A Multi-dimensional visual history on the upper falls of the Genesee River, Rochester, NY

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The Economics of Spruce Budworm Outbreaks in the Lake States: An Overview

Economic effects of spruce budworm outbreaks in the Lake States were examined. The recent outbreak caused spruce and fir mortality on 420 thousand ha (I.OS million acres) of commercial forest land in the Lake States. Two models of Lake States spruce-fir markets were developed. A Static Economic Model established the nature of the Lake States spruce-fir market and a Comparative Static Model examined changes brought about by spruce budworm outbreaks. Outbreaks result in short-run supply shifts which probably decrease total revenue to stumpage owners but do not affect demand. The magnitude of long-run impacts were dependent on developing Lake States markets and forest management techniques. Further research is necessary on the value of short-run losses to stumpage owners so that the costs of forest management can be compared with outbreak losses. Long-run shifts in demand can be facilitated by attracting new industry to the area, developing new markets for the spruce-fir resource, and demonstrating that the spruce-fir resource can provide a continuous fiber source in the future. These shifts would provide the price incentives that land managers require to undertake intensive forest management. Research on the development of new markets for the spruce-fir resource is needed. As markets develop, the long-run impacts become less severe. Technology transfer programs already exist to aid land managers in developing management strategies to increase yields of spruce-fir and minimize outbreak impact

Medullary Thyroid Carcinoma: Australian Experience with Genetic Testing

Linkage analysis has been performed in four pedigrees with multiple endocrine neoplasia type 2A (MEN 2A) or familial medullary thyroid carcinoma (MTC) using pericentromeric chromosome 10 probes. Important information regarding carrier status has been provided in 10 individuals, many of whom would not have been identified by pentagastrin stimulation testing. We have also used pulsed field gel electrophoresis (PFGE) to link the probes H4JRBP and pMCK2 to a 150 kb fragment. Using PFGE, no evidence was found in DNA from lymphocytes of a major DNA rearrangement in two individuals affected with MEN 2A and an individual with MEN 2B compared with normals. Metastatic MTC from one patient has been used to generate a cDNA library which will be used to screen for candidate MEN 2A and MEN 2B gen

Optical Spectroscopy of the Surface Population of the rho Ophiuchi Molecular Cloud: The First Wave of Star Formation

We present the results of optical spectroscopy of 139 stars obtained with the Hydra multi-object spectrograph. The objects extend over a 1.3 square degree area surrounding the main cloud of the rho Oph complex. The objects were selected from narrowband images to have H alpha in emission. Using the presence of strong H alpha emission, lithium absorption, location in the Hertzsprung-Russell diagram, or previously reported x-ray emission, we were able to identify 88 objects as young stars associated with the cloud. Strong H alpha emission was confirmed in 39 objects with line widths consistent with their origin in magnetospheric accretion columns. Two of the strongest emission-line objects are young, x-ray emitting brown dwarf candidates with M8 spectral types. Comparisons of the bolometric luminosities and effective temperatures with theoretical models suggest a medianage for this population of 2.1 Myr which is signifcantly older than the ages derived for objects in the cloud core. It appears that these stars formed contemporaneously with low mass stars in the Upper Scorpius subgroup, likely triggered by massive stars in the Upper-Centaurus subgroup.Comment: 35 pages of postscript which includes seven figures (some of which are multi-panel) and four postscript tables. Astronomical Journal (in press

Cabozantinib for previously treated radioiodine-refractory differentiated thyroid cancer: Updated results from the phase 3 COSMIC-311 trial

Cabozantinib; Differentiated thyroid cancer; Tyrosine kinase inhibitorCabozantinib; Cáncer de tiroides diferenciado; Inhibidor de la tirosina quinasaCabozantinib; Càncer de tiroides diferenciat; Inhibidor de la tirosina quinasaBackground At an interim analysis (median follow-up, 6.2 months; n = 187), the phase 3 COSMIC-311 trial met the primary end point of progression-free survival (PFS): cabozantinib improved PFS versus a placebo (median, not reached vs. 1.9 months; p < .0001) in patients with previously treated radioiodine-refractory differentiated thyroid cancer (RAIR-DTC). The results from an exploratory analysis using an extended datacut are presented. Methods Patients 16 years old or older with RAIR-DTC who progressed on prior lenvatinib and/or sorafenib were randomized 2:1 to oral cabozantinib tablets (60 mg/day) or a placebo. Placebo patients could cross over to open-label cabozantinib upon radiographic disease progression. The objective response rate (ORR) in the first 100 randomized patients and the PFS in the intent-to-treat population, both according to Response Evaluation Criteria in Solid Tumors version 1.1 by blinded, independent review, were the primary end points. Results At the data cutoff (February 8, 2021), 258 patients had been randomized (cabozantinib, n = 170; placebo, n = 88); the median follow-up was 10.1 months. The median PFS was 11.0 months (96% confidence interval [CI], 7.4–13.8 months) for cabozantinib and 1.9 months (96% CI, 1.9–3.7 months) for the placebo (hazard ratio, 0.22; 96% CI, 0.15–0.32; p < .0001). The ORR was 11.0% (95% CI, 6.9%–16.9%) versus 0% (95% CI, 0.0%–4.1%) (p = .0003) with one complete response with cabozantinib. Forty placebo patients crossed over to open-label cabozantinib. Grade 3/4 treatment-emergent adverse events occurred in 62% and 28% of the cabozantinib- and placebo-treated patients, respectively; the most common were hypertension (12% vs. 2%), palmar–plantar erythrodysesthesia (10% vs. 0%), and fatigue (9% vs. 0%). There were no grade 5 treatment-related events. Conclusions At extended follow-up, cabozantinib maintained superior efficacy over a placebo in patients with previously treated RAIR-DTC with no new safety signals.This study was sponsored by Exelixis, Inc., (Alameda, California). We thank the patients and their families, the investigators, and the site staff. Writing and editorial assistance was provided by Alexus Rivas, PharmD, and Michael Raffin (Fishawack Communications, a part of Fishawack Health, Conshohocken, Pennsylvania) and was funded by Exelixis

Atrial fibrillation in hemodialysis patients: clinical features and associations with anticoagulant therapy

Using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS), we determined incidence, prevalence, and outcomes among hemodialysis patients with atrial fibrillation. Cox proportional hazards models, to identify associations with newly diagnosed atrial fibrillation and clinical outcomes, were stratified by country and study phase and adjusted for descriptive characteristics and comorbidities. Of 17,513 randomly sampled patients, 2188 had preexisting atrial fibrillation, with wide variation in prevalence across countries. Advanced age, non-black race, higher facility mean dialysate calcium, prosthetic heart valves, and valvular heart disease were associated with higher risk of new atrial fibrillation. Atrial fibrillation at study enrollment was positively associated with all-cause mortality and stroke. The CHADS2 score identified approximately equal-size groups of hemodialysis patients with atrial fibrillation with low (less than 2) and higher risk (more than 4) for subsequent strokes on a per 100 patient-year basis. Among patients with atrial fibrillation, warfarin use was associated with a significantly higher stroke risk, particularly in those over 75 years of age. Our study shows that atrial fibrillation is common and associated with elevated risk of adverse clinical outcomes, and this risk is even higher among elderly patients prescribed warfarin. The effectiveness and safety of warfarin in hemodialysis patients require additional investigation

ACTH-secreting medullary thyroid cancer: a case series

Medullary thyroid cancer (MTC) is a rare neuroendocrine tumour that originates from the parafollicular cells of the thyroid gland. The most common presentation of MTC is with a single nodule; however, by the time of diagnosis, most have spread to the surrounding cervical lymph nodes. Cushing’s syndrome is a rare complication of MTC and is due to ectopic adrenocorticotrophic hormone (ACTH) secretion by tumour cells. Cushing’s syndrome presents a challenging diagnostic and management issue in patients with MTC. Tyrosine kinase inhibitors (TKI) previously used for the management of metastatic MTC have become an important therapeutic option for the management of ectopic ACTH in metastatic MTC. The article describes three cases of ectopic ACTH secretion in MTC and addresses the significant diagnostic and management challenges related to Cushing’s syndrome in metastatic MTC

The Initial Mass Function and Disk Frequency of the Rho Ophiuchi Cloud: An Extinction-Limited Sample

We have completed an optical spectroscopic survey of an unbiased, extinction-limited sample of candidate young stars covering 1.3 square degrees of the Rho Ophiuchi star forming region. While infrared, X-ray, and optical surveys of the cloud have identified many young stellar objects (YSOs), these surveys are biased towards particular stages of stellar evolution and are not optimal for studies of the disk frequency and initial mass function.We have obtained over 300 optical spectra to help identify 135 association members based on the presence of H-alpha in emission, lithium absorption, X-ray emission, a mid-infrared excess, a common proper motion, reflection nebulosity, and/or extinction considerations. Spectral types along with R and I band photometry were used to derive effective temperatures and bolometric luminosities for association members to compare with theoretical tracks and isochrones for pre-main-sequence stars. An average age of 3.1 Myr is derived for this population which is intermediate between that of objects embedded in the cloud core of Rho Ophiuchi and low mass stars in the Upper Scorpius subgroup. Consistent with this age we find a circumstellar disk frequency of 27% plus or minus 5%. We also constructed an initial mass function for an extinction-limited sample of 123 YSOs (A_v less than or equal to 8 mag), which is consistent with the field star initial mass function for YSOs with masses > 0.2 M_sun. There may be a deficit of brown dwarfs but this result relies on completeness corrections and requires confirmation.Comment: 46 pages, 7 figures, 4 table

A Burgessian critique of nominalistic tendencies in contemporary mathematics and its historiography

We analyze the developments in mathematical rigor from the viewpoint of a Burgessian critique of nominalistic reconstructions. We apply such a critique to the reconstruction of infinitesimal analysis accomplished through the efforts of Cantor, Dedekind, and Weierstrass; to the reconstruction of Cauchy's foundational work associated with the work of Boyer and Grabiner; and to Bishop's constructivist reconstruction of classical analysis. We examine the effects of a nominalist disposition on historiography, teaching, and research.Comment: 57 pages; 3 figures. Corrected misprint