LEARNED BEHAVIOR: RACE, RELIGION, ETHNICITY AND THE EVOLUTION OF EDUCATION IN 19TH CENTURY BALTIMORE, MARYLAND, 1825 - 1872

This thesis examines the complex relationship between religion and racial/ethnic identity through the perspective of the evolving systems of public and private education in 19th century Baltimore. In doing so, this thesis argues that public education was constructed as a means of shaping a unified American identity, and that this purpose was understood by all relevant stakeholders. These stakeholders, regardless or their religious, racial or ethnic affiliation all fought to shape the public schools into something that validated their affiliations and included them in the definition of American citizenship

The Effects of Cooling During Gait on Gait Endurance in Persons with Multiple Sclerosis Using the Six Minute Walk Test

Background: Persons with MS (pwMS) are limited in their mobility due to thermosensitivity. Exercising at a sufficient volume and intensity to increase mobility can result in increased core temperatures and resultant worsening of symptoms. The use of cooling garments to lower core temperature has been found to be a successful means of allowing pwMS to exercise for longer periods. Previous studies have relied on precooling for an extended period of time prior to activity, to achieve improved exercise performance. Cooling during the performance itself, or pericooling, may allow for similar performance gains to be realized without spending the time needed for precooling. Objectives: The purpose of this study is to examine the effects of pericooling on the Six Minute Walk Test (6MWT) performance in pwMS. It was hypothesized that pwMS would have better 6MWT performance while wearing a cooling vest then compared to a noncooled condition. If our hypothesis were correct, it would suggest that pwMS could achieve improved exercise performance without engaging in precooling activities. Methods: A randomized crossover design was used. Patients were randomized into cooled or uncooled conditions. Cooled subjects would perform a 6MWT, donning a commercially available cooling vest immediately prior to the walk. Walks would be performed once a week for three weeks. Total 6MWT distance and minute-by-minute distance was recorded. Fatigue during the walk was measured using the Visual Analog Scale of Fatigue. Uncooled subjects would perform the identical protocol without a cooling device. Following the three walks in one condition, subjects would undergo a two-week washout period and then repeat the same protocol in whatever condition they did not experience initially. Results: Six females with mild MS (EDSS 2.67) completed the study. Pericooling resulted in walking significantly, (F (1,17) = 4.63, p = .046, partial η2 = .214) farther in the cooled condition (1257’) than in the uncooled condition (1154’). There was no significant difference in VAFS scores between the 2 conditions. Conclusions: Pericooling, delivered via a commercially available cooling vest resulted in better 6MWT scores than an uncooled condition in pwMS. As most studies of cooling in MS utilize cooling prior to an activity, these results indicate an alternative and less time consuming means of achieving the beneficial effects of cooling

The Lantern Vol. 72, No. 1, Fall 2004

• Jazz • Bifocal Brainfreeze • A Mug of Tea • Autumn Blend • Montana Skies • Madeleine Parenthesis • Ghosts Come Out at Night • Time • 144 Cromwell Road • Market East • Secret • Stream • What Might Have Been or What Never Was • Buried Mirth • Conversations With a Writer • Churning Through • Chum-Salmon Intentions • Cages • Lola Sang of Green Glass Landscapes • Peg\u27s Antiques • Life at 120 Decibelshttps://digitalcommons.ursinus.edu/lantern/1165/thumbnail.jp

Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma and the Orthopedic Trauma Association

OBJECTIVES: Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established. METHODS: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations. RESULTS: A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use. CONCLUSIONS: In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks

Lower NPAS3 expression during the later stages of abnormal lung development in rat congenital diaphragmatic hernia

Purpose Congenital diaphragmatic hernia (CDH) is characterized by a developmental defect in the diaphragm, pulmonary hypoplasia and pulmonary hypertension. NPAS3 is a PAS domain transcription factor regulating Drosophila tracheogenesis. NPAS3 null mice develop pulmonary hypoplasia in utero and die after birth due to respiratory failure. We aimed to evaluate NPAS3 expres- sion during normal and abnormal lung development due to CDH. Methods CDH was induced by administering 100 mg/ml nitrofen to time-pregnant dams on embryonic day (E) 9 of gestation. Lungs were isolated on E15, E18 and E21 and NPAS3 localization was determined by immunohisto- chemistry and quantified using Western blotting. Results We found that only E21 hypoplastic CDH lungs have reduced expression of NPAS3 in the terminal sac- cules. Western blotting confirmed the down-regulation of NPAS3 protein in the nitrofen-induced hypoplastic lungs. Conclusions We demonstrate for the first time that ni- trofen-induced hypoplastic CDH lungs have reduced NPAS3 expression in the terminal saccules during the later stages of abnormal lung development. Our findings suggest that NPAS3 is associated with pulmonary hypoplasia in CDH.Supported by the Children’s Hospital Research Institute of Manitoba; RK is the recipient of a Career Enhancement Award from the Canadian Child Health Clinician Scientist Program and a New Investigator Salary Award from the Canadian Institutes of Health Research, Manitoba Lung Association and the Children’s Hospital Research Institute

Evidence of Remediation-Induced Alteration of Subsurface Poly- and Perfluoroalkyl Substance (PFAS) Distribution at a Former Firefighter Training Area

Poly- and perfluoroalkyl substances (PFASs) are a class of fluorinated chemicals that are utilized in firefighting and have been reported in groundwater and soil at several firefighter training areas. In this study, soil and groundwater samples were collected from across a former firefighter training area to examine the extent to which remedial activities have altered the composition and spatial distribution of PFASs in the subsurface. Log K[subscript oc] values for perfluoroalkyl acids (PFAAs), estimated from analysis of paired samples of groundwater and aquifer solids, indicated that solid/water partitioning was not entirely consistent with predictions based on laboratory studies. Differential PFAA transport was not strongly evident in the subsurface, likely due to remediation-induced conditions. When compared to the surface soil spatial distributions, the relative concentrations of perfluorooctane sulfonate (PFOS) and PFAA precursors in groundwater strongly suggest that remedial activities altered the subsurface PFAS distribution, presumably through significant pumping of groundwater and transformation of precursors to PFAAs. Additional evidence for transformation of PFAA precursors during remediation included elevated ratios of perfluorohexane sulfonate (PFHxS) to PFOS in groundwater near oxygen sparging wells

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Differences in adolescents' physical activity from school-travel between urban and suburban neighbourhoods in Metro Vancouver, Canada

Objective: To investigate differences in moderate-to-vigorous physical activity (MVPA) from school-travel between adolescents in urban and suburban neighbourhoods and to describe its relative contribution to MVPA on school days. Methods: We measured 243 adolescents (51% male, grades 8–10) from Vancouver's walkable downtown core and its largely car-dependent suburb Surrey (fall 2011, 2013). We estimated mean school-travel MVPA from accelerometry (hour before/after school on ≥2 days; n = 110, 39% male) and compared school-travel MVPA by neighbourhood type and school-travel mode. The influence of mean school-travel MVPA on mean school-day MVPA (≥600 min valid wear time on ≥2 days) was examined by linear regression. Results: Over half of students used active modes (urban: 63%, suburban: 53%). Those using active travel and living in the urban neighbourhood obtained the most school-travel MVPA (22.3 ± 8.0 min). Urban passive travellers used public transit and obtained more school-travel MVPA than suburban students (16.9 ± 6.2 vs. 8.0 ± 5.3, p <0.001), who were primarily driven. Regardless of mode or neighbourhood type, over one-third of school-day MVPA was explained by school-travel MVPA (R2 = 0.38, p <0.001). Conclusion: Urban dwelling may facilitate greater school-travel MVPA in adolescents. School-travel MVPA is an important contributor to adolescents' school-day MVPA. Where feasible, physically active options for school-travel should be promoted, including public transit

Evidence of Remediation-Induced Alteration of Subsurface Poly- and Perfluoroalkyl Substance Distribution at a Former Firefighter Training Area

Poly- and perfluoroalkyl substances (PFASs) are a class of fluorinated chemicals that are utilized in firefighting and have been reported in groundwater and soil at several firefighter training areas. In this study, soil and groundwater samples were collected from across a former firefighter training area to examine the extent to which remedial activities have altered the composition and spatial distribution of PFASs in the subsurface. Log <i>K</i>_oc values for perfluoroalkyl acids (PFAAs), estimated from analysis of paired samples of groundwater and aquifer solids, indicated that solid/water partitioning was not entirely consistent with predictions based on laboratory studies. Differential PFAA transport was not strongly evident in the subsurface, likely due to remediation-induced conditions. When compared to the surface soil spatial distributions, the relative concentrations of perfluorooctanesulfonate (PFOS) and PFAA precursors in groundwater strongly suggest that remedial activities altered the subsurface PFAS distribution, presumably through significant pumping of groundwater and transformation of precursors to PFAAs. Additional evidence for transformation of PFAA precursors during remediation included elevated ratios of perfluorohexanesulfonate (PFHxS) to PFOS in groundwater near oxygen sparging wells