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Over the past decade, the percentage of adults in the United States who use some form of social media has roughly doubled, increasing from 36 percent in early 2009 to 72 percent in 2019. There has been a corresponding increase in research aimed at understanding opinions and beliefs that are expressed online. However, the generalizability of findings from social media research is a subject of ongoing debate. Social media platforms are conduits of both information and misinformation about vaccines and vaccine hesitancy. Our research objective was to examine whether we can draw similar conclusions from Twitter and national survey data about the relationship between vaccine hesitancy and a broader set of beliefs. In 2018 we conducted a nationally representative survey of parents in the United States informed by a literature review to ask their views on a range of topics, including vaccine side effects, conspiracy theories, and understanding of science. We developed a set of keyword-based queries corresponding to each of the belief items from the survey and pulled matching tweets from 2017. We performed the data pull of the most recent full year of data in 2018. Our primary measures of belief covariation were the loadings and scores of the first principal components obtained using principal component analysis (PCA) from the two sources. We found that, after using manually coded weblinks in tweets to infer stance, there was good qualitative agreement between the first principal component loadings and scores using survey and Twitter data. This held true after we took the additional processing step of resampling the Twitter data based on the number of topics that an individual tweeted about, as a means of correcting for differential representation for elicited (survey) vs. volunteered (Twitter) beliefs. Overall, the results show that analyses using Twitter data may be generalizable in certain contexts, such as assessing belief covariation. [ABSTRACT FROM AUTHOR]

• Few studies elicited the public's vaccine beliefs using open-ended questions. • Concerns about vaccine safety are the most commonly stated beliefs. • Mistrust in physicians, pharma, and the government may exacerbate hesitancy. • The majority of studies (57%) focused on HPV vaccines. • Nearly a third of the studies exclusively examined Latinos and African Americans. While childhood vaccines are safe and effective, some parents remain hesitant to vaccinate their children, which has led to outbreaks of vaccine preventable diseases. The goal of this systematic review was to identify and summarize the range of beliefs around childhood vaccines elicited using open-ended questions, which are better suited for discovering beliefs compared to closed-ended questions. PubMed, Embase, and PsycINFO were searched using keywords for childhood vaccines, decision makers, beliefs, and attitudes to identify studies that collected primary data using a variety of open-ended questions regarding routine childhood vaccine beliefs in the United States. Study designs, population characteristics, vaccine types, and vaccine beliefs were abstracted. We conducted a qualitative analysis to conceptualize beliefs into themes and generated descriptive statistics. Of 1727 studies identified, 71 were included, focusing largely on parents (including in general, and those who were vaccine hesitant or at risk of hesitancy). Seven themes emerged: Adverse effects was most prominent, followed by mistrust , perceived lack of necessity , pro-vaccine opinions , skepticism about effectiveness , desire for autonomy , and morality concerns. The most commonly described beliefs included that vaccines can cause illnesses; a child's immune system can be overwhelmed if receiving too many vaccines at once; vaccines contain harmful ingredients; younger children are more susceptible to vaccine adverse events; the purpose of vaccines is profit-making; and naturally developed immunity is better than that acquired from vaccines. Nearly a third of the studies exclusively assessed minority populations, and more than half of the studies examined beliefs only regarding HPV vaccine. Few studies used open-ended questions to elicit beliefs about vaccines. Many of the studies that did so, focused on HPV vaccine. Concerns about vaccine safety were the most commonly stated beliefs about childhood vaccines, likely because studies were designed to capture barriers and challenges to vaccination. [ABSTRACT FROM AUTHOR]

Objective: Obesity is preventable and yet continues to be a major risk factor for chronic disease. Multiple prevention approaches have been proposed across multiple settings where people live, work, learn, worship, and play. This review searched the vast literature on obesity prevention interventions to assess their effects on daily energy consumed and energy expended.Methods: This systematic review (PROSPERO registration CRD42017077083) searched seven databases for systematic reviews and studies reporting energy intake and expenditure. Two independent reviewers screened 5,977 citations; data abstraction supported an evidence map, comprehensive evidence tables, and meta-analysis; critical appraisal assessed risk of bias; and the quality of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results: Hundreds of published reviews were identified. However, few studies reported on energy intake and expenditure to determine intervention success. Ninety-nine studies across all intervention domains were identified. Few areas demonstrated statistically significant effects across studies; school-based approaches and health care initiatives reduced energy consumed, education reduced energy consumed and increased energy expended, and social-group approaches increased energy expenditure.Conclusions: Despite the amount of research on obesity prevention interventions, very few studies have provided relevant information on energy intake and expenditure, two factors determining weight gain. Future research needs to fill this gap to identify successful public health policies. [ABSTRACT FROM AUTHOR]

In this study, daily maps of snow cover distribution and sea ice extent produced by NOAA's interactive multisensor snow and ice mapping system (IMS) were validated using in situ snow depth data from observing stations obtained from NOAA's National Climatic Data Center (NCDC) for calendar years 2006 to 2010. IMS provides daily maps of snow and sea ice extent within the Northern Hemisphere using data from combination of geostationary and polar orbiting satellites in visible, infrared and microwave spectrums. Statistical correspondence between the IMS and in situ point measurements has been evaluated assuming that ground measurements are discrete and continuously distributed over a 4 km IMS snow cover maps. Advanced Very High Resolution Radiometer (AVHRR) land and snow classification data are supplemental datasets used in the further analysis of correspondence between the IMS product and in situ measurements. The comparison of IMS maps with in situ snow observations conducted over a period of four years has demonstrated a good correspondence of the data sets. The daily rate of agreement between the products mostly ranges between 80% and 90% during the Northern Hemisphere through the winter seasons when about a quarter to one third of the territory of continental US is covered with snow. Further, better agreement was observed for stations recording higher snow depth. The uncertainties in validation of IMS snow product with stationed NCDC data were discussed. [ABSTRACT FROM AUTHOR]

The article discusses the International/Intercultural committee's projects, which includes the 2008 World Conference in Russia and its plans to increase the number of international members. Gratitude is paid to the 2008 World Conference Committee Co-chairs, Tunde Szecsi and Manana Salakaja. Also, organizer of the "Spouses' Committee" Gillian Potter is recognized. Attention is paid to strategies for increasing membership outside of the U.S.

Purpose: To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system. Design: Retrospective cohort study. Participants: Forty-five thousand eighty-two veterans who underwent cataract surgery in the VHA. Methods: The National Patient Care Database was used to identify all VHA patients who underwent outpatient extracapsular cataract surgery and who underwent only 1 cataract surgery within 90 days of the index surgery between October 1, 2005, and September 30, 2007. Data collected include demographics, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications. Adjusted odds ratios (ORs) of factors predictive of complications were calculated using logistic regression modeling. Main Outcome Measures: Intraoperative and postoperative ocular complications within 90 days of cataract surgery. Results: During the study period, 53786 veterans underwent cataract surgery; 45082 met inclusion criteria. Common preoperative systemic and ocular comorbidities included diabetes mellitus (40.6%), chronic pulmonary disease (21.2%), age-related macular degeneration (14.4%), and diabetes with ophthalmic manifestations (14.0%). The most common ocular complications were posterior capsular tear, anterior vitrectomy, or both during surgery (3.5%) and posterior capsular opacification after surgery (4.2%). Predictors of complications included: black race (OR, 1.38; 95% confidence interval [CI], 1.28–1.50), divorced status (OR, 1.10; 95% CI, 1.03–1.18), never married (OR, 1.26; 95% CI, 1.14–1.38), diabetes with ophthalmic manifestations (OR, 1.33; 95% CI, 1.23–1.43), traumatic cataract (OR, 1.80; 95% CI, 1.40–2.31), previous ocular surgery (OR, 1.29; 95% CI, 1.02–1.63), and older age. Conclusions: In a cohort of United States veterans with a high preoperative disease burden, selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications. Further large-scale studies are warranted to investigate cataract surgery outcomes for non-VHA United States patient populations. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

The phase 3 FIRST trial demonstrated significant improvement in progression-free survival (PFS) and overall survival (OS) with an immune-stimulatory agent, lenalidomide, in combination with low-dose dexamethasone until disease progression (Rd continuous) vs melphalan +prednisone + thalidomide (MPT) in transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM). Rd continuous similarly extended PFS vs fixed-duration Rd for 18 cycles (Rd18). Outcomes in the Canadian/US subgroup (104 patients per arm) are reported in this analysis. Rd continuous demonstrated a significant improvement in PFS vs MPT (median, 29.3 vs 20.2 months; HR, 0.69 [95% CI, 0.49-0.97]; p = 0.03326) and an improvement vs Rd18 (median, 21.9 months). Median OS was 56.9 vs 46.8 months with Rd continuous vs MPT (p = 0.15346) and 59.5 months with Rd18. The overall response rate was higher with Rd continuous and Rd18 (78.8% and 79.8%) vs MPT (65.4%). In the 49.0%, 52.9%, and 29.8% of patients with at least very good partial response in the Rd continuous, Rd18, and MPT arms, respectively, the median PFS was 56.0, 30.9, and 40.2 months, respectively. The most common grade 3/4 treatment-emergent adverse events were neutropenia (28.4%, 30.1%, and 52.0%), anemia (23.5%, 21.4%, and 23.5%), and infections (37.3%, 30.1%, and 24.5%) with Rd continuous, Rd18, and MPT, respectively. These results were consistent with those in the intent-to-treat population, confirming the benefit of Rd continuous vs MPT in the Canadian/US subgroup and supporting the role of Rd continuous as a standard of care for transplant-ineligible patients with NDMM., (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background: Advanced prosthetic knees allow for more dynamic movements and improved quality of life, but payers have recently started questioning their value. To answer this question, the differential clinical outcomes and cost of microprocessor-controlled knees (MPK) compared to non-microprocessor controlled knees (NMPK) were assessed., Methods: We conducted a literature review of the clinical and economic impacts of prosthetic knees, convened technical expert panel meetings, and implemented a simulation model over a 10-year time period for unilateral transfemoral Medicare amputees with a Medicare Functional Classification Level of 3 and 4 using estimates from the published literature and expert input. The results are summarized as an incremental cost effectiveness ratio (ICER) from a societal perspective, i.e., the incremental cost of MPK compared to NMPK for each quality-adjusted life-year gained. All costs were adjusted to 2016 U.S. dollars and discounted using a 3% rate to the present time., Results: The results demonstrated that compared to NMPK over a 10-year time period: for every 100 persons, MPK results in 82 fewer major injurious falls, 62 fewer minor injurious falls, 16 fewer incidences of osteoarthritis, and 11 lives saved; on a per person per year basis, MPK reduces direct healthcare cost by $3676 and indirect cost by $909, but increases device acquisition and repair cost by $6287 and total cost by $1702; on a per person basis, MPK is associated with an incremental total cost of $10,604 and increases the number of life years by 0.11 and quality adjusted life years by 0.91. MPK has an ICER ratio of $11,606 per quality adjusted life year, and the economic benefits of MPK are robust in various sensitivity analyses., Conclusions: Advanced prosthetics for transfemoral amputees, specifically MPKs, are associated with improved clinical benefits compared to non-MPKs. The economic benefits of MPKs are similar to or even greater than those of other medical technologies currently reimbursed by U.S. payers.

Chinese American pregnant women and women of childbearing age face economic, cultural and linguistic barriers in accessing mainstream health care services. The Charles B. Wang Community Health Center developed a culturally and linguistically competent genetic education workshop for high-risk Chinese American prenatal patients. Patients referred for genetic counseling for thalassemia, abnormal triple screen results, and/or advanced maternal age were recruited to participate in the workshop. The workshop provided basic "genetic 101" education, focusing on topics that were directly relevant to the patients' reasons for referral. The effectiveness of the workshop was measured using a quasi-experimental design with pre-post surveys administered to intervention and control group participants. The evaluation also included a genetic counselor assessment and a pilot study of genetic counseling appointment length. Overall, workshop participants showed significant increases in knowledge, positive attitude and self-efficacy regarding genetic services as compared to their control group counterparts. The pilot appointment length study data revealed that the workshop reduced the length of the genetic counseling appointment time by 40%. These positive findings suggest that it would be worthwhile to replicate the genetic education workshop at other health agencies serving Chinese-speaking populations and that further evaluation research should be conducted.