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Background: Many educational disciplines, especially in health professions, are required by accrediting bodies to introduce or include health informatics (HI); however, faculty (academics) teaching this content may not be well prepared. Objective: The aim of this project was to explore how a doctoral physical therapy (DPT) program could more accurately represent compliance with HI accreditation requirements by identifying hidden instances of relevant content within the curriculum. Method: This exploratory, mixed methods, action research study utilised document review, questionnaires and interviews in the collection of quantitative and qualitative data to enable assessment of knowledge about HI, to determine if HI content was already incorporated in current courses, and, whether the content was accurately reflected in course student learning objectives (SLOs). Change in faculty understanding of HI as a result of this study was also assessed. Results: Of 16 DPT faculty, 13 participated in the pre-interview questionnaire; 8 (50%) representing 22/39 courses participated in the full study. Most were unfamiliar with HI and had unrecognised HI already incorporated in their courses leading to several SLO revisions and additions. Interview and post-interview questionnaire results documented significant increases in HI understanding among faculty. Conclusion: Physical therapy and HIM collaboration was successful in identifying HI content hiding in plain sight. Results revealed multiple instances of unrecognised HI content across the DPT curriculum. Revised and newly added SLOs, with others likely to follow due to this study, will assist faculty with future reaccreditation and in preparing graduates to more fully utilise HI in today's digital healthcare environments. [ABSTRACT FROM AUTHOR]

Background: Eutrophication of freshwater ecosystems resulting from nitrogen and phosphorus pollution is a major environmental stressor across the globe. In this systematic review, we compiled and synthesized literature on sestonic and benthic chlorophyll a (chl-a) responses to total nitrogen (TN) and total phosphorus (TP) concentrations in the water column in streams and rivers to provide a state-of-the-science summary of nutrient impacts on these endpoints. This review was motivated by the need for comprehensive information on stressor-response relationships for the most common nutrient and biotic response measures used by state-level environmental managers in the United States to assess eutrophication of lotic ecosystems and support environmental decision making. Methods: Searches for peer-reviewed and non-peer-reviewed articles were conducted using bibliographic databases, specialist websites, and search engines. These returns were supplemented with citation mapping and requests for material from experts. Articles were screened for relevance using pre-determined eligibility criteria, and risk of bias was evaluated for each included article based on study type-specific criteria. Narrative summaries and meta-analysis were used to evaluate four primary stressor-response relationships: TN-benthic chl-a, TP-benthic chl-a, TN-sestonic chl-a, and TP-sestonic chl-a. Potential effects of modifying factors and study validity on review conclusions were assessed via sensitivity and sub-group analysis and meta-regression. Results: Meta-analysis of 105 articles, representing 439 cause-effect pairs, showed that mean effect sizes of both benthic and sestonic chl-a responses to TN and TP were positive. Of the four stressor-response relationships examined, TP-sestonic chl-a had the most positive relationship, followed by TN-benthic chl-a, TN-sestonic chl-a, and TP-benthic chl-a. For individual U.S. states, mean effect sizes for the four stressor-response relationships were mostly positive, with a few exceptions. Chlorophyll measurement method had a moderately significant influence on mean effect size for TP-sestonic chl-a, with chl-a responding more strongly to TP if fluorometry versus spectrophotometry was used. Year of publication had a significant negative effect on mean effect size, as did mean nutrient concentration for both sestonic chl-a nutrient relationships. When the same study measured both TN and TP, chl-a tended to respond similarly to both nutrients. Sensitivity analysis indicated that conclusions are robust to studies with high risk of bias. Conclusions: This systematic review confirms that nutrients consistently impact primary producer biomass in streams and rivers worldwide. It builds on previous literature syntheses evaluating chl-a responses to nutrient concentrations and confirms that benthic and sestonic chl-a respond positively to nutrients across a range of stream and river conditions, but also points to limits on these relationships (e.g., potential saturation at high nutrient concentrations). Lack of consistent reporting of contextual data limited our ability to examine how moderating factors influenced these stressor-response relationships. Overall, we provide nutrient managers responsible for protecting the quality of lotic ecosystems with a comprehensive evidence base for chl-a responses to TN and TP concentrations in the water column. [ABSTRACT FROM AUTHOR]

The new urban politics (NUP) literature has helped to draw attention to a new generation of entrepreneurial urban regimes involved in the competition to attract investment to cities. Interurban competition often had negative environmental consequences for the urban living place. Yet knowledge of the environment was not very central to understanding the NUP. Entrepreneurial urban regimes today are struggling to deal with climate change and reductions in greenhouse gas emissions. Carbon reduction strategies could have profound implications for interurban competition and the politics of urban development. This paper explores the rise of a distinctive low-carbon urban polity—carbon control—and examines its potential ramifications for a new environmental politics of urban development (NEPUD). The NEPUD signals the growing centrality of carbon control in discourses, strategies and struggles around urban development. Using examples from cities in the US and Europe, the paper examines how these new environmental policy considerations are being mainstreamed in urban development politics. Alongside competitiveness, the management of carbon emissions represents a new yet at the same time contestable mode of calculation in urban governance. [ABSTRACT FROM PUBLISHER]

Deutz P. and Gibbs D. Industrial ecology and regional development: eco-industrial development as cluster policy, Regional Studies. Aspects of industrial ecology fit closely with work in regional development investigating clustering, networking, and local economic development. However, there has been limited cross-fertilization between these bodies of literature. This paper uses an empirical focus on eco-industrial developments in the USA to postulate that industrial ecology can be viewed as a distinct cluster concept and to consider the implications of this for both industrial ecology and regional development policies. [image omitted] Deutz P. et Gibbs D. L'ecologie industrielle et l'amenagement du territoire: le developpement industriel ecologique comme politique d'agglomeration, Regional Studies. Des aspects de l'ecologie industrielle sont en correlation etroite avec des recherches dans le domaine de l'amenagement du territoire qui examinent l'agglomeration, la connexion et le developpement local economique. Cependant, il y a eu peu de synergie entre ces faisceaux de documentation. Cet article porte de facon empirique sur les developpements industriels ecologiques aux E-U afin de postuler que l'on peut envisager l'ecologie industrielle comme une notion indeniable d'agglomeration et en considerer les retombees a la fois pour l'ecologie industrielle et les politiques d'amenagement du territoire. Ecologie industrielle Parcs industriels ecologiques Symbiose industrielle Agglomerations regionales Connexion Deutz P. und Gibbs D. Industrieokologie und Regionalentwicklung: oko-industrielle Entwicklung als Cluster-Politik, Regional Studies. Die Aspekte der Industrieokologie sind eng mit der Arbeit der Regionalentwicklung verzahnt, was die Untersuchung von Clusterbildungen, Netzwerken und lokaler Wirtschaftsentwicklung anbelangt. Die gegenseitige Befruchtung zwischen diesen Literaturkorpern fiel jedoch bisher eher begrenzt aus. In diesem Beitrag wird anhand eines empirischen Fokus auf den okoindustriellen Entwicklungen in den USA postuliert, dass sich die Industrieokologie als eigenstandiges Cluster-Konzept betrachten lasst, und es werden die Auswirkungen auf die Politiken fur Industrieokologie und Regionalentwicklung untersucht. Industrieokologie Oko-Industrieparks Industriesymbiose Regionalentwicklung Cluster Netzwerke Deutz P. y Gibbs D. Ecologia industrial y desarrollo regional: desarrollo ecoindustrial como politica de aglomeracion, Regional Studies. Los aspectos de la ecologia industrial estan estrechamente vinculados al trabajo en el desarrollo regional que estudia la aglomeracion, las redes y el desarrollo economico local. Sin embargo, la mutua hibridacion entre estos organismos de literatura ha estado limitada. En este articulo usamos un enfoque empirico sobre los desarrollos ecoindustriales en los EE.UU. para postular que la ecologia industrial puede considerarse un concepto distintivo de aglomeraciones y para considerar que efectos tiene esto en la ecologia industrial y las politicas de desarrollo industrial. Ecologia industrial Parques ecoindustriales Simbiosis industrial Desarrollo regional Aglomeraciones Redes [ABSTRACT FROM AUTHOR]

Krueger R. and Gibbs D. 'Third wave' sustainability? Smart growth and regional development in the USA, Regional Studies. Increasingly concepts of sustainable development are finding their way into local and regional development strategies. This is also true in the USA, though not through the Local Agenda 21 process, as is the case in much of the rest of the world. The approach to 'sustainable development' in the USA is a set of policy approaches collectively referred to as 'smart growth'... [ABSTRACT FROM AUTHOR]

This article examines factors that motivate major powers to participate in humanitarian interventions, with a case study of US intervention in Somalia during the period 1992-93. Two potential explanations are assessed: First, the article considers the conventional perspective that the United States intervention was guided by humanitarian considerations, particularly a desire to attenuate effects of famine, war, and political disorder in Somalia. Second, US intervention may have reflected realpolitik considerations, e.g. maintaining control over traditional spheres of influence for reasons of national power and prestige, as well as gaining access to potential oil supplies. While altruistic concerns may have had some influence on US conduct, this study finds that humanitarianism was (at best) mixed with considerations of national interest. [ABSTRACT FROM AUTHOR]

Reports a case on leiomyosarcoma of the colon as an intussusception 30 years after an abdominal irradiation treatment for a Wilms' tumor in Georgia. Pain as the most common symptom of leiomyosarcoma; Association between second malignancies and abdominal irradiation; Incidence of second malignant neoplasms after primary treatment of childhood cancers.

Examines the effects of dispositions on rearrest for domestic violence, using a sample of adults arrested for misdemeanor domestic violence in Hamilton County, Ohio. Methods used to track arrestees after their sentences; Effects of domestic violence; Factors which influence the cause of domestic violence.

Using symbolic interactionist theory to derive the basic proposition that an empirical relationship between the creedal and consequential dimensions of religiosity should appear only to the extent to which one's religious identity is salient, we examined a sample of Protestant church members in Indianapolis (N= 604). A relationship appeared only for those dependent variables in which the organized church was directly implicated, and even then only in the very highest salience category. With the proviso that a very high level of salience is required to produce a relationship, all of the other studies of the relationship of religious orthodoxy to political attitudes and behavior fall neatly into place. Evidence is also presented which indicates that the theory predicts behavior at the extremes of the creedal continuum, making separate theories of religious and political extremism unnecessary. [ABSTRACT FROM AUTHOR]

Pediatric patients admitted for trauma may have unique risk factors of unplanned readmission and require condition-specific models to maximize accuracy of prediction. We used a multicenter data set on trauma admissions to study risk factors and predict unplanned 7-day readmissions with comparison to the 30-day metric. Data from 28 hospitals in the United States consisting of 82,532 patients (95,158 encounters) were retrieved, and 75% of the data were used for building a random intercept, mixed-effects regression model, whereas the remaining were used for evaluating model performance. The variables included were demographics, payer, current and past health care utilization, trauma-related and other diagnoses, medications, and surgical procedures. Certain conditions such as poisoning and medical/surgical complications during treatment of traumatic injuries are associated with increased odds of unplanned readmission. Conversely, trauma-related conditions, such as trauma to the thorax, knee, lower leg, hip/thigh, elbow/forearm, and shoulder/upper arm, are associated with reduced odds of readmission. Additional predictors include the current and past health care utilization and the number of medications. The corresponding 7-day model achieved an area under the receiver operator characteristic curve of 0.737 (0.716, 0.757) on an independent test set and shared similar risk factors with the 30-day version. Patients with trauma-related conditions have risk of readmission modified by the type of trauma. As a result, additional quality of care measures may be required for patients with trauma-related conditions that elevate their risk of readmission. • 7-Day readmission may correlate with preventable readmission better than longer metrics but is more difficult to predict than the 30-day metric. • The current and past health care utilization correlates with the risk of readmission • The risk factors of 7-day readmission are similar to those of 30-day readmission. [ABSTRACT FROM AUTHOR]

The remarkable advances of artificial intelligence (AI) technology are revolutionizing established approaches to the acquisition, interpretation, and analysis of biomedical imaging data. Development, validation, and continuous refinement of AI tools requires easy access to large high-quality annotated datasets, which are both representative and diverse. The National Cancer Institute (NCI) Imaging Data Commons (IDC) hosts large and diverse publicly available cancer image data collections. By harmonizing all data based on industry standards and colocalizing it with analysis and exploration resources, the IDC aims to facilitate the development, validation, and clinical translation of AI tools and address the well-documented challenges of establishing reproducible and transparent AI processing pipelines. Balanced use of established commercial products with open-source solutions, interconnected by standard interfaces, provides value and performance, while preserving sufficient agility to address the evolving needs of the research community. Emphasis on the development of tools, use cases to demonstrate the utility of uniform data representation, and cloud-based analysis aim to ease adoption and help define best practices. Integration with other data in the broader NCI Cancer Research Data Commons infrastructure opens opportunities for multiomics studies incorporating imaging data to further empower the research community to accelerate breakthroughs in cancer detection, diagnosis, and treatment. Published under a CC BY 4.0 license.

Competing Interests: Conflicts of interest None disclosed.

Background: In this study, trauma-specific risk factors of prolonged length of stay (LOS) in pediatric trauma were examined. Statistical and machine learning models were used to proffer ways to improve the quality of care of patients at risk of prolonged length of stay and reduce cost., Methods: Data from 27 hospitals were retrieved on 81,929 hospitalizations of pediatric patients with a primary diagnosis of trauma, and for which the LOS was >24 h. Nested mixed effects model was used for simplified statistical inference, while a stochastic gradient boosting model, considering high-order statistical interactions, was built for prediction., Results: Over 18.7% of the encounters had LOS >1 week. Burns and corrosion and suspected and confirmed child abuse are the strongest drivers of prolonged LOS. Several other trauma-specific and general pediatric clinical variables were also predictors of prolonged LOS. The stochastic gradient model obtained an area under the receiver operator characteristic curve of 0.912 (0.907, 0.917)., Conclusions: The high performance of the machine learning model coupled with statistical inference from the mixed effects model provide an opportunity for targeted interventions to improve quality of care of trauma patients likely to require long length of stay., Impact: Targeted interventions on high-risk patients would improve the quality of care of pediatric trauma patients and reduce the length of stay. This comprehensive study includes data from multiple hospitals analyzed with advanced statistical and machine learning models. The statistical and machine learning models provide opportunities for targeted interventions and reduction in prolonged length of stay reducing the burden of hospitalization on families., (© 2020. International Pediatric Research Foundation, Inc.)

Lower prediagnostic circulating 25-hydroxyvitamin D (25[OH]D)-considered the best marker of total vitamin D exposure-is associated with higher mortality risk among colorectal cancer (CRC) patients. However, it is unknown whether this association differs by the vitamin D-binding protein (GC) isoform Gc2 (encoded by GC rs4588*C>A, Thr436Lys), which may substantially affect vitamin D metabolism and modify associations of 25(OH)D with colorectal neoplasm risk. Prediagnostic 25(OH)D-mortality associations according to Gc2 isoform were estimated using multivariable Cox proportional hazards regression among 1281 CRC cases (635 deaths, 483 from CRC) from two large prospective cohorts conducted in the United States (Cancer Prevention Study-II) and Europe (European Prospective Investigation into Cancer and Nutrition). 25(OH)D measurements were calibrated to a single assay, season standardized, and categorized using Institute of Medicine recommendations (deficient [<30], insufficient [30 - <50], sufficient [≥50 nmol/L]). In the pooled analysis, multivariable-adjusted hazard ratios (HRs) for CRC-specific mortality associated with deficient relative to sufficient 25(OH)D concentrations were 2.24 (95% CI 1.44-3.49) among cases with the Gc2 isoform, and 0.94 (95% CI 0.68-1.22) among cases without Gc2 (P interaction = .0002). The corresponding HRs for all-cause mortality were 1.80 (95% CI 1.24-2.60) among those with Gc2, and 1.12 (95% CI 0.84-1.51) among those without Gc2 (P interaction = .004). Our findings suggest that the association of prediagnostic vitamin D status with mortality among CRC patients may differ by functional GC isoforms, and patients who inherit the Gc2 isoform (GC rs4588*A) may particularly benefit from higher circulating 25(OH)D for improved CRC prognosis., (© 2020 UICC.)

Recent studies, including genome-wide association studies, have identified several putative low-penetrance susceptibility loci for melanoma. We sought to determine their generalizability to genetic predisposition for multiple primary melanoma in the international population-based Genes, Environment, and Melanoma (GEM) Study. GEM is a case-control study of 1,206 incident cases of multiple primary melanoma and 2,469 incident first primary melanoma participants as the control group. We investigated the odds of developing multiple primary melanoma for 47 SNPs from 21 distinct genetic regions previously reported to be associated with melanoma. ORs and 95% confidence intervals were determined using logistic regression models adjusted for baseline features (age, sex, age by sex interaction, and study center). We investigated univariable models and built multivariable models to assess independent effects of SNPs. Eleven SNPs in 6 gene neighborhoods (TERT/CLPTM1L, TYRP1, MTAP, TYR, NCOA6, and MX2) and a PARP1 haplotype were associated with multiple primary melanoma. In a multivariable model that included only the most statistically significant findings from univariable modeling and adjusted for pigmentary phenotype, back nevi, and baseline features, we found TERT/CLPTM1L rs401681 (P = 0.004), TYRP1 rs2733832 (P = 0.006), MTAP rs1335510 (P = 0.0005), TYR rs10830253 (P = 0.003), and MX2 rs45430 (P = 0.008) to be significantly associated with multiple primary melanoma, while NCOA6 rs4911442 approached significance (P = 0.06). The GEM Study provides additional evidence for the relevance of these genetic regions to melanoma risk and estimates the magnitude of the observed genetic effect on development of subsequent primary melanoma., (©2015 American Association for Cancer Research.)

A discussion among industry leaders on improving performance in the era of quality improvement.