Lower extremities

How might global health evidence waste away? The thing that generates evidence in this case, the metabolism, offers some possible answers to this question. But it does so, sometimes, only when things devolve. This essay takes up the case of amputation in the case of diabetes. The ethnography of atrophy highlights how knowing and embodiment wither, all while the thing that is supposed to absorb the world – the metabolism – offers less and less return on such a promise

Lifelines

Harris Solomon takes readers into the trauma ward of one of Mumbai’s busiest public hospitals, narrating the stories of the patients, providers, families, and frontline workers who experience and treat traumatic injury from traffic

Lifelines

Harris Solomon takes readers into the trauma ward of one of Mumbai’s busiest public hospitals, narrating the stories of the patients, providers, families, and frontline workers who experience and treat traumatic injury from traffic

Remote Effects of OFA Disruption on the Face Perception Network Revealed by Consecutive TMS-FMRI

The face perception system is comprised of a network of connected regions including the middle fusiform gyrus (“fusiform face area” or FFA), the inferior occipital gyrus (“occipital face area” or OFA), and the posterior part of the superior temporal sulcus. These regions are typically active bilaterally but may show right hemisphere dominance. The functional magnetic resonance imaging (fMRI) response of the right FFA is normally attenuated for face stimuli of the same compared to different identities, called fMR-adaptation. The recovery in fMRI signal, or release from fMR-adaptation, for faces of different identities indicates that the neural population comprising the FFA is involved in coding face identity. Patients with prosopagnosia who are unable to visually recognize faces and who show right OFA damage, nonetheless show face-selective activation in the right FFA (Rossion et al., 2003; Steeves et al., 2006). However, the sensitivity to face identity is abnormal in the right FFA and does not show the typical release from adaptation for different face identities (Steeves et al., 2009). This indicates that in these patients the FFA is not differentiating face identity and suggests that an intact right OFA is integral for face identity coding. We used offline repetitive transcranial magnetic stimulation (TMS) to temporarily disrupt processing in the right OFA in healthy subjects. We then immediately performed fMRI to measure changes in blood oxygenation level dependent (BOLD) signal across the face network using a face fMR-adaptation paradigm. We hypothesized that TMS to the right OFA would induce abnormal face identity coding in the right FFA, reflected by a decreased adaptation response. Indeed, activation for different but not same identity faces in the right FFA decreased after TMS was applied to the right OFA compared to sham TMS and TMS to a control site, the nearby object-selective right lateral occipital area (LO). Our findings indicate that TMS to the OFA selectively disrupts face but not butterfly identity coding in both the OFA and FFA. Congruent with mounting evidence from both patients and healthy subjects, here we causally demonstrate the importance of the often-overlooked OFA for normal face identity coding in the FFA

Understanding the complex relationships among actors involved in the implementation of public-private mix (PPM) for TB control in India, using social theory.

BACKGROUND: Public Private Partnerships (PPP) are increasingly utilized as a public health strategy for strengthening health systems and have become a core component for the delivery of TB control services in India, as promoted through national policy. However, partnerships are complex systems that rely on relationships between a myriad of different actors with divergent agendas and backgrounds. Relationship is a crucial element of governance, and relationship building an important aspect of partnerships. To understand PPPs a multi-disciplinary perspective that draws on insights from social theory is needed. This paper demonstrates how social theory can aid the understanding of the complex relationships of actors involved in implementation of Public-Private Mix (PPM)-TB policy in India. METHODS: Ethnographic research was conducted within a district in a Southern state of India over a 14 month period, combining participant observations, informal interactions and in-depth interviews with a wide range of respondents across public, private and non-government organisation (NGO) sectors. RESULTS: Drawing on the theoretical insights from Bourdieu's "theory of practice" this study explores the relationships between the different actors. The study found that programme managers, frontline TB workers, NGOs, and private practitioners all had a crucial role to play in TB partnerships. They were widely regarded as valued contributors with distinct social skills and capabilities within their organizations and professions. However, their potential contributions towards programme implementation tended to be unrecognized both at the top and bottom of the policy implementation chain. These actors constantly struggled for recognition and used different mechanisms to position themselves alongside other actors within the programme that further complicated the relationships between different actors. CONCLUSION: This paper demonstrates that applying social theory can enable a better understanding of the complex relationship across public, private and NGO sectors. A closer understanding of these processes is a prerequisite for bridging the gap between field-level practices and central policy intentions, facilitating a move towards more effective partnership strategies for strengthening local health systems. The study contributes to our understanding of implementation of PPP for TB control and builds knowledge to help policy makers and programme managers strengthen and effectively implement strategies to enable stronger governance of these partnerships

Mood Management Intervention for College Smokers with Elevated Depressive Symptoms: A Pilot Study

Objective This pilot study examined smoking reduction and cessation among college smokers with elevated depressive symptomatology participating in a group-based behavioral counseling, mood management, and motivational enhancement combined intervention (CBT). Participants & Methods Fifty-eight smokers (smoked ≥ 6 days in the past 30) were randomized to six sessions of CBT (n=29) or a nutrition-focused attention-matched control group (CG, n=29). Results Relative to CG participants, significantly more CBT participants reduced smoking intensity by 50% (χ2(1, N=58)=4.86, p=.028) at end of treatment. Although CBT participants maintained smoking reductions at 3- and 6-month follow-up, group differences were no longer significant. No group differences in cessation emerged. Finally, participants in both groups evidenced increased motivation to reduce smoking at end of treatment (F(1, 44)=11.717, p=.001, ηp2=.207). Conclusions Findings demonstrate the utility of this intervention for smoking reduction and maintenance of reductions over time among a population of college students with elevated depressive symptomatology

Spike sorting for large, dense electrode arrays

Developments in microfabrication technology have enabled the production of neural electrode arrays with hundreds of closely spaced recording sites, and electrodes with thousands of sites are under development. These probes in principle allow the simultaneous recording of very large numbers of neurons. However, use of this technology requires the development of techniques for decoding the spike times of the recorded neurons from the raw data captured from the probes. Here we present a set of tools to solve this problem, implemented in a suite of practical, user-friendly, open-source software. We validate these methods on data from the cortex, hippocampus and thalamus of rat, mouse, macaque and marmoset, demonstrating error rates as low as 5%