Search

Reproductive abnormalities, that could lead to possible effects at the population level, have been observed in wild fish throughout the United States, with high prevalence in largemouth bass (LMB; Micropterus salmoides) and smallmouth bass (Micropterus dolomieu). Estrone (E1) and atrazine (ATR) are common environmental contaminants often associated with agricultural land use. 17alpha-ethinylestradiol (EE2) is a contaminant associated with wastewater treatment effluent, and a representative, well-studied estrogen commonly used for fish toxicity testing. Our objective was to assess whether early gonad recrudescence in adult fish was a period of sensitivity for alterations in reproductive condition and function. Adult male LMB were exposed from post-spawning to early gonad recrudescence to either a mixture of E1 (47.9 ng/L) + ATR (5.4 µg/L), or EE2 (2.4 ng/L) in outdoor experimental ponds. Gonad samples were collected from fish just prior to the start of exposure (July), at the end of the exposure period (December), the following spring just prior to spawning (April), and post spawning (May). Gonadosomatic index (GSI) was significantly reduced in E1 + ATR-exposed and EE2-exposed males compared to control at every post-exposure time point. Reduced sperm count and sperm motility were observed in the mixture treatment (E1 + ATR) compared to the control. Sperm motility was also reduced in the EE2 treatment. These data together indicate that estrogenic endocrine-disrupting compounds can lessen the reproductive condition of adult male LMB, and that effects of exposure during early gonad recrudescence can persist at least through the subsequent spawning cycle. [ABSTRACT FROM AUTHOR]

Introduction: The standard of care consolidation therapy for acute myeloid leukemia is high-dose cytarabine or intermediate-dose cytarabine, which are traditionally given inpatient. At Moffitt Cancer Center, we have moved the administration of high-dose cytarabine and intermediate-dose cytarabine to the outpatient setting through the inpatient/outpatient program. To facilitate outpatient administration, high-dose cytarabine and intermediate-dose cytarabine are given in a shorter interval of every 10 h instead of 12 h. The safety of a shorter duration interval of high-dose cytarabine and intermediate-dose cytarabine is unknown. This study aims to assess the safety and feasibility of administering high-dose cytarabine and intermediate-dose cytarabine consolidation therapy in the inpatient/outpatient setting. Methods: This is a retrospective chart review to analyze acute myeloid leukemia patients treated with inpatient/outpatient high-dose cytarabine or intermediate-dose cytarabine consolidation therapy at Moffitt Cancer Center from January 1, 2015, through November 1, 2018. The primary objective was to determine the incidence of hospitalization during the inpatient/outpatient administration of high-dose cytarabine or intermediate-dose cytarabine. Results: Two hundred fifty-three of 255 cycles of high-dose cytarabine/intermediate-dose cytarabine were delivered outpatient over the reviewed time period to 118 patients. No patients receiving outpatient high-dose cytarabine/intermediate-dose cytarabine consolidation required hospitalization during chemotherapy. Our incidence of hospitalization (24%) after chemotherapy is consistent with the reported literature. Through the inpatient/outpatient administration of high-dose cytarabine and intermediate-dose cytarabine, 1265 inpatient days were saved with an approximate revenue of $3,135,176 generated in our study period. Conclusion: Inpatient/outpatient administration of high-dose cytarabine and intermediate-dose cytarabine is both safe and feasible. Moving high-dose cytarabine/intermediate-dose cytarabine administration to the outpatient setting resulted in significant additional revenue vs. inpatient administration. [ABSTRACT FROM AUTHOR]

Ten novel breeding lines of quinoa (Chenopodium quinoa Willd) suitable to be grown in the Pacific Northwest of the United States were developed and utilized for extrusion processing. Understanding how a particular breeding line performs during food processing and which properties determine its performance can promote the use of quinoa as an ingredient in value‐added products, such as extruded snacks. In this study, extrusion characteristics of the whole seed flours of the novel quinoa breeding lines were evaluated using a co‐rotating twin‐screw extruder at two temperatures (110°C and 125°C), three screw speeds (200, 350, and 500 rpm), and a moisture content of 18% (w.b.). The expansion ratio (ER) ranged from 1.15 to 2.33 and was negatively influenced by the fat content in the flours. Breeding line 11WAQ‐104.88 (WAQ10) exhibited the greatest potential for use in direct expanded foods as it had the highest ER for all conditions studied. Strong correlations were found between ER and pasting properties of the flours, proving the usefulness of the pasting test for flour quality evaluation before extrusion processing. The results demonstrate the potential of using quinoa for producing direct expanded food products and highlight the importance of selecting specific breeding lines for desired product characteristics. Practical Application: This study provides the extrusion processing characteristics of 10 new quinoa breeding lines. Based on the information gained, it will be easier for the food industry, including breeders as well as processors, to select the right quinoa variety based on their requirements, and may further help to enhance the use of quinoa. [ABSTRACT FROM AUTHOR]

The article discusses a study which found that the largest marijuana companies engage in corporate social responsibility activities that mimic those the tobacco industry uses to influence politics and regulation, encourage increased consumption, and target marginalized communities. Topics include risks to youth, risks to disadvantaged communities, and recommendations to minimize harm.

Precise measurement of urban land (UL) is an essential tool for planning in a world of accelerating change and increasing risk, but analysis has traditionally faced methodological and conceptual challenges. This review traces the evolution of UL measurement in the United States (US) from early attempts at quantification through current innovative approaches that analyze the qualities of UL. Researchers now have tools better suited to multi-scalar and complex conceptualization of urban systems. Given this maturation, critical reflection on research design has become essential to UL research, in particular the alignment of measurement tools with desired outcomes and planning goals. [ABSTRACT FROM AUTHOR]

Proximity soundings have long been used to explore how the vertical structure of temperature, humidity, and winds influence convective storms and their associated hazards. In severe thunderstorm research and forecasting, convective parameters are often used to summarize certain characteristics of the sounding. While extremely useful, these parameters are unable to describe the rich complexity that is readily apparent in hodographs and skew T–logp diagrams. Motivated by a desire to retain more of these details, the present study uses self-organizing maps (SOMs) to group soundings based on their full vertical structure. The analysis makes use of a sample of more than 10 000 model proximity soundings for right-moving supercells associated with tornadoes and significant severe hail and straight-line winds in the contiguous United States (CONUS). Separate SOMs are developed for the wind and thermodynamic profiles, each with 3 × 3 nodes, resulting in a set of nine hodographs and nine skew T–logp diagrams that broadly represent the spectrum of near-storm environments for significant severe right-moving supercells in the CONUS. Both SOMs are shown to provide a good representation of the variability in key convective parameters, although, for the thermodynamic SOM, variations in LCL heights and midlevel lapse rates are somewhat limited. Based on the soundings assigned to them, the SOM nodes are characterized in terms of their associated hazards, their relationship with storm mode and mesocyclone strength, and their spatial and temporal variability. Potential applications of the SOMs in severe weather forecasting and idealized numerical simulations are also highlighted. [ABSTRACT FROM AUTHOR]

Objective: To determine whether vaginal progesterone for programmed endometrial preparation is noninferior to intramuscular progesterone in terms of live birth rates from frozen embryo transfer (FET).Design: Three-armed, randomized, controlled noninferiority trial.Setting: Multicenter fertility clinic.Patient(s): A total of 1,346 volunteer subjects planning vitrified-warmed transfer of high-quality nonbiopsied blastocysts were screened, of whom 1,125 subjects were ultimately enrolled and randomly assigned to treatment.Intervention(s): The subjects were randomly assigned to receive, in preparation for FET, 50 mg daily of intramuscular progesterone (control group), 200 mg twice daily of vaginal micronized progesterone plus 50 mg of intramuscular progesterone every third day (combination treatment), or 200 mg twice daily of vaginal micronized progesterone.Main Outcome Measure(s): The primary outcome was live birth rate per vitrified-warmed embryo transfer. The secondary outcomes were a positive serum human chorionic gonadotropin test 2 weeks after FET, biochemical pregnancy loss, clinical pregnancy, clinical pregnancy loss, total pregnancy loss, serum luteal progesterone concentration 2 weeks after FET, and patient's experience and attitudes regarding the route of progesterone administration, on the basis of a survey administered to the subjects between FET and pregnancy test.Result(s): A total of 1,060 FETs were completed. The live birth rate was significantly lower in women receiving only vaginal progesterone (27%) than in women receiving intramuscular progesterone (44%) or combination treatment (46%). Fifty percent of pregnancies in women receiving only vaginal progesterone ended in miscarriage.Conclusion(s): The live birth rate after vaginal-only progesterone replacement was significantly reduced, due primarily to an increased rate of miscarriage. Vaginal progesterone supplemented with intramuscular progesterone every third day was noninferior to daily intramuscular progesterone, offering an effective alternative regimen with fewer injections.Clinical Trial Registration Number: NCT02254577. [ABSTRACT FROM AUTHOR]

Background Intake of trans fatty acids (TFAs) increases LDL cholesterol, decreases HDL cholesterol, and increases the risk of heart disease morbidity and mortality. Many food products potentially contain industrially produced or ruminant TFAs. However, little is known about the dietary sources of plasma TFA concentrations. Objective The objective of this study was to examine associations between foods consumed and plasma TFA concentrations using 24-h dietary recall data and plasma TFA measures among adults aged ≥20 y who participated in the NHANES 2009–2010 in the United States. Methods Over 4400 food products in the dietary interview data were categorized into 32 food and beverage groups/subgroups. Four major plasma TFAs (palmitelaidic acid, elaidic acid, vaccenic acid, linolelaidic acid) and the sum of the 4 TFAs (sumTFAs) were analyzed using GC-MS. Multivariable linear regression analyses were conducted to identify associations of plasma TFAs with all 32 food and beverage groups/subgroups, controlling for the potential confounding effects of 11 demographic, socioeconomic, behavioral, lifestyle, and health-related variables. Results Consumption of the following food groups/subgroups was significantly associated with elevated plasma TFA concentrations: cream substitutes (P  < 0.001 for palmitelaidic acid, elaidic acid, vaccenic acid, and sumTFAs); cakes, cookies, pastries, and pies (P  < 0.001 for elaidic acid, vaccenic acid, and sumTFAs; P  < 0.05 for linolelaidic acid); milk and milk desserts (P  < 0.01 for palmitelaidic acid and vaccenic acid; P  < 0.05 for linolelaidic acid and sumTFAs); beef/veal, lamb/goat, and venison/deer (P  < 0.01 for vaccenic acid; P  < 0.05 for sumTFAs); and butters (P  < 0.001 for palmitelaidic acid and vaccenic acid; P  < 0.05 for sumTFAs). Conclusions The findings suggest that the above 5 food groups/subgroups could be the main dietary sources of plasma TFAs among adults in the United States in 2009–2010. [ABSTRACT FROM AUTHOR]

Toddler milk products are ultraprocessed milk-based beverages promoted for children aged 9 through 36 months. They often contain added sugars, which may contribute to unhealthy dietary habits. Aggressive promotion of toddler milk, particularly to the Latinx population, has likely led to rapid rises in sales. The study aims were to qualitatively explore caregivers' experiences with, beliefs about, and attitudes toward toddler milk; to explore caregivers' reactions to health claims and product warnings on toddler milk packaging; and explore whether perceptions of toddler milk differ by Latinx ethnicity. Focus group discussions and in-depth interviews were conducted. Fifteen online in-depth interviews and 4 online focus groups with US caregivers of children aged 9 through 36 months who reported serving toddler milk to their children were conducted in 2021. Audio files were transcribed, coded, and analyzed in NVivo. A thematic analysis with a hybrid analytical approach of deductive and inductive coding was conducted. Caregivers struggled to discern toddler milk from infant formula and perceived formula as a larger term that included toddler milk. Participants described offering toddler milk to their children for its convenience, nutritional profile, and perceived benefits tied to health claims present on the labels. Participants reported that health claims on toddler milk packaging attracted their attention; most participants did not express skepticism about the veracity of the claims. An "added sugar" warning increased understanding of the presence of added sugar in a toddler milk product. Latinx and non-Latinx participants largely reported similar perceptions, beliefs, and patterns of provision of toddler milk. Health claims may lead caregivers to perceive toddler milk as a nutritionally adequate product. Research is needed to investigate caregiver-directed interventions for informing caregivers about the distinction between infant formula and toddler milk. [ABSTRACT FROM AUTHOR]

The article discusses the need to amend Federal Rule of Evidence 106 and pre-Rules common law doctrine of completeness. It mentions potential amendment alternatives for Rule 106 designed to address the fairness deficit currently permitted by some interpretations of the Rule. It also mentions completion over a hearsay objection, and by covering oral statements specifically under the Rule and cross-examine witnesses and limited exception to standard operating procedure.

Objective To quantify the representation of women trainees and faculty and to explore associations between them at Pain Medicine (PM) fellowship programs in the United States. Setting PM fellowship programs accredited by the Accreditation Council for Graduate Medical Education. Methods All PM programs approved for at least four fellows as of December 2017 were identified. Websites of these programs were reviewed to determine the number and gender of current fellows and faculty, and programs were contacted to verify the information. Results A total of 56 PM programs were eligible; of these, 48 PM programs (86%) provided information about the gender distribution of fellows. Women comprised ∼25% of PM fellows. PM programs with a female rather than male fellowship program director (PD) had 2.40 times increased odds of a female trainee. Proportion of female faculty and division chief gender were not significantly associated with trainee gender composition. The adjusted odds of a faculty member being female was 1.99 times greater for PM programs with a female vs male PD and 3.13 times greater for programs with a female vs male division chief. Conclusions Women are underrepresented throughout all levels of academic pain medicine. The presence of women in leadership roles is associated with higher proportions of female trainees and faculty, highlighting the need for more female role models in academic pain medicine. [ABSTRACT FROM AUTHOR]

In recent decades, public and private environmental entities have been purchasing or leasing water rights across the Western United States (U.S.) in efforts to restore river flows and aquatic ecosystems. The need to pay for flow restoration arises from the fact that state governments did not begin to reserve water for instream purposes until the 1970s, long after water rights had become over‐appropriated and flows were substantially depleted in most rivers. As a consequence, flow depletion has become the leading cause of fish endangerment in the U.S., including the imperilment of two‐thirds of all native fish species in the Colorado River system. This paper takes stock of the progress made in buying water for the environment, specifically by reviewing and analyzing more than 50 transactions executed by public and private entities and the sources of funding underpinning these transactions. We conclude that nongovernmental actors — such as environmental organizations and state water trusts — are integral to regional efforts to restore river flows; these nongovernmental actors executed more than two‐thirds of the transactions we documented. However, we also conclude that the long‐term success of these nongovernmental actors depends upon the availability of sustained public funding that enables them to build capacity and engage in the large number of transactions needed to restore flows across each state. Research Impact Statement: River flow restoration is needed to stem widespread aquatic species declines but much greater public/private funding and transactional expertise is needed. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to improve understanding of the differences in cigarette use behavior and exposure for participants smoking their own brand of cigarettes in a clinical setting versus smoking under natural conditions. Methods: Adult daily smokers (N = 163) attended 2 clinic visits where they smoked through a CReSS™ topography device. Participants collected cigarette butts smoked without a CReSS™ device and completed a diary of location, mood, and activity for each cigarette smoked. Cigarette butts were used to determine mouth level nicotine (MLN). Least square means (LSMs) were estimated from mixed effects models. Results: The LSM for MLN was higher among participants who smoked cigarettes in the clinical setting. LSM MLN was 1.589 [95% CI: 1.312, 1.924] mg/cig for cigarettes smoked in the clinic and 1.087 [95% CI: 0.902, 1.310] mg/cig for cigarettes smoked outside of the clinic; we found differences between race and sex. Conclusions: Our results show nicotine intake and some smoking behavior are significantly biased upwards when studied in a clinical setting. Therefore, tobacco smoke exposure determinations in a clinical setting may not be completely generalizable to smoke exposure determinations in naturalistic settings. [ABSTRACT FROM AUTHOR]

Because the effects of children’s exposure to intimate partner violence (IPV) carry long lasting consequences for the affected children, IPV exposure may impose a significant economic burden to localities, states, and society at large, made explicit over the victim’s lifetime and over a wide range of behaviors and outcomes, including use of social services, health and healthcare utilization, educational outcomes, workforce productivity, and criminal behavior. While much research has been conducted on the effect of IPV exposure on multiple short- and long-term outcomes, no research to date has examined the economic burden associated with IPV exposure. Using an incidence-based approach, we estimated the aggregate discounted costs associated with healthcare spending, criminal behavior, and labor market productivity accrued by a 20-year-old victim in 2016 projected to the age of 65, applying a 3% discount rate. The average lifetime costs derived from childhood IPV exposure are estimated to be over $50,000 per victim (2016 U.S. dollars) due to increased healthcare costs ($11,000), increased crime costs ($14,000), and productivity losses ($26,000). Over an annual birth cohort of young adults, these costs amount to over $55 billion nationwide. IPV exposure imposes a substantial economic burden to society at large in the form of increased healthcare costs, increased crime costs, and reduced productivity. This study offers an explicit quantification of substantial lifetime costs, which should encourage policy makers to redouble efforts to reduce the incidence of IPV and successfully ameliorate its effects on IPV-exposed children. [ABSTRACT FROM AUTHOR]

There is a war raging over the admissibility of the prior bad acts of criminal defendants in federal trials. While many circuits treat Federal Rule of Evidence 404(b) as a rule of "inclusion" and liberally admit such prior bad-acts evidence with predictably explosive effects on criminal juries, a few circuits are developing rigorous standards designed to foreclose prosecutorial use of such bad-acts evidence. This Article chronicles the well-documented permissive admission of the prior bad acts of criminal defendants notwithstanding the prohibition on such evidence by Federal Rule of Evidence 404(b)(1), as well as recent efforts by some federal circuits to restrict such evidence. In light of these contemporary developments, the Judicial Conference Advisory Committee on Evidence Rules is currently considering amendments to Federal Rule of Evidence 404(b) to restore the intended exclusionary purpose of the Rule. This Article details several drafting alternatives being considered by the Committee, as well as the likely costs and benefits of each, and proposes a simple and elegant fix for what ails Rule 404(b)--a more protective balancing test that admits the prior bad acts of criminal defendants only when their probative value outweighs any unfair prejudice to the defendant. Tipping the scale in favor of exclusion of prior bad-acts evidence would restore the protective purpose of Rule 404(b), while continuing to permit the government to admit such evidence in appropriate and necessary circumstances. This balance would bring Rule 404(b) into alignment with existing Federal Rule of Evidence 609, which allows the felony convictions of testifying criminal defendants to be admitted for impeachment purposes only when their probative value outweighs unfair prejudice. This Article takes on the thorny contemporary issues surrounding the admissibility of prior badacts evidence and identifies the optimal amendment to Federal Rule of Evidence 404(b). This amendment would resolve the current conflict among the federal circuits and restore the prohibition on trial by character, which is a cornerstone of the American criminal process. [ABSTRACT FROM AUTHOR]

Logistics is a cost sensitive industry with large and fast growing routing networks. In this paper we devise a computational, robust optimization method for the strategic routing decisions of a logistics' customer, i.e., a company that uses the services of different freight forwarders to meet its transportation demands between several sources, sinks, and hubs. The costs of such transports are determined by tariff systems that typically show economies of scale and reward the consolidation of goods that complement each other in properties relevant for transport, such as weight and volume. In the strategic planning phase, routes and hubs have to be chosen roughly one year ahead, in particular, before the actual demand is known. Our method anticipates the fluctuation of demands by minimizing the worst-case cost over a restricted scenario set. The combination of a realistic cost function, a robust modeling of uncertainty, and large-scale networks leads to highly intractable models. We show that the corresponding adversary problem is NP-hard. To nevertheless find solutions for real instances with very good worst-case cost we derive a carefully relaxed and simplified mixed-integer linear program that solves well for large instances because of its powerful linear programming relaxation. We test the method for real-world instances. The results show that robust optimization can significantly reduce worst-case cost. Furthermore, we derive from our method two heuristic techniques to solve even larger networks and report on the corresponding computational results. Neglecting the typical uncertainty about demand values can cause significant cost in logistic routing problems. This paper provides for a practical method to avoid such costs. [ABSTRACT FROM AUTHOR]

Criticism of the hearsay exceptions embodied in the Federal Rules of Evidence has reached a fever pitch in recent years. With scholars calling for the abrogation of the entire hearsay regime or of individual exceptions within it and the Advisory Committee on Evidence Rules exploring hearsay amendments, the time for genuine hearsay soul-searching may be at hand. This Article suggests that aggressive proposals to scuttle existing doctrine entirely in favor of alternative approaches to hearsay are overly broad, rejecting the benefits of significant portions of existing doctrine that are functioning well and threatening costly consequences that could make matters worse for hearsay. On the opposite end of the spectrum, narrow proposals to amend individual hearsay exceptions one at a time accomplish too little and may undermine the utility of long-standing and rational hearsay exceptions that permit the flow of helpful information into the trial process. As an alternative to these proposals at opposite ends of the spectrum, this Article reveals a ready hearsay reform right under our noses that hits that sweet spot in between a sweeping, aggressive reform and an unduly narrow, limited fix. The Article suggests borrowing the trustworthiness exception that is a current feature of the business and public records exceptions and extending its application to additional hearsay exceptions in Federal Rule of Evidence 803. This change would make hearsay statements falling within the existing requirements of the Rule 803 exceptions presumptively admissible, but would afford the opponent of those hearsay statements the opportunity to show that the particular circumstances surrounding the statements render them untrustworthy and inadmissible. Fleshing out this concept first advanced in my previous work, this Article explains why an expanded trustworthiness exception could be the silver bullet that takes an important step toward rationalizing hearsay doctrine. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship between diminished ovarian reserve and pregnancy outcomes in a large cohort of women achieving pregnancy through in vitro fertilization (IVF). We evaluated antral follicle count (AFC) and baseline FSH as a measure of ovarian reserve. Secondarily, we assessed whether diminished ovarian reserve was associated with aneuploidy among spontaneous abortions.Design: Retrospective cohort study.Setting: Multicenter private practice.Patient(s): All patients aged 21-44 years undergoing fresh autologous IVF cycles during 2009-2013 that resulted in positive serum hCG with recorded baseline FSH levels.Intervention(s): None.Main Outcome Measure(s): Live births per early pregnancy, biochemical pregnancies, clinical pregnancy losses, and aneuploidy rates in products of conception among pregnancy losses.Result(s): A total of 9,489 cycles among 8,214 patients were analyzed. There was no association between live birth and ovarian reserve among pregnant IVF patients under the age of 35 years. Among patients 35 years of age and older, elevated baseline FSH was associated with a higher risk of pregnancy loss, which increased with increasing age. AFC was not significantly associated with pregnancy loss at any age. No associations were found between ovarian reserve measures and aneuploidy in products of conception in age-adjusted analyses, although the power to effectively evaluate this was limited.Conclusion(s): Diminished ovarian reserve is not associated with an increase in miscarriage among younger women achieving pregnancy through IVF. Elevated FSH is associated with a higher risk of IVF pregnancy loss among older patients. We found no evidence to confirm that diminished ovarian reserve is associated with increased aneuploidy among spontaneous abortions. [ABSTRACT FROM AUTHOR]

Aims To estimate the prevalence and predictors of failed biochemical verification of self-reported abstinence among participants enrolled in trials of hospital-initiated smoking cessation interventions. Design Comparison of characteristics between participants who verified and those who failed to verify self-reported abstinence. Settings Multi-site randomized clinical trials conducted between 2010 and 2014 in hospitals throughout the United States. Participants Recently hospitalized smokers who reported tobacco abstinence 6 months post-randomization and provided a saliva sample for verification purposes ( n = 822). Measurements Outcomes were salivary cotinine-verified smoking abstinence at 10 and 15 ng/ml cut-points. Predictors and correlates included participant demographics and tobacco use; hospital diagnoses and treatment; and study characteristics collected via surveys and electronic medical records. Findings Usable samples were returned by 69.8% of the 1178 eligible trial participants who reported 7-day point prevalence abstinence. The proportion of participants verified as quit was 57.8% [95% confidence interval (CI) = 54.4, 61.2; 10 ng/ml cut-off] or 60.6% (95% CI = 57.2, 63.9; 15 ng/ml). Factors associated independently with verification at 10 ng/ml were education beyond high school education [odds ratio (OR) = 1.51; 95% CI = 1.07, 2.11], continuous abstinence since hospitalization (OR = 2.82; 95% CI = 2.02, 3.94), mailed versus in-person sample (OR = 3.20; 95% CI = 1.96, 5.21) and race. African American participants were less likely to verify abstinence than white participants (OR = 0.64; 95% CI = 0.44, 0.93). Findings were similar for verification at 15 ng/ml. Verification rates did not differ by treatment group. Conclusions In the United States, high rates (40%) of recently hospitalized smokers enrolled in smoking cessation trials fail biochemical verification of their self-reported abstinence. [ABSTRACT FROM AUTHOR]

Heavy college drinking is associated with risky sexual behavior. It is therefore important to identify groups that are especially vulnerable to alcohol-influenced sexual risk (e.g., unplanned/unexpected sex). Undergraduates with elevated social anxiety represent one such vulnerable group given that social anxiety is associated with fear of intimacy and heavier drinking in intimate situations and situations with expected negative affect. Drinking to cope with negative affect induced by fear of intimacy might render socially anxious undergraduates vulnerable to risky sexual behavior, yet no known studies have examined this relationship. The current study tested whether social anxiety was related to alcohol-related sexual behaviors among current (past-month) drinking undergraduates (88.1% female; 77.6% non-Hispanic Caucasian) with higher (i.e., clinically elevated) social anxiety (HSA;n = 40) or lower (more normative) social anxiety (LSA;n = 94). Coping motives were examined as a moderator of the social anxiety-risky sexual behavior relationship. Gender was a covariate. HSA students reported more frequent alcohol-influenced sexual risk including regretted sexual situations, unprotected sex, sex with unwanted partners, unwanted sex, pressured/forced to have sex, and pressured someone to have sex. Coping motives significantly interacted with social anxiety group in the prediction of risky sexual behaviors except regretted sexual situations, such that HSA students with greater coping motives experienced more frequent sexual risk when drinking. Findings indicate that HSA students may be particularly vulnerable to risky sexual behaviors and suggest that coping motivated drinking may be an important target for therapeutic interventions geared toward reducing risky sexual behaviors among this high-risk population. [ABSTRACT FROM PUBLISHER]

Background: Electronic cigarettes (e-cigarettes) have become the most common tobacco product used among adolescents in the United States (US). Prior research has shown that peer e-cigarette use was associated with increased risk of own e-cigarette use. Nonetheless, there is little empirical evidence on the directionality of these associations—if peer use predicts own use (peer influence) or if own use predicts peer use (peer selection). Methods: We estimated the association between peer and own e-cigarette use among US adolescents 12–17 years of age. We used the cross-lagged model to investigate the mutual relationship between peer and own e-cigarette use over time using data from a population-based longitudinal study, Population Assessment of Tobacco and Health. Stratified analyses were conducted by sex and age subgroups. Results: Results from a cross-lagged model showed a statistically significant predicting path leading from peer use at the prior time point to own use at the following time point, but not vice versa. Conclusions: We found strong relationships between peer e-cigarette use and own e-cigarette use at within-individual levels. Peer influence paths were more robust than peer selection paths for e-cigarette use. Incorporating peers into prevention and intervention programs may help enhance these strategies. [ABSTRACT FROM AUTHOR]

The growth of distance education has necessitated strong evidence of quality for institutions of higher education, and numerous standards and principles of quality have been developed, such as Quality Matters™ (Quality Matters). These systems are often considered only at the course level to guide design and improve student outcomes, but they can also help to pull the institution together and galvanize advancement in online development. Adopting online quality standards can be a complex process that requires changes to institutional culture. This article describes how the use of the Community of Practice (CoP) framework engaged a campus-wide network of individuals in adoption of the Quality Matters training, rubric, and review process to advance distance education support and online course development. Using Social Network Analysis, researchers were able to identify the strengths and weakness of the CoP during the early adoption phase of Quality Matters to quantitatively measure the connections among members of the community. Based on a survey administered to every participant who attended the Applying the Quality Matters Rubric™ (APPQMR) workshop, researchers analyzed connections across the Quality Matters™ (Quality Matters) Community of Practice (CoP). This analysis indicated strong cohesion of the network based on work related to distance education but low density for connections based on Quality Matters. Furthermore, it demonstrated that significant connections existed between members prior to the adoption of Quality Matters and identified key influencers within the network. The results also indicated that the Quality Matters leadership team at the institution is highly central to the Quality Matters CoP network. The results can be used to identify strategies to further adoption of Quality Matters at the institution by strengthening the CoP. [ABSTRACT FROM AUTHOR]

Introduction: Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling.Methods: We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013. We analyzed the number of pregnant women who received physician-provided smoking cessation counseling indicated by procedure billing codes (ie, G0436 and G0437) and medication (ie, nicotine replacement therapy, bupropion, or varenicline) located in outpatient managed care encounter and fee-for-service claims data. We estimated the number of Medicaid-insured pregnant smokers using the national smoking prevalence (14%) in this population and the number of live births reported in Kansas.Results: Annually from 2010 to 2013, approximately 27.2%-31.6% of pregnant smokers had claims for nicotine replacement therapy, bupropion, or varenicline. Excluding claims for bupropion, a medication commonly prescribed to treat depression, claims ranged from 9.3% to 11.1%. Following implementation of Medicaid coverage for smoking cessation counseling, less than 1% of estimated smokers had claims for counseling.Conclusions: This low claims rate suggests that simply changing policy is not sufficient to ensure use of newly implemented benefits, and that there probably remain critical gaps in smoking cessation treatment.Implications: This study evaluates the use of Medicaid reimbursement for smoking cessation counseling among low-income pregnant women in Kansas. We describe the Medicaid claims rates of physician-provided smoking cessation counseling for pregnant women, an evidence-based and universally recommended treatment approach for smoking cessation in this population. Our findings show that claims rates for smoking cessation benefits in this population are very low, even after policy changes to support provision of cessation assistance were implemented. Additional studies are needed to determine whether reimbursement is functioning as intended and identify potential gaps between policy and implementation of evidence-based smoking cessation treatment. [ABSTRACT FROM AUTHOR]

The article discusses how the leading companies in the world serve as models of high reliability in the U.S. military health system (MHS). Topics covered include how the 2014 "Military Health System Review" urges healthcare system leaders to implement effective strategies that are used by other high-performing organizations and the common attributes of high-reliability organizations (HROs) such as universal understanding of business processes and proactive evaluation and removal of risk.

Background: The increasing popularity of non-cigarette nicotine products, especially among youth, highlights the need for greater attention to their potential risks, including nicotine addiction and other substance use and addiction.Objectives: To examine the extent to which nicotine product use co-occurs with other substance use and addiction among youth and adults, describe the demographic groups and types of nicotine products associated with an increased risk of such co-occurrence, and discuss implications for research, prevention, clinical practice, and policy.Methods: Analyzing 2014 data from two nationally representative US surveys, the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) study, we examined the co-occurrence between nicotine product use and alcohol and other drug use and addiction.Results: Individuals of all ages who reported using nicotine products of any kind were significantly more likely than nonusers to report alcohol, marijuana, other drug, and poly-substance use and to meet diagnostic criteria for a substance-use disorder. Users of multiple nicotine products generally were the most likely to engage in alcohol and other drug use and to be addicted to these other substances.Conclusions: The substantial co-occurrence of all forms of nicotine use and other substance use and addiction underscores the need to control the growing use of non-cigarette nicotine products among youth and to incorporate all forms of nicotine product use into substance use and addiction research, prevention, clinical practice, and policy efforts. [ABSTRACT FROM AUTHOR]

Upward of 70% of lesbian, gay, and bisexual (LGB) youth experience some degree of parental rejection of their sexual identity, which is problematic in light of research documenting links between parental rejection and psychological difficulties in LGB youth. Additionally, emerging research suggests that ethnic minority LGB youth may be at greater risk to experience parental rejection than ethnic majority LGB youth. However, this research is inconclusive and has significant gaps. The current study is one of the first to include a multiethnic sample of LGB youth and their parents to investigate how ethnicity may be related to parental rejection. Specifically, the current study examined ethnic differences in parental rejection as well as in intrapersonal variables (i.e., homonegativity and traditional gender role beliefs), which are thought to be related both to ethnicity and parental rejection. Additionally, indirect effects of ethnicity on parental rejection through homonegativity and traditional gender role beliefs were examined. Participants included 90 parents (ages 32-63) and their 90 LGB children (ages 15-24). Fifty-nine percent of the sample were ethnic minority. Significant ethnic differences were found in parental rejection and homonegativity, but not in traditional gender role beliefs. Homonegativity was found to fully mediate the relation between ethnicity and parental rejection. These results provide important information on why ethnic minority parents, in general, may have a more difficult time accepting their LGB children than ethnic majority parents. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

The article reviews the exhibition "We Are One: Mapping America's Road from Revolution to Independence" at the Art Museums of ColonialWilliamsburg in Virginia from March 6, 2016 to January 29, 2017.

Prior research has demonstrated that teachers' professional knowledge and motivation are strongly related to students' learning and motivation. Symptoms of teachers' stress and burnout (e.g., emotional exhaustion) are also thought to influence students' achievement, but no empirical study has tested this prediction. Using multilevel analyses and a representative sample consisting of 1,102 German elementary school teachers and their students, we addressed this gap in knowledge by examining the association between teachers' emotional exhaustion and students' achievement in mathematics, and by testing whether classroom composition moderates this relation. We controlled for teachers' gender, their years of experience, their teaching certificate, and the composition of the class, and on the student level for students' gender, language spoken at home, socioeconomic status, and cognitive ability. Results revealed that teachers' emotional exhaustion was significantly negatively related to students' mathematics achievement, even after teacher characteristics and classroom composition were controlled for. Classroom composition moderated this relation, whereby teachers' emotional exhaustion was more strongly related to students' achievement in classes with a high percentage of language minority students. These results highlight the importance of teachers' well-being for students' learning. [ABSTRACT FROM AUTHOR]

Background: Underage drinking and its effects have been researched extensively. However, no study to date has examined how the levels of drinking that have been defined as risky for adults might relate to youth who have a heightened physiological vulnerability to alcohol.Objectives: To examine a range of drinking measures that go beyond common measures of youth alcohol use to gain a more detailed understanding of the nature of underage drinking and its associated correlates and outcomes.Methods: Analyzing data from a 2013 nationally representative US survey, we examined a variety of measures of alcohol use among 24,445 youth (weighted N = 381,155,562), the demographic groups most likely to have reported drinking in these ways, and associations between these measures of drinking and a number of adverse outcomes.Results: On all measures of potentially risky drinking, including meeting diagnostic criteria for an alcohol use disorder, underage drinkers exceeded the rates found for adults. Independent of sex, race, and age, youth who reported drinking in ways that exceeded guidelines set for adults had increased odds of meeting diagnostic criteria for an alcohol, tobacco, or other drug use disorder, and of reporting a number of health problems.Conclusions: The high rates at which youth report engaging in a range of risky drinking behaviors suggest a need for a more nuanced approach to substance use and mental health screening and interventions in clinical practice. The findings also underscore the need to address apparent misconceptions about what constitutes unhealthy or unsafe alcohol use among youth. [ABSTRACT FROM AUTHOR]

Objective: Gestational diabetes mellitus (GDM) is associated with substantial morbidity for mothers and their offspring. While clinical and basic research activities on this important disease grow constantly, there is no concise analysis of global architecture of GDM research. Hence, it was the objective of this study to assess the global scientific performance chronologically, geographically and in relation to existing research networks and gender distribution of publishing authors.Study Design: On the basis of the New Quality and Quantity Indices in Science (NewQIS) platform, scientometric methods were combined with modern visualizing techniques such as density equalizing mapping, and the Web of Science database was used to assess GDM-related entries from 1900 to 2012.Results: Twelve thousand five hundred four GDM-related publications were identified and analyzed. The USA (4295 publications) and the UK (1354 publications) dominated the field concerning research activity, overall citations and country-specific Hirsch-Index, which quantified the impact of a country's published research on the scientific community. Semi-qualitative indices such as country-specific citation rates ranked New Zealand and the UK at top positions. Annual collaborative publications increased steeply between the years 1990 and 2012 (71 to 1157 respectively). Subject category analysis pointed to a minor interest of public health issues in GDM research. Gender analysis in terms of publication authorship revealed a clear dominance of the male gender until 2005; then a trend towards gender equity started and the activity of female scientists grew visibly in many countries. The country-specific gender analysis revealed large differences, i.e. female scientists dominated the scientific output in the USA, whereas the majority of research was published by male authors in countries such as Japan.Conclusion: This study provides the first global sketch of GDM research architecture. While North-American and Western-European countries were dominating the GDM-related scientific landscape, a disparity exists in terms of research output between developed and low-resource countries. Since GDM is linked to considerable mortality and morbidity of mothers and their offspring and constitutes a tremendous burden for the healthcare systems in underserved countries, our findings emphasize the need to address disparities by fostering research endeavors, public health programs and collaborative efforts in these nations. [ABSTRACT FROM AUTHOR]

The United States Sentencing Commission ("Commission") created the United States Sentencing Guidelines ("Guidelines") to bring uniformity and fairness to criminal sentencing in the United States. Since their inception and application by judges in 1987, the Guidelines have lacked a definition for "arrest" in section 4A1.2(a)(2). This absence of a definition developed a circuit split over whether traffic citations fall within the meaning of "arrest" for purposes of determining a defendant's criminal history, and thus, his criminal sentence. This Note argues that the United States Supreme Court should adopt the Ninth Circuit's approach to defining "arrest" in the context of section 4A1.2(a)(2), because this approach aligns with current Supreme Court precedent (particularly with relevant Fourth Amendment case law); reflects the goals and purposes of the Guidelines; and matches a defendant's culpability, likelihood of recidivating, and sentence while decreasing sentencing disparity among similarly situated defendants. [ABSTRACT FROM AUTHOR]

The article discusses civil war in United Sates and mentioned ratification of the Fourteenth Amendment in the country. Topics discussed include Emancipation Proclamation by U.S. president Abraham Lincoln, liberation of slaves in the country and social ecology of Southern states of U.S. Racial discrimination in the country is mentioned.

The composition and structure of native riverine ecosystems are tightly linked to natural hydrologic variability. By managing river flows for water supplies and power generation, water management agencies have inadvertently caused considerable degradation of riverine ecosystems and associated biodiversity. New approaches for meeting human needs for water while conserving the ecological integrity of riverine ecosystems are greatly needed. We describe an approach for identifying the natural flooding characteristics that must be protected or restored to maintain riparian ( floodplain) ecosystems along meandering rivers. We developed a computer model to simulate flood-driven changes in the relative abundance of riparian patch types along the Yampa River in Colorado ( U.S.A.). The model is based on research suggesting that the duration of flooding at or above 209 m3 per second (125% of bankfull discharge) is particularly important in driving lateral channel migration, which is responsible for initiating ecological succession in the Yampa's riparian forest. Other hydrologic variables, such as the magnitude of annual peak flows, were not as strongly correlated with lateral channel migration rates. Model simulations enabled us to tentatively identify a threshold of alteration of flood duration that could lead to substantial changes in the abundance of forest patch types over time should river flows be regulated by future water projects. Based on this analysis, we suggest an ecologically compatible water management approach that avoids crossing flood alteration thresholds and provides opportunity to use a portion of flood waters for human purposes. Recommended improvements to the Yampa model include obtaining additional low-elevation aerial photographs of the river corridor to enable better estimation of channel migration rates and vegetation changes. These additional data should greatly improve the model's accuracy and predictive capabilities and therefore... [ABSTRACT FROM AUTHOR]

Discusses studies in biodiversity conservation focusing on animal species, populations, ecosystems, landscapes, and other levels of biological organization. Biodiversity on small and large geographic scales; Description of functional conservation areas and how to determine this environmental function; Challenges faced by conservationists; Case study of the Yampa River in Colorado; Conclusions and comments.

As federal partners, the Veterans Health Administration (VA) and the Indian Health Service (IHS) agreed to share resources, such as education. The VA Geriatric Scholars Program, a workforce development program, provides one of its training programs on team-based primary care of elders to clinicians working in IHS and Tribal Health Programs. The practical impact of that training is described. A mixed methods approach was applied to the course's evaluation survey at five clinics in the Northwestern Plains, Southwest, Pacific Coast, and Alaska. Quantitative approaches assessed participants' self-reported intention to improve recognition and assessment of common geriatric syndromes. A qualitative approach applied to open-ended text responses revealed intensions to improve team-based care. Among the 51 respondents in our sample, we found significant improvements in self-reported ability to recognize previously unfamiliar potential risks to elders' health and safety, t(49) = 8.0233, p <.001, as well as increased comfort with conducting geriatric assessments and increased confidence in interprofessional team-based communication. Improvements to team-based care included enhanced clinical skills, organizational factors and the need to train additional employees. This evaluation demonstrates the value of sharing resources among federal partners and its value for participants in IHS and Tribal Health Programs. [ABSTRACT FROM AUTHOR]

The paper provides a comprehensive empirical assessment of American stimulus policies aimed at renewable energy (RE) technologies. We use an indicator-based methodology to assess progress with respect to energy, environmental and socio-economic issues resulting from RE stimulus programs linked to the American Recovery and Reinvestment Act, and review and analyze the emerging but scattered literature. Overall, our results indicate that stimulus programs have had a positive effect on the RE sector. This is despite the fact that they were originally planned to work in combination with a greenhouse gas ‘cap-and-trade’ system, which has not been implemented. From the methodological perspective, our approach is resource-intensive and our analysis highlights numerous challenges, notably related to causality and additionality. Despite these limitations, this research improves our understanding of the broad effects and impacts of RE stimulus programs. [ABSTRACT FROM AUTHOR]

When used effectively, social media benefits hospitals through increased revenue, employee recruitment, and increased customer satisfaction. Although 72% of adults who use the Internet engage in social media, little is known about its prevalence among hospitals and the ways in which hospitals use it. We examined hospital characteristics associated with social media use and how U.S. hospitals use Facebook. Through analysis of websites and Facebook pages, we found that seven in 10 hospitals use social media and that 9% of hospitals with a Facebook page do not provide a link to it from their web page. The odds of social media use were greater in large, urban, nonprofit hospitals; at hospitals affiliated with universities or health systems; and at hospitals that emphasize quality metrics or educational information. Hospitals use Facebook as a dissemination strategy to educate consumers, acknowledge staff, and share news of the hospital's awards. However, the majority of hospitals do not actively engage consumers on Facebook pages. We conclude that this lack of engagement is a lost opportunity to enhance customer service, improve quality of care, and build loyalty. For hospital executives, we illustrate that Facebook is underutilized and that considerable opportunity exists for consumer engagement at a low cost. For policymakers, there is a greater use of social media by nonprofit hospitals, compared to for-profit facilities. As Facebook is most commonly used as an educational tool, it is another example of nonprofit hospitals' heightened focus on health promotion and disease prevention. [ABSTRACT FROM AUTHOR]

The Advisory Committee for the Federal Rules of Evidence was hard at work in 2013 trying to bring resolution to a mystery that has plagued Rule 801(d)(1)(B) since its enactment thirty-eight years ago. Scholars, judges, and litigants have long pondered why the drafters of Rule 801(d)(1)(B) carved out a hearsay exemption for prior consistent statements admitted to repair impeaching attacks on witness motivations, but failed to extend the same treatment to other similarly situated prior consistencies admitted to repair other types of impeaching attacks. In May 2013, the Advisory Committee proposed an amendment to Rule 801(d)(1)(B) in an effort to end the mysterious disparate treatment of prior consistent witness statements by expanding the hearsay exemption to include prior consistent statements ignored by the original Rule. Although the proposed amendment is on track to take effect December 1, 2014, it has encountered strong criticism regarding its potential to liberally admit witness hearsay. This Article seeks to find a constructive path forward by highlighting the beneficial purposes of the proposed amendment and exploring criticisms levied against it. The Article concludes that an amendment of Rule 801(d)(1)(B) is in keeping with the policies underlying the original Rule and with the broader operation of the Federal Rules of Evidence. After examining several drafting alternatives for an amended Rule 801(d)(1)(B), however, the Article concludes that a simple and straightforward amendment that applies a single standard to substantive availability of all prior consistent statements would be superior to the proposed amendment because it would eliminate the confusion that has plagued the existing Rule and chart a clear course for prior consistent statements in the future. [ABSTRACT FROM AUTHOR]

The article discusses social impact investing in the U.S., focusing on the benefits of this type of investing on the environment, community development, and healthcare systems. It looks at the history of impact investing, which started in the 1960s, and the benefits associated with it. Other topics of the article include the differences between impact investing and government funding/grants, investing based off of community health needs assessments (CHNA), and public-private partnerships. It also discusses philanthropic organizations, such as the Kresge Foundation and the MetLife Foundation, who partner with community development financial institutions (CDFI) to aid in health, housing and environmental projects.

Serotyping data for pneumococci causing invasive and noninvasive disease in 2008-2009 and 2010-2011 from ≥43 US centers were compared with data from preconjugate vaccine (1999-2000) and postconjugate vaccine (2004-2005) periods. Prevalence of 7-valent pneumococcal conjugate vaccine serotypes decreased from 64% of invasive and 50% of noninvasive isolates in 1999-2000 to 3.8% and 4.2%, respectively, in 2010-2011. Increases in serotype 19A stopped after introduction of 13-valent pneumococcal vaccine (PCV13) in 2010. Prevalences of other predominant serotypes included in or related to PCV13 (3, 6C, 7F) also remained similar for 2008-2009 and 2010-2011. The only major serotype that increased from 2008-2009 to 2010-2011 was nonvaccine serotype 35B. These data show that introduction of the 7-valent vaccine has dramatically decreased prevalence of its serotypes and that addition of serotypes in PCV13 could provide coverage of 39% of isolates that continue to cause disease. [ABSTRACT FROM AUTHOR]

We couple meteoric 10Be measurements with mass balance analysis of 9Be to estimate the soil residence time (SRT) of a biogeomorphically stable Ultisol in the Southern Piedmont physiographic region of the southeastern United States. We estimate SRT after correcting the meteoric 10Be inventory to account for observed 9Be losses, which indicate that more than half of the 9Be weathered from primary minerals has been leached from the upper 18.3 m of the Ultisol. Our estimates of minimum SRT range between 1.3-1.4 Ma and between 2.6-3.1 Ma under high and low (2.0 and 1.3 x 106 atoms cm-2 yr-1, respectively), estimates of 10Be delivery. Denudation rates of the physiographic region corroborate our estimates. We redefine pedogenic time constraints in the Southern Piedmont, and demonstrate that the assumption of complete meteoric 10Be retention in acidic soil systems cannot always be made; the latter has far-reaching consequences for soil, sediment, river, and ocean research using meteoric 10Be. [ABSTRACT FROM AUTHOR]

The skill of NOAA's official monthly U.S. precipitation forecasts (issued in the middle of the prior month) has historically been low, having shown modest skill over the southern United States, but little or no skill over large portions of the central United States. The goal of this study is to explain the seasonal and regional variations of the North American subseasonal (weeks 3–6) precipitation skill, specifically the reasons for its successes and its limitations. The performances of multiple recent-generation model reforecasts over 1999–2015 in predicting precipitation are compared to uninitialized simulation skill using the atmospheric component of the forecast systems. This parallel analysis permits attribution of precipitation skill to two distinct sources: one due to slowly evolving ocean surface boundary states and the other to faster time-scale initial atmospheric weather states. A strong regionality and seasonality in precipitation forecast performance is shown to be analogous to skill patterns dictated by boundary forcing constraints alone. The correspondence is found to be especially high for the North American pattern of the maximum monthly skill that is achieved in the reforecast. The boundary forcing of most importance originates from tropical Pacific SST influences, especially those related to El Niño–Southern Oscillation. We discuss physical constraints that may limit monthly precipitation skill and interpret the performance of existing models in the context of plausible upper limits. Significance Statement: Skillful subseasonal precipitation predictions have societal benefits. Over the United States, however, NOAA's official U.S. monthly precipitation forecast skill has been historically low. Here we explore origins for skill of North American week-3 to week-6 precipitation predictions. Skill arising from initial weather states is compared to that arising from ocean surface boundary states alone. The monthly and seasonally varying pattern of U.S. monthly precipitation skill is appreciably derived from boundary constraints, linked especially with El Niño–Southern Oscillation. Forecasts of opportunity are identified, despite the low skill of monthly precipitation forecasts on average. Potential limits of monthly precipitation skill are explored that provide insight on the juxtaposition of "skill deserts" over the central United States with high skill regions over western North America. [ABSTRACT FROM AUTHOR]