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Quintilian famously claimed that satire was tota nostra, or totally ours, but this innovative volume demonstrates that many of Roman Satire's most distinctive characteristics derived from ancient Greek Old Comedy. Jennifer L. Ferriss-Hill analyzes the writings of Lucilius, Horace, and Persius, highlighting the features that they crafted on the model of Aristophanes and his fellow poets: the authoritative yet compromised author; the self-referential discussions of poetics that vacillate between defensive and aggressive; the deployment of personal invective in the service of literary polemics; and the abiding interest in criticizing individuals, types, and language itself. The first book-length study in English on the relationship between Roman Satire and Old Comedy, Roman Satire and the Old Comic Tradition will appeal to students and researchers in classics, comparative literature, and English.

Researchers have long struggled to identify causal effects in nonexperimental settings. Many recently proposed strategies assume ignorability of the treatment assignment mechanism and require fitting two models-one for the assignment mechanism and one for the response surface. This article proposes a strategy that instead focuses on very flexibly modeling just the response surface using a Bayesian nonparametric modeling procedure, Bayesian Additive Regression Trees (BART). BART has several advantages: it is far simpler to use than many recent competitors, requires less guesswork in model fitting, handles a large number of predictors, yields coherent uncertainty intervals, and fluidly handles continuous treatment variables and missing data for the outcome variable. BART also naturally identifies heterogeneous treatment effects. BART produces more accurate estimates of average treatment effects compared to propensity score matching, propensity-weighted estimators, and regression adjustment in the nonlinear simulation situations examined. Further, it is highly competitive in linear settings with the \"correct\" model, linear regression. Supplemental materials including code and data to replicate simulations and examples from the article as well as methods for population inference are available online.

Insulin resistance and obesity are associated with reduced gonadotropin-releasing hormone (GnRH) release and infertility. Mice that lack insulin receptors (IRs) throughout development in both neuronal and non-neuronal brain cells are known to exhibit subfertility due to hypogonadotropic hypogonadism. However, attempts to recapitulate this phenotype by targeting specific neurons have failed. To determine whether astrocytic insulin sensing plays a role in the regulation of fertility, we generated mice lacking IRs in astrocytes (astrocyte-specific insulin receptor deletion [IRKOGFAP] mice). IRKOGFAP males and females showed a delay in balanopreputial separation or vaginal opening and first estrous, respectively. In adulthood, IRKOGFAP female mice also exhibited longer, irregular estrus cycles, decreased pregnancy rates, and reduced litter sizes. IRKOGFAP mice show normal sexual behavior but hypothalamic-pituitary-gonadotropin (HPG) axis dysregulation, likely explaining their low fecundity. Histological examination of testes and ovaries showed impaired spermatogenesis and ovarian follicle maturation. Finally, reduced prostaglandin E synthase 2 (PGES2) levels were found in astrocytes isolated from these mice, suggesting a mechanism for low GnRH/luteinizing hormone (LH) secretion. These findings demonstrate that insulin sensing by astrocytes is indispensable for the function of the reproductive axis. Additional work is needed to elucidate the role of astrocytes in the maturation of hypothalamic reproductive circuits.

This book offers conceptual and practical insights into the complex interactions between ecotourism and the natural environment, with consideration given to government policy, marketing by suppliers, consumer behaviour and visitor/environmental management. Illustrated by international case studies the roles of and interplay between tour operators, their clients, resource managers and local communities are examined. This creates a comprehensive and insightful overview of the factors that work for and against the achievement of environmental sustainability in and through ecotourism. The result is a critical examination of ecotourism and environmental sustainability that highlights ideas for best practice and proposes new directions for future research

Background Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. Methods We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care. We conducted qualitative semi-structured interviews with 108 employees (22 senior leaders, 42 middle managers, 37 front-line providers and 7 staff). Transcripts of audio recordings were analyzed using a priori codes based on the Consolidated Framework for Implementation Research. We used constant comparison analysis to synthesize codes into meaningful domains. Results Sites described actions taken to foster patient-centered care in seven domains: 1) leadership; 2) patient and family engagement; 3) staff engagement; 4) focus on innovations; 5) alignment of staff roles and priorities; 6) organizational structures and processes; 7) environment of care. Within each domain, we identified multi-faceted strategies for implementing change. These included efforts by all levels of organizational leaders who modeled patient-centered care in their interactions and fostered willingness to try novel approaches to care amongst staff. Alignment and integration of patient centered care within the organization, particularly surrounding roles, priorities and bureaucratic rules, remained major challenges. Conclusions Transforming healthcare systems to focus on patient-centered care and better serve the “whole” patient is a complex endeavor. Efforts to transform healthcare culture require robust, multi-pronged efforts at all levels of the organization; leadership is only the beginning. Challenges remain for incorporating patient-centered approaches in the context of competing priorities and regulations. Through actions within each of the domains, organizations may begin to truly transform to patient-driven care.

Institutional investors are increasingly pushing their investee companies to address environmental, social and governance (ESG) issues—a phenomenon commonly called ESG stewardship. Scholars have put forward various reasons for investors’ enthusiasm for ESG stewardship. They include the financial materiality of ESG issues, a desire to appeal to ESG-conscious customers, and the scope for fund operators to charge higher fees for funds that pursue ESG strategies. There is, however, another critical factor at play. ESG stewardship is also underpinned by a transnational development—what this article calls the ‘global ESG stewardship ecosystem’. This global ecosystem is comprised of various ESG-focused actors, including United Nations agencies, institutional investors, investor networks, service providers to institutional investors, and NGOs and activist organizations. These actors operate in a highly networked manner at the transnational level to develop and disseminate norms of ESG stewardship throughout global markets, and encourage and coordinate investors’ ESG stewardship activities on the ground. This article highlights the scale, complexity and influence of the global ESG stewardship ecosystem, revealing it to be a significant facilitator of institutional investors’ ESG stewardship. This insight calls into question important contemporary assumptions and theories about institutional investors, including claims that they are ‘rationally reticent’, under-invest in corporate governance activities, and are incapable of overcoming collective action challenges. The global ESG stewardship ecosystem is also a remarkable example of the transnational influences shaping contemporary corporate governance. The ecosystem underpins the development and dissemination of norms of ESG stewardship and also assists institutional investors to undertake ESG stewardship ‘on the ground’ in the various markets in which they operate. The transnational influence of the ecosystem has important implications for national law makers and regulators who are focused on ESG investing and investor participation in public company corporate governance.

Spexin (SPX), a recently identified adipokine, shows potential in enhancing insulin sensitivity, offering promising implications for metabolic health. This study aimed to investigate the effect of 8 weeks of high intensity interval training (HIIT) on insulin resistance through liver gluconeogenesis, lipolysis, inflammation, oxidative stress, and lipogenesis in Type 2 diabetic rats with a special focus on the role of SPX. In this study, 28 male Wistar rats were divided into four groups: Healthy Control (CON), Diabetes Control (T2D), HIIT, and Diabetes+HIIT (T2D+HIIT). After diabetes induction (high-fat diet+streptozotocin), the exercise groups underwent an 8-week HIIT protocol. HOMA-β, HOMA-IR, QUICKI, fasting blood sugar, insulin, and SPX were measured in liver and serum. The expression of Galanin/2, FOXO-1, PGC-1α, G6Pase, PEPCK, CPT1A, AMPK, PPARα, ACC, FAS, SREBP-1c, SIRT-1, and inflammatory/antioxidant markers were analyzed in the liver. Our results showed that HOMA-β, QUICKI, insulin, and serum level of SPX levels were higher in T2D+HIIT than T2D group. Similarly, SPX, GALR2, FOXO-1, PGC-1α, CPT1A, PPARα, AMPK, and SIRT-1 levels were higher in the livers of rats in the T2D+HIIT than T2D group. However, HOMA-IR, PEPCK, G6Pase, ACC, FAS, and SREBP-1c levels were lower in T2D+HIIT than T2D group. Also, HIIT+T2D reduced inflammation and increased antioxidants, indicating an improved overall health status of the liver. HIIT benefits diabetic liver with reducing gluconeogenesis, inflammation, oxidative stress, and lipogenesis while increasing lipolysis. These improvements coincided with elevated hepatic SPX signaling and are associated with reduced insulin resistance. These findings suggest a potential association between HIIT induced SPX signaling modulation in liver and improving insulin resistance, though further mechanistic studies are required to confirm the causality.

Glycoprotein non-metastatic melanoma protein B (GPNMB) is produced by macrophages and mediates cardiac repair through direct interaction with an orphan G-protein-coupled receptor, GPR39.

Reproduction requires adequate energy stores for parents and offspring to survive. Kiss1 neurons, which are essential for fertility, have the potential to serve as the central sensors of metabolic factors that signal to the reproductive axis the presence of stored calories. Paradoxically, obesity is often accompanied by infertility. Despite excess circulating levels of insulin and leptin, obese individuals exhibit resistance to both metabolic factors in many neuron types. Thus, resistance to insulin or leptin in Kiss1 neurons could lead to infertility. Single deletion of the receptors for either insulin or the adipokine leptin from Kiss1 neurons does not impair adult reproductive dysfunction. However, insulin and leptin signaling pathways may interact in such a way as to obscure their individual functions. We hypothesized that in the presence of genetic or obesity-induced concurrent insulin and leptin resistance, Kiss1 neurons would be unable to maintain reproductive function. We therefore induced a chronic hyperinsulinemic and hyperleptinemic state in mice lacking insulin receptors in Kiss1 neurons through high fat feeding and examined the impact on fertility. In an additional, genetic model, we ablated both leptin and insulin signaling in Kiss1 neurons (IR/LepRKiss mice). Counter to our hypothesis, we found that the addition of leptin insensitivity did not alter the reproductive phenotype of IRKiss mice. We also found that weight gain, body composition, glucose and insulin tolerance were normal in mice of both genders. Nonetheless, leptin and insulin receptor deletion altered pubertal timing as well as LH and FSH levels in mid-puberty in a reciprocal manner. Our results confirm that Kiss1 neurons do not directly mediate the critical role that insulin and leptin play in reproduction. However, during puberty kisspeptin neurons may experience a critical window of susceptibility to the influence of metabolic factors that can modify the onset of fertility.

Background Implementation fidelity is critical to the internal and external validity of implementation research. Much of what is written about implementation fidelity addresses fidelity of evidence-informed interventions rather than fidelity of implementation strategies . The documentation and reporting of fidelity to implementation strategies requires attention. Therefore, in this scoping review, we identify the extent and quality of documentation and reporting of fidelity of implementation strategies that were used to implement evidence-informed interventions. Methods A six-stage methodological framework for scoping studies guided our work. Studies were identified from the outputs of the Effective Practice and Organization of Care (EPOC) review group within the Cochrane Database of Systematic Reviews. EPOC’s primary focus, implementation strategies influencing provider behavior change, optimized our ability to identify articles for inclusion. We organized the retrieved articles from the systematic reviews by journal and selected the three journals with the largest number of retrieved articles. Using a data extraction tool, we organized retrieved article data from these three journals. In addition, we summarized implementation strategies using the EPOC categories. Data extraction pertaining to the quality of reporting the fidelity of implementation strategies was facilitated with an “Implementation Strategy Fidelity Checklist” based on definitions adapted from Dusenbury et al. We conducted inter-rater reliability checks for all of the independently scored articles. Using linear regression, we assessed the fidelity scores in relation to the publication year. Results Seventy-two implementation articles were included in the final analysis. Researchers reported neither fidelity definitions nor conceptual frameworks for fidelity in any articles. The most frequently employed implementation strategies included distribution of education materials ( n  = 35), audit and feedback ( n  = 32), and educational meetings ( n  = 25). Fidelity of implementation strategies was documented in 51 (71 %) articles. Inter-rater reliability coefficients of the independent reviews for each component of fidelity were as follows: adherence = 0.85, dose = 0.89, and participant responsiveness = 0.96. The mean fidelity score was 2.6 (SD = 2.25). We noted a statistically significant decline in fidelity scores over time. Conclusions In addition to identifying the under-reporting of fidelity of implementation strategies in the health literature, we developed and tested a simple checklist to assess the reporting of fidelity of implementation strategies. More research is indicated to assess the definitions and scoring schema of this checklist. Careful reporting of details about fidelity of implementation strategies will make an important contribution to implementation science.