Reflections On The Current State Of Healthcare Transition for Young Adult Women With Turner Syndrome: Strategies For Facilitating Autonomy and Self-Management

The transition to adult-centered healthcare is a critical period for emerging adults, especially those with special healthcare needs (SHCNs). Considering the ongoing medical monitoring necessary for women with Turner syndrome (TS), it is essential that the transition process be comprehensive and well-coordinated. The aims of this study were to invite young women with TS to reflect on their healthcare transition experiences, to explore participants’ perceived control of their medical management, and to identify ways in which genetic counselors can be involved in multidisciplinary healthcare teams. The hypotheses were that young women with TS are motivated to learn more about their diagnosis, benefit from counseling on how to develop self-management skills, and believe it would be useful to speak with a genetic counselor as adolescents. Study participants included twenty-two women between the ages of 18 and 30 years with a diagnosis of TS. A mixed method study design was used, consisting of quantitative data collection via an online survey tool and follow-up qualitative interviews. Interviews were transcribed and reviewed for major themes using data driven coding and subsequent exploratory thematic analysis. Results demonstrated that participants who received counseling on the development of self-management skills as adolescents were more confident, independent, and satisfied with their transition to adult-centered medical care than participants who did not. Six major themes were identified in participant interviews. These included diagnosis disclosure, TS education, genetics knowledge, transition support, patient autonomy, and multidisciplinary care. In conclusion, young adult women with TS are highly motivated to achieve autonomy in their healthcare and would appreciate being given additional information about their condition at a younger age. Healthcare providers should carefully consider patient preferences in order to provide patients with optimal support and appropriate resources. New recommendations for clinical practice should incorporate involvement of genetic counselors in the multidisciplinary healthcare teams of girls and women with TS

Experiential Education and Instructional Technology: Adapting Face-To-Face Courses to Online Spaces

In an effort to sustain institutional change championing experiential education, the members of this panel collaborated on the facilitation of a series of professional development workshops. One of the workshops, a session on adapting experiential coursework to online spaces, was specifically developed in response to a need identified by faculty themselves. This presentation will share the literature and best practices behind this workshop and engage audience members in a truncated version of the workshop’s activities

Figuring Out Gas & Galaxies In Enzo (FOGGIE). IV. The Stochasticity of Ram Pressure Stripping in Galactic Halos

We study ram pressure stripping in simulated Milky Way-like halos at z>=2 from the Figuring Out Gas & Galaxies In Enzo (FOGGIE) project. These simulations reach exquisite resolution in their circumgalactic medium (CGM) gas owing to FOGGIE's novel refinement scheme. The CGM of each halo spans a wide dynamic range in density and velocity over its volume---roughly 6 dex and 1000 km/s, respectively---translating into a 5 dex range in ram pressure imparted to interacting satellites. The ram pressure profiles of the simulated CGM are highly stochastic, owing to kpc-scale variations of the density and velocity fields of the CGM gas. As a result, the efficacy of ram pressure stripping depends strongly on the specific path a satellite takes through the CGM. The ram-pressure history of a single satellite is generally unpredictable and not well correlated with its approach vector with respect to the host galaxy. The cumulative impact of ram pressure on the simulated satellites is dominated by only a few short strong impulses---on average, 90% of the total surface momentum gained through ram pressure is imparted in 20% or less of the total orbital time. These results reveal an erratic mode of ram pressure stripping in Milky-Way like halos at high redshift---one that is not captured by a smooth spherically-averaged model of the circumgalactic medium.Comment: 18 pages, 10 figures. Submitted to Ap

100% RAG: Architectural Education | Theory vs. Practice, Volume 2, Number 4

100% RAG: Architectural Education | Theory vs. Practice, Syracuse School of Architecture, Student Newspaper, Volume 2, Number 4. Student newsletter from student contributors of Syracuse School of Architecture in 1977

Glycine supplementation extends lifespan of male and female mice.

Diets low in methionine extend lifespan of rodents, though through unknown mechanisms. Glycine can mitigate methionine toxicity, and a small prior study has suggested that supplemental glycine could extend lifespan of Fischer 344 rats. We therefore evaluated the effects of an 8% glycine diet on lifespan and pathology of genetically heterogeneous mice in the context of the Interventions Testing Program. Elevated glycine led to a small (4%-6%) but statistically significant lifespan increase, as well as an increase in maximum lifespan, in both males (p = 0.002) and females (p \u3c 0.001). Pooling across sex, glycine increased lifespan at each of the three independent sites, with significance at p = 0.01, 0.053, and 0.03, respectively. Glycine-supplemented females were lighter than controls, but there was no effect on weight in males. End-of-life necropsies suggested that glycine-treated mice were less likely than controls to die of pulmonary adenocarcinoma (p = 0.03). Of the 40 varieties of incidental pathology evaluated in these mice, none were increased to a significant degree by the glycine-supplemented diet. In parallel analyses of the same cohort, we found no benefits from TM5441 (an inhibitor of PAI-1, the primary inhibitor of tissue and urokinase plasminogen activators), inulin (a source of soluble fiber), or aspirin at either of two doses. Our glycine results strengthen the idea that modulation of dietary amino acid levels can increase healthy lifespan in mice, and provide a foundation for further investigation of dietary effects on aging and late-life diseases

Glycine supplementation extends lifespan of male and female mice.

Diets low in methionine extend lifespan of rodents, though through unknown mechanisms. Glycine can mitigate methionine toxicity, and a small prior study has suggested that supplemental glycine could extend lifespan of Fischer 344 rats. We therefore evaluated the effects of an 8% glycine diet on lifespan and pathology of genetically heterogeneous mice in the context of the Interventions Testing Program. Elevated glycine led to a small (4%-6%) but statistically significant lifespan increase, as well as an increase in maximum lifespan, in both males (p = 0.002) and females (p \u3c 0.001). Pooling across sex, glycine increased lifespan at each of the three independent sites, with significance at p = 0.01, 0.053, and 0.03, respectively. Glycine-supplemented females were lighter than controls, but there was no effect on weight in males. End-of-life necropsies suggested that glycine-treated mice were less likely than controls to die of pulmonary adenocarcinoma (p = 0.03). Of the 40 varieties of incidental pathology evaluated in these mice, none were increased to a significant degree by the glycine-supplemented diet. In parallel analyses of the same cohort, we found no benefits from TM5441 (an inhibitor of PAI-1, the primary inhibitor of tissue and urokinase plasminogen activators), inulin (a source of soluble fiber), or aspirin at either of two doses. Our glycine results strengthen the idea that modulation of dietary amino acid levels can increase healthy lifespan in mice, and provide a foundation for further investigation of dietary effects on aging and late-life diseases

Canagliflozin extends life span in genetically heterogeneous male but not female mice.

Canagliflozin (Cana) is an FDA-approved diabetes drug that protects against cardiovascular and kidney diseases. It also inhibits the sodium glucose transporter 2 by blocking renal reuptake and intestinal absorption of glucose. In the context of the mouse Interventions Testing Program, genetically heterogeneous mice were given chow containing Cana at 180 ppm at 7 months of age until their death. Cana extended median survival of male mice by 14%. Cana also increased by 9% the age for 90th percentile survival, with parallel effects seen at each of 3 test sites. Neither the distribution of inferred cause of death nor incidental pathology findings at end-of-life necropsies were altered by Cana. Moreover, although no life span benefits were seen in female mice, Cana led to lower fasting glucose and improved glucose tolerance in both sexes, diminishing fat mass in females only. Therefore, the life span benefit of Cana is likely to reflect blunting of peak glucose levels, because similar longevity effects are seen in male mice given acarbose, a diabetes drug that blocks glucose surges through a distinct mechanism, i.e., slowing breakdown of carbohydrate in the intestine. Interventions that control daily peak glucose levels deserve attention as possible preventive medicines to protect from a wide range of late-life neoplastic and degenerative diseases

Isolation and Mutagenesis of a Capsule-Like Complex (CLC) from Francisella tularensis, and Contribution of the CLC to F. tularensis Virulence in Mice

BACKGROUND: Francisella tularensis is a category-A select agent and is responsible for tularemia in humans and animals. The surface components of F. tularensis that contribute to virulence are not well characterized. An electron-dense capsule has been postulated to be present around F. tularensis based primarily on electron microscopy, but this specific antigen has not been isolated or characterized. METHODS AND FINDINGS: A capsule-like complex (CLC) was effectively extracted from the cell surface of an F. tularensis live vaccine strain (LVS) lacking O-antigen with 0.5% phenol after 10 passages in defined medium broth and growth on defined medium agar for 5 days at 32°C in 7% CO₂. The large molecular size CLC was extracted by enzyme digestion, ethanol precipitation, and ultracentrifugation, and consisted of glucose, galactose, mannose, and Proteinase K-resistant protein. Quantitative reverse transcriptase PCR showed that expression of genes in a putative polysaccharide locus in the LVS genome (FTL_1432 through FTL_1421) was upregulated when CLC expression was enhanced. Open reading frames FTL_1423 and FLT_1422, which have homology to genes encoding for glycosyl transferases, were deleted by allelic exchange, and the resulting mutant after passage in broth (LVSΔ1423/1422_P10) lacked most or all of the CLC, as determined by electron microscopy, and CLC isolation and analysis. Complementation of LVSΔ1423/1422 and subsequent passage in broth restored CLC expression. LVSΔ1423/1422_P10 was attenuated in BALB/c mice inoculated intranasally (IN) and intraperitoneally with greater than 80 times and 270 times the LVS LD₅₀, respectively. Following immunization, mice challenged IN with over 700 times the LD₅₀ of LVS remained healthy and asymptomatic. CONCLUSIONS: Our results indicated that the CLC may be a glycoprotein, FTL_1422 and -FTL_1423 were involved in CLC biosynthesis, the CLC contributed to the virulence of F. tularensis LVS, and a CLC-deficient mutant of LVS can protect mice against challenge with the parent strain