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The purpose of this study was to examine the association between prior emergency department (ED) visit or hospitalization and subsequent suicide attempt among homeless youth aged 10-17 years old.With New York statewide databases, a case-control design was conducted. Cases and controls were homeless patients with an ED visit or hospitalization due to suicide attempt (cases) or appendicitis (controls) between April and December. We examined ED and inpatient records for 90 days prior to the visit for suicide attempt or appendicitis. The primary exposure variable was prior healthcare utilization for any reason other than the following four reasons: mental health disorder, substance use, self-harm, and other injuries. Multivariable logistic regression models, with year fixed effect and hospital random effect, were used.A total of 335 cases and 742 controls were identified. Cases had lower odds of prior healthcare utilization for any reason other than the four reasons listed above. (adjusted Odds Ratio [aOR]: 0.53, p-value = 0.03).The association between prior healthcare utilization and decreased risk of suicide attempt among homeless youth may be due to comprehensive care provided during healthcare utilization. It may also reflect the presence of a social network that provided a protective effect.

Galaxy number counts in the $K$-, $H$-, $I$-, $R$-, $B$- and $U$-bands from the Durham Extragalactic Astronomy and Cosmology catalogue could be well-fitted over their whole range using luminosity function (LF) parameters derived from the SDSS at the bright region and required only modest luminosity evolution with the steepening of the LF slope ($\alpha$), except for a sudden steep increase in the $B$-band and a less steep increase in the $U$-band at faint magnitudes that required a starburst evolutionary model to account for the excess faint number counts. A cosmological model treating Hubble expansion as an Einstein curvature required less correction at faint magnitudes than a standard $\Lambda$CDM model, without requiring dark matter or dark energy. Data from DR17 of the SDSS in the $g$, $i$, $r$, $u$ and $z$ bands over two areas of the sky centred on the North Galactic Cap (NGC) and above the South Galactic Cap (SGC), with areas of 5954 and 859 sq. deg., respectively, and a combined count of 622,121 galaxies, were used to construct bright galaxy number counts and galaxy redshift/density plots within the limits of redshift $\leq0.4$ and mag $\leq20$. Their comparative densities confirmed an extensive void in the Southern sky with a deficit of 26\% out to a redshift $z$$\leq$0.15. Although not included in the number count data set because of its incompleteness at fainter magnitudes, extending the SDSS redshift-number count survey to fainter and more distant galaxies with redshift $\leq1.20$ showed a secondary peak in the number counts with many QSOs, bright X-ray and radio sources, and evolving irregular galaxies with rapid star formation rates. This sub-population at redshifts of 0.45--0.65 may account for the excess counts observed in the $B$-band., Comment: 20 pages, 15 figures

Objective Our objective was to gauge adherence to nationally endorsed protocols in implementation of pulse oximetry (POx) screening for critical congenital heart disease (CCHD) in infants after mandate by all states and to assess associated characteristics. Study Design Between March and October 2019, an online questionnaire was administered to nurse supervisors who oversee personnel conducting POx screening. The questionnaire used eight questions regarding performance and interpretation of screening protocols to measure policy consistency, which is adherence to nationally endorsed protocols for POx screening developed by professional medical societies. Multilevel linear regression models evaluated associations between policy consistency and characteristics of hospitals and individuals, state of hospital location, early versus late mandate adopters, and state reporting requirements. Results Responses from 189 nurse supervisors spanning 38 states were analyzed. Only 17% received maximum points indicating full policy consistency, and 24% selected all four options for potential hypoxia that require a repeat screen. Notably, 33% did not recognize ≤90% SpO2 as an immediate failed screen and 31% responded that an infant with SpO2 of 89% in one extremity will be rescreened by nurses in an hour rather than receiving an immediate physician referral. Lower policy consistency was associated with lack of state reporting mandates (beta = –1.23 p = 0.01) and early adoption by states (beta = –1.01, p Conclusion When presented with SpO2 screening values on a questionnaire, a low percentage of nurse supervisors selected responses that demonstrated adherence to nationally endorsed protocols for CCHD screening. Most notably, almost one-third of respondents did not recognize ≤90% SpO2 as a failed screen that requires immediate physician follow-up. In addition, states without reporting mandates and early adopter states were associated with low policy consistency. Implementing state reporting requirements might increase policy consistency, but some inconsistency may be the result of unique protocols in early adopter states that differ from nationally endorsed protocols. Key Points

OBJECTIVE This study aims to describe differences in health care utilization between homeless and nonhomeless minors with diabetes. RESEARCH DESIGN AND METHODS Data from the Healthcare Cost and Utilization Project’s Statewide Inpatient Database from New York for years 2009–2014 were examined to identify pediatric patients RESULTS A total of 643 homeless and 10,559 nonhomeless patients were identified. The hospitalization rate was higher among homeless minors, with 3.64 per 1,000 homeless population compared with 0.38 per 1,000 in the nonhomeless population. A statistically significant higher readmission rate was detected among homeless minors (20.4% among homeless and 14.1% among nonhomeless, P < 0.01). Lower rates of DKA (odds ratio 0.75, P = 0.02), lower hospitalization costs (means ratio 0.88, P < 0.01), and longer LOS (incidence rate ratio 1.20, P < 0.01) were detected among homeless minors compared with nonhomeless minors. CONCLUSIONS This study found that among minors with diabetes, those who are homeless experience a higher hospitalization rate than the nonhomeless. Housing instability, among other environmental factors, may be targeted for intervention to improve health outcomes.

Objective:To evaluate the impact of state-mandated policies for pulse oximetry screening on healthcare utilisation, with a focus on use of echocardiograms.Data sources/study setting:Healthcare Cost and Utilisation Project, Statewide Inpatient Databases from 2008 to 2014 from six states.Methods:We defined pre- and post-mandate cohorts based on dates when pulse oximetry became mandated in each state. Linear segmented regression models for interrupted time series assessed associations between implementation of the screening and changes in rate of newborns with Critical CHD-negative echocardiogram results. We also evaluated the changes in rate of newborns who underwent echocardiogram but were not diagnosed with any health issues that could cause hypoxemia.Results:We identified 5967 critical CHD-negative echocardiograms (2847 and 3120 in the pre- and post-mandate periods, respectively). Our models detected a statistically significant increasing trend in rate of critical CHD-negative echocardiograms in the pre-mandate period (Incidence Rate Ratio: 1.08, p = 0.02), but did not detect any statistical differences in changes between pre- and post-mandate periods (Incidence Rate Ratio: 0.93, p = 0.14). Among non-Whites, an increasing trend of Critical CHD-negative echocardiogram during the pre-mandate period was detected (Incidence Rate Ratio 1.12, p < 0.01) and was attenuated during the post-mandate period (Incidence Rate Ratio 0.89, p = 0.02). Similar results were observed in the sensitivity analyses among both Whites and non-Whites.Conclusions:Results suggest that mandatory state screening policies are associated with reductions in false-positive screening rates for hypoxemic conditions, with reductions primarily attributed to trends among non-Whites.

ObjectiveTo assess differences in rates of postpartum hospitalisations among homeless women compared with non-homeless women.DesignCross-sectional secondary analysis of readmissions and emergency department (ED) utilisation among postpartum women using hierarchical regression models adjusted for age, race/ethnicity, insurance type during delivery, delivery length of stay, maternal comorbidity index score, other pregnancy complications, neonatal complications, caesarean delivery, year fixed effect and a birth hospital random effect.SettingNew York statewide inpatient and emergency department databases (2009–2014).Participants82 820 and 1 026 965 postpartum homeless and non-homeless women, respectively.Main outcome measuresPostpartum readmissions (primary outcome) and postpartum ED visits (secondary outcome) within 6 weeks after discharge date from delivery hospitalisation.ResultsHomeless women had lower rates of both postpartum readmissions (risk-adjusted rates: 1.4% vs 1.6%; adjusted OR (aOR) 0.87, 95% CI 0.75 to 1.00, p=0.048) and ED visits than non-homeless women (risk-adjusted rates: 8.1% vs 9.5%; aOR 0.83, 95% CI 0.77 to 0.90, pConclusionsTwo factors likely led to lower rates of hospital readmissions among homeless women. First, barriers including lack of transportation, payment or childcare could have impeded access to postpartum inpatient and emergency care. Second, given New York State’s extensive safety net, discharge planning such as respite and sober living housing may have provided access to outpatient care and quality of life, preventing adverse health events. Additional research using outpatient data and patient perspectives is needed to recognise how the factors affect postpartum health among homeless women. These findings could aid in lowering readmissions of the housed postpartum population.

Substance abuse, particularly among homeless youths, is a significant public health challenge in the United States. Detailed data about health care utilization resulting from this preventable behavior remain sparse. This study aimed to compare health care utilization rates related to substance abuse among homeless and nonhomeless youths.A secondary data analysis evaluated records of homeless and nonhomeless patients under age 25 with a primary diagnosis of substance abuse, identified in 2013 and 2014 New York Statewide Inpatient and Emergency Department (ED) Databases. Outcomes included ED visit rate, hospitalization rate, in-hospital mortality, cost, length of stay (LOS), intensive care unit (ICU) utilization, and revisit or readmission rate. Multivariable regression models with a year fixed effect and facility random effect were used to evaluate the association between homelessness and each outcome.A total of 68,867 cases included hospitalization or an ED visit related to substance abuse (68,118 nonhomeless and 749 homeless cases). Rates of ED visits related to substance abuse were 9.38 and 4.96, while rates of hospitalizations related to substance abuse were 10.53 and 1.01 per 1,000 homeless and nonhomeless youths, respectively. Homeless patients were more likely to utilize and revisit the ICU, be hospitalized or readmitted, incur higher costs, and have longer LOS than nonhomeless youths (all p0.01).The hospitalization and ED visit rates related to substance abuse were 10 and two times higher among homeless youths compared with nonhomeless youths, respectively. Detailed observation is needed to clarify whether homeless youths receive high-quality care for substance abuse when necessary.

Key Points Question Do patients who receive care at hospitals that make higher profits have a higher probability of cesarean delivery compared with hospitals that make less profits? Findings In this cross-sectional, nationally representative study using hospital discharge data between 2010 and 2014, women delivering at hospitals with higher profits per procedure were associated with an increased probability of undergoing cesarean delivery. Meaning These findings suggest an association between financial incentives and the US cesarean delivery rate., This cross-sectional study of discharge data from a national database of US hospitals examines the association of profits hospitals received from cesarean procedures and rates of cesarean delivery., Importance A high cesarean delivery rate in US hospitals indicates the potential overuse of this procedure; however, underlying causes of the excessive use of cesarean procedures in the US have not been fully understood. Objective To investigate the association between the probability of cesarean delivery at the patient-level and profit per procedure from cesarean deliveries. Design, Setting, and Participants This observational, cross-sectional study used a nationally representative sample of hospital discharge data from women at low risk for cesarean birth who delivered newborns between 2010 and 2014 in the US. Data were gathered from the Nationwide Readmissions Database from the Healthcare Cost and Utilization Project, compiled by the Agency for Healthcare Research and Quality. Data cleaning and analyses were conducted between August 2019 and May 2020. Exposures Hospital-level median value of profits from cesarean deliveries, defined as the difference between the charge and the cost for cesarean delivery calculated for each hospital. Main Outcomes and Measures Our primary outcome was the individual-level probability of undergoing a cesarean delivery. We examined the association with the hospital-level median value of profits per procedure for cesarean delivery (defined as the difference between the charge and the cost for cesarean delivery) using hierarchical regression models adjusted for patient and hospital characteristics and year-fixed effects. Results A total of 13 215 853 deliveries were included in our analyses (mean [SE] age, 27.4 [0] years), of which 2 202 632 (16.7%) were cesarean deliveries. After adjusting for potential confounders, pregnant women were more likely to have a cesarean birth when they delivered at hospitals with higher profits per procedure from cesarean deliveries. Women cared for at hospitals with the highest (adjusted odds ratio, 1.08; 95% CI, 1.02-1.14; P = .005) and second-highest profit quartiles (adjusted odds ratio, 1.07; 95% CI, 1.02-1.13; P = .007) had higher probabilities of a cesarean delivery compared with those cared for at hospitals in the lowest profit quartile. Conclusions and Relevance In this cross-sectional study of US nationally representative hospital discharge data, hospitals with higher profits per cesarean procedure were associated with an increased probability of delivering newborns through cesarean birth. These findings highlight the potential influence financial incentives play in determining a high cesarean delivery rate in the US.

Objective: This study aims to describe differences in healthcare utilization between homeless and non-homeless minors with diabetes mellitus (DM). Research Design and Methods: Data from the Healthcare Cost and Utilization Project’s Statewide Inpatient Database from New York for years 2009-2014 was examined to identify pediatric patients Results: A total of 643 homeless and 10,559 non-homeless cases were identified. The hospitalization rate was higher among homeless minors, with 3.64 per 1,000 homeless population and 0.38 per 1,000 non-homeless population, respectively. A statistically significant higher readmission rate was detected among homeless minors (20.4% among homeless and 14.1% among non-homeless, p p=0.02), hospitalization costs (point estimate 0.88, p p Conclusions: This study found that among minors with DM, those who are homeless experience a higher hospitalization rate than the non-homeless. Housing instability, among other environmental factors, may be targeted for intervention to improve health outcomes.

Objective: This study aims to describe differences in healthcare utilization between homeless and non-homeless minors with diabetes mellitus (DM). Research Design and Methods: Data from the Healthcare Cost and Utilization Project’s Statewide Inpatient Database from New York for years 2009-2014 was examined to identify pediatric patients Results: A total of 643 homeless and 10,559 non-homeless cases were identified. The hospitalization rate was higher among homeless minors, with 3.64 per 1,000 homeless population and 0.38 per 1,000 non-homeless population, respectively. A statistically significant higher readmission rate was detected among homeless minors (20.4% among homeless and 14.1% among non-homeless, p p=0.02), hospitalization costs (point estimate 0.88, p p Conclusions: This study found that among minors with DM, those who are homeless experience a higher hospitalization rate than the non-homeless. Housing instability, among other environmental factors, may be targeted for intervention to improve health outcomes.

Suicide remains the leading cause of death among homeless youth. We assessed differences in health-care utilization between homeless and nonhomeless youth presenting to the emergency department or hospital after a suicide attempt. New York Statewide Inpatient and Emergency Department Databases (2009–2014) were used to identify homeless and nonhomeless youth aged 10–17 who utilized health-care services following a suicide attempt. To evaluate associations with homelessness, we used logistic regression models for use of violent means, intensive care unit utilization, log-transformed linear regression models for hospitalization cost, and negative binomial regression models for length of stay. All models adjusted for individual characteristics with a hospital random effect and year fixed effect. We identified 18,026 suicide attempts with health-care utilization rates of 347.2 (95% confidence interval (CI): 317.5, 377.0) and 67.3 (95% CI: 66.3, 68.3) per 100,000 person-years for homeless and nonhomeless youth, respectively. Length of stay for homeless youth was statistically longer than that for nonhomeless youth (incidence rate ratio = 1.53, 95% CI: 1.32, 1.77). All homeless youth who visited the emergency department after a suicide attempt were subsequently hospitalized. This could suggest a higher acuity upon presentation among homeless youth compared with nonhomeless youth. Interventions tailored to homeless youth should be developed.

Importance A high cesarean delivery rate in US hospitals indicates the potential overuse of this procedure; however, underlying causes of the excessive use of cesarean procedures in the US have not been fully understood. Objective To investigate the association between the probability of cesarean delivery at the patient-level and profit per procedure from cesarean deliveries. Design, Setting, and Participants This observational, cross-sectional study used a nationally representative sample of hospital discharge data from women at low risk for cesarean birth who delivered newborns between 2010 and 2014 in the US. Data were gathered from the Nationwide Readmissions Database from the Healthcare Cost and Utilization Project, compiled by the Agency for Healthcare Research and Quality. Data cleaning and analyses were conducted between August 2019 and May 2020. Exposures Hospital-level median value of profits from cesarean deliveries, defined as the difference between the charge and the cost for cesarean delivery calculated for each hospital. Main Outcomes and Measures Our primary outcome was the individual-level probability of undergoing a cesarean delivery. We examined the association with the hospital-level median value of profits per procedure for cesarean delivery (defined as the difference between the charge and the cost for cesarean delivery) using hierarchical regression models adjusted for patient and hospital characteristics and year-fixed effects. Results A total of 13 215 853 deliveries were included in our analyses (mean [SE] age, 27.4 [0] years), of which 2 202 632 (16.7%) were cesarean deliveries. After adjusting for potential confounders, pregnant women were more likely to have a cesarean birth when they delivered at hospitals with higher profits per procedure from cesarean deliveries. Women cared for at hospitals with the highest (adjusted odds ratio, 1.08; 95% CI, 1.02-1.14;P = .005) and second-highest profit quartiles (adjusted odds ratio, 1.07; 95% CI, 1.02-1.13;P = .007) had higher probabilities of a cesarean delivery compared with those cared for at hospitals in the lowest profit quartile. Conclusions and Relevance In this cross-sectional study of US nationally representative hospital discharge data, hospitals with higher profits per cesarean procedure were associated with an increased probability of delivering newborns through cesarean birth. These findings highlight the potential influence financial incentives play in determining a high cesarean delivery rate in the US.

Recent changes in UK research funding priorities have led to the emergence of large challenge-led, societally embedded research opportunities. We used semi-structured interviews with 27 academic, management and professional staff at the University of Edinburgh to explore the life cycles of selected projects and centres from planning and preparation through to decommissioning. We observed the degree to which pursuit of challenge-led opportunities induced the emergence of new project-level organizational forms or changed academics’ modus operandi from “Mode 1” research to “Mode2” knowledge production. We further explored the levels of management input and administrative support expected and received by the project organization from its host academic schools, colleges the university. We found that the size, complexity and disciplinary, interdisciplinary or transdisciplinary scope of the initiatives influenced their emergence as autonomous project organisations. “Role strain” affected many respondents as they sought to balance Mode 1 academic and Mode 2 leadership and management roles in their project organizations. Further exploration of the distribution of leadership management and professional support functions among project organizations and the support structures of academic schools, colleges and the university is warranted. We suggest that the university might usefully act as a boundary organization and adopt a Mode 2 knowledge exchange mission in support of multi-stakeholder projects. This paper was submitted to the 35th European Group for Organizational Studies colloquium (EGOS2019). A shorter version of this paper, which focuses on the institutional logics observed among the university staff, is also available at SocArXiv ("Nurturing cross-disciplinary research: Institutional logics, hybrid Spaces and meta-organization at a research university").

The emergence of “big research” has given rise to a variety of organizational environments (e.g. powerful research labs, projects and centres) that complement and transcend the traditional departmental structures of universities. Success in building and sustaining these “organized research units” and in reconciling their competing interests is central to the mission of a research university. In this preliminary study, we focus on individual experiences of working in cross-disciplinary research projects and centres within a large research university. Through interviewing key individuals (project leaders, academic and non-academic staff) engaged in running large research projects and/or centres, we aim to unpack the diversity and dynamics of different institutional logics at work at different stages of the organized research unit (ORU) life cycle. We seek to draw general conclusions in terms of managing and reconciling the research missions of ORUs, the university, and its external stakeholders (government, industry and society in general). This paper was submitted to the 35th European Group for Organizational Studies colloquium (EGOS2019). A longer version of this paper, which interprets our results from the perspective of Mode 2 knowledge production, is available at SocArXiv ("Nurturing Project Organizations: A Mode 2 Mission for the University?").

BACKGROUND AND OBJECTIVES: Asthma is widely prevalent among US children, particularly in homeless children, who often lack proper medication storage or the ability to avoid environmental triggers. In this study, we assess asthma-attributed health care use among homeless youth. We hypothesize that asthma hospitalization rates, symptom severity, and admission through the emergency department (ED) will be higher among homeless youth compared with nonhomeless youth. METHODS: This secondary data analysis identified homeless and nonhomeless pediatric patients ( RESULTS: We identified 71 837 asthma hospitalizations, yielding 73.8 and 2.3 hospitalizations per 1000 homeless and nonhomeless children, respectively. Hospitalization rates varied by nonhomeless income quartile, with low-income children experiencing higher rates (5.4) of hospitalization. Readmissions accounted for 16.0% of homeless and 12.5% of nonhomeless hospitalizations. Compared with nonhomeless patients, homeless patients were more likely to be admitted from the ED (odds ratio 1.96; 95% confidence interval: 1.82–2.12; P < .01), and among patients >5 years old, homeless patients were more likely to receive ventilation (odds ratio 1.45; 95% confidence interval: 1.01–2.09; P = .04). No significant differences were observed in ICU admittance, cost, or length of stay. CONCLUSIONS: Homeless youth experience an asthma hospitalization rate 31 times higher than nonhomeless youth, with higher rates of readmission. Homeless youth live under uniquely challenging circumstances. Tailored asthma control strategies and educational intervention could greatly reduce hospitalizations.

OBJECTIVE: Regionalization directs patients to high‐volume hospitals for specialized care. We investigated regionalization trends and outcomes in pediatric cardiac surgery. DATA SOURCES/STUDY SETTING: Statewide inpatient data from eleven states between 2000 and 2012. STUDY DESIGN: Mortality, length of stay (LOS), and cost were assessed using multivariable hierarchical regression with state and year fixed effects. Primary predictor was hospital case‐volume, categorized into low‐, medium‐, and high‐volume tertiles. DATA COLLECTION/EXTRACTION METHODS: We used Risk Adjustment for Congenital Heart Surgery‐1 (RACHS‐1) to select pediatric cardiac surgery discharges. PRINCIPAL FINDINGS: In total, 2841 (8.5 percent), 8348 (25.1 percent), and 22 099 (66.4 percent) patients underwent heart surgeries in low‐, medium‐, and high‐volume hospitals. Mortality decreased over time, but remained higher in low‐ and medium‐volume hospitals. High‐volume hospitals had lower odds of mortality and cost than low‐volume hospitals (odds ratio [OR] 0.59, P

This study investigated patient characteristics in paediatric hospitalisations for hypertrophic cardiomyopathy. We used Nationwide Inpatient Sample, which is the largest all-payer inpatient database in the United States, yielding nationally representative estimates, from 2001 to 2014. ICD-9-CM diagnostic codes identified hospitalisations for patients with hypertrophic cardiomyopathy and

OBJECTIVE: This study aims to describe differences in health care utilization between homeless and nonhomeless minors with diabetes. RESEARCH DESIGN AND METHODS: Data from the Healthcare Cost and Utilization Project’s Statewide Inpatient Database from New York for years 2009–2014 were examined to identify pediatric patients

Background An easy-to-operate ECG recorder should be useful for newborn screening for heart conditions, by health care workers – or parents. We developed a one-piece electrode strip and a compact, 12‑lead ECG recorder for newborns. Method We enrolled 2582 newborns in a trial to assess abilities of parents to record a 12‑lead ECG on their infants (2–4 weeks-old). Newborns were randomized to recordings by parents (1290) or our staff (1292 controls). Educational backgrounds of parents varied, including 64% with no more than a high school diploma. Results For newborns randomized to parent recorded ECGs, 94% of parents completed a 10-minute recording. However, 42.6% asked for verbal help, and 12.7% needed physical help. ECG quality was the same for recordings by parents versus staff. Conclusions By use of a one-piece electrode strip and a compact recorder, 87% of parents recorded diagnostic quality ECGs on their newborn infants, with minimal assistance.

Background: Anaphylaxis is a severe and potentially fatal allergic response. Early-life exposure to rural environments may help protect against allergic reaction. This study assesses urban/rural differences by age and race/ethnicity in emergency department (ED) pediatric visit rates for food-induced anaphylaxis. Methods: This observational study examined 2009–2014 inpatient and ED data from New York and Florida, using ICD-9-CM diagnostic code (995.6) to identify food-induced anaphylaxis cases

The purpose of the study is to examine (1) nationally representative incidence rates of Emergency Department (ED) visits due to sudden cardiac arrest (SCA) in pediatric and young adult populations, (2) basic characteristics of the ED visits with SCA, and (3) patient and hospital factors associated with survival after SCA. We used the Nationwide Emergency Department Sample from 2006 to 2013. ICD-9-CM diagnostic codes identified ED visits due to SCA for patients ≤ 30 years old. Outcomes included yearly incidence of ED visits for SCA, and survival to hospital discharge. Predictors of interest were age groups, sex, and SCA case volume. A logistic regression model adjusted by patient- and hospital-level variables was used. Stratified analyses of age by (

Population declines of the endangered razorback sucker Xyrauchen texanus in the Colorado River basin have been attributed to predation by and competition with nonnative fishes, habitat alteration, and dam construction. The reproductive health and seasonal variation of the reproductive end points of razorback sucker populations are currently unknown. Using nonlethal methods, we characterized the plasma hormonal fluctuations of reproductively mature female and male razorback suckers over a 12-month period in a hatchery by measuring their vitellogenin (VTG) and three sex hormones: 17β-estradiol (E2), testosterone (T), and 11-ketotestosterone (KT). Fish were identified as reproductive or nonreproductive based on their body weight, VTG, and sex hormone profiles. In reproductive females, the E2 concentration increased in the fall and winter, and increases in T and VTG concentrations were generally associated with the spawning period. Mean T concentrations were consistently greater in reproductive femal...

Lungs of adult mice exposed to hyperoxia as newborns are simplified and exhibit reduced function much like that observed in people who had bronchopulmonary dysplasia (BPD) as infants. Because survivors of BPD also show increased risk for symptomatic respiratory infections, we investigated how neonatal hyperoxia affected the response of adult mice infected with influenza A virus infection.To determine whether neonatal hyperoxia increased the severity of influenza A virus infection in adult mice.Adult female mice exposed to room air or hyperoxia between Postnatal Days 1 and 4 were infected with a sublethal dose of influenza A virus.The number of macrophages, neutrophils, and lymphocytes observed in airways of infected mice that had been exposed to hyperoxia as neonates was significantly greater than in infected siblings that had been exposed to room air. Enhanced inflammation correlated with increased levels of monocyte chemotactic protein-1 (CCL2) in lavage fluid, whereas infection-associated changes in IFN-gamma, IL-1beta, IL-6, tumor necrosis factor-alpha, KC, granulocyte-macrophage colony-stimulating factor, and macrophage inflammatory protein-1alpha, and production of virus-specific antibodies, were largely unaffected. Increased mortality of mice exposed to neonatal hyperoxia occurred by Day 14 of infection, and was associated with persistent inflammation and fibrosis.These data suggest that the disruptive effect of hyperoxia on neonatal lung development also reprograms key innate immunoregulatory pathways in the lung, which may contribute to exacerbated pathology and poorer resistance to respiratory viral infections typically seen in people who had BPD.

This article describes the development and testing of the Cancer Rehabilitation Questionnaire (CRQ) in patients with colorectal cancer. A descriptive, correlational survey was conducted in a sample of patients with colon or rectal cancer who received care at an outpatient cancer clinic at a large, northeastern U.S. academic medical center. Patients were identified from the Tumor Registry (N = 327) and received a mailed questionnaire. One hundred and three patients with colorectal cancer completed the demographic questionnaire, the CRQ developed by the investigators, and the Quality of Life Index (QLI). Significant differences were found between individuals with colon cancer and individuals with rectal cancer on the total CRQ (p < .005) and the physical, future orientation, and role-relationship subscales. For the QLI, significantly lower scores were reported on the family subscale for patients with rectal cancer in comparison with those with colon cancer. More attention to rehabilitation issues and quality of life is required across the trajectory of the cancer experience. With the increasing incidence of colorectal cancer, nurses in rehabilitation practice must address the issues affecting patients with this disease as they progress from diagnosis to treatment and rehabilitation.

A previous qualitative study [Nurse Education Today 20 (2000) 499] investigated perceptions of nurse teachers, student nurses and preceptors of the theory-practice gap said to exist within nursing. One theme was views of how the theory-practice gap could be closed. A subsequent quantitative study is reported here, in which this theme was translated into three factors. A full factorial experimental design was used to study the effect of these factors on theoretical knowledge and practical skill acquisition in a sample of first year undergraduate student nurses from one institution of higher education (n=19). The effect of whether a nurse teacher or preceptor taught students theoretical elements relating to a clinical specialty, whether the nurse teacher and preceptor collaborated on the content of what was taught to students and whether students went straight to, or delayed the clinical specialty following theoretical input, was examined. The results demonstrated preceptors were more effective than nurse teachers in promoting theoretical knowledge relating to their clinical specialty. Collaboration between the preceptors and nurse teachers on teaching content was ineffective at increasing theoretical knowledge. Delay between theoretical input and clinical experience was not detrimental for medical placements and for rehabilitation placements, resulted in an improved theoretical knowledge.

The mathematical treatment and graphical representation of Special Relativity (SR) are well established, yet carry deep implications that remain hard to visualize. This paper presents a new graphical interpretation of the geometry of SR that may, by complementing the standard works, aid the understanding of SR and its fundamental principles in a more intuitive way. From the axiom that the velocity of light remains constant to any inertial observer, the geodesic is presented as a line of constant angle on the complex plane across a set of diverging reference frames. The resultant curve is a logarithmic spiral, and this view of the geodesic is extended to illustrate the relativistic Doppler effect, time dilation, length contraction, the twin paradox, and relativistic radar distance in an original way, whilst retaining the essential mathematical relationships of SR. Using a computer-generated graphical representation of photon trajectories allows a visual comparison between the relativistic relationships and their classical counterparts, to visualize the consequences of SR as velocities become relativistic. The model may readily be extended to other situations, and may be found useful in presenting a fresh understanding of SR through geometric visualization., Comment: Preprint of an article accepted for publication in Int. J. Mod. Phys. C, 21 Oct 2015. DOI 10.1142/S0129183116500558

The reactivity of a series of organometallic rare earth and actinide complexes with hemilabile NHC-ligands towards substrates with acidic C-H and N-H bonds is described. The synthesis, characterisation and X-ray structures of the new heteroleptic mono- and bis(NHC) cyclopentadienyl complexes LnCp2(L) 1 (Ln = Sc, Y, Ce; L = alkoxy-tethered carbene [OCMe2CH2(1-C{NCHCHNiPr})]), LnCp(L)2 (Ln = Y) 2, and the homoleptic tetrakis(NHC) complex Th(L)4 4 are described. The reactivity of these complexes, and of the homoleptic complexes Ln(L)3 (Ln = Sc 3, Ce), with E-H substrates is described, where EH = pyrrole C4H4NH, indole C8H6NH, diphenylacetone Ph2CC(O)Me, terminal alkynes RC[triple bond, length as m-dash]CH (R = Me3Si, Ph), and cyclopentadiene C5H6. Complex 1-Y heterolytically cleaves and adds pyrrole and indole N-H across the metal carbene bond, whereas 1-Ce does not, although 3 and 4 form H-bonded adducts. Complexes 1-Y and 1-Sc form adducts with CpH without cleaving the acidic C-H bond, 1-Ce cleaves the Cp-H bond, but 2 reacts to form the very rare H+-[C5H5]--H+ motif. Complex 1-Ce cleaves alkyne C-H bonds but the products rearrange upon formation, while complex 1-Y cleaves the C-H bond in diphenylacetone forming a product which rearranges to the Y-O bonded enolate product.

A set of β-ketoimidazolium and β-ketoimidazolinium salts of the general formula [R(1)C(O)CH2{CH[NCR(3)CR(3)N(R(2))]}]X (R(1) = (t)Bu, naphth; R(2) = (i)Pr, Mes, (t)Bu; R(3) = H, Me, (H)2; X = Cl, Br) show contrasting reactivity with superhydride bases MHBEt3; two are reduced to chiral β-alcohol carbene-boranes R(1)CH(OH)CH2{C(BEt3)[NCR(3)CR(3)N(R(2))]} 2 (R(1) = (t)Bu; R(2) = (i)Pr, Mes; R(3) = H), two with bulky R(2) substituents are reduced to chiral β-borate imidazolium salts [R(1)CH(OBEt3)CH2{CH[NCR(3)CR(3)N(R(2))]}]X 3 (R(1) = (t)Bu, naphth; R(2) = Mes, (t)Bu; R(3) = H, Me; X = Cl, Br), and the two saturated heterocycle derivatives remain unreduced but form carbene-borane adducts R(1)C(O)CH2{C(BEt3)[NCR(3)CR(3)N(R(2))]} 4 (R(1) = (t)Bu, naphth; R(2) = Mes; R(3) = (H)2). Heating solutions of the imidazolium borates 3 results in the elimination of ethane, in the first example of organic borates functioning as Brønsted bases and forming carbene boranes R(1)CH(OBEt2)CH2{C[NCR(3)CR(3)N(R(2))]} 5 (R(1) = naphth; R(2) = Mes; R(3) = Me). The 'abnormal' carbene borane of the form 2 R(1)CH(OH)CH2{CH[NC(BEt3)CR(3)N(R(2))]} (R(1) = (t)Bu; R(2) = (t)Bu; R(3) = H), is also accessible by thermolysis of 3, suggesting that the carbene-borane alcohol is a more thermodynamically stable combination than the zwitterionic imidazolium borate. High-temperature thermolysis also can result in complete cleavage of the alcohol arm, eliminating tert-butyloxirane and forming the B-N bound imidazolium borate 7. The strong dependence of reaction products on the steric and electronic properties of each imidazole precursor molecule is discussed.

Concentrations of total mercury (Hg) and methylmercury (MeHg) were determined in water, sediment, periphyton, spiders, and amphibians from the streams and desert marsh downstream from Arivaca Lake, Arizona, to better understand their distribution and bioaccumulation. Mean concentrations of MeHg in water ranged from 0.09 to 0.93 ng/L, and mean concentrations of total Hg in sediment ranged from 10.4 to 126 μg/kg. Hg and MeHg in water and sediments downstream from Arivaca Lake were low enough that they did not exceed human health or ecological thresholds. Hg and MeHg between sites ranged from 0.11 to 1.90 μg/g Hg and 0.01 to 0.3 μg/g MeHg in periphyton, from 0.09 to 0.25 μg/g Hg and 0.04 to 0.10 μg/g MeHg in spiders, and from 0.15 to 0.38 μg/g Hg and 0.14 to 0.35 μg/g MeHg in adult bullfrogs. No Hg toxicity data exist for periphyton or spiders, but MeHg concentrations in tadpoles (0.04 ± 0.005 μg/g) were lower than those known to cause sublethal effects and subchronic mortality. The mean total Hg concentration in adult bullfrogs in the present study was 0.24 μg/g, which is slightly lower than the mean (0.37 μg/g) from an Hg-contaminated wetland in California. MeHg bioaccumulated at each successive trophic level, and MeHg bioconcentration factors from the Arivaca watershed were similar to those for periphyton but greater than amphibians in other studies. Local resource managers can use these data to determine if water should be released from Arivaca Lake to recharge the aquifer downstream or to decrease Hg methylation in the reservoir.

With increasing power consumption of computer systems, faster and larger cooling fans are used and acoustic noise management becomes difficult. In this paper, we show that by locking a pair of cooling fan motors into a common frequency and 180 degrees out of phase, the dominant tone most perceptible by human ear can be reduced.

The purpose of this calculation is to evaluate the thermal performance of the Naval Long and Naval Short spent nuclear fuel (SNF) waste packages (WP) in the repository emplacement drift. The scope of this calculation is limited to the determination of the temperature profiles upon the surfaces of the Naval Long and Short SNF waste package for up to 10,000 years of emplacement. The temperatures on the top of the outside surface of the naval canister are the thermal interfaces for the Naval Nuclear Propulsion Program (NNPP). The results of this calculation are intended to support Licensing Application design activities.

The Single Heater Test (SHT) is the first of three in-situ thermal tests included in the site characterization program for the potential nuclear waste monitored geologic repository at Yucca Mountain. The heating phase of the SHT started in August 1996 and was concluded in May 1997 after 9 months of heating. Cooling continued until January 1998, at which time post-test characterization of the test block commenced. Numerous thermal, hydrological, mechanical, and chemical sensors monitored the coupled processes in the unsaturated fractured rock mass around the heater (CRWMS M&O 1999). The objective of this calculation is to benchmark a numerical simulation of the rock mass thermal behavior against the extensive data set that is available from the thermal test. The scope is limited to three-dimensional (3-D) numerical simulations of the computational domain of the Single Heater Test and surrounding rock mass. This calculation supports the waste package thermal design methodology, and is developed by Waste Package Department (WPD) under Office of Civilian Radioactive Waste Management (OCRWM) procedure AP-3.12Q, Revision 0, ICN 3, BSCN 1, Calculations.

The purpose of this calculation is to determine the thermal response of the 44-boiling water reactor (BWR) waste package (WP) to the hypothetical regulatory fire accident. The objective is to calculate the temperature response of the waste package materials to the hypothetical short-term fire defined in 10 CFR 7 1, Section 73(c)(4), Reference 1. The scope of the calculation includes evaluation of the accident with the waste package above ground, at the Yucca Mountain surface facility. The scope of this calculation is limited to the two-dimensional waste package temperature calculations to support the waste package design. The information provided by the sketches attached to this calculation is that for the potential design of the type of WP considered in this calculation. In addition to the nominal design configuration thermal load case, the effects of varying the BWR thermal load are determined. The associated activity is the development of engineering evaluations to support the Licensing Application (LA) design activities.

The objective of this calculation is to evaluate the thermal response of the 21-PWR WP (pressurized water reactor waste package) to the regulatory fire event. The scope of this calculation is limited to the two-dimensional waste package temperature calculations to support the waste package design. The information provided by the sketches attached to this calculation (Attachment IV) is that of the potential design of the type of waste package considered in this calculation. The procedure AP-3.12Q.Calculations (Reference 1), and the Development Plan (Reference 24) are used to develop this calculation.

The objective of this calculation is to evaluate the structural response of the waste package during the horizontal and vertical lifting operations in order to support the waste package lifting feature design. The scope of this calculation includes the evaluation of the 21 PWR UCF (pressurized water reactor uncanistered fuel) waste package, naval waste package, 5 DHLW/DOE SNF (defense high-level waste/Department of Energy spent nuclear fuel)--short waste package, and 44 BWR (boiling water reactor) UCF waste package. Procedure AP-3.12Q, Revision 0, ICN 0, calculations, is used to develop and document this calculation.

The purpose of this calculation is to evaluate the structural response of the standard high-level waste (HLW) canister and the HLW canister containing the cans of immobilized plutonium (''can-in-canister'' throughout this document) to the drop event during the handling operation. The objective of the calculation is to provide the structure parameter information to support the canister design and the waste handling facility design. Finite element solution is performed using the commercially available ANSYS Version (V) 5.4 finite element code. Two-dimensional (2-D) axisymmetric and three-dimensional (3-D) finite element representations for the standard HLW canister and the can-in-canister are developed and analyzed using the dynamic solver.

The carboxyl substituent effects for branched carboxylic acids have been determined by carbon-13 Fourier ransform nuclear magnetic resonance of eighteen measured and reported branched acids. For α-branched systems the substituent effects are α = 15.3 ppm, β = 2.6 ppm, γ = −1.9 ppm, δ = 0.9 ppm and ϵ = 0.5 ppm. For other branched acids, the determined carboxyl substituent effects are α = 19.2 ppm, β = 2.1 ppm, γ = −1.4 ppm, δ = 0.6 ppm, and ϵ = 0.6 ppm.

The 13C n.m.r. spectra of a series of 37 bicyclic ketones have been recorded to examine the variations in 13C shieldings with structure and with methyl substitution. Several examples of six skeletal types were included: bicyclo[4.4.0]decanones, bicyclo[4.1.0]heptanones, bicyclo-[3.1.0]hexanones, bicyclo[3.2.2]nonanones, bicyclo[3.2.1]- and -[3.3.0]octanones as well as bicyclo[2.1.1]hexan-2-one, nopinone (6,6-dimethylbicyclo[3.1.1]heptan-2-one), and two methyl derivatives of the latter. The observed trends associated with methyl substitution follow well-defined patterns and offer further support for the application of 13C shieldings as aids for stereochemical assignments especially through the well known γ effects. The variation in the shieldings of the carbonyl carbons in these systems suggested that bond eclipsing interactions have an important influence on this parameter. With this notion, the heretofore puzzling variations observed for the cycloalkanones are readily interprétable in terms of their favored conformations.

When a single injection of 500 I.U. of human chorionic gonadotropin (hCG) is given to rats there is an initial acute rise of plasma testosterone and of testicular content for both cyclic AMP and testosterone. This response correlates with an increase in both lyase and 17 alpha-hydroxylase activities. Thereafter both plasma and testicular testosterone decline and do not increase after a second injection of hCG. During this period of desensitization, isolated Leydig cells were insensitive to the steroidogenic stimulatory effect of both hCG and dibutyryl cyclic AMP. The post-cyclic AMP block is not due to an alteration of the cyclic AMP-dependent protein kinase but it is correlated with a decrease in both lyase and 17 alpha-hydroxylase activities of the Leydig cell's microsomes. This decrease is not caused by the absence of the recently described cytosol activator of this enzyme because its addition did not restore the enzymatic activity. Within 60 to 96 h after hCG injection there was a spontaneous increase of both plasma and testicular testosterone and this parallels the recovery of lyase and 17 alpha-hydroxylase activities. These results suggest that both enzymatic activities are regulated, directly or indirectly, by hCG, and that this is partly responsible for the hCG-induced steroidogenic refractoriness of Leydig cells.