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Summary: Background: Family based treatment is an effective, multipronged approach to address obesity as it plagues families. Objective: To investigate the relationships among sociodemographic characteristics (e.g., education and income), body mass index (BMI) and race/ethnicity with readiness to change for parents enrolled in the Primary care pediatrics, Learning, Activity and Nutrition (PLAN) study. Methods: Multivariate linear regressions tested two hypotheses: (1) White parents will have higher levels of baseline readiness to change, when compared to Black parents; (2) parents with higher income and education will have higher levels of readiness to change at baseline. Results: A positive relationship exists between baseline parent BMI and readiness to change (Pearson correlation, 0.09, p < 0.05); statistically significant relationships exist between parent education level (−0.14, p < 0.05), income (0.04, p < 0.05) and readiness to change. Additionally, a statistically significant relationship exists, with both White (β, −0.10, p < 0.05), and Other, non‐Hispanic (−0.10, p < 0.05) parents exhibiting lower readiness to change than Black, non‐Hispanic parents. Child data did not indicate significant relationships between race/ethnicity and readiness to change. Conclusions: Results demonstrate that investigators should consider sociodemographic characteristic factors and different levels of readiness to change in participants enrolling in obesity interventions. [ABSTRACT FROM AUTHOR]

Background: Online communication has become an integral aspect of daily life for young people internationally. Very little research has examined whether the association between social media use and well‐being depends on who young people engage with (i.e. real, or virtual friendships). Methods: Data were drawn from a subsample of students (N = 38,736) who took part in the School Health Research Network (SHRN) 2019 Student Health and Well‐being (SHW) survey. A series of multivariable regression models were used to assess the association between who adolescents were communicating with online and well‐being, controlling for confounders: passive social media use; friendship quality; and cyberbullying. We also tested whether these associations were modified based on gender. Results: Students are highly engaged on social networking sites, and these sites are used to communicate with existing friendship groups and develop virtual friendships. Frequent online communication with best friends (b =.340, p <.001) and bigger friendship groups (b =.397; p <.001) was associated with higher levels of well‐being. However, the frequency of online contact with virtual friends made online was negatively and significantly associated with well‐being (b = −.760; p <.001), with a larger negative association for girls than boys. Conclusions: Online communication with virtual friendship networks were associated with lower mental well‐being, with stronger associations for girls than boys; however, frequent online communication with 'real' friends was associated with better well‐being. Our results indicate the importance of considering the nature of adolescent online communication, rather than just its quantity, in developing interventions to improve adolescent well‐being. [ABSTRACT FROM AUTHOR]

Micro‐macro models provide a powerful tool to study the relationship between microscale mechanisms and emergent macroscopic behavior. However, the detailed microscopic modeling requires tracking and evolving a potentially high‐dimensional configuration space at high computational cost. In this work, we present a novel parallel algorithm for simulating a high‐dimensional micro‐macro model of a gliding motility assay. We utilize a holistic approach aligning the data residency and simulation scales with the hybrid CPU and multi‐GPU hardware. Our novel approach achieves a speedup factor of 9.25× over previous GPU‐accelerated micro‐macro methods on the same hardware. Furthermore, by decoupling dependencies in the microstructure update, we are able to efficiently distribute the microstructure over multiple GPUs with minimal overhead. We test on up to four GPUs and observe excellent scaling, suggesting that significant further speedups are achievable with additional GPUs. Our approach enables micro‐macro simulations of higher complexity and resolution than would otherwise be feasible. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incremental associations between the implementation of expanded Medicaid eligibility and prerelease Medicaid enrollment assistance on Medicaid enrollment for recently incarcerated adults. Data Sources/Study Setting: Data include person‐level merged, longitudinal data from the Wisconsin Department of Corrections and the Wisconsin Medicaid program from 2013 to 2015. Study Design: We use an interrupted time series design to estimate the association between each of two natural experiments and Medicaid enrollment for recently incarcerated adults. First, in April 2014 the Wisconsin Medicaid program expanded eligibility to include all adults with income at or below 100% of the federal poverty level. Second, in January 2015, the Wisconsin Department of Corrections implemented prerelease Medicaid enrollment assistance at all state correctional facilities. Data Collection/Extraction Methods: We collected Medicaid enrollment, and state prison administrative and risk assessment data for all nonelderly adults incarcerated by the state who were released between January 2013 and December 2015. The full sample includes 24 235 individuals. Adults with a history of substance use comprise our secondary sample. This sample includes 12 877 individuals. The primary study outcome is Medicaid enrollment within the month of release. Principal Findings: Medicaid enrollment in the month of release from state prison grew from 8 percent of adults at baseline to 36 percent after the eligibility expansion (P‐value <.01) and to 61 percent (P‐value <.01) after the introduction of enrollment assistance. Results were similar for adults with a history of substance use. Black adults were 3.5 percentage points more likely to be enrolled in Medicaid in the month of release than White adults (P‐value <.01). Conclusions: Medicaid eligibility and prerelease enrollment assistance are associated with increased Medicaid enrollment upon release from prison. States should consider these two policies as potential tools for improving access to timely health care as individuals transition from prison to community. [ABSTRACT FROM AUTHOR]

Detailed anatomical maps of individual organs and entire animals have served as invaluable entry points for ensuing dissection of their evolution, development, and function. The pharynx of the nematode Caenorhabditis elegans is a simple neuromuscular organ with a self‐contained, autonomously acting nervous system, composed of 20 neurons that fall into 14 anatomically distinct types. Using serial electron micrograph (EM) reconstruction, we re‐evaluate here the connectome of the pharyngeal nervous system, providing a novel and more detailed view of its structure and predicted function. Contrasting the previous classification of pharyngeal neurons into distinct inter‐ and motor neuron classes, we provide evidence that most pharyngeal neurons are also likely sensory neurons and most, if not all, pharyngeal neurons also classify as motor neurons. Together with the extensive cross‐connectivity among pharyngeal neurons, which is more widespread than previously realized, the sensory‐motor characteristics of most neurons define a shallow network architecture of the pharyngeal connectome. Network analysis reveals that the patterns of neuronal connections are organized into putative computational modules that reflect the known functional domains of the pharynx. Compared with the somatic nervous system, pharyngeal neurons both physically associate with a larger fraction of their neighbors and create synapses with a greater proportion of their neighbors. We speculate that the overall architecture of the pharyngeal nervous system may be reminiscent of the architecture of ancestral, primitive nervous systems. [ABSTRACT FROM AUTHOR]

The recurrent motor branch of the median nerve is an important nerve for function of the hand.3 Variant anatomy has been well described and implicated in cases of isolated thenar muscle neuropathy.5 We present a variant of median nerve anatomy causing isolated motor neuropathy, which to the authors' knowledge, has not been previously described. Group II describe distal accessory TMB, group IV proximal accessory TMB and group III high median nerve division leading to a bifid nerve.3 This classification is not exhaustive and other variations are described. [Extracted from the article]

We document the dramatic decline in the United States of mother sole custody arrangements following divorce. Our empirical analysis uses Wisconsin court records data spanning more than two decades (1988-2010). Updating earlier analyses that showed significant increases in shared custody, we estimate that shared custody (where children spend at least 25% of time with each parent) has now replaced sole-mother custody as the most common post-divorce parenting arrangement-accounting for just over half (50.3%) of all cases in the most recent cohort available. We discuss the institutional context for these changes in custody in the United States, the sociodemographic factors associated with custody outcomes, and the implications for policy and practice. [ABSTRACT FROM AUTHOR]

There has been growing concern over declines in populations of honey bees and other pollinators which are a vital part to our food security. It is imperative to identify factors responsible for accelerated declines in bee populations and develop solutions for reversing bee losses. While exact causes of colony losses remain elusive, risk factors thought to play key roles are ectoparasitic mites Varroa destructor and neonicotinoid pesticides. The present study aims to investigate effects of a neonicotinoid pesticide Imidacloprid and Varroa mites individually on survivorship, growth, physiology, virus dynamics and immunity of honey bee workers. Our study provides clear evidence that the exposure to sublethal doses of Imidacloprid could exert a significantly negative effect on health and survival of honey bees. We observed a significant reduction in the titer of vitellogenin (Vg), an egg yolk precursor that regulates the honey bees development and behavior and often are linked to energy homeostasis, in bees exposed to Imidacloprid. This result indicates that sublethal exposure to neonicotinoid could lead to increased energy usage in honey bees as detoxification is a energy-consuming metabolic process and suggests that Vg could be a useful biomarker for measuring levels of energy stress and sublethal effects of pesticides on honey bees. Measurement of the quantitative effects of different levels of Varroa mite infestation on the replication dynamic of Deformed wing virus (DWV), an RNA virus associated with Varroa infestation, and expression level of immune genes yields unique insights into how honey bees respond to stressors under laboratory conditions. [ABSTRACT FROM AUTHOR]

We present the case of an 18-year-old female who underwent replantation following total scalp avulsion, where a successful outcome can have a major impact on future quality of life. The arterial anastomosis was completed first and released allowing the scalp to be perfused which aided identification of veins on the scalp flap. Microsurgical reconstruction of major scalp defects following scalp avulsion. [Extracted from the article]

It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty. We present analysis of perioperative blood tests and transfusion rates in 107 patients undertaking unilateral hybrid hip resurfacing arthroplasty by the senior author at a single institution over a three-year period. We conclude that routine perioperative testing of haemoglobin levels for hip resurfacing arthroplasty procedures does not assist in clinical management. We recommend that postoperative blood testing only be considered should the patient demonstrate clinical signs of symptomatic anaemia or if particular clinical circumstances necessitate. [ABSTRACT FROM AUTHOR]

- The spotfin chub Erimonax monachus is a rare cyprinid fish endemic to the Tennessee River drainage, and it is federally listed as threatened in the USA. Microhabitat use of spotfin chubs was studied via stream snorkelling in the Emory River watershed, Tennessee, one of the last remaining populations of this species. We used a Bayesian generalised linear mixed model to evaluate microhabitat covariates related to the presence/absence of spotfin chubs among eight stream sites across three seasons (early summer, late summer and fall). In general, spotfin chubs were more likely to be present in microhabitats characterised by boulder/bedrock substrates, medium to high velocity, and medium depth (typical of the run habitat). However, the patterns were not necessarily consistent among seasons or stream sites, due partly to interactions between microhabitat and macrohabitat covariates. Specifically, spotfin chubs were more selective of bedrock and boulder substrate at smaller stream sites where they were less abundant, and they were more selective of higher velocity at warmer stream temperatures (early and late summer). Our data indicate that spotfin chubs may exhibit flexible microhabitat use to some extent, and their microhabitat use may differ by macrohabitat characteristics such as stream size and water temperature. This study provided a refined understanding of microhabitat use of spotfin chubs and suggests that effective conservation of this declining species should identify and protect available suitable habitat across space and time. [ABSTRACT FROM AUTHOR]

Using the geometric framework for the first time in a field study of ant nutritional biology, we show that Ectatomma ruidum colonies actively regulate protein–carbohydrate intake, self-selecting a carbohydrate-biased diet. These data, combined with quantitative recruitment data, provide a more comprehensive understanding of colony-level nutritional requirements of ants. Abstract in Spanish is available at [ABSTRACT FROM AUTHOR]

In a recent examination of the integrated nature of inflation, Culver and Papell (Journal of Applied Econometrics, 1997) applied a range of unit root and stationarity tests to data from a panel of 13 OECD economies. The results obtained were mixed. While little evidence of stationarity was detected using univariate methods, rejection of the unit root hypothesis was observed under panel data unit root testing, although rejection was found to be sensitive to cross-sectional variation. In this note the results of Culver and Papell are reconsidered in light of conditional heteroskedasticity detected in the inflation rate series. Using a more appropriate univariate testing procedure combining local-to-unity detrending and joint maximum likelihood estimation of a unit root testing equation and GARCH process, strong evidence in favour of stationarity is detected in 11 of 13 economies examined. In contrast to the univariate findings of Culver and Papell, the results obtained herein using an alternative univariate procedure provide evidence in support of their I(0) inference drawn using panel methods. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: An interdisciplinary, proactive perspective allows providers to engage in productive, long-term collaborative relationships with corporations, while 1) maintaining patient care improvements; 2) maintaining legality; 3) enhancing technical and clinical innovation; and 4) providing fair compensation for work done. The case study approach is used to demonstrate an effective approach to compliant behavior. [Copyright &y& Elsevier]

Objectives: Fifty-six consecutive neurologically impaired pediatric children underwent laryngotracheal separation (LTS) for acute recurrent and chronic aspiration in the last 18 years. The population demographics, indications for surgery, and comorbidities are reviewed. This study reports early and late complications and survivorship including admissions for pneumonia/aspiration. Diagnosis related group (DRGs) and work relative value units (wRVUs) were measured to document the potential benefits before and after LTS. Study Design: Retrospective review of patient charts and records in an electronic medical record during an 18 year period. Methods: Information was obtained by a chart review and utilization of the electronic medical record. Patient specific DRG and wRVU data on their hospitalizations and outpatient encounters at the Alfred I. duPont Hospital for Children of the Nemours Foundation and survival data were recorded. Data was analyzed using chi-square analysis, a two-tailed t test, and a Fisher's Exact test. Results: Laryngotracheal separation achieved complete control of aspiration in all the children. A significant reduction in the number of hospital admissions for pneumonias after surgery was noted. After LTS there was a reduced average number of DRGs per month (p < .001) as well as wRVUs. Transient fistula formation (11%) was the most common complication. No patient had his or her procedure reversed to date. Conclusion: Laryngotracheal separation is 100% effective in controlling aspiration in all of neurologically impaired children in this study, It is a valuable procedure to prolong the life of children who have intractable aspiration. After LTS, a decrease in DRGs and wRVUs reduces health care costs for these patients. Prior to LTS, all medical and surgical treatment options for aspiration should be discussed and considered, based on the extent of the child's underlying neurologic status, ability to verbally communicate, degree of upper airway obstruction, and hope of recovery of neurologic function. Laryngoscope, 2009 [ABSTRACT FROM AUTHOR]

The Dickey-Fuller unit root test is known to suffer severe oversizing in the presence of innovation variance breaks. In this paper, forward and reverse Dickey-Fuller regressions are proposed as a means of correcting this size distortion. The results of Monte Carlo experimentation show such an approach to result in both satisfactory size properties and increased power relative to previously suggested solutions. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Gastroesophageal reflux disease (GERD) is common in children, and extraesophageal reflux disease (EORD) has been implicated in the pathophysiology of otitis media (OM). We sought to 1) determine the incidence of pepsin/pepsinogen presence in the middle ear cleft of a large sample of pediatric patients undergoing myringotomy with tube placement for OM; 2) compare this with a control population of pediatric patients undergoing middle ear surgery (cochlear implantation) with no documented history of OM; 3) analyze potential risk factors for OM in children with EORD demonstrated by the presence of pepsin in the middle ear cleft; and 4) determine if pepsin positivity at the time of myringotomy with tube placement predisposes to posttympanostomy tube otorrhea. Study Design and Methods: Study Group: prospective samples of 509 pediatric patients (n = 893 ear samples) undergoing myringotomy with tube placement for recurrent acute OM and/or otitis media with effusion in a tertiary care pediatric hospital with longitudinal follow-up of posttympanostomy tube otorrhea. Control Group: prospective samples of 64 pediatric patients (n = 74 ears) with negative history of OM undergoing cochlear implantation at one of the three tertiary care pediatric hospitals. A previously validated, highly sensitive and specific modified enzymatic assay was used to detect the presence of pepsin in the middle ear aspirates of study and control patients. Risk factors for OM and potentially associated conditions, including GERD, allergy, and asthma were analyzed for the study group through review of the electronic medical record and correlated topresence of pepsin in the middle ear space. Study patients were followed longitudinally postoperatively to determine the incidence of posttympanostomy tube otorrhea. Results: The incidence of pepsin in the middle ear cleft of the study group was 20% of patients and 14% of ears, which is significantly higher than 1.4% of control patients and 1.5% of control ears ( P < .05). Study patients younger than 1 year had a higher rate of purulent effusions and pepsin in the middle ear cleft ( P < .05). Patients with pepsin in the middle ear cleft were more likely to have an effusion at the time of surgery than patients without pepsin in the middle ear cleft ( P < .05). There was no statistical association found between the presence of pepsin and clinical history of GERD, allergy, asthma, or posttympanostomy tube otorrhea. Conclusions: Pepsin is detectable in the middle ear cleft of 20% of pediatric patients with OM undergoing tympanostomy tube placement, compared with 1.4% of controls; recovery of pepsin in the middle ear space of pediatric patients with OM is an independent risk factor for OM. Patients under 1 year of age have a higher incidence of purulent effusions and pepsin-positive effusions. Clinical history of GERD, allergy, and asthma do not seem to correlate with evidence of EORD reaching the middle ear cleft. The presence of pepsin in the middle ear space at the time of tube placement does not seem to predispose to posttympanostomy tube otorrhea. [ABSTRACT FROM AUTHOR]

In primary lowland rain forest in Brunei Darussalam, we studied arboreal ant communities to evaluate whether densities and spacing of spatially territorial taxa along 2.9 km of well-studied trails are consistent with existence of a continuous mosaic of dominant ants. A median intercolony distance of 24.5 m, about twice or less distances over which colonies of most included species regularly ranged, suggested a relatively continuous mosaic. Despite relying on nesting sites in preformed plant cavities, carpenter ants contributed > 70 percent of mapped colonies. Most belonged to the Camponotus ( Colobopsis) cylindricus (COCY) complex, including SE Asia's ‘exploding’ ants. Their lack of aggression against certain Polyrhachis species was associated with interspecific territory sharing by members of the two groups, and with a dominance-discovery trade-off. Experimental approaches yielded evidence for two putative contributors to positive association. Larger-bodied Polyrhachis parasitize food-finding abilities of smaller, more populous Camponotus workers, and the two taxa cooperate in territorial defense. Highly territorial and predatory weaver ants ( Oecophylla smaragdina) were an important component of the ant mosaic in primary forest, second only to codominant COCY and Polyrhachis taxa. Members of the genus Crematogaster were significantly associated with Oecophylla in baiting censuses and regularly monopolized near-nest baits to the exclusion of weaver ants. Litter ant abundances differed between territories of Oecophylla and less predatory COCY species, but direction of difference was inconsistent over time. The densely packed mosaic of spatially territorial, and differentially predatory, taxa in Bornean rain forest likely contributes to spatial variation in ant effects on plant and arthropod communities. [ABSTRACT FROM AUTHOR]

Objective: We sought to confirm the finding of pepsin/pepsinogen in the middle ear fluid of children with otitis media in a larger sample size using a sensitive and specific pepsin assay. Study Design and Setting: We evaluated 152 children (225 ear samples) in a prospective study at a tertiary care children’s hospital. The presence of pepsin in middle ear aspirates was determined using enzymatic assay. Results: Of the patients, 14.4 percent (22 of 152) had detectable pepsin activity in one or both of the ear samples with no pepsin activity detected in control serum. Average pepsin concentration in the samples was 96.6 ± 170.8 ng/ml, ranging from 13 to 687 ng/ml. Pepsin concentration in the middle ear of children younger than 1.0 year was significantly higher than in older age groups. Conclusion and Significance: Results indicate that pepsin/pepsinogen is present in the middle ears of children with otitis media, although not at the high rate previously reported. Gastric reflux may be one causative factor in the pathogenesis of otitis media. [Copyright &y& Elsevier]

Laryngotracheo-esophageal cleft is a rare congenital anomaly that results from complete or partial failure of the development of the tracheoesophageal septum. The presenting symptoms include stridor, respiratory distress, and coughing or cyanotic episodes with feeding. There are four classifications for laryngeal clefts; the severity depends on the type present. We discuss the anesthesia management of a neonate with a Type IV cleft who presented for an emergency gastric division to prevent pulmonary aspiration and later returned for final repair of the defect. [ABSTRACT FROM AUTHOR]

Objective: To describe increasing incidence and changing microbiology of head and neck abscesses in children admitted to the hospital during the first quarters of 2000 through 2003. Study design and setting: Retrospective data warehouse review identified 89 children less than 19 years of age admitted to a tertiary care pediatric hospital during the first quarters of 2000 through 2003 for suspicion of head and neck abscess involving the neck, face, and peritonsillar, retropharyngeal, and parapharyngeal spaces; and for orbital and intracranial complications of acute sinusitis. Outcome measures: Outcome measures included the incidence of infection admissions and description of infection location and microbiology, calculated by χ2 technique. Results: The incidence of infections increased in 2003. The greatest increase was in neck abscesses and complications of acute sinusitis. Conclusions: The increase in group A strep infections may be related to its biologic properties. Significance: Group A strep remains a significant cause of head and neck infections in children. [Copyright &y& Elsevier]

Feeding extensively on plant exudates and honeydews, many tropical arboreal ant species exhibit δ15N values characteristic of herbivores. Consistent with hypothesized herbivory, these taxa behave in feeding assays as though more N-deprived than are strictly carnivorous ants. However, to an as yet uncertain degree, relationships with N-upgrading and/or recycling microsymbionts may lower isotopic ratios, making ants appear to be more herbivorous than they actually are. Nutritional (N) contributions from microsymbionts have been inferred for a variety of ant taxa based on intracellular or extracellular associations between ants and bacteria. However, stronger and more specific inferences are possible when variability in microsymbiont locations within the digestive system is considered in the context of taxonomic variability in ant diets and digestive anatomy. Diets of exudate feeders may vary predictably in ratios of usable carbohydrates (CHOs) to N, depending on the extent to which they tend melezitose-producing Homoptera. Status of the peritrophic membrane, proventricular structure, and number and placement of Malpighian tubules can be interpreted as traits contributing to supply of N and/or CHOs to microsymbionts. In general, a more integrative understanding of ant diets, digestive anatomy, and associated microsymbionts helps to set out specific hypotheses to be tested experimentally and (where possible) in a phylogenetic context. [ABSTRACT FROM AUTHOR]

Many publicly owned treatment works in North America are exceeding permitted limits for total cyanide in their wastewater treatment effluents. A recently introduced rapid, segmented, flow-injection analysis procedure using UV digestion and amperometric detection of the membrane-separated cyanide was used to investigate the various scenarios by which elevated cyanide levels might be present in wastewater treatment plant effluent. A number of significant interferences can produce false positive bias during sample analysis with the traditional acid distillation technique, but are minimized or absent with the new analytical method. However, increased levels of cyanide were found in some chlorinated wastewaters compared to the levels before chlorination, suggesting a fast reaction mechanism associated with the disinfectant and some precursor in the wastewater. In particular, the contact of chlorine with nitrite in the presence of a carbon precursor appears to contribute to cyanide formation during wastewater treatment and sample handling. This paper explores the scenarios under which cyanide can form during wastewater treatment as well as those in which a false bias for total cyanide can be obtained during sample processing and provides guidance for appropriate sample handling, screening, and processing to ensure valid analytical results. [ABSTRACT FROM AUTHOR]

We report a case of perioperative management of a toddler with plastic bronchitis complicated by tracheal obstruction. We discuss our management of this case as well as the diverse group of patients who may present with this disease. We also reviewed the literature regarding medical management of cast bronchitis. [ABSTRACT FROM AUTHOR]

Objective Adenoidectomy alone or with tonsillectomy (A±T) is an effective surgical intervention in the management of otitis media in children, especially when it is performed in conjunction with insertion of pressure equalization tubes (PETs). Otorrhea and persistent tympanic membrane (TM) perforation are frequent complications. This study evaluates the effectiveness of intermediate duration middle ear ventilation using laser tympanic membrane fenestration (LTMF) without tube insertion and as an adjunct to adenoidectomy in resolving middle ear disease within the first 90 days after surgery. Study Design This pilot study was a multicenter, prospective clinical cohort trial. Institutional review board approval and informed consent were obtained. The study involved four tertiary care pediatric otolaryngology departments. Fifty children (96 ears) were treated with LTMF in conjunction with A±T from June 1, 1998, through March 30, 1999. Ages ranged from 9 months to 12 years. Patients undergoing A±T who would have been recommended for PET insertion instead underwent middle ear ventilation with LTMF using the OtoLAM™ device (ESC/Sharplan, Yokneam, Israel). Patients were seen at 30, 60, and 90 days postoperatively. Resolution of otitis media with effusion was determined by clinical examination, which included pneumatic otoscopy, audiometry, and tympanometry. Results Of the treated ears, 88%, 86%, and 83% had clinical resolution of middle ear disease at 30, 60, and 90 days, respectively. Preoperatively, 45% (n = 85) of ears had normal hearing; 92% (n = 49) had normal hearing at 90 days. Eighty-nine percent (n = 92) had type C2 or B tympanograms preoperatively, and 12% (n = 60) had type C2 or B at 90 days. Conclusion Laser tympanic membrane fenestration in conjunction with adenoidectomy was effective in restoring normal middle ear function at 90 days post-treatment in greater than 80% of children who otherwise may have had placement of PETs. [ABSTRACT FROM AUTHOR]

Research Objective: Substance use disorders (SUDs) are endemic and undertreated among the 1.2 million individuals incarcerated in state prisons. Reentry to the community is characterized by elevated rates of morbidity and mortality, particularly due to drug overdose. Treatment of SUDs before and during the reentry period reduces the risk of relapse and overdose. However, most formerly incarcerated adults with SUD do not receive any treatment in the initial weeks and months post‐release. We estimate the impact of Medicaid enrollment on the likelihood of receiving any health care, and SUD‐related care specifically, in the 30‐days post‐incarceration for adults with a history of substance use. Study Design: We study a natural experiment in which the Wisconsin Department of Corrections introduced prerelease Medicaid enrollment assistance. All adults with income below 100% of the federal poverty level were eligible for Medicaid throughout the study period. Using person‐level longitudinal data that links Corrections and Medicaid data, we implemented two‐stage least squares (2SLS) instrumental variables (IV) analysis. Two variables comprised the instruments corresponding to two policy periods: a 3‐month enrollment assistance implementation period and the fully operational enrollment assistance program. The key assumption is that timing of release is unrelated to the outcomes, conditional on the other variables in the model. Outcomes included care received within 30‐days of release: any outpatient visit (all‐cause, SUD, and opioid use disorder [OUD]), medication for OUD (MOUD), emergency department and inpatient events (all‐cause and drug overdose). Population Studied: The population includes 18,187 adults ages 18–64 incarcerated by the state, with a history of substance use, who were released between April 2014 – December 2016. Principal Findings: The instruments were correlated with Medicaid enrollment in the month of release (F‐statistic of 455). The likelihood of Medicaid coverage in the month of release increased from 39% at baseline, to 56% after introduction of the enrollment assistance program to 69% after it was fully operational. At baseline, the percentage of adults with health care use within 30‐days of release was 16% for any outpatient visit, 2.5% for an SUD‐related visit, 0.7% for an OUD‐related visit, 0.3% for MOUD, 5.5% for any ED visit, and 0.8% for an inpatient visit. Acquiring Medicaid coverage increased the likelihood of outpatient health care use within 30‐days of release (p < 0.05) by 26 percentage points (pp) for any outpatient visit, 2.6 pp for OUD‐related outpatient visit, 3.6 pp for an SUD‐related outpatient visit, and 1.5 pp for MOUD. Medicaid coverage was not associated with a change in emergency or inpatient care. Conclusions: Medicaid coverage among adults releasing from prison increased immediate access to outpatient care overall and for SUDs specifically for adults with a history of substance use. However, it did not reduce the likelihood of emergency or inpatient care. These findings highlight the important contribution, and potential limitations, of Medicaid coverage alone as a strategy to improve post‐release access to care and reduce overdose risk. Implications for Policy or Practice: Study findings highlight the potential positive impact of the proposed federal Medicaid Reentry Act on access to outpatient care for formerly incarcerated adults during the high‐risk, immediate post‐release period. Primary Funding Source: Wisconsin Partnership Program. [ABSTRACT FROM AUTHOR]

Cook, Holly and Turner recently developed a hypothesis of a positive relationship between the durability of consumers' expenditure and the asymmetric behaviour it exhibits. Supportive evidence was found by applying Sichel's tests of business cycle asymmetry to the component series of UK consumers' expenditure, which represent goods of differing durability, in this paper the relationship is re-examined using the original data, by implementing Stock's diagnostic tests of time deformation. The results provide further support for the durability-asymmetry hypothesis. [ABSTRACT FROM AUTHOR]

The objective of this study was to review experience, outcome, and satisfaction after a laryngotracheal separation (LTS) procedure in pediatric patients. Chart reviews and phone questionnaires were used. Factors reviewed included hospitalizations and infections prior to and after LTS, morbidity, and impact on quality of life. Twenty-one pediatric patients ranging in age from 8 to 172 months underwent LTS. Follow-up time ranged from 1 to 49 months. Complications were minor. Eighty-eight percent of patients had fewer hospitalizations or were discharged for the first time after LTS. Number of pneumonias and suctioning frequency decreased, mobility increased in patients with prior tracheostomies, and care requirements decreased in 95% of patients. Parents reported satisfaction and improved quality of life. LTS is a low-risk, successful procedure which increases quality of life and decreases morbidity in pediatric patients with irreversible upper airway dysfunction. [ABSTRACT FROM AUTHOR]

Objective: To compare intracapsular tonsillectomy (IT) and traditional tonsillectomy (TT) in treating recurrent adenotonsillitis or streptococcal pharyngitis. Design: Retrospective chart review. Setting: Tertiary care pediatric referral center. Results: Of 166 patients who met all inclusion criteria, 117 received TT and 49 received IT. Seventeen TT patients and 8 IT patients were treated at least once postoperatively for streptococcal pharyngitis or tonsillitis. The mean number of infections after surgery in each group did not reach statistical significance (P = 0.295). Conclusion: There was no difference between the IT and TT groups in postoperative infection rates. [Copyright &y& Elsevier]

Objectives: Describe the changing incidence, microbiology and management of head and neck abscesses in children admitted during the first quarters of 2000–2003.Methods: Retrospective chart and data warehouse review in a tertiary care pediatric hospital. A broad range of ICD-9 codes were used to identify 965 potentially appropriate patient encounters in children <19 years admitted during the first quarters of 2000–2003 with possible head and neck abscesses, excluding mastoiditis. Data review confirmed 89 relevant infections. Outcome measures included incidence of infections relative to total hospital admissions evaluated by chi-square technique and evaluation of abscess location, management, and microbiology.Results: Forty-two of 2310 hospital admissions (1.8%) during the first quarter of 2003 were compared to 13 of 1791 (0.7%), 18 of 2141 (0.8%), and 16 of 2192 admissions (0.7%) in 2000, 2001, and 2002, respectively (P < 0.004). 38 peritonsillar, retropharyngeal or parapharyngeal infections; 26 neck infections; 13 orbital or intracranial complications of acute sinusitis; and 12 facial infections were identified. Sixty-six (74%) were managed surgically, 2 additional ones were drained by needle aspiration. Various streptococcal species were identified in 28 cultures, staphylococcus in 6, atypical mycobacterium in 3, and other organisms in 20; cultures from some patients revealed multiple organisms.Conclusions: The incidence and proportion of head and neck infections in children admitted to the study hospital increased significantly during the first quarter of 2003. The most common organism identified was group A streptococcus. This is in agreement with reports from other institutions of an increasing incidence of streptococcal infections. [Copyright &y& Elsevier]

Background: The aim of this study was to determine the successof fasciotomy of lower limb compartments with elevated intra­compartmentpressure. Methods: The present report is a retrospective cohort studyat No. 3 Combat Support Hospital involving a survey and case notereview of patients who had undergone fasciotomy for compartmentsyndrome at least 6 months earlier (December 1997-December2000). Results: Fourteen patients met the inclusion criteria. Elevenreported success with complete resolution of symptoms and returnto military fitness levels. Two reported no change and significantresidual symptoms. One reported worse symptoms and one required re-operationwith a successful result. Conclusion: Surgical decompression is the accepted treatment ofcompartment syndrome as proven by pressure manometry, after failureof conservative treatment. [ABSTRACT FROM AUTHOR]