George Crumb and Makrokosmos, Volume 1

In the words of David Burge, George Crumb provided his listeners with something of the sensation of awe, wonder, and enigmatic beauty that he himself felt concerning the \u27mysteries.\u27 He named movements after geological eras, referred to images as coming from \u27the dark land,\u27 invented visual symbols for his scores, and concocted numerological schemes. For many listeners these extra musical trappings provided an avenue into the music itself, allowing them to listen to it openly and with interest rather than with resistance and skepticism (Burge, 1990, p. 212)

Suicide in older adults : helping case managers engage in difficult conversations : a project based upon an independent investigation in collaboration the producer of the film Talking with Dolores , Darlene O\u27Connor

Suicide among older adults is an increasing mental health concern in the United States, and yet depression and other signs of suicide often go unnoticed. The film and discussion guide Talking with Dolores was funded by the Massachusetts Department of Public Health to increase awareness of warnings of depression and suicide in the elderly and demonstrate ways of conversing with them about suicide. Because of their unique contact with older individuals in their own homes, geriatric case managers are positioned as a gateway to necessary psychosocial support for elders, yet may not be receiving adequate training for the initial detection of severe depression and suicide risk. Professional social workers are frequently put into the position of providing training related to the psychosocial needs of clients who are cared for by geriatric case managers. Thus, case managers and social workers alike may benefit from training tools which might increase capabilities of case managers to confront these emotionally charged issues. This study explores whether geriatric case managers think this film/discussion would be a useful training tool for increasing their awareness and comfort in discussing depression and suicide with clients. The data from two focus groups of geriatric case managers in Boston, MA indicated that they perceived that the Talking with Dolores training effectively reminded them of their important role in providing psychosocial support to their clients and helped them identify signs of suicide, but did not sufficiently provide them with concrete skills in the management of suicidal ideation. The qualitative data revealed some speculation that Talking with Dolores would increase their comfort in discussing depression and suicide with clients. Participants thought it could be a helpful training tool for geriatric case managers. They reported a lack of knowledge and training on the subject was the inhibiting factor for not discussing suicide with their clients. Additional quantitative data showed that the sample\u27s exposure to the Dolores training increased knowledge about suicide risk in the elderly but did not increase their comfort level in discussing suicide with clients

Concert recording 2021-04-22a

[Track 1]. Sicilienne and rigaudon in the style of Francoeur / Kriesler -- [Track 2]. Suite for violin and orchestra in A minor, op. 10. I. Presto ; [Track 3]. II. Adadio / Sinding -- [Track 4]. Concerto for violin no. 1 in A minor. I. Allegro ; II. Adagio / J.S. Bach -- [Track 5]. Violin concerto in B minor opus 35. I. Allegro moderato ; II. Andante ; III. Alegro moderato / Rieding

Interactions and Mechanisms of Respiratory Tract Biofilms Involving Streptococcus Pneumoniae and Nontypeable Haemophilus Influenzae

The pathology associated with human respiratory tract bacterial agents that exist as opportunistic commensals in the nasopharynx cause infections. This is particularly true for the middle ear disease otitis media (OM) and exacerbations of chronic obstructive pulmonary disease (COPD). Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) are a commonly recurrent combination and the formation of bacterial biofilms by these pathogens in the bronchial airway or middle ear contributes significantly to the chronic nature of these diseases. While S. pneumoniae and NTHi have been extensively studied in mono-culture, our knowledge about how they exist together, either in their free-living (planktonic) form or as a biofilm, or indeed the implication of co-infection is still limited. Several key elements are believed to contribute or are induced: (1) a set of sugar metabolic pathways; (2) surface structures in S. pneumoniae and NTHi when they are able to co-exist equally; (3) epithelial cell contact that dramatically increases the rate of biofilm formation; (4) chemical modifications of NTHi surface structures involved in host cell interactions; and (5) transcription factors that regulate particular surface molecules and the switch to a biofilm state. There appears to be multiple mechanisms involved and that these are active under specific conditions

Development and Implementation of the Use of Optically Stimulated Luminescent Detectors in the Radiological Physics Center Anthropomorphic Quality Assurance Phantoms

The Radiological Physics Center (RPC) uses both on-site and remote reviews to credential institutions for participation in clinical trials. Anthropomorphic quality assurance (QA) phantoms are one tool the RPC uses to remotely audit institutions, which include thermoluminescent dosimeters (TLDs) and radiochromic film. The RPC desires to switch from TLD as the absolute dosimeter in the phantoms, to optically stimulated luminescent dosimeters (OSLDs), but a problem lies in the angular dependence exhibited by the OSLD. The purpose of this study was to characterize the angular dependence of OSLD and establish a correction factor if necessary, to provide accurate dosimetric measurements as a replacement for TLD in the QA phantoms. A 10 cm diameter high-impact polystyrene spherical phantom was designed and constructed to hold an OSLD to study the angular response of the dosimeter under the simplest of circumstances for both coplanar and non-coplanar treatment deliveries. OSLD were irradiated in the spherical phantom, and the responses of the dosimeter from edge-on angles were normalized to the response when irradiated with the beam incident normally on the surface of the dosimeter. The average normalized response was used to establish an angular correction factor for 6 MV and 18 coplanar treatments, and for 6 MV non-coplanar treatments specific to CyberKnife. The RPC pelvic phantom dosimetry insert was modified to hold OSLD, in addition to the TLD, adjacent to the planes of film. Treatment plans of increasing angular beam delivery were developed, three in Pinnacle v9.0 (4-field box, IMRT, and VMAT) and one in Accuray’s MultiPlan v3.5.3 (CyberKnife). The plans were delivered to the pelvic phantom containing both TLD and OSLD in the target volume. The pelvic phantom was also sent to two institutions to be irradiated as trials, one delivering IMRT, and the other a CyberKnife treatment. For the IMRT deliveries and the two institution trials, the phantom also included film in the sagittal and coronal planes. The doses measured from the TLD and OSLD were calculated for each irradiation, and the angular correction factors established from the spherical phantom irradiations were applied to the OSLD dose. The ratio of the TLD dose to the angular corrected OSLD dose was calculated for each irradiation. The corrected OSLD dose was found to be within 1% of the TLD measured dose for all irradiations, with the exception of the in-house CyberKnife deliveries. The films were normalized to both TLD measured dose and the corrected OSLD dose. Dose profiles were obtained and gamma analysis was performed using a 7%/4 mm criteria, to compare the ability of the OSLD, when corrected for the angular dependence, to provide equivalent results to TLD. The results of this study indicate that the OSLD can effectively be used as a replacement for TLD in the RPC’s anthropomorphic QA phantoms for coplanar treatment deliveries when a correction is applied for the dosimeter’s angular dependence

Accounting for Detection Heterogeneity and Host Movements in a House Finch-Mycoplasma gallisepticum Disease System

Any opinions, findings and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation.During the course of my dissertation research, I made use of capture-recapture methods to investigate local house finch (Carpodacus mexicanus) demography and movements in the context of understanding seasonal Mycoplasma gallisepticum (MG) infection dynamics. Capture-recapture design, estimation, and modeling explicitly accounts for variable detectability of individuals and provides a framework for making multi-model inference, thereby incorporating inherent model selection uncertainty (via Akaike information criterion) into the inferential process. The biological focus throughout my research has generally been centered on the relationship between local spatial scale host population structure, movements, and host-pathogen dynamics. Broadly, my work illustrates the importance of accounting for animal detection probabilities when estimating epidemiological statistics and parameters. I also highlight the importance of considering different forms of animal movements (either biologically induced or as a consequence of sampling design) with respect to understanding dynamics in the finch-MG system (specifically), but also applicable to other host-pathogen systems (generally). I estimate host transient movements, completely observable within-study area movements, proportional recruitment, and temporary movements from the study area (representing partially observable movements); all of which are very important elements to consider for understanding the dynamics of highly mobile animal populations (especially in the presence of a virulent pathogen). My research, conducted at a local spatial scale in Ithaca, NY complements analyses using House Finch Disease Survey data (Dhondt et al. 1998) at a broader spatial scale, and provides a point of entry for understanding the critical linkage of scale dependent processes influencing finch-MG dynamics. Throughout this dissertation, I have sought to characterize the structure of this local finch population, and establish how both host population structure and movements lead to a better overall understanding of MG infection dynamics. As such, the complete body of work produced here represents the most comprehensive investigation of wildlife disease dynamics to date, which has incorporated and accounted for sampling and biologically driven heterogeneity in host encounter probabilities. Beyond the proximate benefits that this research contributes to understanding of the finch-MG system, my hope is that this work will in part serve as a precedent for future empirical investigations of wildlife-pathogen dynamics.Cornell Department of Natural Resources, Cornell Laboratory of Ornithology, and National Science Foundation (under Grant No. DEB-0094456

The use of metabolomics to investigate biomarker profiles as potential early risk factors for development of type ii diabetes mellitus

ABSTRACT THE USE OF METABOLOMICS TO INVESTIGATE BIOMARKERS PROFILES AS POTENTIAL EARLY RISK FACTORS FOR DEVELOPMENT OF TYPE II DIABETES by JENNELLE ARNEW MAY 2012 Advisor: Dr. Smiti Gupta Major: Nutrition and Food Science Degree: Masters of Science Type 2 Diabetes affects an estimated 17.5 million individuals in the United States and is considered to be one of the most pressing public health issues of our time. To date, the exact cause of type 2 diabetes remains unclear, however, it is considered to be an interplay between environmental and genetic factors. Emerging technologies for metabolomics analysis increases the capacity to detect the onset of disease or ideally, the pre-diseased state. Metabolomics has the potential to find early metabolic changes related to diabetes progression prior to many clinical symptoms. Although this technology is considered to be in its infancy many believe that metabolomics strategies can have an impact on the discovery of pathological biomarkers for diabetes progression. Given this emerging technology that is available, the increasing burden of diabetes, earlier identification of ¡®at risk¡¯ individuals is particularly important. The objective of this study was to determine if metabolomics analytical techniques could identify differences in the metabolic profiles of persons at risk for developing diabetes. A heterogeneous non-diabetic sample of persons with and without risk factors for development of diabetes were recruited for this pilot study. A standard questionnaire was conducted to assess risk factors for diabetes. Fasting blood and urine samples were collected and frozen at -800 C. Bivariate correlations were determined to investigate the linear relationship between the risk factors. Urinary metabolite profiles were analyzed by proton nuclear magnetic resonance (1H NMR) spectra. The processed, digitized NMR spectral data was analyzed using multivariate data analysis software, SIMCA P+. Partial Least Squares Discriminant Analysis (PLS-DA) Score Plot showed a clear separation between the urinary metabolomic profiles of subject based on a BMI ¡Ý 27 kg/m2. PLS correlation plot showed a significant correlation between the urinary profiles between BMI and fasting blood sugar in this non-diabetic population. The data suggests and in agreement with the hypothesis, that 1H NMR was able to detect changes in the urinary profiles of a non-heterogeneous non-diabetic population with the greatest degree of discrimination based on BMI of 27 kg/m2. Based on current clinical practices, the identification of the metabolites causing discriminating in the urinary profiles based on obesity may be a relevant focus for predicting risk in a non-diabetic population. This study was considered a pilot for a future project and was not designed to provide a high degree of precision. However, this project does provide greater insight that metabolomics is a sensitive tool that is able to differentiate between the metabolic profiles of human urinary profiles based on BMI, thus making it important to use the project characteristics for a larger trial