18 results
Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm
- Nesrine Lajmi, Sofia Alves-Vasconcelos, Apostolos Tsiachristas, Andrew Haworth, Kerrie Woods, Charles Crichton, Theresa Noble, Hizni Salih, Kinga A. Várnai, Harriet Branford-White, Liam Orrell, Andrew Osman, Kevin M. Bradley, Lara Bonney, Daniel R. McGowan, Jim Davies, Matthew S. Prime, Andrew Bassim Hassan
-
- Journal:
- Cambridge Prisms: Precision Medicine / Volume 2 / 2024
- Published online by Cambridge University Press:
- 26 March 2024, e4
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
The personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outcomes across all cancer types, financial, technological and operational barriers need to be addressed. For example, complete integration and certification of the ‘molecular tumour board’ into ‘standard of care’ ensures a unified clinical decision pathway that both counteracts fragmentation and is the cornerstone of evidence-based delivery inside and outside of a research setting. Generally, integrated delivery has been restricted to specific (common) cancer types either within major cancer centres or small regional networks. Here, we focus on solutions in real-world integration of genomics, pathology, surgery, oncological treatments, data from clinical source systems and analysis of whole-body imaging as digital data that can facilitate cost-effectiveness analysis, clinical trial recruitment, and outcome assessment. This urgent imperative for cancer also extends across the early diagnosis and adjuvant treatment interventions, individualised cancer vaccines, immune cell therapies, personalised synthetic lethal therapeutics and cancer screening and prevention. Oncology care systems worldwide require proactive step-changes in solutions that include inter-operative digital working that can solve patient centred challenges to ensure inclusive, quality, sustainable, fair and cost-effective adoption and efficient delivery. Here we highlight workforce, technical, clinical, regulatory and economic challenges that prevent the implementation of precision oncology at scale, and offer a systematic roadmap of integrated solutions for standard of care based on minimal essential digital tools. These include unified decision support tools, quality control, data flows within an ethical and legal data framework, training and certification, monitoring and feedback. Bridging the technical, operational, regulatory and economic gaps demands the joint actions from public and industry stakeholders across national and global boundaries.
61 Network Segregation Predicts Processing Speed in the Cognitively Healthy Oldest-old
- Sara A Nolin, Mary E Faulkner, Paul Stewart, Leland Fleming, Stacy Merritt, Roxanne F Rezaei, Pradyumna K Bharadwaj, Mary Kathryn Franchetti, Daniel A Raichlen, Courtney J Jessup, Lloyd Edwards, G Alex Hishaw, Emily J Van Etten, Theodore P Trouard, David S Geldmacher, Virginia G Wadley, Noam Alperin, Eric C Porges, Adam J Woods, Ronald A Cohen, Bonnie E Levin, Tatjana Rundek, Gene E Alexander, Kristina M Visscher
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 367-368
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Understanding the factors contributing to optimal cognitive function throughout the aging process is essential to better understand successful cognitive aging. Processing speed is an age sensitive cognitive domain that usually declines early in the aging process; however, this cognitive skill is essential for other cognitive tasks and everyday functioning. Evaluating brain network interactions in cognitively healthy older adults can help us understand how brain characteristics variations affect cognitive functioning. Functional connections among groups of brain areas give insight into the brain’s organization, and the cognitive effects of aging may relate to this large-scale organization. To follow-up on our prior work, we sought to replicate our findings regarding network segregation’s relationship with processing speed. In order to address possible influences of node location or network membership we replicated the analysis across 4 different node sets.
Participants and Methods:Data were acquired as part of a multi-center study of 85+ cognitively normal individuals, the McKnight Brain Aging Registry (MBAR). For this analysis, we included 146 community-dwelling, cognitively unimpaired older adults, ages 85-99, who had undergone structural and BOLD resting state MRI scans and a battery of neuropsychological tests. Exploratory factor analysis identified the processing speed factor of interest. We preprocessed BOLD scans using fmriprep, Ciftify, and XCPEngine algorithms. We used 4 different sets of connectivity-based parcellation: 1)MBAR data used to define nodes and Power (2011) atlas used to determine node network membership, 2) Younger adults data used to define nodes (Chan 2014) and Power (2011) atlas used to determine node network membership, 3) Older adults data from a different study (Han 2018) used to define nodes and Power (2011) atlas used to determine node network membership, and 4) MBAR data used to define nodes and MBAR data based community detection used to determine node network membership.
Segregation (balance of within-network and between-network connections) was measured within the association system and three wellcharacterized networks: Default Mode Network (DMN), Cingulo-Opercular Network (CON), and Fronto-Parietal Network (FPN). Correlation between processing speed and association system and networks was performed for all 4 node sets.
Results:We replicated prior work and found the segregation of both the cortical association system, the segregation of FPN and DMN had a consistent relationship with processing speed across all node sets (association system range of correlations: r=.294 to .342, FPN: r=.254 to .272, DMN: r=.263 to .273). Additionally, compared to parcellations created with older adults, the parcellation created based on younger individuals showed attenuated and less robust findings as those with older adults (association system r=.263, FPN r=.255, DMN r=.263).
Conclusions:This study shows that network segregation of the oldest-old brain is closely linked with processing speed and this relationship is replicable across different node sets created with varied datasets. This work adds to the growing body of knowledge about age-related dedifferentiation by demonstrating replicability and consistency of the finding that as essential cognitive skill, processing speed, is associated with differentiated functional networks even in very old individuals experiencing successful cognitive aging.
73 Identification of 24-Month Cognitive Trajectories Among Clinical High Risk for Psychosis (CHR-P) Using Latent Class Mixture Modeling
- Ryan M. Guest, Jean Addington, Carrie E. Bearden, Kristin S. Cadenhead, Barbara A. Cornblatt, Daniel H. Mathalon, Diana O. Perkins, Ming T. Tsuang, Scott W. Woods, Tyrone D. Cannon, Matcheri S. Keshavan, William S. Stone, Elaine F. Walker
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 857-858
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Cohort studies demonstrate that people who later develop schizophrenia, on average, present with mild cognitive deficits in childhood and endure a decline in adolescence and adulthood. Yet, tremendous heterogeneity exists during the course of psychotic disorders, including the prodromal period. Individuals identified to be in this period (known as CHR-P) are at heightened risk for developing psychosis (~35%) and begin to exhibit cognitive deficits. Cognitive impairments in CHR-P (as a singular group) appear to be relatively stable or ameliorate over time. A sizeable proportion has been described to decline on measures related to processing speed or verbal learning. The purpose of this analysis is to use data-driven approaches to identify latent subgroups among CHR-P based on cognitive trajectories. This will yield a clearer understanding of the timing and presentation of both general and domain-specific deficits.
Participants and Methods:Participants included 684 young people at CHR-P (ages 12–35) from the second cohort of the North American Prodromal Longitudinal Study. Performance on the MATRICS Consensus Cognitive Battery (MCCB) and the Wechsler Abbreviated Scale of Intelligence (WASI-I) was assessed at baseline, 12-, and 24-months. Tested MCCB domains include verbal learning, speed of processing, working memory, and reasoning & problem-solving. Sex- and age-based norms were utilized. The Oral Reading subtest on the Wide Range Achievement Test (WRAT4) indexed pre-morbid IQ at baseline. Latent class mixture models were used to identify distinct trajectories of cognitive performance across two years. One- to 5-class solutions were compared to decide the best solution. This determination depended on goodness-of-fit metrics, interpretability of latent trajectories, and proportion of subgroup membership (>5%).
Results:A one-class solution was found for WASI-I Full-Scale IQ, as people at CHR-P predominantly demonstrated an average IQ that increased gradually over time. For individual domains, one-class solutions also best fit the trajectories for speed of processing, verbal learning, and working memory domains. Two distinct subgroups were identified on one of the executive functioning domains, reasoning and problem-solving (NAB Mazes). The sample divided into unimpaired performance with mild improvement over time (Class I, 74%) and persistent performance two standard deviations below average (Class II, 26%). Between these classes, no significant differences were found for biological sex, age, years of education, or likelihood of conversion to psychosis (OR = 1.68, 95% CI 0.86 to 3.14). Individuals assigned to Class II did demonstrate a lower WASI-I IQ at baseline (96.3 vs. 106.3) and a lower premorbid IQ (100.8 vs. 106.2).
Conclusions:Youth at CHR-P demonstrate relatively homogeneous trajectories across time in terms of general cognition and most individual domains. In contrast, two distinct subgroups were observed with higher cognitive skills involving planning and foresight, and they notably exist independent of conversion outcome. Overall, these findings replicate and extend results from a recently published latent class analysis that examined 12-month trajectories among CHR-P using a different cognitive battery (Allott et al., 2022). Findings inform which individuals at CHR-P may be most likely to benefit from cognitive remediation and can inform about the substrates of deficits by establishing meaningful subtypes.
Prolonged severe acute respiratory coronavirus virus 2 (SARS-CoV-2) viral shedding in lower-respiratory specimens of critically ill patients does not correlate with nasopharyngeal swab results
- Part of
- Daniel M. Brailita, Allison M. Cushman-Vokoun, Macy G. Wood, Ann M. Crowley, Sharleen A. Rapp, Paul D. Fey, Mark E. Rupp, Angela L. Hewlett
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 4 / April 2023
- Published online by Cambridge University Press:
- 24 May 2022, pp. 678-679
- Print publication:
- April 2023
-
- Article
- Export citation
Outcomes in the age of competency-based medical education: Recommendations for emergency medicine training in Canada from the 2019 symposium of academic emergency physicians
- Teresa M. Chan, Quinten S. Paterson, Andrew K. Hall, Fareen Zaver, Robert A. Woods, Stanley J. Hamstra, Alexandra Stefan, Daniel K. Ting, Brent Thoma
-
- Journal:
- Canadian Journal of Emergency Medicine / Volume 22 / Issue 2 / March 2020
- Published online by Cambridge University Press:
- 25 March 2020, pp. 204-214
- Print publication:
- March 2020
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Objectives
The national implementation of competency-based medical education (CBME) has prompted an increased interest in identifying and tracking clinical and educational outcomes for emergency medicine training programs. For the 2019 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, we developed recommendations for measuring outcomes in emergency medicine training in the context of CBME to assist educational leaders and systems designers in program evaluation.
MethodsWe conducted a three-phase study to generate educational and clinical outcomes for emergency medicine (EM) education in Canada. First, we elicited expert and community perspectives on the best educational and clinical outcomes through a structured consultation process using a targeted online survey. We then qualitatively analyzed these responses to generate a list of suggested outcomes. Last, we presented these outcomes to a diverse assembly of educators, trainees, and clinicians at the CAEP Academic Symposium for feedback and endorsement through a voting process.
ConclusionAcademic Symposium attendees endorsed the measurement and linkage of CBME educational and clinical outcomes. Twenty-five outcomes (15 educational, 10 clinical) were derived from the qualitative analysis of the survey results and the most important short- and long-term outcomes (both educational and clinical) were identified. These outcomes can be used to help measure the impact of CBME on the practice of Emergency Medicine in Canada to ensure that it meets both trainee and patient needs.
Stress perception following childhood adversity: Unique associations with adversity type and sex
- Allison M. LoPilato, Jean Addington, Carrie E. Bearden, Kristin S. Cadenhead, Tyrone D. Cannon, Barbara A. Cornblatt, Daniel H. Mathalon, Thomas H. McGlashan, Diana O. Perkins, Ming T. Tsuang, Scott W. Woods, Elaine F. Walker
-
- Journal:
- Development and Psychopathology / Volume 32 / Issue 1 / February 2020
- Published online by Cambridge University Press:
- 08 March 2019, pp. 343-356
-
- Article
- Export citation
-
Childhood adversity is associated with poor mental and physical health outcomes across the life span. Alterations in the hypothalamic–pituitary–adrenal axis are considered a key mechanism underlying these associations, although findings have been mixed. These inconsistencies suggest that other aspects of stress processing may underlie variations in this these associations, and that differences in adversity type, sex, and age may be relevant. The current study investigated the relationship between childhood adversity, stress perception, and morning cortisol, and examined whether differences in adversity type (generalized vs. threat and deprivation), sex, and age had distinct effects on these associations. Salivary cortisol samples, daily hassle stress ratings, and retrospective measures of childhood adversity were collected from a large sample of youth at risk for serious mental illness including psychoses (n = 605, mean age = 19.3). Results indicated that childhood adversity was associated with increased stress perception, which subsequently predicted higher morning cortisol levels; however, these associations were specific to threat exposures in females. These findings highlight the role of stress perception in stress vulnerability following childhood adversity and highlight potential sex differences in the impact of threat exposures.
A prospective study of transmission of Multidrug-Resistant Organisms (MDROs) between environmental sites and hospitalized patients—the TransFER study
- Luke F. Chen, Lauren P. Knelson, Maria F. Gergen, Olga M. Better, Bradly P. Nicholson, Christopher W. Woods, William A. Rutala, David J. Weber, Daniel J. Sexton, Deverick J. Anderson, for the CDC Prevention Epicenters Program
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 40 / Issue 1 / January 2019
- Published online by Cambridge University Press:
- 14 November 2018, pp. 47-52
- Print publication:
- January 2019
-
- Article
- Export citation
-
Objective
Hospital environmental surfaces are frequently contaminated by microorganisms. However, the causal mechanism of bacterial contamination of the environment as a source of transmission is still debated. This prospective study was performed to characterize the nature of multidrug-resistant organism (MDRO) transmission between the environment and patients using standard microbiological and molecular techniques.
SettingProspective cohort study at 2 academic medical centers.
DesignA prospective multicenter study to characterize the nature of bacterial transfer events between patients and environmental surfaces in rooms that previously housed patients with 1 of 4 ‘marker’ MDROs: methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, and MDR Acinetobacter baumannii. Environmental and patient microbiological samples were obtained on admission into a freshly disinfected inpatient room. Repeat samples from room surfaces and patients were taken on days 3 and 7 and each week the patient stayed in the same room. The bacterial identity, antibiotic susceptibility, and molecular sequences were compared between organisms found in the environment samples and patient sources.
ResultsWe enrolled 80 patient–room admissions; 9 of these patients (11.3%) were asymptomatically colonized with MDROs at study entry. Hospital room surfaces were contaminated with MDROs despite terminal disinfection in 44 cases (55%). Microbiological Bacterial Transfer events either to the patient, the environment, or both occurred in 12 patient encounters (18.5%) from the microbiologically evaluable cohort.
ConclusionsMicrobiological Bacterial Transfer events between patients and the environment were observed in 18.5% of patient encounters and occurred early in the admission. This study suggests that research on prevention methods beyond the standard practice of room disinfection at the end of a patient’s stay is needed to better prevent acquisition of MDROs through the environment.
Passive range of motion exercise to enhance growth in infants following the Norwood procedure: a safety and feasibility trial
- Linda M. Lambert, Felicia L. Trachtenberg, Victoria L. Pemberton, Janine Wood, Shelley Andreas, Robin Schlosser, Teresa Barnard, Kaitlyn Daniels, Ann T. Harrington, Nicholas Dagincourt, Thomas A. Miller, for the Pediatric Heart Network Investigators
-
- Journal:
- Cardiology in the Young / Volume 27 / Issue 7 / September 2017
- Published online by Cambridge University Press:
- 23 March 2017, pp. 1361-1368
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Objective
The aim of this study was to evaluate the safety and feasibility of a passive range of motion exercise programme for infants with CHD.
Study designThis non-randomised pilot study enrolled 20 neonates following Stage I palliation for single-ventricle physiology. Trained physical therapists administered standardised 15–20-minute passive range of motion protocol, for up to 21 days or until hospital discharge. Safety assessments included vital signs measured before, during, and after the exercise as well as adverse events recorded through the pre-Stage II follow-up. Feasibility was determined by the percent of days that >75% of the passive range of motion protocol was completed.
ResultsA total of 20 infants were enrolled (70% males) for the present study. The median age at enrolment was 8 days (with a range from 5 to 23), with a median start of intervention at postoperative day 4 (with a range from 2 to 12). The median hospital length of stay following surgery was 15 days (with a range from 9 to 131), with an average of 13.4 (with a range from 3 to 21) in-hospital days per patient. Completion of >75% of the protocol was achieved on 88% of eligible days. Of 11 adverse events reported in six patients, 10 were expected with one determined to be possibly related to the study intervention. There were no clinically significant changes in vital signs. At pre-Stage II follow-up, weight-for-age z-score (−0.84±1.20) and length-for-age z-score (−0.83±1.31) were higher compared with historical controls from two earlier trials.
ConclusionA passive range of motion exercise programme is safe and feasible in infants with single-ventricle physiology. Larger studies are needed to determine the optimal duration of passive range of motion and its effect on somatic growth.
Contributors
-
- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
-
- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
-
- Chapter
- Export citation
Contributors
-
- By Tod C. Aeby, Melanie D. Altizer, Ronan A. Bakker, Meghann E. Batten, Anita K. Blanchard, Brian Bond, Megan A. Brady, Saweda A. Bright, Ellen L. Brock, Amy Brown, Ashley Carroll, Jori S. Carter, Frances Casey, Weldon Chafe, David Chelmow, Jessica M. Ciaburri, Stephen A. Cohen, Adrianne M. Colton, PonJola Coney, Jennifer A. Cross, Julie Zemaitis DeCesare, Layson L. Denney, Megan L. Evans, Nicole S. Fanning, Tanaz R. Ferzandi, Katie P. Friday, Nancy D. Gaba, Rajiv B. Gala, Andrew Galffy, Adrienne L. Gentry, Edward J. Gill, Philippe Girerd, Meredith Gray, Amy Hempel, Audra Jolyn Hill, Chris J. Hong, Kathryn A. Houston, Patricia S. Huguelet, Warner K. Huh, Jordan Hylton, Christine R. Isaacs, Alison F. Jacoby, Isaiah M. Johnson, Nicole W. Karjane, Emily E. Landers, Susan M. Lanni, Eduardo Lara-Torre, Lee A. Learman, Nikola Alexander Letham, Rachel K. Love, Richard Scott Lucidi, Elisabeth McGaw, Kimberly Woods McMorrow, Christopher A. Manipula, Kirk J. Matthews, Michelle Meglin, Megan Metcalf, Sarah H. Milton, Gaby Moawad, Christopher Morosky, Lindsay H. Morrell, Elizabeth L. Munter, Erin L. Murata, Amanda B. Murchison, Nguyet A. Nguyen, Nan G. O’Connell, Tony Ogburn, K. Nathan Parthasarathy, Thomas C. Peng, Ashley Peterson, Sarah Peterson, John G. Pierce, Amber Price, Heidi J. Purcell, Ronald M. Ramus, Nicole Calloway Rankins, Fidelma B. Rigby, Amanda H. Ritter, Barbara L. Robinson, Danielle Roncari, Lisa Rubinsak, Jennifer Salcedo, Mary T. Sale, Peter F. Schnatz, John W. Seeds, Kathryn Shaia, Karen Shelton, Megan M. Shine, Haller J. Smith, Roger P. Smith, Nancy A. Sokkary, Reni A. Soon, Aparna Sridhar, Lilja Stefansson, Laurie S. Swaim, Chemen M. Tate, Hong-Thao Thieu, Meredith S. Thomas, L. Chesney Thompson, Tiffany Tonismae, Angela M. Tran, Breanna Walker, Alan G. Waxman, C. Nathan Webb, Valerie L. Williams, Sarah B. Wilson, Elizabeth M. Yoselevsky, Amy E. Young
- Edited by David Chelmow, Virginia Commonwealth University, Christine R. Isaacs, Virginia Commonwealth University, Ashley Carroll, Virginia Commonwealth University
-
- Book:
- Acute Care and Emergency Gynecology
- Published online:
- 05 November 2014
- Print publication:
- 30 October 2014, pp ix-xiv
-
- Chapter
- Export citation
Contributors
-
- By Roland C. Anderson, Jennifer A. Basil, Cécile Bellanger, Jean G. Boal, Gordon M. Burghardt, Robyn Crook, Anne-Sophie Darmaillacq, Ludovic Dickel, Frank W. Grasso, Tamar Gutnick, Binyamin Hochner, Sönke Johnsen, Noam Josef, Christelle Jozet-Alves, Michael J. Kuba, Tatiana S. Leite, Jennifer A. Mather, Ronald O’Dor, Daniel Osorio, Nadav Shashar, Tal Shomrat, James B. Wood, Sarah Zylinski
- Edited by Anne-Sophie Darmaillacq, Ludovic Dickel, Jennifer Mather, University of Lethbridge, Alberta
-
- Book:
- Cephalopod Cognition
- Published online:
- 05 July 2014
- Print publication:
- 10 July 2014, pp x-xii
-
- Chapter
- Export citation
Contributors
-
- By Judah Ariel, Leonito (Jun) Bacalando, Daniel Bartz, Dean Bialek, Maxine A. Burkett, Elizabeth Caldwell, Mary-Elena Carr, Kristin Casper, David Freestone, Catherine Gascoigne, Alice Graff, David Hodgkinson, Michele Klein Solomon, Stephen Leonard, Siobhán McInerney-Lankford, llona Millar, Nicola Peart, Ann Powers, Rosemary Rayfuse, Maketo Robert, Madeleine Rubenstein, Kristína Šabová, Clive Schofield, Jan Šrytr, Leslie A. Stein, Jenny Grote Stoutenburg, Christopher Stucko, Jasper Teulings, Diego Villarreal, Koko Warner, Jacob David Werksman, Mary Christina Wood, Katrina M. Wyman, Lucy Young
- Edited by Michael B. Gerrard, Gregory E. Wannier
-
- Book:
- Threatened Island Nations
- Published online:
- 05 February 2013
- Print publication:
- 21 January 2013, pp ix-xvi
-
- Chapter
- Export citation
Contributors
-
- By Basem Abdelmalak, Linda S. Aglio, Daniel Alam, Maged Argalious, Carlos A. Artime, Rahul G. Baijal, David Beebe, Michael S. Benninger, Carol R. Bradford, Paul C. Bryson, Brian Burkey, Richard M. Cooper, Jacek B. Cywinski, Onur Demirci, D. John Doyle, Thomas Edrich, Louise Ellard, Matthew R. Eng, Nicole M. Fowler, Ursula Galway, John George, Carin A. Hagberg, David W. Healy, Marshal B. Kaplan, Paul Kempen, Ashish Khanna, Alan Kominsky, Tatyana Kopyeva, Biao Lei, Emad B. Mossad, Vladimir Nekhendzy, Edward Noguera, Megan Nolan, Mauricio Perilla, Marc Popovich, Gazanfar Rahmathulla, Gail I. Randel, William H. Rosenblatt, Twain Russell, Mona Sarkiss, Joseph Scharpf, Tracey Straker, David E. Traul, Robert Weil, Sivan Wexler, David T. Wong, Benjamin Wood, Jie Zhou
- Edited by Basem Abdelmalak, John Doyle
-
- Book:
- Anesthesia for Otolaryngologic Surgery
- Published online:
- 05 November 2012
- Print publication:
- 18 October 2012, pp xi-xiv
-
- Chapter
- Export citation
8 - PHAROS: an architecture for next-generation core optical networks
- from Part II - Network architectures
-
- By Ilia Baldine, Renaissance Computing Institute, USA, Alden W. Jackson, BBN Technologies, USA, John Jacob, BAE Systems, USA, Will E. Leland, BBN Technologies, USA, John H. Lowry, BBN Technologies, USA, Walker C. Milliken, BBN Technologies, USA, Partha P. Pal, BBN Technologies, USA, Subramanian Ramanathan, BBN Technologies, USA, Kristin Rauschenbach, BBN Technologies, USA, Cesar A. Santivanez, BBN Technologies, USA, Daniel M. Wood, Verizon Federal Network Systems, USA
- Edited by Byrav Ramamurthy, University of Nebraska, Lincoln, George N. Rouskas, North Carolina State University, Krishna Moorthy Sivalingam
-
- Book:
- Next-Generation Internet
- Published online:
- 05 October 2012
- Print publication:
- 03 February 2011, pp 154-178
-
- Chapter
- Export citation
-
Summary
Introduction
The last decade has seen some dramatic changes in the demands placed on core networks. Data has permanently replaced voice as the dominant traffic unit. The growth of applications like file sharing and storage area networking took many by surprise. Video distribution, a relatively old application, is now being delivered via packet technology, changing traffic profiles even for traditional services.
The shift in dominance from voice to data traffic has many consequences. In the data world, applications, hardware, and software change rapidly. We are seeing an unprecedented unpredictability and variability in traffic patterns. This means network operators must maintain an infrastructure that quickly adapts to changing subscriber demands, and contain infrastructure costs by efficiently applying network resources to meet those demands.
Current core network transport equipment supports high-capacity global-scale core networks by relying on higher speed interfaces such as 40 and 100 Gb/s. This is necessary but in and of itself not sufficient. Today, it takes considerable time and human involvement to provision a core network to accommodate new service demands or exploit new resources. Agile, autonomous, resource management is imperative for the next-generation network.
Today's core network architectures are based on static point-to-point transport infrastructure. Higher-layer services are isolated within their place in the traditional Open Systems Interconnection (OSI) network stack. While the stack has clear benefits in collecting conceptually similar functions into layers and invoking a service model between them, stovepiped management has resulted in multiple parallel networks within a single network operator's infrastructure.
Contributors
-
- By Nicholas B. Allen, Stephanie Assuras, Robert M. Bilder, Joan C. Borod, John L. Bradshaw, Warrick J. Brewer, Ariel Brown, Nik Brown, Tyrone Cannon, Audrey Carstensen, Cameron S. Carter, Luke Clark, Phyllis Chua, Thilo Deckersbach, Richard A. Depue, Tali Ditman, Aleksey Dumer, David E. Fleck, Lara Foland-Ross, Judith M. Ford, Nelson Freimer, Paolo Fusar-Poli, Nathan A. Gates, Terry E. Goldberg, George Graham, Igor Grant, Melissa J. Green, Michelle M. Halfacre, Wendy Heller, John D. Herrington, Garry D. Honey, Jennifer E. Iudicello, Henry J. Jackson, J. David Jentsch, Donald Kalar, Paul Keedwell, Ester Klimkeit, Nancy S. Koven, Donna A. Kreher, Gina R. Kuperberg, Edythe London, Dan I. Lubman, Daniel H. Mathalon, Patrick D. McGorry, Philip McGuire, George R. Mangun, Gregory A. Miller, Albert Newen, Jack B. Nitschke, Jaak Panksepp, Christos Pantelis, Mary Philips, Russell A. Poldrack, Scott L. Rauch, Susan M. Ravizza, Steven Paul Reise, Nicole Rinehart, Angela Rizk-Jackson, Trevor W. Robbins, Tamara A. Russell, Fred W. Sabb, Cary R. Savage, Kimberley R. Savage, J. Cobb Scott, Marc L. Seal, Larry J. Seidman, Paula K. Shear, Marisa M. Silveri, Nadia Solowij, Laura Southgate, G. Lynn Stephens, D. Stott Parker, Stephen M. Strakowski, Simon A. Surguladze, Kate Tchanturia, René Testa, Janet Treasure, Eve M. Valera, Kai Vogeley, Anthony P. Weiss, Sarah Whittle, Stephen J. Wood, Steven Paul Woods, Murat Yücel, Deborah A. Yurgelun-Todd
- Edited by Stephen J. Wood, University of Melbourne, Nicholas B. Allen, University of Melbourne, Christos Pantelis, University of Melbourne
-
- Book:
- The Neuropsychology of Mental Illness
- Published online:
- 10 May 2010
- Print publication:
- 01 October 2009, pp xv-xx
-
- Chapter
- Export citation
Contributors
-
- By Donald Addington, Jean Addington, Kelly Allott, Amanda Baker, Gregor Berger, Michael Berk, Max Birchwood, Warrick J. Brewer, Peter Burnett, Tyrone Cannon, Andrew Chanen, Philippe Conus, Barbara Cornblatt, Thomas Craig, Alex Fornito, David Fowler, Shona M. Francey, John Gleeson, Susy Harrigan, Meredith Harris, Leanne Hides, Christian G. Huber, Henry J. Jackson, Anthony F. Jorm, Eóin Killackey, Joachim Klosterkötter, Martin Lambert, Tim Lambert, Shon Lewis, Don Linszen, Dan Lubman, Nellie Lucas, Craig Macneil, Ashok K. Malla, Max Marshall, Louise K. McCutcheon, Patrick D. McGorry, Catharine McNab, Maria Michail, Anthony P. Morrison, Merete Nordentoft, Ross M. G. Norman, Keith H. Nuechterlein, Christos Pantelis, Lisa J. Phillips, Richie Poulton, Paddy Power, Jo Robinson, Frauke Schultze-Lutter, Jim van Os, José Luis Vázquez-Barquero, Dennis Velakoulis, Darryl Wade, Daniel Weinberger, Durk Wiersma, Stephen J. Wood, Annemarie Wright, Murat Yücel, Alison R. Yung, Robert B. Zipursky
- Edited by Henry J. Jackson, University of Melbourne, Patrick D. McGorry
-
- Book:
- The Recognition and Management of Early Psychosis
- Published online:
- 10 August 2009
- Print publication:
- 19 February 2009, pp xi-xvi
-
- Chapter
- Export citation
Aripiprazole in the treatment of the psychosis prodrome: An open-label pilot study
- Scott W. Woods, Elizabeth M. Tully, Barbara C. Walsh, Keith A. Hawkins, Jennifer L. Callahan, Shuki J. Cohen, Daniel H. Mathalon, Tandy J. Miller, Thomas H. McGlashan
-
- Journal:
- The British Journal of Psychiatry / Volume 191 / Issue S51 / December 2007
- Published online by Cambridge University Press:
- 02 January 2018, pp. s96-s101
- Print publication:
- December 2007
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Background
Research studies for the treatment of the putative prodromal phase of psychotic disorders have begun to appear
AimsTo obtain preliminary evidence of the short-term efficacy and safety of aripiprazole treatment in people with the psychosis prodrome
MethodFifteen participants meeting prodrome criteria (mean age 17.1 years, s.d.=5.5) enrolled in an open-label, single-site trial with fixed-flexible dosing of aripiprazole (5–30 mg/day) for 8 weeks
ResultsIn the mixed-effects repeated-measures analysis, improvement from baseline on the Scale of Prodromal Symptoms total score was statistically significant by the first week. No participant converted to psychosis and 13 completed treatment. Neuropsychological measures showed no consistent improvement; mean weight gain was 1.2 kg. Akathisia emerged in 8 participants, but the mean Barnes Akathisia Scale score fell to baseline levels by the final visit. Adverse events were otherwise minimal
ConclusionsAripiprazole shows a promising efficacy and safety profile for the psychosis prodrome. Placebo-controlled studies are indicated
The Sloan Digital Sky Survey QSO absorption line catalogue
- Donald G. York, Daniel Vanden Berk, Gordon T. Richards, Arlin P. S. Crotts, Pushpa Khare, James Lauroesch, Martin Lemoine, Scott Burles, Mariangela Bernardi, Francisco J. Castander, Josh Frieman, Jon Loveday, Avery Meiksin, Robert Nichol, David Schlegel, Donald P. Schneider, Mark Subbarao, Chris Stoughton, Alex Szalay, Brian Yanny, Yusra Alsayyad, Abhishek Kumar, Britt Lundgren, Natela Shanidze, Johnny Vanlandingham, Matthew Wood, Britt Baugher, Jon Brinkmann, Robert Brunner, Masaaka Fukugita, Patrick B. Hall, Timothy M. Heckman, Lewis M. Hobbs, Craig J. Hogan, Lam Hui, Edward B. Jenkins, Daniel Kunstz, Brice Menard, Osamu Nakamura, Jean M. Quashnock, Michael Stein, Aniruddha R. Thakar, David Turnshek, Daniel E. Welty, the SDSS Collaboration
-
- Journal:
- Proceedings of the International Astronomical Union / Volume 1 / Issue C199 / March 2005
- Published online by Cambridge University Press:
- 06 October 2005, pp. 58-64
- Print publication:
- March 2005
-
- Article
-
- You have access Access
- Export citation
-
The spectra of the Sloan Digital Sky Survey (SDSS) are being used to construct a catalogue of QSO absorption lines, for use in studies of abundances, relevant radiation fields, number counts as a function of redshift, and other matters, including the evolution of these parameters. The catalogue includes intervening, associated, and BAL absorbers, in order to allow a clearer definition of the relationships between these three classes. We describe the motivation for and the data products of the project to build the SDSS QSO absorption line catalogue.