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This article samples the career of Dr. Guy O. Seymour, whose undergraduate studies were completed at La Universidad Interamericana in Puerto Rico. He earned his MA and PhD in clinical, counseling, and community psychology at Boston University. The first bilingual person of color appointed to the professional staff of the city of Boston's general hospital, he founded the nation's first multicultural internship program and rose to be the chief psychologist of the Boston Department of Health and Hospitals. His career path led him to develop psychological services in nontraditional workspaces, including medical, police, fire, and correction departments and for the International Olympic Games. At the end of his career, a family member's encounter with marijuana laws led to an interest in advocacy for criminal justice reform. Since retirement from practice, he has continued to volunteer with efforts to decriminalize marijuana possession and to abolish cash bail for pretrial and misdemeanor offenses. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Study Design. Randomized clinical trial. Objectives. Early physical therapy (PT) with specific stabilization training has been shown to benefit individuals after lumbar spinal surgery but has not been studied in patients after cervical spine surgery. The primary purpose of this study was to compare clinical outcomes between early cervical spine stabilizer (ECS) training and usual care (UC) in patients after anterior cervical discectomy and fusion (ACDF) surgery. The secondary purpose was to determine test-retest reliability of strength and endurance tests of cervical spinal stabilizers in this patient population. Methods. Forty participants who were scheduled for ACDF surgery were randomized into either the ECS group or the UC group. After surgery, participants received their assigned group intervention during their hospital stay and continued their assigned intervention for 12 weeks. All participants had phone follow-ups twice during the first 6 weeks to address questions or problems. Clinical outcome measures including pain level using the Numeric Pain Rating Scale (NPRS), disability level using the Neck Disability Index (NDI), Craniocervical Flexor Strength (CCF-S), and Craniocervical Flexor Endurance (CCF-E) were collected three times: before surgery and 6 and 12 weeks after surgery. Test-retest reliability was assessed in the first 10 participants. Results. There was no significant interaction between the groups over time for any of the outcome measures. However, all participants made significant improvements in all four outcome measures at 6 and 12 weeks post surgery. The results showed good-to-excellent test-retest reliability for the CCF-S and CCF-E tests. Conclusions. Both ECS training and UC resulted in the same amount of improvement at 6 and 12 weeks; therefore, both therapy approaches appear to have similar and positive effects on patients in their first 3 months of recovery after ACDF. Both the CCF-S and CCF-E tests can be used reliably to assess the strength and endurance of the cervical spinal stabilizers for patients after ACDF surgery. The study was registered with the ClinicalTrials.gov (NIH, U.S. National Library of Medicine, identifier # NCT01519115) Protocol Registration system.

Heat stress causes morbidity and mortality and is increasing with climate change. Heat stress can pose particular challenges in northern regions not well adapted to heat. To assist decision makers, we identified the relative vulnerability of census tracts within Michigan to factors that increase exposure to heat stress or reflect susceptibilities in the population based on a California heat vulnerability index. In the MI-Environment assessment, we used a Geographic Information System (GIS) to combine future ensemble climate model projections to create a total of 9 geospatial and demographic variables. As part of a broader planned cumulative environmental exposure assessment, the statewide heat vulnerability index (HVI) maps display the location and relative magnitude of exposure on three metrics: built environment (Place), future expected long-term temperature averages (Temperature), and population susceptibility (People). We observed varied and distinct patterns for each of the three component indices. We assessed how equitably those exposures are distributed by racial and socioeconomic factors. This analysis showed that each of the component indices and the aggregate HVI are disproportionately distributed along racial and socioeconomic lines in Michigan. Census tracts with higher percentages of people of color had larger exposure to HVI factors with a deviation from equity of -0.115 [95% CI -0.108, -0.122]. Similarly, for census tracts with higher percentage of people experiencing poverty, the deviation from equity was -0.101 [95% CI -0.094, -0.107]. The MI-Environment visualization tool can help communities prepare for climate change and resolve inequities by identifying census tracts with the most vulnerable residents and highest potential exposures.

OBJECT The purpose of this study was to evaluate the safety and effectiveness of 2-level total disc replacement (TDR) using a Mobi-C cervical artificial disc at 48 months' follow-up. METHODS A prospective randomized, US FDA investigational device exemption pivotal trial of the Mobi-C cervical artificial disc was conducted at 24 centers in the US. Three hundred thirty patients with degenerative disc disease were randomized and treated with cervical total disc replacement (225 patients) or the control treatment, anterior cervical discectomy and fusion (ACDF) (105 patients). Patients were followed up at regular intervals for 4 years after surgery. RESULTS At 48 months, both groups demonstrated improvement in clinical outcome measures and a comparable safety profile. Data were available for 202 TDR patients and 89 ACDF patients in calculation of the primary endpoint. TDR patients had statistically significantly greater improvement than ACDF patients for the following outcome measures compared with baseline: Neck Disability Index scores, 12-Item Short Form Health Survey Physical Component Summary scores, patient satisfaction, and overall success. ACDF patients experienced higher subsequent surgery rates and displayed a higher rate of adjacent-segment degeneration as seen on radiographs. Overall, TDR patients maintained segmental range of motion through 48 months with no device failure. CONCLUSIONS Four-year results from this study continue to support TDR as a safe, effective, and statistically superior alternative to ACDF for the treatment of degenerative disc disease at 2 contiguous cervical levels. Clinical trial registration no.: NCT00389597 (clinicaltrials.gov)

Study design A prospective, randomized, multicenter Food and Drug Administration Investigation Device Exemption study using total disc replacement as surgical treatment of degenerative disc disease at 1 or 2 contiguous levels of the cervical spine. Objective To evaluate the safety and effectiveness of total disc replacement at single or 2 contiguous levels through 48 months of follow-up. Summary of background data Cervical total disc replacement has been shown to be a safe and effective alternative to anterior cervical discectomy and fusion at 24 months. Its motion-preserving capabilities may avoid accelerating adjacent segment pathology and thereby lower the rate of associated complications. Methods Patients were randomized in a 2:1 ratio (total disc replacement [TDR]: anterior cervical discectomy and fusion [ACDF]) at 24 sites. Ultimately, 164 patients received TDR at 1 level and 225 patients received TDR at 2 contiguous levels. An additional 24 patients (15 one-level, 9 two-level) were treated with TDR as training cases.Outcome measures included neck disability index, visual analogue scale neck and arm pain, Short Form 12-item Health Survey (SF-12) Mental Composite Score (MCS) and Physical Composite Score (PCS), range of motion, major complication rates, and secondary surgery rates. Patients received follow-up examinations at regular intervals through 4 years after surgery. Results Preoperative characteristics were statistically similar for the 1- and 2-level patient groups. Four-year follow-up rates were 83.1% (1-level) and 89.0% (2-level). There was no statistically significant difference between 1- and 2-level TDR groups for all clinical outcome measures. Both TDR groups experienced significant improvement at each follow-up when compared with preoperative scores. One case of migration was reported in the 2-level TDR group. Conclusion A 4-year post hoc comparison of 1- and 2-level TDR patients concurrently enrolled in a 24-center, Food and Drug Administration Investigation Device Exemption clinical trial indicated no statistical differences between groups in clinical outcomes, overall complication rates, and subsequent surgery rates. Level of evidence 1.

Four novel antiviral WIN compounds, that contain a methyl tetrazole ring as well as isoxazole, pyridazine or acetylfuran rings, have had their structures determined in human rhinovirus serotype 14 at 2.9 A resolution. These compounds bind in the VP1 hydrophobic pocket, but are shifted significantly towards the pocket pore when compared to previously examined WIN compounds. A putative water network at the pocket pore is positioned to hydrogen bond with these four WIN compounds, and this network can account for potency differences seen in structurally similar WIN compounds.

This paper describes the use of a custom-configured computer-controlled firearms training simulator to measure perception response (reaction) time (RT) to a stimulus in which the degree of threat presented is a manipulable variable across trials. The computer records the number of frames of videotape traversed between the point of presentation of the threat in the video stimulus and the point at which the subject responds by drawing the firearm. For the purposes of data analysis, these frame-count measures are converted to RT measurements. Example data are presented that capture perception RT at both thedraw-stimulus and thefire-stimulus points in situations for which either only one threat or more than one threat exists. Other elements, such as degree of threat and accuracy of response, provide additional data.

Study design Prospective randomized clinical trials. Objective To compare the outcome data with respect to clinical success rates and incidence of adjacent level disease (ALD) in patients after total disc arthroplasty (TDA) or anterior cervical fusion (ACDF) for 1- and 2-level cervical disc disease. Summary of background data Previously published studies have provided evidence that ACDF procedure for cervical degenerative disc disease (DDD) may increase the stress on the nonoperated adjacent cervical segments, thus possibly increasing the risk of degeneration at these levels. The theoretical assumption that TDA may reduce the incidence of future ALD by preserving motion at the affected segments has, however, never been validated by clinical evidence. Methods One hundred seventy patients with established symptomatic cervical disc disease at 1 or 2 levels participated in 3 prospective randomized clinical trials at 2 institutions. Participating subjects were randomized to receive TDA (treatment; n = 113) or ACDF (control; n = 57) by 6 independent investigating surgeons. Visual analogue pain scores (0-100), Neck Disability Index, neurological examination, and cervical spine radiographs were collected at enrollment and then 6 weeks and 3, 6, 12, 24, 36, and 48 months after surgery. Patients with persistent symptoms during the follow-up period were investigated for adjacent segment disease (ASD) with computed tomography/magnetic resonance imaging of the cervical spine, neurophysiology, and subsequent active interventions. Results At the median follow-up of 42 months (range: 28-54 months), 9 (14.3%) ACDF and 19 (16.8%) TDA patients developed and were actively treated for ASD. Osteopenia dust energy x-ray absorptiometry T scores of -1.5 to -2.4) (P = 0.04; 95% confidence interval [CI]: 0.007-0.223) and concurrent lumbar degenerative disease (P = 0.02; 95% CI: 0.003-0.196) significantly increased the risk of ASD. Conclusion The risk of developing adjacent segment degeneration was equivalent at median 38 months after both ACDF and TDA procedures in cervical DDD. Osteopenia and concurrent lumbar DDD significantly increase the risk of ALD.

A prospective, randomized, multicenter, Food and Drug Administration-regulated Investigational Device Exemption clinical trial.To evaluate the safety and effectiveness of the ProDisc-L (Synthes Spine, West Chester, PA) lumbar total disc replacement compared to circumferential spinal fusion for the treatment of discogenic pain at 1 vertebral level between L3 and S1.As part of the Investigational Device Exemption clinical trial, favorable single center results of lumbar total disc replacement with the ProDisc-L have been reported previously.Two hundred eighty-six (286) patients were treated on protocol. Patients were evaluated before and after surgery, at 6 weeks, 3, 6, 12, 18, and 24 months. Evaluation at each visit included patient self-assessments, physical and neurologic examinations, and radiographic evaluation.Safety of ProDisc-L implantation was demonstrated with 0% major complications. At 24 months, 91.8% of investigational and 84.5% of control patients reported improvement in the Oswestry Low Back Pain Disability Questionnaire (Oswestry Disability Index [ODI]) from preoperative levels, and 77.2% of investigational and 64.8% of control patients met theor =15% Oswestry Disability Index improvement criteria. Overall neurologic success in the investigational group was superior to the control group (91.2% investigational and 81.4% control; P = 0.0341). At 6 weeks and 3 months follow-up time points, the ProDisc-L patients recorded SF-36 Health Survey scores significantly higher than the control group (P = 0.018, P = 0.0036, respectively). The visual analog scale pain assessment showed statistically significant improvement from preoperative levels regardless of treatment (P0.0001). Visual analog scale patient satisfaction at 24 months showed a statistically significant difference favoring investigational patients over the control group (P = 0.015). Radiographic range of motion was maintained within a normal functional range in 93.7% of investigational patients and averaged 7.7 degrees.ProDisc-L has been found to be safe and efficacious. In properly chosen patients, ProDisc-L has been shown to be superior to circumferential fusion by multiple clinical criteria.

Several approaches to using simulation as a method for teaching good judgment in the use of firearms by law enforcement officers and military personnel were investigated for their potential applications to research: the GAMMA Live Fire Video Training System, the FireArms Training Systems Simulator (FATS), and the Judgment Under Stress Training (JUST) simulator. Each instrument uses real-time, computer-controlled, life-sized projected video images of scenarios that may or may not present a threat, and handguns that fire real or simulated ammunition. The subjects respond to a sequence of “shoot/no-shoot” judgment scenarios resulting in data on judgment, reaction time, and accuracy. The JUST simulator was found to be more easily modifiable in capturing data on performance at microanalytic levels. Although true interactive simulations are not feasible with this system, this was not seen as a hindrance to its usefulness for research.

Study Design. This was a prospective multicenter clinical trial of a lumbar interbody fusion cage with a minimum of 4 years'follow-up. Objectives. To determine whether the early positive clinical results in fusions with lumbar cages, such as the Bagby and Kuslich (BAK) cage, are maintained beyond 2 years. Summary of Background Data. Threaded cages have been used increasingly for the treatment of symptomatic degenerative intervertebral disc disease. Concerns about the long-term clinical outcomes of this procedure have been posed, particularly regarding bony fusion viability, revision rates, potential adjacent level disease, and late complications. Methods. The study cohort was a 196-patient subset from a prospective investigational device exemption. In addition to early postoperative examinations, these patients were examined biannually with a minimum of 4 years' follow-up. Patient outcome was assessed by a 6-point scale that evaluated pain relief, and functional improvement was determined by changes in activities of daily living. Fusion rates and return to work were determined. Complications and secondary operations were reported and categorized as non-device related or device related. Results. The patient cohort with 4-year follow-up represented 25.6% of the original study population eligible at that time. Overall, the largest percentage of pain relief and functional improvements occurred by 3 months, and these improvements were maintained at each follow-up. Overall fusion rate was 91.7% and 95.1% at 2 and 4 years, respectively. In this cohort, 39.5% of patients were working or were able to work within 3 months of surgery. After 4 years, 62.7% of patients were gainfully employed or able to work. The late-occurring complication rate in this cohort was 13.8% (27/196). Complications necessitating a second operation occurred in 8.7% (17/196), whereas re-operations that were deemed device related were performed in 3.1% (6/196). Conclusions. This study indicates that the early positive benefits of interbody fusion cage procedures are maintained through 4 years with acceptably low morbidity.

A new channel dynamics scheme (alternative system predictor in real time (ASPIRE)), designed specifically for real-time river flow forecasting, is introduced to reduce uncertainty in the forecast. ASPIRE is a storage routing model that limits the influence of catchment model forecast errors to the downstream station closest to the catchment. Comparisons with the Muskingum routing scheme in field tests suggest that the ASPIRE scheme can provide more accurate forecasts, probably because discharge observations are used to a maximum advantage and routing reaches (and model errors in each reach) are uncoupled. Using ASPIRE in conjunction with the Kalman filter did not improve forecast accuracy relative to a deterministic updating procedure. Theoretical analysis suggests that this is due to a large process noise to measurement noise ratio.

Differences in the frequency content of the vertically polarized sferic signal from cloud-to-ground discharges and the horizontally polarized sferic signal from cloud-to-cloud discharges are reported. A model has been developed to consider these differences and to explain the trends in the frequency content of the measured sferics in the frequency range from 10 kHz to 300 kHz.

Many response curves have been calculated for multiple‐electrode logging devices passing through thin beds (Guyod, 1944, parts 5, 6, 7, 8, 9, 10, and 11). For conditions where one can assume equal resistivity material above and below the thin bed, all electrodes in a line normal to the interfaces, and bore hole effects negligible, a function [Formula: see text] is introduced to make possible rapid computations. Tables and examples are included.

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Deafness in the student of the elementary and secondary schools remains a challenge to educators, parents, and to the physician. Education of the parent and the instructor, of the student, is one of the keynotes of its possible correction. The family physician and the otologist must be ever on the lookout for minimal deafness or have the problem referred to them for diagnosis and possible therapy. The parent often honestly believes the student is daydreaming and thus does not pay attention when spoken to. The parent often tells the examiner, "My Johnny hears when it is something he wants to hear, but never hears when asked to do something." The instructors, in their busy schedule, often believe the same of the student and do not have the time to delve into the individual problem. Many articles have appeared in the journals concerning state-wide and metropolitan investigations of youth hearing problems.

A mathematical simulation of the human hearing mechanism, involving the non-linear effect of the middle ear, has been used to compute the risk of impairment for hearing produced by impulse noise. This model provides, therefore, a reference method which can be used for evaluating the loudness of any kind of acoustical noise. The results of impulse noise analysis obtained from different damage-risk criteria can then be compared with the results of the theoretical model, allowing for evaluation of the respective merits of these criteria.

The middle ear muscle reflex may be described as a feedback process which reduces the sound transmission in the middle ear when the level detected in the brain is too high. The effect of this reflex is an increase of the stapedius muscle stiffness, resulting in a change of the stapes response. The contraction process of the stapedius muscle results in a reduction of the middle ear transmission, but also in an increase of resonance and of the cut-off frequency of the middle ear. Both effects, as predicted by the model, appear to be similar to those reported for animals and inferred for humans. The model is implemented in a feedback process, starting from the brain, where a threshold detector elaborates the contraction command and sends it back to the stapedius muscle through a low-pass filter.

Damage-risk criteria for impulse noise does not presently take the spectrum of the impulse into account; however, it is known that the human auditory system is spectrally tuned. The present paper advocates the extension to impulse noise of the noise dose concept which is widely used for continuous noise. This approach is based upon sound exposure instead of sound pressure. An A-weighting filter or an octave band analysis can then be used to take the spectral content of the impulses into account. The equipment needed for applying these procedures for impulse noise is an integrating sound level meter or a digital Fourier processor. Generalized spectral methods have been evaluated by means of an impulse simulation applied to a mathematical model of the human hearing mechanism. The results of this simulation agree with the most recent experiments on impulse noise and fully support the proposed rating methods. This conclusion must be emphasized as it leads the derivation of a uniform procedure for predicting loudness and damage risk for hearing which is applicable for continuous noise as well as for impulse noise.