A Severe Case of Ipilimumab-Induced Ileocolitis Refractory to Glucocorticosteroids and Infliximab

Ipilimumab is a monoclonal antibody that works as an immunotherapeutic agent through selective targeting of T cells to strengthen the response to metastatic melanoma. It is well known that this pharmaceutical agent can cause the adverse effect of colitis. We report a rare presentation of ileocolitis refractory to both glucocorticosteroids and infliximab with a resultant pneumatosis and perforation requiring subtotal colectomy and end ileostomy

Measurement of competing pathways in a shock-induced phase transition in zirconium by femtosecond diffraction

The traditional picture of solid-solid phase transformations assumes an ordered parent phase transforms into an ordered daughter phase via a single unique pathway. Zirconium and its prototypical phase transition from hexagonal close-packed (hcp) to simple hexagonal (hex-3) structure has generated considerable controversy over several decades regarding which mechanism mediates the transformation. However, a lack of in situ measurements over the relevant atomistic timescales has hindered our ability to identify the true pathway. In this study, we exploit femtosecond X-ray diffraction coupled with nanosecond laser compression to give unprecedented insights into the complexities of how materials transform at the lattice level. We observe single-crystal zirconium changing from hcp to a hex-3 structure via not one but three competing pathways simultaneously. Concurrently, we also observe a broad diffuse background underlying the sharp Bragg diffraction during the transition. We corroborate our observation of the diffuse signal with multimillion-atom molecular dynamics simulations using a machine-learned interatomic potential. Our study demonstrates that the traditional mechanistic view of transitions may fail for even an elemental metal and that the mechanisms by which materials transform are far more intricate than generally thought

The Grizzly, November 14, 1995

Date of Graduation to Change • Election Day \u2795: The Results are in! • European Adventure • Women Taking Action Through Self-Defense • Jamieson to Speak • Job Club on Campus • Pi Nu Epsilon Sponsors Messiah Chat • Can-tastic! • Debate: King of Prussia Renovations • Talk Show Circus • What I Think • How Can You Say That God is the Truth? • The Only True Judge is God • Concert Band and Jazz Ensemble to Perform Saturday • Going Medieval on the Mall • The Tempest a Success • Ethnic-American Writers Series Presents Lisa Jones • The Bookstore is Changing: Voice Your Opinion • Philosophy Major Now Available • Football Falls to Dickinson, 27-12 • Runners Compete at Regional Championships • Local Karate Students Medal at 1995 Mediterranean Games • Field Hockey Team Falls in ECAC Semishttps://digitalcommons.ursinus.edu/grizzlynews/1369/thumbnail.jp

The Grizzly, February 20, 1996

Talk Show Trouble • Major Fair 1996 • J.D. Salinger: A Grizzly Staffer!; The Skipped Diploma • Boxer Tommy Morrison HIV-Positive • Swedish Vocal Ensemble to Perform • Meet the Candidates: A Largely Biased Commentary • Take it Back, Captain Jack? • Blatant Generalizations • You Bet Your Life • Confessions of a Computer Dork • To Bus or Not to Bus • Vicki Abt Revisited • Free Speech, Abortion, and Presidential Politics • Valentine\u27s Spectacular Brings Elegant Dining to Zack\u27s • WVOU: State of the Nation • Airband Proceeds to Help Student Ryan Auch • Guys Come Up Short in Muhlenberg • Lady Bears Get Crushed by Muhlenberg • Bears Place Four at Eastern Regionalshttps://digitalcommons.ursinus.edu/grizzlynews/1375/thumbnail.jp

The Grizzly, October 10, 1995

Diversity Committee Report • The Stolen Credit Card Conundrum • The Juice is Loose • Greek Service Requirements • Green Bringing Awareness to Campus • More Rules Change Pledging • Statement on Hazing • Circus Trial = Circus Ending • Debate: U.C. Sculptures • The Myth of Unity and Diversity • More Than a Protest? • Homosexuality: Not a Good Alternative • Intelligently Expressing Your Opinion? • Gossip, Responsibility, and Education • Failing Ourselves, Failing Others • Shackled by the Life Chain • The Not-so-Traditional Tradition: Is There Really a Fall Day? • No ID, No Cover Charge • Alumna Spotlight: Mary Harris • Trumpeter Mike Mossman to Lead Jazz Quintet at Ursinus • Sophomores To Focus On Campus Pride • Dr. Juan Espadas Receives Award • Team Loses to Widener and F&M • Ursinus Finishes Eighth at Susquehanna Fall Classic • Big Plays Doom Football Team • Streak Continues • Team Splits Conference Gameshttps://digitalcommons.ursinus.edu/grizzlynews/1365/thumbnail.jp

ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

BACKGROUND: In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. OBJECTIVES: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines. METHODS: This systematic review was conducted on 4 critical questions, each focusing on the adoption and effectiveness of 4 intervention strategies: (1) reminders, (2) educational outreach visits, (3) audit and feedback, and (4) provider incentives. A scoping review of the Rx for Change database of systematic reviews was used to identify promising guideline implementation interventions aimed at providers. Inclusion and exclusion criteria were developed a priori for each question, and the published literature was initially searched up to 2012, and then updated with a supplemental search to 2015. Two independent reviewers screened the returned citations to identify relevant reviews and rated the quality of each included review. RESULTS: Audit and feedback and educational outreach visits were generally effective in improving both process of care (15 of 21 reviews and 12 of 13 reviews, respectively) and clinical outcomes (7 of 12 reviews and 3 of 5 reviews, respectively). Provider incentives showed mixed effectiveness for improving both process of care (3 of 4 reviews) and clinical outcomes (3 reviews equally distributed between generally effective, mixed, and generally ineffective). Reminders showed mixed effectiveness for improving process of care outcomes (27 reviews with 11 mixed and 3 generally ineffective results) and were generally ineffective for clinical outcomes (18 reviews with 6 mixed and 9 generally ineffective results). Educational outreach visits (2 of 2 reviews), reminders (3 of 4 reviews), and provider incentives (1 of 1 review) were generally effective for cost reduction. Educational outreach visits (1 of 1 review) and provider incentives (1 of 1 review) were also generally effective for cost-effectiveness outcomes. Barriers to clinician adoption or adherence to guidelines included time constraints (8 reviews/overviews); limited staffing resources (2 overviews); timing (5 reviews/overviews); clinician skepticism (5 reviews/overviews); clinician knowledge of guidelines (4 reviews/overviews); and higher age of the clinician (1 overview). Facilitating factors included guideline characteristics such as format, resources, and end-user involvement (6 reviews/overviews); involving stakeholders (5 reviews/overviews); leadership support (5 reviews/overviews); scope of implementation (5 reviews/overviews); organizational culture such as multidisciplinary teams and low-baseline adherence (9 reviews/overviews); and electronic guidelines systems (3 reviews). CONCLUSION: The strategies of audit and feedback and educational outreach visits were generally effective in improving both process of care and clinical outcomes. Reminders and provider incentives showed mixed effectiveness, or were generally ineffective. No general conclusion could be reached about cost effectiveness, because of limitations in the evidence. Important gaps exist in the evidence on effectiveness of implementation interventions, especially regarding clinical outcomes, cost effectiveness and contextual issues affecting successful implementation

Microcavity-like exciton-polaritons can be the primary photoexcitation in bare organic semiconductors.

Strong-coupling between excitons and confined photonic modes can lead to the formation of new quasi-particles termed exciton-polaritons which can display a range of interesting properties such as super-fluidity, ultrafast transport and Bose-Einstein condensation. Strong-coupling typically occurs when an excitonic material is confided in a dielectric or plasmonic microcavity. Here, we show polaritons can form at room temperature in a range of chemically diverse, organic semiconductor thin films, despite the absence of an external cavity. We find evidence of strong light-matter coupling via angle-dependent peak splittings in the reflectivity spectra of the materials and emission from collective polariton states. We additionally show exciton-polaritons are the primary photoexcitation in these organic materials by directly imaging their ultrafast (5 × 106 m s-1), ultralong (~270 nm) transport. These results open-up new fundamental physics and could enable a new generation of organic optoelectronic and light harvesting devices based on cavity-free exciton-polaritons.EPSRC (EP/R025517/1), EPSRC (EP/M025330/1), ERC Horizon 2020 (grant agreements No 670405 and No 758826), ERC (ERC-2014-STG H2020 639088), Netherlands Organisation for Scientific Research, Swedish Research Council (VR, 2014-06948), Knut and Alice Wallenberg Foundation 3DEM-NATUR (no. 2012.0112), Royal Commission for the Exhibition of 1851, CNRS (France), US Department of Energy, Office of Science, Basic Energy Sciences, CPIMS Program, Early Career Research Program (DE-SC0019188)

Brain imaging of the cortex in ADHD: a coordinated analysis of large-scale clinical and population-based samples

Objective: Neuroimaging studies show structural alterations of various brain regions in children and adults with attention deficit hyperactivity disorder (ADHD), although nonreplications are frequent. The authors sought to identify cortical characteristics related to ADHD using large-scale studies. Methods: Cortical thickness and surface area (based on the Desikan–Killiany atlas) were compared between case subjects with ADHD (N=2,246) and control subjects (N=1,934) for children, adolescents, and adults separately in ENIGMA-ADHD, a consortium of 36 centers. To assess familial effects on cortical measures, case subjects, unaffected siblings, and control subjects in the NeuroIMAGE study (N=506) were compared. Associations of the attention scale from the Child Behavior Checklist with cortical measures were determined in a pediatric population sample (Generation-R, N=2,707). Results: In the ENIGMA-ADHD sample, lower surface area values were found in children with ADHD, mainly in frontal, cingulate, and temporal regions; the largest significant effect was for total surface area (Cohen’s d=−0.21). Fusiform gyrus and temporal pole cortical thickness was also lower in children with ADHD. Neither surface area nor thickness differences were found in the adolescent or adult groups. Familial effects were seen for surface area in several regions. In an overlapping set of regions, surface area, but not thickness, was associated with attention problems in the Generation-R sample. Conclusions: Subtle differences in cortical surface area are widespread in children but not adolescents and adults with ADHD, confirming involvement of the frontal cortex and highlighting regions deserving further attention. Notably, the alterations behave like endophenotypes in families and are linked to ADHD symptoms in the population, extending evidence that ADHD behaves as a continuous trait in the population. Future longitudinal studies should clarify individual lifespan trajectories that lead to nonsignificant findings in adolescent and adult groups despite the presence of an ADHD diagnosis

New member of the V1V2-directed CAP256-VRC26 lineage that shows increased breadth and exceptional potency.

CAPRISA, 2016.Abstract available in pdf