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PurposeIn this paper, the authors propose a new lens to examine international humanitarian organizations' responsibilities in the context of project closure, what authors call “an ethics of the temporary”. The authors offer this as an orienting ethical ideal to facilitate the moral imagination of humanitarian planners, practitioners and stakeholders.Design/methodology/approachThe authors drew on recent philosophical work on responsibilities for global justice to analyze an ethical concern inherent to humanitarian practice, the proper scope of responsibility in the context of closure of humanitarian projects.FindingsThe ethics of the temporary includes four elements: situating humanitarian action temporally with attention to the past and how it shapes a current crisis and crisis response, focusing attention on anticipating and seeking to mitigate potential harm, promoting sustainability and greater equity going forward and emphasizing inclusive, collaborative approaches. The authors propose a set of questions that can foster discussion and reflection about the scope of humanitarian responsibilities at project closure.Practical implicationsAlthough the authors' work is primarily conceptual, it has many practical implications for humanitarian policy and practice. It can support critical reflection and offers a process for considering the scope of responsibility at project closure and decisions around how to close a given intervention in a manner that avoids causing harm and advances equity.Originality/valueVery little work has been done on ethical closure of humanitarian projects. Most literature offers critiques. This essay contributes a new approach to closure, the ethical ideal and practice of an ethics of the temporary.

PDF file - 55K, Table describing survival times and causes of death for surgery historical control dogs.

PDF file - 63K, Table that summarizes the immune monitoring carried out, by dog.

With recent approval of the first dendritic cell (DC) vaccine for patient use, many other DC vaccine approaches are now being tested in clinical trials. Many of these DC vaccines employ tumor cell lysates (TL) generated from cells cultured in atmospheric oxygen (∼20% O2) that greatly exceeds levels found in tumors in situ. In this study, we tested the hypothesis that TLs generated from tumor cells cultured under physiologic oxygen (∼5% O2) would be more effective as a source for DC antigens. Gene expression patterns in primary glioma cultures established at 5% O2 more closely paralleled patient tumors in situ and known immunogenic antigens were more highly expressed. DCs treated with TLs generated from primary tumor cells maintained in 5% O2 took up and presented antigens to CD8 T cells more efficiently. Moreover, CD8 T cells primed in this manner exhibited superior tumoricidal activity against target cells cultured in either atmospheric 20% O2 or physiologic 5% O2. Together, these results establish a simple method to greatly improve the effectiveness of DC vaccines in stimulating the production of tumoricidal T cells, with broad implications for many of the DC-based cancer vaccines being developed for clinical application. Cancer Res; 71(21); 6583–9. ©2011 AACR.

PDF file - 75K, Contains descriptions of two methods used to acquire clinical histology and T cell response data.

PDF file - 72K, Table that contains clinical information on the dogs enrolled in the vaccination cohort arm of the study.

Supplementary Tables 1-3, Figures 1-6 and Methods from Oxygen Is a Master Regulator of the Immunogenicity of Primary Human Glioma Cells

The issue of reparations to the descendants of persons enslaved in the United States is receiving increasing attention in both the public sphere (e.g., 2020 Presidential campaigns) and in academic circles. However, the term “reparations” often goes undefined in such discussions, despite the fact that different types of government action (e.g., an apology versus financial payments) are associated with varying levels of public opposition (or support). We also know little about how attitudes toward reparations explicitly targeting the consequences of slavery differ from attitudes toward more generic race-targeted policies. Drawing on data from an online survey of white Americans conducted in 2016, we examine how levels of opposition to a range of different race-targeted government actions varies by (1) the type and aims of the intervention, and (2) whites’ social locations and political orientations. Regarding policy type, whites are least opposed to selected symbolic reparations (e.g., a memorial to enslaved persons) and to policies designed to ensure “fair treatment” of black Americans in the workplace. Whites are most opposed to reparations in the form of direct financial payments to black Americans and to policies involving “preferential treatment” of blacks in the workplace. In addition, whites who are older, more conservative, and who view race relations as unimportant are most opposed to the reparations and other race-based policies we examine. We conclude with suggestions for future work on this timely topic.

In this short article, we provide an update and extension of Thomas C. Wilson’s study, “Whites’ Opposition to Affirmative Action: Rejection of Group-based Preferences as well as Rejection of Blacks.” Wilson drew on data from the 1996 General Social Survey (GSS) to revisit a long-standing debate in the racial attitudes literature concerning whether anti-black prejudice (e.g., “new racism”) or ostensibly race-neutral opposition to group-based policies generally (i.e., “principled objections”) is the primary determinant of whites’ opposition to affirmative action in the form of “preferential hiring and promotion for blacks.” We analyze data from the 2000–2018 GSS to replicate and extend key aspects of Wilson’s work. As in the prior study, we find mixed support for the new racism and principled objections perspectives, providing an important update on white Americans’ beliefs about affirmative action for the twenty-first century.

Highlights • SRS has emerged as an alternative to WBRT for surgically resected brain metastases. • Pre-therapy radiomic features are predictive of local control after cavity SRS. • Radiomic features were superior to clinical features for predicting local control., Purpose Adjuvant radiosurgery to the cavities of surgically resected brain metastases provides excellent local tumor control while reducing the risk of deleterious cognitive decline associated with whole brain radiotherapy. A subset of these patients, however, will develop disease recurrence following radiosurgery. In this study, we sought to assess the predictive capability of radiomic-based models, as compared with standard clinical features, in predicting local tumor control. Methods We performed a retrospective chart review of patients treated with adjuvant radiosurgery for resected brain metastases at the “Institution” from 2009 to 2019. Shape, intensity and texture based radiomics features of the cavities were extracted from the pre-radiosurgery treatment planning MRI scans and trained using a gradient boosting technique with K-fold cross validation. Results In total, 71 cavities from 67 treated patients were included for analysis. The 6 and 12 month local control estimates were 86% and 76%, respectively. The 6 and 12 month overall survival was 78% and 55%, respectively. Thirty-six patients developed intracranial failures outside of the surgical cavity. The predictive model for local control trained on imaging features from the whole cavity achieved an area-under-the-curve (AUC) of 0.73 on the validation set versus an AUC of 0.40 for the clinical features. Conclusions Here we report a single institutional experience using radiomic-based predictive modeling of local tumor control following adjuvant Gamma Knife radiosurgery for resected brain metastases. We found the radiomics features to provide more robust predictive models of local control rates versus clinical features alone. Such techniques could potentially prove useful in the clinical setting and warrant further investigation.

A new class of electron bean negative tone resist materials has been developed based on heterometallic rings. The initial resist performance demonstrates a resolution of 15 nm half-pitch but at the expense of a low sensitivity. To improve sensitivity a 3D Monte Carlo simulation is used that utilizes a secondary and Auger electron generation model. The simulation suggests that the sensitivity can be dramatically improved while maintaining high resolution by incorporating appropriate chemical functionality around the metal–organic core. The new resists designs based on the simulation have the increased sensitivity expected and illustrate the value of the simulation approach.

This study examines the racial stratification beliefs of white Americans who have decision-making power at work (managers and supervisors) and of those (subordinates) who lack such power. We focus on whether these groups vary in overall levels of support for, and in determinants of, beliefs about racial inequality. Pooled cross-sectional analyses of data from the 1977 to 2014 General Social Surveys (GSS) reveal that, among both white supervisors and subordinates, support is greatest for a motivation-based explanation of black disadvantage, followed by (in order) explanations focusing on blacks’ lesser educational chances, discrimination against blacks, and finally, blacks’ supposed lesser ability. In line with Group Position Theory, our multivariate analyses reveal few differences across the supervisory divide in levels of support for, or in the determinants of, whites’ beliefs about black disadvantage. Differences that do exist align with alternative perspectives including Social Dominance Theory, a Group Self-Interest Model, and Intergroup Contact Theory. We conclude by discussing the theoretical and methodological implications of our findings for future research pertaining to what does and does not work to ameliorate racial inequality in the workplace.

Do school security policies affect how safe parents perceive schools to be, and do they influence parental choice behavior? We address these questions using data from a survey that asked U.S. paren...

Characterizing the motile properties of glioblastoma tumor cells could provide a useful way to predict the spread of tumors and to tailor the therapeutic approach. Radiomics has emerged as a diagnostic tool in the classification of tumor grade, stage, and prognosis. The purpose of this work is to examine the potential of radiomics to predict the motility of glioblastoma cells. Tissue specimens were obtained from 31 patients undergoing surgical resection of glioblastoma. Mean tumor cell motility was calculated from time-lapse videos of specimen cells. Manual segmentation was used to define the border of the enhancing tumor T1-weighted MR images, and 107 radiomics features were extracted from the normalized image volumes. Model parameter coefficients were estimated using the adaptive lasso technique validated with leave-one-out cross validation (LOOCV) and permutation tests. The R-squared value for the predictive model was 0.60 with p-values for each individual parameter estimate less than 0.0001. Permutation test models trained with scrambled motility failed to produce a model that out-performed the model trained on the true data. The results of this work suggest that it is possible for a quantitative MRI feature-based regression model to non-invasively predict the cellular motility of glioblastomas.

Practical Implications: Future research by sociologists and other social and behavioral scientists should explicitly consider threat's affective dimension in order to provide a more robust picture of racial prejudice in the United States.

To investigate the incidence, seasonal variation, and differences among age, sex, and race for rhegmatogenous retinal detachment (RRD) repair, retinal break (RB) treatment, and posterior vitreous detachment (PVD) in the Intelligent Research in Sight (IRIS) Registry.Retrospective database study.Patients in the IRIS Registry who underwent RRD repair, RB treatment, or cataract surgery (CS) based on Current Procedural Terminology codes and PVD diagnosis based on International Classification of Diseases, Ninth and Tenth Revision, codes.Daily incidence rates were defined as the ratio of patients who underwent RRD repair or RB treatment and patients with a diagnosis of PVD to the total number of patients followed on a given day within the IRIS Registry. The CS group was included as a comparison for seasonal variation. Rates were stratified by decade of life, sex, and race.Time series trends for incidence rates of RRD, RB, and PVD.A total of 7 115 774 patients received a diagnosis of incident PVD, 237 646 patients underwent RRD repair, and 359 022 patients underwent RB treatment. Also included were 5 940 448 patients who underwent CS. The mean daily incidence for RRD repair, RB treatment, PVD diagnosis, and CS were 0.46 per 100 000 patients, 0.70 per 100 000 patients, 13.90 per 100 000 patients, and 11.80 per 100 000 patients, respectively. Men showed higher incidence of RRD repair and RB treatment than women, whereas women showed higher incidence of PVD diagnosis. Rhegmatogenous retinal detachment incidence was higher in White people compared with other races. Seasonal decreases in PVD, RB treatment, RRD repair, and CS corresponded to national holidays, with larger decreases in winter months. Kaplan-Meier estimates showed that RRD repair and RB treatment typically occurred within 60 days of PVD diagnosis.Within the IRIS Registry, the highest incidence of RRD was in the 6th and 7th decade of life. There was a higher incidence of RRD repair and RB treatment in men compared with women. The seasonal variation associated with national holidays was less pronounced for RRD repair and RB treatment.

Background and importance Pedicle subtraction osteotomy (PSO) is a 3-column osteotomy used to correct rigid, large magnitude sagittal spinal deformity. PSO is an inherently destabilizing procedure intraoperatively, with high risk of neurological deficits from vertebral body subluxation or translation during osteotomy closure. Traditionally, PSO closure has been performed utilizing compression or cantilevering forces across adjacent level instrumentation. Such forces can loosen the instrumentation or cause abrupt subluxation or translation due to the magnitude of force required for PSO closure, resulting in neurological injury. Here, we report using a flexible hinge-powered operating table for controlled closure of PSO in 1o increments via remote-control power of the table, without compression or cantilevering force required across implants. Clinical presentation The patient is a 68-yr-old man with a history of prior L2-S1 anterior-posterior fusion, healed sacral fracture, and left sacroiliac joint fusion presenting to our institution with severe back pain while standing. X-rays demonstrated significant sagittal malalignment with pelvic incidence (PI) of 79o and lumbar lordosis (LL) of 37o, while computed tomography scan confirms complete bone healing around prior interbody fusion sites, resulting in rigid sagittal deformity. Due to rigid PI-LL mismatch of 42o, we planned for L2-pelvis revision fusion with L4 PSO. Conclusion Here we demonstrate the utility of a flexible hinge-powered operating table for closure of PSO site. This technique eliminates force application to adjacent implants, minimizing vertebral body subluxation, or translation. We believe this allows for safer, more controllable osteotomy closure that minimizes risk of neurological injury.

Study Design: Retrospective study. Objective: Proximal junctional failure (PJF) commonly occurs as a recognized potential outcome of fusion surgery. Here we describe a unique series of patients with multilevel spine fusion including the cervical spine, who developed PJF as an odontoid fracture. Methods: We performed a single site retrospective review of patients with prior fusion that included a cervical component, who presented with an odontoid fracture between 2012 and 2019. Radiographic measurements included C2-C7 SVA, C2-C7 lordosis, T1 slope, Occiput-C2 angle, proximal junctional kyphosis, and cervical mismatch. Associated fractures, medical comorbidities, and treatments were determined via chart review after IRB approval. Results: Nine patients met inclusion criteria. 5 reported trauma with subsequent onset of pain. All patients sustained a Type II odontoid fracture. 5 with associated C1/Jefferson fractures. In all patients, pre-injury Occiput-C2 angle was outside normative range; C2-C7 SVA was greater than 4 cm in 6 patients; T1-slope minus cervical lordosis was greater than 18.5 degrees in 6 patients. 7 patients were treated operatively with extension of fusion to C1 and 2 patients declined operative treatment. Conclusion: In this series of 9 patients with multilevel fusion with type II odontoid fractures, all patients demonstrated abnormal pre-fracture sagittal alignment parameters and a greater than normal association of C1 fractures was noted. Further study is needed to establish the role of poor sagittal alignment with compensatory occiput-C2 angulation as a predisposing factor for odontoid fracture as a proximal junctional failure mechanism.

In this study, we explore the relationship between racial identity and white Americans’ views on reparations to African Americans for slavery and the legacy of racial inequality it spawned. More specifically, we draw on data from an original 2016 survey to examine the association between various dimensions of White racial identity and support for a range of reparative measures targeting African Americans. The White racial identity dimensions we examine are prominence, salience, private self-regard, public self-regard, and verification. The views on reparations we analyze are an apology, a memorial, financial payments, special scholarships for university attendance, preferential hiring and promotion, fair treatment in jobs, and improving the economic and social conditions of black Americans. Consistent with prior work, we find that private self-regard (pride) is a key predictor of whites’ opposition to reparative policy targeting blacks. At the same time, we observe that public self-regard (respondents’ perception of others’ respect for whites) consistently predicts support for these same reparative policies. We draw on identity theory and recent scholarship on whiteness to explain these patterns. Our findings contribute to a growing body of work on how racial identity shapes white Americans’ racial policy attitudes.

The dorsal root ganglion (DRG) is structurally complex and pivotal to systems processing nociception. Whole mount analysis allows examination of intricate microarchitectural and cellular relationships of the DRG in three-dimensional (3D) space.We present DRGquant a set of tools and techniques optimized as a pipeline for automated image analysis and reconstruction of cells/structures within the DRG. We have developed an open source software pipeline that utilizes machine learning to identify substructures within the DRG and reliably classify and quantify them.Our methods were sufficiently sensitive to isolate, analyze, and classify individual DRG substructures including macrophages. The activation of macrophages was visualized and quantified in the DRG following intrathecal injection of lipopolysaccharide, and in a model of chemotherapy induced peripheral neuropathy. The percent volume of infiltrating macrophages was similar to a commercial source in quantification. Circulating fluorescent dextran was visualized within DRG macrophages using whole mount preparations, which enabled 3D reconstruction of the DRG and DRGquant demonstrated subcellular spatial resolution within individual macrophages.Here we describe a reliable and efficient methodologic pipeline to prepare cleared and whole mount DRG tissue. DRGquant allows automated image analysis without tedious manual gating to reduce bias. The quantitation of DRG macrophages was superior to commercial solutions.Using machine learning to separate signal from noise and identify individual cells, DRGquant enabled us to isolate individual structures or areas of interest within the DRG for a more granular and fine-tuned analysis. Using these 3D techniques, we are better able to appreciate the biology of the DRG under experimental inflammatory conditions.

OBJECTIVE Pelvic fixation with S2-alar-iliac (S2AI) screws is an established technique in adult deformity surgery. The authors’ objective was to report the incidence and risk factors for an underreported acute failure mechanism of S2AI screws. METHODS The authors retrospectively reviewed a consecutive series of ambulatory adults with fusions extending 3 or more levels, and which included S2AI screws. Acute failure of S2AI screws was defined as occurring within 6 months of the index surgery and requiring surgical revision. RESULTS Failure occurred in 6 of 125 patients (5%) and consisted of either slippage of the rods or displacement of the set screws from the S2AI tulip head, with resultant kyphotic fracture. All failures occurred within 6 weeks postoperatively. Revision with a minimum of 4 rods connecting to 4 pelvic fixation points was successful. Two of 3 (66%) patients whose revision had less fixation sustained a second failure. Patients who experienced failure were younger (56.5 years vs 65 years, p = 0.03). The magnitude of surgical correction was higher in the failure cohort (number of levels fused, change in lumbar lordosis, change in T1–pelvic angle, and change in coronal C7 vertical axis, each p < 0.05). In the multivariate analysis, younger patient age and change in lumbar lordosis were independently associated with increased failure risk (p < 0.05 for each). There was a trend toward the presence of a transitional S1–2 disc being a risk factor (OR 8.8, 95% CI 0.93–82.6). Failure incidence was the same across implant manufacturers (p = 0.3). CONCLUSIONS All failures involved large-magnitude correction and resulted from stresses that exceeded the failure loads of the set plugs in the S2AI tulip, with resultant rod displacement and kyphotic fractures. Patients with large corrections may benefit from 4 total S2AI screws at the time of the index surgery, particularly if a transitional segment is present. Salvage with a minimum of 4 rods and 4 pelvic fixation points can be successful.

IMPORTANCE: Recent studies have demonstrated the successful application of artificial intelligence (AI) for automated retinal disease diagnostics but have not addressed a fundamental challenge for deep learning systems: the current need for large, criterion standard–annotated retinal data sets for training. Low-shot learning algorithms, aiming to learn from a relatively low number of training data, may be beneficial for clinical situations involving rare retinal diseases or when addressing potential bias resulting from data that may not adequately represent certain groups for training, such as individuals older than 85 years. OBJECTIVE: To evaluate whether low-shot deep learning methods are beneficial when using small training data sets for automated retinal diagnostics. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study, conducted from July 1, 2019, to June 21, 2020, compared different diabetic retinopathy classification algorithms, traditional and low-shot, for 2-class designations (diabetic retinopathy warranting referral vs not warranting referral). The public domain EyePACS data set was used, which originally included 88 692 fundi from 44 346 individuals. Statistical analysis was performed from February 1 to June 21, 2020. MAIN OUTCOMES AND MEASURES: The performance (95% CIs) of the various AI algorithms was measured via receiver operating curves and their area under the curve (AUC), precision recall curves, accuracy, and F1 score, evaluated for different training data sizes, ranging from 5120 to 10 samples per class. RESULTS: Deep learning algorithms, when trained with sufficiently large data sets (5120 samples per class), yielded comparable performance, with an AUC of 0.8330 (95% CI, 0.8140-0.8520) for a traditional approach (eg, fined-tuned ResNet), compared with low-shot methods (AUC, 0.8348 [95% CI, 0.8159-0.8537]) (using self-supervised Deep InfoMax [our method denoted as DIM]). However, when far fewer training images were available (n = 160), the traditional deep learning approach had an AUC decreasing to 0.6585 (95% CI, 0.6332-0.6838) and was outperformed by a low-shot method using self-supervision with an AUC of 0.7467 (95% CI, 0.7239-0.7695). At very low shots (n = 10), the traditional approach had performance close to chance, with an AUC of 0.5178 (95% CI, 0.4909-0.5447) compared with the best low-shot method (AUC, 0.5778 [95% CI, 0.5512-0.6044]). CONCLUSIONS AND RELEVANCE: These findings suggest the potential benefits of using low-shot methods for AI retinal diagnostics when a limited number of annotated training retinal images are available (eg, with rare ophthalmic diseases or when addressing potential AI bias).

Construct: We investigated whether a situational judgment test (SJT) designed to measure professionalism in physicians predicts residents' performance on (a) Accreditation Council for Graduate Medical Education (ACGME) competencies and (b) a multisource professionalism assessment (MPA). Background: There is a consensus regarding the importance of assessing professionalism and interpersonal and communication skills in medical students, residents, and practicing physicians. Nonetheless, these noncognitive competencies are not well measured during medical education selection processes. One promising method for measuring these noncognitive competencies is the SJT. In a typical SJT, respondents are presented with written or video-based scenarios and asked to make choices from a set of alternative courses of action. Interpersonally oriented SJTs are commonly used for selection to medical schools in the United Kingdom and Belgium and for postgraduate selection of trainees to medical practice in Belgium, Singapore, Canada, and Australia. However, despite international evidence suggesting that SJTs are useful predictors of in-training performance, end-of-training performance, supervisory ratings of performance, and clinical skills licensing objective structured clinical examinations, the use of interpersonally oriented SJTs in residency settings in the United States has been infrequently investigated. The purpose of this study was to investigate whether residents' performance on an SJT designed to measure professionalism-related competencies-conscientiousness, integrity, accountability, aspiring to excellence, teamwork, stress tolerance, and patient-centered care-predicts both their current and future performance as residents on two important but conceptually distinct criteria: ACGME competencies and the MPA. Approach: We developed an SJT to measure seven dimensions of professionalism. During calendar year 2017, 21 residency programs from 2 institutions administered the SJT. We conducted analyses to determine the validity of SJT and USMLE scores in predicting milestone performance in ACGME core competency domains and the MPA in June 2017 and 3 months later in September 2017 for the MPA and 1 year later, in June 2018, for ACGME domains. Results: At both periods, the SJT score predicted overall ACGME milestone performance (r = .13 and .17, respectively; p < .05) and MPA performance (r = .19 and .21, respectively; p < .05). In addition, the SJT predicted ACGME patient care, systems-based practice, practice-based learning and improvement, interpersonal and communication skills, and professionalism competencies (r = .16, .15, .15, .17, and .16, respectively; p < .05) 1 year later. The SJT score contributed incremental validity over USMLE scores in predicting overall ACGME milestone performance (ΔR = .07) 1 year later and MPA performance (ΔR = .05) 3 months later. Conclusions: SJTs show promise as a method for assessing noncognitive attributes in residency program applicants. The SJT's incremental validity to the USMLE series in this study underscores the importance of moving beyond these standardized tests to a more holistic review of candidates that includes both cognitive and noncognitive measures.

In this chapter, I examine the structure, determinants, and selected attitudinal consequences of racial identity among white Americans. In 2014, the General Social Survey included five items tapping five aspects or dimensions of racial identity: prominence, salience, private self-regard, public self-regard, and verification. These items reflect our understanding of identity as a multidimensional phenomenon and are useful to a research agenda casting racial identity in such terms. However, given the inherent limitations of single-item indicators of various aspects of identity, and in light of the underdevelopment of research on white racial identity, exploration of multi-item measurement strategies for racial identity is also warranted. I use factor and reliability analyses to examine the structure of white racial identity, finding sufficient inter-item consistency to support creation of a five-item “identity intensity” index (alpha = 0.84). I then use regression analysis to expand our understanding of white racial identity as both “social product and social force” (Rosenberg 1981), by modeling how it is shaped by sociodemographic factors, while also carrying implications for whites’ racial policy attitudes.

Once the accepted norm during Harvey Cushing's time, the mantra of work to the exclusion of family and lifestyle is now recognized as deleterious to overall well-being. A number of neurosurgical residency training programs have implemented wellness programs to enhance the physical, mental, and emotional well-being of trainees and faculty. This manuscript highlights existing organized wellness education within neurosurgery residency programs in order to describe the motivations behind development, structure, and potential implementation strategies, cost of implementation, and identify successes and barriers in the integration process. This manuscript is designed to serve as a "how-to" guide for other programs who may identify a need in their own trainees and begins the discussion of how to develop wellness, leadership, grit, and resiliency within our future generation of neurosurgeons.

We develop a new technique for transferring metal contacts to create ultrathin solar cells from 2D materials., Two-dimensional transition metal dichalcogenides are promising candidates for ultrathin optoelectronic devices due to their high absorption coefficients and intrinsically passivated surfaces. To maintain these near-perfect surfaces, recent research has focused on fabricating contacts that limit Fermi-level pinning at the metal-semiconductor interface. Here, we develop a new, simple procedure for transferring metal contacts that does not require aligned lithography. Using this technique, we fabricate vertical Schottky-junction WS2 solar cells, with Ag and Au as asymmetric work function contacts. Under laser illumination, we observe rectifying behavior and open-circuit voltage above 500 mV in devices with transferred contacts, in contrast to resistive behavior and open-circuit voltage below 15 mV in devices with evaporated contacts. One-sun measurements and device simulation results indicate that this metal transfer process could enable high specific power vertical Schottky-junction transition metal dichalcogenide photovoltaics, and we anticipate that this technique will lead to advances for two-dimensional devices more broadly.

OBJECTIVE To assess the relationship between preoperative volume of primary intracranial gliomas in dogs as determined via MRI and survival time after surgical debulking and adjunctive immunotherapy. DESIGN Retrospective cohort study. ANIMALS 47 client-owned dogs enrolled in clinical trials regarding glioma treatments. PROCEDURES Medical records of all dogs undergoing craniotomy at the University of Minnesota Veterinary Medicine Center with histologically confirmed glioma between 2008 and 2015 were retrospectively reviewed, and outcome data were collected. Preoperative T2-weighted or post–gadolinium administration T1-weighted MRI scans, performed at several referral institutions with scanners of magnet strengths ranging from 0.5 to 3.0 T, were used to measure tumor volumes as a percentage of total calvarial volume. Data were analyzed to assess the effect of each 2% fraction of tumor volume on median survival time (MST) after surgery and adjuvant treatment. RESULTS Tumor volumes ranged from 0.5% to 12.2% of total intracranial volume. Overall MST was 185 days (range, 2 to 802 days). No association was identified between preoperative tumor volume and MST. Only 3 (6%) dogs had low-grade tumors that had relatively small volumes, measuring 1.4%, 2.1%, and 4.3% of total calvarial volume. The MST for these 3 dogs (727 days) was longer than that for high-grade tumors (174 days); however, owing to the low number of dogs with low-grade tumors, no statistical comparison was performed. CONCLUSIONS AND CLINICAL RELEVANCE Preoperative tumor volume determined via MRI was neither associated with nor predictive of outcome following surgery and adjunctive treatment for dogs with glioma. Tumor grade was predictive of outcome, but unlike tumor volume that was measured with MRI, invasive biopsy was necessary to definitively diagnose tumor grade.

Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles are one spine anomaly associated with NF1, although they are a fairly uncommon pathology. Surgical techniques to treat these meningoceles, usually undertaken only when the patient is symptomatic, are targeted at decreasing the size of the protrusion and improving lung capacity. Surgical interventions discussed in the literature include shunting the pseudomeningocele, primary repair with laminectomy, thoracoscopic plication, and reinforcement of the closure with cement, muscle, or fascia. Authors here report the case of a 43-year-old woman with NF1 with worsening pulmonary function tests and in whom shunting of the pseudomeningocele failed. Subsequently, a posterolateral thoracotomy was performed. The dura mater was reconstructed and primarily closed. On this closure a Gore-Tex soft-tissue patch was placed along with polypropylene mesh and Evicel fibrin sealant, followed by titanium mesh. At the end of the procedure, a chest tube was left in place and therapeutic pneumoperitoneum was performed to decrease the dead space as the lung did not fully expand with positive-pressure ventilation. The patient’s pulmonary function tests improved after the procedure.Thoracic meningoceles are uncommon and difficult pathologies to treat surgically. Although shunting is arguably the least invasive surgical option, it can fail in some patients. When it does fail, there are other options that require a multidisciplinary approach and careful attention to the dural closure and reinforcing layers.

We show that by design we can create a new resist materials for electron beam lithography, based on a supramolecular assembly. The initial studies show that via this supramolecular approach high resolution structures can be written which showunprecedented selectivity when exposed to etch conditions involving plasmas.

Recent trends in graduate medical education have emphasized the mastery of nontechnical skills, especially leadership, for neurosurgical trainees. Accordingly, we introduced leadership development and self-awareness training to interns attending the Society of Neurological Surgeons Post-Graduate Year 1 Boot Camp in the Northeast (New England/New York/New Jersey) region in 2015. Feedback about the session was collected from interns. While neurosurgical interns conveyed a desire to receive more information on improving their leadership skills, most indicated that guidance seemed to be lacking in this critical area. We discuss some of the professional development needs uncovered during this process.

We thank Dr. Soliz for his expedient comments (1) regarding our work evaluating seven artificial intelligence (AI) algorithms in a head-to-head fashion (2). We welcome the opportunity to clarify these points of concern. We agree that the two U.S. Food and Drug Administration–approved diabetic retinopathy (DR) systems, one of which was tested in our study, use a threshold of moderate nonproliferative DR (NPDR) or higher for referral. We set the threshold to any DR versus no DR because that represents the clinical practice at the Veterans Affairs (VA) teleretinal system, as stated in our methods. All participating companies were aware of the study threshold prior to submitting their algorithms and were allowed to adjust their algorithms accordingly. As the VA manages one of the largest teleretinal screening systems in the U.S., …

Summary Human autoantibodies to contactin-associated protein-like 2 (CASPR2) are often associated with neuropathic pain, and CASPR2 mutations have been linked to autism spectrum disorders, in which sensory dysfunction is increasingly recognized. Human CASPR2 autoantibodies, when injected into mice, were peripherally restricted and resulted in mechanical pain-related hypersensitivity in the absence of neural injury. We therefore investigated the mechanism by which CASPR2 modulates nociceptive function. Mice lacking CASPR2 (Cntnap2−/−) demonstrated enhanced pain-related hypersensitivity to noxious mechanical stimuli, heat, and algogens. Both primary afferent excitability and subsequent nociceptive transmission within the dorsal horn were increased in Cntnap2−/− mice. Either immune or genetic-mediated ablation of CASPR2 enhanced the excitability of DRG neurons in a cell-autonomous fashion through regulation of Kv1 channel expression at the soma membrane. This is the first example of passive transfer of an autoimmune peripheral neuropathic pain disorder and demonstrates that CASPR2 has a key role in regulating cell-intrinsic dorsal root ganglion (DRG) neuron excitability., Highlights • Treatment with human CASPR2-Abs causes mechanical hypersensitivity in mice • CASPR2-Abs remain PNS restricted and enhance pain behavior without neural injury • Pain behavior is increased in Cntnap2−/− mice (lacking full-length CASPR2) • CASPR2 regulates DRG cell excitability via Kv1 channel trafficking to the membrane, Dawes et al. show that CASPR2, the target of an autoimmune pain disorder, regulates sensory function through tuning of primary afferent excitability. Human autoantibodies to CASPR2 cause pain-related hypersensitivity and enhance DRG cell excitability through reduced Kv1 channel function.

Space power systems require photovoltaics that are lightweight, efficient, reliable, and capable of operating for years or decades in space environment. Current solar panels use planar multijunction, III-V based solar cells with very high efficiency, but their specific power (power to weight ratio) is limited by the added mass of radiation shielding (e.g., coverglass) required to protect the cells from the high-energy particle radiation that occurs in space. Here, we demonstrate that III-V nanowire-array solar cells have dramatically superior radiation performance relative to planar solar cell designs and show this for multiple cell geometries and materials, including GaAs and InP. Nanowire cells exhibit damage thresholds ranging from ∼10-40 times higher than planar control solar cells when subjected to irradiation by 100-350 keV protons and 1 MeV electrons. Using Monte Carlo simulations, we show that this improvement is due in part to a reduction in the displacement density within the wires arising from their nanoscale dimensions. Radiation tolerance, combined with the efficient optical absorption and the improving performance of nanowire photovoltaics, indicates that nanowire arrays could provide a pathway to realize high-specific-power, substrate-free, III-V space solar cells with substantially reduced shielding requirements. More broadly, the exceptional reduction in radiation damage suggests that nanowire architectures may be useful in improving the radiation tolerance of other electronic and optoelectronic devices.

Quantum correlations between parts of a composite system most clearly reveal themselves through entanglement. Designing, maintaining, and controlling entangled systems is very demanding, which raises the stakes for understanding the efficacy of entanglement-free, yet quantum, correlations, exemplified by quantum discord. Discord is defined via conditional mutual entropies of parts of a composite system, and its direct measurement is hardly possible even via full tomographic characterization of the system state. Here we design a simple protocol to detect and quantify quantum discord in an unentangled bipartite system. Our protocol relies on a characteristic of discord that can be extracted from repeated direct measurements of certain correlations between subsystems of the bipartite system. The proposed protocol opens a way of extending experimental studies of discord to electronic systems but can also be implemented in quantum-optical systems., Comment: 10 pages, 9 figures. arXiv admin note: substantial text overlap with arXiv:1901.11514

This chapter explores how five dimensions of white racial identity are associated with one another and with white Americans’ racial attitudes. Drawing on data from the 2014 General Social Survey Identity Module, we first examine the relationships among five aspects of whites’ racial identities: prominence, salience, private self-regard, public self-regard, and verification. We then examine the implications of these aspects of racial identity for whites’ reported and preferred distance from, stereotypes about, and support for policies designed to benefit black Americans. In so doing, we contribute to the long-standing identity theory project of demonstrating how identities shape other elements of social life, including the construction and maintenance of social inequalities. We also contribute to the growing research literature on “whiteness” and its implications for intergroup relations in the United States.

OBJECTIVE To determine incidence of and risk factors for major complications occurring in dogs within 30 days after cytoreductive surgery performed by a single pair of surgeons for treatment of suspected primary intracranial masses. DESIGN Retrospective cohort study. ANIMALS 160 client-owned dogs that underwent cytoreductive surgery for treatment of suspected primary intracranial masses between January 2009 and December 2015 at a veterinary teaching hospital. PROCEDURES Medical records were retrospectively reviewed for complications occurring within 30 days after surgery. Data (eg, signalment, clinical signs, previous treatments, preoperative neurologic examination findings, neuroanatomical location, time from onset of clinical signs to surgery, surgical approach, and histopathologic diagnosis) were analyzed for associations with death and with development of major complications other than death. RESULTS 21 (13.1%) dogs died (11 during hospitalization and 10 after discharge) and 30 (18.8%) developed major complications other than death during the first 30 days after surgery. Dogs with abnormal preoperative neurologic examination findings were more likely to develop complications or die. Dogs undergoing a suboccipital approach were more likely to die. The most common postoperative complications other than death were seizures (n = 18 [11.3%]), worsening of neurologic status (6 [3.8%]), and aspiration pneumonia (6 [3.8%]). CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study provided valuable information on predisposing factors, odds of major complications or death, and incidences of major complications or death in dogs during the first 30 days after undergoing cytoreductive surgery for treatment of suspected primary intracranial masses. Careful case selection may help improve outcomes and minimize complications.

This work elucidates a novel pain mechanism generated by rheumatoid arthritis–associated autoantibodies, uncoupled from inflammation, that is dependent on immune complex formation and activation of neuronal FcγRI., Rheumatoid arthritis–associated joint pain is frequently observed independent of disease activity, suggesting unidentified pain mechanisms. We demonstrate that antibodies binding to cartilage, specific for collagen type II (CII) or cartilage oligomeric matrix protein (COMP), elicit mechanical hypersensitivity in mice, uncoupled from visual, histological and molecular indications of inflammation. Cartilage antibody–induced pain-like behavior does not depend on complement activation or joint inflammation, but instead on tissue antigen recognition and local immune complex (IC) formation. smFISH and IHC suggest that neuronal Fcgr1 and Fcgr2b mRNA are transported to peripheral ends of primary afferents. CII-ICs directly activate cultured WT but not FcRγ chain–deficient DRG neurons. In line with this observation, CII-IC does not induce mechanical hypersensitivity in FcRγ chain–deficient mice. Furthermore, injection of CII antibodies does not generate pain-like behavior in FcRγ chain–deficient mice or mice lacking activating FcγRs in neurons. In summary, this study defines functional coupling between autoantibodies and pain transmission that may facilitate the development of new disease-relevant pain therapeutics.

The criminal population of U.S. prisons has increased dramatically in recent years, leaving policymakers with difficult decisions in regard to the allocation of resources and how to plan for the long-term care of the criminal population. Although prison forecasts are conducted by every state, no consensus has emerged on how the population is best projected. This chapter seeks to provide guidance on this issue by examining the literature on prison forecasting. Using the success and failure of the models established in the literature as a guide, we provide a series of best practices for the forecasting of the prison population.