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The current phenomenological study was undertaken, during the COVID-19 pandemic induced school closures, with the purpose to explore successes and challenges of implementing virtual education and collecting suggestions for improving virtual teaching practice. Data was collected using purposive sampling via social media, using open-ended survey. 141 teachers, teaching kindergarten and elementary school, from different regions submitted their responses. In our research findings, three success themes and five major challenges have emerged from the voice of teachers experiencing a rapid and unprepared shift to virtual education. Suggestions for improving digital education revolved around engagement strategies, training, access, school policies and collaboration among teachers. The finding of the research can help in informing areas of focus for reimagining the approach to education for an uncertain future.

Objectives Declines in mortality have historically been associated with improvements in physical health across generations. While life expectancy in most high-income countries continues to increase, there is evidence that younger generations, particularly in the United States, are less healthy than previous generations at the same age. We compared generational trends in physical health in the United States, England, and continental Europe to explore whether other regions have experienced a similar pattern of worsening health across cohorts. Methods Using data from nationally representative studies of adults aged ≥50 years from the United States (Health and Retirement Study, n = 26,939), England (English Longitudinal Study of Ageing, n = 14,992) and 11 continental European countries (Survey of Health, Ageing and Retirement in Europe, n = 72,595), we estimated differences in the age-adjusted prevalence of self-reported chronic disease and disability and observer-measured health indicators across pseudo-birth cohorts (born <1925, 1925–1935, 1936–1945, 1946–1954, 1955–1959). Results Age-adjusted prevalence of doctor-diagnosed chronic disease increased across successive cohorts in all regions. Trends in disability prevalence were more regionally varied. Still, in both the United States and Europe, we observed a structural break in disability trends, with declines observed in prewar cohorts slowing, stalling, or reversing for cohorts born since 1945. Discussion In all regions, we found evidence for worsening health across cohorts, particularly for those born since 1945. While more chronic disease in younger cohorts need not necessarily translate to worse quality of life or higher rates of functional limitation, there is some suggestion that worsening chronic disease morbidity may be spilling over into worsening disability. [ABSTRACT FROM AUTHOR]

Background: Most clinical studies of alcohol use disorder (AUD) treatment have short follow‐up periods, underestimating the full benefits of alcohol treatment. Furthermore, clinical studies only consider one treatment cycle and do not account for the need for multiple episodes to treat a chronic recurrent condition. Methods: A validated microsimulation model of the long‐term drinking patterns of people with AUD in the United States simulated 10,000 individuals resembling those from a large clinical trial. The model was used to assess the impact of (1) 1‐year, 5‐year, and lifetime horizon on alcohol treatment cost‐effectiveness estimates and (2) no, one, two, four, and unlimited additional treatment episodes on alcohol treatment cost‐effectiveness estimates. Model outcomes included healthcare costs, crime costs, labor market productivity, life expectancy, quality‐adjusted life years (QALYs), alcohol‐related hospitalizations, and deaths. Cost‐effectiveness analyses were conducted for two perspectives: a healthcare perspective that included costs from hospitalization and AUD treatment, and a broader societal perspective that also included crime costs and productivity. Results: The incremental cost per additional QALY gained for alcohol treatment compared with no treatment decreased from $55,590 after 1 year to $78 when healthcare costs and QALYs were tracked over the lifetime, that is, treatment became more cost effective. Treatment was cost saving for any time frame when the impacts on crime and labor productivity were also accounted for in a societal perspective. Access to multiple treatment episodes dominated (i.e., it was more effective and less costly) than no‐treatment and one‐episode scenarios. From a healthcare perspective, incremental costs per additional QALY for increasing from a maximum of two to four treatment episodes was $499 and from four to unlimited episodes was $5049. The unlimited treatment scenario dominated all others from a societal perspective. Results were robust in sensitivity analyses. Conclusions: A long‐term perspective and multiple episodes of alcohol treatment improve cost‐effectiveness estimates. When societal impacts are included, alcohol treatment is cost saving. Results support the value of alcohol treatment. [ABSTRACT FROM AUTHOR]

The objectives of this study were to 1) assess intimate partner violence (IPV) policy and standard practices of United States (US) children's hospitals, 2) describe system-level barriers to addressing IPV within children's hospitals, and 3) explore potential associations between hospital system factors and standard IPV practices. For this cross-sectional survey of US children's hospitals, we recruited a single individual from each hospital to complete an anonymous survey assessing hospital IPV policy and institution-level practice standards. Participants could upload their hospital's IPV policy for review. We recruited via professional listservs and snowball sampling. Among 36 respondents, most were at academic (94%) and/or free-standing (66%) children's hospitals in an urban setting (77%). Most (79%) reported having a hospital IPV policy. Most policies included standard response to IPV disclosure (86%), guidelines for child protective services (CPS) reporting related to IPV (75%), IPV documentation (71%), and IPV screening (68%). Review of provided policies revealed variability in other components, including indications for CPS reporting, which were subjective at some institutions. Most (71%) reported their hospital actively partnered with a community IPV agency. Hospitals that partnered with a community IPV agency were more likely to report employee IPV education (84% vs. 40%, p 0.02), availability of an IPV advocate (76% vs. 20%, p 0.006), and use of environmental IPV cues (e.g., posters; 80% vs. 40%, p 0.04). This exploratory study found variability in IPV policy and institution-level practices between hospitals. Further work is needed to better define and disseminate best practices to address IPV in children's hospitals. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic was accompanied by an "infodemic"–an overwhelming excess of accurate, inaccurate, and uncertain information. The social media-based science communication campaign Dear Pandemic was established to address the COVID-19 infodemic, in part by soliciting submissions from readers to an online question box. Our study characterized the information needs of Dear Pandemic's readers by identifying themes and longitudinal trends among question box submissions. Methods: We conducted a retrospective analysis of questions submitted from August 24, 2020, to August 24, 2021. We used Latent Dirichlet Allocation topic modeling to identify 25 topics among the submissions, then used thematic analysis to interpret the topics based on their top words and submissions. We used t-Distributed Stochastic Neighbor Embedding to visualize the relationship between topics, and we used generalized additive models to describe trends in topic prevalence over time. Results: We analyzed 3839 submissions, 90% from United States-based readers. We classified the 25 topics into 6 overarching themes: 'Scientific and Medical Basis of COVID-19,' 'COVID-19 Vaccine,' 'COVID-19 Mitigation Strategies,' 'Society and Institutions,' 'Family and Personal Relationships,' and 'Navigating the COVID-19 Infodemic.' Trends in topics about viral variants, vaccination, COVID-19 mitigation strategies, and children aligned with the news cycle and reflected the anticipation of future events. Over time, vaccine-related submissions became increasingly related to those surrounding social interaction. Conclusions: Question box submissions represented distinct themes that varied in prominence over time. Dear Pandemic's readers sought information that would not only clarify novel scientific concepts, but would also be timely and practical to their personal lives. Our question box format and topic modeling approach offers science communicators a robust methodology for tracking, understanding, and responding to the information needs of online audiences. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol consumption increased in the early phases of the COVID‐19 pandemic in the United States. Alcohol use disorder (AUD) and risky drinking are linked to harmful health effects. This paper aimed to project future health and cost impacts of shifts in alcohol consumption during the COVID‐19 pandemic. Design: An individual‐level simulation model of the long‐term drinking patterns for people with life‐time AUD was used to simulate 10 000 individuals and project model outcomes to the estimated 25.9 million current drinkers with life‐time AUD in the United States. The model considered three scenarios: (1) no change (counterfactual for comparison); (2) increased drinking levels persist for 1 year ('increase‐1') and (3) increased drinking levels persist for 5 years ('increase‐5'). Setting: United States. Participants: Current drinkers with life‐time AUD. Measurements: Life expectancy [life‐years (LYs)], quality‐adjusted life‐years (QALYs), alcohol‐related hospitalizations and associated hospitalization costs and alcohol‐related deaths, during a 5‐year period. Findings Short‐term increases in alcohol consumption (increase‐1 scenario) resulted in a loss of 79 000 [95% uncertainty interval (UI]) 26 000–201 000] LYs, a loss of 332 000 (104 000–604 000) QALYs and 295 000 (82 000–501 000) more alcohol‐related hospitalizations, costing an additional $5.4 billion ($1.5–9.3 billion) over 5 years. Hospitalizations for cirrhosis of the liver accounted for approximately $3.0 billion ($0.9–4.8 billion) in hospitalization costs, more than half the increase across all alcohol‐related conditions. Health and cost impacts were more pronounced for older age groups (51+), women and non‐Hispanic black individuals. Increasing the duration of pandemic‐driven increases in alcohol consumption in the increase‐5 scenario resulted in larger impacts. Conclusions: Simulations show that if the increase in alcohol consumption observed in the United States in the first year of the pandemic continues, alcohol‐related mortality, morbidity and associated costs will increase substantially over the next 5 years. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Drug-drug interactions (DDIs) are among the most common causes of adverse drug reactions and are further complicated by genetic variants of drug-metabolizing enzymes. The aim of this study is to quantify and describe potential DDIs, drug-gene interactions (DGIs), and drug-drug-gene interactions (DDGIs) in a community-based population. STUDY DESIGN: This was an analysis of deidentified retail pharmacy prescription data for 4761 individuals. METHODS: Data were first assessed for DDIs, and individuals were stratified to a risk category using the logic of a commercially available digital DDGI tool. To calculate the frequency of potential DGIs and DDGIs, genotypes were imputed and randomly allocated to the cohort 100 times via Monte Carlo simulation according to each variant's frequency in the general population. RESULTS: The probability of a DDI of any impact was 26.0% and increased to 49.6% (95% CI, 48.4%-50.7%) when drug-metabolizing phenotypes were ascribed according to the distribution of variants of 11 genes as found in a Caucasian population. There was a 7.8% probability of major DDIs, which increased to a 10.1% (95% CI, 9.5%-10.8%) probability with the addition of genetic contributions. The probability of DDGIs of any impact was correlated with the number of medications. Antidepressants, antiemetics, blood products and modifiers, analgesics, and antipsychotics had the highest probability of DDGIs. CONCLUSIONS: The probability of drug interaction risk increased when phenotypes associated with genetic polymorphisms were attributed to the population. These data suggest that pharmacogenomic assessment may be useful in predicting drug interactions and severity when evaluating patient medication profiles. [ABSTRACT FROM AUTHOR]

The coronavirus 2019 (COVID-19) pandemic triggered global declines in life expectancy. The United States was hit particularly hard among high-income countries. Early data from the United States showed that these losses varied greatly by race/ethnicity in 2020, with Hispanic and Black Americans suffering much larger losses in life expectancy compared with White people. We add to this research by examining trends in lifespan inequality, average years of life lost, and the contribution of specific causes of death and ages to race/ethnic life-expectancy disparities in the United States from 2010 to 2020. We find that life expectancy in 2020 fell more for Hispanic and Black males (4.5 and 3.6 y, respectively) compared with White males (1.5 y). These drops nearly eliminated the previous life-expectancy advantage for the Hispanic compared with the White population, while dramatically increasing the already large gap in life expectancy between Black and White people. While the drops in life expectancy for the Hispanic population were largely attributable to official COVID-19 deaths, Black Americans saw increases in cardiovascular diseases and "deaths of despair" over this period. In 2020, lifespan inequality increased slightly for Hispanic and White populations but decreased for Black people, reflecting the younger age pattern of COVID-19 deaths for Hispanic people. Overall, the mortality burden of the COVID-19 pandemic hit race/ethnic minorities particularly hard in the United States, underscoring the importance of the social determinants of health during a public health crisis. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety and effectiveness of the Flow Redirection Endoluminal Device (FRED) flow diverter in support of an application for Food and Drug Administration approval in the USA. Methods 145 patients were enrolled in a prospective, single-arm multicenter trial. Patients with aneurysms of unfavorable morphology for traditional endovascular therapies (large, wide-necked, fusiform, etc) were included. The trial was designed to demonstrate noninferiority in both safety and effectiveness, comparing trial results with performance goals (PGs) established from peer-reviewed published literature. The primary safety endpoint was death or major stroke (National Institutes of Health Stroke Scale score ≥4 points) within 30 days of the procedure, or any major ipsilateral stroke or neurological death within the first year. The primary effectiveness endpoint was complete occlusion of the target aneurysm with ≤50% stenosis of the parent artery at 12 months after treatment, and in which an alternative treatment of the target intracranial aneurysm had not been performed. Results 145 patients underwent attempted placement of a FRED device, and one or more devices were placed in all 145 patients. 135/145 (93%) had a single device placed. Core laboratory adjudication deemed 106 (73.1%) of the aneurysms large or giant. A safety endpoint was experienced by 9/145 (6.2%) patients, successfully achieving the safety PG of <15%. The effectiveness PG of >46% aneurysm occlusion was also achieved, with the effectiveness endpoint being met in 80/139 (57.6%) Conclusion As compared with historically derived performance benchmarks, the FRED flow diverter is both safe and effective for the treatment of appropriately selected intracranial aneurysms. [ABSTRACT FROM AUTHOR]

Explanations for lagging life expectancy in the United States compared to other high-income countries have focused largely on "deaths of despair," but attention has also shifted to the role of stalling improvements in cardiovascular disease and the obesity epidemic. Using harmonized data from the U.S. Health and Retirement Study and English Longitudinal Study of Ageing, we assess differences in self-reported and objective measures of health, among older adults in the United States and England and explore whether the differences in body mass index (BMI) documented between the United States and England explain the U.S. disadvantage. Older adults in the United States have a much higher prevalence of diabetes, low high-density lipoprotein cholesterol, and high inflammation (C-reactive protein) compared to English adults. While the distribution of BMI is shifted to the right in the United States with more people falling into extreme obesity categories, these differences do not explain the cross-country differences in measured biological risk. We conclude by considering how country differences in health may have affected the burden of coronavirus disease 2019 mortality in both countries. [ABSTRACT FROM AUTHOR]

Accurate blood pressure measurement is essential to appropriately diagnose and treat hypertension. Blood pressure is usually measured by taking a single automated office blood pressure (AOBP) reading, but there are newer, fully automated devices that calculate the mean of several blood pressure readings. A quality improvement initiative was conducted in a US ambulatory care setting to determine whether there were differences in the accuracy of blood pressure measurement when measuring mean AOBP versus single AOBP. A population of 126 patients attending a transitional care clinic at an urban hospital were randomly assigned to receive mean AOBP measurement at the beginning of their appointment, at the end of their appointment, or not at all. This randomised prospective evaluation did not find conclusive evidence regarding the use of mean AOBP measurement versus single AOBP measurement. However, using a fully automated device that calculates mean AOBP may be useful in busy clinical settings, allowing nurses to spend more time on other aspects of their role such as patient education and care coordination. [ABSTRACT FROM AUTHOR]

Objective: To describe physicians' variation in de-adopting concurrent statin and fibrate therapy for type 2 diabetic patients following a reversal in clinical evidence.Data Sources: We analyzed 2007-2015 claims data from OptumLabs® Data Warehouse, a longitudinal, real-world data asset with de-identified administrative claims and electronic health record data.Study Design: We modeled fibrate use among Medicare Advantage and commercially insured type 2 diabetic statin users before and after the publication of the ACCORD lipid trial, which found statins and fibrates were no more effective than statins alone in reducing cardiovascular events among type 2 diabetic patients. We modeled fibrate use trends with physician random effects and physician characteristics such as age and specialty.Data Extraction: We identified patient-year-quarters with one year of continuous insurance enrollment, type 2 diabetes diagnoses, and fibrate use. We designated the physician most responsible for patients' diabetes care based on evaluation and management visits and prescriptions of glucose-lowering drugs.Principal Findings: Fibrate use increased by 0.12 percentage points per quarter among commercial patients (95% CI, 0.10 to 0.14) and 0.17 percentage points per quarter among Medicare Advantage patients (95% CI, 0.13 to 0.20) before the trial and then decreased by 0.16 percentage points per quarter among commercial patients (95% CI, -0.18 to -0.15) and 0.05 percentage points per quarter among Medicare Advantage patients (95% CI, -0.06 to -0.03) after the trial. However, 45% of physicians treating commercial patients and 48% of physicians treating Medicare Advantage patients had positive trends in prescribing following the trial. Physicians' characteristics did not explain their variation (pseudo R2  = 0.000).Conclusion: On average, physicians decreased fibrate prescribing following the ACCORD lipid trial. However, many physicians increased prescribing following the trial. Observable physician characteristics did not explain variations in prescribing. Future research should examine whether physicians vary similarly in other de-adoption settings. [ABSTRACT FROM AUTHOR]

Although there has been no direct empirical evidence linking sexual dysfunction (SD) with gun ownership, speculation has been widespread and persistent for decades. In this paper, we formally examine the association between SD and gun ownership. Our primary hypothesis, derived from the psychosexual theory of gun ownership, asserts that men experiencing SD are more likely to personally own guns than other men. To test this hypothesis, we used recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 780 men, and binary logistic regression to model gun ownership as a function of SD. Our key finding is that men experiencing SD are no more likely to own guns than men without SD. This interpretation was supported across several indicators of SD (performance anxiety, erection trouble, and ED medication) and gun ownership (personal gun ownership, purchasing a gun during the pandemic, and keeping a gun in one's bedroom). To our knowledge, we are the first to have directly tested the association between SD and gun ownership in America. Our findings are important because they contribute to our understanding of factors associated with gun ownership by challenging the belief that phallic symbolism and masculinity somehow drive men with SD to purchase guns. Our results also remind us of the perils of gun culture rhetoric, which, in this case, function to discredit gun owners and to further stigmatize men with ED. We conclude by calling for more evidence-based discussions of SD and guns in society. [ABSTRACT FROM AUTHOR]

Aims: To estimate US population health utilities for subgroups defined by alcohol use disorder (AUD) status and consumption level. Design Cross‐sectional survey. Setting: Community settings in the United States (i.e. excluding institutional settings). Participants: A total of 36,042 adults (age 18+) in non‐institutional settings in the United States. Measurements We used 12‐item Short Form Survey (SF‐12) data from the National Epidemiologic Survey on Alcohol and Related Conditions–III to calculate mean Short Form–6 dimension (SF‐6D) utility scores across World Health Organization alcohol consumption risk levels—very high risk, high risk, medium risk, low risk and an additional abstinent level—for three groups: (1) the general population (n = 36,042), (2) individuals with life‐time AUD (n = 9925) and (3) individuals with current AUD (n = 5083), and assessed minimally important differences (MIDs) between consumption levels. Each group is a subset of the previous group. Findings The general population's mean SF‐6D utility was higher than that of individuals with life‐time or current AUD across all consumption risk levels (0.79 versus 0.76 for both AUD groups). For all groups, SF‐6D utilities increased as consumption risk level decreased to non‐abstinent levels, and reducing consumption from very high risk to any lower level was associated with a statistically significant and meaningful improvement in utility. For individuals with life‐time or current AUD, becoming abstinent from high‐, medium‐ and low‐risk levels was associated with significantly and meaningfully worse utilities. Conclusions: Higher alcohol consumption risk levels appear to be associated with lower health index scores for the general population and individuals with a history of alcohol use disorder, meaning that higher alcohol consumption is associated with worse health‐related quality of life. [ABSTRACT FROM AUTHOR]

Background: Patient registries are organized systems that use observational methods to collect uniform data on specified outcomes in a population defined by a particular disease, condition, or exposure. Data collected in registries often coincide with data that could support clinical trials. Integrating clinical trials within registries to create registry-embedded clinical trials offers opportunities to reduce duplicative data collection, identify and recruit patients more efficiently, decrease time to database lock, accelerate time to regulatory decision-making, and reduce clinical trial costs. This article describes a project of the Clinical Trials Transformation Initiative (CTTI) intended to help clinical trials researchers determine when a registry could potentially serve as the platform for the conduct of a clinical trial. Methods: Through a review of registry-embedded clinical trials and commentaries, semi-structured interviews with experts, and a multi-stakeholder expert meeting, the project team addressed how to identify and describe essential registry characteristics, practices, and processes required to for conducting embedded clinical trials intended for regulatory submissions in the United States. Results: Recommendations, suggested practices, and decision trees that facilitate the assessment of whether a registry is suitable for embedding clinical trials were developed, as well as considerations for the design of new registries. Essential registry characteristics include relevancy, robustness, reliability, and assurance of patient protections. Conclusions: The project identifies a clear role for registries in creating a sustainable and reusable infrastructure to conduct clinical trials. Adoption of these recommendations will facilitate the ability to perform high-quality and efficient prospective registry-based clinical trials. [ABSTRACT FROM AUTHOR]

Background: Traumatic thoracic aortic injuries (TAIs) carry a substantial mortality. Our study aim was to evaluate the impact of insurance status on outcomes in severely injured trauma patients after either thoracic endovascular aortic repair (TEVAR) or open repair using the National Trauma Data Bank Research Data Set (NTDB-RDS).Methods: The NTDB-RDS was reviewed for outcomes in severely injured patients and TAI repair method (TEVAR vs open). Patients were divided into insured (Medicaid, Medicare, private insurance) and uninsured (self-pay) status groups. Patients were further divided by injury severity score (ISS) of 15-24 and ≥25 to adjust for injury burden. Demographic characteristics and outcome measures were compared. Chi-square, t-test, and analysis of variance were used with significance defined as P < .05.Results: Within the NTDB-RDS, a review of nearly 1 million patients led to 241 that underwent repair for TAI and had insurance status and repair type documented. 88.8% (214/241) of patients were insured, while 11.2% (27/241) of patients were uninsured. There were no significant differences in repair type based on insurance status. For open repair with an ISS ≥25, mortality was significantly higher in the uninsured group compared with insured (55.5% vs 21.9%, P = .001).Conclusion: For open repair in patients with TAI and high injury burden, uninsured status was associated with a significant increase in mortality rate compared with insured patients. Future studies should investigate the effect of insurance type on TAI outcomes and causes of higher mortality in uninsured patients. [ABSTRACT FROM AUTHOR]

In the article, the author discusses topics like the abolition of the juvenile justice system in the U.S., its impact on African American children and youth, and the 2012 murder of 17-year-old African American Trayvon Martin. Other topics include the launching of the #BlackLivesMatter movement in 2013, the criminalization of school discipline, school to prison pipeline, and the proposed framework of support to reform the current juvenile justice system as of September 2020.

Objective: To understand the effect of physician payment incentives on the allocation of health care resources.Data Sources/study Setting: Review and analysis of the literature on physician payment incentives.Study Design: Analysis of current physician payment incentives and several ways to modify those incentives to encourage increased efficiency.Principal Findings: Fee-for-service payments can be incorporated into systems that encourage efficient pricing - prices that are close to the provider's marginal cost - by giving consumers information on provider-specific prices and a strong incentive to choose lower cost providers. However, efficient pricing of services ultimately will need to be supplemented by incentives for efficient production of health and functional status.Conclusions: The problem with current FFS payment is not paying a fee for each service, per se, but the way in which the fees are determined. [ABSTRACT FROM AUTHOR]

The article focuses on the future of medication management through precision medicine for populations. Topics include the high prevalence of prescription drug use and its associated costs, common adverse drug reactions (ADRs) caused by drug interactions and genetic factors, and the potential of pharmacogenomics (PGx) to guide personalized treatment by predicting drug-gene interactions and adverse reactions.

Blunt thoracic aortic injuries (BTAIs) carry a substantial mortality rate. Our study aimed to compare the outcomes of thoracic endovascular aortic repair (TEVAR) with open repair from trauma centers across the United States using the National Trauma Data Bank–Research Data Set (RDS). The National Trauma Data Bank–RDS was reviewed for thoracic aortic injures and repair methods. Patients were divided into two groups: TEVAR versus open repair. Demographics and outcomes were compared between groups. Mortality rate was adjusted using the observed/expected mortality (O/E), with TRISS methodology by using the Revised Trauma Score with the Injury Severity Score. Chi-square test and t -test were used with significance defined as P < 0.05. Within the 2016 RDS, there were 275 cases that underwent operative repair for BTAI. Of the 275 operative cases, 62.5% (172/275) had TEVAR and 37.5% (103/275) underwent open repair. Mean age in TEVAR group was 41 and open repair group was 36 (P > 0.05). Mean Injury Severity Score for TEVAR was 36 versus 35 for open repair (P > 0.05). Mean Revised Trauma Score was 6.7 in TEVAR versus 5.5 in open group (P > 0.05). TEVAR patients had significantly lower crude mortality rate versus open repair (11% versus 25.2%, P < 0.005). When adjusted using O/E, the TEVAR group also had significantly less deaths versus open repair (0.40 versus 0.68, P < 0.000008). For BTAIs, thoracic endovascular aortic repairs were superior to open repair on injury-adjusted, all-cause mortality. [ABSTRACT FROM AUTHOR]

The article examines how the decisions of the U.S. Supreme Court in privacy cases like Carpenter v. United States have expanded the coverage of the Fourth Amendment from tangible things to ideas and discussions between people.

Recent commentary has questioned the validity of the US Court of Appeals for the Federal Circuit's use of Rule 36 affirmances in deciding appeals from the US Patent and Trademark Office (USPTO). One article in particular posits that 35 U.S.C. § 144 and 15 U.S.C. § 1071(a)(4) require the Federal Circuit to write an opinion in every appeal from the USPTO and therefore the court's use of Rule 36 affirmances, particularly with appeals of cases from the America Invents Act, is improper. This Article presents a reasoned counterpoint to that argument. A complete analysis of the statutory text, the legislative history, the historical context of the statutes, and other considerations, including other applicable Federal Rules of Appellate Procedure, the delegation of authority under the Rules Enabling Act, and traditional deference afforded the judiciary in how it applies procedural rules, support the conclusion that Rule 36 affirmances are entirely within the authority and discretion of the court. A contrary conclusion would rest on a slender reed of statutory text and would create a rare situation-- perhaps the only instance--in which Congress has directly dictated procedure for the federal courts of appeal since the enactment of the Rules Enabling Act. [ABSTRACT FROM AUTHOR]

Analysts interested in physician market concentration often have access to tax identification numbers (TINs), but not the number of truly independent negotiating units (NUs). Health plans do know the true number of NUs, and, using 2014 claims data for Minnesota physicians from a large midwestern health plan, we compare Herfindahl-Hirschman Index (HHI) measures of physician market concentration using TINs versus NUs at the county and metropolitan statistical area (MSA) levels for thirteen specialties. We found that HHIs computed using TINs versus NUs were similar across Minnesota. Two MSAs in Minnesota met the Department of Justice's definition of highly concentrated markets. There is reason to believe that the discrepancy between TIN and NU HHIs may vary by insurance product and region of the country, and so we encourage other researchers to work with health plans to replicate our study. [ABSTRACT FROM AUTHOR]

The ideas contained in this article were first presented in a summarized form at the International Marketing Session of the American Marketing Association Conference In December, 1959, and subsequently delivered in an expanded version at the Eighth Annual Conference of the Great Lakes States Industrial Development Council at Purdue University in January, 1960. Because of current wide discussion of the subject and its importance to marketers especially, Professor Dowd's analysis is reproduced here in its entirety. Professor Dowd offers proof that, although prices of products may be high because of increased costs of raw materials, taxes, labor, and declining efficiency of productive organization, U.S. exports are not being priced out of world markets. The popular belief is based upon an erroneous statistical comparison of two "abnormal" years, 1957 and 1958. Nevertheless, American producers may not be maintaining their share of world exports since they are not applying the principles of modern marketing management, essential to successful domestic selling, to increasingly important foreign markets. [ABSTRACT FROM AUTHOR]

Japanese wholesale marketing methods are quite different from those in the United States. Many manufacturers engage in no marketing activities at all; and even those which have sales departments usually relegate them to a subordinate position! Even more intriguing, wholesale organizations dominate all distribution and one large wholesaler may control production in an entire industry. The author, who knows Japan firsthand, gives some insights into this situation. [ABSTRACT FROM AUTHOR]

Objective: Although research suggests racial/ethnic disparities in influenza vaccination and mortality rates, few studies have examined racial/ethnic trends among US adolescents. We used national cross-sectional data to determine (1) trends in influenza vaccination rates among non-Hispanic white (hereinafter, white), non-Hispanic black (hereinafter, black), and Hispanic adolescents over time and (2) whether influenza vaccination rates among adolescents varied by race/ethnicity. Methods: We analyzed provider-reported vaccination histories for 2010-2016 from the National Immunization Survey–Teen. We used binary logistic regression models to determine trends in influenza vaccination rates by race/ethnicity for 117 273 adolescents, adjusted for sex, age, health insurance, physician visit in the previous 12 months, vaccination facility type, poverty status, maternal education level, children in the household, maternal marital status, maternal age, and census region of residence. We calculated adjusted probabilities for influenza vaccination for each racial/ethnic group, adjusted for the same demographic characteristics. Results: Compared with white adolescents, Hispanic adolescents had higher odds (adjusted odds ratio [aOR] = 1.11; 95% confidence interval [CI], 1.06-1.16) and black adolescents had lower odds (aOR = 0.95; 95% CI, 0.90-1.00) of vaccination. Compared with white adolescents, Hispanic adolescents had significantly higher adjusted probabilities of vaccination for 2011-2013 (2011: 0.22, P < .001; 2012: 0.23, P < .001; 2013: 0.26, P < .001). Compared with white adolescents, black adolescents had significantly lower probabilities of vaccination for 2016 (2016: 0.21, P < .001). Conclusions: Targeted interventions are needed to improve adolescent influenza vaccination rates and reduce racial/ethnic disparities in adolescent vaccination coverage. [ABSTRACT FROM AUTHOR]