Sustaining Gains: Short Message Service (SMS)-Geographic Information Systems (GIS) Enabled Model for Diabetes Self-Care

Adherence to care and treatment of chronic conditions is a well-researched area. In the context of diabetes, many experts have identified self-care adherence as one of the major factors influencing patients’ health outcomes. Cases of non-adherence to self-care among diabetic patients have been well documented. The adverse effects of non-adherence are costly to both the patient and the healthcare industry. This proposed research attempts to mitigate the problem of non-adherence to care by incorporating mobile technology as a tool of support to promote care adherence. Specifically, the use of cellular phone Short Message Service (SMS) and Geographic Information System (GIS) technology to increase adherence to self-care amongst diabetes patients is investigated

\u3cem\u3eBataclanismo\u3c/em\u3e! Or, How Deco Bodies Transformed Postrevolutionary Mexico City

In the spring of 1925, Santa Anita\u27s Festival of Flowers seemed to follow its tranquil trend of previous years. The large displays of flowers, the selection of indias bonitas (as the contestants of beauty pageants organized in an attempt to stimulate indigenism were known) and the boat-rides on the Viga Canal, all communicated what residents of neighboring Mexico City had come to expect of the small pueblo in the Federal District since the Porfiriato: the respite of a peaceful pastoral, the link to a colorful past, and the promise that mexicanidad was alive and well in the campo. Unfortunately, wrote Manuel Rámirez Cárdenas of El Globo, the modern newspaper, the next day, this idyllic tradition was rudely interrupted by a group of audacious, scantily clad women. The culprits were actresses of Mexico City\u27s Lírico theater, who walked around Santa Anita\u27s streets in picaresque clothing —stage outfits that left little to the imagination, particularly in broad daylight—and upset visitors and campesinos alike. According to Cárdenas, abuelitas and mamás were shocked by the display, averting their eyes from the female spectacle in fear of el pecado mortal. Thankfully, for the mothers and grandmothers in the audience, the festival continued in predictable fashion after the initial uproar. Organizers continued with the traditional dances, and judges selected an india bonita from a pool of young, decente mestizo girls to represent the pueblo and the festival. Unbeknownst to the residents of rural Santa Anita, the daring actresses of El Lírico were part of a new phenomenon that had swept through Mexico City like wildfire, turned the entertainment world upside down, and pushed many to reconsider what constituted female beauty, decency, and lo mexicano. A few months earlier, on February 12th, a grand variety spectacle named Voilá Paris: La Ba-ta-clán premiered in Teatro Iris and instantly sent shock waves throughout the Mexican entertainment world and the larger metropolis. The show featured seminude and nude French actresses, who performed dances and acts that appeared to be a mix of classical ballet, Ziegfeld Follies chorus lines, and tableaux vivants. Within weeks, Mexican copycat productions capitalized on the enormous success of the show, triggering a new entertainment phenomenon named after the original production: Bataclanismo. It also launched a new kind of female star, the bataclana, who came to represent the erotic, and more dangerous, attributes of the flapper for Mexican audiences, and whose body became the site of contested and divergent notions of modernity. In this article, I explore bataclanismo as a normative discourse that reached far beyond the theater into the practice of everyday life. I do so to gauge the transition of changing ideals of femininity in Mexico from 1925 to 1935, and the influence these changes had on the development of urban space. Drawing on Elizabeth Grosz\u27 and Doreen Massey\u27s insights that place and gender are mutually constitutive, this article examines the articulation between the embodied city and changing gender norms in the wake of both the Mexican revolution and the advent of twentieth-century global capital. Analyzing these relationships from Judith Butler\u27s perspective of gender performance, especially as read through bodies, I argue that a new transnational aesthetic of feminine embodiment celebrated in bataclanismo influenced a distinct urban modernity and sociability in Mexico City. This new ideal female physique that stressed length, height, and androgyny—what I term a Deco body—helped to reconfigure Mexico City in terms of gender, space and race. It ushered in new gender ideals, helped visualize urban modernity, and bridged the gap between two divergent discourses that accompanied revolutionary reform, indigenismo and mestizaje, paving the way for a mestizo modernity

Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer

The risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individual patients are at greatest risk of poor post-operative liver performance remains a challenge. Here we report results from a multicentre observational clinical trial (ClinicalTrials.gov NCT03213314) which aimed to inform personalised pre-operative risk assessment in liver cancer surgery by evaluating liver health using quantitative multiparametric magnetic resonance imaging (MRI). We combined estimation of future liver remnant (FLR) volume with corrected T1 (cT1) of the liver parenchyma as a representation of liver health in 143 patients prior to treatment. Patients with an elevated preoperative liver cT1, indicative of fibroinflammation, had a longer post-operative hospital stay compared to those with a cT1 within the normal range (6.5 vs 5 days; p = 0.0053). A composite score combining FLR and cT1 predicted poor liver performance in the 5 days immediately following surgery (AUROC = 0.78). Furthermore, this composite score correlated with the regenerative performance of the liver in the 3 months following resection. This study highlights the utility of quantitative MRI for identifying patients at increased risk of poor post-operative liver performance and a longer stay in hospital. This approach has the potential to inform the assessment of individualised patient risk as part of the clinical decision-making process for liver cancer surgery

Back to BAC: The Use of Infectious Clone Technologies for Viral Mutagenesis

Bacterial artificial chromosome (BAC) vectors were first developed to facilitate the propagation and manipulation of large DNA fragments in molecular biology studies for uses such as genome sequencing projects and genetic disease models. To facilitate these studies, methodologies have been developed to introduce specific mutations that can be directly applied to the mutagenesis of infectious clones (icBAC) using BAC technologies. This has resulted in rapid identification of gene function and expression at unprecedented rates. Here we review the major developments in BAC mutagenesis in vitro. This review summarises the technologies used to construct and introduce mutations into herpesvirus icBAC. It also explores developing technologies likely to provide the next leap in understanding these important viruses

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

Illusion and well-being: A social psychological perspective on mental health.

Many prominent theorists have argued that accurate perceptions of the self, the world, and the future are essential for mental health. Yet considerable research evidence suggests that overly positive selfevaluations, exaggerated perceptions of control or mastery, and unrealistic optimism are characteristic of normal human thought. Moreover, these illusions appear to promote other criteria of mental health, including the ability to care about others, the ability to be happy or contented, and the ability to engage in productive and creative work. These strategies may succeed, in large part, because both the social world and cognitive-processing mechanisms impose niters on incoming information that distort it in a positive direction; negative information may be isolated and represented in as unthreatening a manner as possible. These positive illusions may be especially useful when an individual receives negative feedback or is otherwise threatened and may be especially adaptive under these circumstances. Decades of psychological wisdom have established contact with reality as a hallmark of mental health. In this view, the well-adjusted person is thought to engage in accurate reality testing, whereas the individual whose vision is clouded by illusion is regarded as vulnerable to, if not already a victim of, mental illness. Despite its plausibility, this viewpoint is increasingly difficult to maintain (cf. Lazarus, 1983). A substantial amount of research testifies to the prevalence of illusion in normal human cognition (see Fiske& Taylor, 1984; In this article, we review research suggesting that certain illusions may be adaptive for mental health and well-being. In particular, we examine evidence that a set of interrelated positive illusions-namely, unrealistically positive self-evaluations, exaggerated perceptions of control or mastery, and unrealistic optimism-can serve a wide variety of cognitive, affective, and social functions. We also attempt to resolve the following paraPreparation of this article was supported by National Science Foundation Grant BNS 83-08524, National Cancer Institute Grant CA 36409, and Research Scientist Development Award MH 00311 from the National Institute of Mental Health to Shelley E. Taylor. Jonathon D. Brown was supported by a University of California, Los Angeles, Chancellor's fellowship and by a Southern Methodist University new-faculty seed grant. We owe a great deal to a number of individuals who commented on earlier drafts: Nancy Cantor, Edward Emery, Susan Fiske, Tony Greenwald, Connie Hammen, Darrin Lehman, Chuck McClintock, Dick Nisbett, Lee Ross, Bill Swann, Joanne Wood, and two anonymous reviewers. Correspondence concerning this article should be addressed to Shelley E. Taylor, University of California, Department of Psychology, 405 Hilgard Avenue, Los Angeles, California 90024-1563. Our healthy individuals find it possible to accept themselves and their own nature without chagrin or complaint.. . . They can accept their own human nature with all of its discrepancies from the ideal image without feeling real concern. It would convey the wrong impression to say that they are self-satisfied. What we must rather say is that they can take the frailties and sins, weaknesses and evils of human nature in the same unquestioning spirit that one takes or accepts the characteristics of nature, (p. so that one is able to take in matters one wishes were different without distorting them to fit these wishes. (1953, p. 349) Since Jahoda's report, the position that the mentally healthy person perceives reality accurately has been put forth in major works by To summarize, then, although it is not the only theoretical perspective on the mentally healthy person, the view that psychological health depends on accurate perceptions of reality has been widely promulgated and widely shared in the literature on mental health. Social Cognition, Reality, and Illusion Early theorists in social cognition adopted a view of the person's information-processing capabilities that is quite similar to the viewpoint just described. These theorists maintained that the social perceiver monitors and interacts with the world like a naive scientist (see It rapidly became evident, however, that the social perceiver's actual inferential work and decision making looked little like these normative models. Rather, information processing is full of incomplete data gathering, shortcuts, errors, and biases (see At this point, we exchange the terms error and bias for a broader term, illusion. There are several reasons for this change in terminology. Error and bias imply short-term mistakes and distortions, respectively, that might be caused by careless oversight or other temporary negligences (cf. Funder, 1987). Illusion, in contrast, implies a more general, enduring pattern of error, bias, or both that assumes a particular direction or shape. As the evidence will show, the illusions to be considered (unrealistically positive self-evaluations, exaggerated perceptions of control, and unrealistic optimism) do indeed seem to be pervasive, enduring, and systematic. Illusion is denned as a perception that represents what is perceived in a way different from the way it is in reality. An illusion is a false mental image or conception which may be a misinterpretation of a real appearance or may be something imagined. It may be pleasing, harmless, or even useful (Stein, 1982, p. 662). The definition of an illusion as a belief that departs from reality presupposes an objective grasp of reality. This point puts us on the perilous brink of philosophical debate concerning whether one can ever know reality. Fortunately, at least to some degree, the methodologies of social psychology spare us this frustrating conundrum by providing operational definitions. In some cases, evidence for illusions comes from experimental work that manipulates feedback provided to a person (e.g., whether the person succeeded or failed on a task) and measures the individual's perceptions or recall of that feedback; this paradigm can provide estimates of an individual's accuracy as well as information about the direction (positive or negative) of any distortions. As will be seen, people typically distort such feedback in a self-serving manner. More subjective self-evaluations (e.g., how happy or well-adjusted one is) do not have these same objective standards of comparison. In such cases, an illusion is implied if the majority of people report that they are more (or less) likely than the majority of people to hold a particular belief. For example, if most people believe that they are happier, better adjusted, and more skilled on a variety of tasks than most other people, such perceptions provide evidence suggestive of an illusion. Illusions about the future are operationally difficult to establish because no one knows what the future will bring. If it can be shown, however, that most people believe that their future is more positive than that of most other people or more positive than objective baserate data can support, then evidence suggestive of illusions about the future is provided. We now turn to the evidence for these illusions. Positive Illusions and Social Cognition Any taxonomy of illusions is, to some extent, arbitrary. Many researchers have studied biases in the processing of self-relevant information and have given their similar phenomena different names. There is, however, considerable overlap in findings, and three that consistently emerge can be labeled unrealistically positive views of the self, exaggerated perceptions of personal control, and unrealistic optimism. Those familiar with the research evidence will recognize that much of the evidence for these positive illusions comes from experimental studies and from research with college students. We will have more to say about potential biases in the experimental literature later in this article. At present, it is important to note that all three of the ILLUSION AND WELL-BEING 195 illusions to be discussed have been documented in noncollege populations as well. Unrealistically Positive Views of the Self As indicated earlier, a traditional conception of mental health asserts that the well-adjusted individual possesses a view of the self that includes an awareness and acceptance of both the positive and negative aspects of self. In contrast to this portrayal, evidence indicates that most individuals possess a very positive view of the self (see Furthermore, the things that people are not proficient at are perceived as less important than the things that they are proficient at (e.g., In sum, far from being balanced between the positive and the negative, the perception of self that most individuals hold is heavily weighted toward the positive end of the scale. Of course, this imbalance does not in and of itself provide evidence that such views are unrealistic or illusory. Evidence of this nature is, however, available. First, there exists a pervasive tendency to see the self as better than others. Individuals judge positive personality attributes to be more descriptive of themselves than of the average person but see negative personality attributes as less descriptive of themselves than of the average person People also tend to use their positive qualities when appraising others, thereby virtually assuring a favorable self-other comparison Although the tendency to see the self as better than others is attenuated somewhat when the others being evaluated are close friends or relatives A second source of evidence pertaining to the illusory quality of positive self-perceptions comes from investigations in which self-ratings have been compared with judgments made by observers. In sum, the perception of self that most individuals hold is not as well-balanced as traditional models of mental health suggest. Rather than being attentive to both the favorable and unfavorable aspects of self, normal individuals appear to be very cognizant of their strengths and assets and considerably less aware of their weaknesses and faults. Evidence that these flattering self-portrayals are illusory comes from studies in which researchers have found that (a) most individuals see themselves as better than the average person and (b) most individuals se