scholarly journals RRApp, a robust randomization app, for clinical and translational research

2017 ◽  
Vol 1 (6) ◽  
pp. 323-327 ◽  
Author(s):  
Chengcheng Tu ◽  
Emma K. T. Benn
Keyword(s):  
Randomized Clinical Trials ◽  
Early Stage ◽  
Research Capacity ◽  
Constructive Feedback ◽  
Medical Institutions ◽  
Academic Medical ◽  
The Us ◽  
Randomization Scheme ◽  
Block Randomization ◽  
User Friendly

While junior clinical researchers at academic medical institutions across the US often desire to be actively engaged in randomized-clinical trials, they often lack adequate resources and research capacity to design and implement them. This insufficiency hinders their ability to generate a rigorous randomization scheme to minimize selection bias and yield comparable groups. Moreover, there are limited online user-friendly randomization tools. Thus, we developed a free robust randomization app (RRApp). RRApp incorporates 6 major randomization techniques: simple randomization, stratified randomization, block randomization, permuted block randomization, stratified block randomization, and stratified permuted block randomization. The design phase has been completed, including robust server scripts and a straightforward user-interface using the “shiny” package in R. Randomization schemes generated in RRApp can be input directly into the Research Electronic Data Capture (REDCap) system. RRApp has been evaluated by biostatisticians and junior clinical faculty at the Icahn School of Medicine at Mount Sinai. Constructive feedback regarding the quality and functionality of RRApp was also provided by attendees of the 2016 Association for Clinical and Translational Statisticians Annual Meeting. RRApp aims to educate early stage clinical trialists about the importance of randomization, while simultaneously assisting them, in a user-friendly fashion, to generate reproducible randomization schemes.

TTIP, CETA, and TiSA Behind Closed Doors

2017 ◽  
Author(s):  
Panagiotis Delimatsis
Keyword(s):  
European Union ◽  
Global Governance ◽  
Early Stage ◽  
European Parliament ◽  
Trade Negotiations ◽  
The European Union ◽  
The Us ◽  
The Eu

Secrecy and informality rather than transparency traditionally reign trade negotiations at the bilateral, regional, and multilateral levels. Yet, transparency ranks among the most basic desiderata in the grammar of global governance and has been regarded as positively related to legitimacy. In the EU’s case, transparent trade diplomacy is quintessential for constitutional—but also for broader political—reasons. First, even if trade matters fall within the EU’s exclusive competence, the EU executive is bound by the Treaty on the Functioning of the European Union (TFEU) to inform the European Parliament, the EU co-legislator, in regular intervals. Second, transparency at an early stage is important to address public reluctance, suspicion, or even opposition regarding a particular trade deal. This chapter chronicles the quest for and turning moments relating to transparency during the EU trade negotiations with Canada (CETA); the US (TTIP), and various WTO members on services (TiSA).

From Bench to Bedside: New Technologies for Cancer Diagnosis and Treatment

2008 ◽  
Vol 5 (2) ◽  
Author(s):  
Michal-Ruth Schweiger ◽  
Hans Lehrach
Keyword(s):  
Cancer Diagnosis ◽  
New Technologies ◽  
Early Stage ◽  
Predictive Biomarkers ◽  
Patient Treatment ◽  
Malignant Neoplasms ◽  
Advanced Stage ◽  
Common Cause ◽  
The Us ◽  
Risk Patients

According to the centre for disease control (CDC) malignant neoplasms are the second most common cause of death in the US in 2004 (1). One of the major problems is that most of the cancers are diagnosed in an advanced stage, which prohibits curative treatment. In order to circumvent these problems, we need to develop strategies that allow identification of risk patients and tumors at an early stage. In addition, it is necessary to identify prognostic and predictive biomarkers that guide patient treatment at different stages of the disease.

A Comparison of IHEs and Non-IHEs as Anchor Institutions and Lead Agents of Promise Neighborhoods Projects

2021 ◽  
pp. 001312452110497
Author(s):  
Whitney Impellizeri ◽  
Vera J. Lee
Keyword(s):  
Higher Education ◽  
Institutions Of Higher Education ◽  
Considerable Time ◽  
Multiple Stakeholders ◽  
Anchor Institutions ◽  
Medical Institutions ◽  
Academic Medical ◽  
The Individual ◽  
Promise Neighborhood ◽  
Anchor Institution

Place-based initiatives, such as the federal Promise Neighborhoods grant, attempt to coordinate interventions, supports, and services with a myriad of organizations to targeted communities. Although Institutions of Higher Education (IHEs), inclusive of academic medical institutions, are among the most overall researched anchor institution, Non-Institutions of Higher Education (NIHEs) have led more Promise Neighborhood grants since the inception of the program in 2010. Therefore, this study compared the revitalization efforts proposed by IHEs ( n = 5) and NIHE ( n = 5) in their applications for Promise Neighborhoods grants awarded between 2016 and 2018. Although similarities existed within and across the applications from NIHEs and IHEs, namely focused on improving academics and health/wellness, the specific interventions, supports, and services proposed by each lead institution largely reflected the individual needs of the targeted communities. The findings from this study illustrate how IHEs and NIHEs are similarly positioned to effectuate change within their communities. Implementing place-based initiatives requires anchor institutions to allocate considerable time and resources in order to adapt to the current needs of the community in real time. Therefore, future lead agents of Promise Neighborhoods should seek to promote an environment that fosters on-going collaboration and mutual trust across and within multiple stakeholders, while also exploring sustainability efforts to extend gains made beyond the duration of the grant.

scholarly journals Recognizing and Alleviating Moral Distress Among Obstetrics and Gynecology Residents

2014 ◽  
Vol 6 (3) ◽  
pp. 457-462 ◽  
Author(s):  
Julie Aultman ◽  
Rachel Wurzel
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Moral Distress ◽  
Residency Education ◽  
Obstetrics And Gynecology ◽  
Professional Identity Development ◽  
Moral Concepts ◽  
Clinical Encounters ◽  
Medical Institutions ◽  
Academic Medical

Abstract Background Obstetrics and gynecology residents face difficult clinical situations and decisions that challenge their moral concepts. Objective We examined how moral and nonmoral judgments about patients are formulated, confirmed, or modified and how moral distress may be alleviated among obstetrics-gynecology residents. Methods Three focus groups, guided by open-ended interview questions, were conducted with 31 obstetrics-gynecology residents from 3 academic medical institutions in northeast Ohio. Each focus group contained 7 to 14 participants and was recorded. Two investigators independently coded and thematically analyzed the transcribed data. Results Our participants struggled with 3 types of patients perceived as difficult: (1) patients with chronic pain, including patients who abuse narcotics; (2) demanding and entitled patients; and (3) irresponsible patients. Difficult clinical encounters with such patients contribute to unalleviated moral distress for residents and negative, and often inaccurate, judgment made about patients. The residents reported that they were able to prevent stigmatizing judgments about patients by keeping an open mind or recognizing the particular needs of patients, but they still felt unresolved moral distress. Conclusions Moral distress that is not addressed in residency education may contribute to career dissatisfaction and ineffective patient care. We recommend education and research on pedagogical approaches in residency education in a model that emphasizes ethics and professional identity development as well as the recognition and alleviation of moral distress.

scholarly journals CNN-based Diagnosis System on Skin Cancer using Ensemble Method Weighted by Cubic Precision

2021 ◽  
Author(s):  
Pengcheng Jiang
Keyword(s):  
User Interface ◽  
Skin Cancer ◽  
Language Processing ◽  
Classification Accuracy ◽  
Model Updating ◽  
Early Stage ◽  
Model Performance ◽  
Diagnosis System ◽  
Cancer Symptoms ◽  
User Friendly

<i>Abstract</i>— One of the most prevalent diseases, skin cancer, has been proven to be treatable at an early stage. Thus, techniques that allow individuals to identify skin cancer symptoms early are in great demand. This paper proposed an interactive skin lesion diagnosis system based on the ensemble of multiple sophisticated CNN models for image classification. The performance of ResNet50, ResNeXt50, ResNeXt101, EfficientNetB4, Mobile-NetV2, MobileNetV3, and MnasNet are investigated separately as ensemble components. Then, using various criteria, we constructed ensembles and compared the accuracy they achieved. Moreover, we designed a method to update the ensemble for new data and examined its performance. In addition, a few natural language processing (NLP) techniques were used to make our system more user-friendly. To integrate all the functionalities, we built a user interface with PyQt5. As a result, MobileNetV3 achieved 91.02% as the best accuracy among all single models; ensemble weighted by cubic precision achieved 92.84% accuracy as the highest one in this study; a notable improvement in accuracy demonstrated the effectiveness of the model updating approach, and a system with all of the desired features was successfully developed. These findings benefit in two aspects. For model performance, applying cubic precisions can increase ensemble learning classification accuracy. For the developed diagnosis system, it can aid in the

scholarly journals Population-based Estimate of the Prevalence of HER-2 Positive Breast Cancer Tumors for Early Stage Patients in the US

2010 ◽  
Vol 28 (9) ◽  
pp. 963-968 ◽  
Author(s):  
Kathleen A. Cronin ◽  
Linda C. Harlan ◽  
Kevin W. Dodd ◽  
Jeffrey S. Abrams ◽  
Rachel Ballard-Barbash
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Population Based ◽  
The Us ◽  
Her 2 ◽  
Positive Breast Cancer

scholarly journals Pathways Through Peer Assessment: Implementing Peer Assessment in a Lower Secondary Physics Classroom

2020 ◽  
Vol 18 (8) ◽  
pp. 1465-1484 ◽  
Author(s):  
Laura Ketonen ◽  
Markus Hähkiöniemi ◽  
Pasi Nieminen ◽  
Jouni Viiri
Keyword(s):  
Formative Assessment ◽  
Early Stage ◽  
Peer Assessment ◽  
Peer Feedback ◽  
Data Sources ◽  
Constructive Feedback ◽  
Audio Recordings ◽  
Field Notes

AbstractPeer assessment has been shown to advance learning, for example, by improving one’s work, but the variance of learning benefits within or between studies has not been explained. The purpose of this case study was to examine what kinds of pathways students have through peer assessment and to study which factors affect them when peer assessment is implemented in the early stage of physics studies in the context of conducting and reporting inquiry. Data sources used include field notes, audio recordings of lessons, student lab reports, written peer feedback, and student interviews. We examined peer assessment from the perspective of individual students and found 3 profiles of peer assessment: (1) students that improved their lab report after peer assessment and expressed other benefits, (2) students that did not improve their lab report but expressed other benefits, and (3) students that did not experience any benefits. Three factors were found to explain these differences in students’ pathways: (1) students’ engagement in conducting and reporting inquiry, (2) the quality of received feedback, and (3) students’ understanding of formative assessment. Most students experienced some benefits of peer assessment, even if they did not put effort into their own work or receive constructive feedback. Nevertheless, in this case study, both improving one’s work and experiencing other benefits of peer assessment required sufficient accomplishment of all 3 factors.

scholarly journals 2518 InCHOIR learning lab: A TL1 and workforce development initiative at Mount Sinai

2018 ◽  
Vol 2 (S1) ◽  
pp. 57-57
Author(s):  
Emma K. T. Benn ◽  
Janice L. Gabrilove ◽  
Layla Fattah ◽  
Emilia Bagiella
Keyword(s):  
Translational Research ◽  
Randomized Clinical Trials ◽  
Early Stage ◽  
Added Value ◽  
Senior Faculty ◽  
Research Staff ◽  
School Of Medicine ◽  
Lecture Series ◽  
Wide Range ◽  
Mount Sinai

OBJECTIVES/SPECIFIC AIMS: Science and clinical practice are widely regarded as being complementary and synergistic. In an effort to enhance the team science, translational research capacity of the TL1 scholars at Icahn School of Medicine at Mount Sinai (ISMMS), the InCHOIR learning lab aims to provide an accessible, workforce-wide lecture series on the fundamental methods and concepts of randomized clinical trials. METHODS/STUDY POPULATION: The InCHOIR learning lab is a monthly 1 hour lecture series delivered by a range of expert clinical and translational researchers, followed by a 1 hour “Meet the Expert” session. The InCHOIR lecture series has covered a wide range of topics including, but not limited to: Decision Models; Race and Causal Inference; Innovative Strategies for Assessing Environmental Health across the Life Course; Statistics for Geneticists and Genetics for Statisticians; and From the Lab to Translation to Policy—The Neuroscience of Addiction. The “Meet the Expert” session offers TL1 predoctoral and postdoctoral scholars and KL2 scholars the opportunity to have intimate, informal discussions with experts about their career trajectories. RESULTS/ANTICIPATED RESULTS: Feedback from participants has been overwhelmingly positive. Participants have gained important insights into key topics relevant to early stage researchers. The “Meet the Expert” sessions have yielded honest and important conversations about crucial topics ranging from finding effective mentors to essential strategies for establishing a work-life balance, to overcoming adversity as underrepresented minorities and women in translational research. DISCUSSION/SIGNIFICANCE OF IMPACT: Attendance at the InCHOIR learning lab is increasing month on month, indicating the perceived need for this learning not just from early stage researchers, but also from students, senior faculty, and research staff more generally. The InChoir series provides added value through the creation of a video library, fostering new collaborations and contributing to the Icahn School of Medicine at Mount Sinai and Graduate Medical Education landscape. Priorities for the program are to increase internal visibility, in order to continue to grow attendance by MSHS students, research staff, nurses, postdoctoral fellows and residents. The program is also exploring how to engage external participation from regional CTSAs and from community advocates actively involved in community-academic research partnerships.

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