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Background and Objectives: While inpatient withdrawal management/acute stabilization can improve outcomes for individuals with opioid use disorder (OUD), patients often leave treatment early due to mood, tension, and cravings associated with opioid withdrawal. The aim of this study was to evaluate the feasibility and preliminary effectiveness of a novel virtual reality (VR) based intervention; 3D Therapy Thrive (3DTT). Methods: Subjects with OUD (N = 32) were recruited from a community acute stabilization program and received up to two sessions of 3DTT. They completed questionnaires related to their overall satisfaction with the experience and side effects; as well as those related to mood, tension, and cravings. Results: There were no reported side effects and the majority of subjects (94%) reported high satisfaction with the experience. Out of 62 patients approached, 33 patients agreed to participate (53%) 33 patients completed one, and 17 of these patients (52%) completed both sessions of 3DTT, with 19 participants (58%) completing their treatment protocols. Compared to baseline, 3DTT participants reported significant reductions in depression, tension, and cravings (p's < 0.001). Discussion and Conclusions: This pilot study supports the feasibility and preliminary effectiveness of 3DTT for improving outcomes for inpatients with OUD. Future randomized controlled trials are necessary to evaluate the efficacy of 3DTT for improving retention, reducing cravings, and improving mood and tension. Scientific Significance: This is the first study to evaluate the feasibility of a psychologically informed VR intervention in inpatients with OUD. [ABSTRACT FROM AUTHOR]

Shared appreciation mortgages (SAMs) feature mortgage payments that adjust with house prices. They are designed to stave off borrower default by providing payment relief when house prices fall. Some argue that SAMs may help prevent the next foreclosure crisis. However, home owners' gains from payment relief are mortgage lenders' losses. A general equilibrium model in which financial intermediaries channel savings from saver to borrower households shows that indexation of mortgage payments to aggregate house prices increases financial fragility, reduces risk‐sharing, and leads to expensive financial sector bailouts. In contrast, indexation to local house prices reduces financial fragility and improves risk‐sharing. [ABSTRACT FROM AUTHOR]

Ibrutinib is effective in patients with chronic lymphocytic leukaemia ( CLL); however, treatment resistance remains a problem. Ublituximab is a novel, glycoengineered anti- CD20 monoclonal antibody with single-agent activity in relapsed CLL. We report the results of a phase 2 study evaluating combination therapy with ibrutinib and ublituximab in patients with relapsed or refractory CLL. Patients received ibrutinib 420 mg once daily. Ublituximab was administered on days 1, 8 and 15 of cycle 1 followed by day 1 of cycles 2-6. Response assessments were completed at cycles 3 and 6; patients then continued on ibrutinib monotherapy per standard of care. Forty-one of 45 enrolled patients were evaluable for efficacy. Safety was consistent with prior experience for each drug, with infusion reactions the most prevalent adverse event. Combination therapy resulted in an overall response rate ( ORR) of 88% at 6 months. In the 20 patients with high-risk features (17p or 11q deletions or TP53 mutation) and evaluable for efficacy, the ORR was 95%, with three patients (15%) achieving negative minimal residual disease. Median time to response was 8 weeks. Ublituximab in combination with ibrutinib resulted in rapid and high response rates. The long-term clinical benefit of ublituximab will be defined by an ongoing phase 3 trial ( NCT 02301156). [ABSTRACT FROM AUTHOR]

The upgrades of the Belle experiment and the KEKB accelerator aim to increase the data set of the experiment by a factor 50. This will be achieved by increasing the luminosity of the accelerator which requires a significant upgrade of the detector. A new pixel detector based on DEPFET technology will be installed to handle the increased reaction rate and provide better vertex resolution. One of the features of the DEPFET detector is a long integration time of 20~\mu\s, which increases detector occupancy up to 3%. The detector will generate about 22 GB/s of data. An FPGA-based two-level read-out system, the Data Handling Hub, was developed for the Belle II pixel detector. The system consists of 40 read-out and eight controller modules. All modules are built in \mu\TCA form factor using Xilinx Virtex-6 FPGA and can utilize up to 4 GB DDR3 RAM. The system was successfully tested in the beam test at DESY in January 2014. The functionality and the architecture of the Belle II Data Handling Hybrid system as well as the performance of the system during the beam test are presented in the paper. [ABSTRACT FROM PUBLISHER]

SUMMARY We estimate a DSGE (dynamic stochastic general equilibrium) model where rare large shocks can occur, by replacing the commonly used Gaussian assumption with a Student's t-distribution. Results from the Smets and Wouters ( American Economic Review 2007; 97: 586-606) model estimated on the usual set of macroeconomic time series over the 1964-2011 period indicate that (i) the Student's t specification is strongly favored by the data even when we allow for low-frequency variation in the volatility of the shocks, and (ii)) the estimated degrees of freedom are quite low for several shocks that drive US business cycles, implying an important role for rare large shocks. This result holds even if we exclude the Great Recession period from the sample. We also show that inference about low-frequency changes in volatility-and, in particular, inference about the magnitude of Great Moderation-is different once we allow for fat tails. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Patients with diffuse large B cell lymphoma (DLBCL) who are not candidates for or recur after autologous stem cell transplant have a poor overall prognosis. We conducted a phase II study of sorafenib (formerly BAY 43-9006) in the treatment of relapsed DLBCL. Fourteen patients were enrolled and assessed for response. Median number of cycles administered was 3 (range, 1-12). Common grade 3 toxicities included fatigue (29%), rash/desquamation (21%) and diarrhea (14%). One complete response (CR) was observed (the 14th patient enrolled). Response rate was 7% (90% CI, 0.4 - 30%). Duration of response was 6 months. Median progression-free survival (PFS) was 2 months (90% CI, 1 - 5 months). Median overall survival (OS) was 9 months (90% CI, 5 - 16 months). Although sorafenib has demonstrated activity in solid malignancies it demonstrated low single agent activity in treatment of DLBCL. [ABSTRACT FROM AUTHOR]

Purpose: Although image-guided percutaneous drainage is increasingly being used to treat Crohn's disease-related abdominopelvic abscesses, surgery is seldom avoided. The aim of this study was to compare outcomes following the treatment of intra-abdominal Crohn's abscesses with percutaneous drainage followed by surgery to those after surgery alone. Methods: We retrospectively reviewed the charts of patients treated for Crohn's-related abdominopelvic abscesses at Mount Sinai Medical Center between April 2001 and June 2010. Patients who underwent drainage followed by surgery were compared to those who underwent surgery alone. Differences in operative and postoperative outcomes were compared. Results: Seventy patients with Crohn's disease-related abdominopelvic abscesses were identified, 38 (54%) of whom underwent drainage before surgery. Percutaneous drainage was technically successful in 92% of patients and clinically successful in 74% of patients. No differences in rate of septic complications ( p = 0.14) or need for stoma creation ( p = 0.78) were found. Patients who underwent percutaneous drainage had greater overall hospital lengths of stay (mean 15.8 versus 12.2 days, p = 0.007); 8.6% of patients had long-term postponement of surgery after percutaneous drainage. Conclusions: In our series, the treatment of Crohn's abscesses with percutaneous drainage prior to surgery did not decrease the rate of postoperative septic complications. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the Central Bank Liquidity Tools Conference by the Federal Reserve Bank of New York is presented. Topics include the problems in liquidity provision, funding and market liquidity, and policy responses to illiquidity. It features several speakers including Bengt Holmstrom, Patrick Bolton, and Franklin Allen.

Background: To obtain an ideal outcome in breast augmentation procedures, breast implants may be overfilled to reduce wrinkles and improve longevity. Determination of the optimal volume for saline-filled breast implants remains problematic for plastic surgeons. Objective: We sought to evaluate the effect of overfilling or underfilling implants on sensory response and on implant shell mechanical properties. Methods: Fifty-three Mentor Style 1600 smooth saline-filled mammary implants (275-cc base volume) were examined. Saline fill volumes ranged from 230 cc to 1650 cc. Implants were incubated at 37°C and 100% humidity for 6 weeks. Before destructive testing to determine strength, elasticity, and toughness, 22 women ranging in age from 18 to 55 years graded the implants for firmness to palpation. Objective indices of firmness were measured by durometer. Results: Implants filled 50% above manufacturer''s recommended volume were considered firm, whereas implants 50% below manufacturer''s recommended volume were considered natural or soft. A linear relationship was observed between sensory response and durometer hardness data. Fill volume did not affect shell mechanical properties: shell strength, toughness, and elasticity remained unchanged (P > .05). Conclusions: Saline-filled breast implants can be safely filled far beyond manufacturer''s recommendations with regard to the mechanical properties of the Silastic polymer implant shell. Clinical judgment is required to avoid hardness due to overfill. Repeating this study using an in vivo incubation method is required to determine how overfill will affect implant shells over time in the harsh milieu of a biologic environment. [Copyright &y& Elsevier]

A 38 year-old United States Air Force active duty male in excellent health presented to the flight medicine clinic with a two week history of shortness of breath, fatigue, and unexplained bruising. Initial laboratory analysis was significant for pancytopenia with evidence of immature cells suggestive of leukaemia. The patient was admitted to hospital for emergency workup. Bone marrow biopsy and molecular analysis confirmed the diagnosis of acute promyelocytic leukaemia (APL). Induction therapy consisting of all-trans retinoic acid (ATRA) plus arsenic was promptly initiated and complete remission achieved after 35 days of treatment. Acute promyelocytic leukaemia, an extremely aggressive subtype of acute myeloid leukaemia, was considered to be one of the most deadly forms of cancer prior to the introduction of effective ATRA- based therapy in the late 1990s. Drawing parallels with the aviation environments' crew resource management (CRM), we discuss the importance of team work and collaboration in military medical resource management (MMRM). Because the military health care infrastructure in the United States is complex and relies heavily on civilian medical services, the implementation of MMRM is important to ensure good outcomes in cases that require rapid diagnosis and treatment such as APL. [ABSTRACT FROM AUTHOR]

Minimally invasive surgery uses optical cameras and special surgical tools in order to operate from an environment one step removed from the body cavity of interest to the surgeon. It has been suggested that constraints posed by this arrangement, in particular the lack of direct haptic feedback to the surgeon, may affect the surgeon's ability to identify tissues and accurately maneuver inside the body cavity. In the present study, the ability of laypeople to detect artificial tumors of various hardness values embedded in silicone gels was assessed in a simulated MIS environment. Participants explored the gels under three conditions all with remote viewing; using the unrestricted bare finger, using a stick-like surgical tool also unrestricted, and using the surgical tool restricted by its insertion through an operating port as in MIS. Participants were significantly more accurate and more efficient at tumor detection with the finger as compared to the other methods of exploration, and they were also better at detecting harder tumors as compared to softer ones. The potential implications of these results for the role of haptic perception in minimally invasive surgery are discussed. [ABSTRACT FROM PUBLISHER]