Marsden, Funa Ye, Hannah Rowan, James Balmforth, Joe Farley, KatherineMelançon, Kyle Zeto, Lawrence Lek, Martin Lang, The No Collective & Tom Davies. Semblances of the natural occur in much of the work-surrounding a contemporary conversation on the aesthetisization of this as a lifestyle choice. The continued presence of representational distanciation in art and design (that which functions as an analogue of action) is increased via the context in which work is shown. And surprisingly this is evermore the case as image becomes participatory, as pictorial language becomes expressly relational

Conserved enhancers control notochord expression of vertebrate Brachyury.

The cell type-specific expression of key transcription factors is central to development and disease. Brachyury/T/TBXT is a major transcription factor for gastrulation, tailbud patterning, and notochord formation; however, how its expression is controlled in the mammalian notochord has remained elusive. Here, we identify the complement of notochord-specific enhancers in the mammalian Brachyury/T/TBXT gene. Using transgenic assays in zebrafish, axolotl, and mouse, we discover three conserved Brachyury-controlling notochord enhancers, T3, C, and I, in human, mouse, and marsupial genomes. Acting as Brachyury-responsive, auto-regulatory shadow enhancers, in cis deletion of all three enhancers in mouse abolishes Brachyury/T/Tbxt expression selectively in the notochord, causing specific trunk and neural tube defects without gastrulation or tailbud defects. The three Brachyury-driving notochord enhancers are conserved beyond mammals in the brachyury/tbxtb loci of fishes, dating their origin to the last common ancestor of jawed vertebrates. Our data define the vertebrate enhancers for Brachyury/T/TBXTB notochord expression through an auto-regulatory mechanism that conveys robustness and adaptability as ancient basis for axis development

Proceedings of the 3rd BEAT-PCD Conference and 4th PCD Training School

Abstract Primary ciliary dyskinesia (PCD) is a chronic suppurative airways disease that is usually recessively inherited and has marked clinical phenotypic heterogeneity. Classic symptoms include neonatal respiratory distress, chronic rhinitis since early childhood, chronic otitis media, recurrent airway infections leading to bronchiectasis, chronic sinusitis, laterality defects with and without congenital heart disease including abnormal situs in approximately 50% of the cases, and male infertility. Lung function deteriorates progressively from childhood throughout life. ‘Better Experimental Approaches to Treat Primary Ciliary Dyskinesia’ (BEAT-PCD) is a network of scientists and clinicians coordinating research from basic science through to clinical care with the intention of developing treatments and diagnostics that lead to improved long-term outcomes for patients. BEAT-PCD activities are supported by EU funded COST Action (BM1407). The third BEAT-PCD conference and fourth PCD training school were held jointly in February 2018 in Lisbon, Portugal. Presentations and workshops focussed on advancing the knowledge and skills relating to PCD in: basic science, epidemiology, diagnostic testing, clinical management and clinical trials. The multidisciplinary conference provided an interactive platform for exchanging ideas through a program of lectures, poster presentations, breakout sessions and workshops. Three working groups met to plan consensus statements. Progress with BEAT-PCD projects was shared and new collaborations were fostered. In this report, we summarize the meeting, highlighting developments made during the meeting

Sex differences in limb and joint stiffness in recreational runners

Purpose. Female runners are known to be at greater risk from chronic running injuries than age-matched males, although the exact mechanisms are often poorly understood. The aim of the current investigation was to determine if female recreational runners exhibit distinct limb and joint stiffness characteristics in relation to their male counterparts. Methods. Fourteen male and fourteen female runners ran over a force platform at 4.0 m · s–1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system operating at 250 Hz. Measures of limb and joint stiffness were calculated as a function of limb length and joint moments divided by the extent of limb and joint excursion. All stiffness and joint moment parameters were normalized to body mass. Sex differences in normalized limb and knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that normalized limb (male = 0.18 ± 0.07, female = 0.37 ± 0.10 kN · kg · m–1) and knee stiffness (male = 5.59 ± 2.02, female = 7.34 ± 1.78 Nm · kg · rad–1) were significantly greater in female runners. Conclusions. On the basis that normalized knee and limb stiffness were shown to be significantly greater in female runners, the findings from the current investigation may provide further insight into the aetiology of the distinct injury patterns observed between sexes. Key words: running, sex, limb stiffness, biomechanic

Short Term Effects of Gossip Behavior on Self-Esteem

Gossip is a frequent social activity, yet there is little research on the experience of providing gossip and how it impacts upon well-being of the gossiper. The present research aimed to investigate the effect of gossip behavior on the self-esteem of the gossiper. In Study 1, 140 participants were asked to write either a positive or negative description of a target person. Self-esteem was significantly reduced after providing a negative description but there was no effect of providing a positive one. In Study 2, 112 participants were asked to share information about someone they knew. Self-esteem decreased significantly regardless of the valence of the information. This research suggests that the act of gossiping is one which leads to self‐criticism regardless of valence