For the Love of Robots: Posthumanism in Latin American Science Fiction Between 1960-1999

Posthumanism—understood as a symbiotic relationship between humans and technology—is quickly and surely becoming an inextricable part of daily life. In an era where technology can be worn as an extension of—and an enhancement to—our bodies, traditional science fiction tropes such as robots and cyborgs resurface and reformulate questions on critical aspects of human experience: who are we and what do our (imagined) technologies say about our world? Such questions are far more complex than they appear. Their answers should not come from one source alone, as humanness is experienced differently across time and cultural systems. In this sense, it is imperative to focus critical attention on works beyond the English-language canon in order to discover alternative readings of the posthuman, understand how varying historical, social, and economic contexts give new meanings to robots, cyborgs and hyper-technological imaginaries, and provide balancing perspectives to the ideas presented in canon posthuman science fiction from the developed world. To this end, this study centers on posthuman science fiction from Latin America. The primary works included here are limited only to Mexico, Chile, and Argentina—three of the countries with the greatest science fiction output in the region. This study explores the intersections of gender, sexualities, and posthumanism, as well as the underlying sociopolitical implications of such narratives. They exhibit an undeniable influence of canon Anglophone science fiction in terms of tropes (robots as mates for humans, cybernetic doppelgangers, technological utopias and dystopias) as well as problematic representations of gender, sex, and race. Yet, at the same time, posthuman elements in these Latin American narratives exhibit distinct local traits. Moreover, robot and cyborg figures enhance and renew discourses of political corruption, dictatorial trauma, surveillance, social and ecological decline. This study aims to outline the ways in which Latin American posthuman science fiction stands apart from the canon and proves itself as a legitimate genre. Simultaneously, this project seeks to supplement the nascent critical corpus on Latin American science fiction. It is my hope that this study’s insights will contribute to the field’s growth and success with scholars and readers alike

Responding to Vaccine Safety Signals during Pandemic Influenza: A Modeling Study

Background: Managing emerging vaccine safety signals during an influenza pandemic is challenging. Federal regulators must balance vaccine risks against benefits while maintaining public confidence in the public health system. Methods: We developed a multi-criteria decision analysis model to explore regulatory decision-making in the context of emerging vaccine safety signals during a pandemic. We simulated vaccine safety surveillance system capabilities and used an age-structured compartmental model to develop potential pandemic scenarios. We used an expert-derived multi-attribute utility function to evaluate potential regulatory responses by combining four outcome measures into a single measure of interest: 1) expected vaccination benefit from averted influenza; 2) expected vaccination risk from vaccine-associated febrile seizures; 3) expected vaccination risk from vaccine-associated Guillain-Barre Syndrome; and 4) expected change in vaccine-seeking behavior in future influenza seasons. Results: Over multiple scenarios, risk communication, with or without suspension of vaccination of high-risk persons, were the consistently preferred regulatory responses over no action or general suspension when safety signals were detected during a pandemic influenza. On average, the expert panel valued near-term vaccine-related outcomes relative to long-term projected outcomes by 3∶1. However, when decision-makers had minimal ability to influence near-term outcomes, the response was selected primarily by projected impacts on future vaccine-seeking behavior. Conclusions: The selected regulatory response depends on how quickly a vaccine safety signal is identified relative to the peak of the pandemic and the initiation of vaccination. Our analysis suggested two areas for future investment: efforts to improve the size and timeliness of the surveillance system and behavioral research to understand changes in vaccine-seeking behavior

The Eucational Value of the Use of a Simcapture-Feedback Process in the Training of Obstetrics and Gynecology Residents

The educational value of the use of a Simcapture-feedback process in the training of obstetrics and gynecology Residents Joseph Patruno, MD, Timothy Pellini, MD, Martin Martino, MD, Grace Bova Lehigh Valley Health Network, Allentown, Pennsylvania Abstract: Background: The basis of renowned training hospitals like LVHN is a well-defined and effectively applied method for optimal teaching, especially in the operating room. Unfortunately, many physicians don’t provide the immediate and detailed feedback most valuable to residents. Thus, video feedback and detailed surveys shown to surgeons upon procedure completion are tools used to potentially optimize the educational experience for Obstetrics and Gynecology residents in the operating room. Method: For each chosen OB/Gyn procedure the surgical field was recorded. After the surgery, detailed surveys were given to each physician to assess the resident’s performance on each particular part of the operation. A debrief was also stimulated to discuss the specific weaknesses and strengths that the resident displayed during the procedure. Later that day, an Educational Value Survey was sent to both physicians to obtain feedback on how educationally effective the video and debriefing process were. Simultaneously, the same survey was sent to a control resident and attending who had done a similar procedure without the video and survey aspect present. Results: Attending surgeons’ responses in the subject cases were significantly higher with respect to the timeliness and effectiveness of the debrief than the responses from the control cases. Generally, both attendings and residents found the surgeries with the SimCapture video and evaluation tools more educationally valuable than those without the stimulated feedback resources. Conclusions: SimCapture video feedback as well as detailed evaluation forms can enhance the teaching and learning for residents doing OB/Gyn procedures. Additionally, with this foundation in place attending surgeons are able to engage the resident in a structured debrief after a surgery. Introduction: In a teaching hospital, attending surgeons are expected to provide immediate and comprehensive feedback to residents in order to improve surgery techniques and patient care. Unfortunately this expected debrief does not always occur or often the feedback given isn’t direct & clear enough to be effective. However the SimCapture technology used for video feedback as well as a series of surveys filled out by both surgeons are possible resources that can be utilized in order to optimize the educational value of a procedure. According to the BID model for teaching in the operating room created by Dr. Nicole K. Roberts (2009) the learner must be “actively involved in creating learning objective & proposing how instruction might be extended to future practice” (p.300). This model is easy to use because it solely requires brief conversation between attending and resident while scrubbing, operating, & closing. By utilizing these events that occur at every operation, very little additional time is required from either surgeon. Furthermore, the educational value of written assessments regarding resident’s surgical performance has also been rendered valid and useful. Such assessments “encourage the faculty and the resident to focus on areas of demonstrated competence and those areas needing improvement” (Dougherty et all, 2013, p.333). Detailed evaluation forms allow for the surgeons to reflect on each step of the procedure. These forms are most useful when completed directly after the surgery, allowing for more comprehensive recollection of the operation. Likewise, the resident benefits more from the stimulated debrief soon after he finishes the procedure. The stimulated debrief in this project utilizes the “Operative Performance Rating System “ (OPRS). Using this form, both surgeons can assess the resident’s performance for each part of the procedure. Although these evaluations have not get been validated for Ob/Gyn procedures, they have proven to be especially effective in general surgery. Unlike more broad evaluations of technical skill, the OPRS offers a “controlled, systematic, observation/evaluation and appropriate sampling of performance across the entire performance domain” (Larson et al, 2005, p. 646). Thus, the OPRS allows evaluators to rate the residents on a likert scale for each step of the procedure as well as more general surgical flow and knowledge. Detailed feedback like this provides the residents with specific surgical skills and methods that need improvement. The objective of our study is to determine the educational value of SimCapture video feedback as well as post-procedure evaluation forms with respect to Obstetrical and Gynecological procedures. We anticipate that these tools will enhance both the learning and teaching process for the residents and attendings respectively. Materials and Methods: In order to evaluate whether the SimCapture video and survey forms combined made a positive effect on the educational value of an operation we filmed about 40 OR cases. Among these cases included Cesarean sections, Robotically-assisted Laparoscopic Hysterectomies, Hysteroscopies, Bilateral Tubal Ligations, and Laparoscopically-Assisted Vaginal Hysterectomies. After choosing several cases to record from the OR list, the team found both the attending and resident on the case and informed them on the SimCapture project and asked for permission to film their upcoming procedure in the OR. Upon consent, the team set up the video system and oriented the OR staff to the project. During the procedure, only the surgeon’s hands were recorded. The residents were all assigned a number; thus, a resident number was associated with each video instead of individual’s names. Annotations were made within the video to indicate when the resident is operating. After the procedure was complete, both attending and resident were asked to fill out both a milestone form and an OPRS evaluation. The OPRS having questions specific to each step of the particular type of case. Having completed the surveys, the resident was asked to reflect on what he thought his weaknesses and strengths were in that particular case. This ignited the debriefing conversation, often resulting in meaningful discussion between both surgeons regarding the resident’s technique and skill level. Later that day, a survey was sent to both the attending and resident to assess the educational significance of their procedure that day. Among these questions were ones about the questions asked, the effectiveness of the debrief, and the overall educational value of the case. Each questions required a response between 1-5, usually 1 relating to least educational and 5 being most educationally valuable. Concurrently, another set of the same educational value surveys was sent to a control attending and resident that had participated in a similar case that day. Thus, the control data would allow us to evaluate the overall effect of the SimCapture and feedback process on the educational process. Using these cases for controls allows us to determine how well residents are regularly being effectively taught, especially via a debrief after the procedure. The questions in this survey asked responders to answer the following questions on a likert scale 1 being “strongly disagree” and 5 being “strongly agree”. 1. I/the resident came adequately prepared 2. Optimal training provided? 3. The questions asked by the attending were fair & appropriately challenging 4. There was an appropriate debrief before, during & after the case? 5. My opinion of my performance correlates with the attending’s perception of my performance. 6. Specific, timely, & valuable feedback was given. 7. I would rate the overall educational value of this case as… (1-Poor and 5-Excellent) The responses were then compiled into four separate groups: control residents, subject residents, control attendings, and subject attendings. The mean response for each question for each group was calculated. Then the controls’ and subjects’ mean responses were compared to assess the overall educational effect of the video and feedback process. Statistical analysis was also done. A t-test was performed to obtain p-values for the data set. Using the results of the t-test, we were able to determine the statistical significance and validity of each question for the residents (controls and subjects) and attendings (controls and subjects). Results: By the end of our six-week collection period, forty total cases were recorded: seventeen Cesarean Sections, eight Robotic Hysterectomies, twelve Hysteroscopies, and three Bilateral Tubal Ligations. We also collected fifteen control cases: four Cesarean Sections, one Robotic Hysterectomy, eight Hysteroscopies, and two Bilateral Tubal Ligations. Twelve out of twenty-three OB/Gyn residents participated in the study: two interns, five in their second year of residency, three in their third, and two in their fourth. Twenty-two different attendings participated as well. A brief comparison of the controls and subjects was done with the mean responses to each question. These results are as follows. The more statistically significant differences will be further discussed. Refer to Table 1 in the Appendix to see the average values for each question. 1. I/the resident came adequately prepared Residents: Similar responses regardless of process Attendings: Similar responses regardless of process 2. Optimal training provided? Residents: Interestingly, the controls felt more optimally trained in the OR than the subject did Attendings: Similar responses regardless of process 3. The questions asked by the attending were fair & appropriately challenging Residents: Controls’ responses were higher; felt they had been asked more appropriate questions Attendings: Controls’ responses were slightly higher 4. There was an appropriate debrief before, during & after the case? Residents: Subjects’ responses were higher. Not surprisingly, as there was better communication during the debrief developed by the process Attendings: Subjects’ responses were generally much higher. The attendings were alert to the stimulated debriefing process 5. My opinion of my performance correlates with the attending’s perception of my performance. Residents: Similar responses regardless of process Attendings: Similar responses regardless of process 6. Specific, timely, & valuable feedback was given Residents: Similar responses; feel they are getting feedback in either process Attendings: Subjects’ responses were higher; attendings felt much more confident regarding their feedback with this process guiding them 7. I would rate the overall educational value of this case as… (1-Poor and 5-Excellent) Residents: Subjects’ responses were higher. The educational value ties together importance of preparation, supervision, education, debriefing, and feedback, several of which the SimCapture/feedback process aimed to enhance. Attendings: Subjects’ responses were higher as well. The following is a chart (Figure 1) of the average response for residents (both control and subject) and the p values from the t-test. The highlighted columns are the values that are most statistically significant. (Figure 1) The following is a chart (Figure 2) of the average response for attendings (both control and subject) and the p values from the t-test. The highlighted columns are the values that are most statistically significant. (Figure 2) Furthermore, in the subject’s surveys there was a question about the value of using SimCapture video as a form of feedback. 87% of subject cases had residents who saw value in using video as a method of feedback. 75% of the subject cases had attendings who felt the video feedback could be useful for optimal teaching and learning Discussion: The residents in the subject cases found the surgeries with the SimCapture and feedback process generally more educationally valuable. Many of the residents enjoyed the opportunity to receive direct and detailed feedback from their mentors. The residents also benefitted from reflecting on their own performance, considering both their strengths and weaknesses. However, the residents’ responses that were particularly statistically significant were about the questions asked during surgery; interestingly, the controls felt that the questions asked were more fair and appropriate than the subjects. This difference may be due to the presence of the SimCapture equipment and team. This addition to the OR may have made the attendings feel as though the resident was in the spotlight and, therefore, did not need as many questions. The attendings who participated in the SimCapture and feedback process were able to recognize the educational importance of the debrief after a procedure. The attendings in subject cases felt significantly more confident about the timeliness and value of the feedback they gave to the resident after the procedure. By stimulating a debrief session between both surgeons directly after the procedure, attendings were able to recall specific challenges and strengths the resident displayed in the surgery. Thus, they felt they were able to deliver complete and procedure-specific criticism to the residents. Additionally the attendings also became more aware of the debriefing process. Many attendings further discovered the value and effectiveness of giving immediate, detailed feedback. Some of the anonymous comments left on the educational value survey were, “I need to debrief more. We have to go after cases to meet the next patient and sometime don\u27t take the time that we should be”… “I may ask the resident more questions during the case to assess their understanding”. Thus, this process increased personal teaching awareness, hopefully motivating the attendings to provide more comprehensive and timely feedback to the residents after a procedure. Regarding the use of SimCapture video as feedback, most of the faculty and residents who participated in the cases felt the video technology could be an effective and useful form of feedback. Several surgeons requested to view their videos upon completion and were able to easily visualize their weaknesses and strengths with the objective point of view on the camera. One of the limits of this research was the lack of a large cohort of control cases. Due to our time constraint, we were unable to get the widespread responses we had hoped for both control and subject cases. Additionally many residents and attednings did not fill out the educational value surveys at all. Others completed them days after the surgery, which could possibly limit their ability to recall the specifics of the residents’ performances in the particular cases. Lastly, in some of the subject cases we were not able to stimulate a debrief due the surgeon’s schedules. In these cases both surgeons filled out the OPRS evaluations but were unable to discuss the resident’s performance in the procedure. The lack of this debrief may have affected our final response data. Conclusion: Overall the SimCapture video and the OPRS evaluations feedback method was educationally valuable. Attendings especially found the guided feedback process specifically helpful and effective. We expect that attendings will try to incorporate more timely and detailed feedback to their residents in their everyday practice. The detailed OPRS evaluations provided residents with specific areas of technique that need improvements. By enhancing the teaching and learning process in the OR, residents are able to learn more advanced skills faster and more efficiently. Attendings are able to assess the resident’s direct areas of weakness or strength with a simple feedback mechanism. Essentially, the SimCapture with feedback process can potentially advance the way residents are trained, thus improving patient care. Acknowledgements: Thank you to my project mentor Dr. Joseph Patruno, as well as Dr. Timothy Pellini, Dr. Martin Martino, Dr. Hubert Huang, Diane Leuthard, the library services, and all the residents, physicians, nurses, and faculty in the OB/GYN department. This project would not have been possible without your support. Finally, thank you to Dr. Joseph Napolitano and the Dorothy Rider Pool Health Care Trust for giving me this opportunity and incredible experience. References: Dougherty, P, Kasten, S.J., Reynolds, R.K., Prince, M.E., Lypson, M.L. (2013, June). Intraoperative Assessment of Residents. Jornal of Graduate Medicine, 333-334. http://dx.doi.org/10.4300/JGME-D-13-00074.1 Larson, J.L., Williams, R. G., Ketchum, J, Boehler, M.L., Dunnington, G.L. (2005, October). Feasibility, reliability, and validity of operative performance rating system for evaluating surgery residents.Surgery, 138 (4), 640-649. http://dx.doi.org/10.1016/j.surg.2005.07.017 Levy, B. (2012, April). Experience Counts. Obstetrics & Gynecology, 119(4), 693-694. Roberts, N.K., Williams, R.G., Kim, M.J., Dunnington, G.L. (2009, February). The Briefing, Intraoperative Teaching, Debriefing Model for Teaching in the Operating Room. Journal of the American College of Surgeons, 208(2), 299-303. http://dx.doi.org/10.1016/j/jamcollsurg.2008.10.024 Swing, S.R. (2007).The ACGME outcome project: retrospective and prospective. Medical Teacher, 29, 648-654. http://dx.doi.org/10.1080/0142159070139290

miRNAs as common regulators of the transforming growth factor (TGF)-β pathway in the preeclamptic placenta and cadmium-treated trophoblasts: Links between the environment, the epigenome and preeclampsia

Preeclampsia (PE) is a pregnancy disorder characterized by high blood pressure and proteinuria that can cause adverse health effects in both mother and fetus. There is no current cure for PE other than delivery of the fetus. While the etiology is unknown, poor placentation of the placenta due to aberrant signaling of growth and angiogenic factors has been postulated as causal factors of PE. In addition, environmental contaminants, such as the metal cadmium (Cd), have been linked to placental toxicity and increased risk of developing PE. Here, we use a translational study design to investigate genomic and epigenomic alterations in both placentas and placental trophoblasts, focused on the angiogenesis-associated transforming growth factor-beta (TGF-β) pathway. Genes within the TGF-β pathway displayed increased expression in both the preeclamptic placenta and Cd-treated trophoblasts. In addition, miRNAs that target the TGF-β pathway were also significantly altered within the preeclamptic placenta and Cd-treated trophoblasts. Integrative analysis resulted in the identification of a subset of Cd-responsive miRNAs, including miR-26a and miR-155, common to preeclamptic placentas and Cd-treated trophoblasts. These miRNAs have previously been linked to PE and are predicted to regulate members of the TGF-β pathway. Results from this study provide future targets for PE treatment

miRNAs as common regulators of the transforming growth factor (TGF)-β pathway in the preeclamptic placenta and cadmium-treated trophoblasts: Links between the environment, the epigenome and preeclampsia

Preeclampsia (PE) is a pregnancy disorder characterized by high blood pressure and proteinuria that can cause adverse health effects in both mother and fetus. There is no current cure for PE other than delivery of the fetus. While the etiology is unknown, poor placentation of the placenta due to aberrant signaling of growth and angiogenic factors has been postulated as causal factors of PE. In addition, environmental contaminants, such as the metal cadmium (Cd), have been linked to placental toxicity and increased risk of developing PE. Here, we use a translational study design to investigate genomic and epigenomic alterations in both placentas and placental trophoblasts, focused on the angiogenesis-associated transforming growth factor-beta (TGF-β) pathway. Genes within the TGF-β pathway displayed increased expression in both the preeclamptic placenta and Cd-treated trophoblasts. In addition, miRNAs that target the TGF-β pathway were also significantly altered within the preeclamptic placenta and Cd-treated trophoblasts. Integrative analysis resulted in the identification of a subset of Cd-responsive miRNAs, including miR-26a and miR-155, common to preeclamptic placentas and Cd-treated trophoblasts. These miRNAs have previously been linked to PE and are predicted to regulate members of the TGF-β pathway. Results from this study provide future targets for PE treatment

Religion as practices of attachment and materiality: the making of Buddhism in contemporary London

This article aims to explore Buddhism’s often-overlooked presence on London’s urban landscape, showing how its quietness and subtlety of approach has allowed the faith to grow largely beneath the radar. It argues that Buddhism makes claims to urban space in much the same way as it produces its faith, being as much about the practices performed and the spaces where they are enacted as it is about faith or beliefs. The research across a number of Buddhist sites in London reveals that number of people declaring themselves as Buddhists has indeed risen in recent years, following the rise of other non-traditional religions in the UK; however, this research suggests that Buddhism differs from these in several ways. Drawing on Baumann’s (2002) distinction between traditionalist and modernist approaches to Buddhism, our research reveals a growth in each of these. Nevertheless, Buddhism remains largely invisible in the urban and suburban landscape of London, adapting buildings that are already in place, with little material impact on the built environment, and has thus been less subject to contestation than other religious movements and traditions. This research contributes to a growing literature which foregrounds the importance of religion in making contemporary urban and social worlds

Food safety metrics relevant to low- and middle-income countries

London School of Hygiene and Tropical MedicineRoyal Veterinary College, LondonWorld Health OrganizationFood and Agriculture Organization of the United Nation

Reduced Na+ and higher K+ channel expression and function contribute to right ventricular origin of arrhythmias in Scn5a+/− mice

Brugada syndrome (BrS) is associated with ventricular tachycardia originating particularly in the right ventricle (RV). We explore electrophysiological features predisposing to such arrhythmic tendency and their possible RV localization in a heterozygotic Scn5a+/− murine model. Nav1.5 mRNA and protein expression were lower in Scn5a+/− than wild-type (WT), with a further reduction in the RV compared with the left ventricle (LV). RVs showed higher expression levels of Kv4.2, Kv4.3 and KChIP2 in both Scn5a+/− and WT. Action potential upstroke velocity and maximum Na+ current (INa) density were correspondingly decreased in Scn5a+/−, with a further reduction in the RV. The voltage dependence of inactivation was shifted to more negative values in Scn5a+/−. These findings are predictive of a localized depolarization abnormality leading to slowed conduction. Persistent Na+ current (IpNa) density was decreased in a similar pattern to INa. RV transient outward current (Ito) density was greater than LV in both WT and Scn5a+/−, and had larger time constants of inactivation. These findings were also consistent with the observation that AP durations were smallest in the RV of Scn5a+/−, fulfilling predictions of an increased heterogeneity of repolarization as an additional possible electrophysiological mechanism for arrhythmogenesis in BrS

ISA-TAB-Nano: A Specification for Sharing Nanomaterial Research Data in Spreadsheet-based Format

BACKGROUND AND MOTIVATION: The high-throughput genomics communities have been successfully using standardized spreadsheet-based formats to capture and share data within labs and among public repositories. The nanomedicine community has yet to adopt similar standards to share the diverse and multi-dimensional types of data (including metadata) pertaining to the description and characterization of nanomaterials. Owing to the lack of standardization in representing and sharing nanomaterial data, most of the data currently shared via publications and data resources are incomplete, poorly-integrated, and not suitable for meaningful interpretation and re-use of the data. Specifically, in its current state, data cannot be effectively utilized for the development of predictive models that will inform the rational design of nanomaterials. RESULTS: We have developed a specification called ISA-TAB-Nano, which comprises four spreadsheet-based file formats for representing and integrating various types of nanomaterial data. Three file formats (Investigation, Study, and Assay files) have been adapted from the established ISA-TAB specification; while the Material file format was developed de novo to more readily describe the complexity of nanomaterials and associated small molecules. In this paper, we have discussed the main features of each file format and how to use them for sharing nanomaterial descriptions and assay metadata. CONCLUSION: The ISA-TAB-Nano file formats provide a general and flexible framework to record and integrate nanomaterial descriptions, assay data (metadata and endpoint measurements) and protocol information. Like ISA-TAB, ISA-TAB-Nano supports the use of ontology terms to promote standardized descriptions and to facilitate search and integration of the data. The ISA-TAB-Nano specification has been submitted as an ASTM work item to obtain community feedback and to provide a nanotechnology data-sharing standard for public development and adoption

Sexual epigenetic dimorphism in the human placenta: implications for susceptibility during the prenatal period

Sex-based differences in response to adverse prenatal environments and infant outcomes have been observed, yet the underlying mechanisms for this are unclear. The placental epigenome may be a driver of these differences