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Research priorities for adult hospital medicine: A survey of US hospital medicine leaders
Get PDFHospital medicine (HM), a well-established clinical specialty, requires clarity of research priorities to identify target areas for investment in HM research infrastructure and activities. The Society of Hospital Medicine's Research Committee developed a 20-item survey and used purposeful sampling of US hospitalist leaders to prioritize primary research topic domains and subdomains. Respondents were asked to rank their HM research priorities using a scale (1 [highest] to 8 [lowest]). Of 239 surveys distributed, 81 (34%) responded. Respondents were predominantly White (53%) and from academic institutions (57%). “Overall, 46% of respondents were male and 33% were female.” Top-ranked research domains were innovation in care delivery (median 2, IQR 1,3), value-based care (median 3.5, IQR 2,6), and health disparities (median 4, IQR 2,5). This survey identified top HM research priorities including systems-based topics and health disparities, aligning with HM's identity as a specialty focused on improving systems of care and inequities in care
Forum: Lévi-Strauss’s “The Mathematics of Man”
Get PDFIn a recent issue (Vol. 67, No. 2), we published a new translation, by Matthew Carey, of Claude Lévi-Strauss's seminal but often overlooked essay “The Mathematics of Man,” which was originally published in French in 1956. As Susanne Küchler suggested in her introduction to the text, Lévi-Strauss's insistence on seeing mathematics as more than just a means of quantification and statistical analysis should be of enduring inspiration to anthropologists interested in how models and other forms of patterned transformation operate within social and cultural life, as well as in how we attempt as anthropologists to gain an analytical handle on them. In continued collaboration with Küchler, in the present issue we have invited anthropologists whose work speaks to these concerns to comment on the contemporary relevance of Lévi-Strauss's argument, encouraging them to be as explicit about the shortcomings and potential dangers of Lévi-Strauss's call to mathematics as they may be of its enduring insights and promise
Spinal epidural abscess post-ureteroscopy: A case report
Get PDFBackground: Spinal epidural abscess (SEA) is an uncommon but potentially life-threatening infection that requires prompt identification and treatment. Early SEAs may present with non-specific symptoms, including fever, chills, headache, and back pain, before progressing to neurologic dysfunction. To our knowledge, there have been no reports of immunocompetent patients with a history of recurrent UTIs presenting with SEA following ureteroscopy (URS) and lithotripsy (LL). Case presentation: In this article, we present two cases of spinal abscess formation after ureteroscopy in patients with histories of recurrent urinary tract infections but without previous spinal pathology. Both patients required procedural intervention and one patient sustained lasting neurological deficits. Conclusions: It is important that urologists be aware of this possible complication to ensure the early diagnosis of the disease to facilitate appropriate management.</p
Understanding Protein Dynamics in Hearing and Beyond through Thermodynamic Stability and Conformational Dynamics
Get PDFProteins are not static structures; they are dynamic machines whose motions underpin nearly all aspects of biological function. While structure prediction tools such as AlphaFold have revolutionized biology and made atomic level protein structures widely accessible, understanding the landscapes of folding, flexibility, and mechanical behavior remains a major area of investigation. This dissertation presents a set of experimental and computational work illuminating protein conformational dynamics as a way of understanding protein function. First, we investigated the unfolding dynamics of the final four extracellular domains of cadherin-23 (CDH23EC25–MAD28), a protein essential for hearing. Using all-atom simulations, we saw that the membrane-adjacent domain (MAD28) of cadherin-23 unfolds first under tension, but using hydrogen-deuterium exchange mass spectrometry we concluded that the unfolding behavior is likely driven by the topology of the folded MAD28 rather than a difference of thermodynamic stability. We go on to use calcium depletion and two deafness-causing mutations to show that instability in ECs will cascade into MAD28, but that destabilization of MAD28 alone does not affect ECs, likely due to stabilizing interactions in EC27. These insights represent the first experimental exploration of MAD (in)stability and present a molecular basis for the impact domain unfolding has on healthy and diseased CDH23 function. In parallel, we used simulations to study insulin-degrading enzyme, discovering that it engages with substrates using “beta grab” interactions, that it undergoes a grinding motion to promote substrate unfolding, and that targeted mutations can tune these functions. We also introduce DynaLab, a computational notebook to run and analyze coarse-grained simulations in Upside that was built to make protein dynamics more accessible. Collectively, the insights presented here offer a deeper understanding of how critical motions are for protein function and how we can deploy available tools to demystify protein conformational dynamics
Everything, Everywhere, All at Once: Recorded Song at the End of the World
No full textThis project explores recorded songs as a mode through which the crises of our present historical moment become sensible. It conceives of songs as listening environments that position listeners with respect to an object world—the voices, instruments, and spaces that fill a song. It identifies a tendency for post-millennial pop songs to frustrate the listener’s capacity to get a grip on the song’s environment. The four chapters explore two distinct ways that song and studio figure such incapacity: dissolution, which pushes objects just beyond the listener’s reach through blur and dispersal; and definition, which throws objects into states of sharp focus that register as artificial or hallucinatory. Taken together, these terms produce a figurative space—or, as I call it, a metalistening environment—according to which listeners apprehend the realities presented in and through song. The dissertation’s chapters traverse this space through four distinct tropes laid out over four chapters. Chapter One (“Setting the Tone”) introduces dissolution through a close reading of “Nobody” by indie-pop artist Mitski. It explores what happens when the expressive persona that grounds a song dissolves into its atmosphere, arguing that such dissolution betrays a distrust in personal expression as a political mode. Chapter Two (“Holding It Together”) develops the notion of dissolution by listening to the sonic atmospheres of Billie Eilish’s award-winning song “What Was I Made For?,” a song whose calming effect, I show, issues from how it is able to convert an under-resourced listening environment into a source of abundance. Chapter Three (“Making an Appearance”) shifts the dissertation’s focus away from the blurry and ambiguous toward the focused and hyperreal. As a way into definition, the chapter centers an analysis of Charli XCX’s song “Sympathy Is a Knife,” arguing that the artist registers a loss of reality that accords with our image-obsessed media culture. Chapter Four (“Staying in Contact”) pursues the clarity and precision associated with definition through the concept of the phatic, a communicative mode concerned with affirming presence rather than engaging in symbolic exchange. It theorizes such affirmations of presence as a backstop to meaning breakdown and undifferentiated experience, a provisional form of clarity that functions simultaneously as opening and closure to forms of sociality
Writing Home, Writing Hope: Epistolary Kinship Across Korea's Divided Diasporas
No full text The Korean War (1950–1953) left behind two million civilian casualties, ten million separated families, and over 100,000 orphans—producing the largest number of dispersed families in Korean history. Its effects reverberate today not only on the Korean Peninsula but also in diasporic sites such as Poland and Sakhalin Island. This dissertation examines how Korean families displaced by colonialism, war, and Cold War divisions sustained kinship and articulated hope through letter writing. It explores the often competing yet easily conflated notions of home versus homeland, as well as the alienation, privatization, and mediation of hope, through cases of what I call “epistolary kinship”—familial ties maintained across time and space via correspondence—within the Korean diasporas. Drawing on de Certeau’s notion of spatial practice, this study argues that letter writing constituted a form of home-making and hope-making amid displacement. The dissertation centers on four case studies that span distinct periods, geographies, and modes of separation. Chapter 1 examines the everyday letters of Alice Hyun, a Korean/American eldest daughter writing to her father in 1930s Hawai‘i, showing how gendered responsibilities shaped diasporic kinship and temporarily alienated her from collective political action—tensions that later re-emerged in her defection to North Korea. Chapter 2 turns to the letters of Yi Chungsŏp—modernist artist and Korean War refugee—who corresponded with his wife and children in Japan in the early 1950s. His illustrated marginalia and visual paratexts expressed privatized grief and longing shaped by postcolonial, wartime ruptures within an interethnic family. Chapter 3 analyzes the letters of North Korean war orphans sent to Eastern Europe, distinguishing among publicized, personalized, and privatized articulations of hope and kinship under conditions of state surveillance and abrupt repatriation. These letters reveal how affective ties challenged official narratives of ideological loyalty. Chapter 4 explores letters written by Sakhalin Koreans to a Japan-based civic activist between the 1970s and 1990s, demonstrating how epistolary networks enabled mediated family reunions and sustained emotional belonging across decades of immobility. Through these case studies, the dissertation highlights the heterogeneity of Korean diasporic experiences shaped by colonial legacies and Cold War geopolitics, as well as differentiated meanings of “home” and “hope” across lines of class, gender, language, generation, and ideology. In all four cases, the epistolary space served as a material and textual medium through which Korean diasporic families sought not only to overcome alienation but also to transform the sociopolitical, economic, and cultural conditions that constrained their mobility. This study thus calls for renewed attention to the enduring role of correspondence in sustaining kinship and connecting divided communities. Foregrounding family letters as a key site for examining multiple layers of displacement, the dissertation contributes to broader conversations in diaspora, kinship, and epistolary studies, while expanding historical understandings of Korean migration and family separation. </p
When Structure Takes Over: The Autonomy of Global Supply Chain Networks Beyond Firm Capacity and Institutional Constraints
Get PDFBuilding on research that highlights the role of governance, institutional, and network structures in shaping global value chains (Gereffi et al., 2005; Coe & Yeung, 2015; Coleman, 1998), this study investigates why firms in the semiconductor industry continued to outsource production after the 2020–2023 chip shortage, despite significant shifts in risk and cost (Miller, 2022; European Commission, 2022). I analyze how persistent outsourcing patterns are produced not only by firm capabilities or national policies, but also by the autonomous effects of supply chain network structure itself (Coleman, 1988; Granovetter, 1985). Using an original dataset of 160 publicly traded semiconductor firms and 517 buyer-supplier ties, I apply social network analysis, Quadratic Assignment Procedure (QAP), and Exponential Random Graph Models (ERGM) to systematically disentangle the influence of governance (firm capacity), institutional (state and role similarity), and network (triadic closure) structures on the formation of long-term supplier relationships. While prior research has emphasized the explanatory power of firm resources and state intervention (Williamson, 1981; Goldberg et al., 2024), my results show that institutional similarity—such as shared supply chain role or headquarters country—strongly predicts tie formation within a network, whereas differences in market capitalization and R&D spending do not. Most crucially, the analysis reveals that network structure—specifically, the prevalence of triadic closure—exerts an independent and statistically significant effect on the persistence of outsourcing ties, even after accounting for institutional similarity. This suggests that global supply chain networks can partially decouple from both firm-level capacity and institutional arrangements, sustaining legacy patterns through path-dependent network effects. I argue that, following the chip shortage crisis, the supply chain network itself has become a stabilizing force, locking firms into enduring hybrid relationships and limiting the impact of policy or market interventions
Reconstruction’s Legacies: A Comparative Analysis of W.E.B. Du Bois’s, James S. Allen’s, and Harry Haywood’s Interpretations of Reconstruction
No full textThis paper compares Harry Haywood’s, James S. Allen’s, and W. E. B. Du Bois’s historical interpretations of Reconstruction and its relationship to their contemporary political and social projects from the 1920s to 1940s. By comparing their approaches, we gain a deeper understanding of the relationship between race and democracy, the political significance of Reconstruction, and their hermeneutical engagements with black history. Their historical readings of Reconstruction were largely similar. The primary difference between them was in Allen and Haywood’s belief in a Marxist, stagist teleology and Du Bois’s belief in a more open, contingent temporality. Allen’s and Haywood’s stagist approach attempted to complete Reconstruction’s unfinished revolution by establishing the right to self-determination. Through an interracial revolution, black people would create a black republic that would decide whether to remain in the United States or secede, ensuring democratic development regardless of the broader nation’s support. Skeptical of such a revolution, Du Bois instead proposed that black people adapt to segregation by utilizing their collective purchasing power to create a consumer cooperative movement that would help them secure democratic control over the private and public sectors for their collective development. For Du Bois, Reconstruction left a tradition of economic cooperation that black people should continue, adapted to their contemporary political conditions. However, Du Bois’s belief in a peaceful consumer cooperative movement failed to address the history of Jim Crow violence, a problem Haywood’s and Allen’s stagist belief in revolution partially addressed
PANCS-Binders: A rapid, high-throughput binder discovery platform
Get PDFProteins that selectively bind to a target of interest are foundational in research, diagnostics and therapeutics. Current approaches for discovering binders are laborious and time-consuming, taking months or more, and have a high failure rate. Here we establish phage-assisted noncontinuous selection of protein binders (PANCS-Binders), an in vivo selection platform that links the life cycle of M13 phage to target protein binding through proximity-dependent split RNA polymerase biosensors, allowing for comprehensive screening of whether a variant binds a target with high fidelity. We showcase PANCS-Binders by screening multiple protein libraries each against a panel of 95 separate targets, thereby individually assessing more than 1011 protein–protein interaction pairs, in 2 days. These selections yielded large, high-quality datasets and hundreds of novel binders, which can be affinity matured or directly used in mammalian cells to inhibit or degrade targets. We believe that PANCS-Binders accelerates and simplifies the binder discovery process, which will help unlock new creative potential in proteome targeting with engineered binder-based biotechnologies
Programming the Continuum: Towards Better Techniques for Developing Distributed Science Applications
Get PDFAdvances in networks, accelerators, and cloud services encourage programmers to reconsider where to compute—such as when fast networks make it cost-effective to compute on remote accelerators despite added latency. Workflow and cloud-hosted serverless computing frameworks can manage multi-step computations spanning federated collections of cloud, high-performance computing, and edge systems, but rely on simple abstractions that pose challenges when building applications composed of multiple distinct software with differing communication and patterns. This dissertation introduces new techniques for programming distributed science applications deployed across the computing continuum—research infrastructure that spans personal, cloud, edge, and high-performance computing (HPC) systems. TaPS, a benchmarking suite for reliable evaluation of parallel execution frameworks, is developed and used to investigate limitations in existing solutions. This investigation motivates the design of ProxyStore, a library that extends the pass-by-reference model to distributed applications with the goal of decoupling data flow from control flow. ProxyStore's object proxy paradigm enables the dynamic selection of different data movement methods, depending on what data are moved, where data are moved, or when data are moved—a long-standing challenge in distributed applications. Three high-level patterns—distributed futures, streaming, and ownership—extend the low-level proxy paradigm to support science applications spanning bioinformatics, federated learning, and molecular design, in which substantial improvements in runtime, throughput, and memory usage are demonstrated. Last, Academy, a federated agents system, supports the creation and deployment of pervasive autonomous agents, decentralizing control flow across stateful entities. These techniques encompass an open-source toolbox for developing novel and performant science applications and federated frameworks for the computing continuum