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BACKGROUND AND OBJECTIVES: Youthwith either autismspectrumdisorder (ASD) or gender dysphoria (GD) alone have also been shown to be at greater risk for mental health (MH) concerns; however, very little research has considered how cooccurring ASD and GD may exacerbate MH concerns. The purpose of this study was to examine associations between ASD, GD, andMH diagnoses (anxiety, depression, eating disorder, suicidality, and self-harm) among US adolescent populations. METHODS: This is a secondary analysis of a large administrative dataset formed by 8 pediatric health system members of the PEDSnet learning health system network. Analyses included descriptive statistics and adjusted mixed logistic regression models testing for associations between combinations of ASD and GD diagnoses andMH diagnoses as recorded in the patient's electronicmedical record. RESULTS: Based on data from 919 898 patients aged 9 to 18 years, adjusted mixed logistic regression indicated significantly greater odds of each MH diagnosis among those with ASD alone, GD alone, and cooccurring ASD/GD diagnoses compared with those with neither diagnosis. Youth with cooccurring ASD/GD were at significantly greater risk of also having anxiety (average predicted probability, 0.75; 95% confidence interval, 0.68-0.81) or depression diagnoses (average predicted probability, 0.33; 95% confidence interval, 0.24-0.43) compared with youth with ASD alone, GD alone, or neither diagnosis. CONCLUSIONS: Youthwith cooccurring ASD/GD aremore likely to also be diagnosedwithMH concerns, particularly anxiety and depression. This study highlights the need to implement developmentally appropriate, gender-affirmingMH services and interventions for youthwith cooccurring ASD/GD. [ABSTRACT FROM AUTHOR]

Background: Emotional intelligence (EI) is a predictive factor of academic success in undergraduate Doctor of Medicine (MD) programs. Although some research suggests a positive association between EI and academic success in MD programs, other research reports neither an association nor a negative correlation between the two variables. The current study aimed to resolve these contradictory findings by conducting a systematic review and a meta-analysis using research from 2005 to 2022. Methods: Data were analyzed using a multilevel modeling approach to (a) estimate the overall relationship between EI and academic success in MD programs and (b) determine whether the mean effect size varies according to country (United States vs. non-United States countries), age, EI test, EI task nature (ability-based vs. trait-based), EI subscales, and academic performance criteria (grade point average vs. examinations). Results: Findings from 20 studies (m = 105; N = 4,227) indicated a positive correlation between EI and academic success (r =.13, 95% CI [.08, –.27], p <.01). Moderator analyses indicated that the mean effect size significantly varied according to EI tests and EI subscales. Moreover, three-level multiple regression analyses showed that between-study variance explained 29.5% of the variability in the mean effect size, whereas within-study variance explained 33.5% of the variability in the mean effect. Conclusions: Overall, the current findings show that EI is significantly, albeit weakly, related to academic success in MD programs. Medical researchers and practitioners can therefore focus on integrating EI-related skills into the MD curriculum or target them through professional development training and programs. [ABSTRACT FROM AUTHOR]

Copyright of Medical Anthropology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article looks at ways to encourage law student engagement with critical legal thought in the U.S. Topics discussed include the need for CLT in legal education, role of legal education in ensuring critical metamorphosis or a meaningful critical awakening, and the tendency of the nature of the law school classroom to restrict access to legal thought.

Objective: To examine the factor structure of the Screen for Child Anxiety Related Emotional Disorders – Parent Report (SCARED-P) in young children and elucidate normative levels of parent-reported anxiety using a nationally representative sample of parents of children ages 5–12 years living in the United States. Method: The 41-item SCARED-P was administered to parents of 1,570 youth who were selected to match the U.S. population on key demographic variables. SCARED-P model fit and mean score differences by age, race/ethnicity, and sex were assessed. Results: SCARED-P model fit and subscale reliability appeared almost identical in younger children (ages 5–8) and older children (ages 9–12), although model fit for a five-factor model was poor in both groups. Symptoms of generalized anxiety increased from age 5 to 12, while symptoms of separation anxiety disorder decreased. Parents reported significantly more symptoms of social anxiety in females than males. No significant differences by race/ethnicity were found for mean levels of anxiety or model fit. Conclusions: The SCARED-P shows some utility as an anxiety screening instrument in a representative sample of U.S. youth as young as 5-years-old, but caution should be used when interpreting subscale scores. [ABSTRACT FROM AUTHOR]

The United States has experienced prolonged severe shortages of vital medications over the past two decades. The causes underlying the severity and prolongation of these shortages are complex, in part due to the complexity of the underlying supply chain networks, which involve supplier-buyer interactions across multiple entities with competitive and cooperative goals. This leads to interesting challenges in maintaining consistent interactions and trust among the entities. Furthermore, disruptions in supply chains influence trust by inducing over-reactive behaviors across the network, thereby impacting the ability to consistently meet the resulting fluctuating demand. To explore these issues, we model a pharmaceutical supply chain with boundedly rational artificial decision makers capable of reasoning about the motivations and behaviors of others. We use multiagent simulations where each agent represents a key decision maker in a pharmaceutical supply chain. The agents possess a Theory-of-Mind capability to reason about the beliefs, and past and future behaviors of other agents, which allows them to assess other agents' trustworthiness. Further, each agent has beliefs about others' perceptions of its own trustworthiness that, in turn, impact its behavior. Our experiments reveal several counter-intuitive results showing how small, local disruptions can have cascading global consequences that persist over time. For example, a buyer, to protect itself from disruptions, may dynamically shift to ordering from suppliers with a higher perceived trustworthiness, while the supplier may prefer buyers with more stable ordering behavior. This asymmetry can put the trust-sensitive buyer at a disadvantage during shortages. Further, we demonstrate how the timing and scale of disruptions interact with a buyer's sensitivity to trustworthiness. This interaction can engender different behaviors and impact the overall supply chain performance, either prolonging and exacerbating even small local disruptions, or mitigating a disruption's effects. Additionally, we discuss the implications of these results for supply chain operations. [ABSTRACT FROM AUTHOR]

We study the effects of European immigration to the U.S. during the Age of Mass Migration (1850–1920) on economic prosperity. Exploiting cross-county variation in immigration that arises from the interaction of fluctuations in aggregate immigrant flows and of the gradual expansion of the railway network, we find that counties with more historical immigration have higher income, less poverty, less unemployment, higher rates of urbanization, and greater educational attainment today. The long-run effects seem to capture the persistence of short-run benefits, including greater industrialization, increased agricultural productivity, and more innovation. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were: 1) to determine the short-term impact of the SleepTrackTXT2 intervention on air-medical clinician fatigue during work shifts and 2) determine the longer-term impact on sleep quality over 120 days. Methods: We used a multi-site randomized controlled trial study design with a targeted enrollment of 100 (ClinicalTrials.gov NCT02783027). The intervention was behavioral (non-pharmacological) and participation was scheduled for 120 days. Participation was voluntary. All consented participants answered baseline as well as follow-up surveys. All participants answered text message queries, which assessed self-rated fatigue, sleepiness, concentration, recovery, and hours of sleep. Intervention participants received additional text messages with recommendations for behaviors that can mitigate fatigue. Intervention participants received weekly text messages that promoted sleep. Our analysis was guided by the intent-to-treat principle. For the long-term outcome of interest (sleep quality at 120 days), we used a two-sample t-test on the change in sleep quality to determine the intervention effect. Results: Eighty-three individuals were randomized and 2,828 shifts documented (median shifts per participant =37, IQR 23–49). Seventy-one percent of individuals randomized (n = 59) participated up to the 120-day study period and 52% (n = 43) completed the follow-up survey. Of the 69,530 text messages distributed, participants responded to 61,571 (88.6%). Mean sleep quality at 120 days did not differ from baseline for intervention (p > 0.05) or control group participants (p > 0.05), and did not differ between groups (p > 0.05). There was no change from baseline to 120 days in the proportion with poor sleep quality in either group. Intra-shift fatigue increased (worsened) over the course of 12-hour shifts for participants in both study arms. Fatigue at the end of 12-hour shifts was higher among control group participants than participants in the intervention group (p < 0.05). Pre-shift hours of sleep were often less than 7 hours and did not differ between the groups over time. Conclusions: The SleepTrackTXT2 behavioral intervention showed a positive short-term impact on self-rated fatigue during 12-hour shifts, but did not impact longer duration shifts or have a longer-term impact on sleep quality among air-medical EMS clinicians. [ABSTRACT FROM AUTHOR]

Objective: Stroke is the leading cause of disability in the United States with most of these patients being transported by emergency medical services. These providers are the first medical point of contact and must be able to rapidly and accurately identify stroke and transport these patients to the appropriate facilities for treatment. There are many conditions that have similar presentations to stroke and can be mistakenly identified as potential strokes, thereby affecting the initial prehospital triage. Methods: A retrospective observational study examined patients with suspected strokes transported to a single comprehensive stroke center (CSC) by a helicopter emergency medical service (HEMS) agency from 2007 through 2013. Final diagnosis was extracted from the Get with the Guidelines (GWTG) database and hospital discharge diagnosis for those not included in the database. Frequencies of discharge diagnosis were calculated and then stratified into interfacility vs. scene transfers. Results: In this study 6,243 patients were transported: 3,376 patients were screened as potential strokes, of which 2,527 had a final diagnosis of stroke (2,242 ischemic stroke and 285 transient ischemic attack), 166 had intracranial hemorrhage, and 655 were stroke mimics. Stroke mimics were more common among scene transfers (223, 32%) than among interfacility transfers (432, 16%). Conclusions: In our study approximately 20% of potential stroke patients transported via HEMS were mimics. Identifying the need for CSC resources can be an important factor in creating a prehospital triage tool to facilitate patient transport to an appropriate health care facility. [ABSTRACT FROM PUBLISHER]

This article examines questions of agency, identity, and fan-industry collaboration underpinning the fabrication of an exclusively feminine personification of excessive film fandom. Dubbed "the screen-struck girl," this white, adolescent figure was presented in American fan magazines and popular newspapers of the 1910s as a pathological consumer and a self-erasing aspiring star. However, in autobiographical letters to the press, girl fans proudly self-identified as movie bingers and aspiring actresses. Investigating girl fans' willing and public adherence to such a pejorative stereotype, I complicate our understanding of early twentieth-century female fan agency and its relation to Hollywood's burgeoning press machine. [ABSTRACT FROM AUTHOR]

In this article we devise an endogenous growth model with R&D, physical capital, and human capital with several externalities. The model is calibrated to the US economy and used to quantitatively evaluate the effect on growth and welfare of implementing different budget-neutral policies. The welfare effects of different policies are calculated by taking into account the transitional dynamics of the economy after the policy reform. Our main findings have policy implications; mainly, subsidies to research are the most welfare-increasing amongst the budget-neutral policies, and the optimal structure of subsidies entails substantially increasing the subsidy to R&D, maintaining a zero subsidy to production, and reducing the subsidy to education, so as to keep the intertemporal government budget balanced. A detailed sensitivity analysis shows the robustness of these results. [ABSTRACT FROM PUBLISHER]

Sequeira T. N. and Lopes A. F. Does a federal country need federal transfers when it has labour mobility?, Regional Studies. This work empirically tests optimum currency area theory for members of a given monetary union (the United States). The United States is recognized as a country where labour mobility between states is high. This paper jointly assesses the consequences of having federal transfers and labour mobility in terms of the states' cyclical output. It is concluded that federal transfers undoubtedly contribute to increase cyclical output. However, out-migration may increase or decrease cyclical output, depending on certain conditions. As federal transfers proved to be much more important than migration, the answer to the question in the paper's title is 'yes'. [image omitted] Sequeira T. N. et Lopes A. F. Un pays federal, a-t-il besoin des transferts federaux quand il est deja dote de la mobilite du travail?, Regional Studies. Cet article cherche a tester empiriquement la theorie des zones monetaires optimales pour ce qui est des pays-membres d'une union monetaire donnee (a savoir, les Etats-Unis). On considere les Etats-Unis comme un pays ou la mobilite interregionale du travail est importante. Cet article cherche donc a evaluer les consequences des transferts federaux et de la mobilite du travail du point de vue de la production cyclique des etats. Cela amene a la conclusion suivante: les transferts federaux contribuent indubitablement a une hausse de la production cyclique. Toujours est-il que le solde migratoire negatif pourrait accroitre ou decroitre la production cyclique, suivant la conjoncture. Donne que les transferts federaux s'averent plus importants que ne l'est la migration, la reponse a la question posee est 'oui'. Migration interne Transferts federaux Convergence cyclique Enquete a echantillon permanent Generalized method of moments (GMM) Sequeira T. N. und Lopes A. F. Benotigt ein foderaler Staat einen Finanzausgleich zwischen den Bundesstaaten, wenn seine Arbeitskrafte mobil sind?, Regional Studies. In diesem Beitrag uberprufen wir auf empirische Weise die Theorie der optimalen Wahrungsraume fur die Mitglieder einer bestehenden Wahrungsunion (der Vereinigten Staaten). Die USA gelten als Land mit hoher Mobilitat von Arbeitskraften innerhalb der Bundesstaaten. In diesem Beitrag untersuchen wir gemeinsam die Folgen eines Finanzausgleichs zwischen den Bundesstaaten und einer Mobilitat von Arbeitskraften fur die zyklische Produktionsleistung der Staaten. Wir ziehen den Schluss, dass der Finanzausgleich zwischen den Bundesstaaten zweifellos zu einer Erhohung der zyklischen Produktionsleistung beitragt. Allerdings kann die zyklische Produktionsleistung in Abhangigkeit von bestimmten Bedingungen aufgrund von Abwanderung zu- oder abnehmen. Da sich der Finanzausgleich zwischen Bundesstaaten als deutlich wichtiger erweist als die Migration, lasst sich die Frage in der Uberschrift bejahen. Interne Migration Finanzausgleich zwischen Bundesstaaten Zyklische Konvergenz Paneldaten Generalized method of moments (GMM) Sequeira T. N. y Lopes A. F. ¿Necesita un pais federal transferencias entre las diferentes regiones si la fuerza de trabajo es movil?, Regional Studies. En este trabajo comprobamos desde un punto de vista empirico la teoria de las areas monetarias optimas para los miembros de una determinada union monetaria (los Estados Unidos). Estados Unidos es reconocido como un pais cuya movilidad laboral entre los estados es alta. En este articulo valoramos conjuntamente las consecuencias de disponer de transferencias entre las diferentes regiones y la movilidad laboral en terminos del rendimiento ciclico de los estados. Concluimos que las transferencias entre las regiones contribuyen sin duda a aumentar el rendimiento ciclico. Sin embargo, la emigracion puede causar un aumento o una disminucion del rendimiento ciclico en funcion de ciertas condiciones. Puesto que se ha demostrado que las transferencias entre regiones son mucho mas importantes que las migraciones, la respuesta a la pregunta del titulo es afirmativa. Migracion interna Transferencias entre regiones Convergencia ciclica Datos del panel Metodo generalizado de momentos (Generalized method of moments (GMM)) [ABSTRACT FROM AUTHOR]

Abstract: The emerging US carbon nano-manufacturing sector accounts for 40% of nanotechnology product marketplace, thus, there is a significant potential for increased risks arising from workers'' exposure to carbon nanofibers (CNF). This research aims at developing a low-cost/evidence-based tool, thereby, increasing the sustainability of CNF manufacturing firms. The following specific aims achieve the study objective: Aim 1 — To present a technical discussion of the proposed concept for risk analysis and protection measures; Aim 2 — To describe the manufacturing process utilized for the CNF production; Aim 3 — To describe the hazards typically encountered in a CNF manufacturing facility; and, Aim 4 — To document the application of the proposed tool for risk analysis and intervention strategy development. In this study, a four-step methodology was developed to protect worker health in the nano-manufacturing enterprise through the generation of improvement actions (i.e., suggested changes in the hazard/work environment characteristics and individual capabilities without specifying how changes are made) followed by interventions (i.e., workplace solutions which specify how changes are being implemented). The methodology was implemented in a CNF manufacturing enterprise in the Midwest of the US. The data collected were based on detailed observations and interviews with worker and management personnel. A detailed flow process analysis was conducted for the nano-manufacturing operation. Eleven hazards were identified at the facility. Analysis indicated that the computed risk scores ranged from moderate (i.e., requiring one to start with incremental changes, then, explore substantial changes, if needed) to very high (i.e., substantial changes should be planned in the short term, followed by incremental changes). A detailed intervention plan was presented for the identified hazards on the basis of criteria of applicability, cost, benefit and feasibility. Management personnel were in agreement with the findings of the study. In conclusion, a low-cost/evidence-based tool was developed and implemented to assess and manage the risks associated with exposure to CNF production in a manufacturing enterprise. Preliminary validation of the tool suggests that management personnel were in agreement with the study findings. Further application of the systematic methodology is warranted. [Copyright &y& Elsevier]

Focuses on the case of Wal-Mart Stores, Inc. versus Samara Bros. in the United States. Discussion of trade dress protection and the Lanham Act; Presentation of case facts; Impact of the Supreme court decision on the lower courts.

Explores the performative dimensions of charismatic renewal in the U.S. Distinct traditions of the Episcopal Church of America; Forms of the gift of tongues; Sequence of acts in a healing ritual.

Presents an update on neuroscience in the United States as of March 2002. Observation of obsessive behavior in mice; Link between hormone therapy and the prevention of age-related cognitive decline in women; Use of polymers in the treatment of spinal cord injuries.

Presents newsbriefs related to neurosciences in the United States as of December 2001. Study conducted by Rothschild Hospital in Paris on the occurrence of amyotrophic lateral sclerosis in human immunodeficiency syndrome patients; Survey conducted by The Scientist and Abbott, Langer and Associates; Donation from Michael J. Fox Foundation for Parkinson's Research for stem cell research.

Reports on the importance of giving medical attention to migraine attacks. Number of adults who suffer from migraine headaches in the U.S. as of June 2002; Over-the-counter medications used by U.S. citizens to treat their pain.

Abstract: We describe a concept for an instrument to measure the thickness of the ice shell on a planetary body such as Jupiter’s moon Europa. Unlike a high powered and massive device such as an ice-penetrating radar, the instrument would be a passive receiver of a naturally occurring signal generated by interactions of deep penetrating cosmic ray neutrinos. We discuss the basic concept and consider the instrument design requirements from the perspective of a NASA Outer Planet Orbiter Mission. We show results of simulations, compare signal-to-noise estimates, and examine possible components and configurations for the antenna, receiver, and electronics. We note some options that can be used to reduce mass and power. Finally, we present a list of issues that would need further study to produce a more concrete design. [Copyright &y& Elsevier]

Type 1 diabetes (T1D) is a chronic condition affecting nearly 1.9 million people in the United States. Young adults (YAs) with T1D face unique challenges in managing their condition, experiencing poorer health and well-being than other age groups. The current study is evaluating the Resilient, Empowered, Active Living (REAL) intervention, previously shown to improve glucose levels and quality of life among YAs with diabetes, using telehealth delivery (REAL-T) to expand reach and accessibility. This paper reports on the methodology and baseline participant characteristics of the REAL-T study. REAL-T is a two-arm randomized controlled trial that recruited 18–30 year olds with T1D via clinics and social media advertising. Data collection, which was adapted to be fully remote due to COVID-19, occurs every three months for one year. Participants receive either usual care or a 6-month telehealth occupational therapy intervention. The primary outcome is glycated hemoglobin (A1c); secondary outcomes include diabetes distress, quality of life, and continuous glucose monitor-derived measures. The study enrolled a diverse sample of 209 YAs with T1D. Analysis of baseline data indicates equivalence between the intervention and control groups. Study participants have notably higher diabetes distress and poorer mental well-being than similar populations. The REAL-T study successfully adapted to remote implementation during the COVID-19 pandemic. By examining long-term outcomes, mediating pathways, and cost-effectiveness, the study will contribute knowledge of the impact of tailored interventions for YAs with T1D, designed to reduce disparities and improve health and well-being in this population. [ABSTRACT FROM AUTHOR]

Background: The COVID 19 pandemic adversely impacted delivery of preventive, routine, urgent, and essential care worldwide. Dialysis access care was particularly affected due to the lack of specific guidelines regarding procedures for its creation and maintenance. Early guidance by Centers for Medicare and Medicaid was inadvertently interpreted as guidance to stop dialysis access procedures. Prompt action by professional societies was needed to furnish detailed guidance to establish essential nature of these procedures., Methods: The American Society of Diagnostic and Interventional Nephrology (ASDIN) issued a joint statement with Vascular Access Society of the Americas (VASA) - "Maintaining Lifelines for ESKD Patients" to clearly establish the role of vascular access as a lifeline for ESKD (End Stage Kidney Disease) patients and the importance and urgency of its timely management. ASDIN also conducted a survey in mid-2020, that was administered to the ASDIN database as well as shared with the general public via the organization's social media platforms. The respondents reported their experiences in the care of dialysis access, practice patterns and the utility of the ASDIN-VASA statement during the COVID 19 pandemic., Results: Of the 2030 individual surveys sent, 581 were opened and 53 (9.1%) responses were received from different parts of the country and from different practice settings. ASDIN COVID 19 triage document was frequently utilized and 83% of respondents found the document valuable. The survey also revealed multiple obstacles, including logistical and financial issues that led to significant disruption of services., Conclusions: The care of dialysis access was significantly affected in the United States during the COVID 19 pandemic due to multiple reasons. ASDIN actions provided valuable specific guidance regarding and explored barriers to dialysis access care. We describe those results and discuss strategies to prevent COVID 19 transmission with innovative strategies of providing access care. Individualized decision making is of essence when considering dialysis access procedures.

The cost and health burden of ESRD continues to increase globally. Total Medicare expenditure on dialysis has increased from 229 million USD in 1973 to 35.4 billion USD in 2016. Dialysis access can represent almost a tenth of these costs. Central venous catheters have been recognized as a significant factor driving costs and mortality in this population. Home dialysis, which includes peritoneal dialysis and home hemodialysis, is an effective way of reducing costs related to renal replacement therapy, reducing central venous catheter usage and in many cases improving the clinical and psychosocial aspects of patients' health. Addressing access-related issues for peritoneal dialysis, urgent-start peritoneal dialysis and home hemodialysis can have impact on the success of home dialysis. This article reviews issues related to dialysis access for home therapies., (Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Hydrophilic polymer coatings on intravascular devices lower friction between the device and vasculature, thereby reducing trauma during interventional procedures. Polymer coating embolism-the detachment and downstream embolism of polymer particles-has been reported as an iatrogenic complication of coated interventional devices affecting the vasculature and various organs. The Food and Drug Administration (FDA) acknowledges this complication and continues to work with stakeholders to close gaps in performance testing and standards related to polymer coating integrity. Recent innovations within interventional technologies have led to development of new hydrophilic-coated devices with expanded indications for use. The 2018 FDA draft guidance for intravascular guidewires expands the application of particulate generation testing to most devices and recommends labeling changes to increase industry awareness. This article highlights current procedural trends where the phenomenon of polymer coating embolism may be more prevalent. It describes the mechanisms of polymer separation, reported clinical sequelae, and risk factors for relevant indications. These procedural trends and associated risk factors articulate the need for particulate testing and support the FDA's draft guidance recommendations for performance testing of applied coatings. If standardized, particulate assessments may allow characterization and comparisons of coating integrity among devices from various manufacturers, and are an important foundation for setting particulate limits. As hydrophilic coatings enable endovascular treatment for a range of patient populations, setting particulate limits or finding alternative solutions without compromise to device function may be essential. Particulate testing is relevant to physicians, regulators, and manufacturers for the purposes of product development and quality improvement of interventional devices.