Positive and Negative Deviant Counties: Identification of Factors Associated with Health Outcomes

Rural counties in the United States vary drastically on metrics related to socioeconomic status and dominant economic industry as well as health behaviors and outcomes. This study sought to understand the underlying structural reasons why some rural counties have better or worse than expected health outcomes using a positive deviance (PD) approach. The study aimed to: 1) create an area deprivation index and divide counties into quartiles using the index; 2) identify positive, negative, and non-deviant counties using health outcome metrics; 3) analyze differences between deviance on a variety of local public health system metrics; and 4) analyze differences between deviance on a variety of health service system metrics. All data were secondary, with data on public health systems derived from NACCHO’s 2016 National Profile of Local Health Departments (LHDs) and data on healthcare systems derived from HRSA’s 2016-2017 Area Health Resource File. Multivariate analysis, nonparametric analysis, and multinomial logistic regression were conducted. Results indicated that public health systems in positive deviant counties were more likely to have their next year’s budget exceed their current budget compared to negative and non-deviant counties. Public health systems in negative deviant counties had much lower rates of completed community health assessments, community health improvement plans, and strategic plans. LHDs overseen by their local government were 6.20 (p=.001) times more likely to be positive deviant, and negative deviant counties were much less likely (OR=0.12, pp 17.28 physicians per 10,000 population), while negative deviant counties were less likely (OR=.35, pp=.38) compared to non-deviant counties. Future research should continue using the PD approach for population-level studies and seek to understand which components of local public health and healthcare systems are associated with better population health

Isoelectric focusing of proteins and peptides

Egg-white solution was chosen as the reference solution in order to assess the effects of operational parameters (voltage, flow rate, ampholine pH range and concentration, and protein concentration) of the RIEF apparatus on protein resolution. Topics of discussion include: (1) comparison of RIEF apparatus to conventional IEF techniques (column and PAG) with respect to resolution and throughput; (2) peptide and protein separation (AHF, Thymosin - Fraction 5, vasoactive peptide, L-asparaginase and ACP); and (3) detection of peptides - dansyl derivatives of amino acids and peptides, post-focusing fluorescent labeling of amino acids, peptides and proteins, and ampholine extraction from focused gels

Tuning of antigen sensitivity by T cell receptor-dependent negative feedback controls T cell effector function inflammed tissues

Activated T cells must mediate effector responses sufficient to clear pathogens while avoiding excessive tissue damage. Here we have combined dynamic intravital microscopy with ex vivo assessments of T cell cytokine responses to generate a detailed spatiotemporal picture of CD4+ T cell effector regulation in the skin. In response to antigen, effector T cells arrested transiently on antigen presenting cells, briefly producing cytokine and then resuming migration. Antigen recognition led to PD-1 upregulation of the programmed death-1 (PD-1) glycoprotein by T cells and blocking its canonical ligand, programmed death-ligand 1 (PD-L1), lengthened the duration of migration arrest and cytokine production, showing that PD-1 interaction with PD-L1 is a major negative feedback regulator of antigen responsiveness. We speculate that the immune system employs a mechanism involving T cell recruitment, transient activation, and rapid desensitization, allowing the T cell response to rapidly adjust to changes in antigen presentation and minimize collateral injury to the host

Cytotoxic T Lymphocyte Antigen-4 Accumulation in the Immunological Synapse Is Regulated by TCR Signal Strength

AbstractCD28 and CTLA-4 engagement with B7 expressed by APCs generates critical regulatory signals for T cell activation. CD28 is expressed on the T cell surface and enhances T cell expansion, while CTLA-4 localizes primarily to an intracellular compartment and inhibits T cell proliferation. We demonstrate that CTLA-4 has several unique trafficking properties that may regulate its ability to attenuate a T cell response. Importantly, accumulation of CTLA-4 at the immunological synapse is proportional to the strength of the TCR signal, suggesting that cells receiving stronger stimuli are more susceptible to CTLA-4-mediated inhibition. This may represent a novel feedback control mechanism in which a stimulatory signal regulates the recruitment of an inhibitory receptor to a functionally relevant site on the cell surface

What Are 5 FAQs About Faculty Roles in the Flipped Classroom

Our topic today is, what are the five frequently asked questions about faculty roles in the flipped classroom? This is a helpful topic for those of you who are faculty, as you think about your changing role in the flipped environment. It\u27s also helpful for those of you who are faculty developers, as you think about how to develop programs and professional development opportunities for faculty on your campus. Barbi Honeycutt, Ph.D., currently serves as the Director of Graduate Teaching Programs at North Carolina State University and as Adjunct Assistant Professor in the Department of Leadership, Policy, Adult and Higher Education the College of Education at NC State. She created Flip It Consulting in 2011. She and her colleagues design and deliver programs to teach you how to flip your workshops, seminars, training sessions, classes, and meetings. Sarah Egan Warren is a Flip It Associate and the Education & Training Director of Reify Media, LLC, a Raleigh-based online media company. Sarah also serves as the Assistant Director for the Professional Writing Program at NC State University. Her dedication to student-centered learning inspires her to keep up to date on instructional technology and trends. A dynamic and versatile teacher, speaker, and advisor, Sarah combines her experiences inside and outside the classroom to provide clear, concise, and comprehensive workshops, presentations, lectures, and learning resources.https://knowledge.e.southern.edu/onlineseminars/1029/thumbnail.jp

O teatro como discurso político e social da cultura afro-brasileira

Trabalho de conclusão de curso (graduação)—Universidade de Brasília, Instituto de Artes, Departamento de Artes Cênicas, 2016.Este Trabalho de Conclusão de Curso tem como objetivo apresentar a experiência do projeto “O Teatro como discurso político e social da cultura afro-brasileira”, que trabalha a linguagem teatral no contexto escolar, na Escola Dr. Herculano Pimentel, com alunos do ensino médio em idade entre 15 e 17 anos. O projeto procura ressaltar elementos da linguagem teatral como: expressão corporal e sensorial, espaço, interação, jogos teatrais, criação de cena e leitura dramática, associando-os às produções artísticas e culturais afro-brasileiras. Buscou-se, no exercício prático, uma mudança paradigmática acerca de conceitos como “autoaceitação”, “embranquecimento” e “valorização étnica”, partindo de discussões sobre a relevância do espaço da comunidade escolar como livre expressão do negro e do mestiço, pautando-se no trabalho realizado pelo Teatro Experimental do Negro e suas contribuições para construção da identidade negra no Brasil. Assim, esta pesquisa tem o intuito, ainda, de refletir sobre o discurso social e político do teatro, evidenciando as questões raciais

A randomised phase I study of etrolizumab (rhuMAb β7) in moderate to severe ulcerative colitis.

ObjectiveEtrolizumab (rhuMAb β7, anti-β7, PRO145223) is a humanised monoclonal antibody targeting the β7 subunit of the heterodimeric integrins α4β7 and αEβ7, which are implicated in leucocyte migration and retention in ulcerative colitis (UC). This randomised phase I study evaluated the safety and pharmacology of etrolizumab in patients with moderate to severe UC.DesignIn the single ascending dose (SAD) stage, etrolizumab (0.3, 1.0, 3.0, 10 mg/kg intravenous, 3.0 mg/kg subcutaneous (SC) or placebo) was administered 4:1 (n=25) in each cohort. In the multiple dose (MD) stage, new patients received monthly etrolizumab (0.5 mg/kg SC (n=4), 1.5 mg/kg SC (n=5), 3.0 mg/kg SC (n=4), 4.0 mg/kg intravenous (n=5)) or placebo (n=5). The pharmacokinetics was studied and Mayo Clinic Score evaluated at baseline, day 29 (SAD), and days 43 and 71 (MD).ResultsIn the SAD stage, there were no dose limiting toxicities, infusion or injection site reactions. Two impaired wound healing serious adverse events occurred in two patients receiving etrolizumab. In the MD stage, there were no dose limiting toxicities, and no infusion or injection site reactions. Headache was the most common adverse event, occurring more often in etrolizumab patients. Antietrolizumab antibodies were detected in two subjects. The duration of β7 receptor full occupancy was dose related. A clinical response was observed in 12/18 patients, and clinical remission in 3/18 patients treated with etrolizumab in the MD stage, compared with 4/5 and 1/5 placebo patients, respectively.ConclusionEtrolizumab is well tolerated in moderate to severe UC. Further investigation is warranted

Autoimmunization of Ewes Against Pregnancy-associated Glycoproteins Does Not Interfere with the Establishment and Maintenance of Pregnancy

doi:10.1017/S1751731109004145Pregnancy-associated glycoproteins (PAGs) are a large grouping of placental proteins that belong to the aspartic peptidase gene family. Although useful to detect pregnancy in ruminant species, the function of these molecules is unclear. Several PAGs expressed by trophoblast binucleate cells can enter the maternal circulation, suggesting that they could have a systemic role in altering maternal physiology. The objective of this work was to examine whether these circulating placental antigens were important in pregnancy by actively immunizing ewes against them. PAGs were purified by pepstatin-affinity chromatography and conjugated to the immunogenic protein, keyhole limpet hemocyanin (KLH). Ewes were immunized with PAG-KLH conjugate (n522) or with KLH alone (n59), and bred to intact rams. Blood samples, collected on Day 0 (day of estrus), Day 10, Days 15 to 25 and weekly throughout pregnancy, were analyzed for PAG by an ELISA. On Day 30, pregnancy was confirmed by ultrasound. Ewes immunized against PAG-KLH produced a range of reactive anti-PAG titers, whereas all immunized ewes had high anti-KLH immunoreactivity. PAGs became detectable in the anti-KLH (control) ewes at Day 21.662.2 of pregnancy. Those ewes immunized against PAGs (n57), that had very low immunoreactivity toward PAGs, had measurable PAG by Day 22.961.3, and their PAG serum profiles throughout pregnancy did not differ from the controls. Those exhibiting moderate to high anti-PAG immunoreactivity (n515), had significantly lower PAG concentrations than controls, with antigen not becoming detectable until Day 48.1615.6. The decrease in circulating PAG in the immunized animals did not correlate with changes in pregnancy rates, lamb number or lamb birth weight. These results suggest that while PAGs may play a role in maintaining pregnancy, their major contribution is likely to be at the fetal-maternal interface. Their actions at extra-placental sites are presumably of more secondary importance.This work was supported by NIH Grant HD21896 and the Animal Reproductive Biology Group of the University of Missouri Food for the 21st Century Program