Search

The attacks of September 11, 2001, put terrorism at the forefront of the American political landscape. Donald Trump played into these fears of terrorism through his political rhetoric during his presidency, particularly targeting international students as "threats" to the nation. However, we argue that the labeling of international students as security threats was not started after 9/11 nor invented by Trump. Through historical records and accounts across decades of policies related to this issue, we seek to answer two questions: How has the U.S. government monitored visa policies and programs for international students? How have U.S. national policies evolved to view international students as national security threats? We found that mistrust of this population has been embedded throughout U.S. immigration history and that federal tracking policies emerged incrementally from long-held security concerns. The essay closes with a discussion on why the entire population of international students should not be scapegoated due to these fears.

The typical process for assessing inter-rater reliability is facilitated by training raters within a research team. Lacking is an understanding if inter-rater reliability scores "between" research teams demonstrate adequate reliability. This study examined inter-rater reliability between 16 researchers who assessed fundamental motor skills using the Test of Gross Motor Development-3rd edition. Total score agreement (ICC = 0.363) and locomotor subscale agreement (ICC = 0.383) were "very poor," while ball skills subscale agreement (ICC = 0.478) was "poor." Consistencies of total (ICC = 0.757), locomotor (ICC = 0.730), and ball skills (ICC = 0.746) scores were "fair." Component percentage agreement ranged from 40.5% to 96.2%. These data suggest that there are significant differences in how different research groups evaluate fundamental motor skills based on the subjective nature of scoring. Consistency and agreement among users need to be addressed in motor development research to allow for direct comparisons across studies that use process-oriented measures.

This investigatory study sought to explore the range and variation of well-being initiatives on a select cross-section of college campuses across the United States and in Canada. This whitepaper seeks to highlight innovative practices that may inspire institutions to consider new ways of promoting well-being for both students and employees. In this whitepaper, we report findings from 10 participating higher education institutions across three major categories: student-serving programs, employee-serving programs, and hybrid programs. The qualitative data collected from key stakeholder interviews and focus groups were analyzed for trends between and across institutions. Importantly, the results of this study are intended to be hypothesis-generating as opposed to hypothesis-testing. In an effort to describe the state of the field with respect to both common and innovative practices the findings have generated additional questions for further research. Several themes emerged from this study: (1) Campuses have not adopted a universally-accepted definition of well-being; (2) While many institutions are using iterations of the wellness wheel and its various dimensions (e.g. physical, emotional, intellectual, social, spiritual, financial) to guide their efforts, there is not a dominant model for structuring or measuring well-being initiatives on campus; (3) There appears to be a systematic shift from use of the term "wellness" to "well-being"; (4) While many institutions are still utilizing traditional health education practices, there appears to be a movement toward more systemic, environmental approaches to well- being, including structural, organizational, and financial strategies, in addition to a range of policy initiatives; (5) There is a range of engagement in well-being initiatives, with significant variance based on institutional philosophy; and (6) Many institutions are designing well-being initiatives that address health disparities--particularly among underrepresented or marginalized populations.

Varying rates of complications have been reported for prehospital sedation with ketamine, and the relationship to dosing has not been studied on a large scale. We evaluated the association between prehospital ketamine dosing and rates of intubations and other adverse events in patients with behavioral emergencies. Using the 2018/2019 ESO public-use research datasets, we included all non-traumatic, adult behavioral and drug-related EMS encounters with ketamine administration. Based on consensus guidelines, we stratified patients into "above" and "at/below" the maximum dosing for sedation (2 mg/kg IV/IO or 5 mg/kg IM) using the highest single dose of ketamine given. We created propensity scores for matched subjects using 1:1 propensity score matching. Using logistic regression, we compared rates of intubation and other airway interventions, antipsychotic coadministration, improvement reported by EMS, hypoxia, hypotension, and cardiac arrest between the two groups. We included 2383 patients: 478 in the above and 1905 in the at/below dose group. Above-dose ketamine was associated with a higher rate of intubation or supraglottic airway placement (6.4% v 3.3%, OR 2.0, 95% CI 1.00–3.90). Other airway interventions were similar (40.0% v 40.0%, OR 1, 95% CI 0.80–1.30). The above-dose group also showed a higher rate of improvement noted by EMS clinicians (92.5% v 88.7%, OR 1.6, 95% CI 1.01–2.40). The rates of antipsychotic coadministration, hypoxia, hypotension, and cardiac arrest were similar between the cohorts. Patients given ketamine doses above consensus recommendations for sedation appeared more likely to receive prehospital intubation but not more likely to experience other adverse events. [ABSTRACT FROM AUTHOR]

The use of genetic markers, specifically Short Tandem Repeats (STRs), has been a valuable tool for identifying persons of interest. However, the ability to analyze additional markers including Single Nucleotide Polymorphisms (SNPs) and Insertion/Deletion (INDELs) polymorphisms allows laboratories to explore other investigative leads. INDELs were chosen in this study because large panels can be differentiated by size, allowing them to be genotyped by capillary electrophoresis. Moreover, these markers do not produce stutter and are smaller in size than STRs, facilitating the recovery of genetic information from degraded samples. The INDEL Ancestry Informative Markers (AIMs) in this study were selected from the 1000 Genomes Project based on a fixation index (FST) greater than 0.50, high allele frequency divergence, and genetic distance. A total of 25 INDEL-AIMs were optimized and validated according to SWGDAM guidelines in a five-dye multiplex. To validate the panel, genotyping was performed on 155 unrelated individuals from four ancestral groups (Caucasian, African, Hispanic, and East Asian). Bayesian clustering and principal component analysis (PCA) were performed revealing clear separation among three groups, with some observed overlap within the Hispanic group. Additionally, the PCA results were compared against a training set of 793 samples from the 1000 Genomes Project, demonstrating consistent results. Validation studies showed the assay to be reproducible, tolerant to common inhibitors, robust with challenging casework type samples, and sensitive down to 125 pg. In conclusion, our results demonstrated the robustness and effectiveness of a 25 loci INDEL system for ancestry inference of four ancestries commonly found in the United States. [ABSTRACT FROM AUTHOR]

We evaluated the psychometric properties of the Trauma Informed Practice Scales – School Counseling Programs Version scores using item response theory with a sample of 270 school counselors. Participants ranged in age from 24 to 69 years (M = 42.82, SD = 9.96). Participants identified as female (81.5%), male (14.1%) or unreported (4.4%,). Participants' racial and ethnic backgrounds were: White (79.3%), African American or Black (5.6%), Multiracial (5.2%), Latino/Hispanic/Spanish (4.8%), American Indian/Alaskan Native (0.4%), Other (0.4%), or unreported (4.4%). Participants from 14 states completed an online survey, which included demographics questions and the TIPS-SCP. After removing the poorly performing items, partial credit model estimates explained 58.63% of the variance in participant responses. We found psychometric evidence to support its ability to capture trauma informed practices in schools and school counseling programs. The TIPS-SCP is a brief instrument to provide school counselors with a self-assessment of their trauma informed practices. The TIPS-SCP can aid school counselors in making data-informed decisions about immediate and future incorporations of integrating trauma informed practices into their schools and school counseling programs. [ABSTRACT FROM AUTHOR]

Objectives: We previously described derivation and validation of the emergency department trigger tool (EDTT) for adverse event (AE) detection. As the first step in our multicenter study of the tool, we validated our computerized screen for triggers against manual review, establishing our use of this automated process for selecting records to review for AEs. Methods: This is a retrospective observational study of visits to three urban, academic EDs over 18 months by patients ≥ 18 years old. We reviewed 912 records: 852 with at least one of 34 triggers found by the query and 60 records with none. Two first‐level reviewers per site each manually screened for triggers. After completion, computerized query results were revealed, and reviewers could revise their findings. Second‐level reviewers arbitrated discrepancies. We compare automated versus manual screening by positive and negative predictive values (PPVs, NPVs), present population trigger frequencies, proportions of records triggered, and how often manual ratings were changed to conform with the query. Results: Trigger frequencies ranged from common (>25%) to rare (1/1000) were comparable at U.S. sites and slightly lower at the Canadian site. Proportions of triggered records ranged from 31% to 49.4%. Overall query PPV was 95.4%; NPV was 99.2%. PPVs for individual trigger queries exceeded 90% for 28–31 triggers/site and NPVs were >90% for all but three triggers at one site. Inter‐rater reliability was excellent, with disagreement on manual screening results less than 5% of the time. Overall, reviewers amended their findings 1.5% of the time when discordant with query findings, more often when the query was positive than when negative (47% vs. 23%). Conclusions: The EDTT trigger query performed very well compared to manual review. With some expected variability, trigger frequencies were similar across sites and proportions of triggered records ranged 31%–49%. This demonstrates the feasibility and generalizability of implementing the EDTT query, providing a solid foundation for testing the triggers' utility in detecting AEs. [ABSTRACT FROM AUTHOR]

This article analyzes the People's Republic of China's elite-making higher education policies that began in the early 1990s, notably with the 211 Project and then 985 Project, which led to the formation of the C9 League, a group of nine leading institution's dubbed China's "Ivy League." This elite grouping is compared with other Chinese universities in terms of global rankings from 2003 to 2015 to ascertain the separation by these top tiered institutions. Furthermore, the C9 League will be compared with other global elite coalitions in the United States, Canada, Australia, and the United Kingdom over the same period. University rankings, despite considerable criticism, have provided the Chinese leadership with key benchmarks for their vision of world-class higher education. This article finds that the C9 League has made some separation from other Chinese universities and has also caught up with its Western peers (notably passing Canada's U15) in terms of international rankings.

Villainification is the process of creating single actors as the faces of systemic harm, with those hyperindividualized villains losing their ordinary characteristics. Like heroification, there is a simplified portrayal of historical actors, but villainification has particularly harmful consequences. We suggest that villainification obscures the way in which evil operates through everyday actions and unquestioned structures because of the focus on the whim of one person. Although it is unfortunate that we do not often see how we can inadvertently help others and make systemic change, it is very disturbing when we fail to see our own part in the suffering of others. This article critiques one-dimensional portrayals of evildoers in K-12 social studies and popular sentiment and offers a framework via the political theory of Hannah Arendt to educate for a sensibility of interconnected responsibility among members of a society instead of blaming one person for systemic harm or diffusing blame into an amorphous entity (e.g., "society").

BACKGROUND AND OBJECTIVES: Children hospitalized with a mental health crisis often receive pharmacologic restraint for management of acute agitation. We examined associations between pharmacologic restraint use and race and ethnicity among children admitted for mental health conditions to acute care nonpsychiatric children's hospitals. METHODS: We performed a retrospective cohort study of children (aged 5-≤18 years) admitted for a primary mental health condition from 2018 to 2022 at 41 US children's hospitals. Pharmacologic restraint use was defined as parenteral administration of medications for acute agitation. The association of race and ethnicity and pharmacologic restraint was assessed using generalized linear multivariable mixed models adjusted for clinical and demographic factors. Stratified analyses were performed based on significant interaction analyses between covariates and race and ethnicity. RESULTS: The cohort included 61 503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81; 95% confidence interval [CI], 0.72-0.92), Asian (aOR, 0.82; 95% CI, 0.68-0.99), or other race and ethnicity (aOR, 0.68; 95% CI, 0.57-0.82) were less likely to receive pharmacologic restraint. There was no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males (aORs, 0.49-0.68), except for Hispanic males, and not found in females (aORs, 0.83-0.93). Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth (aOR, 0.65; 95% CI, 0.47-0.91). CONCLUSIONS: Non-Hispanic Black children were significantly more likely to receive pharmacologic restraint. More research is needed to understand reasons for these disparities, which may be secondary to implicit bias and systemic and interpersonal racism. [ABSTRACT FROM AUTHOR]

Black Americans bear the greatest burden of HIV, accounting for 43% of new diagnoses. Yet Black Americans also evidence the lowest utilization rates of Pre-Exposure Prophylaxis (PrEP), a highly effective biomedical strategy for preventing HIV infection. Predictors of PrEP acceptance vary; however, little is known about psychological distress, such as post-traumatic stress disorder (PTSD) symptoms, as a predictor. In this cross-sectional study, n = 195 Black Americans, evidencing behaviors found in the research literature to heighten risk for contracting HIV (e.g. sex work, injection drug use) ages 18-29, 55% cisgender women, 39.5% cisgender men, 3% transgender/non-binary, completed audio-computer-assisted self-interviews. Bivariate analyses indicated significant positive associations between PTSD symptoms and PrEP acceptance and self-confidence. In multinomial logistic regression analyses, after controlling for Perceived HIV Risk, participants had a higher likelihood of responding they 'probably would' take PrEP (as opposed to 'definitely would not' take PrEP) if they reported higher levels of PTSD symptoms. Post-hoc analyses revealed a curvilinear relationship between PTSD symptoms and PrEP acceptance with those reporting the highest level of PTSD in the sample having slightly lower PrEP acceptance than those reporting moderately high levels of PTSD. Findings are discussed in the context of the negative impacts of high levels of PTSD and potential positive adaptations subsequent to moderate levels of PTSD that could be relevant to advances in HIV prevention efforts. [ABSTRACT FROM AUTHOR]

Introduction: The opioid epidemic in the United States is an ongoing public health crisis that is in part fueled by excessive prescribing by physicians. Percutaneous nephrolithotomy (PCNL) is a procedure that conventionally involves opioid prescriptions for adequate post-operative pain control. We aimed to evaluate the feasibility of a non-opioid pain regimen by evaluating post-operative outcomes in PCNL patients discharged without opioids. Materials and methods: As a quality improvement measure to reduce opioid consumption our department began routinely prescribing oral ketorolac instead of oxycodone–acetaminophen for pain control after PCNL. We retrospectively compared patients undergoing PCNL who had received ketorolac prescriptions (NSAID) to those who received oxycodone–acetaminophen prescriptions (NARC). Demographic, operative, and post-operative factors were obtained and compared in both groups. Peri-operative factors and demographics were compared using either Chi-squared tests, Mann–Whitney U tests. Surgical outcomes were compared between the two groups using Chi-squared tests and Fisher's exact tests. Multivariate logistic regression analysis was performed to determine whether ketorolac use was an independent predictor of post-surgical pain-related encounters. Primary outcome was unplanned pain-related healthcare encounters inclusive of office phone calls, unscheduled office visits, and emergency department (ED) visits. Secondary outcome measures were non-pain-related healthcare encounters, hospital readmissions, pain-related rescue medications prescribed, and post-op complications. Results: There were similar demographics and peri-operative characteristics amongst patients in both cohorts. There was no significant difference identified between NSAID and NARC regarding unplanned pain-related encounters (8/70, 11.4% vs. 10/70, 14.3%, p = 0.614). However, NARC experienced more unplanned phone calls (42, 60% vs. 24, 34.3%, p = 0.004). Multivariate analysis revealed only prior stone surgery was predictive of pain-related encounters after PCNL (p = 0.035). Conclusion: Our results show that there were no significant differences in pain-related encounters between those who received ketorolac and oxycodone–acetaminophen following PCNL. A non-opioid pathway may mitigate the potential risk associated with opioid prescription without compromising analgesia. Prospective comparative studies are warranted to confirm feasibility. [ABSTRACT FROM AUTHOR]

We evaluate the determinants of officer support for their agency participating in the 1033 Program: a program that facilitates the flow of military hardware to local law enforcement agencies. In doing so, we provide insight into why officers demand such equipment, which, in turn, may partially explain patterns of program participation and equipment usage. We utilize a series of random forest models to examine survey data collected from officers in a large police department, finding that being White and exhibiting animus toward minority communities are highly predictive of officer support across models. Our findings validate long‐held public concerns regarding the distributional patterns and consequences of 1033 transfers: concerns that have led to a number of proposed policy changes at the state and federal levels meant to restrict program usage (e.g., EO‐13688, HR‐1694, MO HB‐330). Policy makers should consider how out‐group animus may drive distributional patterns and usage when considering policy reform. [ABSTRACT FROM AUTHOR]

Barberry (Berberis thunbergii) is a widely established invasive shrub in temperate forests of the northeastern United States with the potential to alter soil arthropod communities through changes to soil nutrient cycling and acidity.We compared soil arthropod taxa and functional feeding groups between invaded and nearby control areas in a paired observational survey.Community ordination analysis suggested minimal differences between barberry and control samples. In contrast, pairwise differences revealed elevated densities of multiple taxa in barberry‐invaded soils.Among taxa that were able to be defined by functional feeding group and were collected at higher densities under barberry, all were detritivores. For example, barberry‐invaded soils harboured an average of 40% more Isopoda and more than twice as many Diplopoda per unit dry compared with control samples. Differences we observed between barberry and control samples despite the limited study spatiotemporal scope demonstrate the potential for invasions to restructure soil arthropod communities.Observed patterns potentially reflects elevated leaf litter decomposition rates associated with the invasion and results also highlight the need to integrate site‐specific environmental attributes when assessing the impact of invading plants on soil ecosystems. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is a range of pathologies arising from fat accumulation in the liver in the absence of excess alcohol use or other causes of liver disease. Its complications include cirrhosis and liver failure, hepatocellular carcinoma, and eventual death. NAFLD is the most common cause of liver disease globally and is estimated to affect nearly one-third of individuals in the United States. Despite knowledge that the incidence and prevalence of NAFLD are increasing, the pathophysiology of the disease and its progression to cirrhosis remain insufficiently understood. The molecular pathogenesis of NAFLD involves insulin resistance, inflammation, oxidative stress, and endoplasmic reticulum stress. Better insight into these molecular pathways would allow for therapies that target specific stages of NAFLD. Preclinical animal models have aided in defining these mechanisms and have served as platforms for screening and testing of potential therapeutic approaches. In this review, we will discuss the cellular and molecular mechanisms thought to contribute to NAFLD, with a focus on the role of animal models in elucidating these mechanisms and in developing therapies. [ABSTRACT FROM AUTHOR]

Background Female underrepresentation in oncology clinical trials can result in outcome disparities. We evaluated female participant representation in US oncology trials by intervention type, cancer site, and funding. Materials and Methods Data were extracted from the publicly available Aggregate Analysis of ClinicalTrials.gov database. Initially, 270,172 studies were identified. Following the exclusion of trials using Medical Subject Heading terms, manual review, those with incomplete status, non-US location, sex-specific organ cancers, or lacking participant sex data, 1650 trials consisting of 240,776 participants remained. The primary outcome was participation to prevalence ratio (PPR): percent females among trial participants divided by percent females in the disease population per US Surveillance, Epidemiology, and End Results Program data. PPRs of 0.8-1.2 reflect proportional female representation. Results Females represented 46.9% of participants (95% CI, 45.4-48.4); mean PPR for all trials was 0.912. Females were underrepresented in surgical (PPR 0.74) and other invasive (PPR 0.69) oncology trials. Among cancer sites, females were underrepresented in bladder (odds ratio [OR] 0.48, 95% CI 0.26-0.91, P =.02), head/neck (OR 0.44, 95% CI 0.29-0.68, P <.01), stomach (OR 0.40, 95% CI 0.23-0.70, P <.01), and esophageal (OR 0.40 95% CI 0.22-0.74, P <.01) trials. Hematologic (OR 1.78, 95% CI 1.09-1.82, P <.01) and pancreatic (OR 2.18, 95% CI 1.46-3.26, P <.01) trials had higher odds of proportional female representation. Industry-funded trials had greater odds of proportional female representation (OR 1.41, 95% CI 1.09-1.82, P =.01) than US government and academic-funded trials. Conclusions Stakeholders should look to hematologic, pancreatic, and industry-funded cancer trials as exemplars of female participant representation and consider female representation when interpreting trial results. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorders (AUD) are prevalent and often go untreated. Patients are commonly screened for AUD in primary care, but existing treatment programs are failing to meet demand. Digital therapeutics include novel mobile app-based treatment approaches which may be cost-effective treatment options to help fill treatment gaps. The goal of this study was to identify implementation needs and workflow design considerations for integrating digital therapeutics for AUD into primary care. Methods: We conducted qualitative interviews with clinicians, care delivery leaders, and implementation staff (n = 16) in an integrated healthcare delivery system in the United States. All participants had experience implementing digital therapeutics for depression or substance use disorders in primary care. Interviews were designed to gain insights into adaptations needed to optimize existing clinical processes, workflows, and implementation strategies for use with alcohol-focused digital therapeutics. Interviews were recorded and transcribed and then analyzed using a rapid analysis process and affinity diagramming. Results: Qualitative themes were well represented across health system staff roles. Participants were enthusiastic about digital therapeutics for AUD, anticipated high patient demand for such a resource, and made suggestions for successful implementation. Key insights regarding the implementation of digital therapeutics for AUD and unhealthy alcohol use from our data include: (1) implementation strategy selection must be driven by digital therapeutic design and target population characteristics, (2) implementation strategies should seek to minimize burden on clinicians given the large numbers of patients with AUD who are likely to be interested in and eligible for digital therapeutics, and (3) digital therapeutics should be offered alongside many other treatment options to accommodate individual patients' AUD severity and treatment goals. Participants also expressed confidence that previous implementation strategies used with other digital therapeutics such as clinician training, electronic health record supports, health coaching, and practice facilitation would be effective for the implementation of digital therapeutics for AUD. Conclusions: The implementation of digital therapeutics for AUD would benefit from careful consideration of the target population. Optimal integration requires tailoring workflows to meet anticipated patient volume and designing workflow and implementation strategies to meet the unique needs of patients with varying AUD severity. Contributions to the literature: Provides insights regarding the best ways to implement app-based treatments for alcohol use disorder (AUD) in primary care. Represents the perspectives of a variety of stakeholders including care delivery leaders, clinicians, and implementation staff. Identifies the following recommendations to improve the implementation of digital therapeutics for AUD: (1) plan for high patient volume, (2) support teams during implementation, and (3) account for individual patient needs. [ABSTRACT FROM AUTHOR]

After a long decline, the Labor Force Participation Rate (LFPR) of older men in the United States leveled off in the 1980s, and began to increase in the late 1990s. We examine how changes in Social Security rules affected these trends. We attribute only a small portion of the decline from the 1960s-80s to the increasing generosity of Social Security over this period. Increases in the Full Retirement Age and the Delayed Retirement Credit explain one quarter to one half of the recent increase in the LFPR. Increasing educational attainment and increasing LFPR of married women also contributed to the recent rise. (Contains 10 figures, 6 tables, and 36 footnotes.)

Context: Appalachia has been characterized by its poverty, a factor associated with tuberculosis, yet little is known about the disease in this region. Purpose: To determine whether Appalachian tuberculosis risk factors, trends, and rates differ from the rest of the United States. Methods: Analysis of tuberculosis cases reported to the Centers for Disease Control and Prevention's National Tuberculosis Surveillance System (NTSS) within the 50 states and the District of Columbia from 1993 through 2005. Results: The 2005 rate of tuberculosis in rural Appalachia was 2.1/100,000, compared to 2.7/100,000 in urban Appalachia. Urban non-Appalachia had a 2005 tuberculosis rate of 5.4/100,000. Over the 13-year period, tuberculosis rates fell in Appalachia at an annual rate of 7.8%. In one age group (15- to 24-year-olds) the rates increased at an annual rate of 2.8%. Foreign-born Hispanics were the largest racial/ethnic group in this age group. When private providers gave exclusive care for tuberculosis disease, Appalachians were less likely to complete therapy in a timely manner when compared to non-Appalachians (OR 0.6, 95% CI 0.5-0.7). Conclusions: Tuberculosis rates and trends are similar in urban and rural Appalachia. It is crucial for public health officials in Appalachia to address the escalating TB rate among 15- to 24-year-olds by focusing prevention efforts on the growing numbers of foreign-born cases. Due to the increased risk of treatment failure among Appalachians who do not seek care from the health department, public health authorities must ensure completion of treatment for patients who seek private providers.

Using item response theory, we examined the psychometric properties of scores on the Trauma-Informed Practice Scales – Supervision Version (TIPS-SV) – a unidimensional measure of supervisees' perceptions of their supervisors' adherence to trauma-informed supervision – in a sample of 312 supervisees. Implications for research and supervision practice are discussed. [ABSTRACT FROM AUTHOR]

Field performance of herbaceous annual plants is largely determined by plant architecture and flowering performance. A Petunia axillaris × P. exserta F7 recombinant inbred line population was grown in four field environments across the United States, and phenotyped for seven plant habit and flowering-related traits: plant height (Height), maximum (MaxWid) and minimum (MinWid) plant width, vigor, compactness (Comp), flowering canopy coverage (Flow) and flower color retention (ColorRet). Robust QTL (rQTL; QTL detected in two or more environments) were identified for all traits except minimum canopy width and were distributed across five of the seven Petunia chromosomes. The largest effect rQTL explained up to 23.8, 19.7, 16.7, 16, 25.7, and 36.9% of the observed phenotypic variation for Flow, Vigor, Comp, ColorRet, Height and MaxWid, respectively. rQTL for Flow, Comp, Height, and MaxWid colocalized on Chr 2, indicating this region could be particularly useful for mining candidate genes underlying important field performance traits in petunia. [ABSTRACT FROM AUTHOR]

Many professional chaplaincy organizations in the United States have board certified healthcare chaplains since the 1920s and documented how they have adapted their process as the profession has grown. In 2019, the Association of Professional Chaplains and the National Association of Catholic Chaplains sought the perspectives of key stakeholders about professional chaplaincy board certification. This study reports the results from 50 semi-structured interviews with certification candidates, certification committee members, and chaplaincy managers in the United States. Participants discussed the preparation of the certification application, the certification interview, the ease and difficulty of certification competencies, and the evolving workforce. This study demonstrated divergent views on many aspects of board certification, but participants predominately respected and valued the process. Chaplains with varying levels of experience discussed how board certification strengthens multidisciplinary respect and collaboration. Participants reported difficulties with competencies that required translating between theory and practice. [ABSTRACT FROM AUTHOR]

The article focuses on analyzing the characteristics of motorcycle-involved crashes in the U.S. from 2011 to 2021, aiming to provide insights for injury prevention and policy changes. Topics discussed include demographic trends among motorcyclists, factors contributing to crashes such as alcohol involvement and helmet use, and regional variations in crash occurrence.

South American camelids (SACs) have become increasingly popular as livestock and companion animals in the Midwestern United States. With increased ownership, postmortem evaluations and samples available for diagnostic assessment are being submitted more frequently to veterinary diagnostic laboratories. We searched archived pathology records at the Wisconsin Veterinary Diagnostic Laboratory (WVDL) between 2009–2019 for SAC cases. Postmortem records from 166 alpacas and 27 llamas were included, with an average of 1.42 diagnoses per animal. The overall average diagnostic rate was 79.8%. Abortion and neonatal cases (fetus to 1-wk-old) had the lowest diagnostic rate (33.3%) and was the only group with a diagnostic rate statistically significantly lower than the average. The most common diagnoses were gastrointestinal parasitism and suboptimal nutritional status or inanition; 78% of cases diagnosed with suboptimal nutritional status were also parasitized. The gastrointestinal parasites identified most frequently were Eimeria sp. and strongyles, especially Nematodirus sp. Our findings may aid allocation of diagnostic resources to better serve regional SAC populations and provide a framework for practitioners who send samples to laboratories for analysis. Submission of whole bodies, euthanized animals, fresh tissue, and inclusion of placental tissues in abortion cases are recommended for optimal diagnostic outcome. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies illustrate significant increases in pelvic fracture incidence; however, there is a paucity of information on the incidence of osteoporotic pelvic ring injuries based on large-scale examinations of geographically and ethnically diverse populations. This study addresses the epidemiology of osteoporotic pubic ramus fractures in the United States and details differences in incidence rates with respect to age, gender, and race. Materials and Methods: National Electronic Injury Surveillance System (NEISS) data between 2002 and 2019 was gathered for individuals aged 60 and above presenting to U.S. emergency departments with ramus fractures. Incidence rates for ramus injuries were calculated using adjusted U.S. Census Bureau estimates of population. Fracture incidences were calculated for age, gender, and race strata. Results: The overall incidence rate of pubic ramus fractures in the United States between 2002 and 2019 was 13.47 per 1,000,000 people 60 years and older (95% confidence limit: 9.92-17.01). The incidence of pubic ramus fractures for females in the US was 21.71 (16.08-27.34). Rates of ramus fracture increased overall (P <.001) and for both genders between the ages of 60 and 100, though the rate increase was significantly greater in females than in males (P <.001). In terms of race, incidence was highest Asian females and lowest in Native American and Pacific Islander men. Discussion/Conclusion: : As the first national study addressing the epidemiology of ramus injuries in the United States, this work reveals these injuries comprise a significant fracture risk in the elderly. In addition, it highlights gender and ethnic strata that are more susceptible to these injuries. [ABSTRACT FROM AUTHOR]

This investigatory study sought to explore the range and variation of well-being initiatives on a select cross-section of college campuses across the United States and in Canada. This whitepaper seeks to highlight innovative practices that may inspire institutions to consider new ways of promoting well-being for both students and employees. In this whitepaper, we report findings from 10 participating higher education institutions across three major categories: student-serving programs, employee-serving programs, and hybrid programs. The qualitative data collected from key stakeholder interviews and focus groups were analyzed for trends between and across institutions. Importantly, the results of this study are intended to be hypothesis-generating as opposed to hypothesis-testing. In an effort to describe the state of the field with respect to both common and innovative practices the findings have generated additional questions for further research. Several themes emerged from this study: (1) Campuses have not adopted a universally-accepted definition of well-being; (2) While many institutions are using iterations of the wellness wheel and its various dimensions (e.g. physical, emotional, intellectual, social, spiritual, financial) to guide their efforts, there is not a dominant model for structuring or measuring well-being initiatives on campus; (3) There appears to be a systematic shift from use of the term "wellness" to "well-being"; (4) While many institutions are still utilizing traditional health education practices, there appears to be a movement toward more systemic, environmental approaches to well- being, including structural, organizational, and financial strategies, in addition to a range of policy initiatives; (5) There is a range of engagement in well-being initiatives, with significant variance based on institutional philosophy; and (6) Many institutions are designing well-being initiatives that address health disparities—particularly among underrepresented or marginalized populations. [ABSTRACT FROM AUTHOR]

Racial discrepancies among patients in the United States undergoing orthopedic trauma surgery have not been investigated. Issues relating to socioeconomic status and access to care have played a role in the health outcomes of racial groups. In orthopedic surgery, recent joint arthroplasty literature has shown significant racial differences in the use of elective joint arthroplasty. Furthermore, studies also suggest increased rates of early complication in racial minority groups. In general, little information exists on the postoperative outcomes of racial minority groups in orthopedic surgery. We retrospectively queried the National Surgical Quality Improvement Program database to identify patients undergoing orthopedic trauma surgery between 2008 and 2016. Patients of all ages who underwent orthopedic trauma surgery were identified using Current Procedural Terminology codes. Patients classified as either Black or White were included in the study. Demographic data, comorbidities, and basic surgical data were compared between the groups. Adverse outcomes in the initial 30 days postoperative were also examined. Higher frequencies of deep wound infection (0.5% vs 0.3%, P=.002) were noted among Black patients, with decreased mortality (0.3% vs 0.6%, P=.004) and postoperative transfusion (2.7% vs 3.8%, P<.001) rates, compared with White patients. Clear differences exist in the demographic, surgical, and outcome data between Black and White patients undergoing orthopedic trauma surgery. More epidemiological studies are required to further investigate racial differences in orthopedic trauma surgery. [Orthopedics. 2022;45(2):71-76.]. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is underdiagnosed and undertreated in medical settings, in part due to a lack of AUD assessment instruments that are reliable and practical for use in routine care. This study evaluates the test‐retest reliability of a patient‐report Alcohol Symptom Checklist questionnaire when it is used in routine care, including primary care and mental health specialty settings. Methods: We performed a pragmatic test‐retest reliability study using electronic health record (EHR) data from Kaiser Permanente Washington, an integrated health system in Washington state. The sample included 454 patients who reported high‐risk drinking on a behavioral health screen and completed two Alcohol Symptom Checklists 1 to 21 days apart. Subgroups of these patients who completed both checklists in primary care (n = 271) or mental health settings (n = 79) were also examined. The primary measure was an Alcohol Symptom Checklist on which patients self‐reported whether they experienced each of the 11 AUD criteria within the past year, as defined by the Diagnostic and Statistical Manual of Mental Disorders‐5th edition (DSM‐5). Results: Alcohol Symptom Checklists completed in routine care and documented in EHRs had excellent test‐retest reliability for measuring AUD criterion counts (ICC = 0.79, 95% CI: 0.76 to 0.82). Test‐retest reliability estimates were also high and not significantly different for the subsamples of patients who completed both checklists in primary care (ICC = 0.82, 95% CI: 0.77 to 0.85) or mental health settings (ICC = 0.74, 95% CI: 0.62 to 0.83). Test‐retest reliability was not moderated by having a past two‐year AUD diagnosis, nor by the age or sex of the patient completing it. Conclusions: Alcohol Symptom Checklists can reliably and pragmatically assess AUD criteria in routine care among patients who screen positive for high‐risk drinking. The Alcohol Symptom Checklist may be a valuable tool in supporting AUD‐related care and monitoring AUD criteria longitudinally in routine primary care and mental health settings. [ABSTRACT FROM AUTHOR]

President Biden and Congress are advancing an ambitious tax and spending package that will help to combat climate change and address historic wealth inequality. Nonetheless, more can and should be done to combat climate change and to limit global warming to 2 degrees Celsius above pre-industrial temperatures -- a goal we are not currently on track to achieve according to the latest UN studies. Among other regulatory tools, the United States regulates greenhouse gas (GHG) emitting activities through taxing provisions. The utility of regulating through tax policy in the context of climate change is two-fold. First, as others have noted, a tax is particularly well suited to make GHG-emitting activities comparatively more expensive in a way that can force taxpayers to bear the externalized social costs of GHG-emitting activities resulting in climate change. Second, tax policy can be crafted to redistribute wealth and income in light of the disproportionate (or regressive) burden that is likely to fall on low-income and marginalized communities as a result of climate change harms -- such as extreme weather events, food insecurity, and migration patterns. The Code does not currently adequately fulfill either of these regulatory purposes. In part, this may be because of the view shared by many that there is a conflict between regulating to limit GHG emissions through a carbon tax and regulating to advance progressive policies. This Article uses the nonrefundable tax credit for carbon capture, utilization, and sequestration in section 45Q of the Code, and an implicit regressive carbon tax on the public created by failing to curb climate change, to urge an end to arguments pitting a carbon tax or improved Pigouvian subsidies (such as a revised section 45Q as discussed herein) against progressive goals. The time has arrived to move past a perpetuation of current policy -- which is a poor tool for curbing GHG emissions and which is entrenching regressive results of climate change -- and to implement a policy that is more transparently designed to both actualize green goals and achieve progressive results. [ABSTRACT FROM AUTHOR]

Purpose: Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors. Methods: This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels. Results: Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI). Conclusion: Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention. [ABSTRACT FROM AUTHOR]

This article explores the ways in which gendered processes play out through the professionalization of chaplains in healthcare settings. It describes how gender manifests within organizations, how literature addresses the role of gender in professionalization, and considerations for professional chaplaincy. Fifty interviews with U.S. chaplains were analyzed to explore the relationship between the professionalization of chaplaincy and male and female positionality. Although gender theory moves beyond binary conceptualizations of gender, all participants in this study self‐identified as male or female and our data were analyzed accordingly. The language and professionalization efforts used by male and female chaplains mirror the gendered cultural expectations associated with these groups. This article notes how the patriarchal structures of both religious and healthcare institutions are inextricably embedded in the chaplaincy profession; thus, female chaplains have found it necessary to challenge these systems from the beginning. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To characterize patterns of surgery among pediatric patients during terminal hospitalizations in children's hospitals. METHODS: We reviewed patients ≤20 years of age who died among 4 424 886 hospitalizations from January 2013-December 2019 within 49 US children's hospitals in the Pediatric Health Information System database. Surgical procedures, identified by International Classification of Diseases procedure codes, were classified by type and purpose. Descriptive statistics characterized procedures, and hypothesis testing determined if undergoing surgery varied by patient age, race and ethnicity, or the presence of chronic complex conditions (CCCs). RESULTS: Among 33 693 terminal hospitalizations, the majority (n = 30 440, 90.3%) of children were admitted for nontraumatic causes. Of these children, 15 142 (49.7%) underwent surgery during the hospitalization, with the percentage declining over time (P < .001). When surgical procedures were classified according to likely purpose, the most common were to insert or address hardware or catheters (31%), explore or aid in diagnosis (14%), attempt to rescue patient from mortality (13%), or obtain a biopsy (13%). Specific CCC types were associated with undergoing surgery. Surgery during terminal hospitalization was less likely among Hispanic children (47.8%; P < .001), increasingly less likely as patient age increased, and more so for Black, Asian American, and Hispanic patients compared with white patients (P < .001). CONCLUSIONS: Nearly half of children undergo surgery during their terminal hospitalization, and accordingly, pediatric surgical care is an important aspect of end-of-life care in hospital settings. Differences observed across race and ethnicity categories of patients may reflect different preferences for and access to nonhospital-based palliative, hospice, and end-of-life care. [ABSTRACT FROM AUTHOR]

The article examines pedestrian fatalities in the United States between 2011 and 2021, underscoring the influence of speed on the severity of injuries. Utilizing the National Highway Transportation Safety Administration's Fatality and Injury Reporting System Tool (FIRST), the study analyzes data related to fatal and nonfatal pedestrian crashes, encompassing demographics, blood alcohol levels, impaired statuses of pedestrians and drivers and crash locations.

Dog importation data from 2018–2020 were evaluated to ascertain whether the dog importation patterns in the United States changed during the COVID-19 pandemic, specifically with regard to denial of entry. Dog denial of entry reports from January 1, 2018, to December 31, 2020, stored within the Centers for Disease Control and Prevention (CDC) Quarantine Activity Reporting System (QARS), were reviewed. Basic descriptive statistics were used to analyze the data. Reason for denial, country of origin, and month of importation were all examined to determine which countries of origin resulted in the largest number of denials, and whether there was a seasonal change in importations during the COVID-19 pandemic (2020), compared to previous years (2018 and 2019). During 2020, CDC denied entry to 458 dogs. This represents a 52% increase in dogs denied entry compared to the averages in 2018 and 2019. Dogs were primarily denied entry for falsified rabies vaccination certificates (56%). Three countries exported 74% of all dogs denied entry into the United States, suggesting that targeted interventions may be needed for certain countries. Increased attempts to import inadequately vaccinated dogs from countries with canine rabies in 2020 may have been due to the increased demand for domestic pets during the COVID-19 pandemic. Educational messaging should highlight the risk of rabies and the importance of making informed pet purchases from foreign entities to protect pet owners, their families, and the public. [ABSTRACT FROM AUTHOR]

Substantial, involved, and expensive efforts to promote the dissemination of scientific knowledge and career interest in Science, Technology, Engineering, and Mathematics (STEM) are enthusiastically supported by many scientific, federal, and local organizations. The articulated underlying goals for these efforts include an enhanced public understanding of science and science-related policy, an increased diversity in STEM careers, and an increase in the future STEM workforce. This effort is primarily driven by an underperformance of the United States that includes poor test performance and limited number of students pursuing STEM degrees. Despite this investment, attitudes toward STEM have not notably changed. The goal of this project was to determine students' attitudes toward STEM in response to a previously established scientific outreach event. This event was used to address three common goals in STEM outreach: STEM literacy, diversity and inclusion, and career preparedness. We found there was a notable difference in the attitudes toward scientific activities and interest in pursuing a "Science Career" after participation in this event. Strikingly, interest in hypothesis development, the keystone of all STEM disciplines, was the least liked of all the activities offered during the event. Our data suggest that events designed to enhance interest in pursuing a STEM career may benefit from different elements compared with events designed to increase understanding of STEM literacy concepts, such as hypothesis development. [ABSTRACT FROM AUTHOR]

In a fair and equitable criminal justice system, one's race should not influence their sentencing outcomes. Research studies conducted in the United States often report evidence that ethnic minorities are at an increased risk for receiving more punitive punishments at the time of their sentencing. The existing scholarship, however, has largely focused on assessing differences between Black and Hispanic defendants in relation to White defendants. There has been far less academic exploration of potential sentencing disparities among other less populated ethnic groups, including American Indians. To address this gap in knowledge, we use data collected from the United States Sentencing Commission to test whether American Indians receive different sentencing outcomes when compared to other racial groups. Our study findings indicate that American Indian defendants are more likely to be sentenced to prison than White, Black, and Hispanic defendants, but among those incarcerated, American Indians received similar sentence lengths to Whites. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has had a significant impact on the economy, health care, and society as a whole. To prevent the spread of infection, local governments across the United States issued mandatory lockdowns and stay-at-home orders. In the surgical world, elective cases ceased to help "flatten the curve" and prevent the infection from spreading to hospital staff and patients. We explored the effect of the cancellation of these procedures on trainee operative experience at our high-volume, multihospital neurosurgical practice. Methods: Our department cancelled all elective cases starting March 16, 2020, and resumed elective surgical and endovascular procedures on May 11, 2020. We retrospectively reviewed case volumes for 54 days prelockdown and 54 days postlockdown to evaluate the extent of the decrease in surgical volume at our institution. Procedure data were collected and then divided into cranial, spine, functional, peripheral nerve, pediatrics, and endovascular categories. Results: Mean total cases per day in the prelockdown group were 12.26 ± 7.7, whereas in the postlockdown group, this dropped to 7.78 ± 5.5 (P = 0.01). In the spine category, mean cases per day in the prelockdown group were 3.13 ± 2.63; in the postlockdown group, this dropped to 0.96 ± 1.36 (P < 0.001). In the functional category, mean cases per day in the prelockdown group were 1.31 ± 1.51, whereas in the postlockdown group, this dropped to 0.11 ± 0.42 (P < 0.001). For cranial (P = 0.245), peripheral nerve (P = 0.16), pediatrics (P = 0.34), and endovascular (P = 0.48) cases, the volumes dropped but were not statistically significant decreases. Conclusion: The impact of this outbreak on operative training does appear to be significant based solely on statistics. Although the drop in case volumes during this time can be accounted for by the pandemic, it is important to understand that this is a multifactorial effect. Further studies are needed for these results to be generalizable and to fully understand the effect this pandemic has had on trainee operative experience. [ABSTRACT FROM AUTHOR]

Background: Evidence regarding the initiation of antipsychotic medications across individual cholinesterase inhibitors (ChEIs) to manage the behavioral symptoms of dementia is lacking. Objectives: This study compared the risk of initiation of antipsychotic medications among older adults with dementia treated with the ChEIs donepezil, rivastigmine, or galantamine. Methods: This retrospective cohort study used multiyear (2013–2015) Medicare claims data involving Parts A, B, and D. The study sample included community-dwelling older adults (aged ≥ 65 years) with a diagnosis of dementia. The study identified new users of ChEIs and followed them for up to 180 days for antipsychotic initiation. The ChEIs included donepezil, rivastigmine, and galantamine, whereas antipsychotics included typical and atypical agents. Donepezil was used as the reference category as it is the most commonly used ChEI and only acts on acetylcholinesterase, whereas both rivastigmine and galantamine have dual mechanisms of action. Multivariable Cox proportional hazards regression compared the risk of and time to antipsychotic initiation among the three ChEIs, adjusting for other risk factors. Results: The study cohort consisted of 178,441 older adults with dementia who were new users of ChEIs. A total of 23,433 (15.14%) donepezil users, 4114 (19.04%) rivastigmine users, and 324 (15.77%) galantamine users initiated antipsychotics. The mean time to antipsychotic initiation among patients who received antipsychotics was 109.29 ± 69.72 days for donepezil users, 96.70 ± 71.60 days for rivastigmine users, and 104.15 ± 72.53 days for galantamine users. The Cox regression analysis showed that rivastigmine (adjusted hazard ratio [aHR] = 1.27; 95% confidence interval [CI], 1.20–1.34) was significantly associated with antipsychotic initiation compared with donepezil, whereas no significant difference was observed between galantamine and donepezil (aHR = 0.98; 95% CI, 0.81–1.20). Conclusion: The study found a 27% increased risk of antipsychotic initiation among users of rivastigmine compared with donepezil users. There was no difference between galantamine and donepezil for antipsychotic initiation. Although the limitations of the study should be considered, the results suggest that donepezil or galantamine may be more appropriate treatments for older patients with dementia, to minimize antipsychotic use. [ABSTRACT FROM AUTHOR]

Aquatic plants (macrophytes) are important components of freshwater ecosystems and serve numerous functions, both physical and biological, that help to structure aquatic communities. However, invasive macrophytes may negatively alter ecosystem properties. Non-native invasive species have been identified as a major cause of biodiversity loss and the increasing prevalence of invasive species has prompted studies to help understand their impacts and to conserve biodiversity. Studying mechanisms of invasion also gives ecological insight into how communities are structured and assembled. This study examined a set of potential factors influencing invasion including biotic resistance, exposure, and water depth using mixed-effects models on macrophyte survey data collected from twenty-nine lakes across the United States. The results of this study indicated that biotic resistance measured from native species richness, exposure due to fetch, and water depth interact, often in non-linear ways to influence probability of invasive species occurrence at a given location; however, models explained a relatively low percentage of variation in probabilities. It is likely that strong predictive principles governing macrophyte invasions do not exist, at least among comparisons across a range of ecosystem types and environmental conditions. However, ecologists should continue to search for general patterns within definable ecosystem units to increase understanding about factors contributing to invasibility. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated possible differences in glioblastoma (GBM) survival attributable to ethnicity. The goal of this study was to quantify oncogenic differences and evaluate the overall survival (OS) and progression-free survival (PFS) differences in GBM patients across race/ethnicity using both population-based surveillance and institutional data sets from the United States (US) and Mexico. Retrospective cohort study comprising the Texas Cancer Registry (TCR, n = 4134) and referral institutions located in US (n = 254) and Mexico (n = 47) were evaluated. Primary outcomes include OS and PFS. Oncogenic differences attributable to ethnicity were assessed. IDH1/IDH2 status was evaluated by sequencing in US and Mexico samples. Kaplan-Meier and Cox proportional hazards regression for survival analysis. A total of 4134 GBM patients were identified from the TCR data set, ethnicity comparison demonstrated that Hispanic patients were diagnosed at a significantly younger age compared to non-Hispanic white patients (NHW) (median: 58 vs. 62, P < 0.001) and had improved OS (hazard ratio: 0.82, P < 0.001). In the oncogenic analysis, we observed a significant enrichment of IDH1/IDH2 mutations in Mexican Hispanic patients compared to US Hispanic patients (29.8% vs. 7.9%, P = 0.012); IDH2 mutations drove this difference. Post-progression survival was significantly shorter in patients from Mexico than US (3.0 vs. 11.4 months; P < 0.001), while OS remained similar. IDH2 mutations are more prevalent in Mexican Hispanic individuals compared to US individuals and may be a crucial contributor to the previously reported survival benefit of Hispanic individuals in large population databases. These findings are critical for both screening of IDH2 mutations and targeted interventions in GBM. [ABSTRACT FROM AUTHOR]

Collaborations between American and Chinese universities have been critical to global knowledge production. Chinese students accounted for over a third of all international students in the United States prior to COVID-19, but the pandemic paused most global mobility in 2020. We argue that this international mobility to the United States will not fully recover if larger stressors are left unaddressed. First, relations between the United States and China have deteriorated in recent years, especially under the Trump administration, with growing suspicion against Chinese researchers and scholars. Second, viral acts of violence and anti-Asian incidents have painted the United States as unsafe for Chinese students. Finally, given the mismanaged response to the pandemic, it may take years before trust returns from abroad. While the Biden administration has promised to curb some of these issues, the perceptions of the United States may have been permanently altered, especially as China has improved its domestic higher education sector in recent years. [ABSTRACT FROM AUTHOR]

Volatile nitrogen oxides (N2O, NO, NO2, HONO, ...) can negatively impact climate, air quality, and human health. Using soils collected from temperate forests across the eastern United States, we show microbial communities involved in nitrogen (N) cycling are structured, in large part, by the composition of overstory trees, leading to predictable N‐cycling syndromes, with consequences for emissions of volatile nitrogen oxides to air. Trees associating with arbuscular mycorrhizal (AM) fungi promote soil microbial communities with higher N‐cycle potential and activity, relative to microbial communities in soils dominated by trees associating with ectomycorrhizal (ECM) fungi. Metagenomic analysis and gene expression studies reveal a 5 and 3.5 times greater estimated N‐cycle gene and transcript copy numbers, respectively, in AM relative to ECM soil. Furthermore, we observe a 60% linear decrease in volatile reactive nitrogen gas flux (NOy ≡ NO, NO2, HONO) as ECM tree abundance increases. Compared to oxic conditions, gas flux potential of N2O and NO increase significantly under anoxic conditions for AM soil (30‐ and 120‐fold increase), but not ECM soil—likely owing to small concentrations of available substrate (NO3‐) in ECM soil. Linear mixed effects modeling shows that ECM tree abundance, microbial process rates, and geographic location are primarily responsible for variation in peak potential NOy flux. Given that nearly all tree species associate with either AM or ECM fungi, our results indicate that the consequences of tree species shifts associated with global change may have predictable consequences for soil N cycling. [ABSTRACT FROM AUTHOR]

Over half of global rivers and streams lack perennial flow, and understanding the distribution and drivers of their flow regimes is critical for understanding their hydrologic, biogeochemical, and ecological functions. We analyzed nonperennial flow regimes using 540 U.S. Geological Survey watersheds across the contiguous United States from 1979 to 2018. Multivariate analyses revealed regional differences in no‐flow fraction, date of first no flow, and duration of the dry‐down period, with further divergence between natural and human‐altered watersheds. Aridity was a primary driver of no‐flow metrics at the continental scale, while unique combinations of climatic, physiographic and anthropogenic drivers emerged at regional scales. Dry‐down duration showed stronger associations with nonclimate drivers compared to no‐flow fraction and timing. Although the sparse distribution of nonperennial gages limits our understanding of such streams, the watersheds examined here suggest the important role of aridity and land cover change in modulating future stream drying. Plain Language Summary: A majority of global streams are nonperennial, flowing only part of the year, and are critical for sustaining flow downstream, providing habitat for many organisms, and regulating chemical and biological processes. Using long‐term U.S. Geological Survey measurements for 540 watersheds across the contiguous United States, we mapped patterns and examined the causes of no‐flow fraction, the fraction of each climate year with no flow, no‐flow timing, the date of the climate year on which the first recorded no flow takes place, and length of the dry‐down period, the average number of days from a local peak in daily flow to the first occurrence of no flow. We found differences in patterns of no‐flow characteristics between regions, with higher no‐flow fraction, earlier timing, and shorter dry‐down duration in the western United States. No‐flow fractions were greater and less variable in natural watersheds, while no‐flow timing was earlier and dry‐down duration was shorter in human‐modified watersheds. Aridity had the greatest effect on intermittence across the United States, but unique combinations of climate, biophysical, and human impacts were important in different regions. The number of gages measuring streamflow in nonperennial streams is small compared to perennial streams, and increased monitoring is needed to better understand drying behavior. Key Points: Three metrics reveal regional and human‐driven patterns of nonperennial flow: no‐flow fraction, day of first no flow, and dry‐down durationStreams with human modifications generally dry more quickly than unmodified streams, especially in California and the Southern Great PlainsClimate strongly influences no‐flow fraction and timing, but physiographic variables are more important for the duration of dry down [ABSTRACT FROM AUTHOR]

Steadily increasing ethnic and cultural diversity in the United States has led employers to see intercultural competence as a valuable and necessary trait for those entering the workforce, including students studying psychology. One high-impact practice that may increase students' multicultural awareness is study abroad. The current research examined the effectiveness of a cultural scavenger hunt offered during two short-term study abroad programs to increase participants' intercultural competencies. Cultural competence was assessed in Study 1 (N = 10) using the Miville-Guzman Universality-Diversity Scale–Short Form. Results indicated a statistically significant increase across all subscales. In Study 2 (N = 16), the Cross-Cultural Adaptability Inventory was utilized. Results from Study 2 demonstrated statistically significant improvements in the Emotional Resilience subscale. These findings suggest that a cultural scavenger hunt may assist participants in actively engaging in the local culture and facilitate the initial development of intercultural competencies. [ABSTRACT FROM AUTHOR]

Background The economic burden of cancer in the United States is substantial, and better understanding it is essential in informing health care policy and innovation. Leptomeningeal carcinomatosis (LC) represents a late complication of primary cancer spreading to the leptomeninges. Methods The IBM MarketScan Research databases were queried for adults diagnosed with LC from 2001 to 2015, secondary to 4 primary cancers (breast, lung, gastrointestinal, and melanoma). Health care resource utilization (HCRU) and treatment utilization were quantified at baseline (1-year pre-LC diagnosis) and 30, 90, and 365 days post-LC diagnosis. Results We identified 4961 cases of LC (46.3% breast cancer, 34.8% lung cancer, 13.5% gastrointestinal cancer, and 5.4% melanoma). The median age was 57.0 years, with 69.7% female and 31.1% residing in the South. Insurance status included commercial (71.1%), Medicare (19.8%), and Medicaid (9.1%). Median follow-up was 66.0 days (25th percentile: 24.0, 75th percentile: 186.0) and total cumulative costs were highest for the gastrointestinal subgroup ($167 768) and lowest for the lung cancer subgroup ($145 244). There was considerable variation in the 89.6% of patients who used adjunctive treatments at 1 year, including chemotherapy (64.3%), radiotherapy (57.6%), therapeutic lumbar puncture (31.5%), and Ommaya reservoir (14.5%). The main cost drivers at 1 year were chemotherapy ($62 026), radiation therapy ($37 076), and specialty drugs ($29 330). The prevalence of neurologic impairments was 46.9%, including radiculopathy (15.0%), paresthesia (12.3%), seizure episode/convulsive disorder not otherwise specified (11.0%), and ataxia (8.0%). Conclusions LC is a devastating condition with an overall poor prognosis. We present the largest study of LC in this real-world study, including current treatments, with an emphasis on HCRU. There is considerable variation in the treatment of LC and significant health care costs. [ABSTRACT FROM AUTHOR]

Suicide-related behaviors are over-represented among youth with autism spectrum disorder (ASD). A more thorough understanding of the connections between ASD and suicide-related behaviors may help to identify potential avenues for prevention efforts and can inform clinical care for youth with ASD. This manuscript presents a conceptualization of suicide risk among youth with ASD based on the Interpersonal Theory of Suicide, in order to spur discussion and future research. This manuscript also provides preliminary clinical recommendations for improving suicide prevention efforts among youth with ASD based on hypothesized risk and protective factors. [ABSTRACT FROM AUTHOR]

The article describes the legal defects inherent in the U.S. Department of Defense's (DoD) law enforcement DNA indexing program. Topics covered include the U.S. government's weak constitutional interest in taking DNA samples from service members, a brief history of DNA profiling and the DNA Identification Act of 1994. It also discusses the factors that set the DoD's program apart from its constitutionally approved civilian forebear.

This study proposes a method for calculating the annual incidence rate of sibling bereavement among US youth using national epidemiological data. The proposed model combines data on family household size with national death statistics to calculate the number of siblings affected by the death of a child annually. From 2012 to 2015, an average of 61,389 children per year experienced the death of a sibling, resulting in an estimate of 0.0832% of children bereaved by the death of a sibling annually. Data indicate a need for greater awareness and dialog concerning the frequency with which children experience the death of a sibling. [ABSTRACT FROM AUTHOR]

Background: Sleep and mood are critical factors that contribute to health and wellness and are of particular interest to collegiate athletes who are juggling high physical, academic, and social demands. The aim of this study was to examine how psychological measures, player status, and sex-related factors were associated with perceived sleep quality.Hypothesis: Higher levels of global sleep dysfunction will be related to poor mood and increased anxiety, and there will be differences in sleep dysfunction in male compared with female athletes as well as regarding playing status.Study Design: Prospective cohort study.Level Of Evidence: Level 4.Methods: During the 2016 through 2018 National Collegiate Athletic Association (NCAA) seasons, the Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States, and Sports Anxiety Scale-2 questionnaires were administered to 230 soccer athletes at 6 separate time points throughout each season.Results: PSQI results yielded scores ≥5 in 54% of observations. Increased sleep dysfunction was significantly related to decreased vigor and increased tension, depression, anger, fatigue, somatic anxiety, worry, and concentration disruption, although effect sizes (ES) were trivial (ES, -0.03 to 0.15). The odds ratio (OR) of reporting global sleep dysfunction increased by 8%, 9%, and 25% for every 1-unit increase in tension (OR, 1.08; 95% CI, 1.02-1.16; P = 0.015), fatigue (OR, 1.09; 95% CI, 1.03-1.16; P = 0.002), and concentration disruption (OR, 1.25; 95% CI, 1.09-1.45; P = 0.002), respectively. The odds of reporting global sleep dysfunction were 55% lower for males than females (OR, 0.45; 95% CI, 0.25-0.79; P = 0.006).Conclusion: Global sleep dysfunction was prevalent in NCAA soccer players and was related to negative mental health outcomes. Female participants experienced increased odds of reporting global sleep dysfunction.Clinical Relevance: Regular monitoring allows for a greater understanding of the interrelatedness between sleep and mental health in athletes. [ABSTRACT FROM AUTHOR]

If the U.S. Supreme Court's recent decision in American Needle v. National Football League. etal. were to be summarized in a single sports headline, it might well read, "American Needle Kicks Three Field Goals; Shuts Out NFL 9-0." In a relatively rare venture into antitrust permissibility in the sports industry, the nine Supreme Court justices handed plaintiff American Needle a unanimous win and gave a small Illinois embroidery company a chance to try its case against the National Football League (NFL) in federal court on remand. At the crux of the case lay an issue central to all of sports law--whether a league, in this case the NFL, should be (a) deemed a "single entity" and granted antitrust immunity for certain claims arising under Section I of the Sherman Act or (b) characterized as a joint venture of individual teams that compete against each other. For many years, American Needle had a contract to produce apparel for NFL teams. The contract was not renewed when the NFL partnered with a sole licensee, Reebok, in 2000. American Needle filed suit alleging that the exclusive NFL-Reebok merchandising contract represented an illegal restraint of trade under antitrust laws. The NFL defended against the lawsuit by arguing that the league, its affiliates, and teams were a single entity and, in turn, shielded from such antitrust inquiry. The purpose of this legal case brief is twofold. First, it will provide an overview of the decision and summarize the underlying legal rationale and doctrines. Second, it will discuss how the American Needle opinion may affect the sports industry. [ABSTRACT FROM AUTHOR]