35333 research outputs found
Sort by
The Correlation Of Surgeon Subspecialty With Outcomes Following Surgery For Geriatric Femoral Neck Fractures And Ankle Fractures
No full textAs over 90% of orthopaedic surgeons pursue subspecialization, it remains to be seen how subspecialization is correlated with patient outcomes for surgeries across subspecialty cohorts. Geriatric femoral neck fractures are common and typically managed with hemiarthroplasty (HA), total hip arthroplasty (THA), or percutaneous pinning (PP) by an on-call orthopaedic surgeon, who may subspecialize in arthroplasty, trauma, or other areas. Ankle fractures are also performed by orthopaedic surgeons who may subspecialize in foot & ankle, trauma, or other areas. The current study assessed if perioperative and longer-term outcomes for femoral neck fracture surgery or ankle fracture surgery are correlated with orthopaedic surgeon subspecialty. The PearlDiver M161 Ortho administrative dataset was utilized for this study. For femoral neck fractures, the dataset was queried to identify patients age 65 or greater that underwent HA, THA, or PP. The subspecialty of the treating surgeon for the femoral neck fracture patients was defined as arthroplasty, trauma, or non-arthroplasty/non-trauma. Exclusion criteria included polytrauma as well as concurrent neoplasms and infections. For ankle fractures, the dataset was queried to identify adult patients (age 18 or greater) that underwent surgery. The subspecialty of the treating orthopaedic surgeon was defined as foot & ankle, trauma, or non-foot & ankle/non-trauma. Exclusion criteria included polytrauma as well as concurrent neoplasms and infections. For each of the surgery types, 90-day perioperative adverse events were assessed and compared between surgeon cohorts using multivariate logistic regression, with “non-arthroplasty/non-trauma” serving as the reference for femoral neck fracture patients and “non-foot & ankle/non-trauma” serving as the reference for ankle fracture patients. Five-year revisions/dislocations were assessed, and Kaplan-Meier curves were compared with log rank tests. For femoral neck fractures: A total of 150,728 surgeries were identified. Arthroplasty surgeons performed THA at a higher rate than trauma or non-arthroplasty/non-trauma surgeons (28.1% versus 7.7% and 12.8% respectively, p\u3c0.001). Ninety-day outcomes were quite similar across each of the subspecialties of treating surgeons for each of the surgery types. For HA, the only differences were that the trauma cohort demonstrated a slightly higher rate of aggregated severe adverse events (OR: 1.15, p=0.001) but a lower rate of transfusions (OR: 0.80, p=0.002), compared to the non-arthroplasty/non-trauma group as the reference cohort. For THA no differences were identified. For PP, the only differences were that the arthroplasty cohort demonstrated a lower rate of urinary tract infections (OR: 0.68, p\u3c0.001) and the trauma cohort demonstrated a lower rate of minor adverse events (OR: 0.79, p=0.004). For HA, five-year revision rates were statistically different but were within 1% between cohorts (arthroplasty 97.2%, trauma: 97.8%, non-arthroplasty/non-trauma: 98.2%) as well as for five-year dislocation rates (arthroplasty 96.8%, trauma: 97.8%, non-arthroplasty/non-trauma: 97.5%). For THA, five-year revision (arthroplasty 93.8%, trauma: 95.0%, non-arthroplasty/non-trauma: 93.9%) and dislocation rates (arthroplasty 96.3%, trauma: 96.9%, non-arthroplasty/non-trauma: 95.7%) were not statistically different between subspecialty cohorts. For PP, five-year revision rates (arthroplasty 95.1%, trauma: 95.2%, non-arthroplasty/non-trauma: 93.8%) were not statistically different. For ankle fractures: A total of 146,490 ankle fracture patients were identified, of which 4.2% were operated on by a foot & ankle surgeon, 3.5% by a trauma surgeon, and 92.3% by a non-foot & ankle/non-trauma surgeon. Relative to non-foot & ankle/non-trauma cohort patients, foot & ankle cohort patients had lower odds of aggregated any adverse events (OR 0.85) and major adverse events (OR 0.84), as well as surgical site infections (OR 0.75), AKI (OR 0.79), pneumonia (OR 0.68), urinary tract infection (OR 0.81) and readmission (OR 0.79) (p\u3c0.05 for each). Trauma cohort patients had increased odds of deep vein thrombosis (OR 1.23), surgical site infections (OR 1.28), acute kidney injury (OR 1.23), and readmission (OR 1.27) (p\u3c0.05 for all). No differences were found in 5-year revision rates between subspecialty cohorts (p=0.4) Overall, orthopaedic surgeons of different subspecialties had different treatment distributions for geriatric femoral neck fractures, but 90-day adverse outcomes and five-year rates of revision/dislocation were clinically quite similar. While surgeons of different orthopaedic subspecialties may operate on ankle fractures, the current study found that foot and ankle surgeons demonstrated better outcomes for several perioperative medical complications but not five-year revision rates. This can provide confidence that those who self-select to be on orthopaedic call and treat geriatric femoral neck fractures are performing comparable to their peers using overall metrics. Specialized training in the management of complex lower extremity injuries appears to be beneficial, as evidenced by the positive outcomes reported in foot & ankle procedure
B-spline Representations for Hyperspectral Inverse Rendering
Full text linkThis work explores the use of a B-spline-based approach for hyperspectral inverse rendering from RGB images, experimenting on both spectral and geometric reconstruction. While the B-spline method is less accurate than brute-force optimization, it offers significant improvements in computational efficiency- reducing both runtime and memory usage.
Our experiments show that the B-spline representation can approximate smooth spectral data effectively but struggles with sharper spectral features unless more knots are introduced. Notably, wavelengths near the edges of the visible spectrum (around 400 nm and 700 nm) were less stable during optimization, reflecting lower convergence reliability. Despite these challenges, the final RGB renders produced from B-spline-reconstructed spectra were visually accurate, indicating metameric equivalence to the ground-truth spectra.
These results position B-splines as a practical trade-off between accuracy and efficiency for spectral reconstruction in differentiable rendering pipelines, particularly for applications where real-time performance or resource constraints preclude brute-force methods
Site Optimization for a Dual Crisis: Co-Prioritizing Carbon and Biodiversity to Improve Conservation Impact in Indonesia
Full text linkAs the dual crises of climate change and biodiversity loss accelerate and human expansion reshapes the planet, calls to preserve Earth’s remaining wilderness have grown more urgent. However, in the race to protect as much as possible, as fast as possible, society risks missing what matters most. Not all conservation sites are equally valuable, and without strategic prioritization, limited resources may be squandered while critical ecosystems disappear. Few places illustrate this challenge as vividly as Indonesia: a rainforest nation that is home to some of the richest biodiversity and densest forest carbon stores on Earth but where conservation efforts are constrained by intensive land use pressures and limited resources. This essay examines how carbon and biodiversity co-prioritization could improve the efficiency and impact of Indonesia’s protection efforts. GIS spatial analysis, supplemented with insights from literature reviews and interviews with on-the-ground stakeholders, explores the overlaps between carbon storage, biodiversity value and existing conservation sites to identify Indonesia’s most valuable areas. This study finds that carbon and biodiversity are not strongly co-located. Existing conservation efforts, both legally designated protected areas and forest carbon projects, are largely misaligned with the highest value conservation areas, possibly due to political, financial, and logistical barriers. However, a site-selection strategy that co-prioritizes high carbon density and high biodiversity value could protect half of Indonesia’s most biodiverse areas and substantial carbon stocks on just 5% of its land. This essay’s findings reveal opportunities for future conservation efforts that are intentional, co-prioritized, and creative. It offers a model for data-driven site selection that could improve the efficiency and impact of protection efforts in Indonesia and other ecologically rich regions around the world
Citrus Farming, Tourism, and Globalization: Jeju Island’s Transformation Under South Korea’s State-Led Development
Full text linkThe Williams Prize in East Asian Studies is awarded to Caitlin Hong for her outstanding senior thesis, “Citrus, Capital, and Control: Jeju Island’s Transformation under State-Led Development.”
Hong’s work exemplifies intellectual ambition, methodological rigor, and original insight. Through an interdisciplinary blend of historical analysis and ethnographic fieldwork, she offers the first comprehensive English-language account of Jeju Island’s citrus farming industry, tracing its development from the postwar period to the present day.
Demonstrating extraordinary initiative, Hong designed and executed an independent research trip to Jeju Island, conducting interviews with citrus farmers, laborers, and experts, while also consulting numerous primary sources in Korean unavailable outside the island. Her investigation illuminates the social, economic, and political forces shaping agricultural life on the island, including globalization, labor migration, and climate change. In scope, depth, and scholarly contribution, her thesis surpasses expectations for undergraduate research and stands as a model of interdisciplinary scholarship in East Asian Studies
How To Increase The Public’s Awareness Of Car-T Therapy? A Pilot Mixed Methods Study
Full text linkBackground: Chimeric Antigen Receptor (CAR) T-cell therapy is a combination of antibody and T cell receptor (TCR), which allows T-cells to recognize and attack cancer cells. It has shown effectiveness in treating hematological malignancies, but has been less effective for solid tumors. Clinically, it is the first FDA-approved gene therapy as it uses lentivirus to modify the genome of T cells that are infused back into patients. Preclinically, laboratory research is being conducted to enhance this treatment through multiple genetic modifications. Concurrently, integrating community research to understand the public’s awareness of CAR-T is essential for making this therapy more widely understood and accessible. In this pilot mixed method study, we assessed the relationship between having friends and/or family members with cancer and a person’s awareness of CAR-T therapy, and explored methods to enhance public awareness of this treatment. Methods: A cross-sectional pilot survey was conducted from May to July 2024 with 124 individuals who had lived in Connecticut, US, for at least one year. Multivariable logistic regression was used to assess the association between having friends and/or family members with a cancer diagnosis and one’s awareness of CAR-T. In July 2024, follow-up in-person or virtual interviews with five survey participants further explored their views on cancer treatments, immunotherapy, and CAR-T. The qualitative interview data were analyzed using the constant comparative method.
Results: The 124 survey participants were 39 years old on average, 43.9% male, 58.1% had at least some college education level, and 70.7% had a friend and/or family member with a cancer diagnosis. Approximately 16.1% of participants were aware of CAR-T therapy. We did not find evidence of an association between having friends and/or family members with a cancer diagnosis and one’s awareness of CAR-T therapy (odds ratio (OR) = 1.97, 95% confidence interval (CI): 0.47–8.17). The qualitative data revealed that effective communication from clinicians and researchers was important to the participants’ understanding and being open to use of CAR-T as a cancer treatment option.
Conclusion: CAR-T is a highly effective novel treatment for cancer that has a rapidly expanding role in clinical practice. Despite its promise and rapid adaptation into clinical protocols, our findings suggest that there is limited public awareness of CAR-T. Therefore, there is a need for researchers to educate the public about CAR-T, so that this therapy is better understood and seen as a potentially acceptable therapy for certain cancers. This will help to ensure basic science research on CAR-T is as impactful as possible for patients in the future
SWIFT: Strong-signal Weighted PRS Integration for Fine-Tuning
No full textPolygenic risk scores (PRS) hold immense promise for personalized medicine but suffer from reduced accuracy in non-European populations, hindering equitable application. We introduce SWIFT (Strong-signal Weighted PRS Integration for Fine-Tuning), a novel framework to enhance cross-population PRS prediction by optimally combining base scores from diverse ancestries using only GWAS summary statistics. SWIFT employs a GWAS subsampling technique based on data fission to generate internal training and tuning sets, circumventing the need for external validation cohorts. A key innovation is its focus on strong genetic signals (p \u3c 0.1) for estimating robust combination weights via cross-validation, which mitigates overfitting and significantly reduces computational burden. We evaluated SWIFT across 22 complex traits using data from five populations (EUR, AFR, AMR, EAS, SAS) and independent validation cohorts (UK Biobank, All of Us). Applied to state-of-the art base methods (PRS-CSx, X-Wing, JointPRS), SWIFT achieved predictive accuracy comparable or superior to the recent LEOPARD integration method and baseline implementations. Crucially, SWIFT demonstrated a 3.5- to 9.5-fold reduction in computational runtime compared to LEOPARD and exhibited robust performance even when using a single, unified LD reference panel. SWIFT provides an efficient, robust, and practical approach to improve the accuracy and applicability of PRS across diverse populations, representing a significant step towards more equitable genomic medicine
The Impact Of Climate Change On Japanese Encephalitis Trends In China
Full text linkJapanese encephalitis (JE) is a mosquito-borne viral disease that poses a significant public health threat across Asia, including China. Climate change has been increasingly recognized as a key driver of JE transmission dynamics, influencing mosquito vector distribution and virus proliferation. This study aimed to assess how climatic variables affect the ecological suitability for Japanese encephalitis virus (JEV) transmission, using species distribution modeling with MaxEnt.
Using climate data from WorldClim and JE incidence data from published sources, we applied the MaxEnt model to identify the key environmental predictors of JE transmission and project future risk areas under changing climatic conditions. The results indicate that precipitation in the driest month (Bio14), annual precipitation (Bio12), and annual mean temperature (Bio01) are the most influential factors shaping JE transmission patterns.
Future projections under four Shared Socioeconomic Pathway (SSP) scenarios (SSP126, SSP245, SSP370, and SSP585) for 2021–2040 suggest a northward expansion of JE-suitable habitats, with high-risk areas increasing in central and eastern China under higher-emission scenarios. These projected scenarios indicate a substantial rise in JE suitability across previously low-risk regions, emphasizing the role of climate change in reshaping disease transmission patterns.
Climate-adaptive public health interventions, including enhanced vector surveillance, targeted vaccination programs, and climate-resilient disease prevention strategies are urgently needed. By integrating climate modeling into JE risk assessments, this study provides valuable insights for mitigating the future burden of JE in China
Joint Realities: Prevalence, Frequency, And Modality Of Cannabis Use By Sexual Identity In A Multi-State Brfss Sample (2022–2023)
No full textCannabis use has increased substantially among U.S. adults, yet disparities by sexual orientation and sex remain underexplored, particularly regarding frequency and consumption modality (Hammond et al., 2022; Dyar, 2022). Leveraging 2022–2023 Behavioral Risk Factor Surveillance System (BRFSS) data from eight U.S. states, this study examined patterns of past-month cannabis use among U.S. adults, stratified by sexual orientation–sex group (e.g., bisexual women, gay men).Guided by minority stress theory and prior research (Dyar, 2022; Meyer, 2003; Poole et al., 2021; Schofield et al., 2023), we hypothesized that sexual minority adults, especially bisexual individuals across both sexes, would report: (1) higher prevalence of past-month cannabis use; (2) more frequent use among past-month users; and (3) greater engagement in non-traditional and multimodal consumption (e.g., vaping, edibles, dabbing) than their heterosexual peers. Bisexual women reported the highest prevalence of cannabis use (39.7%), with bisexual (32.5%) and gay (29.6%) men also exceeding heterosexual peers (17.2%). Adjusted odds of cannabis use were significantly higher among bisexual women (AOR = 2.49; p \u3c .001), bisexual men (AOR = 1.57; p = .026), and gay men (AOR = 1.64; p = .022) compared to heterosexual counterparts. Among past-month users, bisexual women (18.7 days/month) reported significantly more frequent use than heterosexual women (16.0 days/month) (IRR = 1.14; p = .044); no significant frequency differences were found among men. Multimodal use (e.g., using two or more consumption modalities in a month) was most common among bisexual men (68.0%) and bisexual women (59.4%). In adjusted models, bisexual men (AOR = 2.30; p = .003) and bisexual women (AOR = 1.88; p = .002) had significantly greater odds of multimodal use than heterosexual peers. These findings reveal consistent disparities across prevalence, frequency, and modality—particularly among bisexual adults—and underscore the need for identity-informed public health surveillance and interventions. As cannabis use becomes increasingly normalized, inclusive data systems and targeted harm reduction strategies are essential for addressing inequities in cannabis-related behaviors
Power Outages And Power-Dependent Home Medical Equipment In The United States: A Spatial Analysis
Full text linkBackground: Extreme weather events pose risks to the power grid, threatening the wellbeing of individuals reliant on electricity to meet their health needs. The aim of this study is to identify geographical locations in the U.S. that have both high risk of power outage impact and high proportions of power-dependent durable medical equipment (DME) users.
Methods: To achieve this, I used the HHS emPOWER historical map dataset from years 2017 to 2022 and overlaid EAGLE-I data with county-level power outage data from the same study years. Using Local Moran’s I, I found spatially significant high-high clusters of each variable and then intersected cluster layers in ArcGIS Pro to find significant high-high clusters of both DME use and power outages.
Results: Through this analysis, I identified vulnerable areas for high levels of power outages and DME; the two risk factors co-occur to the greatest degree in northwest Texas, Appalachia, and Michigan. Significant differences in both DME use and power outage person-time were found across counties of low, medium, and high levels of social vulnerability, indicating disparities between social factors as measured by the Center for Disease Control and Prevention’s Social Vulnerability Index; socioeconomic status, race and ethnicity, language, and housing. Results can inform prioritization of public health interventions to safeguard the health of vulnerable populations during power outages
Chapter 1: A Brief History of Archival Appraisal. In Selecting and Appraising Archives and Manuscripts
No full textThis chapter traces the evolution of archival appraisal theory and practice in the United States, situating it within shifting technological, social, and intellectual contexts from the late nineteenth century to the present. In this roughly chronological account, the chapter underscores continuity and disruption in selecting and appraising archival records. It highlights the influence and ongoing critiques of Theodore Schellenberg’s evidential and informational values, as well as subsequent expansions by Maynard Britchford and others. It explores transformative moments such as F. Gerald Ham’s call for coordinated documentation, the development of the Black Box model, the rise of documentation strategy, and the essentialist turn toward evidence in the digital era. Attention is given to macroappraisal, functional analysis, and the Minnesota Method as frameworks for integrating multiple approaches. Later sections engage with postmodern critiques, revealing how a focus on power, justice, and pluralism has reshaped appraisal practices. The author emphasizes that understanding the history of appraisal equips archivists to select appropriate appraisal methods for their contexts; navigate questions of value, bias, and representation; and fulfill the profession’s responsibility to select a diverse record of human experience for ongoing preservation and use