Digital Commons Network^™

Too Dangerous To Deploy? The Challenge Language Models Pose To Regulating Ai In Canada And The Eu, Robert Diab

UBC Law Review

No abstract provided.

Maintaining Legitimacy: Artificial Intelligence, Automated Decision Making, And Reasonableness Review Under Canadian Administrative Law, Bradley Henderson

UBC Law Review

No abstract provided.

Insights Gained From Applying Molecular Techniques To Gray Triggerfish (Balistes Capriscus Gmelin, 1789) In The Mexican Caribbean, The Southern And Northwestern Gulf Of Mexico, Geaceli G. Orive

Theses and Dissertations

This study focuses on Balistes capriscus (Gray Triggerfish), a reef-associated species dependent on hard-bottom habitats in the Gulf of Mexico (GOM). Using mitochondrial DNA barcoding and phylogenetic analyses, genetic structure across four sites was assessed: Rio Grande Valley (RGV), Veracruz, Chinchorro Bank, and Xahuayxol. Samples from RGV and Veracruz exhibited limited haplotype diversity, minimal nucleotide divergence, and weak genetic differentiation-patterns consistent with recent population expansion and ongoing connectivity within the GOM. While the study centered on B. capriscus, all individuals from Chinchorro and Xahuayxol unexpectedly grouped with Canthidermis maculata (Spotted Oceanic Triggerfish), suggesting misidentification, cryptic diversity, or taxonomic uncertainty in …

Summer 2025, Georgia Library Quarterly

Georgia Library Quarterly

No abstract provided.

The Impact Of The Covid-19 Pandemic On The Lives Of Individuals In Kuwaiti Society During Curfew, Hend Batel Al-Ma’Seb, Maha Meshari Al-Sejari

Journal of Arts and Social Sciences

The main aim of this study is to assess the extent to which the Covid-19 pandemic has affected individuals in Kuwaiti society in its various aspects, such as economic conditions, social relations, personal hygiene, and physical health, which are determined by demographic factors such as age, gender, marital status, and level of education. The study employed a descriptive approach and recruited 703 individuals who lived in Kuwait during the pandemic. The main tool used was an online questionnaire. This questionnaire consists of several sections, including an introduction, demographic information about respondents, and a scale of the impact of the pandemic …

Socioeconomic Inequality In Child Malnutrition In Sudan: Results From The Multiple Indicator Cluster Survey (2014), Huda Mohamed Mukhtar Ahmed, Mutaz Fikri Mohamed Osman Digna

Journal of Arts and Social Sciences

This study investigates the association between nutrition indicators such as height/weight-for-age and weight-for-height with socioeconomic variables in Sudan, using the Multiple Indicator Cluster Survey data, 2014. These variables include Household's wealth quintiles, mother's highest education level, head of household's highest level of education, place of residence, age and gender of the child, region, and access sanitation facilities A concentration index and curve and a probit model used were to measure the socioeconomic inequality in under-five children malnutrition. The findings showed that the child's age (P = 0.000), mother's education of secondary and above (P = 0.046), and households’ richest quintile …

The Role Of Microfinance In Improving Global Economy, Khamphou Milayome

Doctoral Dissertations (DBA)

This study investigates microfinance’s role in enhancing the global economy by examining its impact on economic growth, unemployment, and political stability. Secondary data from MIX Market and WDI were used in this study to assess these relationships. Multiple regression was conducted with EViews software to test regression models with the independent variables related to microfinance and microfinance institutions (MFIs). Using the data from South Asia and Southeast Asian countries, this study finds that microfinance significantly improves economic growth, reduces the unemployment rate, and strengthens political stability. Microeconomic variables used in the study are borrowing amounts and the cost per borrower. …

The Effect Of Diet Formulations Containing Different Protein Sources On Energy And Nitrogen Utilization In Lactating Jersey Cows, Kortney Ann Harpestad

Department of Animal Science: Dissertations, Theses, and Student Research

It is well understood that lactating dairy cows require metabolizable protein (MP) for milk yield and milk protein synthesis. Diets with conventional feed sources like corn and soybean meal (SBM) may not sufficiently meet all MP and amino acid (AA) requirements so supplementation with more rumen undegradable protein (RUP) rich feeds or rumen-protected AA can be fed to support animal performance. The growth trajectory of biofuels has resulted in dramatic increases in the production of feeds like heat treated soybean meal (HTSBM). While the chemical composition of this product is understood, there is a need to better understand how HTSBM …

Prioritizing Privacy In Artificial Intelligence: A Practitioner-Grounded, Layered Framework, Prince Boadi

Masters Theses & Doctoral Dissertations

As artificial intelligence (AI) systems rapidly assume responsibility for processing large volumes of sensitive personal data, organizations struggle to identify which privacy safeguards deserve immediate, sustained investment. This study develops a practitioner-informed framework that ranks and organizes privacy controls for AI environments, thereby bridging the persistent gap between regulatory mandates and implementation realities. Using grounded theory and thematic analysis of 152 qualitative responses drawn from experts in technology, healthcare, government, defense, and education, we coded interview data in ATLAS.ti to surface three interdependent control layers—Strategic Governance Controls, Operational Controls, and Technical Controls—that map closely to the NIST Privacy Framework and …

Rates Of Appropriate Initiation Of Low Dose Aspirin Prophylaxis As Indicated By The Gestosis Score In Early Pregnancy: A Cross-Sectional Study, Mundlapati Usha, Nathasha Hk, Akkamma A. Satyaraddi, Geetanjali M. Katageri

Digital Journal of Clinical Medicine

Introduction: Pre-clampsia is a multisystem disorder in pregnancy. Initiating Low Dose Aspirin (LDA) in early pregnancy is recommended to prevent development of pre-eclampsia in high-risk women. Gestosis score is a simple screening tool for predicting women at risk for developing pre-eclampsia. It can be done by any health care provider even in the periphery. This study highlights the degree of awareness amongst obstetric healthcare providers in prediction and prevention of pre-eclampsia and the rates of appropriate initiation of Aspirin.

Methodology: 134 pregnant women were included in the study. The parameters for calculating the GESTOSIS score were retrieved from …

Enhancing The Value Of Satellite Earth Observations For Coastal Management: Tools For Collaboration And Co-Development, Nicole Dejeet Bartlett

Graduate Doctoral Dissertations

Despite unprecedented satellite Earth observation (EO) capabilities and free data availability, widespread adoption in coastal management remains limited due to persistent communication barriers between satellite experts and coastal practitioners. This dissertation addresses the fundamental challenge of translating satellite EO technical capabilities into management-relevant applications. Through synthesis of literature, stakeholder interviews, and two multi-year co-development case studies in Virginia's Middle Peninsula and Cape Cod, Massachusetts, this research identifies systematic barriers to satellite EO adoption and develops innovative frameworks for overcoming them.

The work argues for a common language between satellite product developers and coastal managers, identifying communication barriers spanning technical, institutional, …

The Role Of Androgen Receptor And B2/Alu Sine Rna Interaction In Hippocampal Dendritic Development, Troy A. Richter

Graduate Doctoral Dissertations

Once dismissed as “junk”, transposable elements have recently gained recognition for their regulatory roles, especially in the brain. During development, circulating androgens promote proper morphological development of hippocampal neurons. We and others have shown that murine B2 SINE RNA is a regulator in the rodent hippocampus. It is unknown, however, if B2 is necessary for the proper development of hippocampal neurons. This dissertation investigates the role of murine B2 in the development of primary hippocampal neurons in combination with androgen treatment. We first examined the role of ALU SINE and androgen receptor in a prostate cancer cell model and found …

Foundations Of Quality: A Toolkit For Professional Growth In Infant/Toddler Classrooms, Amber A. Hulin

Masters Projects

This project aims to tackle the issue of inconsistencies in the educational experiences provided by many early childhood programs. This project focuses primarily on the infant/toddler age group. Chapter 1 identifies a key contributing factor in these inconsistencies: a shortage of high-quality teachers due to lack of infant/toddler focused content in teacher preparation programs and further professional development. Chapter 2 reviews the literature including what a high-quality educator is and how a high-quality educator impacts a child’s development. It also identifies the various teacher preparation programs and highlights the lack of infant/toddler content in professional development. Chapter 3 presents a …

The Need For Specialized Career Development Services For Collegiate Student-Athletes, Scott Victor-Allen Spaanstra

Masters Projects

Research has shown that college students benefit greatly from career development services provided by their university (Bridgstock et al., 2019). However, many collegiate student-athletes may find it difficult to utilize their on-campus career development resources due to additional time constraints, stress and pressure, and struggle with athletic identity (Carodine et al., 2001). This project explores the importance of specialized career development support for student-athletes at collegiate universities as specialized career development services have been shown to benefit students (Patton & McMahon, 2021). This project will introduce career development services to help student-athletes as well as provide the tools to evaluate …

Contextualization Of Harmonized Cognitive Assessment Protocol (Hcap) In An Aging Population In Rural Low-Resource Settings In Africa: Experiences And Strategies Adopted To Optimize Effective Adaption Of Cognitive Tests In Kenya, Roselyter Riang’A, Eunice Muthoni, Niranjani Nagarajan, Felix Agoi, Patrick Mwangala, Alden Gross, Jean Ikanga, Kenneth Langa, Edward Miguel, Anthony Ngugi

Population Health, East Africa

Cross-cultural adaptation of cognitive assessments is crucial for detecting Alzheimer's disease (AD) and related dementias (ADRD) in aging populations. This study documents the adaptation of the Harmonized Cognitive Assessment Protocol (HCAP) for a pilot study on the Longitudinal Study of Health and Aging in Kenya (LOSHAK) in rural Kilifi County, Kenya, highlighting challenges and strategies for optimizing outcomes. As part of the LOSHAK feasibility phase, cognitive tests including: the Swahili Mental State Examination, 10-word recall, animal naming, story recall, clock drawing, and making change, were administered to 202 participants (≥45 years) from the Kaloleni/Rabai Health and Demographic Surveillance System (KRHDSS). …

Midlife Cognitive Testing In Africa: Validity Of The Harmonised Cognitive Assessment Protocol In The Kenya Life Panel Survey, Alden Gross, Madeline Duhon, Eric Ochieng, Jean Ikanga, William Dow, Jinkook Lee, Michael Walker, Michelle Layvant, Anthony Ngugi, Joshua Ehrlich

Population Health, East Africa

Objectives: Cohort studies of ageing and cognitive decline typically do not begin fielding comprehensive cognitive assessments until older adulthood. However, for identifying preventable dementia risk factors, there is strong value in beginning at earlier ages. The case is especially compelling in sub-Saharan Africa, where the number of older individuals is expected to triple in the next three decades, and where risk factors may operate more intensively at earlier ages. This study reports on the adaptation and validity of the Harmonised Cognitive Assessment Protocol (HCAP) approach in the Kenya Life Panel Survey (KLPS), collected among middle-aged respondents.

Design: To evaluate the …

Bridging The Capacity Building Gap For Antimicrobial Stewardship Implementation: Evidence From Virtual Communities Of Practice In Kenya, Ghana, And Malawi, Ana De Lima, Kwame Buabeng, Mavis Sakyi, Hope Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui

Pathology, East Africa

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning …

Dp-Brem: Differentially-Private And Byzantine-Robust Federated Learning With Client Momentum, Xiaolan Gu, Ming Li, Li Xiong

Faculty, Staff and Student Publications

Federated Learning (FL) allows multiple participating clients to train machine learning models collaboratively while keeping their datasets local and only exchanging the gradient or model updates with a coordinating server. Existing FL protocols are vulnerable to attacks that aim to compromise data privacy and/or model robustness. Recently proposed defenses focused on ensuring either privacy or robustness, but not both. In this paper, we focus on simultaneously achieving differential privacy (DP) and Byzantine robustness for cross-silo FL, based on the idea of learning from history. The robustness is achieved via client momentum, which averages the updates of each client over time, …

Pain Acceptance In Chronic Postoperative Pain: Concept Analysis, Sajini M Thekkel, Constance M Johnson, Meagan Whisenant, Deniz Dishman

Faculty, Staff and Student Publications

Purpose: Chronic postoperative pain (CPOP) is a potential outcome of otherwise successful surgery that can persist for months, with its prevalence varied by surgical type, genetic predispositions, and psychosocial factors. Pain acceptance offers better outcomes to these patient populations by fostering a willingness to experience pain without resistance. This analysis examines how pain acceptance contributes to psychological well-being, helps reduce opioid misuse, and enhances quality of life, even in the presence of CPOP.

Design: The concept analysis approach follows Walker and Avant's framework (2019).

Methods: A literature search across PubMed, Web of Science, and CINAHL yielded 276 articles, of which …

Syncope As The First Clue To A Congenital Heart Defect, Ravi Soni, Victoria Morris, Benjamin Karfunkle

Faculty, Staff and Student Publications

No abstract provided.

Effectiveness And Safety Of Chronic Diuretic Use In Older Adults: An Umbrella Review Of Recently Published Systematic Reviews And Meta-Analyses Of Randomized-Controlled Trials, Eveline Van Poelgeest, Konstantinos Prokopidis, Tuğba Erdogan, Min Ji Kwak, Karolina Piotrowicz, Luca Paoletti, Annette Eidam, Fatma Özge Kayhan Koçak, Birkan Ilhan, Alessia Beccacece, George Soulis, Serdar Özkök, Gulistan Bahat, Eva Topinková, Joost Daams, M Louis Handoko, Parag Goyal, Jerzy Gąsowski, Antonio Cherubini, Nicola Veronese, Giuseppe Dario Testa, Wade Thompson, Nathalie Van Der Velde, European Geriatric Medicine Society Special Interest Groups Of I. Pharmacology; Ii. Cardiovascular Disease And Iii. Systematic Review And Meta-Analysis

Faculty, Staff and Student Publications

Background: Healthcare providers should balance the potential risks and benefits of chronic diuretic use, particularly in older adults, as with age, diuretic benefits may decline and risks increase. A comprehensive synthesis and critical evaluation of the available evidence on chronic diuretic treatment effects is currently lacking.

Methods: We conducted an umbrella review of systematic reviews and meta-analyses published since 2018 on health outcomes associated with diuretic use in randomized-controlled trials (RCTs). We conducted random-effects meta-analysis for pooled effect estimates and narratively summarized data that could not be pooled.

Results: We included 741 effect estimations from 117 systematic reviews (SRs) on …

A Systematic Clinical Framework For Postimplantation Monitoring In Thalamic Neuromodulation: Insights From Twiddler's Syndrome, Shalin Shah, Ganne Chaitanya, Jeston Chin, Nicholas Delcimmuto, Jay R Gavvala

Faculty, Staff and Student Publications

This case described a 25-year-old pregnant woman with refractory multifocal epilepsy, diagnosed in 2020 and treated with bilateral thalamic deep brain stimulation (DBS) targeting the centromedian and pulvinar nuclei. Prior to DBS, she experienced daily focal seizures, often progressing to generalized tonic-clonic seizures despite optimal medication. Presurgical evaluations revealed multifocal epilepsy with right hemispheric involvement and diffuse band heterotopia. Given the extensive neurophysiological and radiographic findings, DBS was chosen over resective surgery. Following implantation in December 2023, initial stimulation settings resulted in some seizure control but also development of new symptoms, including shock-like sensations down her neck. After 43 seizure-free …

Large-Scale Copy Number Variant Analysis In Genes Linked To Parkinson’S Disease, Zied Landoulsi, Katja Lohmann, Eva-Juliane Vollstedt, Emily Wedgwood-Benn, Lisa-Marie Niestroj, Björn-Hergen Laabs, Sebastian Sendel, Alexander Balck, Max Borsche, Dennis Lal, Anne Grünewald, Norbert Brüggemann, Andre Franke, Andrew Hicks, Meike Kasten, Kirsten E Zeuner, Lara M Lange, Wolfgang Lieb, Brit Mollenhauer, Heike Pawlack, Peter P Pramstaller, Amke Caliebe, Inke R König, Patrick May, Christine Klein

Faculty, Staff and Student Publications

Genetic studies of Parkinson's disease (PD) have focused on single nucleotide variants (SNVs), with limited attention to copy number variants (CNVs). This study investigates CNVs in PD using candidate PD-related genes and genome-wide approaches. We identified CNVs from the ProtectMove project genotyping data of 2364 PD patients and 2909 controls using PennCNV. We validated 119 of 137 detected CNVs in PD-related genes (87%) using MLPA/qPCR, including 104 in PRKN, six in PARK7, four in SNCA, and others in LRRK2, RAB32, and VPS35. CNVs were present in 2.4% of patients and 1.5% of controls. Notably, 0.9% of patients carried potentially disease-causing …

Does Midbrain Atrophy Distinguish Progressive Supranuclear Palsy From Frontotemporal Dementia?, Mauro César Quintão E Silva Cunningham, Sarah Teixeira Camargos, Vinícius Ribeiro Jeunon, Natalia Pessoa Rocha, Antônio Lúcio Teixeira, Thiago De Oliveira Maciel, Elisa De Paula França Resende, Francisco Eduardo Costa Cardoso, Paulo Caramelli, Leonardo Cruz De Souza

Faculty, Staff and Student Publications

Background: The diagnostic value of midbrain atrophy for distinguishing behavioral variant frontotemporal dementia (bvFTD) from progressive supranuclear palsy (PSP) is unclear.

Objective: To investigate whether measures of midbrain atrophy differentiate PSP from bvFTD.

Methods: We included four groups: healthy controls (n = 19), PSP-Richardson syndrome (n = 20), bvFTD (n = 19) and Parkinson's disease (PD; n = 12). The following quantitative and qualitative measures were calculated: Hummingbird sign rating scale [HBS-RS], global midbrain atrophy [GMA], midbrain area, midbrain/pons ratio, the Magnetic Resonance Parkinsonism Index (MRPI), the MRPI 2.0 and brainstem volume.

Results: Compared to controls, PSP and bvFTD had …

Sex Differences In Etiologies, Risk Factors, And Outcomes Among Young Adult Patients With Acute Ischemic Stroke, Ekta G Shah, Manish Bhojwani, Kelly Chang, Deepa Dongarwar, Nicole R Gonzales, Erica Jones, Audrey Sarah Cohen, Anjail Z Sharrief

Faculty, Staff and Student Publications

Background: The incidence of ischemic stroke is increasing among young adults. Several studies have demonstrated sex differences in risk and outcomes; however, findings are inconsistent. We sought to evaluate sex differences in stroke risk factors, etiology, and disposition in a diverse cohort of patients admitted to a comprehensive stroke center for evaluation.

Methods: We conducted a retrospective study of patients 18-45 years admitted between January 1, 2015 and September 30, 2021 with an acute ischemic stroke. Patient demographics, risk factors, and disposition were extracted from our institutional inpatient stroke registry and inpatient electronic medical record. Stroke etiology was assigned based …

Poor Correlation Between Inflammatory And Brain Injury Biomarkers After Neonatal Intraventricular Hemorrhage: A Pilot Study, Ankit Agarwal, Miriam Zamorano, Aidan Collier, Braden Oldham, Kaleigh Riggs-Harpur, Thao L Nguyen, David I Sandberg, Stephen A Fletcher, Manish N Shah, Brandon A Miller

Faculty, Staff and Student Publications

Background: This study investigated changes in hemoglobin and neuroinflammatory and brain injury biomarkers (tumor necrosis factor-alpha [TNF-α] and glial fibrillary acidic protein [GFAP]) in early stages of cerebrospinal fluid (CSF) diversion in preterm neonates with intraventricular hemorrhage (IVH). We hypothesized that patients with higher CSF hemoglobin levels would have higher TNF-α and GFAP levels.

Methods: This prospective study included infants with grade 3 or 4 IVH. All had ventricular reservoirs that were placed following standard neurosurgical care. The first CSF sample was collected on the day of reservoir placement. Subsequent samples were from clinically indicated CSF withdraws to decompress ventricles. …

Traumatic Brain Injury And Risk Of Malignant Brain Tumors In Civilian Populations, Sandro Marini, Amr R Alwakeal, Hunter Mills, Joshua D Bernstock, Ahmad Mashlah, Muhammad T Hassan, Jakob Gerstl, Farid Radmanesh, Gundolf Schenk, Sharat Israni, Rachel Grashow, E Antonio Chiocca, Cathra Halabi, Anthony Digiorgio, Stephen T Magill, Geoffrey T Manley, Saef Izzy, Ross Zafonte

Faculty, Staff and Student Publications

Importance: A 2024 US study reported that veterans of the Iraq and Afghanistan wars affected by traumatic brain injury (TBI) had an increased risk of developing brain tumors. However, studies among civilians have shown conflicting results and have not replicated the association between TBI and brain tumor risk.

Objective: To examine whether history of TBI in US adult civilians is associated with a risk of subsequent development of malignant brain tumors.

Design, setting, and participants: This retrospective cohort study used data from a tertiary academic medical center (Mass General Brigham [MGB]) patient data registry encompassing January 1, 2000, to January …

The Effect Of Maternal Antioxidant Vitamin Supplementation On Maternal And Cord Blood Adiponectin Concentrations, Jessica L Pippen, Paula Mcgee, James M Roberts, Leslie Myatt, Michael W Varner, Alan T N Tita, Ronald J Wapner, John M Thorp, Brian M Mercer, Beth A Plunkett, Sean C Blackwell, Anthony Sciscione, George R Saade

Faculty, Staff and Student Publications

Adiponectin is a hormone that modulates glucose regulation and fatty acid oxidation. Low adiponectin concentration has been associated with increased insulin resistance. Studies show a beneficial effect of vitamin E supplementation on insulin sensitivity. We aimed to investigate the association of prenatal antioxidant supplementation with increased adiponectin concentrations in pregnant participants and their newborn infants.Secondary analysis of a randomized control trial of prenatal vitamin C and E supplementation to prevent preeclampsia in low-risk nulliparous participants. Plasma of participants at time of randomization (9-16 weeks gestation) and delivery, and neonatal cord blood were analyzed by specific enzyme-linked immunosorbent assay for adiponectin …

Isolation And Functional Properties Of Highly-Purified N-Terminal Domain Of Human Napi2b By Scalable “Resin Overload” Technique, Daria Savenkova, Irina Makarenko, Daria Nedorezova, Ramziya Kiyamova, Mikhail Bogdanov

Faculty, Staff and Student Publications

Despite the enthusiasm and advances in the purification of native and engineered full-length membrane proteins, little attention has been paid to their fragments which could serve as attractive inspiration for function, regulation, or targeting of full-length membrane protein with therapeutic antibodies (Abs). Production of recombinant fragments of "therapeutic" membrane proteins for early-stage discovery research requires their purification to near homogeneity. It is important not only for the production of biotherapeutic antibodies but also for structural and functional studies of competitive protein-Abs, protein-protein, and lipid-protein interactions which heavily rely on the purity and quality of the isolated protein fragment of interest. …

2025 European Leukemianet Recommendations For The Management Of Chronic Myeloid Leukemia, Jane F Apperley, Dragana Milojkovic, Nicholas C P Cross, Henrik Hjorth-Hansen, Andreas Hochhaus, Hagop Kantarjian, Jeffrey H Lipton, Hemant Malhotra, Dietger Niederwieser, Jerald Radich, Philippe Rousselot, Susanne Saussele, Charles A Schiffer, Richard Silver, Simona Soverini, Leif Stenke, Anna Turkina, Luis Felipe Casado, Fausto Castagnetti, Francisco Cervantes, Richard E Clark, Jorge Cortes, Michael Deininger, Timothy P Hughes, Jeroen Janssen, Qian Jiang, Dong-Wook Kim, Richard A Larson, Francois X Mahon, Michael Mauro, Jiri Mayer, Franck E Nicolini, Fabrizio Pane, Delphine Rea, Johan Richter, Gianantonio Rosti, Giuseppe Saglio, Rüdiger Hehlmann

Faculty, Staff and Student Publications

In this 5th version of the European LeukemiaNet guidance for adult patients, there are important changes in several areas of management based on evidence available since 2020, including the World Health Organisation's reclassification of CML as a biphasic disease. Previous advice to switch the tyrosine kinase inhibitor (TKI) on failure of molecular milestones, is modified to better account for individual patient circumstances. Our recommendations are summarized in tables designed to be read in conjunction with the text which offers justification and additional advice. We describe decision-making for first-line treatment, both in available drugs and their initial dosing. Similarly we elaborate …