Yale School Research Articles

87. Infectious Disease Diversity, Equity, and Antiracism (ID2EA): A Dedicated Curriculum for Infectious Disease Professionals

BackgroundSystemic bias in the health care system has adverse effects on health outcomes. Educational programs examining the relationship between structural racism and health inequities are needed to translate knowledge into equitable care. The Yale School of Medicine Infectious Disease (ID) Section designed and piloted an innovative Infectious Disease Diversity, Equity, and Anti-Racism (ID2EA) curriculum to better understand and confront these issues.MethodsThe ID Section collaborated with pedagogical experts to create a curriculum. A baseline survey of ID faculty and trainees was used to gauge relevant knowledge, attitudes, skills, and topics of interest to participants. The curriculum was designed as a “roadmap” of interactive sessions (“roadmap stops”) focused on topics identified by respondents. Evaluations were performed after events to guide curriculum development and monitor its acceptance and effectiveness.ResultsAll respondents (n=28) to the baseline survey agreed that discussion of race and ethnicity should be integrated into medical training. Most respondents (96%) had experience or knowledge of racial microaggressions in the workplace. Fewer (75%) felt comfortable talking to patients about race and only 68% felt confident teaching learners how to decrease bias in care. The survey identified topics of highest priority to participants, including building trust with patients (75%), providing racially sensitive care (68%) and establishing dialogue with community members (57%). Roadmap stops were constructed based on these priorities, with sessions on race-based medical experimentation and inequities, racial segregation and its impact on health, medical mistrust, and a skill building session on improving patient-centered communication. On follow-up surveys (n=18-28), most participants (93%) saw the sessions as a valuable way to spend time and the majority (91%) reported an impact on their understanding of racism in healthcare; specific changes in thinking were qualitatively coded. ConclusionOur findings demonstrate the positive impact of a curriculum to help understand racism and inequities in medicine. Building and implementing a diversity, inclusion, and anti-racism curriculum in ID sections is feasible, beneficial, and valued.Disclosures Jaimie Meyer, MD, Gilead Sciences (Scientific Research Study Investigator) Sheela Shenoi, MD, MPH, Merck (Other Financial or Material Support, SS’s spouse worked for Merck pharmaceuticals 1997-2007 and retains company stock in his retirement account. There is no conflict of interest, but it is included in the interest of full disclosure.) Marjorie Golden, MD, Iterum Pharmaceuticals (Consultant)

Marxism and Deconstruction: Symposium at the Conference on Contemporary Genre Theory and the Yale School, 1 June 1984

The Symposium at the Conference on Contemporary Genre Theory and the Yale School took place on June 1, 1984, at the Center for Continuing Education on the University of Oklahoma campus in Norman. Panelists Barbara Johnson, Louis Mackey and J. Hillis Miller fielded questions for two hours from about one hundred students and scholars who had gathered to hear their remarks. Scheduled for the last day of the Conference, the Symposium gave the students an opportunity to raise questions and engage the panelists in a dialogue while allowing the panelists to respond to other papers given at the conference and to clarify or expand on their own presentations. The dynamics of this session, the clash of viewpoints and the theoretical, philosophical and political differences which emerged from this discussion made the Symposium one of the most stimulating events of the Conference.The Symposium had not been designed by the conference organizers to address as exclusively as it did the question of the relationship between Marxism and deconstruction. The discussion in the Symposium arose out of what was generally felt to be the unfortunate omission of Marxist viewpoints from the conference schedule. Specifically, the impetus arose from a presentation by David Gross during the session on Drama and Contemporary Theory on “Brecht and Modern Theory.” Gross uses Brecht's poem “A Worker Reads History” as an illustration of the critical/skeptical attitude toward the act of reading (history)—an example of Brecht's strategy of “estrangement” and Marx's “relentless criticism of everything existing,” which seems in significant ways like a deconstructive reading. Gross concluded his presentation with a challenge that deconstruction address economic, social and political institutions much more explicitly.During the Symposium Barbara Johnson focused on the ways in which both deconstruction and Marxism decenter the subject in a critique of the bourgeois notion of identity and selfhood. Responding to Johnson, Louis Mackey commented on the possibility of rapprochement between these two theories. (Mackey presented a deconstructive reading of St. Anselm's Proslogium at the conference.) The result was an exploratory foray into the differences between a critique and a political action, both of which center around the subversion of authority.What emerged was a discussion of the relationship between linguistic and social/historical modes of analysis in current literary theory. As forms of literary criticism, structuralism and post-structuralism have brought about a revolution in critical theory. Focusing on the conditions of signification, structuralist theories examine the sign and ways in which the sign produces meaning. Deconstruction subverts the structuralist enterprise, taking the analysis deeper into language, philosophically and historically analyzing the basic assumptions of Western culture and how these assumptions affect the way we use language. The result is a literary criticism which has extraliterary implications. As Barbara Johnson noted during the Symposium, deconstruction is “an attack on the way in which discourse functions in patterns of domination.” This attack is also relentlessly self-critical in its examination of the hierarchies which perpetuate repression in Western culture—an examination that deconstruction shares with Marxism. Traditional Marxist concern for the structures of economic and political life has expanded in the hands of literary Marxists to include a broad range of cultural and critical activities in which structuralism and post-structuralism have had a significant impact. Like deconstruction, Marxism is also concerned with the ways in which discourse functions in patterns of political effacement and domination.In practice, however, linguistic theories have tended to ignore history while social/historical approaches have often systematically ignored language. Can Marxism and deconstruction rescue each other from the blindnesses of each approach? ls there a way of combining Marxism and deconstruction that remains loyal to both? Do Marxism and deconstruction share structural similarities as modes of analysis? Will any combining of the two necessarily privilege one over the other? This symposium represents an inquiry into just this area where these two critical theories both overlap and fail to meet.In the discussion which follows, each of the panelists fuses theory and practice in unique ways. The transcription does, on the whole, retain the original wordings of the questions and the responses from the panelists. We have made changes only when necessary to impose grammatical and syntactical clarity on the flow of spoken discourse.

Our Advisor

In recognition of the distinguished scholar J. Hillis Miller's long service to the journal as an advisory editor and author, Genre has reprinted a transcript of a symposium to conclude the conference “Contemporary Genre Theory and the Yale School.” The conference was held at the University of Oklahoma in 1984. Panelists Barbara Johnson, Louis Mackey, and J. Hillis Miller comment on work presented at the conference over the previous two days and respond to questions from the audience. Much of the discussion focuses on an appraisal of the differences between deconstructive and Marxist approaches within the discipline of literary studies.

Joseph R. Bertino: In Memoriam (1930–2021)

Joseph R. Bertino: In Memoriam (1930–2021)

Implementing a Full Time Equivalent-Supported Hematology/Oncology Fellowship Core Faculty Program May Improve Faculty Engagement in Education, Mentorship, and Recruitment

Background:The American Council of Graduate Medical Education (ACGME) requires every U.S. residency and fellowship training program to designate Core Faculty (CF) who participate in teaching and mentoring trainees. With increasing recognition of competing faculty responsibilities in academic medicine, many groups have recently recommended providing CF with salary support in exchange for their educational efforts, yet few programs have implemented such initiatives. During the 2020-2021 academic year (AY), the Hematology and Medical Oncology Fellowship Program at Yale School of Medicine created a CF program with 10% full time equivalent (FTE) support to 18 CF selected for their dedication to teaching and mentoring fellows. These CF were given responsibilities in participation in fellow conferences, fellow mentorship, and fellowship recruitment. Mentorship Committees (MC) were also launched during the 2020-2021 AY, with each first-year fellow assigned to a group of CF members for career planning and guidance throughout the AY.Methods:We performed a mixed-methods study to explore the impact of our FTE-supported CF program utilizing a combination of faculty and fellow survey data, free-text written comments, and data on faculty participation in educational activities. At the end of the 2020-2021 AY, an online survey utilizing the Qualtrics platform was sent via email to all 18 CF members and all 24 Hematology/Oncology fellows. All CF members and fellows were asked questions about the CF program, while only the CF members and the eight first-year fellows were asked questions regarding the MC. The surveys consisted of multiple choice and open-ended questions with free-text responses and were distributed from June-July 2021. Quantitative data was obtained regarding faculty attendance at the fellowship program's weekly New Patient conference and availability of faculty for fellowship recruitment interviews for both the 2019-2020 AY and the 2020-2021 AY.Results:A total of 14 (77.8%) CF members and 13 (54.2%) fellows responded to the survey. Among CF respondents, 11 (78.5%) reported that both their overall job satisfaction and sense of involvement in the fellowship program and its educational mission increased by either “a little” or “a lot” as a result of becoming a CF member. In free-text comments, positive aspects of being a CF member included “satisfaction in being an integral part of fellowship education,” a “sense of commitment” to the educational mission of the fellowship program and improved “communication with colleagues and house staff.” As a result of being a CF member, seven (21.1%) reported increased attendance at fellow conferences, nine (27.3%) devoted more time to mentoring and advising fellows, and seven (21.1%) increased their participation in fellowship recruitment compared to prior years. Five (15.5%) CF members felt that they had not appreciably changed their activities, but rather that they received much appreciated recognition and support for activities they were already engaged in prior to becoming a CF member.Among fellow respondents, six (46.2%) noted that following implementation of the CF program, faculty attendance at fellow educational conferences increased. One fellow praised the CF program for “identifying teachers who are very committed to educating fellows” and another commented “fantastic faculty and education overall”. Three (37.5%) first year fellows responded to questions about MC, with all three indicating that the MC assisted “a little” or “a lot” in identifying or elucidating their career path.Thirty-eight (36.5%) faculty participated in New Patient conference in 2019-2020 vs. 50 (46.7%) in 2020-2021. Of faculty who were designated CF in 2020, 12 (75%) attended New Patient conference a median of 9 times in 2019-2020 vs. 18 (100%) a median of 20.5 times in 2020-2021. In terms of recruitment, 14 (87.5%) CF reported availability to interview a median of 2 times during 2019-2020 vs. 17 (94.4%) a median of 8.5 times during 2020-2021.Conclusions:Our FTE-supported CF program was viewed enthusiastically by fellows and participating faculty, resulting in increased faculty conference attendance, mentorship of trainees, and involvement in recruitment. MCs may hold promise in guiding career decisions for first year Hematology/Oncology fellows. DisclosuresPodoltsev: CTI BioPharma: Honoraria; Bristol-Myers Squib: Honoraria; Celgene: Honoraria; Novartis: Honoraria; Incyte: Honoraria; Blueprint Medicines: Honoraria; Pfizer: Honoraria; PharmaEssentia: Honoraria.

Hawks et al. Respond

AffiliationsLaura Hawks is with the Medical College of Wisconsin, Milwaukee. Emily A. Wang and Benjamin Howell are with the Yale School of Medicine, New Haven, CT. Steffie Woolhandler and David U. Himmelstein are with Hunter College, City University of New York, New York, NY, and Harvard Medical School, Boston, MA. David Bor and Danny McCormick are with the Cambridge Health Alliance, Cambridge, MA, and Harvard Medical School.

Tribute to Lewis Landsberg: A Giant of Academic Medicine.

Tribute to Lewis Landsberg: A Giant of Academic Medicine.

Creating cascading non-linear solutions for the UN sustainable development goals through green chemistry

Paul T. Anastas is the Teresa and H. John Heinz III Professor in the Practice of Chemistry for the Environment. He has appointments in the School of the Environment and Yale School of Public Health. In addition, Prof. Anastas serves as the Director of the Center for Green Chemistry and Green Engineering at Yale. Anastas took public service leave from Yale to serve as the Assistant Administrator for the US Environmental Protection Agency and the Agency Science Advisor from 2009-2012. Julie B. Zimmerman holds joint appointments as a Professor in the Department of Chemical and Environmental Engineering and School of the Environment (YSE) at Yale University. She also serves at the Senior Associate Dean for Academic Affairs at YSE as well as the Deputy Director of Center for Green Chemistry & Green Engineering at Yale. Prior to joining the faculty at Yale, Zimmerman worked as an Program Manager in the Office of Research and Development at the US EPA.

Hospitals and methadone treatment: A good place to start

If you have a question about methadone treatment in a hospital, Melissa Weimer, DO, is a great person to ask. Not only is she medical director of the Addiction Medicine Consult Service at the Yale School of Medicine, but she also has authored many publications on treating addiction in a hospitalized setting. A trend‐setter in working with opioid treatment program (OTP) partnerships, she is full of information designed to help physicians and others ease their patients' withdrawal and help them onto a maintenance schedule, whether with buprenorphine or methadone.

Demographic Differences in Medical Students' Perceptions of Respect for Diversity Among Faculty.

Purpose: Faculty role modeling is critical to medical students’ professional development to provide culturally adept, patient-centered care. The behaviors displayed by faculty can directly influence students’ attitudes and behaviors and is considered a part of the “hidden curriculum.” 1 However, little is known about students’ perceptions of faculty role modeling of respect for diversity. The purpose of our study was to examine the perceptions of faculty role modeling of respect for diversity among a nationally representative sample of medical students and to assess the extent to which perceptions varied by student demographics. We hypothesized that students from historically marginalized groups (females; racial/ethnic minorities; and lesbian, gay, or bisexual [LGB]) and older students with greater lived experiences would be more likely to have a negative perception of faculty respect for diversity. Approach/Methods: This cross-sectional study analyzed data from respondents of the 2016 and 2017 Association of American Medical Colleges Graduate Questionnaire (AAMC-GQ). The AAMC-GQ surveyed graduating students at the 140 accredited allopathic U.S. medical schools with graduates as of 2017. Students’ responses from the GQ were linked to self-reported demographic data via AAMC data applications and services, including the American Medical College Application Service, Medical College Admissions Test, and Electronic Residency Application Service. Demographic variables included sex (male vs female), race/ethnicity, sexual orientation (heterosexual, LGB, or unknown), and age. Using multivariable logistic regression, we examined the extent to which student-reported faculty respect for diversity varied by demographic characteristics and sequentially adjusted all logistic regression models first for demographics then for marital status and financial variables. Results: The final study sample consisted of survey responses from 28,778 students, which represented 75.4% of the total 38,160 U.S. medical graduates in 2016 and 2017. Of 28,778 respondents, 48.6% were female, 5.2% identified as LGB. Most identified as White, 20.7% Asian, 5.1% as Black/African American, 8.5% Hispanic/Latinx, and 0.3% American Indian/Alaskan Native/Native Hawaiian or Pacific Islander (AIAN-NHOPI). Over a third (36.8%) of Black/African American students reported a lack of faculty respect for diversity compared with 14.4% of White students—a 3-fold higher odds of perceived lack of respect (OR, 3.24; 95% CI, 2.86–3.66) after adjusting for other demographics and covariates. AIAN-NHOPI (OR, 1.73; 95% CI, 1.03–2.92), Asian (OR, 1.62; 95% CI, 1.49–1.75), and Hispanic/Latinx (OR, 1.43; 95% CI, 1.26–1.75) students also had higher odds compared with White students, as did female compared with male students (OR, 1.17; 95% CI, 1.10–1.25), LGB (OR, 1.96; 95% CI, 1.74–2.22), and “unknown” sexual orientation (OR, 1.79; 95% CI, 1.29–2.47) compared with heterosexual students. Discussion: Over 1 in 6 medical students in our sample reported that faculty lacked respect for diversity. Medical students who identified as racial/ethnic minorities, females, LGB, and older students had higher odds of reporting that faculty lacked respect for diversity when compared with their majority counterparts. This perceived lack of respect for diversity may manifest itself during faculty–patient interactions. Gaps in patient–provider communication perpetuate health disparities and lead to higher levels of bias toward females, LGB, and racial/ethnic minority patients. 2–5 Our study also raises concern that for certain subgroups, a greater prevalence of the perceived lack of faculty respect for diversity may contribute to a more negative institutional psychological climate. Our findings support prior literature that negative faculty behavior contributes to the hidden curriculum. 1 Significance: This study’s findings highlight the need for medical schools, accrediting bodies, and leaders in academia to reaffirm their approach to creating an inclusive environment for all students. Students from marginalized groups disproportionately reported a lack of respect for diversity among faculty, which has important implications for patient care, the learning environment, and the well-being of trainees. Acknowledgments: Louisa Holaday, MD, and Joe Ross, MD, MHS (Yale School of Medicine), provided advice and nonfinancial support for this study. No compensation was given for these contributions.

Implementing Live Virtual Surgery in the COVID Era: Overcoming Medicolegal, Technical, and Educational Hurdles.

Due to current health concerns related to the coronavirus disease of 2019, remote learning has been adopted at every academic level. In congruence with policies drafted by academic surgical societies, a majority of medical schools nationwide have decided against accepting visiting medical students.1,2 As such, there has been an emergence of virtual adaptations of educational sessions and clinical rotations across a variety of medical specialties.3,4 Because surgical education occurs primarily in the operating room, adopting a virtual model for surgical education presents distinct challenges. At the Yale School of Medicine, we designed the first virtual surgical rotation format to center around livestream plastic surgeries across key areas of the specialty.5 Successfully implementing this teaching modality required overcoming medicolegal challenges, the logistical and technical details involved in the creation of this educational modality, and educational hurdles. In coordination with the Yale School of Medicine and the Yale Graduate Medical Education office, the virtual rotation was registered as a formal course for credit through the Association of American Medical College’s Visiting Student Application Service, identical to in-person visiting electives. By formally registering for the virtual rotation through the Visiting Student Application Service, virtual rotators met the same medical malpractice liability coverage and Health Insurance Portability and Accountability Act requirements as in-person rotating subinterns. Many of the participating students used the virtual rotation toward clinical credit for their graduation requirements. In addition, patients completed written consent forms for the hospital and university, giving permission to livestream surgery. (See Document, Supplemental Digital Content 1, which shows the photographic consent form for patients agreeing to participate in the livestream surgery, https://links.lww.com/PRS/E735.) These steps enabled clinical information to be shared freely with students in a remote learning environment. The technical challenges included high-quality visual capture of the surgery, real-time transmission to enrolled students, and real-time interactive communication between students and the surgical team. For image capture, we utilized a high-definition resolution, loupe-mounted camera with two-times and three-times magnification options. Loupe magnification enabled optimal macro image transmission for viewing of detailed surgical anatomy. For more macroscopic surgeries, a nonmagnified camera would be preferable. The high-definition camera captured images onto a computer that livestreamed images to the virtual participants using a Zoom platform (Zoom Video Communications, San Jose, Calif.) with password protection. To enable real-time two-way communication, speakers were strategically placed in the operating room to allow faculty and students to continuously discuss the case (Figs. 1 and 2).Fig. 1.: Setup of the live-stream surgery, with images transmitted to participants via Zoom, with password protection and communication between surgeon and applicants in real time.Fig. 2.: High-definition resolution, loupe-mounted camera was used for the video streaming of the procedures from the surgeon point of view.The virtual surgery curriculum included one live surgery per day spanning the breadth of plastic surgery, which replicated many of the benefits of being physically present in the operating room. Students could view a surgery step by step from the attending’s viewpoint. In addition, a multitude of students can simultaneously participate in the same case, unlike with in-person rotations. Participants were able to reference case-relevant study materials during the operation, which may enhance understanding of the procedure. The development of live virtual surgery poses some initial challenges, but ultimately it can be replicated with ease to create a surgical rotation more authentic to the in-person experience as pandemic restrictions continue. By elucidating the process by which we implemented livestreamed surgeries, other interested institutions will be able to easily traverse the necessary medicolegal and technical aspects of constructing similar models.

Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole-Brain Radiation Therapy

Whole brain radiation therapy (WBRT) is often employed as an effective treatment to palliate symptoms, improve intracranial control, and potentially improve survival for patients with brain metastasis, although it is also known to have deleterious cognitive effects. Despite multiple trials having identified strategies to help mitigate neurocognitive decline after WBRT, we hypothesized there may be barriers to integrating these techniques into routine clinical practice. The aim of this study was to characterize national practice patterns related to neurocognitive preservation strategies utilized during WBRT.We conducted an online survey of all American Society for Radiation Oncology-registered radiation oncologists (RO), excluding trainees, regarding their practice patterns and attitudes towards employing memantine, an N-methyl-D-aspartate receptor antagonist, and hippocampal avoidance (HA) whole brain radiotherapy. Both techniques have been shown to reduce cognitive decline when compared to conventional whole brain radiotherapy in patients undergoing WBRT. The Pearson χ2 tests for categorical variables or student's t-test for continuous variables were used to assess associations between provider characteristics and prescribing of either memantine or HA. All statistical tests were two-sided and a P-value < 0.05 was considered statistically significant.A total of 4,408 radiation oncologists were invited to participate in the survey, of whom 424 (9.6%) completed the survey. Among respondents, 79.6% reported having offered memantine, 72.6% HA, and 63.1% both for any of their patients undergoing WBRT. Nearly half (47.4%) of RO offered memantine for most (76-100%) of their WBRT patients. Common reasons for not offering memantine included limitations of current evidence (36.8%) as well as concerns about adverse effects (23.0%) and medication cost (23.0%). Most RO offered HA (66.5%) to a minority (1-50%) of their WBRT patients. Common reasons for not offering HA included resource-intense treatment planning and treatment delay (43.6%), concern about obtaining insurance approval (38.5%), and having no patients who met their criteria for HA (22.2%). RO with were more likely to prescribe memantine (P < 0.001), while HA was more likely prescribed by central nervous system specialists (P < 0.001) and RO in academic settings (P = 0.03).Our survey suggests that the majority of respondents offer approaches for neurocognitive preservation during WBRT for their patients. However, universal and consistent adoption of these approaches may be limited by current evidence and logistical hurdles to administration. Further efforts are needed to broaden education and reduce barriers among RO in order to improve implementation of neurocognitive-sparing techniques in patients undergoing WBRT.V. Jairam: None. H.S. Park: Employee; Yale School of Medicine. J.B. Yu: Consultant; Augmenix / Boston Scientific. Advisory Board; Galera pharmaceuticals. R.S. Bindra: None. J.N. Contessa: None. K.R. Jethwa: Honoraria; Radoncquestions.com, LLC.

Health Management Workforce Capacity-Building in Liberia, Post-Ebola.

Following the Ebola crisis in Liberia in 2014–15, the Liberian Ministry of Health developed a strategy to build a fit-for-purpose health workforce, focusing on both health care providers and health managers. To help fulfill national capacity-building goals for health management, a team of faculty, staff, and practitioners from the Yale School of Medicine, the University of Liberia, the National Public Health Institute of Liberia, and the Ministry of Health collaboratively developed and launched the health management program in Liberia in July 2017. The team worked to build specific management and leadership competencies for healthcare workers serving in management and leadership roles in Liberia’s health sector using two concurrent strategies—1) implementation of a hospital-based partnership-mentorship model in the two largest hospitals in the capital city of Monrovia, and 2) establishment of an executive education-style advanced Certificate in Health Systems Leadership and Management at the University of Liberia. Here we describe the health management program in Liberia, its focus, and its evolution from program launch in 2017 to the present, as well as ongoing efforts to transition program activities to local partner ownership by the end of 2021.

Prostate cancer nomenclature at diagnosis can affect treatment decisions.

Prostate cancer nomenclature at diagnosis can affect treatment decisions.

Emerging Role of Genomic Analysis in Clinical Evaluation of Lean Individuals With NAFLD.

HepatologyVolume 74, Issue 4 p. 2241-2250 Concise Review Emerging Role of Genomic Analysis in Clinical Evaluation of Lean Individuals With NAFLD Sílvia Vilarinho, Corresponding Author roloomba@ucsd.edu silvia.vilarinho@yale.edu Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine, New Haven, CT These authors contributed equally to this work. ADDRESS CORRESPONDENCE AND REPRINT REQUESTS TO: Rohit Loomba, M.D., M.H.Sc. Division of Gastroenterology and Hepatology, University of California at San Diego 1W202, ACTRI Building La Jolla, CA, 92093-0887 E-mail: roloomba@ucsd.edu Tel.: 858-246-2201 or Sílvia Vilarinho, M.D., Ph.D. Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine New Haven, CT 06520 E-mail: silvia.vilarinho@yale.edu Tel.: 858-246-2201Search for more papers by this authorVeeral Ajmera, orcid.org/0000-0001-5626-0942 NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, CA These authors contributed equally to this work.Search for more papers by this authorMelanie Zheng, Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine, New Haven, CTSearch for more papers by this authorRohit Loomba, Corresponding Author roloomba@ucsd.edu orcid.org/0000-0002-4845-9991 NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, CA ADDRESS CORRESPONDENCE AND REPRINT REQUESTS TO: Rohit Loomba, M.D., M.H.Sc. Division of Gastroenterology and Hepatology, University of California at San Diego 1W202, ACTRI Building La Jolla, CA, 92093-0887 E-mail: roloomba@ucsd.edu Tel.: 858-246-2201 or Sílvia Vilarinho, M.D., Ph.D. Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine New Haven, CT 06520 E-mail: silvia.vilarinho@yale.edu Tel.: 858-246-2201Search for more papers by this author Sílvia Vilarinho, Corresponding Author roloomba@ucsd.edu silvia.vilarinho@yale.edu Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine, New Haven, CT These authors contributed equally to this work. ADDRESS CORRESPONDENCE AND REPRINT REQUESTS TO: Rohit Loomba, M.D., M.H.Sc. Division of Gastroenterology and Hepatology, University of California at San Diego 1W202, ACTRI Building La Jolla, CA, 92093-0887 E-mail: roloomba@ucsd.edu Tel.: 858-246-2201 or Sílvia Vilarinho, M.D., Ph.D. Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine New Haven, CT 06520 E-mail: silvia.vilarinho@yale.edu Tel.: 858-246-2201Search for more papers by this authorVeeral Ajmera, orcid.org/0000-0001-5626-0942 NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, CA These authors contributed equally to this work.Search for more papers by this authorMelanie Zheng, Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine, New Haven, CTSearch for more papers by this authorRohit Loomba, Corresponding Author roloomba@ucsd.edu orcid.org/0000-0002-4845-9991 NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, CA ADDRESS CORRESPONDENCE AND REPRINT REQUESTS TO: Rohit Loomba, M.D., M.H.Sc. Division of Gastroenterology and Hepatology, University of California at San Diego 1W202, ACTRI Building La Jolla, CA, 92093-0887 E-mail: roloomba@ucsd.edu Tel.: 858-246-2201 or Sílvia Vilarinho, M.D., Ph.D. Department of Internal Medicine, Section of Digestive Diseases and of Pathology, Yale School of Medicine New Haven, CT 06520 E-mail: silvia.vilarinho@yale.edu Tel.: 858-246-2201Search for more papers by this author First published: 07 July 2021 https://doi.org/10.1002/hep.32047 Supported by National Institute of Environmental Health Sciences (5P42ES010337), National Center for Advancing Translational Sciences (5UL1TR001442), Department of Defense Peer Reviewed Cancer Research Program (W81XWH-18-2-0026), National Institute of Diabetes and Digestive and Kidney Diseases (U01DK061734, R01DK106419, R01DK121378, R01DK124318, P30DK120515, K23DK119460, and K08 DK113109), National Heart, Lung, and Blood Institute (P01HL147835), and National Institute on Alcohol Abuse and Alcoholism (U01AA029019), and Doris Duke Charitable Foundation (2019081). Potential conflict of interest: Dr. Loomba consults and received grants from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Galmed, Gilead, Intercept, Janssen, Madrigal, NGM, and Pfizer. He consults for Alnylam/Regeneron, Amgen, Arrowhead, CohBar, Glympse, Ionis, Inipharm, Metacrine, Novartis, Novo Nordisk, Sagimet, 89Bio, and Viking. He received grants from Allergan, Boehringer Ingelheim, Galectin, Genfit, Inventiva, Merck, and Siemens. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. 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In Memoriam: J. Hillis Miller (1928–2021)

In MemoriamJ. Hillis Miller (1928–2021) Andrzej Warminski (bio) I knew Hillis for a long time—it would be going on forty-six years now—first as a graduate student of comparative literature in the 1970s at Yale; then as a colleague, also at Yale, in the early 1980s; and then finally as a colleague in the Department of English and Comparative Literature at the University of California, Irvine since 1989. J. Hillis Miller's path traversed not one but at least four careers. The first of these was his nearly twenty years at Johns Hopkins (1953–1972), where he distinguished himself as a talented scholar of Victorian literature and as the American "ambassador" for the Geneva School of literary theory. Hillis was also a prominent member of the school. (If you pick up Sarah Lawall's old book on the Geneva School of literary critics, Critics of Consciousness [1968], you will find there chapters devoted to Marcel Raymond, Albert Béguin, Georges Poulet, Jean-Pierre Richard, Jean Starobinski, Jean Rousset, and … J. Hillis Miller. Or should one say "EeLEES MeelER"?) Hillis's second career spanned the memorable years at Yale (1972–1986), when (along with Paul de Man, Harold Bloom, and Geoffrey Hartman) he gained fame (and notoriety) as a member of the "Yale School" of deconstructive literary criticism. The third career would be his years (1986–2001) as indefatigable Distinguished Professor of English and Comparative Literature at UC Irvine, where he, along with Jacques Derrida (whom Hillis brought to UCI), was the main shaper of UCI's reputation as a center for the rigorous study of "theory." But his fourth career would have to be Hillis's years since retirement. Hillis's achievements in "retirement" constituted what would be a full and very distinguished career for lesser mortals. This is the case not only in regard to the volume of publications—I count at least fifteen books (with more in [End Page v] production) and numerous articles—and an international lecturing schedule that many a younger scholar would not be able to keep up with. (Particularly in China—imagine what kind of trip you have to take to get from Deer Isle, Maine, to Beijing!) It was also true of Hillis's work as teacher and mentor. Since "retirement" Hillis served as chair or member on the dissertation committees of many students in English and in comparative literature. I know that he also supervised dissertations at UCLA, UC Berkeley, and the University of Queensland. This is a remarkable record, and not just in terms of quantity. As anybody who has known Hillis within the academic context would affirm, Hillis was the most generous teacher that any of us will ever come across. His was above all an intellectual generosity: Hillis's willingness to see students' thoughts and projects through to the end without either preemptive acceptance or dismissal. But it was also a simply personal generosity with his time and effort that must have been a response to a genuinely ethical imperative—indeed, the equivalent of a religious "calling" or vocation—to treat others with the respect due to "the other." If Hillis was what one calls a "beloved" teacher, it is no doubt because students recognized this trait and appreciated being treated with respect—intellectual and personal. On the personal side: I have many memories of time with Hillis, a lot of them also involving Derrida, for instance, our annual ritual picking up Derrida at the airport—first at JFK, then at LAX—to take him to New Haven and Laguna Beach, respectively. From LAX we would drive to Irvine, Derrida would pick up his rental car, and then Derrida would drive the rental car, together with Hillis, to Laguna, with me following them, Derrida's very heavy suitcase (full of paper) in the trunk. After his long flight from Paris, Derrida would be weaving all over MacArthur Boulevard (and later Newport Coast Drive). I remember despairing, "Oh God, he's going to get himself killed, and he'll get Hillis killed too!"—while trying to make sure I didn't run into them, what with Derrida braking erratically on the hills. … Hillis and I sometimes...

Evolving technology trends and regulatory pathways in the tissue engineered product space

<div class="authors authors-lg"><div class="author"><div class="author-img"><img src="https://cdn.insights.bio/uploads/WF-ConfPhoto3.jpg copy.png" data-image="1"></div><div class="author-det"> <b>William Fodor</b> received his B.S. degree in Genetics and his Ph.D. degree in Molecular Genetics from The Ohio State University. He then completed his post-doctoral training in Immunobiology at the Yale School of Medicine (Mentor, R.A. Flavell). Dr. Fodor started his industrial career as a founding scientist of Alexion Pharmaceuticals, Inc. During his tenure at Alexion he directed the xenotransplantation, cell and tissue and organ engineering programs and advanced the program to include a pilot manufacturing facility for cell production. Dr. Fodor then moved to academia as an Associate Professor in the Center for Regenerative Biology at the University of Connecticut where he spent 3 years renovating his research to focus on stem cell biology for tissue repair. Dr. Fodor then returned to industry as Senior Director of Product Development at Viacell Inc., where he was responsible for various stem cell product development projects for hematologic indications as well as islet stem cell applications for diabetes. Following his tenure at Viacell, he continued his career in biotechnology as an independent consultant, serving many clients within the regenerative medicine field. Dr. Fodor’s relationship with Biostage was first as a consultant then as the Chief Scientific Officer, his current role. </div></div></div>

Understanding the Barriers to Pooled SARS-CoV-2 Testing in the United States.

ABSTRACTPooled testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection is instrumental for increasing test capacity while decreasing test cost. Pooled testing programs permit sustainable, long-term surveillance measures, which are essential for the early detection of virus resurgence in communities or the emergence of variants of concern. While numerous pooled approaches have been proposed to increase test capacity, uptake by laboratories has been limited. On 9 December 2020, we invited 362 U.S. laboratories that inquired about the Yale School of Public Health SalivaDirect test to participate in a survey to evaluate testing constraints and pooling strategies for SARS-CoV-2 testing. The survey was distributed using Qualtrics, and three reminders were sent. The survey closed on 21 January 2021. Of 93 responses received (25.7% response rate), 90 were from Clinical Laboratory Improvement Amendments (CLIA)-certified laboratories conducting SARS-CoV-2 testing. The remaining three were excluded from the analyses. Responses indicated that the major barriers to the uptake of pooled testing in the United States may not simply be the number of tests a laboratory can process per day, but rather the lack of clear protocols and adequate resources; laboratories are working with fixed physical and human capital constraints. Importantly, laboratories across the country are heterogeneous in infrastructure and workflow. The need for SARS-CoV-2 testing will remain for years to come. Testing programs can be maintained through pooled PCR testing strategies, and while statisticians, operations researchers, and others with expertise in sampling design have important value to add, laboratories require support on how to transition from traditional diagnostic testing to pooled surveillance.IMPORTANCE While numerous pooled SARS-CoV-2 testing approaches have been described in an effort to increase testing capacity and decrease test prices, uptake by laboratories has been limited. Responses to our survey of United States-based laboratories highlight the importance of consulting end-users—those that solutions are being designed for—so challenges can be addressed in a manner tailored to meet the specific needs out in the field. It may be surprising to those designing pooled testing strategies to learn that laboratories view pooling as more time-consuming than testing samples individually, and therefore that it is thought to create delays in test reporting.

Cultural Production and Reception

This symposium aims to challenge existing knowledge and develop new insights on how the reception (i.e., evaluation and consumption) of cultural goods shape its production by bringing leading scholars in the study of creative industries. Our symposium brings together cutting-edge research investigating the mechanisms by which audiences and evaluators of cultural goods facilitate or alter producers’ production strategies. We use different disciplinary lenses from economic sociology to social psychology to expand and deepen our understanding of the relationship between the field of reception and the field of production of cultural goods and contribute to the development of this emerging literature. We believe this symposium will generate an insightful discussion and fuel further inquiry into the role of audiences and evaluators in shaping cultural production. Where do innovations come from? Diversity & innovation in popular music, 1958-2016 Presenter: Khwan Kim; INSEAD Presenter: Noah Askin; INSEAD The stickiness of category labels: Audience perception and evaluation of change in creative markets Presenter: Greta Hsu; U. of California, Davis Presenter: Balazs Kovacs; Yale School of Management Presenter: Amanda Sharkey; U. Of Chicago Art on demand: Managing the tension between art and commerce in the “Porcelain Capital” of China Presenter: Siyin Chen; U. of Toronto, Rotman School of Management Presenter: Chen-Bo Zhong; U. of Toronto Presenter: Marlys K. Christianson; U. of Toronto Revisiting exclusionary practices: How honorary organizations affect creative production Presenter: Daphné Baldassari; U. of Toronto

Identity Dynamics in Crisis Contexts

Organizations now face more crises, from global pandemics and economic depressions to business catastrophes – all of which can strain operational processes and performance (Wright et al., 2020; Williams et al., 2017). Research has shown that crises can engender organizational growth, learning, and identity (Fink et al., 1971), and such dynamics can trickle down to the individual and group levels. Scholars describe organizational identification as an alignment between individual and collective identities, resulting in a sense of unity between the person and their organization (e.g., Ashforth et al., 2008; Gutierrez et al., 2010) – even amidst “a backdrop of change and ‘outside’ elements” (Cheney and Thompkins, 1987: 5). The ways in which a group identity can shape and be shaped by individual and organizational effects in crisis contexts, however, remain largely underexplored. This symposium brings together four field-based investigations of the interplay of individual, group, and organizational identity dynamics. First, Creary examines different identity strategies that organizational members used to prevent the organizational death of a community hospital. Second, Creary and colleagues unpack independent workers’ experiences during the pandemic, and how they created a greater sense of resilience during this time of crisis. Third, Mudiyanselage and Vough consider the effects the COVID-19 pandemic had on teachers’ identities, centering on identity instability. Finally, Eun and Wrzesniewski focus on identity dynamics for those caring for the most ill patients across two units in a major academic medical hospital during the COVID-19 crisis, and how this process affected identity transitions and outcomes. Michael Pratt, a distinguished scholar with influential research on identity, identification, and meaning, will serve as the discussant to provide both theoretical and practical implications as well as future research directions. IDENTITY DYNAMICS IN CRISIS CONTEXTS Presenter: Eunice Eun; Yale School of Management Presenter: Amy Wrzesniewski; Yale U.