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AUTISM CARE CONTINUUM: EXPLORING SPECIALTY SERVICES ACROSS THE LIFESPAN WITHIN U.S. ACADEMIC MEDICAL CENTERS
No full textAutistic people—particularly adults—experience high rates of co-occurring mental health problems and often report unmet service needs. Although several barriers to accessing quality care are well-documented, the broader landscape of autism-specific services across the lifespan remains under-researched. This two-part thesis aimed to address this gap by examining the availability of autism-specific services, as well as patterns in service utilization and associated costs, among autistic children and adults. The first study employed a systematic web-scraping protocol and data extraction procedure to identify and characterize autism specialty services offered by U.S. academic medical centers. This work revealed a general lack of autism specialty services for autistic adults, especially with respect to post-diagnostic supports, and uneven geographic distribution of services across the U.S. The second study analyzed population-level Medicaid claims data to compare service use and expenditures between autistic children and adults. The odds of utilizing psychiatric inpatient/ER services increased by 35-125% for autistic adolescents and adults compared to children, despite similar rates of outpatient service use. Sex, race/ethnicity, and co-occurring mental health conditions further predicted psychiatric service utilization. Findings highlight disparities in autism-specific services, underscoring the need for more equitable, comprehensive support across the lifespan
Reframing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Biological Basis of Disease and Recommendations for Supporting Patients.
No full textMyalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a worldwide challenge. There are an estimated 17-24 million patients worldwide, with an estimated 60 percent or more who have not been diagnosed. Without a known cure, no specific curative medication, disability lasting years to being life-long, and disagreement among healthcare providers as to how to most appropriately treat these patients, ME/CFS patients are in need of assistance. Appropriate healthcare provider education would increase the percentage of patients diagnosed and treated; however, in-school healthcare provider education is limited. To address the latter issue, the New Jersey Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Association (NJME/CFSA) has developed an independent, incentive-driven, learning program for students of the health professions. NJME/CFSA offers a yearly scholarship program in which applicants write a scholarly paper on an ME/CFS-related topic. The efficacy of the program is demonstrated by the 2024-2025 first place scholarship winner\u27s essay, which addresses the biological basis of ME/CFS and how the healthcare provider can improve the quality of life of ME/CFS patients. For the reader, the essay provides an update on what is known regarding the biological underpinnings of ME/CFS, as well as a medical student\u27s perspective as to how the clinician can provide care and support for ME/CFS patients. The original essay has been slightly modified to demonstrate that ME/CFS is a worldwide problem and for publication
Impact of Extended Reality on Robot-Assisted Surgery Training: A Systematic Review and Meta-Analysis
No full textRobot-assisted surgeries (RAS) have an extremely steep learning curve. Because of this, surgeons have created many methods to practice RAS outside the operating room. These training models usually include animal or plastic models; however, extended reality simulators have recently been introduced into surgical training programs. This systematic review and meta-analysis was conducted to determine if extended reality simulators can improve the performance of robotic novices and how their performance compares to the conventional training of surgeons on surgical robots. Using the PRISMA 2020 guidelines, a systematic review was performed searching PubMed, Embase, Web of Science, and Cochrane library for studies that compared the performance of robotic novices that received no additional training, trained with extended reality, or trained with inanimate physical simulators (conventional additional training). Articles that gauged performance using GEARS or time to complete measurements were included, while articles that did not make this comparison were excluded. A meta-analysis was performed on the 15 studies found using SPSS to compare the performance outcomes of the novices after training. Robotic novices trained with extended reality simulators showed a statistically significant improvement in time to complete (Cohen\u27s d = -0.95, p = 0.02) compared to those with no additional training. Extended reality training also showed no statistically significant difference in performance in time to complete (Cohen\u27s d = 0.65, p = 0.14) or GEARS scores (Cohen\u27s d = -0.093, p = 0.34) compared to robotic novices trained with conventional models. This meta-analysis seeks to determine if extended reality simulators translate complex skills to surgeons in a low-cost and low-risk environment
Fabrication of Nanofiber Hydrogel Composites and Their Effects on Single-Cell Morphology
No full textRegenerating highly aligned soft tissues such as nerves, skeletal muscle, and cardiac tissue remains a major challenge in biomedical engineering due to the complex structural and biochemical cues needed to guide cellular behavior. Tissue engineering scaffolds for aligned soft tissue must allow massive cell infiltration and provide cues that direct cell alignment. Aligned nanofibers offer direction cues but must be included at low density to leave room for cell population. This thesis presents a strategy for fabricating and characterizing nanofiber-embedded hydrogel composites where a permissive hydrogel matrix supports the low density aligned nanofiber architecture. We hypothesized that embedded aligned nanofibers could induce cell alignment through the hydrogel when fibers are not in direct contact with cells. Aligned polycaprolactone (PCL) nanofibers blended with polyethylene glycol-methacrylate (PEG-Me) were embedded within gelatin-based hydrogels via a dip coating process. Key fabrication parameters (PEG-Me content, gelatin concentration, solution temperature, withdrawal speed, and fiber density) were systematically varied to assess their effects on film thickness, fiber distribution, and scaffold architecture. Cell studies showed that nanofiber alignment significantly influenced cell morphology, promoting preferential orientation along the embedded fibers compared to randomly oriented controls. Cell alignment was induced even when the distance between cells and fibers was estimated to be \u3e20 µm and fiber content represented only \u3c 1% of total composite cross-sectional area. These findings validate the ability of nanofibers embedded in a hydrogel matrix to induce cell alignment without direct contact. This demonstrates a platform for engineering aligned soft tissue scaffolds and provides a foundation for future applications in 3D tissue reconstruction and regenerative medicine
Computer Organization with ARM64
No full textThis book is intended to be used for a first course in computer organization, or computer architecture. It assumes that all digital components can be constructed from fundamental logic gates.
The book begins with number representation schemes and assembly language for the ARM-64 architecture, including assembler directives and floating point instructions. It then describes the machine language instruction formats, and shows the student how to translate an assembly language program to machine language.
There is then an introduction to boolean algebra and digital logic, followed by a description of the memory hierarchy, including cache memory, RAM, and virtual memory.
The book concludes with brief descriptions of some alternative architectures. Each section concludes with a list of exercises (solutions are available to instructors who have adopted this text in a course).
This book is an open source book. This means that not only is the pdf version available (to potential students and teachers) for free download, but that the original (LaTeX) source files are also available (to potential authors and contributors). Based on the model of open source software, open source for textbooks is a relatively new paradigm in which many authors and contributors can cooperate to produce a high quality product, for no compensation. For details on the rationale of this new paradigm, and citations for other open source textbooks, see the journal Publishing Research Quarterly, Vol. 30, No. 1, March 2014. The source materials and pdf files of this book are licensed with the Creative Commons NonCommercial license, which means that they may be freely used, copied, or modified, but not for financial gain.
The source files for this book are available at rdw.rowan.edu (search for Bergmann) and at cs.rowan.edu/∼bergmann/bookshttps://rdw.rowan.edu/textbooks/1001/thumbnail.jp
Turning Toward Being: The Podcast: Ronald Barnett
No full textIn this conversation, the editors of JOIE explore with Ronald Barnett (Emeritus Professor of Higher Education, University College London Faculty of Education and Society) the possible contributions of ontological inquiry within the ecological university
One Individual’s Culmination is Another’s Abyss: The Matter of Mattering
No full textOne individual’s culmination is another’s new beginning and yet another’s abyss. The abyss is nihilism. The challenge of such a Big Idea as The Culmination (the event, not the title of Robert Pippin’s book) is to weave the hermeneutic tapestry of the meaning of Being (Sein) as disclosed in poetry, aesthetics, and the life-world, while coaxing the lumbering Hegelian camel of German Idealism through the eye of the narrow needle of Dasein’s (Heideggerian) finitude. The world and entanglement are disclosed in a nondiscursive (preconceptual) manner as mattering. The way forward in philosophy lies through innovations in “mattering”—not a conceptual sense we humans make in relating to the world, but a nondiscursive distinction to which human beings are attuned. In a dialectical gesture worthy of Hegel, a reversal based in the phenomena themselves occurs as “discovery” is the original sense of truth and statement predication is derivative on it. Examples and counter-examples, provided by Dominque Janicaud. Heidegger’s ontological engagement with metaphysics as the culmination of German Idealism is elaborated in detail. Second, the implications for ontological education in a positive sense in a post metaphysical age are engaged and explored as “coming from nothing” and “learning to learn.
The CDK8 Kinase Module: A Novel Player in the Transcription of Translation Initiation and Ribosomal Genes
Get PDFSurvival following stress is dependent upon reprogramming transcription and translation. Communication between these programs following stress is critical for adaptation but is not clearly understood. The Cdk8 kinase module (CKM) of the Mediator complex modulates the transcriptional response to various stresses. Its involvement in regulating translational machinery has yet to be elucidated, highlighting an existing gap in knowledge. Here, we report that the CKM positively regulates a subset of ribosomal protein (RP) and translation initiation factor (TIF)-encoding genes under physiological conditions in Saccharomyces cerevisiae. In mouse embryonic fibroblasts and HCT116 cells, the CKM regulates unique sets of RP and TIF genes, demonstrating some conservation of function across species. In yeast, this is mediated by Cdk8 phosphorylation of one or more transcription factors which control RP and TIF expression. Conversely, the CKM is disassembled following nutrition stress, permitting repression of RP and TIF genes. The CKM also plays a transcriptional role important for promoting cell survival, particularly during translational machinery stress triggered by ribosome-targeting antibiotics. Furthermore, in mammalian cells, the activity of CDK8 and its paralogue, CDK19, promotes cell survival following ribosome inhibition. These results provide mechanistic insights into the CKM\u27s role in regulating expression of a subset of genes associated with translation
