Minnesota Center Research Articles

Occasions for an Empirical History of Philosophy of Science: American Philosophers of Science at Work in the 1950s and 1960s

The text- and argument-focused histories of philosophy that we have are mainly interested in teasing out the details of the positions taken on philosophical issues by individual philosophers. But this is a long way from having a historical explanation of the larger-scale trajectory of philosophical development. An empirical history of philosophy, however, examines the institutionalized places and venues for philosophical work that provide a rich, shared structure for the promotion of particular sorts of work. Mid-twentieth-century philosophers of science such as Herbert Feigl and Philipp Frank knew what they were doing—they were creating the space to promote certain sorts of work in venues such as the Institute for the Unity of Science and the Minnesota Center for Philosophy of Science and, ultimately, in publication venues such as Daedalus and the Minnesota Studies in Philosophy of Science. Here the engine of progress is the institution-building activity of committed philosophers making a space within th...

The Prevalence of Serious Infectious Complications in a Cohort of Non-Referred Patients with Newly Diagnosed Chronic Lymphocytic Leukemia (CLL) Compared to Controls: Results of a Cohort Study

Abstract 4610 IntroductionInfections are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (CLL). Up to 50% of CLL patients develop infectious complications, and 30–50% of all deaths in CLL patients are attributed to infections. Despite these data, the available research on infectious complications in CLL is primarily limited to patients participating in clinical trials of chemotherapy, obscuring the distinction between the risk of infection due to the disease's natural history relative to the risk associated with therapy related immune suppression. METHODS:The Mayo Clinic Rochester (MCR), a tertiary referral center in rural southeastern Minnesota, is also the primary hematology center for southeastern Minnesota, northern Iowa, and western Wisconsin. There are no metropolitan areas or hematology specialty centers within a ∼50 mile radius. To explore the natural history of infection in a community-based cohort of CLL patients, we used the Mayo Clinic CLL database to identify all patients with newly diagnosed CLL who resided within 50 miles of MCR and diagnosed between January, 1999 and December, 2009. The comparison cohort consisted of 689 adult patients who also resided within 50 miles of MCR who were seen for a general medical examination between September, 2002 and December, 2009 and who were enrolled as controls in a case-control study of non-Hodgkin lymphoma. All hospitalizations at MCR among both cohorts were audited to document hospitalization with infection and cross-referenced with the Mayo Clinic infection database, which includes all culture results obtained from hospitalized MCR patients. Serologies and viral assays were also reviewed. Patients whose cultures were negative but who were given a clinical diagnosis of infection (e.g. pneumonia) and who were treated with a full course of antibiotic therapy were considered to have a culture negative infection. RESULTS:In May 2010, there were 2022 CLL patients in the Mayo Clinic CLL Database diagnosed between 1999 and 2009. Of these, 174 (9%) were local CLL patients residing within 50 miles of MCR. Median age at diagnosis for these non-referred CLL patients was 69 years (range 27–97). Most had early stage disease (60% stage 0; 32% stage I-II). On prognostic evaluation, 121 (75%) patients were CD38 negative, 66 (61%) ZAP-70 negative, 47 (50%) IGHV mutated, and 56 (62%) had either no abnormality or 13q14- as a sole abnormality on FISH analysis. 64 (37%) patients progressed to require treatment for CLL during follow-up.After median follow-up of 4.0 years (range 0–11), 32 (18.4%) CLL patients were hospitalized with infection at least once as compared to 20/689 (2.9%) individuals in the control cohort (odds ratio=7.5; p<0.0001) Figure 1A. Even prior to receiving treatment for CLL, the rate of hospitalization for infection remained higher than the control cohort (p=0.002; Figure 1B). The 32 CLL patients hospitalized with infection were admitted with infection a total of 89 times (median 1 hospitalization for infection per patient). A specific infectious organism was identified by cultures or serologies in 60 (63%) of the 89 infections in CLL cases and 10/27 (37%) infections among controls. Hospitalization for an opportunistic infection (e.g. cytomegalovirus, cryptococcus, filamentous fungi, mycobacteria, Pneumocystis) occurred in 5/174 (3%) CLL patients during follow-up compared to 0/689 controls (p<0.001). [Display omitted] [Display omitted] Finally, we performed a pooled multivariable analysis of all patients (n=863) to identify factors (age, sex, CLL diagnosis, CLL treatment) associated with infection risk. Most factors were independently associated with hospitalization for infection [Age (per year, OR=1.03, p=0.02), sex (male, OR=4.0, p<0.001), diagnosis of CLL (OR=2.1, p=0.09), and treatment for CLL (OR=5.9, p<0.001)]. In univariate analysis of CLL patients [sex (OR=4.2, p=0.01), higher Rai stage (p=0.046), unfavorable (del 17p13; del 11q23) FISH [OR=4.6, p=0.02] and unmutated IGHV [OR=2.8, p=0.07]) were associated with risk of infection. CONCLUSIONS:In this cohort study, patients with newly diagnosed CLL had a 7.5-fold risk of hospitalization for infection relative to the control cohort. After 4 year follow-up, ∼1 in 5 CLL patients required hospitalization for infection. Although CLL treatment was a substantial risk factor for infection, the risk of infection among untreated patients remained higher than controls. Disclosures:Kay:Biothera: Research Funding; Clegene: Research Funding; Cephalon: Research Funding; Genentech: Research Funding; Glaxo Smith Kline: Research Funding; Hospira: Research Funding; Novartis: Research Funding; Supergen: Research Funding; Calistoga: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Emergent Biosolutions (Formerly Trubion): Membership on an entity's Board of Directors or advisory committees. Zent:GlaxoSmithKline: Research Funding; Genentech: Research Funding; Genzyme: Research Funding.

Infectious Complications Among Individuals with Monoclonal B-Cell Lymphocytosis (MBL): A Prospective Case-Control Study of Newly Diagnosed Patients,

Abstract 3903▪▪This icon denotes a clinically relevant abstract INTRODUCTION:Monoclonal B-Cell Lymphocytosis is an asymptomatic hematologic condition characterized by the presence of small populations of clonal B-cells in the blood or bone marrow occurring in 3–5% of the general population over age 40. Although MBL is considered the precursor state to CLL and other sub-types of indolent non-Hodgkin Lymphoma, most individuals with MBL will not develop a B-cell malignancy. It is unknown, however, whether individuals with MBL may be at risk for other adverse outcomes associated with CLL, such as increased risk of infection. To explore this aspect, we evaluated the risk of hospitalization for infection among patients with clinically recognized MBL and compared this to a cohort of general medicine patients and a cohort of CLL patients. METHODS:The Mayo Clinic Rochester (MCR), a tertiary referral center in rural southeastern Minnesota, is also the primary hematology center for southeastern Minnesota, northern Iowa, and western Wisconsin. There are no metropolitan areas or hematology specialty centers within a 50 mile radius. To explore the natural history of infection in a local, community dwelling cohort of individuals with clinically identified, CLL-phenotype MBL, we used the Mayo Clinic CLL database to identify all patients with newly diagnosed MBL seen in the MCR Hematology Division between January 1999 and December 2009. Analysis was limited to MBL cases who resided within 50 miles of MCR. The comparison cohort consisted of 689 adult patients also resided within 50 miles of MCR who were seen for a general medical examination between September 2002 and December 2009 and who were enrolled as controls in a case-control study of non-Hodgkin lymphoma. Rates of infection among individuals with MBL were also compared to a cohort of 174 patients with newly diagnosed CLL diagnosed in the same time interval and who resided within 50 miles of MCR. All hospitalizations in these 3 groups were audited to document hospitalization with infection including cross-referenced with the electronic Mayo Clinic infection database, which contains all culture results obtained from hospitalized patients at MCR. Serologies and viral assays (e.g. CMV viral load) were also reviewed. Patients whose cultures were negative but who were given a clinical diagnosis of infection (e.g. pneumonia) and who were treated with a full course of antibiotics were considered to have a culture negative infection. Among the cases, only hospitalizations after CLL or MBL diagnosis were considered. RESULTS:In May 2010, there were 524 individuals in the Mayo Clinic MBL/CLL Database with the diagnosis of CLL-phenotype MBL made between January 1999 – December 2009. Of these, 154 (29%) patients resided within a 50 mile radius of Mayo Clinic and were considered a local, community-based cohort of MBL patients. Median age at MBL diagnosis for these 154 patients was 70 years (range 45–94).After median follow-up of 4.2 years (range 0.3–10.6 years), 25 (16%) individuals with MBL were hospitalized with infection as compared to 20/689 (3%) individuals in the control population (odds ratio MBL relative to control=6.5; p<0.001) and 32/174 (18%) in the cohort of patients with newly diagnosed CLL (OR MBL relative to CLL=0.9; p=0.61) (Figure 1). The 25 MBL patients hospitalized for infection were hospitalized a total of 39 times (median 1 hospitalization for infection per individual). A specific infectious organism was identified by cultures or serologies in 8/39 (21%) hospitalizations among individuals with MBL, 10/27 (37%) hospitalizations for infection among controls, and 60 (63%) of the 89 hospitalizations for infection in CLL cases.Finally we performed a pooled multivariable analysis of all patients (n=1017) adjusting for age, sex, presence of MBL, diagnosis of CLL, and whether patients with CLL or MBL received treatment for CLL during follow-up. All factors were independently associated with risk of hospitalization for infection [Age (per year, OR=1.02, p=0.02), sex (male, OR=2.6, p=0.001), presence of MBL (OR=3.3, p<0.001), diagnosis of CLL (OR=3.0, p=0.002), and treatment for CLL (OR=3.3, p<0.001)]. CONCLUSIONS:In this cohort study, patients with newly diagnosed clinical-MBL had a 6.5 fold risk of hospitalization for infection relative to the control cohort. MBL was an independent risk factor for hospitalization for infection after controlling for age, sex, and treatment. [Display omitted] Disclosures:Zent:GlaxoSmithKline: Research Funding; Genentech: Research Funding; Genzyme: Research Funding. Kay:Biothera: Research Funding; Clegene: Research Funding; Cephalon: Research Funding; Genentech: Research Funding; Glaxo Smith Kline: Research Funding; Hospira: Research Funding; Novartis: Research Funding; Supergen: Research Funding; Calistoga: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Emergent Biosolutions (Formerly Trubion): Membership on an entity's Board of Directors or advisory committees.

The Minnesota Center Against Violence and Abuse (MINCAVA)

The Minnesota Center Against Violence and Abuse (MINCAVA) was established in 1994 through an appropriation of the Minnesota Legislature. Located at the University of Minnesota, MINCAVA conducts original research, develops extensive collections of translational materials, provides higher education training on family violence prevention, and disseminates information globally. Over a dozen professional and student staff work on projects funded by federal, state, and private sources and collaborate closely with national and global advisory boards and partner agencies as well as local community-based and national advocacy organizations. The Center operates multiple project-specific and general websites that receive millions of unique visits each year from dozens of countries.

Book review: Tara Williams Fortune with Mandy R. Menke (2010). Struggling learners and language immersion education: Research-based, practitioner-informed responses to educators’ top questions. Minneapolis, MN: University of Minnesota Center for Advanced Research on Language Acquisition. 139 pp. US$45.00 (paperback). ISBN 978-0-9843996-0-4

Book review: Tara Williams Fortune with Mandy R. Menke (2010). Struggling learners and language immersion education: Research-based, practitioner-informed responses to educators’ top questions. Minneapolis, MN: University of Minnesota Center for Advanced Research on Language Acquisition. 139 pp. US$45.00 (paperback). ISBN 978-0-9843996-0-4

A Tale of Two Technologies: Hydraulic Fracturing and Geologic Carbon Sequestration

ADVERTISEMENT RETURN TO ISSUEPREVViewpointNEXTA Tale of Two Technologies: Hydraulic Fracturing and Geologic Carbon SequestrationJoseph A. Dammel, Jeffrey M. Bielicki, Melisa F. Pollak, and Elizabeth J. Wilson*View Author Information University of Minnesota Center for Science, Technology, and Public Policy, 301 19th Avenue South, Minneapolis, Minnesota 55455, United StatesE-mail: [email protected]Cite this: Environ. Sci. Technol. 2011, 45, 12, 5075–5076Publication Date (Web):May 17, 2011Publication History Received21 April 2011Accepted26 April 2011Published online17 May 2011Published inissue 15 June 2011https://doi.org/10.1021/es201403cCopyright © 2011 American Chemical SocietyRIGHTS & PERMISSIONSArticle Views3265Altmetric-Citations13LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InReddit PDF (854 KB) Get e-AlertsSUBJECTS:Carbon sequestration,Energy,Fluids,Sequestration,Shale Get e-Alerts

Advancing Nursing Science Through Health Trajectory Research

The Minnesota Center for Health Trajectory Research has focused on developing ways to better understand how interventions influence health trajectories during transitional, acute, or chronic health challenges across the life span. The health trajectory perspective advances nursing science by providing a person-centered point of view that emphasizes change in health over time within individuals, families, groups, or communities. Theoretical considerations and statistical modeling approaches used in studying health trajectories, along with exemplars from nursing research studies from this special issue of Nursing Research, are highlighted.

Survey of Regional Laser Centers: A Minnesota Perspective

Laser use in medicine is rapidly expanding as patients seek treatment for medical and cosmetic purposes. Concern is mounting about the unsupervised use of lasers and similar devices by nonphysician personnel. Minnesota is currently one of the few states with no legislation regarding the uses of lasers. To determine whether laser centers in Minnesota meet professional standards and guidelines for patient safety. Public resources were used to identify all businesses with laser services in Minnesota cities with a population of at least 1,000 people. Each laser center was contacted, and a "secret shopper," a person who posed as a potential patient administered a telephone survey. A wide range of physicians and nonphysician personnel offer laser services in Minnesota. Supervision was not standardized and varied widely across the laser centers. As the demand for laser services increases, the use of lasers must be clearly defined and regulated to prevent patient injury. The authors have indicated no significant interest with commercial supporters.

Editorial

The early modern period of world history (ca. 1300-1800) was marked by a rapidly increasing level of global interaction. Between the aftermath of Mongol conquest in the East and the onset of industrialization in the West, a framework was established for new kinds of contacts and collective self-definition across an unprecedented range of human and physical geographies. The Journal of Early Modern History, the official journal of the University of Minnesota Center for Early Modern History, is the first scholarly journal dedicated to the study of early modernity from this world-historical perspective, whether through explicitly comparative studies, or by the grouping of studies around a given thematic, chronological, or geographic frame.

Psychometric and Genetic Architecture of Substance Use Disorder and Behavioral Disinhibition Measures for Gene Association Studies

Using large twin, family, and adoption studies conducted at the Minnesota Center for Twin and Family Research, we describe our efforts to develop measures of substance use disorder (SUD) related phenotypes for targets in genome wide association analyses. Beginning with a diverse set of relatively narrow facet-level measures, we identified 5 constructs of intermediate complexity: nicotine, alcohol consumption, alcohol dependence, illicit drug, and behavioral disinhibition. The 5 constructs were moderately correlated (mean r=.57) reflecting a general externalizing liability to substance abuse and antisocial behavior. Analyses of the twin and adoption data revealed that this general externalizing liability accounted for much of the genetic risk in each of the intermediate-level constructs, though each also exhibited significant unique genetic and environmental risk. Additional analyses revealed substantial effects for age and sex, significant shared environmental effects, and that the mechanism of these shared environmental effects operates via siblings rather than parents. Our results provide a foundation for genome wide association analyses to detect risk alleles for SUDs as well as novel insights into genetic and environmental risk for SUDs.

Complementary and alternative medicine: use and disclosure in radiation oncology community practice

The aims of this study were to evaluate the frequency of complementary and alternative medicine (CAM) use among radiation oncology patients, the coping strategies that influenced this use, and the rates of disclosure of CAM use to their healthcare providers. One hundred fifty-three patients undergoing radiation therapy for various neoplasms at rural cancer centers in Minnesota completed the Mayo Complementary and Alternative Medicine Use Survey and the Coping Inventory for Stressful Situations questionnaires. Data regarding CAM use was also compared with provider consultation notes in the medical record at the onset of radiation therapy to determine rates of patient disclosure of CAM use to their healthcare providers. A total of 153 participants completed the study with 61.4% females and 38.6% males and a mean age of 64.9 years. The two most frequent diagnoses of participants were breast cancer (43.8%) and prostate cancer (22.9%). CAM use was reported in 95% of the participants and was categorized into three domains: treatments and techniques, vitamins, and herbs and supplements. The three most frequently reported treatments and techniques were spiritual healing/prayer (62.1%), exercise (19.6%), and music (17.6%). The top three most frequently used biologically based CAM therapies were multivitamins (48.1%), calcium (37.3%), and vitamin with minerals (21.5%). The most frequently used herbs and other dietary supplements were fish oil (19.0%), flaxseed (15.0%), glucosamine (15.0%), and green tea (15.0%). The most common reason cited for CAM treatments and techniques use was previous use (26.1%), for use of vitamins and minerals was recommendation by a physician (33.0%), and for use of herbs and other supplements was previous use (19.0%). One hundred twelve participants reported taking vitamins, minerals, or supplements, and 47% of those 112 did not disclose this use to their providers. Consistent with previous research, our study found that the majority of cancer patients used CAM treatments. Spiritual healing/prayer was the most commonly reported, followed by multivitamins. Patients reported using CAM primarily due to previous use and physician recommendation. Unfortunately, disclosure of CAM use to healthcare providers was relatively low.

Exploring Ways of Knowing: Symposia for Health and Wellness Providers

In May 2007 the Life Science Foundation and the University of Minnesota's Center for Spirituality and Healing launched the first Ways of Knowing Symposium for health care, complementary and alternative medicine and traditional healing professionals. The event, subtitled Exploring the Role of Intuition in Health and Healing, featured presentations by nurse researchers, scientists, and members of teams from Abbott Northwestern Hospital, Minneapolis, Minnesota, who described how they were trained to use intuition comfortably in their daily hospital routines (Kreitzer & Franquemont, 2007 ). The 2008 Symposium, Exploring Culture-Based Healing Traditions and Practices, brought together culture-based healing researchers Stanley Krippner, PhD, and Marilyn Schlitz, PhD, with healers from Hawaiian, Native American, Hispanic, African, and Peruvian traditions. Healing, health, and wellness were viewed from multiple perspectives in an atmosphere of mutual respect and curiosity ( Kreitzer & Franquemont, 2008). By the third Ways of Knowing Symposium in 2009, Exploring the Relationship Between Ways of Being and Well Being, registration was full 7 weeks prior to the event. Why is exploring ways of knowing so important now? Why do health care providers line up for a symposium on this topic in spite of very full schedules and the economic downturn? One answer is that health providers directly or indirectly engage in life's most profound questions: What creates and sustains life? What allows life to thrive? How do we respond to death? What can be done to heal and to help? As a result, providers are at the nexus of societal changes. They embody the actual and symbolic hope for the health and wellness of individuals, communities, nations, and the world. Therefore, health professionals are impacted by today's escalating health care costs, an outdated system, increased workloads due to systemic problems and the economic downturn, a more self-educated public due to the huge amount of health information (and misinformation) available on the Internet, and expanding multicultural populations. Beyond these factors, health care professionals are central to a profound revolution in our understanding of the body. THE HARD AND SOFT SIDES OF HEALTH CARE In 1899, Sigmund Freud created a method for exploring the unconscious mind through dreams and laid the groundwork for psychology and psychiatry. Since their establishment, most Western health care has been divided into the soft , social sciences (performed by psychiatrists, psychologists, social workers, counselors, and spiritual guides) and the hard, physical sciences of biochemistry and body mechanics (performed by physicians, nurses, health researchers, etc.). Healing practices outside of conventionally accepted methods, such as chiropractic, naturopathy, and acupuncture were placed in the soft category if they were categorized at all. This dichotomy, which tended to define what true, relevant healing knowledge was and was not, dominated health education and the health care system for decades. Knowledge is changing all that. Research results indicate that the neat split between hard and soft is artificial. For example, if part of the brain is injured or destroyed are the associated abilities lost forever? The answer is not necessarily. The brain has plasticity-the ability to change in response to experience. Research by Merzenich (2004, 2007 ), Stein (2006), and others reveals that the brain can create new paths for the lost skill to utilize. Davidson (2001) takes the concept of brain plasticity further, suggesting that happiness and compassion are skills we can learn just as we learn to play piano or golf ( Davidson et al., 2003). Other research results suggest that happiness strengthens our immune system ( Davidson, 2007 ). In short, it appears that "soft " can influence "hard." In the last two decades, we've come to understand more about the role of emotions. …

The Low Countries in the Sixteenth Century: Erasmus, Religion and Politics, Trade and Finance (review)

Reviewed by: The Low Countries in the Sixteenth Century: Erasmus, Religion and Politics, Trade and Finance Henk van Nierop The Low Countries in the Sixteenth Century: Erasmus, Religion and Politics, Trade and Finance. By James D.Tracy. [Variorum Collected Studies Series, 808.] (Burlington, Vermont: Ashgate Publishing Company. 2005. Pp. xii, 346. $124.95.) One of the most prolific, versatile, and creative historians of the sixteenth-century Netherlands, and more generally of Renaissance and Reformation Europe, is undoubtedly James Tracy. Having begun his long career with a dissertation, and then a book, on The Politics of Erasmus (1978), he became interested in the history of the Habsburg Netherlands as the backdrop to the great humanist's thinking, which eventually resulted in a monograph on the political and religious history of the county of Holland before the Revolt, Holland under Habsburg Rule (1990). While working in the archives at The Hague, he became interested in Holland's public debt system, which apparently predated England's famous "Financial Revolution" of the 1690s by at least one century and a half. This resulted in a long article (republished in the volume under review) and another book, A Financial Revolution in the Habsburg Netherlands (1985). Professor Tracy's interest in financial matters was broadened in a study of Emperor Charles V, Impresario of War (2002), which focuses on the ways the emperor paid for his wars in Europe and North Africa. As director of the University of Minnesota's Center for Early Modern History he also became involved with the history of long-distance trade, editing two volumes on the rise, and the political economy, of merchant empires in the early modern world (1990, 1991). In the meantime he continued to publish on Erasmus (Erasmus of the Low Countries, 1996), and produced a textbook on Europe's Reformations 1450–1650 (1999). His latest book The Founding of the Dutch Republic came out in January 2008, focusing on how the province of Holland largely on its own paid for the initial stages of the Revolt, thereby safeguarding its own vital interests at the expense of the peripheral Dutch provinces. In between, he dabbles with fields as diverse as the correspondence of Justus Lipsius (thus combining his interests in early Dutch Humanism and sixteenth-century Dutch politics), and relations between the Low Countries and the Ottoman Empire. Unsurprisingly, James Tracy's research over many years has resulted in a great number of articles in various journals and volumes of conference papers. Fourteen of these have been published in the present volume of essays. Its structure reflects the author's interests: there is a section on "Erasmus" (five essays), a section on "Religion and Politics in the Low Countries" (four essays), and a section on "Finance and Trade: Netherlands Perspectives" (five essays). Two essays have been published previously in The Catholic Historical Review ("Erasmus and the Arians" and "With and Without the Counter-Reformation"). Since many of these essays have been published in various journals and volumes not readily available, this volume will undoubtedly find a wide readership. All papers in this volume have retained their original pagination, as is customary in Ashgate's Variorum series. While this practice undoubtedly facilitates [End Page 156] the retrieval of references, the bewildering variety of lay-outs and type-sets has resulted in a volume less handsome than the author deserves, for a price that may be called rather stiff. Henk van Nierop University of Amsterdam Copyright © 2008 The Catholic University of America Press

“False-Positive” Cardiac Catheterization Laboratory Activation Among Patients With Suspected ST-Segment Elevation Myocardial Infarction

Allowing the emergency department physician to activate the cardiac catheterization laboratory is a key strategy to reduce door-to-balloon times in patients with ST-segment elevation myocardial infarction (STEMI). There are limited data on the frequency of "false-positive" catheterization laboratory activation in patients undergoing percutaneous coronary intervention for suspected STEMI. To determine the prevalence, etiology, and outcomes of false-positive cardiac catheterization laboratory activation in patients with a suspected STEMI. Prospective registry from a regional system that includes transfer of patients with STEMI from 30 community and rural hospitals with pretransfer catheterization laboratory activation for percutaneous coronary intervention at a tertiary cardiovascular center in Minnesota. A total of 1345 patients were enrolled from March 2003 to November 2006. Prevalence of false-positive catheterization laboratory activation in patients with suspected STEMI by 3 criteria: no culprit coronary artery, no significant coronary artery disease, and negative cardiac biomarker results. Of the 1335 patients with suspected STEMI who underwent angiography, 187 (14%; 95% confidence interval [CI], 12.2%-16.0%) had no culprit coronary artery and 127 (9.5%; 95% CI, 8.0%-11.2%) did not have significant coronary artery disease. Cardiac biomarker levels were negative in 11.2% (95% CI, 9.6%-13.0%) of patients. The combination of no culprit artery with negative cardiac biomarker results was present in 9.2% (95% CI, 7.7%-10.9%) of patients. Thirty-day mortality was 2.7% (95% CI, 0.4%-5.0%) without vs 4.6% (95% CI, 3.4%-5.8%) with a culprit coronary artery (P = .33). The frequency of false-positive cardiac catheterization laboratory activation for suspected STEMI is relatively common in community practice, depending on the definition of false-positive. Recent emphasis on rapid door-to-balloon times must also consider the consequences of false-positive catheterization laboratory activation.

Evolution of a Course in Veterinary Clinical Pathology: The Application of Case-Based Writing Assignments to Focus on Skill Development and Facilitation of Learning

To encourage application and critical thinking, case-based writing assignments and grading rubrics were developed for use in a second-year core clinical pathology course. Objectives were to describe how this teaching technique was adapted to a large-class setting and how student perceptions of the learning experience guided modifications of this teaching technique over two presentations of the course and plans for a third presentation. Our goal was to enhance learning by encouraging application of course material to clinical situations and thereby improve students' ability to organize and communicate information. Furthermore, we evaluated the influence of instructor feedback on the learning process. With assistance from the University of Minnesota Center for Writing, assignments and grading rubrics were developed. Students completed course evaluation surveys designed to elicit feedback on the impact of the assignments. Increased learner confidence was reflected in larger self-reported increases in understanding of the material and ability to apply information and in increased feelings of preparedness for class and examinations. A large majority of students advocated the use of such assignments in the course in future years, and modifications to make grading and evaluation of assignments more efficient are underway. Investment of faculty and student time in case-based writing assignments in the veterinary clinical pathology curriculum appears to increase student engagement with material and learner confidence. Future studies should address the impact of this type of assignment more specifically on clinical reasoning and communication skills and on long-term retention of material.

Environmental, parental, and personal influences on food choice, access, and overweight status among homeless children

In-depth interviews were conducted with homeless children ( n=56, aged 6–13 years) in an urban center in Minnesota, USA, to determine factors influencing food choice, food access, and weight status, with interview questions developed using the Social Cognitive Theory. Interview transcripts were coded and then evaluated both collectively and by weight status (<85th percentile=normal weight vs. ⩾85th percentile=overweight). Forty-five percent of children were overweight. Environmental, parental, and personal factors emerged as common themes influencing food access and choice. Despite children's personal food preferences, homelessness and the shelter environment created restrictive conditions that influenced food choice and access. Shelter rules, lack of adequate storage and cooking facilities, and limited food stores near the shelter, impacted the type and quality of food choices, ultimately affecting hunger, weight status, and perceived health.

Second annual robotics summer camp for underrepresented students

The University of Minnesota Center for Distributed Robotics and the Digital Technology Center hosted the second annual Technology Day Camp, a week long camp targeting underrepresented students such as girls, African Americans, and Hispanics from the Twin Cities metro area. Students were surveyed prior to the camp revealing a strong proclivity towards math and science, but a resistance to the perceived lifestyle of computer scientists. With an emphasis on the college experience, building hardware, creating software, and interacting with robots, the camp implemented proposed changes from the previous year as well as new activities with a special emphasis on robotics. The successes and failures are discussed in an effort to provide insight for organizations hosting similar programs, new research questions are presented, and a materials list is provided.

Minnesota Center for Twin and Family Research

The Minnesota Center for Twin and Family Research (MCTFR) houses a collection of longitudinal, community-based twin-family and adoptee-family projects that focus on the mental health outcomes of adolescent youth with a special focus on the development of substance use and related behavior disorders. The Minnesota Twin Family Study includes epidemiological investigations of 11- and 17-year-old twins, an examination of 11-year-old twins selected for being at high risk for having a childhood disruptive behavior disorder, and a supplemental registry of young adult twins age 18 years and older who are not enrolled in these longitudinal studies. Also, part of the MCTFR is the Sibling Interaction and Behavior Study, a complementary prospective investigation of adolescent sibling pairs in families with adoptive and biological offspring. MCTFR participants from these various projects are assessed in person and through multiple informants to provide comprehensive coverage of psychological adjustment, mental health, and psychosocial risk/protective factors. Measurement of EEG and autonomic nervous system reactivity is also part of the assessment battery for twin families. This article provides an overview of study design and includes a review of recent MCTFR findings.

Minnesota Center for Twin and Family Research

AbstractThe Minnesota Center for Twin and Family Research (MCTFR) houses a collection of longitudinal, community-based twin-family and adoptee-family projects that focus on the mental health outcomes of adolescent youth with a special focus on the development of substance use and related behavior disorders. The Minnesota Twin Family Study includes epidemiological investigations of 11- and 17-year-old twins, an examination of 11-year-old twins selected for being at high risk for having a childhood disruptive behavior disorder, and a supplemental registry of young adult twins age 18 years and older who are not enrolled in these longitudinal studies. Also, part of the MCTFR is the Sibling Interaction and Behavior Study, a complementary prospective investigation of adolescent sibling pairs in families with adoptive and biological offspring. MCTFR participants from these various projects are assessed in person and through multiple informants to provide comprehensive coverage of psychological adjustment, mental health, and psychosocial risk/protective factors. Measurement of EEG and autonomic nervous system reactivity is also part of the assessment battery for twin families. This article provides an overview of study design and includes a review of recent MCTFR findings.

The Architecture of a Mobile Outreach Echocardiography Service

We describe the outreach echocardiography program at our tertiary care referral center in southeast Minnesota. Cardiac sonographers from our institution transport ultrasonographic imaging equipment to regional hospitals and clinics where they perform complete transthoracic echocardiographic examinations. Digital images from standard 2-dimensional, color flow, and Doppler echocardiography are transferred to our clinic for interpretation by a cardiologist. The outreach program enables physicians without access to echocardiography to use this powerful diagnostic tool in the local evaluation of patients with suggested or known heart disease. We detail the organization of our outreach echocardiography program and emphasize the team approach that facilitates optimal image acquisition, prompt interpretation, and timely reporting of results.