Positive and Negative Experiences With Supportive Services and Programming: Gaps and Recommendations From Youth Experiencing Homelessness

Services for youth experiencing homelessness (YEH) are designed with limited input from the youth themselves. This study explored the experiences and recommendations for services aimed at mitigating the negative effects of homelessness among youth. A total of 45 interviews were conducted with YEH (ages 15 to 24, M = 21.5 years) who experienced at least one night of homelessness. Transcripts were coded by using a modified constructivist grounded theory approach. YEH reported myriad challenges to navigating disjointed programming and misguided policies. Recommendations from YEH for policy and programmatic change include peacekeeping and diffusion training for program staff, trauma-informed approaches, and conflict resolution among agency staff; and integrate creative outlets and transitional services into existing programs. Programming supporting YEH must extend beyond meeting only basic needs to creating opportunities for safety, autonomy, and growth. Programs targeting youth homelessness need input from YEH in their design and implementation

Preconditioning Involves Selective Mitophagy Mediated by Parkin and p62/SQSTM1

Autophagy-dependent mitochondrial turnover in response to cellular stress is necessary for maintaining cellular homeostasis. However, the mechanisms that govern the selective targeting of damaged mitochondria are poorly understood. Parkin, an E3 ubiquitin ligase, has been shown to be essential for the selective clearance of damaged mitochondria. Parkin is expressed in the heart, yet its function has not been investigated in the context of cardioprotection. We previously reported that autophagy is required for cardioprotection by ischemic preconditioning (IPC). In the present study, we used simulated ischemia (sI) in vitro and IPC of hearts to investigate the role of Parkin in mediating cardioprotection ex vivo and in vivo. In HL-1 cells, sI induced Parkin translocation to mitochondria and mitochondrial elimination. IPC induced Parkin translocation to mitochondria in Langendorff-perfused rat hearts and in vivo in mice subjected to regional IPC. Mitochondrial depolarization with an uncoupling agent similarly induced Parkin translocation to mitochondria in cells and Langendorff-perfused rat hearts. Mitochondrial loss was blunted in Atg5-deficient cells, revealing the requirement for autophagy in mitochondrial elimination. Consistent with previous reports indicating a role for p62/SQSTM1 in mitophagy, we found that depletion of p62 attenuated mitophagy and exacerbated cell death in HL-1 cardiomyocytes subjected to sI. While wild type mice showed p62 translocation to mitochondria and an increase in ubiquitination, Parkin knockout mice exhibited attenuated IPC-induced p62 translocation to the mitochondria. Importantly, ablation of Parkin in mice abolished the cardioprotective effects of IPC. These results reveal for the first time the crucial role of Parkin and mitophagy in cardioprotection

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Psychoneural Isomorphism: From Metaphysics to Robustness

At the beginning of the 20th century, Gestalt psychologists put forward the concept of psychoneural isomorphism, which was meant to replace Fechner’s obscure notion of psychophysical parallelism and provide a heuristics that may facilitate the search for the neural correlates of the mind. However, the concept has generated much confusion in the debate, and today its role is still unclear. In this contribution, I will attempt a little conceptual spadework in clarifying the concept of psychoneural isomorphism, focusing exclusively on conscious visual perceptual experience and its neural correlates. Firstly, I will outline the history of our concept, and its alleged metaphysical and epistemic roles. Then, I will clarify the nature of isomorphism and rule out its metaphysical role. Finally, I will review some epistemic roles of our concept, zooming in on the work of Jean Petitot, and suggest that it does not play a relevant heuristic role. I conclude suggesting that psychoneural isomorphism might be an indicator of robustness for certain mathematical descriptions of perceptual content

“It's Being Compassionate, Not Making Assumptions”: Transmasculine and Nonbinary Young Adults' Experiences of “Women's” Health Care Settings

BackgroundTransgender and nonbinary (TNB) individuals assigned female sex at birth experience discrimination, misgendering, problems with insurance, and denial of services when accessing health care. This study aimed to understand the experiences of TNB young adults in accessing "women's" health care-a form of care that is structurally gendered that few studies have investigated.MethodsIn 2015, we conducted in-depth interviews with 20 TNB young (ages 18-29) adults assigned female sex at birth. We thematically analyzed the data.ResultsParticipants described feelings of comfort and trust-and lack thereof-at every step of the health care-seeking process, including scheduling, checking in, waiting, and interactions with clinicians and other staff. Gendered language served as a constant stressor; participants-especially nonbinary participants-noted few opportunities to provide their correct pronouns and names. Participants relayed negative experiences associated with waiting rooms in "women's" health care spaces, where TNB patients are forced to disclose their identity simply through their presence or owing to actions of staff that out them. These concerns deterred some from seeking care, with most expressing discomfort or anxiety that caused them to feel unsafe. Participants described "women's" health care providers making assumptions about their anatomy, reproductive desires, sexual orientation, and sexual practices, as well as inappropriately and harmfully emphasizing their bodies and TNB identities during health care interactions. Clinician competence and humility engendered participants' feelings of safety and undergirded their interest in engaging with "women's" health care.ConclusionsA lack of patient-centered, TNB-competent care in structurally gendered health settings exacerbates health care and health inequities for TNB young adults

Objective activity tracking in spine surgery: a prospective feasibility study with a low-cost consumer grade wearable accelerometer

Patient-reported outcome measures (PROMs) are commonly used to estimate disability of patients with spinal degenerative disease. Emerging technological advances present an opportunity to provide objective measurements of activity. In a prospective, observational study we utilized a low-cost consumer grade wearable accelerometer (LCA) to determine patient activity (steps per day) preoperatively (baseline) and up to one year (Y1) after cervical and lumbar spine surgery. We studied 30 patients (46.7% male; mean age 57 years; 70% Caucasian) with a baseline activity level of 5624 steps per day. The activity level decreased by 71% in the 1$^{st}$ postoperative week (p < 0.001) and remained 37% lower in the 2$^{nd}$ (p < 0.001) and 23% lower in the 4$^{th}$ week (p = 0.015). At no time point until Y1 did patients increase their activity level, compared to baseline. Activity was greater in patients with cervical, as compared to patients with lumbar spine disease. Age, sex, ethnic group, anesthesia risk score and fusion were variables associated with activity. There was no correlation between activity and PROMs, but a strong correlation with depression. Determining activity using LCAs provides real-time and longitudinal information about patient mobility and return of function. Recovery took place over the first eight postoperative weeks, with subtle improvement afterwards