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Earth ovens, hearths, and middens are common archaeological features in western North America that contain the residues of everyday activities. Ethnographic and archaeological research indicates that these in-ground food preparation features were frequently reused over many months and years. These quotidian features therefore can be productively thought of as having use-lives or biographies. Here we present a framework for interpreting these archaeological food preparation feature biographies and the palimpsest nature of earth oven features. We illustrate the value of this framework through paleoethnobotanical analysis of archived soil samples from a bulk food processing site on the Columbia-Fraser Plateau in northeastern Washington State. While this site and other food preparation sites throughout the Plateau are largely interpreted as remains of intensive geophyte processing, our finds indicate that a wide range of economic plants were processed at this location, indicative of a dynamic and flexible subsistence system. We suggest that residents and visitors to the Pend Oreille Valley from ca. 2700 to 500 cal BP frequently returned to and reused earth oven features as they processed multiple plant food taxa including nodding onion (Allium cernuum), camas (Camassia quamash), goosefoot chenopod seeds (cf. Chenopodium atrovirens), and pine nuts (Pinus spp.). We see a biographical approach as a potential solution to the common “palimpsest problem” and suggest that this framework may be a fruitful way of investigating multiple food preparation recipes, methods, and events, as well as adding paleoenvironmental datasets to biographical or life-history archaeological rhetoric. [ABSTRACT FROM AUTHOR]

The cone operation has revolutionized care for patients with Ebstein anomaly; however, acute post-operative right ventricular dysfunction (RVD) is common in this patient population. A single-center, retrospective review of 28 patients with Ebstein anomaly who underwent cardiac MRI (CMR) prior to cone reconstruction of the tricuspid valve was conducted. Measurements of atrial and ventricular size/function were assessed. Post-operative RVD was defined as the presence of moderate or severe systolic dysfunction on discharge echo. A two-tail t test was employed to compare the two groups. The average age at operation was 21.4 years (range 1.6–57.8) and 14 (50%) had RVD at discharge. Patients with post-operative RVD had significantly larger pre-operative right atrial (RA) maximum volume (p = 0.016) and RA minimum volume (p = 0.030). Patients with RVD had smaller pre-operative left atrial (LA) minimum volume (p = 0.012). Larger pre-operative right ventricular (RV) end-systolic volume (p = 0.046), lower RV ejection fraction (0.029), and smaller left ventricular (LV) end-diastolic volume (p = 0.049) were significantly associated with post-operative RVD. Post-operative RVD was associated with longer milrinone duration (p = 0.009) and higher maximum milrinone dose (p = 0.005) but was not associated with intensive care or hospital length of stay (p = 0.19 and 0.67, respectively). Increased RA and RV dilation and decreased LA and LV volumes are associated with the development of post-operative RVD following cone operation for Ebstein anomaly. Post-operative RVD affects milrinone dose and duration but is not associated with increased length of stay. [ABSTRACT FROM AUTHOR]

Paleoethnobotanical assemblages from the Northwestern region of North America often yield geophyte subterranean organs, but these carbonized remains are difficult to identify to species or genus level. We examine 11 species (8 genera) of the most ethnographically prevalent Northwest geophyte foods for macro- and micro-morphologic geophyte features, with a focus on bulbs from the Asparagales and Liliales orders. In this contribution, we discuss ethnographic practices which may affect archaeological material and provide digital photographic and quantitative references for both fresh and carbonized geophytes. We determine that pavement epidermal cells are the most diagnostic criteria for identifying bulbs in paleoethnobotanical assemblages. These identification standards provide researchers with comparative material to address questions of plant use, preparation, and stewardship across the greater Northwest Coast and Columbia-Fraser Plateau cultural and geographic regions. [ABSTRACT FROM AUTHOR]

Examining community views on genetic/epigenetic research allows collaborative technology development. Parent perspectives toward genetic/epigenetic testing for autism spectrum disorder (ASD) are not well-studied. Parents of children with ASD (n = 131), non-ASD developmental delay (n = 39), and typical development (n = 74) completed surveys assessing genetic/epigenetic knowledge, genetic/epigenetic concerns, motives for research participation, and attitudes/preferences toward ASD testing. Most parents (96%) were interested in saliva-based molecular testing for ASD. Some had concerns about privacy (14%) and insurance-status (10%). None (0%) doubted scientific evidence behind genetic/epigenetic testing. Most reported familiarity with genetics (88%), but few understood differences from epigenetics (19%). Child developmental status impacted insurance concerns (p = 0.01). There is broad parent interest in a genetic/epigenetic test for ASD. It will be crucial to carefully consider and address bioethical issues surrounding this sensitive topic while developing such technology. [ABSTRACT FROM AUTHOR]

Methadone is effective treatment for opioid addiction, but regulations restrict its use. Methadone medical maintenance treats stabilized methadone patients in a medical setting, but only experimental programs have been studied.To evaluate the implementation of the first methadone medical maintenance program established outside a reseach setting.One-year program evaluation.A public hospital and a community opioid treatment program.Methadone patients with>1 year of clinical stability. Eleven generalist physicians and 4 hospital pharmacists.Regulatory exemptions were requested. Physicians and pharmacists were trained. Patients were transferred to the medical setting and permitted 1-month supplies of methadone.Patient eligibility and willingness to enroll, treatment retention, urine toxicology results, change in addiction severity and functional status, medical services provided, patient and physician satisfaction, and physician attitudes toward methadone maintenance.Regulatory exemptions were obtained after a 14-month process, and the program was cited in federal policy as acceptable for widespread implementation. Forty-nine of 684 patients (7.2%) met stability criteria, and 30 enrolled. Twenty-eight were retained for 1 year, and 2 transferred to other programs. Two patients had opioid-positive urine tests and were managed in the medical setting. Previously unmet medical needs were addressed, and the Addiction Severity Index (ASI) medical composite score improved over time (P=.02). Patient and physician satisfaction were high, and physician attitudes toward methadone maintenance treatment became more positive (P=.007).Methadone medical maintenance is complex to arrange but feasible outside a research setting, and can result in good clinical outcomes. [ABSTRACT FROM AUTHOR]