Sensory sensitivity as a link between concussive traumatic brain injury and PTSD.

Traumatic brain injury (TBI) is one of the most common injuries to military personnel, a population often exposed to stressful stimuli and emotional trauma. Changes in sensory processing after TBI might contribute to TBI-post traumatic stress disorder (PTSD) comorbidity. Combining an animal model of TBI with an animal model of emotional trauma, we reveal an interaction between auditory sensitivity after TBI and fear conditioning where 75 dB white noise alone evokes a phonophobia-like phenotype and when paired with footshocks, fear is robustly enhanced. TBI reduced neuronal activity in the hippocampus but increased activity in the ipsilateral lateral amygdala (LA) when exposed to white noise. The white noise effect in LA was driven by increased activity in neurons projecting from ipsilateral auditory thalamus (medial geniculate nucleus). These data suggest that altered sensory processing within subcortical sensory-emotional circuitry after TBI results in neutral stimuli adopting aversive properties with a corresponding impact on facilitating trauma memories and may contribute to TBI-PTSD comorbidity

A Comparative Study on the Blue House National Petition System

학위논문 (석사) -- 서울대학교 대학원 : 국제대학원 국제학과(한국학전공), 2020. 8. 한정훈.본 논문은 청와대 국민청원제도의 특징과 의미에 대해 살펴보겠다. 청와대 국민청원제도는 문재인 정부가 설치한 대(對)정부 및 청와대 관계자의 전자청원제도이다. 청와대 국민청원제도는 제도 출범 후 국민적 주목을 많이 받았다. 그러나 국내 학계로부터의 비판도 적지 않다. 하지만 아쉬운 점은 현재 국내 학계에 청와대 국민청원제도에 대한 연구가 많지 않은 점이다. 그래서 본 논문은 이를 평가하기 위해 청와대 국민청원제도가 한국 국내 현존의 비슷한 전자청원/민원/국민제안제도 (국민신문고와 국회 국민동의청원 전자청원제도)와 해외 민주주의 국가(영국과 미국)의 전자청원제도와 비교, 청와대 국민청원제도의 특성과 의미를 살펴보겠다. Leston-Banderiad와 Tiburico가 제시한 기존 평가 프레임워크의 참고와 재구성을 통해서 본 논문은 청와대 국민청원제도, 국내, 외 전자청원제도의 비교적 질적 연구를 실시한다. 본 논문은 청와대 국민청원제도의 특징과 유효성 도출을 시도한다. 본 논문은 각 전자청원제도의 법률적, 제도적 프레임워크 비교와 실제 청원의 사례 분석을 통해서 청와대 국민청원제도의 장단점, 특징, 의미, 유효성을 살펴보겠다. 연구결과, 청와대 국민청원제도는 국민신문고와 국회의 전통적 청원제도와 신설된 국민동의청원 전자청원제도에 비해 상대적으로 절차가 적고 비용이 적어 문턱이 낮다. 또한 청와대 국민청원제도는 다른 비슷한 국내적 제도에 비해 정부와 더 직접적인 의사소통 채널이라서 국민들은 청와대 국민청원제도를 선호한다. 동시에, 법률적 영향력이 상대적으로 미미함에도 불구하고 청와대 국민청원제도를 통해서 국민의 여론과 의견이 정치관에 반영된다. 특히 청와대 국민청원제도는 사회적 주목을 많이 받기 때문에 국민들로 하여금자신의 의견을 표하고 사회 이슈를 반영할 수 있다. 청와대 국민청원제도의 청원은 사회적 논의를 시작하고 사회와 정치권에 영향을 자주 미칠 수도 있다. 그러나 청와대 국민청원제도의 두 가지 약점은 다음과 같다. 정치 제도의 시각으로 보면 한국은 대통령제 국가라서 행정부, 입법부, 사법부 삼권이 분립되어 있다. 그렇기 때문에 사실 청와대 국민청원제도의 법률적 영향력은 상대적으로 미미한다. 이는 미국 위 더 피플 전자청원제도에서도 볼 수 있다. 반면, 영국은 의원내각제 국가라서 영국의 공동전자청원제도를 통해서 행정부와 입법부에 함께 청원할 수 있다. 따라서 이론적으로 봤을 때 영국 전자청원제도의 법률적 영향력이 한국과 미국의 전자청원제도보다 더 강하다. 반면, 한국 정부는 삼권분립 원칙을 엄격하게 지켜야 하기 때문에 이론상, 청와대 국민청원제도의 정책적 영향력이 영국의 제도보다 미약하다. 또한 현재 한국 청와대 국민청원제도는 법률적 근거가 없다는 약점이 있다. 그렇기 때문에 최악의 경우에는 현재 미국 위 더 피플 전자청원제도처럼 미래의 행정부는 이러한 전자청원제도를 무시할 수도 있다. 결과적으로 본 논문은 법률, 정책적 영향력 기준으로만 전자청원제도를 평가하는 것은 매우 부족하다는 것을 지적한다. 그렇기 때문에 본 논문은 연구방법론적인 차원에서 전자청원제도를 평가할 때 더 포괄적인 기준을 적용할 필요가 있다고 강조한다.This paper explores the characteristics, meanings, and efficacy of the Blue House Electronic Petition (e-petition) System. The Blue House e-petition is a system constructed and currently running by the Moon Jae-in administration. This e-petition system has attracted many attentions from the public since launching. However, this system has also been occasionally criticised by scholars. So far, academia has devoted very little effort to study this highly popular petition system in Korea systematically. Thus, it is both important and meaningful to conduct research in the Blue House e-petition system. By drawing on and combining existing evaluation frameworks suggested by Leston-Banderiad and Tiburcio, qualitative comparative research has been conducted on the Blue House e-petition system to evaluate the characteristics, meanings, and efficacies in multiple perspectives. A two-pronged approach has been chosen, in which the system has been compared with similar existing systems both domestically (the epeople.go.kr system, and the national assembly petition system) and internationally (the electronic petition system run by the United Kingdom Government and Parliament, and the We the People electronic petition system run by the White House of the United States). Through comparing the legal and structural frameworks of each e-petition systems and analysing actual petition examples, this paper has deduced the strong and weak points, and the characteristics, meanings and efficacy of the Blue House e-petition system. This research concludes the reason why Koreans prefer the Blue House e-petition system is its lower barriers of entry and less complicated procedures; thus, the cost of petition is more economical than other domestic petition systems. Besides, the Blue House e-petition system establishes a direct channel of communication between the people and the heart of the government. Even though it might lack the necessary influence in legislation, the system is an excellent tool in terms of letting the public express their opinions. Given that the system has gathered a lot of public attention, social connections and discussions on particular issues may be started through petitioning and, occasionally, it may exert its impact not only on legislation but also on the society as a whole as this research has shown. This research has also pointed out the systems two main weak points. First, intrinsically, the Republic of Korea, like the United States, has adopted the presidential system, in which the executive, legislative and judicial branches are separated according to the principle of separation of powers. The United Kingdom, while adopting a parliamentary system, also has an e-petition system running which simultaneously submits e-petitions to both the executive and legislative branches of the government. Therefore, in theory, the UK e-petition system has a stronger influence on legislation. In contrast, since the Korean government has to uphold the principle of separation of powers, in theory the Blue House e-petition system has a weaker influence in legislation compare to its UK counterpart. The second weak point is the lack of a substantial legal foundation, which has rendered the Blue House e-petition system a somewhat fragile one. In the worst-case scenario, governments in the future could outright disregard the system since there is no legal obligation to maintain it. The current state of the We the People e-petition system shows us precisely that scenario, when the Trump administration is only paying, at best, lukewarm attention to the e-petition system established by his predecessor, President Obama. Finally, in a research methodological perspective, this paper argues that it would be too narrow to evaluate the e-petition system only from the legislation and policy perspectives. A broader scope of the evaluation is necessary when assessing an e-petition system.I. 서론 1 1. 문제제기 1 2. 기존문헌 6 3. 방법론 청원제도의 평가방법 11 II. 한국의 청원제도 33 1. 한국 청원제도의 역사와 발전 33 2. 청와대 국민청원제도 49 III. 청와대 국민청원제도의 대내적 비교 74 1. 국민신문고 74 2. 국회 국민동의청원제도 90 3. 청와대 국민청원제도의 대내적 비교 101 IV. 청와대 국민청원제도의 대외적 비교 117 1. 영국 전자청원제도 공동전자청원제도 117 2. 미국 전자청원제도 "위 더 피플" 전자청원제도 136 3. 한, 영, 미 삼국의 전자청원제도 비교 149 4. 청와대 국민청원제도의 대외적 비교 소결 174 V. 결론 178 참고문헌 182 Abstract 202Maste

A randomised trial comparing three Delphi feedback strategies found no evidence of a difference in a setting with high initial agreement

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Rural Health in Virginia: Disparities, Dilemmas, and Overview of a JMU School of Nursing Solution

Background: There is no unified definition of rurality; this makes studying rurality, rural health, and associated health disparities and health outcomes difficult. Rural Americans constitute approximately 15% of the U.S. population, and they experience multiple barriers to healthcare and numerous health disparities as a result, particularly related to chronic disease, mental health, and increased lifestyle-linked health risks. Rural Americans should be viewed as a unique and vulnerable population, one with specific health promotion and disease prevention needs. Local problem: Although Virginia as a whole is a wealthy state, much inequity exists between the “Golden Crescent” and the “Rural Horseshoe” regions of Virginia, which includes the western portion of the State. Rural Virginians face higher unemployment, a higher poverty rate, and decreased access to care. One such area is Page County, Virginia, a local underserved health professional shortage area. Methods: In 2018, JMU obtained a HRSA grant focusing on Nursing Education, Practice, Quality, and Retention called, “The Undergraduate Primary Care and Rural Education (UPCARE) Project: a Community-based Nursing Education Collaboration. Intervention: The UPCARE Project allows JMU School of Nursing to respond to the needs for 1) BSN student education focusing on community health and primary care in a rural area, and 2) the creation two RN preceptor positions which incorporate a enhanced primary care RN role within 4 Rural Health Clinics (RHCs), all of whom are facilitated by a faculty-led grant team, including a Nurse Liaison. This two-pronged approach enables nurses to work to meet the health needs of the residents of Page County, Virginia. It is an innovative approach in keeping with Virginia’s State Rural Health Plan. Results: The JMU UPCARE Project is a collaborative, community-focused solution to the rural health disparities facing Page County. To date, nine students have started their clinical experiences in Page County, and two RN preceptors are starting their enhanced primary care RN role in the Rural Health Clinics. Conclusions/ Implications: This presentation will focus on rural health nursing in general, rural health disparities in Virginia, the creation of the UPCARE Project as part of the solution to meet the health care needs of rural Virginians. In keeping with the theme of the conference, the presentation will focus on the development of an enhanced primary care RN role, which is designed for RNs to work at the top of their practice scope

A Mouse with a Monoclonal Primary lmmunoglobulin Repertoire not Further Diversified by V-Gene Replacement

We have generated a monoclonal B-cell mouse by introducing homozygous, nonfunctional RAG-2 alleles and a λ1 light-chain transgene into the quasi-monoclonal (QM) mouse, which contains a “knocked-in” VHDJH rearrangement. Thus, this mouse, which we call MonoB, is devoid of T cells and contains preformed heavy- and light-chain genes encoding immunoglobulin with an anti-NP specificity. The MonoB mouse allows us to examine immunoglobulin diversity in the absence of processes mediated by V(D)J recombination and T cells. Here we report that not only is the MonoB's primary immunoglobulin repertoire monoclonal, but also that its secondary repertoire is not further diversified by V-gene replacement or gene conversion. Among 99 heavy-chain and 41 λ light-chain genes from peripheral B cells of the MonoB mouse, there were no V-gene replacements. When compared to the QM mouse, which has RAG activity, and for which V-gene replacement is the major diversifying mechanism, these data suggest that V-gene replacement is mediated by V(D)J recombination and not by other recombination systems

Building successful and sustainable academic health science partnerships: exploring perspectives of hospital leaders

Background: Clinical work-based internships form a key component of health professions education. Integral to these internships, academic health science partnerships (AHSPs) exist between universities and teaching hospitals. Our qualitative descriptive study explored the perspectives of hospital leadership on AHSPs: what they are composed of, and the facilitators and barriers to establishing and sustaining these partnerships.     Methods: Fifteen individuals in a variety of hospital leadership positions were purposively sampled to participate in face-to-face interviews, after which a thematic analysis was conducted.Results: Participants reported that healthcare and hospital infrastructure shapes and constrains the implementation of clinical education. The strength of the hospitals’ relationship with the medical profession facilitated the partnership, however other health professions’ partnerships were viewed less favourably. Participants emphasized the value of hospital leaders prioritizing education. Further, our findings highlighted that communication, collaboration, and involvement are considered as both facilitators and barriers to active engagement. Lastly, opportunities stemming from the partnership were identified as research, current best practice, improved patient care, and career development.Conclusion: Our study found that AHSPs involve the drive of the university and hospitals to gain valued capital, or opportunities. Reciprocal communication, collaboration, and involvement are modifiable components that are integral to optimizing AHSPs

Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort

BACKGROUND: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. METHODS: Children initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis. Outcomes of interest were: first-line ART failure (clinical, immunologic, or virologic), change to second-line, and attrition (death or loss to program ). Cumulative incidence was computed for first-line failure and second-line initiation, with attrition as a competing event. RESULTS: In 27,031 children, median age at ART initiation was 6.7 years. Median baseline CD4% for children ≤5 years of age was 13.2% and CD4 count for those >5 years was 258 cells per microliter. Almost all (94.4%) initiated a nonnucleoside reverse transcriptase inhibitor; 5.3% a protease inhibitor, and 0.3% a triple nucleoside reverse transcriptase inhibitor-based regimen. At 1 year, 7.7% had failed and 14.4% had experienced attrition; by 5 years, the cumulative incidence was 25.9% and 29.4%, respectively. At 1 year after ART failure, 13.7% had transitioned to second-line and 11.2% had experienced attrition; by 5 years, the cumulative incidence was 31.6% and 25.9%, respectively. CONCLUSIONS: High rates of first-line failure and attrition were identified in children within 5 years after ART initiation. Of children meeting failure criteria, only one-third were transitioned to second-line ART within 5 years

A Dual Platform Approach to Transcript Discovery for the Planarian Schmidtea Mediterranea to Establish RNAseq for Stem Cell and Regeneration Biology

The use of planarians as a model system is expanding and the mechanisms that control planarian regeneration are being elucidated. The planarian Schmidtea mediterranea in particular has become a species of choice. Currently the planarian research community has access to this whole genome sequencing project and over 70,000 expressed sequence tags. However, the establishment of massively parallel sequencing technologies has provided the opportunity to define genetic content, and in particular transcriptomes, in unprecedented detail. Here we apply this approach to the planarian model system. We have sequenced, mapped and assembled 581,365 long and 507,719,814 short reads from RNA of intact and mixed stages of the first 7 days of planarian regeneration. We used an iterative mapping approach to identify and define de novo splice sites with short reads and increase confidence in our transcript predictions. We more than double the number of transcripts currently defined by publicly available ESTs, resulting in a collection of 25,053 transcripts described by combining platforms. We also demonstrate the utility of this collection for an RNAseq approach to identify potential transcripts that are enriched in neoblast stem cells and their progeny by comparing transcriptome wide expression levels between irradiated and intact planarians. Our experiments have defined an extensive planarian transcriptome that can be used as a template for RNAseq and can also help to annotate the S. mediterranea genome. We anticipate that suites of other 'omic approaches will also be facilitated by building on this comprehensive data set including RNAseq across many planarian regenerative stages, scenarios, tissues and phenotypes generated by RNAi

NPY and MC4R Signaling Regulate Thyroid Hormone Levels during Fasting through Both Central and Peripheral Pathways

SummaryFasting-induced suppression of the hypothalamic-pituitary-thyroid (HPT) axis is an adaptive response to decrease energy expenditure during food deprivation. Previous studies demonstrate that leptin communicates nutritional status to the HPT axis through thyrotropin-releasing hormone (TRH) in the paraventricular nucleus (PVN) of the hypothalamus. Leptin targets TRH neurons either directly or indirectly via the arcuate nucleus through pro-opiomelanocortin (POMC) and agouti-related peptide/neuropeptide Y (AgRP/NPY) neurons. To evaluate the role of these pathways in vivo, we developed double knockout mice that lack both the melanocortin 4 receptor (MC4R) and NPY. We show that NPY is required for fasting-induced suppression of Trh expression in the PVN. However, both MC4R and NPY are required for activation of hepatic pathways that metabolize T4 during the fasting response. Thus, these signaling pathways play a key role in the communication of fasting signals to reduce thyroid hormone levels both centrally and through a peripheral hepatic circuit