Technologies-That-Must-Not-Be-Named: Understanding and Implementing Advanced Search Technologies in E-Discovery

Even for those who are aware of the existence of advanced search and review tactics beyond keyword search, many questions remain for attorneys and judges alike. First, what are the new and emerging technologies? While courts and commentators mention the existence of the technologies, there is not much guidance with regard to what the new technologies are and what they accomplish. Second, are the new technologies superior to the manual review process? Understandably, attorneys are hesitant to use an unfamiliar e-discovery product that may not work better than the e-discovery process to which they are already accustomed. Third, if attorneys do use a new search and review process, what standards of accuracy or defensibility is a court likely to impose? When managing the discovery process, attorneys want to be sure that the method of production satisfy the expectations of the court

Technologies-That-Must-Not-Be-Named: Understanding and Implementing Advanced Search Technologies in E-Discovery

The Federal Rules of Civil Procedure were created to promote the “just, speedy, and inexpensive determination of every action and proceeding.” Unfortunately, in the world of e-discovery, case determinations are often anything but speedy and inexpensive. The manual review process is notoriously one of the most expensive parts of litigation. Beyond expense, the time and effort required to carry out large-scale manual review places an immense burden on parties, nearly destroying the possibility of assessing the merits of early settlement before expensive review has already been carried out

Impacts of Summer Drought and Climate Change Conditions on Hydropower Resources and Power System Reliability in the PJM Region

The United States power grid is a large, complex, and interconnected system that involves the coordination of numerous entities (e.g., power plant owners/operators, regulators, stakeholders, etc.). As such, any type of extreme event can potentially threaten the economic, safe, and reliable operation of the grid. One such example is summer drought (i.e., events predominantly characterized by elevated temperatures and reduced precipitation), which have impacts spanning all aspects of the power system, especially generation resources through changes in water availability and temperature. Additionally, although heavily dependent on region, climate change can potentially increase the likelihood and severity of drought conditions, illustrating the necessity for understanding the potential impacts of droughts within a climate change context. Accordingly, our analysis investigated the impacts of nine drought and climate change conditions on hydropower plants in the PJM region as of 2030, relative to a historical baseline, using the Hydrologic and Water Quality System (commonly referred to as HAWQS). We found that the historical drought of 2007 was the worst-case scenario in terms of overall generation reduction, followed by proposed 2030 moderate and severe climate change drought conditions, respectively. Because the most similar technology to hydropower is natural gas combustion turbines (in terms of ancillary grid services), replacement of lost generation can induce significant economic consequences for the region\u27s electricity producers and consumers alike. Furthermore, impacts also aect broader grid reliability via reduced generation capacity available to satisfy electricity demand | this was found to not be an issue in the forecasted 2030 PJM generation eet, but if coal plant retirement is accelerated beyond current plans, then an inability to satisfy peak demand becomes apparent across most scenarios post 50% retirement

Discovery of Sexual Dimorphisms in Metabolic and Genetic Biomarkers

Metabolomic profiling and the integration of whole-genome genetic association data has proven to be a powerful tool to comprehensively explore gene regulatory networks and to investigate the effects of genetic variation at the molecular level. Serum metabolite concentrations allow a direct readout of biological processes, and association of specific metabolomic signatures with complex diseases such as Alzheimer's disease and cardiovascular and metabolic disorders has been shown. There are well-known correlations between sex and the incidence, prevalence, age of onset, symptoms, and severity of a disease, as well as the reaction to drugs. However, most of the studies published so far did not consider the role of sexual dimorphism and did not analyse their data stratified by gender. This study investigated sex-specific differences of serum metabolite concentrations and their underlying genetic determination. For discovery and replication we used more than 3,300 independent individuals from KORA F3 and F4 with metabolite measurements of 131 metabolites, including amino acids, phosphatidylcholines, sphingomyelins, acylcarnitines, and C6-sugars. A linear regression approach revealed significant concentration differences between males and females for 102 out of 131 metabolites (p-values<3.8 x 10(-4); Bonferroni-corrected threshold). Sex-specific genome-wide association studies (GWAS) showed genome-wide significant differences in beta-estimates for SNPs in the CPS1 locus (carbamoyl-phosphate synthase 1, significance level: p<3.8 x 10(-10); Bonferroni-corrected threshold) for glycine. We showed that the metabolite profiles of males and females are significantly different and, furthermore, that specific genetic variants in metabolism-related genes depict sexual dimorphism. Our study provides new important insights into sex-specific differences of cell regulatory processes and underscores that studies should consider sex-specific effects in design and interpretation

Smoking Cessation Considerations for People with Multiple Sclerosis

Background: Comprehensive care of people with multiple sclerosis integrates disease modifying therapy, symptom management and minimization of risk factors for disease progression. Cigarette smoking is a modifiable risk factor associated with development and progression of disease and increased disability. However, little is known about specific factors that affect smoking cessation in patients with multiple sclerosis or how to integrate smoking cessation into specialized multiple sclerosis care. Methods: Twenty-nine active smokers with multiple sclerosis were surveyed at the James Q. Miller Multiple Sclerosis clinic at the University of Virginia Health. Demographics, smoking history, multiple sclerosis history, interest in quitting, barriers to quitting and cessation modalities of interest were collected, specifically interest in working with a clinical pharmacist for cessation. Results: Seventy-six percent of individuals believed that there was no relationship between smoking and MS diagnosis and 52% were unaware of any relationship between smoking and disease progression. Less than half of patients (41%) reported receiving counseling from a primary care physician or neurologist about the importance of smoking cessation. Common barriers to quitting included enjoyment of smoking (76%) and cravings (55%). Seventy-six percent of patients expressed interest in utilizing pharmacotherapy and 37% were interested in working closely with a clinical pharmacist. Conclusions: It is critical that providers caring for patients with multiple sclerosis assess smoking status and educate smokers about the relationship between smoking and disease progression. Efforts should be made to better understand patient-specific barriers to quitting and preferred methods of treatment, including pharmacotherapy and behavioral therapy. A multidisciplinary approach to smoking cessation that includes a clinical pharmacist may aid in the development of individualized care plans with frequent monitoring to improve patient success. &nbsp; Article Type: Case Stud

From CBPR to RCT: Lessons Learned Over 10 years with Interventions in Public Housing

Session presented on Monday, July 28, 2014: Purpose: The purpose of this presentation is to describe the lessons learned after 10 years of community engaged tobacco cessation interventions with women in public housing in the Southeastern US. The original academic-community partnership in one Southeastern US metropolitan region identified the health area of interest, assessment of need, and developed an overall plan of action, including a multi-level and ecological based intervention at the neighborhood, peer group, and individual level. Primary outcomes measured were smoking abstinence at 6 and 12 months post intervention. Methods: A community based participatory research (CBPR) approach was used to develop, implement and evaluate a culturally tailored intervention strategy to assist women in public housing to quit smoking . A feasibility study (n=10 women) was conducted in one public housing neighborhood, followed by a pilot study (n=103 women) in two public housing neighborhoods. With promising 6 month tobacco abstinence outcomes (39% treatment condition vs. 11.5% control ) and other behavioral and psychosocial measures, funding was received for a larger randomized controlled trial (RCT) in 16 neighborhoods (n=410 women) across two states. In the RCT, the tobacco abstinence outcomes were less promising, with 12 month abstinence rates of 12% in treatment neighborhoods vs. 5% in control neighborhoods. Additional analyses and discussions ensued to better understand the outcomes and lessons learned. Results: A CBPR approach was used with mutual interest of both the community and academic partners in the initial two neighborhoods. The partnership worked together over 3 years to develop strategies, methods, and materials, which fostered the interest and buy-in of the participating neighborhoods. With the implementation of the RCT in expanded regions in two states, neighborhoods were selected based on inclusion criteria, initial interest, with 2-3 months of time to cultivate relationships and trust. Lessons learned in working with high risk vulnerable populations and implementation of CBPR developed RCT\u27s include: 1) Time to cultivate relationships and interest varies, but the longer positive history, the more likelihood of trust and engagement; 2) Community and organizational readiness vary from neighborhood, residents, and housing authority managers to include goodness of fit, capacity, and operations; 3) Challenges with maintaining intervention fidelity in real world community based interventions with differing readiness levels; and 4) Influence of neighborhood moderators to include social and environmental context and changes in impoverished public housing communities (crime and violence, neighborhood stress, social cohesion) over time. Conclusion: Outcomes in randomized controlled trials in community-based clusters (i.e., neighborhoods, churches, schools, clinics) will likely vary according to stakeholder engagement, readiness, and social/environmental contexts. Further considerations regarding methods, approaches, and funding sources are needed with the implementation of community-engaged interventions based on these and other factors as we attempt to eliminate disparities in these high-risk vulnerable communities