Reconstructing Identity: Carlton Burgan, Patient Zero in the Development of Plastic Surgery, Civil War through World War I

Plastic surgery has played an integral role in helping people achieve societal expectations of appropriate physical appearance since its inception. Through the story of Carlton Burgan, a Union soldier during the American Civil War, who suffered severe facial trauma by mercury poisoning, this thesis hopes to reconstruct the conversation around plastic surgery’s origins as it is influenced by societal standards of the day. Specifically, this thesis argues that the seminal moments leading to plastic surgery being seen as a worthwhile medical specialty was during the Civil War, not World War I as so many scholars have put forth. Violent acts to the body as a method to advance plastic surgery techniques is explored in relation to acceptable physical appearance. Societal beauty standards on the time are posited to be the force behind the development of plastic surgery techniques, not plastic surgeons themselves. Plastic surgery evolved as the United States grew and began to embrace the Second Industrial Revolution’s influence on attitudes about beauty, leading to changes in societal beliefs about what is suitable in terms of appearance. This thesis argues that the new science of psychology that emerged in parallel to the Second Industrial Revolution is the main strategy for plastic surgery to be reconstructed as a worthwhile medical specialty. The exploration of plastic surgery procedures of the nose, face and genitalia are discussed due to their importance in constructing societal appearance standards. The thesis concludes with a return to the story of Carlton Burgan and his role as a change agent in medicine

2012 Cumberland County Law Enforcement Case File Review

Since 1998, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) has required all states that receive formula grant funding through the Juvenile Justice Delinquency Prevention Act to determine the rate of minority youth in confinement. In 2002, OJJDP enhanced this requirement to include other key decision points (e.g., arrest, referral, diversion, detention, petition, adjudication, probation, confinement, and bind over) in the juvenile justice process.This expanded view allows for a more comprehensive assessment of how minority youth are treated by various juvenile justice system actors (e.g., law enforcement, corrections, and the courts). The Act’s goal is to ensure that all youth, regardless of race or ethnicity, are afforded an equal and fair treatment by the juvenile justice system. In Maine, the Juvenile Justice Advisory Group (JJAG) partners with the Muskie School of Public Service at the University of Southern Maine to carry out disproportionate minority contact (DMC) research. For the past seven years, the Muskie School has been establishing relative rate indices for all nine decision points to gauge whether DMC occurs in Maine, and if so at what decision point and where

A new multi locus variable number of tandem repeat analysis scheme for epidemiological surveillance of Xanthomonas vasicola pv. musacearum, the plant pathogen causing bacterial wilt on banana and enset

Xanthomonas vasicola pv. musacearum (Xvm) which causes Xanthomonas wilt (XW) on banana (Musa accuminata x balbisiana) and enset (Ensete ventricosum), is closely related to the species Xanthomonas vasicola that contains the pathovars vasculorum (Xvv) and holcicola (Xvh), respectively pathogenic to sugarcane and sorghum. Xvm is considered a monomorphic bacterium whose intra-pathovar diversity remains poorly understood. With the sudden emergence of Xvm within east and central Africa coupled with the unknown origin of one of the two sublineages suggested for Xvm, attention has shifted to adapting technologies that focus on identifying the origin and distribution of the genetic diversity within this pathogen. Although microbiological and conventional molecular diagnostics have been useful in pathogen identification. Recent advances have ushered in an era of genomic epidemiology that aids in characterizing monomorphic pathogens. To unravel the origin and pathways of the recent emergence of XW in Eastern and Central Africa, there was a need for a genotyping tool adapted for molecular epidemiology. Multi-Locus Variable Number of Tandem Repeat Analysis (MLVA) is able to resolve the evolutionary patterns and invasion routes of a pathogen. In this study, we identified microsatellite loci from nine published Xvm genome sequences. Of the 36 detected microsatellite loci, 21 were selected for primer design and 19 determined to be highly typeable, specific, reproducible and polymorphic with two- to four- alleles per locus on a sub-collection. The 19 markers were multiplexed and applied to genotype 335 Xvm strains isolated from seven countries over several years. The microsatellite markers grouped the Xvm collection into three clusters; with two similar to the SNP-based sublineages 1 and 2 and a new cluster 3, revealing an unknown diversity in Ethiopia. Five of the 19 markers had alleles present in both Xvm and Xanthomonas vasicola pathovars holcicola and vasculorum, supporting the phylogenetic closeliness of these three pathovars. Thank to the public availability of the haplotypes on the MLVABank database, this highly reliable and polymorphic genotyping tool can be further used in a transnational surveillance network to monitor the spread and evolution of XW throughout Africa.. It will inform and guide management of Xvm both in banana-based and enset-based cropping systems. Due to the suitability of MLVA-19 markers for population genetic analyses, this genotyping tool will also be used in future microevolution studies

Optimization of Dengue Epidemics: a test case with different discretization schemes

The incidence of Dengue epidemiologic disease has grown in recent decades. In this paper an application of optimal control in Dengue epidemics is presented. The mathematical model includes the dynamic of Dengue mosquito, the affected persons, the people's motivation to combat the mosquito and the inherent social cost of the disease, such as cost with ill individuals, educations and sanitary campaigns. The dynamic model presents a set of nonlinear ordinary differential equations. The problem was discretized through Euler and Runge Kutta schemes, and solved using nonlinear optimization packages. The computational results as well as the main conclusions are shown.Comment: Presented at the invited session "Numerical Optimization" of the 7th International Conference of Numerical Analysis and Applied Mathematics (ICNAAM 2009), Rethymno, Crete, Greece, 18-22 September 2009; RepositoriUM, id: http://hdl.handle.net/1822/1083

Vranesh\u27s Colorado Water Law

This digital resource contains only an abstract, cover image and table of contents information from the published book. Print copy of book is available in the University of Colorado’s Wise Law Library: http://lawpac.colorado.edu/record=b236738~S0 Contents: An introduction to Colorado water rights -- The nature of the right -- Water adjudication and administration -- Transfer of water rights -- Water organizations -- Federal-state water relations -- Protection of water quality in Colorado -- Transmountain and interstate waters -- Condemnation of rightshttps://scholar.law.colorado.edu/books_reports_studies/1144/thumbnail.jp

Detailed molecular characterisation of acute myeloid leukaemia with a normal karyotype using targeted DNA capture

This work is licensed under a Creative Commons Attribution 3.0 Unported License.-- et al.Advances in sequencing technologies are giving unprecedented insights into the spectrum of somatic mutations underlying acute myeloid leukaemia with a normal karyotype (AML-NK). It is clear that the prognosis of individual patients is strongly influenced by the combination of mutations in their leukaemia and that many leukaemias are composed of multiple subclones, with differential susceptibilities to treatment. Here, we describe a method, employing targeted capture coupled with next-generation sequencing and tailored bioinformatic analysis, for the simultaneous study of 24 genes recurrently mutated in AML-NK. Mutational analysis was performed using open source software and an in-house script (Mutation Identification and Analysis Software), which identified dominant clone mutations with 100% specificity. In each of seven cases of AML-NK studied, we identified and verified mutations in 2-4 genes in the main leukaemic clone. Additionally, high sequencing depth enabled us to identify putative subclonal mutations and detect leukaemia-specific mutations in DNA from remission marrow. Finally, we used normalised read depths to detect copy number changes and identified and subsequently verified a tandem duplication of exons 2-9 of MLL and at least one deletion involving PTEN. This methodology reliably detects sequence and copy number mutations, and can thus greatly facilitate the classification, clinical research, diagnosis and management of AML-NK.We acknowledge the use of the National Institute of Health Research (NIHR) Biomedical Research Centre, University of Cambridge. We thank Drs J Craig and C Crawley of Cambridge University NHS Hospitals trust for allowing us to approach their patients for samples. GV is funded by a Wellcome Trust Senior Fellowship in Clinical Science. Work in GV’s laboratory is also funded by Leukaemia Lymphoma Research and the Kay Kendal Leukaemia Fund.Peer Reviewe

Cortical mechanisms of sensory motor attenuation in a SCI participant

Somatosensory attenuation (SMA) is a phenomenon where a self-generated touch feels weaker than an externally generated touch of the same intensity. The brain uses a forward model to predict the sensory consequences of our actions and in turn attenuates the afferent sensory feedback of our own movements. Even though SMA has been studied extensively, there is a lack of understanding of how the S1 multi-unit neurophysiology and the perception of SMA are correlated. In this study, we record the perceptual and sensorimotor Multi-Unit Activity (MUA) of SMA in a chronically implanted SCI participant using a force comparison paradigm. We hypothesize that the perception of SMA will correlate with the S1 MUA. That is, when the two taps are of the same intensity, the S1 response for a self-generated tap will be lower than that of an externally generated tap and when the two taps are perceived to be the same at the Point of Subjective Equality (PSE), the S1 response will be the same for the two taps. Additionally, we also perform a behavioral healthy controls comparison of SMA to study how SMA may vary between our SCI participant and healthy controls. Contrary to our predictions, the perceptual and S1 neurophysiological amplification of self-generated force compared to an externally generated force was observed in our SCI participant when the two forces were of the same intensity. Importantly, we further found that there was a correlation between the perception of the force and the S1 MUA. That is, when the self-generated tap was perceived to be of a higher intensity compared to an externally generated tap of the same force intensity, the S1 MUA was higher for the self-generated tap compared to the externally generated tap. Similarly, when the two taps were perceived to be of the same intensity (at different absolute force intensities) at the PSE, the MUA in S1 for the two taps were similar. The result of our study suggests that an amplification of self-generated stimulus is observed in our SCI participant and that the S1 MUA is related to the behavioral perception of force intensity

Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review.

BackgroundVoluntary medical male circumcision (VMMC) remains an essential component of combination HIV prevention services, particularly in priority countries in sub-Saharan Africa. As VMMC programs seek to maximize impact and efficiency, and to support World Health Organization guidance, specific uptake-enhancing strategies are critical to identify.MethodsWe systematically reviewed the literature to evaluate the impact of service delivery interventions (e.g., facility layout, service co-location, mobile outreach) on VMMC uptake among adolescent and adult men. For the main effectiveness review, we searched for publications or conference abstracts that measured VMMC uptake or uptake of HIV testing or risk reduction counselling within VMMC services. We synthesized data by coding categories and outcomes. We also reviewed studies assessing acceptability, values/preferences, costs, and feasibility.ResultsFour randomized controlled trials and five observational studies were included in the effectiveness review. Studies took place in South Africa, Tanzania, Uganda, Zambia, and Zimbabwe. They assessed a range of service delivery innovations, including community-, school-, and facility-based interventions. Overall, interventions increased VMMC uptake; some successfully improved uptake among age-specific subpopulations, but urban-rural stratification showed no clear trends. Interventions that increased adult men's uptake included mobile services (compared to static facilities), home-based testing with active referral follow-up, and facility-based HIV testing with enhanced comprehensive sexual education. Six acceptability studies suggested interventions were generally perceived to help men choose to get circumcised. Eleven cost studies suggested interventions create economies-of-scale and efficiencies. Three studies suggested such interventions were feasible, improving facility preparedness, service quality and quantity, and efficiencies.ConclusionsInnovative changes in male-centered VMMC services can improve adult men's and adolescent boys' VMMC uptake. Limited evidence on interventions that enhance access and acceptability show promising results, but evidence gaps persist due to inconsistent intervention definition and delivery, due in part to contextual relevance and limited age disaggregation

Economic compensation interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review and meta-analysis.

BackgroundEconomic compensation interventions may help support higher voluntary medical male circumcision (VMMC) coverage in priority sub-Saharan African countries. To inform World Health Organization guidelines, we conducted a systematic review of economic compensation interventions to increase VMMC uptake.MethodsEconomic compensation interventions were defined as providing money or in-kind compensation, reimbursement for associated costs (e.g. travel, lost wages), or lottery entry. We searched five electronic databases and four scientific conferences for studies examining the impact of such interventions on VMMC uptake, HIV testing and safer-sex/risk-reduction counseling uptake within VMMC, community expectations about compensation, and potential coercion. We screened citations, extracted data, and assessed risk of bias in duplicate. We conducted random-effects meta-analysis. We also reviewed studies examining acceptability, values/preferences, costs, and feasibility.ResultsOf 2484 citations identified, five randomized controlled trials (RCTs) and three non-randomized controlled trials met our eligibility criteria. Studies took place in Kenya, Malawi, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe. Meta-analysis of four RCTs showed significant impact of any economic compensation on VMMC uptake (relative risk: 5.23, 95% CI: 3.13 to 8.76). RCTs of food/transport vouchers and conditional cash transfers generally showed increases in VMMC uptake, but lotteries, subsidized VMMC, and receiving a gift appeared somewhat less effective. Three non-randomized trials showed mixed impact. Six additional studies suggested economic compensation interventions were generally acceptable, valued for addressing key barriers, and motivating to men. However, some participants felt they were insufficiently motivating or necessary; one study suggested they might raise community suspicions. One study from South Africa found a program cost of US$91 per additional circumcision and US$450-$1350 per HIV infection averted.ConclusionsEconomic compensation interventions, particularly transport/food vouchers, positively impacted VMMC uptake among adult men and were generally acceptable to potential clients. Carefully selected economic interventions may be a useful targeted strategy to enhance VMMC coverage

An Examination of the Effects of Increased Response Requirement and Delay on Reinforcer Selection.

This study examined the effect that increased response requirement, or effort, (Study 1) and delay to reinforcement (Study 2) have on reinforcer selection and response allocation. A reinforcer assessment using a token system was conducted within the classroom setting to determine high and low preference stimuli. The independent variable (effort or delay) was systematically manipulated for high preference stimuli. The results for eight participants indicated that increased levels of effort and delay independently influenced reinforcer preference and response allocation. The results revealed highly idiosyncratic responding to the different levels of the independent variables. The findings for increased response requirement are also discussed in behavioral economic terms