A Tribute to William S. Geimer

A Tribute to William S. Geimer Meredith Susan Palmer* * Associate Dean for Student Affairs and Admissions, Washington and Lee University School of Law, J.D., 1985, Washington and Lee University. Truly, I say to you, as you did it to one of the least of these my brethren, you did it to me.1 Bill Geimer is not a man of material things. But somehow, in the material things that he chose to have around him - the mementos, the odd souvenirs, the offerings from students, clients, friends - I find the story of the man, the teacher, and the lawyer Bill Geimer is to me. In my mind's eye, I see Bill's office here at Washington and Lee as I first saw it, as a hesitant first-year law student approaching the sanctum sanctorum of a faculty member. There is a desktop name plate, regular Army issue, decorated with grenades or something equally militaristic and intimidating. But next to that is a picture of Dr. Martin Luther King, with his stirring words evoking hope for justice and freedom on earth. And next to that, a membership certificate for the Lawyer's Alliance for Nuclear Arms Control, and a drawing of Quijote, lance raised to a windmill. How could this be? While reconciling the seemingly irreconcilable is the everyday task of the law student, no trick of logic could make these disparate pieces fit; one simply had to get to know the man. That one could do so as a law student is itself part of what defines Bill Geimer. The student who came to know Bill heard a story of a kid from the rural south, off to a small state university to play basketball but who, like countless kids before him, spent a bit more time playing than studying. Come Graduation Day, with no game plan, he joined Uncle Sam's family. A grounding in tanks, guns, and tactics preceded duty with the military police, but something else happened during those years. Assigned to assist with an investigation, he finds an aptitude for the law, an appreciation of justice, and a burning sense of the unfairness of justice denied. The young man who returned from service to go on to a distinguished career as a law student at the University of North Carolina was a man with a game plan, and a mission. It was no surprise that Bill's mission as a lawyer was not in the office towers of Atlanta or the corporate boardrooms of Wall Street, but among the plain folks of Fayetteville, North Carolina, and later in the community of migrant farm labor working and living hard under the hot Carolina sun. I see another memento, this time in Bill's home. It's an odd piece of, well, let's call it folk art. Crudely carved, frankly ugly. Taste is a delicate thing, so one observes diplomatically that it is an "interesting" object. There's a story, of course, a story of a client for whom Bill had worked, putting together the paperwork to get a fledgling arts-and-crafts shop off the ground. This client, like many Bill served, claimed not to have the cash to pay. But, the client said, he could give Bill this valuable piece of work. Barter being a fundamentally more honest exchange and thus appealing to Bill, the transaction was concluded. Not until Bill brought his sculpture home did he discover the price tag stuck to the underside, for something substantially less than the agreed-upon fee. He kept the awkward thing, price tag intact, I think as a reminder of his own fallibility, of the ingenuity of the ordinary man, and of the need to forget neither. Another memento, in some ways the most important to this former student, is a large, faded, well-handled poster on the professor's office door. A young man in Carolina Blue goes up for a shot, stretching for the basket, with seconds left on the clock. Anyone who knows Bill Geimer knows that he is devoted to Carolina basketball. In fact, Bill may have spent so much time watching the Tar Heels play that he began to confuse teaching with coaching. As a former student of Bill's, I'm not sure that was a bad thing.

Better governance, better access: practising responsible data sharing in the METADAC governance infrastructure.

BACKGROUND: Genomic and biosocial research data about individuals is rapidly proliferating, bringing the potential for novel opportunities for data integration and use. The scale, pace and novelty of these applications raise a number of urgent sociotechnical, ethical and legal questions, including optimal methods of data storage, management and access. Although the open science movement advocates unfettered access to research data, many of the UK's longitudinal cohort studies operate systems of managed data access, in which access is governed by legal and ethical agreements between stewards of research datasets and researchers wishing to make use of them. Amongst other things, these agreements aim to respect the reasonable expectations of the research participants who provided data and samples, as expressed in the consent process. Arguably, responsible data management and governance of data and sample use are foundational to the consent process in longitudinal studies and are an important source of trustworthiness in the eyes of those who contribute data to genomic and biosocial research. METHODS: This paper presents an ethnographic case study exploring the foundational principles of a governance infrastructure for Managing Ethico-social, Technical and Administrative issues in Data ACcess (METADAC), which are operationalised through a committee known as the METADAC Access Committee. METADAC governs access to phenotype, genotype and 'omic' data and samples from five UK longitudinal studies. FINDINGS: Using the example of METADAC, we argue that three key structural features are foundational for practising responsible data sharing: independence and transparency; interdisciplinarity; and participant-centric decision-making. We observe that the international research community is proactively working towards optimising the use of research data, integrating/linking these data with routine data generated by health and social care services and other administrative data services to improve the analysis, interpretation and utility of these data. The governance of these new complex data assemblages will require a range of expertise from across a number of domains and disciplines, including that of study participants. Human-mediated decision-making bodies will be central to ensuring achievable, reasoned and responsible decisions about the use of these data; the METADAC model described in this paper provides an example of how this could be realised

DataSHIELD – new directions and dimensions

In disciplines such as biomedicine and social sciences, sharing and combining sensitive individual-level data is often prohibited by ethical-legal or governance constraints and other barriers such as the control of intellectual property or the huge sample sizes. DataSHIELD (Data Aggregation Through Anonymous Summary-statistics from Harmonised Individual-levEL Databases) is a distributed approach that allows the analysis of sensitive individual-level data from one study, and the co-analysis of such data from several studies simultaneously without physically pooling them or disclosing any data. Following initial proof of principle, a stable DataSHIELD platform has now been implemented in a number of epidemiological consortia. This paper reports three new applications of DataSHIELD including application to post-publication sensitive data analysis, text data analysis and privacy protected data visualisation. Expansion of DataSHIELD analytic functionality and application to additional data types demonstrate the broad applications of the software beyond biomedical sciences

Vertical and horizontal asymmetries are related to slower sprinting and jump performance in elite youth female soccer players

Inter-limb asymmetries have been shown to be greater during vertical jumping compared to horizontal jumping. Notable inter-limb differences have also been established at an early age in male youth soccer players. Furthermore, given the multi-planar nature of soccer, establishing between-limb differences from multiple jump tests is warranted. At present, a paucity of data exists regarding asymmetries in youth female soccer players and their effects on physical performance. The aims of this study were to quantify inter-limb asymmetries from unilateral jump tests and examine their effects on speed and jump performance. Nineteen elite youth female soccer players performed a single leg countermovement jump (SLCMJ), single, triple, and crossover hops for distance and a 20 m sprint test. Test reliability was good to excellent (ICC = 0.81-0.99) and variability acceptable (CV = 1.74-5.42%). A one-way ANOVA highlighted larger asymmetries from the SLCMJ compared to all other jump tests (p < 0.05). Pearson’s correlations portrayed significant relationships between vertical asymmetries from the SLCMJ and slower sprint times (r = 0.49-0.59). Significant negative relationships were also found between horizontal asymmetries during the triple hop test and horizontal jump performance (r = -0.47 to -0.58) and vertical asymmetries during the SLCMJ and vertical jump performance (r = -0.47 to -0.53). The results from this study highlight that the SLCMJ appears to be the most appropriate jump test for identifying between-limb differences with values ~12% showing negative associations with sprint times. Furthermore, larger asymmetries are associated with reduced jump performance and would appear to be direction-specific. Practitioners can use this information as normative data to be mindful of when quantifying inter-limb asymmetries and assessing their potential impact on physical performance in youth female soccer players

The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation

The level of the acute osteoporotic vertebral fracture, fracture type and grade of fracture deformation were determined in 107 consecutive patients and related to pain, disability, activities of daily living (ADL) and quality of life (QoL) after 3 weeks, 3, 6 and 12 months. Two-thirds of the fractured patients were women and with a similar average age, around 75 years, as the men. Fifty-eight of the acute fractures were located in the thoracic spine and 49 in the lumbar spine and predominantly at the Th12 and L1 levels. Sixty-nine percent of the fractures were wedge, 19% concave and 12% crush fractures. There were 22 mildly, 50 moderately and 35 severely deformed vertebrae. The grade of fracture deformation was not related to gender, age or fracture location. Severely deformed vertebrae predominantly (92%) occurred among the crush fracture type. One year after the fracture, irrespective of fracture level, fracture type or grade of fracture deformation, 4/5 still had pronounced pain and deteriorated QoL. Initial severe fracture deformation by far was the worst prognostic factor for severe lasting pain and disability, and deterioration of ADL and QoL. Factors like fracture level, lumbar fractures tended to improve steadily while thoracic deteriorated, type of fracture, the wedge and concave resulting in less pain and better QoL than the crush fracture type and gender influenced to a lesser extent the outcomes during the year after the acute fracture

'HepCheck Dublin': An Intensified Hepatitis C Screening Programme in a Homeless Population Demonstrates the Need for Alternative Models of Care

Background: Hepatitis C virus (HCV) is one of the main causes of chronic liver disease worldwide. Prevalence of HCV in homeless populations ranges from 3.9% to 36.2%. The HepCheck study sought to investigate and establish the characterisation of HCV burden among individuals who attended an intensified screening programme for HCV in homeless services in Dublin, Ireland. Methods: The HepCheck study was conducted as part of a larger European wide initiative called HepCare Europe. The study consisted of three phases; 1) all subjects completed a short survey and were offered a rapid oral HCV test; 2) a convenience sample of HCV positive participants from phase 1 were selected to complete a survey on health and social risk factors and 3) subjects were tracked along the referral pathway to identify whether they were referred to a specialist clinic, attended the specialist clinic, were assessed for cirrhosis by transient elastography (Fibroscan) and were treated for HCV. Results: 597 individuals were offered HCV screening, 73% were male and 63% reported having had a previous HCV screening. We screened 538 (90%) of those offered screening, with 37% testing positive. Among those who tested positive, 112 (56%) were ‘new positives’ and 44% were ‘known positives’. Undiagnosed HCV was prevalent in 19% of the study sample. Active past 30-day drug use was common, along with attendance for drug treatment. Unstable accommodation was the most common barrier to attending specialist appointments and accessing treatment. Depression and anxiety, dental problems and respiratory conditions were common reported health problems. 46 subjects were referred to specialised services and two subjects completed HCV treatment. Conclusions: This study demonstrates that the current hospital-based model of care is inadequate in addressing the specific needs of a homeless population and emphasises the need for a community-based treatment approach. Findings are intended to inform HepCare Europe in their development of a community-based model of care in order to engage with homeless individuals with multiple co-morbidities including substance abuse, who are affected by or infected with HCV

Subaqueous basaltic magmatic explosions trigger phreatomagmatism: a case study from Askja, Iceland

Sequences of basaltic pillow lavas that transition upwards with systematic gradation from pillow fragment breccias to fluidal bomb-bearing breccia to bomb-bearing lapilli tuffs are common at Askja volcano, Iceland. Based on the detailed textural investigation of three of these sequences, we argue that they record temporally continuous transition from effusive to explosive products that were erupted from and deposited at or near a single subaqueous vent. The recognition of such sequences is important as they provide evidence for controls on the onset of explosive activity in subaqueous environments. Such investigations are complicated by the interplay of magmatic gas expansion, phreatomagmatic and mechanical granulation fragmentation mechanisms in the subaqueous eruptive environment. All of the sequences studied at Askja have textural, componentry and sedimentological characteristics suggestive of a close genetic and spatial relationship between the pillow lavas and all of the overlying glassy clastic deposits. The identification of magma fragmentation signatures in pyroclasts was accomplished through detailed textural studies of pyroclasts within the full range of grain sizes of a given deposit i.e. bomb/blocks, lapilli and fine ash. These textural characteristics were compared and evaluated as discriminators of fragmentation in pyroclastic deposits. The presence of angular vitric clasts within the breccia and lapilli tuff displaying fragile glassy projections indicates little or no postdepositional textural modification. A shift in vesicle and clast textures between the pillow lavas and the large concentration of fluidal bombs in the breccia indicate that the phreatomagmatic explosions were initially triggered by magmatic vesiculation. The initial magmatic gas expansion may have been triggered by depressurization caused by the drainage of the ice-confined lake surrounding Askja. The Fuel Coolant Interactions (FCI) of the more efficient phreatomagmatic explosion was enabled by the increase in the surface area to volume ratio of the fluidal bombs in the water, producing a premix of magma and water. The onset and increasing influence of phreatomagmatic fragmentation is preserved in the presence of very fine blocky ash particles and diminished presence of larger particles such as fluidal bombs. The textural, sedimentological and environmental characteristics of these deposits suggest that phreatomagmatic explosions can be triggered by initial magmatic gas expansion, but that it is likely one of many mechanisms for triggering such explosions