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Papers by Elizabeth Brown

Research paper thumbnail of The Role of Altruistic Values in Motivating Underrepresented Minority Students for Biomedicine

Bioscience, 2015

Understanding how cultural values influence undergraduate students' science research experien... more Understanding how cultural values influence undergraduate students' science research experiences and career interest is important in efforts to broaden participation and to diversify the biomedical research workforce. The results from our prospective longitudinal study demonstrated that underrepresented minority student (URM) research assistants who see the altruistic value of conducting biomedical research feel more psychologically involved with their research over time, which, in turn, enhances their interest in pursuing a scientific research career. These altruistic motives are uniquely influential to URM students and appear to play an important role in influencing their interest in scientific research careers. Furthermore, seeing how research can potentially affect society and help one's community does not replace typical motives for scientific discovery (e.g., passion, curiosity, achievement), which are important for all students. These findings point to simple strategi...

Research paper thumbnail of 222 Right Heart Catheterization in Patients with Pulmonary Arterial Hypertension: Practice Patterns Observed in the REVEAL Registry

J Heart Lung Transplant, 2011

Right ventricular reverse remodeling, as measured by improvement in right ventricular volumes and... more Right ventricular reverse remodeling, as measured by improvement in right ventricular volumes and mass by MRI, was observed by 3 months in patients who underwent PTE surgery. This is the largest series of patients with pre and post PTE MRI assessment so far reported. Magnetic resonance imaging is a valuable tool to evaluate cardiac remodeling, potentially replacing the need for invasive haemodynamic follow up.

Research paper thumbnail of The effect of head and jaw position on respiratory related motion of the genioglossus

Journal of applied physiology (Bethesda, Md. : 1985), Jan 21, 2016

Head and jaw position influence upper airway patency and electromyographic (EMG) activity of the ... more Head and jaw position influence upper airway patency and electromyographic (EMG) activity of the main upper airway dilator muscle, the genioglossus. However, it is not known if changes in genioglossus EMG activity translate into altered muscle movement during respiration. The aim of this study was to determine the influence of head and jaw position on dilatory motion of the genioglossus in healthy adult males during quiet breathing by measuring the displacement of the posterior tongue in 6 positions - neutral, head extension, head flexion, mouth opening and mandibular advancement. Respiratory related motion of the genioglossus was imaged using Spatial Modulation of Magnetization (SPAMM) in 12 awake male participants. Tissue displacement was quantified with harmonic phase (HARP) analysis. The genioglossus moved anteriorly beginning immediately before or during inspiration and there was greater movement in the oropharynx than in the velopharynx in all positions. Anterior displacements...

Research paper thumbnail of To grab and to hold: Cultivating communal goals to overcome cultural and structural barriers in first-generation college students’ science interest

Translational Issues in Psychological Science, 2015

Homogeneity within science limits creativity and discovery, and can feed into a perpetuating cycl... more Homogeneity within science limits creativity and discovery, and can feed into a perpetuating cycle of underrepresentation. From enhancing social justice to alleviating health and economic disadvantages, broadening participation in science is imperative. We focus here on first-generation students (FGS) and identify factors which grab and hold science interest among this underrepresented group. Might the culture and norms within science unintentionally limit FGS' participation? We argue that two distinct aspects of communal goals contribute to FGS' underrepresentation at different stages of the STEM pipeline: cultural perceptions of science as uncommunal (little emphasis on prosocial behavior and collaboration) and the uncommunal structure of STEM graduate education and training. Across 2 studies we investigated factors that catch (Study 1) and hold (Study 2) FGS' science interest. In Study 1, we find only when FGS believe that working in science will allow them to fulfill prosocial communal purpose goals are they more intrinsically interested in science. Yet, later in the pipeline science education devalues prosocial communal goals creating a structural mobility barrier among FGS. Study 2 found that FGS generally want to stay close to home instead of relocating to pursue a graduate education. For FGS (versus continuing-generation students), higher prosocial communal goal orientation significantly predicted lower residential mobility. We discuss implications for interventions to counteract the uncommunal science education and training culture to help improve access to FGS and other similarly situated underrepresented populations.

Research paper thumbnail of The Tyranny of the Multitude is a Multiplied Tyranny: Is the United States Financial Regulatory Structure Undermining U.S. Competitiveness?

Research paper thumbnail of Will the Federal Insurance Office Improve Insurance Regulation?

Research paper thumbnail of Postdoctoral Training in Geropsychology: Guidelines for Formal Programs and Continuing Education

Professional Psychology Research and Practice, 1995

Research paper thumbnail of E Pluribus Unum - Out of Many, One: Why the United States Needs a Single Financial Services Agency

Page 1. American Law & Economics Association Annual Meetings Year 2005 Paper 33 E Pluribus Un... more Page 1. American Law & Economics Association Annual Meetings Year 2005 Paper 33 E Pluribus Unum–Out of Many, One: Why the United States Needs a Single Financial Services Agency Elizabeth F. Brown University of St. Thomas ...

Research paper thumbnail of Quality of evidence revealing subtle gender biases in science is in the eye of the beholder

Proceedings of the National Academy of Sciences of the United States of America, Jan 12, 2015

Scientists are trained to evaluate and interpret evidence without bias or subjectivity. Thus, gro... more Scientists are trained to evaluate and interpret evidence without bias or subjectivity. Thus, growing evidence revealing a gender bias against women-or favoring men-within science, technology, engineering, and mathematics (STEM) settings is provocative and raises questions about the extent to which gender bias may contribute to women's underrepresentation within STEM fields. To the extent that research illustrating gender bias in STEM is viewed as convincing, the culture of science can begin to address the bias. However, are men and women equally receptive to this type of experimental evidence? This question was tested with three randomized, double-blind experiments-two involving samples from the general public (n = 205 and 303, respectively) and one involving a sample of university STEM and non-STEM faculty (n = 205). In all experiments, participants read an actual journal abstract reporting gender bias in a STEM context (or an altered abstract reporting no gender bias in exper...

Research paper thumbnail of Closing the communal gap: The importance of communal affordances in science career motivation

Journal of Applied Social Psychology, 2015

To remain competitive in the global economy, the United States (and other countries) is trying to... more To remain competitive in the global economy, the United States (and other countries) is trying to broaden participation in science, technology, engineering, and mathematics (STEM) by graduating an additional 1 million people in STEM fields by 2018. Although communion (working with, helping, and caring for others) is a basic human need, STEM careers are often (mis)perceived as being uncommunal. Across three naturalistic studies, we found greater support for the communal affordance hypothesis, that perceiving STEM careers as affording greater communion is associated with greater STEM career interest, than two alternative hypotheses derived from goal congruity theory. Importantly, these findings held regardless of major (Study 1), college enrollment (Study 2), and gender . For undergraduate research assistants, mid-semester beliefs that STEM affords communion predicted end of the semester STEM motivation (Study 3). Our data highlight the importance of educational and workplace motivational interventions targeting communal affordances beliefs about STEM.

Research paper thumbnail of From Bench to Bedside: A Communal Utility Value Intervention to Enhance Students’ Biomedical Science Motivation

Journal of Educational Psychology, 2015

Research paper thumbnail of Effective method for the heat inactivation of Blastomyces dermatitidis

Medical mycology, 2014

Manipulation of Blastomyces dermatitidis requires the use of containment level 3 (CL3) practices.... more Manipulation of Blastomyces dermatitidis requires the use of containment level 3 (CL3) practices. However, access to CL3 laboratories is limited and working conditions are restrictive. We describe the validation of a "heat-killing" method to inactivate B. dermatitidis, thus allowing cellular material to be removed from the CL3 laboratory for subsequent DNA isolation that is suitable for genetic applications.

Research paper thumbnail of Estimating the effectiveness in HIV prevention trials by incorporating the exposure process: Application to HPTN 035 data

Biometrics, Jan 20, 2014

Estimating the effectiveness of a new intervention is usually the primary objective for HIV preve... more Estimating the effectiveness of a new intervention is usually the primary objective for HIV prevention trials. The Cox proportional hazard model is mainly used to estimate effectiveness by assuming that participants share the same risk under the covariates and the risk is always non-zero. In fact, the risk is only non-zero when an exposure event occurs, and participants can have a varying risk to transmit due to varying patterns of exposure events. Therefore, we propose a novel estimate of effectiveness adjusted for the heterogeneity in the magnitude of exposure among the study population, using a latent Poisson process model for the exposure path of each participant. Moreover, our model considers the scenario in which a proportion of participants never experience an exposure event and adopts a zero-inflated distribution for the rate of the exposure process. We employ a Bayesian estimation approach to estimate the exposure-adjusted effectiveness eliciting the priors from the histori...

Research paper thumbnail of Defining the elusive 'medical practice

Rhode Island medical journal (2013), 2013

Research paper thumbnail of An imputation method for interval censored time-to-event with auxiliary information: analysis of the timing of mother-to-child transmission of HIV

Statistical communications in infectious diseases, Jan 21, 2010

The timing of mother-to-child transmission (MTCT) of HIV is critical in understanding the dynamic... more The timing of mother-to-child transmission (MTCT) of HIV is critical in understanding the dynamics of MTCT. It has a great implication to developing any effective treatment or prevention strategies for such transmissions. In this paper, we develop an imputation method to analyze the censored MTCT timing in presence of auxiliary information. Specifically, we first propose a statistical model based on the hazard functions of the MTCT timing to reflect three MTCT modes: in utero, during delivery and via breastfeeding, with different shapes of the baseline hazard that vary between infants. This model also allows that the majority of infants may be immuned from the MTCT of HIV. Then, the model is fitted by MCMC to explore marginal inferences via multiple imputation. Moreover, we propose a simple and straightforward approach to take into account the imperfect sensitivity in imputation step, and study appropriate censoring techniques to account for weaning. Our method is assessed by simula...

Research paper thumbnail of Find distance function, hide model inference

2011 IEEE Conference on Visual Analytics Science and Technology (VAST), 2011

Faced with a large, high-dimensional dataset, many turn to data analysis approaches that they und... more Faced with a large, high-dimensional dataset, many turn to data analysis approaches that they understand less well than the domain of their data. An expert's knowledge can be leveraged into many types of analysis via a domain-specific distance function, but creating such a function is not intuitive to do by hand. We have created a system that shows an initial visualization, adapts to user feedback, and produces a distance function as a result. Specifically, we present a multidimensional scaling (MDS) visualization and an iterative feedback mechanism for a user to affect the distance function that informs the visualization without having to adjust the parameters of the visualization directly. An encouraging experimental result suggests that using this tool, data attributes with useless data are given low importance in the distance function.

Research paper thumbnail of Impact of Pill Sharing on Drug Resistance Due to a Wide-Scale Oral Prep Intervention in Generalized Epidemics

Journal of AIDS & Clinical Research, 2013

Background: The first antiretroviral drug (Truvada) to be used as a pre-exposure prophylaxis (PrE... more Background: The first antiretroviral drug (Truvada) to be used as a pre-exposure prophylaxis (PrEP) in preventing HIV transmission is about to be approved. Behavioral studies suggest that a portion of users may share anti-retroviral drugs with sex partners, family, or friends. Pill sharing will decrease PrEP efficacy and adherence level, and potentially create an environment favorable for the development of drug resistance. We aim to evaluate the potential impact of pill sharing on the PrEP effectiveness and on the rates of drug-resistance development in heterosexual populations.

Research paper thumbnail of Healthy humans with a narrow upper airway maintain patency during quiet breathing by dilating the airway during inspiration

The Journal of physiology, 2014

A patent upper airway is essential for survival. Increased age, obesity and some upper airway ana... more A patent upper airway is essential for survival. Increased age, obesity and some upper airway anatomical features are associated with failure to maintain upper airway patency during sleep, leading to obstructive sleep apnoea. However, many healthy subjects with these risk factors do not develop this condition. The aim of this study was to determine how anatomical factors and active dilator muscle contraction contribute to upper airway patency in healthy volunteers across a broad range of age and body mass index (BMI). A 'tagged' magnetic resonance imaging technique quantified respiratory-related motion of the anterior and lateral walls of the upper airway during quiet breathing in the supine position. Fifty-two subjects aged 22-68 years with BMI from 17.5 to 40.1 kg m(-2) were studied. Higher BMI was associated with smaller airway cross-sectional area at the level of soft palate (P < 0.05). The genioglossus moved anteriorly to dilate the upper airway during inspiration. T...

Research paper thumbnail of Update in pulmonary medicine

Clinics in podiatric medicine and surgery, 2002

Chronic inflammation in many pulmonary diseases, such as sarcoidosis and IPF, lead to end-stage l... more Chronic inflammation in many pulmonary diseases, such as sarcoidosis and IPF, lead to end-stage lung disease and fibrosis. In other diseases, such as chronic thromboembolic disease and emphysema, long-term complications can result in pulmonary hypertension and cor pulmonale. Therapeutic options for end-stage lung disease are quite limited. One possible solution is lung transplantation. Although fraught with potential serious complications, including infection, rejection, and death, lung transplantation may offer overall improvement in mortality rates and quality of life.

Research paper thumbnail of Tongue Stiffness is Lower in Patients With Obstructive Sleep Apnea During Wakefulness Compared With Matched Control Subjects

Sleep, Jan 20, 2014

This study aimed to determine whether tongue stiffness (shear modulus) in patients with obstructi... more This study aimed to determine whether tongue stiffness (shear modulus) in patients with obstructive sleep apnea (OSA) is different for controls matched for age, sex, and body mass index (BMI), and to investigate the effect of continuous positive airway pressure (CPAP) on stiffness. Controlled experimental study. Medical research institute. Patients with OSA and age-, sex-, and BMI-matched healthy controls. Magnetic resonance elastography was performed in nine patients with OSA (apnea-hypopnea index (AHI) > 15 events/h) and seven controls (AHI < 10 events/h) matched for age, sex, and BMI. Six of these OSA subjects were also scanned while 10 cmH2O CPAP was applied. Mean isotropic shear modulus and anisotropic shear moduli parallel and perpendicular to the muscle fascicles in the tongue were calculated. Tongue shear modulus in patients with OSA was lower than that in matched controls (2.68 ± 0.35 (mean ± standard deviation) kPa versus 2.98 ± 0.44 kPa, P < 0.001). Shear modulus...

Research paper thumbnail of The Role of Altruistic Values in Motivating Underrepresented Minority Students for Biomedicine

Bioscience, 2015

Understanding how cultural values influence undergraduate students' science research experien... more Understanding how cultural values influence undergraduate students' science research experiences and career interest is important in efforts to broaden participation and to diversify the biomedical research workforce. The results from our prospective longitudinal study demonstrated that underrepresented minority student (URM) research assistants who see the altruistic value of conducting biomedical research feel more psychologically involved with their research over time, which, in turn, enhances their interest in pursuing a scientific research career. These altruistic motives are uniquely influential to URM students and appear to play an important role in influencing their interest in scientific research careers. Furthermore, seeing how research can potentially affect society and help one's community does not replace typical motives for scientific discovery (e.g., passion, curiosity, achievement), which are important for all students. These findings point to simple strategi...

Research paper thumbnail of 222 Right Heart Catheterization in Patients with Pulmonary Arterial Hypertension: Practice Patterns Observed in the REVEAL Registry

J Heart Lung Transplant, 2011

Right ventricular reverse remodeling, as measured by improvement in right ventricular volumes and... more Right ventricular reverse remodeling, as measured by improvement in right ventricular volumes and mass by MRI, was observed by 3 months in patients who underwent PTE surgery. This is the largest series of patients with pre and post PTE MRI assessment so far reported. Magnetic resonance imaging is a valuable tool to evaluate cardiac remodeling, potentially replacing the need for invasive haemodynamic follow up.

Research paper thumbnail of The effect of head and jaw position on respiratory related motion of the genioglossus

Journal of applied physiology (Bethesda, Md. : 1985), Jan 21, 2016

Head and jaw position influence upper airway patency and electromyographic (EMG) activity of the ... more Head and jaw position influence upper airway patency and electromyographic (EMG) activity of the main upper airway dilator muscle, the genioglossus. However, it is not known if changes in genioglossus EMG activity translate into altered muscle movement during respiration. The aim of this study was to determine the influence of head and jaw position on dilatory motion of the genioglossus in healthy adult males during quiet breathing by measuring the displacement of the posterior tongue in 6 positions - neutral, head extension, head flexion, mouth opening and mandibular advancement. Respiratory related motion of the genioglossus was imaged using Spatial Modulation of Magnetization (SPAMM) in 12 awake male participants. Tissue displacement was quantified with harmonic phase (HARP) analysis. The genioglossus moved anteriorly beginning immediately before or during inspiration and there was greater movement in the oropharynx than in the velopharynx in all positions. Anterior displacements...

Research paper thumbnail of To grab and to hold: Cultivating communal goals to overcome cultural and structural barriers in first-generation college students’ science interest

Translational Issues in Psychological Science, 2015

Homogeneity within science limits creativity and discovery, and can feed into a perpetuating cycl... more Homogeneity within science limits creativity and discovery, and can feed into a perpetuating cycle of underrepresentation. From enhancing social justice to alleviating health and economic disadvantages, broadening participation in science is imperative. We focus here on first-generation students (FGS) and identify factors which grab and hold science interest among this underrepresented group. Might the culture and norms within science unintentionally limit FGS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; participation? We argue that two distinct aspects of communal goals contribute to FGS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; underrepresentation at different stages of the STEM pipeline: cultural perceptions of science as uncommunal (little emphasis on prosocial behavior and collaboration) and the uncommunal structure of STEM graduate education and training. Across 2 studies we investigated factors that catch (Study 1) and hold (Study 2) FGS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; science interest. In Study 1, we find only when FGS believe that working in science will allow them to fulfill prosocial communal purpose goals are they more intrinsically interested in science. Yet, later in the pipeline science education devalues prosocial communal goals creating a structural mobility barrier among FGS. Study 2 found that FGS generally want to stay close to home instead of relocating to pursue a graduate education. For FGS (versus continuing-generation students), higher prosocial communal goal orientation significantly predicted lower residential mobility. We discuss implications for interventions to counteract the uncommunal science education and training culture to help improve access to FGS and other similarly situated underrepresented populations.

Research paper thumbnail of The Tyranny of the Multitude is a Multiplied Tyranny: Is the United States Financial Regulatory Structure Undermining U.S. Competitiveness?

Research paper thumbnail of Will the Federal Insurance Office Improve Insurance Regulation?

Research paper thumbnail of Postdoctoral Training in Geropsychology: Guidelines for Formal Programs and Continuing Education

Professional Psychology Research and Practice, 1995

Research paper thumbnail of E Pluribus Unum - Out of Many, One: Why the United States Needs a Single Financial Services Agency

Page 1. American Law & Economics Association Annual Meetings Year 2005 Paper 33 E Pluribus Un... more Page 1. American Law & Economics Association Annual Meetings Year 2005 Paper 33 E Pluribus Unum–Out of Many, One: Why the United States Needs a Single Financial Services Agency Elizabeth F. Brown University of St. Thomas ...

Research paper thumbnail of Quality of evidence revealing subtle gender biases in science is in the eye of the beholder

Proceedings of the National Academy of Sciences of the United States of America, Jan 12, 2015

Scientists are trained to evaluate and interpret evidence without bias or subjectivity. Thus, gro... more Scientists are trained to evaluate and interpret evidence without bias or subjectivity. Thus, growing evidence revealing a gender bias against women-or favoring men-within science, technology, engineering, and mathematics (STEM) settings is provocative and raises questions about the extent to which gender bias may contribute to women's underrepresentation within STEM fields. To the extent that research illustrating gender bias in STEM is viewed as convincing, the culture of science can begin to address the bias. However, are men and women equally receptive to this type of experimental evidence? This question was tested with three randomized, double-blind experiments-two involving samples from the general public (n = 205 and 303, respectively) and one involving a sample of university STEM and non-STEM faculty (n = 205). In all experiments, participants read an actual journal abstract reporting gender bias in a STEM context (or an altered abstract reporting no gender bias in exper...

Research paper thumbnail of Closing the communal gap: The importance of communal affordances in science career motivation

Journal of Applied Social Psychology, 2015

To remain competitive in the global economy, the United States (and other countries) is trying to... more To remain competitive in the global economy, the United States (and other countries) is trying to broaden participation in science, technology, engineering, and mathematics (STEM) by graduating an additional 1 million people in STEM fields by 2018. Although communion (working with, helping, and caring for others) is a basic human need, STEM careers are often (mis)perceived as being uncommunal. Across three naturalistic studies, we found greater support for the communal affordance hypothesis, that perceiving STEM careers as affording greater communion is associated with greater STEM career interest, than two alternative hypotheses derived from goal congruity theory. Importantly, these findings held regardless of major (Study 1), college enrollment (Study 2), and gender . For undergraduate research assistants, mid-semester beliefs that STEM affords communion predicted end of the semester STEM motivation (Study 3). Our data highlight the importance of educational and workplace motivational interventions targeting communal affordances beliefs about STEM.

Research paper thumbnail of From Bench to Bedside: A Communal Utility Value Intervention to Enhance Students’ Biomedical Science Motivation

Journal of Educational Psychology, 2015

Research paper thumbnail of Effective method for the heat inactivation of Blastomyces dermatitidis

Medical mycology, 2014

Manipulation of Blastomyces dermatitidis requires the use of containment level 3 (CL3) practices.... more Manipulation of Blastomyces dermatitidis requires the use of containment level 3 (CL3) practices. However, access to CL3 laboratories is limited and working conditions are restrictive. We describe the validation of a "heat-killing" method to inactivate B. dermatitidis, thus allowing cellular material to be removed from the CL3 laboratory for subsequent DNA isolation that is suitable for genetic applications.

Research paper thumbnail of Estimating the effectiveness in HIV prevention trials by incorporating the exposure process: Application to HPTN 035 data

Biometrics, Jan 20, 2014

Estimating the effectiveness of a new intervention is usually the primary objective for HIV preve... more Estimating the effectiveness of a new intervention is usually the primary objective for HIV prevention trials. The Cox proportional hazard model is mainly used to estimate effectiveness by assuming that participants share the same risk under the covariates and the risk is always non-zero. In fact, the risk is only non-zero when an exposure event occurs, and participants can have a varying risk to transmit due to varying patterns of exposure events. Therefore, we propose a novel estimate of effectiveness adjusted for the heterogeneity in the magnitude of exposure among the study population, using a latent Poisson process model for the exposure path of each participant. Moreover, our model considers the scenario in which a proportion of participants never experience an exposure event and adopts a zero-inflated distribution for the rate of the exposure process. We employ a Bayesian estimation approach to estimate the exposure-adjusted effectiveness eliciting the priors from the histori...

Research paper thumbnail of Defining the elusive 'medical practice

Rhode Island medical journal (2013), 2013

Research paper thumbnail of An imputation method for interval censored time-to-event with auxiliary information: analysis of the timing of mother-to-child transmission of HIV

Statistical communications in infectious diseases, Jan 21, 2010

The timing of mother-to-child transmission (MTCT) of HIV is critical in understanding the dynamic... more The timing of mother-to-child transmission (MTCT) of HIV is critical in understanding the dynamics of MTCT. It has a great implication to developing any effective treatment or prevention strategies for such transmissions. In this paper, we develop an imputation method to analyze the censored MTCT timing in presence of auxiliary information. Specifically, we first propose a statistical model based on the hazard functions of the MTCT timing to reflect three MTCT modes: in utero, during delivery and via breastfeeding, with different shapes of the baseline hazard that vary between infants. This model also allows that the majority of infants may be immuned from the MTCT of HIV. Then, the model is fitted by MCMC to explore marginal inferences via multiple imputation. Moreover, we propose a simple and straightforward approach to take into account the imperfect sensitivity in imputation step, and study appropriate censoring techniques to account for weaning. Our method is assessed by simula...

Research paper thumbnail of Find distance function, hide model inference

2011 IEEE Conference on Visual Analytics Science and Technology (VAST), 2011

Faced with a large, high-dimensional dataset, many turn to data analysis approaches that they und... more Faced with a large, high-dimensional dataset, many turn to data analysis approaches that they understand less well than the domain of their data. An expert's knowledge can be leveraged into many types of analysis via a domain-specific distance function, but creating such a function is not intuitive to do by hand. We have created a system that shows an initial visualization, adapts to user feedback, and produces a distance function as a result. Specifically, we present a multidimensional scaling (MDS) visualization and an iterative feedback mechanism for a user to affect the distance function that informs the visualization without having to adjust the parameters of the visualization directly. An encouraging experimental result suggests that using this tool, data attributes with useless data are given low importance in the distance function.

Research paper thumbnail of Impact of Pill Sharing on Drug Resistance Due to a Wide-Scale Oral Prep Intervention in Generalized Epidemics

Journal of AIDS & Clinical Research, 2013

Background: The first antiretroviral drug (Truvada) to be used as a pre-exposure prophylaxis (PrE... more Background: The first antiretroviral drug (Truvada) to be used as a pre-exposure prophylaxis (PrEP) in preventing HIV transmission is about to be approved. Behavioral studies suggest that a portion of users may share anti-retroviral drugs with sex partners, family, or friends. Pill sharing will decrease PrEP efficacy and adherence level, and potentially create an environment favorable for the development of drug resistance. We aim to evaluate the potential impact of pill sharing on the PrEP effectiveness and on the rates of drug-resistance development in heterosexual populations.

Research paper thumbnail of Healthy humans with a narrow upper airway maintain patency during quiet breathing by dilating the airway during inspiration

The Journal of physiology, 2014

A patent upper airway is essential for survival. Increased age, obesity and some upper airway ana... more A patent upper airway is essential for survival. Increased age, obesity and some upper airway anatomical features are associated with failure to maintain upper airway patency during sleep, leading to obstructive sleep apnoea. However, many healthy subjects with these risk factors do not develop this condition. The aim of this study was to determine how anatomical factors and active dilator muscle contraction contribute to upper airway patency in healthy volunteers across a broad range of age and body mass index (BMI). A 'tagged' magnetic resonance imaging technique quantified respiratory-related motion of the anterior and lateral walls of the upper airway during quiet breathing in the supine position. Fifty-two subjects aged 22-68 years with BMI from 17.5 to 40.1 kg m(-2) were studied. Higher BMI was associated with smaller airway cross-sectional area at the level of soft palate (P < 0.05). The genioglossus moved anteriorly to dilate the upper airway during inspiration. T...

Research paper thumbnail of Update in pulmonary medicine

Clinics in podiatric medicine and surgery, 2002

Chronic inflammation in many pulmonary diseases, such as sarcoidosis and IPF, lead to end-stage l... more Chronic inflammation in many pulmonary diseases, such as sarcoidosis and IPF, lead to end-stage lung disease and fibrosis. In other diseases, such as chronic thromboembolic disease and emphysema, long-term complications can result in pulmonary hypertension and cor pulmonale. Therapeutic options for end-stage lung disease are quite limited. One possible solution is lung transplantation. Although fraught with potential serious complications, including infection, rejection, and death, lung transplantation may offer overall improvement in mortality rates and quality of life.

Research paper thumbnail of Tongue Stiffness is Lower in Patients With Obstructive Sleep Apnea During Wakefulness Compared With Matched Control Subjects

Sleep, Jan 20, 2014

This study aimed to determine whether tongue stiffness (shear modulus) in patients with obstructi... more This study aimed to determine whether tongue stiffness (shear modulus) in patients with obstructive sleep apnea (OSA) is different for controls matched for age, sex, and body mass index (BMI), and to investigate the effect of continuous positive airway pressure (CPAP) on stiffness. Controlled experimental study. Medical research institute. Patients with OSA and age-, sex-, and BMI-matched healthy controls. Magnetic resonance elastography was performed in nine patients with OSA (apnea-hypopnea index (AHI) > 15 events/h) and seven controls (AHI < 10 events/h) matched for age, sex, and BMI. Six of these OSA subjects were also scanned while 10 cmH2O CPAP was applied. Mean isotropic shear modulus and anisotropic shear moduli parallel and perpendicular to the muscle fascicles in the tongue were calculated. Tongue shear modulus in patients with OSA was lower than that in matched controls (2.68 ± 0.35 (mean ± standard deviation) kPa versus 2.98 ± 0.44 kPa, P < 0.001). Shear modulus...