NIPS + FTS = ?: A consideration of the next steps of prenatal screening

Since its introduction less than four years ago, noninvasive prenatal screening (NIPS) has been widely adopted as a screening tool for women at a high-risk for fetal aneuploidy. As use expands into the general population, questions arise concerning the integration of NIPS into preexisting screening routines. We surveyed 208 practicing genetic counselors to assess the current use of NIPS. Genetic counselors were queried as to the advantages/disadvantages of offering NIPS to all patients regardless of a priori risk. Results indicate substantial variation in practice. The majority of participants report offering NIPS in conjunction with another method of screening for fetal aneuploidy, indicating that NIPS is being used as an addition rather than as a replacement. Most offer NIPS with another form of screening, predominantly either first trimester ultrasound, NT, and an MSAFP (45.1%, n=78), or first trimester serum screening, with or without an NT, and an MSAFP (19.7%, n=34). Counselors are evenly split on the merits of expanding the use of NIPS to the general population (con: 55.3%, n=105; pro: 44.7%, n=85). The lack of consensus among respondents suggests that practice guidelines might benefit counselors at this time. In addition, the respondents emphasize the significance of better educating providers about the risks, benefits, and limitations of the test

Ownership as a Basis for Summary Jurisdiction in Chapter XI Arrangements

Noting the importance of determining whether a bankruptcy court has summary jurisdiction, the authors point out that, absent consent, the factors necessary to make this determination are uncertain. This paper examines the controversy as to whether possession of disputed property by the debtor is the only sufficient basis to give summary jurisdiction or whether ownership, apart from possession, will also suffice. The authors examine the commentators-Collier and Remington-as well as the case law and pending legislation on the issue. In conclusion, they recommend the adoption of a substantial proprietary interest test as a standard for summary jurisdiction

MEMS 411: Rotational Inertia Demo

The purpose of this project was to create a tool that demonstrates rotational inertia. Rotational inertia is a topic that is taught in many physics classes except in our experiences, there has not been a safe and easy way to demonstrate the concept. The classic method is having someone sit on a swivel chair with weights in their arms, but this can lead to injuries due to the unsafe nature of the method. We have created a device that can easily showcase rotational inertia, even to children by creating this device for a science center demo. With this device, anyone can understand the effects of rotational inertia in a fun, simple, and safe way

An Apparatus to Quantify Lengthwise Flexural Rigidity Profiles of Endovascular Devices

Endovascular procedures require access to distal anatomical sites through the vasculature using catheters and guidewires. Quantitative frameworks for device behavior during procedures hold the potential to drive device design through greater understanding of the mechanical behavior of endovascular devices, and offer the potential to personalize care based on a patient\u27s particular vascular anatomy. However, data that would facilitate this technology are lacking, partly due to undisclosed material properties from manufacturers and partly due to the intricate variations along the length of each device due to material changes and the intersections between them. We developed a three-point bend test methodology on a custom apparatus to measure lengthwise flexural rigidity profiles of endovascular devices commonly used to target the neurovasculature. The methodology demonstrated high repeatability and was able to characterize transition zones. We applied the method to generate the first comprehensive, quantitative library of device flexural rigidities, spanning guidewires, intermediate guide catheters, and long sheaths. Additional plots examining relationships between flexural rigidity, device diameter, and length reveal application-specific trends in flexural properties. This methodology and the data allow for standardized characterization and comparisons to aid device selection, and have the potential to both enhance surgical planning and inform future innovation

Effects of aging and coronary artery disease on sympathetic neural recruitment strategies during end-inspiratory and end-expiratory apnea

In response to acute physiological stress, the sympathetic nervous system modifies neural outflow through increased firing frequency of lower-threshold axons, recruitment of latent subpopulations of higher-threshold axons, and/or acute modifications of synaptic delays. Aging and coronary artery disease (CAD) often modify efferent muscle sympathetic nerve activity (MSNA). Therefore, we investigated whether CAD (n = 14; 61 ± 10 yr) and/or healthy aging without CAD (OH; n = 14; 59 ± 9 yr) modified these recruitment strategies that normally are observed in young healthy (YH; n = 14; 25 ± 3 yr) individuals. MSNA (microneurography) was measured at baseline and during maximal voluntary end-inspiratory (EI) and end-expiratory (EE) apneas. Action potential (AP) patterns were studied using a novel AP analysis technique. AP frequency increased in all groups during both EI- and EE-apnea (all P \u3c 0.05). The mean AP content per integrated burst increased during EI- and EE-apnea in YH (EI: Δ6 ± 4 APs/burst; EE: Δ10 ± 6 APs/burst; both P \u3c 0.01) and OH (EI: Δ3 ± 3 APs/burst; EE: Δ4 ± 5 APs/burst; both P \u3c 0.01), but not in CAD (EI: Δ1 ± 3 APs/burst; EE: Δ2 ± 3 APs/burst; both P = NS). When APs were binned into clusters according to peak-to-peak amplitude, total clusters increased during EI- and EE-apnea in YH (EI: Δ5 ± 2; EE: Δ6 ± 4; both P \u3c 0.01), during EI-apnea only in OH (EI: Δ1 ± 2; P \u3c 0.01; EE: Δ1 ± 2; P = NS), and neither apnea in CAD (EI: Δ -2 ± 2; EE: Δ -1 ± 2; both P = NS). In all groups, the AP cluster size-latency profile was shifted downwards for every corresponding cluster during EI- and EE-apnea (all P \u3c 0.01). As such, inherent dysregulation exists within the central features of apnea-related sympathetic outflow in aging and CAD

Age Differences in Barriers to Cardiac Rehabilitation

Older patients with heart disease experience more CR barriers, and the nature of their barriers differs from those of younger patients. Health care professionals should identify and address these barriers in order to optimize the benefits of CR use for elderly patients.York's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c