cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract 865: Impact of race and health insurance on delays in breast cancer diagnosis and treatment in the District of Columbia

Background: Delays in follow-up after breast cancer screening are thought to contribute to disparities in breast cancer outcomes. The primary objective of this study is to determine the impact of race as well as health insurance status on the diagnostic delay time, defined as the number of days from abnormal screening to definitive diagnosis. In addition, we analyze the effects of race and health insurance status on the treatment delay time, defined as the number of days from definitive breast cancer diagnosis to treatment initiation. Methods: This is a retrospective study of 695 women examined for breast cancer between 1997 and 2009 at seven hospitals and clinics located in the District of Columbia. The outcomes of interest were the diagnostic delay time and the treatment delay time. We used full-factorial and main-effects ANOVA models to test for significant differences in these outcomes between African-American and white women with and without some type of health insurance. Results: The mean diagnostic delay time was 37 days for insured white women, 76 days for uninsured white women, 75 days for insured African-American women, and 73 days for uninsured African-American women. In fitting a full-factorial ANOVA model, we found that insured white women had a significantly shorter delay in diagnosis than insured African-American women (p=0.0001) as well as uninsured white women (p=0.0007). Furthermore, a main-effects ANOVA model showed that after controlling for insurance status, African-American women had a mean treatment delay time of 45 days, which was significantly longer than the mean treatment delay time of only 17 days for white women (p Conclusions: Insured African-American women and uninsured white women waited more than twice as long to reach their definitive diagnosis than insured white women. African-American women also waited more than three times as long as white women for treatment initiation following definitive diagnosis. Lack of health insurance markedly decreased the speed of diagnostic resolution in white women, but having health insurance did not increase the speed of diagnostic resolution in African-American women. These results suggest that lack of health insurance may not be the primary barrier to optimal diagnostic resolution and treatment initiation in African-American women. It will be important to determine what other factors serve as the primary barriers, as well as if these delays affect the final breast cancer outcome for the patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 865.
Comparison of Angle Decomposition Methods for Wave-Equation Migration

Angle domain common image gathers o↵er advantages for subsurface image analysis in complex media. We compare two angle decomposition methods using extended images and wave propagation directions based on Poynting vectors of the source and receiver wavefields. We evaluate the ability of each method to produce accurate and e cient angle gathers for wave-equation migration in the presence of multi-arrivals and in the subsalt environment. Both methods are characterized by features that make them attractive in di↵erent situations.
A Comparison of Practical Methods for Determining the Bacterial Content of Milk

The American Public Health Association appointed a committee in 1905 to formulate standard laboratory methods for the bacterial examination of milk, following the example set by a similar committee on water analysis. The methods of milk examination in vogue at present are so widely different in the different laboratories that results cannot be compared. These different results are due to at least four factors, viz., the medium employed, the temperature of incubation, the period of incubation, and the degree of shaking before plating. The media usually employed are agar or gelatin. There are undoubtedly some arguments in favor of the use of gelatin, but the difficulty in handling gelatin plates, especially in warm weather, and the great loss occasioned by the presence of liquefying colonies probably more than counterbalance the advantages. The addition of litmus and dextrose or lactose is a common practice. The temperature of incubation has been the subject of considerable discussion, inasmuch as some workers favor incubation at 370 C, others at 200 . Since certain bacteria multiply more rapidly at 370 than at 200 , the former temperature has been often employed, so that in many laboratories counts are made after 24 hours5 incubation at 370 . It is true, however, that at 200 a higher count can be obtained than at 370 , and this fact seems to be of sufficient importance to advocate incubation at the lower temperature. It is generally conceded that at 370 multiplication is more rapid than at 200 , so that plates can be counted at an earlier date. Finally the numbers may vary with the degree of violence used in shaking milk dilutions preparatory to plating, as has been shown recently by Rosenau and McCoy.1 The points just mentioned explain to some extent the varying
Gender Difference and Indifference in the Writings of Pope Innocent III

Both R. Howard Bloch and Jean Leclercq have recently included the name of Pope Innocent HI (1198-1216) among the ranks of medieval misogynistic writers. Such an anti-feminist designation results from his treatise De miseria humanae conditionis (1195), which he authored whilst a cardinal deacon, as Lothario de Segni. However, the passages cited by Bloch and Leclercq only appear misogynistic when we consider them superficially. If we look at the entire corpus of Innocent’s writings and his actions, in their proper contexts, we discover that this Pope can not be so easily categorized. Rather, our analysis will show that there is much more diversity in his perspective on gender than originally thought. The De miseria should be seen in its unique context when evaluating its attitude towards women. Books I and HI of the treatise belonged to the contemptus mundi tradition which emphasised the vileness and misery of human existence. Moreover, John C. Moore has recently proposed that Book II is a speculum curialis which reflected the questionable moral practices Innocent observed during his career in the Roman Curia.
Building and Sustaining a Hospital-Based Nursing Research Program edited by Nancy M. Albert

Current trends in hospital nursing, particularly the push for Magnet status, require already busy nurses to not only pursue undergraduate and advanced degrees, but also to pursue and promote clinic...
Optical design and initial results from NIST's AMMT/TEMPS facility

The National Institute of Standards and Technology's (NIST) Physical Measurement and Engineering Laboratories are jointly developing the Additive Manufacturing Measurement Testbed (AMMT)/ Temperature and Emittance of Melts, Powders and Solids (TEMPS) facilities. These facilities will be co-located on an open architecture laser-based powder bed fusion system allowing users full access to the system's operation parameters. This will provide users with access to machine-independent monitoring and control of the powder bed fusion process. In this paper there will be emphasis on the AMMT, which incorporates in-line visible light collection optics for monitoring and feedback control of the powder bed fusion process. We shall present an overview of the AMMT/TEMPS program and its goals. The optical and mechanical design of the open architecture powder-bed fusion system and the AMMT will also be described. In addition, preliminary measurement results from the system along with the current status of the system will be described.
FANCD2 Maintains Fork Stability in BRCA1/2-Deficient Tumors and Promotes Alternative End-Joining DNA Repair

BRCA1/2 proteins function in homologous recombination (HR)-mediated DNA repair and cooperate with Fanconi anemia (FA) proteins to maintain genomic integrity through replication fork stabilization. Loss of BRCA1/2 proteins results in DNA repair deficiency and replicative stress, leading to genomic instability and enhanced sensitivity to DNA-damaging agents. Recent studies have shown that BRCA1/2-deficient tumors upregulate Polθ-mediated alternative end-joining (alt-EJ) repair as a survival mechanism. Whether other mechanisms maintain genomic integrity upon loss of BRCA1/2 proteins is currently unknown. Here we show that BRCA1/2-deficient tumors also upregulate FANCD2 activity. FANCD2 is required for fork protection and fork restart in BRCA1/2-deficient tumors. Moreover, FANCD2 promotes Polθ recruitment at sites of damage and alt-EJ repair. Finally, loss of FANCD2 in BRCA1/2-deficient tumors enhances cell death. These results reveal a synthetic lethal relationship between FANCD2 and BRCA1/2, and they identify FANCD2 as a central player orchestrating DNA repair pathway choice at the replication fork.
IMPLEMENTING MATHEMATICS TEACHING REFORM: A CASE STUDY OF MATHEMATICS CLASSROOMS IN CHINA

This study describes the implementation of teaching reform in secondary mathematics classrooms in a rural poverty school in southwest China where a school-wide teaching experiment took place. Classroom teaching and learning practices are primarily concerned with classroom organizations, interactions and social norms. The results indicate that a collective learning approach was taken in the classroom reform, in which mathematical communications, understanding and engagement of students in learning were promoted. However, there was a lack of diversity of thinking and arguments on solving problems among different level students, which implies the mathematical teaching still focuses on acquiring knowledge over generating knowledge.
Pulling Levers on Gang Violence in London and St. Paul

This chapter compares and contrasts two focused deterrence pulling levers strategies in two cities, 4000 miles apart: London, England, and St. Paul, Minnesota. Based on qualitative interviews with key stakeholders in both cities and analysis of secondary data, the chapter examines program efficacy, issues of fidelity in Group Violence Intervention, innovation in transforming theory into practice, and context-specific challenges to directing gang-violence cessation. The community-police nexus in gang intervention and possible “spillover effects” of focused deterrence strategies on vicariously treated gangs are discussed. The chapter explores how and why “pulling levers” failed in London but succeeded in St. Paul, with implications for research, policy, and practice.
Organic Removal Mechanisms in Biophysical Treatment Systems

An experimental program was conducted to evaluate the significance of enhanced biodegradation, bioregeneration, and metabolic end product (MEP) adsorption in a bench-scale biophysical reactor using phenol as the substrate. Radiotracer methods and a desorption-extraction procedure that measures the amount of adsorbed phenol were used to discriminate between the various mechanisms. The results showed the major benefit of PAC addition under steady-state conditions to be MEP adsorption. Furthermore, adsorption reversibility was established as the controlling mechanism for bioregeneration. Reversibly adsorbed phenol could be desorbed to regenerate the PAC, but irreversibly adsorbed MEP could not. PAC, therefore, acts as a storage reservoir during shock loads via an adsorption-desorption sequence.
Valence Photoelectron Spectroscopy of Non-Volatile Organometallic Molecules

Ultraviolet photoelectron spectroscopy (UPS) has been instrumental in developing modern molecular electronic structure theory. The energy difference between the neutral molecule ground state and the low-lying cationic states, measured as ionization energies by UPS, is the closest measure of orbital energies described by molecular orbital theory.1 In addition, the ionizations independently provide information on electron configurations, charge potentials, bond strengths and other properties that relate to chemical reactivity in molecular systems.1, 2 Historically, high-quality photoelectron spectroscopy has been most informative for molecular species in the gas phase. However, many molecular systems of interest are not sufficiently stable or volatile for gas-phase UPS investigations. In an effort to provide high quality electronic structure data for such systems we are investigating methods for obtaining photoelectron spectra of molecules in thin films in which the surface-molecule and intermolecular interactions are relatively weak; thus approaching the gas phase limit. Previously we reported the ionizations of molecules containing metal-metal quadruple bonds3 and the first ever valence photoeleciron spectrum of C60,4, 5 and found that the valence ionizations of these molecules in thin films closely resemble their gas-phase photoeleciron spectra. The differences (and similarities) between thin film and gas-phase data provide additional information about intermolecular interactions and electron relaxation in bulk materials. Here we present the UPS of ferrocene tethered to a gold surface via an alkanethiol chain. Ferrocene-terminated alkanethiols are known to form stable monolayers and have been characterized extensively.6, 7
Ordered silicon nanowire array based solar cells produced by metal assisted chemical etching

Solar cells consisting of extremely uniform and ordered large-area arrays of silicon micropillars are fabricated using metal-assisted chemical etching. Micropillar diameter, pitch, height, and core-shell doping profiles are optimized for light trapping and carrier collection.
Hyperfine structure in the 6 2 D 3 / 2 and 6 2 D 5 / 2 states of Rb 87 and Rb 85

Improved measurements of hyperfine splittings in the $6\phantom{\rule{0.16em}{0ex}}{}^{2}{D}_{3/2}$ and $6\phantom{\rule{0.16em}{0ex}}{}^{2}{D}_{5/2}$ states of $^{87}\mathrm{Rb}$ and $^{85}\mathrm{Rb}$ have been performed using Doppler-free, double-resonance, optical pumping laser spectroscopy. The small sizes of the splittings and their associated coupling constants limit the fractional precision of the results, but when these results are combined with past measurements and scaling rules, they provide a reasonably complete and satisfactory characterization of the entire hyperfine structure in the $6\phantom{\rule{0.16em}{0ex}}{}^{2}{D}_{3/2}$ and $6\phantom{\rule{0.16em}{0ex}}{}^{2}{D}_{5/2}$ manifolds of $^{87}\mathrm{Rb}$ and $^{85}\mathrm{Rb}$.
Modular Design of Strategies for the Best-of-n Problem

In this chapter, we provide a high level perspective of collective decision-making strategies and identify the fundamental processes that characterize their functioning. Successively, we propose a minimal modular control structure of a collective decision-making strategy and define a set of guidelines and constraints to support the design of specific modules. Finally, we define a general modeling methodology and show how this methodology can be instantiated to study macroscopic properties of specific strategies.
The Aryl Hydrocarbon Receptor and Immunity

The aryl hydrocarbon receptor (AhR), originally discovered as a xenobiotic receptor involved in upregulating metabolic enzymes, has become increasingly linked to physiological processes such as cell cycle regulation and cellular differentiation as well as disease states associated with these processes. The immune system is composed of numerous effector cells and protein mediators with specialized functions, all of which are highly dependent on cell cycle regulation and cellular differentiation and therefore offer a plethora of potential targets for modulation by the AhR. Indeed, the vast majority of studies support a direct or indirect influence of the AhR in most aspects of immunity. The focus of this chapter is to discuss these studies. Although AhR activation by dioxin and nondioxin ligands is a primary method for evaluating AhR-mediated effects, there is the possibility for off-target effects by AhR ligands (i.e., not AhR mediated) or for effects that do not accurately reflect the physiological function of the AhR (i.e., exogenous vs. endogenous ligands). Therefore, more emphasis will be given to immune effects that have been demonstrated to be AhR dependent by either the use of a chemical AhR antagonist or the knockdown or knockout of the AhR.
Sonographic Findings of Gallbladder Perforation With Hepatic Abscesses

Gallbladder perforation is a complication of gallbladder disease. There are high morbidity and mortality rates, and it is believed that this is due to the delay in diagnosis and when the condition ...
Expectations versus Reality of Pakistan China FTA

Abstract. Pakistan-China FTA was implemented with lot of fanfare and was expected to improve Pakistani export potential and business competitiveness. However, the successive governments failed to improve local competitiveness through effective regulation resulting in (a) missed opportunity to exploit the FTA to the benefit of Pakistan and (b) a trade balance favouring only China. Keywords. International trade. JEL. F13, F40, F50.
Review of The Politics of Scale: A History of Range Science by Nathan Sayre

Sayre, NF The Politics of Scale: A History of Range Science Chicago: University of Chicago Press; 2017 288 pages, ISBN: Paper 978-022-608-X
Multilevel Analysis and Results

This chapter presents and discusses the results of multilevel logit regression equations examining the effects on poverty of the individual characteristics of Mexican Americans and Mexican immigrants in addition to the contextual level characteristics of SPUMAs in the Southwestern United States. These populations have emerged as ones that necessitate a multitude of analyses given their expected growth rates and levels of poverty in the coming decades. The preceding chapters examined the effects of individual level characteristics on the log odds of three different types of poverty, and offered quite a bit of insight into the nature of the disadvantages faced by both populations, i.e., Mexican Americans and Mexican immigrants. However, little has been done to examine the impact of contextual level characteristics with respect to these groups. Given the fact that Mexican Americans and Mexican immigrants maintain high rates of employment and more often reside in dual-parent households, it becomes essential to examine other influences than personal characteristics, which may be imparting significant impacts on poverty.
Maximum standard metabolic rate corresponds with the salinity of maximum growth in hatchlings of the estuarine northern diamondback terrapin (Malaclemys terrapin terrapin): Implications for habitat conservation

Abstract I evaluated standard metabolic rates (SMR) of hatchling northern diamondback terrapins (Malaclemys terrapin terrapin) across a range of salinities (salinity = 1.5, 4, 8, 12, and 16 psu) that they may encounter in brackish habitats such as those in the Maryland portion of the Chesapeake Bay, U.S.A. Consumption of O2 and production of CO2 by resting, unfed animals served as estimates of SMR. A peak in SMR occurred at 8 psu which corresponds closely with the salinity at which hatchling growth was previously shown to be maximized (salinity ∼ 9 psu). It appears that SMR is influenced by growth, perhaps reflecting investments in catabolic pathways that fuel anabolism. This ecophysiological information can inform environmental conservation and management activities by identifying portions of the estuary that are bioenergetically optimal for growth of hatchling terrapins. I suggest that conservation and restoration efforts to protect terrapin populations in oligo-to mesohaline habitats should prioritize protection or creation of habitats in regions where average salinity is near 8 psu and energetic investments in growth appear to be maximized.
Perioperative and Survival Outcomes Following Neoadjuvant FOLFIRINOX versus Gemcitabine Abraxane in Patients with Pancreatic Adenocarcinoma.

Context Neoadjuvant chemotherapy is increasingly used in borderline resectable and locally advanced pancreatic cancer to facilitate surgical resection. Objective To compare progression free survival and overall survival in patients receiving neoadjuvant FOLFIRINOX with those receiving gemcitabine/abraxane. Design Retrospective cohort study. Setting University of Colorado Hospital from 2012-2016. Participants Patients with pancreatic adenocarcinoma. Interventions Neoadjuvant FOLFIRINOX or gemcitabine/abraxane. Outcome Measures Perioperative outcomes, progression free survival, and overall survival were compared between groups. A multivariate Cox proportional hazard model was applied to evaluate survival outcomes. Results We identified 120 patients: 83 (69.2%) FOLFIRINOX and 37 (30.8%) gemcitabine/abraxane. The FOLIFRINOX group was younger and had a lower ECOG performance status (p 0.05). Insulin-dependent diabetes and a poor-to-moderate pathologic response was associated with worse progression free survival and overall survival. Conclusion Neoadjuvant FOLFIRINOX may improve progression free survival by increasing the proportion of patients undergoing surgical resection. Improved understanding of the role for selection bias and longer follow up are needed to better define the impact of neoadjuvant FOLFIRINOX on overall survival.
Use of bacterial spores in monitoring water quality and treatment

Because Clostridium perfringens spores are both specific to sewage contamination and environmentally stable, they are considered as possible conservative indicators of human fecal contamination and possible surrogates for environmentally stable pathogens. This review discusses the reasons and summarizes methods for monitoring spores in water. Cultural methods are still preferred over qPCR for routine water quality monitoring because of their low costs. Membrane filter (MF) methods are preferred over the more laborious and less accurate most probable number methods. The most commonly used MF media are TSC medium and mCP medium. TSC normally allows higher recoveries than mCP. TSC produces fewer false-positive results than mCP; however, it does produce more false-negatives. Two newer methods have substantial potential, CP Chromo Select agar, which allows better recoveries and greater specificity than mCP, and the Fung double tube method, which creates anaerobic conditions and allows enumeration of colonies in tubes in 5-6 hours. Aerobic spores are not associated with fecal contamination but they can be surrogates for environmentally stable pathogens in monitoring water for treatment efficacy; Bacillus cereus spores are normally measured on nutrient agar by the MF method.
BCL3 expression promotes resistance to alkylating chemotherapy in gliomas

The response of patients with gliomas to alkylating chemotherapy is heterogeneous. However, there are currently no universally accepted predictors of patient response to these agents. We identify the nuclear factor κB (NF-κB) co-regulator B cell CLL/lymphoma 3 (BCL-3) as an independent predictor of response to temozolomide (TMZ) treatment. In glioma patients with tumors that have a methylated O6-methylguanine DNA methyltransferase (MGMT) promoter, high BCL-3 expression was associated with a poor response to TMZ. Mechanistically, BCL-3 promoted a more malignant phenotype by inducing an epithelial-to-mesenchymal transition in glioblastomas through promoter-specific NF-κB dimer exchange. Carbonic anhydrase II (CAII) was identified as a downstream factor promoting BCL-3–mediated resistance to chemotherapy. Experiments in glioma xenograft mouse models demonstrated that the CAII inhibitor acetazolamide enhanced survival of TMZ-treated animals. Our data suggest that BCL-3 might be a useful indicator of glioma response to alkylating chemotherapy and that acetazolamide might be repurposed as a chemosensitizer for treating TMZ-resistant gliomas.
An Overview of Unconventional (Fraudulent) Treatments of Cancer

Cancer fear runs rampant, and it is not polite to even question the so-called facts. Frequent news stories, television documentaries and magazine features often refer to an “epidemic” of cancer as the price for the benefits of modern civilization. Today everyone seems to believe that the additives, synthetic colorings, flavorings and hormones in food, the water we drink, the polluted air we breathe, cigarettes, hair dyes, saccharine, cyclamates, etc. etc. — you name it — everything is suspected, proven, or feared as a cancer-causing agent, a carcinogen. And so it is popular to believe that modern technology has made us victims of adulterated, over-processed food, and filled our workplaces and total environment with cancer-causing chemicals.
Effect of Type of Peat Casing Layer and the Addition of Calcium Chloride to Watering Treatments on Quality and Shelf-Life of Fresh Mushrooms

Abstract Beelman, R. B., Quinn, J. J., Okereke, A., Schisler, L. C, Muthersbaugh, H. R. and Evensen, K. 1986. Effect of peat casing layer and the addition of calcium chloride to watering treatments on quality and shelf life of fresh mushrooms. Cultivated mushrooms, Agaricus bisporus (PSU # 310 strain), were grown under the same conditions except for peat type (sphagnum vs Bonaparte) and the concentration of CaCl 2 added to water applied during cropping. Concentrations of CaCl 2 added to the water were 0. 000, 0. 011, 0. 055, 0. 110 and 0. 550%. The addition of increasing concentrations of CaCl 2 had a tendency to decrease yield, increase size and decrease moisture content of the mushrooms; these trends were significant when sphagnum peat was used but not with Bonaparte. In general, use of Bonaparte peat resulted in greater yield, smaller mushrooms and higher moisture and calcium content compared to sphagnum. Calciumn content of the mushrooms was not significantly increased by increased levels of CaCl 2 added to the water. Postharvest storage studies indicated that use of increasing concentrations of CaCl 2 in water did delay mushroom development as evidenced by cap opening and deterioration of external appearance. This effect was apparently more related to moisture content of mushrooms than rate of respiration and was speculated to be due to increased microbial growth associated with mushroom with higher moisture.
Symmetric Geoodular Spaces

10.1. Definition. [L.V. Sabinin 81, 91b] a partial left odular (diodular) space M is said to be partially symmetric if sx = (—l)x, x ∈M, is a partial automorphism of M. Note that s x,y = (Lxy)−1 x, see Chapter 1. a left (p, k)-canonical partial odular (diodular) space is said to be locally symmetric if sx = (—l)x, x ∈ M, is a Cr-smooth local automorphism of M. It is called a globally symmetric space if for any point x ∈ M there exists a global automorphism sx which coincides with sx = (—1)x whenever the latter map is defined.
Tithing and Bankruptcy

In 1998 Congress passed the Religious Liberty and Charitable Donation Protection Act. At the expense of creditors, the Act protects the rights of debtors to make religious and charitable contributions and the ability of religious and charitable institutions to keep the donations. This Article interprets the results of ground-breaking empirical research into the effects of the Act in its first two years of existence. Although some outcomes are predictable, others are quite surprising. For example, by building a discretionary cushion into the Chapter 13 debtor's budget, the Act might increase the rate at which Chapter 13 payment plans are completed.
The mutual interface scattering cross section

Scattering by the ocean surface or seafloor is often characterized by the interface scattering strength, the decibel equivalent of the scattering cross section per unit solid angle per unit area (referred to subsequently as the interface scattering cross section for brevity). The scattering cross section is a statistical second moment that allows modeling of the mean-square scattered pressure. Use of the interface scattering cross section requires that the incident field can be approximated by a single plane wave, a condition that is not satisfied when the interface is ensonified in the near field of a large array, as in synthetic-aperture sonar (SAS), or when multipath propagation is important as in modeling reverberation. The mutual cross section introduced in this presentation is a generalization of the interface scattering cross section to include ensonification by multiple plane waves. Examples of application to SAS and the ocean waveguide will be shown. In the latter case, it is seen that the mutual cross section can model peaks in the reverberation time series that occur as a result of multipath convergence on the interface. (Work supported by ONR.)Scattering by the ocean surface or seafloor is often characterized by the interface scattering strength, the decibel equivalent of the scattering cross section per unit solid angle per unit area (referred to subsequently as the interface scattering cross section for brevity). The scattering cross section is a statistical second moment that allows modeling of the mean-square scattered pressure. Use of the interface scattering cross section requires that the incident field can be approximated by a single plane wave, a condition that is not satisfied when the interface is ensonified in the near field of a large array, as in synthetic-aperture sonar (SAS), or when multipath propagation is important as in modeling reverberation. The mutual cross section introduced in this presentation is a generalization of the interface scattering cross section to include ensonification by multiple plane waves. Examples of application to SAS and the ocean waveguide will be shown. In the latter case, it is seen that the mutual...
Azaallyl-derived ring formation via redox coupling in first row transition metals

Abstract The reductive coupling of a chelated diimine ligand, Me2C(CH NCH2(2-py))2 (dmp(PM)2), by (TMEDA)TiCl2 afforded a Ti(IV) species containing a cyclopropane ring, Me2cPr(cis-2,3-NCH2(2-py))2TiCl2 (1). Dimeric [{Me2C(CH2N CH(2-py)(CH2(µ-N)CH2(2-py)}Mg]2 (3) was generated in the magnesium reduction of Me2C(CH2N CH(2-py))2 (dmp(PI)2) as its reduction incurred HAT. A di-azaallyl precursor was used to generate 7-membered ring chelates [{DBM(PI− )(PI2−)}CrIII]2 (4) and [{DBM(PI)(PI′)}Fe]2 (5). Structural studies of 1, 3 and 4 are included, as are electronic assessments of the reductive coupling to afford 1, and the paramagnetism of 3.
Chapter 13 Conglomerate Mergers and Acquisitions

This chapter focuses on the legally-relevant economic effects and legality of conglomerate mergers and acquisitions (hereinafter conglomerate mergers) under U.S. antitrust law and E.C./E.U. competition law. Conglomerate mergers are mergers that are neither horizontal nor vertical—i.e., are mergers between MPs that (1) are not equal-best-placed, respectively best-placed and second-placed, or respectively best-placed and well-enough-placed to affect the oligopolistic margins that a best-placed MP would find ex ante profitable to attempt to contrive and (2) are not in a supplier-supplied relationship to each other. Three types of conglomerate mergers can be distinguished:
Ambulatory surgery center payment models: current trends and future directions

The total health care expenditure in 2017 was $3.5 trillion dollars—an increase of 3.9% over the previous year and up from $2.6 trillion in 2010 (1,2). With these numbers predicted to grow at an annual rate of 5.5%, the Centers for Medicare and Medicaid Services (CMS) have been piloting new programs and payment systems to reduce costs and incentivize physicians and healthcare organizations to provide cost-effective care (2-4). In 1983, medicare introduced the inpatient prospective payment system in the hopes that hospitals and physicians would start to provide more patient care in the outpatient setting. Since then, the number of surgeries performed as outpatient procedures has increased dramatically from 3.7 million in 1981 to over 32.0 million in 2005 (5). In 2017, more than 50% of all outpatient surgeries were conducted in ambulatory surgery centers (ASCs)—a market which is projected to reach $40 billion in 2020 (6).
Janus Kinase Inhibitors

To control gene expression, cytokines and other extracellular molecules utilize the Janus kinase (JAK) and signal transducers and activators of transcription (STAT). Dysregulation of the JAK-STAT pathway has been implicated in a myriad of inflammatory and hematologic disorders. Targeted JAK inhibitors (Jakinibs) are already in clinical use for rheumatoid arthritis, myelofibrosis, and polycythemia vera. These recent developments have spurred further interest in using Jakinibs to treat other cutaneous autoinflammatory disorders such as psoriasis, atopic dermatitis, and alopecia areata. While only two Jakinibs are currently FDA approved for human use, many new agents in this class are under investigation. Preliminary findings are promising, showing that Jakinibs have the potential to become a significant alternative medication class for cutaneous autoinflammatory disorders. This review will present an overview of this novel drug class, the mechanics of the signaling pathway, and clinical data in support of its therapeutic benefit.
Long-term outcomes in patients with obesity and renal disease after sleeve gastrectomy.

Morbid obesity is a barrier to kidney transplant in patients with end-stage renal disease (ESRD). Laparoscopic sleeve gastrectomy (SG) is an increasingly considered intervention, but the safety and long-term outcomes are uncertain. We reviewed prospectively collected data on patients with ESRD and chronic kidney disease (CKD) undergoing SG from 2011 to 2018. There were 198 patients with ESRD and 45 patients with CKD (stages 1-4) who met National Institutes of Health guidelines for bariatric surgery and underwent SG; 72% and 48% achieved a body mass index of ≤ 40 and ≤ 35 kg/m2 , respectively. The mean percentages of total weight loss and excess weight loss were 18.9 ± 10.8% and 38.2 ± 20.3%, respectively. SG reduced hypertension (85.8% vs 52.1%), decreased antihypertensive medication use (1.6 vs 1.0) (P < .01 each), and reduced incidence of diabetes (59.6% vs 32.5%, P < .01). Of the 71 patients with ESRD who achieved a body mass index of ≤ 40 kg/m2 , 45 were waitlisted and received a kidney transplant, whereas 10 remain on the waitlist. Mortality rate after SG was 1.8 per 100 patient-years, compared with 7.3 for non-SG. Patients with stage 3a or 3b CKD exhibited improved glomerular filtration rate (43.5 vs 58.4 mL/min, P = .01). In conclusion, SG safely improves transplant candidacy while providing significant, sustainable effects on weight loss, reducing medical comorbidities, and possibly improving renal function in stage 3 patients.
The Seasonal Cycle of Upper-Ocean Mixing at 8°N in the Bay of Bengal

AbstractWe describe the seasonal cycle of mixing in the top 30–100 m of the Bay of Bengal as observed by moored mixing meters (χpods) deployed along 8°N between 85.5° and 88.5°E in 2014 and 2015. A...
Biomechanical Computed Tomography analysis (BCT) for clinical assessment of osteoporosis

The surgeon general of the USA defines osteoporosis as "a skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture." Measuring bone strength, Biomechanical Computed Tomography analysis (BCT), namely, finite element analysis of a patient's clinical-resolution computed tomography (CT) scan, is now available in the USA as a Medicare screening benefit for osteoporosis diagnostic testing. Helping to address under-diagnosis of osteoporosis, BCT can be applied "opportunistically" to most existing CT scans that include the spine or hip regions and were previously obtained for an unrelated medical indication. For the BCT test, no modifications are required to standard clinical CT imaging protocols. The analysis provides measurements of bone strength as well as a dual-energy X-ray absorptiometry (DXA)-equivalent bone mineral density (BMD) T-score at the hip and a volumetric BMD of trabecular bone at the spine. Based on both the bone strength and BMD measurements, a physician can identify osteoporosis and assess fracture risk (high, increased, not increased), without needing confirmation by DXA. To help introduce BCT to clinicians and health care professionals, we describe in this review the currently available clinical implementation of the test (VirtuOst), its application for managing patients, and the underlying supporting evidence; we also discuss its main limitations and how its results can be interpreted clinically. Together, this body of evidence supports BCT as an accurate and convenient diagnostic test for osteoporosis in both sexes, particularly when used opportunistically for patients already with CT. Biomechanical Computed Tomography analysis (BCT) uses a patient's CT scan to measure both bone strength and bone mineral density at the hip or spine. Performing at least as well as DXA for both diagnosing osteoporosis and assessing fracture risk, BCT is particularly well-suited to "opportunistic" use for the patient without a recent DXA who is undergoing or has previously undergone CT testing (including hip or spine regions) for an unrelated medical condition.
Right Atrial Thrombus in a Patient With COVID-19

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic. Evidence suggests a strong association between COVID-19 and pro-thrombotic states. We report our experience in managing a patient with COVID-19 complicated by a right atrial thrombus. We highlight the successful use of half-dose anticoagulation in the treatment of right atrial thrombus in a patient with COVID-19. To our knowledge, this is a first reported case of right atrial thrombus in a COVID-19 patient who was treated successfully with half-dose anticoagulation.
Examining Social Determinants of Health in Childhood Asthma Management.

Purpose Social determinants of health (SDoHs) influence how well a family manages children's asthma. The aim of this study was to examine the influence of SDoHs on family asthma management. Design A cross-sectional exploratory study was conducted with 292 children in grades 2 to 5 who had current asthma and their parents to examine associations between SDoHs and the families' asthma management, quality of life, and healthcare utilization. Methods Data were collected from both child and parent. Social determinants of health include the child's race/ethnic group, age, gender, and asthma severity and the family's socioeconomic status and language spoken in the home, and the school was the community-level variable. Parents and children completed asthma management and quality-of-life scales and parents reported on the children's emergency department visits and hospitalizations for asthma. Results Worse quality of life was reported by families with lower socioeconomic status and African American children. Asthma severity was associated with parents' asthma management but not children's asthma self-management. Families who spoke Spanish at home had the lowest socioeconomic status yet performed significantly more asthma management than English-speaking families. Conclusions The findings highlight factors the clinical nurse specialist should address in educational interventions.
Distinguishing distress from disorder: Black-white patterns in the determinants of and links between depressive symptoms and major depression.

Abstract Background Black Americans experience higher levels of psychological distress but similar or lower rates of psychiatric disorders than Whites. This study aimed to clarify discordant distress-disorder patterns by distinguishing the sociodemographic and psychosocial risks (e.g. socioeconomic status, stress exposure) associated with distress and disorder among Blacks and Whites and by evaluating the distress-disorder linkage within and across racial groups. Methods Secondary analysis of the Nashville Stress and Health Study (n=1,246), a cross-sectional community epidemiologic survey of Blacks and Whites in Nashville, Tennessee, was used to assess distress (CES-D depressive symptoms scale) and major depressive disorder (MDD; based on the CIDI). Race-stratified models assessed correlates of each outcome and the distress-disorder association among racial groups; interactions considered potential moderating effects of SES and stress exposure on this association within each group. Results Distress and disorder were differentially shaped by risk factors and varied by race. Increases in distress were associated with greater disorder risk among both racial groups. However, a significant interaction between distress and stress exposure indicated that odds of “chronic” MDD (lifetime and past-year prevalence) depends on level of stress exposure for Blacks only. Conclusions This study informs the “race paradox in mental health” by demonstrating that distress and disorder have etiologies that vary within and across racial groups, and the distress-disorder association depends on stress exposure among Black Americans. This has implications for public health practice, as pinpointing the protective mechanisms underlying Blacks’ low disorder rates despite elevated risk exposure may inform more effective avenues of intervention.
WINDOW DRESSING IN BOND MUTUAL FUNDS

We examine portfolio credit quality holding and daily return patterns in a large sample of bond mutual funds and document evidence of window dressing. Using portfolio credit quality holdings data, we find that bond funds on average hold significantly more government bonds during disclosure than nondisclosure, presumably to present a safer portfolio to shareholders. Multiple-index market models estimated with daily returns data corroborate these findings. We detect differences in factor loadings on days surrounding disclosure dates that indicate systematic tilting of the portfolio toward higher quality instruments.
Female Sexual Dysfunction After Pelvic Fracture: A Comprehensive Review of the Literature.

Abstract Background Female sexual dysfunction (FSD) after pelvic fracture (PFx) has garnered little attention in the urology literature. Aim To review and summarize the current evidence regarding female PFx-related sexual function. Methods We performed a systematic review in accordance with PRISMA guidelines, including PubMed, EMBASE, and MEDLINE. We included only English-language manuscripts and abstracts with sufficient data for inclusion. We used the search terms “female sexual dysfunction AND pelvic fracture,” “sexual dysfunction AND pelvic fracture,” and “female pelvic fracture AND sexual dysfunction.” A total of 177 articles were identified; 41 abstracts were reviewed; of which, 19 manuscripts were reviewed. Fifteen met inclusion criteria for analysis. Outcomes The main outcome measures of this study are rates and types of female sexual dysfunction after pelvic fracture. Results FSD is prevalent after PFx, with reported rates between 25% and 62%. Three studies used the validated Female Sexual Function Index. The other 12 used non-validated questionnaires or adapted quality-of-life questionnaires with specific questions regarding FSD. The most common complaints include difficulty with intercourse, dyspareunia, orgasmic dysfunction, genitourinary pain, decreased interest in intercourse, decreased satisfaction with intercourse, and pelvic floor dysfunction. Only 1 study addressed resolution of dysfunction (30 of 98 patients [30.4%]). Clinical Implications FSD is prevalent and an under-recognized sequela of pelvic fracture. This requires future prospective study to better characterize sexual dysfunction and identify effective treatments in trauma survivors. Strength and Limitations To Increase awareness of FSD after pelvic trauma and the impact on the quality of life in trauma survivors. The current literature is limited by a lack of standardized assessment of FSD, limited follow-up, and minimal discussion of treatment options, in addition to the inherent bias of retrospective studies. Conclusions FSD after traumatic PFx is not uncommon, occurs mostly in young women, and can be morbid. FSD after PFx is underreported in the urology literature. Thus, all female PFx patients should be screened for FSD by validated questionnaires. The published literature offers little knowledge as to the epidemiology, evaluation, definition, and potential treatments of FSD after PFx. Prospective studies are needed to better understand female sexual function in trauma survivors and the potential methods for prevention and rehabilitation, all within the context of a multidisciplinary approach. Walton AB, Leinwand GZ, Raheem O, et al. Female Sexual Dysfunction After Pelvic Fracture: A Comprehensive Review of the Literature. J Sex Med 2021;18:467–473.
Connect through PLAY: a randomized-controlled trial in afterschool programs to increase adolescents' physical activity.

The current study is a randomized controlled trial to test a novel 10-week climate-based intervention within pre-existing afterschool programs, designed to increase moderate-to-vigorous physical activity (MVPA) in underserved (low-income, minority status) middle school youth by addressing youth social developmental needs. Participants (n = 167; 56% female; 62% Black; 50% overweight/obese) enrolled in 6 middle schools were randomized to either the Connect through PLAY intervention or a wait-list control. Process evaluation measures (i.e., observations of external evaluators; staff surveys) indicated that essential elements were implemented with fidelity, and staff endorsed implementation ease/feasibility and acceptability. Regression analysis demonstrated that participation in the intervention (vs. control) was associated with an increase of 8.17 min of daily accelerometry-measured MVPA (56 min of additional weekly MVPA) at post-intervention controlling for baseline MVPA, school, gender, and weight status. The results provide support for social-motivational climate-based interventions for increasing MVPA in underserved youth that can inform future school-based health initiatives. Trial Registration: NCT03850821: https://clinicaltrials.gov/ct2/show/study/NCT03850821?term=NCT03850821&rank=1
Outcomes of Direct Oral Anticoagulants in Atrial Fibrillation Patients Across Different Body Mass Index Categories.

Abstract Objectives This study sought to evaluate direct oral anticoagulant (DOAC) outcomes (vs. warfarin) in patients with atrial fibrillation (AF) across body mass index (BMI) categories, including ≥40 and Background Clinical trials have not systematically tested the fixed DOAC dosing in underweight and morbidly obese patients. Methods We retrospectively included consecutive patients with nonvalvular AF with CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75, Diabetes, Stroke/transient ischemic attack/systemic thromboembolism, Vascular disease, Age 65-74, Sex) of ≥1 receiving OACs at our hospital system (2010–2018). Patients were categorized into groups 1 (underweight: BMI of Results We included 36,094 patients with a mean age of 74 ± 11 years and CHA2DS2-VASc of 3.4 ± 1.5. Groups 1 through 4 included 455 (1.3%), 18,339 (50.8%), 13,376 (37.1%), and 3,924 (10.9%) patients, respectively. DOAC use ranged from 49% to 56%. At 3.8 follow-up years, with multivariable Cox regression, DOACs (vs. warfarin) were associated with lower risk of ischemic stroke, bleeding, and mortality across all BMI groups, with hazard ratios (HRs) of 0.73 (95% confidence interval [CI]: 0.63 to 0.85), 0.75 (95% CI: 0.64 to 0.87), 0.75 (95% CI: 0.65 to 0.88), and 0.75 (95% CI: 0.64 to 0.87) (p Conclusions In patients with nonvalvular AF, DOACs compared to warfarin were associated with better safety and effectiveness across all BMI categories, including underweight and morbidly obese patients.
Utilizing Vocational Rehabilitation to Support Post-School Transition for Students With Learning Disabilities:

In addition to supporting the academic goals of students with learning disabilities, secondary special education teachers are tasked with providing services designed to improve post-school outcomes...