A canonical enriched Adams-Hilton model for simplicial sets

For any 1-reduced simplicial set $K$ we define a canonical, coassociative coproduct on \Om C(K), the cobar construction applied to the normalized, integral chains on $K$, such that any canonical quasi-isomorphism of chain algebras from \Om C(K) to the normalized, integral chains on $GK$, the loop group of $K$, is a coalgebra map up to strong homotopy. Our proof relies on the operadic description of the category of chain coalgebras and of strongly homotopy coalgebra maps given in math.AT/0505559.Comment: 28 pages. This revised version incorporates operadic techniques developed in math.AT/050555

CoHochschild homology of chain coalgebras

Generalizing work of Doi and of Idrissi, we define a coHochschild homology theory for chain coalgebras over any commutative ring and prove its naturality with respect to morphisms of chain coalgebras up to strong homotopy. As a consequence we obtain that if the comultiplication of a chain coalgebra $C$ is itself a morphism of chain coalgebras up to strong homotopy, then the coHochschild complex \cohoch (C) admits a natural comultiplicative structure. In particular, if $K$ is a reduced simplicial set and $C_{*}K$ is its normalized chain complex, then \cohoch (C_{*}K) is naturally a homotopy-coassociative chain coalgebra. We provide a simple, explicit formula for the comultiplication on \cohoch (C_{*}K) when $K$ is a simplicial suspension. The coHochschild complex construction is topologically relevant. Given two simplicial maps $g,h:K\to L$, where $K$ and $L$ are reduced, the homology of the coHochschild complex of $C_{*}L$ with coefficients in $C_{*}K$ is isomorphic to the homology of the homotopy coincidence space of the geometric realizations of $g$ and $h$, and this isomorphism respects comultiplicative structure. In particular, there a isomorphism, respecting comultiplicative structure, from the homology of \cohoch(C_{*}K) to H_{*}\op L|K|, the homology of the free loops on the geometric realization of $K$.Comment: 30 pages; some minor structural changes, new explicit formulas for comultiplicative structure in the case of suspensions; final version, to appear in JPA

Concussion Competencies: A Framework for School-Based Concussion Management (flyer)

This volume grew out of many years of clinical practice, research, and program projects. It is the culmination of more than 50 years of work with kids, brains, and schools. While there is research behind the Competencies and the underlying content, the intent was to create a user-friendly manual that cut across levels of responsibility and care. Concussion Competencies was not intended to be a textbook in the traditional manner; however, the Competencies have been shown to be a useful approach to teaching this material. This volume is organized around a set of Competencies that have been shown to be useful to practitioners in the field. The 10 Compentencies fall into three main areas of information we have found to be important for effective work with students (and parents): SECTIONS 1. Biological aspects of concussion 2. Behavioral aspects of concussion 3. Programmatic considerations An important consideration is that not everyone who works with kids and concussions needs the same depth of training. With this in mind, chapters are broken by type of reader. AUDIENCE / CONSTITUENTS • Superintendents, Boards, and Administrators • Athletic Directors and Coaches • Licensed and Ancillary Health Care Providers • Teachers • Parents and Students The 10 Competencies address: • Biological Aspects of concussion management • Behavioral aspects of concussion • Programmatic considerations. This volume intends to: • Bridge the gaps between schools, community health care and families; • Focus on behavior and not medicine; • Assume that schools are a proper focus of activity, but does not assume all schools have equal resources; • Elevate the role of the student-patient and the family in the recovery process. The material is aimed at a broad range of interested parties: • School Superintendents, Boards, and Administrators • Athletic Directors and Coaches • Teachers • Licensed and Ancillary Health Care Providers • Parents and Students

Factors associated with retention in Option B+ in Malawi: a case control study.

IntroductionThere are limited data on factors associated with retention in Option B+. We sought to explore the characteristics of women retained in Option B+ in Malawi, with a focus on the role of HIV disclosure, awareness of partner HIV status, and knowledge around the importance of Option B+ for maternal-child health. Methods We performed a case-control study of HIV-infected women in Malawi initiated on antiretroviral therapy (ART) under Option B+. Cases were enrolled if they met criteria for default from Option B+ (out of ART for >60 days), and controls were enrolled in approximately 3:1 ratio if they were retained in care for at least 12 months. We surveyed socio-demographic characteristics, HIV disclosure and awareness of partner HIV status, self-report about receiving pre-ART education, and knowledge of Option B+. Univariate logistic regression was performed to determine factors associated with retention. Multivariate logistic regression model was used to evaluate the relationship between HIV disclosure, Option B+ knowledge, and retention after adjusting for age, schooling, and travel time to clinic.ResultsWe enrolled 50 cases and 153 controls. Median age was 30 years (interquartile range (IQR) 25-34), and the majority (82%) initiated ART during pregnancy at a median gestational age of 24 weeks (IQR 16-28). Ninety-one per cent of the cases (39/43) who started ART during pregnancy defaulted by three months postpartum. HIV disclosure to the primary sex partner was more common among women retained in care (100% versus 78%, p < 0.001). Odds of retention were significantly higher among women with: age >25 years (odds ratio (OR) 2.44), completion of primary school (OR 3.06), awareness of partner HIV status (OR 5.20), pre-ART education (OR 6.17), higher number of correct answers to Option B+ knowledge questions (OR 1.82), and support while taking ART (OR 3.65). Pre-ART education and knowledge were significantly correlated (r = 0.43, p < 0.001). In multivariate analysis, awareness of partner HIV status (OR 4.07, 95% confidence interval (CI) 1.51-10.94, p = 0.02) and Option B+ knowledge (OR 1.60, 95% CI 1.15-2.23, p = 0.004) remained associated with retention.ConclusionsInterventions that address partner disclosure and strengthen pre-ART education around the benefits of ART for maternal and child health should be evaluated to improve retention in Malawi's Option B+ programme

Concussion competencies: a training model for school-based concussion management

This study reports on the use of ten knowledge competencies related to the behavioral management of concussion in schools. Trainings using these competencies as learning objectives were delivered to school personnel. This aims of the use of competencies in this way are to streamline the education of key stakeholders, to establish clear roles and responsibilities for constituents and equip individuals working with students following a concussion with the relevant knowledge to optimize outcomes. The majority of participants, primarily speech language pathologists working as related service providers in the schoolswhere the trainings occurred, judged the use of the competencies to be informative and useful to their practice both immediately following the training and at a 5-month follow-up. The greatest gains in knowledge were noted by those participants self-reporting the least amount of knowledge pre-training. Participants also ranked the perceived value and relative importance of each of the ten competencies

Mitigating Ischemic Injury of Stem Cell-Derived Insulin-Producing Cells after Transplant.

The advent of large-scale in vitro differentiation of human stem cell-derived insulin-producing cells (SCIPC) has brought us closer to treating diabetes using stem cell technology. However, decades of experiences from islet transplantation show that ischemia-induced islet cell death after transplant severely limits the efficacy of the therapy. It is unclear to what extent human SCIPC are susceptible to ischemia. In this study, we show that more than half of SCIPC die shortly after transplantation. Nutrient deprivation and hypoxia acted synergistically to kill SCIPC in vitro. Amino acid supplementation rescued SCIPC from nutrient deprivation, likely by providing cellular energy. Generating SCIPC under physiological oxygen tension of 5% conferred hypoxia resistance without affecting their differentiation or function. A two-pronged strategy of physiological oxygen acclimatization during differentiation and amino acid supplementation during transplantation significantly improved SCIPC survival after transplant

The Effect of in-Service Methodology on Learning Transfer for School Personnel Managing Students following Concussion

Background: It is essential to increase the knowledge base of teachers involved in facilitating return to learning in middle school students following a concussion. However, the best method to enhance the transfer of learning for teachers remains to be elucidated. Application of Adult Learning Theory (ALT) is a plausible solution to this problem. Purpose: The purpose of this randomized post-test study was to examine the effects of ALTon the transfer of learning in teachers who work with individuals with concussion. Methods: A convenience sample of 169 teachers at four middle schools were randomized to receive an in-service regarding concussion management either in ALT or traditional lecture format. Vignettes approximating classroom practice evaluated learning transfer. Results: one-way between subjects ANOVA revealed no significant difference between the methods of educational delivery on group assessment scores (p¼.22). Additionally, a regression analysis did not identify any demographic variables that predicted learning transfer (p¼.65). A statistically significant difference existed for four questions (1, 4, 7, 25) between the groups (p¼.03, .02, .01, .00, respectively). These vignettes were those that assessed information that was likely novel to the learner. Discussion: The current study demonstrated that ALT applied to teacher in-service did not impact transfer of learning immediately post training compared to a traditional lecture format. Future research should continue to examine the effects of various educational strategies to enhance learning transfer for teachers managing students in the classroom after concussion