Stanford Research Articles

Review of forbidden intimacies: Polygamies at the limits of Western tolerance By MelanieHeath, Stanford, CA: Stanford University Press. 2023. 292 pp.

Review of forbidden intimacies: Polygamies at the limits of Western tolerance By MelanieHeath, Stanford, CA: Stanford University Press. 2023. 292 pp.

Lawful sins: Abortion rights and reproductive governance in Mexico By Elyse OnaSinger, Stanford: Stanford University Press. 2022. 260 pp.

Lawful sins: Abortion rights and reproductive governance in Mexico By Elyse OnaSinger, Stanford: Stanford University Press. 2022. 260 pp.

Knowledge mapping of chronic insomnia: a bibliometric analysis (2000-2023).

Recently, significant scientific research breakthroughs have been witnessed in the treatment of chronic insomnia. However, it seems that there is currently no bibliometric analysis of this. Therefore, we hope to comprehensively review and analyze the scholarly system and research focus in the field of chronic insomnia treatment through bibliometric methods. Between 2000 and 2023, we explored various papers in relation to the treatment of chronic insomnia in the Web of Science Core Collection(WOSCC) database. Subsequently, the collected papers were subjected to bibliometric analysis utilizing CiteSpace, VOSviewer, and the "bibliometric" package in R language. With China and the United States(USA) among them, a total of 2937 papers were published across 49 countries. Publications related to the treatment of chronic insomnia were increasing year by year. The Laval University, Washington University, Pittsburgh University, and Stanford University were key research institutions. The journal Sleep was widely popular in the field and was also one of the most cited journals. These papers came from 148 authors, with Morin, Charles M., Roth, Thomas, Espie, Colin A., Harvey, Allison G., and Buysse, Daniel J. publishing the most papers and Morin, cm being co-cited the most. The treatment process of chronic insomnia can be divided into three main stages: drug intervention, diseases related to chronic insomnia, and cognitive behavioral therapy and mental health. Keywords such as "children and adolescents", "novel coronavirus pneumonia" (COVID-19), "mental health" and "heart failure" have become the focus of current research. We carried out a detailed bibliometric review of the development trends and research results of chronic insomnia research through this study for the first time. The information it provides reveals recent research hotspots and cutting-edge issues, providing valuable reference materials for researchers focusing on the treatment of chronic insomnia.

HIV-1 drug resistance among naïve patients in Armenia in 2017–2021

Background. The increased antiretroviral therapy (ART) coverage of patients in the absence of routine drug resistance (DR) tests highlight the importance of HIV-1 drug resistance surveillance in Armenia. Aim. The aim of this study was a determination of the prevalence of HIV-1 DR on a large-scale cohort of HIV-infected citizens of the Republic of Armenia who had no experience of taking antiretroviral drugs. Materials and methods. The study was carried out on a cohort of more than 20% of PLHIV in the Republic of Armenia. The resulting 982 nucleotide sequences of the HIV-1 pol gene fragment, encoding the protease and reverse transcriptase region, as well as 367 sequences of the integrase gene, were analyzed using the Stanford University database and the CPR tool for the presence of drug resistance mutations and determination of the resistance level to ARV drugs. The HIV-1 subtype was determined using the Stanford University database and confirmed by phylogenetic analysis. Results. The overall prevalence of HIV DR to ARV drugs in naïve patients was 13.8%. Resistance to non-nucleoside reverse transcriptase inhibitors was 11.2%, nucleotide reverse transcriptase inhibitors — 1.4%, protease inhibitors — 2.0% and integrase inhibitors — 0.5%. The predominant genetic variant among viruses containing DR mutations was subtype B. Resistance was most often recorded among men who have sex with men living in Yerevan. Conclusion. In our study, prevalence of DR was high only for the NNRTI drugs. The results show that the first-line ARV drugs recommended in current national guidelines are highly likely to be effective. The analysis was carried out on a significant proportion of HIV-infected citizens of the Republic of Armenia, which increases the reliability and accuracy of the data obtained.

Telematic music transmission, resistance and touch

ABSTRACT This article retraces the history of telematic performance from early videophone experiments by the Electronic Café in the 1980s, through a series of ambitious digital art installations at museums like the Centre Pompidou. Onto this history, I map a series of netmusic projects I initiated in this period, from ISDN performances at the Sonar Festival to my installation Global String at Ars Electronica. This sets the context for collaborative online performances held during the COVID pandemic with artists like Paul Sermon and the Chicks on Speed. I finish by describing the Hybrid Live project connecting Goldsmiths and Iklectik Art Labs in London with Stanford University’s CCRMA and SFJazz in California. I describe the low latency audio transport used, the importance of audiovisual synchronisation and the computer vision abstractions resulting in a London-New York remote dance performance. By situating current work in these histories, and closely examining the qualities of the network necessary for the transmission of a sense of embodied experience – and therefore trust – we understand that network performance occurs in its own space, one distinct from physical co-presence.

Design of Ternary and Quaternary Asynchronous Up/Down Counter using CNTFET

This paper presents designs of ternary and quaternary up/down counters of single and multiple digits using CNTFET. The proposed counters have a special feature of counting in dual mode; up counting and down counting which makes these designs distinct from other existing designs. The proposed counters are designed using ternary/quaternary D flip-flops and a dynamic successor-predecessor circuit. The D flip-flops are built using standard ternary/quaternary inverters (STI/SQI) with an additional reset feature. The proposed dynamic successor-predecessor circuit has the capability of acting either as a successor or as a predecessor circuit based on a control signal. Counter circuits of multiple digits have been achieved with the help of a few additional transistors along with the single-digit counter circuits. All the proposed designs have been simulated in HSPICE using Stanford University’s 32 nm CNTFET model and simulation results have been noted. When compared with existing designs, the proposed designs show improvements in power and energy efficiency.

Evaluation of the Efficacy of a Novel Dermatotomy Device for Central Venous Cannulation

To test the effectiveness of a novel wire-guided scalpel (Guideblade) to create a precise dermatotomy incision for central venous catheter (CVC) insertion. Prospective, nonrandomized interventional study. Stanford University, single-center teaching hospital. Cardiac and vascular surgical patients (n = 100) with planned CVC insertion for operation. A wire-guided scalpel was used during CVC insertion. A total of 188 CVCs were performed successfully with a wire-guided scalpel without the need for additional equipment in 100 patients, and 94% of CVCs were accomplished with only a single dermatotomy attempt. "No bleeding" or "minimal bleeding" at the insertion site was observed in 90% of patients 30 minutes after insertion and 80.7% at the conclusion of surgery. The wire-guided scalpel was effective in performing dermatotomy for CVC with a 100% success rate and a very high first-attempt rate. The wire-guided scalpel may decrease bleeding at the CVC insertion site.

The outcome of revision total hip arthroplasty for instability.

Instability is a common indication for revision total hip arthroplasty (THA). However, even after the initial revision, some patients continue to have recurrent dislocation. The aim of this study was to assess the risk for recurrent dislocation after revision THA for instability. Between 2009 and 2019, 163 patients underwent revision THA for instability at Stanford University Medical Center. Of these, 33 (20.2%) required re-revision due to recurrent dislocation. Cox proportional hazard models, with death and re-revision surgery for periprosthetic infection as competing events, were used to analyze the risk factors, including the size and alignment of the components. Paired t-tests or Wilcoxon signed-rank tests were used to assess the outcome using the Veterans RAND 12 (VR-12) physical and VR-12 mental scores, the Harris Hip Score (HHS) pain and function, and the Hip disability and Osteoarthritis Outcome score for Joint Replacement (HOOS, JR). The median follow-up was 3.1 years (interquartile range 2.0 to 5.1). The one-year cumulative incidence of recurrent dislocation after revision was 8.7%, which increased to 18.8% at five years and 31.9% at ten years postoperatively. In multivariable analysis, a high American Society of Anesthesiologists (ASA) grade (hazard ratio (HR) 2.72 (95% confidence interval (CI) 1.13 to 6.60)), BMI between 25 and 30 kg/m2 (HR 4.31 (95% CI 1.52 to 12.27)), the use of specialized liners (HR 5.39 (95% CI 1.97 to 14.79) to 10.55 (95% CI 2.27 to 49.15)), lumbopelvic stiffness (HR 6.03 (95% CI 1.80 to 20.23)), and postoperative abductor weakness (HR 7.48 (95% CI 2.34 to 23.91)) were significant risk factors for recurrent dislocation. Increasing the size of the acetabular component by > 1 mm significantly decreased the risk of dislocation (HR 0.89 (95% CI 0.82 to 0.96)). The VR-12 physical and HHS (pain and function) scores improved significantly at mid term. Patients requiring revision THA for instability are at risk of recurrent dislocation. Higher ASA grades, being overweight, a previous lumbopelvic fusion, the use of specialized liners, and postoperative abductor weakness are significant risk factors.

CRF08_BC subtype is more prone to ART failure and new-generation NNRTI-resistance under long-term first-line ART

ObjectiveTo investigate the characteristics of drug resistance mutations (DRMs) and their contextual influence on drug susceptibility in CRF07_BC and CRF_08BC subtypes. MethodsPatients with virological failure were genotyped using phylogenetic analysis. DRMs and susceptibility to antiretroviral drugs were analysed using the Stanford University HIV Drug Resistance Database. ResultsSix HIV subtypes were identified among 1296 successfully amplified sequences, with the CRF07_BC subtype prevailing at a rate of 91.7%, followed by CRF08_BC. Overall, the CRF07_BC and CRF08_BC subtypes were similar in the distribution and frequency of DRMs, the most common DRMs were K103N and M184V. However, among patients with antiretroviral therapy duration of ≥3 y who developed resistance, CRF08_BC exhibited a higher mutation frequency at sites 184, 138, 221, and 188 (Chi-square test, P < 0.05), and compared with CRF07_BC, patients with CRF08_BC had higher prevalence of abacavir, emtricitabine, lamivudine, doravirine, etravirine, and rilpivirine resistance. Moreover, there was an increased prevalence of cross-resistance between efavirenz/nevirapine and new-generation NNRTIs in patients with CRF08_BC; doravirine (r = 1.0), rilpivirine (r = 0.93), and etravirine (r = 0.86) resistance highly correlated with efavirenz/nevirapine. ConclusionsThe present study provides valuable insights into the profile of DRMs and resistance patterns in patients with CRF07_BC and CRF08_BC experiencing treatment failure in Butuo. These findings have the potential to contribute to future strategies for HIV control and treatment.

Antipsychotic medications associated with increased length of hospital stay in autoimmune encephalitis and multiple sclerosis: A retrospective study

BackgroundAntipsychotic medications (APMs) and selective serotonin reuptake inhibitors (SSRIs) are frequently utilized in patients with neuroinflammatory disorders, such as autoimmune encephalitis and multiple sclerosis (MS). This retrospective study investigates how in-hospital treatment with APMs and SSRIs in patients with these neuroinflammatory diseases are associated with differences in hospital length-of-stay (LOS) and mortality. MethodsWe evaluated all the inpatients in the Stanford University Hospital from 2008 to 2023 diagnosed with either non-infectious encephalitis or MS and subdivided them into those who did or did not receive APMs or SSRIs while hospitalized. We then analyzed whether hospital LOS and mortality differed with these medications. ResultsAmong inpatients with non-infectious encephalitis (n = 114), those who were exposed to APMs had a significantly increased mean LOS (11.8 vs 20.9 days, p < 0.01). For inpatients with MS (n = 1095), treatment with an APM was associated with a significant increase in mean LOS (2.8 vs. 7.1, p < 0.00001). When comparing typical to atypical APMs given to subjects with MS, those who received atypical APMs showed a significant increase in LOS (4.3 vs 10.5, p < 0.01), although typical APMs showed significantly increased risk of mortality (p < 0.05). For inpatients with MS and SSRI use, there was a significant increase in mean hospital LOS (3.5 vs 5.3, p < 0.01), with a significant difference found in those who received fluoxetine or citalopram, but not sertraline or escitalopram. Finally, several healthcare disparities were found, including that Black patients were more likely to receive APMs, and those with MS were more likely to receive typical rather than atypical APMs. Conversely, Black patients with MS were less likely to receive SSRI treatment. ConclusionsThere was a statistically significant increase in LOS associated with APM use in non-infectious encephalitis and MS, as well as with SSRI use in MS. These data reflect the importance of these medications in these neuroinflammatory disorders and suggest that further investigation into their risks and benefits would be warranted.

Simple models vs. deep learning in detecting low ejection fraction from the electrocardiogram.

Deep learning methods have recently gained success in detecting left ventricular systolic dysfunction (LVSD) from electrocardiogram (ECG) waveforms. Despite their high level of accuracy, they are difficult to interpret and deploy broadly in the clinical setting. In this study, we set out to determine whether simpler models based on standard ECG measurements could detect LVSD with similar accuracy to that of deep learning models. Using an observational data set of 40 994 matched 12-lead ECGs and transthoracic echocardiograms, we trained a range of models with increasing complexity to detect LVSD based on ECG waveforms and derived measurements. The training data were acquired from the Stanford University Medical Center. External validation data were acquired from the Columbia Medical Center and the UK Biobank. The Stanford data set consisted of 40 994 matched ECGs and echocardiograms, of which 9.72% had LVSD. A random forest model using 555 discrete, automated measurements achieved an area under the receiver operator characteristic curve (AUC) of 0.92 (0.91-0.93), similar to a deep learning waveform model with an AUC of 0.94 (0.93-0.94). A logistic regression model based on five measurements achieved high performance [AUC of 0.86 (0.85-0.87)], close to a deep learning model and better than N-terminal prohormone brain natriuretic peptide (NT-proBNP). Finally, we found that simpler models were more portable across sites, with experiments at two independent, external sites. Our study demonstrates the value of simple electrocardiographic models that perform nearly as well as deep learning models, while being much easier to implement and interpret.

Out for Blood: Tyler Shultz and Theranos

In early 2014, recent Stanford University graduate Tyler Shultz was in a quandary. He had been working at Theranos, a blood-diagnostic company founded by Elizabeth Holmes, a Stanford-dropout wunderkind, for almost a year. Shultz had learned enough about the company to realize that its practices and the efficacy of its much-touted finger-prick blood-testing technology were questionable and that the company was going to great lengths to hide this fact from the public and from regulators.Theranos and Holmes were Silicon Valley darlings, enjoying positive press and lavish attention from potential investors and technology titans alike. Just as companies like PayPal had revolutionized the stagnant payments industry and Uber had upended the for-hire transportation sector, Theranos had been positioned as the latest technology firm to substantially disrupt yet another mature sector: the medical laboratory business. By the start of 2014, the company had raised more than $400 million in funding, and had an estimated market valuation of $9 billion.Shultz's situation was exacerbated by the fact that his grandfather, the highly respected former US Secretary of State George Shultz, was on the Theranos board and was one of Elizabeth Holmes's biggest supporters.But Tyler Shultz worried about the customers he was convinced were receiving highly unreliable and often inaccurate blood-test results. With so much at stake, Shultz wondered how he should proceed. Should he raise his concerns with the firm's investors? Blow the whistle externally? Report to industry regulators? Go away quietly?This case and its subsequent four brief follow-up cases are based largely on interviews with Tyler Shultz, and outline the dilemma he faced and the various steps he would take both to extricate himself from his unsavory position and let the public know the full extent of the deception at Theranos.Five optional handouts are available to instructors to further discussion after the case has been debriefed. The handouts serve as additional decision points for the students if your class time permits.

Do firms with technological capabilities rush in? Evidence from the timing of licensing of Stanford inventions

This study investigates the influence of licensees’ technological capabilities on the timing of technology licensing in university technology commercialization. Drawing on the appropriation-collaboration tension from the literature on university technology licensing and intellectual property management, we propose that while the licensee’s technological capabilities drive early licensing by averting technological obsolescence, this effect diminishes significantly with an overlap in the technological domain of the focal invention due to expropriation concerns. Cox regression analysis of Stanford University’s invention dataset confirmed our hypotheses. This research reveals that technology licensing experiences delays with the most suitable licensees, namely, those with strong technological capabilities in the knowledge domain of the invention for licensing. This study contributes theoretical insights to the technology market literature and provides practical implications for licensing managers and industry partners in technology commercialization.

Training the next generation of community-engaged physicians: a mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era

BackgroundMedical school curricula strive to train community-engaged and culturally competent physicians, and many use service learning to instill these values in students. The current standards for medical service learning frameworks have opportunities for improvement, such as encouraging students to have more sustainable and reciprocal impact and to ingrain service learning as a value to carry throughout their careers rather than a one-time experience. PEDS 220: A COVID-19 Elective is a Stanford University course on the frontlines of this shift; it provides timely education on the COVID-19 pandemic, integrating community-oriented public health work to help mitigate its impact.MethodsTo analyze our medical service learning curriculum, we combined qualitative and quantitative methods to understand our students’ experiences. Participants completed the Course Experience Questionnaire via Qualtrics, and were invited to complete an additional interview via Zoom. Interview transcripts were analyzed using an interactive, inductive, and team-based codebook development process, where recurring themes were identified across participant interviews.ResultsWe demonstrate through self-determination theory that our novel curriculum gives students valuable leadership and project management experience, awards strong academic and community-based connections, and motivates them to pursue future community-engaged work.ConclusionsThis educational framework, revolving around students, communities, and diversity, can be used beyond the COVID-19 pandemic at other educational institutions to teach students how to solve other emergent global health problems. Using proven strategies that empower future physicians to view interdisciplinary, community-engaged work as a core pillar of their responsibility to their patients and communities ensures long-term, sustainable positive impact.Trial registrationN/A.

Inside the April 2024 Issue.

Dear Readers, We are thrilled to bring you the first issue of the ninth volume of POCUS Journal. Published since 2016, POCUS Journal is the only multi-disciplinary, peer-reviewed, POCUS-focused journal that is free for authors and readers alike. We are grateful for the vision of our founder Dr. Amer and for the support of CINQUILL Medical Publishers, Inc. as we enter our ninth year of publication. POCUS is an ever-changing field as clinicians seek out better and faster solutions for patient care at the bedside. We at POCUS Journal continue to evolve as well. Our editorial board is growing to meet the demands of our high volume and high-quality manuscript submissions. We welcome Dr. Andre Kumar of Stanford University and Dr. Manpreet Malik of Emory University to the Internal Medicine section. We also welcome Dr. Andrea of the University of Southern California to the Pediatrics section. Natalie joins us from Queen’s University as the Social media Editor. If you haven’t seen her high-yield on social media I highly encourage you to visit POCUS Journal on X and Instagram for summaries of research articles and other content published in our journal. A journal our size also needs help with statistics, and we are excited that Nicholas has joined our team from the University of Toronto as Statistical Editor. We also have a new Editorial Director of Artificial Intelligence, Dr. Bredon Crawford. We are the first journal to feature an AI bot on our website, which is thanks to Dr. Crawford. Its name is “PJ” and you can find it on the bottom right of our website: www.pocusjournal.com. And finally, we are excited to have had Kathryn Matsushita join our team as , helping us preserve our standard of high quality publishing as the volume of submitted articles and size of our issues continues to grow. With the addition of these new members, I also share the bittersweet news that our Managing Editor Braeden Hill will be leaving POCUS Journal to pursue MD/PhD studies at The University of Toronto. started at POCUS Journal in 2020 as Social Media Editor and his contributions these past few years have been remarkable. We welcome Laura Guzman of Queen’s University into the role of Managing Editor. Every issue I oversee at POCUS Journal strikes me as better than the last, with fascinating cases and important research that answers key questions related to point of care ultrasound. This issue is no exception. Please find our author guidelines here: https://pocusjournal.com/author-guidelines/ Sincerely, Benjamin T. Galen, MD Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY Editor-In-Chief POCUS Journal

Figures of Possibility: Aesthetic Experience, Mysticism, and the Play of the Senses By NiklausLargier, Stanford University Press. 2022. pp. 304. $28.00 (paperback)

Figures of Possibility: Aesthetic Experience, Mysticism, and the Play of the Senses By NiklausLargier, Stanford University Press. 2022. pp. 304. $28.00 (paperback)

Matias E. Margulis, Shadow Negotiators: How UN Organizations Shape the Rules of World Trade for Food Security Stanford University Press, 2023

Matias E. Margulis, Shadow Negotiators: How UN Organizations Shape the Rules of World Trade for Food Security Stanford University Press, 2023

‘Landscapes’: Andy Warhol and Victor Hugo’s collaborations in gay sex and art

ABSTRACT In 2014, the Cantor Arts Center at Stanford University received 3600 contact sheets from Andy Warhol’s Minox 35EL camera, charting the full range of his black-and-white photography from 1976 until his death in 1987. A remarkable subset of the sheets capture explicit gay sexual activity, most shot for Warhol’s late-1970s Torsos and Sex Parts series. I provide a history and visual analysis of these pornographic images, many of which star Warhol’s friend, artist Victor Hugo. Warhol had been interested in ‘sex parts’ since the 1950s, but in Hugo he found his ideal muse and sexual performer. As Warhol’s paid collaborator, Hugo procured men whom Warhol and his studio assistants photographed nude and engaged in sex with Hugo. Scrutinizing gestures visible in the contact sheets, I argue that Hugo was engaged in a competition for artistic authorship and control in these photo shoots: the ‘art’ of gay sex was where Hugo could outshine Warhol.

Sentiment Analysis - An optimized Weighted Horizontal Ensemble approach

Sentiment Analysis has gained authority as one of the primary means of analyzing feedbacks and opinion by individuals, organizations and governments. The result of sentiment analysis informs an organization on areas to improve and how best to manage customers. While sentiment analysis may be misleading as no algorithm has been considered 100% efficient, the choice of algorithms can optimize the result based on the dataset in question. This paper aims at studying various algorithms and implementing a weighted horizontal ensemble algorithm as a panacea to low confidence level in the results of sentiment analysis. We designed a system that implements the original Naive Bayes algorithm, Multinomial Naïve Bayes algorithm, Bernoulli Native Bayes algorithm, Logistic Regression algorithm, Linear Support Vector Classifier algorithm and the Stochastic Gradient Descent algorithm. Our dataset was sourced from the Stanford University. It contains fifty thousand (50,000) movie reviews. Dataset from the Nigerian movie review was used to test the models. The reviews were encoded as a sequence of word indices. An accuracy of over 91% was achieved. The Ensemble technique delivered an F1-measure of 90%. Ensemble technique provides a more reliable confidence level on sentiment analysis. The researchers also discovered that change in writing style can affect the performance of sentiment analysis

Does the type of privacy-protective behaviour matter? An analysis of online privacy protective action and motivation

ABSTRACT Individual decisions to protect privacy online are complex. Most research has treated privacy protection measures as a single, unitary category. This paper challenges this notion by looking at multiple categories of privacy protection behaviour. Our data are from the Oxford Internet Survey (OxIS) as well as insights from the semi-structured interviews. We find two types of privacy protective actions, which we call security actions and preventive actions. We use logistic regression, based on protection motivation theory, to investigate what leads people to take either type of action. The contribution of this research is three-fold. First, it shows that individual privacy protection cannot be treated as a single category. Second, it demonstrates that there are different motivations underlying different privacy protection actions. Finally, it proposes an expansion of protection motivation theory to include a contextual aspect based on Nissenbaum (2009, Privacy in context. Stanford University Press). This expansion considers the privacy context defined by actor, activity, values and norms. We suggest that future work on privacy should consider multiple categories and contextual settings.