Building power through reindigenization: Sharing the story of Menikanaehkem.

Culture shapes and animates how community organizing is understood and carried out in specific contexts. Many frameworks for examining organizing, however, do not effectively attend to the influences of culture. Greater understanding of how culture can be imbued in organizing can help to ground it in the social realities of organizing participants and can advance approaches to organizing that honor the past and present of specific cultures. This study details local culturally grounded community organizing work rooted in Indigenous, and specifically Menominee, culture. First, it provides a description of the formation of the organization Menikanaehkem in the Menominee Nation and includes examples of how current organizing practices of Menikanaehkem build from long-standing Menominee cultural practices. It then highlights the reinvigoration of cultural practices, or re-indigenization, as an important goal for community power building in Menikanaehkem. It ends with a discussion of the importance of culture in frameworks for understanding, analyzing, and promoting organizing as an endeavor to advance well-being in a way that also interrupts cycles of structural oppression, such as legacies of settler colonialism.

Differentiating non-responders from responders in children with moderate and severe asthma exacerbations.

Objective: Our goal was to assess factors associated with non-response to treatment in children presenting to the Emergency Department (ED) with moderate and severe asthma exacerbations. Methods: A retrospective chart review was completed from 9/2014 to 2/2017 for patients with a discharge diagnosis of asthma exacerbation. The Modified Pulmonary Index Score (MPIS) was used to quantify illness acuity. The rate of change of MPIS per hour was calculated, and differentiated responders from non-responders. After examining a histogram of ΔMPIS/h, a threshold of ΔMPIS/h > 0 was used to define response for duration of ED stay. Children included were >2 years and had initial MPIS > 10. Results: Eight hundred and fifty-two children were included. There were 178 (21%) non-responders and 674 (79%) responders. Non-responders were significantly older (7.0 ± 4.0 versus 5.6 ± 3.2 years; p < 0.001), but there were no differences in gender, race, ethnicity or insurance status. There was also no statistical difference in time to first albuterol treatment (50 ± 41 versus 43 ± 40 min; p = 0.05), or in time to corticosteroid (95 ± 75 versus 79 ± 64 min; p = 0.06). Non-responders were significantly more likely to arrive by ambulance (OR 2.2; 95% CI 1.6-3.2), to be admitted to the hospital (OR 2.7; 95% CI 1.8-4.0), and to be admitted to the ICU (OR 5.0; 95% CI 3.1-8.1). Conclusions: One in five children with exacerbations did not respond to treatment. These children were older and more likely to be admitted. Non-measured factors, possibly genetic, may contribute to response to treatment.

Retrospective evaluation of recurrent secondary septic peritonitis in dogs (2000-2011): 41 cases.

OBJECTIVE: To describe the clinical characteristics of recurrent septic peritonitis in dogs. DESIGN: Multicenter retrospective observational study. ANIMALS: Client-owned dogs with recurrent septic peritonitis. SETTING: Three university emergency and referral hospitals. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000-2011). Forty one dogs met the inclusion criteria for recurrent peritonitis. All dogs underwent relaparotomy. The original cause of septic peritonitis in these cases included previous surgery for gastrointestinal foreign body removal (n = 26), gastrointestinal neoplasia (n = 3), gastric or duodenal ulceration (n = 3), biliary tract leakage (n = 2), and single instance for each of the following: penetrating foreign body, hernia strangulation, intussusception, mesenteric volvulus, infection of the laparotomy incision, prostatic abscess, and trauma. Eighteen animals survived to discharge. There was no difference detected between survivors and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical management, or provision of appropriate initial antimicrobials. The survival rate for dogs having recurrent peritonitis was 43.9% (18/41 dogs). CONCLUSIONS: This retrospective study did not identify any significant prognostic indicators for dogs with recurrent peritonitis and that the mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis.

Prospective evaluation of tissue plasminogen activator in 11 cats with arterial thromboembolism.

The purpose of this study was to evaluate the clinical response and side effects of tissue plasminogen activator (tPA) for the treatment of feline arterial thromboembolism (ATE). Previous reports of conservative and thrombolytic therapy were used to provide a historical control group of cats with ATE. The study was terminated due to a high frequency of adverse outcomes. tPA was administered to 11 cats with clinical signs of ATE for a median duration of 4.0 h (range 2-12h) prior to treatment. Pulses were restored in 40% of limbs within 4h and 53% within 24h. Motor function was restored to 33% of limbs within 24h. Adverse effects were seen in 11/11 cats following administration of tPA including azotemia (n=5), neurological signs (n=5), cardiac arrhythmias (n=5), hyperkalemia (n=4), acidosis (n=2) and sudden death in one cat. Ultimately, three cats (27%) were discharged alive from the hospital. While signs compatible with thrombolysis were noted in many cats following tPA administration, a high rate of side effects and low rate of hospital discharge were noted in this study.

Beta4 integrin subunit gene expression correlates with tumor size and nuclear grade in early breast cancer.

In vitro data support a role for the alpha6beta4 integrin in tumor cell migration and invasion, particularly in breast carcinoma cells, but clinical data on this potentially important integrin are limited. The beta4 integrin subunit has been shown to cluster with genes characteristic of basal/myoepithelial cells in cDNA microarray analyses of breast cancer, and the subset of breast cancers with increased expression of genes characteristic of basal/myoepithelial cells appears to be particularly aggressive. The purpose of this study was to determine whether alpha6beta4 integrin expression correlates with aggressive clinicopathologic features of breast cancer and whether expression of this integrin has prognostic significance in early breast cancer. We evaluated tumor expression of the beta4 integrin subunit gene in a cohort of patients with early invasive breast carcinoma by in situ hybridization and correlated expression levels with multiple clinicopathologic characteristics. We also evaluated expression of laminin-5 protein, the principal ligand of alpha6beta4, in this patient cohort. Although we observed a slight trend towards decreased disease-free survival for patients whose tumors had high beta4 gene expression and coexpression of laminin-5, this did not reach statistical significance (P=0.11). However, we did observe a correlation between beta4 mRNA expression and both tumor size (P=0.01) and tumor nuclear grade (P<0.01). These results do not demonstrate prognostic significance for beta4 gene expression and/or laminin-5 protein expression in early breast cancer, but increased beta4 gene expression in larger tumors and in higher grade tumors does support a potential role for the alpha6beta4 integrin in tumor progression.

Isolated unilateral absence of right proximal pulmonary artery: surgical repair and follow-up.

The isolated unilateral absence of a proximal pulmonary artery is a rare congenital lesion with a diverse clinical presentation. If the connecting ductus arteriosus closes after birth, the ipsilateral pulmonary artery will lose its source of blood supply, resulting in hypoplasia or obliteration of intrapulmonary vessels. Despite a seemingly benign early clinical course, a significant number of untreated patients will develop pulmonary hypertension, hemoptysis, and recurrent respiratory infections. Early detection and surgical repair provides restoration of physiologic pulmonary circulation, regression of pulmonary hypertension, and the potential for normal distal pulmonary vascular development.

Adhesion-independent alpha6beta4 integrin clustering is mediated by phosphatidylinositol 3-kinase.

Clustering of cell-surface integrins is known to augment integrin-mediated signal transduction, but mechanisms of integrin clustering are poorly understood. Here we report that adhesion-independent clustering of alpha6beta4 integrin, known to be important in mediating tumor cell motility, is driven by phosphatidylinositol 3-kinase (PI3K) but does not require activation of the PI3K-Akt pathway. We observed clustering of alpha6beta4 in breast carcinoma cells after adhesion-independent cross-linking of the beta4 integrin subunit. Clustering was significantly blocked when cross-linking was performed in the presence of PI3K inhibitors LY294002 and wortmannin. In contrast, no significant inhibition of clustering was observed with protein kinase C inhibitor GF109203X, rapamycin, or heparin. Although alpha6beta4 clustering was blocked by PI3K inhibitors, clustering was not associated with increased PI3K lipid kinase activity or increased phosphorylation of Akt. A novel role for PI3K in alpha6beta4 integrin clustering is proposed.

Chromogenic in situ hybridization for alpha6beta4 integrin in breast cancer: correlation with protein expression.

The alpha6beta4 integrin is the receptor for the basement membrane protein laminin-5. Recent studies suggest that alpha6beta4 integrin expression in invasive breast carcinomas may be a poor prognostic factor. Because we have not had reliable results with commercially available antibodies for the immunohistochemical detection of alpha6beta4 integrin in archival paraffin-embedded tissues, we designed a probe to detect beta4 integrin subunit mRNA in paraffin sections. In situ hybridization for beta4 mRNA was performed on paraffin-embedded tissue sections of 25 invasive breast carcinomas using a hyperbiotinylated oligonucleotide DNA probe. Immunohistochemical staining was performed on corresponding frozen tumor sections using two commercially available antibodies to the beta4 integrin subunit. All cases positive for beta4 protein by one or both antibodies were also positive for beta4 mRNA by in situ hybridization, but three cases with beta4 mRNA expression were negative by immunohistochemistry with both antibodies. These findings suggest that in situ hybridization appears to be a sensitive method for detecting beta4 integrin mRNA, but it appears to identify some cases that either lack beta4 protein or express variants not recognized with commercial antibodies directed to particular extracellular or cytoplasmic domains.