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338 The Alabama Genomic Health Initiative: Integrating Genomic Medicine into Primary Care
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- Nita A Limdi, Devin Absher, Irf Asif, Lori Bateman, Greg Barsh, Kevin M. Bowling, Gregory M. Cooper, Brittney H. Davis, Kelly M. East, Candice R. Finnila, Blake Goff, Susan Hiatt, Melissa Kelly, Whitley V. Kelley, Bruce R. Korf, Donald R. Latner, James Lawlor, Thomas May, Matt Might, Irene P. Moss, Mariko Nakano-Okuno, Tiffany Osborne, Stephen Sodeke, Adriana Stout, Michelle L. Thompson
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue s1 / April 2023
- Published online by Cambridge University Press:
- 24 April 2023, pp. 100-101
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OBJECTIVES/GOALS: Supported by the State of Alabama, the Alabama Genomic Health Initiative (AGHI) is aimed at preventing and treating common conditions with a genetic basis. This joint UAB Medicine-HudsonAlpha Institute for Biotechnology effort provides genomic testing, interpretation, and counseling free of charge to residents in each of Alabama’s 67 counties. METHODS/STUDY POPULATION: Launched in 2017, as a state-wide population cohort, AGHI (1.0) enrolled 6,331 Alabamians and returned individual risk of disease(s) related to the ACMG SF v2.0 medically actionable genes. In 2021, the cohort was expanded to include a primary care cohort. AGHI (2.0) has enrolled 750 primary care patients, returning individual risk of disease(s) related to the ACMG SF v3.1 gene list and pre-emptive pharmacogenetics (PGx) to guide medication therapy. Genotyping is done on the Illumina Global Diversity Array with Sanger sequencing to confirm likely pathogenic / pathogenic variants in medically actionable genes and CYP2D6 copy number variants using Taqman assays, resulting in a CLIA-grade report. Disease risk results are returned by genetic counselors and Pharmacogenetics results are returned by Pharmacists. RESULTS/ANTICIPATED RESULTS: We have engaged a statewide community (>7000 participants), returning 94 disease risk genetic reports and 500 PGx reports. Disease risk reports include increased predisposition to cancers (n=38), cardiac diseases (n=33), metabolic (n=12), other (n=11). 100% of participants harbor an actionable PGx variant, 70% are on medication with PGx guidance, 48% harbor PGx variants and are taking medications affected. In 10% of participants, pharmacists sent an active alert to the provider to consider/ recommend alternative medication. Most commonly impacted medications included antidepressants, NSAIDS, proton-pump inhibitors and tramadol. To enable the EMR integration of genomic information, we have developed an automated transfer of reports into the EMR with Genetics Reports and PGx reports viewable in Cerner. DISCUSSION/SIGNIFICANCE: We share our experience on pre-emptive implementation of genetic risk and pharmacogenetic actionability at a population and clinic level. Both patients and providers are actively engaged, providing feedback to refine the return of results. Real time alerts with guidance at the time of prescription are needed to ensure future actionability and value.
Building an infrastructure to support the development, conduct, and reporting of informative clinical studies: The Rockefeller University experience
- Rhonda G. Kost, Rita K. Devine, Mark Fernands, Riva Gottesman, Manoj Kandpal, Robert B. MacArthur, Barbara O’Sullivan, Michelle Romanick, Andrea Ronning, Sarah Schlesinger, Jonathan N. Tobin, Roger Vaughan, Maija Neville-Williams, James G. Krueger, Barry S. Coller
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 13 April 2023, e104
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Introduction:
Clinical trials are a vital component of translational science, providing crucial information on the efficacy and safety of new interventions and forming the basis for regulatory approval and/or clinical adoption. At the same time, they are complex to design, conduct, monitor, and report successfully. Concerns over the last two decades about the quality of the design and the lack of completion and reporting of clinical trials, characterized as a lack of “informativeness,” highlighted by the experience during the COVID-19 pandemic, have led to several initiatives to address the serious shortcomings of the United States clinical research enterprise.
Methods and Results:Against this background, we detail the policies, procedures, and programs that we have developed in The Rockefeller University Center for Clinical and Translational Science (CCTS), supported by a Clinical and Translational Science Award (CTSA) program grant since 2006, to support the development, conduct, and reporting of informative clinical studies.
Conclusions:We have focused on building a data-driven infrastructure to both assist individual investigators and bring translational science to each element of the clinical investigation process, with the goal of both generating new knowledge and accelerating the uptake of that knowledge into practice.
418 Activation of the Glucagon-Like Peptide-1 Pathway in Obese Pre-Diabetic Individuals Improves Endothelial Function Independently of Weight Loss
- Mona Mashayekhi, Joshua A. Beckman, Erica M. Garner, Hui Nian, Chang Yu, Sara E. Howard, Bradley Perkins, Jessica K. Devin, John R. Koethe, Jonathan D. Brown, Heidi Silver, James M. Luther, Nancy J. Brown
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- Journal:
- Journal of Clinical and Translational Science / Volume 6 / Issue s1 / April 2022
- Published online by Cambridge University Press:
- 19 April 2022, pp. 81-82
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OBJECTIVES/GOALS: We aimed to determine if GLP-1 receptor agonists exert beneficial effects on surrogate measures of cardiovascular function independently of weight loss. Our objective was to compare the outcomes between GLP-1 receptor agonist treatment versus a similar drug without cardiovascular benefit versus weight loss through diet alone. METHODS/STUDY POPULATION: We enrolled 88 individuals with obesity (BMI ≥ 30kg/m2) and pre-diabetes and randomized them in a 2:1:1 ratio to 14 weeks of the GLP-1 receptor agonist liraglutide, the dipeptidyl peptidase-4 inhibitor sitagliptin, or hypocaloric diet. Sitagliptin blocks degradation of endogenous GLP-1 but does not cause weight loss or lower adverse cardiovascular outcomes. Treatment was double-blinded and placebo-controlled for drug, and unblinded for diet. Primary endpoints were flow-mediated dilation (FMD) to assess endothelial vasodilatory function, and plasminogen activator inhibitor-1 (PAI-1) to assess endothelial fibrinolytic function. We used a general linear model for each outcome and included gender as a covariate for FMD. Baseline characteristics were similar. Mean age was 50, with 32% men and 13% black. RESULTS/ANTICIPATED RESULTS: At 14 weeks, diet and liraglutide caused weight loss (diet -4.3 ± 3.2 kg, P<0.01; liraglutide -2.7 ± 3.2, P<0.01), while sitagliptin did not (-0.7 ± 2.0, P=0.17). Diet did not improve FMD at 14 weeks compared to baseline (+0.9%, 95% CI [-1.5, 3.3], P=0.46). FMD tended to increase after liraglutide and sitagliptin but was not significant (liraglutide +1.2 [-0.3, 2.8], P=0.12; sitagliptin +1.6 [-0.6, 3.8], P=0.15). Given that liraglutide and sitagliptin work through the same GLP-1 pathway, we combined the liraglutide and sitagliptin groups for overall effect on FMD, which was significantly improved from baseline (+1.4 [0.1, 2.8], P=0.04). Diet and liraglutide improved PAI-1 at 14 weeks (diet -4.4U/mL, [-8.5, -0.2], P=0.04; liraglutide -3.4 [-6.0, -0.7], P=0.01), while sitagliptin did not (-1.4 [-5.1, 2.3], P=0.46). DISCUSSION/SIGNIFICANCE: Activation of the GLP-1 pathway by liraglutide or sitagliptin improves FMD independent of weight loss, while PAI-1 improvement is weight-loss dependent and is only seen after liraglutide or diet. Our study suggests the cardiovascular benefit of liraglutide may be due to combined improvements in endothelial vasodilatory and fibrinolytic function.
The Rockefeller Team Science Leadership training program: Curriculum, standardized assessment of competencies, and impact of returning assessments
- Roger Vaughan, Michelle Romanick, Donna Brassil, Rhonda Kost, Maija Neville-Williams, Riva Gottesman, Rita Devine, Prasanth Manukonda, Andrea Ronning, Barbara O’Sullivan, Bernadette Capili, Robert Macarthur, Jonathan N. Tobin, Tesheia Johnson, Eugene D. Shapiro, Emma Meagher, James Krueger, Sarah Schlesinger, Barry S. Coller
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- Journal:
- Journal of Clinical and Translational Science / Volume 5 / Issue 1 / 2021
- Published online by Cambridge University Press:
- 13 August 2021, e165
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The ability to effectively lead an interdisciplinary translational team is a crucial component of team science success. Most KL2 Clinical Scholars have been members of scientific teams, but few have been team science leaders. There is a dearth of literature and outcome measures of effective Team Science Leadership in clinical and translational research. We focused our curriculum to emphasize Team Science Leadership, developed a list of Team Science Leadership competencies for translational investigators using a modified Delphi method, and incorporated the competencies into a quantitative evaluation survey. The survey is completed on entry and annually thereafter by the Scholar; the Scholar’s primary mentor and senior staff who educate and interact with the Scholar rate the Scholar at the end of each year. The program leaders and mentor review the results with each Scholar. The survey scales had high internal consistency and good factor structure. Overall ratings by mentors and senior staff were generally high, but ratings by Scholars tended to be lower, offering opportunities for discussion and career planning. Scholars rated the process favorably. A Team Science Leadership curriculum and periodic survey of attained competencies can inform individual career development and guide team science curriculum development.
The Rockefeller University Clinical Scholars (KL2) program 2006–2016
- Sarah J. Schlesinger, Michelle Romanick, Jonathan N. Tobin, Donna Brassil, Rhonda G. Kost, Rita Devine, Barbara O’Sullivan, Roger D. Vaughan, Yupu Liang, Joel Correa da Rosa, Maija Williams, James G. Krueger, Barry S. Coller
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- Journal:
- Journal of Clinical and Translational Science / Volume 1 / Issue 5 / October 2017
- Published online by Cambridge University Press:
- 02 February 2018, pp. 285-291
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Introduction and Methods
The Rockefeller Clinical Scholars (KL2) program began in 1976 and transitioned into a 3-year Master’s degree program in 2006 when Rockefeller joined the National Institute of Health Clinical and Translational Science Award program. The program consists of ∼15 trainees supported by the Clinical and Translational Science Award KL2 award and University funds. It is designed to provide an optimal environment for junior translational investigators to develop team science and leadership skills by designing and performing a human subjects protocol under the supervision of a distinguished senior investigator mentor and a team of content expert educators. This is complemented by a tutorial focused on important translational skills.
ResultsSince 2006, 40 Clinical Scholars have graduated from the programs and gone on to careers in academia (72%), government service (5%), industry (15%), and private medical practice (3%); 2 (5%) remain in training programs; 39/40 remain in translational research careers with 23 National Institute of Health awards totaling $23 million, foundation and philanthropic support of $20.3 million, and foreign government and foundation support of $6 million. They have made wide ranging scientific discoveries and have endeavored to translate those discoveries into improved human health.
ConclusionThe Rockefeller Clinical Scholars (KL2) program provides one model for translational science training.
On the dynamics of turbulence near a free surface
- Oscar Flores, James J. Riley, Alexander R. Horner-Devine
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- Journal of Fluid Mechanics / Volume 821 / 25 June 2017
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- 22 May 2017, pp. 248-265
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We report on direct numerical simulations to examine the spectral behaviour of turbulence close to and at a flat, stress-free surface. We find, consistent with field measurements near such a free surface, that an inertial-range type of behaviour is obtained for the horizontal components of the velocity at and near the stress-free surface, at horizontal wavelengths for which the vertical velocity is much smaller than the horizontal components. At approximately an integral length scale from the stress-free surface, the flow has adjusted back to more classical isotropic turbulence. The behaviour of the turbulence near the stress-free surface is similar to that observed recently for strongly stratified flows, and we argue that the causes of that behaviour are the same in both flows: the suppression of the large-scale vertical velocity and the allowance of strong vertical shearing of the horizontal velocity leading to a downscale transfer of energy and to the development of the $-5/3$ spectra for the horizontal velocities.
Severe Influenza in 33 US Hospitals, 2013–2014: Complications and Risk Factors for Death in 507 Patients
- Nirav S. Shah, Jared A. Greenberg, Moira C. McNulty, Kevin S. Gregg, James Riddell IV, Julie E. Mangino, Devin M. Weber, Courtney L. Hebert, Natalie S. Marzec, Michelle A. Barron, Fredy Chaparro-Rojas, Alejandro Restrepo, Vagish Hemmige, Kunatum Prasidthrathsint, Sandra Cobb, Loreen Herwaldt, Vanessa Raabe, Christopher R. Cannavino, Andrea Green Hines, Sara H. Bares, Philip B. Antiporta, Tonya Scardina, Ursula Patel, Gail Reid, Parvin Mohazabnia, Suresh Kachhdiya, Binh-Minh Le, Connie J. Park, Belinda Ostrowsky, Ari Robicsek, Becky A. Smith, Jeanmarie Schied, Micah M. Bhatti, Stockton Mayer, Monica Sikka, Ivette Murphy-Aguilu, Priti Patwari, Shira R. Abeles, Francesca J. Torriani, Zainab Abbas, Sophie Toya, Katherine Doktor, Anindita Chakrabarti, Susanne Doblecki-Lewis, David J. Looney, Michael Z. David
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 36 / Issue 11 / November 2015
- Published online by Cambridge University Press:
- 30 July 2015, pp. 1251-1260
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- November 2015
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BACKGROUND
Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013–2014 influenza season. Little is known about the epidemiology of severe influenza during this season.
METHODSA retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.
RESULTSA total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4–6.9], P=.006 and 50–64 years, 2.5 [1.3–4.9], P=.007; reference age 18–49 years), male sex (1.9 [1.1–3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9–37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2–1.4], P<.001).
CONCLUSIONRisk factors for death among US patients with severe influenza during the 2013–2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season.
Infect. Control Hosp. Epidemiol. 2015;36(11):1251–1260
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- 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
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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- By Magdalena Anitescu, Charles E. Argoff, Arash Asher, Nyla Azam, Nomen Azeem, Sachin K. Bansal, Jose E. Barreto, Rodrigo A Benavides, Niteesh Bharara, Justin B. Boge, Robert B. Bolash, Thomas K. Bond, Christopher Centeno, Zachariah W. Chambers, Jonathan Chang, Grace Chen, Hamilton Chen, Jeffry Chen, Jianguo Cheng, Natalia Covarrubias, Claire J. Creutzfeldt, Gulshan Doulatram, Amirpasha Ehsan, Ike Eriator, Jeff Ericksen, Mark Etscheidt, Frank J. E. Falco, Jack Fu, Timothy Furnish, Annemarie E. Gallagher, Kingsuk Ganguly, Eugene Garvin, Cliff Gevirtz, Scott E. Glaser, Brandon J. Goff, Harry J. Gould, Christine Greco, Jay S. Grider, Maged Guirguis, Qiao Guo, Justin Hata, John Hau, Garett J. Helber, Eric R. Helm, Lori Hill Marshall, Dean Hommer, Jeffrey Hopcian, Eric S. Hsu, Jakun Ing, Tracy P. Jackson, Gaurav Jain, Chrystina Jeter, Alan David Kaye, James Kelly, Soorena Khojasteh, Ankur Khosla, Daniel Krashin, Monika A. Krzyzek, Prasad Lakshminarasimhiah, Steven Michael Lampert, Garrett LaSalle, Quan D. Le, Ankit Maheshwari, Edward R. Mariano, Joaquin Maury, John P. McCallin, John Michels, Natalia Murinova, Narendren Narayanasamy, Rebekah L. Nilson, Elliot Palmer, Vikram B. Patel, Devin Peck, Donald B. Penzien, Danielle Perret Karimi, Tilak Raj, Michael R. Rasmussen, Mohit Rastogi, Rahul Rastogi, Nashaat N. Rizk, Rinoo V. Shah, Paul A. Sloan, Julian Sosner, A. Raj Swain, Minyi Tan, Natacha Telusca, Santhosh A. Thomas, Andrea Trescot, Michael Truong, Jason Tucker, Richard D. Urman, Brandon A. Van Noord, Nihir Waghela, Irene Wu, Jiang Wu, Jijun Xu, Jinghui Xie, William Yancey
- Edited by Alan David Kaye, Louisiana State University, Rinoo V. Shah
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- Case Studies in Pain Management
- Published online:
- 05 October 2014
- Print publication:
- 16 October 2014, pp xi-xv
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- By J. Todd Arnedt, Sharon Aronovich, Alon Y. Avidan, Alp Sinan Baran, Johnathan Barkham, Lizabeth Binns, Tiffany J. Braley, Devin Brown, Paul R. Carney, Philip Cheng, Ronald D. Chervin, Naricha Chirakalwasan, Wattanachai Chotinaiwattarakul, Deirdre A. Conroy, Charles R. Davies, Dawn Dore-Stites, Alan S. Eiser, Todd Favorite, Barbara T. Felt, James D. Geyer, Jennifer R. Goldschmied, Cathy A. Goldstein, John J. Harrington, Fauziya Hassan, Judith L. Heidebrink, Joseph I. Helman, Shelley Hershner, Timothy F. Hoban, Edward D. Huntley, Rahul K. Kakkar, Douglas Kirsch, Raman K. Malhotra, Beth A. Malow, Lauren O’Connell, Shalini Paruthi, Meredith D. Peters, Scott M. Pickett, Satya Krishna Ramachandran, Fouad Reda, Daniel I. Rifkin, Emerson Robinson, Helena M. Schotland, Q. Afifa Shamim-Uzzaman, Anita Valanju Shelgikar, Renée A. Shellhaas, Jeffrey J. Stanley, Leslie M. Swanson, Mihai C. Teodorescu, Mihai C. Teodorescu, Sheila C. Tsai, Katherine Wilson, Michael E. Yurcheshen, Sarah Nath Zallek
- Edited by Ronald D. Chervin
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- Book:
- Common Pitfalls in Sleep Medicine
- Published online:
- 05 April 2014
- Print publication:
- 10 April 2014, pp x-xiv
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Multihospital Outbreak of Clostridium difficile Ribotype 027 Infection: Epidemiology and Analysis of Control Measures
- Mamoon A. Aldeyab, Michael J. Devine, Peter Flanagan, Michael Mannion, Avril Craig, Michael G. Scott, Stephan Harbarth, Nathalie Vernaz, Elizabeth Davies, Jon S. Brazier, Brian Smyth, James C. McElnay, Brendan F. Gilmore, Geraldine Conlon, Fidelma A. Magee, Feras W. Darwish Elhajji, Shaunagh Small, Collette Edwards, Chris Funston, Mary P. Kearney
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 32 / Issue 3 / March 2011
- Published online by Cambridge University Press:
- 02 January 2015, pp. 210-219
- Print publication:
- March 2011
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Objective.
To report a large outbreak of Clostridium difficile infection (CDI; ribotype 027) between June 2007 and August 2008, describe infection control measures, and evaluate the impact of restricting the use of fluoroquinolones in controlling the outbreak.
Design.Outbreak investigation in 3 acute care hospitals of the Northern Health and Social Care Trust in Northern Ireland.
Interventions.Implementation of a series of CDI control measures that targeted high-risk antibiotic agents (ie, restriction of fluoroquinolones), infection control practices, and environmental hygiene.
Results.A total of 318 cases of CDI were identified during the outbreak, which was the result of the interaction between C. difficile ribotype 027 being introduced into the affected hospitals for the first time and other predisposing risk factors (ranging from host factors to suboptimal compliance with antibiotic guidelines and infection control policies). The 30-day all-cause mortality rate was 24.5%; however, CDI was the attributable cause of death for only 2.5% of the infected patients. Time series analysis showed that restricting the use of fluoroquinolones was associated with a significant reduction in the incidence of CDI (coefficient, —0.054; lag time, 4 months; P = .003).
Conclusion.These findings provide additional evidence to support the value of antimicrobial stewardship as an essential element of multifaceted interventions to control CDI outbreaks. The present CDI outbreak was ended following the implementation of an action plan improving communication, antibiotic stewardship, infection control practices, environmental hygiene, and surveillance.
Roemer's “General” Theory of Exploitation Is a Special Case: The Limits of Walrasian Marxism
- James Devine, Gary Dymski
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- Journal:
- Economics & Philosophy / Volume 7 / Issue 2 / October 1991
- Published online by Cambridge University Press:
- 05 December 2008, pp. 235-275
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In a series of recent writings, John Roemer (1982a, 1982b, 1985, 1988) has made a provocative claim: exploitation and class are merely second-order concepts within Marxian theory, because both phenomena derive directly from differential ownership of productive assets (DOPA); indeed, exploitation remains a consistent index of economic injustice only if a “property relations” conception of exploitation replaces the common “labor-value” view. In sum, property relations, not the labor exchange, the labor proces, labor values, or even capitalist accumlation should be the central concern of Marxian theory.
Walrasian Marxism Once Again: A Reply to John Roemer
- James Devine, Gary Dymski
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- Journal:
- Economics & Philosophy / Volume 8 / Issue 1 / April 1992
- Published online by Cambridge University Press:
- 05 December 2008, pp. 157-162
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John Roemer's comment (1992) succinctly summarizes the logical structure of his own theory of capitalist exploitation, but misunderstands the main points of our critique. He reduces his argument to two propositions. The first is an “empirical proposition”about the “root causes of exploitation”: X + Y →Z, where X is the existence of differential ownership of means of production (DOPA), Y is coercion in the labor process, and Z is the capitalist class structure and exploitation. The second is the strictly theoretical proposition X + not-Y -”Z, the truth of which he demonstrates, given most of the assumptions of a Walrasian economic model. He concludes that these two propositions, taken together, demonstrate the primacy of DOPA in explaining capitalist class relations. This much is true – subject to the various limitations we have indicated in our article – but only within the restricted confines of a Walrasian framework. This purely theoretical conclusion has no force as an empirical conclusion: this is the point at which Roemer's interpretation goes awry. For obviously, DOPA is a crucial element of empirical reality. But because Roemer's Walrasian framework precludes other equally crucial elements of empirical reality (which are also conceptually central to Marxian discourse), an irreducible distance remains therein between the theoretical and the empirical.
The Peace of Illusions: American Grand Strategy from 1940 to the Present
- T. James Devine
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- Journal:
- Canadian Journal of Political Science/Revue canadienne de science politique / Volume 40 / Issue 4 / December 2007
- Published online by Cambridge University Press:
- 21 November 2007, pp. 1071-1072
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The Peace of Illusions: American Grand Strategy from 1940 to the Present, Christopher Layne, Cornell Studies in Security Affairs; Ithaca and London: Cornell University Press, 2006, pp. 304, xi.
In The Peace of Illusions, Christopher Layne explores the issue of American grand strategy, past, present and future. Adopting a classical realist approach, which incorporates both domestic politics and external security concerns, Layne offers provocative conclusions about the nature of American foreign policy and the challenges facing the country in the years to come. This book contributes to a debate that began with the end of the Cold War. It was eclipsed by September 11, but has re-emerged as scholars have begun to contemplate the limits of US hegemony and the need for coherent strategy.
Immediate and delayed stimulus repetitions evoke different ERPs in a serial-probe recognition task
- STEPHEN L. CRITES, PEDRO DELGADO, JAMES V. DEVINE, DORA I. LOZANO
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- Journal:
- Psychophysiology / Volume 37 / Issue 6 / November 2000
- Published online by Cambridge University Press:
- 15 December 2000, pp. 850-858
- Print publication:
- November 2000
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In this study we examined whether event-related potentials (ERPs) associated with stimulus repetition and recognition in a serial-probe recognition task were comparable to ERPs in other tasks that are more typically used to investigate old/new ERP effects. The experiment consisted of 320 trials in which a recognition probe followed a four-item memory set; 160 trials consisted of images depicting common objects that were easy to label (EL task), and 160 trials consisted of images depicting abstract patterns that were difficult to label (DL task). Nineteen participants indicated whether a probe that followed each memory set was or was not presented in the memory set. Half of the probes matched, and half did not match, an item in the preceding memory set. ERPs appeared to reflect two processes—one that differentiated between recently presented stimuli and other stimuli and another that distinguished between repeated stimuli and new stimuli. ERPs to recent probes were more positive than ERPs to other probes in the EL and DL tasks. ERPs to match (old) probes were more positive than ERPs to nonmatch (new) probes only in the EL task.
Event-related potentials and serial position effects in a visual probe recognition task
- STEPHEN L. CRITES, JAMES V. DEVINE, DORA I. LOZANO, SELENE MORENO
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- Journal:
- Psychophysiology / Volume 35 / Issue 3 / May 1998
- Published online by Cambridge University Press:
- 01 May 1998, pp. 293-304
- Print publication:
- May 1998
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In two experiments, we explored the utility of using event-related brain potentials (ERPs) evoked during picture recognition to examine the cognitive and neural processes underlying primacy and recency effects. Each experiment consisted of 210 trials in which a recognition probe followed a 12-picture sequence (105 match and 105 nonmatch trials). The 105 match-probe trials consisted of 35 trials in which the probe matched a prime memory set item (Positions 1–3), 35 in which the probe matched a middle memory set item (Positions 6–8), and 35 in which the probe matched a recent memory set item (Positions 10–12). Behavioral results revealed recency but not primacy effects in both experiments. Recent probes, compared with prime and middle probes, evoked ERPs that were more positive from approximately 300 to 400 ms; this enhanced positivity occurred in a positive component peaking around 315 ms and a negative component peaking around 365 ms. These findings fit more closely with the notion of short-term memory as an activation of elements in long-term memory than as a distinct memory store (or stores) separate from long-term memory.
Scintillation Counter Performance at the SMU Radiocarbon Laboratory∗
- James M Devine, Herbert Haas
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- Journal:
- Radiocarbon / Volume 29 / Issue 1 / 1987
- Published online by Cambridge University Press:
- 18 July 2016, pp. 12-17
- Print publication:
- 1987
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Results are presented of a study of counter performance and vial characteristics for three liquid scintillation counters used at the SMU Radiocarbon Laboratory: the Intertechnique LS20, Packard Tri-Carb 460C, and LKB Wallac Rack Beta 1217. Modifications to photomultiplier tube high voltage, pre-amplifier gain, energy window settings, counting vial design, and sample holder design have resulted in reduced background, higher counting efficiency, and greater long-term stability for the Intertechnique and Packard counters. Square quartz counting vials are used in the Intertechnique and Packard counters with excellent results. Use of Teflon vials in the LKB counter requires careful cleaning procedures and long counting times.