This paper studies the contribution of sulfa drugs, a groundbreaking medical innovation in the 1930s, to declines in US mortality. For several infectious diseases, sulfa drugs represented the first effective treatment. Using time-series and difference-in-differences methods, we find that sulfa drugs led to a 24 to 36 percent decline in maternal mortality, 17 to 32 percent decline in pneumonia mortality, and 52 to 65 percent decline in scarlet fever mortality between 1937 and 1943. Altogether, sulfa drugs reduced mortality by 2 to 3 percent and increased life expectancy by 0.4 to 0.7 years. We also find that sulfa drugs benefited whites more than blacks. (JEL I12, L65, N32, N72)

Abstract: How do teachers develop and use political knowledge to create equitable and inclusive conditions for and with disabled students, particularly disabled students of color? In this essay, we build on concepts of political teacher knowledge in mathematics education, critical inclusive mathematics education and disability studies to explore teacher knowledges that support disabled students’ mathematical learning. We focus on four aspects of political knowledge for teaching mathematics: (1) knowledge as relational and unfolding over time, (2) understanding and negotiating the political contexts in which we teach mathematics, (3) deconstructing deficit discourses about marginalized students, and (4) learning to creatively resist the systems for and with our students. To develop our theoretical analysis, we use a counterstory of a middle school Latino student named Luis and his Latina mathematics teacher, Ms. Marquez. Our aim is to open up discussions in mathematics teacher educational research about the politics at play in teaching inclusive mathematics.

Minimally invasive, specifically, robot-assisted mitral valve surgery has evolved as a method to intervene on mitral valve disease without a median sternotomy while providing the advantages of excellent visualization and allowing for precise technical movements in a small space with the goal to decrease surgical invasiveness, post-operative pain, and hospital length of stay. As patient interest in minimally invasive cardiac procedures become more prevalent and patients seek the opportunity to undergo robotic valve surgery, institutions worldwide are exploring the potential of establishing a robotic mitral valve surgery program. While robust existing experience in open surgical mitral valve repair, careful patient selection, a dedicated team, and institution support are fundamental factors to implement a new robotic mitral valve surgery program, we believe that simulation team training prior to transitioning to live cases is also crucial and should be incorporated to establish a successful mitral valve surgery program.

Background: Neurotypical young adults show task-based modulation and stability of their eye movements across tasks. This study aimed to determine whether persons with aphasia (PWA) modulate their eye movements and show stability across tasks similarly to control participants. Methods: Forty-eight PWA and age-matched control participants completed four eye-tracking tasks: scene search, scene memorization, text-reading, and pseudo-reading. Results: Main effects of task emerged for mean fixation duration, saccade amplitude, and standard deviations of each, demonstrating task-based modulation of eye movements. Group by task interactions indicated that PWA produced shorter fixations relative to controls. This effect was most pronounced for scene memorization and for individuals who recently suffered a stroke. PWA produced longer fixations, shorter saccades, and less variable eye movements in reading tasks compared to controls. Three-way interactions of group, aphasia subtype, and task also emerged. Text-reading and scene memorization were particularly effective at distinguishing aphasia subtype. Persons with anomic aphasia showed a reduction in reading saccade amplitudes relative to their respective control group and other PWA. Persons with conduction/Wernicke's aphasia produced shorter scene memorization fixations relative to controls or PWA of other subtypes, suggesting a memorization specific effect. Positive correlations across most tasks emerged for fixation duration and did not significantly differ between controls and PWA. Conclusion: PWA generally produced shorter fixations and smaller saccades relative to controls particularly in scene memorization and text-reading, respectively. The effect was most pronounced recently after a stroke. Selectively in reading tasks, PWA produced longer fixations and shorter saccades relative to controls, consistent with reading difficulty. PWA showed task-based modulation of eye movements, though the pattern of results was somewhat abnormal relative to controls. All subtypes of PWA also demonstrated task-based modulation of eye movements. However, persons with anomic aphasia showed reduced modulation of saccade amplitude and smaller reading saccades, possibly to improve reading comprehension. Controls and PWA generally produced stabile fixation durations across tasks and did not differ in their relationship across tasks. Overall, these results suggest there is potential to differentiate among PWA with varying subtypes and from controls using eye movement measures of task-based modulation, especially reading and scene memorization tasks.

Pulmonary arterial hypertension (PAH) is a progressive disease characterized by elevated pulmonary vascular resistance (PVR) leading to right heart failure and premature death. The increased PVR results in part from pulmonary vascular remodeling and sustained pulmonary vasoconstriction. Excessive pulmonary vascular remodeling stems from increased pulmonary arterial smooth muscle cell (PASMC) proliferation and decreased PASMC apoptosis. A rise in cytosolic free Ca²⁺ concentration ([Ca²⁺]_cyt) in PASMC is a major trigger for pulmonary vasoconstriction and a key stimulus for PASMC proliferation and migration, both contributing to the development of pulmonary vascular remodeling. PASMC from patients with idiopathic PAH (IPAH) have increased resting [Ca²⁺]_cyt and enhanced Ca²⁺ influx. Enhanced Ca²⁺ entry into PASMC due to upregulation of membrane receptors and/or Ca²⁺ channels may contribute to PASMC contraction and proliferation and to pulmonary vasoconstriction and pulmonary vascular remodeling. We have shown that the extracellular Ca²⁺-sensing receptor (CaSR), which is a member of G protein-coupled receptor (GPCR) subfamily C, is upregulated, and the extracellular Ca²⁺-induced increase in [Ca²⁺]_cyt is enhanced in PASMC from patients with IPAH in comparison to PASMC from normal subjects. Pharmacologically blockade of CaSR significantly attenuate the development and progression of experimental pulmonary hypertension in animals. Additionally, we have demonstrated that dihydropyridine Ca²⁺ channel blockers (e.g., nifedipine), which are used to treat PAH patients but are only effective in 15-20% of patients, activate CaSR resulting in an increase in [Ca²⁺]_cyt in IPAH-PASMC, but not normal PASMC. Our data indicate that CaSR functionally couples with transient receptor potential canonical (TRPC) channels to mediate extracellular Ca²⁺-induced Ca²⁺ influx and increase in [Ca²⁺]_cyt in IPAH-PASMC. Upregulated CaSR is necessary for the enhanced extracellular Ca²⁺-induced increase in [Ca²⁺]_cyt and the augmented proliferation of PASMC in patients with IPAH. This review will highlight the pathogenic role of CaSR in the development and progression of PAH.

Stable-isotope ratios of carbon (13C/12C; δ13C) and nitrogen (15N/14N; δ15N) in animal tissues are analyzed to estimate animal foraging ecology because these ratios reflect those of an animal's diet. This reflection is generally indirect, as stable-isotope ratios change with trophic level. These differences, called discrimination factors (reported as Δ), vary considerably by species and tissue. Variations in discrimination factors used in stableisotope mixing models can lead to inaccurate estimates of diets. Therefore, determining accurate discrimination factors specific to species and tissue is important. We established the Δ13C and Δ15N values between diet and blood and feathers from chicks and juveniles of the California Condor (Gymnogyps californianus). Hatchlings were fed rats for 76-119 days, whereas juveniles were fed dairy calves for 64 days. The mean Δ13C and Δ15N values ( ± SD) between chick feathers and rat muscle were 0.4 ± 0.4‰ and 3.1 ± 0.2‰, respectively; those between chicks' whole blood and rat muscle were -0.7 ± 0.1‰ and 1.7 ± 0.1‰, respectively. The mean Δ13C and Δ15N values between juvenile condors' plasma and calf muscle were 0.9 ± 0.2‰ and 3.3 ± 0.7‰, respectively; those between juveniles' red blood cells and calf muscle were 0.3 ± 0.3‰ and 1.8 ± 0.1‰, respectively; and those between juveniles' whole blood and calf muscle were 0.3 ± 0.3‰ and 1.9 ± 0.2‰, respectively. We report the first discrimination factors for the Cathartidae (New World vultures), and our findings will have important applications in studies of the critically endangered California Condor's foraging ecology. © The Cooper Ornithological Society 2013.

Given that neurocognitive impairment is a frequent complication of HIV-1 infection in Spanish-speaking adults, the limited number of studies assessing HIV-associated neurocognitive disorders (HAND) in this population raises serious clinical concern. In addition to being appropriately translated, instruments need to be modified, normed, and validated accordingly. The purpose of the current study was to examine the diagnostic utility of the HIV Dementia Scale (HDS) and International HIV Dementia Scale (IHDS) to screen for HAND in Spanish-speaking adults living with HIV infection. Participants were classified as either HAND (N = 47) or No-HAND (N = 53) after completing a comprehensive neuropsychological evaluation. Receiver operating characteristic analyses found the HDS (AUC = .706) was more sensitive to detecting HAND than the IHDS (AUC = .600). Optimal cutoff scores were 9.5 for the HDS (PPV = 65.2%, NPV = 71.4%) and 9.0 for the IHDS (PPV = 59.4%, NPV = 59.1%). Canonical Correlation Analysis found the HDS converged with attention and executive functioning. Findings suggest that while the IHDS may not be an appropriate screening instrument with this population, the HDS retains sufficient statistical validity and clinical utility to screen for HAND in Spanish-speaking adults as a time-efficient and cost-effective measure in clinical settings with limited resources.

Developmental changes in the temporal and spatial regulation of gene expression drive the emergence of normal mature brain function, while disruptions in these processes underlie many neurodevelopmental abnormalities. To solidify our foundational knowledge of such changes in a primate brain with an extended period of postnatal maturation like in human, we investigated the whole-genome transcriptional profiles of rhesus monkey brains from birth to adulthood. We found that gene expression dynamics are largest from birth through infancy, after which gene expression profiles transition to a relatively stable state by young adulthood. Biological pathway enrichment analysis revealed that genes more highly expressed at birth are associated with cell adhesion and neuron differentiation, while genes more highly expressed in juveniles and adults are associated with cell death. Neocortex showed significantly greater differential expression over time than subcortical structures, and this trend likely reflects the protracted postnatal development of the cortex. Using network analysis, we identified 27 co-expression modules containing genes with highly correlated expression patterns that are associated with specific brain regions, ages or both. In particular, one module with high expression in neonatal cortex and striatum that decreases during infancy and juvenile development was significantly enriched for autism spectrum disorder (ASD)-related genes. This network was enriched for genes associated with axon guidance and interneuron differentiation, consistent with a disruption in the formation of functional cortical circuitry in ASD.

In a survey of infection prevention programs, leaders reported frequent clinical and infection prevention practice modifications to avoid coronavirus disease 2019 (COVID-19) exposure that exceeded national guidance. Future pandemic responses should emphasize balanced approaches to precautions, prioritize educational campaigns to manage safety concerns, and generate an evidence-base that can guide appropriate infection prevention practices.