Accidental Ghosts

Accidental Ghosts is a collection of narrative lyrics that examine the cyclical and often paradoxical relationships between children, parents, and grandparents. Many of the poems bear witness to parents as caretakers, to the mirrored identities among relatives, and to preserving a family's historical memory. In order to take claim of family stories, Accidental Ghosts also persists in defying what goes unsaid between generations

Email from Aaron Katzel Regarding Revised Project Green Talking Points

Email (8/31/2008 11:49 am)From: Aaron Katzel To: Alan Pryor, Elias Habayeb, Jeff Swiatek, Jens Berding, Anastasia Kelly, Patricia Skigen, H. Rodgin Cohen, Michael Wiseman, Robert Risoleo, Sanoke Viswanathan, Anthony Santomero, Liou Cao re: Revised Project Green talking points Attaching 20080829 Primary dealer - talking point

Relación entre los patrones antropométricos del recién nacido y su erupción dental decidua, Hospital EsSalud Marino Molina - 2016

Determina la relación entre los patrones antropométricos del recién nacido y su erupción dental decidua en infantes que acuden al servicio de crecimiento y desarrollo del Hospital EsSalud Marino Molina en el 2016. Utiliza los estándares internacionales del recién nacido con base en el proyecto INTERGROWTH-21st para la valoración del patrón antropométrico y la tabla de cronología de la dentición humana (Logan y Kronfeld ligeramente modificada por McCall y Schour) para la valoración de la erupción dental. El diseño de la investigación es descriptiva, observacional y transversal. La muestra está constituida por 233 infantes que acudieron al servicio de crecimiento y desarrollo. La calibración se realizó con una experta en Odontología Pediátrica (valor de Kappa de 0,866). Se evalúan 233 pacientes durante los meses de octubre y noviembre del 2016. Utiliza la pruebas de chi cuadrado, pruebas no paramétricas U de Mann-Whitney. Encuentra asociación estadísticamente significativa entre la erupción dental y los patrones antropométricos del recién nacido, se hallaron medias de erupción para los grupos de gran peso al nacer: 9,13 erupciones y para los de longitud alta al nacer: 6,67 erupciones. Se encuentran también distribuciones similares de retraso y adelanto en la erupción dental: 7,9% y 10,5%; 10,3% y 11,6% respectivamente en los diferentes grupos y por último el 33,3% de los infantes prematuros presentan retraso en la erupción, ninguno presenta adelanto.Tesi

Response to exercise rehabilitation in smoking and nonsmoking patients with intermittent claudication

AbstractBackgroundThe purpose was to compare the changes in claudication pain, ambulatory function, daily physical activity, peripheral circulation, and health-related quality of life following a program of exercise rehabilitation in smoking and nonsmoking patients with peripheral arterial disease (PAD) limited by intermittent claudication.Methods and resultsThirty-nine smokers (63 ± 4 pack-year smoking history; mean ± SE) and 46 nonsmokers (former smokers who had a 51 ± 7 pack-year smoking history who quit 14 ± 2 years prior to investigation) completed the study. The 6-month exercise rehabilitation program consisted of intermittent treadmill walking to near maximal claudication pain 3 days per week, with progressive increases in walking duration and intensity during the program. Measurements were obtained on each patient before and after rehabilitation. Following exercise rehabilitation the smokers and nonsmokers had similar improvements in these measures, as initial claudication distance increased by 119% in the smokers (P < .001) and by 97% in the nonsmokers (P < .001), and absolute claudication distance increased by 82% (P < .001) and 59% (P < .001) in the smokers and nonsmokers, respectively. Furthermore, exercise rehabilitation improved (P < .05) ambulatory function, daily physical activity, peripheral circulation, and health-related quality of life in the smokers and nonsmokers.ConclusionExercise rehabilitation is an effective therapy to improve functional independence in both smoking and nonsmoking patients with PAD limited by intermittent claudication. Therefore, smokers with intermittent claudication are prime candidates for exercise rehabilitation because their relatively low baseline physical function does not impair their ability to regain lost functional independence to levels similar to nonsmoking patients with PAD

Association between Physical Activity and Mortality in Patients with Claudication

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Treadmill exercise activates subcortical neural networks and improves walking after a stroke

BACKGROUND AND PURPOSE: Stroke often impairs gait thereby reducing mobility and fitness and promoting chronic disability. Gait is a complex sensorimotor function controlled by integrated cortical, subcortical, and spinal networks. The mechanisms of gait recovery after stroke are not well understood. This study examines the hypothesis that progressive task-repetitive treadmill exercise (T-EX) improves fitness and gait function in subjects with chronic hemiparetic stroke by inducing adaptations in the brain (plasticity).METHODS: A randomized controlled trial determined the effects of 6-month T-EX (n=37) versus comparable duration stretching (CON, n=34) on walking, aerobic fitness and in a subset (n=15/17) on brain activation measured by functional MRI.RESULTS: T-EX significantly improved treadmill-walking velocity by 51% and cardiovascular fitness by 18% (11% and -3% for CON, respectively; P&lt;0.05). T-EX but not CON affected brain activation during paretic, but not during nonparetic limb movement, showing 72% increased activation in posterior cerebellar lobe and 18% in midbrain (P&lt;0.005). Exercise-mediated improvements in walking velocity correlated with increased activation in cerebellum and midbrain.CONCLUSIONS: T-EX improves walking, fitness and recruits cerebellum-midbrain circuits, likely reflecting neural network plasticity. This neural recruitment is associated with better walking. These findings demonstrate the effectiveness of T-EX rehabilitation in promoting gait recovery of stroke survivors with long-term mobility impairment and provide evidence of neuroplastic mechanisms that could lead to further refinements in these paradigms to improve functional outcomes

Oral leukoplakia and risk of progression to oral cancer: A population-based cohort study

BACKGROUND: The optimal clinical management of oral precancer remains uncertain. We investigated the natural history of oral leukoplakia, the most common oral precancerous lesion, to estimate the relative and absolute risks of progression to cancer, the predictive accuracy of a clinician\u27s decision to biopsy a leukoplakia vis-à-vis progression, and histopathologic predictors of progression. METHODS: We conducted a retrospective cohort study (1996-2012) of patients with oral leukoplakia (n = 4886), identified using electronic medical records within Kaiser Permanente Northern California. Among patients with leukoplakia who received a biopsy (n = 1888), we conducted a case-cohort study to investigate histopathologic predictors of progression. Analyses included indirect standardization and unweighted or weighted Cox regression. RESULTS: Compared with the overall Kaiser Permanente Northern California population, oral cancer incidence was substantially elevated in oral leukoplakia patients (standardized incidence ratio = 40.8, 95% confidence interval [CI] = 34.8 to 47.6; n = 161 cancers over 22 582 person-years). Biopsied leukoplakias had a higher oral cancer risk compared with those that were not biopsied (adjusted hazard ratio = 2.38, 95% CI = 1.73 to 3.28). However, to identify a prevalent or incident oral cancer, the biopsy decision had low sensitivity (59.6%), low specificity (62.1%), and moderate positive-predictive value (5.1%). Risk of progression to oral cancer statistically significantly increased with the grade of dysplasia; 5-year competing risk-adjusted absolute risks were: leukoplakia overall = 3.3%, 95% CI = 2.7% to 3.9%; no dysplasia = 2.2%, 95% CI = 1.5% to 3.1%; mild-dysplasia = 11.9%, 95% CI = 7.1% to 18.1%; moderate-dysplasia = 8.7%, 95% CI = 3.2% to 17.9%; and severe dysplasia = 32.2%, 95% CI = 8.1%-60.0%. Yet 39.6% of cancers arose from biopsied leukoplakias without dysplasia. CONCLUSIONS: The modest accuracy of the decision to biopsy a leukoplakia vis-à-vis presence or eventual development of oral cancer highlights the need for routine biopsy of all leukoplakias regardless of visual or clinical impression. Leukoplakia patients, particularly those with dysplasia, need to be closely monitored for signs of early cancer

Patient-Reported Outcomes Integrated Within an Electronic Medical Record in Patients With Head and Neck Cancer

PURPOSE: Patient-reported outcome (PRO) tools lead to clinical benefits, including improved overall survival for patients with cancer. However, routine implementation of PROs in clinical practice within the electronic medical record (EMR) by integrated health care delivery systems remains limited. We studied the use of a PRO tool for patients with head and neck cancer (HNC) integrated in an EMR at Kaiser Permanente in Northern California. METHODS: Between August 2017 and December 2019, patients with newly diagnosed HNC were surveyed at baseline, then every 3 months using the Functional Assessment of Cancer Therapy-General 7 and Functional Assessment of Cancer Therapy-Head and Neck (version 4). A medical assistant performed a baseline survey on diagnosis and then notified patients electronically per surveillance protocol. Patients who did not respond to online PRO surveys could complete them via telephone or in-person appointments with medical assistants. Abnormal findings on PRO surveys were referred to appropriate members of the care team or the treating Otolaryngology-Head and Neck Surgery physicians. RESULTS: Two hundred ninety patients received baseline surveys. Patients received up to a maximum of eight subsequent surveys. Of a total of 597 electronic surveys, 585 (97.9%) were completed. The percentage of patients completing each interval survey ranged from 92% to 100%. Multivariate Poisson regression analysis showed patients with English as their primary language and an online secure account were the most likely to complete surveys compared with those patients with non-English as a primary language and without an online account. CONCLUSION: PRO tools can be effectively used within the EMR for patients with HNC with a high response rate provided there is strong engagement from a dedicated member of the care team. This has important implications for designing clinical trials and symptom monitoring in clinical practices that incorporate EMRs

Optogenetics: Molecular and Optical Tools for Controlling Life with Light

Optogenetic tools are genetically-encoded reagents that, when targeted to specific brain cells, enable their activity to be controlled by light. These tools are having broad impact on science, and may serve clinical roles as well. 150-word Biography: Ed Boyden is Associate Professor of Biological Engineering and Brain and Cognitive Sciences, at the MIT Media Lab and the MIT McGovern Institute. He leads the Synthetic Neurobiology Group, which develops tools for analyzing and engineering the circuits of the brain. These technologies, created often in interdisciplinary collaborations, include 'optogenetic' tools, which enable the activation and silencing of neural circuit elements with light, 3-D microfabricated neural interfaces, and robotic methods for performing single-cell analyses in living brain. He has received the NIH Director's New Innovator Award, the Society for Neuroscience Research Award for Innovation in Neuroscience, the Paul Allen Distinguished Investigator Award, the Perl/UNC prize, the A. F. Harvey Prize, the Grete Lundbeck “Brain” Prize, amongst other recognitions. He has contributed to over 300 peer-reviewed papers, current or pending patents, and articles, and has given over 200 invited talks on his work