Community Collaboration to Develop a Curriculum on Settler Colonialism and the Social Determinants of Health.

American Indian/Alaska Native (AI/AN) communities continue to experience health disparities and poor health outcomes, which are influenced by social determinants of health. The theory of settler colonialism provides a framework for understanding the structures that affect social determinants of health and the resulting health disparities. Western biomedicine and medical education have been implicated in perpetuating settler colonialism, and as a result Indigenous medical educators and leaders have called for increased education and understanding of the structural and social determinants of health affecting Indigenous populations.

Why the Indian Health Care Improvement Act Has Failed to Effectively Fund Workforce Development for the Indian Health Service.

The Indian Health Service (IHS) faces severe workforce shortages due to underfunding and underdevelopment of clinical training programs. Unlike other direct federal health care systems that have implemented clinical training paradigms as central parts of their success, the IHS has no formalized process for developing such programs internally or in partnership with academic institutions. While the Indian Health Care Improvement Act (IHCIA) authorizes mechanisms by which the IHS can support overall workforce development, a critical portion of the act (U.

Combining Off-flow, a Nextflow-coded program, and whole genome sequencing reveals unintended genetic variation in CRISPR/Cas-edited iPSCs.

Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-Cas nucleases and human induced pluripotent stem cell (iPSC) technology can reveal deep insight into the genetic and molecular bases of human biology and disease. Undesired editing outcomes, both on-target (at the edited locus) and off-target (at other genomic loci) hinder the application of CRISPR-Cas nucleases. We developed Off-flow, a Nextflow-coded bioinformatic workflow that takes a specific guide sequence and Cas protein input to call four separate off-target prediction programs (CHOPCHOP, Cas-Offinder, CRISPRitz, CRISPR-Offinder) to output a comprehensive list of predicted off-target sites.

Regular aspirin use among a sample of American Indians/Alaskan Natives in the Upper Midwest region of the United States.

Despite high prevalence of cardiovascular disease (CVD) and CVD risk factors among American Indian or Alaska Native adults (AI/AN), there is little information on aspirin use in this population. This survey-based study seeks to understand prevalence of aspirin use in a sample of AI/AN adults in the Upper Midwestern United States. In-person and telephone based surveys were conducted querying self-reported CVD and CVD risk factors, aspirin use, and aspirin related discussion with clinicians.

Non-canonical functions of a mutant TSC2 protein in mitotic division.

Tuberous Sclerosis Complex (TSC) is a debilitating developmental disorder characterized by a variety of clinical manifestations. TSC is caused by mutations in the TSC1 or TSC2 genes, which encode the hamartin/tuberin proteins respectively. These proteins function as a heterodimer that negatively regulates the mechanistic Target of Rapamycin Complex 1 (mTORC1).

Electrical impedance spectroscopy detects skin barrier dysfunction in childhood atopic dermatitis.

Background: Skin barrier dysfunction is associated with the development of atopic dermatitis (AD), however methods to assess skin barrier function are limited. We investigated the use of electrical impedance spectroscopy (EIS) to detect skin barrier dysfunction in children with AD of the CARE (Childhood AlleRgy, nutrition, and Environment) cohort.

Methods: EIS measurements taken at multiple time points from 4 months to 3-year-old children, who developed AD (n = 66) and those who did not (n = 49) were investigated.

Evaluating Disparities in Colon Cancer Survival in American Indian/Alaskan Native Patients Using the National Cancer Database.

Background: Studies demonstrate higher mortality rates from colon cancer in American Indian/Alaskan Native (AI/AN) patients compared to non-Hispanic White (nHW). We aim to identify factors that contribute to survival disparities.

Methods: We used the National Cancer Database to identify AI/AN (n = 2127) and nHW (n = 527,045) patients with stage I-IV colon cancer from 2004 to 2016.

Improving Use of Antibiotics for Pediatric Pneumonia in Community Hospital Emergency Departments.

Background And Objectives: The majority of pediatric patients present to community-hospital emergency departments (EDs). Pneumonia is among the most common reasons for ED visits; however, prescribing narrow-spectrum antibiotics occurs at rates below established best practices. We sought to increase prescription of narrow-spectrum antibiotics for pediatric pneumonia in 5 community hospital EDs using an interdisciplinary learning collaborative.

Factors Associated With Health Care Professionals' Choice to Practice in Rural Minnesota.

Importance: Rural health inequities are due in part to a shortage of health care professionals in these areas.

Objective: To determine the factors associated with health care professionals' decisions about where to practice.

Design, Setting, And Participants: This prospective, cross-sectional survey study of health care professionals in Minnesota was administered by the Minnesota Department of Health from October 18, 2021, to July 25, 2022.

Learning to walk the walk: Incorporating praxis for decolonization in global health education.

Colonial history has deeply influenced the structures that govern global health. Though many curricula promote equity, few focus on developing competency in understanding and dismantling colonialism, and the structural barriers to global health equity. To dismantle colonial structures and create equitable collaborations, learners must be able to recognise how colonialism permeates global health practice.

Implementation and first experiences with a multimodal mentorship curriculum for medicine-paediatrics residents.

Introduction: Mentorship increases trainee productivity, promotes career satisfaction and reduces burnout. Beginning in 2016, our Medicine-Paediatrics residency program developed and implemented a longitudinal mentorship curriculum among trainees. We report initial experiences with that program and discuss potential future directions.

Jack Michael's Contributions to the Treatment of Autism.

Jack Michael dedicated his life to teaching behavior analysis. He was passionate about Skinner's works and his enthusiasm was contagious. Jack's primary goal for his students was that they be able to analyze behavior like Skinner analyzed behavior, but with a little bit of Jack Michael sprinkled in here and there.

Application of the SARS-CoV-2-S1 ACE-2 receptor interaction as the basis of the fully automated assay to detect neutralizing SARS-CoV-2-S1 antibodies in blood samples.

A quantitative, high throughput, fully automated diagnostic method for the detection of neutralizing anti-SARS-CoV-2 antibodies was developed on the Phadia system based on the interaction of SARS-CoV-2 S1 protein and the human ACE-2 receptor. This method was compared to the current state of the art plaque reduction neutralization test (PRNT) and a high correlation between the two methods was observed. Using a large cohort of blood samples from convalescent patients and controls the method displays very high sensitivity and specificity (99,8% and 99.

Frequency and Nature of Communication and Handoff Failures in Medical Malpractice Claims.

Background: The Joint Commission has identified miscommunication as a leading cause of sentinel events, the most serious adverse events, but it is unclear what role miscommunications play in malpractice claims. We sought to determine the proportion of medical malpractice claims involving communication failure and describe their nature, including providers involved, locations, miscommunications types, costs, and the potential for handoff tools to avert risk and associated costs.

Methods: We retrospectively reviewed a random sample of malpractice claims from 2001 to 2011, collected in CRICO Strategies' Comparative Benchmarking System, a national claims database.

Standing on the Shoulders of a Giant: Remembrances of Jack Michael, Part 2.

In Part 1 of these remembrances of Jack Michael, we briefly described Jack's history in terms of how he became a behavior analyst (Sundberg & Schlinger, 2021). We pointed out that he was one of the first to apply the principles of behavior analysis discovered in the experimental laboratory to the area of rehabilitation. In so doing, Jack was perhaps the first applied behavior analyst.

Vitamin E infused highly cross-linked cemented cups in total hip arthroplasty show good wear pattern and stabilize satisfactorily: a randomized, controlled RSA trial with 5-year follow-up.

Background and purpose - Vitamin E infused highly cross-linked polyethylene (VEPE) was introduced in order to enhance oxidative resistance in highly cross-linked polyethylene cups in total hip arthroplasty (THA). We have, with a follow-up of 5 years, evaluated wear characteristics of 2 identically designed cemented cups with the only difference being the material, VEPE or ultra-high molecular weight polyethylene (UHMWPE). Furthermore, we report cup migration and clinical outcome.

Changing the Paradigm of School-Based Physical Therapist Service Delivery: Using Evidence to Support Intensive Intervention.

Purpose: The purpose of this article is to highlight the paradigm shift away from the typical model of direct service delivery of consistent frequency and duration in the school setting to accommodate an intensive progressive resistive exercise intervention. School-based physical therapists describe how they applied an evidence-based intensive intervention with multiple students in an urban public school district.

Summary Of Key Points: The school-based physical therapists had to modify the typical service delivery model and overcome other challenges to implement this intensive intervention approach.

Preserved periprosthetic bone stock at 5 years post-operatively with uncemented short hip stem in both collared and collarless version.

Introduction: Previous bone density studies have generally shown bone resorption around both cemented and uncemented total hip arthroplasty (THA) stems. This is presumed to be due to stress shielding. Short stems have been introduced partly to preserve bone in the proximal femur by a more physiological loading of the bone.

A tissue-bioengineering strategy for modeling rare human kidney diseases in vivo.

The lack of animal models for some human diseases precludes our understanding of disease mechanisms and our ability to test prospective therapies in vivo. Generation of kidney organoids from Tuberous Sclerosis Complex (TSC) patient-derived-hiPSCs allows us to recapitulate a rare kidney tumor called angiomyolipoma (AML). Organoids derived from TSC2 hiPSCs but not from isogenic TSC2 or TSC2 hiPSCs share a common transcriptional signature and a myomelanocytic cell phenotype with kidney AMLs, and develop epithelial cysts, replicating two major TSC-associated kidney lesions driven by genetic mechanisms that cannot be consistently recapitulated with transgenic mice.

Emergency department staff perceptions about the care of children with mental health conditions.

Objective: The number of children with mental health (MH) conditions who present to the emergency department (ED) is increasing. This study aimed to gain insight into the lived experiences of ED staff caring for children with MH conditions and to understand perceptions of current ED resources and what is needed to optimize care.

Methods: This was a qualitative study informed by complexity science theory utilizing a phenomenological approach.

Global Health Education during the COVID-19 Pandemic: Challenges, Adaptations, and Lessons Learned.

Global health education programs should strive continually to improve the quality of education, increase access, create communities that foster excellence in global health practices, and ensure sustainability. The COVID-19 pandemic forced the University of Minnesota's extensive global health education programs, which includes a decade of hybrid online and in-person programing, to move completely online. We share our experience, a working framework for evaluating global health educational programming, and lessons learned.

Standing on the Shoulders of a Giant: Remembrances of Jack Michael, Part 1.

In 1959, Jack Michael and his PhD student Ted Ayllon published "The Psychiatric Nurse as a Behavioral Engineer" (Ayllon & Michael, 1959). That study was Ayllon's doctoral dissertation and was the first empirical demonstration of how the principles of behavior (e.g.

Loss of Tsc1 in cerebellar Purkinje cells induces transcriptional and translation changes in FMRP target transcripts.

Tuberous sclerosis complex (TSC) is a genetic disorder that is associated with multiple neurological manifestations. Previously, we demonstrated that loss in cerebellar Purkinje cells (PCs) can cause altered social behavior in mice. Here, we performed detailed transcriptional and translational analyses of -deficient PCs to understand the molecular alterations in these cells.