Artificial intelligence, robotics, and automation viewed through the context of the previous four decades.

Computers and applications of computers into our world have changed dramatically during the past five decades, from early days of minimal central processing unit capacity, limited memory and without advantage of global networking. In this article, the author highlights the application of predictive artificial intelligence in use globally over the last 40 years in process industries. It discusses the novel application of process automation and robotics in health clinical high-volume laboratory use that began as a Canadian innovation initiative and followed by similar innovation extending to other countries.

Loss of SORCS2 is Associated with Neuronal DNA Double-Strand Breaks.

SORCS2 is one of five proteins that constitute the Vps10p-domain receptor family. Members of this family play important roles in cellular processes linked to neuronal survival, differentiation and function. Genetic and functional studies implicate SORCS2 in cognitive function, as well as in neurodegenerative and psychiatric disorders. DNA damage and DNA repair deficits are linked to ageing and neurodegeneration, and transient neuronal DNA double-strand breaks (DSBs) also occur as a result of neuronal activity. Here, we report a novel role for SORCS2 in DSB formation. We show that SorCS2 loss is associated with elevated DSB levels in the mouse dentate gyrus and that knocking out SORCS2 in a human neuronal cell line increased Topoisomerase IIß-dependent DSB formation and reduced neuronal viability. Neuronal stimulation had no impact on levels of DNA breaks in vitro, suggesting that the observed differences may not be the result of aberrant neuronal activity in these cells. Our findings are consistent with studies linking the VPS10 receptors and DNA damage to neurodegenerative conditions.

Hemp and buckwheat are valuable sources of dietary amino acids, beneficially modulating gastrointestinal hormones and promoting satiety in healthy volunteers.

PURPOSE: This study evaluated the postprandial effects following consumption of buckwheat, fava bean, pea, hemp and lupin compared to meat (beef); focussing on biomarkers of satiety, gut hormones, aminoacids and plant metabolites bioavailability and metabolism. METHODS: Ten subjects (n = 3 men; n = 7 women; 42 ± 11.8 years of age; BMI 26 ± 5.8 kg/m2) participated in six 1-day independent acute interventions, each meal containing 30 g of protein from buckwheat, fava bean, pea, hemp, lupin and meat (beef). Blood samples were collected during 24-h and VAS questionnaires over 5-h. RESULTS: Volunteers consumed significantly higher amounts of most amino acids from the meat meal, and with few exceptions, postprandial composition of plasma amino acids was not significantly different after consuming the plant-based meals. Buckwheat meal was the most satious (300 min hunger scores, p < 0.05).Significant increase in GLP-1 plasma (AUC, iAUC p = 0.01) found after hemp compared with the other plant-based meals. Decreased plasma ghrelin concentrations (iAUC p < 0.05) found on plant (hemp) vs. meat meal. Several plasma metabolites after hemp meal consumption were associated with hormone trends (partial least squares-discriminant analysis (PLS-DA): 4-hydroxyphenylpyruvic acid, indole 3-pyruvic acid, 5-hydoxytryptophan, genistein and biochanin A with GLP-1, PYY and insulin; 3-hydroxymandelic acid and luteolidin with GLP-1 and ghrelin and 4-hydroxymandelic acid, benzoic acid and secoisolariciresinol with insulin and ghrelin. Plasma branched-chain amino acids (BCAAs), (iAUC, p < 0.001); and phenylalanine and tyrosine (iAUC, p < 0.05) were lower after buckwheat comparison with meat meal. CONCLUSION: Plants are valuable sources of amino acids which are promoting satiety. The impact of hemp and buckwheat on GLP-1 and, respectively, BCAAs should be explored further as could be relevant for aid and prevention of chronic diseases such as type 2 diabetes. Study registered with clinicaltrial.gov on 12th July 2013, study ID number: NCT01898351.

The Impact of Kindness in Medical Student Education in Rural South Dakota.

All medical students at the University of South Dakota Sanford School of Medicine (SSOM) have rural healthcare rotations. Because SSOM has adopted kindness as a focal point in its new five year strategic plan, we designed a qualitative study to assess students' perception of kindness in the rural setting.

Undercarboxylated osteocalcin has no adverse effect on endothelial function in rabbit aorta or human vascular cells.

Undercarboxylated osteocalcin (ucOC) improves glucose metabolism; however, its effects on endothelial cell function are unclear. We examined the biological effect of ucOC on endothelial function in animal models ex vivo and human cells in vitro. Isometric tension and immunohistochemistry techniques were used on the aorta of male New Zealand white rabbits and cell culture techniques were used on human aortic endothelial cells (HAECs) to assess the effect of ucOC in normal and high-glucose environments. Overall, ucOC, both 10 and 30 ng/ml, did not significantly alter acetylcholine-induced blood vessel relaxation in rabbits (p > .05). UcOC treatment did not cause any significant changes in the immunoreactivity of cellular signalling markers (p > .05). In HAEC, ucOC did not change any of the assessed outcomes (p > .05). UcOC has no negative effects on endothelial function which is important to reduce the risks of off target adverse effects if it will be used as a therapeutic option for metabolic disease in the future.

Large Solitary Fibrous Tumor of the Kidney.

Solitary fibrous tumors (SFT) are rare mesenchymal neoplasms that can affect any soft tissue in the body. Given their infrequency, no definitive risk factors have been identified. Typically, surgical extrication en bloc is the only known curative treatment option for SFTs; however, systemic therapy can be used for metastatic or unresectable disease. Only 10 perent to 15 perent of SFTs are aggressive in behavior and termed malignant, leading to a high survival rate for affected patients. Surveillance is required post-operatively to detect recurrence.

Comparison of Physical Activity, Healthy Eating Habits, and Knowledge of Diabetes and Pre-diabetes in Rural Reservation and Off-reservation Communities.

INTRODUCTION: Residents in two small rural communities on the Northern Great Plains completed surveys to determine their community's needs for physical activity, healthy eating habits, and knowledge of diabetes/pre-diabetes. METHODS: One rural American Indian reservation (Community A) and one off-reservation (Community B) were selected for the study. Both communities had similar population size, medical clinic, pharmacy, grocery store and fitness center. Surveys were collected in-person during local community events. RESULTS: More respondents in Community A (41 percent) compared to Community B (18 percent) used the Fitness Center and had more vigorous physical activity (44 percent vs. 5 percent respectively). Compared to Community A, Community B respondents bought more fruits and vegetables (85 percent vs. 96 percent respectively). While a higher rate of diabetes (15.1 percent) in the American Indian population has been reported, this study did not find a significant difference when comparing these two rural communities. Fewer respondents with diabetes in Community A (25 percent), compared to Community B (85 percent) had attended diabetes education. More respondents in Community A (31 percent) than B (13 percent) had pre-diabetes. CONCLUSIONS: Community A's fitness center had personal trainers that provided education, motivation and encouraged individuals to exercise. The majority of respondents in Communities A (85 percent) and B (96 percent) purchased fruits and vegetables. Fruits and vegetables were readily available in the local grocery stores for both small rural communities. More individuals with diabetes (83 percent) in Community B had attended diabetes education classes. More Community A respondents had pre-diabetes; however, diabetes prevention education could reduce their risk of developing type 2 diabetes by 58 percent.

Osteocalcin does not influence acute or chronic inflammation in human vascular cells.

Some human observational studies have suggested an anti-inflammatory role of osteocalcin (OCN). An inflammatory protocol using interferon-γ and tumor necrosis factor-α (10 ng/ml) was employed to examine the acute (24 hr) and chronic (144 hr) effects of uncarboxylated OCN (ucOCN) in commercial, primary, subcultured human aortic endothelial cells (HAEC), and human smooth muscle cells (HASMCs). The inflammatory protocol increased phosphorylation of intracellular signaling proteins (CREB, JNK, p38, ERK, AKT, STAT3, STAT5) and increased secretion of adhesion markers (vascular cell adhesion molecule-1, intracellular adhesion molecule-1, monocyte chemoattractant protein-1) and proinflammatory cytokines (interleukin-6 [IL-6], IL-8). After acute inflammation, there were no additive or reductive effects of ucOCN in either cell type. Following chronic inflammation, ucOCN did not affect cell responses, nor did it appear to have any pro- or anti-inflammatory effects when administered acutely or chronically on its own in either cell type. Additionally, ucOCN did not affect lipopolysaccharide (LPS)-induced acute inflammation in HAECs or HASMCs. The findings of this study do not support a causal role for OCN within the models of vascular inflammation chosen. Further confirmatory studies are warranted.

Skin Cancer Prevention and Screening Behaviors among Agricultural Workers: A Survey of the Attendees of the Sioux Falls Farm Show.

INTRODUCTION: Agricultural workers are at a higher risk for skin cancer due to excessive amounts of sun exposure, poor sun safety practices, and limited access to healthcare. This study aimed to assess skin cancer history, sun protection practices, and skin cancer surveillance measures among Midwestern agricultural workers. METHODS: Individuals that attended the 2020 Sioux Falls Farm Show were asked to complete a 12-question survey on sun exposure, sun protective practices, and skin cancer surveillance. Survey responses were aggregated and analyzed using Microsoft Excel. RESULTS: A total of 99 individuals participated in the study, of which 70 identified as agricultural workers. Most individuals reported working outdoors eight to 10 hours daily for 10-12 months of the year. Most participants reported poor sun protection habits, such as limited sunscreen and limited wide-brimmed hat use. A large number of participants reported they had previously received a professional skin check, although 33 percent reported never examining their own skin for suspicious lesions. CONCLUSIONS: Midwestern agricultural workers present a unique population that could benefit from improved skin cancer prevention. Opportunities for improvement include education of skin cancer preventative measures using platforms that are likely to reach rural agricultural workers and education regarding skin self-examinations. This study identified high risk factors of this population including substantial sun exposure, poor sun protection, and minimal self-skin examinations. Our findings may help guide future methods to increase skin cancer education, prevention, and surveillance in agricultural workers.

Human vascular cell responses to the circulating bone hormone osteocalcin.

The purpose of this study was to characterize the direct effects of uncarboxylated osteocalcin (ucOCN) on vascular cell biology in vitro, to assess its potential function in pathophysiological conditions such as atherosclerosis. Human aortic endothelial cells (HAECs) and smooth muscle cells (HASMCs) were treated with ucOCN (0.1-50 ng/ml) and changes in phosphorylation of intracellular signaling proteins, angiogenesis, proliferation, migration, monolayer permeability, and protein secretion were measured. In HAECs, phosphorylated JNK and CREB were decreased with ucOCN (p < 0.05). In HASMCs, phosphorylated p70S6K and NF-ΚB were increased by ucOCN (p < 0.05). Cell proliferation increased in both cell types dose dependently which was blocked by AKT and ERK pathway inhibitors. ucOCN did not affect cell permeability, angiogenesis, or migration. The direct activity of ucOCN on vascular cells is recognized, particularly its proliferative effects. However, at least in physiological settings, it does not appear that osteocalcin may directly promote atherogenesis based on the outcomes measured.

Skin Cancer Education in the Rural Salon.

INTRODUCTION: Due to an increase in the incidence of skin cancer and a shortage of primary care and specialty physicians in rural areas, creative public health strategies must be employed to address disparities in skin cancer education, prevention, and detection. METHODS: Hair salons in eastern South Dakota communities with populations less than 15,000 were visited in-person by medical student facilitators. Hair professionals at these locations completed pre-survey assessments for baseline self-assessed comfort with detecting suspicious skin lesions and with educating patrons on skin cancer prevention strategies. Their likelihood to both alert patrons of suspicious skin lesions and encourage them to have their lesion evaluated by a physician was also assessed. A 20-minute educational PowerPoint presentation was given. Final assessment was evaluated with a post-presentation survey. RESULTS: Self-assessed hair professional comfort with identifying suspicious skin lesions was higher in post-survey results, in addition, the educational presentation increased comfort with sharing skin cancer prevention information with patrons. Hair professionals also reported increased likelihood that they would alert patrons to suspect skin lesions. Also, hair professionals reported increased likelihood that they would encourage patrons to seek medical care for their concerning lesions. CONCLUSIONS: Hair professionals may act as lay skin cancer educators in rural salons. Educational programs for hair professionals can increase their comfort with detecting lesions suspicious for skin cancer, increase their comfort with sharing skin protection information with patrons, and increase their likelihood of both alerting their patrons about suspicious skin lesions and encouraging their patrons to have their suspicious lesions evaluated.

A Novel Three-Dimensional Human Peritubular Microvascular System.

Human kidney peritubular capillaries are particularly susceptible to injury, resulting in dysregulated angiogenesis, capillary rarefaction and regression, and progressive loss of kidney function. However, little is known about the structure and function of human kidney microvasculature. Here, we isolated, purified, and characterized human kidney peritubular microvascular endothelial cells (HKMECs) and reconstituted a three-dimensional human kidney microvasculature in a flow-directed microphysiologic system. By combining epithelial cell depletion and cell culture in media with high concentrations of vascular endothelial growth factor, we obtained HKMECs of high purity in large quantity. Unlike other endothelial cells, isolated HKMECs depended on high vascular endothelial growth factor concentration for survival and growth and exhibited high tubulogenic but low angiogenic potential. Furthermore, HKMECs had a different transcriptional profile. Under flow, HKMECs formed a thin fenestrated endothelium with a functional permeability barrier. In conclusion, this three-dimensional HKMEC-specific microphysiologic system recapitulates human kidney microvascular structure and function and shows phenotypic characteristics different from those of other microvascular endothelial cells.

The Impact of a Rural Training Track on Medical Students Specialty Choice.

BACKGROUND: Compare the expectations and outcomes of students involved in rural medical training versus those of urban trainees. METHODS: Survey items relating to primary care interest were added to program evaluation surveys already being sent at the beginning and end of the primary clinical year. Students from the graduating class of 2016 and the class of 2017 responded to the surveys (N=115). Responses from students trained in rural sites were compared with students trained in medium or large communities. For the purposes of the survey, primary care was not specifically defined and was open to participants' interpretation. Primary care is commonly thought of as the medical care from the doctor who sees a patient first and provides treatment or decides the other specialist care that the patient may need. Primary care specialties can include family medicine, internal medicine, pediatrics and obstetrics and gynecology. RESULTS: Most students enter their primary clinical year undecided about specialty choice and preferred practice location. At the end of the primary clinical year, most students have decided on a specialty and most report wanting to practice in communities similar to where they trained during that year. Before the primary clinical year student attitudes toward primary care are not significantly different based on selected training site. However at the end of the primary clinical year, students who had been trained in small communities were significantly more likely to choose primary care compared with students trained in medium to large communities. CONCLUSIONS: For students who begin the primary clinical year undecided regarding specialty choice, and practice location, the community size of the training site plays a large role in the decisions they will make. A majority of students trained in small communities chose to go into primary care and practice in small communities.

Epidemiologic Study of Bacteria Zoonotic Diseases in South Dakota: 2010-2014.

BACKGROUND: Although the burden of infectious diseases has decreased dramatically due to advances in health care, disease prevention and numerous public health efforts and innovations, zoonotic diseases continue to pose a problem in terms of both existing and emerging diseases. These risks are of particular concern in rural areas, in which there is more contact with animals for occupational and recreational purposes. As a rural and agricultural state, South Dakota has a large percentage of its population at risk of exposure to zoonotic diseases through their substantial contact time with animals. METHODS: De-identified data from the South Dakota Department of Health containing the variables and diseases of interest from the time period of 2010-2014 was obtained. From this data were calculated the incidence rates by county, and seasonal and demographic patterns of the diseases were plotted. RESULTS: The incidence of disease in South Dakota were higher than the national rates for campylobacteriosis (threefold), cryptosporidiosis (sixfold), enterohemorrhagic E. coli (fourfold), Q fever (tenfold), salmonellosis (1.2-fold), and tularemia (14-fold). Only listeriosis had a lower incidence than the national rate among zoonoses included in this study. Seasonality of campylobacteriosis in the state was earlier in the year than is reported for the disease nationally. CONCLUSION: Zoonotic infections are a substantial threat to health in South Dakota. There is a need to develop collaboration between healthcare providers, public health professionals, livestock producers, veterinarians, and sportsmen to develop a strategy to address this issue.

Correlations between community size and student perceptions of value.

INTRODUCTION: The purpose of this study was to determine if medical students' feeling of being valued was correlated to community size. The study, conducted in several communities in South Dakota, examined students' feeling of value relating to attending physicians, healthcare teams and patients. METHODS: Student value items were added to student satisfaction surveys sent out to students at the end of their primary clinical year and data collected from two graduating classes of students (n=114). Student responses were grouped by clinical campus and mean responses by community size were calculated. Additionally, student encounter logs were reviewed for study participants to gauge participation levels during clinical encounters. RESULTS: The degree to which students felt valued by their physician attending, the healthcare team and the patients decreased consistently as community size increased. Differences were statistically significant between students in the smallest and largest communities. Additionally, students in the community of 15 000 felt significantly more valued than students in the community of 170 000. Furthermore, there also appears to be a relationship between the percentage of participation in patient care by students and community size. Students in the smaller, rural communities participated at a higher percentage rather than observing. CONCLUSIONS: There appears to be a relationship between community size and the extent to which students feel value. The degree to which students felt valued decreased consistently as community size increased. Differences were statistically significant between students in the smallest communities and the two largest communities. Students in the smaller, rural communities participated at a higher percentage. Additional studies are needed to address whether students participate more as a result of feeling valued, or whether participation leads to an enhanced perception of value by students.

Early Survey Results from the Minnesota Medical Cannabis Program.

As part of its legislative mandate, the Minnesota Department of Health's Office of Medical Cannabis (OMC) is required to study and report on the state's medical cannabis program. This article describes preliminary findings from the OMC's research about who is using the program and whether patients and their certifying health care practitioners are noticing benefits and harms.