Concept: Cornell University
EDITORIAL: David Pimentel is a professor of ecology and agricultural sciences at Cornell University, Ithaca, NY 14853-0901. His Ph.D. is from Cornell University and had postdoctoral research at the University of Chicago, MIT, and fellowship at Oxford University (England). He was awarded a distinguished honorary degree from the University of Massachusetts. His research spans the fields of energy, population ecology, biological pest control, pesticides, sustainable agriculture, land and water conservation, livestock, and environmental policy. Pimentel has published more than 700 scientific papers and 37 books and has served on many national and government committees including the National Academy of Sciences; President’s Science Advisory Council; U.S Department of Agriculture; U.S. Department of Energy; U.S. Department of Health, Education and Welfare; Office of Technology Assessment of the U.S. Congress; and the U.S. State Department. He is currently Editorial Advisor for BMC Ecology. In this article, he reflects on 50 years since the publication of Rachel Carson’s influential book, Silent Spring.
Background: Suicide clusters at Cornell University and the Massachusetts Institute of Technology (MIT) prompted popular and expert speculation of suicide contagion. However, some clustering is to be expected in any random process. Aim: This work tested whether suicide clusters at these two universities differed significantly from those expected under a homogeneous Poisson process, in which suicides occur randomly and independently of one another. Method: Suicide dates were collected for MIT and Cornell for 1990-2012. The Anderson-Darling statistic was used to test the goodness-of-fit of the intervals between suicides to distribution expected under the Poisson process. Results: Suicides at MIT were consistent with the homogeneous Poisson process, while those at Cornell showed clustering inconsistent with such a process (p = .05). Conclusions: The Anderson-Darling test provides a statistically powerful means to identify suicide clustering in small samples. Practitioners can use this method to test for clustering in relevant communities. The difference in clustering behavior between the two institutions suggests that more institutions should be studied to determine the prevalence of suicide clustering in universities and its causes.
Results from an acoustic ray-tracing program using daily meteorological profiles are presented to explain ‘release-site biases’ for homing pigeons at three experimental sites in upstate New York where W. T. Keeton and his co-workers at Cornell University conducted extensive releases between 1968 and 1987 in their investigations of the avian navigational ‘map’. The sites are the Jersey Hill and Castor Hill fire towers, and another near Weedsport, where control pigeons from the Cornell loft vanished in random directions, in directions consistently >50 deg clockwise and in directions ∼15 deg clockwise from the homeward bearing, respectively. Because Cornell pigeons were disoriented at Jersey Hill whereas birds from other lofts were not, it is inferred that Jersey Hill lies within an acoustic ‘shadow’ zone relative to infrasonic signals originating from the Cornell loft’s vicinity. Such signals could arise from ground-to-air coupling of near-continuous microseisms, or from scattering of direct microbaroms off terrain features, both of which are initially generated by wave-wave interactions in the deep ocean. HARPA runs show that little or no infrasound from the loft area arrived at Jersey Hill on days when Cornell pigeons were disoriented there, and that homeward infrasonic signals could have arrived at all three sites from directions consistent with pigeon departure bearings, especially on days when these bearings were unusual. The general stability of release-site biases might be due to influences of terrain on transmission of the homeward signals under prevailing weather patterns, whereas short-term changes in biases might be caused by rapid shifts in atmospheric conditions.
Background Mantle-cell lymphoma is generally incurable. Initial treatment is not standardized but usually includes cytotoxic chemotherapy. Lenalidomide, an immunomodulatory compound, and rituximab, an anti-CD20 antibody, are active in patients with recurrent mantle-cell lymphoma. We evaluated lenalidomide plus rituximab as a first-line therapy. Methods We conducted a single-group, multicenter, phase 2 study with induction and maintenance phases. During the induction phase, lenalidomide was administered at a dose of 20 mg daily on days 1 through 21 of every 28-day cycle for 12 cycles; the dose was escalated to 25 mg daily after the first cycle if no dose-limiting adverse events occurred during the first cycle and was reduced to 15 mg daily during the maintenance phase. Rituximab was administered once weekly for the first 4 weeks and then once every other cycle until disease progression. The primary end point was the overall response rate. Secondary end points included outcomes related to safety, survival, and quality of life. Results A total of 38 participants were enrolled at four centers from July 2011 through April 2014. The median age was 65 years. On the basis of the Mantle Cell Lymphoma International Prognostic Index scores, the proportions of participants with low-risk, intermediate-risk, and high-risk disease at baseline were similar (34%, 34%, and 32%, respectively). The most common grade 3 or 4 adverse events were neutropenia (in 50% of the patients), rash (in 29%), thrombocytopenia (in 13%), an inflammatory syndrome (“tumor flare”) (in 11%), anemia (in 11%), serum sickness (in 8%), and fatigue (in 8%). At the median follow-up of 30 months (through February 2015), the overall response rate among the participants who could be evaluated was 92% (95% confidence interval [CI], 78 to 98), and the complete response rate was 64% (95% CI, 46 to 79); median progression-free survival had not been reached. The 2-year progression-free survival was estimated to be 85% (95% CI, 67 to 94), and the 2-year overall survival 97% (95% CI, 79 to 99). A response to treatment was associated with improvement in quality of life. Conclusions Combination biologic therapy consisting of lenalidomide plus rituximab was active as initial therapy for mantle-cell lymphoma. (Funded by Celgene and Weill Cornell Medical College; ClinicalTrials.gov number, NCT01472562 .).
This article describes advances in the behavioral self-management of chronic disease from the perspective of a 25-year trajectory of National Institute of Health-funded research in arthritis and cardiopulmonary diseases that has sought to develop a transdisciplinary understanding of how applied behavioral science can be used to improve health behaviors, functional status, and health outcomes. The article traces the arc of a novel research program-conducted in collaboration with physician-scientists at Columbia, Weill Cornell Medical College, and New York University School of Medicine-that runs through social cognitive theory, behavioral economics, and the emerging science of positive psychology in an effort to develop promising new approaches to fostering the adoption and maintenance of health-related behavioral change. The article concludes with what has been learned and what the implications of the work are for advancing behavioral self-management and patient education to improve patient outcomes and achieve the compression of morbidity.
Michaël Grynberg is an Obstetrician Gynecologist specialized in reproductive medicine. After 1 year as a visiting fellow in the Department of Reproductive Medicine at Cornell University, he returned to work in France as an Attending Physician in the Division of Reproductive Medicine at the University Hôpital Antoine Béclère, Clamart, France. In 2011, he completed his PhD on the topic of the regulation of follicular growth and anti-Müllerian hormone production. Since 2014, he has been Professor of Reproductive Medicine and the Head of the Department of Reproductive Medicine and Fertility Preservation at the University Hospital Jean Verdier, Bondy, France. Since 2017, he has become the Head of the Department of Reproductive Medicine and Fertility Preservation at the University Hospital Antoine Béclère, Clamart, France. In addition, he is an active member of the basic research unit INSERM U 1133, University Paris Diderot-CNRS UMR 8251. His research interests initially include the assessment of ovarian follicular status and the regulation of anti-Müllerian hormone, a key peptide in the ovarian function. Over the past 5 years, he has expanded his field of research with oncofertility. Indeed, female fertility preservation has recently emerged in the field of reproductive medicine. He is a pioneer on this topic in France and has recently become the President of the French Society of Oncofertility. He, along with his colleagues, has published over 100 peer-reviewed articles in international journals and books.
Objective To evaluate the utility of ultrasound in identifying fetuses with uncommon chromosomal abnormalities that would be considered not detectable by cell-free fetal deoxyribonucleic acid (cfDNA). Study Design We performed a retrospective study of fetuses with chromosomal abnormalities that would be undetectable by cfDNA, who underwent an 11- to 14-week ultrasound from 2006 to 2016. Results There were 43 pregnancies included. First-trimester ultrasound revealed a fetal abnormality in 19 (44.2%) cases, of which 13 (30.2%) had a thickened nuchal translucency. There were an additional four fetuses with second-trimester sonographic abnormalities. Overall, 23 (53.5%) fetuses were found to have a major anomaly diagnosed by ultrasound. The rate of first-trimester sonographic abnormalities varied widely based on category of chromosomal abnormalities with high rates seen with triploidy (87.5%) and autosomal trisomy (80%) and lower rates seen with structurally abnormal chromosomes (33.3%), trisomy mosaicism (27.3%), other forms of mosaicism (11.1%), and deletions or duplications (25.0%), p < 0.001. Conclusion The majority of fetuses with uncommon chromosomal abnormalities in our cohort had major sonographic anomalies. The use of first-trimester ultrasound with nuchal translucency measurement may offer utility in identifying fetuses with risk of aneuploidy that would not be detectable with cfDNA.
Simulation is used in many aspects of medical training but less so for echocardiography instruction in paediatric cardiology. We report our experience with the introduction of simulator-based echocardiography training at Weill Cornell Medicine for paediatric cardiology fellows of the New York-Presbyterian Hospital of Columbia University and Weill Cornell Medicine. Knowledge of CHD and echocardiographic performance improved following simulation-based training. Simulator training in echocardiography can be an effective addition to standard training for paediatric cardiology trainees.
Bibliometrics and scientometrics are novel closely related scientific fields measuring and analyzing scientific publications in a certain area. Although spirituality, religion and health (S/R&H) field has been a growing study area in recent years, only a few bibliometric studies have been conducted on published literature in S/R&H. In this study, we aimed to perform bibliometric and scientometric analysis of the documents published in the Journal of Religion and Health, which is one of the most significant and productive journals in spirituality, religion and health field, during the period of 1975 to 2016. We used Thomson Reuters Web of Science database for the publication analyses. A total of 2683 papers were found and most of them were original articles (1655, 62.1%) followed by book reviews (780, 29.3%) and editorial materials (169, 6.3%). We found that the USA was the most productive country with 1665 papers and 62.45% of total literature followed by Australia and Canada. Cornell University in the USA was found to publish the highest number of documents with 73 papers and to cover 2.74% of the total literature followed by Duke University and Weill Cornell Medical College. A total of 2973 keywords were detected to be used. Most used five keywords were “religion,” “spirituality,” “religiosity,” “health” and “mental health” (n = 253, 250, 97, 71 and 41 times, respectively). Our bibliometric and scientometric study of one of the most important leading journals in S/R&H area may encourage researchers to carry out further studies in this field.
OBJECTIVE Craniopharyngiomas arise from the pituitary stalk, and in adults they are generally located posterior to the chiasm extending up into the third ventricle. The extended endonasal approach (EEA) can provide an ideal corridor between the bottom of the optic chiasm and the top of the pituitary gland (chiasm-pituitary corridor [CPC]) for their removal. A narrow CPC in patients with a prefixed chiasm and a large tumor extending up and behind the chiasm has been considered a contraindication to EEA, with a high risk of visual deterioration and subtotal resection. METHODS A database of all patients treated in the authors' center (Weill Cornell Medical College, NewYork-Presbyterian Hospital) between July 2004 and August 2016 was reviewed. Patients with craniopharyngiomas who underwent EEA with the goal of gross-total resection (GTR) were included in the study. Patients with postfixed chiasm or limited available preoperative imaging were excluded. Using preoperative contrast-enhanced T1-weighted sagittal midline MR images, the authors calculated the CPC as well as the distance from the chiasm to the top of the tumor (CTOT). From these numbers, they calculated a ratio of the CPC to the CTOT as a measure of difficulty in removing the tumors through the EEA and called this ratio the corridor index (CI). The relationship between the CI and the ability to achieve GTR and visual outcome were measured. RESULTS Thirty-four patients were included in the study. The mean CPC was 10.1 mm (range 5.2-19.1 mm). The mean CTOT was 12.8 mm (range 0-28.3 mm). The median CI was 0.8; the CI ranged from 0.4 to infinity (for tumors with a CTOT of 0). Thirty-two patients had GTR (94.1%) and 2 had subtotal resection. The CPC value had no relationship with our ability to achieve GTR and no effect on visual or endocrine outcome. CONCLUSIONS EEA for craniopharyngioma is generally considered the first-line surgical approach. Although a narrow corridor between the top of the pituitary gland and the bottom of the chiasm may seem to be a relative contraindication to surgery for larger tumors, the authors' data do not bear this out. EEA appears to be a successful technique for the majority of midline craniopharyngiomas.