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Small, isolated populations can be especially sensitive to poor habitat conditions due to their limited capacity to adapt or disperse. Management of such populations, with an objective to implement the most effective strategies, is a conservation priority. The Norfolk Island morepork (Ninox novaeseelandiae undulata) is a Critically Endangered hawk‐owl endemic to Norfolk Island with an estimated population of 25 individuals. This species faces compounding threats from habitat degradation and loss, as well as inbreeding depression. It presents an exemplar for the development of habitat management strategies for top‐order predators in small, isolated systems. We paired fine‐scale light detection and ranging‐derived habitat variables with tracking data to quantify habitat suitability and the relative importance of environmental variables. Maximum entropy modeling indicated vegetation patch size and canopy height were important habitat variables, with moreporks more likely to be found in larger patches and canopy heights above 7 m. Morepork presence was not strongly influenced by the type of wooded vegetation; rather, the species appears to be a generalist occupier of forested areas. We demonstrate that suitable habitat during the breeding season is currently constrained, with coverage limited to one‐third (34%) of the island and an estimated carrying capacity of 36 morepork pairs. Restoration of native forest in cleared areas adjacent to existing wooded patches, with a specific goal to increase patch size, was the optimized management strategy to increase in situ carrying capacity. This study has demonstrated how habitat suitability modeling can inform targeted habitat restoration to enhance threatened species recovery. [ABSTRACT FROM AUTHOR]

Objective: Climate change is fueling the rapid range expansion of invasive species in freshwater ecosystems. This has led to mounting calls from natural resource managers for more robust predictions of invasive species distributions to anticipate threats to species of concern and implement proactive conservation and restoration actions. Here, we applied recent advances in fish sampling and statistical modeling in river networks to estimate the current and future watershed‐scale spatial distribution of nonnative Smallmouth Bass Micropterus dolomieu. Methods: We integrated a spatial stream network (SSN) model of stream temperature, landscape environmental covariates, and Smallmouth Bass occurrence data based on environmental DNA (eDNA) detections to develop an SSN species distribution model (SDM) representing current Smallmouth Bass distributions in the Chehalis River, Washington State, a large coastal river basin of ongoing watershed‐scale restoration. The SDM was informed by spatially intensive eDNA sampling from 135 locations in the main stem and major tributaries. We then applied downscaled climate change projections to the SSN SDM to predict Smallmouth Bass range expansion in the basin by late century. Result: We identified high levels of spatial autocorrelation at hydrological distances of ≤10 km in our eDNA data set, underscoring the importance of applying an SSN modeling framework. Stream temperature was identified as the most important environmental covariate explaining variability in Smallmouth Bass occurrence. Model predictions estimated that current suitable summer habitat for Smallmouth Bass habitat spans 681 km and is projected to nearly double by late century (1333 km) under a moderate climate change scenario. Current and future suitable habitat for Smallmouth Bass is prevalent in important tributaries for spring Chinook Salmon Oncorhynchus tshawytscha, a species of major conservation concern in the Chehalis River and more broadly along the Pacific coast. In both the main stem and tributaries, the SSN SDM predictions of the upstream leading edges of Smallmouth Bass closely align with (within 4.8 km) edges identified by spatially intensive eDNA sampling. Conclusion: Our study highlights the value of integrating SSN models with rapidly growing eDNA data sets for accurate and precise riverine fish distribution estimation. Our application provides crucial insights for anticipating the impacts of shifting invasive species on Pacific salmon Oncorhynchus spp. in a warming world. Impact statementClimate change is fueling the rapid range expansion of invasive species in freshwater ecosystems. Our study highlights how combining recent advances in modeling (spatial stream network modeling) and fish sampling (eDNA) on river networks can provide spatially explicit information for anticipating the impacts of shifting invasive species on Pacific salmon in an increasingly warming world. [ABSTRACT FROM AUTHOR]

Heterotrophic bacteria hydrolyze high molecular weight (HMW) organic matter extracellularly prior to uptake, resulting in diffusive loss of hydrolysis products. An alternative 'selfish' uptake mechanism that minimises this loss has recently been found to be common in the ocean. We investigated how HMW organic matter addition affects these two processing mechanisms in surface and bottom waters at three stations in the North Atlantic Ocean. A pulse of HMW organic matter increased cell numbers, as well as the rate and spectrum of extracellular enzymatic activities at both depths. The effects on selfish uptake were more differentiated: in Gulf Stream surface waters and productive surface waters south of Newfoundland, selfish uptake of structurally simple polysaccharides increased upon HMW organic matter addition. The number of selfish bacteria taking up structurally complex polysaccharides, however, was largely unchanged. In contrast, in the oligotrophic North Atlantic gyre, despite high external hydrolysis rates, the number of selfish bacteria was unchanged, irrespective of polysaccharide structure. In deep bottom waters (> 4000 m), structurally complex substrates were processed only by selfish bacteria. Mechanisms of substrate processing—and the extent to which hydrolysis products are released to the external environment—depend on substrate structural complexity and the resident bacterial community. [ABSTRACT FROM AUTHOR]

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Objectives: Gains in pitch from gender affirming voice training (GVT) alone in trans women have historically been shown to decline after 1 year. Currently no standard exists for length and type of GVT that yields meaningful behavioral change and patient satisfaction with voice outcomes in trans women. This study aims to determine whether GVT alone leads to sustained pitch elevation and patient satisfaction in trans women. Methods: Retrospective review from 2016 to 2020 of trans women patients who underwent GVT alone for voice change. Charts were reviewed for acoustic analysis of pitch including sustained vowel fundamental frequency, speaking fundamental frequency, and quality of life data from the Trans Woman Voice Questionnaire at pre‐therapy, immediate post‐therapy, and extended post‐therapy time intervals. Results: A total of 157 patients presented to our Voice Center, of which 34 participated in the full course of GVT. Patients underwent an average of six sessions of GVT (range 5–7) over an average of 13.14 weeks (range 6–16). Average time between completing GVT and presenting for extended follow‐up was 11.37 months (range 6–31). Compared to initial presentation prior to therapy, at extended follow‐up after completing GVT average change in F0/a/, SF0, and TWVQ were 64.6 Hz, 31.3 Hz, and 32.45. No significant change was noted between immediate post‐therapy and extended post‐therapy acoustic measures. TWVQ demonstrated continued improvement between immediate post‐therapy and extended post‐therapy. Conclusions: In self‐selected patients who present for extended follow‐up, GVT alone can result in sustained pitch elevation and voice‐related quality life in trans women. Level of Evidence: 4 Laryngoscope, 133:2340–2345, 2023 This study aims to determine whether VT alone leads to sustained pitch elevation and patient satisfaction in trans women. Retrospective review from 2016‐2020 of trans women patients who underwent VT alone for voice change. Compared to initial presentation prior to therapy, at extended follow‐up after completing VT average change in F0/a/, SF0 and TWVQ were 64.6 Hz, 31.3 Hz, and 32.45. In self‐selected patients who present for extended follow‐up, VT alone can result in sustained pitch elevation and voice‐related quality life in trans women. [ABSTRACT FROM AUTHOR]

Background: Effective treatments for dry mouth of Sjogren's syndrome are limited and hampered by adverse effects. The aim of LEONIDAS‐1 was to explore the feasibility of salivary electrostimulation in individuals with primary Sjogren's syndrome, as well as parameters required to inform the design of a future phase III trial. Methods: Multicentre, parallel‐group, double‐blind, randomised sham‐controlled trial in two UK centres. Participants were randomised (1:1, computer‐generated) to active or sham electrostimulation. The feasibility outcomes included screening/eligibility ratio, consent, and recruitment and drop‐out rates. Preliminary efficacy outcome included dry mouth visual analogue scale, Xerostomia Inventory, the EULAR Sjögren's syndrome patient reported index‐Q1, and unstimulated sialometry. Results: Forty‐two individuals were screened, of whom 30 (71.4%) met the eligibility criteria. All eligible individuals consented to recruitment. Out of the 30 randomised participants (active n = 15, sham n = 15), 4 dropped out and 26 (13 vs. 13) completed all study visits as per protocol. Recruitment rate was 2.73 participants/month. At 6‐month post‐randomisation the difference in mean reduction in visual analogue scale, xerostomia inventory and EULAR Sjögren's syndrome patient reported index‐Q1 scores between groups were 0.36 (95% CI: −0.84, 1.56), 3.31 (0.43, 6.18), and 0.23 (−1.17, 1.63), respectively; unstimulated salivary flow increased by a mean of 0.98 mL/15 min, all in favour of the active group. No adverse events were reported. Conclusion: LEONIDAS‐1 results support progression to a phase III definitive randomised controlled trial of salivary electrostimulation in individuals with Sjogren's syndrome. Xerostomia inventory could be considered the primary patient‐centred outcome measure and the corresponding observed treatment effect could inform the sample size of a future trial. [ABSTRACT FROM AUTHOR]

Summary: Multiple myeloma (MM) and anti‐MM therapy cause profound immunosuppression, leaving patients vulnerable to coronavirus disease 2019 (COVID‐19) and other infections. We investigated anti‐severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) antibodies longitudinally in ultra‐high‐risk patients with MM receiving risk‐adapted, intensive anti‐CD38 combined therapy in the Myeloma UK (MUK) nine trial. Despite continuous intensive therapy, seroconversion was achieved in all patients, but required a greater number of vaccinations compared to healthy individuals, highlighting the importance of booster vaccinations in this population. Reassuringly, high antibody cross‐reactivity was found with current variants of concern, prior to Omicron subvariant adapted boostering. Multiple booster vaccine doses can provide effective protection from COVID‐19, even with intensive anti‐CD38 therapy for high‐risk MM. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to evaluate patient satisfaction with speech‐language therapy televisits and to identify factors influencing the level of satisfaction. Methods: Participants were recruited from an academic tertiary voice and swallowing center who had completed ≥1 telehealth session of speech‐language therapy with a speech‐language pathologist between March, 2020 and April, 2021. Patient satisfaction was assessed using the Short Assessment of Patient Satisfaction (SAPS), a validated 7‐item survey. Demographic characteristics of participants were collected from a review of patient charts. Results: 65/239 patients completed the SAPS survey, representing a response rate of 27%. The average age of study participants was 54.92 ± 16.45 years, with 49.2% identifying as female, 33.9% as male, and 16.9% as trans‐female. The mean SAPS score was 22.60 ± 3.89, with 84.62% of patients satisfied or very satisfied with their visit. Patients were most satisfied with provider respect (3.91 ± 0.34) and care received (3.74 ± 0.64), and least satisfied with visit length (2.32 ± 1.38) and explanation of treatment results (2.62 ± 1.72). Patient satisfaction was positively correlated with younger age and an increased number of televisits. Satisfaction did not differ significantly by gender identity, type of therapy received, insurance type, travel distance, or prior in‐person therapy. Conclusion: Clinicians are able to achieve high patient satisfaction with speech‐language therapy when delivered by telehealth. Patient satisfaction remained high across diverse patient populations and range of clinical needs. Clinicians should remain cognizant of the unique limitations of older patients when conducting telehealth visits. Lay Summary: Clinicians are able to achieve high patient satisfaction with speech‐language therapy when delivered via telehealth. Satisfaction remained high regardless of gender identity, type of therapy received, type of insurance, travel distance, or completion of prior in‐person therapy. Level of Evidence: 4 Laryngoscope, 133:895–900, 2023 [ABSTRACT FROM AUTHOR]

Why do people shift their strategies for solving problems? Past work has focused on the roles of contextual and individual factors in explaining whether people adopt new strategies when they are exposed to them. In this study, we examined a factor not considered in prior work: people's evaluations of the strategies themselves. We presented undergraduate participants from a moderately selective university (N = 252; 64.8% women, 65.6% White, 67.6% who had taken calculus) with two strategies for solving algebraic word problems and asked them to rate these strategies and their own strategy on a variety of dimensions. Participants' ratings loaded onto two factors, which we label quality and difficulty. Participants' initial evaluations of the quality of the strategies were associated with whether they used the strategies at posttest, and this effect held even when controlling for individual and contextual factors. However, people's evaluations of the difficulty of the strategies were not consistently associated with their later adoption of those strategies. We also examined individual and contextual predictors of strategy ratings and strategy adoption. Participants' need for cognition and their spatial visualization ability were associated with their strategy evaluations, and the framing of the story problems was associated with their strategy adoption. The findings highlight that strategy adoption depends on multiple interacting factors, and that to understand strategy change, it is critical to examine how people evaluate strategies. [ABSTRACT FROM AUTHOR]

X‐linked adrenoleukodystrophy (ALD) is a rare inherited neurological disorder that poses considerable challenges for clinical management throughout the lifespan. Although males are generally more severely affected than females, the time course and presentation of clinical symptoms are otherwise difficult to predict. Opportunities to improve outcomes for individuals with ALD are rapidly expanding due to the introduction of newborn screening programs for this condition and an evolving treatment landscape. The aim of this comprehensive review is to synthesize current knowledge regarding the neurocognitive and mental health effects of ALD. This review provides investigators and clinicians with context to improve case conceptualization, inform prognostic counseling, and optimize neuropsychological and mental health care for patients and their families. Results highlight key predictive factors and brain‐behavior relationships associated with the diverse manifestations of ALD. The review also discusses considerations for endpoints within clinical trials and identifies gaps to address in future research. To inform futureinvestigations, clinical trials, and multidisciplinary care practices, this comprehensive review synthesizes current knowledge regarding the neurocognitive and mental health effects of ALD across the lifespan. [ABSTRACT FROM AUTHOR]

Background: To date, 1‐year evaluation of pitch elevation in patients undergoing modified Wendler glottoplasty (WG) in combination with VT has not been assessed. Objectives: To determine whether 1‐year pitch elevation is sustained in patients who undergo modified WG in combination with VT for voice feminization. Methods: A retrospective review of patients who underwent WG in combination with voice therapy (VT) was performed from 2016 to 2020. Charts were reviewed for sustained vowel fundamental frequency (F0/a/), speaking fundamental frequency (SF0), and Trans Woman Voice Questionnaire (TWVQ) at preoperative, initial postoperative (3–6 months after surgery), and 12‐month postoperative visits. Results: Change in average F0/a/, SF0 and TWVQ was 50.25 Hz, 32.96 Hz, and 32.6 at 12‐months postoperatively compared to preoperative values. Initial and 12‐month postoperative SF0 were significantly higher than preoperative SF0 (Mann–Whitney U test p = 0.0042, p = 0.0010). There was no difference in initial postoperative and 12‐month postoperative SF0 (p = 0.50). TWVQ at 12 months was significantly lower than preoperative TWVQ (ANOVA p < 0.001, Tukey honestly significant difference HSD p < 0.05). Conclusions: Pitch elevation remains sustained at one year in patients undergoing modified WG in combination with VT. Modified Wendler glottoplasty combined with VT results in relatively long‐term improvements in voice‐related quality of life and is possibly a beneficial addition in the long‐term management of patients who desire voice feminization. Level of Evidence: 4 Laryngoscope, 133:615–620, 2023 [ABSTRACT FROM AUTHOR]

We performed a prospective study of 134 consecutive patients undergoing elective surgery in a single centre between March and July 2022, patients undergoing expedited surgery were excluded (Chelsea and Westminster NHS Foundation Trust; Ref: RIQI117) (Fig. In our study the mean SDM-Q-9 statement scores were in keeping with those previously reported in a cohort study of 81 patients undergoing elective breast surgery using this digital consent platform (mean [SD] 4.1 [ 1.3] to 4.8 [0.5]) [[3]]. Abbreviations SDM shared decision making SDM-Q-9 nine-item SDM Questionnaire Informed consent for surgery is a core component of urological practice [[1]]. [Extracted from the article]

Summary: A 10‐h‐old 56‐kg Thoroughbred filly was presented for treatment of partial failure of passive transfer of immunity and presumed neonatal maladjustment syndrome (NMS). The filly was hospitalised, and supportive care initiated. On Day 5 of hospitalisation, seizures were observed and were controlled with IV administration of diazepam. Due to progression of clinical signs of NMS, magnetic resonance imaging of the filly's brain was performed. During the early anaesthetic recovery period, the filly exhibited cardiopulmonary arrest (CPA) at which point cardiopulmonary cerebral resuscitation (CPCR) was performed for a total of 48 min. During this time, ventricular fibrillation (VF) was observed on ECG and the filly was defibrillated three times at 1–2‐min intervals using 2–4 J/kg of monophasic electrical defibrillation. The filly successfully recovered from CPCR, was discharged 5 days later and was reported healthy 12 months post‐discharge. [ABSTRACT FROM AUTHOR]

Objective: Many people who die by suicide experience major depressive disorder (MDD), but most people with MDD do not die by suicide and many do not report thoughts of death or suicide. This cross‐sectional study examined the potential of personal growth initiative (PGI) skills to protect against suicide ideation among adult psychotherapy outpatients. Method: Adult outpatients (N = 178) completed measures of suicide ideation severity (SI), depressive symptom severity (DEP), and PGI skills (PGI) at intake. Results: Although higher DEP significantly correlated with higher suicide ideation, a significant DEP × PGI interaction, indicated significant positive relations between DEP and SI only when PGI was at or below the mean for this sample. Conclusions: PGI skills may function as a protective factor against the development of suicide ideation even in the presence of severe depressive symptoms. This suggests that training PGI skills might prevent or reduce suicide ideation among depressed patients. [ABSTRACT FROM AUTHOR]

We investigate the determinants of the reservation wage gap between unemployed men and women, using data from the Italian Labour Force Survey. We conduct detailed decomposition analysis at the mean and at different percentiles of the reservation wage distribution using the Recentered Influence Function regression approach. Given the regional differences in labor market participation and employment rates across Italy, we focus on regional differences in the gender reservation wage gap. We find evidence of a positive gender reservation wage gap, which is highest in the South, with men reporting higher reservation wages across all regions and at all percentiles of the reservation wage distribution. The decomposition results suggest that, while a large part of the gender gap in reservation wages is explained by personal characteristics such as education and age, a significant portion of the gap is explained by different job preferences (especially commuting and working time preferences) between men and women. We also find evidence of differences in the relative effects of personal, household and job characteristics across regions, and at different percentiles of the reservation wage distribution. [ABSTRACT FROM AUTHOR]

Peer victimization (PV) is a serious concern for youth and is associated with subsequent suicide ideation in young adulthood. The interpersonal theory of suicide may provide a framework for understanding suicide ideation in this population. Specifically, thwarted belongingness (TB) and perceived burdensomeness (PB) have been significantly associated with suicide ideation among young adults with a history of peer victimization. Additionally, the personality trait of pessimism is associated with elevated suicide ideation. Thus, this study tested the association between self‐reported frequency of retrospective relational (i.e., verbal and indirect) PV in primary and secondary school, thwarted interpersonal needs (TB and PB), and current suicide ideation, as well as how these relations may vary based on current pessimism. Participants were 330 undergraduate students. Nonparametric bootstrap moderated mediation procedures were used to test hypotheses. Results indicated significant indirect effects of frequency of retrospective relational PV and suicide ideation through PB and TB. Contrary to predictions, results did not indicate significant moderated mediation; however, the association between PB and suicide ideation was stronger at lower pessimism levels. We also provide supplemental analysis with optimism as the moderator. These findings suggest that clinicians may consider targeting TB, PB, as well as pessimism and optimism among those with a history of relational PV when assessing and intervening on current suicide ideation. Implications, limitations, and future directions are further discussed. [ABSTRACT FROM AUTHOR]

Chylothorax is an uncommon complication of thoracic surgery and, to our knowledge, has never been documented as a cause of dynamic ST‐segment elevation (STE). A 63‐year‐old woman with history of right pneumonectomy presented with chest pain and regional STE on 12‐lead electrocardiogram (ECG). Normal troponin‐I and a computed tomography (CT) scan showing a large right hemithoracic fluid collection indicated the unique cause of STE, which resolved after thoracentesis, was pericardial inflammation and cardiac compression from chylothorax. This case emphasizes nuances of ECG interpretation in the context of regional STE and explores the pathophysiology that links chylothorax with acute pericarditis. [ABSTRACT FROM AUTHOR]

Objective: Static endoscopic evaluation of swallowing (SEES) is an instrumental evaluation developed for in‐office identification of patients who may benefit from a modified barium swallow study (MBSS). We aim to determine the predictive value of SEES for evaluating dysphagia. Methods: A retrospective case series was performed on adults evaluated for dysphagia using SEES followed by MBSS at a single tertiary care center. Studies were evaluated by two blinded expert raters. Results: Fifty‐eight patients were included. Thin liquid penetration on SEES had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 0.86 (95% CI 0.70‐0.95), 0.63 (95% CI 0.24‐0.91), 0.91 (95% CI 0.76‐0.98), and 0.5 (0.19‐0.81), respectively, for predicting thin liquid penetration on MBSS, and 1.0 (95% CI 0.59‐1.0), 0.29 (95% CI 0.15‐0.47), 0.23 (95% CI 0.10‐0.41), and 1.0 (95% CI 0.69‐1.0) for predicting thin liquid aspiration on MBSS. Thin liquid aspiration on SEES had a sensitivity, specificity, PPV, and NPV of 0.67 (95% CI 0.09‐0.99), 0.85 (95% CI 0.66‐0.96), 0.33 (95% CI 0.04‐0.78), and 0.96 (95% CI 0.79‐1.0), respectively, for predicting thin liquid aspiration on MBSS. Conclusions: SEES may be used as an objective in‐office test to screen for aspiration and penetration. Thin liquid penetration on SEES is moderately sensitive for predicting penetration on MBSS. Absence of thin liquid penetration or aspiration on SEES has a high NPV for excluding aspiration on MBSS. Abnormalities on SEES or the need to view the entire swallowing mechanism should prompt an MBSS for a more complete evaluation of dysphagia. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

Introduction: Goal setting is an integral part of the rehabilitation process and assists occupational therapists to target therapy towards achieving meaningful outcomes. People with mild cognitive impairment or dementia may experience barriers participating in goal setting due to preconceptions that the person cannot participate owing to changes in both cognitive and communicative abilities. The aim of this review was to identify goal setting approaches, common goals identified, and enablers and barriers to goal setting for people with mild cognitive impairment or dementia participating in specific rehabilitation programmes. Methods: Four electronic databases were searched in April 2020 for English language articles that described goal setting processes during a rehabilitation programme for people with mild cognitive impairment or dementia. Studies of all designs were included. Two authors screened citations and full text articles. Data were extracted, synthesised, and presented narratively. Results: Twenty‐seven studies met the eligibility criteria. Both structured and nonstructured goal setting methods were used with common tools including the Canadian Occupational Performance Measure, the Bangor Goal Setting Interview and Goal Attainment Scaling. The nature of goals tended to depend on the scope of the rehabilitation programme in which the person was involved. Goal setting was more difficult for people with more advanced symptoms of dementia and when staff lacked skills and experience working with people with dementia. Use of a structured approach to goal setting, establishment of therapeutic rapport, individualisation of goals, and family involvement were reported to be beneficial. Conclusion: Collaborative goal setting is a foundation of rehabilitation for people with dementia and should not be avoided due to preconceptions that the person cannot participate. Results suggests that occupational therapists can use a number of strategies to maximise participation and engagement and play a pivotal role in upskilling staff to enable effective goal setting for people with mild cognitive impairment or dementia. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: An artificial intelligence (AI) tool was developed using audio clips of cis‐male and cis‐female voices based on spectral analysis to assess %probability of a voice being perceived as female (%Prob♀). This program was validated with 92% accuracy in cisgender speakers. The aim of the study was to assess the relationship of fo on %Prob♀ by a validated AI tool in a cohort of trans females who underwent intervention to feminize their voice with behavioral modification and/or surgery. Study Design: Cohort study. Methods: Fundamental frequency (fo) from prolonged vowel sounds (fo/a/) and fo from spontaneous speech (fo‐sp) were measured using the Kay Pentax Computerized Speech Lab (Montvale, NJ) in trans females postintervention. The same voice samples were analyzed by the AI tool for %Prob♀. Chi‐square analysis and regression models were performed accepting >50% Prob♀ as female voice. Results: Forty‐two patients were available for analysis after intervention. fo‐sp post‐treatment was positively correlated with %Prob♀ (R = 0.645 [P <.001]). Chi‐square analysis showed a significant association between AI %Prob♀ >50% for the speech samples and fo‐sp >160 Hz (P <.01). Sixteen of 42 patients reached an fo‐sp >160 Hz. Of these, the AI program only perceived nine patients as female (>50 %Prob♀). Conclusion: Patients with fo‐sp >160 Hz after feminization treatments are not necessarily perceived as having a high probability of being female by a validated AI tool. AI may represent a useful outcome measurement tool for patients undergoing gender affirming voice care. Level of Evidence: 3 Laryngoscope, 131:2567–2571, 2021 [ABSTRACT FROM AUTHOR]

Background: Antibody‐mediated rejection (AMR) is a leading cause of kidney allograft failure, but its incidence, risk factors, and outcomes are not well understood. Methods: We searched Ovid MEDLINE, Cochrane, EMBASE, and Scopus from January 2000 to January 2020 to identify published cohorts of ≥500 incident adult or 75 pediatric kidney transplant recipients followed for ≥1 year post‐transplant. Results: At least two reviewers screened 5061 articles and abstracts; 28 met inclusion criteria. Incidence of acute AMR was 1.1%‐21.5%; most studies reported 3%‐12% incidence, usually within the first year post‐transplant. Few studies reported chronic AMR incidence, from 7.5%‐20.1% up to 10 years. Almost all patients with acute or chronic AMR received corticosteroids and intravenous immunoglobulin; most received plasmapheresis, and approximately half with rituximab. Most studies examining death‐censored graft failure identified AMR as an independent risk factor. Few reported refractory AMR rates or outcomes, and none examined costs. Most studies were single‐center and varied greatly in design. Conclusions: Cohort studies of kidney transplant recipients demonstrate that AMR is common and associated with increased risk of death‐censored graft failure, but studies vary widely regarding populations, definitions, and reported incidence. Gaps remain in our understanding of refractory AMR, its costs, and resulting quality of life. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: VT is often considered the preferred treatment for vocal feminization in transgender patients. However, Wendler glottoplasty offers a surgical option for increasing fundamental frequency and perception of vocal femininity. We aimed to determine whether the addition of glottoplasty to VT results in greater fundamental frequency elevation and improvement in quality‐of‐life measures. Study Design: Retrospective case series. Methods: Forty‐eight trans female patients were treated for vocal feminization. Twenty‐seven patients underwent VT, and 21 patients underwent VT with additional glottoplasty (VTWG). Pre‐ and posttreatment acoustic measures, Trans Woman Voice Questionnaire (TWVQ), and Voice Handicap Index‐10 (VHI‐10) data were compared. Results: Glottoplasty in combination with VT elevated average speaking fundamental frequency (SF0) to a greater extent than VT alone (P <.0001). The VTWG group achieved a 42‐Hz increase in SF0, whereas the VT group achieved a 15‐Hz increase in SF0. In both the VT and VTWG groups, the lower bound of physiologic range increased by 18 Hz (P =.0008 and P =.016, respectively). The addition of glottoplasty also resulted in greater improvement in voice‐related quality of life. Improvement in TWVQ and VHI‐10 was significantly greater in the VTWG group than the VT group (P =.007 and P =.029, respectively). TWVQ showed statistically significant improvement in the VTWG group only. Conclusions: VT results in SF0 elevation and improvement in VHI‐10. The addition of glottoplasty to VT results in further improvements in SF0 and VHI‐10 and statistically significant improvement in TWVQ. Level of Evidence: 4 Laryngoscope, 131:1588–1593, 2021 [ABSTRACT FROM AUTHOR]

Objective: Criminal justice involvement, substance use, and suicide pose significant public health concerns; however, the unique and synergistic effects of these experiences among high-risk individuals remain understudied. We hypothesized positive main effects for alcohol-related severity, drug-related severity, current criminal justice involvement, and thwarted belonging (TB) on suicide ideation history (SIH) and suicide attempt history (SAH) and that TB would moderate these associations.Method: We report on cross-sectional analyses of self-report assessments completed by 824 adult residential substance use patients.Results: Multinomial logistic regression analyses indicated that as alcohol- and drug-related severity increases, the probability of SIH and SAH increases; however, TB was only associated with a higher SIH probability. Significant two-way interactions (current criminal justice involvement*TB; alcohol-related severity*TB) indicated that (1) those high in TB with current criminal justice involvement were more likely to report a SIH than those without current criminal justice involvement; and (2) those low in TB and alcohol-related severity had the lowest SAH probability, whereas those low in TB and high in alcohol-related severity had the highest SAH probability.Conclusion: The unique and combined effects of interpersonal and contextual risk factors may improve suicide risk conceptualization and assessment, and allow for tailored treatments for this high-risk population. [ABSTRACT FROM AUTHOR]

Objectives: Voice therapy has been the primary treatment for voice feminization in transfemale patients due to concerns that surgery worsens voice quality. We aim to determine the impact of Wendler glottoplasty on acoustic measures of voice.Study Design: Retrospective case series.Methods: Transgender female patients treated for vocal feminization with Wendler glottoplasty at a single tertiary care center were identified. Pre- and postoperative measures were taken with the Kay Elemetrics Real-Time Pitch, Analysis of Dysphonia in Speech and Voice, and Multidimensional Voice Program.Results: Twenty-eight patients were included in this study. There were no statistically significant changes in fundamental frequency variation, peak amplitude variation, soft phonation index, noise-to-harmonics ratio, cepstral peak prominence, or cepstral spectral index of dysphonia at a significance level of P < .05. Average speaking fundamental frequency (SF0) increased from 143 Hz after voice therapy to 163 Hz after surgery (P = .0009). Lower range decreased in 61% and increased in 26% of patients. Upper range decreased in 52% and increased in 48% of patients.Conclusions: Wendler glottoplasty does not worsen voice quality based on acoustic measures. Although most patients experience an increase in average SF0, effects on vocal range are variable with approximately half of patients experiencing a reduction and half experiencing an increase in upper pitch limit.Level Of Evidence: 4 Laryngoscope, 131:583-586, 2021. [ABSTRACT FROM AUTHOR]

Objective: Categorical data analysis is relevant to suicide risk and prevention research that focuses on discrete outcomes (e.g., suicide attempt status). Unfortunately, results from these analyses are often misinterpreted and not presented in a clinically tangible manner. We aimed to address these issues and highlight the relevance and utility of categorical methods in suicide research and clinical assessment. Additionally, we introduce relevant basic machine learning methods concepts and address the distinct utility of the current methods.Method: We review relevant background concepts and pertinent issues with references to helpful resources. We also provide non-technical descriptions and tutorials of how to convey categorical statistical results (logistic regression, receiver operating characteristic [ROC] curves, area under the curve [AUC] statistics, clinical cutoff scores) for clinical context and more intuitive use.Results: We provide comprehensive examples, using simulated data, and interpret results. We also note important considerations for conducting and interpreting these analyses. We provide a walk-through demonstrating how to convert logistic regression estimates into predicted probability values, which is accompanied by Appendices demonstrating how to produce publication-ready figures in R and Microsoft Excel.Conclusion: Improving the translation of statistical estimates to practical, clinically tangible information may narrow the divide between research and clinical practice. [ABSTRACT FROM AUTHOR]

Zero‐inflated ordered probit (ZIOP) and middle‐inflated ordered probit (MIOP) models are finding increasing favour in the discrete choice literature. We propose generalizations to these models – which collapse to their ZIOP/MIOP counterparts under a set of simple parameter restrictions – with respect to the inflation process. These generalizations form the basis of a new specification test of the inflation process in ZIOP and MIOP models. Support for our generalization framework is principally demonstrated by revisiting a key ZIOP application from the economics literature, and reinforced by the reassessment of an important MIOP application from political science. Our specification test supports the generalized models over the original ZIOP/MIOP ones, suggesting an important role for it in modelling zero‐ and middle‐inflation processes. [ABSTRACT FROM AUTHOR]

Several studies have demonstrated the ecological consequences of genetic variation within a single plant species. For example, these studies show that individual plant genotypes support unique composition of the plants' associated arthropod community. By contrast, fewer studies have explored how plant genetic variation may influence evolutionary dynamics in the plant's associated species. Here, we examine how aphids respond evolutionarily to genetic variation in their host plant. We conducted two experiments to examine local adaptation and rapid evolution of the free‐feeding aphid Chaitophorus populicola across genetic variants of its host plant, Populus angustifolia. To test for local adaptation, we collected tree cuttings and aphid colonies from three sites along an elevation/climate gradient and conducted a reciprocal transplant experiment. In general, home aphids (aphids transplanted onto trees from the same site) produced 1.7–3.4 times as many offspring as foreign aphids (aphids transplanted onto trees from different sites). To test for rapid evolution, we used 4 clonally replicated aphid genotypes and transplanted each onto 5 clonally replicated P. angustifolia genotypes. Each tree genotype started with the same aphid genotype composition. After 21 days (~two aphid generations), aphid genotype composition changed (i.e., aphids evolved) and some tree genotypes supported unique evolutionary trajectories of aphids. These results suggest that plant evolution in response to human perturbation, such as climate change and invasive species, will also result in evolutionary responses in strongly interacting species that could cascade to affect whole communities. [ABSTRACT FROM AUTHOR]

Background: Risperidone is a second‐generation antipsychotic drug metabolized to an active metabolite, 9‐hydroxyrisperidone, primarily by cytochrome P450 (CYP) 2D6 and to a lesser extent by CYP3A4. The extent to which drug metabolism genetics impacts risperidone and 9‐hydroxyrisperidone exposure has not been clarified. Objective: A systematic review and meta‐analysis evaluated the impact of genetically defined CYP2D6 function on risperidone pharmacokinetics applying a standardized genotype–phenotype translation system. Methods: A comprehensive electronic database search identified studies reporting relationships between genetically determined CYP2D6 metabolism and risperidone pharmacokinetic properties. The exposure of risperidone or active moiety (risperidone + 9‐hydroxyrisperidone) was measured by dose‐adjusted steady‐state serum or plasma concentration or area under the concentration‐time curve as primary outcomes. Subjects were assigned to CYP2D6 poor metabolizer, intermediate metabolizer, normal metabolizer, or ultrarapid metabolizer groups using a standardized genotype–phenotype translation method. Effect sizes between groups were pooled and stratified by single or multiple dosing regimens. Results: A total of 15 studies involving 2125 adult subjects were included in the meta‐analysis. Following multiple‐dose oral administration, compared with CYP2D6 normal metabolizers, the risperidone dose‐adjusted steady‐state serum/plasma concentration was 2.35‐fold higher in intermediate metabolizers (95% confidence interval [CI] 1.77–3.13, p<0.0001) and 6.20‐fold higher in poor metabolizers (95% CI 5.05–7.62, p<0.0001); the active moiety dose‐adjusted steady‐state concentration was 1.18‐fold higher in intermediate metabolizers (95% CI 1.11–1.25, p<0.0001) and 1.44‐fold higher in poor metabolizers (95% CI 1.23–1.69, p<0.0001). Higher area under the concentration‐time curve of risperidone and active moiety was also found in single‐dose studies. Conclusion: Genetically defined impaired CYP2D6 activity is associated with increased exposure of both risperidone and risperidone + 9‐hydroxyrisperidone in adults receiving oral formulations. Additional studies are needed to quantify the clinical impact of these relationships. [ABSTRACT FROM AUTHOR]

Patient‐reported outcomes can be included as end points in pressure ulcer (PU) intervention trials to provide information to inform decision‐making and improve the lives of patients. However, the challenge for researchers and clinicians is identifying and choosing an appropriate instrument for each particular application that suits their research questions and clinical context. To provide researchers and clinicians with the information needed to inform choice of patient‐reported outcome measures, we compared a generic and disease‐specific measures' ability to discriminate between clinical groups known to differ, and determined their responsiveness to change. We performed analyses on a subset of patients recruited to the PRESSURE 2 trial that completed the pressure ulcer quality of life instrument—prevention version (PU‐QOL‐P) and Short Form 12 Questionnaire (SF12) measures at baseline and 30‐day posttreatment. Known‐group validity and responsiveness‐to‐change analyses were conducted. The analysis sample consisted of 617 patients that completed both measures at baseline. Known‐group validity revealed that some PU‐QOL‐P symptoms and function scales differentiated between people with category 2 PUs and those without PUs. A less meaningful pattern of results was observed for the SF12 scales, suggesting that the PU‐QOL‐P is more sensitive to differences between PU and non‐PU populations. Responsiveness analysis revealed that the PU‐QOL‐P was more responsive in detecting disease severity than the SF12. The PU‐QOL‐P provides a standardized method for assessing PU‐specific symptoms and functioning outcomes and is suitable for quantifying the benefits of PU interventions from the patient's perspective. Generic measures are useful for group comparisons of global quality of life domains. Choice of measure for each particular application should be determined by the purpose of the measurement and the information required. [ABSTRACT FROM AUTHOR]

The article focuses on the feasibility in the use of the inhibitor Panobinostat in patients with relapsed multiple myeloma (MM) alongside dexamethasone and bortezomib. It talks about the clinical trial for progression-free survival (PFS) in patients going through disease relapse. It tells about the need to improve the efficiency of the drugs Dexamethasone, Bortezomib and Thalidomide alongside the inhibitor.

Global peatlands store an unparalleled proportion of total global organic carbon but it is vulnerable to erosion into fluvial systems. Fluvial networks are being recognized as areas of carbon transformation, with eroded particulate organic carbon processed to dissolved organic carbon and CO2. Existing studies indicate biodegradation and photodegradation as key processes controlling the transformation of organic carbon in fluvial systems, with initial concentrations of dissolved organic carbon (DOC) identified as a control on the rate of carbon mineralization. This study manipulates temperature and incident light intensity to investigate carbon mineralization rates in laboratory simulations of peatland sediment transport into fluvial systems. By directly measuring gaseous CO2 emissions from sampled stream water, the relationship of temperature and light intensity with carbon efflux is identified. In simulations where sediment (as particulate organic matter, POM) is absent, temperature is consistently the dominant factor influencing carbon efflux rates. This influence is independent of the initial DOC concentration of the water sample. In simulations where POM was added, representing a peatland river receiving eroded terrestrial sediment, initial DOC concentration predicts 79% of the variation in total gaseous carbon efflux whereas temperature and light intensity predict 12% and 3%, respectively. When sampled stream water's mineralization rates in the presence of added POM are analysed independently, removing DOC as a model variable, the dominant variable affecting CO2 efflux is opposite for each sample. This study presents novel data suggesting peatland erosion introduces further complexity to dynamic stream systems where rates of carbon transformation processes and the influence of specific environmental variables are interdependent. Anthropogenic climate change is identified as a leading risk factor perpetuating peatland erosion; therefore, understanding the fate of terrestrial sediment in rivers and further quantifying the benefits of protecting peatland soils will be of increasing importance to carbon budgeting and ecosystem function studies. [ABSTRACT FROM AUTHOR]

Aim: We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure (IF) and its implications for healthcare delivery.Method: We conducted a retrospective analysis of outcome data of children on home parenteral nutrition (HPN), over a 15-year period.Results: A total of 31 patients received HPN: 15 for short bowel syndrome (SBS), eight neuromuscular disease (NMD) and eight for other causes. The HPN prevalence increased from 1.54 per million children in 2000 to 21.5 in 2016. The outcomes over last 5 years were better than those of previous 10 years. The rate of catheter-related bloodstream infection (CRBSI) had fallen from 4 to 1.3 and IF liver disease (IFALD) from 20% to 7.7%. The aetiology changed over years from SBS being the main cause to NMD contributing 43% to the total in 2016. This was especially relevant as NMD was associated with greater numbers of IFALD (38% vs 6.7%), CRBSI (1.51 vs 0.64/1000 PN days) and mortality.Conclusion: The outcome of long-term parenteral nutrition (PN) has improved. The increasing number of patients with NMD, coupled with their higher burden of care, results in an increasing health care burden, and the planning of intestinal rehabilitation services needs to reflect this. [ABSTRACT FROM AUTHOR]

Suicide in rural areas has not received significant attention in the research literature to this point, although suicide rates are higher among adults and older adults in rural areas than in urban areas. The aims of the study were as follows: (1) establish the feasibility of assessing suicide ideation and history of suicidal behavior; (2) determine preliminary estimates of the prevalence of suicide ideation, and history of suicide attempts; and (3) examine the effectiveness and acceptability of safety and referral plans for individuals whose responses indicated elevated suicide risk, in rural communities with limited access to referral care. Participants were 96 adults aged 40 to 85 years old (M = 57.34, SD = 11.47) residing in West Texas. Our results indicate that 26% of participants endorsed a lifetime history of suicide ideation and/or suicide attempt(s) and 12.5% reported suicide ideation in the past year. In addition, 93.4% of participants reported that participation in our suicide-focused study was an excellent or good experience. Results suggest that individuals in rural communities are willing to talk about suicide, found the experience helpful, and were satisfied with the referral process. [ABSTRACT FROM AUTHOR]

Background: Butylparaben (butyl p‐hydroxybenzoic acid) is a common cosmetic and pharmaceutical preservative reported to induce oxidative stress and endocrine disruption. Embryonic development is sensitive to oxidative stress, with redox potentials playing critical roles in progenitor cell fate decisions. Because pancreatic beta cells have been reported to have low antioxidant gene expression, they may be sensitive targets of oxidative stress. We tested the hypotheses that butylparaben causes oxidative stress in the developing embryo, and that pancreatic beta cells are a sensitive target of butylparaben embryotoxicity. Methods: Transgenic insulin:GFP zebrafish embryos (Danio rerio) were treated daily with 0, 250, 500, 1,000, and 3,000 nM butylparaben. Pancreatic islet and whole embryo development were examined though 7 days postfertilization, and gene expression was measured by quantitative real‐time PCR. Glutathione (GSH) and cysteine redox content were measured at 28 hr postfertilization using HPLC. Results: Butylparaben exposure caused intestinal effusion, pericardial edema, and accelerated yolk utilization. At 250 nM, beta cell area increased by as much as 55%, and increased incidence of two aberrant morphologies were observed‐fragmentation of the islet cluster and ectopic beta cells. Butylparaben concentrations of 500 and 1,000 nM increased GSH by 10 and 40%, respectively. Butylparaben exposure downregulated transcription factor pdx1, as well as genes involved in GSH synthesis, while upregulating GSH‐disulfide reductase (gsr). Conclusions: The endocrine pancreas is a sensitive target of embryonic exposure to butylparaben, which also causes developmental deformities and perturbs redox conditions in the embryo. [ABSTRACT FROM AUTHOR]

ABSTRACT: The northern subspecies of the salt marsh harvest mouse (Reithrodontomys raviventris halicoetes) is morphologically similar to the western harvest mouse (R. megalotis) with which it co‐occurs in the Suisun Marsh, California, USA, and therefore they are difficult to distinguish in the field. The salt marsh harvest mouse is a federal and California state‐listed endangered species, whereas the western harvest mouse has no special status. Thus, our objective was to identify the most effective field metrics that distinguish the species. First we identified a barcode of life and restriction fragment length polymorphism approach for genetically distinguishing between the species. Then we performed univariate tests to examine variation in standard external morphological traits within and between species, and found that differences between species were confounded by sex and age. We then used discriminant function analysis and multiple logistic regression (MLR) to find combinations of characters that resulted in the highest percentages of correct classification based on a data set of individuals with genetically verified species identity. The best model (MLR) correctly classified 90.1 ± 3.5% ( x ¯ ± SD) of individuals, though all approaches performed relatively poorly with smaller, ostensibly younger, mice. Therefore, tail length, body length, and tail diameter, if treated in a comprehensive multivariate context, can yield substantial accuracy for distinguishing between coexisting northern salt marsh and western harvest mice. © 2018 The Wildlife Society. [ABSTRACT FROM AUTHOR]

Objective: Treat-to-target approaches have proved to be effective in rheumatoid arthritis, but have not been studied in psoriatic arthritis (PsA). This study was undertaken to examine the cost-effectiveness of tight control (TC) of inflammation in early PsA compared to standard care.Methods: Cost-effectiveness analyses were undertaken alongside a UK-based, open-label, multicenter, randomized controlled trial. Taking the perspective of the health care sector, effectiveness was measured using the 3-level EuroQol 5-domain, which allows for the calculation of quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios (ICERs) are presented, which represent the additional cost per QALY gained over a 48-week time horizon. Sensitivity analyses are presented assessing the impact of variations in the analytical approach and assumptions on the cost-effectiveness estimates.Results: The mean cost and QALYs were higher in the TC group: £4,198 versus £2,000 and 0.602 versus 0.561. These values yielded an ICER of £53,948 per QALY. Bootstrapped uncertainty analysis suggests that the TC has a 0.07 probability of being cost-effective at a £20,000 threshold. Stratified analysis suggests that with certain costs being controlled, an ICER of £24,639 can be calculated for patients with a higher degree of disease severity.Conclusion: A tight control strategy to treat PsA is an effective intervention in the treatment pathway; however, this study does not find tight control to be cost-effective in most analyses. Lower drug prices, targeting polyarthritis patients, or reducing the frequency of rheumatology visits may improve value for money metrics in future studies. [ABSTRACT FROM AUTHOR]

Objective Bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners are at increased risk for suicidal thoughts and behaviors. We hypothesized the association between (a) lifetime frequency of BDSM-related sexual behaviors and (b) BDSM identification and suicide attempt status would be mediated by acquired capability components (i.e., fearlessness about death and pain tolerance). Gender differences were examined. Method Participants were 576 BDSM practitioners (meanage = 28.71; 66.7% male) recruited from online BDSM-related groups, cross-sectionally. Results Among males, the total indirect effect of acquired capability components in the relation between BDSM-related sexual behaviors and suicide attempt status was significant. The specific indirect effect of perceived pain tolerance in the relation between both BDSM-related sexual behaviors and BDSM identification and suicide attempt status was significant. There were no significant effects for females. Additionally, 12% reported a suicide attempt history. Conclusion Among males, BDSM-related sexual behaviors and BDSM identification were associated with increased acquired capability components, which were positively associated with suicide attempt status. [ABSTRACT FROM AUTHOR]

Most cruise plans include extensive and exhaustive packing lists, which are generated via experience and detailed discussions about upcoming experiments. In particular, it is helpful to plan for the unexpected and to have backup plans for the backup plans. Packing for fieldwork and going to sea is an activity that requires plenty of forethought and a lot of time to deal with planning and logistics. [Extracted from the article]

It is increasingly common for apex predators to face a multitude of complex conservation issues. In Australia, dingoes are the mainland apex predator and play an important role in ecological functioning. Currently, however, they are threatened by hybridization with modern domestic dogs in the wild. As a consequence, we explore how increasing our understanding of the evolutionary history of dingoes can inform management and conservation decisions. Previous research on whole mitochondrial genome and nuclear data from five geographical populations showed evidence of two distinct lineages of dingo. Here, we present data from a broader survey of dingoes around Australia using both mitochondrial and Y chromosome markers and investigate the timing of demographic expansions. Biogeographic data corroborate the presence of at least two geographically subdivided genetic populations, southeastern and northwestern. Demographic modeling suggests that dingoes have undergone population expansion in the last 5,000 years. It is not clear whether this stems from expansion into vacant niches after the extinction of thylacines on the mainland or indicates the arrival date of dingoes. Male dispersal is much more common than female, evidenced by more diffuse Y haplogroup distributions. There is also evidence of likely historical male biased introgression from domestic dogs into dingoes, predominately within southeastern Australia. These findings have critical practical implications for the management and conservation of dingoes in Australia; particularly a focus must be placed upon the threatened southeastern dingo population. [ABSTRACT FROM AUTHOR]

The interpersonal theory of suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) increase suicide ideation; however, studies have found mixed results regarding this hypothesis among psychiatric inpatients. This study aimed to (a) demonstrate how assessing TB and PB using the Interpersonal Needs Questionnaire (INQ) can provide clinically useful information and (b) investigate how statistical methodology may impact the clinical application of the INQ. Participants were 139 (Sample 1) and 104 (Sample 2) psychiatric inpatients. In both samples, ordinal logistic regression results indicated TB and PB, separately, were significant predictors of suicide ideation-related outcomes; however, when examined as simultaneous predictors, TB was no longer a significant predictor. The interaction between TB and PB was not significant for either sample. Despite this, TB and PB scores provided clinically relevant information about suicide ideation-related outcomes. For example, the highest scores on TB and PB indicated a 93% and 95% chance of having some level of distress due to suicide ideation (Sample 1), a 91% and 92% chance of having some level of desire for death, and a 79% and 84% chance of having some level of desire for suicide, respectively (Sample 2). This study also proposes clinical cutoff scores for the INQ (for TB and PB, respectively, cutoff scores were 22 and 17 for distress due to suicide ideation, 33 and 17 for desire for death, and 31 and 22 for desire for suicide). Although these results indicate that multicollinearity between TB and PB may create interpretational ambiguity for clinicians, TB and PB may each be useful separate predictors of suicide ideation-related outcomes in psychiatric inpatient settings and should be incorporated into suicide risk assessment. Key Practitioner Message The 15-item Interpersonal Needs Questionnaire (an assessment of thwarted belongingness and perceived burdensomeness) should be incorporated into suicide risk assessment., Among psychiatric inpatients, greater thwarted belongingness and perceived burdensomeness, as separate predictors, were associated with increased levels of distress due to suicide ideation, desire for death, and desire for suicide., The highest scores on thwarted belongingness and perceived burdensomeness indicated a 79% to 95% chance of experiencing an elevated level of distress due to suicide ideation, desire for death, or desire for suicide., Recommended clinical cutoff scores were provided. For example, thwarted belongingness cutoff score of 31 and perceived burdensomeness cutoff score of 22 maximized the sensitivity and specificity of the INQ to detect some level of desire for suicide. [ABSTRACT FROM AUTHOR]

To date, no study has examined rates of suicide ideation or theory-based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty-seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma-related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation. [ABSTRACT FROM AUTHOR]

We analyse two frequently used measures of the demand for health-hospital visits and out-of-pocket health care expenditure-which have been analysed separately in the existing literature. Given that these two measures of health demand are highly likely to be closely correlated, we propose a framework to jointly model hospital visits and out-of-pocket medical expenditure, which allows for the presence of nonlinear effects of covariates using splines to capture the effects of aging on health demand. The findings from our empirical analysis of the US Health and Retirement Survey indicate that the demand for health varies with age. © 2015 The Authors. Journal of Applied Econometrics published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]