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This is an Open Access article, published by EDP Sciences, under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Context. The Gaia-ESO Survey (GES) is a large public spectroscopic survey that was carried out using the multi-object FLAMES spectrograph at the Very Large Telescope. The survey provides accurate radial velocities, stellar parameters, and elemental abundances for ~115 000 stars in all Milky Way components. Aims. In this paper, we describe the method adopted in the final data release to derive lithium equivalent widths (EWs) and abundances. Methods. Lithium EWs were measured using two different approaches for FGK and M-type stars, to account for the intrinsic differences in the spectra. For FGK stars, we fitted the lithium line using Gaussian components, while direct integration over a predefined interval was adopted for M-type stars. Care was taken to ensure continuity between the two regimes. Abundances were derived using a new set of homogeneous curves of growth that were derived specifically for GES, and which were measured on a synthetic spectral grid consistently with the way the EWs were measured. The derived abundances were validated by comparison with those measured by other analysis groups using different methods. Results. Lithium EWs were measured for ~40 000 stars, and abundances could be derived for ~38 000 of them. The vast majority of the measures (80%) have been obtained for stars in open cluster fields. The remaining objects are stars in globular clusters, or field stars in the Milky Way disc, bulge, and halo. Conclusions. The GES dataset of homogeneous lithium abundances described here will be valuable for our understanding of several processes, from stellar evolution and internal mixing in stars at different evolutionary stages to Galactic evolution. © E. Franciosini et al. 2022., Based on data products from observations made with ESO Telescopes at the La Silla Paranal Observatory under programmes 188.B-3002, 193.B-0936, and 197.B-1074. These data products have been processed by the Cambridge Astronomy Survey Unit (CASU) at the Institute of Astronomy, University of Cambridge, and by the FLAMES/UVES reduction team at INAF/Osservatorio Astrofísico di Arcetri. These data have been obtained from the Gaia-ESO Survey Data Archive, prepared and hosted by the Wide Field Astronomy Unit, Institute for Astronomy, University of Edinburgh, which is funded by the UK Science and Technology Facilities Council. This work was partly supported by the European Union FP7 programme through ERC grant number 320360 and by the Leverhulme Trust through grant RPG-2012-541. We acknowledge the support from INAF and Ministero dell’Istruzione, dell’Università e della Ricerca (MIUR) in the form of the grant “Premíale VLT 2012”. The results presented here benefit from discussions held during the Gaia-ESO workshops and conferences supported by the ESF (European Science Foundation) through the GREAT Research Network Programme. We acknowledge the support from INAF in the form of the grant for mainstream projects “Enhancing the legacy of the Gaia-ESO Survey for open clusters science”. R.S. acknowledges support from the National Science Centre, Poland (2014/15/B/ST9/03981). T.B. was supported by grant no. 2018-04857 from the Swedish Research Council. M.B. is supported through the Lise Meitner grant from the Max Planck Society. We acknowledge support by the Collaborative Research centre SFB 881 (projects A5, A10), Heidelberg University, of the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation). This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant agreement No. 949173). This work made use of Astropy (http://www.astropy.org), a community-developed core Python package for Astronomy (Astropy Collaboration 2013, 2018)., With funding from the Spanish government through the Severo Ochoa Centre of Excellence accreditation SEV-2017-0709.

Introduction Few studies have explored how individual- and practice-level factors influence colorectal cancer screening initiation among Medicaid enrollees newly age eligible for colorectal cancer screening (i.e., turning 50 years). This study explored colorectal cancer screening initiation among newly age-eligible Medicaid enrollees in Oregon. Methods Medicaid claims data (January 2013 to June 2015) were used to conduct multivariable logistic regression (in 2018 and 2019) to explore individual- and practice-level factors associated with colorectal cancer screening initiation among 9,032 Medicaid enrollees. Results A total of 17% of Medicaid enrollees initiated colorectal cancer screening; of these, 64% received a colonoscopy (versus fecal testing). Colorectal cancer screening initiation was positively associated with turning 50 years in 2014 (versus 2013; OR=1.21), being Hispanic (versus non-Hispanic white; OR=1.41), urban residence (versus rural; OR=1.23), and having 4 to 7 (OR=1.90) and 8 or more (OR=2.64) primary care visits compared with 1 to 3 visits in the year after turning 50 years. Having 3 or more comorbidities was inversely associated with initiation (OR=0.75). The odds of screening initiation were also higher for practices with 3 to 4 (OR=1.26) and 8 or more (OR=1.34) providers compared with 1 to 2 providers, and negatively associated with percentage of Medicaid panel age eligible for colorectal cancer screening (OR=0.92). Conclusions Both individual- and practice-level factors are associated with disparities in colorectal cancer screening initiation among Oregon Medicaid enrollees. Future work promoting colorectal cancer screening might focus on additional barriers to the timely initiation of colorectal cancer screening and explore the effect of practice in-reach and population outreach strategies.

Full list of authors: Gilmore, G.; Randich, S.; Worley, C. C.; Hourihane, A.; Gonneau, A.; Sacco, G. G.; Lewis, J. R.; Magrini, L.; Francois, P.; Jeffries, R. D.; Koposov, S. E.; Bragaglia, A.; Alfaro, E. J.; Allende Prieto, C.; Blomme, R.; Korn, A. J.; Lanzafame, A. C.; Pancino, E.; Recio-Blanco, A.; Smiljanic, R.; Van Eck, S.; Zwitter, T.; Bensby, T.; Flaccomio, E.; Irwin, M. J.; Franciosini, E.; Morbidelli, L.; Damiani, F.; Bonito, R.; Friel, E. D.; Vink, J. S.; Prisinzano, L.; Abbas, U.; Hatzidimitriou, D.; Held, E., V; Jordi, C.; Paunzen, E.; Spagna, A.; Jackson, R. J.; Maiz Apellaniz, J.; Asplund, M.; Bonifacio, P.; Feltzing, S.; Binney, J.; Drew, J.; Ferguson, A. M. N.; Micela, G.; Negueruela, I; Prusti, T.; Rix, H-W; Vallenari, A.; Bergemann, M.; Casey, A. R.; de Laverny, P.; Frasca, A.; Hill, V; Lind, K.; Sbordone, L.; Sousa, S. G.; Adibekyan, V; Caffau, E.; Daflon, S.; Feuillet, D. K.; Gebran, M.; Gonzalez Hernandez, J., I; Guiglion, G.; Herrero, A.; Lobel, A.; Montes, D.; Morel, T.; Ruchti, G.; Soubiran, C.; Tabernero, H. M.; Tautvaisiene, G.; Traven, G.; Valentini, M.; Van der Swaelmen, M.; Villanova, S.; Vazquez, C. Viscasillas; Bayo, A.; Biazzo, K.; Carraro, G.; Edvardsson, B.; Heiter, U.; Jofre, P.; Marconi, G.; Martayan, C.; Masseron, T.; Monaco, L.; Walton, N. A.; Zaggia, S.; Borsen-Koch, V. Aguirre; Alves, J.; Balaguer-Nunez, L.; Barklem, P. S.; Barrado, D.; Bellazzini, M.; Berlanas, S. R.; Binks, A. S.; Bressan, A.; Capuzzo-Dolcetta, R.; Casagrande, L.; Casamiquela, L.; Collins, R. S.; D'Orazi, V; Dantas, M. L. L.; Debattista, V. P.; Delgado-Mena, E.; Di Marcantonio, P.; Drazdauskas, A.; Evans, N. W.; Famaey, B.; Franchini, M.; Fremat, Y.; Fu, X.; Geisler, D.; Gerhard, O.; Solares, E. A. Gonzalez; Grebel, E. K.; Gutierrez Albarran, M. L.; Jimenez-Esteban, F.; Jonsson, H.; Khachaturyants, T.; Kordopatis, G.; Kos, J.; Lagarde, N.; Ludwig, H-G; Mahy, L.; Mapelli, M.; Marfil, E.; Martell, S. L.; Messina, S.; Miglio, A.; Minchev, I; Moitinho, A.; Montalban, J.; Monteiro, M. J. P. F. G.; Morossi, C.; Mowlavi, N.; Mucciarelli, A.; Murphy, D. N. A.; Nardetto, N.; Ortolani, S.; Paletou, F.; Palous, J.; Pickering, J. C.; Quirrenbach, A.; Fiorentin, P. Re; Read, J., I; Romano, D.; Ryde, N.; Sanna, N.; Santos, W.; Seabroke, G. M.; Spina, L.; Steinmetz, M.; Stonkute, E.; Sutorius, E.; Thevenin, F.; Tosi, M.; Tsantaki, M.; Wright, N.; Wyse, R. F. G.; Zoccali, M.; Zorec, J.; Zucker, D. B.-- This is an Open Access article, published by EDP Sciences, under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Context. The Gaia-ESO Public Spectroscopic Survey is an ambitious project designed to obtain astrophysical parameters and elemental abundances for 100 000 stars, including large representative samples of the stellar populations in the Galaxy, and a well-defined sample of 60 (plus 20 archive) open clusters. We provide internally consistent results calibrated on benchmark stars and star clusters, extending across a very wide range of abundances and ages. This provides a legacy data set of intrinsic value, and equally a large wide-ranging dataset that is of value for the homogenisation of other and future stellar surveys and Gaia's astrophysical parameters. Aims. This article provides an overview of the survey methodology, the scientific aims, and the implementation, including a description of the data processing for the GIRAFFE spectra. A companion paper introduces the survey results. Methods. Gaia-ESO aspires to quantify both random and systematic contributions to measurement uncertainties. Thus, all available spectroscopic analysis techniques are utilised, each spectrum being analysed by up to several different analysis pipelines, with considerable effort being made to homogenise and calibrate the resulting parameters. We describe here the sequence of activities up to delivery of processed data products to the ESO Science Archive Facility for open use. Results. The Gaia-ESO Survey obtained 202 000 spectra of 115 000 stars using 340 allocated VLT nights between December 2011 and January 2018 from GIRAFFE and UVES. © G. Gilmore et al. 2022. Conclusions. The full consistently reduced final data set of spectra was released through the ESO Science Archive Facility in late 2020, with the full astrophysical parameters sets following in 2022. A companion article reviews the survey implementation, scientific highlights, the open cluster survey, and data products., Based on data products from observations made with ESO Telescopes at the La Silla Paranal Observatory under programme ID 188.B-3002. These data products have been processed by the Cambridge Astronomy Survey Unit (CASU) at the Institute of Astronomy, University of Cambridge, and by the FLAMES/UVES reduction team at INAF/Osservatorio Astrofisico di Arcetri. Public access to the data products is via the ESO SAF, and the Gaia-ESO Survey Data Archive, prepared and hosted by the Wide Field Astronomy Unit, Institute for Astronomy, University of Edinburgh, which is funded by the UK Science and Technology Facilities Council. This work was partly supported by the European Union FP7 programme through ERC grant number 320360 and by the Leverhulme Trust through grant RPG-2012-541. We acknowledge the support from INAF and Ministero dell’ Istruzione, dell’ Università’ e della Ricerca (MIUR) in the form of the grant “Premiale VLT 2012”. The project presented here benefited in development from discussions held during the Gaia-ESO workshops and conferences supported by the ESF (European Science Foundation) through the GREAT Research Network Programme. This research has made use of the SIMBAD database, operated at CDS, Strasbourg, France. R.S. acknowledges support from the National Science Centre, Poland (2014/15/B/ST9/03981). This work was partly supported by the INAF grant for mainstream projects: “Enhancing the legacy of the Gaia-ESO Survey for open cluster science”. F.J.E. acknowledges financial support from the Spanish MINECO/FEDER through the grant AYA2017-84089 and MDM-2017-0737 at Centro de Astrobiología (CSIC-INTA), Unidad de Excelencia María de Maeztu, and from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement no. 824064 through the ESCAPE – the European Science Cluster of Astronomy and Particle Physics ESFRI Research Infrastructures project. T.B. was funded by the “The New Milky Way” project grant from the Knut and Alice Wallenberg Foundation. S.R.B. acknowledges support by the Spanish Government under grants AYA2015-68012-C2-2-P and PGC2018-093741-B-C21/C22 (MICIU/AEI/FEDER, UE). W.J.S. acknowledges CAPES for a PhD studentship. J.M.A. acknowledges support from the Spanish Government Ministerio de Ciencia e Innovación through grants AYA2013-40611-P, AYA2016-75931-C2-2-P, and PGC2018-095049-B-C22. T.M. and others from STAR institute, Liege, Belgium are grateful to Belgian F.R.S.-FNRS for support, and are also indebted for an ESA/PRODEX Belspo contract related to the Gaia Data Processing and Analysis Consortium and for support through an ARC grant for Concerted Research Actions financed by the Federation Wallonie-Brussels.. This research has been partially supported by the following grants: MIUR Premiale “Gaia-ESO survey” (PI S. Randich), MIUR Premiale “MiTiC: Mining the Cosmos” (PI B. Garilli), the ASI-INAF contract 2014-049-R.O: “Realizzazione attività tecniche/scientifiche presso ASDC” (PI Angelo Antonelli), Fondazione Cassa di Risparmio di Firenze, progetto: “Know the star, know the planet” (PI E. Pancino), and Progetto Main Stream INAF: “Chemo-dynamics of globular clusters: the Gaia revolution” (PI E. Pancino). V.A. acknowledges the support from Fundação para a Ciência e Tecnologia (FCT) through Investigador FCT contract nr. IF/00650/2015/CP1273/CT0001. A.J.K. acknowledges support by the Swedish National Space Agency (SNSA). A.B. acknowledges support by ANID, – Millennium Science Initiative Program – NCN19_171, and FONDECYT regular 1190748. E.M. acknowledges financial support from the Spanish State Research Agency (AEI) through project MDM-2017-0737 Unidad de Excelencia “María de Maeztu” – Centro de Astrobiología (CSIC-INTA). T.Z. acknowledges financial support of the Slovenian Research Agency (research core funding no. P1-0188) and the European Space Agency (Prodex Experiment Arrangement No. C4000127986). P.J. acknowledges support FONDECYT Regular 1200703. The work of I.N. is partially supported by the Spanish Government Ministerio de Ciencia, Innovación y Universidades under grant PGC2018-093741-B-C21 (MICIU/AEI/FEDER, UE). Funding for this work has been provided by the ARC Future Fellowship FT160100402. C.A.P. acknowledges financial support from the Spanish Government through research grants MINECO AYA 2014-56359-P, MINECO AYA2017-86389-P, and MICINN PID2020-117493GB-I00. S.F. was supported by the grants 2011-5042 and 2016-03412 from the Swedish Research Council and the project grant “The New Milky Way” from the Knut and Alice Wallenberg Foundation. C.A.S.U. is supported through STFC grants: ST/H004157/1, ST/J00541X/1, ST/M007626/1, ST/N005805/1, ST/T003081/1. Work reported here benefited from support through the GREAT-ITN FP7 project Grant agreement ID: 264895. D.K.F. acknowledges funds from the Alexander von Humboldt Foundation in the framework of the Sofja Kovalevskaja Award endowed by the Federal Ministry of Education and Research and the grant 2016-03412 from the Swedish Research Council. A.H. acknowledges support from the Spanish Government Ministerio de Ciencia e Innovación and ERD Funds through grants PGC-2018-091 3741-B-C22 and CEX2019-000920-S. X.F. acknowledges the support of China Postdoctoral Science Foundation 2020M670023. M.L.L.D. acknowledges the Polish NCN grant number 2019/34/E/ST9/00133. Part of this work was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – Project-ID 138713538 – SFB 881 (“The Milky Way System”, subproject A09). M.Z. acknowledges support from the National Agency for Research and Development (ANID) grants: FONDECYT Regular 1191505, Millennium Institute of Astrophysics ICN12-009, BASAL Center for Astrophysics and Associated Technologies AFB-170002. R.B. acknowledges support from the project PRIN-INAF 2019 “Spectroscopically Tracing the Disk Dispersal Evolution”. H.M.T. acknowledges financial support from the Agencia Estatal de Investigación of the Ministerio de Ciencia, Innovación y Universidades through projects PID2019-109522GB-C51,54/AEI/10.13039/501100011033, and the Centre of Excellence “María de Maeztu” award to Centro de Astrobiología (MDM-2017-0737). J.I.G.H. acknowledges financial support from the Spanish Ministry of Science and Innovation (MICINN) project AYA2017-86389-P, and also from the Spanish MICINN under 2013 Ramѳn y Cajal program RYC-2013-14875. V.P.D. is supported by STFC Consolidated grant ST/R000786/1. N.L. acknowledges financial support from “Programme National de Physique Stellaire” (PNPS) and the “Programme National Cosmology et Galaxies (PNCG)” of CNRS/INSU, France. A.R.C. is supported in part by the Australian Research Council through a Discovery Early Career Researcher Award (DE190100656). Parts of this research were supported by the Australian Research Council Centre of Excellence for All Sky Astrophysics in 3 Dimensions (ASTRO 3D), through project number CE170100013. P.S.B. is supported by the Swedish Research Council through individual project grants with contract Nos. 2016-03765 and 2020-03404. A.M. acknowledges funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 772293 – project ASTEROCHRONOMETRY). J.P. was supported by the project RVO: 67985815. E.D.M. acknowledges the support from FCT through the research grants UIDB/04434/2020 & UIDP/04434/2020 and through Investigador FCT contract IF/00849/2015/CP1273/CT0003. This work was (partially) supported by the Spanish Ministry of Science, Innovation and University (MICIU/FEDER, UE) through grant RTI2018-095076-B-C21, and the Institute of Cosmos Sciences University of Barcelona (ICCUB, Unidad de Excelencia 'María de Maeztu’) through grant CEX2019-000918-M. S.L.M. acknowledges the support of the UNSW Scientia Fellowship program and the Australian Research Council through Discovery Project grant DP180101791. GT acknowledges financial support of the Slovenian Research Agency (research core funding No. P1-0188) and the European Space Agency (Prodex Experiment Arrangement No. C4000127986). S.G.S acknowledges the support from FCT through Investigador FCT contract nr. CEECIND/00826/2018 and POPH/FSE (EC). H.G.L. acknowledges financial support by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – Project-ID 138713538 – SFB 881 (“The Milky Way System”, subproject A04). This work was (partially) supported by the Spanish Ministry of Science, Innovation and University (MICIU/FEDER, UE) through grant RTI2018-095076-B-C21, and the Institute of Cosmos Sciences University of Barcelona (ICCUB, Unidad de Excelencia ’María de Maeztu’) through grant CEX2019-000918-M. T.K. is supported by STFC Consolidated grant ST/R000786/1. M.V. acknowledges the support of the Deutsche Forschungsgemeinschaft (DFG, project number: 428473034). T.M. is supported by a grant from the Fondation ULB. We acknowledge financial support from the Universidad Complutense de Madrid (UCM) and by the Spanish Ministerio de Ciencia, Innovación y Universidades, Ministerio de Economía y Competitividad, from project AYA2016-79425-C3-1-P and PID2019-109522GB-C5[4]/AEI/10.13039/501100011033. U.H. acknowledges support from the Swedish National Space Agency (SNSA/Rymdstyrelsen). D.G. gratefully acknowledges support from the Chilean Centro de Excelencia en Astrofísica y Tecnologías Afines (CATA) BASAL grant AFB-170002. D.G. also acknowledges financial support from the Dirección de Investigación y Desarrollo de la Universidad de La Serena through the Programa de Incentivo a la Investigación de Académicos (PIA-DIDULS). A. Lobel acknowledges support in part by the Belgian Federal Science Policy Office under contract No. BR/143/A2/BRASS. We acknowledge financial support from the Universidad Complutense de Madrid (UCM) and by the Spanish Ministerio de Ciencia, Innovación y Universidades, Ministerio de Economía y Competitividad, from project AYA2016-79425-C3-1-P and PID2019-109522GB-C5[4]/AEI/10.13039/501100011033. A.M. acknowledges the support from the Portuguese Fundação para a Ciência e a Tecnologia (FCT) through the Portuguese Strategic Programme UID/FIS/00099/2019 for CENTRA. T.M. acknowledges financial support from the Spanish Ministry of Science and Innovation (MICINN) through the Spanish State Research Agency, under the Severo Ochoa Program 2020-2023 (CEX2019-000920-S). E.J.A. acknowledges funding from the State Agency for Research of the Spanish MCIU through the “Center of Excellence Severo Ochoa” award to the Instituto de Astrofísica de An- dalucía (SEV-2017-0709).

It is well known that cool star atmospheres depart from local thermodynamic equilibrium (LTE). Accurate abundance determination requires taking those effects into account, but the necessary non-LTE calculations are often lacking. Our goal is to provide detailed estimates of NLTE effects for FGK type stars for all spectral lines from the ultraviolet to the infrared that are potentially useful as abundance diagnostics. The first paper in this series focusses on the light elements Na, Mg and Al. The code PySME is used to compute curves-of-growth for 2158 MARCS model atmospheres in a wide parameter range. Nine abundance points are used to construct individual line curves-of-growth by calculating the equivalent widths of 35 Na lines, 134 Mg lines, and 34 Al lines. The lines are selected from the ultra-violet to the near infrared wavelength range. We demonstrate the power of the new grids with LTE and NLTE abundance analysis by means of equivalent width measurements of five benchmark stars; the Sun, Arcturus, HD84937, HD140283 and HD122563. For Na, the NLTE abundances are lower than in LTE and show markedly reduced line-to-line scatter in the metal-poor stars. For Mg, we confirm previous reports of a significant 0.25 dex LTE ionization imbalance in metal-poor stars that is only slightly improved in NLTE (0.18 dex). LTE abundances based on Mg II lines agree better with models of Galactic chemical evolution. For Al, NLTE calculations strongly reduce a 0.6 dex ionization imbalance seen in LTE for the metal-poor stars. The abundance corrections presented in this work are in good agreement with previous studies for the subset of lines that overlap, except for strongly saturated lines., Comment: 12 pages main text, 7 figures, 14 pages appendix. Accepted for publication in A&A

Full list of authors: Randich, S.; Gilmore, G.; Magrini, L.; Sacco, G. G.; Jackson, R. J.; Jeffries, R. D.; Worley, C. C.; Hourihane, A.; Gonneau, A.; Vazquez, C. Viscasillas; Franciosini, E.; Lewis, J. R.; Alfaro, E. J.; Allende Prieto, C.; Bensby, T.; Blomme, R.; Bragaglia, A.; Flaccomio, E.; Francois, P.; Irwin, M. J.; Koposov, S. E.; Korn, A. J.; Lanzafame, A. C.; Pancino, E.; Recio-Blanco, A.; Smiljanic, R.; Van Eck, S.; Zwitter, T.; Asplund, M.; Bonifacio, P.; Feltzing, S.; Binney, J.; Drew, J.; Ferguson, A. M. N.; Micela, G.; Negueruela, I; Prusti, T.; Rix, H-W; Vallenari, A.; Bayo, A.; Bergemann, M.; Biazzo, K.; Carraro, G.; Casey, A. R.; Damiani, F.; Frasca, A.; Heiter, U.; Hill, V; Jofre, P.; de Laverny, P.; Lind, K.; Marconi, G.; Martayan, C.; Masseron, T.; Monaco, L.; Morbidelli, L.; Prisinzano, L.; Sbordone, L.; Sousa, S. G.; Zaggia, S.; Adibekyan, V; Bonito, R.; Caffau, E.; Daflon, S.; Feuillet, D. K.; Gebran, M.; Gonzalez Hernandez, J., I; Guiglion, G.; Herrero, A.; Lobel, A.; Maiz Apellaniz, J.; Montes, D.; Morel, T.; Soubiran, C.; Spina, L.; Tabernero, H. M.; Traven, G.; Valentini, M.; Van der Swaelmen, M.; Villanova, S.; Wright, N. J.; Abbas, U.; Borsen-Koch, V. Aguirre; Alves, J.; Balaguer-Nunez, L.; Barklem, P. S.; Barrado, D.; Berlanas, S. R.; Binks, A. S.; Bressan, A.; Capuzzo-Dolcetta, R.; Casagrande, L.; Casamiquela, L.; Collins, R. S.; D'Orazi, V; Dantas, M. L. L.; Debattista, V. P.; Delgado-Mena, E.; Di Marcantonio, P.; Drazdauskas, A.; Evans, N. W.; Famaey, B.; Franchini, M.; Fremat, Y.; Friel, E. D.; Fu, X.; Geisler, D.; Gerhard, O.; Solares, E. A. Gonzalez; Grebel, E. K.; Gutierrez Albarran, M. L.; Hatzidimitriou, D.; Held, E., V; Jimenez-Esteban, F.; Jonsson, H.; Jordi, C.; Khachaturyants, T.; Kordopatis, G.; Kos, J.; Lagarde, N.; Mahy, L.; Mapelli, M.; Marfil, E.; Martell, S. L.; Messina, S.; Miglio, A.; Minchev, I; Moitinho, A.; Montalban, J.; Monteiro, M. J. P. F. G.; Morossi, C.; Mowlavi, N.; Mucciarelli, A.; Murphy, D. N. A.; Nardetto, N.; Ortolani, S.; Paletou, F.; Palous, J.; Paunzen, E.; Pickering, J. C.; Quirrenbach, A.; Fiorentin, P. Re; Read, J., I; Romano, D.; Ryde, N.; Sanna, N.; Santos, W.; Seabroke, G. M.; Spagna, A.; Steinmetz, M.; Stonkute, E.; Sutorius, E.; Thevenin, F.; Tosi, M.; Tsantaki, M.; Vink, J. S.; Wright, N.; Wyse, R. F. G.; Zoccali, M.; Zorec, J.; Zucker, D. B.; Walton, N. A., Context. In the last 15 years different ground-based spectroscopic surveys have been started (and completed) with the general aim of delivering stellar parameters and elemental abundances for large samples of Galactic stars, complementing Gaia astrometry. Among those surveys, the Gaia-ESO Public Spectroscopic Survey, the only one performed on a 8m class telescope, was designed to target 100 000 stars using FLAMES on the ESO VLT (both Giraffe and UVES spectrographs), covering all the Milky Way populations, with a special focus on open star clusters. Aims. This article provides an overview of the survey implementation (observations, data quality, analysis and its success, data products, and releases), of the open cluster survey, of the science results and potential, and of the survey legacy. A companion article reviews the overall survey motivation, strategy, Giraffe pipeline data reduction, organisation, and workflow. Methods. We made use of the information recorded and archived in the observing blocks; during the observing runs; in a number of relevant documents; in the spectra and master catalogue of spectra; in the parameters delivered by the analysis nodes and the working groups; in the final catalogue; and in the science papers. Based on these sources, we critically analyse and discuss the output and products of the Survey, including science highlights. We also determined the average metallicities of the open clusters observed as science targets and of a sample of clusters whose spectra were retrieved from the ESO archive. Results. The Gaia-ESO Survey has determined homogeneous good-quality radial velocities and stellar parameters for a large fraction of its more than 110 000 unique target stars. Elemental abundances were derived for up to 31 elements for targets observed with UVES. Lithium abundances are delivered for about 1/3 of the sample. The analysis and homogenisation strategies have proven to be successful; several science topics have been addressed by the Gaia-ESO consortium and the community, with many highlight results achieved. Conclusions. The final catalogue will be released through the ESO archive in the first half of 2022, including the complete set of advanced data products. In addition to these results, the Gaia-ESO Survey will leave a very important legacy, for several aspects and for many years to come. © ESO 2022., Based on data products from observations made with ESO Telescopes at the La Silla Paranal Observatory under programmes ID 188.B-3002, 193-B-0936, and 197.B-1074. These data products have been processed by the Cambridge Astronomy Survey Unit (CASU) at the Institute of Astronomy, University of Cambridge, and by the FLAMES/UVES reduction team at INAF-Osservatorio Astrofisico di Arcetri. Public access to the data products is via the ESO Archive, and the Gaia-ESO Survey Data Archive, prepared and hosted by the Wide Field Astronomy Unit, Institute for Astronomy, University of Edinburgh, which is funded by the UK Science and Technology Facilities Council. This work was partly supported by the European Union FP7 programme through ERC grant number 320360 and by the Leverhulme Trust through grant RPG-2012-541. We acknowledge the support from INAF PRIN and Ministero dell’ Universitá e della Ricerca (MUR) in the form of the grant “Premiale VLT 2012” and “Premiale Mitic”. This work was partly supported by the INAF grant for mainstream projects: “Enhancing the legacy of the Gaia-ESO Survey for open cluster science”. The project presented here benefited in development from discussions held during the Gaia-ESO workshops and conferences supported by the ESF (European Science Foundation) through the GREAT Research Network Programme. This research has made use of the SIMBAD database, operated at CDS, Strasbourg, France. R. Smiljanic acknowledges support from the National Science Centre, Poland (2014/15/B/ST9/03981). F.J.E. acknowledges financial support from the Spanish MINECO/FEDER through the grant AYA2017-84089 and MDM-2017-0737 at Centro de Astrobiología (CSIC-INTA), Unidad de Excelencia Mar a de Maeztu, and from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement no. 824064 through the ESCAPE - The European Science Cluster of Astronomy & Particle Physics ESFRI Research Infrastructures project. T.B. was funded by the “The New Milky Way” project grant from the Knut and Alice Wallenberg Foundation. S.R.B. acknowledges support by the Spanish Government under grants AYA2015-68012-C2-2-P and PGC2018-093741-B-C21/C22 (MICIU/AEI/FEDER, UE). W.J.S. acknowledges CAPES for a PhD studentship. J.M.A. acknowledges support from the Spanish Government Ministerio de Ciencia e Innovaciόn through grants AYA2013-40611-P, AYA2016-75931-C2-2-P, and PGC2018-095049-B-C22. T.M. and others from STAR institute, Liege, Belgium are grateful to Belgian F.R.S.-FNRS for support, and are also indebted for an ESA/PRODEX Belspo contract related to the Gaia Data Processing and Analysis Consortium and for support through an ARC grant for Concerted Research Actions financed by the Federation Wallonie-Brussels. This research has been partially supported by the ASI-INAF contract 2014-049-R.O: “Realizzazione attività tecniche/scientifiche presso ASDC” (PI Angelo Antonelli). V.A.acknowledges the support from Fundação para a Ciência e Tecnologia (FCT) through Investigador FCT contract nr. IF/00650/2015/CP1273/CT0001. AJK acknowledges support by the Swedish National Space Agency (SNSA). AB acknowledges support by ANID, – Millennium Science Initiative Program – NCN19_171, and FONDECYT regular 1190748. E.M. acknowledges financial support from the Spanish State Research Agency (AEI) through project MDM-2017-0737 Unidad de Excelencia “María de Maeztu” – Centro de Astrobiología (CSIC-INTA). T.Z. acknowledges financial support of the Slovenian Research Agency (research core funding no. P1-0188) and the European Space Agency (Prodex Experiment Arrangement No. C4000127986). P.J. acknowledges support FONDECYT Regular 1200703. The work of I.N. is partially supported by the Spanish Government Ministerio de Ciencia, Innovaciόn y Universidades under grant PGC2018-093741-B-C21 (MICIU/AEI/FEDER, UE). Funding for this work has been provided by the ARC Future Fellowship FT160100402. CAP acknowledges financial support from the Spanish Government through research grants MINECO AYA 2014-56359-P, MINECO AYA2017-86389-P, and MICINN PID2020-117493GB-I00. S.F. was supported by the grants 2011-5042 and 2016- 03412 from the Swedish Research Council and the project grant “The New Milky Way” from the Knut and Alice Wallenberg Foundation. CASU is supported through STFC grants: ST/H004157/1, ST/J00541X/1, ST/M007626/1, ST/N005805/1, ST/T003081/1. Work reported here benefited from support through the GREAT-ITN FP7 project Grant agreement ID: 264895. DKF acknowledges funds from the Alexander von Humboldt Foundation in the framework of the Sofja Kovalevskaja Award endowed by the Federal Ministry of Education and Research and the grant 2016-03412 from the Swedish Research Council. A.H. acknowledges support from the Spanish Government Ministerio de Ciencia e Innovaciόn and ERD Funds through grants PGC-2018-091 3741-B-C22 and CEX2019-000920-S. X.F. acknowledge the support of China Postdoctoral Science Foundation 2020M670023. M.L.L. Dantas acknowledges the Polish NCN grant number 2019/34/E/ST9/00133. Part of this work was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – Project-ID 138713538 – SFB 881 (“The Milky Way System”, subproject A09). M.Z. acknowledge support from the National Agency for Research and Development (ANID) grants: FONDECYT Regular 1191505, Millennium Institute of Astrophysics ICN12-009, BASAL Center for Astrophysics and Associated Technologies AFB-170002. R.B. acknowledges support from the project PRIN-INAF 2019 “Spectroscopically Tracing the Disk Dispersal Evolution”. HMT acknowledges financial support from the Agencia Estatal de Investigaciόn of the Ministerio de Ciencia, Innovaciόn y Universidades through projects PID2019-109522GB-C51,54/AEI/10.13039/501100011033, and the Centre of Excellence “María de Maeztu” award to Centro de Astrobiología (MDM-2017-0737). JIGH acknowledges financial support from the Spanish Ministry of Science and Innovation (MICINN) project AYA2017-86389-P, and also from the Spanish MICINN under 2013 Ramøn y Cajal program RYC-2013-14875. V.P.D. is supported by STFC Consolidated grant ST/R000786/1. N.L. acknowledges financial support from “Programme National de Physique Stellaire” (PNPS) and the “Programme National Cosmology et Galaxies (PNCG)” of CNRS/INSU, France. A.R.C. is supported in part by the Australian Research Council through a Discovery Early Career Researcher Award (DE190100656). Parts of this research were supported by the Australian Research Council Centre of Excellence for All Sky Astrophysics in 3 Dimensions (ASTRO 3D), through project number CE170100013. PSB is Supported by the Swedish Research Council through individual project grants with contract Nos. 2016-03765 and 2020-03404. A.M. acknowledges funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement no. 772293 - project ASTEROCHRONOMETRY). J.P. was supported by the project RVO: 67985815. E.D.M. acknowledges the support from FCT through the research grants UIDB/04434/2020 & UIDP/04434/2020 and through Investigator FCT contract IF/00849/2015/CP1273/CT0003. This work was (partially) supported by the Spanish Ministry of Science, Innovation and University (MICIU/FEDER, UE) through grant RTI2018-095076-B-C21, and the Institute of Cosmos Sciences University of Barcelona (ICCUB, Unidad de Excelencia “María de Maeztu”) through grant CEX2019-000918-M. S.L.M. acknowledges the support of the UNSW Scientia Fellowship program and the Australian Research Council through Discovery Project grant DP180101791. G.T. acknowledges financial support of the Slovenian Research Agency (research core funding no. P1-0188) and the European Space Agency (Prodex Experiment Arrangement No. C4000127986). S.G.S. acknowledges the support from FCT through Investigador FCT contract no. CEECIND/00826/2018 and POPH/FSE (EC). H.G.L. acknowledges financial support by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - Project-ID 138713538 – SFB 881 (“The Milky Way System”, subproject A04). This work was (partially) supported by the Spanish Ministry of Science, Innovation and University (MICIU/FEDER, UE) through grant RTI2018-095076-B-C21, and the Institute of Cosmos Sciences University of Barcelona (ICCUB, Unidad de Excelencia “María de Maeztu”) through grant CEX2019-000918-M. T.K. is supported by STFC Consolidated grant ST/R000786/1. M.V. acknowledges the support of the Deutsche Forschungsgemeinschaft (DFG, project number: 428473034). T.M. is supported by a grant from the Fondation ULB. We acknowledge financial support from the Universidad Complutense de Madrid (UCM) and by the Spanish Ministerio de Ciencia, Innovaciόn y Universidades, Ministerio de Economía y Competitividad, from project AYA2016-79425-C3-1-P and PID2019-109522GB-C5[4]/AEI/10.13039/501100011033. U.H. acknowledges support from the Swedish National Space Agency (SNSA/Rymdstyrelsen). D.G. gratefully acknowledges support from the Chilean Centro de Excelencia en Astrofίsica y Tecnologías Afines (CATA) BASAL grant AFB-170002. D.G. also acknowledges financial support from the Direcciόn de Investigaciόn y Desarrollo de la Universidad de La Serena through the Programa de Incentivo a la Investigaciόn de Académicos (PIA-DIDULS). A. Lobel acknowledges support in part by the Belgian Federal Science Policy Office under contract no. BR/143/A2/BRASS. We acknowledge financial support from the Universidad Complutense de Madrid (UCM) and by the Spanish Ministerio de Ciencia, Innovaciόn y Universidades, Ministerio de Economía y Competitividad, from project AYA2016-79425-C3-1-P and PID2019-109522GB-C5[4]/AEI/10.13039/501100011033. AM acknowledges the support from the Portuguese Fundação para a Ciência e a Tecnologia (FCT) through the Portuguese Strategic Programme UID/FIS/00099/2019 for CENTRA. T.M. acknowledges financial support from the Spanish Ministry of Science and Innovation (MICINN) through the Spanish State Research Agency, under the Severo Ochoa Program 2020-2023 (CEX2019-000920-S). E.J.A. acknowledges funding from the State Agency for Research of the Spanish MCIU through the “Center of Excellence Severo Ochoa” award to the Instituto de Astrofisica de Andalucia (SEV-2017-0709).

OBJECTIVES: The objective of this study is to identify demographic and clinical characteristics of patients with a pain diagnosis who fill potentially inappropriate opioid prescriptions within the Oregon Medicaid population. METHODS: Using de-identified Oregon Medicaid claims data (2010-2014), a series of logistic regression models were estimated to identify factors associated with receipt of potential inappropriate opioid prescriptions among patients with acute or chronic pain. Analyses included a total of 204,364 records, representing 118,671 unique patients. RESULTS: The percentage of patients with a pain diagnosis filling at least one inappropriate opioid prescription decreased over the study period, falling from 32.5% in 2010 to 22.3% in 2014. Multivariate logistic regression results indicated that white and older enrollees were more likely to fill an inappropriate prescription over the study period. The odds of filling an inappropriate opioid prescription were also greater for patients with chronic health conditions, psychiatric disorders, and substance use disorder. Results were similar for patients diagnosed with either acute or chronic pain, chronic pain only, or acute pain only. CONCLUSIONS: Inappropriate opioid prescribing for patients with pain diagnoses decreased over the study period, which stands in stark contrast to other state Medicaid programs. However, in 2014, almost 23% of patients in the Oregon Medicaid program filled at least one inappropriate opioid prescription, suggesting additional strategies are needed to further reduce potential inappropriate prescribing. Medicaid programs may consider adopting enhanced prescription drug monitoring program features, enacting pain clinic legislation, and implementing additional prior authorization policies to reduce inappropriate prescribing of opioids.

Objective To examine risk factors associated with falls among homebound community-dwelling older adults, a vulnerable population often possessing functional disabilities and chronic conditions. Design and sample The study was a cross-sectional study utilizing round 6 data of the National Health and Aging Trend Study (NHATS). Descriptive statistics and multiple logistic regression analyses were conducted. A total of 1,356 homebound community-dwelling older adults aged 65 and above participated in the NHATS. Measures The outcome variable was falls within the last month reported in NHATS. Independent variables were selected based on the NHATS disability conceptual model and literature review, including personal conditions, environmental conditions, and physical functioning limitations. Results In the sample population, 21.2% reported falls. Males were more likely to experience a fall than females. Hypertension or depression/anxiety increased risk for falls. Older adults with hearing impairment or balance problems limiting activities were also more likely to fall. Conclusions Public health nurses need to conduct thorough fall risk assessment for homebound older adults, especially those with chronic health problems or functioning limitations. Studies are needed to examine the association between home environment and falls in homebound older adults.

Background The study examined the association of the Affordable Care Act’s 2014 Medicaid expansion on the use of psychosocial services and pharmacotherapies for opioid use disorders among Oregon Medicaid recipients. Methods Logistic regression analysis examined utilization of care before (January 1, 2010–December 31, 2013) and after Medicaid expansion in Oregon (January 1, 2014–December 31, 2016). Results Adult membership in the Oregon Health Plan (Medicaid) increased 180% following Medicaid expansion (2013 = 172,539; 2014 = 482,081) and the number with a diagnosis of OUD nearly doubled (2013 = 6808; 2014 = 13,418). More individuals received psychosocial services (2013 = 4714; 2014 = 8781) and medications (2013 = 3464; 2014 = 6093) for opioid use disorder. The percent of patients receiving psychosocial services (69% to 65%) and the percent of individuals receiving pharmacotherapy (57% to 45%) declined primarily because of a decline in the proportion receiving care in an opioid treatment program (2013 = 41%; 2014 = 33%). Odds of accessing any psychosocial service increased by 8% per year from 2010 to 2013 (AOR = 1.08; 95% CI 1.06–1.11) with an 18% immediate decline associated with Medicaid expansion in 2014 (AOR = 0.82; 95% CI 0.76–0.87). Following Medicaid expansion, the odds of accessing psychosocial services increased 8% per year (2014 through 2016) (AOR = 1.08; 95% CI 1.06–1.11). Use of medications for opioid use disorder found no change in the odds of use in the years prior to Medicaid expansion, an immediate 36% (AOR = 0.64; 95% CI 0.60–0.68) decline in 2014, and a 13% increase per year in 2015 and 2016 (AOR = 1.13; 95% CI 1.09–1.16). Conclusion The number of Medicaid recipients with an opioid use disorder who received psychosocial and pharmacological services increased substantially following Oregon’s Medicaid expansion in 2014. There was a decline, however, in the proportion of individuals with an opioid use disorder receiving care in opioid treatment programs. Electronic supplementary material The online version of this article (10.1186/s13722-019-0160-6) contains supplementary material, which is available to authorized users.

Within gender-diverse populations, gender-affirming changes in gender on record may improve mental or behavioral health. This study uses claims data to investigate whether sex assigned at birth modifies the association between change in gender on record and mental or behavioral health.Adult Oregon Medicaid beneficiaries with gender identity-related diagnoses and enrolled during 2010-2019 were included. Sex assigned at birth was inferred from medical and pharmacy claims and was categorized as assigned female, assigned male, or unknown sex assigned at birth. Self-reported gender ascertained at initial enrollment differing from sex assigned at birth indicated a change in gender on record. Multivariable logistic regression estimated the association between change in gender on record and mental (anxiety, depression, suicidal ideation, post-traumatic stress disorder) or behavioral (alcohol, substance, or tobacco use disorders) health. Analyses were conducted in February 2021.This study included 2,940 transgender and nonbinary adults. Of the 1,451 self-reporting female gender and 1,489 self-reporting male gender, 449 (30.9%) were assigned male at birth, and 303 (20.3%) were assigned female at birth, classified as changing their gender on record. Predicted probability of mental or behavioral conditions was significantly lower in those who changed their gender on record. Sex assigned at birth modified the association with mental health: assigned female at birth reporting female gender had the highest burdens, followed by assigned male at birth reporting male. Secondary analyses using a modified change in gender definition or alternative sex assigned at birth inference method found similar trends.Oregon Medicaid gender-diverse beneficiaries who changed their gender on record had a meaningfully lower probability of mental and behavioral health conditions. Those assigned female at birth reporting female gender had the highest burdens.

Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [rg], twin-based = 0.23-0.53). We estimated the genetic correlation between eating disorder and substance use and disorder phenotypes using data from genome-wide association studies (GWAS). Four eating disorder phenotypes (anorexia nervosa [AN], AN with binge eating, AN without binge eating, and a bulimia nervosa factor score), and eight substance-use-related phenotypes (drinks per week, alcohol use disorder [AUD], smoking initiation, current smoking, cigarettes per day, nicotine dependence, cannabis initiation, and cannabis use disorder) from eight studies were included. Significant genetic correlations were adjusted for variants associated with major depressive disorder and schizophrenia. Total study sample sizes per phenotype ranged from ~2400 to ~537 000 individuals. We used linkage disequilibrium score regression to calculate single nucleotide polymorphism-based genetic correlations between eating disorder- and substance-use-related phenotypes. Significant positive genetic associations emerged between AUD and AN (rg = 0.18; false discovery rate q = 0.0006), cannabis initiation and AN (rg = 0.23; q < 0.0001), and cannabis initiation and AN with binge eating (rg = 0.27; q = 0.0016). Conversely, significant negative genetic correlations were observed between three nondiagnostic smoking phenotypes (smoking initiation, current smoking, and cigarettes per day) and AN without binge eating (rgs = −0.19 to −0.23; qs < 0.04). The genetic correlation between AUD and AN was no longer significant after co-varying for major depressive disorder loci. The patterns of association between eating disorder- and substance-use-related phenotypes highlights the potentially complex and substance-specific relationships among these behaviors. © 2020 Society for the Study of Addiction

Neutron-star mergers were recently confirmed as sites of rapid-neutron-capture (r-process) nucleosynthesis

Summary paragraphThe blood system serves as a key model for cell differentiation and cancer. It is orchestrated by precise spatiotemporal expression of the hematopoietic master regulator PU.11–4. PU.1 gene expression is regulated through enhancer-promoter interactions within a topologically associated domain (TAD)5,6. PU.1 levels increase during myeloid differentiation while failure to do so results in myeloid leukemia7. In contrast, T-cell differentiation requires PU.1 to be completely switched off8–10. Little is known about the precise mechanisms of PU.1 repression, physiological as in T-cell differentiation, or pathological as in leukemia. Here we demonstrate that the down-regulation of PU.1 mRNA is a dynamic process involving an alternative promoter11 in intron 3 that is induced by RUNX transcription factors driving noncoding antisense transcription. Core binding factor (CBF) fusions, RUNX1-ETO and CBFβ-MYH11 in t(8;21) and inv(16) acute myeloid leukemia (AML)12, activate the PU.1 antisense promoter, thus shifting from sense towards antisense transcription and blocking myeloid differentiation. In patients with CBF-AML, we found that an elevated antisense/sense ratio represents a hallmark compared to normal karyotype AML or healthy CD34+ cells. Competitive interaction of the enhancer with the proximal or the antisense promoter are at the heart of differential PU.1 expression during myeloid and T-cell development. Leukemic CBF fusions thus utilize a physiologic mechanism employed by T-cells to decrease sense PU.1 transcription. Our results identify the first example of a sense/antisense promoter competition as a crucial functional switch for gene expression perturbation by oncogenes. This novel basic disease mechanism reveals a previously unknown Achilles heel for future precise therapeutic targeting of oncogene-induced chromatin remodeling.

Introduction This study examines individual- and practice-level predictors of screening modality among 1,484 Medicaid enrollees who initiated colorectal cancer screening (fecal immunochemical test/fecal occult blood tests or colonoscopy) within a year of turning age 50 years. Understanding screening modality patterns for patients and health systems can help optimize colorectal cancer screening initiatives that will lead to high screening completion rates. Methods Multivariable logistic regression was conducted in 2019 to analyze Medicaid claims data (January 2013–June 2015) to explore predictors of colonoscopy screening (versus fecal testing). Results Overall, 64% of enrollees received a colonoscopy and 36% received a fecal immunochemical test/fecal occult blood test. Male (OR=1.21, 95% CI=1.08, 1.37) compared with female enrollees and those with 4–6 (OR=1.57, 95% CI=1.15, 2.15), 7–10 (OR=2.23, 95% CI=1.64, 3.03), and ≥11 (OR=1.79, 95% CI=1.22, 2.65) primary care visits compared with 0–3 visits had higher odds of colonoscopy screening. Non-White, non-Hispanic enrollees (OR=0.71, 95% CI=0.58, 0.87) compared with White, non-Hispanics Whites had lower odds of colonoscopy screening. Practices with an endoscopy facility within their ZIP code (OR=1.50, 95% CI=1.08, 2.08) compared with practices without a nearby endoscopy facility had higher odds of colonoscopy screening. Conclusions Among newly age-eligible Medicaid enrollees who received colorectal cancer screening, non-White, non-Hispanic individuals were less likely and male enrollees and those with ≥4 primary care visits were more likely to undergo colonoscopy versus fecal immunochemical test/fecal occult blood test. Colonoscopy also was the more common modality among adults whose primary care clinic had an endoscopy facility in the same ZIP code. Future research is needed to fully understand patient, provider, and practice preferences regarding screening modality.

The study examines impacts of delivery system reforms and Medicaid expansion on treatment for alcohol use disorders within the Oregon Health Plan (Medicaid). Diagnoses, services and pharmacy claims related to alcohol use disorders were extracted from Medicaid encounter data. Logistic regression and interrupted time series analyses assessed the percent with alcohol use disorder entering care and the percent receiving pharmacotherapy before (January 2010 – June 2012) and after (January 2013 – June 2015) the initiation of Oregon’s Coordinated Care Organization (CCO) model (July 2012 – December 2012). Analyses also examined changes in access following Medicaid expansion (January 2014). Treatment entry rates increased from 35% in 2010 to 41% in 2015 following the introduction of CCOs and Medicaid expansion. The number of Medicaid enrollees with a diagnosed alcohol use disorder increased about 150% from 10,360 (2013) to 25, 454 (2014) following Medicaid expansion. Individuals with an alcohol use disorder who were prescribed a medication to support recovery increased from 2.3% (2010) to 3.8% (2015). In Oregon, Medicaid expansion and health care reforms enhanced access and improved treatment initiation for alcohol use disorders.

BACKGROUND: Hospitalizations due to medical and surgical complications of substance use disorder (SUD) are rising. Most hospitals lack systems to treat SUD, and most people with SUD do not engage in treatment after discharge. OBJECTIVE: Determine the effect of a hospital-based addiction medicine consult service, the Improving Addiction Care Team (IMPACT), on post-hospital SUD treatment engagement. DESIGN: Cohort study using multivariable analysis of Oregon Medicaid claims comparing IMPACT patients with propensity-matched controls. PARTICIPANTS: 18–64-year-old Oregon Medicaid beneficiaries with SUD, hospitalized at an Oregon hospital between July 1, 2015, and September 30, 2016. IMPACT patients (n = 208) were matched to controls (n = 416) using a propensity score that accounted for SUD, gender, age, race, residence region, and diagnoses. INTERVENTIONS: IMPACT included hospital-based consultation care from an interdisciplinary team of addiction medicine physicians, social workers, and peers with lived experience in recovery. IMPACT met patients during hospitalization; offered pharmacotherapy, behavioral treatments, and harm reduction services; and supported linkages to SUD treatment after discharge. OUTCOMES: Healthcare Effectiveness Data and Information Set (HEDIS) measure of SUD treatment engagement, defined as two or more claims on two separate days for SUD care within 34 days of discharge. RESULTS: Only 17.2% of all patients were engaged in SUD treatment before hospitalization. IMPACT patients engaged in SUD treatment following discharge more frequently than controls (38.9% vs. 23.3%, p

Background Colorectal cancer (CRC) screening is underutilized by Medicaid enrollees and the uninsured. Multiple national and state policies were enacted from 2010 to 2014 to increase access to Medicaid and to promote CRC screening among Medicaid enrollees. We aimed to determine the impact of these policies on screening initiation among newly enrolled Oregon Medicaid beneficiaries age-eligible for CRC screening. Methods We identified national and state policies affecting Medicaid coverage and preventive services in Oregon during 2010–2014. We used Oregon Medicaid claims data from 2010 to 2015 to conduct a cohort analysis of enrollees who turned 50 and became age-eligible for CRC screening (a prevention milestone, and an age at which guideline-concordant screening can be assessed within a single year) during each year from 2010 to 2014. We calculated risk ratios to assess whether first year of Medicaid enrollment and/or year turned 50 was associated with CRC screening initiation. Results We identified 14,576 Oregon Medicaid enrollees who turned 50 during 2010–2014; 2429 (17%) completed CRC screening within 12 months after turning 50. Individuals newly enrolled in Medicaid in 2013 or 2014 were 1.58 and 1.31 times more likely, respectively, to initiate CRC screening than those enrolled by 2010. A primary care visit in the calendar year, having one or more chronic conditions, and being Hispanic was also associated with CRC screening initiation. Discussion The increased uptake of CRC screening in 2013 and 2014 is associated with the timing of policies such as Medicaid expansion, enhanced federal matching for preventive services offered to Medicaid enrollees without cost sharing, and formation of Medicaid accountable care organizations, which included CRC screening as an incentivized quality metric. Electronic supplementary material The online version of this article (10.1186/s12913-019-4113-2) contains supplementary material, which is available to authorized users.

Background It is important to understand patterns and predictors of initiation and engagement in treatment for Medicaid-covered individuals with substance use disorders because Medicaid is a major source of payment for addiction treatment in the United States. Our analysis examined similarities and differences in predictors between adults and adolescents. Methods An analysis of Oregon Medicaid claims data for the time period January 2010 through June 2015 assessed rates of substance use and of treatment initiation and engagement using the Healthcare Effectiveness Data and Information Set (HEDIS) definitions. The analysis included individuals aged 13–64 with a new alcohol and other drug dependence diagnosis who met the HEDIS enrollment criteria and did not have cancer. We created 4 logistic regression models to assess treatment initiation and engagement, separately for adults (ages 18–64) and adolescents (ages 13–17). Independent predictors included age, gender, race, the interaction of gender and race, urban/rural residence, presence of any chronic disease, a psychiatric diagnosis, or a pain diagnosis. Results Among adults, odds of initiation were lower in white males than in nonwhite males, white females, and nonwhite females. Conversely, among adolescents, odds of initiation were higher in white males than in the other gender/race groups. Predictors of initiation also went in opposite directions for presence of a psychiatric diagnosis (negative in adults, positive in adolescents) and urban residence (positive in adults, negative in adolescents). We found similar patterns in models of engagement, although for engagement those with a psychiatric diagnosis had lower odds of engagement in both adults and adolescents. Conclusions Predictors of treatment initiation and engagement for alcohol and drug use disorders differed between adults and adolescents on Medicaid. A better understanding of these differences will enable development of targeted treatment programs that are effective within age groups.

Purpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world. Methods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - 80 years. Sepsis was defined as infection plus at least one organ failure. Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients 70 years was independently associated with increased risk of dying. Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. All rights reserved.

Falls in community-dwelling older adults are a complicated phenomenon that are attributed to sociodemographic characteristics, health conditions, functional problems, and environmental factors. The current cross-sectional and correlational study aimed to explore comprehensive risk factors for falls in community-dwelling older adults using a nationally representative data file ( N = 5,930). Descriptive statistics were used and multiple logistic regression analyses were performed. Study findings showed that homebound or semi-homebound older adults were 50% more likely to experience a fall than non-homebound individuals. Impaired balance was the strongest predictor (odds ratio [OR] = 2.37, p < 0.001), followed by problems moving around in the home. Arthritis (OR = 1.39, p = 0.009) and depression or anxiety (OR = 1.28, p = 0.013) were additional risk factors. Community health or home health nurses need to assess these risk factors when planning fall intervention programs for older adults using evidence-based prevention strategies. [ Journal of Gerontological Nursing, 44 (10), 40–48.]

Phosphoinositide (PIP) lipids are anionic phospholipids playing a fundamental role for the activity of several transmembrane and soluble proteins. Among all, phosphoinositol-3',4',5'-trisphosphate (PIP

Imageability is a psycholinguistic variable that indicates how well a word gives rise to a mental image or sensory experience. Imageability ratings are used extensively in psycholinguistic, neuropsychological, and aphasiological studies. However, little formal knowledge exists about whether and how these ratings are associated between and within languages. Fifteen imageability databases were cross-correlated using nonparametric statistics. Some of these corresponded to unpublished data collected within a European research network—the Collaboration of Aphasia Trialists (COST IS1208). All but four of the correlations were significant. The average strength of the correlations (rho =.68) and the variance explained (R2 = 46%) were moderate. This implies that factors other than imageability may explain 54% of the results. Imageability ratings often correlate across languages. Different possibly interacting factors may explain the moderate strength and variance explained in the correlations: (1) linguistic and cultural factors; (2) intrinsic differences between the databases; (3) range effects; (4) small numbers of words in each database, equivalent words, and participants; and (5) mean age of the participants. The results suggest that imageability ratings may be used cross-linguistically. However, further understanding of the factors explaining the variance in the correlations will be needed before research and practical recommendations can be made. © 2017, Psychonomic Society, Inc.

The primordial lithium abundance inferred from WMAP and standard Big Bang nucleosysnthesis is approximately three times higher than the plateau value measured in old metal-poor Population II stars, suggesting that these stars have undergone atmospheric Li depletion. To constrain the physics responsible for such depletion, we conducted a homogeneous analysis of a large sample of stars in the metal-poor globular cluster NGC 6397, covering all evolutionary phases from below the main-sequence turnoff to high up the red-giant branch (RGB). The dwarf, turnoff, and early subgiant stars form a thin abundance plateau, with a sharpe edge in the middle of the subgiant branch, where Li dilution caused by the inward extension of the convective envelope starts (the beginning of the so-called first dredge up). A second steep abundance drop is seen at the RGB bump, again highlighting the need for the onset of nonstandard mixing in this evolutionary phase. Moreover, by also measuring the sodium abundances of the targets, we have gained insight into the degree of pollution by early cluster self-enrichement, and may separate highly polluted, Li-poor and Na-rich stars from stars formed from pristine material. Our observational findings strictly limit both the extent of lithium surface depletion, which in turn constrains the efficiency of mixing below the outer convection zone, and the resulting spread in lithium abundance in metal-poor turn-off stars.

We present a summary of the splinter session "Sun-like stars unlike the Sun" that was held on 09 June 2016 as part of the Cool Stars 19 conference (Uppsala, Sweden). We discussed the main limitations (in the theory and observations) in the derivation of very precise stellar parameters and chemical abundances of Sun-like stars. We outlined and discussed the most important and most debated processes that can produce chemical peculiarities in solar-type stars. Finally, in an open discussion between all the participants we tried to identify new pathways and prospects towards future solutions of the currently open questions., Comment: Resubmitted to AN after minor revision

In a retrospective review of 302 hospital charts, 38 percent of newborns whose mothers planned to exclusively breastfeed received formula before hospital discharge. Those breastfeeding infants who did not receive formula were significantly younger at first breastfeeding than infants who received formula. Significantly more infants born by cesarean (51 percent) received supplementation than those born vaginally (31 percent). Birth between 9 p.m. and 10 a.m. and a hospital stay for more than 24 hours increased odds of supplementation. Nurses can explore barriers to exclusive breastfeeding unique to their hospitals to develop strategies that facilitate breastfeeding support and decrease formula supplementation.

The purpose of this study was to explore the relationship between registered nurse (RN)-to-population ratio and population health indices. A cross-sectional secondary analysis of existing national data was conducted, using counties as the unit of analysis. Data based on 1,929,414 RNs in 33 states in 2012 were obtained from the National Council of State Boards of Nursing's Nursys® database, and county health data were obtained from 2,016 counties from the 2012 County Health Rankings database. Regression analysis indicated that the RN-to-population ratio along with nurse education (percentage of RNs with a BSN or higher degree) and experience (number of years since graduation) was significantly associated with the self-rated health (percentage of adults reporting fair or poor health), mammography screening rates, and teenage birth rates. The associations were all positive: Greater numbers of nurses per capita were associated with better population health indices. These results are consistent with the Nurse Dose concept and support the need for enhanced recognition and policy changes regarding the contribution of nurses to the health of the population. Implications for nursing regulation include the need for sustained and coordinated efforts to support the health of the population through the recruitment and maintenance of a well-educated and experienced nursing workforce.

Colorectal cancer (CRC) can be effectively prevented or detected with guideline concordant screening, yet Medicaid enrollees experience disparities. We used microsimulation to project CRC screening patterns, CRC cases averted, and life-years gained in the population of 68,077 Oregon Medicaid enrollees 50–64 over a five year period starting in January 2019. The simulation estimated the cost-effectiveness of five intervention scenarios - academic detailing plus provider audit and feedback (Detailing+), patient reminders (Reminders), mailing a Fecal Immunochemical Test (FIT) directly to the patient’s home (Mailed FIT), patient navigation (Navigation), and mailed FIT with Navigation (Mailed FIT+Navigation) – compared to usual care. Each intervention scenario raised CRC screening rates compared to usual care, with improvements as high as 11.6 percentage points (Mailed FIT+Navigation) and as low as 2.5 percentage points (Reminders) after one year. Compared to usual care, Mailed FIT+Navigation would raise CRC screening rates 20.2 percentage points after five years - averting nearly 77 cancer cases (a reduction of 113 per 100,000) and exceeding national screening targets. Over a five year period, Reminders, Mailed FIT and Mailed FIT+Navigation were expected to be cost effective if stakeholders were willing to pay $230 or less per additional year up-to-date (at a cost of $22, $59, and $227 respectively per additional person-year up-to-date), whereas Detailing+ and Navigation were more costly for the same benefits. To approach national CRC screening targets, health system stakeholders are encouraged to implement Mailed FIT with or without Navigation and Reminders.

We present the first nest description for the Lawrence's Thrush (Turdus lawrencii), found on 9 February 2011 in the lowland tropical forest at the Tiputini Biodiversity Station, Orellana province, Ecuador. The nest was situated 1.6 m off the ground, tucked in the hollow end of a broken dead tree. The open-cup nest conformed to the shape of the depression in which it was built, and averaged 13.0 cm in diameter and 6.6 cm in depth. The inner cup diameter averaged 8 cm and the maximum depth was 4 cm. The nest was constructed of moss, leafy liverworts, and fungal rhizoids held together with mud. During 6.5 hrs of observation on 13 and 14 February 2011, we observed the female feeding the nestlings while the male remained in the vicinity of the nest. We conclude that the nest composition of Lawrence's Thrush is typical of other thrush species, and based on our limited behavioral data we also conclude parental care is comparable to other Turdus species.

PurposeRecent studies have suggested significant variations in radiotherapy schedules used to treat advanced non-small-cell lung cancer (NSCLC), both between different centers in one country as well as between countries. In this study, different treatment methodologies have been explored using management plans proposed by radiation oncologists regarding general questions and theoretical case histories for patients with advanced NSCLC.Materials and methodsThe survey was conducted by sending a questionnaire to 24 radiotherapy centers in Europe. The questionnaire was composed of two sections. The first section concerned reasons for giving radiotherapy, parameters that influence the choice of total dose and fractionation for radiotherapy and kind of equipment used. The second section concerned the management of five theoretical patients (A–E) regarding the selection of the radiotherapy technique and the aim of treatment (radical or palliative). Furthermore, 19 trials comparing different regimens of palliative radiotherapy in patients with NSCLC were reviewed. There were marked differences in the doses of the investigated radiotherapy schemes, the patient characteristics and the assessed outcome measures.Results70% of the responders answered that the most important factors for deciding what dose and fractionation scheme to use were: metastases, performance status (PS) of the patient, lung function and size of the primary tumour. The most common reasons for giving the treatment were symptom relief, prolongation of life and, in some cases, possibly cure. More than 95% of the responders stated that they would give radiotherapy in each of these cases. The total doses proposed where 20 Gy in five fractions or 30 Gy in ten fractions in 2 weeks for the cases A and D. If the previous two schemes were converted to a fractionation scheme delivering 2 Gy per fraction, the equivalent doses would be 23 and 33 Gy, respectively. For the cases B, C and E, the proposed fractionation schemes were 2 Gy daily to 60–68 Gy in 6 weeks or 2 Gy daily to 68 Gy in 7 weeks. For the case E, 20% of the responders suggested Stereotactic Body Radiotherapy (SBRT) giving 21 Gy three times a week with a day apart to 63 Gy. The total dose and number of fractions of radiotherapy are related to the perceived aims and expectations of treatment. Those aiming at extending life would give significantly higher total doses in a larger number of fractions, whereas those aiming at relieving symptoms would give significantly lower total doses. There is evidence for an increase in survival, in patients who are given higher radiotherapy doses, especially in those patients with better PS.ConclusionsThis survey demonstrates a range of treatment strategies for advanced and inoperable NSCLC within Europe. There are a number of factors that influence the perceived aims of treatment and treatment planning. These factors should be taken into account when evaluating the effectiveness of different irradiation techniques, especially in the determination of radiobiological parameters and dose–response relations. The majority of patients should be treated with short courses of palliative radiotherapy, of one or two fractions. The use of high-dose palliative regimens using many fractions or SBRT should be considered for selected patients with good PS.

For many years the linear-quadratic (LQ) model has been widely used to describe the effects of total dose and dose per fraction at low-to-intermediate doses in conventional fractionated radiotherapy. Recent advances in stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) have increased the interest in finding a reliable cell survival model, which will be accurate at high doses, as well. Different models have been proposed for improving descriptions of high dose survival responses, such as the Universal Survival Curve (USC), the Kavanagh-Newman (KN) and several generalizations of the LQ model, e.g. the Linear-Quadratic-Linear (LQL) model and the Padé Linear Quadratic (PLQ) model. The purpose of the present study is to compare a number of models in order to find the best option(s) which could successfully be used as a fractionation correction method in SRT. In this work, six independent experimental data sets were used: CHOAA8 (Chinese hamster fibroblast), H460 (non-small cell lung cancer, NSLC), NCI-H841 (small cell lung cancer, SCLC), CP3 and DU145 (human prostate carcinoma cell lines) and U1690 (SCLC). By detailed comparisons with these measurements, the performance of nine different radiobiological models was examined for the entire dose range, including high doses beyond the shoulder of the survival curves. Using the computed and measured cell surviving fractions, comparison of the goodness-of-fit for all the models was performed by means of the reduced χ2-test with a 95% confidence interval. The obtained results indicate that models with dose-independent final slopes and extrapolation numbers generally represent better choices for SRT. This is especially important at high doses where the final slope and extrapolation numbers are presently found to play a major role. The PLQ, USC and LQL models have the least number of shortcomings at all doses. The extrapolation numbers and final slopes of these models do not depend on dose. Their asymptotes for the cell surviving fractions are exponentials at low as well as high doses, and this is in agreement with the behaviour of the corresponding experimental data. This is an important improvement over the LQ model which predicts a Gaussian at high doses. Overall and for the highlighted reasons, it was concluded that the PLQ, USC and LQL models are theoretically well-founded. They could prove useful compared to the other proposed radiobiological models in clinical applications for obtaining uniformly accurate cell surviving fractions encountered in stereotactic high-dose radiotherapy as well as at medium and low doses.

Complementary and alternative medicine (CAM) providers are becoming more integrated into the United States health care system. Because patients self-select CAM use, risk adjustment is needed to make the groups more comparable when analyzing utilization. This study examined how the choice of risk adjustment method affects assessment of CAM use on overall health care utilization.Insurance claims data for 2000-2003 from Washington State, which mandates coverage of CAM providers, were analyzed. Three (3) risk adjustment methods were compared in patients with musculoskeletal conditions: Adjusted Clinical Groups (ACG), Diagnostic Cost Groups (DCG), and the Charlson Index. Relative Value Units (RVUs) were used as a proxy for expenditures. Two (2) sets of median regression models were created: prospective, which used risk adjustments from the previous year to predict RVU in the subsequent year, and concurrent, which used risk adjustment measures to predict RVU in the same year.The sample included 92,474 claimants. Prospective models showed little difference in the effect of CAM use on RVU among the three risk adjustment methods, and all models had low predictive power (R(2) ≤0.05). In the concurrent models, coefficients were similar in direction and magnitude for all risk adjustment methods, but in some models the predicted effect of CAM use on RVU differed by as much as double between methods. Results of DCG and ACG models were similar and were stronger than Charlson models.Choice of risk adjustment method may have a modest effect on the outcome of interest.

In breast cancer radiotherapy, significant discrepancies in dose delivery can contribute to underdosage of the tumor or overdosage of normal tissue, which is potentially related to a reduction of local tumor control and an increase of side effects. To study the impact of these factors in breast cancer radiotherapy, a meta analysis of the clinical data reported by Mavroidis et al. (2002) in Acta Oncol (41:471–85), showing the patient setup and breathing uncertainties characterizing three different irradiation techniques, were employed. The uncertainties in dose delivery are simulated based on fifteen breast cancer patients (5 mastectomized, 5 resected with negative node involvement (R-) and 5 resected with positive node involvement (R+)), who were treated by three different irradiation techniques, respectively. The positioning and breathing effects were taken into consideration in the determination of the real dose distributions delivered to the CTV and lung in each patient. The combined frequency distributions of the positioning and breathing distributions were obtained by convolution. For each patient the effectiveness of the dose distribution applied is calculated by the Poisson and relative seriality models and a set of parameters that describe the dose-response relations of the target and lung. The three representative radiation techniques are compared based on radiobiological measures by using the complication-free tumor control probability, P+ and the biologically effective uniform dose, D̿ concepts. For the Mastectomy case, the average P+ values of the planned and delivered dose distributions are 93.8% for a D̿CTV of 51.8 Gy and 85.0% for a D̿CTV of 50.3 Gy, respectively. The respective total control probabilities, PB values are 94.8% and 92.5%, whereas the corresponding total complication probabilities, PI values are 0.9% and 7.4%. For the R- case, the average P+ values are 89.4% for a D̿CTV of 48.9 Gy and 88.6% for a D̿CTV of 49.0 Gy, respectively. The respective PB values are 89.8% and 89.9%, whereas the corresponding PI values are 0.4% and 1.2%. For the R+ case, the average P+ values are 86.1% for a D̿CTV of 49.2 Gy and 85.5% for a D̿CTV of 49.1 Gy, respectively. The respective PB values are 90.2% and 90.1%, whereas the corresponding PI values are 4.1% and 4.6%. The combined effects of positioning uncertainties and breathing can introduce a significant deviation between the planned and delivered dose distributions in lung in breast cancer radiotherapy. The positioning and breathing uncertainties do not affect much the dose distribution to the CTV. The simulated delivered dose distributions show larger lung complication probabilities than the treatment plans. This means that in clinical practice the true expected complications are underestimated. Radiation pneumonitis of Grade 1–2 is more frequent and any radiotherapy optimization should use this as a more clinically relevant endpoint.