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Math performance is negatively related to math anxiety (MA), though MA may impact certain math skills more than others. We investigated whether the relation between MA and math performance is affected by task features, such as number type (e.g., fractions, whole numbers, percentages), number format (symbolic vs. nonsymbolic), and ratio component size (small vs. large). Across two large-scale studies (combined n = 3,822), the MA-performance relation was strongest for large whole numbers and fractions, and stronger for symbolic than nonsymbolic fractions. The MA-performance relation was also stronger for smaller relative to larger components, and MA relating to specific number types may be a better predictor of performance than general MA for certain tasks. The relation between MA and estimation performance changes depending on task features, which suggests that MA may relate to certain math skills more than others, which may have implications for how people reason with numerical information and may inform future interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved). ispartof: Journal Of Experimental Psychology-General vol:152 issue:7 ispartof: location:United States status: accepted

Subsurface oil and gas resources are materially buried thousands of feet underground, have indeterminate characteristics prior to extraction, are mobile within the subsurface, and are economically valuable. These characteristics make claiming resources difficult. Therefore, stakeholders often engage each other in legal debate to determine who can claim oil and gas, access the resource, or benefit from its production. I examine the legal processes that mediate rights and access to subsurface oil and gas resources in historical and contemporary North American contexts. I argue that stakeholders use legal processes to determine what the subsurface resource was, is, or could be; communicate stakeholder interests in the oil and gas resource; and grant legal rights to subsurface resources. I develop this argument across three case studies centered in Texas and Mexico. In the first case, I examine a 6.3-million-acre collection of lands in Texas where the state government owns the subsurface but not the surface. Using archival methods, I reconstruct the legal history of these properties and reveal how stakeholders used legal processes to account for their interests through property relations. In the second case, I explore how subsurface property is legally debated when novel forms of oil and gas drilling open opportunities for resource production. Using archival data related to the 2008 Texas Supreme Court case Coastal v. Garza, I discover that litigants deployed legal argumentation to establish what the resource was, is, or could be. Then, they mobilized that resource to make claims to resources. In the third case, I investigate contracts and how they facilitate private firm access to state-owned subsurface resources in a Mexican natural gas basin. I argue that contracts serve the interests of the state and contract winners. The dissertation illuminates three insights to guide future resource scholarship by 1) situating law relative to the resource, 2) highlighting the complexity of subsurface property, and 3) explaining subsurface property’s heterogeneous dimensionality.

It has been approximately 10 years since the Government Accountability Office (GAO) published its report to Congress entitled, FDA Should Strengthen Its Oversight of Food Ingredients Determined to ...

Ein 24-jahriger tumororthopadischer Patient wurde mit einer periprothetischen Fraktur des linken distalen Femurs nach E‑Scooter-Sturz in der Ambulanz vorgestellt. Elf Jahre zuvor war bei dem Patienten ein Ewing-Sarkom der linken proximalen Tibia diagnostiziert und tumorendoprothetisch versorgt worden. Die aktuelle periprothetische Fraktur erforderte eine knocherne Nachresektion sowie Rekonstruktion mittels Knierevisionsimplantat. Ziel dieser Arbeit ist die Sensibilisierung fur eine neue Gefahrenquelle im dargestellten Risikokollektiv.

Medicine is having a reckoning with systemic racism. While some continue to believe medicine is apolitical and grounded purely in science, history and research reveal that medicine is inseparable from underlying systems, laws, and policies. Obesity is a useful case study. Weight loss trials have shown the immense difficulty in achieving and sustaining weight loss without addressing overlying systems. Barriers are double for Black, Indigenous, and People of Color (BIPOC) with obesity, who must contend with multiple layers of oppressive systems. Increasingly, illness is not a matter of bad luck, but is a function of oppressive structures. COVID-19 likely originates in a deteriorating environment, we have an increasing global burden of disease from oppressive sales of food, sugar, alcohol, guns, nicotine, and other harmful products, and social inequality and resource hoarding are at a peak. Medicine can and must participate in redefining these systems. In doing so, it must center the experiences of BIPOC and push change that alleviates power disparities.

50 Background: Educating staff on new anticancer medications is imperative for patient safety. Infusion nurses at Dana Farber Cancer Institute (DFCI) satellite infusion centers were surveyed on their comfort level administering newer oncology drugs. Results revealed only 57% of nurses were “extremely comfortable or somewhat comfortable,” while 32% of nurses were “somewhat uncomfortable or very uncomfortable.” This project aimed to increase percentage of nurses at the satellites indicating they are “extremely comfortable” or “somewhat comfortable” from baseline of 57% to ≥75%. Methods: An interdisciplinary team including pharmacy, medical oncology, and nursing was formed to analyze workflows around new drug onboarding, staff education, and satellite communication. The team utilized Plan-Do-Study-Act (PDSA) cycle methodology. Tools included process maps and fishbone to identify areas of improvement. Intervention development tools included a Pareto chart and a priority matrix. Results were analyzed using statistical process control charts. Results: PDSA cycle 1 consisted of making the pharmacy driven education sheet, At-A-Glance (AAG), more accessible for new drugs. AAGs for drugs approved by the FDA in the previous 18 months were posted on the DFCI pharmacy intranet page. Nurses were educated on how to access AAG weekly. For PDSA cycle 2, the survey was modified to target individual nurses administering new drugs rather than all nurses. A “Nursing consideration” section was added to the AAG template and workflow developed; Navigation and review of AAG was added to nursing competency. Monthly nursing/pharmacy huddles were established to optimize communication. These interventions increased the percentage of nurses indicating they are “extremely comfortable” or “somewhat comfortable” to ≥75% which was sustainable through PDSA cycle 2 (see Table). Conclusions: Making an easy-to-use nursing education resource accessible improved nursing comfort level. There were challenges with nursing survey due to COVID-19 surge and staff shortages. Routine huddles are essential for sustainability.[Table: see text]

This dissertation offers a select history of the literary portrait genre in Russian culture from its genesis in the 1890s through the 1960s. I define the literary portrait as a succinct account of a particular author's individual or creative personality – in Russian, lichnost' – that readily lends itself to anthologization, in which that literary portrait acquires additional meaning through the comparative or cumulative format in which it participates. In tracing the developments in the genre through a series of representative portrait collections, I focus in particular on two historical moments: 1905-1914, when literary portraiture moved beyond its original Symbolist confines, courted a wider reading audience, and became a key genre for the theorization and explication of Russian modernity; and the post-Revolutionary period, when writers both in emigration and within the Soviet Union repeatedly turned to the genre as a means of shaping narratives about late imperial and early Soviet culture. In the first period, I consider the literary critical portraiture of Iulii Aikhenval'd, Kornei Chukovskii, and Maksimilian Voloshin, and in the second, I consider the memoir-portraits of Vladislav Khodasevich, Kornei Chukovskii, and Iurii Annenkov, as well as Annenkov's work in visual portraiture. I posit that these writers, each in their own way and to their own ends, sought common variables that would unite the heterogeneous literary field of late imperial Russia. In doing so, they created forms of literary historical periodization that focused on cultural continuity rather than aesthetic displacement, and on webs of connections between individual authors rather than distinctions between nominally antithetical movements. These holistic interpretations of late imperial Russian literature demonstrate the pedagogical utility of comparative frameworks that take individuals (lichnostoi) as their units of observation. In constructing such frameworks, these portraitists consistently demonstrate that our understanding of dominant aesthetic movements of the time (the Symbolists and Modernists) and the dominant paradigm of cultural periodization that followed it (the Silver Age) are best calibrated against certain figures (especially Leonid Andreev and Maksim Gor'kii) who are otherwise afforded narrow parts in our inherited literary histories. Thus, I aspire to present literary portraiture as a telling artifact of Russian modernity writ large, and a valuable means of re-examining the literary historical narratives that structure our study of early twentieth-century Russian culture.

7029 Background: Pts with AML in RCTs often do not reflect the population seen in clinical practice due to strict eligibility criteria. This study evaluated criteria from a recent RCT of non-IC against a broad cohort of real-world pts with AML from the Connect® Myeloid Disease Registry (NCT01688011). Methods: Pts were stratified into 3 groups based on the non-IC phase 3 VIALE-A trial eligibility criteria: 1) “eligible” pts who would have met all VIALE-A inclusion criteria; 2) “unfit” pts who would have been ineligible for VIALE-A due to ≥ 1 of the following: abnormal liver/kidney function, high ECOG, recent prior malignancy, comorbidities score ≥ 2 by ACE-27, hepatic grade ≥ 1, AIDS grade ≥ 1; 3) “fit” pts who would have been ineligible for VIALE-A because they would have qualified for IC (defined as: ≤ 74 y of age, low ECOG, no apparent cardiovascular/renal comorbidities, and did not meet any criteria in #2). Baseline characteristics were summarized by eligibility group. Overall survival (OS) by group was estimated using the Kaplan–Meier method. Induction regimens were categorized as IC (any regimens containing 7+3, MEC, CLAG, FLAG) or venetoclax (VEN)-based. Hazard ratios (HRs) for induction regimens among each group were estimated using Cox models adjusted for age, ELN risk, ECOG, frailty score, and comorbidity index. Results: Of 734 enrolled pts with AML (Dec 2021), most were male (61%) and white (84%); median age 71 y (range 55–97). Only 26% of pts (n = 192) were eligible for a non-IC RCT, 45% (n = 327) were ineligible due to unfitness, and 29% (n = 215) were ineligible due to overall fitness. The main reason for non-IC RCT ineligibility was high overall comorbidity grade (n = 265 [36%]). Fit pts intended to undergo transplant more often compared with unfit pts. Median OS for eligible, unfit, and fit pts were 14, 10, and 22 months, respectively. Among unfit pts, those receiving IC had significantly longer OS compared with pts receiving a VEN-based regimen (median OS 14 vs 6 months, respectively; HR: 0.51, 95% CI: 0.27–0.98, P = 0.042; Table). Eligible pts who received IC tended to have shorter median OS (13 months) vs pts who received VEN-based therapies (23 months; not sig.). Conclusions: The majority of pts with ND AML in the Registry would have been ineligible for a non-IC RCT due to being too fit or unfit. Pts ineligible for an RCT due to unfitness but who received IC maintained an OS benefit vs those receiving VEN-based therapies. This analysis suggests that non-IC RCTs may be excluding pts who appear unfit but can potentially tolerate IC and experience improved survival outcomes. Clinical trial information: NCT01688011. [Table: see text]

TPS7065 Background: RARA-positive (RARA+) AML is a novel genomically defined patient subset with an actionable biological target for treatment with tamibarotene, an oral and selective RARα agonist (McKeown 2017). RARA+ patients can be selected by a blood-based biomarker test, with approximately 30% of newly diagnosed (ND) AML patients being RARA+ (Vigil 2017). As a biologically targeted agent for patients with RARA overexpression, tamibarotene has the potential to provide benefit irrespective of mutation or cytogenetic risk classification. In RARA+ ND AML patients ineligible for standard induction therapy, tamibarotene plus azacitidine (aza) led to a CR/CRi rate of 61% and a rapid onset of response (de Botton 2020). Approximately one-third of patients with ND unfit AML do not respond to front-line standard of care venetoclax (ven)/aza (DiNardo 2020). Translational data suggest RARA positivity enriches for monocytic features reported to be associated with ven resistance (Fiore 2020, Pei 2020). This data suggests the RARA biomarker selects for patients who may respond to tamibarotene and may be less likely to respond to ven/aza. Given that tamibarotene plus aza has been generally well tolerated, with no increase in myelosuppression compared to single agent aza (de Botton 2020), it is anticipated that tamibarotene can be administered safely in combination with ven/aza. Methods: This is a Phase 2, open-label, multi-center study in the U.S. and France comparing the clinical activity of tamibarotene/ven/aza to ven/aza in treatment-naive RARA+ AML patients ineligible for standard induction chemotherapy. The primary objectives are to characterize the safety of the combination and to compare the CR/CRi rate of tamibarotene/ven/aza vs. ven/aza, with secondary objectives to compare CR rate, CR/CRh rate, duration of response, and time to response. The overall response rate using tamibarotene/ven/aza following ven/aza treatment failure will be explored. Clinical activity will be characterized by ELN criteria (Dohner 2017). This 3-part trial includes a safety lead-in, randomized efficacy study, and salvage arm. Following the safety lead-in, approximately 80 patients will be randomized 1:1 to receive tamibarotene/ven/aza or ven/aza. Response rates and 95% exact binomial confidence intervals will be calculated by treatment group. In the salvage arm, tamibarotene will be added for study patients randomized to ven/aza who experience progressive disease, relapse, or treatment failure. Patients will be treated with aza at 75 mg/m2 IV/SC daily on days 1-7, ven on days 1-28 per VENCLEXA USPI, followed by tamibarotene at 6 mg twice per day by mouth on days 8-28 of each 28-day cycle. The SELECT AML-1 trial opened in July 2021 with ongoing enrollment. Clinical trial information: NCT04905407.

Aaron DG, Stanford CF (Food and Drug Administration, Cambridge; Massachusetts General Hospital, Boston, MA, USA). Is obesity a manifestation of systemic racism? A ten-point strategy for study and intervention. In the recent past, there has been rising attention to systemic racism. The ensuing discussions have largely focused on COVID-19 and policing. Despite long-standing disparities in obesity across racial and ethnic groups and obesity’s important role in COVID-19 disparities, there has been minimal attention to whether obesity itself could be a manifestation of systemic racism. Nor has there been serious policy attention dedicated to alleviating obesity and its disproportionate burden on BIPOC (Black, Indigenous, and People of Color). We discuss whether obesity’s disproportionate harms to BIPOC may be attributed to systemic racism, and we provide a ten-point strategy for studying and solving the core public health issues at the intersection of obesity and systemic racism.

One of the most powerful tools to arrive in biology in the past decade is high-throughput sequencing, such as Illumina sequencing. These platforms have allowed an unparalleled look at protein-chromatin interactions, mRNA expression, chromatin topology, and a great deal more. Our lab has successfully used these tools to better understand the distribution of cohesin and Nipbl binding in mouse and human cells, with the aim of further clarifying how cohesin and Nipbl regulate gene expression and what genes they regulate. Moreover, we have been able to identify how this binding can change in disease, and correlate these changes with the corresponding gene expression changes taking place in vivo. Careful analysis of ChIP-seq data (chromatin immunoprecipitation coupled with sequencing) has indicated that cohesin binding decreases genome-wide in mouse embryonic fibroblasts (MEFs) derived from a mouse model for Cornelia de Lange Syndrome (CdLS). In fact, cohesin's role in gene activation is most susceptible to Nipbl haploinsufficiency. Moreover, we find that decreased cohesin binding is correlated with the gene expression changes taking place between wildtype and mutant MEFs. Enhancer-promoter interactions, one mechanism by which cohesin can regulate gene expression, are decreased in the mutant MEFs. Our studies have helped characterize how Nipbl haploinsufficiency affects cohesin binding, and suggest how this effect on cohesin binding can affect gene expression in the context of CdLS.Based on the increased severity of the disease phenotype of CdLS patients with mutations in NIPBL versus mutations in the cohesin subunits, it was postulated that NIPBL might have cohesin-independent functions in the cell. To examine this, we have used ChIP-seq in human cells to identify the global distribution of NIPBL-chromatin interactions. We found that, similar to cohesin, NIPBL is enriched at the promoter region. In contrast to other studies however, we found that NIPBL is present at sites also bound by cohesin and CTCF. While most NIPBL -bound regions are shared with cohesin, about 10% of these sites are free of cohesin and CTCF. Further examination of the cohesin-free sites show 273 genes where NIPBL is bound at the promoter, and could be direct genes targets. Of these, 73 are differentially expressed upon siRNA depletion of NIPBL, two of which were examined in detail to show that NIPBL normally represses the expression of these genes independently of cohesin, which is the first time any ability of NIPBL to repress gene expression has been shown. Taken together, our data indicate that mutations in NIPBL may indeed effect expression of NIPBL target genes, suggesting that this may explain in part the differences in disease severity in CdLS patients.Over the past decade, our lab has examined the importance of intact heterochromatin on chromosome 4q in FSHD muscular dystrophy. While we have shown that the loss of cohesin and H3K9me3 present at the D4Z4 repeat array on chromosome 4q is characteristic of the disease, and may underlie expression changes seen in patient myoblasts in vivo, the global differences in heterochromatin in FSHD have not been previously studied. Therefore, we have used several sequencing techniques to identify the genome-wide changes to heterochromatin and gene expression in FSHD, with the intent of being able to identify disease-specific signatures and illuminate the interdependence of the two in disease.

A 24-year-old male patient who suffered a periprosthetic fracture of the left distal femur due to an e‑scooter accident was referred to the outpatient department of tumor orthopedics. The patient had been diagnosed with Ewing's sarcoma of the left proximal tibia 11 years previously that was treated with a tumor endoprosthetic reconstruction. The current periprosthetic fracture required a further bony resection of the distal femur as well as a reconstruction with a knee revision implant. The aim of this case report is to raise awareness for a new potential source of danger in the presented risk group.

Today, the opioid crisis is playing out in the nation’s courts. Litigants have taken a microscope to defendant opioid companies, whose misconduct ignited and exacerbated the opioid crisis. As the litigation continues, one could imagine numerous ways its resolution could contribute to the end of a mutli-decade overdose crisis and prevent future ones. Options include holding defendant companies accountable, releasing previously secret information for research on root causes of the epidemic, and injunctive relief prohibiting future misconduct. Unfortunately, to date, the litigation has not been so capacious. Rather, the participants—judge included—have been preoccupied with rapid monetary settlement. Though understandable, attempts to obtain rapid monetary relief take a narrow view of public health. That is, we will help the most readily identifiable victims, with less regard for structural factors that led to the crisis in the first place. This avoidance of structural change is at odds with public health and fails to meet this moment, defined by the most urgent public health crisis in modern history, the COVID-19 pandemic. To explain why the litigation participants have pursued rapid monetary settlement, this paper uses the lens of agency. As will be shown, the opioid litigation is an agent of public health. That is, given the litigation’s tight connections with public health, it must represent the broad health of the populace. The paper then identifies numerous incentive problems that create misalignment with public health. Viewed in this light, the pursuit of rapid monetary settlement becomes more understandable—though not justifiable. This paper offers solutions for curing these agency problems and ensuring that public health is properly represented in future public health litigation. If there is any time to be capacious as to the scope of public health, that time is now. While corporate misconduct plays a significant role in the spread of COVID-19, it is even more relevant to the opioid crisis, a public health emergency initiated and exacerbated by defendants in the litigation. Therefore, relief must consider not only how to help opioid victims, but to release as much information as possible about root causes and to discourage the misconduct that helped precipitate the epidemic. In other words, the court can and must take a deeper look at broader relief that benefits more people on a longer time scale. Expanding the scope of public health in the opioid litigation could yield more robust public health benefits for current and future generations. It could also create lasting precedent by expressing the norm that sales revenue and economic growth must not come at the expense of human life. Such a norm, operationalized through law, could offer significantly more enduring value than a one-shot bolus of money. This paper, and its companion, together offer a new way of conceiving of public health litigation to maximize its benefits. This conception is grounded in a broad definition of public health. It is too soon to forsake public health for feasibility or realism;in fact, this paper suggests extremely practical ways the judge and litigants can improve the impact of the opioid litigation within civil procedure’s bounds.