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Intimate partner violence (IPV) among college students is a significant problem that negatively affects their physical and emotional health. This study aimed at examining risk factors, especially childhood adversities at the individual, relationship, and community levels, of IPV perpetration among college students. Methods: The sample from seven universities in the U.S. and Canada (N = 3,725) completed an online survey. Major variables included IPV perpetration, five types of childhood adversities, alcohol and drug use, depression, and demographic information. Logistic regression was performed. Results: Peer violence victimization, witnessing parental IPV, experiencing child maltreatment, drug use, and depression were associated with a higher odd of perpetrating IPV. Conclusions: Research and practice must account for exposure to multiple risk factors when intervening with college students. An integrative approach that combines trauma-informed interventions with substance use and mental health treatment may be most successful at IPV perpetration prevention and intervention among college students.

Objective: The purpose of this study was to examine domestic violence (DV) perceptions and their correlates among South Asian (SA) immigrant men and women across the United States. Background: DV disparately impacts SA immigrants in the US due to acculturation, immigration barriers, and SA cultural values. Despite the high prevalence of DV among SAs, little is known about DV perceptions and their correlates among SAs. Studies have only been conducted on DV experiences with victims and women, excluding men leading to gaps in the evidence on DV perceptions. Method: This cross-sectional study included male and female SAs (N = 468) across the 50 US states. Hierarchical multiple regression examined the relationship between DV perceptions with sociodemographic factors, acculturation, and gender-role attitudes. Results: Overall, gender-role attitudes were associated with all four types of DV perceptions, whereas acculturation was associated with two types of DV perceptions. Conclusion: The current study is the first to identify DV perceptions and the correlates associated with DV perceptions among the SA community. Implications: The perceptions and the relationships that emerged in this study have implications for researchers, practitioners, and policymakers. The study findings can be pivotal in designing culturally responsive awareness interventions for SAs. These interventions can be subsequently adapted for other immigrant communities. [ABSTRACT FROM AUTHOR]

The article focuses on the issues of overlapping and adjacent intellectual property rights in biomedical innovation in the U.S., and discusses history of biopharmaceutical trial data silos; and Chrysler Corp. v. Brown and Ariad Pharmaceuticals, Inc. v. Eli Lilly & Co. court case on same.

The article offers the author's insights on experts, who believe in enforcing sanctions against Iran's oil exports. The author says that Kenneth Katzman states that the administration of U.S. President Barack Obama perceives the decline of the popularity and legitimacy of Iran's regime. He mentions that Ayatollah Khomeini, Iran's father of Islamist Revolution, declared himself as the Wali-e-Faqih or the Chief Jurist and Marja-e-taqleed of all Shias. He suggests that people should know the history and difference between the Shia and Sunni.

Abstract: Perceptions of the potential of emerging technologies like carbon capture and storage (CCS) are constructed not just through technical and economic processes but also through discourse, i.e. through compelling narratives about what a technology is, what a technology might become and why it is needed and preferable to competing technologies. The influence of discourse is particularly important in the innovation phases prior to commercialization when innovation activities are focused on research, development and demonstration, and when feasibility and costs of alternatives systems cannot yet be tested by market dynamics. This paper provides a state-level comparative analysis of CCS discourse in the U.S. to provide insights about the socio-political context in which CCS technology is advancing and being considered in four different states: Massachusetts, Minnesota, Montana, and Texas. This research combines analysis of interviews of state-level energy stakeholders and media analysis of state-level newspapers. In semi-structured interviews, state-level energy policy stakeholders were asked to explain their perceptions of the potential opportunities and risks of CCS technology within their unique state context. Interview texts were coded to assess the frequency and extent of various different frames of CCS opportunities and risks including technical, political, economic, environmental, aesthetic, and health/safety. A similar coding scheme was applied to analysis of state-level newspaper coverage of CCS technology. Here, the frequency of these different framings of CCS opportunities and risks in state-level print media was assessed. This analysis demonstrates wide variation in state-level CCS discourse and perceptions of the potential opportunities and risks associated with CCS technology. This mixed-methods approach to characterizing the socio-political context for CCS advancement in these four states contributes to improved understanding of state-level variation in energy technology innovation, provides valuable information about energy technology development in these specific states, and also offers insight into the very different sub-national discourses associated with emerging low-carbon energy technologies in the U.S. [Copyright &y& Elsevier]

The article offers a review of psoriatic arthritis (PsA), known as an inflammatory disease of the skin and the joints, along with the diagnosis and management of the disease. It is estimated that PsA is prevalent in 0.25% of the U.S. population. PsA has five types including asymmetric oligoarthritis, symmetric polyarthritis and spondyloarthropathy. Also mentioned is the treatment for PsA including non-steroidal anti-inflammatory drugs (NSAIDs), intra-articular steroid injections and disease modifying antirheumatic drugs (DMARDs).

Abstract: As a technology that may involve new risks, large-scale infrastructure, and significant government involvement, carbon capture and storage (CCS) faces a wide variety of deployment challenges. Because energy policy in the U.S. is negotiated at the state level, it is important to evaluate what might influence CCS related decisions in the U.S. at that level. This paper presents a detailed analysis of how deployment discussions and decisions regarding CCS are negotiated within Texas, Minnesota, and Massachusetts. These states were chosen based upon their current involvement in CCS research (high, medium, low), potential for deploying CCS (direct, indirect, or absent), and regulation (restructured, regulated). We explore nuances within the policy debates and public discourse surrounding CCS in these three states through the use of legislative and policy analysis, interviews with stakeholders, and media analysis. Using information generated from legislative dockets and state-level newspaper coverage we construct a template of CCS discussions, framing, and policy creation within each study state. [Copyright &y& Elsevier]

The article explores the practice known as McCarthyism, whose example is blacklisting of artists, writers and performers. It indicates that the former U.S. Senator Joseph McCarthy's accusation of communist sympathy, or the House Un-American Activities Committee (HUAC), involved indictment or slander with long-term career ramifications. It also discusses the loyalty dispute between accused communist sympathizer and correspondent Kay Boyle and magazine "The New Yorker."

Purpose: Anti-PD-1/PD(L)1-based combination therapy is the standard of care in first line (1L) for metastatic nonsquamous non-small cell lung cancer (mnsqNSCLC) without driver alterations. This study aimed to evaluate real-world clinical outcomes in this population., Methods: Eligible physicians in the United States, Europe, and Japan abstracted information from medical charts of eligible adult patients with mnsqNSCLC (without EGFR / ALK , no known ROS1 alterations) who initiated 1L anti-PD(L)1-based combination therapy for mnsqNSCLC between 2017 and 2021. Kaplan-Meier analyses were used to assess overall survival (OS), time-to-treatment discontinuation (TTD), and real-world progression-free survival (rwPFS) after 1L initiation., Results: Overall, 142 physicians contributed deidentified data from 430 patients' medical charts. The distribution of PD-L1 expression levels was 31.2% with tumor proportion score (TPS) <1%, 42.3% with TPS 1%-49%, and 26.5% with TPS ≥50%. In 1L, patients received anti-PD(L)1 + chemotherapy (84.6%), anti-PD(L)1 + anti-CTLA4 with or without chemotherapy (11.9%), and anti-PD(L)1 + chemotherapy + anti-vascular endothelial growth factor receptor (3.5%). The median OS was 21.7 months (TPS <1%: 18.3 months; TPS 1%-49%: 21.6 months; TPS ≥50%: 24.0 months). The median TTD was 11.0 months (TPS <1%: 9.1 months; TPS 1%-49%: 10.9 months; TPS ≥50%: 12.2 months). The median rwPFS was 11.2 months (TPS <1%: 9.3 months; TPS 1%-49%: 11.1 months; TPS ≥50%: 13.2 months)., Conclusion: This study assessed the real-world clinical effectiveness of 1L anti-PD(L)1-based combination therapy for mnsqNSCLC. Results from this study were generally consistent with previous clinical trials and published real-world evidence in 1L mnsqNSCLC.

Purpose: The American Academy of Pediatrics emphasized in a 2007 policy statement the importance of educating trainees on the impacts of climate change on children's health, yet few studies have evaluated trainee knowledge and attitudes about climate change-related health effects in children. This multi-institution study assessed pediatric resident and program director (1) knowledge/attitudes on climate change and health, (2) perspectives on the importance of incorporating climate and health content into pediatric graduate medical education, and (3) preferred topics/activities to include in climate and health curricula., Method: This mixed-methods study employed an anonymous cross-sectional survey of pediatric residents and residency program directors from Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN)-affiliated programs. Multivariable regression models and factor analyses were used to examine associations among resident demographics and resident knowledge, attitudes, and interest in a climate change curriculum. A conventional content analysis was conducted for the open-ended responses., Results: Eighteen programs participated in the study with all program directors (100% response rate) and 663 residents (average response rate per program, 53%; overall response rate, 42%) completing respective surveys. Of the program directors, only 3 (17%) felt very or moderately knowledgeable about the association between climate change and health impacts. The majority of residents (n=423, 64%) agreed/strongly agreed that physicians should discuss global warming/climate change and its health effects with patients/families, while only 138 residents (21%) agreed/strongly agreed that they were comfortable talking with patients and families about these issues. Most residents (n=498, 76%) and program directors (n=15, 83%) agreed/strongly agreed that a climate change curriculum should be incorporated into their pediatrics training program., Conclusions: Pediatric residents and program directors support curricula that prepare future pediatricians to address the impact of climate change on children's health; however, few programs currently offer specific training, despite identified needs., (Copyright © 2024 the Association of American Medical Colleges.)

Purpose: To characterize treatment patterns and real-world clinical outcomes of patients with metastatic non-small cell lung cancer (mNSCLC) who developed progression on an anti-PD-1/anti-PD-L1, herein referred to as anti-PD-(L)1, and platinum-doublet chemotherapy., Methods: Eligible oncologists/pulmonologists in the United States, Europe (France, Germany, and United Kingdom), and Japan completed electronic case report forms for patients with mNSCLC (no evidence of EGFR/ALK/ROS1 alterations). Eligible patients had disease progression on/after an anti-PD-(L)1 and platinum-doublet chemotherapy (received concurrently or sequentially), initiated a subsequent line of therapy (LOT) between 2017 and 2021, and had an Eastern Cooperative Oncology Group (ECOG) performance status 0-2 at this subsequent LOT initiation (index date). Overall survival (OS), time to treatment discontinuation (TTD), and real-world progression-free survival (rwPFS) after index were assessed using Kaplan-Meier analysis., Results: Overall, 160 physicians (academic, 54.4%; community, 45.6%) provided deidentified data from 487 patient charts (United States, 141; Europe, 218; Japan, 128; at mNSCLC diagnosis: median age 66 years, 64.7% male, 81.3% nonsquamous, 86.2% de novo mNSCLC; at line of interest initiation: 86.0% ECOG 0-1, 39.6% liver metastases, 18.9% brain metastases, 79.1% smoking history). The most common treatment regimens upon progression after anti-PD-(L)1/platinum-doublet chemotherapy were nonplatinum chemotherapy (50.5%), nonplatinum chemotherapy plus vascular endothelial growth factor receptor inhibitor (12.9%), and platinum-doublet chemotherapy (6.6%). Median OS was 8.8 months (squamous, 7.8 months; nonsquamous, 9.5 months). Median TTD was 4.3 months (squamous, 4.1 months; nonsquamous, 4.3 months). Median rwPFS was 5.1 months (squamous, 4.6 months; nonsquamous, 5.4 months)., Conclusion: In this multiregional, real-world analysis of pooled patient chart data, patients with mNSCLC who had disease progression after anti-PD-(L)1/platinum-doublet chemotherapy had poor clinical outcomes with various treatment regimens, demonstrating an unmet clinical need for effective options after failure on anti-PD-(L)1 and platinum-doublet chemotherapy treatments.

Purpose: To describe trends and patterns of initial percutaneous nephrolithotomy (PCNL) and subsequent procedures from 2010 to 2019 among commercially-insured US adults with urinary system stone disease (USSD)., Methods: Retrospective study of administrative data from the IBM® MarketScan ® Database. Eligible patients were aged 18-64 years and underwent PCNL between 1/1/2010 and 12/31/2019. Measures of interest for analysis of trends and patterns included the setting of initial PCNL (inpatient vs. outpatient), percutaneous access (1 vs. 2-step), and the incidence, time course, and type of subsequent procedures (extracorporeal shockwave lithotripsy [SWL], ureteroscopy [URS], and/or PCNL) performed up-to 3 years after initial PCNL., Results: A total of 8,348 patients met the study eligibility criteria. During the study period, there was a substantial shift in the setting of initial PCNL, from 59.9% being inpatient in 2010 to 85.3% being outpatient by 2019 (P < 0.001). The proportion of 1 vs. 2-step initial PCNL fluctuated over time, with a low of 15.1% in 2016 and a high of 22.0% in 2019 but showed no consistent yearly trend (P = 0.137). The Kaplan-Meier estimated probability of subsequent procedures following initial PCNL was 20% at 30 days, 28% at 90 days, and 50% at 3 years, with slight fluctuations by initial PCNL year. From 2010 to 2019, the proportion of subsequent procedures accounted for by URS increased substantially (from 30.8 to 51.8%), whereas SWL decreased substantially (from 39.5 to 14.7%) (P < 0.001)., Conclusions: From 2010 to 2019, PCNL procedures largely shifted to the outpatient setting. Subsequent procedures after initial PCNL were common, with most occurring within 90 days. URS has become the most commonly-used subsequent procedure type., (© 2022. The Author(s).)

Introduction: Presence of multimorbidity can affect prognosis, treatment, and outcomes of individuals with cancer. However, the prevalence and factors associated with multimorbidity among older late-stage melanoma is not well studied. We estimated the prevalence of any type of pre-existing multimorbidity (autoimmune disorder (AD), physical health conditions (PHC), and mental health conditions (MHC)) among older adults with late-stage melanoma in the United States. We further examined the association of patient-level factors to multimorbidity in late-stage melanoma., Methods: We derived data on older fee-for-service Medicare beneficiaries (age ≥ 66 years) diagnosed with late-stage melanoma between 2011 and 2015 (N = 4,519) from the linked Surveillance, Epidemiology, and End Results cancer registry and Medicare claims. We defined multimorbidity as the prevalence of two or more chronic conditions prior to the diagnosis of melanoma. We used unadjusted and adjusted logistic regressions to examine the association of patient-level factors to multimorbidity., Results: An overwhelming majority (85%) of older patients with late-stage melanoma had multimorbidity. Pre-existing PHC multimorbidity (84%) was the most prevalent, followed by AD (12%), and MHC (6%). Age and region were associated with any and PHC multimorbidity. Sex, marital status, and region were factors associated with pre-existing AD while sex, marital status, and dual eligibility were associated with MHC multimorbidity., Conclusions: Pre-existing multimorbidity was highly prevalent among older individuals with late-stage melanoma; prevalence rates and factors associated with multimorbidity varied by type of chronic conditions. This highlights the need for developing systematic approaches to optimizing care of older patients with late-stage melanoma and multimorbidity., Competing Interests: Declaration of Competing Interest All authors have no conflict of interest to declare, (Copyright © 2020 Elsevier Inc. All rights reserved.)

Abstract: Improvement in overall survival by immune checkpoint inhibitors (ICI) treatment in clinical trials encourages their use for late-stage melanoma. However, in the real-world, heterogeneity of population, such as older patients with multimorbidity, may lead to a slower diffusion of ICIs. The objective of this study was to examine the association of multimorbidity and other factors to ICI use among older patients with late-stage melanoma using real world data.A retrospective cohort study design with a 12-month baseline and follow-up period was adopted with data from the linked Surveillance, Epidemiology, and End Results cancer registry/Medicare database. Older patients (>65 years) with late-stage (stage III/IV) melanoma diagnosed between 2012 and 2015 were categorized as with or without multimorbidity (presence of 2 or more chronic conditions) and ICI use was identified in the post-index period. Chi-square tests and logistic regression were used to evaluate factors associated with ICI use.In the study cohort, 85% had multimorbidity, 18% received any treatment (chemotherapy, radiation, and/or ICI), and 6% received ICI. Only 5.5% of older patients with multimorbidity and 6% without multimorbidity received ICIs. Younger age, presence of social support, lower economic status, residence in northeastern regions, and recent year of diagnosis were significantly associated with ICI use; however, multimorbidity, sex, and race were not associated with ICI use.In the real-world clinical practice, only 1 in 18 older adults with late stage melanoma received ICI, suggesting slow pace of diffusion of innovation. However, multimorbidity was not a barrier to ICI use., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The objective of this study is to assess the impact of immune checkpoint inhibitors (ICIs) and multimorbidity on healthcare expenditures among older patients with late-stage melanoma. Materials & methods: A retrospective longitudinal cohort study using Surveillance, Epidemiology and End Results linked with Medicare claims was conducted. Generalized linear mixed models were used to analyze adjusted relationships of ICI, multimorbidity and ICI-multimorbidity interaction on average healthcare expenditures. Results: Patients who received ICI and those who had multimorbidity had significantly higher average total healthcare expenditures compared with ICI nonusers and no multimorbidity. In the fully adjusted model using ICI-multimorbidity interaction, no excess cost was added by multimorbidity. Conclusion: Use of ICIs, regardless of multimorbidity, is associated with increased healthcare expenditures.

Sickle cell disease (SCD) afflicts millions of people worldwide but is referred to as an orphan disease in the United States. Over the past several decades, there has been an increasing understanding of the pathophysiology of SCD and its complications. While most individuals with SCD in resource-rich countries survive into adulthood, the life expectancy of patients with SCD remains substantially shorter than for the general African-American population. SCD can be cured using hematopoietic stem cell transplantation and possibly gene therapy, but these treatment approaches are not available to most patients, the majority of whom reside in low- and middle-income countries. Until relatively recently, only one drug, hydroxyurea, was approved by the US Food and Drug Administration to ameliorate disease severity. Multiple other drugs (L-glutamine, crizanlizumab, and voxelotor) have recently been approved for the treatment of SCD, with several others at various stages of clinical testing. The availability of multiple agents to treat SCD raises questions related to the choice of appropriate drug therapy, combination of multiple agents, and affordability of recently approved products. The enthusiasm for new drug development provides opportunities to involve patients in low- and middle-income nations in the testing of potentially disease-modifying therapies and has the potential to contribute to capacity building in these environments. Demonstration that these agents, alone or in combination, can prevent or decrease end-organ damage would provide additional evidence for the role of drug therapies in improving outcomes in SCD., Competing Interests: Competing interests: KIA has served on clinical advisory boards and/or served as a consultant for Global Blood Therapeutics, Novartis, Emmaus Life Sciences, Editas Medicine, and Novo Nordisk. PR has no competing interests.Competing interests: YS has patents, owns equity in, and serves on the board of a company EpiDestiny that is developing drug therapy for sickle cell disease. No competing interests were disclosed., (Copyright: © 2020 Rai P and Ataga KI.)

We examined the relationship between persistent osteoporosis medication use and fracture risk among female Medicare beneficiaries diagnosed with osteoporosis using Medicare claims, 2009-2012. Persistent use was associated with reduced risk of fracture and significantly lower total health care costs in the follow-up period. Results were consistent using different analytical methods., Introduction: This study aimed to examine the relationship between medication persistence and fracture risk among female Medicare beneficiaries diagnosed with osteoporosis., Methods: Elderly female Medicare beneficiaries diagnosed with osteoporosis and initiated on osteoporosis medication January 1, 2009-June 30, 2011, were included. Persistent medication use was defined as continuous use (no gap ≥ 60 days) for 1 year or longer. The key outcome was fragility fracture. A difference-in-difference analysis was performed at the log scale of fracture rate using a Poisson regression model with months 1-6 before medication initiation as the pre-initiation period and up to 18 months after as the post-initiation period. Total health care costs were compared using a similar approach. Sensitivity analyses were conducted using different pre- and post-initiation periods., Results: The study included 294,369 patients; 32.9% were persistent osteoporosis medication users and 67.1% non-persistent (< 12 months continuous use). Fracture incidence rates were 16.2 per 100 patient-years pre-initiation and 4.1 post-initiation for persistent users; corresponding rates for non-persistent users were 19.0 and 7.3 per 100 patient-years. The adjusted post-/pre-initiation fracture rate ratios were 0.284 for persistent and 0.411 for non-persistent users. The ratio of the two rate ratios was 0.692 (persistent vs. non-persistent, p < 0.0001), suggesting a significantly greater fracture rate reduction for persistent users. Adjusted cost ratios were significantly lower for persistent users. Sensitivity analyses results were similar., Conclusions: Persistent use of osteoporosis medications was associated with reduced risk of fracture and significantly lower total health care costs. Payers and patients would benefit from interventions aimed at improving medication persistence.