1861-10-14 David Hanscom wishes to know if his son is to be superseded by another officer

https://digitalmaine.com/cw_me_3rd_regiment_corr/1138/thumbnail.jp

Video Capsule Endoscopy as First Procedure for Acute Gastrointestinal Bleeding: An Approach to Minimizing Exposure to SARS-CoV-2 and Conserving Resources

Introduction: Video capsule endoscopy (VCE) has been proposed as an alternative triaging tool for diagnosis of hematemesis and non-hematemesis (GIB). Randomized controlled trials have shown higher detection rates of bleeding with VCE when used as the first procedure compared with standard of care (SOC). This approach has been shown to be safe, and well tolerated. VCE is particularly suitable for the diagnosis of GIB in suspected/established SARS-CoV-2 (COVID) patients as it requires minimal patient contact (one staff person) to set up, and it avoids aerosolization and sedation. We used VCE as the first diagnostic modality in hemodynamically stable patients with GIB. Here we report the outcomes of the first 50 patients undergoing VCE in the COVID era as compared to 57 historical controls in the pre-COVID era. Methods: Hemodynamically stable patients with suspected GIB/severe anemia admitted to our hospital between March and May 2020 and who underwent VCE as the first line diagnostic modality composed the experimental group. Demographic, clinical, and outcome data was collected and analyzed. The control group comprised of patients undergoing evaluation for GIB by SOC at our hospital in January 2020. Continuous variables were compared using Student t-test. Categorical variables were compared using Fisher’s exact test. Results: Patients in both groups had similar baseline characteristics. More patients in the COVID cohort presented with melena and fewer presented with hematochezia as their manifestation of their GIB. This difference was only significant for hematochezia. Bleeding could be localized in 38 (76%) of the COVID cohort patients as compared to 36 (63%) of the historical controls using the first diagnostic modality, p \u3e 0.05 significant. Only 22 (44%) of the VCE patients underwent additional invasive diagnostic/therapeutic maneuvers and the majority were spared more invasive testing. Only 13 (26%) of the VCE patients, as compared to 47 (82%) of the historical controls underwent upper endoscopy for evaluation of GIB. There was no significant difference in transfusion requirements, degree of hemoglobin drop, in-hospital mortality, re-admission or rebleeding rates between the two groups. Conclusion: VCE appears to be a safe alternative to traditional diagnostic evaluation of GIB in the era of COVID. It reduced risk of exposure of staff to endoscopic aerosols, conserved personal protective equipment and reduced staff utilization

HIV prevention trial design in an era of effective pre-exposure prophylaxis.

CAPRISA, 2017.Abstract available in pdf

Unilateral Laminotomy with Bilateral Spinal Canal Decompression for Lumbar Stenosis: A Technical Note

Abstract Lumbar stenosis has become one of the most common spinal pathologies and one that results in neurogenic claudication, back and leg pain, and disability. The standard procedure is still an open laminectomy, which involves wide muscle retraction and extensive removal of the posterior spinal structures. This can lead to instability and the need for additional spinal fusion. We present a systemized and detailed approach to unilateral laminotomy for bilateral decompression, which we believe is superior to the standard open laminectomy in terms of intraoperative visualization, postoperative stability, and degree of invasiveness

Safety, tolerability, pharmacokinetics, and immunological activity ...

This phase 1 study showed the feasibility of combining anti-HIV bnAbs targeting different sites on the HIV envelope in people living without HIV. It also showed that the dual-antibody and triple-antibody combinations were as effective as the individual antibodies at neutralisation, thus justifying a combination approach going forward for additional monoclonal antibody studies for HIV prevention. The fact that modelling predicted the combination neutralisation titre on the basis of the single antibody titres will be valuable for future trial design of different antibody combinations

The genomic landscape of balanced cytogenetic abnormalities associated with human congenital anomalies

Despite the clinical significance of balanced chromosomal abnormalities (BCAs), their characterization has largely been restricted to cytogenetic resolution. We explored the landscape of BCAs at nucleotide resolution in 273 subjects with a spectrum of congenital anomalies. Whole-genome sequencing revised 93% of karyotypes and demonstrated complexity that was cryptic to karyotyping in 21% of BCAs, highlighting the limitations of conventional cytogenetic approaches. At least 33.9% of BCAs resulted in gene disruption that likely contributed to the developmental phenotype, 5.2% were associated with pathogenic genomic imbalances, and 7.3% disrupted topologically associated domains (TADs) encompassing known syndromic loci. Remarkably, BCA breakpoints in eight subjects altered a single TAD encompassing MEF2C, a known driver of 5q14.3 microdeletion syndrome, resulting in decreased MEF2C expression. We propose that sequence-level resolution dramatically improves prediction of clinical outcomes for balanced rearrangements and provides insight into new pathogenic mechanisms, such as altered regulation due to changes in chromosome topology

1861-10-14 David Hanscom wishes to know if his son is to be superseded by another officer

https://digitalmaine.com/cw_me_3rd_regiment_corr/1138/thumbnail.jp

No.483 David Hanscom

Transcript (48 pages) of interview by Erik Solberg with David Hanscom on September 19, 2007Hanscom (b. 1941) grew up in Rumford, Maine. His father introduced him to skiing at an early age and he skied for his high school ski team. He skied the Nordic Combined events, which were comprised of combined scores from cross country skiing and ski jumping. He talks about older equipment, such as pine-tar cross country skis, and skis that had no camber and just dragged. He went to Middlebury College prior to coming to Utah in 1970. Hanscom talks about skiing with the Wasatch Mountain Club, avalanches, and his relationship with Alexis Kelner, which resulted in the publication of a ski touring guide entitled ""Wasatch Tours."" Other topics include avalanche awareness and safety, preparation for the 1985 Salt Lake City Olympic bid, and bringing activities like the World Cup Skiing and World Cup Cross Country to Utah. David speaks about the political nature of the committees, and the people involved. He describes the ‘Little Dell' site discussions and the eventual rejection as the proposed site for the Winter Games cross country and biathlon events. David was also concerned about the ‘legacy' of the choice and the selection of a permanent site was at Wasatch Mountain State Park, which was called Soldier Hollow. The interview concludes with a review of the technological improvement of ski gear from wood skis with leather boots and toe clip bindings, to engineered metal skis and plastic boots with specialized bindings for telemark skiing. Interview is part of the Outdoor Recreation Oral History Project. Interviewed by David Hansco