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Pseudobulbar affect (PBA) or pathological laughing and crying (PLC) is a disorder of affect that occurs in about 10% of multiple sclerosis (MS) patients. The objective of this study was to validate the CNS Emotional Lability Scale (CNS-LS) in MS patients and to correlate the results with the frequency and intensity of episodes of PLC. Physicians at seven private practice referral centers in the United States made a diagnosis concerning PLC based on patient interviews. Clinical coordinators separately administered the CNS-LS, a self-report measure of PLC with seven questions, to MS patients, including patients known to exhibit PLC, patients thought to be free of PLC, and newly diagnosed patients where PLC status was unknown, and the physician was blinded as to the results. A receiver operating characteristic (ROC) curve analysis was performed to define a cut-off best correlating with the physician’s diagnosis. Of 90 MS patients selected to complete the survey, 50 were physician diagnosed with PLC; 40 were without PLC, and 15 of these 90 patients were newly diagnosed with MS (B-6 months). Scores of 17 or higher corresponded to a sensitivity of 0.94 and a specificity of 0.83 (LR -/5.5, LR -/0.07); 89% of patients were correctly diagnosed. The area under the ROC curve was 0.95. Symptoms were greater in patients diagnosed as PLC than in non-PLC patients as evidenced by mean number of episodes/week, number of days/week with episodes, duration of an episode and total time in an episode. Similar results were observed if patients were classified as PLC or non-PLC according to CNS-LS score]-17, suggesting that the CNS-LS is a valid measure for the assessment of PLC in MS patients and could be a useful instrument for clinical and research purposes.

An expert system was desired for a group decision-making process. A highly variable data set from previous groups' decisions was available to simulate past group decisions. This data set has much missing information and contains many possible errors. Classification and regression trees (CART) was selected for rule induction, and compared with multiple linear regression and discriminant analysis. We conclude that CART's decision rules can be used for rule induction. CART uses all available information and can predict observations with missing data. Errors in results from CART compare well with those from multiple linear regression and discriminant analysis. CART results are easier to understand.

An expert system was desired for a group decision-making process. A highly variable data set from previous groups' decisions was available to simulate past group decisions. This data set has much missing information and contains many possible errors. Classification and regression trees (CART) was selected for rule induction, and compared with multiple linear regression and discriminant analysis. We conclude that CART's decision rules can be used for rule induction. CART uses all available information and can predict observations with missing data. Errors in results from CART compare well with those from multiple linear regression and discriminant analysis. CART results are easier to understand.

Influenza epidemics cause substantial morbidity. The seasonal vaccine, an important control measure, is not completely efficacious. This trial assessed the efficacy of a recombinant seasonal vaccine (made in a cell culture rather than with viruses grown in eggs). Reducing the burden of influenza disease requires improved vaccines, and a recombinant influenza vaccine may contribute to this public-health goal. 1 This vaccine contains recombinant hemagglutinin (HA) proteins produced in a serum-free medium by expres SF+ cells. These cells contain recombinant baculovirus vectors carrying genes that code for HA. The process yields recombinant HA that is genetically identical to the selected influenza strains without extraneous egg proteins, formaldehyde, antibiotics, or preservatives. Influenza viruses are grown in eggs to produce the inactivated influenza vaccine (IIV); these viruses typically contain mutations in the genes that code for HA that may reduce vaccine effectiveness. . . .

Abstract Background: Understanding the relationship between dose, lung exposure, and drug efficacy continues to be a challenging aspect of inhaled drug development. An experimental inhalation platform was developed using mometasone furoate to link rodent lung exposure to its in vivo pharmacodynamic (PD) effects. Methods: We assessed the effect of mometasone delivered directly to the lung in two different rodent PD models of lung inflammation. The data obtained were used to develop and evaluate a mathematical model to estimate drug dissolution, transport, distribution, and efficacy, following inhaled delivery in rodents and humans. Results: Mometasone directly delivered to the lung, in both LPS and Alternaria alternata rat models, resulted in dose dependent inhibition of BALf cellular inflammation. The parameters for our mathematical model were calibrated to describe the observed lung and systemic exposure profiles of mometasone in humans and in animal models. We found that physicochemical properties, such as lung fluid solubility and lipophilicity, strongly influenced compound distribution and lung retention. Conclusions: Presently, we report on a novel and sophisticated mathematical model leading to improvements in a current inhaled drug development practices by providing a quantitative understanding of the relationship between PD effects and drug concentration in lungs.

Background: Filming teaching sessions were reported in the medical literature in the 1980s and 1990s but appear to have been an underreported and/or underutilized teaching tool since that time. National faculty development programs, such as the Harvard Macy Institute (HMI) Program for Educators in Health Professions and the Stanford Faculty Development Center for Medical Teachers program, have attempted to bridge this gap in formal instruction in teaching skills through microteaching sessions involving videos for self- and peer-assessment and feedback. Objective: Current video-feedback faculty development initiatives are time intensive and impractical to implement broadly at an institutional level. Further, results of peer feedback have not been frequently reported in the literature at the institutional level. Our research aims to propose a convenient and effective process for incorporating video analysis into faculty devleopment programs. Design: Our work describes a novel technique using video-recorded, simulated teaching exercises to compile multi-dimensional feedback as an aid in faculty development programs that promote teaching-skill development. This research evaluated the effectiveness of a focused teaching practicum designed for faculty in multiple specialty departments with large numbers of older patients into a geriatrics-based faculty development program. Effectiveness of the practicum is evaluated using quantitative scoring and qualitative analysis of self-reflection as well as peer and trainee input. Results: VOTE sessions demonstrate an important exportable product which enable faculty to receive a detailed 360-degree assessment of their teaching. Conclusion: This intervention can be easily replicated and revised, as needed, to fit into the educational curriculum at other academic medical centers.

Academic institutions are starting to recognize the growing public interest in digital humanities research, and there is an increasing demand from students for formal training in its methods. Despite the pressure on practitioners to develop innovative courses, scholarship in this area has tended to focus on research methods, theories and results rather than critical pedagogy and the actual practice of teaching. The essays in this collection offer a timely intervention in digital humanities scholarship, bringing together established and emerging scholars from a variety of humanities disciplines across the world. The first section offers views on the practical realities of teaching digital humanities at undergraduate and graduate levels, presenting case studies and snapshots of the authors’ experiences alongside models for future courses and reflections on pedagogical successes and failures. The next section proposes strategies for teaching foundational digital humanities methods across a variety of scholarly disciplines, and the book concludes with wider debates about the place of digital humanities in the academy, from the field’s cultural assumptions and social obligations to its political visions. Digital Humanities Pedagogy broadens the ways in which both scholars and practitioners can think about this emerging discipline, ensuring its ongoing development, vitality and long-term sustainability.