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Observational studies of diabetic retinopathy (DR) using electronic health record data often determine disease severity using International Classification of Disease (ICD) codes. We investigated the mechanism of missingness for DR severity based on ICD coding using the American Academy of Ophthalmology IRIS® Registry. We included all patient encounters in the registry with a DR ICD-9 or ICD-10 code between January 1, 2014 and June 30, 2021. Demographic, clinical, and practice-level characteristics were compared between encounters with specified and unspecified disease severity. Practices were divided into quartiles based on the proportion of clinical encounters with unspecified DR severity. Encounters with unspecified disease severity were associated with significantly older patient age, better visual acuity, and lower utilization of ophthalmic procedures. Higher volume practices and retina specialist practices had lower proportions of clinical encounters with unspecified disease severity. Results strongly suggest that DR disease severity related to ICD coding is missing not at random.

With temperatures expected to rise across the southern Rocky Mountains, the ability of native fishes to tolerate stream warming has become a critical concern for those tasked with preserving coldwater species. We used common garden experiments to evaluate the thermal tolerance of cutthroat trout ( Oncorhynchus clarkii) fry from five populations important to managers representing three sub-species. Critical thermal maxima (CTMs) were evaluated through traditional exposure trials, while optimal growth and ultimate upper incipient lethal temperatures (UUILTs) were examined over the course of 21-day trials at six static temperature treatments. Whereas CTMs differed among populations (mean = 27.91 °C, SD = 0.35 °C), UUILTs did not (mean = 24.40 °C, SD = 0.04 °C). Comparison of cubic temperature-growth functions to the traditional quadratic functions showed that adding a third-order term for temperature can improve model fit, and revealed substantial differences in optimal growth temperatures (15.4–18.3 °C). Knowledge of these thermal tolerance thresholds will help to predict the consequences of a warming climate, identify suitable habitats for repatriation, and inform water quality temperature standards established to protect these fish into the future.

Background Protein biomarkers may provide insight into kidney disease pathology but their use for the identification of phenotypically distinct kidney diseases has not been evaluated. Methods We used unsupervised hierarchical clustering on 225 plasma biomarkers in 541 individuals enrolled into the Boston Kidney Biopsy Cohort, a prospective cohort study of individuals undergoing kidney biopsy with adjudicated histopathology. Using principal component analysis, we studied biomarker levels by cluster and examined differences in clinicopathologic diagnoses and histopathologic lesions across clusters. Cox proportional hazards models tested associations of clusters with kidney failure and death. Results We identified three biomarker-derived clusters. The mean estimated glomerular filtration rate was 72.9 ± 28.7, 72.9 ± 33.4 and 39.9 ± 30.4 mL/min/1.73 m2 in Clusters 1, 2 and 3, respectively. The top-contributing biomarker in Cluster 1 was AXIN, a negative regulator of the Wnt signaling pathway. The top-contributing biomarker in Clusters 2 and 3 was Placental Growth Factor, a member of the vascular endothelial growth factor family. Compared with Cluster 1, individuals in Cluster 3 were more likely to have tubulointerstitial disease (P Conclusion Plasma biomarkers may identify clusters of individuals with kidney disease that associate with different clinicopathologic diagnoses, histopathologic lesions and adverse outcomes, and may uncover biomarker candidates and relevant pathways for further study.

Objectives: This mixed-methods study compared perspectives of those 'very likely' versus 'very unlikely' to receive a hypothetical COVID-19 vaccine. Methods: We used an explanatory, sequential, mixed- methods design to analyze quantitative data from a rural Pennsylvania sample. Of the 976 participants, 67 selected 'very unlikely' to get the COVID-19 vaccine. Responses to open-ended questions: "What worries you the most about the COVID 19 pandemic?" and "What are your thoughts about a potential COVID 19 vaccine?" were qualitatively compared to answers from the 67 participants who selected 'very likely' to get the COVID-19 vaccine. We used descriptive content analysis to compare themes across the 2 groups. Results: Both groups had thematic commonalities related to their concerns. Themes that were more common among those 'very unlikely' to get vaccinated included concern for politics overriding vaccine safety and rushed vaccine development timeline, whereas themes related to hope and optimism about vaccination were exclusive to the 'very likely' group. Conclusions: Shared beliefs existed across groups with different intents to vaccinate; yet, identification with vaccine spokespersons differed. Messaging campaigns can use these commonalities to address vaccine hesitancy.

ImportanceSpecialist palliative care benefits patients undergoing medical treatment of cancer; however, data are lacking on whether patients undergoing surgery for cancer similarly benefit from specialist palliative care.ObjectiveTo determine the effect of a specialist palliative care intervention on patients undergoing surgery for cure or durable control of cancer.Design, Setting, and ParticipantsThis was a single-center randomized clinical trial conducted from March 1, 2018, to October 28, 2021. Patients scheduled for specified intra-abdominal cancer operations were recruited from an academic urban referral center in the Southeastern US.InterventionPreoperative consultation with palliative care specialists and postoperative inpatient and outpatient palliative care follow-up for 90 days.Main Outcomes and MeasuresThe prespecified primary end point was physical and functional quality of life (QoL) at postoperative day (POD) 90, measured by the Functional Assessment of Cancer Therapy–General (FACT-G) Trial Outcome Index (TOI), which is scored on a range of 0 to 56 with higher scores representing higher physical and functional QoL. Prespecified secondary end points included overall QoL at POD 90 measured by FACT-G, days alive at home until POD 90, and 1-year overall survival. Multivariable proportional odds logistic regression and Cox proportional hazards regression models were used to test the hypothesis that the intervention improved each of these end points relative to usual care in an intention-to-treat analysis.ResultsA total of 235 eligible patients (median [IQR] age, 65.0 [56.8-71.1] years; 141 male [60.0%]) were randomly assigned to the intervention or usual care group in a 1:1 ratio. Specialist palliative care was received by 114 patients (97%) in the intervention group and 1 patient (1%) in the usual care group. Adjusted median scores on the FACT-G TOI measure of physical and functional QoL did not differ between groups (intervention score, 46.77; 95% CI, 44.18-49.04; usual care score, 46.23; 95% CI, 43.08-48.14; P = .46). Intervention vs usual care group odds ratio (OR) was 1.17 (95% CI, 0.77-1.80). Palliative care did not improve overall QoL measured by the FACT-G score (intervention vs usual care OR, 1.09; 95% CI, 0.75-1.58), days alive at home (OR, 0.87; 95% CI, 0.69-1.11), or 1-year overall survival (hazard ratio, 0.97; 95% CI, 0.50-1.88).Conclusions and RelevanceThis randomized clinical trial showed no evidence that early specialist palliative care improves the QoL of patients undergoing nonpalliative cancer operations.Trial RegistrationClinicalTrials.gov Identifier: NCT03436290

As COVID-19 quickly spread across the globe, social media memes (i.e., typically humorous or cute images related to popular culture) about life in a pandemic also spread across the Internet. We conducted a between-subjects online experiment (N = 748) to assess how viewing memes during this pandemic era may influence audiences' stress and coping. In terms of psychological responses, we found that meme viewing (vs. nonmeme content) was associated with stronger cuteness responses, higher levels of reported humor, more positive emotions, and lower levels of information processing. However, meme viewing was not associated with state anxiety, COVID-19-related stress, or COVID-19-related coping efficacy. Furthermore, because memes generated positive emotions that were in turn related to increased COVID-19 coping efficacy, a path analysis found that viewing memes, as compared with nonmeme content, indirectly increased COVID-19 coping efficacy. Looking at the effects of meme type, we found that memes featuring animals were rated as cuter than memes with humans, though the former engendered lower information processing and predicted lower coping efficacy than did human memes. Cuteness responses, generally, were associated with decreased coping efficacy. In contrast, meme captions related to COVID-19 were related to deeper information processing and lower levels of COVID-19-related stress than were captions unrelated to COVID-19. Information processing was, in turn, associated with increased coping efficacy. This research demonstrates that memes, particularly those that relate to a highly stressful context, may help support efforts to cope with the stressor. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Compared with viewing other media content, viewing memes resulted in Internet users experiencing greater humor and positive emotions. When Internet users viewed memes with captions focused on COVID-19, they reported lower COVID-19-related stress levels than if they viewed memes focused on other topics, suggesting that tackling a stressor directly with humorous popular media content can benefit our emotional state and stress levels. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

This is the accepted manuscript version of the work published in its final form as Govender, P., Müller, R., Singh, K., Reddy, V., Eyermann, C. J., Fienberg, S., Ghorpade, S. R., Koekemoer, L., Myrick, A., Schnappinger, D., Engelhart, C., Meshanni, J., Byl, J. A. W., Osheroff, N., Singh, V., Chibale, K., & Basarab, G. S. (2022). Spiropyrimidinetrione DNA Gyrase Inhibitors with Potent and Selective Antituberculosis Activity.Journal of Medicinal Chemistry,65(9), 6903-6925. https://doi.org/10.1021/acs.jmedchem.2c00266 Deposited byshareyourpaper.organdopenaccessbutton.org. We've taken reasonable steps to ensure this content doesn't violate copyright. However, if you think it does you can request a takedown by emailinghelp@openaccessbutton.org.

We compared mercury bioaccumulation in triploid and diploid walleye (Sander vitreus) in Narraguinnep Reservoir, Colorado, USA, and made several hypotheses that sex- and ploidy-specific differences in the allocation of energy towards reproductive development would affect mercury bioaccumulation. We tested our hypotheses with linear regression and a bioenergetics model informed by field data. We found diploid walleye had 28%–31% higher mercury concentrations on average than triploids, but there were no differences between sexes of the same ploidy. Triploids of mature age exhibited minimal gonadal development when compared to diploids. After accounting for reproductive investment, the bioenergetics model accounted for most of the observed difference in average mercury concentration between ploidies for females. Conversely, the energetic cost of producing testes was low, and gonadal development could not explain observed patterns for males. Costs associated with elevated swimming activity and metabolism by diploid males relative to other groups could explain the difference but requires further investigation. The use of triploid fish in stocking programs could prove useful for reducing mercury in fish destined for human consumption.

UNSTRUCTURED Digital mental health solutions are now well recognized as critical to solving the global mental health crisis. As research accelerates, it is now clear that solutions ranging from computer-based therapy programs to virtual reality headsets and smartphone apps to large language model chatbots are of interest, feasible, and hold exciting potential to improve mental health. This research should now consider the next generation of scientific and clinical questions regarding if these new approaches are equitable, valid, effective, implementable, efficacious, and even cost-effective. This paper outlines several of the new frontiers for the next generation of research and introduces JMIR Publications’ partnership with the Society of Digital Psychiatry to further advance these aims.

Abdominal aortic aneurysms (AAA) are typically asymptomatic. When symptomatic, AAA may present as a chief concern of musculoskeletal hip and low back pain. Assessment in the orthopaedic clinic should focus on a holistic examination of the patient.

Spaceflight has several detrimental effects on human and rodent health. For example, liver dysfunction is a common phenotype observed in space-flown rodents, and this dysfunction is partially reflected in transcriptomic changes. Studies linking transcriptomics with liver dysfunction rely on tools which exploit correlation, but these tools make no attempt to disambiguate true correlations from spurious ones. In this work, we use a machine learning ensemble of causal inference methods called the Causal Research and Inference Search Platform (CRISP). It was specifically developed to predict causal features of a binary response variable in high-dimensional input. We used CRISP to search gene expression data for genes truly correlated with a lipid density phenotype using transcriptomic and histological data from the NASA Space Biology Open Science Data Repositories (OSDR). Our approach identified genes and molecular targets not predicted by previous traditional system biology approaches. These genes are likely to play a pivotal role in the liver dysfunction observed in space-flown rodents, and this work opens the door to identifying novel countermeasures for space travel.

Physical inactivity has become an increasingly important concern for public health. "Fitspiration" social media posts may influence attitudes and intentions toward exercising. An online survey (

BACKGROUND: The Unified Medical Language System (UMLS) maps relationships between and within >100 biomedical vocabularies, including Current Procedural Terminology (CPT) codes, creating a powerful knowledge resource which can accelerate clinical research. METHODS: We used synonymy and concepts relating hierarchical structure of CPT codes within the UMLS, (1) guiding surgical experts in expanding the Operative Stress Score (OSS) from 565 originally rated CPT codes to additional, 1,853 related procedures; (2) establishing validity of the association between the added OSS ratings and 30-day outcomes in VASQIP (2015–2018). RESULTS: The UMLS Metathesaurus and Semantic Network was converted into an interactive graph database (https://github.com/dbmi-pitt/UMLS-Graph) delineating ontology relatedness. From this UMLS-graph, the CPT hierarchy was queried obtaining all paths from each code to the hierarchical apex. Of 1,853 added ratings, 43% and 76% were siblings and cousins of original OSS CPT codes. Of 857,577 VASQIP cases (mean age, 64±11years; 91% male; 75% white), 786,122 (92%) and 71,455 (8%) were rated in the original and added OSS. Compared to original, added OSS cases included more females (14% vs 9%) and frail patients (25% vs 19%) undergoing high stress procedures (11% vs 8%; all P

The first installment of this three-part series provided a procedure for quickly recording acceptable fluorescence spectra with classic commercial spectrofluorometers for most samples in common 1-cm pathlength cuvettes. Part 2 described how to correct for instrument response so data can be compared properly between laboratories. This part describes sample-specific concerns that could require modifications of our basic procedure to prevent our data from being inconsistent.

Background and aims Patients undergoing evaluation for liver transplantation face heavy burdens of symptoms, healthcare utilization, and mortality. In other similarly ill populations, specialist palliative care has been shown to benefit patients, but specialist palliative care is infrequently utilized for liver transplantation patients. This project aims to describe the potential benefits of and barriers to specialist palliative care integration in the liver transplantation process. Approach and results We performed qualitative analysis of transcripts from provider focus groups followed by a community engagement studio of patients and caregivers. Focus groups consisted of 14 palliative care specialists and 10 hepatologists from 11 institutions across the US and Canada. The community engagement studio comprised patients and caregivers of patients either currently on the liver transplant wait list or recently post-transplant. The focus groups identified 19 elements of specialist palliative care that could benefit this patient population, including exploring patient's illness understanding and expectations; comprehensive assessment of physical symptoms; discussing patient values; providing caregiver support; providing a safe space to discuss non-curative options; and anticipatory guidance about likely next steps. Identified barriers included role boundaries, differences in clinical cultures, limitations of time and staff, competing goals and priorities, misconceptions about palliative care, limited resources, changes in transplant status, and patient complexity. Community studio participants identified many of the same opportunities and barriers. Conclusions This study found that hepatologists, palliative care specialists, patients, and caregivers identified areas of care for liver transplant patients that specialist palliative care can improve and address.

During the COVID-19 pandemic, the Virtual Training Academy (VTA) was established to rapidly develop a contact-tracing workforce for California. Through June 2021, more than 10 000 trainees enrolled in a contact-tracing or case investigation course at the VTA. To evaluate program effectiveness, we analyzed trainee pre- and postassessment results using the Wilcoxon signed-rank test. There was a statistically significant (P

Part 1 of this three-part series provided a procedure for quickly recording acceptable fluorescence spectra with classic commercial spectrofluorometers for most samples in common 1-cm-pathlength cuvettes. Part 2 of the series describes instrument-specific concerns that require modifications to our initial procedure if we want spectra that can be accurately reproduced in other laboratories. Part 3 will discuss how the sample itself can make reproducibility between instruments challenging.

Scholarship on human rights diplomacy (HRD)—efforts by government officials to engage publicly and privately with their foreign counterparts—often focuses on actions taken to “name and shame” target countries because private diplomatic activities are unobservable. To understand how HRD works in practice, we explore a campaign coordinated by the US government to free twenty female political prisoners. We compare release rates of the featured women to two comparable groups: a longer list of women considered by the State Department for the campaign; and other women imprisoned simultaneously in countries targeted by the campaign. Both approaches suggest that the campaign was highly effective. We consider two possible mechanisms through which expressive public HRD works: by imposing reputational costs and by mobilizing foreign actors. However, in-depth interviews with US officials and an analysis of media coverage find little evidence of these mechanisms. Instead, we argue that public pressure resolved deadlock within the foreign policy bureaucracy, enabling private diplomacy and specific inducements to secure the release of political prisoners. Entrepreneurial bureaucrats leveraged the spotlight on human rights abuses to overcome competing equities that prevent government-led coercive diplomacy on these issues. Our research highlights the importance of understanding the intersection of public and private diplomacy before drawing inferences about the effectiveness of HRD.

Supplemental material, sj-docx-1-asp-10.1177_00037028231181593 for Filter Fluorometer Calibration Without the Fluorometer by Caitlyn M. English, Zechariah B. Kitzhaber, Kazi Ragib I. Sanim, Nikolaos Vitzilaios, Michael E. Hodgson, Tammi L. Richardson and Michael L. Myrick in Applied Spectroscopy

Urgent public attention is needed to make sense of the expanding use of algorithmic and data-driven technologies in the mental health context. On the one hand, well-designed digital technologies that offer high degrees of public involvement and can be used to promote good mental health and crisis support in communities. They can be employed safely, reliably and in a trustworthy way, including to help build relationships, allocate resources, and promote human flourishing. On the other hand, there is clear potential for harm. The list of ‘data harms’ in the mental health context is growing longer, in which people are in worse shape than they would be had the activity not occurred. Examples in this report include the hacking of psychotherapeutic records and the extortion of victims, algorithmic hiring programs that discriminate against people with histories of mental healthcare, and criminal justice and border agencies weaponising data concerning mental health against individuals. Issues also come up not where technologies are misused or faulty, but where technologies like biometric monitoring or surveillance work as intended, and where the very process of ‘datafying’ and digitising individuals’ behaviour – observing, recording and logging them to an excessive degree – carry the potential for inherent harm. Part 1 of this report charts the rise of algorithmic and data-driven technology in the mental health context. It outlines issues which make mental health unique in legal and policy terms, particularly the significance of involuntary or coercive psychiatric interventions in any analysis of mental health and technology. The section makes a case for elevating the perspective of people with lived experience of profound psychological distress, mental health conditions, psychosocial disabilities, and so on, in all activity concerning mental health and technology. Part 2 looks at prominent themes of accountability. Eight key themes are discussed – fairness and non-discrimination, human control of technology, professional responsibility, privacy, accountability, safety and security, transparency and explainability, and promotion of public interest. International law, and particularly the Convention on the Rights of Persons with Disabilities, is also discussed as a source of data governance. Case studies throughout show the diversity of technological developments and draw attention to their real-life implications. Many case studies demonstrate instances of harm. The case studies also seek to ground discussion in the actual agonies of existing technology rather than speculative worries about technology whose technical feasibility is often exaggerated in misleading and harmful ways (for example, Elon Musk’s claim that his ‘AI-brain chips will “solve” autism and schizophrenia’).

Supplemental Material for Public Reactions to Secret Negotiations in International Politics by Rachel Myrick in Journal of Conflict Resolution

Recent legislation facilitates veterans' ability to receive non-Veterans Affairs (VA) surgical care. However, contemporary data comparing the quality and safety of VA and non-VA surgical care are lacking.To compare perioperative outcomes among veterans treated in VA hospitals with patients treated in private-sector hospitals.This cohort study took place across 8 noncardiac specialties in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) and American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from January 1, 2015, through December 31, 2018. Multivariable log-binomial modeling was used to evaluate the association between VA vs private sector care settings and 30-day mortality. Unmeasured confounding was quantified using the E-value. Patients 18 years and older undergoing a noncardiac procedures were included.Surgical care in either a VA or private sector setting.Primary outcome was 30-day postoperative mortality. Secondary outcome was failure to rescue, defined as a postoperative death after a complication.Of 3 910 752 operations (3 174 274 from NSQIP and 736 477 from VASQIP), 1 498 984 (92.1%) participants in NSQIP were male vs 678 382 (47.2%) in VASQIP (mean difference, -0.449 [95% CI, -0.450 to -0.448]; P .001), and 441 894 (60.0%) participants in VASQIP were frail or very frail vs 676 525 (21.3%) in NSQIP (mean difference, -0.387 [95% CI, -0.388 to -0.386]; P .001). Overall, rates of 30-day mortality, complications, and failure to rescue were 0.8%, 9.5%, and 4.7%, respectively, in NSQIP (n = 3 174 274 operations) and 1.1%, 17.1%, and 6.7%, respectively in VASQIP (736 477) (differences in proportions, -0.003 [95% CI, -0.003 to -0.002]; -0.076 [95% CI, -0.077 to -0.075]; 0.020 [95% CI, 0.018-0.021], respectively; P .001). Compared with private sector care, VA surgical care was associated with a lower risk of perioperative death (adjusted relative risk, 0.59 [95% CI, 0.47-0.75]; P .001). This finding was robust in multiple sensitivity analyses performed, including among patients who were frail and nonfrail, with or without complications, and undergoing low and high physiologic stress procedures. These findings were also consistent when year was included as a covariate and in nonparsimonious modeling for patient-level factors. Compared with private sector care, VA surgical care was also associated with a lower risk of failure to rescue (adjusted relative risk, 0.55 [95% CI, 0.44-0.68]). An unmeasured confounder (present disproportionately in NSQIP data) would require a relative risk of 2.78 [95% CI, 2.04-3.68] to obviate the main finding.VA surgical care is associated with lower perioperative mortality and decreased failure to rescue despite veterans having higher-risk characteristics. Given the unique needs and composition of the veteran population, health policy decisions and budgetary appropriations should reflect these important differences.

Background The CDC lists multidrug-resistant PA as a Serious Threat pathogen causing 32,200 hospital infections and 2,700 deaths in the US in 2017. PA resistance is frequent with antibiotic monotherapies. SPR206 is a next generation polymyxin that, in a first in human study, was generally safe and well tolerated at the potential therapeutic dose of 100 mg IV Q8h. The aim of this study was to quantify the dose-range PA killing activity of SPR206 monotherapy in a hollow fiber infection model (HFIM) and to assess if the combination of SPR206 and MEM more effectively reduces bacterial burden and prevents development of resistance than either drug alone. Methods Agar dilution MICs and mutation frequencies (MFs) for SPR206, PMB, & MEM were performed for PA ATCC 27853. A 10-day HFIM dose range study simulating the free PK profiles for SPR206 (50 – 600 mg IV Q8h) quantified PA killing and possible regrowth. A HFIM study compared single vs combination SPR206 100 mg IV Q8h over 1h and MEM 2g IV Q8h over 1h regimens for enhanced PA killing and resistance suppression. Results The SPR206, PMB, & MEM MICs were 0.5, 0.5, and 0.25 mg/L, respectively. The MFs for SPR206 and PMB to 3x, 5x and 8x MIC were -6.2, -6.9, & -7.7 log CFU and -5.3, -6.4, & -7.7 log CFU, respectively. The MF for 3x MIC of MEM was -6.8 log CFU. In a dose-range HFIM, simulated regimens for 50 – 600 mg IV Q8h showed a dose-response effect, with 2.9 – 7.3 log CFU/mL reductions in PA seen at 5h. All regimens had regrowth by isolates with SPR206 MICs of 1 – 8 mg/L. In a HFIM study simulating the SPR206 and MEM clinical regimens, alone and in combination, SPR206 alone killed 5 log CFU/mL of PA at 5h, followed by regrowth. MEM alone killed 3.5 log CFU/mL of PA at 5h, with maximum kill seen on Day 4, followed by regrowth. SPR206 plus MEM killed 0.8 log CFU/mL more PA at 5h vs SPR206 alone and had undetectable PA counts by day 4. Combination therapy prevented regrowth (see figure). Conclusion Conclusions: SPR206 (100 mg IV Q8h) killed 5 log CFU/mL of PA at 5h, but regrowth ensued. SPR206 plus MEM produced 0.8 log CFU/mL more killing of PA at 5h. The killing activity of the 2-drug regimen combined with its resistance prevention effect resulted in undetectable PA counts by Day 4 of treatment. Disclosures Arnold Louie, MD, Curza, Inc.: Grant/Research Support|Prokaryotics: Grant/Research Support|Spero Therapeutics: Grant/Research Support Nicole Cotroneo, B.S., Spero Therapeutics: Employee|Spero Therapeutics: Stocks/Bonds Weiguo Liu, M.D., Spero Therapeutics: Grant/Research Support David Brown, M.B.A., Curza, Inc.: Grant/Research Support|Prokaryotics: Grant/Research Support|Spero Therapeutics: Grant/Research Support Jenny Myrick, B.S., Spero Therapeutics: Grant/Research Support George Drusano, M.D., Curza: Advisor/Consultant|Curza: Grant/Research Support|Prokaryotics: Grant/Research Support|Spero Therapeutics: Grant/Research Support.

Background The obese population is more likely to develop degenerative joint disease requiring total joint arthroplasty (TJA) and also experience increased rates of adverse post-surgical outcomes. This study assessed whether a quantifiable weight loss prior to TJA had any impact on perioperative and 30-day outcomes in obese patients. Method Using the American College of Surgeons-National Surgical Quality Improvement Program database, obese patients who underwent total hip or total knee arthroplasty and lost at least 10% of their total body weight prior to surgery were identified and matched to other obese individuals undergoing the same procedures without weight loss. Perioperative outcomes, including operative time, length of stay, discharge destination, or 30-day adverse events, including complications, re-admissions, re-operations, and mortality, were then compared using conditional Logistic regression analysis. Results Analysis showed no difference between the two groups in terms of operative time, length of stay, discharge destination, or 30-day adverse events, including complications, re-admissions, re-operations, and mortality. Conclusion The results of this study suggest that weight loss alone in the preoperative period may not be sufficient to mitigate the effects of obesity on immediate post-TJA outcomes.

The app evaluation framework of the American Psychiatric Association (APA) has emerged as an adaptable tool for those seeking to navigate the ever-growing space of mental health apps. The authors describe a meeting convened in December 2019 to refine the APA framework. The expert panel comprised 16 individuals across health care fields, with representation from psychiatry, psychology, social work, nursing, clinical informatics, peer support specialists, and individuals with lived mental health experience. This meeting resulted in an update to the APA framework with the addition of clearer question descriptions and the release of an eight-question screener that may be useful in clinical settings.

Phenotypic whole cell high-throughput screening of a ∼150,000 diverse set of compounds against Mycobacterium tuberculosis (Mtb) in cholesterol-containing media identified 1,3-diarylpyrazolyl-acylsulfonamide 1 as a moderately active hit. Structure-activity relationship (SAR) studies demonstrated a clear scope to improve whole cell potency to MIC values of

Relationships between risk perceptions, emotions, and stress are well-documented, as are interconnections between stress, emotion, and media use. During the early COVID-19 pandemic, the public responded psychologically to the threat posed by the pandemic, and frequently utilized media for information and entertainment. However, we lack a comprehensive picture of how perceived risk, emotion, stress, and media affected each other longitudinally during this time. Further, although response to the pandemic was highly politicized, research has yet to address how partisan affiliation moderated relationships between risk, emotion, stress, and media use over time. This three-wave (N = 1021) panel study assessed the interplay of risk, emotion, stress, and media use for Americans with different political affiliations between March and May of 2020. Findings indicate that perceived risk, emotion, and stress at Time 1 predicted media use at Time 2, with predictors varying by type of media. Use of entertainment media and social/mobile media predicted later stress (Time 3), but news consumption did not. Later risk perceptions (Time 3) were not influenced by media use at Time 2. The predictors and consequences of different types of media use were notably different for Republicans and Democrats. In particular, risk perceptions predicted greater news use among Democrats but greater entertainment media use among Republicans. Moreover, social/mobile media use resulted in perceiving the risks of COVID-19 as less serious for Republicans while increasing stress over time for Democrats.