Museum of Contemporary Art San Diego

Primary sclerosing cholangitis (PSC) is a rare autoimmune bile duct disease that is strongly associated with immune-mediated disorders. In this study, we implemented multitrait joint analyses to genome-wide association summary statistics of PSC and numerous clinical and epidemiological traits to estimate the genetic contribution of each trait and genetic correlations between traits and to identify new lead PSC risk-associated loci. We identified seven new loci that have not been previously reported and one new independent lead variant in the previously reported locus. Functional annotation and fine-mapping nominated several potential susceptibility genes such as MANBA and IRF5. Network-based in silico drug efficacy screening provided candidate agents for further study of pharmacological effect in PSC.

Este artículo se propone pensar la cuestión del cruce de las fronteras de las disciplinas artísticas y de los medios, a partir del análisis de las estrategias intermediales de El hipervínculo (Prueba 7) (2018) de Matías Feldman. La obra acude a múltiples entrelazamientos con otras artes y medios, con el fin de entender el fenómeno de las transformaciones culturales de hoy, generadas por las nuevas tecnologías. Por esa razón, consideramos que es un trabajo de particular importancia para el estudio de los vínculos intermediales, tanto por intensificar y multiplicar esos mecanismos, como por abordar una investigación singular sobre las relaciones entre el teatro y los nuevos medios digitales, postulando una reflexión crítica sobre los mismos. En simultaneidad, las interacciones entre la escena y las artes visuales ocupan un lugar determinante, mediante las cuales la obra se pregunta por los cambios en la imagen, la identidad y la percepción contemporáneas.
 PALABRAS CLAVE: INTERMEDIALIDAD-HIPERCULTURALIDAD-TEATRO- MEDIOS DIGITALES-ARTES VISUALES

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method increasingly used to treat psychiatric disorders, primarily depression. Initial studies suggest that rTMS may help to treat addictions, but evaluation in multicenter randomized controlled trials (RCTs) is needed. We conducted a multicenter double-blind RCT in 262 chronic smokers meeting DSM-5 criteria for tobacco use disorder, who had made at least one prior failed attempt to quit, with 68% having made at least three failed attempts. They received three weeks of dailybilat-eral active or sham rTMS to the lateral prefrontal and insular cortices, followed by once weekly rTMS for three weeks. Each rTMS session was administered following a cue-induced craving procedure, and participants were monitored for a total of six weeks. Those in abstinence were monitored for additional 12 weeks. The primary outcome measure was the four-week continuous quit rate (CQR) until Week 18 in the intent-to-treat efficacy set, as determined by daily smoking diaries and verified by urine cotinine measures. The trial was registered at ClinicalTrials.gov (NCT02126124). In the intent-to-treat analysis set (N=234), the CQR until Week 18 was 19.4% following active and 8.7% following sham rTMS (X2 =5.655, p=0.017). Among completers (N=169), the CQR until Week 18 was 28.0% and 11.7%, respectively (X2 =7.219, p=0.007). The reduction in cigarette consumption and craving was significantly greater in the active than the sham group as early as two weeks into treatment. This study establishes a safe treatment protocol that promotes smoking cessation by stimulating relevant brain circuits. It represents the first large multicenter RCT of brain stimulation in addiction medicine, and has led to the first clearance by the US Food and Drug Administration for rTMS as an aid insmok-ing cessation for adults.

Objective: To describe migraine treatment patterns and opioid use in chronic migraine (CM) and episodic migraine (EM) patients. Background: CM remains suboptimally treated. Opioids have been used for acute treatment, but are not recommended for regular use. Design/Methods: Eligible patients were enrolled in a large medical group, ≥18 years, had ≥12 months of continuous enrollment, and had ≥1 claim with a migraine diagnosis in the 12-month period from the screening date to 364 days prior to screening. A physician-administered Semi-Structured Diagnostic Interview, which included questions related to headache symptoms, frequency, disability, medication use, and diagnosis, was used to classify patients as CM or EM. Acute, preventive, and opioid treatment (in the prior 12 months) and baseline characteristics were assessed for CM and EM patients. Results: Of the 192 patients, 129 had CM and 63 had EM. The CM cohort had a mean age of 49.4 (SD=12.6) years and was 93.8% female. The EM cohort had a mean age of 48.9 (SD=15.4) years and was 82.5% female. 67.4% of CM patients and 55.6% of EM patients had ≥1 claim for both acute and preventive medications. 53.5% of CM patients and 36.5% of EM patients had ≥1 opioid claim ( P Conclusions: Approximately two-thirds of CM patients filled prescriptions for both acute and preventive medications in the past year. Over half of CM patients and about a third of EM patients received an opioid prescription in the same time period. Treatment patterns, including opioid use, particularly in CM patients indicate opportunities for better management. Study Supported by: Allergan plc Disclosure: Dr. Pavlovic has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc and the American Headache Society. Dr. Yu has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc employee. Dr. Yu holds stock and/or stock options in Allergan plc, which sponsored research in which Dr. Yu was involved as an investigator. Dr. Yu holds stock and/or stock options in Allergan plc. Dr. Silberstein has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Receives honoraria from Alder Biopharmaceuticals; Allergan, Inc.; Amgen; Avanir Pharmaceuticals, Inc.; eNeura; ElectroCore Medical, LLC; Labrys Biologics; Medscape, LLC; Medtronic, Inc.; Neuralieve; NINDS; Pfizer, Inc.; and Teva Pharmaceuticals. Dr. Silberstein has received research support from His employer receives research support from Allergan, Inc.; Amgen; Cumberland Pharmaceuticals, Inc.; ElectroCore Medical, Inc.; Labrys Biologics; Eli Lilly and Company; Merz Pharmaceuticals; and Troy Healthcare. Dr. Reed has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Vedanta Research. Dr. Reed holds stock and/or stock options in Vedanta Research, which sponsored research in which Dr. Reed was involved as an investigator. Dr. Reed has received research support from Managing Director of Vedanta Research, which has received research funding from Allergan, Amgen, Dr. Reddy’s Laboratories, Eli Lilly, GlaxoSmithKline, Merck & Co., Inc., and Novartis, via grants to the National Headache Foundation. Vedanta Research ha. Dr. Kawahara has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Has served as a consultant Allergan and is a full-time employee of the DaVita Medical Group. Dr. Cowan has nothing to disclose. Dr. Dabbous has nothing to disclose. Dr. Campbell has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc employee. Dr. Campbell holds stock and/or stock options in Allergan plc, which sponsored research in which Dr. Campbell was involved as an investigator. Dr. Campbell holds stock and/or stock options in Allergan plc. Dr. Pulicharam has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Hs served as a consultant and received consulting fees from DaVita Medical Group. Dr. Viswanathan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc. Dr. Viswanathan holds stock and/or stock options in Yes, Allergan plc, which sponsored research in which Dr. Viswanathan was involved as an investigator. Dr. Viswanathan holds stock and/or stock options in Yes, Allergan plc. Dr. Lipton has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Has reviewed for the NIA and NINDS, serves as consultant, advisory board member, or has received honoraria from: Alder, Allergan, Amgen, Autonomic Technologies, Avanir, Boston Scientific, Dr. Reddy’s, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmit. Dr. Lipton has received royalty, license fees, or contractual rights payments from Receives royalties from Wolff’s Headache, 8th Edition, Oxford University Press, 2009 and Informa. Dr. Lipton holds stock and/or stock options in Holds stock options in eNeura Therapeutics and Biohaven. Dr. Lipton has received research support from Support from the NIH, the Migraine Research Foundation, the National Headache Foundation, Allergan plc, Amgen, Dr Reddy’s, and Novartis.

Abstract Since the 1970s there has been an increase in the number of fine art photographs of women with breast cancer. The objectives of this study were to examine: a) how women who have experienced breast cancer reacted and related to a book of nude photographs of other women with breast cancer, and b) their recommendations concerning the presentation of such photos to other women with breast cancer. This photo-elicitation study involved interviews with 15 women who had experienced breast cancer and the findings revealed that the majority of the women felt that the book of nude photographs gave them a sense of hope for the future. In addition, the findings showed some diversity of opinion about when, how and where to use the book of photos. They disagreed if it should be viewed as soon as women are diagnosed with breast cancer or later in their treatment. Finally, the recommendations included having the photos: a) presented to patients by physicians, b) available in physicians’ waiting rooms and chemotherapy rooms, c) available for women’s partners/husbands, and d) included as part of therapy. The results suggest that some women who have had breast cancer, perhaps with more of a postmodern versus modern orientation, benefit from viewing fine art photographs of other women with the same disease. Viewing such photographs assists them in identifying with other women with breast cancer who appear elegant, beautiful, in satisfying relationships and accepting for their physical conditions. 论文摘要 乳腺癌患者：利用同病女性的图片进行的照片引谈调查 自20世纪70年代以来，以罹患乳腺癌女性为拍摄对象的艺术摄影数量不断增加。这篇论文旨在对两方面进行调查研究：一、乳腺癌患者面对一本其他女性患者裸体人像图册的反应与共鸣；二、她们对此类照片的展示方式有何建议。这项照片引谈研究访问了15名乳腺癌患者。绝大部分受访者认为这本图册让她们感觉对未来充满希望。另外，研究还显示受访者对于何时何地以何种方式展示这本图册持有不同见解。有些人认为患者一旦被确诊就应该接触这类图片，另外一些人则认为应该在随后的治疗中使用。受访者对图册使用的建议包括：一、由医生向患者展示；二、放置于候诊区和化疗室；三、向患者的配偶或伴侣展示；四、把图册展示作为治疗的一部分。研究结果表明，那些具有后现代主义而非现代主义倾向的患者更能从这些艺术摄影中汲取正面能量。气质优雅、形象美丽，对两性关系满意并接纳自身生理状况，图片主人公所传达的这些积极信息能帮助此类受访者找到身份认同。 关键词：乳腺癌，摄影，照片引谈Frauen mit Brustkrebs: Photo Elicitation-Interviews unter Verwendung von Fotografien von Frauen mit derselben Krankheit Seit den 1970er Jahren gibt es eine vermehrte Anzahl an Kunstfotografien zu Frauen mit Brustkrebs. Ziel dieser Studie war es zu untersuchen wie a) Frauen, die an Brustkrebs litten, auf ein Buch mit Nacktbildern von andern Frauen mit Brustkrebs reagierten und b) ihre Empfehlungen fur eine Prasentation dieser Fotografien fur andere Frauen mit Brustkrebs ausfielen. Diese Photo Elicitation-Untersuchung beinhaltete Interviews mit 15 Frauen, die an Brustkrebs litten und die Ergebnisse zeigten, dass das Betrachten des Bandes einer Mehrheit der Frauen ein Gefuhl von Hoffnung verlieh. Weiter zeigten die Ergebnisse eine Diversitat von Meinungen daruber, wann, wie und wo der Fotografieband zu verwenden sei. Schliesslich konnten die Fotografien gemass ihren Meinungen a) vom behandelnden Arzt/der behandelnden Arztin den Patientinnen gezeigt werden oder b) in Warteraumen und Chemotherapieraumen aufgelegt werden oder c) den Ehemannern/Partnern der Frauen zur Verfugung gestellt werden oder d) in die Therapie integriert werden. Die Ergebnisse deuten darauf hin, dass einige der Frauen, die Brustkrebs hatten und wahrscheinlich eher uber eine postmoderne, denn moderne Gesinnung verfugen, von der Ansicht von Kunstfotografien von Frauen mit derselben Krankheit profitieren. Das Betrachten solcher Fotografien hilft ihnen, sich mit andern Frauen mit Brustkrebs, die elegant, schon, in befriedigenden Beziehungen lebend und ihre korperliche Verfassung akzeptierend erscheinen, zu identifizieren Schlusselworter: Brustkrebs, Fotografie, Photo Elicitation

A novel soft tissue filler composed of polymethylmethacrylate (PMMA) microspheres suspended in a collagen gel matrix containing 0.3% lidocaine (ArteFill, Artes Medical, Inc.) was recently approved by the Food and Drug Administration for the correction of nasolabial folds. A randomized, multicenter, controlled pivotal trial performed in the United States established the safety and efficacy of this medical device throughout a 12-month study period. The objective was to substantiate the long-term 5-year safety and efficacy of this novel soft tissue PMMA filler. Attempts were made to contact all subjects treated with the PMMA filler that were enrolled in the original pivotal study. Safety was assessed by standard adverse event reporting methods. Efficacy was determined using a validated six-point facial fold assessment photometric grading scale using blinded observers' assessment of standardized photographs. Subjects (n=119) demonstrated significant improvement in nasolabial folds comparing baseline (before any treatment) to 5 years after their last treatment (p<.001). Notably, subjects also demonstrated continued improvement between 6 months after their last treatment and Year 5 (p=.002). No serious unanticipated device-related adverse events were reported. This PMMA filler is the first soft tissue filler to demonstrate continued improvement and persistence of correction over a 5-year period posttreatment.

The risk of brain recurrence after whole-brain radiotherapy for metastatic disease has been infrequently reported, but quoted to be as high as 50%. These values are in the context of autopsy series or clinical trials and thus may not represent experience in routine clinical practice. This retrospective analysis was undertaken: (1) to confirm recursive analysis-based prognostic factors contributing to survival; and (2) to investigate efficacy of Gamma Knife Stereotactic Radiosurgery (GKSRS) in the poorest prognosis population. The records of 85 unselected, consecutive patients receiving whole-brain radiotherapy for brain metastases at Naval Medical Center San Diego were analyzed. Median dose of whole brain radiotherapy was 30 Gy in 10 fractions. These records were categorized by Radiation Therapy Oncology Group (RTOG) categories based on several prognostic factors. Further, analysis of 153 consecutive patients (178 treatments of 396 lesions) receiving GKSRS at the San Diego Gamma Knife Center was made for patients with Karnofsky Performance Status (KPS) < 70 (RTOG class 3). Twenty patients were identified. Median dose of GKSRS was 17.5 Gy at the 61% mean isodose line for all GKSRS patients. Six patients experienced clinical brain recurrences after whole-brain radiotherapy; the actuarial risk of clinical brain recurrence after whole-brain radio therapy approached 30% at 3 years, although few patients survived this long. Survival of patients after whole brain radiotherapy alone by RTOG category mirrored findings of other centers. Patients in class 3 (n = 26) had a median survival in our population of 59 days. For the 20 GKSRS patients with similar performance status and clinical follow-up, the median survival was longer, but not significantly so (162 days; p = 0.467). In the off-protocol setting, clinical brain recurrence of metastatic disease after whole-brain radiotherapy occurs not infrequently in patients with otherwise long survival. The RTOG criteria well describes an extremely poor-prognosis group of patients for whom the single fraction of stereotactic radiosurgery may optimize palliation as well as or better than longer courses of conventional palliative radiotherapy.

A freestanding Gamma Knife radiosurgery center has been open for just over 1 year in La Jolla, Calif., USA, located in the grounds of a medium-sized community hospital. The center employs a full-time medical physicist and neurosurgical nurse together with clerical personnel. The neurosurgeons and radiation oncologists are drawn from the entire community and bill their fees separately. Written protocols for each indication to be treated govern patient eligibility and suggested treatment algorithms. Additionally, each patient to be treated is presented in conference, and a treatment strategy (i.e., radiosurgery, craniotomy, conventional radiation therapy) is decided. Twenty new physicians and physicists have begun training to use the Gamma Knife in the first year. Certification must be achieved before a clinician can be physician of record.