Modular and Cooperative Medical Devices and Related Systems and Methods

The various embodiments disclosed herein relate to modular medical devices, including various devices with detachable modular components and various devices with pivotally attached modular components. Additional embodiments relate to procedures in which various of the devices are used cooperatively. Certain embodiments of the medical devices are robotic in vivo devices

Generating Flower Images and Shapes with Compositional Pattern Producing Networks

Various embodiments are disclosed for generating an image from a Compositional Pattern Producing Network (CPPN). One such method includes receiving, in the CPPN, a series of polar coordinates {r, 0}; outputting, by the CPPN, a series of pixel values, each of the pixel values corresponding to one of the polar coordinates; and displaying the pixel values at the corresponding polar coordinates to product the image

METHODS, SYSTEMS, AND DEVICES FOR SURGICAL ACCESS AND PROCEDURES

The embodiments disclosed herein relate to various medical device components, including components that can be incorporated into robotic and/or in vivo medical devices. Certain embodiments include various actuation system embodiments, including fluid actuation systems, drive train actuation systems, and motorless actuation systems. Additional embodiments include a reversibly lockable tube that can provide access for a medical device to a patient\u27s cavity and further provides a reversible rigidity or stability during operation of the device. Further embodiments include various operational components for medical devices, including medical device arm mechanisms that have both axial and rotational movement while maintaining a relatively compact structure. medical device winch components, medical device biopsy/stapler/clamp mechanisms, and medical device adjustable focus mechanisms

The long noncoding RNA, treRNA, decreases DNA damage and is associated with poor response to chemotherapy in chronic lymphocytic leukemia.

The study of long noncoding RNAs (lncRNAs) is an emerging area of cancer research, in part due to their ability to serve as disease biomarkers. However, few studies have investigated lncRNAs in chronic lymphocytic leukemia (CLL). We have identified one particular lncRNA, treRNA, which is overexpressed in CLL B-cells. We measured transcript expression in 144 CLL patient samples and separated samples into high or low expression of treRNA relative to the overall median. We found that high expression of treRNA is significantly associated with shorter time to treatment. High treRNA also correlates with poor prognostic indicators such as unmutated IGHV and high ZAP70 protein expression. We validated these initial findings in samples collected in a clinical trial comparing the nucleoside analog fludarabine alone or in combination with the alkylating agent cyclophosphamide in untreated CLL samples collected prior to starting therapy (E2997). High expression of treRNA was independently prognostic for shorter progression free survival in patients receiving fludarabine plus cyclophosphamide. Given these results, in order to study the role of treRNA in DNA damage response we generated a model cell line system where treRNA was over-expressed in the human B-CLL cell line OSU-CLL. Relative to the vector control line, there was less cell death in OSU-CLL over-expressing treRNA after exposure to fludarabine and mafosfamide, due in part to a reduction in DNA damage. Therefore, we suggest that treRNA is a novel biomarker in CLL associated with aggressive disease and poor response to chemotherapy through enhanced protection against cytotoxic mediated DNA damage

Language Model Crossover: Variation through Few-Shot Prompting

This paper pursues the insight that language models naturally enable an intelligent variation operator similar in spirit to evolutionary crossover. In particular, language models of sufficient scale demonstrate in-context learning, i.e. they can learn from associations between a small number of input patterns to generate outputs incorporating such associations (also called few-shot prompting). This ability can be leveraged to form a simple but powerful variation operator, i.e. to prompt a language model with a few text-based genotypes (such as code, plain-text sentences, or equations), and to parse its corresponding output as those genotypes' offspring. The promise of such language model crossover (which is simple to implement and can leverage many different open-source language models) is that it enables a simple mechanism to evolve semantically-rich text representations (with few domain-specific tweaks), and naturally benefits from current progress in language models. Experiments in this paper highlight the versatility of language-model crossover, through evolving binary bit-strings, sentences, equations, text-to-image prompts, and Python code. The conclusion is that language model crossover is a promising method for evolving genomes representable as text

Evaluation of Pharmacists' Knowledge of Centers for Medicare and Medicaid Services Medication Drug Plan Star Ratings

Objectives: 1) Evaluate Ohio pharmacists’ awareness about Centers for Medicare and Medicaid Service’s (CMS) Medication Drug Plan (MDP) Star Ratings, 2) identify gaps in knowledge about CMS MDP Star Ratings, and 3) determine interest in continuing education (CE) opportunities with CMS PDP Star Ratings. Methods: A cross-sectional, online survey was conducted in February 2015. The 16-question, pilot-tested survey targeted licensed pharmacists in Ohio practicing in the ambulatory care or community setting. Respondents were surveyed on their self-assessed and actual knowledge on CMS MDP Star Ratings. Respondent’s interest in and preferred source and delivery of CE were evaluated. Data were collected in aggregate; descriptive statistics, ANOVA and chi-square tests were used to characterize and evaluate data. Responses were summarized for all 16 questions using frequencies and percentages. Results: Of 13,235 licensed Ohio pharmacists, 913 pharmacists completed the survey (6.9% response rate). 454 (49.7%) respondents were eligible to complete the survey based on practice setting and of those, 390 (85.9%) were aware of CMS’s MDP Star Ratings. Respondents’ self-assessment of their knowledge regarding CMS Star Ratings aligned with their actual knowledge as defined by performance on three multi-statement knowledge-based assessments. Significant differences existed between self-assessed knowledge groups in their ability to answer greater than 50% of questions correctly (p < .001). The majority of respondents (81.2%) indicated interest in receiving further education on CMS Star Ratings. Conclusions: Survey respondents are aware of CMS MDP Star Ratings, yet few indicated high knowledge levels on the topic. Gaps in knowledge were identified in development and utilization of the rating system, identifying quality measures, and sources utilized to measure achievement of ratings. Respondents indicated interest in opportunities to improve knowledge on the subject and would prefer education provided by their employer with a live presentation.   Type: Student Projec

Benchmarking Relatedness Inference Methods with Genome-Wide Data from Thousands of Relatives

Inferring relatedness from genomic data is an essential component of genetic association studies, population genetics, forensics, and genealogy. While numerous methods exist for inferring relatedness, thorough evaluation of these approaches in real data has been lacking. Here, we report an assessment of 12 state-of-the-art pairwise relatedness inference methods using a data set with 2485 individuals contained in several large pedigrees that span up to six generations. We find that all methods have high accuracy (92–99%) when detecting first- and second-degree relationships, but their accuracy dwindles to \u3c43% for seventh-degree relationships. However, most identical by descent (IBD) segment-based methods inferred seventh-degree relatives correct to within one relatedness degree for \u3e76% of relative pairs. Overall, the most accurate methods are Estimation of Recent Shared Ancestry (ERSA) and approaches that compute total IBD sharing using the output from GERMLINE and Refined IBD to infer relatedness. Combining information from the most accurate methods provides little accuracy improvement, indicating that novel approaches, such as new methods that leverage relatedness signals from multiple samples, are needed to achieve a sizeable jump in performance

Calcium supplements and risk of CVD: A meta-analysis of randomized trials

Background: Vitamin D supplements may only be beneficial for the prevention of osteoporotic fractures when administered with calcium and in individuals with low blood levels of 25(OH)D, but possible hazards of calcium supplements on CVD cannot be excluded. Objectives: We conducted a meta-analysis of all placebo-controlled randomized trials assessing the effects of calcium supplements alone or with vitamin D on CHD, stroke, and all-cause mortality. Methods: A meta-analysis of 11 trials included 7 comparisons of calcium alone compared with control (n = 8634) and 6 comparisons of calcium plus vitamin D compared with control (n = 46,804). Aggregated study-level data were obtained from individual trials and combined using a fixed-effects meta-analysis. The main outcomes included MI, CHD death, any CHD, stroke, and all-cause mortality. Results: Among trials of calcium alone (mean daily dose 1 g), calcium was not significantly associated with any excess risk of MI (RR, 1.15; 95% CI: 0.88, 1.51; n = 219 events), CHD death (RR, 1.24; 95% CI: 0.89, 1.73; n = 142), any CHD (RR, 1.01; 95% CI: 0.75, 1.37; n = 177), or stroke (RR, 1.15; 95% CI, 0.90, 1.46, n = 275). Among 6 trials of combined treatment, supplementation with calcium plus vitamin D was not significantly associated with any excess risk of MI (RR, 1.09; 95% CI: 0.95, 1.25; n = 854), CHD death (RR, 1.04; 95% CI: 0.85, 1.27; n = 391), any CHD (RR, 1.05; 95% CI: 0.93, 1.19; n = 1061), or stroke (RR, 1.02; 95% CI: 0.89, 1.17; n = 885). Likewise, calcium alone, or with vitamin D had no significant associations with all-cause mortality. Conclusions: This meta-analysis demonstrated that calcium supplements were not associated with any significant hazard for CHD, stroke, or all-cause mortality and excluded excess risks above 0.3%–0.5% per year for CHD or stroke. Further trials of calcium and vitamin D are required in individuals with low blood levels of 25(OH)D for the prevention of fracture and other disease outcomes

Crossover interference and sex-specific genetic maps shape identical by descent sharing in close relatives

Simulations of close relatives and identical by descent (IBD) segments are common in genetic studies, yet most past efforts have utilized sex averaged genetic maps and ignored crossover interference, thus omitting features known to affect the breakpoints of IBD segments. We developed Ped-sim, a method for simulating relatives that can utilize either sex-specific or sex averaged genetic maps and also either a model of crossover interference or the traditional Poisson model for inter-crossover distances. To characterize the impact of previously ignored mechanisms, we simulated data for all four combinations of these factors. We found that modeling crossover interference decreases the standard deviation of pairwise IBD proportions by 10.4% on average in full siblings through second cousins. By contrast, sex-specific maps increase this standard deviation by 4.2% on average, and also impact the number of segments relatives share. Most notably, using sex-specific maps, the number of segments half-siblings share is bimodal; and when combined with interference modeling, the probability that sixth cousins have non-zero IBD sharing ranges from 9.0 to 13.1%, depending on the sexes of the individuals through which they are related. We present new analytical results for the distributions of IBD segments under these models and show they match results from simulations. Finally, we compared IBD sharing rates between simulated and real relatives and find that the combination of sex-specific maps and interference modeling most accurately captures IBD rates in real data. Ped-sim is open source and available from https://github.com/williamslab/ped-sim