Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease - United States.

The term "chronic Lyme disease" is used by some health care providers as a diagnosis for various constitutional, musculoskeletal, and neuropsychiatric symptoms (1,2). Patients with a diagnosis of chronic Lyme disease have been provided a wide range of medications as treatment, including long courses of intravenous (IV) antibiotics (3,4). Studies have not shown that such treatments lead to substantial long-term improvement for patients, and they can be harmful (1,5). This report describes cases of septic shock, osteomyelitis, Clostridium difficile colitis, and paraspinal abscess resulting from treatments for chronic Lyme disease. Patients, clinicians, and public health practitioners should be aware that treatments for chronic Lyme disease can carry serious risks

The Ripening of Mangos

This project is a collection of poems which draw influence from Romantic, confessional, and post-modern poetry movements, and can most accurately be described as Confessionalistic, though they are resistant to categorization. The poems function to dismantle archetypal definitions of feminine identity, and instead aim to depict identity to be fluid and multifaceted. The Ripening of Mangos is divided into four sections. The first section deconstructs the \u27angel\u27 or \u27virgin\u27 archetype, while the second deconstructs the \u27monster\u27 or \u27whore\u27 archetype. Section three includes voices of procreation, and functions to complicate the image of \u27the mother.\u27 The last section, Transplanting, shows gendered identity within the context of other power constructs (such as language, sexuality, class, and ethnicity) and shows the transcendence beyond singular notions of identity

Verbal behavior: An empirical review of establishing operations

Establishing Operations are steeped in the science Applied Behavior Analysis and verbal behavior. Their principles are utilized daily in schools, clinics and treatment centers. The purpose of this study was to review the research literature of this principle to affirm its scientific base and identify specific strategies that can be used by educators and practitioners. Results affirmed its scientific base and identified numerous strategies for immediate use. As ABA practitioners state, These principles are thought to be of value only if in the hands of people who use them to improve the lives of others (Carbone, 2004)

BNCI systems as a potential assistive technology: ethical issues and participatory research in the BrainAble project

This paper highlights aspects related to current research and thinking about ethical issues in relation to Brain Computer Interface (BCI) and Brain-Neuronal Computer Interfaces (BNCI) research through the experience of one particular project, BrainAble, which is exploring and developing the potential of these technologies to enable people with complex disabilities to control computers. It describes how ethical practice has been developed both within the multidisciplinary research team and with participants. Results: The paper presents findings in which participants shared their views of the project prototypes, of the potential of BCI/BNCI systems as an assistive technology, and of their other possible applications. This draws attention to the importance of ethical practice in projects where high expectations of technologies, and representations of “ideal types” of disabled users may reinforce stereotypes or drown out participant “voices”. Conclusions: Ethical frameworks for research and development in emergent areas such as BCI/BNCI systems should be based on broad notions of a “duty of care” while being sufficiently flexible that researchers can adapt project procedures according to participant needs. They need to be frequently revisited, not only in the light of experience, but also to ensure they reflect new research findings and ever more complex and powerful technologies

Broad clinical phenotypes associated with TAR-DNA binding protein (TARDBP) mutations in amyotrophic lateral sclerosis

The finding of TDP-43 as a major component of ubiquitinated protein inclusions in amyotrophic lateral sclerosis (ALS) has led to the identification of 30 mutations in the transactive response-DNA binding protein (TARDBP) gene, encoding TDP-43. All but one are in exon 6, which encodes the glycine-rich domain. The aim of this study was to determine the frequency of TARDBP mutations in a large cohort of motor neurone disease patients from Northern England (42 non-superoxide dismutase 1 (SOD1) familial ALS (FALS), nine ALS-frontotemporal dementia, 474 sporadic ALS (SALS), 45 progressive muscular atrophy cases). We identified four mutations, two of which were novel, in two familial (FALS) and two sporadic (SALS) cases, giving a frequency of TARDBP mutations in non-SOD1 FALS of 5% and SALS of 0.4%. Analysis of clinical data identified that patients had typical ALS, with limb or bulbar onset, and showed considerable variation in age of onset and rapidity of disease course. However, all cases had an absence of clinically overt cognitive dysfunction

Deciphering Amyotrophic Lateral Sclerosis: What Phenotype, Neuropathology and Genetics Are Telling Us about Pathogenesis

Amyotrophic lateral sclerosis (ALS) is characterized phenotypically by progressive weakness and neuropathologically by loss of motor neurons. Phenotypically, there is marked heterogeneity. Typical ALS has mixed upper motor neuron (UMN) and lower motor neuron (LMN) involvement. Primary lateral sclerosis has predominant UMN involvement. Progressive muscular atrophy has predominant LMN involvement. Bulbar and limb ALS have predominant regional involvement. Frontotemporal dementia has significant cognitive and behavioral involvement. These phenotypes can be so distinctive that they would seem to have differing biology. But they cannot be distinguished, at least neuropathologically or genetically. In sporadic ALS (SALS), they all are characterized by ubiquitinated cytoplasmic inclusions of TDP-43. In familial ALS (FALS), where phenotypes are indistinguishable from SALS and similarly heterogeneous, each mutated gene has its own genetic and molecular signature. Putting this together, since the same phenotypes can have multiple causes including different gene mutations, there must be multiple molecular mechanisms causing ALS and ALS is a syndrome. But since multiple phenotypes can be caused by one single gene mutation, a single molecular mechanism can cause heterogeneity. What the mechanisms are remain unknown, but active propagation of the pathology neuroanatomically seems to be a principle component. Leading candidate mechanisms include RNA processing, cell-cell interactions between neurons and non-neuronal neighbors, focal seeding from a misfolded protein that has prion-like propagation, and fatal errors introduced during neurodevelopment of the motor system. If fundamental mechanisms can be identified and understood, ALS therapy could rationally target progression and stop disease—a goal that seems increasingly achievable.Stem Cell and Regenerative Biolog

Kant and the Dual Role of the Imagination: Content, Form, and Judgments of Beauty

In this dissertation, I argue for a novel interpretation of Kant’s faculty of the imagination. In addition to providing the prepared sensible manifold, I contend that the imagination also demonstrates a formal capacity – the ability to provide its own lawfulness. This position I term the ‘Dual Role of the Imagination,’ as a faculty capable of providing both form and content. Although the imagination’s products remain determined by the understanding in regular cognition, I demonstrate that aesthetic judgments provide instances where the imagination provides its own lawfulness inspired by beautiful objects in nature and fine art. These beautiful objects, when interacting with the free imagination engaged in harmonious play represent distinct points where nature demonstrates certain rational signs, thereby providing opportunity for the imagination to shape its own forms that demonstrate the possibility of rationality within an otherwise disinterested nature. That is, beautiful objects give the imagination the occasion to reflect on and produce a view of nature as if rationally ordered, or in accord with Kant’s Principle of Purposiveness. To fully grasp the value of aesthetic judgment within Kant’s Critical framework, I argue, the imagination must be seen in its formal capacity since only a faculty capable of forming its own lawfulness that also remains tied to sensibility can bridge the gap between nature and reason. Therefore, this project serves as a defense of the imagination as a formal faculty towards the end of bridging the ‘incalculable gulf’ Kant indicates in the introduction to the Critique of the Power of Judgment. In addition to the historical research, I turn to contemporary scholarship on Kant in terms of his aesthetics and its value to his theory of cognition. There are two prevailing approaches to Kantian aesthetics in contemporary scholarship – the cognitive approach and the interpretive approach. In the cognitive approach, aesthetics is viewed in terms of its value to future cognitions. That is, aesthetic judgments are useful insofar as they either deepen future cognitions, provide new connections for our cognitions, or reveal sensible content that goes beyond our existing cognitions. Most proponents of the cognitive approach have little to say about the power of the imagination within Kant’s transcendental framework, seeing it as an appendage to our conceptual faculty, the understanding. This provides a deflationary reading of the imagination since its products are only relevant to cognition and are not necessarily considered the results of a free and independent faculty. The interpretive approach favors an expanded view of the imagination, allowing it to exist free from the determination of the understanding in cases of aesthetic judgment. Supporters of this view consider the products of the imagination as exceeding regular cognition and opening new fields of knowledge beyond what we commonly experience. Examples of these new fields include the political, societal, historical, and aesthetic – domains of knowledge we may consider to be of a different kind than yielded through common cognition. While expanding the imagination, I argue that this view is needlessly inflationary, providing far more avenues for inquiry than Kant intended for the imagination. That is, while the imagination can demonstrate the possibility of nature as rationally ordered, and thereby span the gulf between nature and reason, this perspective is merely one amongst many possible perspectives. It does not privilege or emphasize a view that Kant clearly intended for his aesthetics. Further, I argue, that this expansion of the imagination risks severing it into two distinct faculties, since it requires a hard division between its activities in the First Critique and Third Critique. This dissertation provides a moderate path between the two prevailing approaches in Kantian scholarship. I seek to offer a reading of the imagination in its dual role within Kant’s transcendental framework. Rather than limiting the imagination’s aesthetic activities to cognition or expanding its capacities to obscure their true value, I focus on strengthening the connection between aesthetic judgment and its place as a bridge between nature and reason. I do this through the imagination as a formal, as well as sensible, faculty. On one hand, the imagination maintains its position as a faculty capable of touching the sensible world. On the other, it is capable of forming its own lawfulness inspired by this connection through natural and artistic beauty. As such, it is the imagination that is shown to be key to achieving Kant’s goal of the Third Critique, bridging the ‘incalculable gulf’ – opening a view of nature as amenable to our rational ends.Philosoph

Cerebellar Integrity in the Amyotrophic Lateral Sclerosis - Frontotemporal Dementia Continuum

Amyotrophic lateral sclerosis (ALS) and behavioural variant frontotemporal dementia (bvFTD) are multisystem neurodegenerative disorders that manifest overlapping cognitive, neuropsychiatric and motor features. The cerebellum has long been known to be crucial for intact motor function although emerging evidence over the past decade has attributed cognitive and neuropsychiatric processes to this structure. The current study set out i) to establish the integrity of cerebellar subregions in the amyotrophic lateral sclerosis-behavioural variant frontotemporal dementia spectrum (ALS-bvFTD) and ii) determine whether specific cerebellar atrophy regions are associated with cognitive, neuropsychiatric and motor symptoms in the patients. Seventy-eight patients diagnosed with ALS, ALS-bvFTD, behavioural variant frontotemporal dementia (bvFTD), most without C9ORF72 gene abnormalities, and healthy controls were investigated. Participants underwent cognitive, neuropsychiatric and functional evaluation as well as structural imaging using voxel-based morphometry (VBM) to examine the grey matter subregions of the cerebellar lobules, vermis and crus. VBM analyses revealed: i) significant grey matter atrophy in the cerebellum across the whole ALS-bvFTD continuum; ii) atrophy predominantly of the superior cerebellum and crus in bvFTD patients, atrophy of the inferior cerebellum and vermis in ALS patients, while ALS-bvFTD patients had both patterns of atrophy. Post-hoc covariance analyses revealed that cognitive and neuropsychiatric symptoms were particularly associated with atrophy of the crus and superior lobule, while motor symptoms were more associated with atrophy of the inferior lobules. Taken together, these findings indicate an important role of the cerebellum in the ALS-bvFTD disease spectrum, with all three clinical phenotypes demonstrating specific patterns of subregional atrophy that associated with different symptomology

Lebensgelassenheit: Meaning and Reflection in Kant's Third Critique and Life After Heidegger's Gelassenheit

This project seeks to demonstrate human value beyond the modern will in the form of an Ur-will, a residue of the will that cannot be attributed to the historic age. By utilizing the seemingly diverse ideas of Heidegger’s Gelassenheit, an attentive releasement towards death, and Kant’s Lebensgefühl, a feeling of life engendered by aesthetic and reflective experience, this work shows how a more primordial relation to both the sensible and the supersensible reveals an underlying harmony between humanity and nature. This harmony opens the space for a dual reorientation, between humanity and the thing, and between humanity and our rational ideas that allows for both Gelassenheit and the ability to reflect on nature in terms of human value. Establishing the Ur-will as an indeterminate tie between the embodied, and sensuous, human and supersensible ideas provides the basis for the possibility of human value existing beyond the modern age and into the ‘new beginning’ prescribed by Heidegger through Gelassenheit

Changes in Motor Unit Number Estimate and Forced Vital Capacity as Predictors of ALS Progression

Background: An independent measure of lower motor neuron function that can be monitored over time is essential to evaluating the effect of drugs or stem cell transplantation and to determining prognosis in amyotrophic lateral sclerosis (ALS).  Longitudinal changes in forced vital capacity-percent of predicted (FVC%) and motor unit number estimate (MUNE) may identify patient groups with more rapid disease progression. Objective: We attempted to define cutoff values for 3-month changes in FVC% and MUNE that identify ALS patients with rapidly progressive disease defined as survival of 30 months or less from symptom onset. Design: Cohort study. Subjects: We report data from 26 ALS patients, 10 patients reported previously and 16 patients not reported previously, except for the reproducibility of their MUNE data. Results: Of the 26 patients, 7 had rapid progression.  Either a 40% decrease in statistical MUNE or a 20% decrease in FVC% over 3 months identified 6 of 7 rapid progressors (Sensitivity=86% 95% confidence interval [CI] 42.1% - 99.6%).  Of the 19 patients without rapid progression, 18 met neither the FVC or MUNE criterion (Specificity = 94.7% CI 95% 74.0% - 99.9%).  In a proportional hazards model, 3 month change in both FVC and MUNE were significantly predictive of decreased survival. Conclusion: We suggest the use of a three-month change in MUNE or FVC% as a secondary enrollment criterion in therapeutic trials or to identify a subgroup of rapid progressors that may respond differently to treatments