Review of the Captain America Graphic Novel 'TRUTH: Red, White and Black' Focusing on Parallels with the Infamous USPHS Syphilis Study at Tuskegee

This review presents the first detailed presentation of the parallelism between the Tuskegee Syphilis Study and the Captain America graphic novel 'TRUTH: Red, White and Black', published as a graphic novel by Marvel Comics in 2004 as a paperback, and then in 2009 as a hardcover. First written, published and distributed monthly in 2003 as pre-sequel seven comic book series to tell the story of the origins of the WWII superhero Captain America. In 2003, Marvel Comics chose to tell a 'very dark story' to explain the origins of Captain America, a half century after the initial introduction of Captain America as a WWII action hero in 1940. By detailing-for the first time-nine parallel aspects between these two storylines, this review demonstrates how Marvel Comics brought the tragic Tuskegee Syphilis Study story into the popular press, thus reaching an audience far beyond traditional bioethics academicians. This review is intended to stimulate and guide classroom discussions on the ethical issues at the core of the infamous Tuskegee Syphilis Study allowing bioethical issues to be made more accessible to the general public, via school curriculums, by the use of graphic novels.

Optimized quasi-optical cross-polarization scattering system for the measurement of magnetic turbulence on the DIII-D tokamak

Simulations and laboratory tests are used to design and optimize a quasi-optical system for cross-polarization scattering (CPS) measurements of magnetic turbulence on the DIII-D tokamak. The CPS technique uses a process where magnetic turbulence scatters electromagnetic radiation into the perpendicular polarization enabling a local measurement of the perturbing magnetic fluctuations. This is a challenging measurement that addresses the contribution of magnetic turbulence to anomalous thermal transport in fusion research relevant plasmas. The goal of the new quasi-optical design is to demonstrate the full spatial and wavenumber capabilities of the CPS diagnostic. The approach used consists of independently controlled and in vacuo aiming systems for the probe and scattered beams (55-75 GHz).

The high-k poloidal scattering system for NSTX-U

An 8-channel, high-k poloidal far-infrared (FIR) scattering system is under development for the National Spherical Torus eXperiment Upgrade (NSTX-U). The 693 GHz poloidal scattering system replaces a 5-channel, 280 GHz high-k toroidal scattering system to study high-k electron density fluctuations on NSTX-U. The FIR probe beam launched from Bay G is aimed toward Bay L, where large aperture optics collect radiation at 8 simultaneous scattering angles ranging from 2° to 15°. The reduced wavelength in the poloidal system results in less refraction, and coupled with a new poloidal scattering geometry, extends measurement of poloidal wavenumbers from the previous limit of 7 cm^-1 up to >40 cm^-1. Steerable launch optics coupled with receiver optics that can be remotely translated in 5 axes allow the scattering volume to be placed from r/a = 0.1 out to the pedestal region (r/a ∼ 0.99) and allow for both upward and downward scattering to cover different regions of the 2D fluctuation spectrum.

Integrated plasma facing component calorimetry for measurement of shot integrated deposited energy in the NSTX-U

The upgrade to the National Spherical Torus eXperiment (NSTX-U) [J. Menard et al., Nucl. Fusion 52, 083015 (2012)] increases the injected neutral beam power up to 12 MW and the plasma current up to I_p = 2 MA for plasma durations up to 5 s. The graphite plasma facing components have been re-designed to handle greater heat and energy fluxes than were seen in NSTX using a castellated design. We present the experimental testing and validation of a castellated graphite target, similar to the prototype tile design, instrumented with thermocouples at various depths in the castellation. During testing, incident heat flux is provided by a programmed electron beam system and surface temperatures are measured via infrared thermography directly viewing the target surface. It was found that the thermocouple response scaled linearly with the measured surface temperature rise regardless of thermocouple depth in the castellation. A sensitivity of 14.3 °C/kJ of deposited energy was found when treating individual castellations as a semi-infinite solid.

Nuclear-Mitochondrial interactions influence susceptibility to HIV-associated neurocognitive impairment

HIV-associated neurocognitive impairment (NCI) is a term established to capture a wide spectrum of HIV related neurocognitive deficits ranging in severity from asymptomatic to dementia. The genetic underpinnings of this complex phenotype are incompletely understood. Mitochondrial function has long been thought to play a role in neurodegeneration, along with iron metabolism and transport. In this work, we aimed to characterize the interplay of mitochondrial DNA (mtDNA) haplogroup and nuclear genetic associations to NCI phenotypes in the CHARTER cohort, encompassing 1025 individuals of European-descent, African-descent, or admixed Hispanic. We first employed a polygenic modeling approach to investigate the global effect of previous marginally associated nuclear SNPs, and to examine how the polygenic effect of these SNPs is influenced by mtDNA haplogroups. We see evidence of a significant interaction between nuclear SNPs en masse and mtDNA haplogroups within European-descent and African-descent individuals. Subsequently, we performed an analysis of each SNP by mtDNA haplogroup, and detected significant interactions between two nuclear SNPs (rs17160128 and rs12460243) and European haplogroups. These findings, which require validation in larger cohorts, indicate a potential new role for nuclear-mitochondrial DNA interactions in susceptibility to NCI and shed light onto the pathophysiology of this neurocognitive phenotype.

Heritage and Stigma. Co-producing and communicating the histories of mental health and learning disability

University engagement with mental health services has traditionally been informed by the vocational and pedagogical links between the two sectors. However, a growth in the interest in public history and in the history of mental healthcare has offered new opportunities for those in the humanities to engage new audiences and to challenge perceptions about care in the past. The introduction of the 'impact agenda' and related funding streams has further encouraged academics to contribute to historical debates, and to those concerning current services. One such example of this is the Arts and Humanities Research Council funded Heritage and Stigma project at the University of Huddersfield, which was conceived to support mental health and learning disability charities in the exploration and dissemination of their own histories. Using this project as a case study, this paper will draw on primary source material to reflect on the opportunities and challenges of working in partnership with such groups. In particular, it will consider the need to address issues of stigma and exclusion in tandem with a critical understanding of the moves to 'community care' instigated by landmark legislation in the form of the 1959 Mental Health Act. Overall, it provides evidence of an inclusive, coproductive model of design and highlights the positive contribution to communicating mental health made by those based in the humanities.

Mathematical modeling of the effects of CK2.3 on mineralization in osteoporotic bone

Osteoporosis is caused by decreased bone mineral density (BMD) and new treatments for this disease are desperately needed. Bone morphogenetic protein 2 (BMP2) is crucial for bone formation. The mimetic peptide CK2.3 acts downstream of BMP2 and increases BMD when injected systemically into the tail vein of mice. However, the most effective dosage needed to induce BMD in humans is unknown. We developed a mathematical model for CK2.3‐dependent bone mineralization. We used a physiologically based pharmacokinetic (PBPK) model to derive the CK2.3 concentration needed to increase BMD. Based on our results, the ideal dose of CK2.3 for a healthy individual to achieve the maximum increase of mineralization was about 409 µM injected in 500 µL volume, while dosage for osteoporosis patients was about 990 µM. This model showed that CK2.3 could increase the average area of bone mineralization in patients and in healthy adults.

Rapid cognitive decline: not always Creutzfeldt-Jakob disease

A patient with rapidly progressive cognitive decline over an approximately four month period was suspected to have sporadic Creutzfeldt-Jakob disease. Features thought to support this diagnosis included psychiatric symptoms (anxiety and depression), visual hallucinations and a visual field defect. However, the finding of papilloedema broadened the differential diagnosis. Although standard brain imaging and electroencephalography had shown only non-specific abnormalities, subsequent cerebral angiography disclosed an intracranial dural arteriovenous fistula. Following embolisation, the patient made a good functional recovery. Intracranial dural arteriovenous fistula merits consideration in any patient with subacute cognitive decline, and should be included in the differential diagnosis of sporadic Creutzfeldt-Jakob disease.

Preliminary measurements of the edge magnetic field pitch from 2-D Doppler backscattering in MAST and NSTX-U (invited)

The Synthetic Aperture Microwave Imaging (SAMI) system is a novel diagnostic consisting of an array of 8 independently phased antennas. At any one time, SAMI operates at one of the 16 frequencies in the range 10-34.5 GHz. The imaging beam is steered in software post-shot to create a picture of the entire emission surface. In SAMI's active probing mode of operation, the plasma edge is illuminated with a monochromatic source and SAMI reconstructs an image of the Doppler back-scattered (DBS) signal. By assuming that density fluctuations are extended along magnetic field lines, and knowing that the strongest back-scattered signals are directed perpendicular to the density fluctuations, SAMI's 2-D DBS imaging capability can be used to measure the pitch of the edge magnetic field. In this paper, we present preliminary pitch angle measurements obtained by SAMI on the Mega Amp Spherical Tokamak (MAST) at Culham Centre for Fusion Energy and on the National Spherical Torus Experiment Upgrade at Princeton Plasma Physics Laboratory. The results demonstrate encouraging agreement between SAMI and other independent measurements.

Plasma diagnostics in spherical tokamaks with silicon charged-particle detectors

Detection of charged fusion products, such as protons and tritons resulting from D(d, p) t reactions, can be used to determine the position and time dependent fusion reaction rate profile in spherical tokamak plasmas with neutral beam heating. We have developed a prototype instrument consisting of 6 ion-implanted-silicon surface barrier detectors combined with collimators in such a way that each detector can accept 3 MeV protons and 1 MeV tritons and thus provides a curved view across the plasma cross section. The combination of the results from all six detectors will provide information on the spatial distribution of the fusion reaction rate. The expected time resolution of about 1 ms makes it possible to study changes in the reaction rate due to slow variations in the neutral beam density profile, as well as rapid changes resulting from MHD instabilities. Details of the new instrument, its data acquisition system, simulation results, and electrical noise testing results are discussed in this paper. First experimental data are expected to be taken during the current experimental campaign at NSTX-U.

Development of a high resolution x-ray spectrometer for the National Ignition Facility (NIF)

A high resolution (E/ΔE = 1200-1800) Bragg crystal x-ray spectrometer is being developed to measure plasma parameters in National Ignition Facility experiments. The instrument will be a diagnostic instrument manipulator positioned cassette designed mainly to infer electron density in compressed capsules from Stark broadening of the helium-β (1s²-1s3p) lines of krypton and electron temperature from the relative intensities of dielectronic satellites. Two conically shaped crystals will diffract and focus (1) the Kr Heβ complex and (2) the Heα (1s²-1s2p) and Lyα (1s-2p) complexes onto a streak camera photocathode for time resolved measurement, and a third cylindrical or conical crystal will focus the full Heα to Heβ spectral range onto an image plate to provide a time integrated calibration spectrum. Calculations of source x-ray intensity, spectrometer throughput, and spectral resolution are presented. Details of the conical-crystal focusing properties as well as the status of the instrumental design are also presented.

The prognostic significance and impact of the CXCR4-CXCR7-CXCL12 axis in primary cutaneous melanoma

BACKGROUND

Expression of the chemokine receptor CXCR4 is known to regulate melanoma metastasis to distant sites with high expression of the CXCL12 ligand. However, the prognostic impact of CXCR4 expression and potential for autocrine-mediated activation of prosurvival mitogen-activated protein kinase signalling remains enigmatic. Furthermore, expression of the decoy receptor CXCR7 within the local cutaneous melanoma microenvironment remains undefined.

OBJECTIVES

To define the contribution and prognostic impact of CXCR4-CXCR7-CXCL12 signalling in primary cutaneous melanomas and the immediate tumour microenvironment.

METHODS

Immunohistochemical/immunofluorescent expression of CXCR4, CXCR7 or CXC12 was analysed in human metastatic melanoma cell lines, primary cutaneous cell types and a retrospective cohort of primary melanomas/benign naevi. CXCL12 secretion by melanoma/cutaneous cells was evaluated by enzyme-linked immunosorbent assay, and autocrine CXCR4-CXCL12 signalling was investigated by addition of a CXCL12-neutralizing antibody.

RESULTS

CXCR4 expression was significantly higher in primary melanomas that subsequently metastasized after 7 years (P = 0·037). Stratification for American Joint Committee on Cancer (AJCC) stage II disease revealed significantly decreased disease-free survival in patients with > 50% CXCR4 expression (P = 0·036), while comparative analysis of CXCL12 expression in the adjacent epidermis of all AJCC stage melanomas revealed increased CXCL12 correlated with prolonged time to metastasis (P = 0·014). CXCR7 was expressed within the primary melanoma microenvironment but was absent on primary tumours. Addition of anti-CXCL12 to BRAF-mutant melanoma cells resulted in downregulation of phospho-CXCR4 and phospho-extracellular signal-related kinase, indicating autocrine CXCR4-CXCL12 signalling.

CONCLUSIONS

CXCR4 expression defines a potential prognostic biomarker for AJCC stage II melanoma. Moreover, targeting the CXCR4-CXCR7-CXCL12 axis may represent a novel therapeutic strategy to prevent early melanoma progression.

Ocular drift along the mental number line

We examined the spontaneous association between numbers and space by documenting attention deployment and the time course of associated spatial-numerical mapping with and without overt oculomotor responses. In Experiment 1, participants maintained central fixation while listening to number names. In Experiment 2, they made horizontal target-direct saccades following auditory number presentation. In both experiments, we continuously measured spontaneous ocular drift in horizontal space during and after number presentation. Experiment 2 also measured visual-probe-directed saccades following number presentation. Reliable ocular drift congruent with a horizontal mental number line emerged during and after number presentation in both experiments. Our results provide new evidence for the implicit and automatic nature of the oculomotor resonance effect associated with the horizontal spatial-numerical mapping mechanism.

The impact of ethnicity/race on the association between the Veterans Aging Cohort Study (VACS) Index and neurocognitive function among HIV-infected persons

The Veterans Aging Cohort Study (VACS) Index was developed as a risk index for health outcomes in HIV, and it has been consistently associated with mortality. It shows a significant, yet relatively weak, association with neurocognitive impairment, and little is known about its utility among ethnic/racial minority groups. We examined whether the association between the VACS Index and neurocognition differed by ethnic/racial group. Participants included 674 HIV-infected individuals (369 non-Hispanic whites, 111 non-Hispanic blacks, and 194 Hispanics). Neurocognitive function was assessed via a comprehensive battery. Scaled scores for each neurocognitive test were averaged to calculate domain and global neurocognitive scores. Models adjusting for demographics and HIV disease characteristics not included in the VACS Index showed that higher VACS Index scores (indicating poorer health) were significantly associated with worse global neurocognition among non-Hispanic whites. This association was comparable in non-Hispanic blacks, but nonsignificant among Hispanics (with similar results for English and Spanish speaking). We obtained comparable findings in analyses adjusting for other covariates (psychiatric and medical comorbidities and lifestyle factors). Analyses of individual neurocognitive domains showed similar results in learning and delayed recall. For other domains, there was an effect of the VACS Index and no significant interactions with race/ethnicity. Different components of the VACS Index were associated with global neurocognition by race/ethnicity. In conclusion, the association between the VACS Index and neurocognitive function differs by ethnic/racial group. Identifying key indicators of HIV-associated neurocognitive impairment by ethnic/racial group might play an important role in furthering our understanding of the biomarkers of neuroAIDS.

One step ahead: The perceived kinematics of others' actions are biased toward expected goals

Action observation is often conceptualized in a bottom-up manner, where sensory information activates conceptual (or motor) representations. In contrast, here we show that expectations about an actor's goal have a top-down predictive effect on action perception, biasing it toward these goals. In 3 experiments, participants observed hands reach for or withdraw from objects and judged whether a probe stimulus corresponded to the hand's final position. Before action onset, participants generated action expectations on the basis of either object types (safe or painful, Experiments 1 and 2) or abstract color cues (Experiment 3). Participants more readily mistook probes displaced in a predicted position (relative to unpredicted positions) for the hand's final position, and this predictive bias was larger when the movement and expectation were aligned. These effects were evident for low-level movement and high-level goal expectancies. Expectations bias action observation toward the predicted goals. These results challenge current bottom-up views and support recent predictive models of action observation.

The oculomotor resonance effect in spatial-numerical mapping

We investigated automatic Spatial-Numerical Association of Response Codes (SNARC) effect in auditory number processing. Two experiments continually measured spatial characteristics of ocular drift at central fixation during and after auditory number presentation. Consistent with the notion of a spatially oriented mental number line, we found spontaneous magnitude-dependent gaze adjustments, both with and without a concurrent saccadic task. This fixation adjustment (1) had a small-number/left-lateralized bias and (2) it was biphasic as it emerged for a short time around the point of lexical access and it received later robust representation around following number onset. This pattern suggests a two-step mechanism of sensorimotor mapping between numbers and space - a first-pass bottom-up activation followed by a top-down and more robust horizontal SNARC. Our results inform theories of number processing as well as simulation-based approaches to cognition by identifying the characteristics of an oculomotor resonance phenomenon.

'Without decontextualisation': the Stanley Royd Museum and the progressive history of mental health care

This paper builds on recent scholarship exploring museum exhibitions and the heritage of mental health care. Using the development of the Stanley Royd Museum in the mid-1970s as a case study, the paper will examine the rationale for the opening of the museum and its link to changing perceptions of mental hospitals in both historical study and what was then 'current' practice. It will then provide an overview of the proposed audience for the new museum and briefly analyse its success in communicating its history to its visitors. Ultimately, it will question how successful mental health professionals were in presenting the progressive nature of institutional care at a time when the system was being radically overhauled and reoriented.

Oral anti-CD3 immunotherapy for HCV-nonresponders is safe, promotes regulatory T cells and decreases viral load and liver enzyme levels: results of a phase-2a placebo-controlled trial

Orally administered anti-CD3 antibodies are biologically active in the gut through induction of regulatory T cells, exert an immune-modulatory effect, and alleviate insulin resistance and liver damage in patients with NASH.

AIMS

To determine the safety of oral anti-CD3 monoclonal antibody (MAb) immunotherapy in chronic HCV patients with associated immune dysfunction.

METHODS

Four groups (n = 9) of chronic HCV patients who were nonresponders to interferon plus ribavirin therapy received oral placebo (group A) or anti-CD3 MAb at one of three dosage levels for 30 days. Patients were followed for safety parameters and serum levels of liver enzymes, virus, cytokines and regulatory T cells.

RESULTS

Oral anti-CD3 immunotherapy was safe and well tolerated; no treatment-related adverse events were noted. The following improvements were noted relative to pretreatment levels: HCV viral load and AST and ALT levels decreased in the low- and high-dose groups following 30 days of therapy. In two of the treated groups, an increase in regulatory T cells (CD4(+) CD25(+) ) was noted. The positive effects were somewhat more apparent in subjects with initially elevated liver enzyme levels.

CONCLUSIONS

Oral anti-CD3 MAb immunotherapy for nonresponder HCV patients was safe and well tolerated. Trends and statistically significant improvements were observed as reductions in viral load and liver enzyme levels, along with an increase in regulatory T-cell levels. These data support a role for the immune system in the pathogenesis of HCV infection and suggest that this immunotherapy is worthy of evaluation in combination with HCV antiviral drugs.

I don't get you. Action observation effects inverted by kinematic variation

Recent studies have reported an intricate interplay between affordance and mirror effects (the imitation of another agent) when participants attend to the concurrent presentation of an object and another agent interacting with it. In the present paper, we compare two experimental settings in which an observed action was presented as a prime for a task involving the categorization of a graspable object. In experiment 1a, the action depicted a reach and grasp gesture whereas in experiment 1b, only the reach phase was presented. This modification led to very different outcomes. Experiment 1a reflected the traditional imitation effect elicited by human motion. Conversely, experiment 1b showed the facilitation of contralateral responses. Affordance effects were found in experiment 1a only for the RVF. Our results support the view that motor simulation processes underlying imitation or joint actions are extremely sensitive to specific phase kinematics.

Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis

BACKGROUND

Recurrent instability following a first-time anterior traumatic shoulder dislocation may exceed 26%. We systematically reviewed risk factors which predispose this population to events of recurrence.

METHODS

A systematic review of studies published before 1 July 2014. Risk factors which predispose recurrence following a first-time traumatic anterior shoulder dislocation were documented and rates of recurrence were compared. Pooled ORs were analysed using random-effects meta-analysis.

RESULTS

Ten studies comprising 1324 participants met the criteria for inclusion. Recurrent instability following a first-time traumatic anterior shoulder dislocation was 39%. Increased risk of recurrent instability was reported in people aged 40 years and under (OR=13.46), in men (OR=3.18) and in people with hyperlaxity (OR=2.68). Decreased risk of recurrent instability was reported in people with a greater tuberosity fracture (OR=0.13). The rate of recurrent instability decreased as time from the initial dislocation increased. Other factors such as a bony Bankart lesion, nerve palsy and occupation influenced rates of recurrent instability.

CONCLUSIONS

Sex, age at initial dislocation, time from initial dislocation, hyperlaxity and greater tuberosity fractures were key risk factors in at least two good quality cohort studies resulting in strong evidence as concluded in the GRADE criteria. Although bony Bankart lesions, Hill Sachs lesions, occupation, physiotherapy treatment and nerve palsy were risk factors for recurrent instability, the evidence was weak using the GRADE criteria-these findings relied on poorer quality studies or were inconsistent among studies.