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The prevalence of direct-to-consumer (DTC) advertising for prescription drugs has led to concerns about how consumers interpret the medical information conveyed in these ads. One strategy for improving lay understanding of medical information involves incorporating quantitative information about a treatment's potential benefits and risks. This literature review investigates laypersons' interpretations of statistical concepts, expanding on past reviews and including terms that may be used in DTC prescription drug advertising. We searched six databases for articles published from January 2000 to October 2021. Articles were included if they were in English and examined general or lay audiences' comprehension of quantitative or statistical concepts, without limiting the context of the studies to medical situations. We identified 25 eligible articles. The evidence suggests that likelihood ratios, odds ratios, probabilities, numbers needed to treat/harm, and confidence intervals hinder comprehension of quantitative information. The results are mixed for information presented as frequencies, percentages, absolute risk reduction, and relative risk reduction. The mixed findings could be due to numeracy, framing as risks or benefits, and operationalization of the outcomes. We found no studies examining interpretations of minimum, maximum, central tendency, power, statistical significance, or hazard ratio. Studies spanning several decades have examined how laypeople interpret statistical concepts. While a few terms are consistently studied, many questions still remain on how to make risk information more understandable to lay audiences, particularly those with low numeracy. [ABSTRACT FROM AUTHOR]

Robotic surgery is perceived to be more complex in obese patients. Objective performance indicators , machine learning–enabled metrics, can provide objective data regarding surgeon movements and robotic arm kinematics. In this feasibility study, we identified differences in objective performance indicators during robotic proctectomy in obese and nonobese patients. Endoscopic videos were annotated to delineate individual surgical steps across 39 robotic proctectomies (1880 total steps). Thirteen patients were obese and 26 were nonobese. Objective performance indicators during the following steps were analyzed: splenic flexure mobilization, left colon mobilization, pelvic dissection, and rectal transection. The following differences were noted during robotic proctectomy in obese patients: during splenic flexure mobilization , more arm swaps, longer camera path length and velocity; during left colon mobilization , longer step time, more arm swaps, higher camera-related metrics (movement, path length, velocity, acceleration, and jerk), greater dominant arm path length, moving time, and wrist articulation; during anterior pelvic dissection , longer energy activation time, camera path length, and moving time; during posterior pelvic dissection , lower nondominant arm velocity, jerk, and acceleration; during left pelvic dissection , longer energy activation time; during right pelvic dissection , greater camera-related metrics (movement, path length, moving time, and velocity); and during rectal transection , longer step time, more arm swaps, master clutch use and camera movements, greater dominant wrist articulation, and longer dominant arm path length. We report step-specific objective performance indicators that differ during robotic proctectomy for obese and nonobese patients. This is the first study to use objective performance indicators to correlate a patient attribute with surgeon movements and robotic arm kinematics during robotic colorectal surgery. [ABSTRACT FROM AUTHOR]

Prior studies have suggested there may be differences in reimbursement and practice patterns by gender. The purpose of this study was to comprehensively evaluate differences in reimbursement, procedural volume, and patient characteristics in total hip arthroplasty (THA) between men and women surgeons from 2013 to 2021. The Medicare Physician and Other Practitioners database from 2013 to 2021 was queried. Inflation-adjusted reimbursement, procedural volume, surgeon information, and patient demographics were extracted for surgeons performing over 10 primary THAs each year. Wilcoxon, t -tests, and multivariate linear regressions were utilized to compare men and women surgeons. Only 1.4% of THAs billed to Medicare between 2013 and 2021 were billed by women surgeons. Men surgeons earned significantly greater reimbursement nationally in 2021 compared to women surgeons per THA ($1,018.56 versus $954.17, P =.03), but no difference was found when assessing each region separately. Reimbursement declined at similar rates for both men and women surgeons (−18.3 versus −19.8%, P =.38). An increase in the proportion of women surgeons performing THA between 2013 and 2021 was seen in all regions except the South. In 2021, the proportion of all THAs performed by women surgeons was highest in the West (3.5%) and lowest in the South (1.0%). Women surgeons had comparable patient populations in terms of age, race, comorbidity status, and Medicaid eligibility to their men counterparts, but performed significantly fewer services per beneficiary (5.6 versus 8.1, P <.001) and fewer unique services (51.1 versus 69.6, P <.001). Average reimbursement per THA has declined at a similar rate for men and women physicians between 2013 and 2021. Women's representation in THA surgery nationwide has nearly doubled between 2013 and 2021, with the greatest increase in the West. However, there are notable differences in billing practices between genders. [ABSTRACT FROM AUTHOR]

Hypertension is a leading risk factor for cardiovascular disease among patients living with HIV (PLWH). Understanding the predictors and patterns of antihypertensive medication prescription and blood pressure (BP) control among PLWH with hypertension (HTN) is important to improve the primary prevention efforts for this high-risk population. We sought to assess important patient-level correlates (eg, race) and inter-facility variations in antihypertension medication prescriptions and BP control among Veterans living with HIV (VLWH) and HTN. We studied VLWH with a diagnosis of HTN who received care in the Veterans Health Administration (VHA) from January 2018 to December 2019. We evaluated HTN treatment and blood pressure control across demographic variables, including race, and by medical comorbidities. Data were also compared among VHA facilities. Predictors of HTN treatment and control were assessed in 2-level hierarchical multivariate logistic regression models to estimate odds ratios (ORs). The VHA facility random-effects parameters from the hierarchical models were used to calculate the median odds ratios to characterize the variation across the different VHA facilities. A total of 17,468 VLWH with HTN (mean age 61 years, 97% male, 54% Black, 40% White) who received care within the VHA facilities in 2018-2019 were included. 73% were prescribed antihypertension medications with higher prescription rates among Black vs White patients (75% vs 71%) and higher prescription rates among patients with a history of cardiovascular disease, diabetes, and kidney disease (>80%), and those receiving antiretroviral therapy and with controlled HIV viral load (∼75%). Only 27% of VLWH with HTN had optimal BP control of systolic BP <130 mmHg and diastolic BP <80 mmHg, with a lower rate of control among Black vs White patients (24% v. 31%). In multivariate regression, Black patients had a higher likelihood of HTN medication prescription (OR 1.32, 95% CI: 1.22-1.42) but were less likely to have optimal BP control (OR 0.82; 0.76-0.88). Important positive correlates of antihypertensive prescription and optimal BP control included: number of outpatient visits in prior year, and histories of diabetes, coronary artery disease, and heart failure. There was about 10% variability in both antihypertensive prescription and BP control patterns between VHA facilities for patients with similar characteristics. There was increased inter-facility variation in antihypertensive prescription among those with a history of heart failure and those not receiving antiretroviral therapy. In a retrospective analysis of large VHA data, we found that VLWH with HTN have suboptimal antihypertensive medication prescription and BP control. Black VLWH had higher HTN medication prescription rates but lower optimal BP control. [ABSTRACT FROM AUTHOR]

This exploratory pilot study aimed to probe the relationship between past experiences of trauma in people who self-identify as "laryngoresponders" compared to those who do not. It also explored the communicative context of past traumatic events in laryngoresponders versus non-laryngoresponders. Prospective, within-subjects experimental design. 29 vocally healthy cisgender women (ages 19 to 56) completed a battery of validated self-report measures relating to their past traumatic experiences. Participants also completed two original self-report measures designed to provide insight about (1) where stress tends to manifest in their body and (2) communicative settings of participants' past trauma. Six participants (21%) self-identified a predictable laryngeal and/or vocal response to acute stress and thus comprise the laryngoresponders group. Laryngoresponders exhibited worse scores on 75% of all trauma-related variables compared to non-laryngoresponders, and Emotional Neglect was disproportionately represented in laryngoresponders. Participants with a reported history of childhood Emotional Neglect (83% of laryngoresponders, 35% of nonlaryngoresponders) reported quantitatively "less ideal" communication experiences in the context of past traumatic experiences. Other investigators identify the larynx as a "vulnerable body pathway" for some women. This pilot study of adult women without voice complaints revealed several commonalities amongst self-reported laryngoresponders, and compels further exploration of the voice-trauma relationship. [ABSTRACT FROM AUTHOR]

As competition for limited water resources in the western United States and other arid and semiarid regions intensifies, there is a need to provide alfalfa (Medicago sativa) growers with knowledge of how water‐optimizing practices impact alfalfa nutrient use. The objective of this research was to evaluate how three water management strategies, and their interactions, influence alfalfa K and P concentration, uptake, uptake efficiency, and internal use efficiency. Alfalfa cultivars, deficit irrigation, and irrigation technologies were tested at two sites in Utah during 2020–2021. A single drought‐tolerant (DT) cultivar ('Ladak II') was compared to a conventional alfalfa cultivar specific to each location. Four irrigation rates (100%, uniform reductions of 25% and 50%, and a targeted reduction of ∼50%) were nested within five pivot irrigation technologies. Few alfalfa K and P nutrient dynamics responded to the interactions of cultivar and rate or technology. Nutrient responses to the irrigation technologies were strongly associated with the technology effect on alfalfa yield such that uptake efficiency was sometimes greater with low‐elevation sprinkler technologies. The K and P responses to deficit irrigation were most pronounced at the uniform or targeted 50% irrigation rate. Alfalfa cultivar had the least impact on alfalfa K and P dynamics, and the DT cultivar never improved uptake or efficiencies. These results indicate that few adjustments in K and P management may be needed with the three water optimization approaches evaluated in this study. The most notable is that K and P fertilizer input can likely be reduced with severe deficit irrigation. Core Ideas: There is a need to identify how combinations of water optimization practices influence alfalfa nutrient management.Irrigation technology and alfalfa cultivar had minor effects on alfalfa K and P dynamics.Irrigation rate had the largest impact on K and P efficiency and use with less irrigation increasing efficiency.K and P fertilizer applications can likely be reduced under deficit irrigation strategies. [ABSTRACT FROM AUTHOR]

Background: Risk for colorectal cancer may accumulate through multiple environmental factors. Understanding their effects, along with genetics, age, and family history, could allow improvements in clinical decisions for screening protocols. We aimed to extend the previous work by recalibrating an environmental risk score (e-Score) for colorectal cancer among a sample of US veteran participants of the Million Veteran Program. Methods: Demographic, lifestyle, and colorectal cancer data from 2011 to 2022 were abstracted from survey responses and health records of 227,504 male Million Veteran Program participants. Weighting for each environmental factor's effect size was recalculated using Veterans Affairs training data to create a recalibrated e-Score. This recalibrated score was compared with the original weighted e-Score in a validation sample of 113,752 (n cases = 590). Nested multiple logistic regression models tested associations between quintiles for recalibrated and original e-Scores. Likelihood ratio tests were used to compare model performance. Results: Age (P < 0.0001), education (P < 0.0001), diabetes (P < 0.0001), physical activity (P < 0.0001), smoking (P < 0.0001), NSAID use (P < 0.0001), calcium (P = 0.015), folate (P = 0.020), and fruit consumption (P = 0.019) were significantly different between colorectal cancer case and control groups. In the validation sample, the recalibrated e-Score model significantly improved the base model performance (P < 0.001), but the original e-Score model did not (P = 0.07). The recalibrated e-Score model quintile 5 was associated with significantly higher odds for colorectal cancer compared with quintile 1 (Q5 vs. Q1: 1.79; 95% CI, 1.38-2.33). Conclusions: Multiple environmental factors and the recalibrated e-Score quintiles were significantly associated with colorectal cancer cases. Impact: A recalibrated, veteran-specific e-Score could be used to help personalize colorectal cancer screening and prevention strategies. [ABSTRACT FROM AUTHOR]

Disparities in healthcare access in the United States have been associated with race and ethnicity, as well as socioeconomic factors. Because delays in imaging may result in delayed diagnosis or clinical management, we are evaluating practices within our radiology department in hopes of decreasing disparities in access to imaging. The objective of this study is to determine the disparities in time to outpatient MRI scheduling and completion by race, ethnicity, primary language, socioeconomic status, insurance and other factors at a tertiary children's hospital. After Institutional Review Board approval, we retrospectively extracted data from all outpatient MRI exams completed at our center between 10/5/2020 and 8/31/2022. Collected data included sex, age, race/ethnicity, primary language, medical complexity, insurance type, address, need for anesthesia, ordering specialty, and order acuity. We determined times to MRI scheduling or completion using mixed effects Cox regression models and determined associations between unadjusted and fully adjusted models. We analyzed 14,002 completed outpatient MRI orders from 9714 unique patients. 56.2% were White, 19.2% Hispanic, 8.4% Asian, 4.5% Black/African-American, 1.4% American Indian/Alaska Native, 0.7% Native Hawaiian/Pacific Islander, 5.7% two or more races/ethnicities, and 3.8% "Other." In fully adjusted models, there was no significant association between race/ethnicity and time to MRI scheduling and completion. In fully adjusted models, time to completion of MRI was slower among those with Medicaid (adjusted hazard ratio [95% confidence interval] of 0.92 [0.87, 0.98]), a primary language other than English (0.90 [0.82, 0.99]), non-complex chronic illness (0.72 [0.67, 0.79]), complex chronic illness (0.72 [0.67, 0.78]) and need for anesthesia (0.75 [0.71, 0.79]). At our tertiary children's hospital, time to completion of outpatient MRI was not associated with race, but was greater among those with Medicaid insurance, whose primary language was not English, and needing anesthesia. Advocating for faster prior authorization by Medicaid, utilizing our hospital's live interpreter phone number for scheduling, and incorporating greater child life support to decrease anesthesia use are considerations for decreasing these disparities, although surveying patients and families most impacted by these discrepancies will be important to identify the most promising interventions. Data are not publicly available to preserve individuals' privacy due to IRB restrictions. Data may be available upon reasonable request by contacting the corresponding author. [ABSTRACT FROM AUTHOR]

Aberrant preterm infant gut microbiota assembly predisposes to early-life disorders and persistent health problems. Here, we characterize gut microbiome dynamics over the first 3 months of life in 236 preterm infants hospitalized in three neonatal intensive care units using shotgun metagenomics of 2,512 stools and metatranscriptomics of 1,381 stools. Strain tracking, taxonomic and functional profiling, and comprehensive clinical metadata identify Enterobacteriaceae , enterococci, and staphylococci as primarily exploiting available niches to populate the gut microbiome. Clostridioides difficile lineages persist between individuals in single centers, and Staphylococcus epidermidis lineages persist within and, unexpectedly, between centers. Collectively, antibiotic and non-antibiotic medications influence gut microbiome composition to greater extents than maternal or baseline variables. Finally, we identify a persistent low-diversity gut microbiome in neonates who develop necrotizing enterocolitis after day of life 40. Overall, we comprehensively describe gut microbiome dynamics in response to medical interventions in preterm, hospitalized neonates. [Display omitted] • Antibiotics and non-antibiotic drugs govern infant gut microbiome development • Antibiotic-associated microbial shifts introduce pathogens and resistance • Hospitalized preterm infants share isogenic C. difficile and S. epidermidis • Microbial development stagnates before late-onset necrotizing enterocolitis Preterm neonates undergo numerous interventions. Thänert, Schwartz, Keen, et al. use multi-omics to show that antibiotics and other drugs alter gut microbiome development, but prenatal factors do not. Microbiome development stagnates before necrotizing enterocolitis ensues, but only among infants who experience this devastating complication after 40 days of life. [ABSTRACT FROM AUTHOR]

Scaup, including both Lesser and Greater (Aythya affinis and Aythya marila, respectively), are a grouping of populous and widespread North American diving ducks. Few influenza type A viruses (IAV) have been reported from these species despite a high prevalence of antibodies to IAV being reported. Existing virologic and serologic data indicate that IAV infection routinely occurs in scaup, yet it is unknown which IAV subtypes are linked to these infections. In this study, we aimed to gain a more complete picture of IAV natural history in Lesser and Greater Scaup from two coastal flyways in North America in 2015-18 (302 samples from California in the Pacific Flyway and 471 samples from Maryland in the Atlantic Flyway). Low prevalence of active IAV infection was detected by real-time reverse-transcription PCR in Lesser Scaup sampled in Maryland and California (2.8% and 8.1%, respectively). A single IAV (HINI) was isolated in embryonated chicken eggs from a bird sampled in California. Similarly low levels were observed in Greater Scaup in California (3.3%). Antibodies to the nucleoprotein as detected with a commercial blocking ELISA were observed in all species and flyway combinations. Antibody seroprevalence estimates were higher in adult Lesser Scaup than in juveniles at both the <0.5 (P<0.001, z=-3.582) and <0.7 serum-sample-to-negative-control absorbance thresholds (P=0.003, z=-2.996). Neutralizing antibodies to HI-H12, H14, and H15 were detected using a microtiter virus neutralization assay, with the highest prevalence of antibodies against H1 (38%), H6 (36%), and H11 (35%). The high prevalence of antibodies to IAV and evidence of previous exposure to numerous subtypes are consistent with a high level of population immunity and a low prevalence of infection. These results must be interpreted in the context of season (winter sampling), as results may vary with the annual influx of naïve juvenile birds. [ABSTRACT FROM AUTHOR]

Little is known about community-based transitions to home hospice care. We used a Straussian grounded theory approach to understand the basic social process of care transitions that patients and their caregivers use when electing hospice care. Participants were recruited from hospice agencies serving 3 counties in New York State. Data were collected through 7 interviews of patients, patient-and-caregiver dyads, and a hospice nurse (n = 10). Data were analyzed using the constant comparative method. Our results generated an emerging grounded theory of the hospice care transition processes rooted in maintaining personhood and autonomy. There were 5 contemporaneous steps: (1) recognizing futility and pursuing comfort; (2) seeking help and input as health declines; (3) shopping for the right services, overcoming obstacles, and self-referring to hospice care; (4) attending to the business of dying while living; and (5) processing and expressing emotions. Although not central to the care transition process, an additional step was identified that occurred after the transition to hospice care: planning for an uncertain future. The hospice care transition process identified in the study reveals important mechanistic targets for the development of interventions that promote patient-centered hospice care transitions in the home setting. [ABSTRACT FROM AUTHOR]

• Need innovative teaching to improve clinical judgment and RN practice readiness. • Adds new perspective to traditional clinical care plan and concept map utilization. • Clinical care worksheets followed by concept maps ideal to build clinical judgment. Nursing faculty must develop innovative strategies to foster pre-licensure student development of clinical judgment and improve practice readiness. Clinical care worksheets are traditionally long, linear assignments to help students identify various elements of patient care. Clinical concept map assignments help student identify relationships and prioritize care needs. Comparison of clinical concept maps and clinical care worksheets was performed with pre-licensure nursing students in their first clinical course. Student and faculty perceptions on clinical judgment development, learning, time spent, and preference of assignment were evaluated. Both assignment types were beneficial to student learning but in different ways. Most students perceived that concept maps contained less busywork and were more helpful to improve learning, thus preferring this assignment. Students and faculty recognized the value of building base knowledge with clinical care worksheets followed by incorporation of clinical concept maps to connect the entire patient care picture and maximize learning. We recommend using clinical care worksheets then advancing to clinical concept maps to help build clinical judgment and learning most efficiently and effectively. [ABSTRACT FROM AUTHOR]

Studies show mixed associations between adolescent social media use and anxiety. This systematic review evaluated research on social media and anxiety among adolescents for direction of associations, social media measures, demographic stratification, anxiety measures, and study quality. We searched for articles published in English before 2021 that tested associations between adolescent social media use and anxiety. Each study underwent screening and data extraction by two reviewers. Measures included direction of associations (positive, negative, null, mixed), social media measures, demographic group stratification, anxiety measures, and study quality (Strengthening of Reporting of Observational Studies in Epidemiology). A total of 32 studies were included. Over half reported positive associations between social media use and anxiety (56.3%). Problematic use was the most common social media measure type (31.4%). Positive associations with anxiety were predominantly observed for measures of problematic use (75.0%) and screen time (72.7%). Among other social media measures, 40.9% showed positive associations. A total of 18 anxiety measures were used. Four studies (12.5%) stratified findings by gender identity. The mean Strengthening of Reporting of Observational Studies in Epidemiology score was 34.1 (standard deviation = 4.3) out of 46. Future work should explore accurate social media use measures that are not based on problematic use. [ABSTRACT FROM AUTHOR]

Intraosseous (IO) administration of vancomycin at the time of total knee arthroplasty (TKA) has been shown to be safer and more effective than intravenous (IV) administration at preventing early periprosthetic joint infection. Previous studies have relied on tourniquet inflation to enhance local tissue concentrations and mitigate systemic release. A single-blinded, randomized clinical trial was performed on 20 patients (10 IV, 10 IO) undergoing primary TKA. The control (IV) group received weight-dosed vancomycin approximately 1 hour prior to the incision and weight-dosed cefazolin immediately prior to the incision. The interventional (IO) group received weight-dosed cefazolin immediately prior to the incision and 500 mg of vancomycin delivered via the IO technique at the time of the incision. Systemic samples for vancomycin levels were taken prior to the incision and at closure. During the procedure, tissue samples were taken from the distal femur, proximal tibia, and suprapatellar synovium. There were no differences in patient demographics or changes in serum creatinine from preoperative to postoperatively between groups. Significant differences in systemic vancomycin levels (ug/mL) were found at the start of the case (IV = 27.9 ± 4.9 versus IO = 0 ± 0, P =.0004) and at the end of the case (IV = 19.6 ± 2.6 versus IO = 7.8 ± 1.0, P =.001). No significant differences were seen in the average vancomycin concentration in the distal femur (IV = 61.0 ± 16.0 versus IO = 66.2 ± 12.3, P =.80), proximal tibia (IV = 52.8 ± 13.5 versus IO = 57.1 ± 17.0, P =.84), or suprapatellar synovial tissue (IV = 10.7 ± 5.3 versus IO = 9.0 ± 3.3, P =.80). There were no complications associated with vancomycin administration in either group. This study demonstrates the utility of IO vancomycin in tourniquetless TKA with similar local tissue and significantly lower systemic concentrations than IV administration. Level 1 therapeutic randomized trial. [ABSTRACT FROM AUTHOR]

To compare injury profiles of meniscal and/or chondral injury in skeletally mature (SM) with immature (SI) patients undergoing primary anterior cruciate ligament reconstruction (ACLR). Current Procedural Terminology code 29888 was queried from January 2012 to April 2020. Patients younger than 22 years who underwent primary ACLR within 6 months of injury were included. Exclusion criteria included age older than 22 years, treatment after 6 months, revision ACLR, concurrent osteotomy, or multiligamentous injury. All patients required a minimum 1-year follow-up. Demographics and intraoperative pathology were recorded. Data were analyzed for factors affecting intra-articular injury and stratified by sport. Of 927 patients (739 SM, 188 SI), the mean age was 16.63 and 14.00 years for the SM and SI cohorts, respectively (P <.001). There were more SM males (51.4%) compared to SI males (81.9%) (P <.001); however, in univariate analysis, sex did not significantly affect the rates of meniscal (P =.519) or chondral injury (P =.961). In total, 887 meniscal injuries were recorded (344 medial, 543 lateral) in 659 patients. SM sustained greater rates of medial meniscal tear (MMT) (P <.001) and underwent higher rates of partial meniscectomy (P =.022). Male sex conferred meniscal injury (95% confidence interval [CI], 0.43-0.81; P =.001). Body mass index prognosticated medial meniscal (95% CI, 1.01-1.06; P =.002) and medial chondral injuries (95% CI, 1.02-1.09; P <.001). Skeletal maturity was a superior predictor of intra-articular pathology than age for all outcomes: MMT (95% CI, 0.00-0.06; P =.002), lateral meniscal tear (95% CI, 0.00-0.75; P =.034), and chondral injury (95% CI, 0.00-0.49; P =.049). In sport subanalysis, soccer anterior cruciate ligament (ACL) injuries were most common (32.6%). Soccer and basketball athletes were more likely SM (P =.016, P =.003 respectively) with increased medial compartment pathology. Football ACL injuries occurred significantly in SI athletes (P =.001) via contact mechanisms (P =.025). Skeletal maturity affects the meniscal and chondral injury profile in ACL-injured patients. SM patients have greater risk of sustaining concomitant meniscal injury, while chondral injury profile depends more on the mechanism of injury. Mechanism of injury and skeletal maturity status affect risk of sports-related ACL rupture and ACL-concurrent pathology in young patients. Patient-specific variables influence injury profiles within each sport. Skeletal maturity rather than age predicts concomitant intra-articular injury risk. Level III, retrospective cohort study. [ABSTRACT FROM AUTHOR]

The stability of a trait refers to the extent to which its expression in a given genotype varies across environments. The more stable a trait, the less variable its expression. Grain yield stability is a central consideration in corn production to ensure that hybrids perform consistently across environments and is frequently quantified given its importance. Little attention has been paid to the stability of corn yield components, kernel number per m² (KN), and kernel weight (KW). Our hypothesis is that while previous research suggests that yield stability of commercial corn hybrids is generally consistent, the stabilities of KN and KW may exhibit significant differences, even when overall yield stability remains constant. This study evaluated the yield and yield component stabilities of 23 commercial corn hybrids conducted on-farm at five location-years in Ontario, Canada, using Finlay–Wilkinson regression. Most (61%) hybrids exhibited average yield stability with β1-values close to 1.0. But seven hybrids displaying average yield stability had KN and/or KW stabilities significantly different than average. While in absolute terms, KW was always more stable than KN across environments, the data indicate that hybrids have different mechanisms to achieve stable yields in terms of relative yield component adjustments. Overall, 14 hybrids had yield component β1-values significantly more or less stable than average. The instances where yield component β1-values differed significantly from 1.0 were almost equally divided between KN and KW. These findings support the potential for hybrid-specific corn management, that is, tailoring management practices to take advantage of hybrid variation in yield component stabilities. [ABSTRACT FROM AUTHOR]

Inpatient management of low-risk patients with venous thromboembolism (VTE) places a large resource burden on the healthcare system. Adult patients diagnosed with deep vein thrombosis (DVT) or pulmonary embolism (PE) in the emergency department (ED) have historically been hospitalized and treated with therapeutic anticoagulation. However, over the last two decades, outpatient treatment of patients with acute DVT and low risk PE has become increasingly accepted as an effective and safe option for patients given the low risk of short-term clinical deterioration. The purpose of this project was to establish a transition of care (TCM) program for patients with acute VTE presenting to the ED. The primary goals for the project included better quality patient follow-up in the Vascular Medicine Nurse Practitioner (NP) within one week and medication adherence. The second goal was increasing appropriate ED discharges for patients with low-risk VTE. Outcome metrics include the rate of early discharge of low-risk patients with VTE, follow-up in the Vascular Medicine NP clinic, and anticoagulant adherence. [ABSTRACT FROM AUTHOR]

Three new carnivorous plant cultivars are named and described: Cephalotus follicularis 'Thumbelina', Drosera 'Red Starburst', and Nepenthes 'Chonk'. [ABSTRACT FROM AUTHOR]