This article is designed to unite theory and practice. The focus of attention is the impact of narrative medicine on clinical records. Specifically important is that records are created through dialogue, whereby patients are able to grow the record through their ability to offer critiques and alternative explanations. Merely allowing patients to peruse their records, through advances in technology, is not sufficient to facilitate this aim. Various theoretical and practical considerations are discussed that may facilitate patient involvement and the creation of more accurate and relevant patient records.

No Alternative? examines education in South Korea beyond daytime K-16 schooling—an escalating phenomenon in an increasingly neoliberal and globalizing society. Ethnographic portraits of private after-schooling, alternative schooling, home schooling, and adult distance education reveal that education producers and consumers often reject mainstream education while simultaneously seeking or embracing its symbolic value.

Outputs from coupled general circulation models (CGCMs) are used in examining tropical Pacific decadal variability (TPDV) and their relationships with El Niño–Southern Oscillation (ENSO). Herein TPDV is classified as either ENSO-induced TPDV (EIT) or ENSO-like TPDV (ELT), based on their correlations with a decadal modulation index of ENSO amplitude and spatial pattern. EIT is identified by the leading EOF mode of the low-pass filtered equatorial subsurface temperature anomalies and is highly correlated with the decadal ENSO modulation index. This mode is characterized by an east–west dipole structure along the equator. ELT is usually defined by the first EOF mode of subsurface temperature, of which the spatial structure is similar to ENSO. Generally, this mode is insignificantly correlated with the decadal modulation of ENSO. EIT closely interacts with the residuals induced by ENSO asymmetries, both of which show similar spatial structures. On the other hand, ELT is controlled by slowly varying ocean adjustments analogous to a recharge oscillator of ENSO. Both types of TPDV have similar spectral peaks on a decadal-to-interdecadal time scale. Interestingly, the variances of both types of TPDV depend on the strength of connection between El Niño–La Niña residuals and EIT, such that the strong two-way feedback between them enhances EIT and reduces ELT. The strength of the two-way feedback is also related to ENSO variability. The flavors of El Niño–La Niña with respect to changes in the tropical Pacific mean state tend to be well simulated when ENSO variability is larger in CGCMs. As a result, stronger ENSO variability leads to intensified interactive feedback between ENSO residuals and enhanced EIT in CGCMs.

Protonic ceramic fuel or electrolysis cells (PCFC/PCEC) have shown promising performance at intermediate temperatures. However, these technologies have not yet been demonstrated in a stack, hence the oxidation behavior of the metallic interconnect under relevant operating environments is unknown. In this work, ferritic stainless steels 430 SS, 441 SS, and Crofer 22 APU were investigated for their use as interconnect materials in the PCFC/PCEC stack. The bare metal sheets were exposed to a humidified air environment in the temperature range from 450 °C to 650 °C, to simulate their application in a PCFC cathode or PCEC anode. Breakaway oxidation with rapid weight gain and Fe outward diffusion/oxidation was observed on all the selected stainless steel materials. A protective coating is deemed necessary to prevent the metallic interconnect from oxidizing. To mitigate the observed breakaway oxidation, state-of-the-art protective coatings, Y2O3, Ce0.02Mn1.49Co1.49O4, CuMn1.8O4 and Ce/Co, were applied to the stainless steel sheets and their oxidation resistance was investigated. Dual atmosphere testing further validated the effectiveness of the protective coatings in realistic PCFC/PCEC environments, with a hydrogen gradient across the interconnect. Several combinations of metal and coating material were found to be viable for use as the interconnect for PCFC/PCEC stacks.

The prenatal period of cortical development is important for the establishment of neural circuitry and functional connectivity of the brain; however, the molecular mechanisms underlying this process remain unclear. Here we report that disruption of the actin-cytoskeletal network in the developing mouse prefrontal cortex alters dendritic morphogenesis and synapse formation, leading to enhanced formation of fear-related memory in adulthood. These effects are mediated by a brain-enriched microRNA, miR-9, through its negative regulation of diaphanous homologous protein 1 (Diap1), a key organizer of the actin cytoskeletal assembly. Our findings not only revealed important regulation of dendritogenesis and synaptogenesis during early brain development but also demonstrated a tight link between these early developmental events and cognitive functions later in life.

The prenatal period of cortical development is important for the establishment of neural circuitry and functional connectivity of the brain; however, the molecular mechanisms underlying this process remain unclear. Here we report that disruption of the actin-cytoskeletal network in the developing mouse prefrontal cortex alters dendritic morphogenesis and synapse formation, leading to enhanced formation of fear-related memory in adulthood. These effects are mediated by a brain-enriched microRNA, miR-9, through its negative regulation of diaphanous homologous protein 1 (Diap1), a key organizer of the actin cytoskeletal assembly. Our findings not only revealed important regulation of dendritogenesis and synaptogenesis during early brain development but also demonstrated a tight link between these early developmental events and cognitive functions later in life.

Adrenergic α2C receptor (ADRA2C) is an inhibitory modulator of the sympathetic nervous system. Knockout mice for this gene show physiological and behavioural alterations that are associated with the fight-or-flight response. There is evidence of positive selection on the regulation of this gene during chicken domestication. Here, we find that the neuronal expression of ADRA2C is lower in human and chimpanzee than in other primates. On the basis of three-dimensional chromatin structure, we identified a cis-regulatory region whose DNA sequences have been significantly accelerated in human and chimpanzee. Active histone modification marks this region in rhesus macaque but not in human and chimpanzee; instead, repressive marks are enriched in various human brain samples. This region contains two neuron-restrictive silencer factor (NRSF) binding motifs, each of which harbours a polymorphism. Our genotyping and analysis of population genome data indicate that at both polymorphic sites, the derived allele has reached fixation in humans and chimpanzees but not in bonobos, whereas only the ancestral allele is present among macaques. Our CRISPR/Cas9 genome editing and reporter assays show that both derived nucleotides repress ADRA2C, most likely by increasing NRSF binding. In addition, we detected signatures of recent positive selection for lower neuronal ADRA2C expression in humans. Our findings indicate that there has been selective pressure for enhanced sympathetic nervous activity in the evolution of humans and chimpanzees.