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The coronavirus disease 2019 (COVID‐19) pandemic has disrupted health care delivery in the United States, with increased reliance on telemedicine visits as opposed to in‐person outpatient appointments. We used national data to evaluate shifts in modes of hepatology outpatient care for patients with cirrhosis during the pandemic. This was a retrospective cohort study among U.S. veterans with cirrhosis. We used linear regression to evaluate absolute and percentage changes from baseline in hepatology in‐person visits and telemedicine visits from January 1, 2020, to August 11, 2020. The proportion of in‐person and telemedicine visits were plotted geographically to demonstrate state‐level shifts in care delivery over time. Patient‐level characteristics in the pre‐COVID and during‐COVID periods were also compared. We identified 5,618 in‐person and 6,210 telemedicine hepatology visits among patients with cirrhosis. In‐person visits significantly declined (−16.0% per week; 95% confidence interval [CI] −20.7, −11.2; P < 0.001), while telemedicine visits significantly increased (61.3% per week; 95% CI 45.1, 77.5; P < 0.001) in the early during‐COVID period. At the U.S. state level, we found that nearly all states experienced a significant shift toward telemedicine over the course of several weeks. Patients over the age of 70 years and Black patients were less likely to receive telemedicine visits in the pre‐COVID period (each P < 0.05), although these differences were eliminated in the during‐COVID periods. Conclusion: Among patients with cirrhosis, hepatology outpatient care delivery has shifted heavily toward telemedicine due to COVID‐19. This occurred across the United States, and changes have been sustained through August 2020. Expanded telemedicine visits among older patients and Black patients may reflect dedicated efforts to increased access to care among these groups. [ABSTRACT FROM AUTHOR]

The Budyko framework posits that a catchment's long-term mean evapotranspiration (ET) is primarily governed by the availabilities of water and energy, represented by long-term mean precipitation (P) and potential evapotranspiration (PET), respectively. This assertion is supported by the distinctive clustering pattern that catchments take in Budyko space. Several semi-empirical, nonparametric curves have been shown to generally represent this clustering pattern but cannot explain deviations from the central tendency. Parametric Budyko equations attempt to generalize the nonparametric framework, through the introduction of a catchment-specific parameter (n or w). Prevailing interpretations of Budyko curves suggest that the explicit functional forms represent trajectories through Budyko space for individual catchments undergoing changes in the aridity index, PETP , while the n and w values represent catchment biophysical features; however, neither of these interpretations arise from the derivation of the Budyko equations. In this study, we reexamine, reinterpret, and test these two key assumptions of the current Budyko framework both theoretically and empirically. In our theoretical test, we use a biophysical model for ET to demonstrate that n and w values can change without invoking changes in landscape biophysical features and that catchments are not required to follow Budyko curve trajectories. Our empirical test uses data from 728 reference catchments in the United Kingdom (UK) and United States (US) to illustrate that catchments rarely follow Budyko curve trajectories and that n and w are not transferable between catchments or across time for individual catchments. This nontransferability implies that n and w are proxy variables for ETP , rendering the parametric Budyko equations underdetermined and lacking predictive ability. Finally, we show that the parametric Budyko equations are nonunique, suggesting their physical interpretations are unfounded. Overall, we conclude that, while the shape of Budyko curves generally captures the global behavior of multiple catchments, their specific functional forms are arbitrary and not reflective of the dynamic behavior of individual catchments. [ABSTRACT FROM AUTHOR]

Introduction: Topical therapies are considered first-line treatment in the management of plaque psoriasis (PSO). However, data on patient-reported outcomes for topicals are scarce. We designed a survey to record the treatment experience of patients with mild-to-moderate PSO using prescription topicals. Methods: An online cross-sectional survey was conducted among adult patients on prescription topicals for mild-to-moderate PSO (body surface area [BSA] ≤ 10%) in the US. Data on treatment goals, changes in PSO after current treatment, satisfaction with current treatment (assessed with the Treatment Satisfaction Questionnaire for Medication [TSQM]), and treatment adherence (how often current treatment was taken as instructed) were collected. Descriptive analysis was used to evaluate outcomes. Results: Of the 175 patients with mild-to-moderate PSO who completed the survey, 67.4% were female, with a median age of 55.0 years and 10.8 years since PSO diagnosis. Patients reported (medians) the use of three topicals since diagnosis, with 5 years on the current prescription topical. The top three treatment goals for current topical treatment were improvements in visible skin, 97.1%; non-skin related symptoms, 62.9%; and social/emotional well-being, 60.0%. Overall, 43.4% of patients reported 0% BSA change and 5.7% reported ≥ 75% BSA reduction. Approximately 75.0% each reported improvement in itch and pain symptoms. Embarrassment/self-consciousness because of skin symptoms persisted in 72.6% of patients. Median TSQM scores for global satisfaction, convenience, and effectiveness ranged between 58 and 72, indicating partial treatment satisfaction, except for side effects, which was high (median: 100). Approximately half of patients (49.7%) reported not being highly adherent to treatment. Conclusion: Contrary to their treatment goals, patients with mild-to-moderate PSO using prescription topicals reported partial effectiveness, incomplete symptom resolution, impacted emotional and social well-being, and suboptimal global satisfaction, effectiveness, adherence, and convenience. Our findings highlight several unmet needs among topical-experienced, systemic-naïve patients with mild-to-moderate PSO using prescription topicals. Plain Language Summary: Psoriasis is a chronic skin disease caused by inflammation in the body. Raised areas, called plaques, are one of the main symptoms. These plaques may be red, flaky, itchy, and/or painful. Living with psoriasis can negatively impact a person's well-being, especially when it affects visible areas such as the head, face, hands and nails, and/or sensitive areas like the genitals. Topical treatments, such as creams and lotions, are often the first therapy a doctor prescribes for psoriasis. Since these treatments are applied directly on the plaques, they can be messy and inconvenient. We conducted an online survey of adults with mild-to-moderate psoriasis, meaning that less than 10% of their body had plaques. We wanted to learn how they felt about their disease and their prescription topical treatments. Most people had psoriasis for about 10 years and had been using their current prescription topical for about 5 years. Approximately three of four people reported embarrassment/self-consciousness because of skin symptoms. Although three of four people reported some improvement in itch and pain, almost all people desired better resolution of plaques in visible areas. People also reported that: their current prescription topical did not completely resolve their symptoms, their emotional and social well-being was still suboptimal, they did not always apply their therapy as often as instructed, and they were not completely satisfied with their treatment overall. These results highlight the need for additional treatment options for people with mild-to-moderate psoriasis, particularly options that offer improved symptom control and are more convenient to use. [ABSTRACT FROM AUTHOR]

Of critical importance to education policy is monitoring trends in education outcomes over time. In the United States, the National Assessment of Educational Progress (NAEP) has provided long-term trend data since 1970; at the state/jurisdiction level, NAEP has provided long-term trend data since 1996. In addition to the national NAEP, all 50 states and United States jurisdictions participate in the state NAEP assessment. Thus, NAEP provides important monitoring and forecasting information regarding population-level academic performance of relevance to national and international goals. However, an inspection of NAEP trend reports shows that relatively simple trend plots are provided; and although these plots are important for communicating general trend information, we argue that much more useful information can be obtained by adopting a Bayesian probabilistic forecasting point of view. The purpose of this paper is to provide a Bayesian probabilistic forecasting workflow that can be used with large-scale assessment trend data generally, and to demonstrate that workflow with an application to the state NAEP assessments. [ABSTRACT FROM AUTHOR]

Obesity, defined as a body mass index of 30 kg/m2 or above, has increased considerably in incidence and frequency within the United States and globally. Associated comorbidities including cardiovascular disease, type 2 diabetes mellitus, metabolic syndrome, and nonalcoholic fatty liver disease have led to a focus on the mechanisms promoting the prevention and treatment of obesity. Commonly utilized in vitro models employ human or mouse preadipocyte cell lines in a 2-dimensional (2D) format. Due to the structural, biochemical, and biological limitations of these models, increased attention has been placed on "organ on a chip" technologies for a 3-dimensional (3D) culture. Herein, we describe a method employing cryopreserved primary human stromal vascular fraction (SVF) cells and a human blood product-derived biological scaffold to create a 3D adipose depot in vitro. The "fat-on-chip" 3D cultures have been validated relative to 2D cultures based on proliferation, flow cytometry, adipogenic differentiation, confocal microscopy/immunofluorescence, and functional assays (adipokine secretion, glucose uptake, and lipolysis). Thus, the in vitro culture system demonstrates the critical characteristics required for a humanized 3D white adipose tissue (WAT) model. [ABSTRACT FROM AUTHOR]

Recent U.S. Supreme Court rulings have limited federal protections for geographically isolated wetlands (GIWs) except where a 'significant nexus' to a navigable water body is demonstrated. Geographic isolation does not imply GIWs are hydrologically disconnected; indeed, wetland-groundwater interactions may yield important controls on regional hydrology. Differences in specific yield (Sy) between uplands and inundated GIWs drive differences in water level responses to precipitation and evapotranspiration, leading to frequent reversals in hydraulic gradients that cause GIWs to act as both groundwater sinks and sources. These reversals are predicted to buffer surficial aquifer dynamics and thus base flow delivery, a process we refer to as landscape hydrologic capacitance. To test this hypothesis, we connected models of soil moisture, upland water table, and wetland stage to simulate hydrology of a low-relief landscape with GIWs, and explored the influences of total wetland area, individual wetland size, climate, and soil texture on water table and base flow variation. Increasing total wetland area and decreasing individual wetland size substantially decreased water table and base flow variation (e.g., reducing base flow standard deviation by as much as 50%). GIWs also decreased the frequency of extremely high and low water tables and base flow deliveries. For the same total wetland area, landscapes with fewer (i.e., larger) wetlands exhibited markedly lower hydrologic capacitance than those with more (i.e., smaller) wetlands, highlighting the importance of small GIWs to regional hydrology. Our results suggest that GIWs buffer dynamics of the surficial aquifer and stream base flow, providing an indirect but significant nexus to the regional hydrologic system. [ABSTRACT FROM AUTHOR]

Despite the decline in U.S. cancer incidence and mortality rates, cancer remains the number one cause of death for people under the age of 85 and one in four people in the U.S. will die of cancer, mainly because of metastasis. Recently, interest in mesenchymal stem cell (MSC) tumor-homing has led to inquires into: (a) why MSCs home to tumors, (b) what the inherent protumor and antitumor consequences are, and (c) how to best capitalize on MSC tumor-homing for cell-based diagnostics and therapy. Here, these questions are reviewed and method for addressing them using animal models and tracking methodologies (or, synonymously, detection methodologies) are discussed. First, MSCs in a regenerative and tumor-homing context are reviewed, followed by MSC delivery and genetic labeling methods for tissue model systems. Finally, the use of the nonoptical methods, magnetic resonance imaging, positron emission tomography, and single photon emission computed tomography, along with optical methods, fluorescence imaging and bioluminescent imaging, are reviewed related to tracking MSCs within disease model settings. The benefits and drawbacks of each detection method in animal models is reviewed along with the utility of each for therapeutic use. STEM CELLS 2011;29:920-927 [ABSTRACT FROM AUTHOR]

The article focuses on the range of bar orders in federal securities fraud settlements in the U.S. It mentions that before the passage of the Private Securities Litigation Reform Act of 1995 (PSLRA), the courts dealt with the equity of orders that eliminates the rights of the third parties. It notes that the PSLRA organized a rising norm by needing the entry of an order barring the contribution claims made by or against certain settling parties in 10b-5 actions.

This article considers some of the implications of an extensive research on executive compensation in the U.S. It has been shown that U.S. chief executive officers (CEOs) receive higher levels of pay than those in other OECD countries. Starting with the basics, a typical call option used in a compensation system allows an executive to purchase a specified number of shares of stock at a fixed exercise price. Typically, options granted to U.S. executives have maturity dates of five to ten years; that is, the right to purchase the stock at the fixed price expires five to ten years after the grant date. Of course, most options are not granted at an exercise price of zero, and many stocks do pay dividends, which an executive who has decided to postpone exercising an option does not receive, so the problem of creating a hedge portfolio is usually more complex than just buying stock. Risk aversion plays no role in option-pricing theory since the risk generated by an option can be eliminated with a hedge portfolio. A problem with the option pricing models typically assume that the grant of the option, the creation of the hedge portfolio and the exercise of the option have no effect on share price. In markets with many small players, this is a reasonable assumption. However, if one of these small players is a top executive in a company, the market might react to the incentive effects of the CEO's option holdings, resulting in a shift of the probability distribution of returns.

Reports on a survey conducted at a Denver, Colorado, high school to assess student opinions about condom distribution in their school. Percentage of students who believe that condom should be distributed in their school; Percentage of students who believe making condoms more accessible would not change the frequency of sexual activity among teens.

Focuses on the Indochinese population in Saint Paul, Minnesota that has established an ethnic enclave economy. Growth of the community in Saint Paul; Business development in the 1980s; Changes in the neighborhood business; Types of business activity observed in block groups; Reflections of the aggregate changes.

Describes the transition of the school nurse to a school nurse practitioner, which occurred during a project which was conducted in Denver, Colorado, in relation to lessons learnt. Details on the role of the school nurse; Information on the School Nurse Practitioner (SNP) Program at the University of Colorado; Results of the project.

The Nineteenth Decennial Census of the United States, covering both population and housing, will be conducted as of April 1, 1970. Plane fling, testing, and preparatory activities have been underway since early in the decade. Extensive discussions with users of census data led to relatively minor changes in subject content as compared to 1960, but a major increase in the amount of statistics to be tabulated, especially for small geographic areas. For about 60 to 65 percent of the population, the information will be collected through a new mail-out/mail-back system. The rest of the country will be covered by house-to-house canvass. Special efforts to alleviate the serious problem of underenumeration are being undertaken, particularly in the hard-to-enumerate portions of the big cities. The geographic program includes an "address coding guide" through which location identification in most urban areas can be made to specific side of block; this will permit tabulations for new types of small areas. Processing of the data will be performed with the Census Bureau's Fosdic equipment and advanced computers. Dissemination of the census results will be in the traditional type of printed reports but, also, in substantially greater subject and area detail, through magnetic tape, special printouts, etc. To help users exploit the potentialities of the latter material, the Bureau has instituted a "data access" informational program. As in previous censuses, there will be a number of studies to evaluate the 1910 procedures and results. [ABSTRACT FROM AUTHOR]

In order to compare the results of outpatient family crisis therapy with hospitalization, a clinical team from Colorado Psychiatric Hospital treated on an outpatient basis 186 patients considered acutely in need of admission to a psychiatric hospital. The control group consisted of 150 patients from the same population who were routinely hospitalized. In all except 3 of the initial 36 pilot cases, it was possible to avoid hospitalization. Family crisis therapy has proved to be a more economical and less stigmatizing form of psychiatric treatment than hospitalization. Its principles are outlined and the specific participation of the clinical social worker and his role on the crisis therapy team are described. [ABSTRACT FROM AUTHOR]

The Working Group on Peer Review of the Advisory Committee to the Director of NIH has recommended that at least 4 reviewers should be used to assess each grant application. A sample size analysis of the number of reviewers needed to evaluate grant applications reveals that a substantially larger number of evaluators are required to provide the level of precision that is currently mandated. NIH should adjust their peer review system to account for the number of reviewers needed to provide adequate precision in their evaluations. [ABSTRACT FROM AUTHOR]