Simplify, Simplify, Simplify-An Analysis of Two Decades of Judicial Review in the Veterans\u27 Benefits Adjudication System

Prior to the Veterans\u27 Judicial Review Act, the Department of Veterans Affairs existed in splendid isolation, meaning that the Department was insu- lated from judicial review by statute. After the due process revolution of the 1960s and pressure from various veterans\u27 organizations after the Vietnam War, Congress passed the Veterans\u27 Judicial Review Act in 1988. The Act created the U.S. Court of Appeals for Veterans Claims, an Article I court with exclusive jurisdiction over decisions by the Board of Veterans\u27 Appeals. This Article argues that twenty years after the Veterans\u27 Judicial Review Act was imple- mented, the system has become more complex, requiring Congress to amend the Veterans Affairs (VA) adjudication system. Specifically, this article advocates that one of the many levels of regional office review should be eliminated and that the Board of Veterans\u27 Appeals should be regionalized to simplify the sys- tem and provide more timely decisions to our nation\u27s veterans

Bi-allelic variants in CELSR3 are implicated in central nervous system and urinary tract anomalies

CELSR3 codes for a planar cell polarity protein. We describe twelve affected individuals from eleven independent families with bi-allelic variants in CELSR3. Affected individuals presented with an overlapping phenotypic spectrum comprising central nervous system (CNS) anomalies (7/12), combined CNS anomalies and congenital anomalies of the kidneys and urinary tract (CAKUT) (3/12) and CAKUT only (2/12). Computational simulation of the 3D protein structure suggests the position of the identified variants to be implicated in penetrance and phenotype expression. CELSR3 immunolocalization in human embryonic urinary tract and transient suppression and rescue experiments of Celsr3 in fluorescent zebrafish reporter lines further support an embryonic role of CELSR3 in CNS and urinary tract formation.</p

Tuning algorithms for control interfaces for users with upper-limb impairments

Objective: Approximately 40% of Americans with disabilities cannot operate wheeled mobility devices and computers adequately because of diminished upper-limb motor control, sensory limitations, and cognitive impairments. We developed tuning software that can customize control interfaces for individuals with upper-limb impairments. This study compared the differences in each parameter among different diagnostic groups. Design: The age of the subjects ranged from 18 to 80 yrs. The participants were classified into the following groups: athetoid cerebral palsy, spastic cerebral palsy, multiple sclerosis, upper-limb spasticity, and control. We used a validated tuning software protocol to customize an isometric joystick before a virtual tracing or driving task. Tuning parameters were then compared across groups. Results: Seventy-five subjects were included. Gain, the parameter responsible for force-to-output ratios, in each directional axis (leftward gain: P = 0.018; rightward gain: P = 0.003; reverse gain: P = 0.007; forward gain: P = 0.014) was significantly different across the diagnostic groups. Post hoc analyses showed that the control group required smaller leftward gain than spastic cerebral palsy, multiple sclerosis and upper-limb spasticity groups and smaller gain in all other directions compared with spastic cerebral palsy. Conclusions: Gain may be a useful parameter in tuning by clinicians, and efforts aimed at gain customization may aid the development of commercially available tuning software packages. Copyright © 2011 by Lippincott Williams & Wilkins

Joystick Control for Powered Mobility: Current State of Technology and Future Directions

Recent advancements in control interface technology have made the use of end devices such as power wheelchairs easier for individuals with disabilities, especially persons with movement disorders. In this article, we discuss the current state of control interface technology and the devices available clinically for power wheelchair control. We also discuss our research on novel hardware and software approaches that are revolutionizing joystick interface technology and allowing more customizability for individual users with special needs and abilities. Finally, we discuss the future of control interfaces and what research gaps remain

Bi-allelic variants in CELSR3 are implicated in central nervous system and urinary tract anomalies

CELSR3 codes for a planar cell polarity protein. We describe twelve affected individuals from eleven independent families with bi-allelic variants in CELSR3. Affected individuals presented with an overlapping phenotypic spectrum comprising central nervous system (CNS) anomalies (7/12), combined CNS anomalies and congenital anomalies of the kidneys and urinary tract (CAKUT) (3/12) and CAKUT only (2/12). Computational simulation of the 3D protein structure suggests the position of the identified variants to be implicated in penetrance and phenotype expression. CELSR3 immunolocalization in human embryonic urinary tract and transient suppression and rescue experiments of Celsr3 in fluorescent zebrafish reporter lines further support an embryonic role of CELSR3 in CNS and urinary tract formation

Delaying surgery for patients with a previous SARS-CoV-2 infection

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The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Public COAPI Toolkit of Open Access Policy Resources

The Coalition of Open Access Policy Institutions (COAPI, https://sparcopen.org/coapi ) is committed to sharing information and resources to assist in the development and implementation of institutional Open Access (OA) policies. The COAPI Toolkit includes a diverse collection of resources that COAPI members have developed in the course of their OA policy initiatives. These resources are openly accessible and published here under Creative Commons Attribution 4.0 licenses, unless otherwise noted on the resources themselves