Rowan University

After the Mexican Revolution, statesmen and educators envisioned a new urban complex for the National Autonomous University of Mexico to expand public higher education and support the consolidation of the postrevolutionary state. Although construction of Ciudad Universitaria (CU), or University City, would not begin until 1950 due to political upheaval and university-state conflicts, this article examines unbuilt plans and sketches of the project that circulated in the interim decades to trace the urban planning models that shaped it, including other Ibero-American ciudades universitarias , Beaux-Arts architecture, and the Garden City Movement. Despite state rhetoric insisting that the project reflect a Mexican national character, this article shows that early plans drafted between 1928 and 1942 primarily reflected international models because the aesthetics of Mexican revolutionary nationalism were still in development. Although the early plans were never realized, they served as crucial antecedents against which planners eventually imagined a Ciudad Universitaria imbued with Mexicanidad .

Professionalism in medicine has been historically difficult to define, teach, assess, and remediate. While professionalism is vital to the practice of medicine, the lack of consistency across training and disciplines, combined with the often generalized nature of its description, has caused challenges in academic medicine and has led to the weaponization of its use. It is clear that change in this essential competency in medicine is needed, and change has to begin with an honest self-assessment. The purpose of this report is to present an evidence-based rubric for the assessment of professionalism at the institutional level. The literature on professionalism emphasizes the importance of creating and maintaining a culture of professionalism within an educational community that guides expected behaviors and ensures accountability. This rubric presents expected behaviors within the major areas of the academic enterprise through an osteopathic lens, emphasizing the distinctive wisdom of osteopathic philosophy and the guidance it provides for a new landscape of medical professionalism. Through the Senior Leadership Development Program (SLDP) of the American Association of Colleges of Osteopathic Medicine (AACOM), the authors identified six key areas in which to define osteopathic medical professionalism at the institutional level. These are: Definition and Culture; Prematriculation and Matriculation; Preclinical Curriculum; Clinical Curriculum; Student Affairs, Disciplinary Procedure, and Code of Conduct; Patient Care; and Research. Within each area, five clusters of professionalism were utilized to capture the multi-dimensional nature of cultivating a culture of professionalism within a community: Ethics and Integrity, Respect, Teamwork, Accountability, and Self-Management. A four-tier scale was developed to evaluate participants' performance in theseareas. The result of this report is a multi-dimensional and comprehensive rubric that can be utilized by colleges of osteopathic medicine (COMs) to perform self-assessments of how professionalism is conceptualized at their institution. In addition, the rubric can be utilized by segments of the academic enterprise in focused self-assessment and for change efforts at the programmaticlevel. Osteopathic medical professionalism has the potential to carve a new pathway for the future of professionalism in academic medicine. This institutional self-assessment rubric for COMs is the first step in a change process that can clarify and specify how professionalism is defined, so that appropriate and meaningful teaching, assessment, and remediation can follow. Future research on this rubric will be to conduct formal validation analysis in order to standardize its application in an effort to broaden its use and potential impact.

During continental rifting, two main types of faults accommodate crustal extension and thinning, namely high-angle normal faults and large-offset (“low-angle”) detachment faults. Classical interpretations of Atlantic-type rifted margins assume a predominance of high-angle normal faults in the proximal margin and of extensional detachment faults in the most distal domain; however, the structural interpretation of the so-called necking domain in between remains disputed.Identifying high-angle faults and extensional detachment faults at rifted margins is challenging because: (1) seismic reflection images may not allow interpreters to indisputably locate the top basement and/or recognize syn-tectonic sedimentary sequences; and (2) the interpretation of extensional detachment faults is often debatable due to their faint topographic and stratigraphic expressions and the common overprint of their exhumed footwall by high-angle normal faults or erosion. Yet, the accurate identification of high-angle and extensional detachment faults is crucial for understanding the stratigraphic, thermal and isostatic evolutions of rift systems, all of which are fundamental to successful predictions.We present a methodology to interpret crustal-scale seismic reflection images of magma-poor rifted margins and test the reliability of structural interpretations via geometrical criteria. We use TGS line 140 located offshore Portugal, north of the Peniche peninsula, as a case study.

Corporate misconduct can have devastating consequences for organizational stakeholders. Yet firms diverge sharply in how their boards respond to such infringements, especially when deciding whether to dismiss the CEO. We theorize that boards interpret misconduct through the lens of organizational identity orientation—that is, the nature of assumed relationships between an organization and its stakeholders. Using a machine learning analysis of shareholder letters from S&P 500 firms (2004–2017), we show that organizational identity orientation shapes dismissal decisions. Firms with individualistic orientations, which emphasize personal achievement, are more likely to dismiss CEOs as misconduct is seen as an individual failing. In contrast, firms with collectivistic orientations, which emphasize interdependence, are less likely to dismiss CEOs as misconduct is interpreted as diffuse and systemic. These findings reveal how organizational identity orientation shapes boards’ interpretations of responsibility, offering new insights into why firms experience different accountability outcomes in response to wrongdoing.

BackgroundIn prior research, the Digital Assessment of Cognition (DAC), a brief digitally administered neuropsychological protocol that assesses verbal episodic memory, verbal working memory, and language, has been used to classify a small sample of memory clinic patients (n = 77) into four meaningful clinical groups.ObjectiveThe current research sought to extend these findings with a considerably larger sample.MethodsThe DAC was administered to 179 ambulatory care/memory clinic patients (45.30% female; 91.10% Caucasian). A comprehensive analysis of DAC core outcome measures and behavior reflecting process/errors was undertaken. Traditional paper/pencil assessment was also obtained. Using Jak, Bondi criteria (2009), paper/pencil test results classified patients into five groups: cognitively unimpaired (CU; n = 74), subtle cognitive impairment (SCI; n = 21), amnestic mild cognitive impairment (aMCI; n = 21), combined dysexecutive/mixed MCI (dys/mxMCI; n = 22), and mild dementia (n = 41).ResultsThe aMCI group presented with many of the classic features consistent with amnesia, i.e., rapid forgetting, reduced free recall clustering, and profligate responding to recognition foils. Latency for correct recognition responding was slower for aMCI compared to the CU group and appears to be associated with a neurocognitive network measuring both memory and language-related operations. SCI and dys/mxMCI groups tended to produce more perseverations on working memory test trials; and produced lower scores on DAC executive outcome measures that assessed auditory span and semantic fluency.ConclusionsThese findings support the criterion and construct validity of the DAC. When brought to scale the DAC could be an effective tool to assess for emergent MCI and dementia syndromes.

Biomaterials play an increasing role in intervertebral disc regeneration and require preclinical testing, typically performed using organ culture and invitro models. Native human discs are limited, and animal models often fail to mimic human disc degeneration. Thus, enzymes like chondroitinase ABC (chABC) and papain are used to simulate degenerative tissue changes and enable biomaterial injection. In previous work, we characterized the biomechanical and morphological effects of papain, which forms cavities in the disc. In contrast, chABC does not form cavities, but its biomechanical effects remain insufficiently characterized. This study aims to evaluate the macroscopic and biomechanical effects of chABC-specifically, range of motion (ROM), neutral zone (NZ), and disc height-in a bovine organ culture model, and assess the distribution of an injected hydrogel, comparing the results to published papain data. Four groups of fresh bovine tail segments were prepared (n ≥ 10) and three received injections of chABC, papain, or PBS, followed by 7 days of culture. For papain and PBS, published data were supplemented with new specimens. Complex simulated physiological loading was applied to diminish disc swelling. The maximum volume of a serum-albumin-hydrogel was injected into all four groups. ROM, NZ, and disc height were measured before and after enzyme treatment, loading, and injection. Post-injection, microCT scans visualized material distribution within the discs. ChABC increased ROM by up to 92.1%, NZ by up to 79.4%, and decreased disc height by 2.1 mm. Hydrogel injection decreased ROM and NZ but increased disc height in all groups while enzyme treatments allowed more hydrogel injection (0.6 mL for chABC). Exemplary scans showed cloud-like hydrogel spread for chABC and a round-shaped degradation defect for papain. The findings indicate that chABC better simulates disc degeneration, whereas papain better models nucleotomies, and both enzymes preserve annulus integrity-providing valuable models for biomechanical testing.

Introduction: Septic shock is managed in intensive care units (ICU) with markedly high mortality rates despite adequate management. Vasopressors are the cornerstone of management, yet evidence comparing outcomes, by specific agent, is still limited. This study aims to evaluate the impact of vasopressors on mortality, survival and hospital length of stay in septic shock patients admitted to the ICU. Methods: The eICU-CRD database, a publicly available de-identified database, was used for statistical analysis. 1,606 patients admitted for suspected or confirmed septic shock were isolated and stratified by vasopressor type including: dobutamine, dopamine, epinephrine, milrinone, norepinephrine, phenylephrine, vasopressin and non-vasopressors. Demographic data, mortality, survival and ICU length of stay were then quantitatively analyzed by vasopressor administration groups. Analysis included Kaplan Meier survival curves and chi squared analysis for mortality and overall clinical outcomes. Results: Mortality, survival and ICU Length of Stay were statistically different among all groups. Mortality was greatest in the patients receiving Epinephrine (75%) and Milrinone (66.7%) and lowest in the patients receiving Dopamine (12.8%, p< 0.001). Survival was greatest in the dopamine and dobutamine groups and lowest in the epinephrine group (p< 0.001). Length of stay was greatest in the patients receiving milrinone and shortest in the patients receiving epinephrine and phenylephrine (p< 0.001). Overall, norepinephrine had modest reductions in mortality and length of stay and increases in overall survival. Increased survival rates associated with dobutamine over epinephrine suggest that there could be stronger evidence supporting its use in septic shock management. Conclusions: Dobutamine historically has had weak evidence to support its use in septic shock management but the increased survival rates in this study suggests that it should be further considered in the sepsis hour-1 bundle. Future studies should evaluate the inclusion of drugs such as milrinone and phenylephrine in improving outcomes of septic shock patients.

Introduction: Prolonged use of intravenous (IV) vasopressors in critically ill patients increases the risk of ischemic complications, arrhythmias, and catheter-associated infections. Droxidopa, an oral norepinephrine precursor, has gained attention as an off-label adjunct to facilitate vasopressor weaning in the ICU. Despite growing clinical use, the evidence supporting its safety and efficacy in critically ill populations has not been systematically reviewed. Methods: A systematic review was conducted following PRISMA guidelines. Eligible studies included retrospective cohorts, case series, and abstracts reporting primary clinical data on droxidopa use in ICU patients. Outcomes of interest included time to vasopressor discontinuation, droxidopa duration, ICU length of stay (LOS), and ICU mortality. Risk of bias was assessed using ROBINS-I and the JBI Critical Appraisal Checklist. Results: Seven studies comprising 161 ICU patients met inclusion criteria. Median time to vasopressor discontinuation ranged from 29 to 120 hours. Duration of droxidopa use ranged from 87 to 192 hours. ICU LOS was reported in two studies (18–44 days); ICU mortality was inconsistently documented. Most studies reported successful vasopressor discontinuation, though variation in dosing, timing, and reporting limited comparability. Conclusions: Droxidopa may assist in vasopressor weaning in ICU patients, but available evidence remains limited and heterogeneous. Further research is warranted.