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Given the recent focus on powered haulage incidents within the US mining sector, an appraisal of collision avoidance/warning systems (CXSs) through the lens of the available research literature is timely. This paper describes a rapid review that identifies, characterizes, and classifies the research literature to evaluate the maturity of CXS technology through the application of a Technology Readiness Assessment. Systematic search methods were applied to three electronic databases, and relevant articles were identified through the application of inclusion and exclusion criteria. Sixty-four articles from 2000 to 2020 met these criteria and were categorized into seven CXS technology categories. Review and assessment of the articles indicates that much of the literature-based evidence for CXS technology lies within lower levels of maturity (i.e., components and prototypes tested under laboratory conditions and in relevant environments). However, less evidence exists for CXS technology at higher levels of maturity (i.e., complete systems evaluated within operational environments) despite the existence of commercial products in the marketplace. This lack of evidence at higher maturity levels within the scientific literature highlights the need for systematic peer-reviewed research to evaluate the performance of CXS technologies and demonstrate the efficacy of prototypes or commercial products, which could be fostered by more collaboration between academia, research institutions, manufacturers, and mining companies. Additionally, results of the review reveal that most of the literature relevant to CXS technologies is focused on vehicle-to-vehicle interactions. However, this contrasts with haul truck fatal accident statistics that indicate that most haul truck fatal accidents are due to vehicle-to-environment interactions (e.g., traveling through a berm). Lastly, the relatively small amount of literature and segmented nature of the included studies suggests that there is a need for incremental progress or more stepwise research that would facilitate the improvement of CXS technologies over time. This progression over time could be achieved through continued long-term interest and support for CXS technology research.

Women diagnosed with breast cancer undergoing chemotherapy experience cognitive impairment, symptoms of anxiety and depression, and physical side effects including disruption in the diversity and community composition of the gut microbiome. To date, there is limited research exploring the associations among these specific challenges. The present cross-sectional study explored the associations of self-reported cognitive functioning, depression, and anxiety symptoms, and gut microbiome diversity and community composition in women who were diagnosed with and undergoing chemotherapy treatment for breast cancer (BC) compared to cancer-free healthy controls (HC). The BC group displayed higher rates of cognitive dysfunction (p p Akkermansia in BC compared to HC (p p

Aims/hypothesis We aimed to determine the association of depression with dementia risk in people with type 2 diabetes, and to explore the possible mediating role of inflammation in this relationship. Methods The Edinburgh Type 2 Diabetes Study is a prospective cohort of 1066 men and women with type 2 diabetes aged 60–75 years. Cox proportional hazards regression analysis was used to investigate the association between depression, assessed at baseline, and subsequent risk of dementia over 10 years. Depression was defined using the Hospital Anxiety and Depression Scale, while incident dementia was defined using medical records, prescription data and death certificates. The potential mediating effect of systemic inflammation was assessed by adjusting models for a generalised inflammation factor, derived from four inflammatory markers measured at baseline (C-reactive protein, IL-6, TNF-α and fibrinogen), and carrying out an exploratory mediation analysis. Results Dementia developed in 105 participants over a median follow-up of 10.6 years. After adjusting for age and sex, depression was associated with over a 2.5-fold increase in risk of dementia (HR 2.59 [95% CI 1.62, 4.15]). Additional adjustment for the generalised inflammation factor and other covariates did not attenuate the size of association between depression and incident dementia and mediation analysis showed that it was not a mediator. Adjusted logistic regression models showed cross-sectional associations of C-reactive protein and IL-6 with depression. Conclusions/interpretation Depression is an important risk factor for dementia in people with type 2 diabetes. Some inflammatory markers were associated with depression, but systemic inflammation does not appear to mediate the relationship between depression and dementia.

Characterize prevalence of intimate partner violence (IPV) among breast and cervical survivors receiving care in an urban safety-net healthcare system; Examine the relationship between IPV and clinical characteristics, receipt of cancer treatment, and guideline-recommended survivorship care. From 2010 to 2017, breast and cervical cancer survivors were identified and recruited from a large, integrated, safety-net hospital system. Electronic health records (EHR; to measure survivorship care), cancer registry (to measure clinical characteristics), and patient telephone surveys (to measure IPV) were triangulated among 312 survivors. Bivariate and multivariable models assessed the relationship between victimization and clinical characteristics, cancer treatment, and guideline-recommended survivorship care. Among the 312 participants, 54% identified as IPV+. Among breast cancer, IPV+ cancer participants were twice more likely to develop estrogen receptor negative ER- and/or progesterone receptor negative PR- tumor receptors compared with IPV- cancer participants (AOR = 2.31; 95% CI, 1.20, 4.44). IPV+ breast cancer participants were less likely to have surgery and less likely to have hormone therapy as a first course of treatment compared with IPV- participants. There was no relationship between IPV and adherence to guideline-recommended cancer survivorship care. This study expands our current knowledge on how victimization, and specifically IPV, impact health among specialty care. Future research should determine the feasibility of implementing Trauma-Informed Care in oncology practices to better optimize care. At integrated hospital systems, IPV+ cancer participants should utilize social workers, within their oncology clinics, to connect to victim services.

Background The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the practice of endoscopy, but characteristics of COVID patients undergoing endoscopy have not been adequately described. Aims To compare findings, clinical outcomes, and patient characteristics of endoscopies performed during the pandemic in patients with and without COVID-19. Methods This was a retrospective multicenter study of adult endoscopies at six academic hospitals in New York between March 16 and April 30, 2020. Patient and procedure characteristics including age, sex, indication, findings, interventions, and outcomes were compared in patients testing positive, negative, or untested for COVID-19. Results Six hundred and five endoscopies were performed on 545 patients during the study period. There were 84 (13.9%), 255 (42.2%), and 266 (44.0%) procedures on COVID-positive, negative, and untested patients, respectively. COVID patients were more likely to undergo endoscopy for gastrointestinal bleeding or gastrostomy tube placement, and COVID patients with gastrointestinal bleeding more often required hemostatic interventions on multivariable logistic regression. COVID patients had increased length of stay, intensive care unit admission, and intubation rate. Twenty-seven of 521 patients (5.2%) with no or negative COVID testing prior to endoscopy later tested positive, a median of 13.5 days post-procedure. Conclusions Endoscopies in COVID patients were more likely to require interventions, due either to more severe illness or a higher threshold to perform endoscopy. A significant number of patients endoscoped without testing were subsequently found to be COVID-positive. Gastroenterologists in areas affected by the pandemic must adapt to changing patterns of endoscopy practice and ensure pre-endoscopy COVID testing. Electronic supplementary material The online version of this article (10.1007/s10620-020-06593-9) contains supplementary material, which is available to authorized users.

In response to the landmark report “Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering,” the NIH Office of Research on Women’s Health issued a request for applications that funded 14 R01 grants to investigate causal factors to career success for women in STEM. Following completion of the 4-year grants, the grant PIs formed a grassroots collaborative, the Research Partnership on Women in Science Careers. To summarize the work of the Research Partnership, which resulted in over 100 publications. We developed six themes to organize the publications, with a “Best Practices” for each theme at the end of each section: Barriers to Career Advancement; Mentoring, Coaching, and Sponsorship; Career Flexibility and Work-Life Balance; Pathways to Leadership; Compensation Equity; and Advocating for Change and Stakeholder Engagement. Women still contend with sexual harassment, stereotype threat, a disproportionate burden of family responsibilities, a lack of parity in compensation and resource allocation, and implicit bias. Strategies to address these barriers using the Bronfenbrenner ecological model at the individual, interpersonal, institutional, academic community, and policy levels include effective mentoring and coaching, having a strong publication record, addressing prescriptive gender norms, positive counter-stereotype imaging, career development training, networking, and external career programs such as the AAMC Early and Mid-Career Programs and Executive Leadership in Academic Medicine (ELAM). Cultural transformation is needed to address the barriers to career advancement for women. Implementing the best practices noted of the work of the Research Partnership can help to achieve this goal.

While evidence of the mental health effects of bullying has amassed in recent years, less scholarship explores the dynamics of bullying as it manifests in culturally diverse environments. The purpose of this study was to determine how contextual factors influence participation in bullying behaviors in a sample of urban, low-income, ethnic minority students. Using structural equation modeling, researchers tested whether social competence mediates the relationship between (a) parents’ messages about aggression, (b) school belonging, (c) personal control and the outcome of bullying. Results of the study support evidence for a direct relationship between parental messages and bullying, social skills and bullying, parental messages and social skills, and personal control and social skills. Findings also indicate an indirect relationship between personal control and bully perpetration. Implications and directions for future research on contextual factors associated with bullying are discussed.

Stents are used for palliating inoperable malignant bile duct hilar obstruction. It is not clear if bilateral stenting provides any advantage over unilateral stenting in these patients. Compare bilateral and unilateral stenting in malignant hilar obstruction.Studies using stents for palliation in patients with malignant hilar obstruction were selected.Articles were searched in MEDLINE, PubMed, Ovid journals, CINAH, International Pharmaceutical Abstracts, OLDMEDLINE, MEDLINE nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Two reviewers independently searched and extracted data. Any differences were resolved by mutual agreement.Pooled proportions were calculated using both the Mantel-Haenszel method (fixed effects model) and DerSimonian-Laird method (random effects model). The heterogeneity among studies was tested using Cochran's Q test based upon inverse variance weights. The initial search identified 1,640 reference articles, of which 169 were selected and reviewed. Thirteen studies (n = 340) for bilateral metallic stents, eight studies (n = 575) for unilateral metallic stents, eight studies (n = 367) for bilateral plastic stenting, and seven studies (n = 850) for unilateral plastic stenting which met the inclusion criteria were included in this analysis. Pooled data are shown in Tables 1 and 2. The pooled estimates by the fixed and random effect models were similar. The p for chi-squared heterogeneity for all the pooled accuracy estimates was0.10. Bilateral metal stenting seems to have lower odds of overall complications when compared to unilateral metallic stenting. Bilateral metal stents seem to have higher odds of lowering bilirubin than unilateral metal stents, but the 30-day mortality was no different. For metal stents, bilateral metal stents are superior in palliating symptoms due to hyperbilirubinemia. Unilateral plastic stenting seems to have similar odds of overall complications, cholangitis, and 30-day mortality when compared to bilateral plastic stenting for malignant hilar strictures. In patients with malignant hilar stricture, unilateral plastic stenting is comparable to bilateral plastic stenting for adverse events.

Biological degradation rates of six pharmaceuticals and personal care products were examined in soil from a land application site and in adjacent soil with no prior history of effluent exposure. Microbial degradation rates were compared over 2 weeks under standing water or saturated conditions and draining conditions after having been saturated for 3 days. Biological degradation of 17β-estradiol exhibited rapid rates of biological degradation under both saturated and draining conditions. Half-lives for 17β-estradiol ranged from 1.5 to 4 days; 66–97% was lost from the soils. Estriol showed a pattern of biological degradation in both saturated and draining conditions though the half-lives were longer (8.7–25.9 days) than those observed for 17β-estradiol. Twenty-eight percent to 73% of estriol was lost over the 14 days treatment period. Estrone and 17α-ethinylestradiol exhibited slower rates of biological transformation under saturated and draining conditions. Half-lives for estrone ranged between 27.5 and 56.8 days with loss of at most 21%. 17α-ethinylestradiol exhibited half-lives of 22.6–207 days. Half-life data for ibuprofen ranged from 30.4 to 1,706.4 days in this experiment. Losses of up to 17% were observed in draining soils. Triclosan loss was at most 10%, and half-lives were 70.9–398.8 days. In all cases, soils that were draining from saturated conditions exhibited faster degradation rates than soils that remained saturated. Prior exposure of the soil to effluent did not always result in higher biological degradation rates.

Biological degradation rates of estrogen compounds and common pharmaceutical and personal care products (PPCPs) were examined in soils with a long history of exposure to these compounds through wastewater effluent and in soil not previously exposed. Biological degradation rates over 14 days were compared under aerobic and anaerobic conditions. Estrogen compounds including estrone, 17β-estradiol, estriol, and 17α-ethinylestradiol exhibited rapid degradation by soil microorganisms in both aerobic and anaerobic conditions. Rapid degradation rates for estrone, estriol, and 17α-ethinylestradiol occurred in pre-exposed soil under aerobic conditions; half-lives calculated under these conditions were 0.6, 0.7, and 0.8 day, respectively. Unexposed soil showed similar or slightly longer half-lives than pre-exposed soil under aerobic conditions. The exception was 17β-estradiol; in all treatments, degradation in unexposed soil resulted in a shorter half-life (2.1 versus 2.3 days). Anaerobic soils exhibited high biological degradation of estrogens as well. Half-lives of all estrogens ranged from 0.7 to 6.3 days in anaerobic soils. Triclosan degraded faster under aerobic conditions with half-lives of 5.9 and 8.9 days in exposed and unexposed soil. Under anaerobic conditions, triclosan half-lives were 15.3 days in unexposed and 28.8 days in exposed soil. Ibuprofen showed the least propensity toward biological degradation than other chemicals tested. Biological degradation of ibuprofen was only observed in unexposed soil; a half-life of 41.2 days was determined under anaerobic conditions and 121.9 days under aerobic conditions. Interestingly, unexposed soil exhibited a greater ability under anaerobic conditions to biologically degrade tested compounds than previously exposed soil.

BACKGROUND Energized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals’ values with workplace experiences are linked to meaningfulness of work and productivity.

Unprecedented population growth and migration accompanied equally unprecedented land use and land cover change in Latin America during the latter decades of the twentieth century. Country-level data are examined with bivariate statistics to determine relationships between changes in population patterns and land use (agriculture and forest cover) from 1961 to 2001. In South America, large forest areas were eliminated during the period, while exceptionally high rates of forest clearing were ubiquitous in the Central America/Caribbean region. These environmental changes accompanied dissimilar initial population densities and different effects of population change on agriculture. While interacting with a host of political, socio-economic, and geographic processes, it appears that both Malthusian and Boserupian demographic processes were important drivers of deforestation. Given continued, though slowing, population growth, increased urban consumption, and future land use constraints, policy makers face myriad challenges in advancing sustainable agriculture-population dynamics in Latin America.

The development of techniques for imaging the molecular mediators of atherosclerosis is an area of great interest. The ability to image vascular phenotype will create new opportunities for assessing patient risk for aggressive disease at a very early stage and for choosing appropriate treatment strategies in late stages of disease. Ultrasound will undoubtedly play an important role in molecular imaging because of its practicality as a screening test and because intravascular imaging approaches are already widely used as an adjunct to angiographic procedures. This review focuses on the biophysical principles for the diverse set of tools used to evaluate atherosclerosis. General strategies for imaging vascular phenotype include: 1) assessment of histomorphometry by radiofrequency analysis of high-frequency ultrasound; 2) assessment of plaque content by vascular elastic properties; 3) detection of remodeling of the vasa vasorum by contrast ultrasound; and 4) imaging endothelial molecular phenotype with targeted ultrasound contrast agents.

Image Navigation and Registration (INR) is the engineering discipline that deals with the problem of calibrating and stabilizing image geometry, particularly in the domain of geostationary weather satellites where the term appears to have first come into use within the GOES program. GOES I-M represented the transition from spin-stabilization to three-axis control within the GOES program. A spin-stabilized spacecraft, with its large gyroscopic stiffness, is a stable platform for supporting challenging Earth-observation missions from geostationary orbit. Unfortunately, a telescope deployed on a spin-stabilized spacecraft looks towards the Earth only about 5% of the time. NASA and NOAA were justifiably concerned in the GOES I-M epoch by the idea of adapting what was essentially communications satellite attitude control technology to host precision-pointed scanning instruments and accorded special attention to these concerns within the GOES I-M specifications under the heading of INR. The technology and performance of INR systems have evolved considerably since then and the field has found application in a host of non-U.S. systems, including Meteosat, MTSAT, and COMS. This paper looks back at the field beginning with GOES I-M and traces its evolution through Meteosat Second Generation (MSG), MTSAT, COMS, and GOES N-P with advanced stellar-inertial attitude control. It concludes with an analysis of where the field is likely to be heading for the next generation systems, in particular, GOES-R and Meteosat Third Generation (MTG).

Since the 1970s, migration to the Amazon has led to a growing human presence and resulting dramatic changes in the physical landscape of the Northern Ecuadorian Amazon frontier, including considerable deforestation. Over time, a second demographic phenomenon has emerged with the children of the original migrants leaving settler farms to set out on their own. The vast majority have remained in the Amazon region, some contributing to further changes in land use via rural-rural migration to establish new farms and others to incipient urbanization. This paper uses longitudinal, multi-scale data on settler colonists between 1990 and 1999 to analyze rural-rural and rural-urban migration among second-generation colonists within the region. Following a description of migrants and settlers in terms of their individual, household and community characteristics, a multinomial discrete-time hazard model is used to estimate the determinants of out-migration of the second generation settlers to both urban and rural areas. We find significant differences in the determinants of migration to the two types of destinations in personal characteristics, human capital endowments, stage of farm and household lifecycles, migration networks, and access to community resources and infrastructure. The paper concludes with a discussion of policy implications of migrants' choice of rural versus urban destinations.

This paper employs cross-tabular analysis, and multivariate and logistic regression to explore demographic, political-economic, socioeconomic, and ecological patterns of farm households and land use outcomes in an emergent agricultural frontier: the Sierra de Lacandon National Park (SLNP)-a core conservation zone of the Maya Biosphere Reserve (MBR), Peten, Guatemala. Data were obtained from a 1998 probability sample of 241 farm households, the first large detailed household land use survey in Guatemala’s Selva Maya-the largest lowland tropical forest in Central America. Virtually all settler households were poor maize farmers who colonized the SLNP in search of land for subsistence. While they faced similar ecological and economic conditions, land use strategies and patterns of forest clearing varied with demographic, household, and farm characteristics. Findings support and refute elements from previous frontier land use theory and offer policy implications for conservation and development initiatives in the Maya Forest specifically, and in tropical agricultural frontiers in general.

This case study examines the link between marine resource management, and the universal contraceptive use among married couples in the lobster- fishing village of Punta Allen, located in the Sian Ka’an Biosphere Reserve, Quintana Roo, Mexico. Several reasons appear to contribute to small desired and actual family sizes. Some of these include a medical clinic staff effective in promoting family planning, cooperative and private resource ownership, changing cultural attitudes, geographical limitations to population and economic growth, and a desire to conserve the environment for aesthetic and economic motives. Lastly, families desired to preserve a sustained balance between benefiting from lobster harvests today and safeguarding this marine resource for their children in the future.

This study tests four hypotheses related to forest clearing over time in Ecuador’s northern Amazon: (1) a larger increase in population over time on a farm (finca) leads to more deforestation; (2) rates of forest clearing surrounding four primary reference communities differ (spatial heterogeneity); (3) fincas farther from towns/communities experience lower rates of forest clearing over time; and (4) forest clearing differs by finca settlement cohort, viz., by year of establishment of the finca. In this paper, we examine the relationship between forest clearing and key variables over time, and compare three statistical models—OLS, random effects, and spatial regression—to test hypotheses. Descriptive analyses indicate that 7–15% of forest area was cleared on fincas between 1990 and 1999; that more recently established fincas experienced more rapid forest clearing; and that population size and forest clearing are both related to distance from a major community. Controlling for key variables, model results indicate that an increase in population size is significantly related to more forest clearing; rates of forest clearing around the four major communities are not significantly different; distances separating fincas and communities are not significantly related to deforestation; and deforestation rates are higher among more recently established fincas. Key policy implications include the importance of reducing population growth and momentum through measures such as improving information about and provision of family planning services; increasing the low level of girls’ education to delay and reduce fertility; and expanding credit and agricultural extension services to increase agricultural intensification.

A Fourier Transform Infrared Spectrometer (FTS) was used to obtain the transmission spectra of candidate materials for use as infrared (IR) filters in cryogenic receivers. The data cover the range from 50 cm−1 (∼1.5 THz), well below the peak of the 300 K black body spectrum, to 5000 cm−1 (∼150 THz), Z-cut quartz, Goretex, Zitex G and Zitex A, High Density Polyethylene (HDPE), Teflon (PTFE), Fluorogold and Black Polyethylene were measured. The relative effectiveness of each material as a filter is determined by integrating the transmission spectrum multiplied by the Planck distribution to obtain a normalized attenuation for the mid-IR band. Measurements at both room temperature and 8 K are compared.

This paper argues that improving the communication between landholders and ecologists will result in better conservation outcomes for ecosystem management on private land. It examines a case study of ecological research on frogs undertaken on private, agricultural land in south-eastern Australia. The paper questions the traditional separation of ecological science from landholders specifically and the public in general. In addressing this issue the authors wish to improve the relevance of ecology for landholders, raise the profile of social science for ecologists working on private land and examine the implications of improving ecologist – landholder relationships. For landholders, an improved understanding of the ecological context of their agricultural activities may lead to sustainability gains. For ecologists, a deeper appreciation for the social context of their ecological research provides an opportunity to see how their work is perceived and/or acted upon in practice. For both parties, a communicative relationship may minimise future need for ecosystem repair. Such an approach (for both landholders and ecologists) can lead to the break down of stereotypes and/or a greater appreciation of the others’ perspectives, constraints and values with respect to conservation on private land. In the productive discussions arising from conversations between landholders and ecologists, new approaches to sustainable land management and nature conservation may emerge.

Although vaginitis is a common outpatient problem, only 60% of patients can be diagnosed at the initial office visit of a primary care provider using the office procedures of pH testing, whiff tests, normal saline, and potassium hydroxide preps.To determine the most cost-effective diagnostic and treatment approach for the medical management of vaginitis.Decision and cost-effectiveness analyses.Healthy women with symptoms of vaginitis undiagnosed after an initial pelvic exam, wet mount preparations, pH, and the four criteria to diagnose bacterial vaginosis.General office practice.We evaluated 28 diagnostic strategies comprised of combinations of pH testing, vaginal cultures for yeast and Trichomonas vaginalis, Gram's stain for bacterial vaginosis, and DNA probes for Neisseria gonorrhoeae and Chlamydia. Data sources for the study were confined to English language literature.The outcome measures were symptom-days and costs.The least expensive strategy was to perform yeast culture, gonorrhoeae and Chlamydia probes at the initial visit, and Gram's stain and Trichomonas culture only when the vaginal pH exceeded 4.9 (330 dollars, 7.30 symptom days). Other strategies cost 8 dollars to 76 dollars more and increased duration of symptoms by up to 1.3 days. In probabilistic sensitivity analysis, this strategy was always the most effective strategy and was also least expensive 58% of the time.For patients with vaginitis symptoms undiagnosed by pelvic examination, wet mount preparations and related office tests, a comprehensive, pH-guided testing strategy at the initial office visit is less expensive and more effective than ordering tests sequentially.

What is the role of population in driving deforestation? This question was put forth as a discussion topic in the cyberseminar hosted by Population Environment Research Network (PERN) in Spring, 2003. Contributors from diverse backgrounds weighed in on the discussion, citing key factors in the population-deforestation nexus and suggesting further courses of action and research. Participants explored themes of their own choosing, with many coming to the forefront. Scale, time, and place-based effects were cited as areas in need of particular attention. Consumption patterns as the mechanism for spurring deforestation were discussed, drawing attention to the differential patterns associated with urban vs. rural demands on forest resources and land. The applicability of the IPAT formula and the influence of its component parts, affluence and technology, when operating in tandem with population, was debated. The relation of demographic factors to these pathways was critically examined. Institutional and governmental influence, such as infrastructure and policies affecting access and incentives, the valuation of resources, and institutional failures such as mismanagement and corruption emerged as a crucial set of factors. This article synthesizes the critical debates in the population-deforestation literature, makes suggestions for future paths of research, and discussed possible policy and direct action initiatives.

Risk factors for college male sexual aggression that were both theoretically and empirically based were tested using multivariate regression analyses. These included substance abuse patterns, pornography consumption, negative gender-based attitudes, and child sexual abuse experiences. Regression analyses indicated that some gender attitudes, pornography use, and alcohol abuse were significant predictors of perpetration of sexual violence. Although a number of men were sexually abused as children, this risk factor did not predict sexual aggression as an adult. Many men reported alcohol-related sexual coercion and held many rape-supportive attitudes and beliefs. These practices by college men contribute to the prorape cultures found on many campuses. Strategies are needed to identify and intervene with high-risk men to prevent sexual victimization of women in college.

Despite the need to recruit and retain minority faculty in academic medicine, little is known about the experiences of minority faculty, in particular their self-reported experience of racial and ethnic discrimination at their institutions.To determine the frequency of self-reported experience of racial/ethnic discrimination among faculty of U.S. medical schools, as well as associations with outcomes, such as career satisfaction, academic rank, and number of peer-reviewed publications.A 177-item self-administered mailed survey of U.S. medical school faculty.Twenty-four randomly selected medical schools in the contiguous United States.A random sample of 1,979 full-time faculty, stratified by medical school, specialty, graduation cohort, and gender.Frequency of self-reported experiences of racial/ethnic bias and discrimination.The response rate was 60%. Of 1,833 faculty eligible, 82% were non-Hispanic white, 10% underrepresented minority (URM), and 8% non-underrepresented minority (NURM). URM and NURM faculty were substantially more likely than majority faculty to perceive racial/ethnic bias in their academic environment (odds ratio [OR], 5.4; P.01 and OR, 2.6; P.01, respectively). Nearly half (48%) of URM and 26% of NURM reported experiencing racial/ethnic discrimination by a superior or colleague. Faculty with such reported experiences had lower career satisfaction scores than other faculty (P.01). However, they received comparable salaries, published comparable numbers of papers, and were similarly likely to have attained senior rank (full or associate professor).Many minority faculty report experiencing racial/ethnic bias in academic medicine and have lower career satisfaction than other faculty. Despite this, minority faculty who reported experiencing racial/ethnic discrimination achieved academic productivity similar to that of other faculty.

This paper examines potential differences in land use between Q'eqchi Maya and Ladino (Spanish speakers of mixed ancestry) farmers in a remote agricultural frontier in northern Peten, Guatemala. The research site, the Sierra de Lacandon National Park (SLNP), is a core conservation zone of Guatemala's Maya Biosphere Reserve (MBR). In recent years, much has been written about the dramatic process of colonization and deforestation in Peten, Guatemala's largest and northernmost department. Since the early 1980s a rapid rural transformation has occurred where once remote forested regions have been colonized by small farmers, and lands have been converted to maize fields and cattle pastures. Consequently, less than half of the original forest cover in the department remains. Although approximately half of Peten's rural settlers have been Q'eqchi Maya, their land use, and its subsequent impact on Petenero forests, has been little studied. Results suggest that despite heterogeneous land use systems in migrant origin areas, given similar physical and socio-economic conditions following settlement in this remote frontier, Q'eqchi and Ladino farmer land use is remarkably similar. Only a modest land use difference appears to exist between the two groups: Q'eqchi Maya appear to have more extensive swidden maize rotations while Ladinos dedicate more land to pasture.

The gene cluster required for paxilline biosynthesis in Penicillium paxilli contains two cytochrome P450 monooxygenase genes, paxP and paxQ. The primary sequences of both proteins are very similar to those of proposed cytochrome P450 monooxygenases from other filamentous fungi, and contain several conserved motifs, including that for a haem-binding site. Alignment of these sequences with mammalian and bacterial P450 enzymes of known 3-D structure predicts that there is also considerable conservation at the level of secondary structure. Deletion of paxP and paxQ results in mutant strains that accumulate paspaline and 13-desoxypaxilline, respectively. These results confirm that paxP and paxQ are essential for paxilline biosynthesis and that paspaline and 13-desoxypaxilline are the most likely substrates for the corresponding enzymes. Chemical complementation of paxilline biosynthesis in paxG (geranygeranyl diphosphate synthase) and paxP, but not paxQ, mutants by the external addition of 13-desoxypaxilline confirms that PaxG and PaxP precede PaxQ, and are functionally part of the same biosynthetic pathway. A pathway for the biosynthesis of paxilline is proposed on the basis of these and earlier results. Electrophysiological experiments demonstrated that 13-desoxypaxilline is a weak inhibitor of mammalian maxi-K channels (Ki=730 nM) compared to paxilline (Ki=30 nM), indicating that the C-13 OH group of paxilline is crucial for the biological activity of this tremorgenic mycotoxin. Paspaline is essentially inactive as a channel blocker, causing only slight inhibition at concentrations up to 1 microM.

The purpose of this study was to develop a breast cancer model in rats, in which myeloablative chemotherapy and syngeneic bone marrow transplantation (SBMT) could be evaluated systematically for therapeutic effect. The Wistar-Furth (WF) DMBA-4 breast cancer cell line transplanted into naive WF rats produced rapidly growing tumors that were lethal within 2 months. SBMT was performed following preparation with a regimen (Bu-Cy), consisting of busulfan 16 mg/kg by gastric gavage on days -3 and -2 followed by 250 mg/kg of cyclophosphamide i.p. on day -1. Marrow was prepared from the femurs of donors and infused i.v. into the recipient on day 0. In all, 15 rats treated with Bu-Cy without marrow died, while 22 of 25 transplanted rats survived. In total, 16 rats with measurable tumors showed tumor responses following transplantation, but tumors recurred and survival was minimally prolonged. Of nine rats transplanted before clinical tumors were detected, five became long-term survivors that resisted further tumor challenge. It was concluded that the DMBA-4 breast cancer in WF rats could serve to evaluate SBMT following myeloablative doses of chemotherapy at various tumor loads. At large tumor loads therapy was not curative, but at low tumor burdens cures were possible and resistance to subsequent tumor challenge was demonstrated. The model may be useful for further studies of stem cell infusion in rodent tumor systems.

We report the production of high power (20watts average, ∼ 1 Megawatt peak) broadbandTHz light based on coherent emission fromrelativistic electrons. Such sources areideal for imaging, for high power damagestudies and for studies of non-linearphenomena in this spectral range. Wedescribe the source, presenting theoreticalcalculations and their experimentalverification. For clarity we compare thissource with one based on ultrafast lasertechniques.

Infrared radiation from synchrotron storagerings serves as a high-brightness source fordiffraction-limited microspectroscopy inboth the mid- and far-infrared spectralranges. Mid-infrared absorption, due to localvibrational modes within complex molecules,is shown to be sensitive to small chemicalchanges associated with certain diseases.Farinfrared modes are believed to result from thefolding or twisting of larger, morecomplex molecules. The ability for thesynchrotron source to perform microscopy ata frequency of 1 THz is demonstrated.

Terahertz (THz) radiation, which lies in the far-infrared region, is at the interface of electronics and photonics. Narrow-band THz radiation can be produced by free-electron lasers and fast diodes. Broadband THz radiation can be produced by thermal sources and, more recently, by table-top laser-driven sources and by short electron bunches in accelerators, but so far only with low power. Here we report calculations and measurements that confirm the production of high-power broadband THz radiation from subpicosecond electron bunches in an accelerator. The average power is nearly 20 watts, several orders of magnitude higher than any existing source, which could enable various new applications. In particular, many materials have distinct absorptive and dispersive properties in this spectral range, so that THz imaging could reveal interesting features. For example, it would be possible to image the distribution of specific proteins or water in tissue, or buried metal layers in semiconductors; the present source would allow full-field, real-time capture of such images. High peak and average power THz sources are also critical in driving new nonlinear phenomena and for pump-probe studies of dynamical properties of materials.

Purpose. Satraplatin is an orally administered platinum complex that has demonstrated clinical activity and manageable toxicity in phase II trials. The presence of several different platinum-containing species and very little intact parent drug in the systemic circulation indicates extensive biotransformation of satraplatin in vivo. To investigate the basis for the biotransformation of satraplatin, studies were carried out into the stability of the drug in whole blood and various other biological fluids in vitro. Methods. Concentrations of satraplatin and platinum-containing biotransformation products in incubation fluids were measured using high-performance liquid chromatography-inductively coupled plasma mass spectrometry (HPLC-ICPMS). The fate of satraplatin-derived platinum in whole blood in vitro was determined by analysis of blood fractions for platinum by ICPMS. Results. In fresh human whole blood in vitro, satraplatin concentrations fell very rapidly, resulting in a half-life for the disappearance of the drug of only 6.3 min (95% CI, 5.9 to 6.7 min). After the addition of drug to red blood cells that had been prepared from whole blood and suspended in 0.9% NaCl, satraplatin also disappeared very rapidly. Satraplatin was much more stable in fresh human plasma (t1/2 5.3 h) and fully supplemented cell culture medium (t1/2 22 h). Two new platinum-containing species appeared on HPLC-ICPMS platinum chromatograms of methanol extracts of plasma after the addition of the drug to whole blood. Their identities were assigned as the platinum(II) complex known as JM118 and a platinated protein with similar electrophoretic mobility to that of serum albumin. During the incubation of satraplatin in blood, platinum associated with red blood cells at an accumulation half-life of 9.5 min (95% CI, 7.1 to 14.2 min). At equilibrium, 62% of the added platinum was associated with red blood cells in a form that was not exchangeable in methanol or 0.9% NaCl. Conclusions. The rapid disappearance of satraplatin from human blood in vitro depends upon the presence of red blood cells. Generation of JM118 and irreversibly bound membrane- and protein-associated platinum indicates that satraplatin undergoes rapid biotransformation in whole blood.

The identification of cis-sequences responsible for spatiotemporal patterns of gene expression often requires the functional analysis of large genomic regions. In this study a 100-kb zebrafish Hoxa-11b-lacZ reporter gene was constructed and expressed in transgenic mice. PAC clone 10-O19, containing a portion of the zebrafish HoxA-b cluster, was captured into the yeast-bacterial shuttle vector, pPAC-ResQ, by recombinogenic targeting. A lacZ reporter gene was then inserted in-frame into exon 1 of the zfHoxa-11b locus by a second round of recombinogenic targeting. Expression of the zfHoxa-11b-lacZ reporter gene in 10.5 d.p.f. transgenic mouse embryos was observed only in the posterior portion of the A-P axis, in the paraxial mesoderm, neural tube, and somites. These findings demonstrate the utility of recombinogenic targeting for the modification and expression of large inserts captured from P1/PAC clones.

Introduction: Current techniques for estimating catheter tip temperature in ablative therapy for cardiac arrhythmias rely on thermocouples or thermistors attached to or embedded in the tip electrode. These methods may reflect the electrode temperature rather than the tissue temperature during electrode cooling so that the highest temperature away from the ablation site may go undetected. A microwave radiometer is capable of detecting microwave radiation as a result of molecular motion. In this study, we evaluated microwave radiometric thermometry as a new technique to monitor temperature away from the electrode tip during ablative therapy utilizing a saline model. Methods and Results: A microwave radiometer antenna and fluoroptic thermometer were inserted in a test tube with circulating room temperature saline kept constant at 23.5°C while the surrounding saline bath was heated from 37°C to 70°C. For every degree rise in the warm saline bath placed either 5mm or 8mm from the radiometer antenna, the radiometer temperature changed 0.26°C and 0.14°C respectively while the fluoroptic temperature probe remained constant at 23.5°C. The radiometer temperature was highly correlated with the warm saline bath temperature (R2=0.997 for warm saline 5mm from the antenna, R2=0.991 for warm saline 8mm from the antenna). Conclusions: Microwave radiometry can estimate distant temperatures by detecting microwave electromagnetic radiation. The sensitivity of the microwave radiometer is also distance-dependent. The microwave radiometer thus serves as a promising instrument for monitoring temperatures at depth away from the catheter-electrode tip in ablative therapy for cardiac arrhythmias.

We review the properties of infrared synchrotron radiation and particularly those of the beamlines at the NSLS, Brookhaven National Laboratory. We show how this unique, pulsed broadband source with its 1000-fold brightness advantage over thermal sources has been utilized for research programs in surface science, solid-state physics and microscopy and discuss plans for 5 new beamlines at the NSLS.

This paper presents an analysis of conversion of natural habitat to human use on a global scale. Human disturbance of natural systems is classified in a three-category system and ranked using a Habitat Index based on remaining undisturbed and partially disturbed land. Data is analysed by biome and biogeographic province, allowing identification of the biomes and provinces which have been the most impacted by human activity. Temperate biomes are found to be generally more disturbed than tropical biomes. Four of the top five most disturbed biomes are temperate. Certain biomes and geographic areas stand out as conservation priorities, notably the islands of Southeast Asia, Mediterranean vegetation types, Temperate Broadleaf Forests and Tropical Dry Forests. Areas for which data deficiencies exist are identified.

Background In non-small cell lung cancer (NSCLC), interstitial hypertension is a barrier to chemotherapy delivery, and is mediated by platelet derived growth factor receptor (PDGFR). Antagonizing PDGFR with imatinib may improve intra-tumoral delivery of paclitaxel, increasing response rate (RR). Methods This single-stage, open-label phase II study evaluated pulse dose imatinib and weekly paclitaxel in elderly patients with advanced NSCLC. Eligible patients were aged ≥ 70 with untreated, stage IIIB-IV NSCLC and ECOG performance status 0-2. Primary endpoint was RR. Secondary endpoints included median progression free and overall survival (PFS, OS) and correlatives of PDGFR pathway activation. Baseline Charlson Comorbidity Index (CCI) and Vulnerable Elder Survey-13 (VES-13) were correlated with outcomes. Results Thirty-four patients with median age 75 enrolled. Eleven of 29 (38%) were frail by VES-13 score. Overall RR was 11/34 (32%; 95% CI 17%-51%), meeting the primary endpoint. Median PFS and OS were 3.6 and 7.3 months, respectively. High tumoral PDGF-B expression predicted inferior PFS. Frail patients by VES-13 had significantly worse median PFS (3.2 vs. 4.5 months; p=0.02) and OS (4.8 vs. 12 months; p=0.02) than non-frail. Conclusions The combination of imatinib and paclitaxel had encouraging activity as measured by the primary endpoint of RR. However, PFS and OS were typical for elderly patients treated with single agent chemotherapy and the regimen is not recommended for further study. Adjunct imatinib did not overcome the established association of tumoral PDGF-B expression with inferior PFS. VES-13 was a powerful predictor of poor survival outcomes. Frailty should be further studied as a predictor of non-benefit from chemotherapy. Trial Registration ClinicalTrials.gov NCT01011075

The topic of Chief Executive Officer (CEO) compensation has been a focus of interest for many years. The purpose of this article is to explore the ethical dimensions of various generally accepted theories of CEO renumeration. We argue that a contractarian approach, based on the Kantian ethical framework, can be used to augment the existing contingent pay models. While the neoclassical economic model of the firm views the maximization of the shareholders' wealth as the sole responsibility of top management, a contractarian approach regards the balancing of various stakeholders' interests as the primary task of top management. Ethical problems emerge when there are divergent, yet equally justifiable interests which compete in order to channel organizational resources to meet their own needs. In this situation, given the inherent ambiguities and ever present possibilities of multiple perspectives, it may not always be feasible to provide a categorical answer to the question of whether the CEO's decisions are ethical. We suggest that a broad interpretation of the neoclassical theory of the firm, one that is grounded in Kantian and contractarian ethics, can serve as a basis for a reconciliation of different theories of executive compensation.

Background In the context of finite health resources, encouraging self-management of chronic conditions is important. Indeed, it is a key priority in the UK. An increasing number of self-management programmes are becoming available. However, patients may not always choose to participate in them. Some will prefer a more directed or medically orientated treatment. The acceptability of self-management programmes for patients suffering from chronic pain is an important issue. Few measures exist that examine the process of change to a self-management approach. The Pain Stages of Change Questionnaire (PSOCQ) was evaluated for this purpose in the present study. Hypotheses were centred around criterion and construct validity of the PSOCQ. Methods A sample of pain patients was surveyed about their interest in participating in a lay-led self-management programme ('the Expert Patients Programme'). In addition, participants completed two psychometric measures: the Pain Stages of Change Questionnaire (PSOCQ) together with the Chronic Pain Acceptance Questionnaire (CPAQ). This is the first study as far as we are aware to examine these two scales together. The psychometric properties of the PSOCQ were examined. Analyses focused on the associations between the PSOCQ scores and interest in participating in the self-management programme. Further associations were examined between the PSOCQ and the Chronic Pain Acceptance Questionnaire. Results The results demonstrated qualified support for the PSOCQ, in particular the Contemplation sub-scale. There was a significant positive association between interest and likelihood of joining the self-management programme and contemplation scores. The action and maintenance sub-scales appeared to be measuring a unitary dimension. The associations between the PSOCQ and the Chronic Pain Acceptance Questionnaire were in the directions predicted. The limitations of the study were discussed. Conclusion The results showed some support for the PSOCQ as a potentially useful tool in assessing who may or may not be likely to join a self-management course.

The energy requirements of critically ill newborns in the early neonatal period are not established. We hypothesized that the total energy expenditure(TEE) of critically ill newborns is greater than that of normal, healthy, term newborns. TEE was measured in critically ill and normal newborns over a 7d period using the doubly labeled water method (DLW). At study entry, critically ill infants (n=6) had respiratory disease requiring high frequency oscillatory ventilation (used as rescue therapy at our institution) and a respiratory index score (RIS; Paw x%FiO2) of ≥ 2.5. Normal newborns (n=4) were healthy and without medical complications. Infants received an enteral dose of2 H218O; urine was collected daily over one week. Samples were analyzed using Isotope Ratio Mass Spectrometry. Total body water (TBW) at the beginning and end of the study and TEE were then determined. Results are shown below as mean (SD), *p≤ 0.05.

In Greek mythology, Themis, the goddess of justice, is blindfolded so that she may not see those who stand before her, and consequently, so that she can administer justice consistently and impartially. The imagery provides an apt illustration of the formal dimension of justice. Yet it serves only to blind us to the actual workings and character of the practice of doing justice. I have argued here that we must take seriously the full implications of material principles of jusitce. And when we do, there is no longer any conceptual space left in our reflections on justice for the virtue of formal justice. Of course, the just treatment of relevantly similar subjects does result in the equal treatment of these subjects; this, after all, is a logical consequence of acting upon a material principle of justice in similar cases. But this, let me emphasize, is only a consequence of doing justice and as such it reveals only a contingent feature of doing justice. The proponents of the formal dimension of justice have, so to speak, failed to see the trees through the forest. Impressed by the consequence of equality of treatment between cases, they have generalized their observations into specific claims about what it means to do justice to certain subjects. These generalizations, in turn, have led to the unfortunate and misleading reification of the concept of formal justice.

In 1965 a massive growth of Ceratophyllum demersum caused the shut-down of one power station (Ohakuri) on the Waikato River. As a result a study was commenced of the biology of the weeds in the Waikato hydro-electric lakes. There are four major exotic weeds, Ceratophyllum, Lagarosiphon major, Egeria densa and Elodea canadensis, all of which form extensive beds. The first three have only appeared in the lakes since 1960 but Elodea was probably present earlier. Efforts to control the excessive growth by diquat have not proved successful and booms protecting the intake fail when a massive amount of weed is liberated after storms. Reasonable control can be obtained by means of lake lowering in mid-summer. Studies of Lagarosiphon, Egeria and Ceratophyllum have enabled the water temperature range, compensation points and certain nutrient requirements to be established under New Zealand conditions. Significant regions in the upper Waikato River are highly thermal and these waters are rich in arsenic. The weeds accumulate this arsenic and values of over 1000 ppm dry wt. have been recorded. This makes them very unsuitable for stock feed if mechanical harvesting were to be employed.