Theatrical Illness: Tuberculosis and HIV as Presented by La Boheme and Rent

Note: In lieu of an abstract, this is the article\u27s first paragraph. The musical Rent made its Broadway debut on January 25, 1996, a century after the opening performance of the opera, La Boheme. This correlation was a coincidence, though Rent draws significantly on the story of La Boheme, to the extent that a New York Times reviewer deemed it a contemporary answer to Puccini\u27s \u27Boheme. \u27 Each of these productions presents the troubles and tragedies of the bohemian lifestyle in a specific time and place-La Boheme in Paris during the 1830s and Rent in New York City during 1989. Disease, too, is a major theme in each: tuberculosis in La Boheme, and HIV in Rent. Each of the plays illustrate the different effects of the diseases with respect to conceptions of life and death, identity, spiritual promotion, and time. The historical and medical contexts of tuberculosis and HIV manifest in different perceptions of diagnosis and contagion. The extent of influence La Boheme had on Rent calls for a comparison of the representations of these two diseases in their respective historical contexts

Design of a Mission Data Storage and Retrieval System for NASA Dryden Flight Research Center

The Western Aeronautical Test Range (WATR) at the NASA Dryden Flight Research Center (DFRC) employs the WATR Integrated Next Generation System (WINGS) for the processing and display of aeronautical flight data. This report discusses the post-mission segment of the WINGS architecture. A team designed and implemented a system for the near- and long-term storage and distribution of mission data for flight projects at DFRC, providing the user with intelligent access to data. Discussed are the legacy system, an industry survey, system operational concept, high-level system features, and initial design efforts

Pedaling and Public Health: Evaluating a Proposed Bike-Share Program in Philadelphia From a Public Health Perspective

As bike-share programs have gained prominence in Europe and in the United States, their advocates have often cited the health benefits associated with biking for active transportation. This has been the case in Philadelphia as well as many countries throughout the United States. In 2010, the Philadelphia Bikeshare Concept Study provided a proposal for a specific program to be implemented in Philadelphia. Although improvements to public health were cited as motivations for this program, the study did not include in-depth analysis of the program's potential effects on public health. This thesis investigates whether the proposed program can indeed be considered a public health initiative, and if so, what the implications of framing it as a public health initiative may be for the overall design of the program. A statistical analysis of the distribution of the health conditions that could be prevented through active transportation highlights spatial and sociodemographic inequalities, suggesting that in order to effectively promote public health, Philadelphia's bike-share program must take active steps to target the city's most vulnerable communities

Physician Executive Leadership: Assessing a Student-Led Approach to Healthcare Leadership Education in Medical School

Poster presented at: 14th Annual AMA Research Symposium in Orlando, Fl Objective: To investigate the effectiveness of Physican Leadership, an open access, student-led healthcare leadership program at Sidney Kimmel Medical College, in preparing to face five key emerging topics in medical practice: healthcare economics, health policy, care and quality and safety, law and medicine, and patient experience. The Problem: Gaps in Medical Education Healthcare in the US continues to evolve, and topics such as health policy, health finance, and patient experience are not central to the practice of medicine. However, the sheer volume of material students are required to learn in the preclinical years makes it challenging to introduce new subjects into traditional medical school curricula. As a result, these topics in healthcare leadership are often left out. Indeed, only 40-50% of medical student report appropriate training in the practice of medicine, including subjects as medical economics, healthcare systems, and managed care.https://jdc.jefferson.edu/pel/1002/thumbnail.jp

No effect of tart cherry juice or pomegranate juice on recovery from exercise-induced muscle damage in non-resistance trained men

Tart cherry juice (TC) and pomegranate juice (POM) have been demonstrated to reduce symptoms of exercise-induced muscle damage (EIMD), but their effectiveness has not been compared. This randomized, double-blind, parallel study compared the effects of TC and POM on markers of EIMD. Thirty-six non-resistance trained men (age 24.0 (Interquartile Range (IQR) 22.0, 33.0) years, body mass index (BMI) 25.6 ± 4.0 kg·m−2) were randomly allocated to consume 2 × 250 mL of: TC, POM, or an energy-matched fruit-flavored placebo drink twice daily for nine days. On day 5, participants undertook eccentric exercise of the elbow flexors of their non-dominant arm. Pre-exercise, immediately post-exercise, and at 24 h, 48 h, 72 h and 96 h post-exercise, maximal isometric voluntary contraction (MIVC), delayed onset muscle soreness (DOMS), creatine kinase (CK), and range of motion (ROM) were measured. The exercise protocol induced significant decreases in MIVC (p 0.001; max decrease of 26.8%, 24 h post-exercise) and ROM (p = 0.001; max decrease of 6.8%, 72 h post-exercise) and significant increases in CK (p = 0.03; max increase 1385 U·L−1, 96 h post-exercise) and DOMS (p 0.001; max increase of 26.9 mm, 48 h post-exercise). However, there were no statistically significant differences between treatment groups (main effect of group p > 0.05 or group x time interaction p > 0.05). These data suggest that in non-resistance trained men, neither TC nor POM enhance recovery from high-force eccentric exercise of the elbow flexors

Physician Executive Leadership: Student-Led Curriculum to Fill Gaps in Traditional Medical Education

Students at Sidney Kimmel Medical College (SKMC) have identified a gap in the traditional medical curriculum surrounding topics such as telehealth, the patient experience, health policy, medical malpractice, and health care entrepreneurship and innovation, and in response have initiated a student-centered, student-led, student-driven program called Physician Executive Leadership (PEL). PEL provides students with a variety of avenues to engage with these topics, such as lectures from leaders in each of these fields, easy access to weekly news articles on current events in health care, targeted review sessions on the US health care system, and the opportunity to voice and develop ideas through an online publication. To identify the gaps in medical education PEL is best suited to fill, we administered a survey to 174 students at Sidney Kimmel Medical College.The survey contained 20 multiple-choice questions to assess general knowledge on health insurance and reimbursement, health care policy and reform, and care quality and patient experience. It also included a subjective self-assessment of students’ understanding of and interest in these topics. Overall, we found that although the traditional medical school curriculum improved students\u27 understanding of these topics from year to year, it is not sufficient on it\u27s own: on average, students failed to achieve a passing score of 70% in any of the categories tested. Further illustrating the importance of this program, students self-identified a gap between their current level of understanding and what they want to know. Please visit our website www.physicianexecutiveleadership.com to learn more!https://jdc.jefferson.edu/pel/1000/thumbnail.jp

Identifying social distress: a cross-sectional survey of social outcomes 12 to 36 months after colorectal cancer diagnosis

Purpose: To establish the prevalence and determinants of poor social outcomes after a diagnosis of colorectal cancer (CRC). Patients and Methods: All 12- to 36-month survivors of CRC (International Classification of Diseases [10th revision] codes C18 to C20) diagnosed in 2010 or 2011 and treated in the English National Health Service were identified and sent a questionnaire from their treating cancer hospital. This included the Social Difficulties Inventory, a 16-item scale of social distress (SD) comprising everyday living, money matters, and self and others subscales, plus five single items. Sociodemographic and clinical data were also collected. Analyses using descriptive statistics, 2 tests, and logistic regression models were conducted. Results: Response rate was 63.3% (21,802 of 34,467). Of the 21,802 participants, 17,830 (81.8%) completed all SD items; 2,688 (15.1%) of these 17,830 respondents were classified as experiencing SD (everyday living, 19.5%; money matters, 15.6%; self and others, 18.1%). Multivariable analysis demonstrated having three long-term conditions was the strongest predictor of SD (odds ratio [OR], 6.64; 95% CI, 5.67 to 7.77 compared with no long-term conditions), followed by unemployment (OR, 5.11; 95% CI, 4.21 to 6.20 compared with being employed), having recurrent or nontreatable disease (OR, 2.75; 95% CI, 2.49 to 3.04 compared with being in remission), and having a stoma (OR, 2.10; 95% CI, 1.86 to 2.36 compared with no stoma). Additional predictors of SD were young age (< 55 years), living in a more deprived area, nonwhite ethnicity, having advanced-stage disease, having undergone radiotherapy, and being a carer. Conclusion: Although it is reassuring a majority do not experience social difficulties, a minority reported significant SD 12 to 36 months after diagnosis of CRC. The identified clinical and social risk factors are easy to establish and should be used to target support

Validation of an algorithm using inpatient electronic health records to determine the presence and severity of cirrhosis in patients with hepatocellular carcinoma in England: an observational study.

OBJECTIVES:Outcomes in hepatocellular carcinoma (HCC) are determined by both cancer characteristics and liver disease severity. This study aims to validate the use of inpatient electronic health records to determine liver disease severity from treatment and procedure codes. DESIGN:Retrospective observational study. SETTING:Two National Health Service (NHS) cancer centres in England. PARTICIPANTS:339 patients with a new diagnosis of HCC between 2007 and 2016. MAIN OUTCOME:Using inpatient electronic health records, we have developed an optimised algorithm to identify cirrhosis and determine liver disease severity in a population with HCC. The diagnostic accuracy of the algorithm was optimised using clinical records from one NHS Trust and it was externally validated using anonymised data from another centre. RESULTS:The optimised algorithm has a positive predictive value (PPV) of 99% for identifying cirrhosis in the derivation cohort, with a sensitivity of 86% (95% CI 82% to 90%) and a specificity of 98% (95% CI 96% to 100%). The sensitivity for detecting advanced stage cirrhosis is 80% (95% CI 75% to 87%) and specificity is 98% (95% CI 96% to 100%), with a PPV of 89%. CONCLUSIONS:Our optimised algorithm, based on inpatient electronic health records, reliably identifies and stages cirrhosis in patients with HCC. This highlights the potential of routine health data in population studies to stratify patients with HCC according to liver disease severity

One-step fabrication of GeSn branched nanowires

We report for the first time the self-catalyzed, single-step growth of branched GeSn nanostructures by a vapor–liquid–solid mechanism. These typical GeSn nanostructures consist of ⟨111⟩-oriented, Sn-rich (∼8 atom %) GeSn “branches” grown epitaxially on GeSn “trunks”, with a Sn content of ∼4 atom %. The trunks were seeded from Au0.80Ag0.20 nanoparticles followed by the catalytic growth of secondary branches (diameter ∼ 50 nm) from the excess of Sn on the sidewalls of the trunks, as determined by high-resolution electron microscopy and energy-dispersive X-ray analysis. The nanowires, with ⟨111⟩-directed GeSn branches oriented at ∼70° to the trunks, have no apparent defects or change in crystal structure at the trunk–branch interface; structural quality is retained at the interface with epitaxial crystallographic relation. The electrochemical performance of these highly ordered GeSn nanostructures was explored as a potential anode material for Li-ion batteries, due to their high surface-to-volume ratio and increased charge carrier pathways. The unique structure of the branched nanowires led to high specific capacities comparable to, or greater than, those of conventional Ge nanowire anode materials and Ge1–xSnx nanocrystals