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Objective: Research has just begun to identify American college students who study abroad as a group at-risk for sexual violence victimization. The purpose of the current study was to examine the context of these incidents. Participants: We utilized a large longitudinal sample of 2,428 United States college students studying abroad for between 4 and 21 weeks in 12 different foreign countries. Methods: We estimated descriptive statistics and logistic regression models to assess prevalence and correlates of sexual victimization abroad, as well as effect size comparisons to quantify changes in drinking abroad. Results: Over one-fifth of students experienced sexual violence while abroad, including sexual assault and verbal coercion. Women, younger students, those who experienced sexual violence prior, and heavier drinkers had the greatest odds of sexual violence victimization abroad. Conclusions: Findings point to the need for evidence-based programming to reduce sexual violence risk among American college students studying in foreign countries.

Academic staff owe a duty of fidelity to uphold institutional standards of integrity. They also have their own values and conceptions of integrity as well as personal responsibilities and commitments. The question of how academic practitioners address or reconcile conflicting values and responsibilities has been underexplored in the literature. Before we can examine effectiveness of academic integrity strategies and develop best practices, we need to examine the breadth of integrity decisions. To this end we posited the academic integrity problem as a set of seven dilemmas and presented them to post-secondary education staff (N = 80) located in Europe, North America, Oceania, and Asia. We asked the participants to recommend a solution to each dilemma. This yielded a modest sample of 498 themes across 30 categories. We expected the responses to fall on a binary scale where decisions either support the integrity or ignore it. However, the data suggests that academic integrity decisions are better suited to continuum where participants aim to reconcile personal and institutional obligations. We further argue that academic integrity decisions are predicated on personal experience and therefore pose a challenge for policy standardization and enforcement. We conclude with a discussion of the implications of the findings for practice.

This qualitative study explored the influence of student affairs on academic adjustment and adaptation for 10 Indonesian graduate students at a single campus. Semi-structured interviews explored student affairs' role in adaptation and transition to collegiate life in the United States. Analyses illuminated ways in which participants experienced disequilibrium attending U.S. institutions arising from pre-arrival constructed images of college life in the United States. Student affairs functional areas disrupted these stereotypes for students and devised strategies for Indonesian students to feel more welcomed and included. Study participants described the importance of culturally-relevant student organizations, inclusive environments, and religiously affiliated centers in their adjustment. The article concludes with practical implications for student affairs professionals and higher education institutions.

Purpose: To retrospectively analyze clinical outcomes of patients with "treatment‐resistant" neovascular age‐related macular degeneration or diabetic macular edema who were switched to intravitreal faricimab injections (IFIs) using a "real‐world" treat‐and‐extend (TAE) protocol. Methods: Seventy‐one eyes from 62 patients receiving antivascular endothelial growth factor injections were evaluated before and after switching to IFI. Demographic and clinical data were collected. Primary endpoints were treatment interval extension and presence of intraretinal or subretinal fluid on spectral‐domain optical coherence tomography (OCT) after switching to IFI. Secondary endpoints included best‐corrected visual acuity, average OCT central subfield thickness, and presence of a pigment epithelium detachment and pigment epithelium detachment height. Results: The average treatment interval after switching to IFI significantly increased from 37.6 ± 10.8 days to 45.2 ± 16.6 days (p = 0.0016). At the last follow‐up, 35% of eyes were able to achieve a fluid‐free status post‐IFI. A chi‐square test of independence validated this finding by showing a significant difference in the OCT findings trending towards less or no fluid on follow‐up (X2 [3, N = 71] = 13.0705; p = 0.0003). The average central subfield thickness decreased from 327.2 ± 89.1 μm to 294.8 ± 86.5 μm (p = 0.0294). Best‐corrected visual acuity, intraocular pressure, pigment epithelium detachment presence, and height had no significant difference after switching to IFI. Conclusions: In "treatment‐resistant" patients receiving anti‐VEGF therapy for neovascular age‐related macular degeneration or diabetic macular edema, switching to IFI in a "real‐world" TAE protocol led to statistically significant improvements in treatment interval and retinal fluid on spectral domain OCT. [ABSTRACT FROM AUTHOR]

Objectives. To characterize cannabis-related disorder medical encounter trends in the US Medicare population during 2017 to 2022. Methods. We conducted a descriptive study, which included 56 624 432 beneficiaries aged 65 years or older and 10 247 953 aged 18 to 64 years with disability. All were continuously enrolled in Medicare (Fee-for-Service or Advantage) for 183 or more days before the first day of the calendar year. We identified cannabis-related disorder encounters using International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes and computed annual encounter rates per 10 000 beneficiaries. We used the Mann–Kendall test to analyze trends over time. Results. Annual cannabis-related disorder encounter trends among beneficiaries aged 65 years or older ranged from 15.9 (95% confidence interval [CI] = 15.8, 16.0) to 39.3 (95% CI = 39.1, 39.5) per 10 000. Rates among beneficiaries aged 18 to 64 years with disability ranged from 274.8 (95% CI = 273.6, 276.0) to 373.7 (95% CI = 372.3, 375.2) per 10 000. Rates increased over time across both groups, with average annual increases of 4.3 (95% CI = 3.3, 5.3; P =.01) and 17.1 (95% CI = 11.0, 23.2; P =.02) per 10 000, respectively. Conclusions. Further work is needed to explore the impact of coexisting medical conditions on outcomes that result from cannabis-related disorders. (Am J Public Health. 2024;114(S8):S694–S697. https://doi.org/10.2105/AJPH.2024.307729) [ABSTRACT FROM AUTHOR]

Objective: To describe the work experience and respiratory health of women coal miners in the United States using Coal Workers' Health Surveillance Program (CWHSP) data. Methods: Analysis included CWHSP participants with self-reported sex of female between January 1, 1970, and December 31, 2022, and examined radiographic surveillance, demographics, and job history. National Institute for Occupational Safety and Health-certified physicians classified chest radiographs. Results: Among 8,182 women participants, most worked <10 years and a majority reported working in non-dusty jobs. Among 3,392 with ≥1 year of coal mining tenure, 18 (0.5%) had evidence of pneumoconiosis, with no cases of progressive massive fibrosis. Conclusion: Women coal miners participating in the CWSHP had short mining careers and low pneumoconiosis prevalence. Few worked in the most dusty jobs, indicating limited exposure to coal mine dust. This underscores the need to explore women's roles in mining, and for improved gender-specific employment reporting. Such changes can enhance health and work conditions for women in male-dominated industries. [ABSTRACT FROM AUTHOR]

This study investigated cross-cultural variation in the development of executive functioning (EF) across the preschool period for United States and Chinese children from low and high socioeconomic families using a longitudinal design. Participants included 216 preschool children (n = 125 from the US; n = 91 from Shanghai and Jiangxi, China). On average, children were approximately 4 years old. In the US sample, 56% were female, and in the Chinese sample, 54% were female. Results from multi-level models varied slightly with regard to specific EF domains, but generally indicated that Chinese children experienced greater gains in EF during the preschool period compared to US children. Cross-cultural differences in EF growth did not vary by socioeconomic status. These findings highlight cultural variability in the development of EF and provide a foundation for additional research exploring factors that may help explain differential growth in EF for Chinese children compared to US children during the preschool period.

Background: There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training. Objective: The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education. Methods: A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies. Results: Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration. Conclusion: We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment. [ABSTRACT FROM AUTHOR]

With considerable debate concerning the impact of culture on the expression of callous–unemotional (CU) traits, it is unclear whether the core features of CU traits generalize to youth across cultures. This study aimed to examine whether cultural differences are reflected in the core features of CU traits and the associations among these features. Network analysis was employed to identify the core features and to examine the network structure of CU traits operationalized by the Inventory of Callous Unemotional traits (ICU) in four community youth samples from different nations (Australia, N = 190; the UK, N = 437; the USA, N = 330; China, N = 503). The item "Apologizes to people" was identified as a cross-cultural core feature in the ICU network with a greater centrality of this item compared to others in all four samples. In addition, some items were identified as culture-specific core features in the network, differing in their centrality across samples. The network structures of the youth self-report ICU items were moderately similar across samples, while the structures of parent-report items showed substantial differences. These findings have important implications for cross-cultural research on CU traits as well as practical implications for screening and treatment. The core features of ICU appear to be generalizable in youth across cultures, although cultural-specific manifestations should be noted. [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]

The home numeracy environment is an essential construct that helps explain children's numeracy skills. However, this field has been developed mostly focusing on monolingual English‐speaking families, and cultural differences that contextualize the home environment have not been considered. This study describes the home numeracy environment of Latine families by (1) identifying the more and less common numeracy activities in the home of Latine families; (2) exploring differences, such as family members involved in the activities and generation in the United States; and (3) examining the association between activities and math anxiety and beliefs. Participants were 341 caregiver‐child dyads (M age = 2.9 years, SD = 0.7 months). We found that the less common numeracy activities in the home of Latine families are items commonly used in the literature to measure numeracy home environment. In addition, the role of family members varies across generations. This study provides a foundation for understanding the home numeracy environment of Latine families. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the extent to which personal well-being may be associated with empathy, while controlling for potential confounders. Settings/Location: Residency programs throughout the United States. Subjects: A total of 407 medical residents from residencies including general medicine, surgery, specialized and diagnostic medicine participated in this study. Outcome Measures: Well-being was measured using the modified existential well-being subscale of the spiritual well-being scale. Empathy was measured using the Jefferson Scale of Empathy. Results: Well-being was found to be positively correlated with empathy when adjusted for possible confounders (p < 0.001). In addition to well-being, other factors noted to be statistically significant contributors to higher empathy scores while controlling for the others included age, gender, year in residency, specialty, and work-hours (p < 0.05 for each). After controlling for these factors, a resident's year in residency was not found to be a statistically significant contributor to empathy score. Conclusions: In this study, well-being was associated with empathy in medical and surgical residents. Empathy is a fundamental component of physician competency, and its development is an essential aspect of medical training. These findings suggest that efforts to increase well-being may promote empathy among medical residents. [ABSTRACT FROM AUTHOR]

Objective: The Delta Select line of Channel Catfish Ictalurus punctatus was established in 2006 and has undergone five generations of genetic selection, specifically targeting increased growth rate and carcass yield, and was released to U.S. catfish farmers in 2020. While improvements in growth rate and carcass yield have been confirmed, performance for other important production traits has yet to be evaluated. Infectious disease, particularly bacterial infections caused by Edwardsiella spp., cause significant economic losses to catfish producers in the southeastern United States. Given the economic consequences of these bacterial pathogens, experimental infectivity trials were conducted comparing susceptibility to Edwardsiella spp. between the Delta Select line and a randomly bred line of Channel Catfish originating from the same base population (Delta Control line). Methods: Twenty‐six full‐sib families from each line were used in infectivity trials consisting of a high and a low dose of E. ictaluri (immersion challenge: high dose = 1.6 × 107 CFU/mL, low dose = 8.0 × 106 CFU/mL) and E. piscicida (intracoelomic challenge: high dose = 6.3 × 105 CFU/fish, low dose = 1.9 × 105 CFU/fish). Result: The high challenge dose resulted in the highest mortality for both pathogens (p < 0.001), regardless of selection line. There was no significant difference in cumulative percent mortality between the Delta Select and Delta Control lines following the E. ictaluri challenge at either dose (p = 0.55). Delta Selects had reduced mortality (p < 0.001) in response to E. piscicida challenge compared with the Delta Controls, regardless of dose. Conclusion: These results indicate that selection for increased growth rate and carcass yield in the Delta Select Channel Catfish line did not negatively impact resistance to E. ictaluri while potentially improving resistance to E. piscicida. Impact statementSelection for increased growth and carcass yield in the Delta Select line of Channel Catfish has not impacted susceptibility to Edwardsiella ictaluri and appears to have reduced susceptibility to Edwardsiella piscicida. [ABSTRACT FROM AUTHOR]

Background: In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise in early feasibility studies. The current study describes the BCI-FES clinical trial, which examines the safety and efficacy of this system, compared to conventional physical therapy (PT), to improve gait velocity for those with chronic gait impairment post-stroke. The trial also aims to find other secondary factors that may impact or accompany these improvements and establish the potential of Hebbian-based rehabilitation therapies. Methods: This Phase II clinical trial is a two-arm, randomized, controlled, longitudinal study with 66 stroke participants in the chronic (> 6 months) stage of gait impairment. The participants undergo either BCI-FES paired with PT or dose-matched PT sessions (three times weekly for four weeks). The primary outcome is gait velocity (10-meter walk test), and secondary outcomes include gait endurance, range of motion, strength, sensation, quality of life, and neurophysiological biomarkers. These measures are acquired longitudinally. Discussion: BCI-FES holds promise for gait velocity improvements in stroke patients. This clinical trial will evaluate the safety and efficacy of BCI-FES therapy when compared to dose-matched conventional therapy. The success of this trial will inform the potential utility of a Phase III efficacy trial. Trial registration: The trial was registered as "BCI-FES Therapy for Stroke Rehabilitation" on February 19, 2020, at clinicaltrials.gov with the identifier NCT04279067. [ABSTRACT FROM AUTHOR]

Higher education policies regarding COVID-19 had sweeping implications for campuses and their surrounding communities. This study explored the role of relevant health and health policy expertise in shaping campus responses to COVID-19 using data from 1,983 4-year colleges and universities in the United States. The primary outcomes of interest were the various COVID-19 policies that postsecondary institutions adopted during the 2020-2021 academic year, including instructional modality and testing and vaccine requirements. Overall, after controlling for state-level politics and other factors, the presence of faculty expertise in health administration, public health, or medicine had a statistically significant influence on the COVID policies adopted by colleges and universities. Public health faculty in conjunction with health administration faculty influenced changes in instruction modality between semesters. Public health faculty in conjunction with medical faculty influenced changes in testing policies between semesters. Going forward, health faculty should explore ways to collaborate across disciplines to better leverage their collective expertise. [ABSTRACT FROM AUTHOR]

Lower extremity injuries are prevalent in military trainees, especially in female and older trainees. Modifiable factors that lead to higher injury risk in these subgroups are not clear. The purpose of this study was to identify whether external loading variables during military‐relevant tasks differ by age and sex in U.S. Army trainees. Data was collected on 915 trainees in the first week of Basic Combat Training. Participants performed running and ruck marching (walking with 18.1 kg pack) on a treadmill, as well as double‐/single‐leg drop landings. Variables included: vertical force loading rates, vertical stiffness, first peak vertical forces, peak vertical and resultant tibial accelerations. Comparisons were made between sexes and age groups (young, ≤19 years; middle, 20–24 years; older, ≥25 years). Significant main effects of sex were found, with females showing higher vertical loading rates during ruck marching, and peak tibial accelerations during running and ruck marching (p ≤ 0.03). Males showed higher vertical stiffness during running and peak vertical tibial accelerations during drop landings (p < 0.01). A main effect of age was found for vertical loading rates during running (p = 0.03), however no significant pairwise differences were found between age groups. These findings suggest that higher external loading may contribute to higher overall injury rates in female trainees. Further, higher stiffness during running may contribute to specific injuries, such as Achilles Tendinopathy, that are more prevalent in males. The lack of differences between age groups suggests that other factors contribute more to higher injury rates in older trainees. Highlights: Female trainees showed higher lower extremity loading during running and ruck marching that may predispose them to higher rates of musculoskeletal injury during initial‐entry training.Male trainees showed higher stiffness during running, which may relate to an increased risk of specific musculoskeletal injuries that are more prevalent in males, such as Achilles tendinopathy.Overall, older trainees did not show different lower extremity loading patterns compared to younger, suggesting that these factors are not related to the increased risk for musculoskeletal injury in older trainees. [ABSTRACT FROM AUTHOR]

Research indicates that sleep problems are fairly common in childhood. However, the relationship between child sexual abuse (CSA) and sleep problems and how sleep issues influence psychological symptoms in children presenting for treatment remain unclear. The purpose of this study was to examine the presence of sleep problems and the association between sleep problems and psychological symptoms in youth presenting to treatment following CSA. Participants included 276 non-offending caregiver-child dyads at pre-treatment and 106 dyads at post-treatment. Youth were 6 to 19 years old and predominately female (82.9%). Caregivers were 23 to 72 years old and predominately female (87.4%). Youth and caregivers identified as predominately European American (76.6% and 86.0%, respectively). Results indicated that caregiver endorsement of a particular youth sleep problem (as measured by the Child Behavior Checklist sleep items) at pre-treatment ranged between 17.9 and 51.4%. Sleep problems were positively associated with psychological symptoms per caregiver- and youth self-report. Interestingly, a substantial proportion of youth reported decreased sleep problems at the end of treatment even though the treatment did not target sleep issues. This study highlights the commonality of sleep problems in children who experienced sexual abuse. Findings suggest that CSA interventions that do not directly address sleep may be missing a component that can contribute to successful recovery. The results provide preliminary evidence that sleep problems and mental health concerns among youth who experienced CSA are associated, indicating a need for further investigation into the association and potential implications for treatment. Other implications for future research and treatment following CSA are discussed. [ABSTRACT FROM AUTHOR]

Many studies have examined behavioral and social drivers of COVID-19 vaccination initiation, but few have examined these drivers longitudinally. We sought to identify the drivers of COVID-19 vaccination initiation using the Behavioral and Social Drivers of Vaccination (BeSD) Framework. Participants were a nationally-representative sample of 1,563 US adults who had not received a COVID-19 vaccine by baseline. Participants took surveys online at baseline (spring 2021) and follow-up (fall 2021). The surveys assessed variables from BeSD Framework domains (i.e., thinking and feeling, social processes, and practical issues), COVID-19 vaccination initiation, and demographics at baseline and follow-up. Between baseline and follow-up, 65% of respondents reported initiating COVID-19 vaccination. Vaccination intent increased from baseline to follow-up (p <.01). Higher vaccine confidence, more positive social norms towards vaccination, and receiving vaccine recommendations at baseline predicted subsequent COVID-19 vaccine initiation (all p <.01). Among factors assessed at follow-up, social responsibility and vaccine requirements had the greatest associations with vaccine initiation (all p <.01). Baseline vaccine confidence, social norms, and vaccination recommendations were associated with subsequent vaccine initiation, all of which could be useful targets for behavioral interventions. Furthermore, interventions that highlight social responsibility to vaccinate or promote vaccination requirements could also be beneficial. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic strained the infrastructure of public health systems worldwide and unearthed the social and institutional challenges of operating in a global crisis. This was exacerbated in the United States (U.S.), as public risk communication messages from local, state and federal public officials were rife with conflicting information. In this article, we unpack the perils of flawed risk communication and how it puts people at greater risk for infection and other secondary risks stemming from the pandemic mitigation behaviors. The choice to engage in preventive behaviors, such as social distancing, wearing facemasks, and frequently washing hands, differed dramatically across populations. On one extreme, some individuals, which we call the under-cautious, were hesitant to follow public health guidance regarding preventive behaviors, putting them at risk for COVID-19-associated morbidity. On the other end of this spectrum is another group, the over-cautious, who chose to physically remove themselves from social interactions, going beyond appropriate recommendations from experts to mitigate risk. This group may experience greater secondary risks associated with the pandemic, such as mental health issues, obesity, and a sedentary lifestyle. The infrastructural and communication challenges encountered during the COVID-19 pandemic must be further explored and mitigated. In the future, these campaigns need to target both the under-cautious and the over-cautious, as both extreme groups can potentially suffer health consequences in a pandemic. [ABSTRACT FROM AUTHOR]

Soils contribute 15%–75% of total atmospheric nitrogen oxide (NOx) emissions in agricultural regions during the growing season. However, the impacts of cropland fertilizer management on spatially heterogeneous, temporally episodic NOx emission patterns are highly uncertain. We examine the effects of liquid slurry dairy manure application practices on soil NOx emissions in rainfed, corn‐soybean rotations during spring 2016 and 2017. Daily soil NOx emissions and weekly soil inorganic N measurements were performed in a randomized split–split plot design for 1–4 weeks following manure applications. NOx emissions and soil N with shallow‐disk injection and chisel‐disk manure incorporation methods were compared with unincorporated broadcast practices. Injected manure and chisel‐disk incorporation exhibited two–four times larger mean NOx emissions than those with unincorporated broadcast manure. Larger soil NOx emissions with manure incorporation practices were driven by the predominance of nitrification in these treatments with evidence of soil nitrate production. Soil NOx emission differences between treatments were detectable across order of magnitude changes in daily NOx emissions during two growing seasons. Larger soil NOx emissions associated with manure incorporation practices compared with unincorporated broadcast practices occur alongside larger N2O and smaller NH3 emissions, highlighting important air quality and climate impact tradeoffs for cropland manure fertilizer management choices. Core Ideas: Soil NOx emissions were characterized following rainfed liquid dairy manure applications in the northeastern United States.Soil NOx emissions with manure incorporation were two–four times larger than with unincorporated broadcast manure.Larger soil NOx emissions with manure incorporation were associated with the predominance of nitrification. [ABSTRACT FROM AUTHOR]

Introduction: In the 2023 National Resident Matching Program (NRMP) match, there were 554 unfilled emergency medicine (EM) positions before the Supplemental Offer and Acceptance Program (SOAP). We sought to describe features of EM programs that participated in the match and the association between select program characteristics and unfilled positions. Methods: The primary outcome measures included the proportion of positions filled in relation to state and population density, hospital ownership type, and physician employment model. Secondary outcome measures included comparing program-specific attributes between filled and unfilled programs, including original accreditation type, year of original accreditation, the total number of approved training positions, length of training, urban-rural designation, hospital size by number of beds, resident-to-bed ratio, and the percentage of disproportionate share patients seen. Results: The NRMP Match had 276 unique participating EM programs with 554 unfilled positions. Six states offered 52% of the total NRMP positions available. Five states were associated with two-thirds of the unfilled positions. Public hospitals had a statistically significant higher match rate (88%) when compared to non-profit and for-profit hospitals, which had match rates of 80% and 75%, respectively (P < 0.001). Programs with faculty employed by a health systemhad the highestmatch rate of 87%, followed by clinician partnerships at 79% and private equity groups at 68% (P < 0.001 overall and between all subgroups). Conclusion: The 2023 match in EM saw increased rates in the number of residency positions and programs that did not fill before the SOAP. Public hospitals had higher match rates than for-profit or nonprofit hospitals. Residency programs that employed academic faculty through the hospital or health system were associated with higher match rates. [ABSTRACT FROM AUTHOR]

Background: Nearly half of American adults have hypertension (HTN), and non-Hispanic Black patients are diagnosed at a higher rate than others. Local Problem: Our local clinic population reflected disproportionate rates of uncontrolled HTN among Black patients. Methods: A quality improvement pre-/postintervention design was used to evaluate an educational intervention to reduce blood pressure (BP) and improve self-monitoring of BP in Black patients using the Chronic Care Model. Interventions: A team-based approach was used to redesign clinic workflows and patient education, prescribe self-paced videos from an electronic health record (EHR) patient portal, and provide home BP cuffs. Results: Black participants (n = 79) improved viewing of prescribed videos (7.9% to 68.5%), knowledge scores (67.9 to 75.2), and mean systolic BP (−20.3 mm Hg; P >.001). Conclusions: This team-based approach enhanced patient engagement, self-monitoring skills, EHR-reported BP, and overall BP control for a cohort of Black patients with uncontrolled BP. [ABSTRACT FROM AUTHOR]

Enteric septicemia of catfish (ESC), caused by the gram‐negative enteric bacteria Edwardsiella ictaluri, is a significant threat to catfish aquaculture in the southeastern United States. Antibiotic intervention can reduce mortality; however, antibiotic use results in an imbalance, or dysbiosis, of the gut microbiota, which may increase susceptibility of otherwise healthy fish to enteric infections. Herein, recovery of the intestinal microbiota and survivability of channel catfish in response to ESC challenge was evaluated following a 10‐day course of florfenicol and subsequent probiotic or prebiotic supplementation. Following completion of florfenicol therapy, fish were transitioned to a basal diet or diets supplemented with a probiotic or prebiotic for the remainder of the study. Digesta was collected on Days 0, 4, 8 and 12, beginning on the first day after cessation of antibiotic treatment, and gut microbiota was characterized by Illumina sequencing of the 16S rRNA gene (V4 region). Remaining fish were challenged with E. ictaluri and monitored for 32 days post‐challenge. Florfenicol administration resulted in dysbiosis characterized by inflated microbial diversity, which began to recover in terms of diversity and composition 4 days after cessation of florfenicol administration. Fish fed the probiotic diet had higher survival in response to ESC challenge than the prebiotic (p =.019) and negative control (p =.029) groups. [ABSTRACT FROM AUTHOR]

Using a content analysis methodology, we examined 15 peer‐reviewed articles published between 2009 and 2019 that used qualitative and mixed methods approaches to explore how college and university students experience food insecurity. Concerningly, there was limited variety in the methods employed across these articles and more discussion of methodology was needed. Despite this, our analysis of student statements in these articles yielded three common themes: (1) co‐occurring basic needs; (2) academic, physical, psychological, and social effects of food insecurity; and (3) institutional satisfaction and/or critique. We include implications for research and practice.Context and implicationsRationale for the studyFew qualitative studies centre students' food insecurity experiences in the United States. We examined available research to unearth commonalities across student narratives while connecting food insecurity to broader social class inequality in higher education.Why the new findings matterOur findings underscore the urgent need for additional qualitative food insecurity scholarship that foregrounds student voices. Future researchers examining food insecurity should consider: (a) the nuances of on‐campus food insecurity, (b) the impact of food insecurity on student success, and (c) the linkages between food insecurity and social class in higher education.Implications for policy makersCampus leaders and policy makers can help address campus food insecurity by building holistic wraparound systems to support the multi‐faceted needs of students facing food insecurity. To do this, policy makers and leaders must begin to understand food insecurity as more than a statistic and acknowledge the human experiences of those it affects. [ABSTRACT FROM AUTHOR]

Transgender people, African Americans, and Hispanics face mental health disparities. While mental health care can help, minoritized groups could face discriminatory barriers in accessing it. Discrimination may be particularly pronounced in mental health care because providers have more discretion over accepting patients. Research documents discrimination broadly, including in access to health care, but there is limited empirical research on discrimination in access to mental health care. We provide the first experimental evidence, from a correspondence audit field experiment ("simulated patients" study), of the extent to which transgender and non-binary people, African Americans, and Hispanics face discrimination in access to mental health-care appointments. We find significant discrimination against transgender or non-binary African Americans and Hispanics. We do not find evidence of discrimination against White transgender and non-binary prospective patients. We are mostly inconclusive as to whether cisgender African Americans or Hispanics face discrimination, except we find evidence of discrimination against cisgender African American women. [ABSTRACT FROM AUTHOR]

In 2021, the Ontario government legislatively prohibited most non-competition clauses, the first Canadian government to take this step. The move was unexpected because the political party in power (the Progressive Conservative Party, or PCP) has not traditionally been a strong supporter of workers' rights. However, the PCP wanted to demonstrate a new commitment to the working class, and it knew that banning non-competition clauses would attract little backlash from its business constituency since the common law renders almost all noncompetes illegal in Canada anyway. The common law approach to the enforceability of non-competition clauses is similar in Canada and the United States. Courts in both countries are suspicious of these clauses because they restrict the right of workers to accept jobs within their field. However, Canadian courts are far less likely to enforce non-competition clauses than their American counterparts. This divergence can partly be explained by fundamental differences in employment law architecture, including the fact that a doctrine of inequality of bargaining power guides Canadian courts. This doctrine, developed primarily by the Supreme Court of Canada over the past hal fcentury, is comprised of both a descriptive and a normative element. Descriptively. the doctrine recognizes (1) that work has a psychological component and is integral to human dignity, personal identity, and selfworth in Canadian society; and (2) that the employment relationship is frequently characterized by inequality of bargaining power. Normatively, the doctrine of inequality of bargaining power posits that, due to the importance of work and the reality of inequality of bargaining power, the common law should develop in a manner that considers the vulnerability of employees. Relying on the doctrine of inequality of bargaining power, Canadian courts have refused to sever or rectify unreasonable and over-broad noncompetition clauses. This refusal marks a substantial divergence from courts in the United States. where courts routinely intervene on behalf of employers to read down unreasonable non-competition clauses to Inake them enforceable. This Article examines the treatment of noncompetition clauses in employment contracts through a comparative lens, explaining how Canadian courts (and now legislators) have demonstrated much less tolerance for contractual restrictions on the right to work. [ABSTRACT FROM AUTHOR]

The nephrology and critical care communities have seen an increase in studies exploring acute kidney injury (AKI) epidemiology in children. As a result, we now know that AKI is highly prevalent in critically ill neonates, children, and young adults. Furthermore, children who develop AKI experience greater morbidity and higher mortality. Yet knowledge gaps still exist that suggest a more comprehensive understanding of AKI will form the foundation for future efforts designed to improve outcomes. In particular, the areas of community acquired AKI, AKI in non-critically ill children, and cohorts from low-middle income countries have not been well studied. Longer-term functional outcomes and patient-centric metrics including social determinants of health, quality of life, and healthcare utilization should be the foci of the next phase of scholarship. Current definitions identify AKI-based upon evidence of dysfunction which serves as a proxy for injury; biomarkers capable of identifying injury as it occurs are likely to more accurately define populations with AKI. Despite the strength of the association, the causal and mechanistic relationships between AKI and poorer outcomes remain inadequately examined. A more robust understanding of the relationship represents a potential to identify therapeutic targets. Once established, a more comprehensive understanding of AKI epidemiology in children will allow investigation of preventive, therapeutic, and quality improvement interventions more effectively. [ABSTRACT FROM AUTHOR]

Mutations can cause genetic diseases and the vast majority of these have no effective treatment. They raise some difficult questions on the boundaries of science and social science. Selective breeding to "improve" the human race (eugenics) is often regarded as a Victorian relic or Nazi fantasy. Yet, three fetuses with Down syndrome are aborted each day in the UK. Recent research suggests that the average human has around 60 mutations in their DNA; it seems that we are all mutants. A better understanding of the science will help us make better decisions about these difficult issues.

Temperature and precipitation have been identified as factors that potentially influence eastern wild turkey (Meleagris gallopavo silvestris) reproduction, but robust analyses testing the relationship between weather parameters and turkey nest success are lacking. Therefore, we assessed how weather influenced turkey daily nest survival using 8 years of data collected from 715 nests across the southeastern United States. We also conducted exploratory analyses investigating if weather conditions during or prior to nesting best predicted nest success. We then assessed the possible implications of climate change through 2041–2060 for future eastern wild turkey daily nest survival and nest success for variables determined significant in analyses. During incubation, positive anomalies of minimum daily temperature were associated with greater daily nest survival. Precipitation during nesting was not a good predictor of daily nest survival. Exploratory analyses unexpectedly indicated that weather conditions in January prior to incubation were more important to nest success than weather conditions during incubation. In January, negative anomalies of minimum temperature and greater average daily precipitation were associated with greater nest success. Projections of future nest success or daily nest survival based on these relationships with the predictive covariates, and informed by climate models, suggest that nest success may increase as January precipitation increases and that daily nest survival may increase as temperature during incubation increases. These positive associations could be offset by a negative association between nest success and the expected increases in January minimum average temperature. Additional research is needed to investigate causes of these relationships and assess the implications of climate change for eastern wild turkey poult survival. [ABSTRACT FROM AUTHOR]

Objective: To describe common methodological problems that arise in comparisons of Medicare Advantage (MA) and Traditional Medicare (TM) and within‐MA studies and provide suggestions of how researchers can address these issues. Study Setting: Published research evaluating Medicare coverage options in the United States. Study Design: We considered key conceptual challenges and promising solutions that have been used thus far and suggest additional directions. Data Collection: Not available. Principal Findings: Many existing studies of MA versus TM include significant limitations, such as failing to account for unobserved confounders driving both beneficiary coverage choice and health outcomes once enrolled, not accounting for variation in benefit generosity, provider networks, or plan design across MA plans, and/or having been conducted at a time when MA enrollment was less than a third of all Medicare beneficiaries. We provide a review of methods that can help researchers to overcome these weaknesses and suggest additional methods and data sources that may aid future research. Conclusions: The MA program is becoming an essential part of the US healthcare system. By accounting for non‐random movement into and out of MA and studying the heterogeneity of beneficiary experience across plan and market characteristics, researchers can provide the high‐quality evidence necessary for policymakers to design the program and reform TM in ways that maximize beneficiary outcomes. [ABSTRACT FROM AUTHOR]

Although the viral nature of videos that capture violent and racialized policing of Black Americans in the United States can increase awareness, exposure to race-based violence can result in vicarious traumatization, particularly among Black Americans. The relationship between anticipatory traumatic reactions (ATRs) and racial identity attitudes is not clearly addressed in the extant body of literature. The current study addresses this research disparity by first analyzing group mean differences among Black Americans (N = 138) who were assigned to audiovisual, written, and imaginal exposure groups. The current study also used a cluster analysis of Black Americans to examine the differences between racial identity attitudes and ATRs following media exposure to undue police violence. Results from the study indicated that no differences in ATRs existed based on types of media exposure. Significant differences across three racial identity clusters existed between ATR in association with attitudes of assimilation, miseducation, self-hatred, anti-dominance, and ethnic-racial salience. Findings from the study suggest that mental health professionals should attend to racial identity attitudes as a relevant factor in how Black American clients experience the psychological impact of media exposure to undue police violence. [ABSTRACT FROM AUTHOR]

Mitral valve transcatheter edge-to-edge repair (MTEER) was approved in the United States for treatment of functional mitral regurgitation (FMR) based on results from the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial. The authors sought to analyze outcomes of MTEER in FMR patients who would have been excluded from COAPT. MTEER procedures performed for FMR in the TVT (Transcatheter Valve Therapy) Registry between January 1, 2013, and April 30, 2020, were categorized as "trial-ineligible" if any of the following were present: cardiogenic shock, inotropic support, left ventricular ejection fraction <20%, left ventricular end-systolic dimension >7 cm, home oxygen use, or severe tricuspid regurgitation. Trial-ineligible and trial-eligible groups were compared through 1 year using multivariable models. The primary endpoint was 1-year death or heart failure hospitalization (HFH). Of 6,675 patients who underwent MTEER for FMR, 3,721 (55.7%) were trial-eligible and 2,954 (44.3%) were trial-ineligible. Trial-ineligible patients had lower rates of technical procedural success (86.9% vs 92.6%; P < 0.001) and more frequent in-hospital complications (11.8% vs 5.7%; P < 0.001) compared with trial-eligible patients. A clinically meaningful improvement in health status at 30 days was observed in 78.9% and 77.0% of patients in the trial-ineligible and trial-eligible groups, respectively. There was a higher risk of 1-year death or HFH (HR: 1.73; 95% CI: 1.57-1.91; P < 0.001) in trial-ineligible patients. Among patients who underwent MTEER for FMR in the TVT Registry, nearly one-half would have been ineligible for the COAPT trial. Health status improvement at 30 days was similar in COAPT-ineligible and COAPT-eligible patients, but trial-ineligible patients had higher 1-year rates of death or HFH. [Display omitted] [ABSTRACT FROM AUTHOR]

Nitrofurazone usage in food‐producing animals is prohibited in most countries, including the United States. Regulatory agencies regularly monitor its use in domestic, export/import animals' food products by measuring the semicarbazide (SEM) metabolite as a biomarker of nitrofurazone exposure. However, the use of SEM is controversial because it is also produced in food naturally and thus gives false positive results. A cyano‐metabolite, 4‐cyano‐2‐oxobutyraldehyde semicarbazone (COBS), is proposed as an alternate specific marker of nitrofurazone to distinguish nitrofurazone from treated or untreated animals. A synthetic method was developed to produce COBS via metallic hydrogenation of nitrofurazone. The product was isolated and characterized by one‐ and two‐dimensional nuclear magnetic spectroscopy (NMR) experiments, Fourier‐transform infrared spectroscopy (FT‐IR), and mass spectrometry. The developed synthetic procedure was further extended to synthesize isotopically labeled 4‐[13C]‐cyano‐2‐oxo‐ [2, 3, 4‐13C3]‐butyraldehyde semicarbazone. Labeled COBS is useful as an internal standard for its quantification in food‐producing animals. Thus, the developed method provides a possibility for its commercial synthesis to procure COBS. This is the first synthesis of the alternate specific marker metabolite of nitrofurazone for possible usage in regulatory analysis to solve a real‐world problem. [ABSTRACT FROM AUTHOR]

Purpose: Nonfamily farms are responsible for a disproportionate amount of US agriculture production. The importance of these operations to the volume of agriculture production in the United States has led researchers and policymakers to understand nonfamily farms as large commercial operations. This paper examines whether the distinction between family and nonfamily helps explain the financial outcomes of farm operations and households. Design/methodology/approach: We test for differences in financial outcomes of the household and operations of family and nonfamily farms using an Oaxaca-Blinder decomposition. We compare these results to a decomposition of other possible typologies. Findings: We present evidence that nonfamily farms are a heterogeneous group with a majority of small operations that are dominated by a small number of large operations. We discover that differences associated with the family-nonfamily distinction are largely explained by observable farm and operator characteristics that arise mechanically from the definition. However, we find suggestive evidence that family-nonfamily classification captures differences in economic behavior that lead to higher profitability measures to nonfamily farms. We find little evidence of any inherent structural differences between family and nonfamily farms that helps explain financial outcomes related to leverage or household finances. Practical implications: We conclude that including nonfamily farms in official statistics of farm households may provide a more comprehensive overview of the farm sector, as our results suggest that family and nonfamily farms do not have innate differences that help explain many of their financial outcomes. Originality/value: We incorporate previously unused data on nonfamily farm households and test the difference in mean financial outcomes between family and nonfamily farms. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study aimed to characterize medication-related practices during and immediately following rapid sequence intubation (RSI) in pediatric care units across the United States and to evaluate adverse drug events. METHODS: This was a multicenter, observational study of medication practices surrounding intubation in pediatric and neonatal intensive care unit (NICU) and emergency department patients across the United States. RESULTS: A total of 172 patients from 13 geographically diverse institutions were included. Overall, 24%, 69%, and 50% received preinduction, induction, and neuromuscular blockade, respectively. Induction and neuromuscular blocking agent (NMBA) use was low in NICU patients (52% and 23%, respectively), whereas nearly all patients intubated outside of the NICU received both (98% and 95%, respectively). NICU patients who received RSI medications were older and weighed more. Despite infrequent use of atropine (21%), only 3 patients developed bradycardia after RSI. Of the 119 patients who received an induction agent, fentanyl (67%) and midazolam (34%) were administered most frequently. Hypotension and hypertension occurred in 23% and 24% of patients, respectively, but were not associated with a single induction agent. Etomidate use was low and not associated with development of adrenal insufficiency. Rocuronium was the most used NMBA (78%). Succinylcholine use was low (11%) and administered despite hyperkalemia in 2 patients. Postintubation sedation and analgesia were not used or inadequate based on timing of initiation in many patients who received a non-depolarizing NMBA. CONCLUSIONS: Medication practices surrounding pediatric RSI vary across the United States and may be influenced by patient location, age, and weight. [ABSTRACT FROM AUTHOR]

Background: Spinal cord compression (SCC) in metastatic prostate cancer (MPC) is a critical complication and multiple factors influence the optimal therapeutic strategy. We investigated the differences in practice patterns between teaching hospitals (TH) and non-teaching hospitals (NTH) across the United States. Method: Using the National Inpatient Sample Database (NIS), we performed a retrospective study on hospitalizations with MPC and SCC between 2016 and 2020 in US. We compared demographic factors, comorbidities, treatment modalities, duration of hospitalization, financial expenditures, and mortality between TH and NTH. We also examined the patients' characteristics and outcomes in TH and NTH based on their chosen therapeutic strategy. Results: We identified 11,380 admissions with metastatic prostate cancer and SCC; 9610 in TH and 1770 in NTH. The median cost of hospitalization was $21,922 in TH and $15,141 in NTH. Although the median age and Charlson comorbidity score did not differ between two groups, patients in TH were more likely to receive intervention (radiation or surgery) compared to NTH (Surgery: 28.2% in TH vs. 23.0% in NTH & Radiation: 12.1% in TH vs. 8.2% in NTH). Mortality was lower in TH than NTH (4.5% vs. 7.9%). In both TH and NTH, a higher proportion of patients with private insurance underwent surgery (TH: Surgery 25.1% vs. Radiation 18.8% & NTH: Surgery 27.0% vs. 6.9%). Black patients were more likely to receive radiation than surgery in TH (34.2% vs. 26.8%). Conclusion: This study showed a greater percentage of patients underwent surgical intervention at TH compared to NTH. Additionally, the type of insurance and racial background were associated with distinctive treatment approaches. [ABSTRACT FROM AUTHOR]

Background: Grief and loss are common experiences for children and adolescents, particularly during the COVID‐19 pandemic. Educators feel unprepared to support grieving students due to lack of training. We studied educator experiences receiving grief‐sensitive training as part of the grief‐sensitive schools initiative (GSSI), which provides grief‐sensitive training, online video‐based and print resources, and a financial grant to schools and school districts for use in supporting grieving students. Methods: Fourteen New York and Florida educators who received GSSI training participated in small focus groups or semi‐structured interviews on their experiences receiving GSSI training and supporting grieving students during the pandemic. Transcripts were analyzed using grounded‐theory analysis. Results: Emergent themes included increased confidence engaging grieving students, the desire for recurring trainings, the value of receiving training from an expert on pediatric grief and loss and the opportunity to ask questions, the need for grief‐sensitive training to reflect the cultural diversity of school communities, the unique losses experienced by students during the pandemic, and compassion fatigue and burnout in educators. Implications for School Health Policy, Practice, and Equity: Policymakers should recognize the effects of grief on students' learning and development and collaborate with educators to develop resources. Conclusions: Educators found GSSI training useful in supporting grieving students, particularly during the pandemic. [ABSTRACT FROM AUTHOR]

Objectives Higgs and Gilleard (2015) have uniquely theorized the fourth age as a "social imaginary" of deep old age that blends notions of frailty, abjection, and the moral relations of care. This report evaluates the coherence and reach of the fourth-age imaginary among older adults in relative good health. Methods In a qualitative design and within samples at 5 sites (in Czechia, Germany, Hong Kong, Taiwan, and the United States), 138 adults aged 70+ and still living independently discussed what it would mean to be "not independent" in later life. Replies referenced other people in general, specific people, and one's own actual or potential experience. Results Pooled across sites, the views of our participants confirm the theorized features of the social imaginary. Participants spoke readily of gateway infirmities heralding frailty and of frailty's abjection; expressed dread and abhorrence of dependence, some saying that death would be preferable; and were anxious about nursing homes and about burdening others with an obligation to care for them. Discussion The bleak but formidable reputation of the fourth age impinges on those living in the third. The consonant expression of fourth-age features among older adults on 3 continents supports Gilleard and Higgs's claim that the fourth-age imaginary "contains a universal ontological quality" owing to human corporeality and the senescence to which it is subject. Fourth-age studies that document the lived experience of frailty and dependence have the potential to undermine the imaginary and furnish new narratives for facing the future. [ABSTRACT FROM AUTHOR]

The Medicare Advantage program was created to expand beneficiary choice and to reduce spending through capitated payment to private insurers. However, many stakeholders now argue that Medicare Advantage is failing to deliver on its promise to reduce spending. Three problematic design features in Medicare Advantage payment policy have received particular scrutiny: (1) how baseline payments to insurers are determined, (2) how variation in patient risk affects insurer payment, and (3) how payments to insurers are adjusted for quality performance. The authors analyze the statute underlying these three design features and explore legislative and regulatory strategies for improving Medicare Advantage. They conclude that regulatory approaches for improving risk adjustment and for recouping overpayments from risk-score gaming have the highest potential impact and are the most feasible improvement measures to implement. [ABSTRACT FROM AUTHOR]

As professional sport teams' involvement with corporate social responsibility (CSR) activities are prevalent and expected by the public, there has been more attention on the factors that can influence consumers' reactions to CSR activities. This study investigated the influence of two factors—corporate image and organization choice of communication vehicle—on individuals' responses, perceived motive, and change of attitude to a professional team sports organization's CSR activities. A total of 225 usable surveys were collected from a university located in the southern region of the United States for data analyses. The study showed that corporate image had a main effect on perceived motives, Munfavorable = 5.07, Mfavorable = 5.60, F(1, 216) = 6.38, p <.05, η p 2 =.03 , and attitudes, Munfavorable = 4.64, Mfavorable = 5.49; F(1, 216) = 18.34, p <.05, η p 2 =.08 , toward the team due to CSR activities, while there was no main effect for the professional team sports organization's chosen communication vehicle, F(2, 217) = 1.09, p >.05, for their CSR activities. The importance of building good corporate image and communicating CSR activities to the fan base are also discussed. [ABSTRACT FROM AUTHOR]

A longitudinal analysis of small-scale solar energy generation in the United States is used to demonstrate how transition studies can explain nonlinearity in multidecade changes of consumption-production systems. Nonlinearity involves uneven development of sustainability innovations with episodes of rapid growth but also periods of slow growth, stalling, or even collapse. Factors that affect the increasing feasibility and attractiveness of small-scale solar include technological improvements, declining costs, and changes in global energy markets. However, a more complete explanation of nonlinearity highlights the importance of a type of systems analysis that also includes strategic action and broader societal and policy changes. Specifically, efforts by the utilities constrained the growth of small-scale solar by weakening policy support because of the perceived threat, but the solar industry and advocates responded with countervailing action in a changing context. As the transition developed, strategic action (including goals, targets, tactics, and coalition partners) changed and became more conflictual. However, by the beginning of the 2020 decade, the development of microgrids, digital technologies, storage, and virtual power plants in combination with net-zero energy policies provided indications of potential for a reconfiguration of the relationship that could be less polarized and conflicted. [ABSTRACT FROM AUTHOR]

Dual‐energy x‐ray absorptiometry (DXA) scanning is used for objective determination of body composition, but instrumentation is expensive and not generally available in customary clinical practice. Anthropometric surrogates are often substituted as anticipated correlates of absolute and relative body fat content in the clinical management of obesity and its associated medical risks. DXA and anthropometric data from a cohort of 9230 randomly selected American subjects, available through the ongoing National Health and Nutrition Examination Survey, was used to evaluate combinations of surrogates (age, height, total weight, waist circumference) as predictors of DXA‐determined absolute and relative body fat content. Multiple regression analysis yielded linear combinations of the 4 surrogates that were closely predictive of DXA‐determined absolute fat content (R2 = 0.93 and 0.96 for male and female subjects). Accuracy of the new algorithm was improved over customary surrogate‐based predictors such as body mass index. However prediction of relative body fat was less robust (R2 less than 0.75), probably due to the nonlinear relation between degree of obesity (based on body mass index) and relative body fat. The paradigm was validated using an independent cohort from the National Health and Nutrition Examination Survey, as well as two independent external subject groups. The described regression‐based algorithm is likely to be a sufficiently accurate predictor of absolute body fat (but not relative body fat) to substitute for DXA scanning in many clinical situations. Further work is needed to assess algorithm validity for subgroups of individuals with "atypical" body construction. [ABSTRACT FROM AUTHOR]

Background: There are limited data comparing the beach-chair (BC) versus lateral decubitus (LD) position for arthroscopic anterior shoulder stabilization. Purpose: To identify predictors of instability recurrence and revision after anterior shoulder stabilization and evaluate surgical position and glenoid bone loss as independent predictors of recurrence and revision at short- and midterm follow-ups. Study Design: Cohort study; Level of evidence, 3. Methods: A consecutive series of 641 arthroscopic anterior stabilization procedures were performed from 2005 to 2019. All shoulders were evaluated for glenohumeral bone loss on magnetic resonance imaging. The primary outcomes of interest were recurrence and revision. Multivariable logistic regression models were used to assess the relationships of outcomes with age, position, glenoid bone loss group, and track. Results: A total of 641 shoulders with a mean age of 22.3 years (SD, 4.45 years) underwent stabilization and were followed for a mean of 6 years. The overall 1-year recurrent instability rate was 3.3% (21/641) and the revision rate was 2.8% (18/641). At 1 year, recurrence was observed in 2.3% (11/487) and 6.5% (10/154) of BC and LD shoulders, respectively. The 5-year recurrence and revision rates were 15.7% (60/383) and 12.8% (49/383), respectively. At 5 years, recurrence was observed in 16.4% (48/293) and 13.3% (12/90) of BC and LD shoulders, respectively. Multivariable modeling demonstrated that surgical position was not associated with a risk of recurrence after 1 year (odds ratio [OR] for LD vs BC, 1.39; P =.56) and 5 years (OR for LD vs BC, 1.32; P =.43), although younger age at index surgery was associated with a higher risk of instability recurrence (OR, 1.73 per SD [4.1 years] decrease in age; P <.03). After 1 and 5 years, surgical position results were similar in a separate multivariable logistic regression model of revision surgery as the dependent variable, when adjusted for age, surgical position, bone loss group, and track. At 5 years, younger age was an independent risk factor for revision: OR 1.68 per SD (4.1 years) decrease in age (P <.05). Conclusion: Among fellowship-trained orthopaedic surgeons, there was no difference in rates of recurrence and revision surgery after performing arthroscopic anterior stabilization in either the BC or the LD position at 1- and 5-year follow-ups. In multivariable analysis, younger age, but not surgical position, was an independent risk factor for recurrence. [ABSTRACT FROM AUTHOR]

Bolbophorus damnificus is a digenetic trematode causing significant economic losses within the United States commercial catfish industry. The indirect life cycle is complex, requiring piscivorous birds, aquatic snails, and fish to complete. With federal protections on many piscivorous birds and no FDA‐approved therapeutic treatment for trematode infections in fish, management within the catfish industry is primarily limited to controlling the snail host. Planorbella trivolvis and Biomphalaria havanensis are snails commonly found in commercial catfish ponds and known to transmit B. damnificus. This study evaluated a low‐cost snail trap prototype for monitoring populations of these snails in efforts to better inform treatment regimes. Snail traps were deployed into ponds on a commercial catfish farm and checked weekly throughout the production season. All snails were identified and counted to evaluate trap efficacy. Traps captured significantly more snails in foodfish ponds than in fingerling ponds; however, this trend was not present in monthly box samples. B. havanensis was rarely collected and was only found consistently within one pond, while P. trivolvis was routinely collected from all ponds, although abundance varied widely among ponds. Snail traps could be a useful, low‐cost method to monitor snail populations within ponds and better inform control treatments. [ABSTRACT FROM AUTHOR]

Triple-negative breast cancer (TNBC) and its recently identified subtype, quadruple negative breast cancer (QNBC), collectively account for approximately 13% of reported breast cancer cases in the United States. These aggressive forms of breast cancer are associated with poor prognoses, limited treatment options, and lower overall survival rates. In previous studies, our research demonstrated that VNLG-152R exhibits inhibitory effects on TNBC cells both in vitro and in vivo and the deuterated analogs were more potent inhibitors of TNBC cells in vitro. Building upon these findings, our current study delves into the molecular mechanisms underlying this inhibitory action. Through transcriptome and proteome analyses, we discovered that VNLG-152R upregulates the expression of E3 ligase Synoviolin 1 (SYVN1), also called 3-hydroxy-3-methylglutaryl reductase degradation (HRD1) in TNBC cells. Moreover, we provide genetic and pharmacological evidence to demonstrate that SYVN1 mediates the ubiquitination and subsequent proteasomal degradation of MNK1/2, the only known kinases responsible for phosphorylating eIF4E. Phosphorylation of eIF4E being a rate-limiting step in the formation of the eIF4F translation initiation complex, the degradation of MNK1/2 by VNLG-152R and its analogs impedes dysregulated translation in TNBC cells, resulting in the inhibition of tumor growth. Importantly, our findings were validated in vivo using TNBC xenograft models derived from MDA-MB-231, MDA-MB-468, and MDA-MB-453 cell lines, representing different racial origins and genetic backgrounds. These xenograft models, which encompass TNBCs with varying androgen receptor (AR) expression levels, were effectively inhibited by oral administration of VNLG-152R and its deuterated analogs in NRG mice. Importantly, in direct comparison, our compounds are more effective than enzalutamide and docetaxel in achieving tumor growth inhibition/repression in the AR+ MDA-MD-453 xenograft model in mice. Collectively, our study sheds light on the involvement of SYVN1 E3 ligase in the VNLG-152R-induced degradation of MNK1/2 and the therapeutic potential of VNLG-152R and its more potent deuterated analogs as promising agents for the treatment of TNBC across diverse patient populations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Complex Medicare Advantage (MA) health plan choices may overwhelm immigrants, especially for those facing decision-making constraints due to limited English proficiency (LEP). We examined the trends and patterns of MA enrollment by immigration and English proficiency status. STUDY DESIGN: We employed a cross-sectional design using data from the 2008-2019 Medical Expenditure Panel Survey. METHODS: Our outcome was enrollment in an MA plan. Our primary independent variables were immigration and English proficiency status. We categorized the sample into 3 groups: LEP immigrants, non-LEP immigrants, and US-born residents. After adjusting for individual-level characteristics, we estimated the adjusted rates of MA enrollment for each group. RESULTS: Our adjusted analysis showed that MA enrollment was higher among immigrants than US-born residents, but the highest enrollment was found among LEP immigrants (LEP immigrants: 45.5%; 95% CI, 42.7%-48.2%; non-LEP immigrants: 42.1%; 95% CI, 39.4%-44.8%; US-born residents: 35.1%; 95% CI, 34.5%-35.6%). MA enrollment was higher among LEP immigrants with better health status (good self-reported health: 45.4%; 95% CI, 41.9%-48.8%; poor self-reported health: 41.4%; 95% CI, 37.7%-45.1%). However, we found small to no differences in the adjusted rates of MA enrollment between those with good vs poor self-reported health in both the non-LEP immigrants and US-born residents groups. We found no consistent enrollment patterns by socioeconomic status such as race/ethnicity, education, and income. CONCLUSIONS: Our findings suggest higher MA enrollment among immigrants, especially for LEP immigrants. Future research should study the care experience of immigrants in MA. [ABSTRACT FROM AUTHOR]