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This paper presents a small-area index of the multifactorial phenomenon loosely referred to as gentrification, with application to New York City (NYC). The relative change of key input variables (m...

This chapter looks into genders in early early America. While trans histories have been understudied, gender-variant subjects have been over analysed. Reverend Joseph Israel Lobdell's place in the history of sexology and transgender has been used to mark the emergence of sexological regimes at the turn of the twentieth century. Increasing trans visibility in the current moment has indeed drawn attention to the issues of trans justice, but it has been accompanied by increasing anti-trans violence and targeted backlash. The chapter highlights Anne Hutchinson and Governor John Winthrop arguing the connection of gender to the practice of teaching than to the identity and body of the practitioner.

Populations of many species of grassland‐associated butterflies, moths, and bumblebees in the Great Plains of North America are experiencing steep declines due to habitat loss and degradation—primarily conversion of grasslands to row‐crop agriculture and invasion of woody plants and exotic cool‐season grasses—and insecticide use. These declines are exacerbated by the generally limited dispersal ability of insects, which make local populations susceptible to extirpation following habitat fragmentation. Interest in pollinator conservation has grown substantially in recent years, but information to guide pollinator conservation across the region is limited. We used pollinator biology along with principles of landscape ecology and metapopulation dynamics to develop a simple decision matrix based on patch size and inter‐patch distances to guide landscape‐scale grassland conservation efforts in the U.S. northern Great Plains. When applied to spatial land cover data depicting potential pollinator habitat, the matrix uses landscape characteristics to guide placement of conservation treatments to help ensure persistence of target pollinator populations. Patch size and connectivity thresholds can be set to match characteristics of target species, but in all cases, local management will be necessary to ensure that fine‐grained features such as nectar sources and host plants are present. Applying the matrix to habitat layers for a nine‐state analysis region showed substantial geographic variation in conservation needs, opportunities, and potential treatments. We also demonstrate that non‐native planted cover such as alfalfa and certain grasslands enrolled in the Conservation Reserve Program can substantially enhance landscape structure by increasing grassland patch size and core area while decreasing distance between patches. Pollinators dependent on native prairie will also benefit from planted cover that provides nectar sources and serves as a buffer from pesticides associated with croplands. Consistent with the principles of strategic habitat conservation, targeted monitoring and research will be necessary to validate and adapt the model to meet local conditions.

Covid-19 is a systemic viral respiratory illness that can cause gastrointestinal manifestations. There is evidence that Covid-19 can infect liver tissue and may cause transaminemia. A prognostic model is needed to aid clinicians in determining disease severity. The Model for End-Stage Liver Disease-Sodium (MELD-Na) score is a mortality assessment tool in liver transplant patients that has been found to be prognostic in other clinical situations. This study aimed to determine if the MELD-Na score was associated with disease severity in patients with Covid-19, as assessed by multiple clinical outcomes including death within 30 days of discharge and development of an acute kidney injury (AKI). This is a retrospective cohort study that analyzed patients admitted to a community academic hospital with the diagnosis of Covid-19. The 30-day MELD-Na score was found to be significantly higher in those who died (14.38 ± 6.92) relative to those who survived (9.68 ± 5.69; p = 0.03). Additionally, patients with a MELD-Na score greater than 10 were found to have higher risk of developing an AKI (odds ratio (OR) 3.31 (1.08, 10.17); p = 0.03), need for hemodialysis (OR 9.69 (1.74, 53.96); p = 0.007), require vasopressors (OR 4.55 (1.22, 16.99); p = 0.02), and have a longer hospital stay (OR 4.17 (1.05, 16.47); p = 0.03). The MELD-Na score may serve as a useful clinical scoring system for prognosis in patients admitted to the hospital with Covid-19.

Introduction Prognostic factors are needed to aid clinicians in managing Covid‐19, a respiratory illness. Lymphocytopenia has emerged as a simply obtained laboratory value that may correlate with prognosis. Methods In this article, we perform a retrospective cohort review study on patients admitted to one academic hospital for Covid‐19 illness. We analyzed basic demographic, clinical, and laboratory data to understand the relationship between lymphocytopenia at the time of hospital admission and clinical outcomes. Results We discovered that lymphocyte count is lower (P = .01) and lymphocytopenia more frequent by an odds ratio of 3.40 (95% CI: 1.06‐10.96; P = .04) in patients admitted to the Intensive Care Unit (ICU), a marker of disease severity, relative to those who were not. We additionally find that patients with lymphocytopenia were more likely to develop an acute kidney injury (AKI), a marker of organ failure, during admission by an odds ratio of 4.29 (95% CI: 1.35‐13.57; P = .01). Conclusion This evidence supports the hypothesis that lymphocytopenia can be an early, useful, and easily obtained, prognostic factor in determining the clinical course and disease severity of a patient admitted to the hospital for Covid‐19.

Percutaneous transhepatic cholangiodrainage is an intervention for obstructive jaundice that, although effective in decreasing bilirubin levels, often leads to depletion of regular bile acids that subsequently cause malabsorption, diarrhea, and acute kidney injury. Bile reinfusion (BR) is a method of enteral refeeding of biliary secretions to replenish innate bile acids to the patient. In addition, BR is a low-cost alternative to exogenous bile acid replacement and abates the need for inpatient fluid resuscitation. We report oral BR in a patient with percutaneous transhepatic cholangiodrainage due to choledocholithiasis and review the literature on BR.

Prognostic markers are needed to understand the disease course and severity in patients with Covid-19. There is evidence that Covid-19 causes gastrointestinal symptoms and abnormalities in liver enzymes. We aimed to determine if hepatobiliary laboratory data could predict disease severity in patients with Covid-19. In this retrospective, single institution, cohort study that analyzed patients admitted to a community academic hospital with the diagnosis of Covid-19, we found that elevations of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (AP) at any time during hospital admission increased the odds of ICU admission by 5.12 (95% CI: 1.55–16.89; p = 0.007), 4.71 (95% CI: 1.51–14.69; p = 0.01) and 4.12 (95% CI: 1.21–14.06, p = 0.02), respectively. Hypoalbuminemia found at the time of admission to the hospital was associated with increased mortality (p = 0.02), hypotension (p = 0.03), and need for vasopressors (p = 0.02), intubation (p = 0.01) and hemodialysis (p = 0.002). Additionally, there was evidence of liver injury: AST was significantly elevated above baseline in patients admitted to the ICU (54.2 ± 15.70 U/L) relative to those who were not (9.2 ± 4.89 U/L; p = 0.01). Taken together, this study found that hypoalbuminemia and abnormalities in hepatobiliary laboratory data may be prognostic factors for disease severity in patients admitted to the hospital with Covid-19.

We present a 50-year-old woman with human immunodeficiency virus admitted to the hospital for melenic stools and anemia who underwent esophagogastroduodenoscopy for evaluation of upper gastrointestinal bleed. She is found to have inflammation of the esophagus with ulcerations and crater formation. A biopsy reveals severe inflammation with lymphocytic infiltrates with civatte bodies suggestive of lichenoid esophagitis with the presence of spirochetes (Treponema pallidum). The presence of syphilis in the esophagus causing lichenoid esophagitis is an extremely rare presentation that has never been reported.

Urban park designers have long championed the social underpinnings of their work. Of late, however, certain landscape practitioners have articulated a more explicit connection between park design and social objectives, arguing that the fundamental role of urban parks is to foster equity and justice. Drawing on Marxian geographer David Harvey’s notion of the geographical imagination, this paper interrogates the relationship between parks and social processes by exploring the role that social issues have historically played in urban park design and by unpacking the prevailing imaginaries of social justice landscape architects and designers have employed in contemporary urban park projects. In doing so, it juxtaposes the lofty rhetoric of designing for social justice against the material reality of development-driven urban regeneration. In this way, the geographic imaginary provides a framework for understanding the limited capacity of urban park design to address broader social issues, even as it offers a mechanism for conceiving and articulating alternatives that more completely address the conditions through which social injustice occurs.

Background: Health Systems routinely make investments in clinically driven outreach programs to build for future community needs, improve health outcomes, and serve their community mission. Many community sports programs have limited access to sports medicine care, including access to athletic trainers. Hypothesis/Purpose: The primary purpose of this study was to evaluate the impact of a clinically integrated Certified Athletic Trainer (ATC) Community Sports Outreach Program, by evaluating the outreach into the community, sports clubs, schools, covered events. Methods: The ATC Community Outreach Program monitored key metrics over a 3 and 1/2-year period. Metrics included the partnerships developed with local clubs and schools, number of athletes covered in each organization, games covered and hours spent supporting organizations. Categories were divided into fiscal years (FY) running from September to August. Fiscal Year 2016 was calculated from January – August, as it was the first year of the program. The percentage of growth of the amount of games covered was calculated from the adjacent FY. Results: Over the first 3 and 1/2 years (FY2016-FY2019), the number clubs, schools, programs covered grew from 10, 19, 25, to 31 from FY2016 - FY2019. Number of athletes from 7,363, 12,552, 15,104, to 19,794 from FY2016 - FY2019. The number of community outreach events grew from 6, 11, 57, to 190 from FY2016 - FY2019 (Table/Figure 1.1). The percentage of growth of games covered grew from 183%, 518% to 333% between FY2016 and FY2019. Discussion/Conclusion: Building, maintaining a sports medicine practice is a complex undertaking, and represents a significant investment for the health system and community. In many communities, access to sports medicine care for athletes is very limited. A clinically integrated ATC program can generate a significant impact on the community by building relationships with local sports clubs/schools and improving sports medicine care access to young athletes. Tables/Figures: [Table: see text][Figure: see text]

In October of 1776 Jemima Wilkinson of Cumberland, Rhode Island, claimed to have died and been resurrected by the Spirit of the Lord as a genderless spirit, renamed the “Publick Universal Friend.” As a resurrected spirit, the Friend defied the line between living and dead, body and spirit, divine and human, and male and female. The Friend performed this spiritual state by mixing worldly category signifiers, dressing in a combination of male, female, and priestly clothing. Followers used genderless language for the Friend and in the 1790s founded Jerusalem, New York on lands purchased from the Iroquois Confederacy. Critics denounced the Friend’s gender ambiguity as a sign of devilry, and they linked it to fraud, licentiousness, and murder. This study draws on the methodological commitments of transgender theory to take seriously the Friend’s claim to have transcended gender, and it seeks to investigate religious challenges to gender “before” transgender. For early Americans, radical religious experience could be a site of gender crossing even as it reinforced worldly hierarchies and drove participation in settler colonialism.

Due to the widespread existence and importance of foam, inverse techniques for characterizing industrial foams are of interest. An essential element in an inverse method used to characterize a foam layer is a model of the time-dependent reflectance of a laser pulse. Monte Carlo methods may be used to accurately model reflectance, but these methods are computationally expensive. Computationally efficient methods based on the diffusion approximation have been developed, but this approach is not sufficiently accurate in many cases of interest. Therefore, a computationally efficient and robust method is desirable. This paper presents a computationally efficient method for modeling the time-dependent reflectance of a laser pulse from a non-absorbing, scattering plane layer that is based on reduced-order modeling techniques. The accuracy of the proposed method is demonstrated by comparing reflectance profiles for randomly selected foam layer properties with corresponding profiles that were generated from Monte Carlo simulations.

IntroductionIn the mid 1990s, Cuba implemented a growth-driven strategy to attract remittances from abroad, consisting of the legalization of the U.S. dollar, the expansion of a national network of state-run "dollar stores" (tiendas de recaudacion de divisas - TRDs), the development of government-operated exchange bureaus (Casas de Cambio, S.A. - CADECAS), and the transformation of the banking sector. These measures contributed to increases in the influx of remittances, and to the expansion of international tourism. Annual remittances increased from $537 million in 1995 to more than $900 million in 2005; tourist arrivals rose from 745,000 in 1995 to 2.0 million in 2005; and gross tourism revenues grew from $1.1 billion to $2.1 billion over the same period.Despite the impressive growth recorded during the 1995-2005 period, the amount of annual remittances sent to Cuba was significantly lower than the amounts sent to the Dominican Republic and El Salvador. According to the Inter-American Development Bank (IDB), Latin America and the Caribbean received an estimated $45 billion in remittances in 2004 (Terry 2005). While Cuba only received an estimated $855 million in remittances, or 2 percent of the total amount, the Dominican Republic received $2.2 billion, or 4.9 percent, and El Salvador $2.5 billion, or 5.5 percent.In the case of the Dominican Republic, remittances accounted for 6.6 percent of gross domestic product (GDP) in 1995, compared to 8.2 percent in 2005, and the ratio of remittances to merchandise exports over the same period increased from 21 percent to 39.3 percent. In El Salvador, remittances represented 12.1 percent of GDP in 1995; but rose to 16.7 percent in 2005; meanwhile, the ratio of remittances to merchandise exports increased from 74.1 percent to 83.5 percent.This study examines the unique nature of Cuba's remittance landscape and the magnitude of remittances in the Cuban economy, and compares them with the Dominican Republic and El Salvador.2 These countries were chosen because they share similar demographic characteristics3, their economies are roughly the same size4, and they share cultural values and expectations that strengthen and stimulate the flow of remittances. In the first section, we review the general factors that motivate remittance behavior. Next, we describe and compare the principal characteristics of the remittances landscape in Cuba, the Dominican Republic and El Salvador. And, finally, in the third section, we analyze and compare the magnitude of remittances in the Cuban, Dominican, and Salvadoran economies during the 1995-2005 period.Factors That Influence Remittance Behavior5Family remittances are defined as the portion of earnings (or income) sent by persons working (and residing) abroad for a period greater than one year to friends and relatives in their countries of origin (Garcia and de Palacios 2005). These unrequited unilateral transfers typically exclude debt payments and investments to purchase real or financial assets, which are usually classified as deposits or investments rather than family remittances (Garcia and de Palacios 2005). Periodic payments sent by temporary guest workers are also excluded from the standard definition of remittances, since they represent an indirect form of employee compensation (Garcia & de Palacios, 2005). The traditional definition of family remittances also excludes any personal belongings, including cash and transferable financial assets, that persons working and residing abroad may bring upon their return to their countries of origin, since such assets (in both tangible and intangible form) are usually classified as "migrant transfers"(Garcia and de Palacios 2005).Given these definitions, it is clear that migration is a necessary condition for the existence of remittances. The literature on remittances identifies two economic factors that contribute to migration. On the demand side, there are the so-called "pull factors" such as the demand for labor and intricate social networks that facilitate the migrant's integration in host countries. …

*† ‡ § ** This paper presents the solution to a non-linear model of a circular foil heat flux gage which is exposed to a blackbody source in a vacuum environment. This is the scenario typically used to calibrate a circular foil heat flux gage. The non-linear model is solved using a Green’s function approach. This approach results in an integral equation for the steadystate temperature profile in the gage, which is solved using the method of successive approximations. A relationship between the incident radiative heat flux and the temperature profile is developed using this model. This relationship is compared to previously published relationships which were derived using linear models. The first and simplest linear model neglects emission from the foil. The second linear model is obtained by linearizing the emissive power of the gage. It is shown that these linear models only produce accurate results when the gage design and operating conditions result in a nearly uniform foil temperature. A procedure based on the non-linear model is proposed for optimizing the design of a circular foil heat flux gage. A calibration procedure based on the non-linear model is also proposed.

In this paper, we introduce the Lehigh Ocean Research Craft Autonomous (LORCA) — a high performance USV with applications to surveillance and monitoring tasks. Compact (1.2 m), lightweight (5 kg) and robust (one-piece carbon fiber design), LORCA is capable of speeds of 80 kph (50 mph). It was also designed to be capable of operations in ocean waves, with self-righting ability in all sea states. We first review the LORCA design and technical specifications. We then discuss our initial work in trajectory following where an EKF-based approach is employed for localization and a sample based planner for control. Using only the sensing and computational resources available on a 3DR Pixhawk, we demonstrate effective trajectory following in a riverine environment at peak speeds of 48 kph (30 mph). We conclude with discussions on the limitations of the current approach and planned future work.

Objective To compare 2 hours of daily patching (combined with 1 hour of concurrent near visual activities) with a control group of spectacle wear alone (if needed) for treatment of moderate to severe amblyopia in children 3 to 7 years old. Design Prospective randomized multicenter clinical trial (46 sites). Participants One hundred eighty children 3 to 7 years old with best-corrected amblyopic-eye visual acuity (VA) of 20/40 to 20/400 associated with strabismus, anisometropia, or both who had worn optimal refractive correction (if needed) for at least 16 weeks or for 2 consecutive visits without improvement. Intervention Randomization either to 2 hours of daily patching with 1 hour of near visual activities or to spectacles alone (if needed). Patients were continued on the randomized treatment (or no treatment) until no further improvement was noted. Main Outcome Measure Best-corrected VA in the amblyopic eye after 5 weeks. Results Improvement in VA of the amblyopic eye from baseline to 5 weeks averaged 1.1 lines in the patching group and 0.5 lines in the control group ( P = 0.006), and improvement from baseline to best measured VA at any visit averaged 2.2 lines in the patching group and 1.3 lines in the control group ( P Conclusion After a period of treatment with spectacles, 2 hours of daily patching combined with 1 hour of near visual activities modestly improves moderate to severe amblyopia in children 3 to 7 years old.