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Modern digital technologies are advancing rapidly, driving transformative changes. For Information Systems (IS) educators, maintaining curricula that prepare graduates for the digital economy is imperative. This study developed a knowledge pool of 121 common keywords in digital transformation through literature review and investigated their application in the titles and descriptions of 4,093 IS courses across 315 undergraduate programs in the United States. The findings illustrate how IS educators conceptualize the digital transformation within the IS discipline and incorporate it into curricula. Additionally, the results offer insights for educators aiming to develop course content on digital transformation and update IS undergraduate curricula to align with the demands of modern enterprises in the era of digital transformation. [ABSTRACT FROM AUTHOR]

In literature, many studies try to analyze healthcare usage and generated decision support systems. In this paper, the aim is to generate a decision support system for insurance companies in the United States according to the federal dataset. The data set contains variables from the United States Healthcare Administration formal data group and they are; group of age, group of healthcare insurance, group of nationality, Corporate Social Responsibility (CSR) usage, and Advance Premium Tax Credit (APTC) usage. The best model for each state in the United States is determined with the dataset from 2014 November to 2015 February. In this study, various statistical models are attempted to generate independent and optimal models for each state. In the model selection process, three different metrics are used. Accuracy rate, f1score and precision score are used in the model selection process and models are compared to each other according to these three metrics for each state uniquely. Consequently, the proposed model is used with a decision support scheme to support customer service workers in healthcare insurance companies. The decision support system under consideration can facilitate a substantial decrease in the duration of interactions between customer service representatives and clients. Additionally, this system can generate more logically sound and efficient customer offers. [ABSTRACT FROM AUTHOR]

Across recent years, there has been a growing prevalence of extreme weather events throughout the United States, posing significant challenges to the reliable and resilient operation of power systems. Specifically, summer droughts threaten to severely reduce available generation capacity to meet regional electricity demand, potentially leading to power outages. This underscores the importance of accurate resource adequacy (RA) assessment to ensure the reliable operation of the nation's energy infrastructure. Accurately evaluating the usable capacity of regional generation fleets is a challenging undertaking due to the intricate interactions between power systems and hydro-climatic systems. This paper proposes a systematic and analytical framework to evaluate the impacts of extreme summer drought events on the available capacity of various generating technologies, incorporating both meteorological and hydrologic factors. The framework provides detailed plant-level capacity derating models for hydroelectric, thermoelectric, and renewable power plants, facilitating evaluations with high temporal and spatial resolution. The application of the proposed impact assessment framework to the 2025 generation fleet of the real-world power system within the PJM and SERC regions of the United States yields insightful results. By analyzing the daily usable capacity of 6,055 at-risk generators across the study region, it shows that the summer capacity deration is most significant for hydroelectric and once-through thermal power plants, followed by recirculating thermal power plants and combustion turbines. In the event of the recurrence of the 2007 southeastern summer drought event in the near future, the generation fleet could experience a substantial reduction in available capacity, estimated at approximately 8.5 GW, compared to typical summer conditions. The sensitivity analysis reveals that the usable capacity of the generation fleet would suffer an even more significant decrease under conditions of increasingly severe summer droughts. The proposed approach and the findings of this study provide valuable methodologies and insights, empowering stakeholders to bolster the resilience of power systems against the potentially devastating effects of future extreme drought events. [Display omitted] • A systematic summer droughts generating capacity assessment framework is developed. • Capacity derating models for various generation technologies are presented. • The impacts of summer droughts on generating fleet in PJM and SERC are studied. • Impact of extreme summer drought on usable capacity of generators is significant. [ABSTRACT FROM AUTHOR]

This paper addresses the effective management of water resources during the hydraulic fracturing process used for natural gas extraction. With increasing demand and scrutiny on shale gas production due to economic, environmental, and social factors, effective water management strategies are needed to address the challenges of flow-back water usage during hydraulic fracturing. This research contributes to the existing literature from a multi-period reverse logistics network design perspective with realistic modeling approaches. A mathematical formulation is developed for optimizing the design of a multi-period reverse logistics network for effective water resource management that incorporates production scheduling of a hydraulic fracturing process. This mixed integer programming model determines the optimal locations and capacities of impoundments, treatment facilities, and disposal sites while minimizing fixed and operational costs under constraints such as freshwater withdrawal limits, production schedules, inventory balance, and treatment and disposal options. A two-stage stochastic programming formulation is further developed as a means to address the uncertainty associated with water flows during the fracturing operation. The strategic location and capacity decisions are given in the first stage of this formulation, whereas operational decisions such as water flows are handled in the second stage under independently sampled scenarios. A sample average approximation algorithm is proposed to solve the stochastic formulation. The model is tested on a case study from the United States that explores potential impacts on water resource management due to cost variations, changes in operational parameters, and uncertainty in demands and supplies. The base case setup delivers a 12.8% reduction in freshwater usage. The benefit of multi-period reverse logistics network design is further demonstrated through variations in water demand and equipment degradation. The managerial insights derived through sensitivity analysis highlight the values of the proposed multi-period formulation, capacity expansions, and parameter estimations. • Developed models for multi-period reverse logistics network design. • The model optimizes water resource management during hydraulic fracturing. • Implemented the models on a case study from the United States. • Analyzed the effects of problem parameters on optimal water management strategies. • Derived managerial insights from extensive computational experiments. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 virus has, up to the time of this article, resulted in >770 million cases of COVID-19 illness worldwide, and approximately 7 million deaths, including >1.1 million in the United States. Although defined as a respiratory virus, early in the pandemic, it became apparent that considerable numbers of people recovering from COVID-19 illness experienced persistence or new onset of multi-system health problems, including neurologic and cognitive and behavioral health concerns. Persistent multi-system health problems are defined as Post-COVID-19 Condition (PCC), Post-Acute Sequelae of COVID-19, or Long COVID. A significant number of those with PCC report cognitive problems. This paper reviews the current state of scientific knowledge on persisting cognitive symptoms in adults following COVID-19 illness. A brief history is provided of the emergence of concerns about persisting cognitive problems following COVID-19 illness and the definition of PCC. Methodologic factors that complicate clear understanding of PCC are reviewed. The review then examines research on patterns of cognitive impairment that have been found, factors that may contribute to increased risk, behavioral health variables, and interventions being used to ameliorate persisting symptoms. Finally, recommendations are made about ways neuropsychologists can improve the quality of existing research. [ABSTRACT FROM AUTHOR]

This study employed organizational justice theory to examine the influence of employee perceptions of distributive, procedural, and interactional justice on whether employees trust their supervisors and management. Analysis of survey results from 322 employees of a state prison located in the Southern United States indicate that procedural and interactional justice—but not distributive justice—predict employee trust in both supervisors and management. These findings present important policy implications that suggest that the employing organization would benefit from having mechanisms in place to ensure that decisions follow consistent rules and strategies. Considering the relevance of employee trust to the organization, transparency in the use of pre-determined standards to allocate resources and rewards fairly needs to become a priority in institutions of corrections. [ABSTRACT FROM AUTHOR]

Objectives: This study developed multivariate law enforcement officer (LEO) body models for digital simulation of LEO accommodation in police cruiser cabs. Background: Anthropometrically accurate digital LEO body models, representing the United States LEOs, for computerized LEO cruiser interface simulations are lacking. Methods: Twenty body dimensions (with and without gear combined) of 756 male and 218 female LEOs were collected through a stratified national survey using a data collection trailer that traveled across the US. A multivariate Principal Component Analysis (PCA) approach was used to develop digital LEO body models. Results: Fifteen men and 15 women representing unique body size and shape composition of the LEO population were identified. A combined set of 24 male and female models (removal of 6 redundant models for which female and male models overlapped) is suggested. Conclusions: A set of 24 digital LEO body models in 3-dimensional form, along with their anthropometric measurements, were developed to facilitate LEO cruiser cab design. Application: Digital modeling software developers can use the models and their anthropometric data to build digital avatars for simulated evaluation of LEO cruiser cab configuration, console communication-equipment fitting, and cruiser ingress/egress access arrangement. LEO vehicle and equipment designers also can use eight key body dimensions (i.e., stature, buttock-popliteal length, eye height sitting, knee height sitting, shoulder-grip length, popliteal height, sitting height, and body weight) of the body models to recruit 24 human subjects to physically evaluate their vehicle prototypes for improved vehicle and equipment design. [ABSTRACT FROM AUTHOR]

Wind energy is widely deployed and will likely grow in service of reducing the world's dependency on fossil fuels. The first generation of wind turbines are now coming to the end of their service lives, and there are limited options for the reuse or recycling of the composite materials they are made of. Current literature has verified that there is no existing recycling pathway (i.e., mechanical, chemical, thermal methods of recovery, etc.) for end-of-life materials in wind blades that can meet cost parity with landfilling in the US. However, to the authors' knowledge there is no study to date that uncovers the cost structures associated with repurposing wind turbine blades in the US. Repurposing could offer a cost-competitive advantage through displacement of higher-value products, rather than materials or chemical constituents alone. This study implements life cycle assessment (LCA) and life cycle cost analysis (LCC) to assess the environmental and financial implications at each stage of repurposing wind turbine blades as the primary load-carrying elements for high-voltage transmission line structures in the United States. This case study contribution to knowledge is based on the successful management of construction waste by analyzing an application for repurposing construction demolition waste. Specifically, this study presents an environmental and financial analysis of repurposing wind turbine blades as transmission line poles. Under this case study, our results show that BladePoles have lower greenhouse gas emissions than steel poles, and we anticipate BladePoles will be less costly than steel poles. Overall emissions are most sensitive to combustion emissions, driven primarily by transportation distance and hours of required crane operations during the installation process. Compared to other evaluated recycling methods, repurposing wind blades as BladePoles has the least overall global warming potential. As renewable energy production grows, managing infrastructure at its end-of-life is increasingly relevant—for example, wind turbine blades. This case study presents a financial and environmental analysis of repurposing decommissioned wind turbine blades as transmission poles, called BladePoles. This paper presents the cost and associated greenhouse gas emissions at each stage of the process. The case study also compares this reuse application to typical steel pole deployment, finding that for the same 60-year life span and 161 kV, 230 kV, and 345 kV transmission line poles, the BladePole cost is lower than the steel pole. Greenhouse gas emissions are most sensitive to transportation distance from the wind farm to the transmission project and the time of crane use for installation are key parameters in this case study and reducing them directly reduces the total greenhouse emissions overall. [ABSTRACT FROM AUTHOR]

The construction phase of nuclear construction projects presents various risks and hazards, putting workers in potentially dangerous situations. Safety guidelines provided by Occupational Health and Safety Administration (OSHA) aim to address construction safety concerns, but limitations persist, especially in the context of workers safety and the transportation of Small Modular Reactors (SMRs) and Micro Reactors (MRs) in the nuclear construction domain. This research focuses on identifying issues related to safety guidelines in nuclear construction and aims to develop new guidelines and strengthen existing ones. Through a critical literature review, key factors influencing safety in nuclear construction were identified. A questionnaire survey was prepared in line with those identified key safety factors and distributed among 40 professionals from the United States to gather feedback on these factors in countering safety issues and developing new guidelines in the context of nuclear construction. The findings reveal a lack of specific guidelines concerning the safe transportation of SMRs and MRs, as well as a gap in understanding accidents during the construction and transportation phases of nuclear projects. The results of this research contribute to enhancing safety protocols and addressing the unique challenges faced in nuclear construction. The research has also highlighted the importance of digital technology tools such as Artificial Intelligence (AI), Augmented Reality (AR), Virtual Reality (VR), and Unmanned Aerial Vehicles (UAVs) as emerging digital tools, which could be helpful to counter safety concerns linked to SMRs and MRs in future. [ABSTRACT FROM AUTHOR]

Despite the growing emphasis on workplace diversity and inclusion, ageism remains prevalent in various industries, including construction. Through an extensive review of literature and a United States national-level survey, this paper investigates the adverse impacts of ageism on the overall well-being of the construction workforce, focusing on their mental and physical health. The questionnaire was distributed among individuals working in the construction industry sector who were randomly selected and received 72 responses. The data obtained were analyzed statistically using binomial logistic regression in modeling the relationship between ageism, and mental and physical health of the construction workforce. The research results indicate that ageism has a statistically significant (p < .001) positive relationship between both the mental and physical health of the construction workforce. The results, therefore, show that ageism has an impact on the mental and physical well-being of workers in the construction industry. Furthermore, the results show that individuals in the construction workforce who experience ageism are more likely to have their mental health and physical well-being impacted compared to those who don’t experience ageism. Consequently, the results highlight the need for proactive measures to combat age discrimination and promote a healthier and more inclusive work environment for construction workers of all ages. [ABSTRACT FROM AUTHOR]

Background: Painful diabetic neuropathy (pDN) is the most common cause of neuropathic pain (NP) in the United States. Prolonged continuous theta burst stimulation (pcTBS), a form of repetitive transcranial magnetic stimulation (rTMS), is quick (1-4 minutes) and tolerable for most individuals, compared to high frequency rTMS and can modulate pain thresholds in healthy participants. However, its effects on patients with chronic pain are still unclear. The primary purpose of this preliminary study is to investigate the effects of single session pcTBS targeted at the primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) on a set of self-report measures of pain (SRMP) that assess the (a) sensory-discriminative; (b) affective-motivational; and (c) cognitive-evaluative aspects of pain experience. Methods: For this prospective, single-blind study, forty-two participants with pDN were randomized to receive either pcTBS targeting the M1 or the DLPFC brain regions. SRMP were completed at baseline, post pcTBS and 24h-post pcTBS. A two-way mixed model repeated measures analysis of variance (2 brain regions by 3 time points) was conducted to evaluate the effects of pcTBS stimulation at M1 and DLPFC for each subscale of each SRMP. Results: After a single session of pcTBS targeted at M1 or DLPFC in patients with pDN, statistically significant improvements from baseline to post pcTBS and baseline to 24 h-post pcTBS were observed for different SRMP subscales examining the (a) sensory-discriminative, (b) affective-motivational and (c) cognitive-evaluative components of the pain experience. At 24 h-post pcTBS, none of the participants reported any serious adverse events to the pcTBS treatment, thus demonstrating its feasibility. Conclusions: In pDN patients with NP, our study results demonstrated significant improvement in scores on self-report measures of pain (SRMP) after a single session of pcTBS targeting the M1 and DLPFC brain regions. Future studies should consider utilizing multiple sessions of pcTBS to evaluate its long-term effects on pain perception, safety and tolerability in patients with chronic pain. Clinical Trial Registration: This study was registered on the ClinicalTrials.gov website (NCT04988321). [ABSTRACT FROM AUTHOR]

The strategy-by-doing perspective argues that firms operating in highly dynamic environments can benefit from taking strategic actions in lieu of advance planning because such actions have learning effects that help the firm keep pace with changes in the environment. The implicit assumption is that strategy by doing is effective in dynamic environments but likely not in stable environments. This study challenges this notion and expands the purview of the strategy-by-doing perspective. We first argue that strategy by doing is generally an effective strategy due to the organizational learning it facilitates. We next discuss how environmental dynamism is multidimensional, encompassing both market and technological dynamism. The positive effects of strategy by doing on product-market performance are amplified in highly dynamic environments that feature high levels of both market and technological dynamism. We go on to argue that stable environments are also suitable for strategy by doing, where it can facilitate opportunity creation. However, strategy by doing may hinder performance in mixed environments where one form of dynamism is present and the other is not. Focusing on strategy by doing in the form of product changes, our analysis of 4,000 firms over a period of 20 years shows support for our arguments about environmental contingencies affecting the relationship between strategy by doing and performance. We discuss how these findings have implications for theory and practice. [ABSTRACT FROM AUTHOR]

This article establishes empirically that a persistent culture of "rugged individualism," captured by exposure to the American westward-moving frontier from 1790 to 1890, undermines pro-climate perceptions, environmental performance, and climate change preparedness across counties in the United States. It also demonstrates that individualism is associated with environmental underperformance at the state level, making it more difficult to mitigate the far-reaching consequences of changing climate conditions. To establish external validity of the subnational evidence, I use a global sample of up to 97 countries and provide suggestive evidence that individualism creates barriers to climate change responses worldwide. (JEL D78, H41) [ABSTRACT FROM AUTHOR]

Over the last three decades, a little-noted change has taken place in state lotteries. This change is an increase in the average payout rate, the share of sales that is returned to players in the form of prizes. Because it reduces the rate of implicit taxation on lottery purchases and its accompanying welfare loss, this change has inadvertently made lotteries better, or at least less objectionable. This paper reviews the normative case for reducing the implied tax, documents the rise in payout rates across the United States, offers an explanation for that rise, notes the starring role played by instant games, illustrates its effect on the regressivity of lottery finance, and documents the surprising correlation between the price of instant games and their payout rates. [ABSTRACT FROM AUTHOR]

Background: COVID-19's heavy toll on human health, and its concentration within specific at-risk groups including the socially vulnerable and individuals with comorbidities, has made it the focus of much syndemic discourse. Syndemic theory recognizes that social factors create the conditions that support the clustering of diseases and that these diseases interact in a manner that worsens health outcomes. Syndemics theory has helped to facilitate systems-level approaches to disease as a biosocial phenomenon and guide prevention and treatment efforts. Despite its recognized value, reviews of syndemics literature have noted frequent misuse of the concept limiting its potential in guiding appropriate interventions. Objective: To review how the term 'syndemic' is defined and applied within peer-reviewed literature in relation to COVID-19. Design: A scoping review of definitions within COVID-19 literature published between January 1, 2020 to May 15, 2023 was conducted. Searches took place across six databases: Academic Search Premier, CINAHL, JSTOR, MEDLINE/Pubmed, PsycINFO and Scopus. PRISMA-ScR guidelines were followed. Results: Content analysis revealed that COVID-19 has varied clustered configurations of communicable–non-communicable diseases and novel communicable disease interactions. Spatial analysis was presented as a new strategy to evidence syndemic arrangements. However, syndemics continue to be regarded as universal, with continued misunderstanding and misapplication of the concept. Conclusion: This review found that current applications of syndemics remain problematic. Recommendations are made on the design of syndemic studies. A syndemic framework offers an opportunity for systems-level thinking that considers the full complexity of human-disease interactions and is useful to inform future pandemic preparations and responses. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the second most lethal cancer in the United States (U.S.) with the highest incidence and mortality rates among African Americans (AAs) compared to other racial groups. Despite these disparities, AAs are the least likely to undergo CRC screening, have precancerous colorectal polyps removed, and have CRC detected at stages early enough for curative excision. In addition, compelling evidence links inflammatory dietary patterns to increased CRC and cardiovascular disease risk. Studies show that AA churches can successfully engage in health promotion activities including those related to cancer control. The current study seeks to leverage church-placed Community Health Workers (CHWs) to increase CRC screening and reduce CRC risk. Design and methods: We aim to (1) increase guideline concordant CRC screening uptake using church-placed CHWs trained in screening with a validated instrument, Brief Intervention using Motivational Interviewing, and Referral to Treatment (SBIRT); and (2) reduce dietary risk factors (inflammatory dietary patterns) linked to CRC. The latter will be addressed by culturally adapting an existing, web-based lifestyle program called Alive!. Using a Hybrid Type 1 Implementation-Effectiveness cluster randomized design, we will randomize 22 AA churches into either the dual intervention arm (CHW-led SBIRT intervention plus Alive!) or a usual care arm comprised of CRC prevention educational pamphlets and a list of CRC screening sites. We will recruit 440 subjects and evaluate the effects of both arms on screening uptake (colonoscopy, fecal DNA) (primary outcome) and dietary inflammation score (secondary outcome) at 6-month follow-up, and Life Simple7 (LS7)—a cardiovascular disease (CVD) risk score—at 6 months and 1 year (secondary outcome). Finally, guided by a racism-conscious adaptation of the Consolidated Framework for Implementation Research (CFIR), we will conduct a mixed-methods process evaluation with key stakeholders to understand multi-level influences on CRC screening and CVD risk behaviors. Discussion: Church-placed CHWs are trusted influential connectors between communities and health systems. Studies have shown that these CHWs can successfully implement health prevention protocols in churches, including those related to cancer control, making them potentially important community mediators of CRC screening uptake and CRC/CVD risk reduction. Trial registration: NCT05174286; clinicaltrials.gov; August 31st, 2023 [ABSTRACT FROM AUTHOR]

Background: Engaging patients and community members in healthcare implementation, research and evaluation has become more popular over the past two decades. Despite the growing interest in patient engagement, there is scant evidence of its impact and importance. Boot Camp Translation (BCT) is one evidence-based method of engaging communities in research. The purpose of this report is to describe the uptake by primary care practices of cardiovascular disease prevention materials produced through four different local community engagement efforts using BCT. Methods: EvidenceNOW Southwest (ENSW) was a randomized trial to increase cardiovascular disease (CVD) prevention in primary care practices. Because of its study design, Four BCTs were conducted, and the materials created were made available to participating practices in the "enhanced" study arm. As a result, ENSW offered one of the first opportunities to explore the impact of the BCT method by describing the uptake by primary care practices of health messages and materials created locally using the BCT process. Analysis compared uptake of locally translated BCT products vs. all other products among practices based on geography, type of practice, and local BCT. Results: Within the enhanced arm of the study that included BCT, 69 urban and 13 rural practices participated with 9 being federally qualified community health centers, 14 hospital owned and 59 clinician owned. Sixty-three practices had 5 or fewer clinicians. Two hundred and ten separate orders for materials were placed by 43 of the 82 practices. While practices ordered a wide variety of BCT products, they were more likely to order materials developed by their local BCT. Conclusions: In this study, patients and community members generated common and unique messages and materials for cardiovascular disease prevention relevant to their regional and community culture. Primary care practices preferred the materials created in their region. The greater uptake of locally created materials over non-local materials supports the use of patient engagement methods such as BCT to increase the implementation and delivery of guideline-based care. Yes, patient and community engagement matters. Trial registration and IRB: Trial registration was prospectively registered on July 31, 2015 at ClinicalTrials.gov (NCT02515578, protocol identifier 15–0403). The project was approved by the Colorado Multiple Institutional Review Board and the University of New Mexico Human Research Protections Office. [ABSTRACT FROM AUTHOR]

Background: A heated tobacco product (HTP) authorized for purchase in the United States by the Food and Drug Administration as a reduced harm product was removed from the market after about 2 years of sales. Adults who used the HTP were surveyed to determine the impact of the introduction and removal of the HTP on past and current tobacco behaviors. Methods: Adults who were using the HTP before its United States market removal (n = 502) completed a cross-sectional online survey to determine their tobacco use behaviors at three timepoints: prior to HTP initiation, just before HTP market removal, and at the time of the survey which was administered approximately 10 months post-removal. Descriptive statistics summarized outcome variables and paired bivariate testing was used to compare percent change between timepoints. Multivariable logistic regression and general linear models estimated associations of tobacco use behaviors and cigarette consumption. Results: Overall, significantly fewer adults consumed cigarettes while using HTP than before they tried the product (63.0% vs. 89.9%, p value < 0.0001) and the number of cigarettes consumed per week (CPW) decreased (106.3–39.0, p value < 0.0001). After HTP removal, the percent of adults who consumed cigarettes increased non-significantly (63.0–67.5%, p value = 0.0544) while CPW increased significantly (39.0–76.6 CPW, p value < 0.0001). At the time of the survey, over 25% of the sample continued to use the HTP and 7.2% reported use of no tobacco products. Electronic nicotine delivery system use had increased significantly from the prior period (27.4% increase, p value < 0.0001). Conclusion: This study demonstrates reduction or elimination of combustible cigarette smoking while adults were using HTPs and some increased smoking after market removal, albeit at lower levels. If unable to find satisfying alternatives, adults who smoke and transition to reduced harm products may return to smoking or purchase products illicitly if their preferred products are removed from the regulated market. [ABSTRACT FROM AUTHOR]

In the United States, recent changes to the National Statistical System have amplified the geographic-demographic resolution trade-off. That is, when working with demographic and economic data from the American Community Survey, as one zooms in geographically one loses resolution demographically due to very large margins of error. In this paper, we present a solution to this problem in the form of an AI based open and reproducible geodemographic classification system for the United States using small area estimates from the American Community Survey (ACS). We employ a partitioning clustering algorithm to a range of socio-economic, demographic, and built environment variables. Our approach utilizes an open source software pipeline that ensures adaptability to future data updates. A key innovation is the integration of GPT4, a state-of-the-art large language model, to generate intuitive cluster descriptions and names. This represents a novel application of natural language processing in geodemographic research and showcases the potential for human-AI collaboration within the geospatial domain. [ABSTRACT FROM AUTHOR]

Background: Previous studies have reported conflicting factor structures of the Coping Strategies Questionnaire - Sickle Cell Disease (CSQ-SCD). This study examined the psychometric properties of the CSQ-SCD among adults with SCD in the United States. Methods: This study implemented a cross-sectional study design with web-based self-administered surveys. Individuals with SCD were recruited via an online panel. Psychometric properties, including factorial and construct validity, and internal consistency reliability, of the CSQ-SCD were assessed. Results: A total of 196 adults with SCD completed the survey. Confirmatory factor analysis (CFA), using maximum likelihood estimation and the 13 subscale scores as factor indicators, supported a three-factor model for the CSQ-SCD compared to a two-factor model. Model fit statistics for the three-factor model were: Chi-square [df] = 227.084 [62]; CFI = 0.817; TLI = 0.770; RMSEA [90% CI] = 0.117 [0.101–0.133]; SRMR = 0.096. All standardized factor loadings (except for the subscales isolation, resting, taking fluids, and praying and hoping) were > 0.5 and statistically significant, indicating evidence of convergent validity. Correlations between all subscales (except praying and hoping) were lower than hypothesized; however, model testing revealed that the three latent factors, active coping, affective coping, and passive adherence coping were not perfectly correlated, suggesting discriminant validity. Internal consistency reliabilities for the active coping factor (α = 0.803) and affective coping factor (α = 0.787) were satisfactory, however, reliability was inadequate for the passive adherence coping factor (α = 0.531). Given this overall pattern of results, a follow-up exploratory factor analysis (EFA) was also conducted. The new factor structure extracted by EFA supported a three-factor structure (based on the results of a parallel analysis), wherein the subscale of praying and hoping loaded on the active coping factor. Conclusions: Overall, the CSQ-SCD was found to have less than adequate psychometric validity in our sample of adults with SCD. These results provide clarification around the conflicting factor structure results reported in the literature and demonstrate a need for the future development of a SCD specific coping instrument. [ABSTRACT FROM AUTHOR]

The increasing vulnerability of the population from frequent disasters requires quick and effective responses to provide the required relief through effective humanitarian supply chain distribution networks. We develop scenario-robust optimization models for stocking multiple disaster relief items at strategic facility locations for disaster response. Our models improve the robustness of solutions by easing the difficult, and usually impossible, task of providing exact probability distributions for uncertain parameters in a stochastic programming model. Our models allow decision makers to specify uncertainty parameters (i.e., point and probability estimates) based on their degrees of knowledge, using distribution-free uncertainty sets in the form of ranges. The applicability of our generalized approach is illustrated via a case study of hurricane preparedness in the Southeastern United States. In addition, we conduct simulation studies to show the effectiveness of our approach when conditions deviate from the model assumptions. [ABSTRACT FROM AUTHOR]

Respiratory Syncytial Virus (RSV) is a leading cause of acute respiratory tract infection, with the greatest impact on infants, immunocompromised individuals, and older adults. RSV prevalence decreased substantially in the United States (US) following the implementation of COVID-19-related non-pharmaceutical interventions but later rebounded with abnormal seasonality. The biological and epidemiological factors underlying this altered behavior remain poorly defined. In this retrospective cohort study from 2009 to 2023 in Chicago, Illinois, US, we examined RSV epidemiology, clinical severity, and genetic diversity. We found that changes in RSV diagnostic platforms drove increased detections in outpatient settings post-2020 and that hospitalized adults infected with RSV-A were at higher risk of intensive care admission than those with RSV-B. While population structures of RSV-A remained unchanged, RSV-B exhibited a genetic shift into geographically distinct clusters. Mutations in the antigenic regions of the fusion protein suggest convergent evolution with potential implications for vaccine and therapeutic development. Non-pharmaceutical interventions for COVID-19 also impacted the transmission of other viruses including respiratory syncytial virus (RSV). Here the authors describe the changing epidemiology, clinical severity, and genetic diversity of RSV in Chicago, Illinois, from July 2010 to April 2023. [ABSTRACT FROM AUTHOR]

Background: Congenital cytomegalovirus (cCMV) is the most common congenital viral infection in the United States. Symptomatic infections can cause severe hearing loss and neurological disability, although ~ 90% of cCMV infections are asymptomatic at birth. Despite its prevalence, the long-term neurobehavioral risks of asymptomatic cCMV infections are not fully understood. The objective of this work was to evaluate for potential long-term neurobehavioral sequelae in infants with asymptomatic cCMV. Methods: Infants with cCMV were identified from a universal newborn cCMV screening study in a metropolitan area in the midwestern United States. Asymptomatic infants with cCMV were enrolled in a longitudinal neurodevelopmental study (N = 29). Age- and sex-matched healthy control infants (N = 193) were identified from the Baby Connectome Project (BCP), a longitudinal study of brain and behavioral development. The BCP sample supplemented an additional group of healthy control infants (N = 30), recruited from the same participant registry as the BCP specifically for comparison with infants with asymptomatic cCMV. Neurobehavioral assessments and parent questionnaires, including the Mullen Scales of Early Learning, the Repetitive Behavior Scales for Early Childhood (RBS-EC), and the Infant Toddler Social Emotional Assessment (ITSEA) were administered at 12 months of age. Neurobehavioral scores were compared between infants with asymptomatic cCMV and all identified healthy control infants. Results: Infants with asymptomatic cCMV performed equivalently compared to healthy control infants on the neurobehavioral measures tested at 12 months of age. Conclusions: These results indicate that at 12 months of age, infants with asymptomatic cCMV are not statistically different from controls in a number of neurobehavioral domains. Although follow-up is ongoing, these observations provide reassurance about neurobehavioral outcomes for infants with asymptomatic cCMV and inform the ongoing discussion around universal screening. Additional follow-up will be necessary to understand the longer-term outcomes of these children. [ABSTRACT FROM AUTHOR]

The invasive Asian longhorned tick Haemaphysalis longicornis that vectors and transmits several animal pathogens is significantly expanding in the United States. Recent studies report that these ticks also harbor human pathogens including Borrelia burgdorferi sensu lato, Babesia microti, and Anaplasma phagocytophilum. Therefore, studies that address the interactions of these ticks with human pathogens are important. In this study, we report the characterization of H. longicornis organic anion-transporting polypeptides (OATPs) in interactions of these ticks with A. phagocytophilum. Using OATP-signature sequence, we identified six OATPs in the H. longicornis genome. Bioinformatic analysis revealed that H. longicornis OATPs are closer to other tick orthologs rather than to mammalian counterparts. Quantitative real-time PCR analysis revealed that OATPs are highly expressed in immature stages when compared to mature stages of these ticks. In addition, we noted that the presence of A. phagocytophilum upregulates a specific OATP in these ticks. We also noted that exogenous treatment of H. longicornis with xanthurenic acid, a tryptophan metabolite, influenced OATP expression in these ticks. Immunoblotting analysis revealed that antibody generated against Ixodes scapularis OATP cross-reacted with H. longicornis OATP. Furthermore, treatment of H. longicornis with OATP antibody impaired colonization of A. phagocytophilum in these ticks. These results not only provide evidence that the OATP-tryptophan pathway is important for A. phagocytophilum survival in H. longicornis ticks but also indicate OATP as a promising candidate for the development of a universal anti-tick vaccine to target this bacterium and perhaps other rickettsial pathogens of medical importance. [ABSTRACT FROM AUTHOR]

Background: Dengue virus (DENV) is endemic to many parts of the world and has serious health and socioeconomic effects even in high-income countries, especially with rapid changes in the climate globally. We explored the literature on dengue vector control methods used in high-income, city settings and associations with dengue incidence, dengue prevalence, or mosquito vector densities. Methods: Studies of any design or year were included if they reported effects on human DENV infection or Aedes vector indices of dengue-specific vector control interventions in high-income, city settings. Results: Of 24 eligible sources, most reported research in the United States (n = 8) or Australia (n = 5). Biocontrol (n = 12) and chemical control (n = 13) were the most frequently discussed vector control methods. Only 6 sources reported data on the effectiveness of a given method in reducing human DENV incidence or prevalence, 2 described effects of larval and adult control on Aedes DENV positivity, 20 reported effectiveness in reducing vector density, using insecticide, larvicide, source reduction, auto-dissemination of pyriproxyfen and Wolbachia, and only 1 described effects on human-vector contact. Conclusions: As most studies reported reductions in vector densities, rather than any effects on human DENV incidence or prevalence, we can draw no clear conclusions on which interventions might be most effective in reducing dengue in high-income, city areas. More research is needed linking evidence on the effects of different DENV vector control methods with dengue incidence/prevalence or mosquito vector densities in high-income, city settings as this is likely to differ from low-income settings. This is a significant evidence gap as climate changes increase the global reach of DENV. The importance of community involvement was clear in several studies, although it is impossible to tease out the relative contributions of this from other control methods used. Author summary: Dengue virus is present in many parts of the world and has serious health and socioeconomic effects even in high-income countries, especially with rapid changes in the climate globally. In this study, we explored the literature on dengue vector control methods used in high-income, city settings and associations with number of human dengue infections, and the density of mosquitoes. We found 24 papers with relevant results. Most of these described studies in the United States or Australia. Most were about various forms of biological or chemical control of the mosquitoes. Few papers discussed effects on human dengue infection. We were unable to draw any clear conclusions on how effective mosquito control methods were as we could identify little research on this subject in this specific setting. More research is needed on this topic, particularly as climate change will make more areas of the world vulnerable to dengue infection. [ABSTRACT FROM AUTHOR]

Homozygous familial hypercholesterolemia (HoFH) is an underdiagnosed and undertreated ultra-rare disease. We utilized claims data from the Komodo Healthcare Map database to develop a machine-learning model to identify potential HoFH patients. We tokenized patients enrolled in MyRARE (patient support program for those prescribed evinacumab-dgnb in the United States) and linked them with their Komodo claims. A true positive HoFH cohort (n = 331) was formed by including patients from MyRARE and patients with prescriptions for evinacumab-dgnb or lomitapide. The negative cohort (n = 1423) comprised patients with or at risk for cardiovascular disease. We divided the cohort into an 80% training and 20% testing set. Overall, 10,616 candidate features were investigated; 87 were selected due to clinical relevance and importance on prediction performance. Different machine-learning algorithms were explored, with fast interpretable greedy-tree sums selected as the final machine-learning tool. This selection was based on its satisfactory performance and its easily interpretable nature. The model identified four useful features and yielded precision (positive predicted value) of 0.98, recall (sensitivity) of 0.88, area under the receiver operating characteristic curve of 0.98, and accuracy of 0.97. The model performed well in identifying HoFH patients in the testing set, providing a useful tool to facilitate HoFH screening and diagnosis via healthcare claims data. [ABSTRACT FROM AUTHOR]

Background: It is uncertain if mean platelet volume and periodontitis are related. The objective of this study was to examine the association between levels of mean platelet volume and moderate/severe periodontitis in adult persons who inhabit the U.S. Methods: We screened 6,809 people from the National Health and Nutrition Examination Survey (NHANES 2009–2012). Mean platelet volume was measured in the Mobile Examination Centers (MECs) using the Beckman Coulter analyzer. The category of periodontitis was defined by the CDC/AAP using clinical periodontal parameters. Multiple logistic regression models were employed to examine the distribution for covariate differences across the various independent groups. Four models were employed to examine the relationship between mean platelet volume level and periodontitis. Smoothed curve fitting was utilized to confirm the linearity of the relationships. To determine the impact of factors on the connection between MPV and periodontitis, subgroup analysis and interaction testing were utilized. Results: Results from the multiple logistic regression analysis indicate a significant association between moderate/severe periodontitis and the mean platelet level, even after considering any potential confounding variables (OR = 1.090, 95% CI: 1.019–1.166, P-value = 0.01211). Additionally, those in the upper tertile of mean platelet volume levels had a 21.6% higher probability of developing periodontitis when compared with those in the least tertile of mean platelet levels (OR = 1.216, 95% CI:1.052–1.406, P-value = 0.00816). Moreover, it showed a positive correlation between mean platelet volume (MPV) and moderate/severe periodontitis. Subgroup analyses indicated a positive association between the level of mean platelet volume and moderate/severe periodontitis among individuals who were under 60 years of age, had low income, were obese, never smoked, were heavy drinkers, had hypertension, and had no cardiovascular disease (p < 0.05). However, none of the subgroups exhibited significant interactions (p for interaction > 0.05). Conclusion: A correlation has been found between mean platelet volume levels and periodontal disease in individuals residing in the United States. [ABSTRACT FROM AUTHOR]

Background: Depression is the common mental disease after stroke. Our objective was to investigate the correlation of Life's Essential 8 (LE8), the recently updated evaluation of cardiovascular health, with the occurrence of post-stroke depression (PSD) and all-cause mortality among United States (US) adults. Methods: Participants with stroke were chosen from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. The relationship between LE8 and the risk of PSD was assessed through weighted multiple logistic models. A restricted cubic spline was employed for the examination of correlations. To demonstrate the stability of the results, sensitivity analysis and subgroup analysis were carried out. Furthermore, Cox regression models were used for the correlation between LE8 and all-cause mortality. Results: In this study, a total of 1071 participants were included for analysis. It was observed that LE8 score and PSD risk shared an inverse relationship in per 10 points increase [OR = 0.62 (0.52–0.74, P < 0.001)] in logistic regression models. The analysis of restricted cubic spline demonstrated approximately a noticeable inverse linear association between LE8 score and PSD risk. Sensitivity analysis verified the stability of the findings. Moreover, no statistically significant interactions were identified in subgroup analysis. A reverse association between LE8 score and all-cause mortality was also observed with a 10-point increase [HR = 0.85 (0.78–0.94, P < 0.001)] in cox regression models. Conclusions: A negative correlation was discovered between LE8 score and PSD and all-cause mortality risk among US adults. We need to conduct large-scale prospective studies to further validate our results. [ABSTRACT FROM AUTHOR]

Background: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression. Results: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014). Conclusion: Results suggest that photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine. [ABSTRACT FROM AUTHOR]

Digital health technologies (DHTs) can transform neurological assessments, improving quality and continuity of care. In the United States, the Food & Drug Administration (FDA) oversees the safety and efficacy of these technologies, employing a detailed regulatory process that classifies devices based on risk and requires rigorous review and post-market surveillance. Following FDA approval, DHTs enter the Current Procedural Terminology, Relative Value Scale Update Committee, and Centers for Medicare & Medicaid Services coding and valuation processes leading to coverage and payment decisions. DHT adoption is challenged by rapid technologic advancements, an inconsistent evidence base, marketing discrepancies, ambiguous coding guidance, and variable health insurance coverage. Regulators, policymakers, and payers will need to develop better methods to evaluate these promising technologies and guide their deployment. This includes striking a balance between patient safety and clinical effectiveness versus promotion of innovation, especially as DHTs increasingly incorporate artificial intelligence. Data validity, cybersecurity, risk management, societal, and ethical responsibilities should be addressed. Regulatory advances can support adoption of these promising tools by ensuring DHTs are safe, effective, accessible, and equitable. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the relationship between the total muscle-to-fat ratio (tMFR) and female urinary incontinence (UI), determine whether tMFR can serve as a useful index for predicting UI, and identify factors that may influence this relationship. Methods: We retrospectively analyzed data from 4391 adult women participating in the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. The correlation between tMFR and UI was examined using a dose-response curve generated through a restricted cubic spline (RCS) function, LASSO and multivariate logistic regression. Furthermore, predictive models were constructed incorporating factors such as age, race, hypertension, diabetes, cotinine levels, and tMFR. The performance of these predictive models was evaluated using training and test datasets, employing calibration curves, receiver operating characteristic curves, and clinical decision curves. Mediation effects were also analyzed to explore potential relationships between tMFR and female UI. Results: In a sample of 4391 adult women, 1073 (24.4%) self-reported experiencing UI, while 3318 (75.6%) reported not having UI. Based on the analyses involving LASSO regression and multivariate logistic regression, it was found that tMFR exhibited a negative association with UI (OR = 0.599, 95% CI: 0.497-0.719, P < 0.001). The results from the restricted cubic spline chart indicated a decreasing risk of UI in women as tMFR increased. Furthermore, the model constructed based on logistic regression analysis demonstrated a certain level of accuracy (in the training dataset: area under the curve (AUC) = 0.663; in the test dataset: AUC = 0.662) and clinical applicability. The mediation analysis revealed that the influence of tMFR on the occurrence of UI in women might potentially occur through the blood index lymphocyte count (P = 0.040). Conclusion: A high tMFR serves as a protective factor against UI in women. Furthermore, lymphocyte might be involved in the relationship between tMFR and female UI. [ABSTRACT FROM AUTHOR]

Background: Bronchiectasis is a pulmonary disease characterized by irreversible dilation of the bronchi and recurring respiratory infections. Few studies have described the microbiology and prevalence of infections in large patient populations outside of specialized tertiary care centers. Methods: We used the Cerner HealthFacts Electronic Health Record database to characterize the nature, burden, and frequency of pulmonary infections among persons with bronchiectasis. Chronic infections were defined based on organism-specific guidelines. Results: We identified 7,749 patients who met our incident bronchiectasis case definition. In this study population, the organisms with the highest rates of isolate prevalence were Pseudomonas aeruginosa with 937 (12%) individuals, Staphylococcus aureus with 502 (6%), Mycobacterium avium complex (MAC) with 336 (4%), and Aspergillus sp. with 288 (4%). Among persons with at least one isolate of each respective pathogen, 219 (23%) met criteria for chronic P. aeruginosa colonization, 74 (15%) met criteria for S. aureus chronic colonization, 101 (30%) met criteria for MAC chronic infection, and 50 (17%) met criteria for Aspergillus sp. chronic infection. Of 5,795 persons with at least two years of observation, 1,860 (32%) had a bronchiectasis exacerbation and 3,462 (60%) were hospitalized within two years of bronchiectasis diagnoses. Among patients with chronic respiratory infections, the two-year occurrence of exacerbations was 53% and for hospitalizations was 82%. Conclusions: Patients with bronchiectasis experiencing chronic respiratory infections have high rates of hospitalization. [ABSTRACT FROM AUTHOR]

Background: Racism contributes to health disparities and is a serious threat to public health. Teaching physicians about racism, how to address it in medical practice, and developing high quality and sustainable curricula are essential to combating racism. Objective: This study aimed to (1) describe the experience of racism and anti-racism teaching in residency programs, and elicit recommendations from key informants, and (2) use these data and formative research to develop recommendations for other residencies creating, implementing, and evaluating anti-racism curricula in their own programs. Methods: From May to July 2023, 20 faculty and residents were recruited via convenience sampling for key informant interviews conducted via Microsoft Teams. Interviews were audio recorded, transcribed, and coded. An initial list of themes was developed using theoretical frameworks, and then refined using a grounded-theory approach. A brief online optional anonymous demographic survey was sent to participants in August of 2023. Results: Eighty percent (20/25) of participants approached were interviewed. Seventy-five percent (15/20) answered a brief optional demographic survey. Seven themes emerged: (1) Racism in medicine is ubiquitous; (2) Anti-racism teaching in medicine varies widely; (3) Sustainability strategies should be multifaceted and include recruitment, resource allocation, and outcome measures; (4) Resources are widely available and accessible if one knows where to look; (5) Outcomes and metrics of success should include resident- faculty-, patient- community-, and system-focused outcomes; (6) Curricular strategies should be multilayered, longitudinal, and woven into the curriculum; and (7) Self-reflection and discomfort are necessary parts of the process. Conclusions: This study is one of the first to qualitatively examine perspectives of key stakeholders invested in anti-racism teaching for residents. The Support - Pipeline - Outcomes - Community (SPOC) Model, that was developed using information collected during this study, can be used in the future as a guide for others working to design and implement sustainable and high quality anti-racism curricula for residents. [ABSTRACT FROM AUTHOR]

Pancreatic cancer, particularly pancreatic ductal adenocarcinoma (PDAC), stands as the fourth leading cause of cancer-related deaths in the United States, marked by challenging treatment and dismal prognoses. As immunotherapy emerges as a promising avenue for mitigating PDAC's malignant progression, a comprehensive understanding of the tumor's immunosuppressive characteristics becomes imperative. This paper systematically delves into the intricate immunosuppressive network within PDAC, spotlighting the significant crosstalk between immunosuppressive cells and factors in the hypoxic acidic pancreatic tumor microenvironment. By elucidating these mechanisms, we aim to provide insights into potential immunotherapy strategies and treatment targets, laying the groundwork for future studies on PDAC immunosuppression. Recognizing the profound impact of immunosuppression on PDAC invasion and metastasis, this discussion aims to catalyze the development of more effective and targeted immunotherapies for PDAC patients. [ABSTRACT FROM AUTHOR]

Background: This study aims to thoroughly study the connection between congenital heart disease (CHD) and neurodevelopmental disorders (NDDs) through observational and Mendelian randomization (MR) designs. Methods: This observational study uses data from the National Survey of Children's Health (2020–2021). Multivariable logistic regression and propensity score matching (PSM) were performed to analyze the association. PSM was used to minimize bias for covariates such as age, race, gender, maternal age, birth weight, concussion or brain injury, preterm birth, cerebral palsy, Down syndrome, and other inherited conditions. In MR analyses, inverse variance-weighted measures, weighted median, and MR-Egger were employed to calculate causal effects. Results: A total of 85,314 children aged 0–17 were analyzed in this study. In regression analysis, CHD (p = 0.04), the current heart condition (p = 0.03), and the severity of current heart condition (p < 0.05) had a suggestive association with speech or language disorders. The severity of current heart condition (p = 0.08) has a potential statistically significant association with attention deficit hyperactivity disorder(ADHD). In PSM samples, ADHD(p = 0.003), intellectual disability(p = 0.012), and speech or language disorders(p < 0.001) were all significantly associated with CHD. The severity of current heart condition (p < 0.001) also had a significant association with autism. MR analysis did not find causality between genetically proxied congenital cardiac malformations and the risk of NDDs. Conclusions: Our study shows that children with CHD have an increased risk of developing NDDs. Heart conditions currently and severity of current heart conditions were also significantly associated with these NDDs. In the future, we need to try more methods to clarify the causal relationship between CHD and NDDs. [ABSTRACT FROM AUTHOR]

Background: Drug overdose deaths in the United States exceeded 100,000 in 2021 and 2022. Substance use stigma is a major barrier to treatment and harm reduction utilization and is a priority target in ending the overdose epidemic. However, little is known about the relationship between stigma and overdose, especially in rural areas. We aimed to characterize the association between felt stigma and non-fatal overdose in a multi-state sample of rural-dwelling people who use drugs. Methods: Between January 2018 and March 2020, 2,608 people reporting past 30-day opioid use were recruited via modified chain-referral sampling in rural areas across 10 states. Participants completed a computer-assisted survey of substance use and substance-related attitudes, behaviors, and experiences. We used multivariable logistic regression with generalized estimating equations to test the association between felt stigma and recent non-fatal overdose. Results: 6.6% of participants (n = 173) reported an overdose in the past 30 days. Recent non-fatal overdose was significantly associated with felt stigma after adjusting for demographic and substance use-related covariates (aOR: 1.47, 95% CI: 1.20–1.81). The association remained significant in sensitivity analyses on component fear of enacted stigma items (aOR: 1.48, 95% CI: 1.20–1.83) and an internalized stigma item (aOR: 1.51, 95% CI: 1.07–2.14). Conclusions: Felt stigma related to substance use is associated with higher risk of non-fatal overdose in rural-dwelling people who use drugs. Stigma reduction interventions and tailored services for those experiencing high stigma are underutilized approaches that may mitigate overdose risk. [ABSTRACT FROM AUTHOR]

Background: This study aims to conduct a scientometric analysis and thematically-based narrative review of a century of Taraxacum officinale research (TOR), uncovering patterns, trends, themes, and advancements in the field to provide insights for future investigations. The study followed PRISMA guidelines and utilized the Scopus database with MeSH terms for bibliographic data retrieval. Scientometric mapping employed VOSviewer and R-package-based Bibliometrix, while extracted themes were reviewed narratively. A detailed analysis of TOR was achieved by including only original studies. Results: The findings include the extensive duration of TOR since 1908 and its significant growth, particularly in the last two decades. China emerges as the most productive country, but the United States leads in recognizable and collaborative TOR. The thematic map displays dynamic and diverse themes, with a rich knowledge structure revealed through the analysis of term co-occurrence. The year 2016 represents a turning point in the thematic map, marked by numerical growth and thematic bifurcation. The study extracted several main research topics within the field of TOR, including germination, antioxidant activity, bioherbicide, oxidative stress, Taraxacum kok-saghyz, and heavy metals. These topics represent key areas of investigation and provide insights into the diverse aspects of research surrounding T. officinale. Additionally, emerging topics in TOR encompass toxicity, metabolomics, dandelion extract, and diabetes mellitus. Conclusions: The study consolidated knowledge, highlighted research gaps, and provided directions for future investigations on TOR. [ABSTRACT FROM AUTHOR]

Background: Police violence is increasingly recognized as an urgent public health problem. Basic questions about police violence, however, remain unanswered, including which types of law enforcement agency are responsible for fatal police violence deaths. Methods: We estimated the proportion of police violence deaths in the U.S. (2013–2022) that were attributable to local, county, state, federal, or tribal police agencies, using mapping police violence data. We examined proportions overall, by decedent race/ethnicity, and by state. Results: Nationally, 60% of decedents were killed by municipal, 29% by county, 8% by state, and 3% by federal, police, with < 1% killed by tribal or other officers. These proportions varied by race/ethnicity, with 56% of Native American decedents killed by municipal police compared to 70–75% among other racially minoritized people. While municipal police were responsible for most deaths in most states, in the Southeast, county police predominated. In some Northeastern states (and Alaska), state police were responsible for > 40% of deaths. Conclusions: We identify wide geographic & racial/ethnic variation in the agencies responsible for fatal police violence. Findings suggest that the budgetary and infrastructural shifts required to prevent fatal police violence need to occur at multiple levels of government. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of artificial intelligence (AI) chat programs has opened two distinct paths, one enhancing interaction and another potentially replacing personal understanding. Ethical and legal concerns arise due to the rapid development of these programs. This paper investigates academic discussions on AI in medicine, analyzing the context, frequency, and reasons behind these conversations. Methods: The study collected data from the Web of Science database on articles containing the keyword "ChatGPT" published from January to September 2023, resulting in 786 medically related journal articles. The inclusion criteria were peer-reviewed articles in English related to medicine. Results: The United States led in publications (38.1%), followed by India (15.5%) and China (7.0%). Keywords such as "patient" (16.7%), "research" (12%), and "performance" (10.6%) were prevalent. The Cureus Journal of Medical Science (11.8%) had the most publications, followed by the Annals of Biomedical Engineering (8.3%). August 2023 had the highest number of publications (29.3%), with significant growth between February to March and April to May. Medical General Internal (21.0%) was the most common category, followed by Surgery (15.4%) and Radiology (7.9%). Discussion: The prominence of India in ChatGPT research, despite lower research funding, indicates the platform's popularity and highlights the importance of monitoring its use for potential medical misinformation. China's interest in ChatGPT research suggests a focus on Natural Language Processing (NLP) AI applications, despite public bans on the platform. Cureus' success in publishing ChatGPT articles can be attributed to its open-access, rapid publication model. The study identifies research trends in plastic surgery, radiology, and obstetric gynecology, emphasizing the need for ethical considerations and reliability assessments in the application of ChatGPT in medical practice. Conclusion: ChatGPT's presence in medical literature is growing rapidly across various specialties, but concerns related to safety, privacy, and accuracy persist. More research is needed to assess its suitability for patient care and implications for non-medical use. Skepticism and thorough review of research are essential, as current studies may face retraction as more information emerges. [ABSTRACT FROM AUTHOR]

Groundwater wells are critical infrastructure that enable the monitoring, extraction, and use of groundwater, which has important implications for the environment, water security, and economic development. Despite the importance of wells, a unified database collecting and standardizing information on the characteristics and locations of these wells across the United States has been lacking. To bridge this gap, we have created a comprehensive database of groundwater well records collected from state and federal agencies, which we call the United States Groundwater Well Database (USGWD). Presented in both tabular form and as vector points, USGWD comprises over 14.2 million well records with attributes, such as well purpose, location, depth, and capacity, for wells constructed as far back as 1763 to 2023. Rigorous cross-verification steps have been applied to ensure the accuracy of the data. The USGWD stands as a valuable tool for improving our understanding of how groundwater is accessed and managed across various regions and sectors within the United States. [ABSTRACT FROM AUTHOR]

Noncommunicable diseases (NCD), such as obesity, diabetes, and cardiovascular disease, are defining healthcare challenges of the 21st century. Medical infrastructure, which for decades sought to reduce the incidence and severity of communicable diseases, has proven insufficient in meeting the intensive, long‐term monitoring needs of many NCD disease patient groups. In addition, existing portable devices with rigid electronics are still limited in clinical use due to unreliable data, limited functionality, and lack of continuous measurement ability. Here, a wearable system for at‐home cardiovascular monitoring of postpartum women—a group with urgently unmet NCD needs in the United States—using a cloud‐integrated soft sternal device with conformal nanomembrane sensors is introduced. A supporting mobile application provides device data to a custom cloud architecture for real‐time waveform analytics, including medical device‐grade blood pressure prediction via deep learning, and shares the results with both patient and clinician to complete a robust and highly scalable remote monitoring ecosystem. Validated in a month‐long clinical study with 20 postpartum Black women, the system demonstrates its ability to remotely monitor existing disease progression, stratify patient risk, and augment clinical decision‐making by informing interventions for groups whose healthcare needs otherwise remain unmet in standard clinical practice. [ABSTRACT FROM AUTHOR]

Background: Social support and self-efficacy play a significant role in improving positive psychological well-being in marginalized older adults. However, to date, there are few studies identifying the relationships during the COVID-19 pandemic. We examined the effect of social support and self-efficacy on hopefulness in a majority Black sample of marginalized low-income older adults during the COVID-19 pandemic. Methods: This study used baseline data from a clinical trial designed to increase COVID-19 testing in Essex County, NJ, United States. The dataset involved participants 50 years old or older. We conducted: 1) cross-sectional descriptive/frequency statistics to understand the sociodemographic characteristics, 2) multivariate linear regression to investigate the direct relationships between social support subscales or self-efficacy and hopefulness, and 3) mediation analyses to examine the mediating role of self-efficacy in the relationship between social support and hopefulness. Results: Our findings showed that self-efficacy had a partial mediating effect on the relationship between social support and hopefulness. After adjusting for covariate variables, social support subscales (i.e., emotional/informational, tangible, affectionate, positive social interaction social support) and self-efficacy were significantly associated with hopefulness. The indirect effect of social support via self-efficacy was positive and statistically significant. Conclusion: Self-efficacy mediated the relationship between social support and hopefulness in marginalized older adults aged 50 and over. Further research is needed to identify the various facets of positive psychological well-being using longitudinal data and a larger sample size. [ABSTRACT FROM AUTHOR]

Background: The Planetary Health Diet Index (PHDI) measures adherence to the dietary pattern presented by the EAT-Lancet Commission, which aligns health and sustainability targets. There is a need to understand how PHDI scores correlate with dietary greenhouse gas emissions (GHGE) and how this differs from the carbon footprints of scores on established dietary recommendations. The objectives of this study were to compare how the PHDI, Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to (a) dietary GHGE and (b) to examine the influence of PHDI food components on dietary GHGE. Methods: We used life cycle assessment data from the Database of Food Recall Impacts on the Environment for Nutrition and Dietary Studies to calculate the mean dietary GHGE of 8,128 adult participants in the 2015–2016 and 2017–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Poisson regression was used to estimate the association of (a) quintiles of diet score and (b) standardized dietary index Z-scores with dietary GHGE for PHDI, HEI-2015, and DASH scores. In secondary analyses, we used Poisson regression to assess the influence of individual PHDI component scores on dietary GHGE. Results: We found that higher dietary quality on all three indices was correlated with lower dietary GHGE. The magnitude of the dietary quality-dietary GHGE relationship was larger for PHDI [-0.4, 95% CI (-0.5, -0.3) kg CO2 equivalents per one standard deviation change] and for DASH [-0.5, (-0.4, -0.6) kg CO2-equivalents] than for HEI-2015 [-0.2, (-0.2, -0.3) kg CO2-equivalents]. When examining PHDI component scores, we found that diet-related GHGE were driven largely by red and processed meat intake. Conclusions: Improved dietary quality has the potential to lower the emissions impacts of US diets. Future efforts to promote healthy, sustainable diets could apply the recommendations of the established DASH guidelines as well as the new guidance provided by the PHDI to increase their environmental benefits. [ABSTRACT FROM AUTHOR]

Scandals are momentous events with far-reaching consequences for organizations and society, but we still know relatively little about the contextual conditions that enable them. In this paper, we develop and test a theory of the publicization of organizational misconduct—that is, of how an act of wrongdoing by an organization becomes widely publicized, thereby giving rise to a scandal; or receives little coverage, with little or no consequence for the offending organization. We argue that communities have structural features that affect the social cost of making information public as well as its dissemination, shaping the likelihood of organizational misconduct being publicized in the process. We test and find evidence in support of our arguments using data on sex abuse in the U.S. Catholic Church between 1980 and 2010, and exploring the heterogeneity in the publicization of patterns of misconduct by Catholic clergy across dioceses and over time. We conclude by discussing the implications of our findings for the scholarly understanding of organizational misconduct and scandals across settings. [ABSTRACT FROM AUTHOR]

Purpose: This paper analyses the establishment and evolution of a public oversight body (POB) – the Egyptian Audit Oversight Unit (AOU) – and its implications for local auditing firms and practices. Design/methodology/approach: Primary data were gathered from 34 semi-structured interviews (including follow-up ones) between 2014 and 2020. Secondary data was obtained through publicly available documents and internal memos. Drawing on Debord's (1967) Society of the Spectacle, the insights focus on the POB's conception, materialisation and evolution in a context characterised by weak regulatory structures. Findings: Through a series of acts, the findings reveal how the AOU first accepted the image of "international best practice" oversight (the "metaphorical"), followed by the construction of the local structure and décor replicating a United States (US) style POB archetype (the "transformational") by primarily relying on visible processes/procedures. Yet, these mechanisms emphasised the spectacular nature of oversight, with little improvement for practice and limiting itself to "cracking down" on smaller local firms. A final stage (the "performative") reveals how the AOU seeks to expand its activities beyond its original mandate without challenging the image-driven nature of its oversight. Originality/value: The paper offers two key contributions. First, it reveals how actors, through a combination of symbolic and tangible measures, create a new performative reality of public oversight. Second, it advocates Debord's "spectacle" to complement other theoretical lenses, with a view to illuminating the materialisation stages that bridge the gap between proclaimed oversight policies and actual practices (including conscious and unconscious omissions) within a given political economy context. [ABSTRACT FROM AUTHOR]

This paper investigates the homogeneity of United States aircraft reconnaissance data and the impact of these data on the homogeneity of the tropical cyclone (TC) best track data for the seasons 1949–1987 generated by the China Meteorological Administration (CMA). The evaluation of the reconnaissance data shows that the minimum central sea level pressure (MCP) data are relatively homogeneous, whereas the maximum sustained wind (MSW) data show both overestimations and spurious abrupt changes. Statistical comparisons suggest that both the reconnaissance MCP and MSW were well incorporated into the CMA TC best track dataset. Although no spurious abrupt changes were evident in the reconnaissance-related best track MCP data, two spurious changepoints were identified in the remainder of the best-track MCP data. Furthermore, the influence of the reconnaissance MSWs seems to extend to the best track MSWs unrelated to reconnaissance, which might reflect the optimistic confidence in making higher estimates due to the overestimated extreme wind "observations". In addition, the overestimation of either the reconnaissance MSWs or the best track MSWs was greater during the early decades compared to later decades, which reflects the important influence of reconnaissance data on the CMA TC best track dataset. The wind–pressure relationship (WPR) used in the CMA TC best track dataset is also evaluated and is found to overestimate the MSW, which may lead to inhomogeneity within the dataset between the aircraft reconnaissance era and the satellite era. [ABSTRACT FROM AUTHOR]

Nitrogen oxides (NO x= NO + NO 2) play a critical role in regulating tropospheric chemistry, yet NO x emission estimates are subject to large uncertainties, casting doubt on our ability to accurately model secondary pollutants such as ozone. Bottom-up emissions inventories are subject to a number of uncertainties related to estimates of emission activities, scaling factors, and fuel sources. Here, we provide an additional constraint on NO x emissions and trends using nitrate wet deposition (NWD) fluxes from the United States National Atmospheric Deposition Program (NADP) and the European Monitoring and Evaluation Programme (EMEP). We use these NWD measurements to evaluate anthropogenic and total NO x trends and magnitudes in the global Community Emissions Data System (CEDS) emissions inventory and the GEOS-Chem chemical transport model from 1980–2020. Over both the United States and Europe, observed NWD trends track well with anthropogenic NO x emissions from the CEDS inventory until 2010, after which NWD trends level out in contrast to continued decreases in CEDS. After 2010, NWD trends are able to reproduce total NO x emissions trends when the influences of both anthropogenic and background sources are considered. Observed NWD fluxes are also able to capture NO x emissions decreases over the 2020 COVID-19 lockdown period and are consistent with satellite and surface measurements of NO 2. These results suggest that NWD fluxes constrain total NO x emissions well, whether trends are driven by anthropogenic or background sources. We further compare modeled and observed NWD to provide an additional line of evidence for potential overestimates of anthropogenic NO x in emissions inventories. Over the United States, we find that NWD is overestimated in summer from 1980–2017 by 15 %–20 % on average (interquartile range: 11 %–31 %), with overestimates most prominent in the eastern US after 2000 (20 % on average), implying an overestimate of NO x emissions in the CEDS inventory (0.5×0.5 ° resolution). Over Europe, we find that modeled NWD is overestimated in all seasons from 1980–2017, with the strongest average overestimates occurring in summer and fall (175 % and 170 %, respectively). These overestimates may be reduced by cutting anthropogenic NO x emissions by 50 % in CEDS over Europe (i.e., cutting the 1980–2017 average annual emissions from 2.6 to 1.3 Tg N), but summertime and fall NO x may still need to be reduced further for observations and models to align. Overestimates may extend to other inventories such as the EMEP inventory, which estimates comparable but lower emissions than CEDS, with a 1990–2017 average of 2.1 Tg N relative to the CEDS 1990–2017 average of 2.4 Tg N. We find that NO x emission reductions over Europe improve model ozone at the surface, reducing the model summertime ozone overestimate from 14 % to 2 %. [ABSTRACT FROM AUTHOR]