Kinship Foster Care: A Relatively Permanent Solution

Kinship foster care is intended to provide substantially the same standard of care as children receive in placement with unrelated foster parents. In practice, however, the two differ enormously in New York City. Frequently, agencies place foster children in the homes of relatives with little regard for the adequacy of those homes. This Note evaluates the existing kinship foster care system, and examines the possibility of addressing the program\u27s problems by creating a new legislative category for kinship guardians

Mountain winds (revisited)

The prediction of extremely high wind speeds, at ground level on the downstream side of a mountain range, is possible by solving the initial value problem for a two-layered nonlinear shallow water model of the atmosphere. Three different numerical methods are described to find the solutions which may involve shocks: (1) the vonNeumann-Richtmyer artificial viscosity method, (2) a filtering scheme, and (3) a hybrid method

Numerical methods for meteorology and climatology

Efficient numerical methods for long term weather forecasting are developed. One implicit and one explicit scheme are compared as to accuracy

Microcomputer laboratories in mathematics education

AbstractThis article discusses the mathematical-educational potential of a computational laboratory at the pre-calculus and co-calculus levels. The laboratory envisaged is based on a set of microcomputers, whose use plays a central role in the teaching process, with particular emphasis on algorithmization. A new role for the mathematics teacher and professor is layed out, augmenting the “chalk and talk” methods by active participation as a laboratory instructor. Following a brief description of the integration of such a laboratory into the mathematical education, seven appropriate subjects are discussed, including some new relevant elementary proofs and worked out examples. Emphasis is placed upon the mathematical-educational byproducts (such as error bounds, ill-conditioning, complexity, rate of convergence, etc.) accompanying the implementation of these seven modules. Special attention is given to the removal of “black box” procedures and to the construction of “numerical methods that work”. Extensions and generalizations to more advanced topics are indicated, especially where the results in our modules may serve as points of departure in that direction

Wavelength variation in directional sensitivity of the long- and medium-wave sensitive foveal cones of red-green dichromats

The intensity of a monochromatic light required just to detect 30 Hz flicker as the point of entry of the light was changed in 0.5 mm steps across the eye's entrance pupil and measured throughout the spectrum on 4 protanopes and 5 deuteranopes. In general the directional sensitivity of the foveal cone of these dichromats is minimal in the same part of the spectrum that the spectral sensitivity is maximum. Since the action spectrum of only a single class of cones was evaluated by the procedure, it permits a quantitative comparison of two alternative models for directional sensitivity, one derived from the concept of self-screening, the other from waveguiding. The overall results do not exclude either but are slightly better described by the former than by the latter.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23755/1/0000728.pd

The wavelength variation of the directional sensitivity of the stiles [pi]1([mu])

The variation of the directional sensitivity of Stiles' (1953) [pi]1([mu]) mechanism was measured throughout the spectrum on one deuteranope. For wavelengths greater than about 550 nm, the directional properties measured for [pi]1([mu]) are nearly identical to those for this deuteranope's [pi]5([mu]) mechanism. This supports the hypothesis of Pugh (1976) that [pi]1([mu]) is a composite mechanism so that in the yellow-red part of the spectrum its sensitivity is determined by long- (and/or medium-) wave sensitive cones. It also obviates the contradiction between the single [pi]1([mu]) directional sensitivity result of Stiles (1939) and the suggestion (Enoch and Stiles, 1961) that short-wave sensitive cones are more sensitive to light entering through the edge than through the center of the pupil. This deuteranope's long-wave sensitive cones appear to be most sensitive to backgrounds entering the eye 0.5 mm nasal, to the center of his pupil while his short-wave sensitive cones appear to be most sensitive to light entering 0.2 mm temporal to the center of the pupil. Differences in the estimate of losses in the lens below 450 nm in the spectrum are too large to exclude either self-screening or the Snyder-Pask waveguide theories as applied to this subject's short-wave sensitive cones.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23756/1/0000729.pd

Hemodynamic Effects of a Calcium Channel Promoter, BAY y 5959, are Preserved after Chronic Administration in Ischemic Heart Failure in Conscious Dogs 1

ABSTRACT BAY y 5959 is a dihydropyridine derivative that binds to L-type calcium channels in a voltage-dependent manner and promotes calcium entry into the cell during the plateau of the action potential by influencing mean open time. Because myofilament responsiveness to calcium is preserved in congestive heart failure (CHF), the inotropic responsiveness to this compound should be preserved in CHF, and tolerance should not develop despite long-term treatment. To test these hypotheses, CHF was induced in 14 chronically instrumented dogs by daily (30 Ϯ 5 days) intracoronary microsphere injections. The effects of BAY y 5959 (2-h i.v. infusions of 3 g/kg/min and 10 g/kg/min) were determined before heart failure, after heart failure was established and then 2 h after the end of a 5-day continuous BAY y 5959 intra-atrial infusion. Before CHF, the positive inotropic effect of BAY y 5959 at a dose of 10 g/kg/ min [left ventricular dP/dt (LVdP/dt) increased from 2955 Ϯ 132 mmHg to 4897 Ϯ 426 mmHg, P Ͻ .05] was associated with bradycardia (HR decreased from 92 Ϯ 4 to 78 Ϯ 6 b/min, P Ͻ.05), slight increases in mean arterial pressure (it increased from 100 Ϯ 2 mmHg to 113 Ϯ 5 mmHg, P Ͻ.05) and did not alter left ventricular end-diastolic pressure. In CHF, BAY y 5959 continued to induce dose-dependent increases in left ventricular systolic pressure, LVdP/dt and mean arterial pressure, as well as causing bradycardia and a significant decrease in left ventricular end-diastolic pressure. After a 5-day infusion of BAY y 5959, base-line LVdP/dt and left ventricular end-diastolic pressure improved. The responses of LVdP/dt and mean arterial pressure to BAY y 5959 were similar to those of the control state. The sustained responses in CHF and after long-term infusion suggest that BAY y 5959 may be an effective and potent inotropic agent for treatment of CHF that does not lead to tolerance to its positive inotropic effects. The use of inotropic agents is an important form of therapy for many patients with CHF. Currently used inotropic agents generally fall into one of two classes: ␤-agonists or phosphodiesterase inhibitors. Although they are efficacious in many settings, their use is sometimes limited by afterload-reducing effects, by decreased effectiveness in heart failure, by the development of tolerance and by potential proarrhythmic effects such as sinus tachycardia and ventricular ectopy. BAY y 5959 is a dihydropyridine derivative that binds to L-type calcium channels in a voltage-dependent manner and promotes calcium entry into the cell during the plateau of the action potential by influencing mean open time Received for publication October 17, 1997. 1 This work is supported in part by a Grant-in-Aid from the American Heart Association (National Center) and a grant from Bayer Corporation, West Haven, CT. J.W. and D.B. were supported in part by an Investigatorship Award from the American Heart Association, New York City Affiliate, Inc. ABBREVIATIONS: LA, left atrium; LAP, left atrial pressure; LV, left ventricle; LVdP/dt max , peak left ventricular dP/dt; CHF, congestive heart failure; MAP, mean arterial pressure; LVEDP, left ventricular end-diastolic pressure; LVSP, left ventricular systolic pressure; LAD, left anterior descending artery; LCX, left circumflex coronary artery; BAY y 5959, (Ϫ)

Functional polymorphisms in the P2X7 receptor gene are associated with stress fracture injury

Context: Military recruits and elite athletes are susceptible to stress fracture injuries. Genetic predisposition has been postulated to have a role in their development. The P2X7 receptor (P2X7R) gene, a key regulator of bone remodelling, is a genetic candidate that may contribute to stress fracture predisposition. Objective: To evaluate the putative contribution of P2X7R to stress fracture injury in two separate cohorts, military personnel and elite athletes. Methods: In 210 Israeli Defence Forces (IDF) military conscripts, stress fracture injury was diagnosed (n=43) based on symptoms and a positive bone scan. In a separate cohort of 518 elite athletes, self-reported medical imaging scan-certified stress fracture injuries were recorded (n=125). Non-stress fracture controls were identified from these cohorts who had a normal bone scan or no history or symptoms of stress fracture injury. Study participants were genotyped for functional SNPs within the P2X7R gene using proprietary fluorescence-based competitive allele-specific PCR assay. Pearson Chi-square (χ2) tests, corrected for multiple comparisons, were used to assess associations in genotype frequencies. Results: The variant allele of P2X7R SNP rs3751143 (Glu496Ala- loss of function) was associated with stress fracture injury, while the variant allele of rs1718119 (Ala348Thr- gain of function) was associated with a reduced occurrence of stress fracture injury in military conscripts (P<0.05). The association of the variant allele of rs3751143 with stress fractures was replicated in elite athletes (P<0.05), whereas the variant allele of rs1718119 was also associated with reduced multiple stress fracture cases in elite athletes (P<0.05). Conclusions: The association between independent P2X7R polymorphisms with stress fracture prevalence supports the role of a genetic predisposition in the development of stress fracture injury

Benign splenosis mimicking peritoneal seeding in a bladder cancer patient: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Mavacamten Treatment for Symptomatic Obstructive Hypertrophic Cardiomyopathy: Interim Results From the MAVA-LTE Study, EXPLORER-LTE Cohort.

This study was funded by Bristol Myers Squibb, Princeton, New Jersey, USA. Bristol Myers Squibb’s policy on data sharing is available online at https://www.bms.com/researchers-and-partners/clinicaltrials-and-research/disclosure-commitment.html. Dr Rader has received consulting fees from Medtronic, Bristol Myers Squibb, and ReCor Medical. Dr Ore˛ziak has received personal fees from Bristol Myers Squibb. Dr Saberi has received personal fees from Bristol Myers Squibb. Dr Fermin has received consulting fees from Alnylam, Eidos Therapeutics, Bristol Myers Squibb, and Pfizer. Dr Wheeler has received personal fees and research support from Bristol Myers Squibb. Dr Garcia-Pavia has received consulting and speaking fees from Bristol Myers Squibb, Rocket Pharmaceuticals, and Cytokinetics and speaking fees from Bristol Myers Squibb and Cytokinetics. Dr Zwas has received personal fees from Bristol Myers Squibb. Dr Masri has received grants from Akcea, Pfizer, and Ultromics and consulting fees from Alnylam, Cytokinetics, Eidos Therapeutics, Ionis, and Pfizer. Dr Owens has received consulting fees from Bristol Myers Squibb, Cytokinetics, and Pfizer. Dr Hegde serves on the faculty of the Cardiovascular Imaging Core Laboratory at Brigham and Women’s Hospital, and her institution has received payments for her consulting work from Bristol Myers Squibb. Dr Seidler has received consulting fees or honoraria for lectures from Bristol Myers Squibb and Cytokinetics. Dr Balaratnam and Dr Sehnert are employees of Bristol Myers Squibb and own stock of Bristol Myers Squibb. Shawna Fox is an employee of IQVIA, a partner providing statistics services to Bristol Myers Squibb. Dr Olivotto has received grants from Amicus, Boston Scientific, Bristol Myers Squibb, Cytokinetics, Genzyme, and Menarini International and consulting fees from Amicus, Cytokinetics, Genzyme, MS Pharma, Rocket Pharmaceuticals, and Tenaya Therapeutics.BACKGROUND Data assessing the long-term safety and efficacy of mavacamten treatment for symptomatic obstructive hypertrophic cardiomyopathy are needed. OBJECTIVES The authors sought to evaluate interim results from the EXPLORER-Long Term Extension (LTE) cohort of MAVA-LTE (A Long-Term Safety Extension Study of Mavacamten in Adults Who Have Completed EXPLORER-HCM; NCT03723655). METHODS After mavacamten or placebo withdrawal at the end of the parent EXPLORER-HCM (Clinical Study to Evaluate Mavacamten [MYK-461] in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy; NCT03470545), patients could enroll in MAVA-LTE. Patients received mavacamten 5 mg once daily; adjustments were made based on site-read echocardiograms. RESULTS Between April 9, 2019, and March 5, 2021, 231 of 244 eligible patients (94.7%) enrolled in MAVA-LTE (mean age: 60 years; 39% female). At data cutoff (August 31, 2021) 217 (93.9%) remained on treatment (median time in study: 62.3 weeks; range: 0.3-123.9 weeks). At 48 weeks, patients showed improvements in left ventricular outflow tract (LVOT) gradients (mean change ± SD from baseline: resting: -35.6 ± 32.6 mm Hg; Valsalva: -45.3 ± 35.9 mm Hg), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (median: -480 ng/L; Q1-Q3: -1,104 to -179 ng/L), and NYHA functional class (67.5% improved by ≥1 class). LVOT gradients and NT-proBNP reductions were sustained through 84 weeks in patients who reached this timepoint. Over 315 patient-years of exposure, 8 patients experienced an adverse event of cardiac failure, and 21 patients had an adverse event of atrial fibrillation, including 11 with no prior history of atrial fibrillation. Twelve patients (5.2%) developed transient reductions in site-read echocardiogram left ventricular ejection fraction of <50%, resulting in temporary treatment interruption; all recovered. Ten patients discontinued treatment due to treatment-emergent adverse events. CONCLUSIONS Mavacamten treatment showed clinically important and durable improvements in LVOT gradients, NT-proBNP levels, and NYHA functional class, consistent with EXPLORER-HCM. Mavacamten treatment was well tolerated over a median 62-week follow-up.S