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Internationally representative data of middle-aged adults 45 - 65 years old [n(United States) = 2,150; n(Japan) = 2,318; n(South Korea) = 2,800] from the 2012 Program for International Assessment of Adult Competencies were analyzed to examine the roles of education and literacy in relation to the digital divide. Results from survey-weighted binary logistic regressions showed that both educational attainment and literacy were positively associated with all four measures of information and communication technology (use of the computer, email, online information and transaction) use in all three countries. The middle-aged adults in the United States benefited more from the educational attainment than those in Japan, in terms of email and online information use. The middle-aged adults with lower education and basic skills (i.e., literacy) may benefit from the educational intervention and additional information and communication technology training, and in turn, improve the digital divide in later life, regardless of differences in culture and economy.

Different variants of the selected-response (SR) item type have been developed for various reasons (i.e., simulating realistic situations, examining critical-thinking and/or problem-solving skills). Generally, the variants of SR item format are more complex than the traditional multiple-choice (MC) items, which may be more challenging to test takers and thus may discourage their test engagement on low-stakes assessments. Low test-taking effort has been shown to distort test scores and thereby diminish score validity. We used data collected from a large-scale assessment to investigate how variants of the SR item format may impact test properties and test engagement. Results show that the studied variants of SR item format were generally harder and more time consuming compared to the traditional MC item format, but they did not show negative impact on test-taking effort. However, item position had a dominating influence on nonresponse rates and rapid-guessing rates in a cumulative fashion, even though the effect sizes were relatively small in the studied data.

The unprecedented social disruptions resulting from the COVID-19 pandemic have resulted in rapid change within the family and home. This paper uses semi-structured interviews with parents around the globe to examine the following research questions: 1. How have the spatial and temporal organizations of learning and working in the home been altered throughout the COVID-19 pandemic? 2. What are the alterations in the educational processes and the role of the family in response to the changes caused by the COVID-19 pandemic? We found that typical boundaries, those between the roles of family members, between work or school and home, and between leisure time and work time have been fundamentally blurred. While some of these boundaries are more porous than others, families report fundamental shifts, temporary and permanent in the way they organize their home and family, spatially and temporally, and the roles they take on within the family.

To establish the factor structure of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) in Chinese and American adolescent samples; to assess measurement invariance of the ERQ-CA in Chinese and American adolescent samples and latent means across early adolescents from two diverse cultural settings. The ERQ-CA was administered to 1221 Chinese adolescents (49.3% males) and 1148 American adolescents (50.1% males), and multi-group confirmatory factor analysis was performed to evaluate measurement invariance. (1) Multi-group confirmatory factor analysis of the ERQ-CA demonstrated full configural invariance, full metric invariance, partial scalar invariance, and partial strict invariance. (2) The latent variable mean comparisons revealed significant differences between the two samples; specifically, Chinese adolescents' mean scores on the latent variables of cognitive reappraisal (CR) and expressive suppression (ES) were significantly higher than American adolescents' scores. The findings demonstrated that the ERQ-CA displays appropriate measurement invariance across Chinese and America adolescents and that Chinese adolescents reported higher scores on CR and ES.

Evidence suggests an impact of the COVID-19 pandemic on mental health, particularly among emerging adults. However, theories on altruism born of suffering or adversarial growth suggest that we might also see prosocial behavior as a function of the pandemic, which may protect against mental health challenges. Because cultural values are central in determining prosocial behavior, the current study explored how cultural values were differentially associated with adaptive prosocial behaviors that might protect against mental health challenges. Participants for the current study included 5,682 young people aged 18-25 years from 14 different countries around the world (68% female, 62% college students). Path analyses suggested that there were few differences in patterns as a function of culture, but revealed that horizontal individualism and horizontal and vertical collectivism were indirectly associated with lower levels of depression via prosocial behavior toward family members. Discussion focuses on the importance of coping by strengthening family relationships via prosocial behavior during the pandemic.

This cross-cultural comparison study examined the direct and indirect effects (via several cognitive-affective pathways) of insecure attachment on bulimic behaviors and explored cultural similarities and differences in all pathways of the indirect effect model between female university students from the U.S. and Korea. Our findings from the two cultural samples (N = 421 for the Korean sample, N = 271 for the U.S. sample) generally indicated that both insecure attachment variables were associated with bulimia through three-sequential mediational functions of maladaptive perfectionism, lowered self-esteem, and heightened depression. However, the results also highlighted several culturally specific nuances in the indirect effect paths through which adult attachment insecurity affects bulimic behavior (e.g., adult attachment was indirectly associated with bulimia via maladaptive perfectionism and self-esteem only for the U.S. group). Findings are discussed from the perspectives of adult attachment theory, trans-diagnostic theory, and local cultural context. Limitations, future research directions, and counseling implications are presented.

This meta-analytic study compared the effect of peer-led learning versus non peer-led learning on students' cognitive achievement in post-secondary education. Twenty-eight studies published in English from six countries between 1993 and 2017 were identified and used in the analysis. Result of the analysis on the random-effect model showed a moderate but positive effect, meaning that peer-led learning was associated with higher cognitive achievement than non-peer-led learning. Three study characteristics were examined including duration, student leaders' training, and task type. Only the task type was found significant in moderating the effect of peer-led learning. Student leaders' facilitation of problem-based learning tasks outperformed other types of tasks. Results of this study not only provided suggestions for peer-led learning designers and coordinators but also called for future research of student leaders' readiness as well as online peer-led learning.

This study investigates the identities produced by three L2 teachers of different backgrounds and experiences in an intercultural telecollaborative project that integrated the use of mixed-reality technology. Content-analysis (Hoffman et al., 2011) and multimodal (inter)action analysis (Norris, 2011) were employed to identify the identity elements produced during their multimodal interactions. Using Darvin and Norton's (2015) model of investment (MOI) as an interpretative lens, this study uncovers the different identities held by the participants, and the ways in which they aspired to become good teachers. Findings also show that mixed-reality simulated teaching provided a safe environment for exercising professional agency, thereby facilitating identity development and promoting the sense of getting there. Interactive reflection provided a site of struggle where the value of capital and imagined identities shifted. Dialoguing among the participants allowed them to reassess the value of pre-acquired capital and move to (re)imagining new teacher identities and restructuring ideological structures. Mixed-reality teaching and intercultural professional learning sensitizes the less experienced teachers to the socially and culturally complex roles required for L2 teachers. The mixed-reality simulation technology still has its limitations, mainly where classroom interaction is concerned, because the number of avatar students is small and they cannot move around physically.

Despite increasing advocacy for gender equality, gender prejudice and discrimination persist. The origins of these biases develop in early childhood, but it is less clear whether (1) children's gender attitudes predict discrimination and (2) gender attitudes and discrimination vary by ethnicity and US region. We examine these questions with an ethnically (Asian, Black, Latinx and White) and geographically (Northeast, Pacific Northwest, West, Southeast and Hawaii) diverse sample of 4‐ to 6‐year‐old children (N = 605) who completed measures of gender attitudes and discrimination in a preregistered study. Children, across groups, demonstrated more positive attitudes towards their gender ingroup. Children who showed more pro‐ingroup attitudes also showed more pro‐ingroup behavioural discrimination. Girls showed stronger ingroup favouritism than boys, but ethnic and regional groups generally did not vary in levels of bias. These findings contribute to our understanding of how gender intergroup biases develop and highlight the generalizability of these processes. [ABSTRACT FROM AUTHOR]

Aim: To examine the impact of both individual and cumulative social determinants of health (SDoH) on the likelihood of developing periodontitis, while also exploring any gender disparities in this relationship. Materials and Methods: Data of self‐reported SDoH domains and sub‐items based on Healthy People 2030 were obtained from the U.S. National Health and Nutrition Examination Surveys between 1999 and 2014. Logistic regression models, weighted by survey responses, were used to examine the relationship between SDoH (including eight sub‐items and the cumulative number of unfavourable SDoH) and periodontitis. The results were further analysed by gender. Results: A total of 18,075 participants (8867 males and 9208 females) were included in the main analysis, of which 5814 (32.2%) had periodontitis. The study found that certain unfavourable SDoH were individually associated with higher odds of periodontitis, and the cumulative number of unfavourable SDoH was positively linked to the odds of developing periodontitis. Furthermore, males exposed to more unfavourable SDoH appeared to be more susceptible to developing periodontitis than females. Conclusions: The findings suggest that unfavourable SDoH, especially when they accumulate, are associated with an increased odds of periodontitis and contribute to gender disparities within the U.S. population. [ABSTRACT FROM AUTHOR]

Background: Information on lentigo maligna (LM) and lentigo maligna melanoma (LMM) in the 21st century is scarce. We aimed to elucidate the incidence of LM and LMM using the Surveillance, Epidemiology, and End Results (SEER) 17 Registries. Methods: The data of patients diagnosed between 2000 and 2019 were extracted from the SEER database. The percentage of LM/LMM cases among all melanoma patients, age‐standardized incidence rates, estimated annual percentage changes, and the cumulative incidence of LMM after LM were calculated. Results: The SEER data yielded 95,175 patients with LM/LMM between 2000 and 2019. Cases of LM/LMM accounted for 15.7% of all melanomas. The age‐standardized incidence per 100,000 person‐years for LM increased from 4.16 to 5.61 and for LMM from 1.33 to 2.35 between 2000 and 2019. The annual increase in incidence of LM was 2.42%, and that of LMM was 3.32%. The cumulative incidence of LMM after a primary LM after 10‐year follow‐up was 0.94%. Conclusions: This study provides the first comprehensive analysis of the epidemiological status of LM/LMM in the United States in the 21st century using the population‐based SEER data. [ABSTRACT FROM AUTHOR]

Recent economic development in China not only has improved the overall living standards of Chinese people, but it has also created a new middle class. Another impact of the economic development is the increasing demand for educated workers. Subsequently, the demand for quality higher education has also increased. With more than 50% of the world's top 100 universities located in the United States, the United States is regarded as the number one destination for international students for higher education. Due to the cultural differences between China and the United States, scholars have found that Chinese students encounter the most challenges adjusting to American college life. Lack of Western cultural exposure, different cultural values, the effect of the One-Child Policy, the emphasis on effort, endurance, and hard work in education, the continual impact of the Cultural Revolution's aftermath on people's relationships, the unfulfilled expectations of American college life experiences, and the influence of the Chinese education structure on students' characters and skills-building all have an impact on Chinese students' worldview and their interaction with their new environment. By reviewing the literature on the topic, this article seeks to understand the roots of the challenge to gain insight into the reasons why Chinese students do what they do after they come to the United States for higher education.

The purposes of this study were to compare the differences in the use of geometry in elementary school mathematics textbooks among Finland, Mainland China, Singapore, Taiwan, and the USA and to investigate the relationships between the design of the textbooks and students' performance on large-scale tests such as TIMSS-4 geometry, TIMSS-8 geometry, and PISA space and shape. The content analysis method was used to collect data, and then chi-square tests and correlation analyses were used to analyze data. The results showed that there were significant differences in representation form, problem type, and question format among these mathematics textbooks from the five countries. Moreover, the strength of the positive relationships between visual form (combined form) and students' performance on TIMSS-4 geometry, TIMSS-8 geometry, and PISA space and shape decreases as students advance to higher grades, whereas increasing strength of correlations as students get older is found between contextual problems and students' performance on the three large-scale tests.

Background: Single-cell sequencing (SCS) is a technique used to analyze the genome, transcriptome, epigenome, and other genetic data at the level of a single cell. The procedure is commonly utilized in multiple fields, including neurobiology, immunology, and microbiology, and has emerged as a key focus of life science research. However, a thorough and impartial analysis of the existing state and trends of SCS-related research is lacking. The current study aimed to map the development trends of studies on SCS during the years 2010-2022 through bibliometric software. Methods: Pertinent papers on SCS from 2010 to 2022 were obtained using the Web of Science Core Collection. Research categories, nations/institutions, authors/co-cited authors, journals/co-cited journals, co-cited references, and keywords were analyzed using VOSviewer, the R package "bibliometric", and CiteSpace. Results: The bibliometric analysis included 9,929 papers published between 2010 and 2022, and showed a consistent increase in the quantity of papers each year. The United States was the source of the highest quantity of articles and citations in this field. The majority of articles were published in the periodical Nature Communications. Butler A was the most frequently quoted author on this topic, and his article "Integrating single-cell transcriptome data across diverse conditions, technologies, and species" has received numerous citations to date. The literature and keyword analysis showed that studies involving single-cell RNA sequencing (scRNA-seq) were prominent in this discipline during the study period. Conclusion: This study utilized bibliometric techniques to visualize research in SCS-related domains, which facilitated the identification of emerging patterns and future directions in the field. Current hot topics in SCS research include COVID-19, tumor microenvironment, scRNA-seq, and neuroscience. Our results are significant for scholars seeking to identify key issues and generate new research ideas. [ABSTRACT FROM AUTHOR]

One fundamental way to determine the validity of standardized English-language test scores is to investigate the extent to which they reflect anticipated learning effects in different English-language programs. In this study, we investigated the extent to which the "TOEFL iBT"® practice test reflects the learning effects of students at intensive English programs in the United States and China, as well as extracurricular English-learning activities that may be associated with the expected learning effects. A total of 607 students at the high school level or beyond participated in the United States and China, including 111 students who took 2 forms of the practice test under a pretest and posttest design. The results showed moderate to substantial levels of improvement on each of the TOEFL iBT sections, with different score gain patterns for students in the United States and China. We concluded that students who study at English programs similar to those included in this study can improve their English-language proficiency levels at least moderately over 6 months or longer, as indicated by changes in their scores on the TOEFL iBT practice test. This improvement is consistent with an interpretation of TOEFL iBT scores as indicators of English-language proficiency.

Isawa Shuji studied in the United States and made major contributions to the development of the music education in Japan and Taiwan. This paper provides a perspective of Isawa's activities based on sources in Japanese, Chinese, and English. Isawa was familiar with Western education and music before he went to the United States. In Massachusetts, he attended Bridgewater Normal School and studied music with Luther Whiting Mason. In Japan, Isawa worked with the Music Research Institute to publish Japanese music textbooks "Shogaku shokashu" (1881-84), which combined Japanese traditional music and Western music. In the 1890s, Isawa published "Shogaku shoka" (1892-93), which continued his combination of Japanese and Western ideas ("wayo secchu"). As Chief of the Education Bureau in Taiwan, Isawa believed that the essential goal of education was to teach Taiwanese people the Japanese language. The Shizangan school was the first national language school. Isawa brought Japanese music teachers to Taiwan and introduced Japanese songbooks. He was influential in developing normal schools and primary schools. Isawa influenced the history of music education internationally as he brought Western songs to Japan, combined Japanese traditional music and Western music in his publications, and brought Japanese songbooks to Taiwan.

Modern international studies of educational achievement have grown in terms of participating educational systems. Accompanying this development is an increase in heterogeneity, as more and different kinds of educational systems take part. This growth has been particularly pronounced among low-performing, less economically developed systems. Although studies such as PISA have made modifications to account for increased diversity, the degree to which international assessments serve educational systems at the lower ends of the achievement continuum is understudied. We used modified Wright maps and PISA's definition of proficiency to evaluate the fitness of PISA, especially among low performers. Our findings suggest that there is mismatch between some populations and PISA. Results from a simulation show that such disparities produced biased achievement estimates and correlations with policy relevant variables. Projected PISA growth and new instantiations of PISA, particularly geared toward developing educational systems, make these findings timely and especially relevant.

Perceived health and distresses are associated with the practice of lifestyle modifications, which increases the risk of diabetes and hypertension-related complications. This study aimed to define the characteristics and distribution of perceived health and distresses across the states between people with diabetes and hypertension. Data were derived from a national survey of US adults aged ≥18 years who were interviewed via phone call. Perceived health and distresses were assessed through corresponding questions. An amount of 333,316 respondents (43,911 with diabetes and 130,960 with hypertension) were included in the analysis; 61.8% of people with diabetes and 74.5% of people with hypertension reported having good or better health, while residents in the Southwest region perceived poor health statuses and more distresses. Education level (diabetes: odds ratio [OR] = 0.47–0.79, hypertension: OR = 0.42–0.76), employment status level (diabetes: OR = 1.40–2.22, hypertension: OR = 1.56–2.49), and household income (diabetes: OR = 0.22–0.65, hypertension: OR = 0.15–0.78) were significant factors associated with poorly perceived health among people with diabetes and hypertension, and the use of technology and strategies for policymakers are suggested to improve the perceived health status in this regard. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cancer, as the second leading cause of death in the United States, poses a huge healthcare burden. Barriers to access to advanced therapies influence the outcome of cancer treatment. In this study, we examined whether insurance types affect the quality of cancer clinical care. Materials and Methods: Data for 13,340 cancer patients with Purchased or Medicaid insurance from the All of Us database were collected for this study. The chi-squared test of proportions was employed to determine the significance of patient cohort characteristics and the accessibility of healthcare services between the Purchased and Medicaid insurance groups. Results: Cancer patients who are African American, with lower socioeconomic status, or with lower educational attainment are more likely to be insured by Medicaid. An analysis of the survey questions demonstrated the relationship between income and education level and insurance type, as Medicaid cancer patients were less likely to receive primary care and specialist physician access and more likely to request lower-cost medications. Conclusions: The inequities of the US healthcare system are observed for cancer patient care; access to physicians and medications is highly varied and dependent on insurance types. Socioeconomic factors further influence insurance types, generating a significant impact on the overall clinical care quality for cancer patients that eventually determines treatment outcomes and the quality of life. [ABSTRACT FROM AUTHOR]

Limited real-world evidence exists to better understand the patient experience of living with symptoms and impacts of non-alcoholic steatohepatitis (NASH). This study aimed to (1) describe patient-reported perspectives of NASH symptoms and impacts on patients' daily lives and (2) develop a patient-centered conceptual NASH model. A cross-sectional study using semi-structured qualitative interviews was conducted among adults (≥18 years) in the United States living with NASH. Eligible participants were diagnosed with NASH, had mild to advanced fibrosis (F1-F3), and no other causes of liver disease. The interview guide was informed by a targeted literature review (TLR) to identify clinical signs, symptoms, impacts, and unmet treatment needs of NASH. Participants described their experiences and perspectives around NASH and the symptoms, symptom severity/bother, and impact of NASH on their daily activities. Interviews were audio-recorded and transcribed verbatim for coding and thematic analysis. Twenty participants (age: 42.4 years; female: 50.0%) were interviewed. Participants discussed their experience with NASH symptoms (most frequent: fatigue [75.0%]; weakness/lethargy [70.0%]) and impacts (most frequent: physical and psychological/emotional [70.0% each]; dietary [68.4%]). Participants considered most symptoms to be moderately severe or severe and moderately or highly bothersome. Findings from the TLR and qualitative interviews were incorporated into a conceptual model that describes patient-reported symptoms and impacts of NASH, clinical signs, risk factors, and unmet treatment needs. Our study provides insights into patients' perspectives of NASH symptoms and their impact on their daily lives. These findings may guide patient-physician conversations, supporting patient-centered treatment decisions and disease management. Study findings help to address the gap in current literature about patients' perspectives on NASH and its symptoms as well as its impact on daily life. The study proposes a holistic conceptual model that describes patients' perspectives of living with NASH, including symptoms and their impact, the clinical signs and risk factors of NASH, and the unmet treatment needs of the disease. Healthcare providers can use study findings to inform patient-focused decisions around treatment strategies for NASH. [ABSTRACT FROM AUTHOR]

Purpose: Whether long-term aspirin usage is associated with colorectal cancer (CRC) risk needs more evidence. The study evaluated the association between long-term aspirin use and prevalence of CRC in a large, nationally representative database. Methods: Hospitalized patients aged ≥ 50 years during 2018 were identified in the United States (US) National Inpatient Sample (NIS). Patients without complete information of age, sex, race, income, and insurance status were excluded, as well as those with inflammatory bowel disease (IBD) or malignancies other than CRC. Propensity score matching (PSM) was applied to balance the characteristics between patients with and without long-term aspirin use. Logistic regressions were performed to determine the relationship between long-term aspirin use and the presence of CRC. CRC and aspirin use were identified through the administrative International Classification of Diseases (ICD) codes. Results: Data from 3,490,226 patients were included, in which 688,018 (19.7%) had a record of long-term aspirin use. After 1:1 PSM, there remained 1,376,006 patients, representing 6,880,029 individuals in the US after weighting. After adjusting for confounders, long-term aspirin use was significantly associated with lower CRC odds (adjusted odds ratio [aOR] = 0.64, 95% confidence interval [CI] 0.62, 0.67). This association was not changed when stratified by age, sex, race, body mass index (BMI), and smoking. Conclusions: From a national inpatient dataset, US adults ≥ 50 years on long-term aspirin are less likely to have CRC, regardless of age, sex, race, BMI, and smoking status. [ABSTRACT FROM AUTHOR]

Sweetpotato (Ipomoea batatas L.) is an important staple crop cultivated in over 100 countries, and the storage roots and vines provide food for humans and livestock. Sweetpotato consumption and demand for its value‐added products have increased significantly in the last two decades and have led to new cultivar development, expansion in acreage, and increased demand in the United States and its export markets. Despite the known nutritional components and other health benefits, further research is needed to characterize the genetic diversity and chemical composition related to their storage root qualities, essential in developing consumer‐preferred cultivars that offer host plant resistance against pests and pathogens. There is a critical need for research on non‐pesticidal control approaches that can provide safe, effective, economical, sustainable, and environmentally sound pest and disease management techniques, especially for socially disadvantaged small farmers in the United States. Moreover, climate change can significantly impact future production practices and yield and may directly or indirectly affect crop pests, weeds, and diseases. In this review, we discuss the current status, challenges, and future approaches associated with sweetpotato production practices; health‐promoting properties of sweetpotato cultivars; value‐added products; genetic diversity and germplasm; pest and disease management; weed and water management; pollination ecology; and other agronomic and cultural practices that may impact sustainable sweetpotato production by small‐scale, organic, and large‐scale growers. Core Ideas: Sweetpotato (Ipomoea batatas L.) is an important staple crop cultivated in over 100 countries.US sweetpotato industry faces many production challenges, including pest and diseases, as well as climate change extremes.A comprehensive review by subject matter experts on the challenges of US sweetpotato industry is not available.This review evaluates the current situation, challenges, and future approaches for improving sweetpotato production.Also, current and future impacts of climate change on global sweetpotato production and demand are discussed. [ABSTRACT FROM AUTHOR]

Background: Diabetic kidney disease (DKD) is a prevalent complication of diabetes and the leading cause of end-stage renal disease. Recent evidence suggests that total flavonoids of Astragalus (TFA) has promising effects on diabetes; however, its influence on DKD and the underlying mechanism remains unclear. Methods: In this study, we induced the DKD model using streptozotocin (STZ) in male C57BL/6J mice and utilized glomerular endothelial cell (GEC) lines for in vitro investigations. We constructed a network pharmacology analysis to understand the mechanism of TFA in DKD. The mechanism of TFA action on DKD was investigated through Western blot analysis and multi-immunological methods. Results: Our findings revealed that TFA significantly reduced levels of urinary albumin (ALB). Network pharmacology and intracellular pathway experiments indicated the crucial involvement of the PI3K/AKT signaling pathway in mediating these effects. In vitro experiments showed that TFA can preserve the integrity of the glomerular filtration barrier by inhibiting the expression of inflammatory factors TNF-alpha and IL-8, reducing oxidative stress. Conclusion: Our findings demonstrated that TFA can ameliorates the progression of DKD by ameliorating renal fibrosis and preserving the integrity of the kidney filtration barrier. These results provide pharmacological evidence supporting the use of TFA in the treatment of kidney diseases. [ABSTRACT FROM AUTHOR]

Vaccination is the most effective strategy for preventing infectious diseases such as COVID-19. College students are important targets for COVID-19 vaccines given this population's lower intentions to be vaccinated; however, limited research has focused on international college students' vaccination status. This study explored how psychosocial factors from the Theory of Planned Behavior (TPB; attitudes, perceived behavioral control, subjective norms, and behavioral intentions) related to students' receipt of the full course of COVID-19 vaccines and their plans to receive a booster. Students were recruited via Amazon mTurk and the Office of the Registrar at a U.S. state university. We used binary logistic regression to examine associations between students' psychosocial factors and full COVID-19 vaccination status. Hierarchical multiple regression was employed to evaluate relationships between these factors and students' intentions to receive a booster. The majority of students in our sample (81% of international students and 55% of domestic students) received the complete vaccination series. Attitudes were significantly associated with all students' full vaccination status, while perceived behavioral control was significantly associated with domestic students' status. Students' intentions to receive COVID-19 vaccines were significantly correlated with their intentions to receive a booster, with international students scoring higher on booster intentions. Among the combined college student population, attitudes, intentions to receive COVID-19 vaccines, and subjective norms were significantly related to students' intentions to receive a booster. Findings support the TPB's potential utility in evidence-based interventions to enhance college students' COVID-19 vaccination rates. Implications for stakeholders and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to estimate clinical, economic (including productivity), and health‐related quality of life (HRQoL) outcomes and associated individual characteristics among adults with overweight (OW) or obesity in the United States. Methods: This study included adult respondents with body mass index (BMI) ≥18.5 kg/m2 in the 2017–2018 National Health and Nutrition Examination Survey (NHANES) and 2016 Medical Expenditure Panel Survey. Respondents were classified according to BMI. Individual characteristics were described by BMI categories. Multivariable regression models estimated the association between BMI categories and outcomes, adjusting for individual characteristics. Results: Nearly three‐quarters (73.7%) of NHANES participants were OW or obese. Relative to Normal weight (NW), respondents with Class 3 obesity had more obesity‐related complications (2.07 vs. 4.62, p < 0.001). Higher BMI was associated with significantly lower HRQoL, lower productivity, and higher healthcare expenditures as well as more frequent weight loss attempts in the previous 12 months. Weight loss surgery and prescription anti‐obesity medications (AOMs) were used only by a very small proportion of individuals. Despite frequent weight loss attempts, most respondents did not achieve clinically meaningful weight loss. Conclusions: Adults with OW or obesity experienced worse clinical, economic and HRQoL outcomes than those with NW. Better use of evidence‐based obesity treatments, including prescription AOMs, should be considered to achieve more clinically meaningful weight reduction and improved outcomes in individuals with OW or obesity. [ABSTRACT FROM AUTHOR]

The overarching goal of this study is to examine what is considered most important regarding the depth, breadth and content of space science concepts as reflected in current national science education standards and science curricula in Taiwan and the US. Major findings of this study conclude that many skills and concepts articulated in the standards in both countries are similar, although the structure of the standards is not the same; most space science content is addressed more specifically for a smaller grade span in Taiwan's standards than in the US standards; and "Insights" (an elementary science curriculum in the US) exhibits greater learner self-direction but expects students to comprehend more concepts in about the same amount of time as does the Taiwanese curriculum. Differences in these two curricula could be attributed to the varied content expectations for different clusters of grade span in the science standards. While the US is developing the Next Generation Science Standards, the findings of this study shed light on students' performance expectations in science in different countries, which in turn helps direct focus to areas of science education requiring significant attention, such as science standards, curriculum, and textbook development through international benchmarking. (Contains 5 tables.)

The present study follows a cohort of 17 K-12 teachers through a six-week resident learning experience in science and engineering, and on into the planning and implementation of applications for their classrooms. This Research Experiences for Teachers (RET) program was examined using the strategic approach of design-based research, with its fluid, adaptive management of the complexity of authentic learning "in situ" and its attentive documentation of expected and unexpected events, in process and products, to capture the richness of teachers' and mentors' experiences. Research on effective teacher professional development, adult learning, situated cognition, and learning transfer were utilized to inform the evaluation design. Teachers overall enjoyed the RET experience; they appreciated the faculty expertise and insights, and admired their mentors. In this study the authors see three parts of teacher professional development. The first is knowledge and skills, the intangible tools, cognitive and psychomotor, to do the research tasks. The second is equipment, the physical resources and tangible tools with which to do the work. The third is empowerment--in self-perceptions, motivations, and drive necessary to carry out the plans, provided through initial and ongoing support and communication. Teacher-learners, expert in K-12 science education, learned from university mentors, expert in engineering. Engineer-mentors learned about K-12 science education and the demands of effective teacher development. The result was a change in the practice of both groups of teachers, in K-12 education, in undergraduate engineering (reported by the mentors), and in the adaptive revision of the professional development program itself. (Contains 3 tables.)

This study investigated the level of foreign language anxiety in the classroom, plus the correlation between foreign language anxiety and cooperative learning attitudes and practice among university students at one university in the United States and three universities in Southern Taiwan. Two instruments (The Foreign Language Classroom Anxiety scale by Horwitz et al., 1986 and the Style Analysis Survey by Oxford et al., 1999a) were employed along with ten questions designed by the author: five sought to establish student perceptions of their classrooms' cooperative atmosphere and five concerned students' predilection towards cooperative learning. No significant correlation was found between foreign language anxiety and cooperative learning at the United States University. Of the three Southern Taiwan colleges, results from only one school showed a significant correlation. This was the only school that had a Taiwanese teacher. Appended to this document is a Survey Instrument. (Contains 2 tables.)

Science learning self-efficacy could be regarded as a multi-factor belief which comprises different aspects such as cognitive skills, practical work, and everyday application. However, few studies have investigated the relationships among these factors that compose science learning self-efficacy. Also, culture may play an important role in explaining the relationships among these factors. Accordingly, this study aimed to investigate cultural differences in science learning self-efficacy and examine the relationships within factors constituting science learning self-efficacy by adopting a survey instrument for administration to students in the U.S. and Taiwan. A total of 218 university students (62.40% females) were surveyed in the U.S.A, and 224 university students (49.10% females) in Taiwan were also invited to take part in the study. The results of the structural equation modelling revealed cultural differences in the relationships among the factors of science learning self-efficacy. It was found that U.S. students' confidence in their ability to employ higher-order cognitive skills tended to promote their confidence in their ability to accomplish practical work, strengthening their academic self-efficacy. However, the aforementioned mediation was not found for the Taiwanese participants.

This paper proposes a new epidemic prediction model that hybridizes several models, such as the autoregressive integrated moving average model (ARIMA), random forest (RF), and response surface method (RSM). The modeling process based on ensemble empirical mode decomposition (EEMD) is particularly suitable for dealing with non-stationary and nonlinear data. ARIMA's timeliness and difference have strong deterministic information extraction ability. RF is robust and stable, with fast speed, and strong generalization ability. Under the adjustability and correspondence of the response surface, the comprehensiveness of the model is well demonstrated. Taking the United States as an example, the proposed ARIMA-RF-RSM model is used to explore the development mechanism of the early epidemic according to the data of the early epidemic of coronavirus disease 2019 (COVID-19). The proposed model has high prediction accuracy (mean absolute percentage error (MAPE) is 1.97% and root mean square error (RSME) is 7.24%). It helps to take effective prevention and control measures in time. In addition, the model has universal applicability to the analysis of disease transmission in relevant areas. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress. [ABSTRACT FROM AUTHOR]

The transition towards a global circular economy is widely acknowledged as one of the most promising solutions to counteract resource depletion and environmental deterioration. In alignment with this perspective, there has been a rise in the availability of environmentally friendly products in the consumer market. This shift towards sustainable production and consumption patterns has led to a surge in scholarly interest surrounding biodegradable studies, particularly from the consumer viewpoint, within the context of the circular economy. However, the exploration of this topic, especially concerning the consumer perspective and its role in the circular economy, remains limited in the existing literature search. With the ongoing progression towards a circular economy, there is an evident need for a deeper understanding, extracted from available literature. Utilizing a bibliometric analysis approach, this study aims to enhance comprehension of the present knowledge landscape and delineate potential future research directions linked to consumers' roles in the transition from a linear to a circular economy, as well as their intent to adopt biodegradable products. Employing boolean operators and wildcard searches, a topic exploration was conducted within the Web of Science (WoS) core collection database on August 22, 2022. The study spanned from the first publication in the field in 2017 to the current date. A total of 51 documents were retrieved for comprehensive bibliometric analysis. To visualize research productivity and bibliometric insights, Tableau and VOSviewer were employed as presentation tools. The findings unveil the involvement of 223 authors hailing from 26 countries. The top three research areas encompass Environmental Sciences Ecology (35.3%), Science Technology Other Topics (33.3%), and Engineering (29.4%). Notably, the majority of significant contributors originated from the United States. Leading the pack of core publication journals is the Journal of Cleaner Production, cited 129 times in WoS. Co-authorship and country collaboration networks indicate a minimal level of partnerships. Through keywork co-occurrence network analysis, three prominent themes were identified: process, materials, and consumers. This analysis distinctly elucidates various developmental stages as well as nascent dimensions that constitute potential focal points for future research agendas in the field. [ABSTRACT FROM AUTHOR]

Over the past two decades, there has been a significant growth in articles focusing on the genetics of pheochromocytoma and paraganglioma (PPGL). We used bibliometric methods to investigate the historical changes and trend in PPGL research. There was a total of 1263 articles published in English from 2002 to 2022 included in our study. The number of annual publications and citations in this field has been increasing in the past 20 years. Furthermore, most of the publications originated from the European countries and the United States. The co-occurrence analysis showed close cooperation between different countries, institutions, or authors. The dual-map discipline analysis revealed that majority articles focused on four disciplines: #2 (Medicine, Medical, Clinical), #4 (Molecular, Biology, Immunology), #5 (Health, Nursing, Medicine), and #8 (Molecular, Biology, Genetics). The hotspot analysis revealed the keywords that have been landmark for PPGL genetics research in different time periods, and there was continued interest in gene mutations, especially on SDHX family genes. In conclusion, this study displays the current status of research and future trends in the genetics of PPGL. In future, more in-depth research should concentrate on crucial mutation genes and their specific mechanisms to assist in molecular target therapy. It is hoped that this study may help to provide directions for future research on genes and PPGL. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the accessibility and frequency of cone-beam computed tomography (CBCT) usage and to assess the economic and logistical factors involved with its usage among active American Association of Endodontists (AAE) members, utilizing a web-based survey. A survey of 19 questions was sent to 3,071 AAE members addressing participant access to, along with financial and logistical aspects of CBCT imaging. Descriptive analysis was performed and Fisher exact test utilized to test associations between groups (P <.05). The overall response rate was 14.7% (n = 544). Ninety-five percent of respondents (n = 486) had an in-office CBCT unit, with those graduating after the year 2000 statistically more likely to have one (P <.05). Utilization of CBCT imaging for every case was reported by 40% of providers. Eighty-nine percent reported taking the scan at the consultation visit and 20% included this charge with the consultation fee. For those who charged for the scan separately, 85% charged more than $100. Providers who paid off their unit did so within 1–2 years (41%), 3–4 years (36%), 4–5 years (12%), and 5+ years (11%). Limited field of view was utilized by 95% of respondents. Fifty-eight percent reported interpreting the scans themselves, 38% send only if pathology is expected, and 3% always send their scans to a radiologist. In conclusion, accessibility and utilization of CBCT imaging among United States endodontists has increased and acquisition of this equipment has not made a long lasting financial burden on providers. [ABSTRACT FROM AUTHOR]

This study analyzed geometry problems in four middle-grade mathematics textbook series from Taiwan, Singapore, Finland, and the United States, while exploring the expectations for students' learning experiences with these problems. An analytical framework developed for mathematics textbook problem analysis had three dimensions: representation forms, contextual features, and response types. The results showed that the Taiwanese and Singaporean textbooks contained more problems in combined form, whereas the Finnish and American textbooks contained more problems in verbal and visual forms. The problem distribution across various representation forms was more balanced in the Finnish and Singaporean textbooks than in the Taiwanese and American textbooks. Most problems were non-application and close-ended problems compared to other application and open-ended problems. The Taiwanese textbooks contained the lowest proportion of real-world problems, whereas the American textbooks contained the highest proportion of open-ended problems. Implications of this study's findings for textbook developers and future research directions are discussed.

This article examines inequality in different dimensions of student academic achievement (math, science, and reading) by family background and school context in three East Asian (Taiwan, Japan, and South Korea) and three Western (United States, Germany, and the Czech Republic) nations. Building on Hauser (2009), we develop a novel multiple-indicator multiple-cause (MIMIC) model with a two-level hierarchical linear modeling specification, which allows us to explicitly test whether the several academic achievement constructs respond similarly to variation in family background and variation among schools and countries. The two-level MIMIC model is specified in detail and applied to 2012 Programme for International Student Assessment data. The analysis reveals new empirical insights, such as substantive differences within countries in performance inequality by subject, particularly among East Asian countries. While the data do not support the view of a "virtuous" relationship between excellence and equity in education, nor do they lend strong support to a "vicious" relationship either.

Objective: Our aim was to analyze the trends and hotspots on glial fibrillary acidic protein (GFAP) within the area of Alzheimer's disease (AD) by using a bibliometric method, which is currently missing. Methods: All articles and reviews on GFAP within the area of AD from inception to December 31, 2022, were searched from the Web of Science Core Collection. Full records were derived, imported into Microsoft Excel, and analyzed by BIBLIOMETRC, VOSviewer, and CiteSpace. Results: In total, 2,269 publications, including 2,166 articles, were ultimately included. The number of publications from 81 countries/regions and 527 academic journals increased annually. The top three prolific countries and institutions were the USA, China, and England, the University of Gothenburg (Sweden), Universidade Federal Rio Grande do Sul (Brasilia), and UCL Queen Square Institute of Neurology (England). Henrik Zetterberg from the University of Gothenburg, Kaj Blennow from the University of Gothenburg, and Alexei Verkhratsky from the University of Manchester were the top three prolific and cited authors; Journal of Alzheimer's Disease, Brain Research, and Neuroscience contributed the most publications. The top key areas of research included "molecular, biology, and genetics" and "molecular, biology, and immunology," and the top published and linked meaningful keywords included oxidative stress, inflammation/neuroinflammation, microglia, hippocampus, amyloid, cognitive impairment, tau, and dysfunction. Conclusion: Based on the bibliometric analysis, the number of publications on GFAP within the area of AD has been rapidly increasing, especially in the past several years. Oxidative stress and inflammation are research hotspots, and GFAP in body fluids, especially blood, could be used for large-scale screening for AD. [ABSTRACT FROM AUTHOR]

Objectives: Women are under-represented in the sports literature despite increasing rates of sports participation. Our objective was to investigate the risks and benefits of an elite women's soccer career in five health domains: general, musculoskeletal, reproductive endocrinology, post-concussion, and mental. Methods: An online survey was distributed to retired US college, semi-professional, professional, and national team soccer players using personal networks, email, and social media. Short validated questionnaires were used to evaluate the health domains, including the Patient-Reported Outcomes Measurement Information System (PROMIS), Single Assessment Numerical Evaluation (SANE), Post-Concussion Symptom Scale (PCSS), and Patient Health Questionnaire (PHQ). Results: A total of 560 eligible players responded to the survey over a 1-year period. The highest competitive levels were 73% college, 16% semi-professional, 8% professional, and 4% national team. The mean number of years since retirement was 12 (SD = 9), and 17.0% retired for involuntary reasons. The mean SANE scores (0–100 scale as percentage of normal) were knee = 75% (SD = 23), hip = 83% (SD = 23), and shoulder = 87% (SD = 21). The majority (63%) reported that their current activity level included participation in impact sports. A substantial proportion of players reported menstrual irregularities during their careers: 40% had fewer periods with increasing exercise and 22% had no periods for ≥ 3 months. The players (n = 44) who felt that post-concussion symptoms were due to soccer reported more time-loss concussions (F[2] = 6.80, p = 0.002) and symptom severity (F[2] = 30.26, p < 0.0001). Players who recently retired (0–5 years) reported the highest anxiety/depression scores and lowest satisfaction rates compared with those who retired 19+ years ago. Conclusion: Health concerns include musculoskeletal injuries, post-concussion symptoms, and lower mental health in the early years following retirement. This comprehensive survey provides initial results that will lay the foundation for further analyses and prioritize research studies that can help all female athletes. [ABSTRACT FROM AUTHOR]

This article studies the first-order vector error correction (VEC(1)) model when its noise is a linear process of independent and identically distributed (i.i.d.) heavy-tailed random vectors with a tail index α ∈ (0 , 2) . We show that the rate of convergence of the least squares estimator (LSE) related to the long-run parameters is n (sample size) and its limiting distribution is a stochastic integral in terms of two stable random processes, while the LSE related to the short-term parameters is not consistent. We further propose an automated approach via adaptive shrinkage techniques to determine the cointegrating rank in the VEC(1) model. It is demonstrated that the cointegration rank r0 can be consistently selected despite the fact that the LSE related to the short-term parameters is not consistently estimable when the tail index α ∈ (1 , 2) . Simulation studies are carried out to evaluate the performance of the proposed procedure in finite samples. Last, we use our techniques to explore the long-run and short-run behavior of the monthly prices of wheat, corn, and wheat flour in the United States. [ABSTRACT FROM AUTHOR]

Previous work has shown the robust nature of gender bias in both children and adults. However, much less attention has been paid toward understanding what factors shape these biases. The current preregistered study used parent surveys and child interviews to test whether parents' conversations with their children about and modeling of gender intergroup relations and/or children's self-guided interests about gender (self-socialization) contribute to the formation of gender attitudes, status perceptions, and gender intergroup behaviors among young 4- to 6-year-old children. Our participant sample also allowed us to explore variation by child gender, ethnicity (Asian-, Black-, Latiné-, and White-American), and U.S. geographical region (Northeast, Pacific Northwest, West, Southeast, and Hawaii). Data suggest that children whose parents reported they were especially active in seeking information about gender tended to allocate more resources to same-gender versus other-gender children and expressed less positive evaluations of other-gender children in comparison to children who were less active. By contrast, we found that parents' conversations with their children about gender intergroup relations and about gender-play stereotypes showed few connections with children's gender attitudes. In terms of demographic differences, boys raised in households with more unequal versus equal division of labor perceived that men had higher status than women, but few differences by ethnicity or geographic region emerged. In sum, our study suggests that both self- and parent socialization processes are at play in shaping early gender attitudes, status perceptions, and gender intergroup behavior, although self-socialization seemed to play a larger role. Public Significance Statement: This study suggests that, during the preschool and kindergarten years, the development of gender identity, reflected in seeking out information about what gender means, is associated with early gender biases (favoring one's own-gender group over another). In addition, family context, reflected in parents' division of housework, was associated with boys' perceptions of the social status of men versus women. These findings imply that to promote more egalitarian gender attitudes, we need to focus on multiple factors including the development of gender identity and parent modeling of gender equality. [ABSTRACT FROM AUTHOR]

Purpose: Transgender individuals who pursue gender affirmation medical procedures often need to navigate a complex health system and interact with multiple health care providers in primary and specialty care. We sought to better understand patient, provider, and system level barriers to transgender care in a large integrated health care system in California. Methods: Three 90-min focus groups were conducted with 13 transgender individuals who received specialty care between April and August 2018 in Kaiser Permanente Southern California. Results: Participants cited common adversities such as misgendering and system-wide insensitivity during health care encounters and low levels of understanding of their transgender experience among primary care providers. Provider–patient relationship improvements were recommended for pre- and postsurgical care and service-provider sensitivity training. Suggestions include better care coordination, reducing redundancy in clearance for specialty care services, and enhancing patient support for navigation of gender affirmation services. Participants requested careful consideration when implementing systemwide routine processes such as using pronouns and names when calling patients in for visits or describing procedures on service invoices. Conclusions: Education and training programs for improving transgender care competency and enhancing care coordination between primary care and specialty care for transgender patients are warranted. Including transgender voices with lived-experience as active stakeholders in ongoing efforts such as community advisory boards to identify care gaps may facilitate patient-centered and culturally sensitive transgender care and increased patient satisfaction. Policy Implications: There is a need for systematic training for transgender care competent providers and enhancement of care coordination between primary care and specialty care. [ABSTRACT FROM AUTHOR]

Background: Little is known about whether people who use both tobacco and cannabis (co-use) are more or less likely to have mental health disorders than single substance users or non-users. We aimed to examine associations between use of tobacco and/or cannabis with anxiety and depression. Methods: We analyzed data from the COVID-19 Citizen Science Study, a digital cohort study, collected via online surveys during 2020–2022 from a convenience sample of 53,843 US adults (≥ 18 years old) nationwide. Past 30-day use of tobacco and cannabis was self-reported at baseline and categorized into four exclusive patterns: tobacco-only use, cannabis-only use, co-use of both substances, and non-use. Anxiety and depression were repeatedly measured in monthly surveys. To account for multiple assessments of mental health outcomes within a participant, we used Generalized Estimating Equations to examine associations between the patterns of tobacco and cannabis use with each outcome. Results: In the total sample (mean age 51.0 years old, 67.9% female), 4.9% reported tobacco-only use, 6.9% cannabis-only use, 1.6% co-use, and 86.6% non-use. Proportions of reporting anxiety and depression were highest for the co-use group (26.5% and 28.3%, respectively) and lowest for the non-use group (10.6% and 11.2%, respectively). Compared to non-use, the adjusted odds of mental health disorders were highest for co-use (Anxiety: OR = 1.89, 95%CI = 1.64–2.18; Depression: OR = 1.77, 95%CI = 1.46–2.16), followed by cannabis-only use, and tobacco-only use. Compared to tobacco-only use, co-use (OR = 1.35, 95%CI = 1.08–1.69) and cannabis-only use (OR = 1.17, 95%CI = 1.00–1.37) were associated with higher adjusted odds for anxiety, but not for depression. Daily use (vs. non-daily use) of cigarettes, e-cigarettes, and cannabis were associated with higher adjusted odds for anxiety and depression. Conclusions: Use of tobacco and/or cannabis, particularly co-use of both substances, were associated with poor mental health. Integrating mental health support with tobacco and cannabis cessation may address this co-morbidity. [ABSTRACT FROM AUTHOR]

In this paper we use historic score-reporting records and test-taker metadata to inform data-driven recommendations that support international students in their choice of undergraduate institutions for study in the United States. We investigate the use of Structural Topic Modeling (STM) as a context-aware, probabilistic recommendation method that uses test-takers' selections and metadata to model the latent space of college preferences. We present the model results from two perspectives: 1) to understand the impact of TOEFL score and test year on test-takers' preferences and choices and 2) to recommend to the test-taker additional undergraduate institutions for application consideration. We find that TOEFL scores can explain variance in the probability that test-takers belong to certain preference-groups and, by accounting for this, our system adjusts recommendations based on student score. We also find that the inclusion of year, while not significantly altering recommendations, does enable us to capture minor changes in the relative popularity of similar institutions. The performance of this model demonstrates the utility of this approach for providing students with personalized college recommendations and offers a useful baseline approach that can be extended with additional data sources. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between infant feeding practices and autism spectrum disorder (ASD) among children aged 2–5 years in the United States (US). Methods: Data from the 2016–2020 National Survey of Children's Health, a nationally representative cross-sectional survey, were utilized for this study. Questionnaires were administered to parents of children aged 2–5 years to gather information on ASD diagnosis, infant feeding practices, and demographic factors (e.g., child sex, ethnic group, and maternal age at birth). Logistic regression with sample weights was employed to assess the association between infant feeding practices and ASD, while controlling for demographic variables. Polynomial regression models were used to examine trends in exclusive breastfeeding and ever breastfeeding rates among children with and without ASD. Results: A total of 35,050 children aged 2–5 years were analyzed, including 616 diagnosed with ASD, after excluding participants with missing information on breastfeeding and ASD diagnosis. Of these children with ASD, 76.6% (n = 472) had a breastfeeding history, with 67.5% (n = 416) engaged in partial breastfeeding and 9.1% (n = 56) exclusively breastfed. Adjusted odds ratios for each additional month of breastfeeding compared to never being breastfed were 0.98 (95% CI, 0.96–1.01). The adjusted odds ratios for breastfeeding durations of > 0–6 months, > 6–12 months, > 12–24 months, and > 24 months were 0.81 (95% CI, 0.50–1.31), 0.65 (95% CI, 0.36–1.18), 0.81 (95% CI, 0.44–1.49), and 0.48 (95% CI, 0.23–1.01), respectively. Compared to children who were never breastfed, the adjusted odds ratio for children who were ever breastfed was 0.74 (95% CI, 0.47–1.18). Among children with ASD, the proportion of ever breastfeeding declined from 82.0% in 2017 to 64.3% in 2020, while exclusive breastfeeding decreased from 12.0% in 2016 to 4.2% in 2020. Conclusions and relevance: Although no significant association was found between infant feeding practices and ASD among US children aged 2–5 years, the rates of breastfeeding, particularly exclusive breastfeeding, were suboptimal among children with ASD. This highlights the need for specific policies and practices to promote and support breastfeeding among parents of children with ASD or those at high risk of having a child with ASD. [ABSTRACT FROM AUTHOR]

This study provides a typological analysis of public, four-year institutions implementing programs for men of color (MoC). The purpose of the study is to expand our understanding of the institutional context and conditions in which these interventions operate. As more of these programs emerge, it is important to understand if and how institutional mission, composition, and resources shape supports and opportunities for underrepresented men of color attending four-year public institutions. Through an exhaustive search process, we identified 177 MoC programs across 166 public four-year institutions across the United States and organized them along a range of institutional characteristics. We then applied descriptive statistics and cluster analysis to program search findings. Results show that public institutions implementing MoC programs can be understood as seven clusters or institutional types. This research provides important information and context for stakeholders who are interested in addressing educational disparities for men of color by illuminating the institutional diversity through which these programs are catalyzed and implemented. To date, this is the first study to organize MoC programs located across four-year public institutions by a range of institutional categories. [ABSTRACT FROM AUTHOR]

This article examines the trends in tubal sterilization among young women in the United States. The study found that the rate of tubal sterilization has decreased significantly from 2008 to 2020, suggesting potential barriers to access for women who desire the procedure. The decline in tubal sterilization rates may be due to factors such as delayed childbearing and increased use of long-acting reversible contraception. The study also found disparities in access to tubal sterilization, with white patients more likely to undergo the procedure than black individuals. The findings highlight the importance of ensuring patient autonomy and access to tubal sterilization for all women, including young women, who desire this method of contraception. [Extracted from the article]

Background: The plant-based paleolithic diet (PD) and the paleolithic-like lifestyle (PLL) may reduce the risk of chronic diseases, including colorectal adenomas. These dietary and lifestyle approaches are proposed to exert their effects through mechanisms such as reducing inflammation, oxidative stress, and insulin levels. However, whether PD and PLL is associated with the risk of colorectal cancer (CRC) has not been determined. Methods: A cohort of 74,721 individuals who participated in the PLCO study were included in this analysis. Adherence to the PD and PLL was assessed using PD and PLL scores, where higher scores indicated greater adherence. Multivariable Cox models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of CRC and its subsites (proximal colon cancer and distal CRC). Subgroup analyses were conducted to identify potential effect modifiers. Results: During a mean follow-up of 9.2 years, a total of 694 CRC cases were identified. Participants in the highest compared with the lowest quartiles of PD score had a lower risk of CRC (Q4 vs Q1: HR 0.76, 95% CI 0.61–0.95, Ptrend = 0.009) and proximal colon cancer (Q4 vs Q1: HR 0.73, 95% CI 0.55–0.97, Ptrend = 0.02). A stronger inverse association was observed for PLL score with the risk of CRC (Q4 vs Q1: HR 0.64, 95% CI 0.51–0.81, Ptrend < 0.001), proximal colon (Q4 vs Q1: HR 0.62, 95% CI 0.46–0.83, Ptrend = 0.001) and distal CRC (Q4 vs Q1: HR 0.69, 95% CI 0.48–0.98, Ptrend = 0.03). Subgroup analyses revealed the inverse association of PD score with the risk of CRC was more pronounced in participants with BMI < 30 (Q4 vs Q1: HR 0.68, 95% CI 0.53–0.87) than in those with BMI ≥ 30 (Q4 vs Q1: HR 1.07, 95% CI 0.68–1.67) (Pinteraction = 0.02). Conclusions: Our findings suggest that adhering to the PD and PLL could be a new option to reduce CRC risk. [ABSTRACT FROM AUTHOR]

To investigate aligner treatment protocols among orthodontists in the United States and Canada and assess the factors influencing clinician choices in aligner systems, treatment protocols, and targeted malocclusions for aligners. A validated online questionnaire was developed specifically for this research and consisted of three sections. Section 1 evaluated demographics and experience with aligners. Section 2 assessed patient selection and demands and clinician confidence in treating various malocclusions with aligners. Section 3 evaluated treatment protocols used by clinicians. The American Association of Orthodontists Partners in Research Program distributed the survey via e-mail to active members in the United States and Canada. A total of 160 providers completed the survey. Aligners were used by 65.00% of respondents, with the Invisalign system the most popular (81.25%). Aligners were mostly used for adults (97.50%). Tipping was ranked as the easiest movement (1.79 ± 1.35). Extrusion (4.34 ± 1.53) and root movement (4.31 ± 1.27) were ranked as the most difficult. Most were confident treating mild (98.8%) and moderate (82.5%) crowded cases, spacing (96.9%), and anterior crossbite (85%). Of the providers, 58.12% recommended aligners to be changed weekly. Respondents who were confident addressing some of the severe malocclusions were more likely to use Invisalign. Invisalign is the most popular aligner system, and clinicians seem to be confident using it. Providers are aware of the pitfalls of aligners; they find it challenging to perform root movement and extrusion, and they seem confident treating mild to moderate malocclusions. They avoid complex cases with impactions and severe skeletal problems. [ABSTRACT FROM AUTHOR]

Introduction: Despite being one of the most commonly performed operations in the US, there is a paucity of data on practice patterns and resultant long-term outcomes of groin hernia repair. In this context, we performed a contemporary assessment of operative approach with 5 year follow-up to inform care for the 800000 persons undergoing groin hernia repair annually. Methods: This was a retrospective cohort study of adult patients undergoing elective groin hernia repair in a 20% representative Medicare sample from 2010–17. Surgical approach [minimally invasive (MIS) vs open] was defined using appropriate CPT codes. The primary outcome was operative recurrence at up to 5 years following surgery. We estimated the overall risk of operative recurrence using a multivariable Cox proportional hazards model. Results: Among 118119 patients, the majority (76.4%) underwent an open repair. Compared to patients who underwent MIS repair, patients in the open surgery cohort were older (mean age 72.7 vs 71.0, p < 0.001), more often female (14.4 vs 10.9%, p < 0.001), less often white (86.9 vs 87.7%, p < 0.001), and had a higher prevalence of nearly all measured comorbidities Patients in the open cohort had a lower incidence of operative recurrence at 1-year (1.0 vs 1.5%, p < 0.001), 3-years, (2.5 vs 3.5%, p < 0.001), and 5-years (3.7 vs 4.7%, p < 0.001). In the Cox proportional hazards model, we found that patients who underwent an open groin hernia repair were significantly less likely to experience operative recurrence (HR 0.86, 95% CI 0.79–0.93). Conclusions: In this study, we found that open groin hernia repair was associated with a lower risk of operative recurrence over time. While this may be related to patient comorbidity and age at the index operation, future work should focus on the impact of surgeon volume on outcomes in the modern era. [ABSTRACT FROM AUTHOR]