Improving the Public’s Health Through Sustained, Multidisciplinary Academic and Community Partnerships: The MSM Model

Background: To meet the growing needs of communities with increased chronic conditions, decreased access to health services, and a changing sociocultural environment, there is a critical need for community-oriented physicians equipped with the skills to attend to the health of underserved populations. The Morehouse School of Medicine Community Health Course’s (CHC) purpose is to inculcate service-learning and public health techniques to equip community-oriented physicians with empathy and tools to effectively engage diverse communities and provide care that addresses the social determinants of health to achieve health equity. The purpose of this practice note is to discuss CHC multidisciplinary strategies used to sustain community partner relationships and impact public health. Methods: We work to effectively engage community partners in a number of ways including: a core approach that the partnership is designed to assess, listen to, and meet the communities’ needs; that community partners inform the course curriculum through a community advisory board, an introductory course community panel (of advice for effective engagement), and attendance at course meetings and retreats; a continued relationship between the course faculty and the community site over time; community representatives as co-authors on presentations and publications; and, at times, maintained student contact with the community sites for volunteer activities after completion of the course. Results: The Community Health Course collaborates with its community partners to educate medical students, provide requested services to the communities, and impact the health needs of the communities. The course has developed long-term partnerships varying in lengths from 1 year to over 15 years. The partner organizations over the last ten years have included pre-K-12 schools, independent senior living facilities, youth organizations, community-based organizations, and homeless shelters. Conclusions: Through long-standing collaborations with partnering organizations, the CHC has participated in the development of several sustainable projects traversing multiple levels of the social ecological model

Glaciotectonic deformation associated with the Orient Point–Fishers Island moraine, westernmost Block Island Sound : further evidence of readvance of the Laurentide ice sheet

This paper is not subject to U.S. copyright. The definitive version was published in Geo-Marine Letters 32 (2012): 279-288, doi:10.1007/s00367-012-0296-9.High-resolution seismic-reflection profiles collected across pro-glacial outwash deposits adjacent to the circa 18 ka b.p. Orient Point–Fishers Island end moraine segment in westernmost Block Island Sound reveal extensive deformation. A rhythmic seismic facies indicates the host outwash deposits are composed of fine-grained glaciolacustrine sediments. The deformation is variably brittle and ductile, but predominantly compressive in nature. Brittle deformation includes reverse faults and thrust faults that strike parallel to the moraine, and thrust sheets that extend from beneath the moraine. Ductile deformation includes folded sediments that overlie undisturbed deposits, showing that they are not drape features. Other seismic evidence for compression along the ice front consists of undisturbed glaciolacustrine strata that dip back toward and underneath the moraine, and angular unconformities on the sea floor where deformed sediments extend above the surrounding undisturbed correlative strata. Together, these ice-marginal glaciotectonic features indicate that the Orient Point–Fishers Island moraine marks a significant readvance of the Laurentide ice sheet, consistent with existing knowledge for neighboring coeval moraines, and not simply a stillstand as previously reported.This work was supported by the Connecticut Department of Environmental Protection, and the Atlantic Hydrographic Branch of the National Oceanic and Atmospheric Administration.2013-06-2

Sampling Scarab Beetles in Tropical Forests: The Effect of Light Source and Night Sampling Periods

Light traps have been used widely to sample insect abundance and diversity, but their performance for sampling scarab beetles in tropical forests based on light source type and sampling hours throughout the night has not been evaluated. The efficiency of mercury-vapour lamps, cool white light and ultraviolet light sources in attracting Dynastinae, Melolonthinae and Rutelinae scarab beetles, and the most adequate period of the night to carry out the sampling was tested in different forest areas of Costa Rica. Our results showed that light source wavelengths and hours of sampling influenced scarab beetle catches. No significant differences were observed in trap performance between the ultraviolet light and mercury-vapour traps, whereas these two methods caught significantly more species richness and abundance than cool white light traps. Species composition also varied between methods. Large differences appear between catches in the sampling period, with the first five hours of the night being more effective than the last five hours. Because of their high efficiency and logistic advantages, we recommend ultraviolet light traps deployed during the first hours of the night as the best sampling method for biodiversity studies of those scarab beetles in tropical forests

Transformational Leadership: Creating a Culture of Cross-Institutional IPE Collaboration

Facilitating Structures • Engagement of senior leaders • Mutual appointment to IPE leadership groups • Memorandum of understanding • Joint appointments • Communication and time • Collaboration as a value • Commitment to Trial and Refinement • A Foundation of Trus

The Formation of the First Massive Black Holes

Supermassive black holes (SMBHs) are common in local galactic nuclei, and SMBHs as massive as several billion solar masses already exist at redshift z=6. These earliest SMBHs may grow by the combination of radiation-pressure-limited accretion and mergers of stellar-mass seed BHs, left behind by the first generation of metal-free stars, or may be formed by more rapid direct collapse of gas in rare special environments where dense gas can accumulate without first fragmenting into stars. This chapter offers a review of these two competing scenarios, as well as some more exotic alternative ideas. It also briefly discusses how the different models may be distinguished in the future by observations with JWST, (e)LISA and other instruments.Comment: 47 pages with 306 references; this review is a chapter in "The First Galaxies - Theoretical Predictions and Observational Clues", Springer Astrophysics and Space Science Library, Eds. T. Wiklind, V. Bromm & B. Mobasher, in pres

Smart Skin Patterns Protect Springtails

Springtails, arthropods who live in soil, in decaying material, and on plants, have adapted to demanding conditions by evolving extremely effective and robust anti-adhesive skin patterns. However, details of these unique properties and their structural basis are still unknown. Here we demonstrate that collembolan skin can resist wetting by many organic liquids and at elevated pressures. We show that the combination of bristles and a comb-like hexagonal or rhombic mesh of interconnected nanoscopic granules distinguish the skin of springtails from anti-adhesive plant surfaces. Furthermore, the negative overhang in the profile of the ridges and granules were revealed to be a highly effective, but as yet neglected, design principle of collembolan skin. We suggest an explanation for the non-wetting characteristics of surfaces consisting of such profiles irrespective of the chemical composition. Many valuable opportunities arise from the translation of the described comb-like patterns and overhanging profiles of collembolan skin into man-made surfaces that combine stability against wear and friction with superior non-wetting and anti-adhesive characteristics

Pyronaridine-Artesunate versus Chloroquine in Patients with Acute Plasmodium vivax Malaria: A Randomized, Double-Blind, Non-Inferiority Trial

BACKGROUND: New antimalarials are needed for P. vivax and P. falciparum malaria. This study compared the efficacy and safety of pyronaridine-artesunate with that of chloroquine for the treatment of uncomplicated P. vivax malaria. METHODS AND FINDINGS: This phase III randomized, double-blind, non-inferiority trial included five centers across Cambodia, Thailand, India, and Indonesia. In a double-dummy design, patients (aged >3-≤ 60 years) with microscopically confirmed P. vivax mono-infection were randomized (1:1) to receive pyronaridine-artesunate (target dose 7.2:2.4 mg/kg to 13.8:4.6 mg/kg) or chloroquine (standard dose) once daily for three days. Each treatment group included 228 randomized patients. Outcomes for the primary endpoint, Day-14 cure rate in the per-protocol population, were 99.5%, (217/218; 95%CI 97.5, 100) with pyronaridine-artesunate and 100% (209/209; 95%CI 98.3, 100) with chloroquine. Pyronaridine was non-inferior to chloroquine: treatment difference -0.5% (95%CI -2.6, 1.4), i.e., the lower limit of the 2-sided 95%CI for the treatment difference was greater than -10%. Pyronaridine-artesunate cure rates were non-inferior to chloroquine for Days 21, 28, 35 and 42. Parasite clearance time was shorter with pyronaridine-artesunate (median 23.0 h) versus chloroquine (32.0 h; p<0.0001), as was fever clearance time (median 15.9 h and 23.8 h, respectively; p = 0.0017). Kaplan-Meier estimates of post-baseline P. falciparum infection incidence until Day 42 were 2.5% with pyronaridine-artesunate, 6.1% with chloroquine (p = 0.048, log-rank test). Post-baseline P. vivax or P. falciparum infection incidence until Day 42 was 6.8% and 12.4%, respectively (p = 0.022, log rank test). There were no deaths. Adverse events occurred in 92/228 (40.4%) patients with pyronaridine-artesunate and 72/228 (31.6%) with chloroquine. Mild and transient increases in hepatic enzymes were observed for pyronaridine-artesunate. CONCLUSION: Pyronaridine-artesunate efficacy in acute uncomplicated P. vivax malaria was at least that of chloroquine. As pyronaridine-artesunate is also efficacious against P. falciparum malaria, this combination has potential utility as a global antimalarial drug. TRIAL REGISTRATION: Clinicaltrials.gov NCT00440999