Stigma as a fundamental hindrance to the United States opioid overdose crisis response.

Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis

Creating a Culture of Voting in Direct and Generalist Practice: Training Field Instructors

Social workers have an ethical responsibility to be engaged in policy change, regardless of their practice area or specialization. Voter engagement and the importance of political power through voting is often overlooked in the literature as a valid and important component of social work practice. Creating a culture of nonpartisan voter engagement in practice settings can help empower individuals who have been historically and intentionally disenfranchised from our electoral system. Training for field instructors, faculty, and field staff is a key aspect of voter engagement in social work education. Unfortunately, social work education is unlikely to include substantive content on voter engagement or its connection to social work practice and impact. This article presents one component of a model for integrating voter engagement into social work education: the provision of training for field instructors on nonpartisan voter engagement at two universities over two years. Evaluation findings suggest that pre-existing levels of political efficacy affect the reaction of field instructors to nonpartisan voter engagement training. Furthermore, findings indicate that field instructors who receive voter engagement training are more likely to serve as resources for their students and to consider voter engagement as part of their own practice. We offer evidence on the important role field educators can play in the success of the larger national effort to integrate voter engagement in social work education. Increasing awareness of what social workers, nonprofit, and public agencies are allowed--or even required--to do is a critical first step

Drip Paintings and Fractal Analysis

It has been claimed [1-6] that fractal analysis can be applied to unambiguously characterize works of art such as the drip paintings of Jackson Pollock. This academic issue has become of more general interest following the recent discovery of a cache of disputed Pollock paintings. We definitively demonstrate here, by analyzing paintings by Pollock and others, that fractal criteria provide no information about artistic authenticity. This work has also led to two new results in fractal analysis of more general scientific significance. First, the composite of two fractals is not generally scale invariant and exhibits complex multifractal scaling in the small distance asymptotic limit. Second the statistics of box-counting and related staircases provide a new way to characterize geometry and distinguish fractals from Euclidean objects

Viral Networks: Connecting Digital Humanities and Medical History

This volume of original essays explores the power of network thinking and analysis for humanities research. Contributing authors are all scholars whose research focuses on a medical history topic—from the Black Death in fourteenth-century Provence to psychiatric hospitals in twentieth-century Alabama. The chapters take readers through a variety of situations in which scholars must determine if network analysis is right for their research; and, if the answer is yes, what the possibilities are for implementation. Along the way, readers will find practical tips on identifying an appropriate network to analyze, finding the best way to apply network analysis, and choosing the right tools for data visualization. All the chapters in this volume grew out of the 2018 Viral Networks workshop, hosted by the History of Medicine Division of the National Library of Medicine (NIH), funded by the Office of Digital Humanities of the National Endowment for the Humanities, and organized by Virginia Tech

A Test of the Standard Hypothesis for the Origin of the HI Holes in Holmberg II

The nearby irregular galaxy Holmberg II has been extensively mapped in HI using the Very Large Array (VLA), revealing intricate structure in its interstellar gas component (Puche et al. 1992). An analysis of these structures shows the neutral gas to contain a number of expanding HI holes. The formation of the HI holes has been attributed to multiple supernova events occurring within wind-blown shells around young, massive star clusters, with as many as 10-200 supernovae required to produce many of the holes. From the sizes and expansion velocities of the holes, Puche et al. assigned ages of ~10^7 to 10^8 years. If the supernova scenario for the formation of the HI holes is correct, it implies the existence of star clusters with a substantial population of late-B, A and F main sequence stars at the centers of the holes. Many of these clusters should be detectable in deep ground-based CCD images of the galaxy. In order to test the supernova hypothesis for the formation of the HI holes, we have obtained and analyzed deep broad-band BVR and narrow-band H-alpha images of Ho II. We compare the optical and HI data and search for evidence of the expected star clusters in and around the HI holes. We also use the HI data to constrain models of the expected remnant stellar population. We show that in several of the holes the observed upper limits for the remnant cluster brightness are strongly inconsistent with the SNe hypothesis described in Puche et al. Moreover, many of the HI holes are located in regions of very low optical surface brightness which show no indication of recent star formation. Here we present our findings and explore possible alternative explanations for the existence of the HI holes in Ho II, including the suggestion that some of the holes were produced by Gamma-ray burst events.Comment: 30 pages, including 6 tables and 3 images. To appear in Astron. Journal (June 1999

Extracorporeal Membrane Oxygenation for COVID-19-Associated Multisystem Inflammatory Syndrome in a 5-year-old

Severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) is associated with multisystem inflammatory syndrome in children (MIS-C) that ranges from mild symptoms to cardiopulmonary collapse. A 5-year-old girl presented with shock and a rapid decline in left ventricular function requiring intubation. SARS-CoV-2 was diagnosed by viral Polymerase Chain Reaction (PCR), and she received remdesivir and COVID-19 convalescent plasma. Initial echocardiogram (ECHO) demonstrated low normal left ventricular function and mild left anterior descending coronary artery dilation. She remained hypotensive, despite high-dose epinephrine and norepinephrine infusions as well as stress-dose hydrocortisone. Admission SARS-CoV-2 IgG assay was positive, meeting the criteria for MIS-C. An ECHO 9 hours after admission demonstrated a severe decline in left ventricular function. Due to severe cardiogenic shock, she was cannulated for venoarterial extracorporeal support (ECMO). During her ECMO course, she was treated with remdesivir, intravenous methylprednisolone, intravenous immunoglobulin, and anakinra. She was decannulated on ECMO day 7, extubated the following day, and discharged home 2 weeks later without respiratory or cardiac support. The use of ECMO for cardiopulmonary support for pediatric patients with MIS-C is feasible and should be considered early as part of the treatment algorithm for patients with severe cardiopulmonary dysfunction

A Synthetic Agonist to Vasoactive Intestinal Peptide Receptor-2 Induces Regulatory T Cell Neuroprotective Activities in Models of Parkinson\u27s Disease

A paradigm shift has emerged in Parkinson\u27s disease (PD) highlighting the prominent role of CD4+ Tregs in pathogenesis and treatment. Bench to bedside research, conducted by others and our own laboratories, advanced a neuroprotective role for Tregs making pharmacologic transformation of immediate need. Herein, a vasoactive intestinal peptide receptor-2 (VIPR2) peptide agonist, LBT-3627, was developed as a neuroprotectant for PD-associated dopaminergic neurodegeneration. Employing both 6-hydroxydopamine (6-OHDA) and α-synuclein (α-Syn) overexpression models in rats, the sequential administration of LBT-3627 increased Treg activity without altering cell numbers both in naïve animals and during progressive nigrostriatal degeneration. LBT-3627 administration was linked to reductions of inflammatory microglia, increased survival of dopaminergic neurons, and improved striatal densities. While α-Syn overexpression resulted in reduced Treg activity, LBT-3627 rescued these functional deficits. This occurred in a dose-dependent manner closely mimicking neuroprotection. Taken together, these data provide the basis for the use of VIPR2 agonists as potent therapeutic immune modulating agents to restore Treg activity, attenuate neuroinflammation, and interdict dopaminergic neurodegeneration in PD. The data underscore an important role of immunity in PD pathogenesis

Dynamic Anchoring of PKA Is Essential during Oocyte Maturation

SummaryIn the final stages of ovarian follicular development, the mouse oocyte remains arrested in the first meiotic prophase, and cAMP-stimulated PKA plays an essential role in this arrest. After the LH surge, a decrease in cAMP and PKA activity in the oocyte initiates an irreversible maturation process that culminates in a second arrest at metaphase II prior to fertilization [1]. A-kinase anchoring proteins (AKAPs) mediate the intracellular localization of PKA and control the specificity and kinetics of substrate phosphorylation [2]. Several AKAPs have been identified in oocytes including one at 140 kDa [3, 4] that we now identify as a product of the Akap1 gene. We show that PKA interaction with AKAPs is essential for two sequential steps in the maturation process: the initial maintenance of meiotic arrest and the subsequent irreversible progression to the polar body extruded stage. A peptide inhibitor (HT31) that disrupts AKAP/PKA interactions stimulates oocyte maturation in the continued presence of high cAMP. However, during the early minutes of maturation, type II PKA moves from cytoplasmic sites to the mitochondria, where it associates with AKAP1, and this is shown to be essential for maturation to continue irreversibly

Planet Hunters VII. Discovery of a New Low-Mass, Low-Density Planet (PH3 c) Orbiting Kepler-289 with Mass Measurements of Two Additional Planets (PH3 b and d)

We report the discovery of one newly confirmed planet ($P=66.06$ days, $R_{\rm{P}}=2.68\pm0.17R_\oplus$) and mass determinations of two previously validated Kepler planets, Kepler-289 b ($P=34.55$ days, $R_{\rm{P}}=2.15\pm0.10R_\oplus$) and Kepler-289-c ($P=125.85$ days, $R_{\rm{P}}=11.59\pm0.10R_\oplus$), through their transit timing variations (TTVs). We also exclude the possibility that these three planets reside in a $1:2:4$ Laplace resonance. The outer planet has very deep ($\sim1.3$), high signal-to-noise transits, which puts extremely tight constraints on its host star's stellar properties via Kepler's Third Law. The star PH3 is a young ($\sim1$ Gyr as determined by isochrones and gyrochronology), Sun-like star with $M_*=1.08\pm0.02M_\odot$, $R_*=1.00\pm0.02R_\odot$, and $T_{\rm{eff}}=5990\pm38$ K. The middle planet's large TTV amplitude ($\sim5$ hours) resulted either in non-detections or inaccurate detections in previous searches. A strong chopping signal, a shorter period sinusoid in the TTVs, allows us to break the mass-eccentricity degeneracy and uniquely determine the masses of the inner, middle, and outer planets to be $M=7.3\pm6.8M_\oplus$, $4.0\pm0.9M_\oplus$, and $M=132\pm17M_\oplus$, which we designate PH3 b, c, and d, respectively. Furthermore, the middle planet, PH3 c, has a relatively low density, $\rho=1.2\pm0.3$ g/cm$^3$ for a planet of its mass, requiring a substantial H/He atmosphere of $2.1^{+0.8}_{-0.3}$ by mass, and joins a growing population of low-mass, low-density planets.Comment: 21 pages, 10 figures, 5 tables, accepted into Ap