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Since 2000, there has been a 72% increase in the number of international students attending US institutions of higher education. The increase, specifically of international graduate students, has brought to light the writing challenges experienced by this population of students. This study explored specific writing challenges experienced by international graduate students and determined strategies to alleviate these challenges. Interviews were conducted with 15 international graduate students representing a variety of geographic backgrounds and disciplines. Responses revealed that writing challenges faced related to grammar and vocabulary, organization and flow of ideas, critical thinking, and plagiarism. Participants offered specific suggestions on how subject-matter faculty, friends, and peer mentors could assist in improving English-language writing skills. Implications for higher education institutions are discussed.

Introduction: Gastric cancer ranks as the 5th most prevalent cancer and the 4th leading cause of cancer-related deaths worldwide. Various treatment modalities, including surgical resection, chemotherapy, and radiotherapy, are available for gastric cancer patients. However, disparities related to age, sex, race, socioeconomic factors, insurance status, and demographic factors often lead to delayed time to treatment. Methods: In this retrospective study, conducted between 2004 and 2019, we utilized data from the National Cancer Database (NCDB) to investigate the factors contributing to disparities in the time to first treatment, surgery, chemotherapy, and radiotherapy among gastric cancer patients. Our analysis incorporated several variables, and statistical analysis was conducted to provide valuable insights into these disparities. Results: We observed notable disparities in the timing of treatment for various demographic groups, including age, sex, race, insurance status, geographic location, and facility type. These disparities include longer time to treatment in males (32.67 vs 30.75), Native Americans (35.10 vs 31.09 in Asians), low-income patients (32 vs 31.15), patients getting treatment in an academic setting (36.11 vs 29.61 in community setting), significantly longer time to chemotherapy in 70+ age group (51.13 vs 40.38 in <40 y age group), black race (55.81 vs 47.05 in whites), low income people (49.64 vs 46.74), significantly longer time to radiotherapy in females (101.61 vs 79.75), blacks and Asians (109.68 and 113.96 respectively vs 92.68 in Native Americans) etc. There are various other disparities in time to surgery, chemotherapy, and radiotherapy. Conclusions: Understanding these disparities is crucial in developing targeted strategies to improve timely access to appropriate treatments and enhance outcomes for gastric cancer patients. Future research with updated data and prospective study designs can provide a more comprehensive understanding of the factors influencing patient outcomes in gastric cancer. [ABSTRACT FROM AUTHOR]

Purpose: The relationship among ethnicity, social determinants of health (SDOH), and disparities in poststroke outcomes is complex, and the impact on communication difficulties is unclear. This study investigated the presence and nature of communication difficulties in poststroke non-Hispanic White (PsnHw) and Hispanic U.S. populations using population-level data. Method: We performed a cross-sectional analysis of 2,861 non-Hispanic White and 353 Hispanic poststroke respondents included in the 2014-2018 National Health Interview Survey. Respondents self-reported difficulties communicating in their usual language, in addition to providing information relating to demographics and lifestyle, health care access and utilization, health status, and SDOH. We used univariate statistics, generalized linear models, and an exploratory mediation analysis, to characterize the pattern of differences between these cohorts, examine associations between variables and communication difficulties, and determine the potential intermediate role of cumulative SDOH on the likelihood of reporting communication difficulties. Results: Findings indicated a more challenging life context for the poststroke Hispanic population due to SDOH disparities. Poverty and Internet use were associated with greater and lower odds of communication difficulties for PsnHw, respectively. The mediation analysis showed that ethnicity significantly affected communication difficulties, but only when mediated by SDOH. SDOH accounted for approximately two thirds of the total effect on reporting communication difficulties. Conclusions: This study underscores the need for uniform measures of SDOH in prospective research and for interventions aimed at mitigating health disparities through addressing disparities in SDOH. Future research should focus on evaluating the effectiveness of such strategies in diverse ethnic and socioeconomic poststroke populations. [ABSTRACT FROM AUTHOR]

There is a growing body of literature that documents high rates of intimate partner violence within South Asian American communities, indicating a critical need for research that can respond directly to this issue. From a socioecological perspective, Hindu temples can influence members' behaviors at multiple levels of change and thus may be important sites of collaboration for the prevention of intimate partner violence. Through in-depth qualitative interviews with South Asian families, temple leaders, and community stakeholders, this study indicates that Hindu temples have tremendous capacity to significantly impact intimate partner violence within South Asian American communities. [ABSTRACT FROM AUTHOR]

Background: Primary cardiac sarcomas (PCS) are extremely rare malignant tumors involving the heart. Only isolated case reports have been described in the literature over different periods of time. This pathology has been associated with a dismal prognosis and given its rarity; treatment options are very limited. Furthermore, there are contrasting data about the effectiveness of current treatment modalities in improving the survival of patients with PCS, including surgical resection which is the mainstay of therapy. There is a paucity of data on the epidemiological characteristics of PCS. This study has the objective of investigating the epidemiologic characteristics, survival outcomes, and independent prognostic factors of PCS. Methods: A total of 362 patients were ultimately registered in our study from the Surveillance, Epidemiology, and End Results (SEER) database. The study period was from 2000 to 2017. Demographics such as clinical characteristics, overall mortality (OM), and PCS-specific mortality (CSM) were taken into account. A p value of <0.1 in the univariate analysis leads to the incorporation of the variable into multivariate analysis adjusting for covariates. Adverse prognostic factors were represented by a Hazard Ratio (HR) greater than one. The five-year survival analysis was carried out using the Kaplan–Meier method and the log-rank test was used to compare survival curves. Results: Crude analysis revealed a high OM in age 80+ (HR = 5.958, 95% CI 3.357–10.575, p < 0.001), followed by age 60–79 (HR = 1.429, 95% CI 1.028–1.986, p = 0.033); and PCS with distant metastases (HR = 1.888, 95% CI 1.389–2.566, p < 0.001). Patients that underwent surgical resection of the primary tumor and patients with malignant fibrous histiocytomas (HR = 0.657, 95% CI 0.455–0.95, p = 0.025) had a better OM (HR = 0.606, 95% CI 0.465–0.791, p < 0.001). The highest cancer-specific mortality was observed in age 80+ (HR = 5.037, 95% CI 2.606–9.736, p < 0.001) and patients with distant metastases (HR = 1.953, 95% CI 1.396–2.733, p < 0.001). Patients with malignant fibrous histiocytomas (HR = 0.572, 95% CI 0.378–0.865, p = 0.008) and those who underwent surgery (HR = 0.581, 95% CI 0.436–0.774, p < 0.001) had a lower CSM. Patients in the age range 80+ (HR = 13.261, 95% CI 5.839–30.119, p < 0.001) and advanced disease with distant metastases (HR = 2.013, 95% CI 1.355–2.99, p = 0.001) were found to have a higher OM in the multivariate analyses adjusting for covariates). Lower OM was found in patients with rhabdomyosarcoma (HR = 0.364, 95% CI 0.154–0.86, p = 0.021) and widowed patients (HR = 0.506, 95% CI 0.263–0.977, p = 0.042). Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups, and lower mortality in patients with Rhabdomyosarcoma. Conclusion: In this United States population-based retrospective cohort study using the SEER database, we found that cardiac rhabdomyosarcoma was associated with the lowest CSM and OM. Furthermore, as expected, age and advanced disease at diagnosis were independent factors predicting poor prognosis. Surgical resection of the primary tumor showed lower CSM and OM in the crude analysis but when adjusted for covariates in the multivariate analysis, it did not significantly impact the overall mortality or the cancer-specific mortality. These findings allow for treating clinicians to recognize patients that should be referred to palliative/hospice care at the time of diagnosis and avoid any surgical interventions as they did not show any differences in mortality. Surgical resection, adjuvant chemotherapy, and/or radiation in patients with poor prognoses should be reserved as palliative measures rather than an attempt to cure the disease. [ABSTRACT FROM AUTHOR]

In 2020, Detroit residents' crude kidney disease mortality rate was 1.48 times the state's rate. Evaluated Detroit residents' chronic kidney disease (CKD) knowledge, risk, belief, and preventative practices. Additionally, it examined the association between residents' CKD knowledge, their sociodemographics, CKD risk and belief. 378 Detroit residents, ages 20 years or older, were recruited from May 2019-August 2021 to complete the Qualtrics survey on their CKD knowledge, beliefs, and risk. Descriptive statistics and multiple linear regression were conducted to meet the study's purpose. Most participants were unaware of dry and itchy skin as a CKD symptom (60%). African Americans (β = −1.5; p =.002) and those with a high school education or less (β = −1.46; p =.038) had lower knowledge scores than White residents and those with higher education. Participants' knowledge score increased by 0.64 as CKD risk score increased by 1 (β = 0.64; p =.019). CKD knowledge is low among Detroit residents and associated with race, education, and risk level. Translation to Health Education Practice: African American Detroit residents would benefit from targeted marketing and communication plans that increase their knowledge of CKD prevention. It also depicts key components (e.g., risks factors) that should be communicated in the messages. [ABSTRACT FROM AUTHOR]

Copyright of American Journal of Potato Research is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Many patients use social media or other web-based tools for health information. • Endocrine surgeons have a low utilization of a professional internet presence. • Endocrine surgeons may consider bolstering their professional internet presence. There is a wide range of social media adoption within medical specialties. The use of social media by endocrine surgeons has not been investigated. We undertook this study to describe the use of social media and other platforms by endocrine surgeons. The American Association of Endocrine Surgeons' publicly available website was used to identify practicing endocrine surgeons in the United States. Surgeon demographics and practice characteristics were collected via internet query. Five social media platforms (Facebook, Instagram, Twitter, LinkedIn, YouTube) were investigated for professional accounts. The presence of a non-institutional professional website, an active Healthgrades account, and presence in non-institutional YouTube videos were also queried. One point was assigned for presence on each of the eight platforms. A professional internet presence (PIP) score was calculated. Descriptive statistics were performed on PIP scores to evaluate the relationship between surgeon and practice characteristics and PIP score. A total of 417 endocrine surgeons were studied. LinkedIn (222, 53.2%) and Twitter (110, 26.4%) were the most commonly used platforms. PIP scores were categorized into zero, one, two, and three or more accounts; 26.9% of surgeons had no professional internet presence. Academic surgeons had a significantly different PIP score than community-based surgeons (P < 0.01). There was no significant association between PIP score and surgeon sex, geographic regions, rural versus urban settings, and years of experience. Self-identified US endocrine surgeons have low professional internet presence. Endocrine surgeons may consider bolstering their professional internet presence to disseminate medical information. [ABSTRACT FROM AUTHOR]

Acinetobacter baumannii , a Gram-negative coccobacillus, has become a prevalent nosocomial health threat affecting the majority of hospitals both in the U.S. and around the globe. Microbial cell surface hydrophobicity (CSH) has previously been correlated with virulence, uptake by immune cells, and attachment to epithelial cells. A mutant strain of A. baumannii (ΔtrxA) lacking the redox protein thioredoxin A was found to be more hydrophobic than its wild type (WT) and complemented counterparts, as measured by both Microbial Adhesion to Hydrocarbon (MATH) and salt aggregation. The hydrophobicity of the mutant could be abrogated through treatment with sodium cyanoborohydride (SCBH). This modulation correlated with reduction of disulfide bonds, as SCBH was able to reduce 5,5′-dithio-bis-[2-nitrobenzoic acid] and treatment with the known disulfide reducer, β-mercaptoethanol, also decreased ΔtrxA CSH. Additionally, the ΔtrxA mutant was more readily taken up than WT by J774 macrophages and this differential uptake could be abrogated though SCBH treatment. When partitioned into aqueous and hydrophobic phases, ΔtrxA recovered from the hydrophobic partition was phagocytosed more readily than from the aqueous phase further supporting the contribution of CSH to A. baumannii uptake by phagocytes. A second Gram-negative bacterium, Francisella novicida , also showed the association of TrxA deficiency (FnΔtrxA) with increased hydrophobicity and uptake by J774 cells. We previously have demonstrated that modification of the type IV pilus system (T4P) was associated with the A. baumannii ΔtrxA phenotype, and the Francisella FnΔtrxA mutant also was found to have a marked T4P deficiency. Interestingly, a F. novicida mutant lacking pilT also showed increased hydrophobicity over FnWT. Collective evidence presented in this study suggests that Gram-negative bacterial thioredoxin mediates CSH through multiple mechanisms including disulfide-bond reduction and T4P modulation. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the effects of an intensive cognitive-communication rehabilitation (ICCR) program for young individuals with chronic acquired brain injury. Method: ICCR included classroom lectures; metacognitive instruction, modeling, and application; technology skills training; and individual cognitive-linguistic therapy. Four individuals participated in the intensive program (6 hr with 1-hr lunch break × 4 days × 12 weeks of treatment): 3 participants completed 3 consecutive semesters, and 1 participant completed 1 semester. Two controls did not receive treatment and completed assessments before and after the 12-week treatment interval only. Results: All 4 experimental participants demonstrated significant improvements on at least 1 standardized cognitive-linguistic measure, whereas controls did not. Furthermore, time point significantly predicted participants' scores on 2 of the 4 standardized outcome measures, indicating that as duration in ICCR increased, scores also increased. Participants who completed multiple semesters of ICCR also improved in their therapy and personal goals, classroom behavior, life participation, and quality of life. Conclusion: After ICCR, participants showed gains in their cognitive-linguistic functioning, classroom participation, and individual therapy. They also demonstrated improvements outside the classroom and in their overall well-being. There is a gap between the large population of young adults with acquired brain injury who wish to return to higher education and a lack of rehabilitation programs supporting reentry into academic environments; ICCR is a first step in reducing that gap. [ABSTRACT FROM AUTHOR]

Aim: This study aims to find out the proinflammatory chemokines macrophage inflammatory protein (MIP)-1α and MIP-1β levels in gingival crevicular fluid (GCF) of primary, mixed, and permanent dentitions. Materials and Methods: GCF of 160 individuals (4–15 years of age) was collected by the extracrevicular method. They were categorized into four groups (40 per each group). Group I: subjects with primary dentition (4–5 years of age), Group II: 40 subjects in early transition period (6–8 years), Group III: 40 individuals in the late transition period (9–11 years), and Group IV: 40 individuals with permanent dentition (12–15 years). MIP-lα and MIP-1β levels were determined in the samples of GCF by ELISA method. Data were analyzed by software SPSS Version 20 (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY: USA). Results: MIP-1α and MIP-1β were detected in all samples. The highest mean MIP-1α and MIP-1β concentrations in GCF were detected in the early transition period, while the lowest concentrations were seen in primary dentition group. The chemokine levels were higher in girls than in boys in Group III. There was a substantial rise of MIP-1α and MIP-1β levels during eruption. Conclusions: Since levels of MIP-1α and MIP-1β in GCF are positively associated with tooth eruption, they may perhaps be deemed as novel biomarkers in the eruption process. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether intensive surveillance protocols have resulted in a decreased incidence of colorectal cancer (CRC) in inflammatory bowel disease (IBD).Aims: To determine the prevalence and characteristics of IBD associated high-grade dysplasia (HGD) or CRC that was undetected on prior colonoscopy.Methods: This is a single-center, retrospective study from 1994 to 2013. All participants had a confirmed IBD diagnosis and underwent a colectomy with either HGD or CRC found in the colectomy specimen.The undetected group had no HGD or CRC on prior colonoscopies. The detected group had HGD or CRC identified on previous biopsies.Results: Of 70 participants, with ulcerative colitis (UC) (n = 47), Crohn's disease (CD) (n = 21), and indeterminate colitis (n = 2), 29% (n = 20) had undetected HGD/CRC at colectomy (15 HGD and 5 CRC). In the undetected group, 75% had prior LGD, 15% had indefinite dysplasia, and 10% had no dysplasia (HGD was found in colonic strictures). Patients in the undetected group were more likely to have pancolitis (55 vs. 20%) and multifocal dysplasia (35 vs. 8%). The undetected group was less likely to have CRC at colectomy (25 vs. 62%). There was a trend toward right-sided HGD/CRC at colectomy (40 vs. 20%; p = 0.08). In addition, 84% of the lesions found in the rectum at colectomy were not seen on prior colonoscopy in the undetected group.Conclusions: The prevalence of previously undetected HGD/CRC in IBD found at colectomy was 29%. The high proportion of undetected rectal and right-sided HGD/CRC suggests that these areas may need greater attention during surveillance. [ABSTRACT FROM AUTHOR]

Background: Communication between patients with limited English proficiency (LEP) and telephone triage services has not been previously explored. The purpose of this study was to determine the utilization characteristics of a primary care triage call center by patients with LEP.Methods: This was a retrospective cohort study of the utilization of a computer-aided, nurse-led telephone triage system by English proficiency status of patients empaneled to a large primary care practice network in the Midwest United States. Interpreter Services (IS) need was used as a proxy for LEP.Results: Call volumes between the 587 adult patients with LEP and an age-frequency matched cohort of English-Proficient (EP) patients were similar. Calls from patients with LEP were longer and more often made by a surrogate. Patients with LEP received recommendations for higher acuity care more frequently (49.4% versus 39.0%; P < 0.0004), and disagreed with recommendations more frequently (30.1% versus 20.9%; P = 0.0004). These associations remained after adjustment for comorbidities. Patients with LEP were also less likely to follow recommendations (60.9% versus 69.4%; P = 0.0029), even after adjusting for confounders (adjusted odds ratio [AOR] = 0.65; 95% confidence interval [CI], 0.49, 0.85; P < 0.001).Conclusion: Patients with LEP who utilized a computer-aided, nurse-led telephone triage system were more likely to receive recommendations for higher acuity care compared to EP patients. They were also less likely to agree with, or follow, recommendations given. Additional research is needed to better understand how telephone triage can better serve patients with LEP. [ABSTRACT FROM AUTHOR]

Cross-border labor mobility of hospitality employees has resulted in an increase in illegal immigrants in the workforce. The purpose of this study was to generate a list of top legal issues associated with the employment of foreign workers in the U.S. hospitality industry and to identify factors defined by the importance ratings of these issues. Snowball sampling was used to collect data from hospitality managers. Findings reveal that respondents perceive document verification to be important but may not perceive knowledge of various visa types and employment termination reporting procedures associated with employing foreign workers to be important. Managerial implications are discussed. [ABSTRACT FROM AUTHOR]

In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months (1). Each influenza season since 2004-05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent influenza-associated, medically attended, acute respiratory illness (ARI). This report uses data, as of February 4, 2017, from 3,144 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during November 28, 2016-February 4, 2017, to estimate an interim adjusted effectiveness of seasonal influenza vaccine for preventing laboratory-confirmed influenza virus infection associated with medically attended ARI. During this period, overall vaccine effectiveness (VE) (adjusted for study site, age group, sex, race/ethnicity, self-rated general health, and days from illness onset to enrollment) against influenza A and influenza B virus infection associated with medically attended ARI was 48% (95% confidence interval [CI] = 37%-57%). Most influenza infections were caused by A (H3N2) viruses. VE was estimated to be 43% (CI = 29%-54%) against illness caused by influenza A (H3N2) virus and 73% (CI = 54%-84%) against influenza B virus. These interim VE estimates indicate that influenza vaccination reduced the risk for outpatient medical visits by almost half. Because influenza activity remains elevated (2), CDC and the Advisory Committee on Immunization Practices recommend that annual influenza vaccination efforts continue as long as influenza viruses are circulating (1). Vaccination with 2016-17 influenza vaccines will reduce the number of infections with most currently circulating influenza viruses. Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated as soon as possible. [ABSTRACT FROM AUTHOR]

Purpose: Pseudoexfoliation syndrome (PXS) is an age related microfibrillopathy characterized by deposition of whitish flaky material over various ocular tissues. PXS eyes are known to have thinner corneas and thus can lead to an underestimation in intraocular pressure measurement. The purpose of this study was to find if there is any variation in central corneal thickness and intraocular pressure in PXS eyes and if there was any relationship between them.Methods: A prospective observational study was done on 141 eyes of 85 patients with PXS without glaucoma between November 2015 to April 2017 in the department of Ophthalmology in a tertiary hospital. CCT and IOP were measured by a handheld ultrasonic pachymeter (DGH Technology INC. Pachette 2, USA) and Goldmann applanation tonometer respectively at 4 different times during office hours.Results: A significant reduction of about 10 μm in mean CCT and 1.4 mmHg in mean IOP was noted over the 4 sessions which was statistically significant (P < 0.001). A significant correlation exists between IOP and CCT in PXS eyes at all times during the day (P < 0.001).Conclusion: The CCT measurements show significant thinning throughout the day, similar drop in IOP was also noted. Our study shows that there is a significant correlation between diurnal variation of CCT and IOP. Hence, it is prudent to measure CCT along with IOP at all times. [ABSTRACT FROM AUTHOR]

Background. During the 2012-2013 influenza season, there was cocirculation of influenza A(H3N2) and 2 influenza B lineage viruses in the United States. Methods. Patients with acute cough illness for ⩽7 days were prospectively enrolled and had swab samples obtained at outpatient clinics in 5 states. Influenza vaccination dates were confirmed by medical records. The vaccine effectiveness (VE) was estimated as [100% × (1 - adjusted odds ratio)] for vaccination in cases versus test-negative controls. Results. Influenza was detected in 2307 of 6452 patients (36%); 1292 (56%) had influenza A(H3N2), 582 (25%) had influenza B/Yamagata, and 303 (13%) had influenza B/Victoria. VE was 49% (95% confidence interval [CI], 43%-55%) overall, 39% (95% CI, 29%-47%) against influenza A(H3N2), 66% (95% CI, 58%-73%) against influenza B/Yamagata (vaccine lineage), and 51% (95% CI, 36%-63%) against influenza B/Victoria. VE against influenza A(H3N2) was highest among persons aged 50-64 years (52%; 95% CI, 33%-65%) and persons aged 6 months- 8 years (51%; 95% CI, 32%-64%) and lowest among persons aged ⩾65 years (11%; 95% CI, -41% to 43%). In younger age groups, there was evidence of residual protection from receipt of the 2011-2012 vaccine 1 year earlier. Conclusions. The 2012-2013 vaccines were moderately effective in most age groups. Cross-lineage protection and residual effects from prior vaccination were observed and warrant further investigation. [ABSTRACT FROM AUTHOR]

The article presents an early estimate of seasonal influenza vaccine effectiveness for prevention of influenza virus infection associated with acute respiratory illness (ARI) in the U.S. Of the more than two thousand children and adults with ARI enrolled at the study sites, more than forty percent tested positive for influenza virus.

During the 2012–2013 influenza season, antiviral treatment was underutilized and antibiotics may have been overused among clinicians providing care to outpatients with laboratory-confirmed influenza.Background. Early antiviral treatment (≤2 days since illness onset) of influenza reduces the probability of influenza-associated complications. Early empiric antiviral treatment is recommended for those with suspected influenza at higher risk for influenza complications regardless of their illness severity. We describe antiviral receipt among outpatients with acute respiratory illness (ARI) and antibiotic receipt among patients with influenza.Methods. We analyzed data from 5 sites in the US Influenza Vaccine Effectiveness Network Study during the 2012–2013 influenza season. Subjects were outpatients aged ≥6 months with ARI defined by cough of ≤7 days’ duration; all were tested for influenza by polymerase chain reaction (PCR). Medical history and prescription information were collected by medical and pharmacy records. Four sites collected prescribing data on 3 common antibiotics (amoxicillin-clavulanate, amoxicillin, and azithromycin).Results. Of 6766 enrolled ARI patients, 509 (7.5%) received an antiviral prescription. Overall, 2366 (35%) had PCR-confirmed influenza; 355 (15%) of those received an antiviral prescription. Among 1021 ARI patients at high risk for influenza complications (eg, aged <2 years or ≥65 years or with ≥1 chronic medical condition) presenting to care ≤2 days from symptom onset, 195 (19%) were prescribed an antiviral medication. Among participants with PCR-confirmed influenza and antibiotic data, 540 of 1825 (30%) were prescribed 1 of 3 antibiotics; 297 of 1825 (16%) were prescribed antiviral medications.Conclusions. Antiviral treatment was prescribed infrequently among outpatients with influenza for whom therapy would be most beneficial; in contrast, antibiotic prescribing was more frequent. Continued efforts to educate clinicians on appropriate antibiotic and antiviral use are essential to improve healthcare quality. [ABSTRACT FROM AUTHOR]

This article presents information on the interim estimation of the effectiveness of seasonal influenza vaccine by the U.S. Centers for Disease Control and Prevention from 2013 to 2014. It mentions the objective of this report by the CDC, the methods used by the U.S. Flu Vaccine Effectiveness Network in its study of vaccine effectiveness and the growth in influenza activity in the country.

Many private country clubs across the United States have experienced a declining or flat membership and smaller waitlists of members wanting to join. The objective of this study was to investigate whether member involvement, service quality, and perceived value, influence member satisfaction and intention to renew membership for members of private country clubs. An online survey instrument customized for the country club industry was distributed to members of two country clubs in northeast Ohio. Results indicate that involvement level of members and perceived value impact country club members' satisfaction and intention to renew their membership. Managerial implications are discussed. [ABSTRACT FROM AUTHOR]

At the Harvard Forest, Petersham, MA, the impact of 20 years of annual ammonium nitrate application to the mixed hardwood stand on soil bacterial communities was studied using 16S r RNA genes pyrosequencing. Amplification of 16 S r RNA genes was done using DNA extracted from 30 soil samples (three treatments × two horizons × five subplots) collected from untreated (control), low N-amended (50 kg ha−1 year−1) and high N-amended (150 kg ha−1 year−1) plots. A total of 1.3 million sequences were processed using qiime. Although Acidobacteria represented the most abundant phylum based on the number of sequences, Proteobacteria were the most diverse in terms of operational taxonomic units ( OTUs). Uni Frac analyses revealed that the bacterial communities differed significantly among soil horizons and treatments. Microsite variability among the five subplots was also evident. Nonmetric multidimensional scaling ordination of normalized OTU data followed by permutational manova further confirmed these observations. Richness indicators and indicator species analyses revealed higher bacterial diversity associated with N amendment. Differences in bacterial diversity and community composition associated with the N treatments were also observed at lower phylogenetic levels. Only 28-35% of the 6 936 total OTUs identified were common to three treatments, while the rest were specific to one treatment or common to two. [ABSTRACT FROM AUTHOR]

Because hacking collectives Anonymous and LulzSec have routinely breached supposedly secure computer networks--including Visa, MasterCard, and the Central Intelligence Agency--the threat of cyber terrorism has become more prominent. Many US industries and companies depend on online communication and information storage. If terrorists compromise these capabilities, they could cripple the US economy and perhaps even cause widespread fatalities. Members of Anonymous and LulzSec lack the necessary intent to be prosecuted as cyber terrorists because they hack not to cause fear, but rather to create laughter. Their method of posting all necessary instructions and information regarding intended targets on online message boards could, however, serve as a model for terrorists seeking to cause harm. Indeed, the Anonymous and LulzSec model permits an unknown number of hackers to anonymously participate in attacks. Without the ability to trace these individuals, the Computer Fraud and Abuse Act and all subsequent legislative attempts to improve cyber security and combat cyber terrorism, which require that the identity of perpetrators be known, are ineffective. This Note therefore proposes a new bill that seeks to preempt attacks before they occur. It suggests more extensive public- and private-sector collaboration to anticipate novel hacking techniques and to uncover weaknesses in network security. Most importantly, it concludes that hiring Anonymous and LulzSec members, rather than prosecuting them, will more effectively aid the United States in protecting itself against cyber terrorism. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality among young adults and the elderly. In the United States, TBI is responsible for around 30 percent of all injuries brought on by injuries in general. Vasogenic cerebral edema due to blood-brain barrier (BBB) dysfunction and the associated elevation of intracranial pressure (ICP) are some of the major causes of secondary injuries following traumatic brain injury. Matrix metalloproteinase-9 (MMP-9) is a therapeutic target for being an enzyme that degrades the proteins that make up a part of the microvascular basal lamina as well as inter-endothelial tight junctions of the blood-brain barrier. MMP-9-mediated BBB dysfunctions and the compromise of the BBB is a major pathway that leads the development of vasogenic cerebral edema, elevation of ICP, poor cerebral perfusion and brain herniation following traumatic brain injury. That makes MMP-9 an effective therapeutic target and endogenous or exogenous MMP-9 inhibitors as therapeutic drugs for preventing secondary brain damage after traumatic brain injury. Although our understanding of the mechanisms that underlie the primary and secondary stages of damage following a TBI has significantly improved in recent years, such information has not yet resulted in the successful development of novel pharmacological treatment options for traumatic brain injury. Recent pre-clinical and/or clinical studies have demonstrated that there are several compounds with specific or non-specific MMP-9 inhibitory properties either directly binding and inhibiting MMP-9 or by indirectly inhibiting MMP-9, with potential as therapeutic agents for traumatic brain injury. This article reviews the efficacy of several such medications and potential agents that include endogenous and exogeneous compounds that are at various levels of research and development. MMP-9-based therapeutic drug development has enormous potential in the pharmacological treatment of cerebral edema and/or neuronal injury resulting from traumatic brain injury. • Blood-brain barrier dysfunction leads to cerebral edema formation following traumatic brain injury (TBI). • Matrix metalloproteinase-9 (MMP-9) degrades the basal lamina and endothelial tight junctions of the blood-brain barrier. • There are specific or non-specific MMP-9 inhibitors that directly binding/inhibiting MMP-9 or inhibiting MMP-9 indirectly. • MMP-9 inhibitors have enormous potential for the treatment of cerebral edema and/or neuronal injury following TBI. [ABSTRACT FROM AUTHOR]

Comments on the claims of Catherine Myser that mainstream bioethics is widely regarded as unbiased and consequently taken as the standard against which all nonmainstream bioethical thinking should be compared. Consequence of the failure to understand the cultural origins of mainstream bioethics in the U.S.; Notion that white bioethics is the de facto normal; Significance of culture in bioethics.

Objectives: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is)-innovative yet costly cholesterol-lowering agents-have been subject to substantial prior authorization (PA) requirements and low approval rates. We aimed to investigate trends in insurer approval and reasons for rejection for PCSK9i prescriptions as well as associations between patients' demographic, clinical, pharmacy, payer, and PCSK9i-specific plan/coverage factors and approval.Methods: We examined trends in PCSK9i approval rates and reasons for rejection using medical and prescription claims from 2015 to 2017 for individuals who received a PCSK9i prescription. We used multinomial logistic regression to estimate quarterly risk-adjusted approval rates for initial PCSK9i prescriptions and approval for any PCSK9i prescription within 30, 90, and 180 days of the initial PCSK9i prescription. For a 2016 subsample for whom we had PCSK9i-specific plan policy data, we examined factors associated with approval including PCSK9i-specific plan formulary coverage, step therapy requirements, and number of PA criteria.Results: The main sample included 12 309 patients (mean age 64.8 years [SD = 10.8], 52.1% female, 51.5% receiving Medicare) and was similar in characteristics to the 2016 subsample (n = 6091). Approval rates varied across quarters but remained low (initial prescription, 13%-23%; within 90 days, 28%-44%). Over time, rejections owing to a lack of formulary coverage decreased and rejections owing to PA requirements increased. Lack of formulary coverage and having ≥11 PA criteria in the plan policy were associated with lower odds of PCSK9i prescription approval.Conclusions: These findings confirm ongoing PCSK9i access issues and offer a baseline for comparison in future studies examining the impact of recent efforts to improve PCSK9i access. [ABSTRACT FROM AUTHOR]

Prostate cancer is the most commonly diagnosed cancer disease in men in the Unites States and its management remains a challenge in everyday oncology practice. Thus, advanced therapeutic strategies are required to treat prostate cancer patients. Curcumin (CUR) is a promising anticancer agent for various cancer types. The objective of this study was to evaluate therapeutic potential of novel poly(lactic- co -glycolic acid)- CUR nanoparticles (PLGA-CUR NPs) for prostate cancer treatment. Our results indicate that PLGA-CUR NPs efficiently internalize in prostate cancer cells and release biologically active CUR in cytosolic compartment of cells for effective therapeutic activity. Cell proliferation (MTS), clonogenic, and Western blot analyses reveal that PLGA-CUR NPs can effectively inhibit proliferation and colony formation ability of prostate cancer cells than free CUR. PLGA-CUR NPs showed superior tumor regression compared to CUR in xenograft mice. Further investigations reveal that PLGA-CUR NPs inhibit nuclear ß-catenin and AR expression in cells and in tumor xenograft tissues. It also suppresses STAT3 and AKT phosphorylation and leads to apoptosis via inhibition of key anti-apoptotic proteins, Mcl-1, Bcl-xL and caused induction of PARP cleavage. Additionally, significant downregulation of oncogenic miR21 and up-regulation of miR-205 was observed with PLGA-CUR NPs treatment as determined by RT-PCR and in situ hybridization analyses. A superior anti-cancer potential was attained with PSMA antibody conjugated PLGA-CUR NPs in prostate cancer cells and a significant tumor targeting of 131 I labeled PSMA antibody was achieved with PLGA-CUR NPs in prostate cancer xenograft mice model. In conclusion, PLGA-CUR NPs can significantly accumulate and exhibit superior anticancer activity in prostate cancer. [ABSTRACT FROM AUTHOR]