Indiana University-Purdue University Indianapolis (IUPUI) / The late-onset outcome issue is common in early phase dose- nding clinical trials. This problem becomes more intractable in phase I/II clinical trials because both toxicity and e cacy responses are subject to the late-onset outcome issue. The existing methods applying for the phase I trials cannot be used directly for the phase I/II trial due to a lack of capability to model the joint toxicity{e cacy distribution. We propose a conditional weighted likelihood (CWL) method to circumvent this issue. The key idea of the CWL method is to decompose the joint probability into the product of marginal and conditional probabilities and then weight each probability based on each patient's actual follow-up time. We further extend the proposed method to handle more complex situations where the late-onset outcomes are competing risks or semicompeting risks outcomes. We treat the late-onset competing risks/semi-competing risks outcomes as missing data and develop a series of Bayesian data-augmentation methods to e ciently impute the missing data and draw the posterior samples of the parameters of interest. We also propose adaptive dose- nding algorithms to allocate patients and identify the optimal biological dose during the trial. Simulation studies show that the proposed methods yield desirable operating characteristics and outperform the existing methods.

This thesis will discuss the organization of the letter collection of Ruricius, bishop of Limoges from ca. 485 to 506/7. Ruricius’ two-book collection (found in a unicum, the Codex Sangallensis 190) contains a variety of conventional letter types, set within the specific and complex socio-cultural setting of late 5th to early 6th century Gaul in transition. Ruricius’ collection complements the three other major extant Gallo-Roman letter collections of this period, those of Sidonius Apollinaris, Avitus of Vienne, and Ennodius of Pavia. Yet, as a result of Ruricius’ scanty references to contemporary historical circumstances, his letter collection has traditionally received less attention in studies of letter collections and late 5th century Gaul. However, the value of his letters as a late-antique letter collection for literary study is promising. The aim of this thesis is to engage with the letters of Ruricius and consider them from the perspective of a letter collection with potentially deliberate principles of organization. This is particularly pertinent for the 18-letter Book I, which shows clear signs of deliberate organization by Ruricius. Furthermore, there are compelling hints of deliberate organization in the 65 letters of Book II. This thesis will investigate both Books I and II. Through an analysis of the collection’s organizational principles, themes and imagery, and Ruricius’ self-presentation, we will investigate Ruricius’ presentation of his journey from secular aristocrat to bishop in Book I and his epistolary persona of bishop and guide in Book II.

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AN ABSTRACT OF THE DISSERTATION OF Sarah K. Muno for the Doctor of Philosophy degree in Anthropology, presented on September 26, 2018 at Southern Illinois University Carbondale. TITLE: LABOR AND SOCIAL IDENTITY IN ANCIENT PERU: A BIOARCHAEOLOGICAL PERSPECTIVE MAJOR PROFESSOR: Dr. Izumi Shimada This dissertation presents a bioarchaeological study of labor and social identity in coastal Peru during the Late Intermediate Period (900 – 1470 CE), using data from contemporaneous Middle Sicán (Sicán Precinct and El Brujo, north coast) and Ychsma (Pachacamac, central coast) mortuary contexts. I combine information about funerary treatment with skeletal evidence of trauma, degenerative joint disease, and muscle attachment site morphology (enthesial changes or EC) to test whether inferred commoners were “over-worked” relative to their elite counterparts, as often assumed based on western, Marxist notions of social class. Much of what has been inferred about socio-economic organization in coastal Peru during the Late Intermediate Period is modeled after the parcialidades described in early Spanish chronicles and colonial documents. In this system, occupation, social status, and ethnicity were intimately intertwined, with common fishers and farmers serving as the “productive base” for privileged members of society, including full-time artisans and their elite patrons. Archaeological evidence of elite sponsored large-scale labor projects, including specialized craft production, in pre-Hispanic coastal Peru accords well with the parcialidad model, but assumptions about the social identities of laborers often go untested. Human skeletal data offer a unique opportunity to redress this situation, providing information about life experience – including patterns of physical activity – that are not typically accessible with other kinds of archaeological data. Bioarchaeological studies of physical activity hold great promise for testing hypotheses about social identity and life experience in ancient societies, but they are not without some limitation. People who engage in strenuous physical activity tend to have more degenerative joint disease and enthesial changes than those who do not, but the precise mechanisms behind this are not well understood. Age and body size are known to influence these skeletal markers, although some researchers have suggested certain entheses may be less sensitive to size and thus more informative about activity, than others. In my sample, there were no discernible differences in skeletal trauma, degenerative joint disease, or ECs between elites and non-elites, or between males and females, when statistically controlling for the influence of age and/or size. These results do not support the hypotheses that non-elites were over-burdened by arduous labor tasks or that exemption from such tasks was part of the social privileges afforded to elites. Therefore, conventional perspectives that tend to conflate elite and non-elite identities with oppressor/oppressed or manager/laborer roles appear to have little relevance for characterizing the social dynamics of labor organization in Middle Sicán and Ychsma socities. My study supports, at least in part, previous research that argues some entheses are less prone to the influence of size than others, and may therefore be more reliable indicators of activity. In this sample, strong statistical correlations between EC scores, age, and size as determined from three humeral measurements were found for fibrous entheses, but humeral size did not correlate to scores for the fibrocartilaginous type. However, current uncertainties about the precise etiology of enthesial changes makes it difficult to interpret variation in EC scores with a high degree of certainty, and thus my study also highlights some of the drawbacks associated with using EC scores to infer patterns of activity. Experimental research to better understand how the timing, duration, and severity of muscle stress and strain influence enthesial development and technological innovations to quantify enthesial size and shape will be key to resolving these issues in the future.

This dissertation research focused on breast cancer and social determinants that have been shown to influence the outcomes of this devastating disease. Although heart disease is the leading cause of death for women, more women feel that they will die from breast cancer. Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for many women. There are no known causes of breast cancer, but there are certain genetic and social factors that pre-dispose women to this disease. Also, diagnosis at later stages of disease has been shown to have adverse outcomes for many. This research examined the effects that social determinants had on breast cancer stage of diagnosis. The social determinants researched to examine their influence on breast cancer outcomes were race, geographical location, health insurance, and income. Also, this research examined the influence of Public Health Law, 101-354, enacted to decrease health disparity from breast and cervical cancer for minorities and medically underserved women had on breast cancer diagnosis for women enrolled in the Mississippi Breast and Cervical Cancer Program. Complimentary to PHL 101-354, Public Health Law 106-354, the Breast and Cervical Cancer Treatment Act, was enacted giving states the option of providing health insurance through Medicaid for eligible women with a diagnosis of cancer of the breast or cervix, including precancerous conditions, for treatment services. The results of this study revealed that race and health insurance were the two major factors that negatively impacted stages of breast cancer diagnoses. Although hypothesized, geographical location and income did not significantly affect late stage breast cancer rates.

In Rome, the activity of hunting was a pastime traditionally associated with the emperor and aristocracy. As such, hunting imagery in Roman art became symbolic of masculinity and power, expressions of which were important for the self-representation of status-conscious citizens. More specifically, virtus, often translated as “manliness” or “courage,” is the principal quality that is expressed through hunting scenes, although other ideas such as wealth and erudition were alluded to in these scenes as well. This thesis examines hunting scenes in the media of sarcophagi, mosaics, and silverware from the third to the sixth centuries AD. It focusses on the kinds of hunting imagery found on different media in order to discern the values that were important to patrons in the later Roman period, and the ways in which these values were expressed in the visual arts. In the funerary context, mythological hunting scenes on sarcophagi most often present the deceased as a man of virtus. However, owing to the Entmythologisierung of Roman sarcophagi during the third century, the ways in which virtus was expressed through these scenes underwent significant change during this period. On domestic floor mosaics, virtus was also a principal virtue that was expressed, but other ideas such as wealth and generosity were also displayed on hunting scenes in this medium, both mythological and non-mythological. Moreover, hunting scenes on silverware often highlight the wealth of the vessel’s owner. Additionally, allusions to a patron’s paideia, his formal educational background in Greek and Latin literature, as well as expressions of one’s Christian faith, also served as claims of membership in exclusive groups. / Thesis / Master of Arts (MA)

This thesis examines the evidence surrounding the Roman emperor Justinian’s wars in western Europe (Italy and Spain) and North Africa. It argues that without Procopius’ narrative, we would be left with a very bland, cursory account and even find it difficult to get a full grip on what happened when, even though Jordanes in particular does give some sort of narrative. The thesis focuses on the narrative of Justinian’s western wars offered by sources like Jordanes’, Romana and Getica, Victor of Tonnuna’s Chronicle, Corippus’ epic poem and Marcellinus comes’ Chronicle and its addition. It also discusses when each of these sources was written and where, and the background of the author, so that the reader can identify what was important to the author and the potential biases in the presentation of the events in question. The thesis then compares the narrative of the above sources to the narrative of Procopius in order to determine what information historians and scholars would not have if they did not have Procopius’ work.

No description available.

Considered the most common malignancy in women in the United States and second leading cause of cancer death among women, breast cancer has had a shift in paradigm of treatment within the recent years and undertaken significant research for new targeted treatment with a more molecular driven approach which has led to increased survival rates amongst women diagnosed with early stage breast cancer. The risk of recurrence however persists overtime, particularly in hormone receptor positive breast cancer, which has demonstrated recurrence rates as late as 30 years after initial diagnosis. This leads to a higher need for increased awareness of late recurrence rates in early stage breast cancer patients and reminds us to be wary of any new findings that in other patients may be considered as benign. We present a case of a 67-year-old female with remote history of locally advanced hormone positive breast cancer in 2005 who underwent mastectomy with lymph node dissection followed by adjuvant chemotherapy, radiation, and endocrine therapy for at least 8 years who presented to our clinic 18 years after initial diagnosis with an enlarging nodule in her neck. Patient underwent a thyroid ultrasound which showed a suspicious thyroid nodule concerning for malignancy classified as TIRADS-5. Further systemic imaging via PET-Scan demonstrated surrounding cervical lymphadenopathy adjacent to the thyroid nodule with increased fluorodeoxyglucose (FDG) avidity. She proceeded to undergo a thyroid fine needle biopsy, which was suspicious for malignancy. A repeat thyroid fine needle biopsy was obtained this time confirming metastatic breast cancer. Considering the rarity of such event, we proceeded with further testing of biopsied tissue via cancer type ID, which confirmed presence of metastatic breast cancer in the thyroid. Patient was informed of now metastatic breast cancer diagnosis with plans to start Faslodex and Ibrance. Unfortunately, she developed rapid disease progression with hospitalization due to a recurrent malignant pericardial effusion suggestive of visceral crisis requiring initiation on palliative chemotherapy with Carboplatin and Gemcitabine. Patient has been tolerating systemic chemotherapy well with interval clinical decrease of more than 50% in size of her surrounding cervical lymphadenopathy and resolution of pericardial effusion. The incidence of thyroid metastatic disease from breast cancer is very rare accounting for only 0.2% of fine needle biopsy aspirations. The most common sites of breast cancer metastasis include lung, bone, liver, and brain. On the other hand, the most common primary malignancies that can cause metastasis to the thyroid are kidney, gastrointestinal tract, and lung. However, as of 2018 around 42 cases of metastatic breast cancer found in the thyroid had been reported and it was also noted that metastatic thyroid involvement of breast cancer could be associated with a poor prognosis. This case represents the importance of being aware of the risk of late recurrence in hormone positive breast cancers, which in turn should result in a lower threshold for thorough workup of common clinical findings in these patients.

Religion in the Late Republic was fused to politics. This study considers the relationship between violence, religion, and politics in the Late Republic and Augustan Age. It contends that Roman religion could encourage or discourage violence based upon the circumstances. The strain of Roman expansion on its political and religious institutions contributed to the civil discord that characterized the Late Republic, which created circumstances that were flexible enough for perspectives on each side to see the violence as justified. The ambition of a tribune, a sacrosanct office, could lead to circumvention of the traditional practices of the Senate, causing a religious dilemma if violence was used as a response. Powerful politicians also used religion to legitimize their abuses or obstruct the political aims of their opponents, leading to a contentious atmosphere fraught with violence. The influence of Greek philosophy on religion and morality was of concern for many Romans themselves. These concerns were not laid to rest until the Augustan Age had reshaped Rome's political and religious institutions, which was accompanied by an outpouring of literature embedded with religious symbolism.