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In light of the growing phenomenon of parent-child digital co-play of online games, we conducted a study to understand the different ways of digital co-play and how they can offer opportunities for the child's learning. We analyse four cases of parent-child digital co-play on "Let's Play" gaming videos with "Roblox" on YouTube. Our research method adopts a netnography research approach and multimodal discourse analysis to examine the data. We identify three ways of digital co-play, which include the parent-directed, parent-child negotiated, and child-directed parent-child interaction styles from the analysis of the videos. Following the analysis, we discuss how each of the ways of parent-child digital co-play can be productive in helping the child learn through shared gameplay with parents. We suggest how children can learn through communicating with parents during gameplay, creating something by themselves in the game, modelling parents' in-game behaviour, teaching their parents by sharing their knowledge, and leading the co-play. Our study aims to serve as a conversational starter to contribute to the global discourse on the phenomenon of parent and child shared interactions with digital technology as well as the ways in which learning can be facilitated through such experiences.

In the United States, there is a common stereotype associating brilliance with men. This gender brilliance stereotype emerges early and may undermine women's engagement in many prestigious careers. However, past research on its acquisition has focused almost exclusively on American children's beliefs of White people's intellectual talents. Therefore, less is known about how this stereotype develops in non-Western cultures and whether children consider other social identities such as race in forming this stereotype. To address these issues, the present research (a) provided the first cross-cultural test examining its development in 5- to 7-year-old Chinese and American children and (b) compared children's gender brilliance stereotype of White people with that of Asian people. Studies 1 (N = 96; Chinese children) and 2 (N = 96; Chinese children) revealed that, similar to American children, Chinese children associated brilliance with White men (vs. White women) around the age of 6. In contrast, Studies 3 (N = 96; Chinese children) and 4 (N = 96; American children; 76.9% White) showed that 5- to 7-year-old children from both cultures associated brilliance with Asian women (vs. Asian men). The results suggest that the gender stereotype about brilliance has a racial component and may be culturally consistent. Overall, these findings add to our knowledge of children's acquisition of the gender stereotype about brilliance in non-Western cultural contexts and highlight the importance of considering multiple social identities to understand the acquisition of stereotypes.

Study abroad can be a life-changing experience, but evidence of its effectiveness is mixed. We examine the experience of studying abroad at colleges in the US and China, which are the largest receiving and sending countries of international students respectively. Using data from two comparable national surveys that follow the same design, we estimate causal effects by matching students who studied abroad during college to those who did not, based on their propensity to study abroad. First, we survey student profiles to better understand who studied abroad. We found that parental education and urbanity makes difference in participation. Second, we examine the impact of study abroad on student academic achievement, using multivariate regression and propensity score matching. Finally, we exploit the matched samples to examine impact heterogeneity by student background. We find a positive, statistically significant but small impact on student academic achievement in both countries, with a higher impact for American students.

This research examined the idea that children's inferences about their parents' goals for them is a possible mechanism by which parents' responses to their children's performance contribute to children's psychological functioning. American (N = 447; M[subscript age] = 13.24 years; 49% girls; 95% European American) and Chinese (N = 439; M[subscript age] = 13.36 years; 52% girls) early adolescents reported on parents' responses to their performance, parents' self-worth and self-improvement goals for them, and their psychological functioning (e.g., subjective well-being) twice over a year. The more parents used success-oriented responses, the more their children inferred they held self-worth goals, which predicted enhanced psychological functioning among children over time. The more parents used failure responses, the more their children inferred they held self-improvement goals, but this did not underlie the tendency for parents' failure responses to predict poorer psychological functioning over time. These pathways tended to be stronger in the United States than China.

Bioethicists influence practices and policies in medicine, science, and public health. However, little is known about bioethicists' views. We recently surveyed 824 U.S. bioethicists on a wide range of ethical issues, including topics related to abortion, medical aid in dying, and resource allocation, among others. We also asked bioethicists about their demographic, religious, academic, and professional backgrounds. We find that bioethicists' normative commitments predict their views on bioethical issues. We also find that, in important ways, bioethicists' views do not align with those of the U.S. public: for instance, bioethicists are more likely than members of the public to think abortion is ethically permissible but are less likely to believe compensating organ donors is. Our demographic results indicate the field of bioethics is far less diverse than the U.S. population—less diverse even than other academic disciplines—suggesting far more work needs to be done to build an inclusive field. [ABSTRACT FROM AUTHOR]

Per- and polyfluoroalkyl substances (PFASs) are a family of "forever chemicals" including perfluorooctane sulfonate (PFOS). These toxic chemicals do not break down in the environment or in our bodies. In the human body, PFOS and perfluoroctanoic acid (PFOA) have a half-life (T1/2) of about 4–5 yr so low daily consumption of these chemicals can accumulate in the human body to a harmful level over a long period. Although the use of PFOS in consumer products was banned in the United States in 2022/2023, this forever chemical remains detectable in our tap water and food products. Every American tested has a high level of PFAS in their blood (https://cleanwater.org/pfas-forever-chemicals). In this report, we used a Sertoli cell blood-testis barrier (BTB) model with primary Sertoli cells cultured in vitro with an established functional tight junction (TJ)-permeability barrier that mimicked the BTB in vivo. Treatment of Sertoli cells with PFOS was found to perturb the TJ-barrier, which was the result of cytoskeletal disruption across the cell cytoplasm, disrupting actin and microtubule polymerization. These changes thus affected the proper localization of BTB-associated proteins at the BTB. Using RNA-Seq transcriptome profiling, bioinformatics analysis, and pertinent biochemical and cell biology techniques, it was discovered that PFOS -induced Sertoli cell toxicity through the c-Jun N-terminal kinase (JNK; also known as stress-activated protein kinase, SAPK) and its phosphorylated/active form p-JNK signaling pathway. More importantly, KB-R7943 mesylate (KB), a JNK/p-JNK activator, was capable of blocking PFOS-induced Sertoli cell injury, supporting the notion that PFOS-induced cell injury can possibly be therapeutically managed. NEW & NOTEWORTHY: PFOS induces Sertoli cell injury, including disruption of the 1) blood-testis barrier function and 2) cytoskeletal organization, which, in turn, impedes male reproductive function. These changes are mediated by JNK/p-JNK signaling pathway. However, the use of KB-R7943, a JNK/p-JNK activator was capable of blocking PFOS-induced Sertoli cell injury, supporting the possibility of therapeutically managing PFOS-induced reproductive dysfunction. [ABSTRACT FROM AUTHOR]

Objective: An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD. Methods: This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD. Results: Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83). Conclusion: CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD. [ABSTRACT FROM AUTHOR]

Key point: Social determinants of health interactively influence sinonasal cancer care and prognosis.Housing‐transportation and socioeconomic status showed the largest associations with disparities.The social vulnerability index can reveal the social determinants of sinonasal cancers. [ABSTRACT FROM AUTHOR]

This paper investigates the dynamics of motivation in learning Chinese, prompted by the paradoxical trend of increasing interest in Chinese language study in the United States juxtaposed with low enrollment and retention rates. Incorporating the Complex Dynamic Systems Theory (CDST) (Larsen-Freeman & Cameron, 2008), this research delves into the motivational trajectories of students across various learning phases, considering their learning experiences and contexts within and beyond a Chinese summer program. Data analysis indicates an increased learning motivation during the program, attributed to (1) effective instructional methods, (2) skilled instructors, and (3) a conducive learning environment. A decline in motivation is observed a semester after the program, mainly because of diminished language exposure and limited chances for learning. This study provides insights into the temporal and dynamic dimensions of motivation. Implications for sustaining Chinese learning motivation within and beyond a program are also presented. [ABSTRACT FROM AUTHOR]

Simple Summary: We evaluated the repurposing of a class of non-cancer drugs, phosphodiesterase inhibitors, to increase the potency of an anti-folate chemotherapy drug against non-small-cell lung cancer. We showed that this approach represents a double-edged strategy. While the use of phosphodiesterase inhibitors potentiated the killing of lung cancer cells by combination low-dose anti-folate chemotherapy, in half of the tumors evaluated, the benefit was lost when using higher doses of chemotherapy. Phosphosidesterases (PDEs) are key regulators of cyclic nucleotide signaling, controlling many hallmarks of cancer and playing a role in resistance to chemotherapy in non-small-cell lung cancer (NSCLC). We evaluated the anti-tumor activity of the anti-folate agent pemetrexed (PMX), alone or combined with biochemical inhibitors of PDE5, 8, 9, or 10, against squamous and non-squamous NCSLC cells. Genomic alterations to PDE genes (PDEmut) or PDE biochemical inhibition (PDEi) can sensitize NSCLC to PMX in vitro (observed in 50% NSCLC evaluated). The synergistic activity of PDEi with PMX required microdosing of the anti-folate drug. As single agents, none of the PDEis evaluated have anti-tumor activity. PDE biochemical inhibitors, targeting either cAMP or cGMP signaling (or both), resulted in significant cross-modulation of downstream pathways. The use of PDEi may present a new strategy to overcome PMX resistance of PDEwt NSCLC tumors but comes with important caveats, including the use of subtherapeutic PMX doses. [ABSTRACT FROM AUTHOR]

This research examined a cultural socialization model in which differences in Chinese and American parents' goals for children foster differences in children's emotional distress via parents' responses to children's performance. Chinese and American mothers and their children (N = 397; M[subscript age] = 13.19 years) participated in a 2-wave study spanning a year. Mothers reported on their self-improvement (i.e., children striving to improve) and self-worth (i.e., children feeling worthy) goals, as well as responses to children's performance. Children reported on their emotional distress (e.g., anxiety and depression). Chinese (vs. American) mothers' greater endorsement of self-improvement goals predicted their more frequent use of failure-oriented responses (e.g., highlighting children's mistakes), which accounted for Chinese (vs. American) children's heightened emotional distress over time.

Objective: To explore differences in depressive symptoms for older adults (Black, Latinx, and White) by cognitive status during the 2020 COVID-19 pandemic. Methods: Data from the Health and Retirement Study identified older adults as cognitively normal, cognitively impaired without dementia (CIND), and persons living with dementia (PLWD). Multiple linear regression analyses examined associations between cognitive status and depressive symptoms among these racialized groups. Results: Compared to the cognitively normal older adults racialized as Black, those with CIND reported higher depressive symptoms during the pandemic (overall and somatic) and PLWD had higher somatic symptoms (p <.01). Older adults racialized as White with CIND reported higher somatic (p <.01) symptoms compared to cognitively normal older adults racialized as White. Discussion: The COVID-19 pandemic was a challenging event among older adults racialized as Black with CIND and PLWD. Future studies should examine if these depressive symptoms persist over time. [ABSTRACT FROM AUTHOR]

Modeling ecological patterns and processes often involve large‐scale and complex high‐dimensional spatial data. Due to the nonlinearity and multicollinearity of ecological data, traditional geostatistical methods have faced great challenges in model accuracy. As machine learning has increased our ability to construct models on big data, the main focus of the study is to propose the use of statistical models that hybridize machine learning and spatial interpolation methods to cope with increasingly large‐scale and complex ecological data. Here, two machine learning algorithms, boosted regression tree (BRT) and least absolute shrinkage and selection operator (LASSO), were combined with ordinary kriging (OK) to model plant invasions across the eastern United States. The accuracies of the hybrid models and conventional models were evaluated by 10‐fold cross‐validation. Based on an invasive plants dataset of 15 ecoregions across the eastern United States, the results showed that the hybrid algorithms were significantly better at predicting plant invasion when compared to commonly used algorithms in terms of RMSE and paired‐samples t‐test (with the p‐value <.0001). Besides, the additional aspect of the combined algorithms is to have the ability to select influential variables associated with the establishment of invasive cover, which cannot be achieved by conventional geostatistics. Higher accuracy in the prediction of large‐scale biological invasions improves our understanding of the ecological conditions that lead to the establishment and spread of plants into novel habitats across spatial scales. The results demonstrate the effectiveness and robustness of the hybrid BRTOK and LASOK that can be used to analyze large‐scale and high‐dimensional spatial datasets, and it has offered an optional source of models for spatial interpolation of ecology properties. It will also provide a better basis for management decisions in early‐detection modeling of invasive species. [ABSTRACT FROM AUTHOR]

Information on factors leading to pulmonary arterial hypertension (PAH) treatment discontinuation is limited. This study analyzed 12,902 new PAH medication users to identify predictors of treatment discontinuation. Treatment by accredited pulmonary hypertension centers and combination therapy with PAH agents from different classes were less likely to result in discontinuation. [ABSTRACT FROM AUTHOR]

There is little research on the relationship between phthalates exposure and sleep problems in adult females, with existing studies only assessing the association between exposure to individual phthalates with sleep problems. We aimed to analyse the relationship between phthalates and sleep problems in 1366 US females aged 20 years and older from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) by age stratification. Multivariate logistic regression showed that the fourth quartile of MECPP increased the risk of sleep problems in females aged 20–39 compared with the reference quartile (OR: 1.87, 95% CI: 1.14, 3.08). The WQS index was significantly associated with the sleep problems in females aged 20–39. In the BKMR, a positive overall trend between the mixture and sleep problems in females aged 20–39. In this study, we concluded that phthalates might increase the risk of sleep problems in females aged 20–39. [ABSTRACT FROM AUTHOR]

Limited previous studies investigated the influences of various types of neighborhood factors on adolescent behavior problems. Meanwhile, although previous theoretical frameworks suggested that gender played a significant role in terms of neighborhood impacts on adolescent behavioral problems, few studies investigated the gender differences in such neighborhood influences. Using the year 9 and year 15 data of the national dataset Future of Families and Child Wellbeing Study (FFCWS, overly sampled participants from low-income families), this study examined how the neighborhood structural and process factors can affect adolescent behavioral problems (internalizing and externalizing symptoms) and whether gender worked as a significant moderator for such relationships in the U.S. Structural equation models and multigroup SEM were estimated (N = 3411). Findings suggested that residential instability was associated with increased levels of internalizing symptoms among adolescents at age 15, whereas neighborhood social cohesion was linked to reduced levels of externalizing symptoms throughout adolescence. Furthermore, the moderating effects of gender were found for the association between residential instability and internalizing symptoms. Implications of such findings are further discussed. [ABSTRACT FROM AUTHOR]

The United States is extremely diverse in the racial and ethnic backgrounds of its citizens, which include whites, blacks, Native Americans, Alaskans, Asians, Pacific Islanders, and Hispanics. Such a diverse combination of different racial populations makes the characteristics of accessibility and diversity in American higher education important. The necessity of educating such a vast and diverse population in a climate of competing social demands on limited public resources presents the United States with serious challenges. This paper discusses and analyzes educational transition, innovation and future development in American Higher Education.

The purpose of the meta‐analysis was to evaluate and compare the photodynamic therapy's effectiveness in treating infected skin wounds. The results of this meta‐analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random‐ or fixed‐effect models. For the current meta‐analysis, 6 examinations spanning from 2013 to 2021 were included, encompassing 154 patients with infected skin wounds were the used studies' starting point. Photodynamic therapy had a significantly lower wound ulcer size (MD, −4.42; 95% CI, −7.56–−1.28, p = 0.006), better tissue repair (MD, −8.62; 95% CI, −16.76–−0.48, p = 0.04) and lower microbial cell viability (OR, 0.13; 95% CI, 0.04–0.42, p < 0.001) compared with red light exposure in subjects with infected skin wounds. The examined data revealed that photodynamic therapy had a significantly lower wound ulcer size, better tissue repair and lower microbial cell viability compared with red light exposure in subjects with infected skin wounds. However, given that all examinations had a small sample size, consideration should be given to their values. [ABSTRACT FROM AUTHOR]

Background: As thyroid cancer incidence rises, it is increasingly valuable to recognize disparities in treatment and diagnosis. Prior investigations into social determinants of health (SDoH) are limited to pediatric populations or studies looking at single factors such as race or environmental influences. Utilizing the CDC-social vulnerability index and SEER-patient database to assess the amalgamated, real-world influence of varied SDoH and their quantifiable impact on thyroid cancer disparities across the United States. Methods: In a retrospective cohort study, 199,340 adult thyroid cancer patients from 1975 to 2017 were assessed for significant regression trends in months of follow-up/surveillance, survival, late staging, and treatment receipt across thyroid cancer-subtypes with increasing overall social vulnerability, as well as in 15 SDoH variables regarding socioeconomic status, minority-language status, household composition, and housing-transportation across all the U.S. counties while accounting for sociodemographic regional differences. Results: With increasing overall social vulnerability, decreases in months of follow-up were observed with patients with papillary, follicular, medullary, oncocytic, and anaplastic thyroid cancer (p = 0.001). Comparing lowest with highest vulnerability cohorts, relative decreases in months of surveillance ranged from 55.6% (14.5–6.5 months) with anaplastic to 17% (108.6–90.2) with oncocytic. Socioeconomic status vulnerabilities, followed by vulnerabilities in household composition and housing-transportation type, contributed to these overall trends. Similar survival decreases occurred across all thyroid cancer patients, ranging from 55.9% (9.6–4.2) with anaplastic to 28.3% (97–69.5) with oncocytic. Minority-language status vulnerabilities and housing-transportation types largely contributed to these trends. Increasing overall vulnerability was associated with increased odds of advanced staging for papillary (odds ratio [OR] = 1.07 [confidence interval, CI 1.03–1.12]) and decreased odds of indicated treatment via surgery (lowest, medullary: 0.91 [CI 0.84–0.99]), radiation therapy (lowest, anaplastic: 0.88 [CI 0.82–0.93]), and chemotherapy (lowest, oncocytic: 0.81 [CI 0.67–0.98]) were observed. Vulnerabilities in minority-language status and housing-transportation, followed by socioeconomic status vulnerabilities, were differential contributors to these overall vulnerability trends. Conclusions: Our results show significant detriments in thyroid cancer care and prognosis in the United States with increasing overall social vulnerability while identifying which SDoH quantifiably contribute more to disparities in inter-relational, real-world-like contexts. [ABSTRACT FROM AUTHOR]

Acute flaccid myelitis (AFM) is a serious neurologic condition primarily affecting children; AFM can cause acute respiratory failure and permanent paralysis. AFM is a rare but known complication of various viral infections, particularly those of enteroviruses (EVs). Increases in AFM cases during 2014, 2016, and 2018 were associated with EV-D68 infection. This report examines trends in confirmed AFM cases during 2018-2022 and patients' clinical and laboratory characteristics. The number of AFM cases was low during 2019-2022 (28-47 cases per year); the number of cases remained low in 2022 despite evidence of increased EV-D68 circulation in the United States. Compared with cases during the most recent peak year (2018), fewer cases during 2019-2021 had upper limb involvement, prodromal respiratory or febrile illness, or cerebrospinal fluid pleocytosis, and more were associated with lower limb involvement. It is unclear why EV-D68 circulation in 2022 was not associated with an increase in AFM cases or when the next increase in AFM cases will occur. Nonetheless, clinicians should continue to suspect AFM in any child with acute flaccid limb weakness, especially those with a recent respiratory or febrile illness. [ABSTRACT FROM AUTHOR]

Background: Rivaroxaban 2.5 mg twice daily with aspirin 100 mg daily was shown to be better than aspirin 100 mg daily for preventing cardiovascular (CV) death, stroke or myocardial infarction in patients with either stable coronary artery disease (CAD) or peripheral artery disease (PAD). The cost-effectiveness of this regimen in this population is essential for decision-makers to know. Methods: US direct healthcare system costs (in USD) were applied to hospitalized events, procedures and study drugs utilized by all patients. We determined the mean cost per participant for the full duration of the trial (mean follow-up of 23 months) plus quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) over a lifetime using a two-state Markov model with 1-year cycle length. Sensitivity analyses were performed on the price of rivaroxaban and the annual discontinuation rate. Results: The costs of events and procedures were reduced for Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) patients who received rivaroxaban 2.5 mg orally (BID) plus acetylsalicylic acid (ASA) compared with ASA alone. Total costs were higher for the combination group ($7426 versus $4173) after considering acquisition costs of the study drug. Over a lifetime, patients receiving rivaroxaban plus ASA incurred $27,255 more and gained 1.17 QALYs compared with those receiving ASA alone resulting in an ICER of $23,295/QALY. ICERs for PAD only and polyvascular disease subgroups were lower. Conclusion: Rivaroxaban 2.5 mg BID plus ASA compared with ASA alone was cost-effective (high value) in the USA. COMPASS ClinicalTrials.gov identifier: NCT01776424. [ABSTRACT FROM AUTHOR]

Academic socialization by low-income immigrant mothers from Mainland China was investigated in two studies. Immigrant Chinese mothers of first graders (n = 52; M[subscript age] = 38.69) in the United States (Study 1) and kindergartners (n = 86; M[subscript age] = 36.81) in Hong Kong (Study 2) tell stories that emphasized achieving the best grade through effort more than did African American (n = 39; M[subscript age] = 31.44) and native Hong Kong (n = 76; M[subscript age] = 36.64) mothers, respectively. The emphasis on achievement was associated with mothers' heightened discussion on discrimination (Study 1) and beliefs that education promotes upward mobility (Study 2), as well as children's expectations that a story protagonist would receive maternal criticism for being nonpersistent in learning (Study 2).

Summary: We used data from the NHANES to explore associations of DOBS with femur BMD and osteoporosis in postmenopausal women. We found that DOBS was positively associated with femur BMD and negatively associated with the risk of osteoporosis in postmenopausal women. Purpose: The study aimed to investigate the relationship between dietary oxidative balance score (DOBS) and the risk of osteoporosis in American postmenopausal women. Methods: A total of 3043 participants were included in this study. The linear relationship between DOBS and femur BMD was evaluated using a weighted multivariate linear regression model. The association between DOBS and the risk of osteoporosis was assessed using a weighted logistic regression model, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. Moreover, the relationship was further characterized through smooth curve fitting (SCF) and weighted generalized additive model (GAM) analysis. Results: After adjusting for all covariates, the weighted multivariable linear regression models showed a positive correlation between DOBS and femur BMD. Moreover, the weighted logistic regression model demonstrated that compared to the first tertile of DOBS, the highest tertile of DOBS was significantly associated with a lower risk of osteoporosis, with ORs of 0.418 (95% CI, 0.334, 0.522) for individuals under the age of 70 and 0.632 (95% CI, 0.506, 0.790) for individuals aged 70 or above. Similar trends were also observed in SCF and GAM models. Conclusion: The present study indicated that postmenopausal women with a higher DOBS have a lower risk of femur osteoporosis. This finding may highlight the potential protective role of an antioxidant-rich diet for the bones of the postmenopausal population. Moreover, DOBS may also be a valuable tool in identifying individuals with osteoporosis. Screening and early intervention for osteoporosis may be essential for postmenopausal women with low DOBS. [ABSTRACT FROM AUTHOR]

Background: Older populations have suffered the highest rates of SARS‐CoV‐2 infection and associated complications, including Post‐Acute Sequelae of SARS‐CoV‐2 infection (PASC). Frailty is a geriatric syndrome that often coexists with COVID‐19 infection. The vulnerability to stressors caused by multisystemic dysfunction that characterizes frailty may predispose older adults to develop PASC. Methods: Retrospective cohort study using the VA COVID‐19 Shared Data Resource to identify US veterans testing positive for SARS‐CoV‐2 between July 2021 and February 2022, without prior positive tests and who were alive 30 days after infection. Frailty was calculated using a 31‐item VA Frailty Index generated from electronic health records. We categorized Veterans into robust (FI ≤ 0.10), prefrail (FI: >0.10‐ < 0.21), and frail (FI ≥ 0.21). We assessed the association between frailty and PASC and vaccination and PASC using Cox survival model, adjusting for covariates. Results: We identified 245,857 COVID‐19‐positive veterans surviving 30 days after infection. The mean age was 57.5 ± 16.5 years; 87.2% were males, 68.1% were white, and 9.0% were Hispanic. Almost half of the sample (48.9%) were classified as robust, while 28.3% were pre‐frail and 22.7% were frail; 99,886 (40.6%) were fully vaccinated, and 33,516 (13.6%) received booster doses. Over a median follow‐up of 143 days (IQR = 101), 23,890 (9.7%) patients developed PASC. Within 6 months after infection, frailty and pre‐frailty were associated with a 41% (adjusted HR [aHR]:1.40 (95% CI: 1.35–1.47) and 15% (aHR: 1.17 (95% CI: 1.11–1.19) increase in the risk of PASC compared with the robust, respectively. Vaccination and booster doses before infection were associated with a 27% (aHR: 0.73 (95% CI: 0.71–0.75) and 33% (aHR: 0.66 (95% CI: 0.63–0.69) reduction in the risk of developing PASC, respectively. Conclusions: Frailty was associated with an increased risk of developing PASC. Vaccination was associated with a decreased risk of PASC, further reduced by booster doses. Early recognition of frailty in patients with COVID‐19 may assist in the early identification and management of PASC. [ABSTRACT FROM AUTHOR]

The Asian immigrant population is the fourth largest immigrant population in the United States, and its parenting stress issues have been consistently recognized in previous studies. However, little attention has been paid to neighborhood-level factors and their parenting stress. Using the Study of Asian American Families and 2016 American Community Survey 5-year estimates, this study examined the association between neighborhood structural indexes and Asian immigrant parents' parenting stress, along with the mechanism driving the relationship. We found that cultural orientation and social support fully mediated the effects of economic disadvantages on parenting stress among Asian immigrant parents. Only cultural orientation mediated the direct effects of ethnic heterogeneity on Asian parents' parenting stress. Improving Asian immigrants' living environment, including economic status and ethnic diversity, would be critical to relieve the parenting stress of Asian immigrant families. Interventions and preventions to increase social support, and inform cultural orientation and acculturation are emphasized. [ABSTRACT FROM AUTHOR]

Background: Small cell carcinoma of the bladder is rare and has a poor prognosis. This study aimed to investigate whether radiotherapy after bladdersparing surgery could improve the survival benefits of patients. Methods: This population-based retrospective cohort study used data from the Surveillance, Epidemiology, and End Results cohort in the United States to investigate small cell carcinoma of the bladder. Univariate and multivariate Cox regression analyses were used to identify significant risk factors influencing the clinical prognosis. A propensity score matching (PSM) algorithm was used to reduce the interference of confounding factors in each study group. The matched groups underwent Kaplan--Meier survival analysis to assess the potential survival benefits. Results: Univariate regression analysis demonstrated that age (P<0.001), tumour stage (T stage) (P=0.005), node stage (N stage) (P<0.001), chemotherapy (P<0.001), bone metastasis (P<0.001), liver metastasis (P<0.001), lung metastasis (P=0.005), tumour size (P=0.005), and radiotherapy (P<0.001) were related factors affecting survival. Multivariate regression analysis revealed that age (P=0.001), T stage (P=0.054), N stage (P<0.001), radiotherapy (P=0.010), chemotherapy (P<0.001), bone metastasis (P=0.007), and liver metastasis (P<0.001) were independent factors affecting survival. Moreover, survival analysis was performed on the PSM-matched groups, leading to the following findings: (1) the radiotherapy group exhibited a superior survival prognosis compared with the non-radiotherapy group (P<0.001); (2) the survival prognosis of individuals who underwent radiotherapy and chemotherapy was higher than that of those who underwent chemotherapy alone (P<0.001). Conclusion: The findings of this study suggest that radiotherapy improves survival benefits for patients with small cell carcinoma of the bladder who undergo bladder-sparing surgery. Furthermore, radiotherapy combined with chemotherapy demonstrates a greater survival benefit compared with chemotherapy alone. The results underscore the importance of considering radiotherapy as a valuable treatment option for such patients, highlighting its potential benefits in improving their overall prognosis. [ABSTRACT FROM AUTHOR]

Adequate blood supply, a prerequisite for flap survival after grafting, makes angiogenesis of the flap the biggest problem to be solved. Researches have been conducted around vascularisation in correlation with flap grafting. However, bibliometric analyses systematically examining this research field are lacking. As such, we herein sought to conduct comprehensive comparative analyses of the contributions of different researchers, institutions, and countries to this research space in an effort to identify trends and hotspots in angiogenesis and vascularisation in the context of flap grafting. Publications pertaining to angiogenesis and vascularisation in the context of flap grafting were retrieved from the Web of Science Core Collection. References were then analysed and plotted using Microsoft Excel 2019, VOSviewer, and CiteSpace V. In total, 2234 papers that were cited 40 048 times (17.63 citations/paper) were included in this analysis. The greatest number of studies were from the United States, with these studies exhibiting both the highest number of citations (13 577) and the greatest overall H‐index (60). For The institutions that published the greatest number of studies were WENZHOU MEDICAL UNIVERSITY (681), while UNIVERSITY OF ERLANGEN NUREMBERG has the highest number of citations (1458), and SHANGHAI JIAO TONG UNIVERSITY holds the greatest overall H‐index (20). The greatest number of studies in this research space were published by Gao WY, while Horch RE was the most commonly cited researcher in the field. The VOS viewer software clustered relevant keywords into three clusters, with clusters 1, 2, 3, and 4 corresponding to studies in which the keywords 'anatomy', 'survival', 'transplantation', 'therapy' most frequently appeared. The most promising research hotspot‐related terms in this field included 'autophagy', 'oxidative stress', 'ischemia/reperfusion injury', which exhibited a most recent average appearing year (AAY) of 2017 and after. Generally speaking, the results of this analysis indicate that the number of articles exploring angiogenesis and flap‐related research has risen steadily, with the United States and China being the two countries publishing the greatest proportion of studies in this field. The overall focus of these studies has shifted away from 'infratest and tissue engineering' towards 'mechanisms'. In the future, particular attention should be paid to emerging research hotspots, which include 'ischemia/reperfusion injury' and treatments for promoting vascularization, such as 'platelet‐rich plasma'. In light of these findings, funding agencies should continue increasing their investment in the exploration of the concrete mechanisms and interventional therapeutic relevance of angiogenesis during flap transplantation. [ABSTRACT FROM AUTHOR]

Objective : This study aims to identify gender disparities within the subspecialty of craniofacial surgery as women surgeons remain underrepresented in academia and leadership, arenas heavily dictated by research productivity. Design : All craniofacial articles published in 3 major research journals from 2000 to 2020 were reviewed and evaluated in 5-year increments. Outcomes : Information regarding author gender, authorship distribution, geographic origin, and publication type was collected. ANOVA, χ2, and logistic regression modeling were used for analysis. Results : In total, there were 3684 articles with 15 206 total authors—3128 (20.6%) were women, including 665 (21.3%) first authors, 1980 (63.2%) middle authors, and 487 (15.7%) senior authors. Mean women authorship increased significantly from 2000 to 2020 (0.33 vs 1.22 P <.001) with corresponding significant increases in first and senior authorship (8.63% vs 27.02; 5.65% vs 16.13%; P <.001). Statistically significant trends across time were observed for first and senior authorships (P <.001). Women were more likely to publish original publications as first and senior authors (OR: 1.83, P <.001; OR: 1.37, P =.0012). Women were less likely to publish editorial articles (OR 0.6, P <.001). The United States ranked third in publication output by female first authors but was behind all regions except Africa for output by female senior authors. Conclusion : Although female authorship has increased significantly over the last 2 decades, women remain a minority within the craniofacial literature. Further research is needed to elicit the root of these disparities. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate the cost-effectiveness of nivolumab plus chemotherapy as first-line treatment for patients with advanced gastric, gastroesophageal junction (GEJ), or esophageal adenocarcinoma from the perspective of Chinese and US society. Methods: To conduct the analysis, a state-transitioned Markov model, which included three mutually exclusive health states (progression-free survival (PFS), progressive disease (PD), and death), was developed. Cycle length was set at 3 weeks and lifetime horizon was set at 10 years. Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER) were calculated in the analysis. Willingness-to-pay (WTP) thresholds in the model were set at $37,653.00/QALY in China and $100,000.00/QALY in the US, respectively. Meanwhile, one-way sensitivity analyses and probabilistic sensitivity analyses were conducted to investigate the robustness of the model. Results: Over a lifetime horizon, the ICERs of nivolumab plus chemotherapy versus chemotherapy alone were $430,185.04/QALY and $944,089.78/QALY in China and the US, respectively. Cost of nivolumab and utility for the PFS state had the most significant impact on ICERs both in the US and China based on the results of the one-way sensitivity analyses. In the probabilistic sensitivity analyses, the proportions of nivolumab plus chemotherapy being cost-effective compared with chemotherapy alone were 0%. Conclusions: In conclusion, nivolumab plus chemotherapy is unlikely to be a cost-effective treatment option compared with chemotherapy alone in the first-line setting of advanced gastric, GEJ, or esophageal adenocarcinoma. [ABSTRACT FROM AUTHOR]

Terrestrial water budget (TWB) data over large domains are of high interest for various hydrological applications. Spatiotemporally continuous and physically consistent estimations of TWB rely on land surface models (LSMs). As an augmentation of the operational North American Land Data Assimilation System Phase 2 (NLDAS-2) four-LSM ensemble, this paper describes a dataset simulated from an ensemble of 48 physics configurations of the Noah LSM with multi-physics options (Noah-MP). The 48 Noah-MP physics configurations are selected to give a representative cross-section of commonly used LSMs for parameterizing runoff, atmospheric surface layer turbulence, soil moisture limitation on photosynthesis, and stomatal conductance. The dataset spans from 1980 to 2015 over the conterminous United States (CONUS) at a monthly temporal resolution and a 1/8 ∘ spatial resolution. The dataset variables include total evapotranspiration and its constituents (canopy evaporation, soil evaporation, and transpiration), runoff (the surface and subsurface components), as well as terrestrial water storage (snow water equivalent, four-layer soil water content from the surface down to 2 m, and the groundwater storage anomaly). The dataset is available at 10.5281/zenodo.7109816. Evaluations carried out in this study and previous investigations show that the ensemble performs well in reproducing the observed terrestrial water storage, snow water equivalent, soil moisture, and runoff. Noah-MP complements the NLDAS models well, and adding Noah-MP consistently improves the NLDAS estimations of the above variables in most areas of CONUS. Besides, the perturbed-physics ensemble facilitates the identification of model deficiencies. The parameterizations of shallow snow, spatially varying groundwater dynamics, and near-surface atmospheric turbulence should be improved in future model versions. [ABSTRACT FROM AUTHOR]

Aim: To make a bibliometric analysis on post‐traumatic growth (PTG) after childbirth. Methods: The topic advanced search strategy extracted the information from the Web of Science Core Collection. Descriptive statistics were performed using Excel, and bibliometric analysis was performed using VOSviewer. Results: A total of 362 publications were published in 199 journals were obtained in the WoSCC from 1999 to 2022. Postpartum post‐traumatic growth is in a trend of fluctuating growth, and the United States (N = 156) and Bar‐Ilan University (N = 22) were the top contributing countries and institutions, respectively. Research hotspots mainly focus on theoretical models of PTG, postpartum post‐traumatic stress disorder (PTSD) as a predictor of PTG, facilitators of PTG, and the relationship between mother‐infant attachment and PTG. Conclusion: This bibliometric study provides a comprehensive overview of the current state of research on PTG after childbirth, an area that has received considerable scholarly attention in recent years. However, research on post‐traumatic growth after childbirth is lacking, and further research is needed. [ABSTRACT FROM AUTHOR]

Objectification, treating others merely as things or tools while denying their personhood, results in severe consequences. While prior research predominantly focused on the triggers of objectification, we aimed to investigate a possible intervention. We hypothesized that gratitude could reduce objectification toward general others (i.e., people who are not the benefactors). Across three studies (N = 1007), our hypothesis was supported. Study 1 showed that dispositional gratitude negatively predicted trait objectification. Studies 2 and 3 further found a causal relationship. Specifically, after heightening participants' state of gratitude, participants showed a lower level of objectification towards others (Study 2). Using a scenario study that described a working context, we further showed the alleviating effect of gratitude on objectification toward a group of factory workers, targets often suffering from objectification (Study 3). Our reported effect is prevalent, such that it is observed across samples from two countries (i.e., the United States and China). [ABSTRACT FROM AUTHOR]

Hostile sexism is a blatant and explicit form of sexism consisting of antagonistic attitudes toward women. We hypothesized that men's personal relative deprivation, a subjectively perceived disadvantage, would predict their hostile sexism toward women. In addition, we expected that, if this effect occurs, a sense of control would act as a mediator. Five studies (N = 1352) confirmed these hypotheses. Study 1 showed that personal relative deprivation predicted hostile sexism only for men, but not for women among Chinese college students. In addition, we observed the effect of personal relative deprivation only on hostile sexism, but not on benevolent sexism. Study 2, which employed participants from the United States, directly replicated the findings of Study 1. Studies 3 and 4 further showed that a sense of control acted as a mediator in this process. As such, increased hostile sexism attitude (Study 3) and hostile sexism behavior (Study 4) predicted by personal relative deprivation could result from a reduced sense of control. Study 5 further provided causal evidence that a temporarily induced state of personal relative deprivation resulted in a higher level of hostile sexism via a reduced sense of control. We discuss theoretical and practical implications for relative deprivation, gender inequality, and interventions. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) vaccines are highly efficacious at preventing symptomatic infection, severe disease, and death. Most of the evidence that COVID-19 vaccines also reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on retrospective, observational studies. Specifically, an increasing number of studies are evaluating vaccine effectiveness against the secondary attack rate of SARS-CoV-2 using data available in existing health-care databases or contact-tracing databases. Since these types of databases were designed for clinical diagnosis or management of COVID-19, they are limited in their ability to provide accurate information on infection, infection timing, and transmission events. We highlight challenges with using existing databases to identify transmission units and confirm potential SARS-CoV-2 transmission events. We discuss the impact of common diagnostic testing strategies, including event-prompted and infrequent testing, and illustrate their potential biases in estimating vaccine effectiveness against the secondary attack rate of SARS-CoV-2. We articulate the need for prospective observational studies of vaccine effectiveness against the SARS-CoV-2 secondary attack rate, and we provide design and reporting considerations for studies using retrospective databases. [ABSTRACT FROM AUTHOR]

The structure size of the crater formed by the earth-penetrating nuclear bomb explosion is one of the important parameters for evaluating the earth-penetrating nuclear bomb damage power. Obtaining the structure size of the crater formed by the earth-penetrating nuclear bomb explosion with different yields is great significance for the evaluation and design of the nuclear bomb damage power. In this study, considering the contradictory relationship between the structure size of the earth-penetrating nuclear bomb and the structure size of the equivalent TNT mass, we propose to use the equivalent energy mapping method to realize the finite element numerical simulation of the earth-penetrating nuclear bomb exploding into craters analyzed and compared the simulation results with the structure size of the crater formed by the ESS nuclear bomb explosion in the United States. The analysis results show that the error between the simulated crater radius and the real crater radius is 3.26%, and the error between the simulated crater depth and the real crater depth is 28.57 %. It meets the calculation accuracy error range of crater formation from nuclear explosion to chemical explosion. Therefore, this method provides an effective numerical simulation method and a means of obtaining the structural size data of the explosion crater for the earth-penetrating nuclear bomb cratering. [ABSTRACT FROM AUTHOR]

Background: The national obesity epidemic and trend of obesity prevalence have been characterized by a series of cross‐sectional surveys in the United States, however, less is known about obesity prevalence trajectory by birth cohort. This study aimed to investigate whether trends in obesity and severe obesity prevalence varied by birth cohorts among 1940s–1990s in the United States. Methods: Using data from the National Health and Nutrition Examination Survey 1999–2018. The trends of obesity and severe obesity prevalence were conducted with synthetic birth cohort. Results: There were 60 981 participants (weighted mean age, 38.1 years; female, 50.1%) assigned in 6 birth cohorts (1990s, 1980s, 1970s, 1960s, 1950s, and 1940s) over 1999–2018. The prevalence of obesity and severe obesity increased significantly with age during all birth cohorts except for the 1940s (Ptrend <0.001). For obesity, a significant positive quadratic trend was observed among 1990s birth cohort (Pnon‐linearity = 0.037), while a significant positive linear trend (Plinearity <0.001) among 1980s, 1970s, 1960s, and 1950s birth cohorts. Corresponding to same weighted mean age, the prevalence of both obesity and severe obesity in younger birth cohorts were much higher than the older birth generations. Conclusions: The continued upward trend in obesity and severe obesity prevalence by birth cohort highlighted the need for continuing focus on surveillance of body mass index and identification, implementation, and evaluation of evidence‐based interventions to address this major health problem in the United States. [ABSTRACT FROM AUTHOR]

Despite increasing prevalence of dual sensory impairment (DSI) with increasing age in the United States (US), there is little attention on its disease burden. The objective of this study was to assess the association between DSI and all-cause hospitalization in California Medicare beneficiaries. This cross-sectional study was conducted among all U.S. California Medicare beneficiaries from 2015. Sensory impairment status includes DSI, visual impairment only (VIO), and hearing impairment only (HIO). Hospitalization was defined as at least one inpatient claim in the Inpatient Claim database. Multivariable logistic regression analyses were used to calculate odds ratios (ORs) of hospitalization for DSI. The study sample included 2,574,641 California Medicare beneficiaries. There were 0.1% (n = 3,055), 0.7% (n = 16,896), and 7.1% (n = 181,838) of beneficiaries who had DSI, VIO, and HIO, respectively. Patients aged 85+ years had the highest proportion in all three sensory impairment groups, especially in the DSI group. Both unadjusted and fully adjusted models revealed a higher odds of inpatient stay for beneficiaries with DSI compared with NSI (unadjusted OR = 2.66; 95% CI = 2.46–2.87; fully adjusted OR = 1.41; 95% CI = 1.30–1.54). Subjects with VIO also demonstrated higher odds of hospital admission compared with NSI (fully adjusted OR = 1.48; 95% CI = 1.42–1.53). In a cohort of U.S. California Medicare beneficiaries, subjects with DSI or VIO had a higher odds of hospitalization compared to those with NSI. [ABSTRACT FROM AUTHOR]

The three-tiered School-Wide Positive Behavioral Interventions and Supports (SWPBIS) model is now being implemented in more than 13,000 schools in the United States (Horner, Sugai, & Anderson, 2010). One core feature of Tier One of the SWPBIS model is the identification of social expectations and behavior indicators across all school settings. This study examined the types and frequency of schools' social expectations and behavioral indicators as they were written into their behavior matrices. Participants from 155 schools located in 12 regionally representative states provided a sample of their behavioral matrix. Analyses of the matrices showed that three social expectations (respect, responsibility, and safety) occurred in more than 60% of behavior matrices. In addition, behavior indicators (e.g., walk to the right, quiet voices, hands to self) were identified for the four most frequent social expectations. Regional and state comparisons of social expectation frequency indicate homogeneity of categories across the country. Based on the findings, implications and suggestions for future research and practice are discussed. (Contains 3 tables and 1 figure.)

Background: The concepts of quality of life and family quality of life (FQOL) are increasingly being studied in the field of intellectual disabilities (ID) in China as important frameworks for: (1) assessing families' need for supports and services; (2) guiding organisational and service delivery system changes; and (3) evaluating quality family outcomes. The present study focused on exploring the perceptions of Chinese families who have a child with an ID regarding FQOL as well as examining the factor structure of FQOL concept from Chinese families. Methods: The Chinese version of the "Family Quality of Life Scale" was used to survey Chinese families living in the urban and suburban areas of Beijing who have a child with ID. A total of 442 families participated in this study. Confirmatory factor analysis was used to test the factor structure of FQOL. Multivariate analysis was also used to examine group differences among families in terms of family demographic variables. Results: A five-factor structure of the FQOL construct was found in the Chinese sample, suggesting a similar factor structure found from US families in the literature. Different living conditions (e.g. housing and transportation) tended to affect significantly families' satisfaction ratings of their FQOL. It is also found that family income and severity of disability of the child are predictors of families' satisfaction ratings of FQOL. Conclusion: The preliminary findings of this study suggest a cross-cultural factor structure comparability of FQOL between samples in the USA and China. Results call for further examination of the family-centred service and support as a mediator on the interactive relationship between family characteristics, family needs and FQOL outcomes.

China faces a rapidly emerging HIV epidemic and nationwide resurgence of sexually transmitted infections associated with a growing sex industry. Community empowerment and capacity building through community-based participatory research partnerships show promise for developing, testing, and refining multilevel interventions suited to the local context that are effective and appropriate to address these concerns. However, such efforts are fraught with challenges, both for community collaborators and for researchers. We have built an international team of scientists from Beijing and the United States and collaborating health policy makers, health educators, and care providers from Hainan and Guangxi Province Centers for Disease Prevention and Control and the local counties and towns where we are conducting our study. This team is in the process of testing a community-wide, multilevel intervention to promote female condoms and other HIV prevention within sex-work establishments. This article presents lessons learned from our experiences in the first two study sites of this intervention trial.

Objectives: Adolescents and young adults represent the largest group of new human immunodeficiency virus (HIV) infections in the United States, especially in the South. We wanted to determine whether abstinence only until marriage (AOUM) sex education programs were effective in reducing HIV vulnerability among youth in Mississippi.Methods: Using the 2015 Mississippi Youth Risk Behavior Surveillance System, we examined the effect of AOUM sex education among a sample of youth ages 12 to 18 years on 4 HIV-related sexual risk behaviors.Results: Compared with youth not enrolled in AOUM sex education, we found no statistically significant differences on sexual risk behaviors. Race, age, and gender were significant risk factors in predicting sexual risk behavior.Conclusions: AOUM sex education programs are ineffective in reducing HIV vulnerability among youth in Mississippi. There is an urgent need to implement comprehensive sex education if we are to reduce the numbers of new HIV infections among youth and achieve our goals of ending the HIV epidemic by 2030. [ABSTRACT FROM AUTHOR]

The authors examined cultural differences in parents' responses to their children's performance. In Study 1 (N=421), Chinese 5th graders reported that their parents de-emphasized their academic success and emphasized their academic failure, whereas their American counterparts reported that their parents did the opposite. This partially accounted for Chinese (vs. American) children responding less positively to success and more negatively to failure. In Study 2 (N=128), Chinese and American mothers' responses to their 4th and 5th graders' performance were observed in the laboratory. The cultural differences in children's reports of parents' responses documented in Study 1 were replicated; mothers' responses were also associated with children's subsequent performance. In addition, Chinese mothers were more involved than were American mothers, but their affect was similar. Taken together, the results suggest that parents' responses to children's performance may be a channel for cultural transmission and perpetuation of responses to performance.

Drought monitoring and forecasting systems are used in the United States (U.S.) to inform drought management decisions. Drought forecasting efforts have often been conducted and evaluated at coarse spatial resolutions (i.e., >10‐km), which miss key local drought information at higher resolutions. Addressing the importance of forecasting drought at high resolutions, this study develops statistical models to evaluate 1‐ to 3‐month lead time predictability of meteorological and agricultural summer drought across the western U.S. at a 4‐km resolution. Our high‐resolution drought predictions have statistically significant skill (p ≤ 0.05) across 70%–100% of the western U.S., varying by evaluation metric and lead time. 1‐ to 3‐month lead time drought forecasts accurately represent monitored summer drought spatial patterns during major drought events, the interannual variability of drought area from 1982 to 2020 (r = 0.84–0.93), and drought trends (r = 0.94–0.97). 71% of western U.S summer drought area interannual variability can be explained by cold‐season (November–February) climate conditions alone allowing skillful 3‐month lead time predictions. Pre‐summer drought conditions (represented by drought indices) are the most important predictors for summer drought. Thus, the statistical models developed in this study heavily rely on the autocorrelation of chosen agricultural and meteorological drought indices which estimate land surface moisture memory. Indeed, prediction skill strongly correlates with persistence of drought conditions (r ≥ 0.73). This study is intended to support future development of operational drought early warning systems that inform drought management. Plain Language Summary: Droughts are complex and devastating natural disasters with severe implications in the western U.S. for energy production, agricultural yields, and wildfires, particularly during summer months. Drought monitoring and forecasting systems are used in the U.S. to inform drought management decisions. However, existing products and analyses are typically performed at coarse spatial resolutions (>10‐km). Because summer drought is spatially variable at finer resolutions than current drought monitoring and forecasting systems, it is valuable to develop seasonal drought forecasting systems at higher spatial resolutions. In this study we present a novel statistical modeling framework to forecast summer drought conditions at a high resolution (4‐km) at 1‐ to 3‐month lead times across the western U.S. Our models provide skillful predictions of drought across most of the western U.S., but there is degraded skill in areas where drought tends to be less persistent. Future research can expand on our work by predicting drought at finer temporal resolutions while maintaining the high spatial resolution used in this study's methodology. This research is intended to support development of future operational drought early warning systems that provide high spatial resolution forecasts. Key Points: Statistical models accurately predict summer meteorological and agricultural drought at 1‐, 2‐, and 3‐month lead times at a 4‐km resolutionMost of the interannual variability in summer drought area can be explained by preceding cold‐season climate conditionsStatistical models rely heavily on the autocorrelation of drought indices in drought forecasts [ABSTRACT FROM AUTHOR]

Objectives: To assess the variation of vaccine effectiveness against SARS-CoV-2 infection during the Delta wave according to frailty status among U.S. veterans. Design: Test-negative case-control study of SARS-CoV-2 mRNA vaccine effectiveness. Setting: Veterans Health Administration (VHA) medical centers. Participants: Veterans 19 years and older who had at least one COVID-19/Flu like symptoms and received a SARS-CoV-2 PCR or antigen test at VHA medical centers between July 25 to September 30, 2021. Intervention: mRNA vaccination. Measurements: New SARS-CoV-2 infection. Vaccine effectiveness was defined as 1-odds of vaccination in cases/odds of vaccination in controls, where cases were patients who had a COVID-19 test and tested positive for SARS-CoV-2, and controls were those who tested negative. Frailty was measured using the VA frailty index, categorized as robust (0–<0.1), pre-frail (≥0.1–<0.21) and frail (≥0.21). Results: A total of 58,604 patients (age:58.9±17.0, median:61, IQR:45–72; 87.5%men; 68.1%white; 1.3%African American, 8.3%Hispanic) were included in the study. Of these, 27,733 (47.3%) were robust, 16,276 (27.8%) were prefrail, and 14,595 (24.9%) were frail. mRNA vaccine effectiveness against the Delta variant symptomatic infection was lower in patients with frailty, 62.8 %(95%CI:59.8–65.7), versus prefrail 73.9%(95%CI:72.0–75.7), and robust, 77.0 %(95%CI:75.7–78.3). Conclusions: This test-negative case control study showed that mRNA vaccine effectiveness against infection declined in veterans with frailty. Frailty status is a factor to consider when designing, developing, and evaluating COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Background Gestational exposure to fine particulate matter (PM2.5) has been reported to be associated with an increased risk of fetal death in recent studies, but earlier studies in the past century have usually reported a non-significant association. As such, it remains unknown whether this adverse effect of PM2.5 exposure varies with time. Methods Nearly 49.2 million eligible birth and fetal death records from 1989 to 2004 were selected from the United States (US) birth and fetal death certificate datasets. For each record, the level of prenatal exposure to PM2.5 was taken as the average concentration in the mother's residential county during the entire gestational period, according to well-established estimates of monthly levels across the contiguous US. We first stratified the dataset by the month of the last menstrual period (LMP) and then independently evaluated the nationwide association between PM2.5 exposure and fetal death within each stratum using five typical logit models: unadjusted, covariate-adjusted, propensity-score, double robust, and diagnostic-score models. Finally, we conducted a meta-analysis to pool estimated LMP-specific associations and explored how the overall association varied by LMP month. Results Different models showed temporal heterogeneity in the estimated association between PM2.5 exposure and fetal death. According to the meta-analysis, double robust model estimates were more homogeneous than the rest, and thus the model outcome was recognized as the main result. For each 1-µg/m3 increase in prenatal exposure to PM2.5, the pooled odds ratio (OR) of fetal death was estimated to be 1.08 [95% confidence interval (CI): 1.05, 1.10]. The LMP-specific ORs exhibited a slightly increasing trend and a significant seasonal pattern. Compared with the pooled OR among samples with the LMP in spring, the estimates for summer, fall and winter were higher by 11.1% (95% CI: 6.2%, 16.3%), 27.8% (95% CI: 22.1%, 33.8%) and 28.8% (95% CI: 23.7%, 34.1%), respectively. We also found that temporal patterns in the association between PM2.5 exposure and fetal death could be explained by several population-level indicators or modifiers (i.e. ethnicity, maternal age, gestational weight gain, previous pregnancy of abnormal termination and diabetes). Conclusions Prenatal exposure to PM2.5 can increase the risk of fetal death. The effects of PM2.5 exposure may be modified by complex factors, which leads to a time-varying association. [ABSTRACT FROM AUTHOR]

Background Circulating individual SFAs in pregnant females are critical for maternal and fetal health. However, research on identifying their modifiable factors is limited. Objectives We aimed to examine the associations of total physical activity (PA) and types of PA with circulating individual SFAs during pregnancy in a multiracial/multiethnic cohort of pregnant females in the United States. Methods The study included participants in a nested case–control study (n  = 321) from the Eunice Kennedy Shriver NICHD Fetal Growth Studies–Singleton Cohort. Sampling weights were applied, so the results represented the entire Fetal Growth Cohort. Plasma phospholipid SFAs were measured at 4 visits [10–14 (visit 1), 15–26 (visit 2), 23–31 (visit 3), and 33–39 (visit 4) weeks of gestation] throughout pregnancy. PA of the previous year at visit 1 and since the previous visit at the subsequent visits was assessed using the validated Pregnancy PA Questionnaire. Time-specific and longitudinal associations were examined using multivariable linear and generalized estimating equation models. Results Total PA (metabolic equivalent of task-h/wk) was positively associated with circulating heptadecanoic acid (17:0) at visit 1 (β × 103: 0.07; 95% CI: 0.02, 0.11) and pentadecanoic acid (15:0) at visit 3 (β × 103: 0.09; 95% CI: 0.03, 0.14) independent of sociodemographic, reproductive, pregnancy, and dietary factors. Across the 4 visits, the positive associations with total PA were consistent for pentadecanoic acid (β × 103: 0.06; 95% CI: 0.02, 0.10) and heptadecanoic acid (β × 103: 0.10; 95% CI: 0.06, 0.14). Out of the 4 PA types (i.e. sports/exercise, household/caregiving, transportation, and occupational PA) considered, the magnitude of positive associations was the largest for sports/exercise PA. Conclusions Our findings suggest that maternal PA is positively associated with circulating pentadecanoic and heptadecanoic acids. The findings warrant confirmation by future studies. This trial was registered at clinicaltrials.gov as NCT00912132. [ABSTRACT FROM AUTHOR]

Background: To estimate the incidence, risk factors, and impact on mortality and functional outcomes for early coagulopathy after the return of spontaneous circulation (ROSC) in pediatric out-of-hospital cardiac arrest (OHCA) patients. Methods: A post hoc analysis of the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial was conducted. Early coagulopathy was defined as presence of at least one of the following coagulation abnormalities upon admission: international standard ratio (INR), platelets, and age-adjusted activated partial thromboplastin time (APTT) within 6 h after OHCA and before therapeutic hypothermia initiation. The outcomes included 28-day mortality and functional prognosis. Multivariable logistic regression models were used to explore risk factors and association between early coagulopathy and outcomes. Results: Of the 227 patients included, 152 (67%) were male and the median age was 2.3 years [interquartile range (IQR), 0.7–8.6 years]. The overall 28-day mortality was 63%. The incidence of early coagulopathy was 46%. Lower age, longer duration of chest compression, lower temperature, and higher white blood cell (WBC) upon admission increased the risk of early coagulopathy. Early coagulopathy [OR, 2.20 (95% CI, 1.12–4.39), P = 0.023] was independently associated with 28-day mortality after adjusting for confounders. Conclusions: Early coagulopathy occurred in almost half of pediatric patients with OHCA. Lower age, longer duration of chest compression, lower temperature, and higher WBC increased the risk. The development of early coagulopathy was independently associated with increased mortality. [ABSTRACT FROM AUTHOR]