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For the safe and effective development of evolving autonomous medical robotic systems that traverse the surface of the body, like in breast ultrasound scans, developing phantoms that are durable and mechanically mimic human tissue is critical. In this work, a long lasting, inexpensive, and geometrically customizable phantom is described with mechanical and ultrasound acoustic properties that simulate human breast tissue. In comparison to prior work, a priority was designing a highly elastic phantom outer layer modulus 20 kPa and inner semi-liquid layer to mimic the difficulties of traversing human breast tissue with autonomous medical robotic systems. In addition, ultrasound images of the novel phantom with enclosed tumor are similar to in vivo image of human breast tissue with invasive ductal carcinoma, representing 80% of breast cancer cases. The performance of a force feedback controller on an autonomous ultrasound scanning system was compared for the novel phantom and a commercial phantom. Overall, the controller performed worse on the novel phantom — highlighting the importance of testing autonomous systems on realistic phantoms.

Background Gene therapy offers an etiologically targeted treatment for genetic disorders. Little is known about the acceptance of mortality risk among patients with progressive, fatal conditions. We assessed patients’ and caregivers’ maximum acceptable risk (MAR) of mortality for gene therapy when used to treat Duchenne muscular dystrophy (DMD). Methods The threshold technique was used to assess tolerance for mortality risks using a hypothetical vignette. Gene therapy was described as non‐curative and resulting in a slowing of progression and with a 10‐year benefit duration. MAR was analyzed using interval regression for gene therapy initiated “now”; in the last year of walking well; in the last year of being able to bring arms to mouth; and in newborns (for caregivers only). Results Two hundred eighty‐five caregivers and 35 patients reported the greatest MAR for gene therapy initiated in last year of being able to lift arms (mean MAR 6.3%), followed by last year of walking well (mean MAR 4.4%), when used “now” (mean MAR 3.5%), and when used in the newborn period (mean MAR 2.1%, caregivers only). About 35% would accept ≥200/2000 risk in the last year of being able to lift arms. Non‐ambulatory status predicted accepting 1.8 additional points in MAR “now” compared with ambulatory status (p = 0.010). Respondent type (caregiver or patient) did not predict MAR. Conclusion In this first quantitative study to assess MAR associated with first‐generation DMD gene therapy, we find relatively high tolerance for mortality risk in response to a non‐curative treatment scenario. Risk tolerance increased with disease progression. Patients and caregivers did not have significantly different MAR. These results have implications for protocol development and shared decision making., There are no quantitative data on the risk that parents or adults with Duchenne would accept for a non‐curative gene therapy. We used a survey with threshold technique and a hypothetical treatment vignette to measure maximum acceptable risk (MAR) for death at four timepoints in the life of the person with Duchenne. We find relatively high tolerance for mortality risk that increases with progression. Patients and caregivers overall showed a willingness to accept risk and uncertainty in exchange for the hypothetical benefit profile presented.

Purpose Several gene therapy trials for Duchenne muscular dystrophy initiated in 2018. Trial decision making is complicated by non-curative, time-limited benefits; the progressive, fatal course; and high unmet needs. Here, caregivers and patients prioritize factors influencing decision making regarding participation in early-phase gene therapy trials. Methods We conducted a best-worst scaling experiment among U.S. caregivers and adults with Duchenne (N = 274). Participants completed 11 choice sets, choosing features they cared about most and least when deciding whether to participate in a hypothetical gene therapy trial. We analyzed the data using sequential conditional logistic regression. Results Participants prioritized improved muscle function in trial decision making. Concerns about participation limiting later use of gene transfer and editing were also important, as were improved lung and heart function. Low risk of death fell near the middle. Participants cared least about muscle biopsies and potential for randomization to placebo. Adults with Duchenne and caregivers of non-ambulatory children significantly prioritized improved lung function compared to caregivers of ambulatory children. Conclusion Our data demonstrate prioritization of anticipated benefits and opportunity costs relative to potential harms and procedures in gene therapy trial decision making. Such data inform protocol development, education and advocacy efforts, and informed consent.

Using a cross-sectional sample, this study examined 776 adoptive parents’ attitudes toward gay and lesbian adoption. Analysis was conducted on three subgroups: married fathers, married mothers, and single mothers. Findings include that for married fathers older age, a lower level of education, a Christian religious denomination, higher levels of religiosity, and a conservative political ideology were all factors in a more negative attitude toward gay and lesbian adoption. Factors leading to less tolerant attitudes of married mothers were non-White race, having only technical training or an associate's degree, a Christian religious denomination, a higher level of religiosity, and a conservative political ideology. Single mothers differed somewhat from married couples in that religious affiliation was not a factor, but non-white race, lower levels of education, stay-at-home/retired employment status, higher levels of religiosity, and a conservative political ideology were all identified as significant predi...

Earthquakes are unpredictable can and result in losses of millions of dollars in property damage and large numbers of fatalities. Most of the structural damage occurs when buildings sway back and forth or deflect. This experiment was conducted to determine if bracing the floors of a multistory building would decrease the amount of deflection thus inferring that a building would be safer during an earthquake. The experiment was performed using multistory buildings with varying amounts of bracing. A shaking table was designed and built to simulate an earthquake. Deflection of each building was recorded with a video camera and measurements of the displacement of the top and base of the building were taken using frame-by-frame video software. Deflections were calculated by measuring the displacement of the top of the building in comparison to the bottom. The data collected from this experiment indicated that the deflection decreased as more bracing was added to the building.