Building a Recovery Ecosystem for the Catawba Region

The opioid and addiction crisis has become a defining characteristic of 21st century America, profoundly affecting the Commonwealth of Virginia in terms of lives lost, families devastated, communities compromised, and economic and opportunity costs at multiple levels. This scenario originated with a rapid increase in opioid prescriptions issued to patients by health care providers for various pain diagnoses during the 1990s and into the early 2000s. Despite early warnings that the new opioid formulations were far more addictive than indicated by faulty research trials and marketing claims, treating pain as the “fifth vital sign” became a widespread practice as a rationale for prescribing opioids for a broader array of health conditions. As federal and state policies sought to curtail the increasingly deadly flow of prescription opioids, some people suffering from opioid addiction turned to heroin as a substitute, resulting in additional waves of overdose deaths in the early 2010s and persisting into the current decade. Even as state government agencies and local grassroots organizations have implemented prevention and harm reduction approaches and policies over the past twenty years, the proliferation of illicit and powerful synthetic opioids, including fentanyl and carfentanil, has resulted in increased opioid and other substance use disorder (SUD) acuity, as well as persistently high overdose rates. In response to this ongoing challenge, state legislative and administrative leadership are increasingly making and supporting proposals to transform our healthcare systems and communities into recovery-oriented ecosystems. These ecosystems can support everyone from individuals in acute crisis from SUD, to those thriving in long-term recovery. For example, a key bi-partisan effort from the 2023 Virginia General Assembly Session is a pilot project to transform Catawba Hospital into a treatment center for both acute mental illness and SUDs. The transformation would utilize excess capacity at Catawba Hospital to provide SUD residential treatment and detoxification beds, along with onsite, step-down services to provide a much-needed bridge as individuals return to their home communities. As a first step, the General Assembly is providing $500,000 in funding for the Virginia Department of Behavioral Health and Developmental Services to explore public-private partnerships that can bring SUD services to Catawba. In the years to come, the project will need additional support for capital needs, workforce development, and shoring up the recovery ecosystem. This article explores the policy and sociological frameworks that have brought Virginia’s political and health and human service leadership to this point of innovation and change. Current shifts in policy and program approaches align with a healthcare movement to treat SUD as a chronic disease, following a long history of SUD being treated as a criminal offense and a moral issue. The time is right for immediate and ongoing commitment to innovative approaches to address the unprecedented crises of mental health and SUD among our fellow Virginians

IU Libraries Discovery Layer Task Force Summary Report and Recommendation

The IU Libraries OLE Discovery Layer Task Force reviewed the candidate applications (Blacklight and VuFind) for a new public interface for IUCAT, in terms of how each best supports discovery for the IU Libraries. The Task Force created a rubric of core functionality required by all campuses in a catalog user interface, organized into several broad areas. Criteria have been designated as required, highly desirable, or desirable, and each product has been reviewed and rated according to the rubric (attached as an appendix). This report was prepared for the IU Council of Head Librarians

Chancellor\u27s Citations for Extraordinary Campus Leadership and Service (2014)

The Chancellor’s Citations for Extraordinary Campus Leadership and Service recognize graduating students who are extraordinary campus leaders for their significant service to others

Supply Chain Based Solution to Prevent Fuel Tax Evasion: Proof of Concept Final Report

The goal of this research was to provide a proof-of-concept (POC) system for preventing non-taxable (non-highway diesel use) or low-taxable (jet fuel) petrochemical products from being blended with taxable fuel products and preventing taxable fuel products from cross-jurisdiction evasion. The research worked to fill the need to validate the legitimacy of individual loads, offloads, and movements by integrating and validating, on a near-real-time basis, information from global positioning system (GPS), valve sensors, level sensors, and fuel-marker sensors

Supply Chain Based Solution to Prevent Fuel Tax Evasion: Proof of Concept Final Report

The goal of this research was to provide a proof-of-concept (POC) system for preventing non-taxable (non-highway diesel use) or low-taxable (jet fuel) petrochemical products from being blended with taxable fuel products and preventing taxable fuel products from cross-jurisdiction evasion. The research worked to fill the need to validate the legitimacy of individual loads, offloads, and movements by integrating and validating, on a near-real-time basis, information from global positioning system (GPS), valve sensors, level sensors, and fuel-marker sensors

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Immunological Sex Differences in Socially Promiscuous African Ground Squirrels

Differences in how males and females respond to foreign antigens are common across taxa. Such sexual differences in the immune system are predicted to be greater in species with high promiscuity and sociality as these factors increase the likelihood of disease transmission. Intense sperm competition is thought to further this sexual dichotomy as increased investment in spermatogenesis likely incurs additional immunological costs. Xerus inauris, a ground squirrel found throughout southern Africa, is extremely social and promiscuous with one of the highest male reproductive investments among rodents. These life-history attributes suggest males and females should demonstrate a large dichotomy in immunity. Contrary to our prediction, we found no difference in spleen mass between the sexes. However, we did find significant biases in leukocyte types and red blood cell counts, possibly reflecting responses to parasite types. Among males, we predicted greater investments in spermatogenesis would result in reduced immunological investments. We found a negative association between testes and spleen size and a positive relationship between testes and number of lice suggesting trade-offs in reproductive investment possibly due to the costs associated with spermatogenesis and immunity. We suggest when measuring sexual differences in immunity it is important to consider the effects of reproductive pressures, parasite types, and life history costs

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment