Patient portals are increasingly accepted as part of standard medical care. However, to date, most patient portals provide just passive access to medical data. The use of modern technology such as smartphones and data personalization algorithms offers the potential to make patient portals more person-centered and enabling. The aim of this study is to share our experience in designing and developing a person-centered patient portal following a participatory stakeholder co-design approach. Our stakeholder co-design approach comprised 6 core elements: (1) equal coleadership, including a cancer patient on treatment; (2) patient preference determination; (3) security, governance, and legal input; (4) continuous user evaluation and feedback; (5) continuous staff input; and (6) end-user testing. We incorporated person-centeredness by recognizing that patients should decide for themselves their level of medical data access, all medical data should be contextualized with explanatory content, and patient educational material should be personalized and timely. Using stakeholder co-design, we built, and are currently pilot-testing, a person-centered patient portal smartphone app called Opal. Inclusion of all stakeholders in the design and development of patient-facing software can help ensure that the necessary elements of person-centeredness, clinician acceptability, and informatics feasibility are achieved.

Our understanding of blazars has been greatly increased in recent years by extensive multi-wavelength observations, particularly in the radio, X-ray and gamma-ray regions. Over the past decade the Whipple 10m telescope has contributed to this with the detection of 5 BL Lacertae objects at very high gamma-ray energies. The combination of multi-wavelength data has shown that blazars follow a well-defined sequence in terms of their broadband spectral properties. Together with providing constraints on emission models, this information has yielded a means by which potential sources of TeV emission may be identified and predictions made as to their possible gamma-ray flux. We have used the Whipple telescope to search for TeV gamma-ray emission from eight objects selected from a list of such candidates. No evidence has been found for VHE emission from the objects in our sample, and upper limits have been derived for the mean gamma-ray flux above 390GeV. These flux upper limits are compared with the model predictions and the implications of our results for future observations are discussed.Comment: 15 pages, 2 figures, Accepted for publication in Ap

The Whipple Observatory 10 m γ-ray telescope has been used to survey the error boxes of EGRET unidentified sources in an attempt to find counterparts at energies of 350 GeV and above. Twenty-one unidentified sources detected by EGRET (more than 10% of the total number) have been included in this survey. In no case is a statistically significant signal found in the EGRET error box, which implies that, at least for this sample, the γ-ray spectra of these sources steepen between 100 MeV and 350 GeV. For each EGRET source location, we list candidate associations and derive upper limits on the integral γ-ray flux above 350 GeV.

Neutron exposure poses a unique radiation protection concern because neutrons have a large, energy-dependent relative biological effectiveness (RBE) for stochastic effects. Recent computational studies on the microdosimetric properties of neutron dose deposition have implicated clustered DNA damage as a likely contributor to this marked energy dependence. So far, publications have focused solely on neutron RBE for inducing clusters of DNA damage containing two or more DNA double strand breaks (DSBs). In this study, we have conducted a novel assessment of neutron RBE for inducing all types of clustered DNA damage that contain two or more lesions, stratified by whether the clusters contain DSBs (complex DSB clusters) or not (non-DSB clusters). This assessment was conducted for eighteen initial neutron energies between 1 eV and 10 MeV as well as a reference radiation of 250 keV x-rays. We also examined the energy dependence of cluster length and cluster complexity because these factors are believed to impact the DNA repair process. To carry out our investigation, we developed a user-friendly TOPAS-nBio application that includes a custom nuclear DNA model and a novel algorithm for recording clustered DNA damage. We found that neutron RBE for inducing complex DSB clusters exhibited similar energy dependence to the canonical neutron RBE for stochastic radiobiological effects, at multiple depths in human tissue. Qualitatively similar results were obtained for non-DSB clusters, although the quantitative agreement was lower. Additionally we identified a significant neutron energy dependence in the average length and complexity of clustered lesions. These results support the idea that many types of clustered DNA damage contribute to the energy dependence of neutron RBE for stochastic radiobiological effects and imply that the size and constituent lesions of individual clusters should be taken into account when modeling DNA repair. Our results were qualitatively consistent for (i) multiple radiation doses (including a low-dose 0.1 Gy irradiation), (ii) variations in the maximal lesion separation distance used to define a cluster, and (iii) two distinct collections of physics models used to govern particle transport. Our complete TOPAS-nBio application has been released under an open-source license to enable others to independently validate our work and to expand upon it.