"It Takes a Village"- A Conversation with the Interprofessional Diabetes Clinic at the ECU Health Family Medicine Center.

Interprofessional collaboration and shared understanding positively impact both patients and providers. Current recommendations from the CDC and experts agree that collaboration between diverse professions is necessary to improve patient outcomes and empower patients to selfmanage their chronic conditions.

On the Frequency Carrier Offset and Symbol Timing Estimation for CCSDS 131.2-B-1 High Data-Rate Telemetry Receivers.

In recent years there have been significant developments in satellite transmitter technology to follow the rapid innovation of sensors on-board new satellites. The CCSDS 131.2-B-1 standard for telemetry downlink, released in 2012, is part of the next generation of standards that aims to support the increased data-rate caused by these improvements in resolution. As a result of its relative novelty, this standard currently lacks in-depth analysis by researchers, but it is also strongly supported by the European Space Agency (ESA) for future missions. For these reasons, it seems important to evaluate how major receiver sub-components, such as timing recovery and carrier frequency correction, can be designed and implemented in new receivers that support this standard. The timing error detectors (TED) and frequency error detectors (FED) were therefore studied on the specific peculiarities of CCSDS 131.2-B-1 in its usual environment of Low Earth Orbit (LEO). Estimators have been evaluated highlighting performances, trade-offs and peculiarities of each one with respect to corresponding architectural choices. Finally, a receiver architecture derived from the paper considerations is proposed in the aim of supporting very different mission scenarios. Specifically, the realized architecture employs a parallel feedforward estimator for the timing recovery section and a novel multi-algorithm feedback frequency correction loop to efficiently cover both low symbol rates (5 Mbaud) and high data-rates (up to 500 Mbaud). This solution represents a good trade-off to support these scenarios in a very compact footprint by pushing the clock frequency to the FPGA limit. The FPGA resources occupation on a Zynq Ultrascale+ RFSoC XCZU28DR FPGA is 5202 LUT, 4851 FF, 5 BRAM, and 21 DSP for the timing recovery part, while the frequency recovery section occupies 1723 LUT, 1511 FF, 2.5 BRAM and 32 DSP.

A motor neuron protective role of miR-969 mediated by the transcription factor kay.

Maintenance of motor neuron structure and function is crucial in development and motor behaviour. However, the genetic regulatory mechanism of motor neuron function remains less well understood. In the present study, we identify a novel neuroprotective role of the microRNA miR-969 in Drosophila motor neurons. miR-969 is highly expressed in motor neurons. Loss of miR-969 results in early-onset and age-progressive locomotion impairment. Flies lacking miR-969 also exhibit shortened lifespan. Moreover, miR-969 is required in motor neurons. We further identify kay as a functionally important target of miR-969. Together, our results indicate that miR-969 can protect motor neuron function by limiting kay activity in Drosophila.

Re-assessing the applicability of the Jarman/Bell model and Kay's threshold to the insectivorous aye-aye (Daubentonia madagascariensis).

OBJECTIVES: Jarman/Bell principle and Kay's threshold suggest that large animals should not be able to sustain themselves on insects. However, animals with specialized morphological and/or behavioral adaptations violate these assumptions. Male aye-ayes were recently identified as having an insectivorous diet despite weighing 2.5 kg. We further explored this diet/body size disparity by studying behaviors of an adult female and juvenile male aye-aye. MATERIALS AND METHODS: We collected behavioral data on an adult female and juvenile male aye-aye in Torotorofotsy, Madagascar from January 2016 to December 2017. We used instantaneous sampling to determine the frequency of feeding events and continuous sampling during feeding behaviors to assess duration of feeding bouts. RESULTS: Invertebrates comprised over 88% of the diet for both animals. A Wilcoxon signed-rank test found no significant difference in the female's feeding frequencies between the hot/rainy seasons and the cold/dry seasons. DISCUSSION: Our results support earlier findings that invertebrates are the aye-aye's main resource and corroborate that aye-ayes violate assumptions of the Jarman/Bell model and Kay's threshold. We suggest that the Jarman/Bell principle and Kay's threshold be used as supporting evidence and not to repudiate findings that do not conform to these guidelines.

Mechanical and Structural Evaluation of Tricuspid Bicuspidization in a Porcine Model.

INTRODUCTION: Tricuspid regurgitation (TR) affects approximately 1.6 million Americans and is associated with just a 63.9% 1-year survival rate in its moderate to severe forms due to its asymptomatic nature and late diagnosis and surgical referral. As a result, industrial fervor has begun to broach this topic, with several percutaneous treatment devices currently under development. As much remains unknown about the tricuspid apparatus, the mechanics of these procedures remain unquantified. In this study, a testing apparatus and technique for the evaluation of percutaneous tricuspid valve (TV) bicuspidization were developed for the evaluation of these parameters in twelve porcine hearts. METHODS: The passive relaxed myocardial state and the active contracted state were each induced in six porcine hearts and the bicuspidization experiment was run twice, the second time after induction of TR. TV annular area, cinching force, static leakage through the TV annulus, and annular ellipticity were quantified and compared among the groups. RESULTS: The use of phenol was effective to induce functional TR by increased annular area. Cinching force was not found to differ between any of the testing states, but the bicuspidization experiment was able to reduce the TR annular area to that of its healthy counterpart in addition to reducing static leakage through the TV annulus. Despite appropriately reducing the area, bicuspidization was found to induce a more circular TV annular shape. CONCLUSION: Taken together, these results provide a first mechanical analysis of the TV bicuspidization mechanism and may serve as a point of reference for future clinical animal studies.

Identity, Bipolar Disorder, and the Problem of Self-Narration in Kay Redfield Jamison's An Unquiet Mind and Ellen Forney's Marbles.

The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient's treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison's prose memoir An Unquiet Mind (1995) and Ellen Forney's graphic memoir Marbles (2012) challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward and verbal forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity.

Damus anastomosis associated with REV/Rastelli procedure allows to extend indications for anatomical repair in complex transposition of great arteries.

We report here the indications and the results of a surgical option associating a Damus procedure with a 'Réparation à l'Etage Ventriculaire' (REV)/Rastelli procedure, for anatomical repair of patients presenting with complex transposition of great arteries (TGA), restrictive/remote ventricular septal defect (VSD) and pulmonary stenosis (PS). Five consecutive patients (median age: 11 months (range: 20 days to 15 years)) presenting with complex TGA-VSD-PS and anatomical lesions resulting in a contraindication to a Nikaidoh procedure were included. Two of them presented with a postoperative restrictive left ventricle-to-aorta baffle and secondarily underwent a modified Damus procedure a few days after the REV or Rastelli procedure. In the other 3 patients, the Damus procedure was primarily performed at the time of the REV or Rastelli procedure. No death occurred. At the last follow-up (mean: 31 ± 37 months), all patients displayed an excellent functional status and an unobstructed left ventricular outflow tract in echocardiography. Associating a Damus procedure with a REV/Rastelli procedure can be considered as an effective and low-risk surgical option to extend the indications for anatomical repair in patients with complex TGA-VSD-PS and anatomical findings precluding other surgical options.

STRIPAK complexes: structure, biological function, and involvement in human diseases.

The mammalian striatin family consists of three proteins, striatin, S/G2 nuclear autoantigen, and zinedin. Striatin family members have no intrinsic catalytic activity, but rather function as scaffolding proteins. Remarkably, they organize multiple diverse, large signaling complexes that participate in a variety of cellular processes. Moreover, they appear to be regulatory/targeting subunits for the major eukaryotic serine/threonine protein phosphatase 2A. In addition, striatin family members associate with germinal center kinase III kinases as well as other novel components, earning these assemblies the name striatin-interacting phosphatase and kinase (STRIPAK) complexes. Recently, there has been a great increase in functional and mechanistic studies aimed at identifying and understanding the roles of STRIPAK and STRIPAK-like complexes in cellular processes of multiple organisms. These studies have identified novel STRIPAK and STRIPAK-like complexes and have explored their roles in specific signaling pathways. Together, the results of these studies have sparked increased interest in striatin family complexes because they have revealed roles in signaling, cell cycle control, apoptosis, vesicular trafficking, Golgi assembly, cell polarity, cell migration, neural and vascular development, and cardiac function. Moreover, STRIPAK complexes have been connected to clinical conditions, including cardiac disease, diabetes, autism, and cerebral cavernous malformation. In this review, we discuss the expression, localization, and protein domain structure of striatin family members. Then we consider the diverse complexes these proteins and their homologs form in various organisms, emphasizing what is known regarding function and regulation. Finally, we explore possible roles of striatin family complexes in disease, especially cerebral cavernous malformation.