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Dissolved organic and inorganic carbon (DOC and DIC) influence water quality, ecosystem health, and carbon cycling. Dissolved carbon species are produced by biogeochemical reactions and laterally exported to streams via distinct shallow and deep subsurface flow paths. These processes are arduous to measure and challenge the quantification of global carbon cycles. Here we ask: when, where, and how much is dissolved carbon produced in and laterally exported from the subsurface to streams? We used a catchment‐scale reactive transport model, BioRT‐HBV, with hydrometeorology and stream carbon data to illuminate the "invisible" subsurface processes at Sleepers River, a carbonate‐based catchment in Vermont, United States. Results depict a conceptual model where DOC is produced mostly in shallow soils (3.7 ± 0.6 g/m2/yr) and in summer at peak root and microbial respiration. DOC is flushed from soils to the stream (1.0 ± 0.2 g/m2/yr) especially during snowmelt and storms. A large fraction of DOC (2.5 ± 0.2 g/m2/yr) percolates to the deeper subsurface, fueling deep respiration to generate DIC. DIC is exported predominantly from the deeper subsurface (7.1 ± 0.4 g/m2/yr, compared to 1.3 ± 0.3 g/m2/yr from shallow soils). Deep respiration reduces DOC and increases DIC concentrations at depth, leading to commonly observed DOC flushing (increasing concentrations with discharge) and DIC dilution patterns (decreasing concentrations with discharge). Surprisingly, respiration processes generate more DIC than weathering in this carbonate‐based catchment. These findings underscore the importance of vertical connectivity between the shallow and deep subsurface, highlighting the overlooked role of deep carbon processing and export. Plain Language Summary: Dissolved organic and inorganic carbon (DOC and DIC) are important chemical species that affect water quality, ecosystem health, and carbon dioxide emissions from streams. DOC and DIC are produced through different reactions at and below the ground surface before they are transported to streams through underground flow paths. However, it is difficult to measure and observe these reactions and transport pathways, limiting our understanding of when, where, and how much dissolved carbon species are produced and exported from distinct subsurface depths. Here we used a computational model, BioRT‐HBV, to simulate reactions and transport processes and to better understand the production and export of dissolved carbon at Sleepers River, a small catchment in Vermont, United States. Results show that DOC was primarily produced through shallow subsurface reactions and exported through shallow flow paths. DIC was produced in both the shallow and deep subsurface but primarily exported through deep flow paths. Reactions that produced DOC and DIC occurred faster under warm and wet conditions (summer and spring), while export of DOC and DIC increased under wet conditions (spring, snowmelt, storms). Results suggest that climate change may affect the production and export of dissolved carbon species through increased temperatures and intense storm events. Key Points: Dissolved organic carbon (DOC) was mainly produced in warm summer and exported in wet spring from shallow subsurfaceDissolved inorganic carbon (DIC) was comparably produced in the shallow and deep subsurface but exported mostly from the deep subsurface in wet springDIC originated more from biogenic (soil respiration and deep respiration) than geogenic (carbonate weathering) sources in a carbonate‐based catchment [ABSTRACT FROM AUTHOR]

Understanding soil organic carbon (SOC) response to global change has been hindered by an inability to map SOC at horizon scales relevant to coupled hydrologic and biogeochemical processes. Standard SOC measurements rely on homogenized samples taken from distinct depth intervals. Such sampling prevents an examination of fine‐scale SOC distribution within a soil horizon. Visible near‐infrared hyperspectral imaging (HSI) has been applied to intact monoliths and split cores surfaces to overcome this limitation. However, the roughness of these surfaces can influence HSI spectra by scattering reflected light in different directions posing challenges to fine‐scale SOC mapping. Here, we examine the influence of prescribed surface orientation on reflected spectra, develop a method for correcting topographic effects, and calibrate a partial least squares regression (PLSR) model for SOC prediction. Two empirical models that account for surface slope, aspect, and wavelength and two theoretical models that account for the geometry of the spectrometer were compared using 681 homogenized soil samples from across the United States that were packed into sample wells and presented to the spectrometer at 91 orientations. The empirical approach outperformed the more complex geometric models in correcting spectra taken at non‐flat configurations. Topographically corrected spectra reduced bias and error in SOC predicted by PLSR, particularly at slope angles greater than 30°. Our approach clears the way for investigating the spatial distributions of multiple soil properties on rough intact soil samples. Core Ideas: A novel topographic correction method reduced the effect of surface orientation on lab‐based soil reflectance.A linear empirical approach outperformed two versions of a geometric topographic correction.Bias and error in soil organic carbon predictions were decreased when topographically corrected reflectance spectra were used.Topographic correction advances the use of hyperspectral imaging on intact soil samples displaying natural roughness. [ABSTRACT FROM AUTHOR]

Multisensory, physical, and cognitive dysfunction share age-related physiologic disturbances and may have common health effects. We determined whether the effect of multisensory impairment on physical activity (PA) is explained by physical (timed up and go) or cognitive (Short Portable Mental Status Questionnaire) dysfunction. A National Social Life, Health, and Aging Project participant subset (n = 507) underwent objective sensory testing in 2005–2006 and wrist accelerometry in 2010–2011. We related multisensory impairment to PA using multivariate mixed-effects linear regression and compared the effect magnitude after adjusting for physical then cognitive dysfunction. Worse multisensory impairment predicted lower PA across three scales (Global Sensory Impairment: β = −0.04, 95% confidence interval [−0.07, −0.02]; Total Sensory Burden: β = −0.01, 95% confidence interval [−0.03, −0.003]; and Number of Impaired Senses: β = −0.02, 95% confidence interval [−0.04, −0.004]). Effects were similar after accounting for physical and cognitive dysfunction. Findings suggest that sensory, physical, and cognitive dysfunction have unique mechanisms underlying their PA effects. [ABSTRACT FROM AUTHOR]

Mobile sources are responsible for a substantial controllable portion of the reactive organic carbon (ROC) emitted to the atmosphere, especially in urban environments of the United States. We update existing methods for calculating mobile source organic particle and vapor emissions in the United States with over a decade of laboratory data that parameterize the volatility and organic aerosol (OA) potential of emissions from on-road vehicles, nonroad engines, aircraft, marine vessels, and locomotives. We find that existing emission factor information from Teflon filters combined with quartz filters collapses into simple relationships and can be used to reconstruct the complete volatility distribution of ROC emissions. This new approach consists of source-specific filter artifact corrections and state-of-the-science speciation including explicit intermediate-volatility organic compounds (IVOCs), yielding the first bottom-up volatility-resolved inventory of US mobile source emissions. Using the Community Multiscale Air Quality model, we estimate mobile sources account for 20 %–25 % of the IVOC concentrations and 4.4 %–21.4 % of ambient OA. The updated emissions and air quality model reduce biases in predicting fine-particle organic carbon in winter, spring, and autumn throughout the United States (4.3 %–11.3 % reduction in normalized bias). We identify key uncertain parameters that align with current state-of-the-art research measurement challenges. [ABSTRACT FROM AUTHOR]

Summer streamflow predictions are critical for managing water resources; however, warming‐induced shifts from snow to rain regimes impact low‐flow predictive models. Additionally, reductions in snowpack drive earlier peak flows and lower summer flows across the western United States increasing reliance on groundwater for maintaining summer streamflow. However, it remains poorly understood how groundwater contributions vary interannually. We quantify recession limb groundwater (RLGW), defined as the proportional groundwater contribution to the stream during the period between peak stream flow and low flow, to predict summer low flows across three diverse western US watersheds. We ask (a) how do snow and rain dynamics influence interannual variations of RLGW contributions and summer low flows?; (b) which watershed attributes impact the effectiveness of RLGW as a predictor of summer low flows? Linear models reveal that RLGW is a strong predictor of low flows across all sites and drastically improves low‐flow prediction compared to snow metrics at a rain‐dominated site. Results suggest that strength of RLGW control on summer low flows may be mediated by subsurface storage. Subsurface storage can be divided into dynamic (i.e., variability saturated) and deep (i.e., permanently saturated) components, and we hypothesize that interannual variability in dynamic storage contribution to streamflow drives RLGW variability. In systems with a higher proportion of dynamic storage, RLGW is a better predictor of summer low flow because the stream is more responsive to dynamic storage contributions compared to deep‐storage‐dominated systems. Overall, including RLGW improved low‐flow prediction across diverse watersheds. Plain Language Summary: Water managers across the western United States depend on accurate streamflow prediction models for water planning and allocation during summer months. Historically, these models use snow metrics to predict summer flows, but increasing temperatures across the western US are decreasing snow input and accumulation and increasing early snow melt rates leading to changes in streamflow generation mechanisms. Here, we seek to understand how stream flows will respond under warmer climates in three watersheds with distinct climate and underlying bedrock in the western US. We expanded upon commonly used low‐flow model snow metrics to include snow and streamflow metrics from the previous year as well as groundwater dynamics during the annual recession curve. We found that including variables outside of commonly used snow parameters in the models produced more accurate predictions of summer low flows. We provide a framework for future analysis of streamflow response to warming across the western US. Key Points: Recession limb groundwater proportion is a strong predictor of summer low flowsRecession limb dynamics are especially important for improving low‐flow prediction at rain‐dominated sitesRecession limb groundwater may be a better predictor of low flow at sites where dynamic storage exceeds deep storage [ABSTRACT FROM AUTHOR]

Simple Summary: Risk factors for colorectal cancer (CRC) include age, body mass index, race, smoking history, and sex. However, molecular mechanisms underlying these associations remain unclear. To better define transcriptional mechanisms impacting risk, we hypothesized that stem-cell-enriched colon organoids derived from the healthy epithelium of a diverse, average-risk patient population would provide insight into genes associated with these risk factors. We used network-based approaches to better define transcriptional mechanisms involved in CRC risk and incorporated external, publicly available datasets to prioritize likely biological drivers. Numerous demographic factors have been associated with colorectal cancer (CRC) risk. To better define biological mechanisms underlying these associations, we performed RNA sequencing of stem-cell-enriched organoids derived from the healthy colons of seven European Americans and eight African Americans. A weighted gene co-expression network analysis was performed following RNA sequencing. Module–trait relationships were determined through the association testing of each module and five CRC risk factors (age, body mass index, sex, smoking history, and race). Only modules that displayed a significantly positive correlation for gene significance and module membership were considered for further investigation. In total, 16 modules were associated with known CRC risk factors (p < 0.05). To contextualize the role of risk modules in CRC, publicly available RNA-sequencing data from TCGA-COAD were downloaded and re-analyzed. Differentially expressed genes identified between tumors and matched normal-adjacent tissue were overlaid across each module. Loci derived from CRC genome-wide association studies were additionally overlaid across modules to identify robust putative targets of risk. Among them, MYBL2 and RXRA represented strong plausible drivers through which cigarette smoking and BMI potentially modulated CRC risk, respectively. In summary, our findings highlight the potential of the colon organoid system in identifying novel CRC risk mechanisms in an ancestrally diverse and cellularly relevant population. [ABSTRACT FROM AUTHOR]

This qualitative study evaluates physician training and experience with treatment and prevention services for people who inject drugs (PWID) including medications for opioid use disorder (MOUD) and HIV pre-exposure prophylaxis (PrEP). The Behavioral Model of Healthcare Utilization for Vulnerable Populations was applied as a framework for data analysis and interpretation. Two focus groups were conducted, one with early career physicians (n = 6) and one with mid- to late career physicians (n = 3). Focus group transcripts were coded and analyzed using thematic analysis to identify factors affecting implementation of treatment and prevention services for PWID. Respondents identified that increasing the availability of providers prescribing MOUD was a critical enabling factor for PWID seeking and receiving care. Integrated, interdisciplinary services were identified as an additional resource although these remain fragmented in the current healthcare system. Barriers to care included provider awareness, stigma associated with substance use, and access limitations. Providers identified the interwoven risk factors associated with injection drug use that must be addressed, including the risk of HIV acquisition, notably more at the forefront in the minds of early career physicians. Additional research is needed addressing the medical education curriculum, health system, and healthcare policy to address the addiction and HIV crises in the U.S. South. [ABSTRACT FROM AUTHOR]

Background: Adults aged 65 years and above account for over half of all cancer diagnoses in the United States, but little is known about trend of elderly cancer survival in the United States. We aimed to assess the survival trend for elderly cancer in the United States from 1995 to 2014. Methods: We used data from Surveillance, Epidemiology, and End Results 12 registries and included 1,112,441 eligible patients aged 65 years or older who were diagnosed between 1995 and 2014 with cancer and followed up until December 2019. Overall and stage‐specific 5‐year relative survival, ratio of observed survival to expected survival, with 95% confidence intervals (CIs) of elderly cancer patients stratified by age were estimated during four periods (1995–1999, 2000–2004, 2005–2009, and 2010–2014). Cox proportional hazards models were used to estimate hazard ratios for cancer‐specific death among patients diagnosed during 2000–2004, 2005–2009, 2010–2014, compared diagnoses in 1995–1999. We also calculated stage distribution and treatment rate during four periods. Results: In the United States, 5‐year relative survival for elderly cancer patients improved from 57.3% (95% CIs 57.0–57.5) in 1995–1999 to 60.7% (60.5–60.9) in 2010–2014. After controlling for sociodemographic and tumor characteristics, about a 19% reduction in cancer‐specific deaths among diagnoses in 2010–2014 compared with 1995–1999. Cancer survival improved for elderly patients in all age groups, with exception of stable survival for patients aged 85 and above. Comparing 1995–1999 with 2010–2014, relative survival improved from 84.7% (84.3–85.1) to 86.7% (86.3–87.0) for localized stage and from 12.4% (12.1–12.7) to 18.7% (18.4–19.0) for distant stage for all cancers combined. The trends in stage distribution and treatment rate for all cancers combined were relatively stable. Conclusions: In the United States, survival for elderly cancer patients has improved slightly from 1995 to 2014, possibly mainly due to advances in treatment. Further studies are warranted to explore interventions to improve elderly cancer survival. [ABSTRACT FROM AUTHOR]

Adenocarcinoma (AC) and squamous cell carcinoma (SCC) are the main subtypes of esophageal cancer (EC), but nationwide survival of both EC subtypes has never been reported in China. Our study aimed to estimate the survival trends of EC by subtype in China and compare them with those in the United States for the same period. We used data from 64 Chinese cancer registries, which included EC patients diagnosed during 2008 and 2015 and followed up until 31st December 2017. The 5‐year age‐standardized relative survival by subtype, sex, age group and urban or rural area between 2008 and 2017 were analyzed. We stratified survival estimates by calendar period (2008‐2009, 2010‐2011, 2012‐2014 and 2015‐2017). Data from the SEER 18 program were calculated to estimate the survival of EC in the United States. A further comparison between the survivals in areas covered and not covered by population‐based endoscopic screening programs in China was conducted. A total of 129 962 records were included in the survival analyses. Results revealed that age‐standardized 5‐year relative survivals for AC and SCC increased in both China and the United States from 2008 to 2017. In 2015 to 2017, 5‐year survival from both subtypes in China was better than the United States (SCC: 36.9% vs 18.5%, AC: 34.8% vs 22.3%). The survival for both subtypes was significantly higher in screening areas than in nonscreening areas in China (SCC: 40.6% vs 32.8%; AC: 43.0% vs 31.3%). A survival gap in EC by subtype exists between China and the United States. Our results may support the beneficial effect of population‐based endoscopic screening for survival, and may be poised to inform national policy‐making in both countries. [ABSTRACT FROM AUTHOR]

The low-density lipoprotein receptor (LDLR) controls cellular delivery of cholesterol and clears LDL from the bloodstream, protecting against atherosclerotic heart disease, the leading cause of death in the United States. We therefore sought to identify regulators of the LDLR beyond the targets of current therapies and known causes of familial hypercholesterolemia. We found that cold shock domain–containing protein E1 (CSDE1) enhanced hepatic LDLR messenger RNA (mRNA) decay via its 3′ untranslated region and regulated atherogenic lipoproteins in vivo. Using parallel phenotypic genome-wide CRISPR interference screens in a tissue culture model, we identified 40 specific regulators of the LDLR that were not previously identified by observational human genetic studies. Among these, we demonstrated that, in HepG2 cells, CSDE1 regulated the LDLR at least as strongly as statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. In addition, we showed that hepatic gene silencing of Csde1 treated diet-induced dyslipidemia in mice to a similar degree as Pcsk9 silencing. These results suggest the therapeutic potential of targeting CSDE1 to manipulate the posttranscriptional regulation of the LDLR mRNA for the prevention of cardiovascular disease. Our approach of modeling a clinically relevant phenotype in a forward genetic screen, followed by mechanistic pharmacologic dissection and in vivo validation, may serve as a generalizable template for the identification of therapeutic targets in other human disease states. Controlling CSDE1 to contain cholesterol levels: Therapies that up-regulate the hepatic low-density lipoprotein receptor (LDLR) have been shown to reduce cholesterol concentrations and lower the risk of heart attacks. However, further lowering of cholesterol concentrations beyond what statins can achieve may potentially further reduce heart attack risk. Here, Smith and colleagues conducted a genome-wide CRISPR interference screen to identify further factors involved in hepatic LDLR regulation, identifying cold shock domain–containing protein E1 (CSDE1) as a posttranslational regulator of the stability of LDLR mRNA. Knockdown of Csde1 in mice protected the animals from cholesterol accumulation, even on a cholate-rich diet. These findings suggest that CSDE1 may be a therapeutic target to further lower cholesterol in humans. [ABSTRACT FROM AUTHOR]

Importance: Cardiovascular disease (CVD) is the leading cause of morbidity and death in the US and is the cause of more than 1 of every 4 deaths. Coronary heart disease is the single leading cause of death and accounts for 43% of deaths attributable to CVD in the US. In 2019, an estimated 558 000 deaths were caused by coronary heart disease and 109 000 deaths were caused by ischemic stroke.Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the benefits and harms of statins for reducing CVD-related morbidity or mortality or all-cause mortality.Population: Adults 40 years or older without a history of known CVD and who do not have signs and symptoms of CVD.Evidence Assessment: The USPSTF concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more CVD risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year CVD event risk of 10% or greater has at least a moderate net benefit. The USPSTF concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more of these CVD risk factors and an estimated 10-year CVD event risk of 7.5% to less than 10% has at least a small net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of statin use for the primary prevention of CVD events and mortality in adults 76 years or older with no history of CVD.Recommendation: The USPSTF recommends that clinicians prescribe a statin for the primary prevention of CVD for adults aged 40 to 75 years who have 1 or more CVD risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year CVD risk of 10% or greater. (B recommendation) The USPSTF recommends that clinicians selectively offer a statin for the primary prevention of CVD for adults aged 40 to 75 years who have 1 or more of these CVD risk factors and an estimated 10-year CVD risk of 7.5% to less than 10%. The likelihood of benefit is smaller in this group than in persons with a 10-year risk of 10% or greater. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of initiating a statin for the primary prevention of CVD events and mortality in adults 76 years or older. (I statement). [ABSTRACT FROM AUTHOR]

The evasion of CO2 from inland waters, a major carbon source to the atmosphere, depends on dissolved inorganic carbon (DIC) concentrations. Our understanding of DIC dynamics across gradients of climate, geology, and vegetation conditions however have remained elusive. To understand its large‐scale patterns and drivers, we collated instantaneous and mean (multiyear average) DIC concentrations from about 100 rivers draining minimally‐impacted watersheds in the contiguous United States. Within individual sites, instantaneous concentrations (C) measured at daily to seasonal scales exhibit a near‐universal response to changes in river discharge (Q) in a negative power law form. High concentrations occur at low discharge when DIC‐enriched groundwater dominates river discharge; low concentrations occur under high flow when relatively DIC‐poor shallow soil water predominates river discharge. Such patterns echo the widely observed increase of soil CO2 and DIC with depth and the shallow‐and‐deep hypothesis that emphasizes the importance of flow paths and source water chemistry. Across sites, mean concentrations (Cm) decrease with increasing mean discharge (Qm), a long‐term climate measure, and reachs maxima at around 200 mm/yr. A parsimonious model reveals that high mean DIC arises from soil CO2 accumulation when rates of DIC‐generating reactions are relatively high compared to its export fluxes in arid climates. Although instantaneous and mean DIC concentrations similarly decrease with increasing discharge, results here highlight their distinct drivers: daily to seasonal‐scale instantaneous concentration variations (C) are controlled by subsurface CO2 distribution over depth (from below), whereas long‐term mean concentrations (Cm) are regulated by climate (from above). The results emphasize the significance of land‐river connectivity via subsurface flow paths. They also underscore the importance of characterizing subsurface CO2 distribution to illuminate belowground processes in order to project the future of water and carbon cycles in a warming climate. Key Points: Within individual sites, instantaneous dissolved inorganic carbon (DIC) (C) exhibits a near‐universal dilution pattern with lower concentrations at high discharge (Q)Across sites, DIC (Cm) similarly exhibits a dilution pattern with a lower mean concentration at high mean discharge (Qm) in humid climatesAlbeit similar patterns, results highlight distinct drivers of instantaneous and mean concentrations by subsurface CO2 profiles and climate, respectively [ABSTRACT FROM AUTHOR]

PURPOSE Time from diagnosis to treatment has been associated with worse survival outcomes in non-small-cell lung cancer (NSCLC). However, little is known about the impact of delay in time to diagnosis. We aimed to evaluate the impact of time from radiographic suspicion to histologic diagnosis on survival outcomes using the US SEER-Medicare population database. METHODS We identified patients from the SEER-Medicare data set diagnosed with any stage NSCLC between January 1, 2011, and December 31, 2015, who received stage-appropriate treatment and had a computed tomography scan within 1 year of diagnosis. Time to confirmation was determined as the interval between most recent computed tomography imaging and date of histologic diagnosis. Our primary outcome was overall survival (OS). RESULTS In total, 10,824 eligible patients were identified. The median time to confirmation was 20 (range 0-363) days. Using multivariate Cox regression models, longer time to confirmation was associated with improved OS in all comers driven by stage IV patients after adjustment for age, sex, diagnosis year, histology, and comorbidity index. In a separate landmark analysis excluding patients deceased within 6 months of diagnosis, the association between time to diagnosis and survival was no longer evident. CONCLUSION Time to confirmation of NSCLC was inversely associated with OS in this US SEER population study. This association was lost when patients deceased within 6 months of diagnosis were excluded, suggesting that retrospective registry-claims databases may not be the optimal data source to study time to diagnosis as a quality metric because of the unaccounted confounding effects of tumor behavior. Prospective evaluations of clinically enriched data sources may better serve this purpose. [ABSTRACT FROM AUTHOR]

How does climate control river chemistry? Existing literature has examined extensively the response of river chemistry to short‐term weather conditions from event to seasonal scales. Patterns and drivers of long‐term, baseline river chemistry have remained poorly understood. Here we compile and analyze chemistry data from 506 minimally impacted rivers (412,801 data points) in the contiguous United States (CAMELS‐Chem) to identify patterns and drivers of river chemistry. Despite distinct sources and diverse reaction characteristics, a universal pattern emerges for 16 major solutes at the continental scale. Their long‐term mean concentrations (Cm) decrease with mean discharge (Qm), with elevated concentrations in arid climates and lower concentrations in humid climates, indicating overwhelming regulation by climate compared to local Critical Zone characteristics such as lithology and topography. To understand the CmQm pattern, a parsimonious watershed reactor model was solved by bringing together hydrology (storage–discharge relationship) and biogeochemical reaction theories from traditionally separate disciplines. The derivation of long‐term, steady state solutions lead to a power law form of CmQm relationships. The model illuminates two competing processes that determine mean solute concentrations: solute production by subsurface biogeochemical and chemical weathering reactions, and solute export (or removal) by mean discharge, the water flushing capacity dictated by climate and vegetation. In other words, watersheds function primarily as reactors that produce and accumulate solutes in arid climates, and as transporters that export solutes in humid climates. With space‐for‐time substitution, these results indicate that in places where river discharge dwindles in a warming climate, solute concentrations will elevate even without human perturbation, threatening water quality and aquatic ecosystems. Water quality deterioration therefore should be considered in the global calculation of future climate risks. Key Points: Continental‐scale river chemistry data show that mean discharge predominantly regulates mean concentrations of 16 solutesA simple watershed hydro‐biogeochemical reactor model illuminates that river chemistry is driven by the relative rates of solute addition (by reactions and input) and solute exportWhere river discharge dwindles in a warmer climate, higher concentrations will deteriorate water quality even without human perturbations [ABSTRACT FROM AUTHOR]

Background: Given the inclusion of orthopaedic quality measures in the Centers for Medicare & Medicaid Services national hospital payment programs, the present study sought to assess whether the public reporting of total hip arthroplasty (THA) and total knee arthroplasty (TKA) risk-standardized readmission rates (RSRRs) and complication rates (RSCRs) was temporally associated with a decrease in the rates of these outcomes among Medicare beneficiaries.Methods: Annual trends in national observed and hospital-level RSRRs and RSCRs were evaluated for patients who underwent hospital-based inpatient hip and/or knee replacement procedures from fiscal year 2010 to fiscal year 2016. Hospital-level rates were calculated with use of the same measures and methodology that were utilized in public reporting. Annual trends in the distribution of hospital-level outcomes were then examined with use of density plots.Results: Complication and readmission rates and variation declined steadily from fiscal year 2010 to fiscal year 2016. Reductions of 33% and 25% were noted in hospital-level RSCRs and RSRRs, respectively. The interquartile range decreased by 18% (relative reduction) for RSCRs and by 34% (relative reduction) for RSRRs. The frequency of risk variables in the complication and readmission models did not systematically change over time, suggesting no evidence of widespread bias or up-coding.Conclusions: This study showed that hospital-level complication and readmission rates following THA and TKA and the variation in hospital-level performance declined during a period coinciding with the start of public reporting and financial incentives associated with measurement. The consistently decreasing trend in rates of and variation in outcomes suggests steady improvements and greater consistency among hospitals in clinical outcomes for THA and TKA patients in the 2016 fiscal year compared with the 2010 fiscal year. The interactions between public reporting, payment, and hospital coding practices are complex and require further study.Level Of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Importance: Dental caries is the most common chronic disease in children in the US. According to the 2011-2016 National Health and Nutrition Examination Survey, approximately 23% of children aged 2 to 5 years had dental caries in their primary teeth. Prevalence is higher in Mexican American children (33%) and non-Hispanic Black children (28%) than in non-Hispanic White children (18%). Dental caries in early childhood is associated with pain, loss of teeth, impaired growth, decreased weight gain, negative effects on quality of life, poor school performance, and future dental caries.Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on screening and interventions to prevent dental caries in children younger than 5 years.Population: Asymptomatic children younger than 5 years.Evidence Assessment: The USPSTF concludes with moderate certainty that there is a moderate net benefit of preventing future dental caries with oral fluoride supplementation at recommended doses in children 6 months or older whose water supply is deficient in fluoride. The USPSTF concludes with moderate certainty that there is a moderate net benefit of preventing future dental caries with fluoride varnish application in all children younger than 5 years. The USPSTF concludes that the evidence is insufficient on performing routine oral screening examinations for dental caries by primary care clinicians in children younger than 5 years and that the balance of benefits and harms of screening cannot be determined.Recommendation: The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. (B recommendation) The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children younger than 5 years. (I statement). [ABSTRACT FROM AUTHOR]

BACKGROUND: Large numbers of chemicals require evaluation to determine if their production and use pose potential risks to ecological and human health. For most chemicals, the inadequacy and uncertainty of chemical-specific data severely limit the application of exposure- and risk-based methods for screening-level assessments, priority setting, and effective management. OBJECTIVE: We developed and evaluated a holistic, mechanistic modeling framework for ecological and human health assessments to support the safe and sustainable production, use, and disposal of organic chemicals. METHODS: We consolidated various models for simulating the PROduction-To-EXposure (PROTEX) continuum with empirical data sets and models for predicting chemical property and use function information to enable high-throughput (HT) exposure and risk estimation. The new PROTEX-HT framework calculates exposure and risk by integrating mechanistic computational modules describing chemical behavior and fate in the socioeconomic system (i.e., life cycle emissions), natural and indoor environments, various ecological receptors, and humans. PROTEX-HT requires only molecular structure and chemical tonnage (i.e., annual production or consumption volume) as input information. We evaluated the PROTEX-HT framework using 95 organic chemicals commercialized in the United States and demonstrated its application in various exposure and risk assessment contexts. RESULTS: Seventy-nine percent and 97% of the PROTEX-HT human exposure predictions were within one and two orders of magnitude, respectively, of independent human exposure estimates inferred from biomonitoring data. PROTEX-HT supported screening and ranking chemicals based on various exposure and risk metrics, setting chemical-specific maximum allowable tonnage based on user-defined toxicological thresholds, and identifying the most relevant emission sources, environmental media, and exposure routes of concern in the PROTEX continuum. The case study shows that high chemical tonnage did not necessarily result in high exposure or health risks. CONCLUSION: Requiring only two chemical-specific pieces of information, PROTEX-HT enables efficient screening-level evaluations of existing and premanufacture chemicals in various exposure- and risk-based contexts. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) disparities vary by country and population group, but often have spatial features. This study of the United States state of Virginia assessed CRC outcomes, and identified demographic, socioeconomic and healthcare access contributors to CRC disparities.Methods: County- and city-level cross-sectional data for 2011-2015 CRC incidence, mortality, and mortality-incidence ratio (MIR) were analyzed for geographically determined clusters (hotspots and cold spots) and their correlates. Spatial regression examined predictors including proportion of African American (AA) residents, rural-urban status, socioeconomic (SES) index, CRC screening rate, and densities of primary care providers (PCP) and gastroenterologists. Stationarity, which assesses spatial equality, was examined with geographically weighted regression.Results: For incidence, one CRC hotspot and two cold spots were identified, including one large hotspot for MIR in southwest Virginia. In the spatial distribution of mortality, no clusters were found. Rurality and AA population were most associated with incidence. SES index, rurality, and PCP density were associated with spatial distribution of mortality. SES index and rurality were associated with MIR. Local coefficients indicated stronger associations of predictor variables in the southwestern region.Conclusions: Rurality, low SES, and racial distribution were important predictors of CRC incidence, mortality, and MIR. Regions with concentrations of one or more factors of disparities face additional hurdles to improving CRC outcomes. A large cluster of high MIR in southwest Virginia region requires further investigation to improve early cancer detection and support survivorship. Spatial analysis can identify high-disparity populations and be used to inform targeted cancer control programming. [ABSTRACT FROM AUTHOR]

Background: Small-cell carcinoma is a relatively infrequent pathological variety of esophageal cancer. In this study, a novel nomogram model was developed to evaluate the cancer-specific survival (CSS) and overall survival (OS) of patients with primary esophageal small-cell carcinoma (ESmCC).Materials and Methods: In total, 502 patients with primary ESmCC were identified based on data from 1973 to 2015 retrieved from the surveillance, epidemiology, and end results database. Clinical characteristics such as age at diagnosis, gender, race, site, tumor stage, surgery, radiotherapy, and chemotherapy were included for multivariate logistic analyses to predict CSS and OS. Nomogram models for the prediction of CSS and OS in ESmCC patients were tested with the concordance index (C-index) method and calibration curves.Results: From our multivariate analyses, race, stage, chemotherapy, and radiotherapy, but not surgery, were significantly associated with the CSS of ESmCC patients, while age at diagnosis, stage, chemotherapy, and radiotherapy were significantly associated with their OS. Nomograms were developed using age at diagnosis, race, gender, stage, surgery, radiotherapy, and chemotherapy to predict the two survival measures; these nomograms were verified as accurate in predicting OS and CSS in ESmCC patients, with C-index values of 0.736 and 0.731, respectively.Conclusions: By utilizing easily accessible clinicopathological information, we established a simple but useful tool for predicting the CSS and OS of ESmCC patients that could help to make personalized clinical decisions for patients with this rare malignancy. Cancer-specific survival, esophageal small-cell carcinoma, nomogram, overall survival, surveillance, epidemiology, and end results. [ABSTRACT FROM AUTHOR]

Objective: Marijuana policies in the United States have become more permissive, motivating research on demographic and policy-based differences in behaviors and attitudes towards driving after marijuana use. The Traffic Safety Culture Index is an annual survey with national scope and multiple measures relevant to driving after marijuana use. We tabulated responses to questions about driving after marijuana use from the Traffic Safety Culture Index based on demographic factors, recreational and medical marijuana policies, and per-se marijuana laws. Results: Male, younger, lower-income, and lower-education respondents self-reported driving after marijuana use more than their demographic counterparts, more often reported such behavior to be personally acceptable, and exhibited lower support per-se laws. Drivers in states that legalized medical marijuana self-reported driving after marijuana use slightly more than drivers in states where both medical and recreational were illegal. Support for per-se laws was higher among those in states that legalized recreational marijuana and in states with per-se laws. Demographic differences in our outcomes were consistent and cohesive. On the other hand, we found no predominant pattern suggesting that those in states with liberal marijuana policies were more tolerant of driving after marijuana use. [ABSTRACT FROM AUTHOR]

Background: Cellphone use while driving (CUWD) is a frequent source of distraction for young drivers. These distractions commonly lead to motor vehicle crashes and, in some cases, death. Crash risk differs depending on if the driver is engaging in handheld or hands-free CUWD. This pilot study sought to investigate the differences between handheld versus hands-free CUWD behaviors in younger drivers and the attitudes and social norms that inform them. Methods: Young drivers (mean age: 19.6 years, standard deviation: 0.8 years) were recruited from a large Midwestern city in the United States as part of a pilot study. The 62 enrolled drivers (51 females, 43 non-Hispanic white) completed an online survey measuring behavioral frequencies, attitudes, and social norms regarding talking on the phone, sending messages, and reading messages. These cross-sectional data were then categorized and used for a descriptive analysis. Results: The majority of young drivers reported participating in some form of handheld CUWD, with reading messages being the most popular (95%). Only 43% of participants used hands-free technology for sending messages and 30% for reading messages, while half reported not using the technology at all. Whereas handheld messaging behaviors were viewed negatively by the participants, they were unsure of the impact on their driving ability and the legality surrounding hands-free messaging behaviors. Conclusions: Handheld CUWD behaviors were more popular among young drivers compared to hands-free CUWD. Further, even though young drivers understood handheld cellphone use while driving is unsafe, they engaged in it anyway. The findings of this pilot study highlight the importance of better educational initiatives and optimizing hands-free interventions for young driver use cases. [ABSTRACT FROM AUTHOR]

Background: To compare quality of life of patients treated with cetuximab with or without radiation therapy (±RT) vs. cisplatin±RT for locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN) in the real-world setting.Methods: In this retrospective observational study, electronic medical records and Patient Care Monitor (PCM) survey data from the Vector Oncology Data Warehouse were utilized from adult patients in the United States who received initial treatment with cetuximab±RT or cisplatin±RT for locoregionally advanced SCCHN between January 1, 2007 and January 1, 2017. Quality of life was assessed using PCM index scores and individual PCM items. Cetuximab±RT and cisplatin±RT cohorts were balanced using propensity score weighting. Linear mixed models were used to assess the impact of baseline demographic and clinical characteristics on PCM endpoints.Results: Of 531 patients with locoregionally advanced SCCHN, 187 received cetuximab±RT, and 344 received cisplatin±RT. Before propensity score weighting, the cetuximab±RT cohort was older (mean [SD] age of 63.9 [9.6] years vs. 57.4 [8.6] years), and more likely to be white (82.4% vs. 72.4%) compared to the cisplatin±RT cohort. After propensity score weighting, the two cohort subsamples (cetuximab±RT, N = 60; cisplatin±RT, N = 177) with PCM data showed no significant differences in General Physical Symptoms, Treatment Side Effects, Impaired Ambulation, or Impaired Performance index scores. Patients in the cetuximab±RT cohort had higher Acute Distress index (p = 0.023), Despair index (p = 0.011), and rash (p = 0.003) scores but lower numbness/tingling scores (p = 0.022) than patients in the cisplatin±RT cohort.Conclusions: Significant group differences were observed in this comparative analysis, as the cetuximab±RT cohort had significantly higher Acute Distress index, Despair index, and rash scores compared with the cisplatin±RT cohort but lower numbness/tingling scores. These patterns of symptoms appear consistent with previously reported symptoms associated with the treatment of SCCHN. [ABSTRACT FROM AUTHOR]

This paper examines the effects of the global financial crisis of 2008 on real and accrual-based earnings management activities of foreign companies listed in the United States as American Depositary Receipts (ADRs). The ADR firms are classified according to whether they report under U.S. Generally Accepted Accounting Principles (GAAP) or International Financial Reporting Standards (IFRS). Accrual-based earnings management is measured using the absolute value of performance-matched discretionary accruals. We also use the positive and negative values of performance-matched discretionary accruals to examine income-increasing and income-decreasing earnings management, respectively. Real earnings management proxies are measured using performance-matched measures of the abnormal levels of cash flow from operations, production costs, and discretionary expenses. In summary, our findings indicate no difference in accrual-based earnings management for ADRs reporting under IFRS and U.S. GAAP but suggest that ADRs reporting under IFRS are more likely to manage earnings using income-decreasing discretionary accruals and aggregate real earnings management than ADRs reporting under U.S. GAAP during the financial crisis. [ABSTRACT FROM AUTHOR]

Background: Pembrolizumab (Pembro) in combination with chemotherapy has been approved for the treatment of pretreated advanced NSCLC in the United States and China for its significant efficacy. However, the cost‐effectiveness is unknown considering Pembro's high price. The impact of programmed death ligand 1 (PD‐L1) test on the cost‐effectiveness is also unknown. The current study assessed the cost‐effectiveness of combination therapy for nonsquamous NSCLC from the United States and China public payers' perspective. Materials and Methods: A literature‐based Markov model was conducted using KEYNOTE‐189 trial data to compare cost and quality‐adjusted life years (QALYs) of three treatment strategies for nonsquamous NSCLC: Pembro‐chemotherapy combination and chemotherapy strategy without PD‐L1 test, and treatment strategy according to their PD‐L1 status. Results: In base case analysis, the combination strategy generated an additional 0.78 QALYs and 0.59 QALYs over chemotherapy in the United States and China respectively, resulting in an ICER of $132 392/QALY in the United States and $92 533/QALY in China. In the PD‐L1 ≥1% base case, the ICERs were $77 754/QALY and $56 768/QALY respectively in the United States and China for PD‐L1 test strategy. In the PD‐L1 ≥50% base case, the ICERs were $44 731/QALY and $34 388/QALY respectively in the United States and China for PD‐L1 test strategy. Lowering Pembro price can also partly decrease the ICERs. Conclusion: Compared with chemotherapy, the combination strategy is not cost‐effective for the treatment of NSCLC in the American and Chinese health care system at WTP threshold of $100 000/QALY for the United States and $27 351/QALY for China. Using PD‐L1 test for patient selection and price reduction could improve the cost‐effective probabilities of immunotherapy for nonsquamous NSCLC. [ABSTRACT FROM AUTHOR]

Background: Endocrine therapy (ET) remains a foundation of systemic therapy for HR+/ HER2- metastatic breast cancer (MBC), although chemotherapy (CT) is used in select patients. In this "real-world" study, we explored treatment patterns, health care resource use (HCRU), costs, adverse events (AEs) and overall survival (OS) in Medicare-enrolled, older patients with HR+/HER2- MBC. Methods: Patients with HR+/HER2- MBC (2007-2011) and aged >66 years were retrospectively analyzed using the SEER-Medicare data. Treatment patterns, HCRU, costs, AEs and OS after MBC diagnosis through end of study period (31 December 2013) were examined using descriptive and multivariable analyses. Results: Among 3622 eligible patients, ET was the most common treatment (77%), followed by CT (50%), radiation (48%) and surgery (19%). The proportion of patients treated with ET monotherapy decreased across therapy lines, from 74% in first line (1 L) to 35% in 4 L. The total number of unique therapy regimens used was 181 in 1 L, 171 in 2 L, 128 in 3 L, and 95 in 4 L. The median OS from MBC diagnosis was 25.3 months (95% CI, 24.0-26.7). In multivariable analyses, receipt of CT and combination CT + ET (versus ET monotherapy) in 1 L, metastatic disease at initial diagnosis, larger tumor size, and presence of visceral and brain metastases at MBC diagnosis significantly predicted receipt of 2 L therapy. Conclusions: ET was the most common first-line treatment for study patients, but its use decreased gradually in the subsequent lines. The heterogeneity in the treatment selection highlights a lack of consensus for the management of HR+/HER2- MBC in routine practice. [ABSTRACT FROM AUTHOR]

Architectural glass, especially the float glass, is a fragile part of a building. The architectural glass becomes a large amount of high-speed flying debris under bomb attacks and accidental explosions, thereby causing serious threat to residents. This study investigates the dynamic responses of a normal float glass subjected to blast loading using the explicit dynamic finite element software LS-DYNA. A JH-2 material model, which considers the strain rate effect and damage accumulation, is adopted for the float glass. A preliminary study shows that the present numerical model combined with reasonable material parameters can simulate the failure mode of the glass and the ejection velocity of glass fragments after failure. The verified model is then used to investigate the dynamic damage responses of the float glass under different loading cases. The damage assessment criterion of float glass is established on the basis of the glazing protection levels defined by the General Services Administration of the United States. Comprehensive simulations are conducted on different amounts of explosive and standoff distances. The degrees of glass damage under different loading cases are determined by combining the projection velocity of glass fragments after failure with a kinematic equation. Finally, the damage assessment diagram of float glass under different amounts of explosive is presented and compared with those in FEMA 426. [ABSTRACT FROM AUTHOR]

This study examines whether long-term performance plans and institutional holdings are associated with the level of R&D spending in firms. This paper contributes to the growing literature on the impact of mechanisms to mitigate the short-term focus of managers and investors. This study, unlike prior work, examines two mechanisms simultaneously, longterm performance plans and institutional investor holdings. We find no evidence that the adoption of long-term performance plans has implications for R&D spending. We do find evidence that holdings by institutional investors are positively associated with the level of R&D spending in the firm. These results indicate that the horizon of institutional investors may influence managers' planning horizons and how they decide on long-term investments, but managers' decisions on R&D investments are not affected by the introduction of performance plans. When examining the influence of R&D spending on institutional holdings, the simultaneous equations show that holdings by banks and insurance companies are lower in firms that have higher R&D. In contrast, holdings by "other" institutions are higher in firms that have higher R&D. [ABSTRACT FROM AUTHOR]

Background: The incidence of colorectal cancer ranks among the top three malignant tumors, attributing to more than 50,000 deaths in the United States every year. Survival rate is directly correlated with TNM stage at diagnosis, and identifying the molecules involved in the cancer development process will provide directions to better investigate the mechanisms of colorectal cancer. Materials and methods: Bioinformatics analysis of differentially expressed long noncoding RNAs (lncRNAs), survival analysis, cell proliferation assay, migration assay, and Western blot analysis were performed. Results: Fifty-one lncRNAs were identified between the early stage and late-stage groups. In the survival analysis, we found that Linc01194 is correlated with poor survival of colon cancer patients. In addition, by suppressing the expression of Linc01194 in colon cancer cell lines, cell proliferation and migration were inhibited. Western blot showed that N-cadherin and vimentin were downregulated, whereas E-cadherin was upregulated indicating that the process of epithelial–mesenchymal transition (EMT) was restrained. Conclusion: Linc01194 promotes the proliferation and migration ability of colon cancer cells by activating EMT. It acts as an oncogene in colorectal carcinoma and is associated with worse survival outcome. [ABSTRACT FROM AUTHOR]

Background: International service learning (ISL) is an instructional method used by physical therapist educators in the United States (US) to prepare students for rendering culturally competent care. ISL is a faculty led student learning opportunity that includes academic instruction and community service in an international context. Research exists that explores student experiences with ISL, but studies that evaluate ISL partnerships and include global stakeholder feedback are lacking. The purposes of this study were to: 1) integrate a partnership evaluation component into an existing curriculum-based ISL model and 2) through evaluation identify benefits, drawbacks, and suggestions for improving and sustaining the academic–community partnership. Methods: Community-based participatory research design using a mixed methods approach was used to evaluate a ISL partnership between a US-based physical therapy program and a service site in Ecuador. Participants were 31 staff working at the global service site. Over three years, 11 interviews were conducted and 26 surveys were administered to global partner staff. Data were analyzed using qualitative thematic content analysis and descriptive statistics. Results: Partnership benefits included the following: continuity of ISL team leadership, targeted rehabilitative efforts, sensitivity to cultural norms, respectful communication, and interaction with local community. Drawbacks were as follows: deficits in cultural awareness, language barriers, and poor treatment carryover. Suggestions for sustaining the relationship incorporated: additional pre-trip communication, education of staff, and improved language skills. Conclusion: As more US teams deliver clinical services abroad, intentional evaluation approaches must include the global stakeholder in the planning, implementation, and evaluation phases to maximize partnerships benefits. [ABSTRACT FROM AUTHOR]

Forces of globalization pose challenges and opportunities for understanding the impact of global media, especially discourses of superheroes at the intersection of the global and the local. Using the lens of Structuration Theory, the authors examine how Chinese sojourners make sense of media constructions of superheroes. A focus group interview method and thematic analysis of the interview texts were conducted. Findings in this study revealed both culturally universal constructions of prototypical superheroes and culturally specific, localized Chinese (super)heroes. Besides confirming the dominance of Western-centric superhero structures as gendered male and raced White, the results also suggest an emerging hybrid (super)hero archetype that is both real and imagined and embodies both Eastern and Western cultural values and orientations. [ABSTRACT FROM AUTHOR]

Objective Clinical trials have demonstrated improved outcomes for patients with diffuse large B-cell lymphoma (DLBCL) treated with regimens containing rituximab, but variations in real-world treatment patterns and outcomes have not been studied. The objective of this study was to characterize real-world treatment patterns and outcomes in higher risk DLBCL patients. Methods Patients with an International Prognostic Index score (IPI) ≥3 who received initial rituximab-based therapy from 2005 to 2012 were identified via electronic medical record data from the International Oncology Network. Initial therapy, rates of complete response (CR), post-CR treatments, and outcomes were evaluated. Results Among 257 eligible patients, 75% achieved a CR: 77% (158/206) of patients receiving R-CHOP compared to 71% (36/51) of patients receiving initial therapies other than R-CHOP. Post-CR, 78% of the 158 patients receiving R-CHOP underwent active surveillance; 13% received maintenance rituximab-based treatment; and 6% received radiation therapy. Relapse rates among patients receiving maintenance rituximab, active surveillance, and radiation therapy were 28% (6/21), 19% (24/124), and 0%, (0/10), respectively (P = 0.08). Discussion This study found that active surveillance continues to be the most commonly utilized treatment regimen among DLBCL patients with an IPI score ≥3 achieving a CR on first-line R-CHOP. Other approaches aimed at increasing the time to relapse are being utilized as well, but the clinical benefit of these modalities is unclear. Conclusion Results of this study are consistent with the results from clinical trials and suggest the need for further evaluation of maintenance therapy options for patients at higher risk of relapse. [ABSTRACT FROM AUTHOR]

The microwave land surface emissivity (MLSE) over the continental United States was examined during 2011 as a function of prior rainfall conditions using two independent emissivity estimation techniques, one providing instantaneous estimates based on a clear-scene emissivity principal component (PC) analysis and the other based on physical radiative transfer modeling. Results show that over grass, closed shrub, and cropland, prior rainfall can cause the horizontally polarized 10-GHz brightness temperature (TB) to drop by as much as 20 K, with a corresponding emissivity drop of approximately 0.06, whereby prior rain exhibited little influence on the emissivity over forest because of the dense vegetation. The correlation between emissivity and its leading principal components and the prior rainfall over grass, closed shrub, and cropland is −0.6, while it is only −0.1 over forested areas. Forward-simulated TB using the PC-based emissivity derived from instantaneous Tropical Rainfall Measuring Mission (TRMM) satellite overpasses agrees much better with TRMM Microwave Imager (TMI) observations relative to a climatologically based emissivity, especially after a period of heavy rain. Two potential applications of the PC-based emissivity are demonstrated. The first exploits the time history change of the MLSE to estimate the amount of prior rainfall. The second application is a method to estimate the emissivity underneath precipitating radiometric scenes by first adjusting the surface-sensitive principal components that were derived under clear-sky scenes and then by reconstructing the joint emissivity (all channels simultaneously) from the modified PC structure. The results are applicable to future overland passive microwave rainfall retrieval algorithms to simultaneously detect and estimate precipitation amounts under dynamically changing surface conditions. [ABSTRACT FROM AUTHOR]

The linear dose–response relationship has long been assumed in assessments of health risk from an incremental chemical emission relative to background emissions. In this study, we systematically examine the relevancy of such an assumption with real-world data. We used the reported emission data, as background emissions, from the 2017 U.S. National Emission Inventory for 95 organic chemicals to estimate the central tendencies of exposures of the general U.S. population. Previously published nonlinear dose–response relationships for chemicals were used to estimate health risk from exposure. We also explored and identified four intervals of exposure in which the nonlinear dose–response relationship may be linearly approximated with fixed slopes. Predicted rates of exposure to these 95 chemicals are all within the lowest of the four intervals and associated with low health risk. The health risk may be overestimated if a slope on the dose–response relationship extrapolated from toxicological assays based on high response rates is used for a marginal increase in emission not substantially higher than background emissions. To improve the confidence of human health risk estimates for chemicals, future efforts should focus on deriving a more accurate dose–response relationship at lower response rates and interface it with exposure assessments. [ABSTRACT FROM AUTHOR]

This paper examines the quality of financial reporting of Chinese firms cross-listed in the United States, Hong Kong and noncross-listed Chinese firms. We examine quality of financial reporting based on measures of earnings management, timely loss recognition and price-earnings association. We find that both cross-listings and noncross-listings show significant earnings smoothing and use accruals to manage earnings, and are not timely in loss recognition. We surmise that cross-listing in the United States or Hong Kong has not changed the accounting choices of Chinese cross-listing firms. However, our findings show that the market considers earnings and book value data of cross-listing firms to be more informative than those of noncross-listing firms in the event of good news. Our contribution is to show that in contrast to previous literature, firms from China do not have better reporting quality when they cross-list in the United States. There are still significant accounting deficiencies in many Chinese firms cross-listed in the United States (Financial Times, 2011). [ABSTRACT FROM AUTHOR]

Should commercial firms be prohibited from owning banking institutions? Should the United States remain the only G20 country opposed to the 'mixing of banking and commerce'? These questions have assumed new urgency as the Dodd Frank Act of July 2010 imposed a moratorium on the commercial ownership of industrial loan companies (ILCs), which was the last remaining entry point for commercial firms into banking. This paper specifically examines the role of ILCs in America's financial system from its beginnings in 1910 to the present. Special attention is paid to the performance of commercially owned ILCs prior to, during and after the most recent financial crisis. The examination is based upon both survey data and Federal Deposit Insurance Corporation (FDIC) data, which represents a database of the ILC industry that is the most comprehensive one available to date. The paper also reviews the laws and regulations regarding the mixing of banking and commerce, and discusses the advantages and disadvantages of allowing commercial ownership of banks. [ABSTRACT FROM AUTHOR]

Abstract: Power systems are the basic support of modern infrastructures and protecting them from random failures or intentional attacks is an active topic of research in safety science. This paper is motivated by the following two related problems about cascading failures on power grids: efficient edge attack strategies and lower cost protections on edges. Applying the recent cascading model by adopting a local load redistribution rule, where the initial load of an edge ij is (k i k j ) θ with k i and k j being the degrees of the nodes connected by the edge, we investigate the performance of the power grid of the western United States subject to three intentional attacks. Simulation results show that the effects of different attacks for the network robustness against cascading failures have close relations with the tunable parameter θ. Particularly, the attack on the edges with the lower load in the case of θ <1.4 can result in larger cascading failures than the one on the edges with the higher load. In addition, compared with the other two attacks, a new attack, i.e., removing the edges with the smallest proportion between the total capacities of the neighboring edges of and the capacity of the attacked edge, usually are prone to trigger cascading failures over the US power grid. Our findings will be not only helpful to protect the key edges selected effectively to avoid cascading-failure-induced disasters, but also useful in the design of high-robustness and low-cost infrastructure networks. [Copyright &y& Elsevier]

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Serum proteins are routinely used to diagnose diseases, but are hard to find due to low sensitivity in screening the serum proteome. Public repositories of microarray data, such as the Gene Expression Omnibus (GEO), contain RNA expression profiles for more than 16,000 biological conditions, covering more than 30% of United States mortality. We hypothesized that genes coding for serum- and urine-detectable proteins, and showing differential expression of RNA in disease-damaged tissues would make ideal diagnostic protein biomarkers for those diseases. We showed that predicted protein biomarkers are significantly enriched for known diagnostic protein biomarkers in 22 diseases, with enrichment significantly higher in diseases for which at least three datasets are available. We then used this strategy to search for new biomarkers indicating acute rejection (AR) across different types of transplanted solid organs. We integrated three biopsy-based microarray studies of AR from pediatric renal, adult renal and adult cardiac transplantation and identified 45 genes upregulated in all three. From this set, we chose 10 proteins for serum ELISA assays in 39 renal transplant patients, and discovered three that were significantly higher in AR. Interestingly, all three proteins were also significantly higher during AR in the 63 cardiac transplant recipients studied. Our best marker, serum PECAM1, identified renal AR with 89% sensitivity and 75% specificity, and also showed increased expression in AR by immunohistochemistry in renal, hepatic and cardiac transplant biopsies. Our results demonstrate that integrating gene expression microarray measurements from disease samples and even publicly-available data sets can be a powerful, fast, and cost-effective strategy for the discovery of new diagnostic serum protein biomarkers. [ABSTRACT FROM AUTHOR]

The United States is merging its two polar-orbiting operational environmental satellite programs operated by the Department of Commerce and the Department of Defense into a single system, which is called the National Polar-orbiting Operational Environmental Satellite System (NPOESS). During the next decade, NPOESS will provide global operational data to meet many of the needs of weather forecasters, climate researchers, and global decision makers for remotely sensed Earth science data and global environmental monitoring. The NPOESS Preparatory Project (NPP) will be launched in 2011 as a precursor to NPOESS to reduce final development risks for NPOESS and to provide continuity of global imaging and atmospheric sounding data from the National Aeronautics and Space Administration (NASA) Earth Observing System (EOS) missions. Beginning in 2014, NPOESS spacecraft will be launched into an afternoon orbit and in 2016 into an early-morning orbit to provide significantly improved operational capabilities and benefits to satisfy critical civil and national security requirements for space-based, remotely sensed environmental data. The European Organisation for the Exploitation of Meteorological Satellites (EUMETSAT) Meteorological Operation (MetOp) spacecraft will complement NPOESS in a midmorning orbit. The joint constellation will provide global coverage with a data refresh rate of approximately four hours. NPOESS will observe more phenomena simultaneously from space and deliver a data volume significantly greater than its operational predecessors with substantially improved data delivery to users. Higher-resolution (spatial and spectral) and more accurate imaging and atmospheric sounding data will enable improvements in short- to medium-range weather forecasts. Multispectral and hyperspectral instruments on NPOESS will provide global imagery and sounding products useful to the forecaster that are complementary to those available from geostationary satellites. NPOESS will support the operational needs of meteorological, oceanographic, environmental, climatic, and space environmental remote sensing programs and provide continuity of data for climate researchers. This article that describes NPOESS was completed and accepted for publication prior to the White House decision in February 2010 ordering a major restructuring of the NPOESS program. The Department of Commerce will now assume primary responsibility for the afternoon polar-orbiting operational environmental satellite orbit and the Department of Defense will take primary responsibility for the early morning orbit. However, NPP, as described in this article, is still scheduled to be launched in 2011. Several of the instruments and program elements described in this article are also likely to be carried forward into future U.S. polar-orbiting operational environmental satellite missions. [ABSTRACT FROM AUTHOR]

Abstract: The vulnerability of real-life networks subject to intentional attacks has been one of the outstanding challenges in the study of the network safety. Applying the real data of the US power grid, we compare the effects of two different attacks for the network robustness against cascading failures, i.e., removal by either the descending or ascending orders of the loads. Adopting the initial load of a node j to be with and being the degree of the node j and the set of its neighboring nodes, respectively, where is a tunable parameter and governs the strength of the initial load of a node, we investigate the response of the US power grid under two attacks during the cascading propagation. In the case of , our investigation by the numerical simulations leads to a counterintuitive finding on the US power grid that the attack on the nodes with the lowest loads is more harmful than the attack on the ones with the highest loads. In addition, the almost same effect of two attacks in the case of may be useful in furthering studies on the control and defense of cascading failures in the US power grid. [Copyright &y& Elsevier]

Exposure to mass media related to HIV/AIDS has been linked to attitudinal and behavioral changes. This study aims to identify the source(s) of HIV information for the general Chinese population and examine their association with HIV transmission knowledge and stigmatizing attitude toward people living with HIV/AIDS (PLWHA). A total of 3,716 market workers in Fuzhou, China, participated in a face-to-face survey. Multiple regression models were used to describe correlations among respondents' HIV/STD information sources, HIV transmission knowledge, and stigmatizing attitude toward PLWHA. Mass media sources, such as television programs, newspapers, and magazines, were more frequently identified as the channels for HIV information than interpersonal sources, such as friends and service providers. Exposure to multiple sources of HIV information (where at least one source is mass media) was significantly related to HIV knowledge and less stigmatizing attitude toward PLWHA. Mass media in China has been a major source of HIV information to the public. Enhancing the content and penetration of HIV/AIDS campaigns within various channels of the media can be an important strategy in disseminating HIV knowledge and reducing HIV-related discrimination. [ABSTRACT FROM AUTHOR]

We compared the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) immunohistochemical scoring criterion (30%) for determining HER2 status and the Food and Drug Administration criterion (10%) with fluorescence in situ hybridization (FISH), the HER2 gene amplification method in 328 cases of breast cancer. Of 294 tumor samples successfully analyzed simultaneously by FISH and immunohistochemically, 178 of 196 cases scored 3+ using the 10% and the 30% criteria. Using FISH as the reference, the number of false-positives was reduced from 24 to 9 after application of the 30% criterion. The specificity of immunohistochemical analysis was higher with the 30% (92.0%) vs the 10% (78.8%) criterion. The kappa coefficient between FISH and immunohistochemical analysis was increased to 0.850 (almost perfect agreement; P < .001) after application of the 30% criterion vs 0.757 (substantial agreement) for the 10% criterion; the false-positive rate decreased to 5.1% from 12.2%. The chi(2) test showed that immunohistochemical analysis had significantly higher accuracy with the 30% (94.9%) vs the 10% (87.8%; P = .014) criterion. Our results from a large series of Chinese patients with breast cancer support that the ASCO/CAP 30% criterion may offer better results for assessing HER2 status. [ABSTRACT FROM AUTHOR]

Surveys in the USA, New Zealand, Taiwan, Japan, and China examined attitudes toward the Iraq War and the Cross-Straits Relationship between China and Taiwan. Factor analyses revealed a four-factor solution of justice concerns: (a) national mandate for military intervention, (b) international mandate against military action, (c) procedural justice, and (d) distributive justice issues. Americans and mainland Chinese were significantly different in an in-group favoring direction compared to other societies regarding justice concerns involving their nation. Taiwan, the low-powered society in the Cross-Straits Relationship, was like the uninvolved societies. Justice in international relations is filtered through in-group favoritism for powerful states. [ABSTRACT FROM AUTHOR]

This paper examines how cross-listing impacts analyst coverage and forecast accuracy for U.S. firms that cross-list on foreign exchanges. By focusing on U.S. firms cross-listing abroad, we are able to discriminate between two competing explanations for the improvements in information intermediation experienced by foreign firms cross-listing in the U.S. (Lang, Lins, and Miller 2003); that is, whether the improvements are driven by generic cross-listing effects or by the strict disclosure and regulatory requirements specific to the U.S. markets. Our cross-sectional analysis indicates that cross-listing is negatively associated with analyst coverage, and our time-series analysis yields only marginal evidence of post-cross-listing improvement in forecast accuracy. Thus the cross-listing benefits documented in prior research for foreign firms cross-listing in the U.S. are not generalizable to all cross-listings and may be attributable to the strong disclosure and regulatory environment prevalent in the United States. [ABSTRACT FROM AUTHOR]

HIV/AIDS in China poses many challenges for caregivers and their children. A total of 154 caregivers of HIV/AIDS-affected families were interviewed to examine the children's nutrition intake and body mass index (BMI) in the context of HIV/AIDS in the family. The results showed that 25% of children in HIV/AIDS-affected families were underweight or at risk of being underweight according to US criteria. More than half the children reported that their consumption of protein such as meat, eggs or milk ranged from not at all to two times during the past month. About 40% of the children sometimes or often went hungry due to insufficient food. The study findings underscore the need to improve the nutrition and general health of children of people living with HIV/AIDS. [ABSTRACT FROM AUTHOR]

Perceptions of America as a powerful but malevolent nation decrease its security. On the basis of measures derived from the stereotype content model (SCM) and image theory (IT), 5,000 college students in 11 nations indicated their perceptions of the personality traits of, intentions of, and emotional reactions to the United States as well as their reactions to relevant world events (e.g., 9/11). The United States was generally perceived as competent but cold and arrogant. Although participants distinguished between the United States' government and its citizens, differences were small. Consistent with the SCM and IT, viewing the United States as intent on domination predicted perceptions of lack of warmth and of arrogance but not of competence and status. The discussion addresses implications for terrorist recruitment and ally support. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the impact of culture on contributory behaviors within the context of family, friends, and neighbors among the oldest old in the United States and in China. The study was conducted in suburban areas of Boston in 1996 (n = 465), and later in 1999 a replication of the study was conducted by Chinese researchers in urban areas of Shanghai, China (n = 539). This study found some common factors such as objective measure of health status, assistance received from others, and group affiliation. However, many differences emerged in the study. The range of contributory behaviors toward friends is quite different between the two samples. Some of the correlates' impact is also culturally specific, such as sibling support. These differences reflect variation in respondents' social support as well as social structural differences. Findings from this study suggest that providing more opportunities for elders to participate in groups would facilitate their participation in volunteer activities and improve their overall well-being. [ABSTRACT FROM AUTHOR]

Radio-frequency interference (RFI) is an increasingly serious problem for passive and active microwave sensing of the Earth. To satisfy their measurement objectives, many spaceborne passive sensors must operate in unprotected bands, and future sensors may also need to operate in unprotected bands. Data from these sensors are likely to be increasingly contaminated by RFI as the spectrum becomes more crowded. In a previous paper we reported on a preliminary investigation of RFI observed over the United States in the 6.9-GHz channels of the Advanced Microwave Scanning Radiometer (AMSR-E) on the Earth Observing System Aqua satellite. Here, we extend the analysis to an investigation of RFI in the 6.9- and 10.7-GHz AMSR-E channels over the global land domain and for a one-year observation period. The spatial and temporal characteristics of the RFI are examined by the use of spectral indices. The observed RI?! at 6.9 GHz is most densely concentrated in the United States, Japan, and the Middle East, and is sparser in Europe, while at 10.7 GHz the RFI is concentrated mostly in England, Italy, and Japan. Classification of RFI using means and standard deviations of the spectral indices is effective in identifying strong RFI. In many cases, however, it is difficult, using these indices, to distinguish weak RFI from natural geophysical variability. Geophysical retrievals using RFI-filtered data may therefore contain residual errors due to weak RFI. More robust radiometer designs and continued efforts to protect spectrum allocations will be needed in future to ensure the viability of spaceborne passive microwave sensing. [ABSTRACT FROM AUTHOR]

This article is to encourage and to provide successful experiences to United States (U.S.) institutions that may shy away from developing distance education programs that are to be delivered to foreign countries. Utah State University (USU) has been successfully delivering an interdisciplinary bachelor degree to Asian countries f or four years. The article discusses the methodologies of how to develop and operate an international program from the U.S. to Asian countries. It provides U.S. institutions with the knowledge of Asian education systems, and political and cultural background. [ABSTRACT FROM AUTHOR]