Trial by Fire: The Marshall-Bell Kiln Site in Fredericksburg, Virginia

In 2012 and 2013 community members and local professional archaeologists led by Dovetail Cultural Resource Group worked together to salvage a stoneware waster dump in Fredericksburg, Virginia. More than 17,000 artifacts were recovered, representing two successive potters, Hugh R. Marshall and Francis H. Bell. This article brings together the archaeological and documentary evidence to discuss this short-lived pottery operation of the early 1830s. Considered are the physical attributes of the vessel forms and decorations, and the broader aspects of how this pottery operated within the local community and regional markets

Gender Differences in VO2 and HR Kinetics at the Onset of Moderate and Heavy Exercise Intensity in Adolescents

The majority of the studies on VO2 kinetics in pediatric populations investigated gender differences in prepubertal children during submaximal intensity exercise, but studies are lacking in adolescents. The purpose of this study was to test the hypothesis that gender differences exist in the VO2 and heart rate (HR) kinetic responses to moderate (M) and heavy (H) intensity exercise in adolescents. Twenty-one healthy African-American adolescents (9 males, 15.8 ± 1.1 year; 12 females, 15.7 ± 1 year) performed constant work load exercise on a cycle ergometer at M and H. The VO2 kinetics of the male group was previously analyzed (Lai et al., Appl. Physiol. Nutr. Metab. 33:107–117, 2008b). For both genders, VO2 and HR kinetics were described with a single exponential at M and a double exponential at H. The fundamental time constant (τ1) of VO2 was significantly higher in female than male at M (45 ± 7 vs. 36 ± 11 sec, P \u3c 0.01) and H (41 ± 8 vs. 29 ± 9 sec, P \u3c 0.01), respectively. The functional gain (G1) was not statistically different between gender at M and statistically higher in females than males at H: 9.7 ± 1.2 versus 10.9 ± 1.3 mL min−1 W−1, respectively. The amplitude of the slow component was not significantly different between genders. The HR kinetics were significantly (τ1, P \u3c 0.01) slower in females than males at M (61 ± 16 sec vs. 45 ± 20 sec, P \u3c 0.01) and H (42 ± 10 sec vs. 30 ± 8 sec, P = 0.03). The G1 of HR was higher in females than males at M: 0.53 ± 0.11 versus 0.98 ± 0.2 bpm W−1 and H: 0.40 ± 0.11 versus 0.73 ± 0.23 bpm W−1, respectively. Gender differences in the VO2 and HR kinetics suggest that oxygen delivery and utilization kinetics of female adolescents differ from those in male adolescents. © 2016 The Authors

Minimally invasive presacral approach for revision of an Axial Lumbar Interbody Fusion rod due to fall-related lumbosacral instability: a case report

<p>Abstract</p> <p>Introduction</p> <p>The purpose of this study was to describe procedural details of a minimally invasive presacral approach for revision of an L5-S1 Axial Lumbar Interbody Fusion rod.</p> <p>Case presentation</p> <p>A 70-year-old Caucasian man presented to our facility with marked thoracolumbar scoliosis, osteoarthritic changes characterized by high-grade osteophytes, and significant intervertebral disc collapse and calcification. Our patient required crutches during ambulation and reported intractable axial and radicular pain. Multi-level reconstruction of L1-4 was accomplished with extreme lateral interbody fusion, although focal lumbosacral symptoms persisted due to disc space collapse at L5-S1.</p> <p>Lumbosacral interbody distraction and stabilization was achieved four weeks later with the Axial Lumbar Interbody Fusion System (TranS1 Inc., Wilmington, NC, USA) and rod implantation via an axial presacral approach.</p> <p>Despite symptom resolution following this procedure, our patient suffered a fall six weeks postoperatively with direct sacral impaction resulting in symptom recurrence and loss of L5-S1 distraction. Following seven months of unsuccessful conservative care, a revision of the Axial Lumbar Interbody Fusion rod was performed that utilized the same presacral approach and used a larger diameter implant. Minimal adhesions were encountered upon presacral re-entry. A precise operative trajectory to the base of the previously implanted rod was achieved using fluoroscopic guidance. Surgical removal of the implant was successful with minimal bone resection required. A larger diameter Axial Lumbar Interbody Fusion rod was then implanted and joint distraction was re-established. The radicular symptoms resolved following revision surgery and our patient was ambulating without assistance on post-operative day one. No adverse events were reported.</p> <p>Conclusions</p> <p>The Axial Lumbar Interbody Fusion distraction rod may be revised and replaced with a larger diameter rod using the same presacral approach.</p

Ariel - Volume 11 Number 1

Executive Editors Ellen Feldman Leonardo S. Nasca, Jr. Business Managers Barbara L. Davies Martin B. Getzow News Editor Aaron D. Bleznak Features Editor Dave Van Wagoner CAHS Editor Joan M. Greco Editorial Page Editor Samuel Markind Photography Editor Leonardo S. Nasca, Jr. Sports Editor Paul F. Mansfiel

Survey of overnight academic hospitalist supervision of trainees

In 2003, Accreditation Council for Graduate Medical Education (ACGME) announced the first in a series of guidelines related to the residency training. The most recent recommendations include explicit recommendations regarding the provision of on‐site clinical supervision for trainees of internal medicine. To meet these standards, many internal medicine residency programs turned to hospitalist programs to fill that need. However, much is unknown about the current relationships between hospitalist and residency programs, specifically with regard to supervisory roles and supervision policies. We aimed to describe how academic hospitalists currently supervise housestaff during the on‐call, or overnight, period and hospitalist program leader their perceptions of how these new policies would impact trainee‐hospitalist interactions. Journal of Hospital Medicine 2012; © 2012 Society of Hospital MedicinePeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93713/1/1961_ftp.pd

Better data for teachers, better data for learners, better patient care: college-wide assessment at Michigan State University's College of Human Medicine

When our school organized the curriculum around a core set of medical student competencies in 2004, it was clear that more numerous and more varied student assessments were needed. To oversee a systematic approach to the assessment of medical student competencies, the Office of College-wide Assessment was established, led by the Associate Dean of College-wide Assessment. The mission of the Office is to ‘facilitate the development of a seamless assessment system that drives a nimble, competency-based curriculum across the spectrum of our educational enterprise.’ The Associate Dean coordinates educational initiatives, developing partnerships to solve common problems, and enhancing synergy within the College. The Office also works to establish data collection and feedback loops to guide rational intervention and continuous curricular improvement. Aside from feedback, implementing a systems approach to assessment provides a means for identifying performance gaps, promotes continuity from undergraduate medical education to practice, and offers a rationale for some assessments to be located outside of courses and clerkships. Assessment system design, data analysis, and feedback require leadership, a cooperative faculty team with medical education expertise, and institutional support. The guiding principle is ‘Better Data for Teachers, Better Data for Learners, Better Patient Care.’ Better data empowers faculty to become change agents, learners to create evidence-based improvement plans and increases accountability to our most important stakeholders, our patients

Not only dominant, not only optic atrophy: expanding the clinical spectrum associated with OPA1 mutations

Background: Heterozygous mutations in OPA1 are a common cause of autosomal dominant optic atrophy, sometimes associated with extra-ocular manifestations. Few cases harboring compound heterozygous OPA1 mutations have been described manifesting complex neurodegenerative disorders in addition to optic atrophy. Results: We report here three patients: one boy showing an early-onset mitochondrial disorder with hypotonia, ataxia and neuropathy that was severely progressive, leading to early death because of multiorgan failure; two unrelated sporadic girls manifesting a spastic ataxic syndrome associated with peripheral neuropathy and, only in one, optic atrophy. Using a targeted resequencing of 132 genes associated with mitochondrial disorders, in two probands we found compound heterozygous mutations in OPA1: in the first a 5 nucleotide deletion, causing a frameshift and insertion of a premature stop codon (p.Ser64Asnfs*7), and a missense change (p.Ile437Met), which has recently been reported to have clinical impact; in the second, a novel missense change (p.Val988Phe) co-occurred with the p.Ile437Met substitution. In the third patient a homozygous mutation, c.1180G > A (p.Ala394Thr) in OPA1 was detected by a trio-based whole exome sequencing approach. One of the patients presented also variants in mitochondrial DNA that may have contributed to the peculiar phenotype. The deleterious effect of the identified missense changes was experimentally validated in yeast model. OPA1 level was reduced in available patients\u2019 biological samples, and a clearly fragmented mitochondrial network was observed in patients\u2019 fibroblasts. Conclusions: This report provides evidence that bi-allelic OPA1 mutations may lead to complex and severe multi-system recessive mitochondrial disorders, where optic atrophy might not represent the main feature

Variants in ATP5F1B are associated with dominantly inherited dystonia

Nasca et al. identify a new candidate gene for dystonia, ATP5F1B, encoding a subunit of the mitochondrial ATP synthase (complex V). Likely pathogenic variants in ATP5F1B were associated with early-onset isolated dystonia in two independent families, both with an autosomal dominant mode of inheritance and incomplete penetrance. ATP5F1B is a subunit of the mitochondrial ATP synthase or complex V of the mitochondrial respiratory chain. Pathogenic variants in nuclear genes encoding assembly factors or structural subunits are associated with complex V deficiency, typically characterized by autosomal recessive inheritance and multisystem phenotypes. Movement disorders have been described in a subset of cases carrying autosomal dominant variants in structural subunits genes ATP5F1A and ATP5MC3. Here, we report the identification of two different ATP5F1B missense variants (c.1000A>C;p.Thr334Pro and c.1445T>C;p.Val482Ala) segregating with early-onset isolated dystonia in two families, both with autosomal dominant mode of inheritance and incomplete penetrance. Functional studies in mutant fibroblasts revealed no decrease of ATP5F1B protein amount but severe reduction of complex V activity and impaired mitochondrial membrane potential, suggesting a dominant-negative effect. In conclusion, our study describes a new candidate gene associated with isolated dystonia and confirms that heterozygous variants in genes encoding subunits of the mitochondrial ATP synthase may cause autosomal dominant isolated dystonia with incomplete penetrance, likely through a dominant-negative mechanism

Impacto a longo prazo da pastagem e do cultivo na qualidade do solo no Chaco semi-árido (Argentina)

La deforestación del bosque nativo chaqueño y la reorientación del uso del suelo están en camino de transformar la región hacia uso agrícola. El principal objetivo de este trabajo es evaluar el impacto de diferentes prácticas de uso sobre la calidad del suelo en el Chaco semiárido (Argentina). Estudiamos el comportamiento de parámetros edáficos a lo largo de cuatro años de condiciones experimentales: 1) Clausura (EP) usada como nivel de referencia, 2) Ganadería pastoril (GP), 3) Agricultura vía siembra directa (ZT) y 4) Agricultura vía labranza convencional (CT). Se midieron los parámetros de carbono orgánico del suelo, carbono orgánico (C) particulado y pesado, nitrógeno total (N), C:N ratio, pH, conductividad eléctrica y respiración del suelo. Las muestras fueron tomadas anualmente a 0-5, 5-20 y 20-40 cm de profundidad de suelo. Las diferencias entre tratamientos a lo largo del tiempo fueron evaluadas por un Análisis de Covarianza (ANCOVA) con el tiempo (años) como covariable, los tratamientos como factor grupal y los valores de los componentes resultantes del Análisis de Componentes Principales (PCA) como respuestas. Se detectaron cambios correlacionados con las características del suelo, especialmente en la capa superficial del suelo. Los contenidos de nutrientes incrementaron en los sistemas GP y ZT. Una tendencia opuesta fue detectada para CT donde, además, hubo un impacto negativo sobre la salinidad. Tanto el cambio en el uso del suelo como en las prácticas de manejo dentro de la región del Chaco representan las principales actividades humanas que modifican el paisaje; de esta forma, estas deberían ser analizadas reconociendo la heterogeneidad en las prácticas de producción e identificando sus impactos en sitios específicos. Los resultados de este trabajo refuerzan la utilidad del carbono orgánico del suelo como parámetro individual para monitorear sistemas de manejo de la tierra, especialmente regiones extensas como Chaco que están sujetas a continuos procesos de transformación.A desflorestação da mata nativa do Chaco e a reorientação do uso do solo estão a transformar a região no sentido do seu uso agrícola. O principal objetivo deste trabalho é avaliar o impacto de diferentes práticas de uso na qualidade do solo no Chaco semi-árido. Foi estudado o comportamento, ao longo de quatro anos, dos parâmetros edáficos em condições experimentais: 1) Pastagem de exclusão (PE) utilizada como nível de referência, 2) Pastagem Ativa (GP), 3) Pastagem transformada em agricultura com sementeira direta (ZT) e 4) Pastagem transformada em agricultura sob preparação convencional (CT). Determinou-se no solo o carbono orgânico, o carbono orgânico particulado e pesado (C), o nitrogénio total (N), a relação C:N, pH, condutividade elétrica e a respiração do solo. As amostras de solo foram colhidas anualmente a 0-5, 5-20 e 20-40 cm de profundidade. As diferenças entre tratamentos ao longo do tempo foram avaliadas por Análise de Covariância (ANCOVA) com o tempo (anos) como uma covariável, os tratamentos como fator de grupo e os valores dos componentes resultantes de Análise de Componentes Principais (PCA) como respostas. Foram detetadas alterações correlacionadas com as características do solo, principalmente na sua camada superficial. As concentrações em carbono e nitrogénio aumentaram nos sistemas GP e ZT. Uma tendência oposta foi observada para o sistema TC, onde, além disso, houve um impacto negativo na salinidade. A mudança no uso da terra e as práticas de gestão na região do Chaco representam as principais atividades humanas que modificam a paisagem. Deste modo, estas deveriam ser analisadas reconhecendo a heterogeneidade das práticas de produção e identificando os seus impactos em locais específicos. Os resultados deste trabalho reforçam a utilidade do carbono orgânico do solo como um parâmetro individual para monitorizar os sistemas de gestão da terra, especialmente em regiões de grande dimensão como a região de Chaco que estão sujeitas a processos contínuos de transformação.Deforestation of Chacoan native forests and reorientation of land use are transforming the region into agricultural use. The main purpose of this work was to evaluate the impact of different land uses on soil quality in the semi-arid Chaco (Argentina). We assessed the behaviour of soil parameters over four years of experimental conditions: 1) Exclosure pasture (EP) used as reference level, 2) Grazed pasture (GP), 3) Grazed pasture transformed to agriculture with Zero tillage (ZT) and 4) Grazed pasture transformed to agriculture under Conventional tillage (CT). Soil organic carbon, particulate and heavy organic carbon (C), total nitrogen (N), C:N ratio, pH, electric conductivity and soil respiration were measured. Soil samples were taken yearly at 0-5, 5-20 and 20-40 cm of soil depth. Differences among treatments across time were assessed by Analysis of Covariance (ANCOVA) with time (years) as covariate factor, treatments as group factor and individual scores from Principal Component Analysis (PCA) as responses. Correlated changes in the soil characteristics were detected, especially at the top soil layer. Both carbon and nitrogen contents increased in both GP and ZT systems. An opposite trend was found for CT, which also had a negative impact on salinity. Both land use change and management practices in the Chaco region represent the main human activities that modify the landscape; thus, they should be analysed by recognizing heterogeneity on farming practices and identifying their impacts on a specific site. The results of this work reinforce the utility of soil organic carbon as a single parameter for monitoring land management systems, especially for monitoring large region like Chaco that are subject to continuous transformation processes.Fil: Banegas, Natalia Romina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Investigación Animal del Chaco Semiárido; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Tucumán; ArgentinaFil: Maza, M.. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Viruel, Emilce. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Investigación Animal del Chaco Semiárido; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Nasca, Jose Andres. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Canteros, Francisco Humberto. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Investigación Animal del Chaco Semiárido; Argentina. Universidad Nacional de Tucumán; ArgentinaFil: Corbella, Roberto Daniel. Universidad Nacional de Tucumán; ArgentinaFil: Dos Santos, Daniel Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Biodiversidad Neotropical. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto de Biodiversidad Neotropical. Instituto de Biodiversidad Neotropical; Argentin