Forte (United States)

Visual hallucinations are a core feature of dementia with Lewy bodies and primary psychiatric disease, yet identification of a hallucination vs normal spiritual experience depends on cultural context. Almost no information exists in the medical literature regarding normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation. To assess the characteristics of a normal spiritual experience in an Ojibwe Tribal Nation. This prospective, cross-sectional study was conducted between August 1, 2021, and August 31, 2022, among an Ojibwe Tribal Nation in northern Minnesota. Participants were evaluated at their tribal nation clinic. Cognitively unimpaired tribal Elders who were enrolled members of the tribal nation and aged 55 years or older were invited to participate via fliers, radio advertisements, and health fair presentations. Thirty-seven tribal Elders volunteered. Each participant was asked whether they experienced hallucinations or visions of people, animals, or objects that are not part of the physical world. This was an a priori formulated question and part of a comprehensive neurocognitive evaluation consisting of history and physical examination (including cognitive screening with a subspecialty-trained behavioral neurologist); blood tests for metabolic, nutritional, and thyroid conditions; and noncontrast magnetic resonance imaging brain scan. Four patients were excluded from the present analysis due to having mild cognitive impairment or dementia. Thirty-three cognitively unimpaired tribal Elders (mean [SD] age, 66.0 [7.5] years; 22 women [67%]) were included. Sixteen (48%) answered affirmatively, reporting recurrent visions of the nonphysical world. Generally, these visions were well formed, benevolent in nature, and transient; started in preadolescence; involved spirits or ancestors; and were congruent with cultural and spiritual beliefs of the Ojibwe people. No patients had accompanying dream enactment behavior, dysautonomia, parkinsonism, sleep transition-related hallucinations, or moderate to severe depression to suggest a prodrome of an α-synucleinopathy, hypnopompic or hypnagogic hallucinations, or psychosis. Although based on only 1 Ojibwe Tribal Nation, this study suggests that formed visions of the nonphysical world are common among cognitively healthy Ojibwe individuals and can represent normal spiritual experiences. Clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric disease.

Coincidental with the intensified regulatory and industry focus on the design and conduct of human absorption, metabolism, and excretion (hAME) studies in the past 12 months, we have recently completed our 500th cohort involving radiolabeled test item administration to humans. Here, we build upon a recent industry white paper in this journal1 and share some of our own experiences as a Contract Research Organization based upon collaborations with numerous pharma companies and their differing approaches to design and timing, to add further context to the discussion regarding hAME studies and the pivotal role that drug metabolism and pharmacokinetics plays. In this article, we explore how both changing relationships within the industry and shifting regulatory guidelines are impacting strategies, and compare EU and US pre-study approval requirements, before evaluating the trends from over 500 studies conducted at our global facilities conducted over more than 30 years. We conclude with a review of how improved technical capabilities and strategies are influencing the design and conduct of hAME studies, before speculating on some of the driving factors which may shape the direction they take in the future.

This theme issue of the Interdisciplinary Journal of Partnership Studies addresses government/civic partnerships. Do government services always orient toward hierarchies of domination? Our answer is a resounding no. This article offers as evidence the actions of one government funder that removed hierarchical barriers, working in partnership with diverse grantees to envision a program that prioritizes community relevance and participation. Even as our article revolves around a strategic visioning event, it is a culmination of a government funder living out its guiding principles of mutual respect, joint problem solving, and valuing diversity, as well as the values, experiences, and collaborative spirit that diverse grantees brought. Our collective stories offer a clear example of how a partnership-based government program can engage and promote the strengths, needs, and priorities of the community not only because it is the appropriate and respectful approach, but also because it leads to stronger program results.

The year 1991 proved to be crucial for the Soviet republics, including for Moldova, and in result of incremental democratic transformations and the collapse of the USSR, the Republic of Moldova became an independent state. The year 1991 was the common starting point of independence for most of Soviet Union republics. After the events of August 1991, most of the world believed that the collapse of the Soviet Union meant a departure from the totalitarian past for the former Soviet territories, but the reality proved to be different for most of the former Soviet republics. However, the transition from a totalitarian to a democratic regime proved to be different for each postSoviet state. If the 1989 year is considered the annus mirabilis or the collapse of a utopia, then the year 1991 is the beginning of the post-Cold War era. This paper highlights the most important events of the year 1991 and their impact on the Moldovan society.

In a mass casualty incident, injured and at-risk patients will pass through a continuum of care from many different providers acting as a team in a clinical environment. As presented at MMVR 14 [Kaufman, et al 2006], formative evaluations have shown that simulation practice is nearly as good as, and in some cases better than, live exercises for stimulating learners to integrate their procedural knowledge in new circumstances through experiential practice. However, to date, multiplayer game technologies have given limited physiological fidelity to their characters, thus limiting the realism and complexity of the scenarios that can be practiced by medical professionals. This paper describes the status of a follow-on program to merge medical and gaming technologies so that computer generated, but human-controlled, avatars used in a simulated, mass casualty training environment will exhibit realistic life signs. This advance introduces a new level of medical fidelity to simulated mass casualty scenarios that can represent thousands of injuries. The program is identifying the critical instructional challenges and related system engineering issues associated with the incorporation of multiple state-of-the-art physiological models into the computer generated synthetic representation of patients. The work is a collaboration between Forterra Systems and the SUMMIT group of Stanford University Medical School, and is sponsored by the US Army Medical Command's Telemedicine and Advanced Technologies Research Center (TATRC).

This paper presents a new approach for replacing the current qualified upgrade award (QUA) process in the New England standard market design (SMD). As with the current process, the new process called incremental auction revenue rights (IARR) awards FTR auction revenues to entities that pay for new transmission upgrades making it possible to award additional FTRs in the FTR Auction. The QUA process was designed and implemented as an interim measure and depends heavily on inefficient manual procedures that produce volatile results. Along with the requirements for and characteristics of a permanent award process, the QUA process and the new IARR process are discussed and compared. The proposed rules for nominating relevant paths are introduced. In addition, tables and figures are presented to illustrate the approach

Stewart Pollens. the early pianoforte. Cambridge: Cambridge University Press, 1995. xx, 297 pp. Katalin Komlós. FORTEPIANOS AND THEIR MUSIC: GERMANY, AUSTRIA, AND ENGLAND, 1760–1800. Oxford: Clarendon Press, 1995. 158 pp. Richard K. Lieberman. STEINWAY & SONS. New Haven: Yale University Press, 1995. ix, 374 pp. Jean Bach, producer and director. A GREAT DAY IN HARLEM. ABC Video, 1995. 60 mins. American Music Meets Music Theory J. Peter Burkholder, ALL MADE OF TUNES: CHARLES IVES AND THE USES OF MUSICAL BORROWING. New Haven and London: Yale University Press, 1995. 554 pp. Steven E. Gilbert, THE MUSIC OF GEORGE GERSHWIN. Composers of the Twentieth Century, ed. Allen Forte. New Haven: Yale University Press, 1995. 255 pp. Joseph N. Straus, THE MUSIC OF RUTH CRAWFORD SEEGER. Music in the Twentieth Century, ed. Arnold Whittall. Cambridge: Cambridge University Press, 1995. 260 pp. Jean Bach, producer and director. A GREAT DAY IN HARLEM. ABC Video, 1995. 60 mins.

A child showed a type IIb lipoprotein pattern and triglyceride-enriched cutaneous xanthomas before 1 year of age. The proband and 9 of 18 relatives had elevated plasma levels of low density lipoprotein (LDL) B protein; of these nine relatives, four had elevated LDL of increased density while five had elevated LDL of normal density. Compared with normal LDL, LDL of increased density had less cholesteryl ester and free cholesterol, more apolipoprotein B and triglyceride, and a lower molecular weight and flotation rate (Sf degrees). Patients with LDL of increased density had higher mean plasma levels of triglycerides, very low density lipoproteins, and intermediate density lipoproteins, but lower levels of high density lipoproteins than those with elevated LDL of normal density. Multiple lipoprotein patterns in the father's family suggested the presence of familial combined hyperlipidemia (FCH). The mother of the proband and two of her relatives had type IIa lipoprotein patterns and tendon xanthomas, compatible with familial hypercholesterolemia (FH). High affinity binding, internalization, and degradation of 125I LDL in cultured fibroblasts from the proband and his mother were reduced two- to threefold compared with normal cells, while LDL receptor activity in the proband's father was normal. This unusual proband has apparently inherited both FCH and FH.