3,473 research outputs found

    Prediction-based classification for longitudinal biomarkers

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    Assessment of circulating CD4 count change over time in HIV-infected subjects on antiretroviral therapy (ART) is a central component of disease monitoring. The increasing number of HIV-infected subjects starting therapy and the limited capacity to support CD4 count testing within resource-limited settings have fueled interest in identifying correlates of CD4 count change such as total lymphocyte count, among others. The application of modeling techniques will be essential to this endeavor due to the typically nonlinear CD4 trajectory over time and the multiple input variables necessary for capturing CD4 variability. We propose a prediction-based classification approach that involves first stage modeling and subsequent classification based on clinically meaningful thresholds. This approach draws on existing analytical methods described in the receiver operating characteristic curve literature while presenting an extension for handling a continuous outcome. Application of this method to an independent test sample results in greater than 98% positive predictive value for CD4 count change. The prediction algorithm is derived based on a cohort of n=270n=270 HIV-1 infected individuals from the Royal Free Hospital, London who were followed for up to three years from initiation of ART. A test sample comprised of n=72n=72 individuals from Philadelphia and followed for a similar length of time is used for validation. Results suggest that this approach may be a useful tool for prioritizing limited laboratory resources for CD4 testing after subjects start antiretroviral therapy.Comment: Published in at http://dx.doi.org/10.1214/10-AOAS326 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

    Teaching Social Justice Lawyering: Systematically Including Community Legal Education in Law School Clinics

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    There is a body of literature on clinical legal theory that urges a focus in clinics beyond the single client to an explicit teaching of social justice lawyering. This Article adds to this emerging body of work by discussing the valuable role community legal education plays as a vehicle for teaching skills and values essential to single client representation and social justice lawyering. The Article examines the theoretical underpinnings of clinical legal education, community organizing and community education and how they influenced the authors’ design and implementation of community legal education within their clinics. It then discusses two projects designed to help victims of domestic violence. The first project has been ongoing for several years in a clinic with a long history of incorporating community education into its work. The second project was undertaken for the first time by a clinic teaching community legal education after a long hiatus. Through the discussion of these two projects, the Article evaluates and explains the pedagogical and logistical successes and challenges of incorporating community education into clinical programs and assesses the justice outcomes of their community work, both to the communities served and to their students

    Teaching Social Justice Lawyering: Systematically Including Community Legal Education in Law School Clinics

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    There is a body of literature on clinical legal theory that urges a focus in clinics beyond the single client to an explicit teaching of social justice lawyering. This Article adds to this emerging body of work by discussing the valuable role community legal education plays as a vehicle for teaching skills and values essential to single client representation and social justice lawyering. The Article examines the theoretical underpinnings of clinical legal education, community organizing and community education and how they influenced the authors’ design and implementation of community legal education within their clinics. It then discusses two projects designed to help victims of domestic violence. The first project has been ongoing for several years in a clinic with a long history of incorporating community education into its work. The second project was undertaken for the first time by a clinic teaching community legal education after a long hiatus. Through the discussion of these two projects, the Article evaluates and explains the pedagogical and logistical successes and challenges of incorporating community education into clinical programs and assesses the justice outcomes of their community work, both to the communities served and to their students

    Contribution of Drosophila DEG/ENaC Genes to Salt Taste

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    AbstractThe ability to detect salt is critical for the survival of terrestrial animals. Based on amiloride-dependent inhibition, the receptors that detect salt have been postulated to be DEG/ENaC channels. We found the Drosophila DEG/ENaC genes Pickpocket11 (ppk11) and Pickpocket19 (ppk19) expressed in the larval taste-sensing terminal organ and in adults on the taste bristles of the labelum, the legs, and the wing margins. When we disrupted PPK11 or PPK19 function, larvae lost their ability to discriminate low concentrations of Na+ or K+ from water, and the electrophysiologic responses to low salt concentrations were attenuated. In both larvae and adults, disrupting PPK11 or PPK19 affected the behavioral response to high salt concentrations. In contrast, the response of larvae to sucrose, pH 3, and several odors remained intact. These results indicate that the DEG/ENaC channels PPK11 and PPK19 play a key role in detecting Na+ and K+ salts

    Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions: Workshop Report

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    This report on Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions summarizes the presentations, deliberations and findings of a workshop at NASA Ames Research Center, March 24-26, 2015, which was attended by more than 100 participants representing a diverse mix of science, engineering, technology, and policy areas. The main objective of the three-day workshop was to identify specific knowledge gaps that need to be addressed to make incremental progress towards the development of NASA Procedural Requirements (NPRs) for Planetary Protection during human missions to Mars

    Identification of the intermediate allosteric species in human hemoglobin reveals a molecular code for cooperative switching

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    The 10 ligation species of human cyanomethemoglobin were previously found to distribute into three discrete cooperative free energy levels according to a combinatorial code (i.e., dependent on both the number and configuration of ligated subunits). Analysis of this distribution showed that the hemoglobin tetramer occupies a third allosteric state in addition to those of the unligated (T) and fully ligated (R) species. To determine the nature of the intermediate allosteric state, we have studied the effects of pH, temperature, and single-site mutations on its free energy of quaternary assembly, in parallel with corresponding data on the deoxy (T) and fully ligated (R) species. Results indicate that the intermediate allosteric tetramer has the deoxy (T) quaternary structure. This finding, together with the resolved energetic distribution of the 10 microstates reveals a symmetry rule for quaternary switching - i.e., switching from T to R occurs whenever a binding step creates a tetramer with one or more ligated subunits on each side of the α1β2 intersubunit contact. These studies also reveal significant cooperativity within each α1β2 dimer of the T-state tetramer. The ligand-induced tertiary free energy alters binding affinity within the T structure by 170-fold prior to quaternary switching

    Building a Sustainable Comprehensive Women's Health Program: The Michigan Model

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    The Women's Health Program at the University of Michigan was established in 1993 and has developed into a successful, federally supported program that links clinical research and education activities across the University. It has focused on human resource capacity building, sustainable financial support and infrastructure, and adaptability to change and opportunities. Widely accepted standards, demonstrated value, committed leaders/champions, and participatory culture have contributed to its success and are important to its future.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63102/1/jwh.2006.0192.pd

    Associations between Relative Power on Different Measures of Change of Direction Speed

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    Change of direction speed (CODS) is an important characteristic for successful athletic performance in most sports. However, it stands to reason that different CODS tests may have different athletic attributes that influence success on these assessments. PURPOSE: The purpose of this study was to examine the relationships between relative power and two different measures of CODS. METHODS: Data from 39 NCAA division I (age: 20.1 ± 1.2yrs; height: 164.9 ± 6.5cm; body mass: 63.8 ± 7.8kg) and 18 NCAA division II (age: 19.3 ± 1.2yrs; height: 165.7 ± 5.7cm; body mass: 63.3 ± 6.3kg) women’s soccer teams was collected and analyzed for this study. The 505-agility test (505) and modified T-test (Mod T) were performed on a turf/grass soccer field following a standardized dynamic warm-up. Data was analyzed using IBM SPSS statistics (Version 24.0; IBM Corporation, New York, NY). Person’s correlation coefficient was used to relate relative power to the 505 and Mod T. Linear regression analysis was completed to determine the influence of relative power on the different measures of CODS. RESULTS: A significant large correlation was found between relative power and 505 (r = -0.714, p = 0.0001), but not Mod T (r = 0.259, p = 0.059). Furthermore, regression analysis revealed 51% of the variance in 505 was explained by relative power (p = 0.0001). In comparison, only 7% of the variance in Mod T was explained by relative power (p = 0.059). CONCLUSION: The results of this study reveal a stronger relationship between relative power to 505 performance, but not Mod T. This may be explained by the nature of the tests themselves. Based on the need for greater hip and knee flexion when performing the 505 test in contrast to the Mod. T, it appears that greater lower-body power may significantly impact performance on this measure. This suggests that measures of COD that require less hip and knee flexion may be more reliant on foot speed and quickness. When assessing CODS, strength and conditioning professionals should consider multiple measures of CODS to determine the ability of an athlete to change direction when performing sport-specific tasks
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