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The availability of electronic health record (EHR)-linked biobank data for research presents opportunities to better understand complex ocular diseases. Developing accurate computable phenotypes for ocular diseases for which gold standard diagnosis includes imaging remains inaccessible in most biobank-linked EHRs. The objective of this study was to develop and validate a computable phenotype to identify primary open-angle glaucoma (POAG) through accessing the Department of Veterans Affairs (VA) Computerized Patient Record System (CPRS) and Million Veteran Program (MVP) biobank. Accessing CPRS clinical ophthalmology data from VA Medical Center Eye Clinic (VAMCEC) patients, we developed and iteratively refined POAG case and control algorithms based on clinical, prescription, and structured diagnosis data (ICD-CM codes). Refinement was performed via detailed chart review, initially at a single VAMCEC (n = 200) and validated at two additional VAMCECs (n = 100 each). Positive and negative predictive values (PPV, NPV) were computed as the proportion of CPRS patients correctly classified with POAG or without POAG, respectively, by the algorithms, validated by ophthalmologists and optometrists with access to gold-standard clinical diagnosis data. The final algorithms performed better than previously reported approaches in assuring the accuracy and reproducibility of POAG classification (PPV >83% and NPV >97%) with consistent performance in Black or African American and in White Veterans. Applied to the MVP to identify cases and controls, genetic analysis of a known POAG-associated locus further validated the algorithms. We conclude that ours is a viable approach to use combined EHR-genetic data to study patients with complex diseases that require imaging confirmation.

Perceptions of a crisis communicator’s sincerity drive reactions to an organization’s response amidst a scandal. However, a spokesperson can nonverbally appear sincere while deceptively evading questions and can appear insincere while actually speaking sincere truths. Applying truth-default theory to crisis communication, we assess people’s reactions to a spokesperson varying in sincerity through demeanor and language. In an experiment ( N = 801), adults from across the United States were randomly assigned to view one of four versions of a news interview. The stimuli present the spokesperson replying to questions with sincere or insincere demeanor and sincere language (conveying relevance and clarity) or insincere language (evasion and obfuscation). Results indicate that sincerity in demeanor and language interact to affect (a) account acceptance, (b) negative word-of-mouth intention, and (c) attribution of responsibility. But sincerity in language largely overrides behavioral impressions. Discussion concerns considering evasion and obfuscation as demeanor cues, when violations of relevance and clarity in language undercut a spokesperson’s believability.

Background Delivery of antineoplastic regimens in the pediatric setting is facilitated by a paper roadmap. Paper roadmaps are the key safety tool required for safe ordering. Electronic medical record systems offer technological solutions for ordering antineoplastic regimens, however, do not offer a solution that integrates paper roadmaps digitally. Methods A multidisciplinary project team implemented real-time clinician scanning of paper roadmaps into the electronic medical record. Results The rate of missing roadmaps decreased from an average of 1.6 to 0.8 per week. Pharmacists gained 3 h of productivity daily. Providers spend an average of 35–45 s and a total of seven clicks each time a roadmap is scanned. Overall, the clinical systems analyst spent less than 1 h of total build time. Conclusion Implementing roadmap scanning decreased the rate of missing roadmaps, increased pharmacist productivity, and required a nominal amount of analyst and provider time. In addition, this solution allows for concurrent viewing of the roadmap files from any connected computer, facilitating an easier co-signature process for providers, pharmacists, and nurses. Practice Implications These results suggest that implementing real-time scanning of roadmaps can improve oncology care efficiency while maintaining the same safety rigor that paper roadmaps offer.

Objectives Deaf American Sign Language (ASL) users comprise a linguistic and cultural minority group that is understudied and underserved in health education and health care research. We examined differences in health risk behaviors, concerns, and access to health care among Deaf ASL users and hearing English speakers living in Florida. Methods We applied community-engaged research methods to develop and administer the first linguistically accessible and contextually tailored community health needs assessment to Deaf ASL users living in Florida. Deaf ASL users (n = 92) were recruited during a 3-month period in summer 2018 and compared with a subset of data on hearing English speakers from the 2018 Florida Behavioral Risk Factor Surveillance System (n = 12 589). We explored prevalence and adjusted odds of health behavior, including substance use and health care use. Results Mental health was the top health concern among Deaf participants; 15.5% of participants screened as likely having a depressive disorder. Deaf people were 1.8 times more likely than hearing people to engage in binge drinking during the past month. In addition, 37.2% of participants reported being denied an interpreter in a medical facility in the past 12 months. Conclusion This study highlights the need to work with Deaf ASL users to develop context-specific health education and health promotion activities tailored to their linguistic and cultural needs and ensure that they receive accessible health care and health education.

Chronic lateral ankle instability is the sensation of the ankle giving way along with recurrent sprains, chronic pain and swelling of the ankle for 1 year. The lateral ankle complex comprises the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. The anterior talofibular ligament is the most commonly injured ligament of the lateral ankle. Evaluation comprises a history and physical with concomitant imaging to confirm the diagnosis and can be used to evaluate for concurrent pathology. The most popular treatment is a direct anatomic repair; however, additional options can be used in specific patient populations.

A plants’ water and nutrients are primarily absorbed through roots, which in a natural setting is highly dependent on the 3-dimensional configuration of the root system, collectively known as root system architecture (RSA). RSA is difficult to study due to a variety of factors, accordingly, an arsenal of methods have been developed to address the challenges of both growing root systems for imaging, and the imaging methods themselves, although there is no ‘best’ method as each has its own spectrum of trade-offs. Here, we describe several methods for plant growth or imaging. Then, we introduce the adaptation and integration of three complementary methods, root mesocosms, photogrammetry, and electrical resistance tomography (ERT). Mesocosms can allow for unconstrained root growth, excavation and preservation of 3-dimensional RSA, and modularity that facilitates the use of a variety of sensors. The recovered root system can be digitally reconstructed through photogrammetry, which is an inexpensive method requiring only an appropriate studio space and a digital camera. Lastly, we demonstrate how 3-dimensional water availability can be measured using ERT inside of root mesocosms.

This chapter focuses on navigation from low earth orbit (LEO). It opens with a brief history of early US and Russian satellite navigation systems in LEO. The chapter discusses satellites in LEO today, their role in navigation, and LEO constellations on the horizon. It provides the needed mathematical background and discusses the role of LEO in satellite navigation today, showcasing the performance of the Satelles Iridium‐based GPS augmentation system and demonstrating the benefit of stronger signals. The chapter looks to the future of LEO in navigation and demonstrates that the scale of the proposed Broadband LEO constellations, coupled with the more benign LEO radiation environment, can deliver the positioning performance of GPS with commercial‐off‐the‐shelf components. It provides an analysis of the LEO radiation environment compared to medium Earth orbit.

Over the past two decades, there has been increasing recognition of the importance and merits of increasing representation of historically underrepresented minorities in the health professions. However, people with disabilities are less discussed in these efforts. More than one in four of U.S. adults have a disability; yet it seems that these individuals are less represented in the field of health education. This commentary discusses the merits of increasing representation of people with disabilities in the health education/promotion profession and calls for preparation programs and professional organizations to reduce systemic barriers and facilitate increased representation.

Context: With increased use of cannabis-based products by the public for both recreational and medical use, sports medicine clinicians should be informed of historical context, current legal considerations, and existing evidence with regard to efficacy, safety, and risks in the athletic community. Evidence Acquisition: A review of ClinicalTrials.gov, MEDLINE, and CINAHL from 2015 to present was conducted with emphasis on the most recent literature using search terms, cannabis, nabiximols, cannabinoids, pain management, THC, CBD, and marijuana. Bibliographies based on original search were utilized to pursue further literature search. Study Design: Clinical review. Level of Evidence: Level 3. Results: At present, limited high-quality studies exist for use of cannabinoids for acute pain, chronic pain, or concussion. None of the trials involving cannabinoids included the athletic population. Thus, results from this clinical review are extrapolated to conditions of the sports medicine population. For acute pain, 2 small-randomized double-blinded crossover trials concluded no immediate effect of cannabinoid therapy. More robust evidence exists for treatment of chronic pain conditions through meta-analysis and systemic reviews. Cannabinoid therapy exhibits moderate efficacy as a treatment for some chronic pain conditions. Investigations included a broad spectrum of chronic pain conditions, including neuropathic, musculoskeletal, inflammatory, and central pain conditions, and reveal reduction in pain and improvement of quality of life with limited adverse effects. For concussion, evidence is based on preclinical in vitro and animal models revealing possible neuroprotective effects as well as 2 clinical studies involving the presence of cannabinoids for concussion (some sports-related), but there are no high-quality trials evaluating efficacy for treatment with cannabinoids at this time. Conclusion: Although various biochemical explanations exist on the use of cannabinoid therapy through modulation of the endocannabinoid system for several medical issues affecting athletes, recommendations from clinicians must be extrapolated from a majority of research done in the nonathletic population. Lack of strong-quality clinical evidence, coupled with inconsistent federal and state law as well as purity issues with cannabis-based products, make it difficult for the sports medicine clinician to widely recommend cannabinoid therapeutics at present. Future larger, higher quality clinical research studies with standardized pure extracts will better guide appropriate medical use going forward. At present, evidence for a multitude of therapeutic applications is emerging for cannabinoid treatment approaches. With emphasis placed on patient-centered clinical decisions, cannabinoids hold promise of treatment for athletes with chronic pain conditions. Clinicians who treat the athletic community must consider legal and ethical issues when discussing and recommending the use of cannabinoids, with acknowledgment of inconsistencies in purity of various formulations and concerns of drug testing.

Over the last decade, many neuro-ocular findings have been documented following long-duration spaceflight (LDSF) including optic disc edema, choroidal folds, hyperopic refractive shift, and cotton ...

Background Patients with symptoms of gastroesophageal reflux disease (GERD) are often given a trial of proton pump inhibitors (PPIs). When they respond, patients usually continue PPI therapy. If this empiric treatment fails, esophagogastroduodenoscopy (EGD) is recommended. When EGD findings are equivocal, pH study is warranted. We hypothesize that this algorithm results in prolonged PPI therapy, repetition of EGDs and patient dissatisfaction. This study evaluates the impact of placing a pH probe at the time of the initial EGD. Methods IRB approval was obtained for retrospective chart review of patients who presented with GERD symptoms between August 2015 and March 2019. Patients were included if they underwent EGD with placement of wireless pH probe. Results A total of 379 patients (260 females, 119 males) with average age was 56.7±14.2 years. There were 253/379 (66.7%) patients who had previous EGDs (1-10). Health Satisfaction Survey was completed by 357/379 (94.2%) patients and 250/357 (70%) reported dissatisfaction with GERD control. PPI use was noted in 299/379 (78.8%) patients with average duration of 10.9±9.1 years. Testing off antisecretory medication was performed in 360/379 (94.9%). The average time interval between the clinic visit and performing EGD and pH study was 22±25 days. Conclusion The current GERD algorithm results in prolonged PPI therapy, repeated endoscopies and patient dissatisfaction. Placing a pH probe at the time of initial endoscopy is safe and expedient in a rural setting. Positive pH studies avoid repeating EGDs and negative pH studies warrant a search for potential alternative diagnosis.

Introduction Patient-centered care, particularly shared medical decision making, is difficult to measure in critically ill patients where decisions are often made by a designated surrogate, often receiving information from multiple providers with varying degrees of training. The purpose of this study was to compare short-term satisfaction with care and decision making in patients or surrogates between two neurocritical care units [one staffed by a neurocritical care attending and advanced practice providers (APPs) and one staffed by a neurocritical care attending and resident/fellow trainees] using the Family Satisfaction in the ICU (FS-ICU) survey. Methods Over a 6-month period, the FS-ICU was administered on a tablet device to patients or surrogates at least 24 h after admission and stored on REDCap database. Results One hundred and thirty-four patients or surrogates completed the FS-ICU. The response rates were 59.97% and 46.58% in the APP and trainee units, respectively. There were no differences in patient age, sex, ventilator days or ICU length of stay. Overall, there were no differences in satisfaction with care or perceived shared medical making between the units. Respondents who identified their relationship with the patient as “other” (not a spouse, parent, nor a sibling) were less satisfied with care. Additionally, surrogates who identified as parents of the patient were more satisfied with degree of shared medical decision making. Conclusion This study showed that: (1) collecting FS-ICU in a neurocritical care unit is feasible, (2) overall there is no difference in short-term satisfaction with care or shared decision making between a NICU staffed with trainees compared to one staffed with APPs, and (3) parents of patients have a higher short-term satisfaction with degree of shared medical decision making.

PurposeThis paper examines how informal knowledge transfer processes unfold during the repatriation of Malaysian executives. The goal is to develop a repatriate knowledge transfer process model, explaining the informal process through which repatriates make decisions about and transfer newly acquired knowledge.Design/methodology/approachGiven the unexplored nature of the informal knowledge transfer process the study investigates, this research adopts an exploratory qualitative research approach using interview data from 10 Malaysian corporate executives over a period of 14 months, covering prerepatriation and postrepatriation stages.FindingsThe findings indicate that from the repatriates' perspectives, the process flows during repatriates' knowledge transfer depend on the ability and motivation of repatriates, as well as their opportunity to communicate the newly acquired knowledge to their home country organization. We likewise learned that the repatriates' ability to overcome repatriate adjustment and knowledge transfer challenges is crucial in order for them to proactively initiate informal knowledge transfer.Practical implicationsThis research is significant as it will assist current and future expatriates to plan and prepare for repatriation and eventual knowledge transfer. The findings will also be useful to organizations that employ repatriates in preparing action plans for repatriation rather than solely focusing on expatriation.Originality/valueResearch and practice formally argue that expatriates are expected to transfer knowledge from the home country organization to the host country organization. While on assignment, expatriates become exposed to various types of new knowledge during the assignment, setting them up to disseminate this newly acquired knowledge to their home country organization upon repatriation – however, knowledge transfer upon repatriation is largely informal. This paper examines how this informal knowledge transfer process unfolds in the repatriation context over a period of 14 months by qualitatively tracing the experiences of 10 Malaysian corporate executives.

This paper explores the impact of acculturation conditions, orientations and outcomes on international students in Australia’s tertiary education sector. Specifically, we investigate the factors that facilitate or hinder acculturation of international students within a multidimensional acculturation context ( Arends-Toth & van de Vijver, 2006 ). We used a sequential exploratory mixed-methods design in two studies to investigate acculturation of international students at an Australian university and test how these factors are related to psychological and sociocultural outcomes. In Study 1, we conducted a generic qualitative study using semi-structured interviews with a conventional content analyses approach,which compared the experiences of international students who on average had high numbers of positive experiences versus those who had high numbers of negative experiences. We found that a support network of mixed-nationals, and especially host locals, facilitates positive psychological and sociocultural adjustment, and buffers acculturative stress. Study 2 quantitatively tested the association of factors found in Study 1 (perceived stereotypes, intercultural and ethnic network/resources) with psychological and sociocultural acculturation outcomes. Study 2, shows that perceived negative stereotypes loosen ties with the dominant (host) culture and reinforces ties with the ethnic (non-host) culture. The social resources associated with either culture was found to be useful for acculturation, with both independently contributing to participant well-being. Contact with host locals played a particularly crucial role in developing these resources. Our findings provide foundations for pragmatic policy implications, suggesting value in the development of formally organized contact programs in the early sojourn experience of international students.

BACKGROUND Higher problem severity contraindicates moderation drinking in treatment samples, but has not been well investigated in natural recovery samples with more prevalent moderation outcomes, nor have single studies assessed multiple severity indicators. Therefore, we integrated 5 prospective studies of recent natural recovery attempts to identify multi-indicator profiles that distinguished moderation from abstinence or unstable resolution involving relapse. The study evaluated whether moderation was distinguished by a generalized lower severity profile or whether more complex profiles better differentiated outcomes. METHODS Community-dwelling problem drinkers in the southeastern United States (N = 616, 67% male, 65% white, mean age = 46.5 years) enrolled soon after stopping alcohol misuse without treatment were followed prospectively for a year. Outcome predictors assessed at enrollment included preresolution drinking practices, alcohol-related problems, alcohol dependence, and a behavioral economic measure of the reward value of drinking based on preresolution spending on alcohol versus saving for the future. RESULTS Latent profile analysis of severity indicators supported a 4-profile solution: (i) global low risk on all indicators, (ii) global high risk on all indicators, (iii) high risk limited to drinking practices only, and (iv) high risk limited to alcohol dependence and alcohol-related problems only. Outcomes differed by profile membership (p

Sleep duration improves short-term following bariatric surgery; however, little is known about its association with bodyweight medium- to long-term post-surgery. The purpose of this study was to describe sleep duration and its relationship with BMI and body composition. Forty-nine individuals, with a BMI of 36.6 ± 9.8 kg/m2, regained 26.4 ± 17.8% of their lost weight 9.5 ± 3.3 years post-surgery (range 3–16 years). Sleep logs and ActivPAL3 accelerometers were used to assess sleep duration. Participants averaged 7.9 ± 1.6 h/day and 8.5 ± 1.7 h/day of sleep for weekdays and weekends, respectively (P

Debriefing after a major event is a key component in ongoing improvement in performance. Likewise, reflecting on one’s career at the time of leaving the operating room environment is an opportunity to transmit the lessons learned from decades of surgical practice. The authors, recently retired from daily operating and leaders in American surgery, reflect on the impact of surgical life on surgeons and their personal lives. Observations regarding selection of medical students, surgical trainees and practice models are presented from this perspective.

Addition of plerixafor (P) to granulocyte colony stimulating factor (G-CSF) during peripheral blood mobilization of hematopoietic stem cells (HSC) increases the number of patients meeting collection goals prior to autologous stem cell transplant (aSCT). However, use of P is not universal among transplant centers due to cost. This study aims to compare clinical and financial impacts of using an algorithm-based P mobilization strategy versus use in all patients. This was a single center, retrospective analysis of adult patients with myeloma or amyloidosis receiving aSCT who received apheresis of their HSC between 3/1/2017 and 3/1/2019. Patients prior to 3/1/2018 were classified as receiving P "per algorithm" and those after this date were classified as "up-front" P. For the per-algorithm group, P was given for a pre-apheresis CD34+ cell count of

Background Adolescent and young adult (AYA) hematopoietic cell transplantation (HCT) survivors are at increased risk of metabolic syndrome and lean body mass (LBM) deficits. Resistance training (RT) is a potential intervention to improve LBM, metabolic fitness, and reduce risk of cardiovascular disease. Procedure Eligible participants ages 13-39 years, 80-120 days post-HCT, transfusion independent, and prednisone dose ≤1 mg/kg/day were approached. Baseline assessments of body composition (DXA), anthropometrics, and strength testing were completed and participants were taught a 12-week, home-based RT intervention with weekly remote coaching. Follow-up assessments were at day +200 (FU1) and +365 post-HCT (FU2). Feasibility targets were (a) 60% enrollment of approached patients, (b) 80% completion of weekly phone calls, and (c) 80% completion of the RT intervention and FU1 assessments. Acceptability was based on positive responses in qualitative interviews. Results Twenty of 31 (65%) eligible AYAs enrolled. Three participants failed to complete baseline measurements (2 = scheduling barriers, 1 = passive refusal) and four participants who completed baseline assessments did not receive the intervention (1 = medical reasons, 2 = no longer interested). Of those who completed baseline assessments, 13 received the intervention, completed 88.5% of coaching calls, and 11 (65%) completed FU1. LBM (kg) increased or remained unchanged in nine of nine participants with complete body composition data at FU1 (mean 1.1 kg; 95%CI: 0.4, 1.9). All participants who completed FU1 reported they would recommend the intervention to an AYA HCT survivor. Conclusions A home-based RT intervention in AYA HCT survivors early post HCT is both feasible and acceptable and may maintain or increase LBM.

Infectious diseases, including zoonotic infectious diseases, are some of the leading causes of the global burden of diseases. Public health education/promotion specialists are specifically trained in methods and theory to deliver risk communication that can help decrease the transmissibility, morbidity, and mortality of infectious diseases. However, the limited training of health educators in infectious disease dynamics represents a critical barrier for health educators wishing to engage in this work. In this commentary, we describe the importance of health education/promotion specialists being trained on infectious disease dynamics to engage in effective science and health communication locally and globally.

The science of behavior has effectively addressed many areas of social importance, including the performance management of staff working in human-service settings. Evidence-based performance management entails initial preservice training and ongoing staff support. Initial training reflects a critical first training component and is necessary for staff to work independently within an organization. However, investment in staff must not end once preservice training is complete. Ongoing staff support should follow preservice training and involves continued coaching and feedback. The purpose of this article is to bridge the research-to-practice gap by outlining research-supported initial training and ongoing staff support procedures within human-serving settings, presenting practice guidelines, and sharing information about easy-to-implement ways practitioners may stay abreast of current research.

Road ecology research has tended to focus on wildlife-vehicle collisions (WVCs) while omitting or failing to differentiate domestic (i.e., livestock) animal-vehicle collisions (DAVCs). This has limited our understanding of where, when, and how frequently DAVCs occur, and whether these patterns differ from those for WVCs. We used a 10-year collision data set for the U.S. state of Montana to compare temporal and spatial patterns of DAVCs versus WVCs at multiple scales. WVCs exhibited two diel peaks (dawn and dusk) versus only one prominent peak (late evening/early night) for DAVCs. Seasonal patterns of WVCs and DAVCs were broadly similar, but DAVCs exhibited a more pronounced late-fall peak. At the county scale, DAVCs were overrepresented relative to WVCs in most of eastern Montana and underrepresented in most of western Montana. WVC and DAVC hotpots did not show strong overlap at the 1-mile road segment scale. Our results suggest that DAVCs warrant greater attention, and they may represent a high priority for management and mitigation measures in some areas because (1) they can be locally common even when regionally rare, (2) they are more dangerous to motorists on a per-collision basis than WVCs, and (3) they can present a legal liability for livestock owners. Mitigation measures for DAVCs may differ from those for WVCs and require further development and testing. Future data collection efforts should include information not only on the location and timing of animal-vehicle collisions, but also on the species of animals killed.

Surgery in larger, non-metropolitan, communities may be distinct from rural practice. Understanding these differences may help guide training. We hypothesize that increasing community size is associated with a desire for subspecialty surgeons.We designed a mixed methods study with the ACS Rural Advisory Council. Rural (50,000 people), small non-metropolitan (50,000-100,000), and large non-metropolitan (100,000) communities were compared. Quantitative and qualitative data were analyzed.We received 237 responses, and desire to hire subspecialty-trained surgeons was associated with practice in a large non-metropolitan community, OR 4.5, (1.2-16.5). Qualitative themes demonstrated that rural surgeons limit practices to align with available hospital resources while large non-metropolitan surgeons specialize according to interest and market pressures.Surgery in rural versus large non-metropolitan communities may be more distinct than previously understood. Rural practice requires broad preparation while large non-metropolitan practice favors subspecialty training.

Because there is no single governing sport body in the United States devoted to coaching education, coaching requirements can vary greatly state-to-state and between organizations within the same state. Therefore, it often is up to club programs or universities to devise individual curriculum for coaching education. For those responsible for coaching education, utilizing backwards design can ensure programs meet the learning and professional development needs of coaches. In backwards design, identifying coaches’ needs and creating program-level learning outcomes occurs prior to specific content selection. Additionally, backwards design encourages instructors to select assessments and learning activities that align with the program-level learning outcomes. In this article, a group of faculty describe their experience utilizing backwards design in creating a college/university certificate program focused on sport coaching. Specifically, a description of the following is included: (a) the process used to create program-level learning outcomes, (b) how to emphasize the program-level learning outcomes throughout the program’s coursework, and (c) a specific example from one course in the curriculum. Finally, we provide lessons learned throughout the process and recommendations for program development in hopes that coach developers can utilize this process in designing their own curricula.

Businesses and governments occasionally face crises as a result of being falsely accused of harming their stakeholders. This research seeks to determine how they can most effectively respond using an experiment with 617 participants. Using situational crisis communication theory’s (SCCT) prescribed responses, the study examines unique reputation repair impact of post-crisis response strategies on a government organization compared with a business organization. This study also defines four different types of kategoria as strategies within SCCT’s denial posture and tests their crisis outcomes against other denial posture strategies. Participants were significantly more favorable toward a government organization compared with a business organization. Significant differences were detected in outcomes between different denial posture strategies. Implications for theory and practitioners are discussed.

Obesity can negatively influence walking cadence, reducing the overall intensity of daily activities and increasing the risk of weight gain.\ud \ud \ud Purpose: Objectively describe the walking cadence of individuals’ long-term post-bariatric surgery.\ud \ud \ud Methods: Fifty-eight participants, 51.2 ± 8.9 years old, with a BMI of 34.6 ± 10.1 kg/m2, 10.0 ± 3.1 years post-surgery wore an activPAL accelerometer for 7 consecutive days. Data was analyzed using participants’ current BMI, dichotomized by obesity status, < or ≥ 30 kg/m2.\ud \ud \ud Results: On average, participants walked 5124 ± 2549 steps/day on weekdays and 6097 ± 2786 steps/day on weekend days (p = .003). Participants spent the majority (75%) of their daily steps at a slow-walking average cadence (non-obese: week = 65.3 ± 5.0 steps/min and weekend = 63.8 ± 6.7 steps/min; obese: week = 67.8 ± 8.2 steps/min and weekend = 63.3 ± 6.9 steps/min), with no difference between groups for week or weekend days (p = .153 and .774). The cadence of participants with obesity was significantly lower on weekends compared to weekdays for walking events > 30 s (p = .002) and > 60 s (p = .008) in duration. Weekday cadence of participants without obesity was similar to weekend day cadence across all walking event durations. The majority of walking events occurred below 30 s in duration for all participants.\ud \ud \ud Conclusions: Long-term post-bariatric surgery, movement occurs in short duration bouts at a slow-walking cadence for the majority of movement. Individuals without obesity had similar movement patterns from week to weekend days while participants with obesity significantly lowered their cadence on weekend days.

Aging is a major risk factor for many types of cancer, and the molecular mechanisms implicated in aging, progeria syndromes, and cancer pathogenesis display considerable similarities. Maintaining redox homeostasis, efficient signal transduction, and mitochondrial metabolism is essential for genome integrity and for preventing progression to cellular senescence or tumorigenesis. NAD+ is a central signaling molecule involved in these and other cellular processes implicated in age-related diseases and cancer. Growing evidence implicates NAD+ decline as a major feature of accelerated aging progeria syndromes and normal aging. Administration of NAD+ precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) offer promising therapeutic strategies to improve health, progeria comorbidities, and cancer therapies. This review summarizes insights from the study of aging and progeria syndromes and discusses the implications and therapeutic potential of the underlying molecular mechanisms involved in aging and how they may contribute to tumorigenesis.

Background Training future rural surgeons is critical, but training needs are unclear. We hypothesize perspectives on necessity of subspecialty training differ among rural surgeons by generational cohort. Methods An online survey was sent to ACS Rural Surgery Listserv subscribers. Closed-ended elements were analyzed using bivariate testing and logistic regression. Purposively-sampled respondents participated in qualitative interviews analyzed using principles of grounded theory. Results Generation was irrelevant to respondents’ hiring preferences, but older surgeons were more likely to state subspecialty training was ideal for any future rural surgeon. Controlling for practice context, younger rural surgeons were less likely to favor hiring a subspecialty-trained surgeon (p = 0.019). Themes emerged from qualitative analysis emphasizing broad training and the importance of practice context. Conclusion Across generations, rural surgeons’ perceptions about the training needed for rural surgery are largely stable. Considering practice context will allow educators to better prepare future rural surgeons for rural practices.

Background Context Red flags are questions typically ascertained by providers to screen for serious underlying spinal pathologies. The utility of patient-reported red flags in guiding clinical decision-making for spine care, however, has not been studied. Purpose The aim of this study was to quantify the sensitivity and specificity of patient-reported red flags in predicting the presence of serious spinal pathologies. Study Design This was a retrospective nested case-control study. Patient Sample This study consisted of 120 patients with International Classification of Diseases, Ninth Revision, Clinical Modification codes for spinal pathologies and 380 randomly selected patients, from a population of 4,313 patients seen at a large tertiary care spine clinic between October 9, 2013 and June 30, 2014. Outcome Measures The presence of patient-reported red flags and red flags obtained from medical records was verified for chart review. The spinal pathology (ie, malignancy, fractures, infections, or cauda equina syndrome) was noted for each patient. Methods The sensitivity and specificity of patient-reported red flags for detecting serious spinal pathologies were calculated from data obtained from the 500 patients. Youden's J was used to rank performance. Agreement between patient-reported red flags and those obtained from medical record review was assessed via Cohen's kappa statistic. Results “History of cancer” was the best performing patient-reported red flag to identify malignancy (sensitivity=0.75 [95% confidence intervals, CI 0.53–0.90], specificity=0.79 [95% CI 0.75–0.82]). The best performing patient-reported red flag for fractures was the presence of at least one of the following: “Osteoporosis,” “Steroid use,” and “Trauma” (sensitivity=0.59 [95% CI 0.44–0.72], specificity=0.65 [95% CI 0.60–0.69]). The prevalence of infection and cauda equina diagnoses was insufficient to gauge sensitivity and specificity. Red flags from medical records had better performance than patient-reported red flags. There was poor agreement between patient red flags and those obtained from medical record review. Conclusions Patient-reported red flags had low sensitivity and specificity for identification of serious pathologies. They should not be used in insolation to make treatment decisions, although they may be useful to prompt further probing to determine if additional investigation is warranted.

While T-cell responses to cancer immunotherapy have been avidly studied, long-lived memory has been poorly characterized. In a cohort of metastatic melanoma survivors with exceptional responses to immunotherapy, we probed memory CD8+ T-cell responses across tissues, and across several years. Single-cell RNA sequencing revealed three subsets of resident memory T (TRM) cells shared between tumors and distant vitiligo-affected skin. Paired T-cell receptor sequencing further identified clonotypes in tumors that co-existed as TRM in skin and as effector memory T (TEM) cells in blood. Clonotypes that dispersed throughout tumor, skin and blood preferentially expressed an IFNG/TNF-high signature, which had a strong prognostic value for patients with melanoma. Remarkably, clonotypes from tumors were found in patient skin and blood up to 9 years later, with skin maintaining the most focused tumor-associated clonal repertoire. These studies reveal that cancer survivors can maintain durable memory as functional, broadly distributed TRM and TEM compartments. Turk and colleagues analyze exceptional responders to checkpoint blockade for melanoma, and detect tissue-resident memory and effector memory T-cell clonotypes in skin and blood, respectively, up to 9 years after treatment.

This book is a treasure trove of information to help practitioners and organizational leaders improve services for individuals with intellectual and developmental disabilities (IDD) by applying organizational behavior management (OBM) practices. The present chapter supplements this information by providing recommendations for advancing OBM practice and research within IDD service settings. We accomplish this aim by sharing practical strategies for strengthening the IDD workforce and describing peer review, the use of performance scorecards, and strategic planning within a behavioral systems approach.

Chronically uncontrolled hyperglycemia is the leading cause of end-stage renal disease (ESRD) necessitating dialysis. During times of transition to hemodialysis (HD) or peritoneal dialysis (PD), considerations must be given to insulin dosing adjustments for persons with diabetes (PWD) in efforts to maintain glycemic control. However, literature is sparse with few clear and direct practical clinical recommendations for therapeutic adjustments. The objective of this systematic review was to identify and report the evidence and gaps in the literature for adjustments in therapeutic insulin recommendations when initiating HD or PD in patients with ESRD and diabetes mellitus. A literature search using PubMed, CENTRAL, MEDLINE, CINAHL, Google Scholar, and ClinicalTrials.gov revealed 184 results. After removing duplicates and articles not reaching pre-specified criteria, 29 relevant articles remained for further analysis. The most common recommendation regarding HD was to reduce the basal insulin dose up to 25% on HD days to prevent hypoglycemia, although a lack of consensus exists on the percent reduction. Little information was found as to insulin management with continuous ambulatory PD (CAPD) or automated PD (APD). During PD, insulin may be administered subcutaneously, intraperitoneally, or with the dialysis fluid. Administration of insulin with dialysate may necessitate a dose increase of up to 30% due to a loss to tubing and dilution. Furthermore, the use of dextrose-based dialysate may require additional insulin to mitigate systemic impact of dextrose absorption on blood glucose. Overall, a gap exists in the primary literature regarding recommendations for prophylactically adjusting insulin therapy when initiating HD or PD, or when switching between the two. Greater research is needed to clarify ideal alterations in insulin dosing, administration techniques, and product selections for this patient population. Disclosure R. Tumlinson: None. E. Blaine: None. M. Colvin: None. T. G. Haynes: None. H. P. Whitley: None.

BACKGROUND In the past 20 years, there has been an increase in the number of college students with disabilities (SWDs) in the United States. Students with disabilities may have not received relevant, or accessible, sexual health education from medical providers, parents, or school health educators. Because of the lack of this education, the college social environment, and developmental timing of traditional college aged students, SWDs are at risk of engaging in health compromising sexual behavior. METHODS We conducted a secondary data analysis of traditionally aged (18- to 24-year-olds) college students who completed the National College Health Assessment administered in Fall 2017 and Spring 2018 (N = 95,119). We use prevalence and generalized linear models to describe self-reported sexual health behavior and outcomes among college students without disabilities and SWDs, by disability category. RESULTS Findings indicate that college students with disabilities-particularly students with attention-deficient hyperactivity disorder, psychiatric conditions, and multiple disabilities-are at higher risk than students without disabilities to engage in health compromising sexual health behavior and that students with multiple disabilities have higher adjusted prevalence ratios of being diagnosed and/or treated for a sexually transmitted infection. CONCLUSIONS Students with disabilities are not a monolithic population and there is cross-disability variability of engaging in health compromising and health promoting behavior. These findings highlight the need for college health promotion specialists and clinicians to advocate for accessible, sex positive, disability inclusive sexual health education.

Objective To explore the role of several genetic polymorphisms (APOE e4, BDNF Met, and COMT Val) in executive functioning performance in patients with pharmacoresistant temporal lobe epilepsy (TLE). Methods Ninety-three adults (51 female, mean age = 39 years) with TLE completed executive functioning measures as part of a comprehensive preoperative neuropsychological evaluation, including Trail Making Test (Part B), Wisconsin Card Sorting Test (Conceptual Level Responses and Perseverative Errors), Color Word Interference from the Delis Kaplan Executive Function System, and measures of phonemic and semantic verbal fluency. Genotyping of the APOE, BDNF, and COMT genes was conducted using DNA extracted from peripheral blood or brain tissue (from epilepsy surgery). Results After adjustment for general cognitive ability, COMT Val carriers showed poorer performance on semantic verbal fluency and color word interference than non-carriers, and BDNF Met carriers showed poorer performance on phonemic verbal fluency than those without a Met allele. Significance Results suggest that COMT and BDNF polymorphisms are associated with performance on several EF measures in patients with TLE, including tasks assessing verbal fluency and response inhibition and account for up to 16% of the variance in test performance. The APOE polymorphism was not significantly associated with any of the executive function measures analyzed.

Growing evidence points to the role of authentic leadership in enhancing followership. Yet little is known about the factors that determine whether followers perceive leaders as displaying authentic leadership. In the present research, we examine the impact of leaders' championing of collective (group) interests on authentic leadership. Study 1 shows experimentally that compared to a leader who advances personal interests, a leader who advances the interests of a collective is (a) perceived as offering more authentic leadership and (b) more likely to inspire followership. Findings are followed up in a field study revealing that leaders' championing of collective interests is associated with greater perceived authentic leadership and followership (in terms of voting intentions). Furthermore, results indicate that shared self-categorization is a boundary condition of these relationships such that the relationship between a leader's championing of collective (group) interests and authentic leadership (and followership) is more pronounced for perceivers who self-categorize as members of the group that a leader is leading (rather than of a different group). In sum, findings suggest that leaders are regarded as more authentic to the extent that they are true to the collective identity of the group that they lead.

Glaucoma leads to millions of cases of visual impairment and blindness around the world. Its susceptibility is shaped by both environmental and genetic risk factors. Although over 120 risk loci have been identified for glaucoma, a large portion of its heritability is still unexplained. Here we describe the foundation of the Genetics of GLaucoma Evaluation in the AMish (GGLEAM) study to investigate the genetic architecture of glaucoma in the Ohio Amish, which exhibits lower genetic and environmental heterogeneity compared to the general population. To date, we have enrolled 81 Amish individuals in our study from Holmes County, Ohio. As a part of our enrollment process, 62 GGLEAM study participants (42 glaucoma-affected and 20 unaffected individuals) received comprehensive eye examinations and glaucoma evaluations. Using the data from the Anabaptist Genealogy Database, we found that 80 of the GGLEAM study participants were related to one another through a large, multigenerational pedigree containing 1586 people. We plan to integrate the health and kinship data obtained for the GGLEAM study to interrogate glaucoma genetics and pathophysiology in this unique population.

Background Continuous tracking of ambulatory activity in real-world settings using step activity monitors has many potential uses. However, feasibility, accuracy, and correlation with performance measures in stroke patients have not been well-established. Objective The primary study objective was to determine adherence with wearing a consumer-grade step activity monitor, the Fitbit Charge HR, in home-going ischemic stroke patients during the first 90 days after hospital discharge. Secondary objectives were to (1) determine accuracy of step counts of the Fitbit Charge HR compared with a manual tally; (2) calculate correlations between the Fitbit step counts and the mobility performance scores at discharge and 30 days after stroke; (3) determine variability and change in weekly step counts over 90 days; and (4) evaluate patient experience with using the Fitbit Charge HR poststroke. Methods A total of 15 participants with recent mild ischemic stroke wore a Fitbit Charge HR for 90 days after discharge and completed 3 mobility performance tests from the National Institutes of Health Toolbox at discharge and Day 30: (1) Standing Balance Test, (2) 2-Minute Walk Endurance Test, and (3) 4-Meter Walk Gait Speed Test. Accuracy of step activity monitors was assessed by calculating differences in steps recorded on the step activity monitor and a manual tally during 2-minute walk tests. Results Participants had a mean age of 54 years and a median modified Rankin scale score of 1. Mean daily adherence with step activity monitor use was 83.6%. Mean daily step count in the first week after discharge was 4376. Daily step counts increased slightly during the first 30 days after discharge (average increase of 52.5 steps/day; 95% CI 32.2-71.8) and remained stable during the 30-90 day period after discharge. Mean step count difference between step activity monitor and manual tally was –4.8 steps (–1.8%). Intraclass correlation coefficients for step counts and 2-minute walk, standing balance, and 4-meter gait speed at discharge were 0.41 (95% CI –0.14 to 0.75), –0.12 (95% CI –0.67 to 0.64), and 0.17 (95% CI –0.46 to 0.66), respectively. Values were similarly poor at 30 days. Conclusions The use of consumer-grade Fitbit Charge HR in patients with recent mild stroke is feasible with reasonable adherence and accuracy. There was poor correlation between step counts and gait speed, balance, and endurance. Further research is needed to evaluate the association between step counts and other outcomes relevant to patients, including patient-reported outcomes and measures of physical function.

Purpose: Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. Methods: The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. Results: This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. Conclusion: The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.

Gulf War Veterans' Illnesses (GWI) encompasses a broad range of unexplained symptomology specific to Veterans of the Persian Gulf War. Gastrointestinal (GI) distress is prominent in veterans with GWI and often presents as irritable bowel syndrome (IBS). Neurotoxins, including organophosphorus pesticides and sarin gas, are believed to have contributed to the development of GWI, at least in a subset of Veterans. However, the effects of such agents have not been extensively studied for their potential impact to GI disorders and immunological stability. Here we utilized an established murine model of GWI to investigate deleterious effects of diisopropyl fluorophosphate (DFP) exposure on the mucosal epithelium in vivo and in vitro. In vivo, acute DFP exposure negatively impacts the mucosal epithelium by reducing tight junction proteins and antimicrobial peptides as well as altering intestinal microbiome composition. Furthermore, DFP treatment reduced the expression of IL-17 in the colonic epithelium. Conversely, both IL-17 and IL-17C treatment could combat the negative effects of DFP and other cholinesterase inhibitors in murine intestinal organoid cells. Our findings demonstrate that acute exposure to DFP can result in rapid deterioration of mechanisms protecting the GI tract from disease. These results are relevant to suspected GWI exposures and could help explain the propensity for GI disorders in GWI Veterans.

Lateral interbody fusion (LIF) is traditionally performed in lateral decubitus on a breaking surgical table to improve L4-L5 access. Prone transpsoas (PTP) LIF may improve sagittal alignment and facilitate single-position circumferential procedures; but may require manipulation of the iliac crest for L4-L5 accessibility.Healthy adult volunteers (n = 41) were positioned as if for surgery in right-lateral decubitus on a radiolucent breaking table, and also prone on a Jackson-style surgical frame atop a custom PTP bolster. Iliac crest distance from the L5 superior endplate, and coronal and sagittal plane alignments were measured from fluororadiographs obtained in each of 5 positions: standard lateral decubitus (LD), prone-hips and spine neutral (PR-NN), prone-hips neutral and spine coronally bent (PR-NCB), prone-hips extended and spine neutral (PR-EN), and prone-hips extended and spine coronally bent (PR-ECB).L4-L5 accessibility was lowest in prone-neutral and improved in all augmented positional configurations: PR-NNPR-ENLDPR-ECBPR-NCB. Coronal bending with the PTP positioner created greater accessibility than that achieved by lateral decubitus breaking (PR-NCBLD, P = 0.0480). Coronal angulations were greatest in LD, and statistically different from both prone neutral (LDPR-NN, P0.0001) and prone coronally bent (LDPR-NCB, P0.0001). Lordosis was greatest in extended prone positions and lowest in lateral decubitus: PR-ENPR-ECBPR-NCBPR-NNLD. All prone positions showed significantly greater lordosis than lateral decubitus (P0.001).Compared with lateral decubitus, prone positioning provides equivalent or better L4-L5 LIF access around the iliac crest when a positioner is used that enables coronal bending, and improved positional lordosis, which may facilitate segmental correction and achievement of surgical alignment goals.

Female-led ventures are penalized in funding and valuation when catering to male-dominated industries due to a “lack of fit.”, Are female founding CEOs penalized when raising funds for their ventures based on industry served? Across an observational study conducted on ventures seeking funding (N = 392) and an experimental study conducted on investors allocating venture funding (N = 130), we find evidence for a “lack of fit” effect: Female-led ventures catering to male-dominated industries receive significantly less funding at significantly lower valuations than female-led ventures catering to female-dominated industries. In contrast, male-led ventures attain similar funding and valuation outcomes regardless of the gender dominance of the industries to which they cater. We confirm that this is because investors perceive lower degrees of fit between founding CEO and venture for female-led ventures catering to male- as opposed to female-dominated industries (with no perceived fit differences for male-led ventures across industries). Degree of investor sophistication emerges as a potential attenuating factor, appearing to help reduce gender bias from perceived lack of fit.

Teaching any subject can be difficult, but teaching GNSS offers a unique set of challenges. GNSS is built upon a set of complex and interdisciplinary engineering achievements. The modernization of these systems today continues to push the boundaries of orbital mechanics,signal processing, modern physics, rocket science, and a host of other fields. But for all of the technological complexities of GNSS, it has turned into one of the most recognized and widely used utilities throughout the world. Everyone has become a capable ”Navigator” through the simple act of owning a cell phone. So how does one boil all of this information down in to a 10 week graduate engineering course? Furthermore, how does one go beyond giving students a theoretical background to give them the vocational tools necessary to innovate and carry the field of navigation forward? At Stanford, the GPS course has always strived to achieve proficiency in the theory and practice. The class has served as the inspiration to many who join the navigation profession and continue to lead in the field today. With the emergence of the GNSS Analysis Tools from Google[1], many new opportunities have arisen that allow students to explore the world of GNSS by following their passions and their own creativity. The GNSS Analysis Tools available on Android[2], allow anyone with an Android phone to record and analyze raw GNSS measurements. By raw GNSS measurements, we’re not simply referring to pseudoranges. After all, a pseudorange is a derived measurement. Truly raw measurements are comprised of the time stamps associated with satellite signal reception and transmission,C/N0, and other values used to generate a position,velocity, and time (PVT) solution. With these measurements available to the masses, everyone can tinker and toy with real GNSS data and the Stanford GPS course has wholeheartedly embraced these new tools. Over the years, the course has been molded to enhance student engagement and encourage newcomers from diverse professional backgrounds. The goal has been to help them explore the intersection between their passions and GNSS. As a project based course, students learn of the different subsystems while they develop their own personal projects using the GNSS Analysis Tools. These projects can take inspiration from their current work and interests or they can be derived from any aspect of GNSS that piques their interest. They even benefit from their lack of experience in the field as it frees them to explore ideas that many of us might not pursue ourselves. Midway through the course, the students are prompted to create a project that uses the skills developed within the class and are given little direction during the initial brainstorming.There is some scoping and guidance from the instructors as the course goes on, but these projects are largely born of the student’s own volition. This paper exhibits some of the projects that these students were able to accomplish in a mere matter of weeks. An example project includes the use of neural networks to improve position estimates on trajectories with non-Gaussian noise [3]. In this project, the students were able to build and train a neural network to recognize simulated multipath error and then tested this network using real world data. In another project, the students used building models to reconstruct non-line-of-sight (NLOS) pseudoranges from obstructed satellites and project those NLOS signals on to ”virtual satellites”in an effort to construct a more accurate PVT solution [4]. These projects and more will be presented to highlight the promise these modern tools bring to project oriented teaching. The goal of this paper is to serve as an inspiration to those teaching or considering teaching GNSS. Whether instructing undergraduates, graduates, or professionals,this paper presents some of the opportunities that arise when students have a chance to creatively pursue GNSS themselves. REFERENCES [1] van Diggelen, Frank, and Mohammed Khider. ”GNSS analysis tools from Google.” Inside GNSS 13 (2018): 51. [2] https://github.com/google/gps-measurement-tools/releases/tag/2.0.0.1 [3] Kosec, Matej, and John Poothokaran. ”Comparison of Kalman filters and LSTM networks for GPS trajectory smoothing in the presence of simulated multipath noise.” Stanford GPS Class (2018). [4] Pratz, Scott, and Riley Culberg. ”NLOS Identification and Correction from Known Building Structures.” Stanford GPS Class (2018).

There is a growing need for vehicle positioning information to support Advanced Driver Assistance Systems (ADAS), Connectivity (V2X), and Autonomous Driving (AD) features. These range from a need for road determination ($, 8 pages, 4 figures, ION GNSS+ 2020

We present a low-cost, highly configurable receiver and external CW generator for frequency shift keying (FSK) based backscatter communication systems. The receiver uses a Nordic Semiconductor nRF24L01+ chip and an Arduino UNO to enable backscatter communication on any of 125 channels within the 2.4 GHz industrial, scientific, and medical (ISM) band. The receiver supports FSK modulation at up to 2.0 Mbps. Paired with an Arduino-based carrier generator, this system allows users to choose a backscatter uplink channel that minimizes interference from other 2.4 GHz devices (e.g. Wi-Fi and Bluetooth). As an example of a power-critical sensing application where backscatter can be used favorably, we present a wireless, digital neural recording system that leverages a 1.0 Mbps FSK backscatter uplink. The neural recording system has a 3 dB frequency response of 0.8 Hz to 220 Hz and uplinks up to 120 kbps of biopotential data at a sample rate of 500 Hz, with 16 bits of precision per sample. The packet uplink rate is 500 packets per second.

PURPOSE: Determine the feasibility of a remotely delivered mobile health (mHealth) supported intervention to improve diet and physical activity in hematologic malignancy survivors. METHODS: Pilot randomized controlled trial of a 16-week intervention for improving diet and physical activity: individualized goal-setting (daily steps, sodium, percent saturated fat, percent added sugar intake) per feedback from mHealth trackers (Fitbit for activity; Healthwatch360 for diet), supplemented by a Facebook peer support group. Controls accessed the trackers without goal-setting or peer support. Everyone received standardized survivorship counseling with tailored advice from a clinician. Actigraphy and food frequency questionnaires assessed activity and diet at baseline and follow-up. RESULTS: Forty-one participants (51.2% male; median age 45.1y; 7.0y from treatment) were randomized (24 intervention; 17 control). Fitbit and Healthwatch360 use were more common among intervention versus control participants (75.0% versus 70.6% and 50.0% versus 17.7% of eligible days, respectively). Most intervention participants (66.7%) engaged with Facebook; overall, 91.7% interacted with the study’s mHealth applications. While no comparisons in activity or dietary outcomes between intervention versus control group met statistical significance, the intervention was associated with greater reductions in the targeted dietary factors and improvements in Healthy Eating Index-2015 score, moderate-vigorous physical activity time, and daily steps. Participant retention at 6-months was 90.2%. CONCLUSIONS: An intervention for cardiovascular risk reduction based on individualized goal-setting enhanced by mHealth and social media peer support was feasible and acceptable among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Effective and easily disseminated strategies that improve diet and reduce sedentary time in this population are needed. Registered in ClinicalTrials.gov (NCT03574012) on June 29, 2018.

High-resolution cameras have become very helpful for plant phenotyping by providing a mechanism for tasks such as target versus background discrimination, and the measurement and analysis of fine-above-ground plant attributes. However, the acquisition of high-resolution (HR) imagery of plant roots is more challenging than above-ground data collection. Thus, an effective super-resolution (SR) algorithm is desired for overcoming resolution limitations of sensors, reducing storage space requirements, and boosting the performance of later analysis, such as automatic segmentation. We propose a SR framework for enhancing images of plant roots by using convolutional neural networks (CNNs). We compare three alternatives for training the SR model: i) training with non-plant-root images, ii) training with plant-root images, and iii) pretraining the model with non-plant-root images and fine-tuning with plant-root images. We demonstrate on a collection of publicly available datasets that the SR models outperform the basic bicubic interpolation even when trained with non-root datasets. Also, our segmentation experiments show that high performance on this task can be achieved independently of the SNR. Therefore, we conclude that the quality of the image enhancement depends on the application., Under review. Submitted to Applications in Plant Sciences (APPS)

Background Laminin-α2-related congenital muscular dystrophy (LAMA2-CMD) is a devastating genetic disease caused by mutations in the LAMA2 gene. These mutations result in progressive muscle wasting and inflammation leading to delayed milestones, and reduced lifespan in affected patients. There is currently no cure or treatment for LAMA2-CMD. Preclinical studies have demonstrated that mouse laminin-111 can serve as an effective protein replacement therapy in a mouse model of LAMA2-CMD. Methods In this study, we generated a novel immunocompromised dyW mouse model of LAMA2-CMD to study the role the immune system plays in muscle disease progression. We used this immune-deficient dyW mouse model to test the therapeutic benefits of recombinant human laminin-111 and laminin-211 protein therapy on laminin-α2-deficient muscle disease progression. Results We show that immunodeficient laminin-α2 null mice demonstrate subtle differences in muscle regeneration compared to immunocompetent animals during early disease stages but overall exhibit a comparable muscle disease progression. We found human laminin-111 and laminin-211 could serve as effective protein replacement strategies with mice showing improvements in muscle pathology and function. We observed that human laminin-111 and laminin-211 exhibit differences on satellite and myoblast cell populations and differentially affect muscle repair. Conclusions This study describes the generation of a novel immunodeficient mouse model that allows investigation of the role the immune system plays in LAMA2-CMD. This model can be used to assess the therapeutic potential of heterologous therapies that would elicit an immune response. Using this model, we show that recombinant human laminin-111 can serve as effective protein replacement therapy for the treatment of LAMA2-CMD.