• 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals

      Varma, Niraj; Cygankiewicz, Iwona; Turakhia, Mintu; Heidbuchel, Hein; Hu, Yufeng; Chen, Lin Yee; Couderc, Jean‐Philippe; Cronin, Edmond M.; Estep, Jerry D.; Grieten, Lars; Lane, Deirdre A.; Mehra, Reena; Page, Alex; Passman, Rod; Piccini, Jonathan; Piotrowicz, Ewa; Piotrowicz, Ryszard; Platonov, Pyotr G.; Ribeiro, Antonio Luiz; Rich, Robert E.; Russo, Andrea M.; Slotwiner, David; Steinberg, Jonathan S.; Svennberg, Emma (2021-01-29)
      This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health (“mHealth”) technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
    • A Better Way to Spend $500,000: How the Juvenile Justice System Fails Girls

      Beyer, Marty; Blair, Gillian; Katz, Sarah; Simkins, Sandra (2003)
    • A Buddhist Contribution to Artificial Intelligence?

      Duckworth, Douglas S. (2020)
      Significant questions confront Buddhist traditions in the wake of emergent technologies: can the human body be configured in a certain way, such that it reveals a new world or environment to inhabit beyond optimized self-preservation or survival? Can we manipulate our bodies with technologies—inhibited (or enhanced) by a chemical, a trauma, a contemplative technique, or an implant—such that we are reoriented to a transformed and liberating understanding of the nature of the world and our being in it? As new technologies enhance certain domains of cognitive performance by modelling and extending the structure and capacities of cognition, Buddhism, with a theory of mind and mental development in the absence of an independent essence, owner, or agent like a self, can potentially be a valuable resource. Buddhism provides a useful theoretical foundation to articulate not only the potentials for engineering intelligence, but also by identifying problems in this project.
    • A Case Against Collaboration

      Rebouché, Rachel (2017)
      In family law, as in other legal disciplines, the use of alternative dispute resolution has dramatically increased. In a process called collaborative divorce, separating spouses hire attorneys who agree to work together—almost entirely outside of the court system—to reach a settlement ending the marriage. A team of experts, including mental health professionals, financial neutrals, and parenting coordinators, helps the parties resolve conflicts and settle property, support, and custody disputes. For divorcing couples, the collaborative process promises emotional healing and avoidance of contentious litigation. Advocates for collaborative divorce describe the transformational effects of the process in an evangelical tone. But collaborative divorce has costs. Collaboration can include considerations of marital fault that feminists helped eliminate from divorce laws. By focusing on conflict resolution, even for the purpose of building post-divorce relationships, collaborative negotiations introduce judgments of “good” and “bad” marital conduct, potentially reinforcing stereotyped gender roles, such as the blameless wife and the guilty husband. These heteronormative paradigms are out of date: gender roles have evolved, the population of married people has changed, and marriage rights have extended to couples of the same sex. Collaborative processes also have distributive consequences. Collaboration privileges wealthy parties who may understate their bargaining power. At the same time, collaboration may not reach vulnerable spouses who could benefit from therapeutic interventions. Collaborative divorce can be blind to situational power and structural inequality. The purpose of these critiques is not to undermine therapeutic approaches or to argue that law should ignore spousal misconduct. Rather, this Article suggests that advocates for collaborative divorce—including some feminist scholars who have theorized the shortcomings of no-fault divorce laws—might understand better how parties negotiate, and what they may sacrifice, within a collaborative framework.
    • A complex systems perspective on policy standards for teacher learning and development

      Garner, Joanna K.; Kaplan, Avi; 0000-0002-2898-0085 (2020-09)
      In the United States, the Interstate Teacher Assessment Consortium (InTASC) Standards and Learning Progressions inform pre-service teacher curricula and in-service teacher professional development and evaluation policies (Council of Chief State School Officers, CCSSO, 2013). We apply a complex dynamic systems (CDS) lens to analyze the Standards document’s ontological assumptions about the nature of teaching and teachers’ professional learning. Our inductive and model-guided content analysis revealed that the Standards’ representation of effective teaching highlights the contextual and iterative, feedback-driven nature of teacher learning and change. Teachers’ learning is described as non-linear and as requiring qualitative reconfigurations of expertise. The development of critical teaching dispositions reflects processes typically associated with identity system exploration. These ideas are congruent with complex dynamic systems theories of teachers’ learning and identity formation such as the Dynamic Systems Model of Role Identity (DSMRI). We derive two conceptual behavioral landscapes for teachers’ practices and for their means of learning. We close by proposing that the findings underscore the importance of partnerships among researchers, practitioners, and policymakers in the use, application, and revision of policy.
    • A Decade of Research on Social Media and Journalism: Assumptions, Blind Spots, and a Way Forward

      Lewis, Seth C.; Molyneux, Logan; 0000-0001-7382-3065 (2018-11-08)
      Amid a broader reckoning about the role of social media in public life, this article argues that the same scrutiny can be applied to the journalism studies field and its approaches to examining social media. A decade later, what hath such research wrought? In the broad study of news and its digital transformation, few topics have captivated researchers quite like social media, with hundreds of studies on everything from how journalists use Twitter, Facebook, Instagram, YouTube, and Snapchat to how such platforms facilitate various forms of engagement between journalists and audiences. Now, some 10 years into journalism studies on social media, we need a more particular accounting of the assumptions, biases, and blind spots that have crept into this line of research. Our purpose is to provoke reflection and chart a path for future research by critiquing themes of what has come before. In particular, our goal is to untangle three faulty assumptions—often implicit but no less influential—that have been overlooked in the rapid take-up of social media as a key phenomenon for journalism studies: (1) that social media would be a net positive; (2) that social media reflects reality; and (3) that social media matters over and above other factors.
    • A Legal Mandate That Authorizers Consider Fiscal and Other Impacts of Charter School Expansion

      DeJarnatt, Susan L. (2019)
      Pennsylvania’s Constitution mandates that the Commonwealth provide “for the maintenance and support of a thorough and efficient system of public education to serve the needs of the Commonwealth.” Pennsylvania decided to add charter schools to this system in 1997, a decision that, like all legislation, must be considered in light of this constitutional commitment to public education and to its role in preparing the Commonwealth’s students for their participation in democracy. Charter schools cost money and the vast bulk of that money comes directly out of the budgets of Pennsylvania school districts. Pennsylvania spent nearly $1.7 billion on charter schools in 2016-2017. Pennsylvania also underfunds its school districts. It ranks 46 out of 50 states for the state contribution to education funding and has the dubious honor of having the largest gap in the country between highly funded districts and poorly funded ones. Those districts also have the responsibilities of authorizing new charter schools, exercising oversight over existing schools, and determining whether to renew or revoke charters. Some charter proponents argue that Pennsylvania’s Charter School Law bars school districts from giving any consideration to the financial impact on districts when they authorize or renew charter schools. This belief conflicts with the plain language of the Charter School Law and its legislative history, and is not supported by court decisions. It rests on a few decisions of the Charter Appeals Board (CAB) which have misinterpreted the language and intent of the Charter School Law. Not one opinion from the Pennsylvania appellate courts has held that authorizers are forbidden from any consideration of financial impact. Balancing the needs and interests of all of the stakeholders in the public education system—students, families, teachers, support staff, administrators, schools—both traditional and charter, tax payers, retirees, and communities—is an enormous challenge. Charter schools are part of that public education system. But requiring school districts to completely ignore the financial impact of their decisions about charter growth cannot be the response to that challenge. If charters must be granted and renewed without any consideration of their financial impact on the school system as a whole, Pennsylvania will be even further impaired in its ability to meet its constitutional obligations. Thus, authorizers not only may consider financial impact, they must do so.
    • A Letter to Mary Daly

      Levitt, Laura S. (2012)
    • A Nonobvious Comparison: Nonobviousness Decisions at the PTAB and in the Federal Courts

      Mandel, Gregory N. (2016)
      In an effort to elucidate how the challenges of nonobviousness decisions affect different decision-makers, this article presents an original dataset of nonobviousness decisions throughout the patent decision process. This dataset includes nonobviousness decisions at the Patent and Trademark Office and in the federal courts for the time period subsequent to the effective date of the Leahy-Smith America Invents Act’s (AIA) first-to-file provisions. The results provide strong evidence that nonobviousness decisions are highly indeterminate: similarly situated decision-makers in the same cases reach differing conclusions on nonobviousness at a strikingly high rate. The data does not support the hypothesis that technologically sophisticated decision-makers are better able to make judgements from the perspective of a person of ordinary skill in the art. Finally, the analysis provides some potential support for the possibility that technologically trained individuals may exhibit slightly less of a hindsight bias than untrained decision-makers. Comparing the data reported here with earlier studies of nonobviousness decisionmaking indicates that both the district courts and the Federal Circuit reacted significantly to the Supreme Court’s nonobviousness decision in KSR v. Teleflex in 2007 by establishing a higher threshold for patentees to demonstrate nonobviousness. Subsequent to the AIA of 2011, however, both judicial bodies have reverted to nonobviousness decisionmaking that is more consistent with pre-KSR outcomes.
    • A Novel Cell Penetrating Peptide for the Differentiation of Human Neural Stem Cells

      Ma, Weili; Jin, Geun-woo; Gehret, Paul M.; Chada, Neil C.; Suh, Won H.; 0000-0002-4036-8307 (2018-07-09)
      Retinoic acid (RA) is a bioactive lipid that has been shown to promote neural stem cell differentiation. However, the highly hydrophobic molecule needs to first solubilize and translocate across the cell membrane in order to exert a biological response. The cell entry of RA can be aided by cell penetrating peptides (CPPs), which are short amino acid sequences that are able to carry bioactive cargo past the cell membrane. In this work, a novel cell penetrating peptide was developed to deliver RA to human neural stem cells and, subsequently, promote neuronal differentiation. The novel CPP consists of a repeating sequence, whose number of repeats is proportional to the efficiency of cell penetration. Using fluorescence microscopy, the mode of translocation was determined to be related to an endocytic pathway. The levels of β-III tubulin (Tubb3) and microtubule associated protein 2 (MAP2) expression in neural stem cells treated with RA conjugated to the CPP were assessed by quantitative immunocytochemistry.
    • A Personalized Self-image: Gender and Branding Practices Among Journalists

      Molyneux, Logan; 0000-0001-7382-3065 (2019-09-11)
      As the field of journalism becomes increasingly unrecognizable, the messages that identify the journalist, their work, and their affiliations are of increasing importance. This study envisions journalism and social media both as gendered spaces and examines their intersection as the setting of much of journalists’ branding work. In this setting, gender’s influence on the extent, style, and target of journalists’ branding efforts is examined using data from two different datasets (content analysis and survey). The findings suggest that female journalists take a more personalized approach by speaking about themselves in their profiles and their tweets and focusing more resources and attention on their individual brands. This suggests that female journalists are not well served by male-dominated news organizations and therefore turn to a more personalized self-image in their branding efforts. This understanding is particularly important as societies and newsrooms both work toward a more inclusive, egalitarian future.
    • A Randomized Study of Endobronchial Valves for Advanced Emphysema

      VENT Study Research Group (2010-09-23)
      BACKGROUND: Endobronchial valves that allow air to escape from a pulmonary lobe but not enter it can induce a reduction in lobar volume that may thereby improve lung function and exercise tolerance in patients with pulmonary hyperinflation related to advanced emphysema. METHODS: We compared the safety and efficacy of endobronchial-valve therapy in patients with heterogeneous emphysema versus standard medical care. Efficacy end points were percent changes in the forced expiratory volume in 1 second (FEV1) and the 6-minute walk test on intention-to-treat analysis. We assessed safety on the basis of the rate of a composite of six major complications. RESULTS: Of 321 enrolled patients, 220 were randomly assigned to receive endobronchial valves (EBV group) and 101 to receive standard medical care (control group). At 6 months, there was an increase of 4.3% in the FEV1 in the EBV group (an increase of 1.0 percentage point in the percent of the predicted value), as compared with a decrease of 2.5% in the control group (a decrease of 0.9 percentage point in the percent of the predicted value). Thus, there was a mean between-group difference of 6.8% in the FEV1 (P=0.005). Roughly similar between-group differences were observed for the 6-minute walk test. At 12 months, the rate of the complications composite was 10.3% in the EBV group versus 4.6% in the control group (P=0.17). At 90 days, in the EBV group, as compared with the control group, there were increased rates of exacerbation of chronic obstructive pulmonary disease (COPD) requiring hospitalization (7.9% vs. 1.1%, P=0.03) and hemoptysis (6.1% vs. 0%, P=0.01). The rate of pneumonia in the target lobe in the EBV group was 4.2% at 12 months. Greater radiographic evidence of emphysema heterogeneity and fissure completeness was associated with an enhanced response to treatment. CONCLUSIONS: Endobronchial-valve treatment for advanced heterogeneous emphysema induced modest improvements in lung function, exercise tolerance, and symptoms at the cost of more frequent exacerbations of COPD, pneumonia, and hemoptysis after implantation. (Funded by Pulmonx; ClinicalTrials.gov number, NCT00129584.)
    • A Rare Case of Primary Anorectal Melanoma and a Review of the Current Landscape of Therapy

      Yeung, Ho-Man; Gupta, Brinda; Kamat, Bhishak; 0000-0002-7188-9738 (2020-08-02)
      Introduction: Anorectal mucosal melanoma (ARMM) is an uncommon and highly aggressive malignancy. Given its rarity, there is insufficient evidence on the optimal medical management which presents as a clinical challenge to its diagnosis and treatment. Treatment of ARMM typically involves a multimodal approach including surgical resection, chemotherapy, targeted therapy and/or immunotherapy. Case Presentation: Here, we present a case of a 78-year-old female who presented with a four-month history of rectal bleeding and bowel incontinence. Ultimately, colonoscopy revealed a mass at the anal verge, and biopsy of the mass showed malignant cells that stained positive for S100, Melan-A and HMB-45, consistent with the diagnosis of malignant melanoma. Molecular testing revealed no BRAF, KIT or NRAS gene mutations. PD-L1 immunohistochemistry showed tumor proportion score of 1%. She underwent abdominoperineal resection with a plan to initiate immunotherapy with an anti-PD-1 checkpoint inhibitor. This case highlights a rare aggressive malignancy and reviews its treatment option, which are mostly extrapolated from its cutaneous counterpart and some derived from a few case reports. Due to its rarity, there is no consensus guideline for the treatment of ARMM.
    • A Survey on the Impact of COVID-19 on Lacrimal Surgery: The Asia-Pacific Perspective

      Nair, Akshay Gopinathan; Narayanan, Natasha; Ali, Mohammad Javed; Narayanan|0000-0002-9670-7865 (2020-11-04)
      Aim: To assess the impact of the COVID-19 pandemic-related lockdown on lacrimal surgery among oculoplastic surgeons in the Asia-Pacific region. Methods: An institutional board review approved anonymous electronic survey was sent out via email to oculoplastic surgeons across the Asia-Pacific region. All responses were tabulated and analysed. Results: A total of 259 valid responses were received. Nearly 87% of the surgeons agreed that lacrimal procedures were associated with a high risk of COVID-19 transmission. In all, at the time of taking the survey, 151/259 (58.3%) of the surgeons were not performing any lacrimal surgeries in view of the COVID-19 pandemic and 71/259 (27.4%) of the respondents were only performing emergency lacrimal surgeries. External dacryocystorhinostomy was the most commonly performed lacrimal procedure across the region and lacrimal procedures contributed to at least 25% of the income for nearly a third of the respondents. Majority of the respondents were female (52.9%), but a significantly higher proportion of male oculoplastic surgeons were still performing lacrimal surgeries during the lockdown. Over 75% of respondents indicated that resuming lacrimal procedures is important to their practice. Conclusion: The survey showed that there was a general agreement among the surveyed oculoplastic surgeons in the Asia-Pacific region that lacrimal procedures were associated with a high risk of COVID-19 transmission and over 85% of them of had either stopped performing elective lacrimal surgeries altogether or were providing only emergent care. It is likely that not performing elective lacrimal procedures, COVID-19 has financially impacted a high percentage of the surveyed oculoplastic surgeons.
    • A Win-Win: The Intentional Cultivation of Reciprocal Relationships Between LSP and Community Partners

      Moore-Martínez, Patricia; Pongan, Joshua M. (2018)
      Este artículo identifica una necesidad y presenta un modelo sostenible para incorporar la integración a la comunidad en los cursos de español para fines específicos (EFE). Para combatir el descenso en la matrícula, los programas han aumentado su oferta de EFE—cursos que proporcionan relevancia y valor, igual a la integración de componentes de aprendizaje experiencial. Estos componentes contextualizan el aprendizaje experiencial y abarcan desde entrevistas informativas hasta pasantías estructuradas. El acoplamiento de estas prácticas de alto impacto requiere superar obstáculos: desembolso de recursos o establecimiento de expectativas razonables. Este modelo detalla integraciones de varias intensidades para hacer accesible la práctica a educadores independientemente de su experiencia previa y para asegurar beneficios tanto para los estudiantes como para las comunidades: una relación recíproca.
    • A “Cost-Benefit State”? Reports of Its Birth Have Been Greatly Exaggerated

      Sinden, Amy (2016-11)
      In a spate of recent cases (Michigan v. EPA, EME Homer City v. EPA, and Entergy Corp. v. Riverkeeper), the U.S. Supreme Court has been widely viewed as abruptly changing course in its treatment of cost-benefit analysis (CBA) in environmental decisionmaking. In fact, these cases represent less of a change in course than is commonly believed. They did not so much eliminate the Court’s previously emerging anti-cost presumption as narrow and perhaps more clearly define it. The term “cost-benefit analysis” can refer to a broad range of decisionmaking techniques, and an even longer list of methods involve agencies “considering costs” in one way or another. These cases indicate that the Court’s anti-cost presumption no longer applies to informal CBA or feasibility analysis, but they do nothing to disturb the presumption as applied to other cost consideration tools. Indeed, Riverkeeper can be read to at least gesture in the direction of a continuing presumption against formal CBA. It is not entirely clear that Michigan articulated a pro-cost presumption at all, but to the extent it did, that presumption can be read to exclude or at least de-emphasize formal CBA.
    • Abortion Opportunism

      Rebouché, Rachel (2020-05-18)
      Eleven states have tried to suspend abortion care in response to COVID-19. State officials claim that they will preserve medical supplies, hospital space, and health care capacity by classifyingabortion as an elective, non-essential surgery that must be delayed. Advocacy groups representing abortion providers sued in several states to enjoin these bans. What has emerged is a fight that ignores medical evidence and threatens to exacerbate the current public health emergency. The Executive Order issued in Texas offers an apt example. Though abortion may be available in Texas for the time being, opinions from the U.S. Court of Appeals for the Fifth Circuit provide a troubling roadmap for suspending constitutional rights as a health emergency measure.
    • Abstract: Biopsy through lung parenchymal lesion using virtual bronchoscopy navigation (VBN) Archimedes with EBUS sheath tunneling

      Ramzy, Joseph; Travaline, John M.; Thomas, Jiji; Basile, Matthew; Massetti, Patrick; Criner, Gerard J. (2018-11-19)
      Introduction: The (VBN) device (Archimedes, Broncus Medical Inc.) integrates CT pattern recognition software and fluoroscopy providing realtime airway parenchymal navigation called Bronchoscopic TransParenchymal Nodule Access (BTPNA). We present a case in which BTPNA was guided by radial EBUS sheath tunneling. Case: An 84YO man presented for evaluation of SPN in the LUL. CT showed 2 LUL nodules (1cm, 0.8cm). VBN was begun with a medium bronchoscope (Olympus BF-190 4.3OD, 2.1ID). The lateral nodule was found through airway path. Biopsies were done with forceps and FNA. None were adequate per ROSE. Using an 18G FleXNeedle®, a tunnel opening was created at the posterior wall of (LB3c). A Radial EBUS and sheath were introduced into the tunnel, and images were used to advance the catheter sheath to the lesion. The lesion and adjacent blood vessel were located. The Radial EBUS was removed, and using fluoroscopy brushing of the lesion via the catheter was performed obtaining adequate samples. Pathology revealed benign reactive bronchial cells and macrophages. Discussion: This is the first case using VBN to create a tunnel using a radial EBUS sheath (2mm diameter) through the lung tissue to biopsy a distal SPN. Herth et al. did the first trial using the technique, however their tunnels were created using 2.6mm diameter sheath via a therapeutic bronchoscope (6.3OD, 2.6ID) after airway dilation using a balloon.
    • Adapted Physical Activity to Ensure the Physical and Psychological Well-Being of COVID-19 Patients

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2021-01-29)
      The novel coronavirus disease 2019 (COVID-19) has been responsible for a global pandemic involving massive increases in the daily numbers of cases and deaths. Due to the emergency caused by the pandemic, huge efforts have been made to develop COVID-19 vaccines, the first of which were released in December 2020. Effective vaccines for COVID-19 are needed to protect the population, especially healthcare professionals and fragile individuals, such as older people or chronic-disease-affected patients. Physical exercise training generally has health benefits and assists in the prevention of several chronic diseases. Moreover, physical activity improves mental health by reducing anxiety, depression, and negative mood and improving self-esteem. Therefore, the present review aims to provide a detailed view of the literature, presenting updated evidence on the beneficial effects of adapted physical activity, based on personalized and tailor-made exercise, in preventing, treating, and counteracting the consequences of COVID-19.