Incorporated in 1868, MMC is the state’s largest medical center, licensed for 700 beds and employing more than 9,600 people. Maine Medical Center’s unique role as both a community hospital and a referral center requires an unparalleled depth and breadth of services, including the state’s only allopathic medical school program, through a partnership with Tufts University School of Medicine, and a world-class biomedical research center, the MaineHealth Institute for Research.

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Submissions from 2017

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How long do I have? Observational study on communication about life expectancy with advanced cancer patients., I Henselmans, E M A Smets, P K J Han, H C J C de Haes, and H W M van Laarhoven

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IGFBP4 is required for adipogenesis and influences the distribution of adipose depots., David E. Maridas, Victoria E. DeMambro, Phuong T. Le, Subburaman Mohan, and Clifford J. Rosen

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Implementation of Coordinated Specialty Care for First Episode Psychosis in Maine, a State With Limited Resources: Lessons and Challenges in the Initial Two Years., Douglas R. Robbins and Sarah Lynch

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Is feedback to medical learners associated with characteristics of improved patient care?, Victoria Hayes, Robert Bing-You, Kalli Varaklis, Robert Trowbridge, Heather Kemp, and Dina McKelvy

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Media and Video Game Trends Across Development., Roslyn Gerwin

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Metformin affects cortical bone mass and marrow adiposity in diet-induced obesity in male mice., Sheila Bornstein, Michele Moschetta, Yawara Kawano, Antonio Sacco, Daisy Huynh, Daniel Brooks, Salomon Manier, Heather Fairfield, Carolyne Falank, Aldo M Roccaro, Kenichi Nagano, Roland Baron, Mary Bouxein, Calvin Vary, Irene M Ghobrial, Clifford J Rosen, and Michaela R Reagan

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Online Gaming and Romance., Roselyn Gerwin

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Outcomes in Cardiac Arrest Vary by Center After Correction for Case Mix and Severity of Illness., Teresa May, Philip Stone, Gill Fraser, Richard Riker, and David Seder

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Physiological Biomarkers for Prediction of Imminent Aggression in Minimally Verbal Children With Autism Spectrum Disorder., Diana Cumpanasoiu, Carla Mazefsky, Amy Stedman, Christine Peura, Peng Tian, Yuan Guo, Stratis Ioannidis, Deniz Erdogmus, Matthew Siegel, and M S. Goodwin

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Postresuscitation Experience of Obese and Underweight Patients After Cardiac Arrest., Wendy Craig, Ilka Pinz, Barbara McCrum, Mariam Qazi, Teresa May, Richard Riker, and David Seder

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Repurposing valproate, enteral clonidine, and phenobarbital for comfort in adult ICU patients: a literature review with practical considerations., David J Gagnon, Gabriel V Fontaine, Richard R Riker, and Gilles L Fraser

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Same-session bilateral ureteroscopy: safety and outcomes., Johann P Ingimarsson, Marcelino Rivera, John J Knoedler, and Amy E Krambeck

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Social Media Use for Good: Social Justice and Support for LGBTQ Youth., Erin L. Belfort

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Specialized Inpatient Psychiatry Units for Youth With Autism and Serious Problem Behaviors: Treatment Model and Behavioral Outcomes., Kashi A. Pedersen, Susan L. Santangelo, Robin L. Gabriels, Giulia Righi, and Matthew Siegel

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Text, Cut, and Post: How Adolescent Social Media Use Interacts With Self-Harm and Suicidal Behavior., Erin L. Belfort

The Developing Brain and Online Romance: Meet the Parents., Erin L. Belfort

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Timeliness of access to lung cancer diagnosis and treatment: a scoping literature review., Margo M Jacobsen, Sophie C Silverstein, Michael Quinn, Leo B. Waterston, Christian A Thomas, James C Benneyan, and Paul KJ Han

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Understanding the Parent Experience of Newborn Therapeutic Hypothermia., Roslyn Gerwin

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Working With Families of Adolescents Around Media Use and Limits., Erin L. Belfort

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Screening for behavioral health conditions in primary care settings: a systematic review of the literature., Norah Mulvaney-Day, Tina Marshall, Kathryn Downey Piscopo, Neil Korsen, Sean Lynch, Lucy H Karnell, Garrett E Moran, Allen S Daniels, and Sushmita Shoma Ghose

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One Button Studio, Dina McKelvy and Amy Moore

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Aromatase blockade is associated with increased mortality in acute illness in male mice., Jeannette J. Connerney and Daniel I. Spratt

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Body size and the risk of primary hyperparathyroidism in women: a cohort study., Anand Vaidya, Gary C Curhan, Julie M Paik, Molin Wang, and Eric N Taylor

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Caution warranted regarding transfusion for subarachnoid hemorrhage., Richard R Riker and David B Seder

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Cervical evaluation in pregnancy: proper measurement, evaluation, and management., Joseph R Wax, Angelina Cartin, and Michael G Pinette

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Contemporaneous reproduction of preclinical science: a case study of FSH and fat., Clifford J Rosen and Mone Zaidi

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Distress due to prognostic uncertainty in palliative care: frequency, distribution, and outcomes among hospitalized patients with advanced cancer., Robert Gramling, Susan Stanek, Paul KJ Han, Paul Duberstein, Tim E Quill, Jennifer S Temel, Stewart C Alexander, Wendy G Anderson, Susan Ladwig, and Sally A Norton

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Emergency neurological life support: airway, ventilation, and sedation., Venkatakrishna Rajajee, Becky Riggs, and David B. Seder

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Fatal deer tick virus infection in Maine., Catherine E Cavanaugh, Paul L. Muscat, Sam R Telford, Heidi Goethert, William Pendlebury, Susan P. Elias, Rebecca Robich, Margret Welch, Charles B. Lubelczyk, and Robert P Smith

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Feedback for learners in medical education: What is known? A scoping review., Robert Bing-You, Victoria Hayes, Kalli Varaklis, Robert Trowbridge, Heather Kemp, and Dina McKelvy

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Organizational contributors to the variation in red blood cell transfusion practices in cardiac surgery: survey results from the state of Michigan., Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, and Donald S Likosky

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Pregnancy outcomes for women without a male partner undergoing donor insemination., C S. Ladanyi, Wendy Craig, K A. Maas, A Penzias, and B Lennon

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The most important lessons I learned in training., Michael P Robich

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Using quality improvement tools to reduce chronic lung disease., Alan Peter Picarillo and Waldemar Carlo

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Sensory characteristics of youth at clinical high risk for psychosis., L Diane Parham, Sean Roush, Donna T Downing, Paul G Michael, and William R McFarlane

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Enhancing the Therapeutic Activity of an Immune Checkpoint Inhibitor, Peter C. Brooks, Jennifer M. Caron, and Liangru Contois

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Aligning Opioid Prescribing Pathways, Andrea Lai, Outpatient Pharmacy, Haley Pelletier, Suneela Nayak, Stephen Tyzik, and Ruth Hanselman

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Communication Of Medication Side Effects In An Acute Care Hospital, Deb Bachand, Rachel Caiola, R6 Neurology Med-Surg Unit, Haley Pelletier, Brendan Lilley, Suneela Nayak, Ruth Hanselman, and Stephen Tyzik

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Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, and Ruth Hanselman

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Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, and Ruth Hanselman

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Improving Cardiology Patient Flow In Nuclear Medicine, Kelly Haar, Hannah Sullivan, Kathryn Laverdiere, Nuclear Medicine Department, Haley Pelletier, Stephen Tyzik, Suneela Nayak, and Ruth Hanselman

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Improving Type And Screen Specimen Collection Prior To Elective Surgery, NorDx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, and Ruth Hanselman

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Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, and Maine Medical Center Operational Excellence

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Patient Fall Prevention, R9 West Cardiovascular, Cathy Palleschi, Suneela Nayak, Ruth Hanselman, and Stephen Tyzik

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Strategies To Improve Control Of Blood A1C In Diabetics, Jennifer Aronson, Leanne Bellino, Elizabeth Eisenhardt, Diane Bryant, Haley Pelletier, Internal Medicine Team, and Adult Outpatient Clinic

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Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson; Haley Pelletier; Barbara Bush Children's Hospital-Inpatient, Maine Medical Center; Suneela Nayak; Ruth Hanselman; and Stephen Tyzik

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CD33 Splicing Polymorphism Determines Gemtuzumab Ozogamicin Response in De Novo Acute Myeloid Leukemia: Report From Randomized Phase III Children's Oncology Group Trial AAML0531., Jatinder K Lamba, Lata Chauhan, Miyoung Shin, Michael R Loken, Jessica A Pollard, Yi-Cheng Wang, Rhonda E Ries, Richard Aplenc, Betsy A Hirsch, Susana C Raimondi, Roland B Walter, Irwin D Bernstein, Alan S Gamis, Todd A Alonzo, and Soheil Meshinchi

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Low bone density and bisphosphonate use and the risk of kidney stones., Megan Prochaska, Eric Taylor, Anand Vaidya, and Gary Curhan

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A novel in vivo model for studying conditional dual loss of BLIMP-1 and p53 in B-cells, leading to tumor transformation., Antonio Sacco, Yawara Kawano, Michele Moschetta, Oksana Zavidij, Daisy Huynh, Michaela Reagan, Yuji Mishima, Salomon Manier, Jihye Park, Elizabeth Morgan, Satoshi Takagi, Kwok K Wong, Ruben Carrasco, Irene M Ghobrial, and Aldo M Roccaro

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A phase 1 study of the CXCR4 antagonist plerixafor in combination with high-dose cytarabine and etoposide in children with relapsed or refractory acute leukemias or myelodysplastic syndrome: a pediatric oncology experimental therapeutics investigators' consortium study (POE 10-03)., Todd M Cooper, Edward Allan Racela Sison, Sharyn D Baker, Lie Li, Amina Ahmed, Tanya Trippett, Lia Gore, Margaret E Macy, Aru Narendran, Keith August, Michael J Absalon, Jessica Boklan, Jessica Pollard, Daniel Magoon, and Patrick A Brown

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A taxonomy of medical uncertainties in clinical genome sequencing., Paul K J Han, Kendall L Umstead, Barbara A Bernhardt, Robert C Green, Steven Joffe, Barbara Koenig, Ian Krantz, Leo B Waterston, Leslie G Biesecker, and Barbara B Biesecker

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Cancer care coordination: a systematic review and meta-analysis of over 30 years of empirical studies., Sherri Sheinfeld Gorin, David Haggstrom, Paul K J Han, Kathleen M Fairfield, Paul Krebs, and Steven B Clauser

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Cardiac screening in the noncardiac surgery patient., Waseem Chaudhry and Mylan C Cohen

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Comparison of pre-revision magnetic resonance imaging and operative findings in mechanically assisted crevice corrosion in symptomatic metal-on-polyethylene total hip arthroplasties., Pavel P Morozov, Munib Sana, Brian J McGrory, Steven W Farraher, and Tod G Abrahams

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Congratulations, you're pregnant! Now about your shifts . . . : the state of maternity leave attitudes and culture in EM., Casey Z MacVane, Megan L Fix, Tania D Strout, Kate D Zimmerman, Rebecca B Bloch, and Christine L Hein

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Maine Medical Center Cancer Institute's Prostate Cancer Clinic: A Virtual Clinic in Portland, Maine, Ensures Patients Have Uniform Access to All Specialties, Moritz Hansen

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Normal bone density and trabecular bone score, but high serum sclerostin in congenital generalized lipodystrophy., Josivan Gomes Lima, Lucia Helena C Nobrega, Natalia Nobrega Lima, Marcel Catão Ferreira Dos Santos, Maria de Fatima P Baracho, Renaud Winzenrieth, Francisco Bandeira, Carolina de O Mendes-Aguiar, Francisco Paulo Freire Neto, Leonardo Capistrano Ferreira, Clifford J Rosen, and Selma Maria B Jeronimo

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Perioperative chemotherapy versus postoperative chemoradiotherapy in patients with resectable gastric/gastroesophageal junction adenocarcinomas: a survival analysis of 5058 patients., Timothy L Fitzgerald, Jimmy T Efird, Nelly Bellamy, Suzanne M Russo, Charulata Jindal, Catalina Mosquera, Elizabeth G Holliday, and Tithi Biswas

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PUGS: A novel scale to assess perceptions of uncertainties in genome sequencing., B B Biesecker, S W Woolford, W M P Klein, K B Brothers, K L Umstead, K L Lewis, L G Biesecker, and P K J Han

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Pulmonary Vein Doppler Patterns in Infants with Single Right Ventricle Anomalies After Initial Staged Palliations., Edward C Kirkpatrick, Jessica Steltzer, Pippa Simpson, Amy Pan, Andrea Dragulescu, Christine B Falkensammer, Sarah Gelehrter, Wyman W Lai, Jami Levine, Stephen Miller, Thomas Miller, Jay Pruetz, Ritu Sachdeva, Deepika Thacker, and Peter Frommelt

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Recruiting and retaining community-based preceptors: a multicenter qualitative action study of pediatric preceptors., Gary L Beck Dallaghan, Anton M Alerte, Michael S Ryan, Patricia B Patterson, Jean Petershack, Cynthia Christy, William A Mills, Caroline R Paul, Chris Peltier, Julie K Stamos, Rebecca Tenney-Soeiro, and Chad Vercio

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Serum testosterone concentrations remain stable between injections in patients receiving subcutaneous testosterone., Julie McFarland, Wendy Craig, Nigel J Clarke, and Daniel I. Spratt

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Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health., Ximena Lopez, Maja Marinkovic, Toni Eimicke, Stephen M Rosenthal, and Jerrold S Olshan

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Ten-year cross-sectional study of mechanically assisted crevice corrosion in 1352 consecutive patients with metal-on-polyethylene total hip arthroplasty., Daniel K Hussey and Brian J McGrory

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Variability in Perioperative Fasting Practices Negatively Impacts Nutritional Support of Critically Ill Intubated Patients., Molly J Douglas and David L. Ciraulo

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ARHGAP42 is activated by Src-mediated tyrosine phosphorylation to promote cell motility., Weifeng Luo, Radoslav Janoštiak, Ondřej Tolde, Larisa M Ryzhova, Lenka Koudelková, Michal Dibus, Jan Brábek, Steven K Hanks, and Daniel Rosel

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Bone marrow adipocytes., Mark C Horowitz, Ryan Berry, Brandon Holtrup, Zachary Sebo, Tracy Nelson, Jackie A Fretz, Dieter Lindskog, Jennifer L Kaplan, Gene Ables, Matthew S Rodeheffer, and Clifford J Rosen

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Intracellular lipid droplets support osteoblast function., Elizabeth Rendina-Ruedy, Anyonya R Guntur, and Clifford J Rosen

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Adjunctive Treatment of Psychotic Disorders with Micronutrients., Lewis Mehl-Madrona and Barbara Mainguy

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A new tool to tackle the opioid epidemic: description, utility, and results from the Maine Diversion Alert Program., Brian J Piper, Clare E Desrosiers, Harriet C Fisher, Kenneth L McCall, and Stephanie D Nichols

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A prospective evaluation of the candle wax sign: a visual clue to diagnose aggressive basal cell carcinoma., Brian Patrick O'Donnell and Christine W Duarte

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Associations of maternal prenatal smoking with umbilical cord blood hormones: the Project Viva cohort., Abby F Fleisch, Sheryl L Rifas-Shiman, Lisa B Rokoff, Marie-France Hivert, Christos S Mantzoros, and Emily Oken

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Autoimmune Voltage-Gated Potassium Channelopathy Presenting With Catecholamine Excess., K Amy Stepp, Christin Folker, Marie Tanzer, Jennifer Hayman, Thomas Reynolds, and Leah Mallory

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Cardiovascular risk in survivors of cancer., Henry Chen Zheng, Laura Onderko, and Sanjeev A Francis

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Chronic pain patients' perspectives of medical cannabis., Brian J Piper, Monica L Beals, Alexander T Abess, Stephanie D Nichols, Maurice W Martin, Catherine M Cobb, and Rebecca M DeKeuster

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Education in nephrology fellowship: a survey-based needs assessment., Robert W Rope, Kurtis A Pivert, Mark G Parker, Stephen M Sozio, and Sylvia Bereknyei Merell

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Effects of treadmill exercise on advanced osteoarthritis pain in rats., Joshua Allen, Ian Imbert, Joshua Havelin, Terry Henderson, Glenn Stevenson, Lucy Liaw, and Tamara King

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Exercise reverses pain-related weight asymmetry and differentially modulates trabecular bone microarchitecture in a rat model of osteoarthritis., Jim Cormier, Katherine Cone, Janell Lanpher, Abigail Kinens, Terry Henderson, Lucy Liaw, Edward J Bilsky, Tamara King, Clifford J Rosen, and Glenn W Stevenson

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Healthcare policy and urologic practice., Daniel Pitts and Jesse D Sammon

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Higher maternal protein intake during pregnancy is associated with lower cord blood concentrations of insulin-like growth factor (IGF)-II, IGF binding protein 3, and insulin, but not IGF-I, in a cohort of women with high protein intake., Karen M Switkowski, Paul F Jacques, Aviva Must, Marie-France Hivert, Abby Fleisch, Matthew W Gillman, Sheryl Rifas-Shiman, and Emily Oken

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Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program., Amy J Starmer, Nancy D Spector, Daniel C West, Rajendu Srivastava, Theodore C Sectish, Christopher P Landrigan, and I-PASS Study Group

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Measure accurately, act rapidly, and partner with patients: an intuitive and practical three-part framework to guide efforts to improve hypertension control., Romsai T Boonyasai, Michael K Rakotz, Lisa H Lubomski, Donna M Daniel, Jill A Marsteller, Kathryn S Taylor, Lisa A Cooper, Omar Hasan, and Matthew K Wynia

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Racial differences in prostate-specific antigen-based prostate cancer screening: state-by-state and region-by-region analyses., Tarun Jindal, Naveen Kachroo, Jesse Sammon, Deepansh Dalela, Akshay Sood, Malte W Vetterlein, Patrick Karabon, Wooju Jeong, Mani Menon, Quoc-Dien Trinh, and Firas Abdollah

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Stroke: secondary prevention of ischemic events., Jane G Morris, Emily Carter, and Stephen A Martin

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Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients., Daniel I Spratt, India I Stewart, Clara Savage, Wendy Craig, Norman P Spack, Donald Walt Chandler, Lindsey V Spratt, Toni Eimicke, and Jerrold S Olshan

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Using the Surprise Question To Identify Those with Unmet Palliative Care Needs in Emergency and Inpatient Settings: What Do Clinicians Think?, Samir A. Haydar, Lisa Almeder, Lauren Michalakes, Paul K.J. Han, and Tania D. Strout

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Inhibiting the osteocyte-specific protein sclerostin increases bone mass and fracture resistance in multiple myeloma., Michelle M McDonald, Michaela R Reagan, Scott E Youlten, Sindhu T Mohanty, Anja Seckinger, Rachael L Terry, Jessica A Pettitt, Marija K Simic, Tegan L Cheng, Alyson Morse, Lawrence M T Le, David Abi-Hanna, Ina Kramer, Carolyne Falank, Heather Fairfield, Irene M Ghobrial, Paul A Baldock, David G Little, Michaela Kneissel, Karin Vanderkerken, J H Duncan Bassett, Graham R Williams, Babatunde O Oyajobi, Dirk Hose, Tri G Phan, and Peter I Croucher

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2017 ACC/AHA/HFSA/ISHLT/ACP Advanced Training Statement on Advanced Heart Failure and Transplant Cardiology (Revision of the ACCF/AHA/ACP/HFSA/ISHLT 2010 Clinical Competence Statement on Management of Patients With Advanced Heart Failure and Cardiac Transplant): A Report of the ACC Competency Management Committee., Mariell Jessup, Mark H Drazner, Wendy Book, Joseph C Cleveland, Ira Dauber, Susan Farkas, Mahazarin Ginwalla, Jason N Katz, Peggy Kirkwood, Michelle M Kittleson, Joseph E Marine, Paul Mather, Alanna A Morris, Donna M Polk, Antoine Sakr, Kelly H Schlendorf, and Esther E Vorovich

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Blocking FSH induces thermogenic adipose tissue and reduces body fat., Peng Liu, Yaoting Ji, Tony Yuen, Elizabeth Rendina-Ruedy, Victoria E DeMambro, Samarth Dhawan, Wahid Abu-Amer, Sudeh Izadmehr, Bin Zhou, Andrew C Shin, Rauf Latif, Priyanthan Thangeswaran, Animesh Gupta, Jianhua Li, Valeria Shnayder, Samuel T Robinson, Yue Eric Yu, Xingjian Zhang, Feiran Yang, Ping Lu, Yu Zhou, Ling-Ling Zhu, Douglas J Oberlin, Terry F Davies, Michaela R Reagan, Aaron Brown, T Rajendra Kumar, Solomon Epstein, Jameel Iqbal, Narayan G Avadhani, Maria I New, Henrik Molina, Jan B van Klinken, Edward X Guo, Christoph Buettner, Shozeb Haider, Zhuan Bian, Li Sun, Clifford J Rosen, and Mone Zaidi

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Bone marrow adipose tissue: the first 40 years., Beate Lanske and Clifford Rosen

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Charles Locke Scudder (1860-1949)., David E Clark

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Communicating uncertainty in benefits and harms: a review of patient decision support interventions., Nick Bansback, Madelaine Bell, Luke Spooner, Alysa Pompeo, Paul K J Han, and Mark Harrison

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Deletion of the thyroid hormone-activating type 2 deiodinase rescues cone photoreceptor degeneration but not deafness in mice lacking type 3 deiodinase., Lily Ng, Hong Liu, Donald L St Germain, Arturo Hernandez, and Douglas Forrest

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Development of a Staffing Activity Tool That Works., Heidi E. Morin

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Editors' preface., Joseph F Rappold and Philip C Spinella

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Endovascular aneurysm repair patients who are lost to follow-up have worse outcomes., Caitlin W Hicks, Devin S Zarkowsky, Ian C Bostock, David H Stone, James H Black, Jens Eldrup-Jorgensen, Philip P Goodney, and Mahmoud B Malas

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Energy metabolism of the osteoblast: implications for osteoporosis., Wen-Chih Lee, Anyonya R Guntur, Fanxin Long, and Clifford J Rosen

Factors Associated With Deciding Between Risk-Reducing Salpingo-oophorectomy and Ovarian Cancer Screening Among High-Risk Women Enrolled in GOG-0199: An NRG Oncology/Gynecologic Oncology Group Study., Phuong L. Mai, Marion Piedmonte, Paul K. Han, Richard P. Moser, Joan L. Walker, Gustavo Rodriguez, John Boggess, Thomas J. Rutherford, Oliver Zivanovic, David E. Cohn, J Tate Thigpen, Robert M. Wenham, Michael L. Friedlander, Chad A. Hamilton, Jamie Bakkum-Gamez, Alexander B. Olawaiye, Martee L. Hensley, Mark H. Greene, Helen Q. Huang, and Lari Wenzel

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Genetics of ancestry-specific risk for relapse in acute lymphoblastic leukemia., S E Karol, E Larsen, C Cheng, X Cao, W Yang, L B Ramsey, C A Fernandez, J R McCorkle, S W Paugh, R J Autry, E Lopez-Lopez, B Diouf, S Jeha, C-H Pui, E A Raetz, N J Winick, W L Carroll, S P Hunger, M L Loh, M Devidas, W E Evans, J J Yang, and M V Relling

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Guidelines for family-centered care in neuro-ICU populations: caveats for routine palliative care., Michel T Torbey, Gretchen M Brophy, Panayiotis N Varelas, Julian Bösel, Edward Manno, Mary Kay Bader, Jose I Suarez, David Seder, and W David Freeman