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

Studies on the epidemiology and prognosis of primary breast lymphoma (PBL) are lack for low incidence. Therefore, we aimed to investigate the epidemiological characteristics of PBL and develop nomograms to predict patient survival. Data of patients who were diagnosed with PBL from 1975 to 2011 and incidence rate of PBL from 1975 to 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Time-varying multivariable Cox regression analysis was performed to identify independent prognostic factors for overall survival (OS) and disease-specific survival (DSS). Nomograms were constructed based on the independent prognostic factors identified in multivariate Cox regression analysis. A total of 1427 patients diagnosed with PBL were identified with the average age of 67.1 years. The overall incidence of PBL is 1.35/1,000,000 (adjusted to the United States standard population in 2000) from 1975 to 2017, with a significant upward trend by an annual percentage change (APC) of 2.91 (95%CI 2.29–3.94, P < 0.05). Age, sex, race, year of diagnosis, marital status, histological subtype, Ann Arbor Stage, and treatment modality were assessed as independent prognostic factors for OS and DSS by multivariable Cox regression (P < 0.05). Nomograms were constructed to predict the 1-, 3-, 5-, and 10- year OS and DSS. The concordance index (C-index) and calibration plots showed robustness and accuracy of the nomogram. The overall incidence of PBL was steadily increasing over the past four decades. Nomograms constructed can predicting 1-, 3-, 5-, and 10-year OS and identify patients with high-risk PBL. • The incident of PBL was calculated. • Nomograms were constructed to predict OS and DSS. • Patients are divided into the low-risk, medium-risk, and high-risk. [ABSTRACT FROM AUTHOR]

Social media has become a popular venue for individuals to share the results of their own analysis on financial securities. This paper investigates the extent to which investor opinions transmitted through social media predict future stock returns and earnings surprises. We conduct textual analysis of articles published on one of the most popular social media platforms for investors in the United States. We also consider the readers' perspective as inferred via commentaries written in response to these articles. We find that the views expressed in both articles and commentaries predict future stock returns and earnings surprises. [ABSTRACT FROM PUBLISHER]

Importance: Convalescent plasma is a potential therapeutic option for patients with coronavirus disease 2019 (COVID-19), but further data from randomized clinical trials are needed.Objective: To evaluate the efficacy and adverse effects of convalescent plasma therapy for patients with COVID-19.Design, Setting, and Participants: Open-label, multicenter, randomized clinical trial performed in 7 medical centers in Wuhan, China, from February 14, 2020, to April 1, 2020, with final follow-up April 28, 2020. The trial included 103 participants with laboratory-confirmed COVID-19 that was severe (respiratory distress and/or hypoxemia) or life-threatening (shock, organ failure, or requiring mechanical ventilation). The trial was terminated early after 103 of a planned 200 patients were enrolled.Intervention: Convalescent plasma in addition to standard treatment (n = 52) vs standard treatment alone (control) (n = 51), stratified by disease severity.Main Outcomes and Measures: Primary outcome was time to clinical improvement within 28 days, defined as patient discharged alive or reduction of 2 points on a 6-point disease severity scale (ranging from 1 [discharge] to 6 [death]). Secondary outcomes included 28-day mortality, time to discharge, and the rate of viral polymerase chain reaction (PCR) results turned from positive at baseline to negative at up to 72 hours.Results: Of 103 patients who were randomized (median age, 70 years; 60 [58.3%] male), 101 (98.1%) completed the trial. Clinical improvement occurred within 28 days in 51.9% (27/52) of the convalescent plasma group vs 43.1% (22/51) in the control group (difference, 8.8% [95% CI, -10.4% to 28.0%]; hazard ratio [HR], 1.40 [95% CI, 0.79-2.49]; P = .26). Among those with severe disease, the primary outcome occurred in 91.3% (21/23) of the convalescent plasma group vs 68.2% (15/22) of the control group (HR, 2.15 [95% CI, 1.07-4.32]; P = .03); among those with life-threatening disease the primary outcome occurred in 20.7% (6/29) of the convalescent plasma group vs 24.1% (7/29) of the control group (HR, 0.88 [95% CI, 0.30-2.63]; P = .83) (P for interaction = .17). There was no significant difference in 28-day mortality (15.7% vs 24.0%; OR, 0.59 [95% CI, 0.22-1.59]; P = .30) or time from randomization to discharge (51.0% vs 36.0% discharged by day 28; HR, 1.61 [95% CI, 0.88-2.95]; P = .12). Convalescent plasma treatment was associated with a negative conversion rate of viral PCR at 72 hours in 87.2% of the convalescent plasma group vs 37.5% of the control group (OR, 11.39 [95% CI, 3.91-33.18]; P < .001). Two patients in the convalescent plasma group experienced adverse events within hours after transfusion that improved with supportive care.Conclusion and Relevance: Among patients with severe or life-threatening COVID-19, convalescent plasma therapy added to standard treatment, compared with standard treatment alone, did not result in a statistically significant improvement in time to clinical improvement within 28 days. Interpretation is limited by early termination of the trial, which may have been underpowered to detect a clinically important difference.Trial Registration: Chinese Clinical Trial Registry: ChiCTR2000029757. [ABSTRACT FROM AUTHOR]

Many empirical time series such as asset returns and traffic data exhibit the characteristic of time-varying conditional covariances, known as volatility or conditional heteroscedasticity. Modeling multivariate volatility, however, encounters several difficulties, including the curse of dimensionality. Dimension reduction can be useful and is often necessary. The goal of this article is to extend the idea of principal component analysis to principal volatility component (PVC) analysis. We define a cumulative generalized kurtosis matrix to summarize the volatility dependence of multivariate time series. Spectral analysis of this generalized kurtosis matrix is used to define PVCs. We consider a sample estimate of the generalized kurtosis matrix and propose test statistics for detecting linear combinations that do not have conditional heteroscedasticity. For application, we applied the proposed analysis to weekly log returns of seven exchange rates against U.S. dollar from 2000 to 2011 and found a linear combination among the exchange rates that has no conditional heteroscedasticity. [ABSTRACT FROM AUTHOR]

Examines audience attributes of news media credibility perception, reliance for information and exposure in the agenda-setting process. Susceptibility of trusting audiences to agenda-setting effects; Role of exposure in determining intensity; Measurement of effect of credibility index in a secondary path analysis.

Previous studies have reported that metabolic syndrome (MS) is associated with the development of atrial fibrillation (AF). However, its impact on the atrial substrate properties and catheter ablation in patients with AF is still unclear. This study consisted of 282 patients with AF (216 with paroxysmal AF and 66 with nonparoxysmal AF) who underwent catheter ablation using a 3-dimensional mapping system (NavX). Detailed AF mapping (frequency analysis and complex fractionated electrographic mapping) was performed in 59 patients. The patients were classified on the basis of MS, which was defined according to the guidelines of the National Cholesterol Education Program Adult Treatment Panel III. Patients with MS had larger left atrial sizes, shorter fractionated intervals, and higher dominant frequencies compared with those without it. Higher incidences of complex fractionated atrial electrographic sites located in the left atrial appendage base, coronary sinus, and crista terminalis regions were found in patients with MS. Patients with MS had a higher incidence of recurrent AF compared with those without MS (55% vs 24%, p <0.001). A higher incidence of recurrent AF from non–pulmonary vein origins was observed in patients with MS compared with those without it (45% vs 20%, p = 0.037). In conclusion, MS is associated with larger left atrial size and an arrhythmogenic substrate, which may increase the risk for recurrence after the ablation of AF. Close follow-up with good control of any metabolic disturbances may be needed in patients with MS to improve their outcomes after AF ablation. [Copyright &y& Elsevier]

Competing Interests: S.S. reports grants from Boehringer-Ingelheim and Octapharma, personal fees from Boehringer-Ingelheim, Bayer, Daiichi, Alnylam, Sanofi, Bristol-Myers Squibb, and Pfizer, outside the submitted work.S.K. reports grants and personal fees from Bayer AG, grants and personal fees from Daiichi Sankyo, personal fees from Pfizer-Bristol-Mayers Squibb, grants and personal fees from BTG - Boston Scientific Group, grants from Boehringer-Ingelheim, personal fees from MSD, grants and personal fees from Actelion - Janssen, grants from Servier, outside the submitted work.

A widely used risk prediction tool, the revised NIOSH lifting equation (RNLE), provides the recommended weight limit (RWL), but is limited by analyst subjectivity, experience, and resources. This paper describes a robust, non-intrusive, straightforward approach to automatically extract spatial and temporal factors necessary for the RNLE using a single video camera in the sagittal plane. The participant's silhouette is segmented by motion information and the novel use of a ghosting effect provides accurate detection of lifting instances, and hand and feet location prediction. Laboratory tests using 6 participants, each performing 36 lifts, showed that a nominal 640 pixel × 480 pixel 2D video, in comparison to 3D motion capture, provided RWL estimations within 0.2 kg ( SD  = 1.0 kg). The linear regression between the video and 3D tracking RWL was R 2 = 0.96 (slope = 1.0, intercept = 0.2 kg). Since low definition video was used in order to synchronise with motion capture, better performance is anticipated using high definition video. Practitioner's summary: An algorithm for automatically calculating the revised NIOSH lifting equation using a single video camera was evaluated in comparison to laboratory 3D motion capture. The results indicate that this method has suitable accuracy for practical use and may be, particularly, useful when multiple lifts are evaluated. Abbreviations: 2D: Two-dimensional; 3D: Three-dimensional; ACGIH: American Conference of Governmental Industrial Hygienists; AM: asymmetric multiplier; BOL: beginning of lift; CM: coupling multiplier; DM: distance multiplier; EOL: end of lift; FIRWL: frequency independent recommended weight limit; FM: frequency multiplier; H: horizontal distance; HM: horizontal multiplier; IMU: inertial measurement unit; ISO: International Organization for Standardization; LC: load constant; NIOSH: National Institute for Occupational Safety and Health; RGB: red, green, blue; RGB-D: red, green, blue - depth; RNLE: revised NIOSH lifting equation; RWL: recommended weight limit; SD: standard deviation; TLV: threshold limit value; VM: vertical multiplier; V: vertical distance.

Objective: To evaluate the risk of cancer among patients diagnosed with hemorrhoids and benign anal inflammatory lesions., Methods: A population-based, retrospective cohort study was conducted that included patients diagnosed with hemorrhoids or benign inflammatory anal lesions (eg, anal fissure, fistula, and perianal abscesses) that were registered in the National Health Insurance Research Database in Taiwan between January 1, 2000 and December 31, 2010. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence of these patients to the general population., Results: During a median observation period of 6.23 years, 3080 cancers developed among 70,513 hemorrhoid patients, with a follow-up period of 438,425.6 person-years, entailing the SIR of 1.52 (95% confidence interval [CI], 1.47-1.58). Increased cancer risk (SIR 1.16; 95% CI, 1.11-1.21) was still noted even after excluding the first year of observation. Significant long-term risk for colorectal cancer (SIR 1.50; 95% CI, 1.35-1.66) and prostate cancer (SIR 1.40; 95% CI, 1.17-1.66) was observed after corrections were made for multiple comparisons. In contrast, there was no remarkable increase in cancer risk for patients with inflammatory anal lesions when cancers detected within the first year of diagnosis were excluded., Conclusion: The presence of hemorrhoids is associated significantly with a long-term risk of developing colorectal cancer or prostate cancer. In contrast, benign inflammatory anal lesions do not appear to increase the risk of malignancy., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: In postmarketing surveillance, the US Food and Drug Administration has reported the development of lung masses, thyroid cancer, and skin cancer after amiodarone therapy., Methods: Using the Taiwan National Health Insurance Research database, the authors conducted a population-based cohort study. Patients who were treated with amiodarone between 1997 and 2008 were enrolled. Those with antecedent cancer were excluded. Standardized incidence ratios (SIRs) of cancers were calculated to compare the cancer incidence of the study cohort with that of the general population. A multivariate Cox regression model was used to evaluate the association between cumulative defined daily doses (cDDDs) of amiodarone and cancer occurrence., Results: The study included 6418 subjects, with a median follow-up of 2.57 years. A total of 280 patients developed cancer. The risk of cancer increased with borderline significance (SIR, 1.12; 95% confidence interval [95% CI], 0.99-1.26 [P = .067]). Male patients had a higher risk (SIR, 1.18; 95% CI, 1.02-1.36 [P = .022]). The total cohort of patients and the male patients with > 180 cDDDs within the first year were found to have SIRs of 1.28 (95% CI, 1.00-1.61; P = .046) and 1.46 (95% CI, 1.11-1.89; P = .008), respectively. After adjustment for age, sex, and comorbidities, the hazards ratio was 1.98 (95% CI, 1.22-3.22; P = .006) for the high tertile of cDDDs compared with the low tertile., Conclusions: The results of the current study indicate that amiodarone may be associated with an increased risk of incident cancer, especially in males, with a dose-dependent effect., (Copyright © 2012 American Cancer Society.)

Several studies have suggested that obesity may be associated with a survival advantage in heart failure (HF). The duration of HF likely influences disease severity and may introduce lead-time bias into analyses of outcomes. The aim of this study was to analyze a cohort in which the exact time of HF onset could be determined: patients in the University of Michigan subset of the acute coronary syndromes (ACS) database of the Global Registry of Acute Coronary Events (GRACE) who developed new-onset HF (no history of HF and left ventricular ejection fraction or=30 kg/m(2)). Underweight patients (BMI