The Humanities: What Keeps Us Human

Try to picture a society where the arts and humanities do not exist. There would be no music, art, or literature. Religion and philosophy would be nonexistent, the study of history would be nullified, and intelligent debate would never happen. Obviously, a culture like this would be dry, unimpassioned, and rather incomplete. However, this appears to be the type of world that is commonly depicted as ideal—a world where science, math, and technology reign supreme and the arts take a backseat. Sarah Piper is from Richmond, VA, and is a sophomore double major in Writing, Rhetoric, and Technical Communication and Communication Studies. She\u27s involved in Campus Crusade for Christ and SafeRides, and is also a member of the Honors Program. Sarah writes that For this paper, Professor Lambert encouraged us to pick a topic that we were genuinely interested and invested in, so I decided to explore the place of the humanities in our culture. Since I am pursuing a career in writing, this topic is especially important to me as I think about the relevance of my future line of work and what I can contribute through my knowledge of areas of the humanities

Does masking matter? Shipping noise and fish vocalizations

Shipping creates large near-field background noises at levels similar to or higher than fish vocalizations and in the same critical bandwidths. This noise has the potential to "mask" biologically important signals and prevent fish from hearing them; any interference with the detection and recognition of sounds may impact fish survival. The Lombard effect, whereby vocalizations are altered to reduce or exclude masking effects, is an adaptation that has been observed in mammals and birds. Research is needed to establish whether the Lombard effect occurs in fish to gain a better understanding of the implications of noise pollution on fish populations

a pilot study

Muscular weakness in myasthenia gravis (MG) is commonly assessed using Quantitative Myasthenia Gravis Score (QMG). More objective and quantitative measures may complement the use of clinical scales and might detect subclinical affection of muscles. We hypothesized that muscular weakness in patients with MG can be quantified with the non-invasive Quantitative Motor (Q-Motor) test for Grip Force Assessment (QGFA) and Involuntary Movement Assessment (QIMA) and that pathological findings correlate with disease severity as measured by QMG. Methods This was a cross-sectional pilot study investigating patients with confirmed diagnosis of MG. Data was compared to healthy controls (HC). Subjects were asked to lift a device (250 and 500 g) equipped with electromagnetic sensors that measured grip force (GF) and three- dimensional changes in position and orientation. These were used to calculate the position index (PI) and orientation index (OI) as measures for involuntary movements due to muscular weakness. Results Overall, 40 MG patients and 23 HC were included. PI and OI were significantly higher in MG patients for both weights in the dominant and non-dominant hand. Subgroup analysis revealed that patients with clinically ocular myasthenia gravis (OMG) also showed significantly higher values for PI and OI in both hands and for both weights. Disease severity correlates with QIMA performance in the non-dominant hand. Conclusion Q-Motor tests and particularly QIMA may be useful objective tools for measuring motor impairment in MG and seem to detect subclinical generalized motor signs in patients with OMG. Q-Motor parameters might serve as sensitive endpoints for clinical trials in MG

Homeless community of Alamance County : an action oriented community diagnosis

This document contains an analysis of interviews, focus groups, and relevant background information on the homeless community in Alamance County. The data were compiled by a group of five graduate students from the University of North Carolina at Chapel Hill’s School of Public Health, as part of a community assessment, also known as Action-Oriented Community Diagnosis (AOCD). An AOCD is a process through which a student team works with a community to identify strengths and challenges, presents the findings at a community forum, and facilitates the development of tangible action steps to help the community address the identified challenges. The process involves both research and practice. Bill Adams, executive director of the Allied Churches of Alamance County, and Karen Webb, of the Alamance-Caswell-Rockingham Local Management Entity (formerly the Alamance-Caswell Area Mental Health Program), requested the AOCD in order to learn more about homelessness in the county. Another goal of the assessment was to examine the assets and challenges of service providers who work with individuals experiencing homelessness. The information presented in this document is intended for use as a reference and a resource, and may inform program planning, grant writing, and future community forums. The first section of this report contains background information on homelessness and Alamance County. The second part of the document contains a description of the AOCD methods and a summary of community strengths and challenges, including eight domains that emerged from interviews and focus groups with service providers and individuals experiencing homelessness. These eight domains are: mental health, employment, housing, transportation, substance abuse, reentry from prison or psychiatric facilities, perceptions of homelessness, and communication among service providers or between service providers and homeless individuals. The third part of the document contains a description of the community forum, planned by the community and student team, during which project findings were presented and tangible action steps were generated to address the challenges that emerged during the AOCD process. Finally, the student team’s recommendations conclude the report. The scope of this report is limited to the adult homeless community in Graham and Burlington because that is where most services are concentrated. For the purposes of this AOCD, the homeless population is defined broadly, but most interviewees are shelter guests and many are new residents of Alamance County. The student team presented their findings at a community forum, called Homelessness: Creating Community Change, held on April 27, 2007 at the First Christian United Church of Christ in Burlington. The event brought together more than 160 homeless and formerly homeless individuals, service providers and general community members with an interest in homelessness, to identify and discuss action steps related to the identified themes. The action steps and key discussion points from the forum are listed in Appendix C, and a general presentation of the forum planning process and schedule of events is contained in the body of this document. To conclude, this document describes the AOCD process and analyzes the experiences, perceptions, and frustrations of people experiencing homelessness, and the people who serve them, in Alamance County. The primary data, secondary data, recommendations, and action steps contained in this report may be used to guide future program planning and grant-writing. The student team thanks the people of Alamance County for the challenging work they have done already, and the action steps they have committed to take in the future, to improve the lives of people experiencing homelessness.Master of Public Healt

The process of prioritization of non-communicable diseases in the global health policy arena.

Although non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, the global policy response has not been commensurate with their health, economic and social burden. This study examined factors facilitating and hampering the prioritization of NCDs on the United Nations (UN) health agenda. Shiffman and Smith's (Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet 370: 1370-9.) political priority framework served as a structure for analysis of a review of NCD policy documents identified through the World Health Organization's (WHO) NCD Global Action Plan 2013-20, and complemented by 11 semi-structured interviews with key informants from different sectors. The results show that a cohesive policy community exists, and leaders are present, however, actor power does not extend beyond the health sector and the role of guiding institutions and civil society have only recently gained momentum. The framing of NCDs as four risk factors and four diseases does not necessarily resonate with experts from the larger policy community, but the economic argument seems to have enabled some traction to be gained. While many policy windows have occurred, their impact has been limited by the institutional constraints of the WHO. Credible indicators and effective interventions exist, but their applicability globally, especially in low- and middle-income countries, is questionable. To be effective, the NCD movement needs to expand beyond global health experts, foster civil society and develop a broader and more inclusive global governance structure. Applying the Shiffman and Smith framework for NCDs enabled different elements of how NCDs were able to get on the UN policy agenda to be disentangled. Much work has been done to frame the challenges and solutions, but implementation processes and their applicability remain challenging globally. NCD responses need to be adapted to local contexts, focus sufficiently on both prevention and management of disease, and have a stronger global governance structure

Breast Cancer Index is a predictive biomarker of treatment benefit and outcome from extended tamoxifen therapy: final analysis of the Trans-aTTom study

PURPOSE: The Breast Cancer Index (BCI) HOXB13/IL17BR (H/I) ratio predicts benefit from extended endocrine therapy in hormone receptor–positive (HR(+)) early-stage breast cancer. Here, we report the final analysis of the Trans-aTTom study examining BCI (H/I)'s predictive performance. EXPERIMENTAL DESIGN: BCI results were available for 2,445 aTTom trial patients. The primary endpoint of recurrence-free interval (RFI) and secondary endpoints of disease-free interval (DFI) and disease-free survival (DFS) were examined using Cox proportional hazards regression and log-rank test. RESULTS: Final analysis of the overall study population (N = 2,445) did not show a significant improvement in RFI with extended tamoxifen [HR, 0.90; 95% confidence interval (CI), 0.69–1.16; P = 0.401]. Both the overall study population and N0 group were underpowered due to the low event rate in the N0 group. In a pre-planned analysis of the N(+) subset (N = 789), BCI (H/I)-High patients derived significant benefit from extended tamoxifen (9.7% absolute benefit: HR, 0.33; 95% CI, 0.14–0.75; P = 0.016), whereas BCI (H/I)-Low patients did not (−1.2% absolute benefit; HR, 1.11; 95% CI, 0.76–1.64; P = 0.581). A significant treatment-to-biomarker interaction was demonstrated on the basis of RFI, DFI, and DFS (P = 0.037, 0.040, and 0.025, respectively). BCI (H/I)-High patients remained predictive of benefit from extended tamoxifen in the N(+)/HER2(−) subgroup (9.4% absolute benefit: HR, 0.35; 95% CI, 0.15–0.81; P = 0.047). A three-way interaction evaluating BCI (H/I), treatment, and HER2 status was not statistically significant (P = 0.849). CONCLUSIONS: Novel findings demonstrate that BCI (H/I) significantly predicts benefit from extended tamoxifen in HR(+) N(+) patients with HER2(−) disease. Moreover, BCI (H/I) demonstrates significant treatment to biomarker interaction across survival outcomes

Inducible chromatin priming is associated with the establishment of immunological memory in T cells

Immunological memory is a defining feature of vertebrate physiology, allowing rapid responses to repeat infections. However, the molecular mechanisms required for its establishment and maintenance remain poorly understood. Here, we demonstrated that the first steps in the acquisition of T-cell memory occurred during the initial activation phase of naïve T cells by an antigenic stimulus. This event initiated extensive chromatin remodeling that reprogrammed immune response genes toward a stably maintained primed state, prior to terminal differentiation. Activation induced the transcription factors NFAT and AP-1 which created thousands of new DNase I-hypersensitive sites (DHSs), enabling ETS-1 and RUNX1 recruitment to previously inaccessible sites. Significantly, these DHSs remained stable long after activation ceased, were preserved following replication, and were maintained in memory-phenotype cells. We show that primed DHSs maintain regions of active chromatin in the vicinity of inducible genes and enhancers that regulate immune responses. We suggest that this priming mechanism may contribute to immunological memory in T cells by facilitating the induction of nearby inducible regulatory elements in previously activated T cells

Evolution of Blood-Brain Barrier Permeability in Subacute Ischemic Stroke and Associations With Serum Biomarkers and Functional Outcome

Background and Purpose: In the setting of acute ischemic stroke, increased blood-brain barrier permeability (BBBP) as a sign of injury is believed to be associated with increased risk of poor outcome. Pre-clinical studies show that selected serum biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF alpha), matrix metallopeptidases (MMP), and vascular endothelial growth factors (VEGFs) may play a role in BBBP post-stroke. In the subacute phase of stroke, increased BBBP may also be caused by regenerative mechanisms such as vascular remodeling and therefore may improve functional recovery. Our aim was to investigate the evolution of BBBP in ischemic stroke using contrast-enhanced (CE) magnetic resonance imaging (MRI) and to analyze potential associations with blood-derived biomarkers as well as functional recovery in subacute ischemic stroke patients. Methods: This is an exploratory analysis of subacute ischemic stroke patients enrolled in the BAPTISe study nested within the randomized controlled PHYS-STROKE trial (interventions: 4 weeks of aerobic fitness training vs. relaxation). Patients with at least one CE-MRI before (v1) or after (v2) the intervention were eligible for this analysis. The prevalence of increased BBBP was visually assessed on T1-weighted MR-images based on extent of contrast-agent enhancement within the ischemic lesion. The intensity of increased BBBP was assessed semi-quantitatively by normalizing the mean voxel intensity within the region of interest (ROI) to the contralateral hemisphere ("normalized CE-ROI"). Selected serum biomarkers (high-sensitive CRP, IL-6, TNF-alpha, MMP-9, and VEGF) at v1 (before intervention) were analyzed as continuous and dichotomized variables defined by laboratory cut-off levels. Functional outcome was assessed at 6 months after stroke using the modified Rankin Scale (mRS). Results: Ninety-three patients with a median baseline NIHSS of 9 [IQR 6-12] were included into the analysis. The median time to v1 MRI was 30 days [IQR 18-37], and the median lesion volume on v1 MRI was 4 ml [IQR 1.2-23.4]. Seventy patients (80%) had increased BBBP visible on v1 MRI. After the trial intervention, increased BBBP was still detectable in 52 patients (74%) on v2 MRI. The median time to v2 MRI was 56 days [IQR 46-67]. The presence of increased BBBP on v1 MRI was associated with larger lesion volumes and more severe strokes. Aerobic fitness training did not influence the increase of BBBP evaluated at v2. In linear mixed models, the time from stroke onset to MRI was inversely associated with normalized CE-ROI (coefficient -0.002, Standard Error 0.007, p < 0.01). Selected serum biomarkers were not associated with the presence or evolution of increased BBBP. Multivariable regression analysis did not identify the occurrence or evolution of increased BBBP as an independent predictor of favorable functional outcome post-stroke. Conclusion: In patients with moderate-to-severe subacute stroke, three out of four patients demonstrated increased BBB permeability, which decreased over time. The presence of increased BBBP was associated with larger lesion volumes and more severe strokes. We could not detect an association between selected serum biomarkers of inflammation and an increased BBBP in this cohort. No clear association with favorable functional outcome was observed