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Rewriting Hell: Adaptation, Hope, and the \u27American Dream\u27 in Practice-as-Research
No full textContemporary theatrical adaptation involves deconstructing, reimagining, and rewriting historical plays for modern audiences. Adaptation appropriates theatrical conventions, changes the lens through which the audience may view the play, and offers new entry points into thinking and practice. Adaptation asks, “why this source as theatre now?” and proposes that history provides tools for engagement with contemporary issues. By employing a Practice as Research methodology, which positions creative processes such as script development, rehearsal, or play development as research methods, I investigated the art of historical adaptation. I adapted No Exit, a 1945 existentialist play by Jean-Paul Sartre, into a new play called LAST EXIT. I developed my script through collaborative workshops, staged a formal reading of the final draft, and gathered praxis-based knowledge, including audience feedback and artists’ interpretations of the text, throughout the process. My project explores the following question: how can historical plays help modern audiences respond constructively to current conflicts?
Written during the occupation of Paris in World War II, No Exit was a subversive display of anti-fascist resistance; a statement of hope despite the terrifying circumstances in which the characters find themselves. My adaptation, set in the present-day United States, examines the corruption of democracy, political polarization, and the performance of identity during crisis. As changes reshape the nation’s political, social, and cultural landscape, our collective “ending” feels increasingly uncertain. Yet, Sartre’s message resonates: if you are unhappy with your situation you have only one thing to do…take action. Contemporary adaptations, motivated by the belief that creative production and cultural participation can fortify the best parts of our humanity, allow us to build compassionate, people-centered communities
Comparison of Gluteus Medius Muscle Activation in Women With and Without Patellofemoral Pain
No full textContext: Women with patellofemoral pain (PFP) commonly have hip muscle weakness in comparison with women without PFP. One underlying mechanism for this muscle weakness is inhibition. Although the presence of muscle weakness is well documented in women with PFP, few authors have investigated gluteus medius inhibition in this population. Women are twice as likely to suffer from PFP when compared with men; therefore, we focused on the female population.
Objective: To compare voluntary activation of the gluteus medius between women with and without PFP.
Design: Case-control study.
Setting: Laboratory.
Patients or Other Participants: Twenty-eight female participants: 13 pain-free control participants (age ¼ 21.6 6 3.6 years, height ¼ 1.66 6 0.06 m, mass ¼ 65.4 6 11.3 kg) and 15 participants with PFP (age ¼ 22.3 6 3.2 years, height ¼ 1.66 6 0.07 m, mass ¼ 75.3 6 22.6 kg, duration of pain ¼ 3.5–96 months).
Main Outcome Measure(s): Standing hip-abduction normalized strength (N·m/kg), superimposed-burst force, and gluteus medius central activation ratio (CAR). Linear modeling was used to compare forces and the CAR between groups while controlling for age, mass, and hip-abduction force.
Results: Women with PFP had lower gluteus medius CAR than controls. Overall, after controlling for participant age, mass, and gluteus medius maximal voluntary isometric contraction, the PFP group had an average gluteus medius CAR 2.5% lower than the pain-free control group (control ¼ 98.4% 6 0.01%, PFP ¼ 95.9% 6 0.65%, P ¼ .004).
Conclusions: Women with PFP had reduced voluntary activation of the gluteus medius when assessed with a superimposed burst. Due to the wide range of CAR values found (74%–99%), inhibition was present in some of the participants. This provides evidence that assessment of gluteal voluntary activation could assist with targeted treatment programs for individuals presenting with PFP
Manual Therapy in Conjunction With Other Multimodal Interventions in a Patient With Chronic Pain and Hypertension: A Case Report
No full textChronic pain and hypertension (HTN) are worldwide epidemics that are difficult to manage and frequently encountered as comorbid conditions in patient care. There is a paucity of information regarding the effect that manual therapy has on blood pressure (BP), particularly in those with chronic pain and HTN. This case report describes the management of a patient with chronic pain and HTN. The patient was a 41-year-old female with chronic multisite pain and multiple comorbidities, including HTN. Her BP at the initial evaluation was 147/78 with an oscillated device and 142/82 with a sphygmomanometer in the right arm and 144/80 in the left. The physical examination of the patient warranted a mid-thoracic thrust manipulation in supine. Manual therapy, education, meditation, and aerobic exercise were used throughout the episode of care (seven visits across 9 weeks). Upon reassessment after the thoracic thrust manipulation (5 min of quiet sitting), BP in the right arm was 105/65 with an oscillated device and 105/68 with a sphygmomanometer. Significant improvements in the Patient Specific Functional Scale, Lower Extremity Functional Scale, Numeric Pain Rating Scale, and BP were noted throughout the episode of care. She was able to return to her previous walking program. Improvements in pain, BP, and patient-reported outcomes were made in a patient with chronic multisite pain and HTN. Manual therapy, in conjunction with education, meditation, and aerobic exercise, may have aided in improving this patient\u27s function and BP. Caution should be used when interpreting results from this case report. Future studies should examine the effects of physical therapy intervention, including manual therapy, in those with chronic pain and HTN. Manual therapy could be considered as an intervention to improve chronic pain and HTN
Updated Prevalence Estimates of Obesity Among Adults in the United States, 2005–2018
No full textIntroduction
Body mass index is an imperfect measure of excess adiposity but is ingrained in both research and clinical practice to define and diagnose adult obesity. The addition of waist circumference measure is recommended to fully capture obesity-related health risks at a population level. The latest reframing of obesity by the Lancet Commission relies on body mass index and waist circumference, as well as organ dysfunction and functional limitations, to differentiate between preclinical and clinical obesity. Methods
Using data from the National Health and Nutrition Examination Survey (2005–2018), we adhere to the proposed redefinition to examine obesity trends in the adult U.S. population. Results
In line with previously published estimates of obesity defined solely by body mass index, we show that the prevalence of both preclinical and clinical obesity increased between 2005 and 2018. However, the prevalence of preclinical obesity calculated by BMI plus WC is lower than the estimates derived from using BMI or WC as the sole metrics. Conclusion
Using the Commission’s added measures yields refined population estimates for two categories—preclinical and clinical obesity. These updated estimates separate preclinical cases—at elevated risk and eligible for prevention—from those meeting clinical-obesity criteria, who require intervention
Major Drivers of Consumer Choice of Dairy Milk and Plant-based Milk Alternatives in Coffee
No full textCoffee shops in the United States typically offer several options of dairy milk and plant-based milk alternatives (PBMA) for espresso-based beverages. Although previous studies have explored consumer preferences for dairy or PBMA in general, none have examined what drives their milk or PBMA choices specifically in the context of coffee shops. This study aimed to identify key decision drivers for the choice of milks in coffee, assess the role of lactose-free preferences, and explore whether offering lactose-free cow milk would increase coffee shop visits. Following a preliminary study using in-depth interviews, an online survey was used to collect data from 300 regular coffee drinkers in California, ages 18 and older, consisting of 50% males and 50% females. The survey participants were self-identified as primary dairy milk drinkers, primary PBMA drinkers, or flexitarians, depending on their milk and PBMA consumption habits. The highest-impact drivers for choice of milk for all 3 groups were taste and texture, along with health and nutrition. Dairy milk drinkers\u27 and flexitarians\u27 choices of dairy milk and PBMA were also affected by how familiar the dairy milks and PBMA were to them. Flexitarians and primary PBMA drinkers were more familiar with lactose-free milk than primary dairy milk drinkers. A significant portion of PBMA drinkers (32%) and flexitarians (36%) would be more likely to visit a coffee shop if lactose-free milk was available. The results reveal opportunities for the dairy industry to boost dairy consumption in coffee by promoting lactose-free dairy milk\u27s digestibility and comparable nutrition profile to traditional dairy milk
Integrating LLMs and Causal Inference: Comparing Oral Anticoagulant Effects on Thrombosis Recurrence, Bleeding Risk and Death Using MIMIC-IV Data
No full textMany clinically important variables are found only in medical notes, leaving gaps for prediction and confounding adjustment. We analyzed medical discharge notes for acute-thrombosis admissions in MIMIC-IV. Privacy was preserved by generating synthetic medical notes that mirror the content and structure of the original medical discharge notes, labelling them with reasoning steps and classifications using the DeepSeek-R1 API, and fine-tuning 8–14 billion parameter versions of Llama-3, Qwen-3 and Gemma-3 models with Group Relative Policy Optimization (GRPO). Qwen-3 achieved the highest accuracy on a hold-out set of synthetic notes and de-identified real medical notes.
Variables extracted from medical notes, including family history of clot and provoked versus unprovoked status, were combined with structured fields and passed to a Super Learner formed from non-parametric, semi-parametric and tree learners. The ensemble attained the lowest negative log-likelihood (NLL) when predicting major bleeding and thrombosis recurrence within 3 and 6 months and mortality within 12 months; adding discharge medical note-level covariates reduced loss by 0.2% – 1.7% across outcomes.
Causal effects of Vitamin K Antagonist (VKA) which was primarily Warfarin, and Factor Xa inhibitors (Apixaban, Edoxaban, Rivaroxaban) were estimated with targeted maximum likelihood estimation (TMLE), which uses initial Super Learner fits for the outcome and treatment mechanisms followed by a targeting step that achieves doubly robust, efficient inference. After adjustment for both structured and medical notes-text covariates, VKA increased the risk of major bleeding by 4.5% with 95% C.I of (3.4% – 5.7%) at 3 months and 5.8% with 95% C.I (4.6% – 7.0%) at 6 months and raised thrombosis recurrence by 3.2% with 95% C.I (1.8% – 4.6%) and 3.5% with 95% C.I (2.1% – 5.0%) over the same horizons. No significant difference in 12-month mortality was detected with 95% C.I (–1.7 % to 0.6%).
These findings show that large language models (LLMs) extraction of discharge summaries can improve risk prediction and strengthen confounding control in targeted learning. Incorporating such variables reveals lower short-term risks of bleeding and recurrence with Factor Xa inhibitors compared with VKA while long-term survival remains similar
Changing the World, One Play at a Time
No full textThroughout history, the performing arts have been used as an accessible tool for communication, raising awareness about social issues and affecting positive change. Social justice theatre encompassing documentary theatre, verbatim theatre, and social justice ethnodrama is designed to raise critical consciousness, build community, interrupt, and alter oppressive systemic social patterns, and motivate individuals to promote social change. This chapter addresses how social justice influenced the development of a two-act crime victim advocacy play titled Call this Number and critically analyzes social justice theatre through the lens of narrative engagement theory. This chapter advances understanding of how to develop social justice theatre, ways to assess if social justice goals are being achieved when producing this work, and provide a useful theoretical lens for understanding how social justice theatre can promote social justice goals.https://digitalcommons.chapman.edu/communication_books/1026/thumbnail.jp
Accelerated Molecular Aging in Socioeconomically Disadvantaged Neighborhoods: A Racial/Ethnic Comparison
Full text linkIn the US, racial/ethnic health disparities are undeniable. These disparities partially stem from residing in low socioeconomic neighborhoods, a circumstance to which racial/ethnic minorities are disproportionately exposed. Associations between socioeconomic status (SES) and health may have some underlying molecular mechanisms reflected in the epigenome. Yet, a growing body of research suggests that neighborhood characteristics are not experienced the same way for individuals from differing racial/ethnic backgrounds. The present study evaluated associations between area-based SES and epigenetic age as assessed by the Horvath, Hannum, PhenoAge, and GrimAge epigenetic clocks in a national sample of older non-Hispanic White, non-Hispanic Black, and Hispanic participants. The present study used epigenetic age data from 3790 participants in the 2016 wave of the Health and Retirement Study and census tract SES data from the 2012–2016 American Community Survey. Four epigenetic clocks were regressed on area-based SES, adjusting for age, sex, and educational attainment. Although area-based SES was not significantly associated with Horvath or Hannum clocks, living in lower SES census tracts was associated with older PhenoAge and GrimAge. After considering smoking status, however, only the association with GrimAge remained. Investigating interactions with race/ethnicity suggested that area-based SES was more strongly associated with accelerated Hannum, PhenoAge, and GrimAge among non-Hispanic White participants than for other racial/ethnic groups. These racial/ethnic differences were completely reduced, however, in models that included smoking status. The present results illuminated racially/ethnically distinct patterns of biological (epigenetic aging) and behavioral (smoking) risk for poor health, and suggested that ameliorating low area-based SES may be beneficial for racially/ethnically diverse populations
Adam Smith’s Modeling of Agents: Roots versus Consequences of Action
Full text linkAdam Smith founded his investigations of economic and social exchanges on the roots of human action (sympathy, need, self-interest), unlike the utilitarians (Hume and the neoclassical economists), who centered theirs on the consequences of human action (pleasure, utility of outcome). This distinction is key to understanding the contrast between the two schools of thought, as we emphasize in this chapter