Search

Science, technology, engineering, and mathematics (STEM) education has recently been gaining popularity in a number of countries. This seems to have ramifications for increasing the intensity with which professional development programmes are implemented at both in-service and pre-service teacher levels. The present study provides a systematic literature review on scientific articles published between 2015 and 2021, examining how STEM teacher professional development programmes (STEMTPD) led in the pre-service teacher corpus. Following a screening process, 66 studies were found to be eligible and in compliance with the review criteria. The review's findings indicate a positive trend in STEM-TPD scientific articles, with an increase in publications from year to year in many countries. The majority of studies were conducted in the United States and Turkey using various research methods. The STEM-TPD programme is carried out in three areas, namely, included in existing courses, conducted outside of lectures, and carried out on newly developed courses. We also ultimately discuss the seven most frequently used elements of STEM-TPD and the types of participant collaboration.

This rapid systematic review aims to examine emerging evidence on the effects of COVID-19 on educational institutions and assess the prevalence of e-learning changes in the sector. This paper reviews literature on learning, teaching, and assessment approaches adopted since the COVID-19 outbreak, and assesses the impact on the sector, staff, and students, summarizing findings from peer-reviewed articles. It categorizes these into five key themes: (1) digital learning; (2) e-learning challenges; (3) digital transition to emergency virtual assessment (EVA); (4) psychological impact of COVID-19; and (5) creating collaborative cultures. This represents the first systematic review of COVID-19's impact on education, clarifying current themes being investigated. The author suggests that the term 'emergency virtual assessment' (EVA) is now added for future research discussion. Finally, the paper identifies research gaps, including researching the impact on lesser developed countries, the psychological impact of transition, and the important role of leadership and leadership styles during the transition and handling of the pandemic.

We reviewed 48 articles related to the engineering design process in science education published from 2010 to 2020. There are several previous literature review studies that analyzed the engineering design process in science education. However, we have not found any that investigates projects, discussed topics, as well as the benefits of the implementation of the engineering design process in science education. The research method used was a systematic literature review. This study analyzed the characteristics of the content based on year of publication, type of publications, countries that implement it, research approach, educational stage, and science content. The findings show that the projects used in the implementation of the engineering design processes in science education varied according to the discussed topics. The benefits of the implementation of the engineering design process in science education include cognitive benefits, procedural (skills) benefits, attitudinal benefits, and a combination of the three benefits.

Purpose: Innovation in education is one of the alternative approaches in education to promote creative and higher-order thinking skills, providing hands-on learning and learning in context experience. However, there is a need to combine the ability to produce a commercialised innovation instead, as not many studies have combined innovation and entrepreneurship in an educational approach. This study seeks to examine the pattern of publication, key concepts, citations, and authorship in innovation and entrepreneurship educational research and their collaborations. Methods: This study employed a bibliometric analysis of 1,941 scholarly works related to innovation and entrepreneurship as recorded in the Scopus database on June 20th, 2021, for the past 10 years, starting in 2011. Findings: The findings indicate that since 2011, innovation and entrepreneurship have caught the attention of scholars from both the East and the West, such as the United States, the United Kingdom, Spain, and China, and the number of publications has grown consistently over the 10 years after that. Based on the findings, both innovation and entrepreneurship do rely on each other, and a proper curriculum design structure and management must be considered to assimilate these two elements together in any academic subject. Significance: According to the findings, these two elements are best applied at the tertiary level, and if they work together and blend well, they will aid not only in preparing future generations with good entrepreneurial skills but also in economic and sustainable development. However, while this transdisciplinary approach to educational research has been well received in the West, it has yet to be adequately encouraged in the East. There has been healthy cross-country collaboration, but there is a gap in combining innovation and entrepreneurship in educational research from certain countries vis a vis western countries. The findings of this study may have contributed significantly to increasing the inclusivity and global reach of innovation and entrepreneurship in educational research.

American and global history curriculum frameworks for high schools across the 50 states generally present the topic of the Cold War from the Western political perspective and contain material about the impact of the US-Soviet ideological rivalry on American society. This article argues that since the Cold War impacted the lives of people in the Third World as well, their stories deserve a place in the history curriculum. This article also suggests that since American society is culturally diverse, it is imperative for history educators to teach history in the learners' social and cultural contexts. Therefore, both the Cold War history content and pedagogy should include perspectives from the Third World so that the past is relevant and meaningful for all students learning about the global Cold War.

Mortality surveillance systems can have limitations, including reporting delays, incomplete reporting, missing data, and insufficient detail on important risk or sociodemographic factors that can impact the accuracy of estimates of current trends, disease severity, and related disparities across subpopulations. The Centers for Disease Control and Prevention used multiple data systems during the COVID-19 emergency response—line-level case‒death surveillance, aggregate death surveillance, and the National Vital Statistics System—to collectively provide more comprehensive and timely information on COVID-19‒associated mortality necessary for informed decisions. This article will review in detail the line-level, aggregate, and National Vital Statistics System surveillance systems and the purpose and use of each. This retrospective review of the hybrid surveillance systems strategy may serve as an example for adaptive informational approaches needed over the course of future public health emergencies. (Am J Public Health. 2024;114(10):1071–1080. https://doi.org/10.2105/AJPH.2024.307743) [ABSTRACT FROM AUTHOR]

Objective This study aimed to describe target oxygen saturation (SpO 2) ranges used for premature infants in United States' neonatal intensive care units (NICUs) and to describe if these target SpO 2 ranges have changed in recent years. Study Design A 29-question survey focused on target SpO 2 practices and policies was distributed via the NICU medical directors listservs for the American Academy of Pediatrics Section of Neonatal-Perinatal Medicine and Pediatrix Medical Group between August and October of 2021. Results were collected via Research Electronic Data Capture (REDCap). Results We received responses representing 170 unique, levels 2, 3, and 4 NICUs from 36 states. Most NICUs (130, 78%) have recently changed their SpO 2 targets in response to target SpO 2 clinical trials. Over time, the most commonly reported target SpO 2 range has shifted from 88–92% to 90–95. Of NICUs that changed limits, the most common lower SpO 2 limits increased from 88 to 90% and the upper SpO 2 limits changed from 92 to 95%. The interquartile range for lower SpO 2 limit shifted from 85–88% to 88–90% and the IQR for upper SpO 2 limit decreased from 92–95 to 94–95%. Most NICUs had designated conditions that would allow for deviations from standard target SpO 2 ranges. These most commonly include pulmonary hypertension (152, 95%), severe bronchopulmonary dysplasia (81, 51%), and retinopathy of prematurity (51, 32%). Conclusion Oxygen saturation limits have changed over time with an overall increase in targeted SpO 2. However, there remains considerable interunit variation in SpO 2 policies. There is a need to achieve consensus to optimize clinical outcomes. Key Points What are the SpO 2 ranges in United States' NICUs? There is a shift in SpO 2 ranges for preterm infants in NICUs across United States. Variability still persists in SpO 2 ranges for preterm infants in United States' NICUs. [ABSTRACT FROM AUTHOR]

We assessed the association between troponin levels and all-cause mortality in individuals with chest pain who presented to the Charleston Area Medical Center Emergency Department (CAMC). We identified adult patients with chest pain as defined in the International Classification of Diseases 10 (R07) family group from the CAMC data warehouse between June 6, 2020, and June 6, 2021. These cases required a visit to the emergency room. We created 3 different cohorts to assess the endpoints of all-cause mortality at 30 days and 6 months. Patients were divided into the following 3 categories: negative troponin level, defined as high sensitivity troponin I (HSTNI) assay ≤15 pg/mL for women and ≤20 pg/mL for men; weakly positive, 21–88 pg/mL for men and 16–88 pg/mL for women; and strongly positive, >88 pg/mL for men and women. A propensity score matching analysis was also conducted using the negative group as a control; the weakly and strongly positive groups were compared to the control across differing cardiology covariates. This study introduces novel cutoffs for high-sensitivity troponin I (Beckman Coulter assay, Beckman Coulter, Inc., Chaska Campus, 1000 Lake Hazeltine Drive, Chaska, Minnesota 55318). [ABSTRACT FROM AUTHOR]

Final annual mortality data from the National Vital Statistics System for a given year are typically released 11 months after the end of the calendar year. Provisional data, which are based on preliminary death certificate data, provide an early estimate of deaths before the release of final data. In 2023, a provisional total of 3,090,582 deaths occurred in the United States. The age-adjusted death rate per 100,000 population was 884.2 among males and 632.8 among females; the overall rate, 750.4, was 6.1% lower than in 2022 (798.8). The overall rate decreased for all age groups. Overall age-adjusted death rates in 2023 were lowest among non-Hispanic multiracial (352.1) and highest among non-Hispanic Black or African American persons (924.3). The leading causes of death were heart disease, cancer, and unintentional injury. The number of deaths from COVID-19 (76,446) was 68.9% lower than in 2022 (245,614). Provisional death estimates provide an early signal about shifts in mortality trends. Timely and actionable data can guide public health policies and interventions for populations experiencing higher mortality. [ABSTRACT FROM AUTHOR]

Community-based palliative care (CBPC) models address the growing needs of patients and caregivers with chronic and serious illnesses. From pediatrics to geriatrics, individuals prefer to receive care within their local community and at home. Delivering care at the community level and within the home improves health outcomes, reduces disparities, and supports local economic activity. Various models of CBPC have developed through partnerships with existing services, such as home health agencies, but ongoing challenges and barriers exist for further expansion of specialty palliative care. Advanced practice registered nurses increasingly manage chronic and serious illnesses and are essential for all health care teams, particularly for CBPC. As trusted providers within the community, advanced practice registered nurses create lasting relationships that allow for meaningful exchanges with patients and caregivers. This article reviewed the concept and features of CBPC offered within the United States and describes an advanced practice registered nurse-led embedded palliative care program for advanced lung disease. [ABSTRACT FROM AUTHOR]

Background: Although prior research has estimated the overarching cost burden of heart failure (HF), a thorough analysis examining medical expense differences and trends, specifically among commercially insured patients with heart failure, is still lacking. Thus, the study aims to examine historical trends and differences in medical costs for commercially insured heart failure patients in the United States from 2006 to 2021. Methods: A population-based, cross-sectional analysis of medical and pharmacy claims data (IQVIA PharMetrics® Plus for Academic) from 2006 to 2021 was conducted. The cohort included adult patients (age > = 18) who were enrolled in commercial insurance plans and had healthcare encounters with a primary diagnosis of HF. The primary outcome measures were the average total annual payment per patient and per cost categories encompassing hospitalization, surgery, emergency department (ED) visits, outpatient care, post-discharge care, and medications. The sub-group measures included systolic, diastolic, and systolic combined with diastolic, age, gender, comorbidity, regions, states, insurance payment, and self-payment. Results: The study included 422,289 commercially insured heart failure (HF) patients in the U.S. evaluated from 2006 to 2021. The average total annual cost per patient decreased overall from $9,636.99 to $8,201.89, with an average annual percentage change (AAPC) of -1.11% (95% CI: -2% to -0.26%). Hospitalization and medication costs decreased with an AAPC of -1.99% (95% CI: -3.25% to -0.8%) and − 3.1% (95% CI: -6.86–0.69%). On the other hand, post-discharge, outpatient, ED visit, and surgery costs increased by an AAPC of 0.84% (95% CI: 0.12–1.49%), 4.31% (95% CI: 1.03–7.63%), 7.21% (95% CI: 6.44–8.12%), and 9.36% (95% CI: 8.61–10.19%). Conclusions: The study's findings reveal a rising trend in average total annual payments per patient from 2006 to 2015, followed by a subsequent decrease from 2016 to 2021. This decrease was attributed to the decline in average patient costs within the Medicare Cost insurance category after 2016, coinciding with the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Additionally, expenses related to surgical procedures, emergency department (ED) visits, and outpatient care have shown substantial growth over time. Moreover, significant differences across various variables have been identified. [ABSTRACT FROM AUTHOR]

Objectives: Soccer is one of the most popular youth sports with nearly 3 million annual participants in the United States alone. Importantly, concussion incidence and awareness in youth soccer has prompted implementation of various protective measures. Despite these interventions, no studies have investigated the prevalence of youth soccer concussions over time. The purpose of this study is to analyze trends and etiologies of youth soccer concussions presenting to United States emergency departments (EDs). Methods: Data from National Electronic Injury Surveillance System were analyzed for soccer players 2 to 18 years old sustaining concussions from January 2013 to December 2022. Patient data collected included age, sex, mechanism of injury, diagnosis, loss of consciousness, and disposition. Raw data were used to calculate national estimates based on assigned statistical sample weight of each hospital. Results: 182,462 youth soccer concussions were diagnosed in US EDs (52.6% male). Most common mechanism of injury was head to ball (29%). Between 2013 and 2022, concussions decreased 28%. Overall concussions decreased by 1,449 per year (95% CI: -2383 to -515, p=0.007). Not specified concussions decreased by 340 per year (95% CI: -501 to -180, p=0.001), head to body by 378 per year (95% CI: -527 to -229, p<0.001), head to ground by 275 per year (95% CI: -463 to -87, p=0.01), and other mechanisms by 56 per year (95% CI: -109 to -3, p=0.04). There were no changes in head to ball or head-to-head mechanisms. Exclusion of years 2020 and 2021 due to COVID demonstrated decreases in not specified concussions by 256 per year (95% CI = -394 to -118, p=0.004), head to body by 314 per year (95% CI: -431 to -196, p=0.001), and head to ground by 182 per year (95% CI: -331 to -33, p=0.02). Conclusions: There is a decreasing trend in youth soccer concussions from 2013 to 2022. Although concussion risk is greatest from contact with the ball, there was no decrease in head to ball concussions during the study period despite implementation and utilization of protective gear. This study contributes to growing literature regarding concussions in youth soccer athletes. [ABSTRACT FROM AUTHOR]

Climate change, originating from greenhouse gas emissions, yields profound implications such as escalated temperatures, severe storms, disruptions in food supply chains, and amplified seismic activity, particularly impacting arid regions. As the world's largest economy and the second-largest CO2 emitter, the United States actively leads initiatives aimed at addressing environmental challenges and aligning with the United Nations' Sustainable Development Goals (SDGs) 7 and 13. This study delves into the determinants shaping renewable energy consumption and CO2 emissions within the United States, aiming to elucidate their pivotal role in advancing carbon neutrality efforts. Using quarterly data spanning from 1990 to 2020, this investigation employs the time-varying TVP-SV-VAR model to dissect the dynamic interplay among these variables. The findings reveal intricate connections across short, medium, and long-term periods: renewable energy adoption, eco-innovations, and uncertainties in climate policy were observed to mitigate CO2 emissions. Conversely, financial development exhibited a consistent association with increased CO2 emissions across all timeframes. Additionally, the progression of renewable energy sources showcased responsiveness to climate policy uncertainties, eco-innovations, and financial development across each timeframe. These outcomes hold substantial implications for the United States' pursuit of carbon neutrality goals, emphasizing the pivotal role of promoting renewable energy initiatives. [ABSTRACT FROM AUTHOR]

Motivation: A decade has passed since the outbreak of the so‐called Arab Spring, which led to regime changes in several Arab countries. However, these public protests demonstrated their ineffectiveness in bringing about political and economic improvements, nor did they facilitate a peaceful transition to democracy in Arab countries. Purpose: This article attempts to discuss the obstacles to democratic transformation in Arab countries and the methods that should be followed to achieve democratic transformation, along with showing the international community's response to the Arab Spring. Approach and methods: This article relies on a descriptive, methodological, and analytical approach to the obstacles to democratic transformation in Arab countries by analysing the events and results of the Arab Spring. Findings: The democratic transformation in Arab countries does not require as much concerted effort to protect the right to peaceful assembly as it does to safeguard other rights from violations resulting from certain practices. This is primarily due to significant differences between ideological, intellectual, and political groups within society. Furthermore, democratic transformation in Arab countries necessitates the collective efforts of the international community, particularly Western nations such as the United States, employing a credible and transparent approach free from political or economic interests. These external factors are crucial when it comes to either facilitating or hindering the democratic transition and the implementation of democratic reforms. Policy implications: The Arab Spring showed that peaceful democratic transitions and the conditions for the continuation or replacement of authoritarian regimes require the approval and support of some countries that are devoid of political or economic interests, as they are external factors that can influence and hinder the democratic transition or ensure democratic reforms. This is especially true because public protests are no longer simply a sign of resistance to the regime but rather are rather a potential advance warning of rebellion and the overthrow of said regimes. [ABSTRACT FROM AUTHOR]

Inconsistent engagement in pelvic floor muscle exercise (PFME) among patients with prostate cancer (PC) following radical prostatectomy may have contributed to varying effectiveness in improving urinary incontinence across studies. Identifying factors influencing engagement can help develop effective interventions to maximize participation, enhance urinary function and improve quality of life (QoL). This scoping review aims to systematically search for factors influencing PFME engagement among post radical prostatectomy patients managing urinary incontinence. Eligible publications in English were identified from various databases, including PubMed, CINAHL, ProQuest, PsycINFO and Scopus. A health science librarian was consulted to assist in formulating search terms, encompassing PC, PFME terms and influencing factors terms. We employed Colandrapp™ for data extraction, focusing on key themes such as study characteristics, PFME education and training, recommended sessions, engagement rates and factors influencing PFME engagement following radical prostatectomy. Results were presented in tables and supplemented by a narrative discussion addressing gaps in research knowledge. The synthesis drew from a diverse body of literature, blending quantitative and qualitative approaches, to contribute to a comprehensive understanding of PFME engagement factors. Twelve papers, based on 10 studies published between 2011 and 2018, met our inclusion criteria. The reviewed studies primarily employed longitudinal quantitative designs, except for one study that utilized a mixed‐method design. Only three studies incorporated theories to guide the selection of potential factors influencing PFME engagement. The factors examined across the reviewed studies encompassed aspects related to the patient–partner relationship, patient's action control, planning (dyadic or individual), self‐efficacy, perceived urinary incontinence and the patient–provider relationship. We observed conflicting findings regarding the factors influencing PFME engagement across studies. Our review underscores the importance of theory‐informed studies using rigorous methodology and precise theoretical and operational definitions of potential factors. Such studies can help pinpoint the most influential factors to enhance PFME engagement and, ultimately, improve symptoms and QoL for PC patients. The scoping review also showed critical implications for nursing practice. Nurses should develop individualized and culturally sensitive interventions, integrate health behaviour change theories, assess patient–partner relationships and action control and consider intention's mediating role in the enhancement of PFME engagement following radical prostatectomy. [ABSTRACT FROM AUTHOR]

Introduction: Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis. Methods: Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke‐prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC). Group 1 patients were further divided into Gr. 1A: LAAO + half‐does NOAC (HD‐NOAC) for 6 months followed by aspirin 81 mg/day and Gr. 1B: LAAO + HD‐NOAC. In group 1 patients, with complete occlusion at the 45‐day transesophageal echocardiogram, patients were switched to aspirin, 81 mg/day at 6 months. In case of leak, or dense "smoke" in the left atrium (LA) or enlarged LA, they were placed on long‐term half‐dose (HD) NOAC. Group 2 patients remained on full‐dose NOAC during the whole study period. Results: A total of 92 patients were included in the analysis; group 1: 56 and group 2: 36. After the 45‐day TEE, 31 patients from group 1 remained on baby‐aspirin and 25 on HD NOAC. At 1‐year follow‐up, four stroke, one TIA and six device‐thrombus were reported in group 1A, compared to none in patients in group 1B (5/31 vs. 0/25, p =.03). No bleeding events were reported in group 1, whereas group 2 had five bleeding events (one subdural hematoma, one retinal hemorrhage, and four GI bleedings). Additionally, one stroke was reported in group 2 that happened during brief discontinuation of OAC. Conclusion: In patients with coexistent AF and amyloidosis, half‐dose NOAC following LAAO was observed to be the safest stroke‐prophylaxis strategy. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is a significant cause of female cancer-related deaths in the US. Checking how severe the cancer is helps in planning treatment. Modern AI methods are good at grading cancer, but they are not used much in hospitals yet. We developed and utilized ensemble deep learning algorithms for addressing the tasks of classifying (1) breast cancer subtype and (2) breast cancer invasiveness from whole slide image (WSI) histopathology slides. The ensemble models used were based on convolutional neural networks (CNNs) known for extracting distinctive features crucial for accurate classification. In this paper, we provide a comprehensive analysis of these models and the used methodology for breast cancer diagnosis tasks. Cancer diagnosis and classification are pivotal for effective patient management and treatment planning. In this study, a comprehensive approach is presented utilizing ensemble deep learning techniques to analyze breast cancer histopathology images. Our datasets were based on two widely employed datasets from different centers for two different tasks: BACH and BreakHis. Within the BACH dataset, a proposed ensemble strategy was employed, incorporating VGG16 and ResNet50 architectures to achieve precise classification of breast cancer histopathology images. Introducing a novel image patching technique to preprocess a high-resolution image facilitated a focused analysis of localized regions of interest. The annotated BACH dataset encompassed 400 WSIs across four distinct classes: Normal, Benign, In Situ Carcinoma, and Invasive Carcinoma. In addition, the proposed ensemble was used on the BreakHis dataset, utilizing VGG16, ResNet34, and ResNet50 models to classify microscopic images into eight distinct categories (four benign and four malignant). For both datasets, a five-fold cross-validation approach was employed for rigorous training and testing. Preliminary experimental results indicated a patch classification accuracy of 95.31% (for the BACH dataset) and WSI image classification accuracy of 98.43% (BreakHis). This research significantly contributes to ongoing endeavors in harnessing artificial intelligence to advance breast cancer diagnosis, potentially fostering improved patient outcomes and alleviating healthcare burdens. [ABSTRACT FROM AUTHOR]

Background Several factors affect heart transplant (HTx) and lung transplant (LTx) program outcomes. Variabilities in institutional and community characteristics have been shown to influence survival. At present, half of HTx centers in the United States do not possess a concomitant LTx program. This study sought to better understand the characteristics of HTx with and without LTx programs. Methods Nationwide transplant data were collected from the Scientific Registry of Transplant Recipients (SRTR) in August 2020. SRTR star rating ranges from tier 1 (lowest) to tier 5 (highest). HTx volumes and SRTR star ratings for survival were compared between the centers with heart-only (H0) programs and the centers with heart-lung (HL) programs. Results SRTR star ratings were available for 117 transplant centers with one or more HTx reported. The median number of HTx performed over 1 year was 16 (interquartile range [IQR]: 2–29). The number of HL centers (n = 67, 57.3%) were comparable to H0 centers (n = 50, 42.7%; p = 0.14). The HTx volume at the HL centers (28 [IQR: 17–41]) exceeded the HTx volume at the H0 centers (13 [IQR: 9–23]; p < 0.01), but were comparable to the LTx volume at the HL centers (31 [IQR: 16–46]; p = 0.25). The median HTx one-year survival rating was 3 (IQR: 2–4) at both the H0 and HL centers (p = 0.85). The HTx and LTx volumes were positively associated with the respective 1-year survivals (p < 0.01). Conclusion While the presence of an LTx program is not directly associated with HTx survival, it has a positive association with the HTx volume. The HTx and LTx volumes are positively associated with the 1-year survival. [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) is one of the more common neuropsychiatric disorders in women of reproductive age. Our objective was to compare perinatal outcomes between women with an ADHD diagnosis and those without. Methods: A retrospective population-based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS) United States database. The study included all women who either delivered or experienced maternal death from 2004 to 2014. Perinatal outcomes were compared between women with an ICD-9 diagnosis of ADHD and those without. Results: Overall, 9,096,788 women met the inclusion criteria. Amongst them, 10,031 women had a diagnosis of ADHD. Women with ADHD, compared to those without, were more likely to be younger than 25 years of age; white; to smoke tobacco during pregnancy; to use illicit drugs; and to suffer from chronic hypertension, thyroid disorders, and obesity (p < 0.001 for all). Women in the ADHD group, compared to those without, had a higher rate of hypertensive disorders of pregnancy (HDP) (aOR 1.36, 95% CI 1.28–1.45, p < 0.001), cesarean delivery (aOR 1.19, 95% CI 1.13–1.25, p < 0.001), chorioamnionitis (aOR 1.34, 95% CI 1.17–1.52, p < 0.001), and maternal infection (aOR 1.33, 95% CI 1.19–1.5, p < 0.001). Regarding neonatal outcomes, patients with ADHD, compared to those without, had a higher rate of small-for-gestational-age neonate (SGA) (aOR 1.3, 95% CI 1.17–1.43, p < 0.001), and congenital anomalies (aOR 2.77, 95% CI 2.36–3.26, p < 0.001). Conclusion: Women with a diagnosis of ADHD had a higher incidence of a myriad of maternal and neonatal complications, including cesarean delivery, HDP, and SGA neonates. [ABSTRACT FROM AUTHOR]

Background: Significant psychological impact and prevalence of posttraumatic stress disorder (PTSD) have been well documented in patients sustaining anterior cruciate ligament injury. Purpose: To examine PTSD symptomatology in baseball players after sustaining elbow ulnar collateral ligament (UCL) injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male baseball players of various competition levels (high school through Minor League Baseball [MiLB]) who underwent surgery for a UCL injury between April 2019 and June 2022 participated in the study. Before surgery, patients completed the Impact of Event Scale–Revised (IES-R) to assess PTSD symptomatology. Subgroup analysis was conducted according to level of play and player position. Results: A total of 104 male baseball players with a mean age of 19.4 years (range, 15-29 years) were included in the study; 32 players (30.8%) were in high school, 65 (62.5%) were in college, and 7 (6.7%) were in MiLB. There were 64 (61.5%) pitchers, 18 (17.3%) position players, and 22 (21.2%) 2-way players (both pitching and playing on the field). A total of 30 (28.8%) patients scored high enough on the IES-R to support PTSD as a probable diagnosis, and another 22 patients (21.2%) scored high enough to support PTSD as a clinical concern. Nineteen patients (18.3%) had potentially severe PTSD. Only 4 players (3.8%) were completely asymptomatic. Subgroup analysis revealed college players as significantly more symptomatic than high school players (P =.02), and 2-way players were found to be significantly less susceptible to developing symptoms of PTSD compared with pitchers (P =.04). Conclusion: Nearly 30% of baseball players who sustained a UCL injury qualified for a probable diagnosis of PTSD based on the IES-R. Pitchers and college athletes were at increased risk for PTSD after UCL injury compared with 2-way players and high school athletes, respectively. [ABSTRACT FROM AUTHOR]

The primary purpose of this paper is to review and evaluate the causes of educational poverty in less developed countries. The basic intent in carrying out such a study is to define and derive the role of governing agencies in deliberately creating educational poverty in the country, so that the private interest of the rich and powerful ruling class can be fully safeguarded. This study is of crucial interest to the common man because majority of the people living in less developed countries are poor in spite of the fact, that almost all these countries own ample human and material resources. However, the common man in these countries is continuously suffering, generation after generation, and has been denied access to basic amenities of life. The rich and powerful ruling class, in majority of the less developed countries, has intentionally denied basic education facilities to its people for keeping them ignorant and unaware of their fundamental rights to share national resources and to gain competence for comfortable living in the society. The paper advocates a complete reversal in economic growth policies of the less developed countries so that top priority is given to those projects and programs that directly benefit the common man in the society. In this respect, the author calls for awareness among the people to exercise their economic and social rights so that people of all the strata can share equally the fruits of growth and prosperity.

The immigrant paradox refers to findings that first-generation and less acculturated immigrants generally have better adaptation and health compared with second/third-generation and more acculturated immigrants. Some work supports an immigrant paradox among European Muslims. Further, Pew's telephone interviews of Muslims living in the United States (MLUS)--about half of whom are foreign-born--consistently reveal that United States-born and English-speaking MLUS perceive and experience more discrimination than foreign-born Muslims. We explored the immigrant paradox in a representative sample of 350 MLUS (33% immigrants) as a function of (a) immigrant status, (b) acculturation levels, and (c) age of arrival in the United States (among immigrants). We conducted analyses of covariance and hierarchical regressions after administering standardized measures of discrimination, perceived Islamophobia in America, religiousness, acculturation, depression, anxiety, and stress (and controlling for covariates). United States-born participants reported greater experiences of discrimination and perceptions of Islamophobia. Both United States-born and more acculturated participants reported greater psychological distress, maladaptive religious coping, and religious struggles. Our findings support the presence of an immigrant paradox among MLUS, highlighting a need to extend accessible services to United States-born and more acculturated Muslims. Potential explanations for the paradox are discussed and have implications for future research in this area. [ABSTRACT FROM AUTHOR]

Background. A−β+ ketosis-prone diabetes (KPD) in adults is characterized by presentation with diabetic ketoacidosis (DKA), negative islet autoantibodies, and preserved β-cell function in persons with a phenotype of obesity-associated type 2 diabetes (T2D). The prevalence of KPD has not been evaluated in children. We investigated children with DKA at "T2D" onset and determined the prevalence and characteristics of pediatric A−β+ KPD within this cohort. Methods. We reviewed the records of 716 children with T2D at a large academic hospital and compared clinical characteristics of those with and without DKA at onset. In the latter group, we identified patients with A−β+ KPD using criteria of the Rare and Atypical Diabetes Network (RADIANT) and defined its prevalence and characteristics. Results. Mean age at diagnosis was 13.7 ± 2.4 years: 63% female; 59% Hispanic, 29% African American, 9% non-Hispanic White, and 3% other. Fifty-six (7.8%) presented with DKA at diagnosis and lacked islet autoantibodies. Children presenting with DKA were older and had lower C-peptide and higher glucose concentrations than those without DKA. Twenty-five children with DKA (45%) met RADIANT A−β+ KPD criteria. They were predominantly male (64%), African American or Hispanic (96%), with substantial C-peptide (1.3 ± 0.7 ng/mL) at presentation with DKA and excellent long-term glycemic control (HbA1c 6.6% ± 1.9% at follow-up (median 1.3 years postdiagnosis)). Conclusions. In children with a clinical phenotype of T2D and DKA at diagnosis, approximately half meet criteria for A−β+ KPD. They manifest the key characteristics of obesity, preserved β-cell function, male predominance, and potential to discontinue insulin therapy, similar to adults with A−β+ KPD. [ABSTRACT FROM AUTHOR]

The present study is an attempt to explore the depiction of racism in the era of emancipation by reviewing two representative texts: Of Our Spiritual Strivings by W. E. B. Du Bois, and The Jim Crow Laws and Racism in United States written by David Fremon, and telefilm The Birth of a Nation directed by D. W. Griffith. After the official abolition of slavery by 13th Amendment of the Constitution, the problem of racism not only emerged but reached to its peak in that epoch in United States. It adversely affected both the black and white races for a period of almost one hundred years. Racism divided social milieu in US based on skin color. Dogmatically the darker in color would mean the cursed. The hatred against Blacks was institutionalized. Racially biased laws called Jim Crow Laws were enacted by many southern states. Private gangs such as Ku Klux Klan were formed who would find excuses for lynching and killing the blacks. The blacks were marginalized up to a limit which shook their souls and called ‘double consciousness’ by W.E.B. Du Bois. The essay tries to reconnoiter the traces of miseries of blacks from slavery towards racism through interdisciplinary critique of selected writings and a film. [ABSTRACT FROM AUTHOR]

United States of America is immigrant Nation hence; the word immigration resonates especially strongly with Americans. Critics claim that regulations intended to stop illegal immigration encourage the use of racial profiling by the police, raising the risk of unlawfully detaining and interrogating citizens & legal immigrants. Racism & racial identity are complex social construct. People from all over the world continue to experience racism, which can result in social marginalization when they visit developed nations like the USA. Invisible Man (1952) addresses socio-cultural, economic, political, and ideological issues that African-Americans experienced in 20th century. This study interprets the concept of invisibility in Ralph Ellison’s Invisible Man over Bois’s theory of “Double consciousness”. Story's unnamed young black narrator exists in surrealist America of 20th century dependent on deception to survive. America can only live over pretense. The focus of study is on the struggle of unnamed protagonist to survive and be visible in America. This research will highlight challenges that African Americans face due to their race. It will look at the choice the African Americans make; assimilate or maintain their unique identity. [ABSTRACT FROM AUTHOR]

This study estimates the impacts of pandemic uncertainty on environmental quality in the United States (U.S.). To do so, we introduce a pandemic uncertainty dataset from 1985 to 2021 that will be helpful for a single country, a group of countries, and firm-level analyses. Our baseline models confirm that pandemic uncertainty improves environmental quality, however, it reduces labour force participation. In addition, the income level helps to improve environmental quality. [ABSTRACT FROM AUTHOR]

Introduction: Long-acting lipoglycopeptides such as dalbavancin may have utility in patients with Gram-positive bloodstream infections (BSI), particularly in those with barriers to discharge or who require prolonged parenteral antibiotic courses. A retrospective cohort study was performed to provide further multicenter real-world evidence on dalbavancin use as a sequential therapy for Gram-positive BSI. Methods: One hundred fifteen patients received dalbavancin with Gram-positive BSI, defined as any positive blood culture or diagnosed with infective endocarditis, from 13 centers geographically spread across the United States between July 2015 and July 2021. Results: Patients had a mean (SD) age of 48.5 (17.5) years, the majority were male (54%), with many who injected drugs (40%). The most common infection sources (non-exclusive) were primary BSI (89%), skin and soft tissue infection (SSTI) (25%), infective endocarditis (19%), and bone and joint infection (17%). Staphylococcus aureus accounted for 72% of index cultures, coagulase-negative Staphylococcus accounted for 18%, and Streptococcus species in 16%. Dalbavancin started a median (Q1–Q3) of 10 (6–19) days after index culture collection. The most common regimen administered was dalbavancin 1500 mg as one dose for 50% of cases. The primary outcome of composite clinical failure occurred at 12.2%, with 90-day mortality at 7.0% and 90-day BSI recurrence at 3.5%. Conclusions: Dalbavancin may serve as a useful tool in facilitating hospital discharge in patients with Gram-positive BSI. Randomized controlled trials are anticipated to validate dalbavancin as a surrogate to current treatment standards. [ABSTRACT FROM AUTHOR]

In the United States, annual influenza vaccination is recommended for all persons aged ≥6 months. Using data from four vaccine effectiveness (VE) networks during the 2023-24 influenza season, interim influenza VE was estimated among patients aged ≥6 months with acute respiratory illness-associated medical encounters using a test-negative casecontrol study design. Among children and adolescents aged 6 months-17 years, VE against influenza-associated outpatient visits ranged from 59% to 67% and against influenza-associated hospitalization ranged from 52% to 61%. Among adults aged ≥18 years, VE against influenza-associated outpatient visits ranged from 33% to 49% and against hospitalization from 41% to 44%. VE against influenza A ranged from 46% to 59% for children and adolescents and from 27% to 46% for adults across settings. VE against influenza B ranged from 64% to 89% for pediatric patients in outpatient settings and from 60% to 78% for all adults across settings. These findings demonstrate that the 2023-24 seasonal influenza vaccine is effective at reducing the risk for medically attended influenza virus infection. CDC recommends that all persons aged ≥6 months who have not yet been vaccinated this season get vaccinated while influenza circulates locally. [ABSTRACT FROM AUTHOR]

Background: Transgender individuals are discriminated against in health care environments and consistently experience poorer health outcomes than their cisgender counterparts. Enhancing physician training in transgender‐specific health is critical to closing the transgender health gap. Methods: We conducted a scoping review to identify transgender health training objectives in Internal Medicine and Internal Medicine Subspecialty residency programmes in Canada and the United States. A systematic search was conducted from 1946 to 15 February 2022. Studies were eligible for inclusion if they were written in English, included transgender training objectives, and were aimed at resident physicians in Internal Medicine or Internal Medicine Subspecialty training programmes in Canada or the United States. Findings: We found 4048 papers, of which 11 were included for analysis. Transgender health training objectives were synthesised into five themes, including (1) terminology, physiology, and gender presentation, (2) gender‐affirming care and communication, (3) hormonal and surgical management, (4) routine health management and maintenance, and (5) equity, diversity, and inclusion in clinical care. The majority of objectives pertained to equity, diversity, and inclusion in clinical care, namely, respectful communication and non‐judgemental care of transgender patients. Discussion Our findings provide a comprehensive overview of published transgender health objectives in Canada and the United States and highlight existing gaps in postgraduate medical education for Internal Medicine and Subspecialty programmes. Conclusions: We argue a need for standardisation of transgender‐related residency training and suggest that postgraduate Internal Medicine programmes can utilise this review as a framework to begin enhancing transgender health education for their residents. [ABSTRACT FROM AUTHOR]

Fusarium head blight (FHB) or scab is a devastating disease of barley that severely reduces the yield and quality of the grain. Additionally, mycotoxins produced by the causal Fusarium species can contaminate harvested grain, resulting in food safety concerns and further economic losses. In the Upper Midwest region of the United States, Fusarium graminearum is the primary causal agent, and deoxynivalenol (DON) is the main mycotoxin associated with Fusarium infection. Deployment of resistant cultivars is an important component of an integrated strategy to manage this disease. Unfortunately, few good sources of FHB resistance have been identified from the evaluation of large collections of Hordeum germplasm. Over the past 25 years, many barley mapping populations have been developed with selected resistance sources to identify the number, chromosomal position and allelic effect of quantitative trait loci (QTL) contributing to FHB resistance and DON accumulation. To consolidate the genetic data generated from 14 mapping studies that included 22 bi‐ or tri‐parental mapping populations and three genome‐wide association (GWAS) mapping panels, a consensus map was constructed that includes 4145 SNP, SSR, RFLP and AFLP markers. A meta‐analysis based on this consensus map revealed 96 QTL for FHB resistance and 57 for DON accumulation scattered across the barley genome. Many of the QTL explained a low percentage (<10%) of variation for the traits and were often found significant in only one or a few environments in multi‐year/multi‐location field trials. Moreover, many of the FHB/DON QTL mapped to chromosomal positions coincided with various agro‐morphological traits that could influence the level of disease (e.g. heading date, height, spike density, and spike angle), raising the important question of whether the former are true resistance factors or are simply the result of pleiotropy with the latter. Considering the magnitude of effect, consistency of detection across environments and independence from agro‐morphological traits, only three of 96 QTL for FHB and five of 57 QTL for DON were considered priority targets for marker‐assisted selection (MAS). In spite of the challenge for having a limited number of useful QTL for breeding, genomic selection holds promise for increasing the efficiency of developing FHB‐resistant barley cultivars, an essential component of the overall management strategy for the disease. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted the United States' lack of a nationwide infrastructure for collecting, sharing, and using health data, especially for secondary uses (e.g., population health management and public health). The federal government is taking several important steps to upgrade the nation's health data ecosystem—notably, the Centers for Disease Control and Prevention's Data Modernization Initiative and the Office of the National Coordinator for Health Information Technology's Trusted Exchange Framework and Common Agreement. However, substantial barriers remain. Inconsistent regulations, infrastructure, and governance across federal and state levels and between states significantly impede the exchange and analysis of health data. Siloed systems and insufficient funding block effective integration of clinical, public health, and social determinants data within and between states. In this analytic essay, we propose strategies to develop a nationwide health data ecosystem. We focus on providing federal guidance and incentives to develop state-designated entities responsible for the collection, integration, and analysis of clinical, public health, social determinants of health, claims, administrative, and other relevant data. These recommendations include a regulatory clearinghouse, federal guidance, model legislation and templated regulation, funding to incentive enterprise architecture, regulatory sandboxes, and a 3-pronged research agenda. (Am J Public Health. 2024;114(2):209–217. https://doi.org/10.2105/AJPH.2023.307477) [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to estimate clinical, economic (including productivity), and health‐related quality of life (HRQoL) outcomes and associated individual characteristics among adults with overweight (OW) or obesity in the United States. Methods: This study included adult respondents with body mass index (BMI) ≥18.5 kg/m2 in the 2017–2018 National Health and Nutrition Examination Survey (NHANES) and 2016 Medical Expenditure Panel Survey. Respondents were classified according to BMI. Individual characteristics were described by BMI categories. Multivariable regression models estimated the association between BMI categories and outcomes, adjusting for individual characteristics. Results: Nearly three‐quarters (73.7%) of NHANES participants were OW or obese. Relative to Normal weight (NW), respondents with Class 3 obesity had more obesity‐related complications (2.07 vs. 4.62, p < 0.001). Higher BMI was associated with significantly lower HRQoL, lower productivity, and higher healthcare expenditures as well as more frequent weight loss attempts in the previous 12 months. Weight loss surgery and prescription anti‐obesity medications (AOMs) were used only by a very small proportion of individuals. Despite frequent weight loss attempts, most respondents did not achieve clinically meaningful weight loss. Conclusions: Adults with OW or obesity experienced worse clinical, economic and HRQoL outcomes than those with NW. Better use of evidence‐based obesity treatments, including prescription AOMs, should be considered to achieve more clinically meaningful weight reduction and improved outcomes in individuals with OW or obesity. [ABSTRACT FROM AUTHOR]

Hypoplastic asymmetry due to hemifacial microsomia (HFM) often represents the most difficult reconstruction in the craniomaxillofacial clinic. Although autogenous grafts are generally used for temporomandibular joint reconstruction (TMJR), the use of TMJR prostheses is not well established. The aim of this review was to identify, collect and analyse the use of extended TMJR (eTMJR) prostheses in patients with HFM, describing clinical features, surgical procedures and postoperative complications. Online searches of all major databases were performed according to PRISMA guidelines. All studies with HFM patients treated with the eTMJR prostheses were included. Descriptive statistics were used for data analysis. A total of 19 studies, including 08 case studies, 06 case series and 05 retrospective cohort studies, met the inclusion criteria, where a total of 42 HFM patients were reported from 18 countries, mostly from the United States (05; 26%). Fifteen of the 42 cases (~36%) were male. The mean ± SD (range) age of patients in all studies was 19.79 ± 5.81 (9‐36) years. The mean ± SD (range) of patient follow‐up was 41.30 ± 35.50 (6‐136) months. A total of 5 (10.6%) patients were implanted with bilateral eTMJR prostheses. The Pruzansky classification was used in 18 (~89.5%) studies, OMENS classification in 01 (~5%) study, whereas no classification was reported in one study. Only 01 (7.1%) study had documented the eTMJR classification for the prosthesis used. In growing patients with or without a history of failed autogenous tissues, TMJR prostheses may provide a viable alternative. Randomized studies with large cohorts are warranted to validate these preliminary results. [ABSTRACT FROM AUTHOR]

Background: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. Methods: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. Results: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. Conclusion: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders. [ABSTRACT FROM AUTHOR]

This article, published in the Journal of World Science, explores the importance of maintaining the integrity of halal products and investigates the policies surrounding the halal industry in the United States. The study aims to understand the challenges faced by the industry, gather insights from industry stakeholders, identify non-halal elements in products beyond meat in the Muslim market, and evaluate the effectiveness of halal industry policies. The findings emphasize the need for standardized approaches and strict oversight in the halal industry. The article also highlights the significant growth and global reach of the halal market, as well as its appeal to non-Muslim consumers who prioritize health and ethical considerations. The text provides a detailed protocol for ensuring the halal status of food products according to ISWA standards and discusses the presence of non-halal elements in various products. It concludes by examining the policies adopted in the United States and recommending collaboration between regulatory bodies and industry stakeholders to strengthen halal policies and increase consumer awareness. [Extracted from the article]

Gastrointestinal system (GIS) cancer in pregnancy is a rare disease. Our aim was to evaluate the association between this type of cancer and pregnancy, delivery and neonatal outcomes. We conducted a retrospective population-based cohort study using the Healthcare Cost and Utilization Project, Nation-wide Inpatient Sample (HCUP-NIS). We included all women who delivered or had a maternal death in the US between 2004 and 2014. We compared women with an ICD-9 diagnosis of GIS cancer to those without. Pregnancy, delivery, and neonatal outcomes were compared between the two groups. A total of 9,096,788 women met inclusion criteria. Amongst them, 194 women (2/100,000) had a diagnosis of GIS cancer during pregnancy. Women with GIS cancer, compared to those without, were more likely to be Caucasian, older than 35 years of age, and to suffer from obesity, chronic hypertension, pregestational diabetes and thyroid disease. The cancer group had a lower rate of spontaneous vaginal delivery (aOR 0.2, 95 % CI 0.13–0.27, p<0.001), and a higher rate of preterm delivery (aOR 1.85, 95 % CI 1.21–2.82, p=0.04), and of maternal complications such as blood transfusion (aOR 24.7, 95 % CI 17.11–35.66, p<0.001), disseminated intravascular coagulation (aOR 14.56, 95 % CI 3.56–59.55, p<0.001), venous thromboembolism (aOR 9.4, 95 % CI 2.3–38.42, p=0.002) and maternal death (aOR 8.02, 95 % CI 2.55–25.34, p<0.001). Neonatal outcomes were comparable between the two groups. Women with a diagnosis of GIS cancer in pregnancy have a higher incidence of maternal complications including maternal death, without any differences in neonatal outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate the association of COVID-19 confirmed cases and deaths with mental health, unemployment and financial markets-related search terms for the USA, the UK, India and worldwide using Google Trends. Design/methodology/approach: The authors use Spearman's rank correlation coefficients to assess the relationship between relative search volumes (RSVs) and mental health, unemployment and financial markets-related search terms, with the total confirmed COVID-19 cases as well as deaths in the USA, UK, India and worldwide. The sample period starts from the day 100 cases were reported for the first time, which is 7 March 2020, 13 March 2020, 23 March 2020 and 28 January 2020 for the US, the UK, India and worldwide, respectively, and ends on 25 June 2020. Findings: The results indicate a significant increase in anxiety, depression and stress leading to sleeping disorders or insomnia, further deteriorating mental health. The RSVs of employment are negatively significant, implying that people are hesitant to search for new jobs due to being susceptible to exposure, imposed lockdown and social distancing measures and changing employment patterns. The RSVs for financial terms exhibit the varying associations of COVID-19 cases and deaths with the stock market, loans, rent, etc. Research limitations/implications: This study has implications for the policymakers, health experts and the government. The state governments must provide proper medical facilities and holistic care to the affected population. It may be noted that the findings of this study only lead us to conclude about the relationship between COVID-19 cases and deaths and Google Trends searches, and do not as such indicate the effect on actual behaviour. Originality/value: To the best of the authors' knowledge, this is the first attempt to investigate the relationship between the number of COVID-19 cases and deaths in the USA, UK and India and at the global level and RSVs for mental health-related, job-related and financial keywords. [ABSTRACT FROM AUTHOR]

Objective: To review the nature and extent of bladder exstrophy-epispadias related malpractice litigation in the United States. Methods: Two legal databases (Nexis Uni, WestLaw) were reviewed for state and federal cases using the terms "bladder exstrophy", "cloacal exstrophy", "epispadias", in combination with "medical malpractice", or "negligence", or "medical error", or "complication", or "malpractice", or "tort". Databases were queried from 1948 to 2022 and reviewed for medical and legal details. Results: Our search yielded 16 unique legal cases with 6 fitting established criteria for analysis. Urology and paediatric urologists were named in 50% of cases as were community medical systems. Cause for lawsuit included negligence in surgical performance (50%), primary closure of exstrophy (33%), and post-operative care (50%). Settlement agreement was reached in one case (17%). Outcomes favoured the physician in 60% of trials. Lawsuits alleging negligent surgical performance and/or post-operative care exclusively named urologists with outcomes favouring the surgeon in 66% of cases. The settlement payment (n = 1) was $500,000 and monetary damages (n = 1) equated to $1.3 million. Conclusions: Malpractice litigation related to BEEC treatment is rare. Trial outcomes favour the medical provider. Cases that resulted in financial liability successfully alleged avoidable negligence resulting in irreversible physical damage. The authors recommend families with BEEC seek board-certified paediatric urologists experienced in treating this complex and/or Bladder Exstrophy Centers of Excellence. Further, we recommend surgeons treating BEEC properly educate patients and families on the severity of this major birth defect including its lifelong implications and need for surgical revisions. [ABSTRACT FROM AUTHOR]

The improper arrest or detention of individuals represents a critical human rights concern with far-reaching implications for the rule of law, justice, and social harmony. This research paper addresses a vital and important topic, which is the reasons for the ineffectiveness of legislative measures in reducing the occurrence of illegal arrests. This paper undertakes a comprehensive comparative analysis of the legal systems in some of the United States and Kuwait states, focusing on the sanctions employed to deter and redress improper arrests and detentions. It became clear from this study that common and similar reasons between the two systems would prevent the effectiveness of legislative measures (criminal, functional, and the rule of excluding evidence resulting from the illegal procedure) from achieving its goal. This study concluded that the reasons for legislative measures not achieving their goals are of a different nature, including the lack of sincere desire to implement these measures by the relevant agencies, as well as the difficulty of implementing some of these measures in practice. Finally, this study recommended the need for a legislative, judicial, and executive review of these measures and the need to adopt means to monitor the effectiveness of these measures and the mechanism for their effective implementation. [ABSTRACT FROM AUTHOR]

Preparing teacher candidates to provide learning strategies that support the differentiated needs of students should be at the forefront of all educator preparation programs (EPPs). Teacher candidates must become fluid in providing strategies that promote students' individualized academic and social–emotional growth as well as strategies that support effective collaboration to enhance student productivity across the school environment. This pilot study explored the use of mixed reality (e.g., Mursion) as a tool to support pre-service general and special education teacher preparation and improvement of self-efficacy related to student engagement and instructional strategies. This study collected data on teacher candidates' pre-/post-self-efficacy and participant self-reflections from an EPP in the United States. The results of this study yielded ideas as to how EPPs can better support teacher candidate preparation using a mixed-reality platform, as data revealed participant increase in self-efficacy and gains in the use of student engagement and instructional strategies that supported the use of evidence-based and high-leverage practices. [ABSTRACT FROM AUTHOR]

There is a paucity of research on the true prevalence of psychiatric disorders in Muslim Americans. This research aims to explore the prevalence, correlates and impact of mood disorders, anxiety disorders, and posttraumatic stress disorders (PTSD) in Muslims as compared with a non-Muslim sample. We used propensity scores to match 372 individuals who self-identified as Muslims from The National Epidemiologic Survey on Alcohol and Related Conditions III with a control group (n = 744) from the same dataset. The prevalence of psychiatric disorders was similar in Muslim Americans and non-Muslims. Help-seeking was generally low, but Muslims with a lifetime history of PTSD were less likely than non-Muslims with PTSD to seek help through self-help groups (2.2% vs. 21.1%, p < 0.05). Moreover, Muslims with mood disorders experienced lower mental health scores compared to non-Muslims with mood disorders. Efforts need to be made to identify psychiatric disorders in this faith group and engage in treatment. [ABSTRACT FROM AUTHOR]

Background There are numerous reasons for the increased use of telemedicine in orthopaedic surgery, one of which is the perception that virtual visits are more cost-effective than in-person visits. However, to our knowledge, no studies have compared the cost and time investment of virtual versus in-person visits using the time-driven activity-based costing (TDABC) method. Unlike methods that estimate cost based on charges for services rendered, TDABC provides a more precise measurement of costs, which is essential for assessing cost-effective innovations and moving to value-based healthcare. Questions/purposes (1) Are virtual visits less costly than analogous in-person visits, as measured by TDABC? (2) Does TDABC yield cost estimates that are lower or higher than the ratio of costs to charges (RCC), which is a simple, frequently used costing method? (3) Do the total time commitments of healthcare personnel, and that of the surgeon specifically, vary between the virtual and in-person settings? Methods Patients for this prospective, observational study were recruited from the practices of the highest-volume virtual-visit surgeons of three subspecialties (joints, hand, and sports) in a multihospital, tertiary-care academic institution in a metropolitan area in the Midwestern United States. Each surgeon had at least 10 years of clinical practice. Between June 2021 and September 2021, we analyzed both in-person and virtual return visits with patients who had an established relationship with the surgeon, because this represented the most frequent type of virtual visits and enabled a direct comparison between the two settings. New patients were not included in the study because of the limited availability of new-patient virtual visits; such patients often benefit from in-person physical examinations and on-site imaging. Additionally, patients seen for routine postoperative care were excluded because they were primarily seen in person by a physician assistant. Data were acquired during this period until 90 in-person and 90 virtual visits were collected according to selection criteria; no patients were lost to follow-up. Distinct process maps, which represent the steps involved in a clinic visit used to measure healthcare personnel time invested, were constructed for in-person and virtual clinic visits and used to compare total personnel and surgeon time spent. To calculate TDABC-derived costs, time allocated by personnel to complete each step was measured and used to calculate cost based on each personnel member's yearly salary. From the accounting department of our hospital, we acquired RCC cost data according to the level of service for a return visit. Results The total median cost, as measured by TDABC, was USD 127 (IQR USD 111 to 163) for an in-person visit and USD 140 (IQR USD 113 to 205) for a virtual visit (median difference USD 13; p = 0.16). RCC overestimated TDABC-calculated direct variable cost in five of six service levels (in-person levels 3, 4, and 5 and virtual levels 3 and 5) by a range of USD 25 to 88. Additionally, we found that virtual visits consumed 4 minutes less of total personnel time (in-person: 17 minutes [IQR 13.5 to 23.5 minutes], virtual: 13 minutes [IQR 11 to 19 minutes]; p < 0.001); however, this difference in personnel time did not equate to cost savings because surgeons spent 2 minutes longer on virtual visit activities than they did on in-person activities (in-person: 6 minutes [IQR 4.5 to 9.5 minutes], virtual: 8 minutes [IQR 5.5 to 13 minutes]; p = 0.003). Conclusion Orthopaedic virtual visits did not deliver cost savings compared with in-person visits because surgeons spent more time on virtual visits and participated in virtual visits at the clinical site. Additionally, as anticipated, RCC overestimated costs as calculated by TDABC. These findings suggest that cost is not a primary advantage of transitioning to virtual visits, and that factors such as patient preference and satisfaction should be considered instead. [ABSTRACT FROM AUTHOR]

Hypertension is the leading remediable risk factor for cardiovascular morbidity and mortality in the United States. Excess dietary salt consumption, which is a catalyst of hypertension, initiates an inflammatory cascade via activation of antigen-presenting cells (APCs). This pro-inflammatory response is driven primarily by sodium ions (Na+) transporting into APCs by the epithelial sodium channel (ENaC) and subsequent NADPH oxidase activation, leading to high levels of oxidative stress. Oxidative stress, a well-known catalyst for hypertension-related illness development, disturbs redox homeostasis, which ultimately promotes lipid peroxidation, isolevuglandin production and an inflammatory response. Natural medicinal compounds derived from organic materials that are characterized by their anti-inflammatory, anti-oxidative, and anti-mutagenic properties have recently gained traction amongst the pharmacology community due to their therapeutic effects. Flavonoids, a natural phenolic compound, have these therapeutic benefits and can potentially serve as anti-hypertensives. Flavones are a type of flavonoid that have increased anti-inflammatory effects that may allow them to act as therapeutic agents for hypertension, including diosmetin, which is able to induce significant arterial vasodilation in several different animal models. This review will focus on the activity of flavones to illuminate potential preventative and potential therapeutic mechanisms against hypertension. [ABSTRACT FROM AUTHOR]

Objective: To assess healthcare costs and healthcare resource utilization (HCRU) among adult patients who newly initiated erenumab in the United States. Methods: This retrospective, non‐interventional analysis included adult patients (aged ≥18 years) newly initiating erenumab and who had three consecutive monthly claims for erenumab (11/1/2017–9/1/2019) from the Komodo Health database. Outcomes included migraine‐related and all‐cause costs, use of other preventive/acute migraine medications, and HCRU. All outcomes were compared during the 180‐day pre‐ versus the 180‐day post‐index periods. Cost outcomes were also assessed for longer periods including post‐index Days 91–270 and monthly mean post‐index costs for the longest time of continuous insurance enrollment. Results: Overall, 1839 patients with migraine were included for analysis. Compared to the 180‐day pre‐index period, an increase in total migraine‐related costs (+$2639; p < 0.0001), migraine‐related prescription costs (+$3435, p < 0.0001), all‐cause total costs (+$2977; p < 0.001), and all‐cause prescription costs (+$4102; p < 0.0001) were observed during the 180‐day post‐index period after adjusting for covariates. Conversely, reduction in migraine‐related medical costs (−$896; p < 0.0001), and significantly lower odds of migraine‐related emergency room visits (odds ratio [OR] 0.60, 95% confidence interval [CI] 0.44–0.82; p = 0.001), migraine‐related office visits (OR 0.58, 95% CI 0.53–0.64; p < 0.0001), and migraine‐related neurologist visits (OR 0.69, 95% CI 0.63–0.75; p < 0.0001) were observed during the 180‐days post‐index period. There were significant decreases in the odds of having overall preventive migraine medications (OR 0.81, 95% CI 0.75–0.87; p < 0.0001), acute‐migraine medications (OR 0.92, 95% CI 0.85–1.00; p = 0.038), and triptan (OR 0.79, 95% CI 0.73–0.85; p < 0.0001) during the 180‐day post‐index period. Sensitivity analyses on cost outcomes found no statistically significant differences in pre‐index migraine‐related costs compared to post‐index migraine‐related costs when assessing longer post‐index follow‐up periods. Conclusion: Initiation of therapy with a novel treatment is often associated with an increase in overall healthcare costs due to the entrance costs associated with novel therapy. For a chronic condition such as migraine, cost versus health benefits should be evaluated over a long period (e.g., ≥2 years) to better understand the true benefits of therapy. Data from this study suggest that the entrance cost for erenumab, the primary driver of the high post‐index prescription costs gets mitigated by reduced medical costs over long‐term follow‐up. The results indicate better disease management in adult patients with migraine, which should be an important consideration for both patients and payors, as these findings have shown an offset between migraine‐related prescription and medical costs. [ABSTRACT FROM AUTHOR]

Background: The impact of chronic kidney disease (CKD) on atrial fibrillation outcomes (AF) is not well understood. Methods: We conducted analyses of comorbid AF and CKD related death in the United States from 1999 to 2020 using descriptive epidemiology. Results: Age-adjusted mortality rates (AAMR) per 100,000 increased from 0.39 in 1999 to 1.65 in 2020. Non-Hispanic populations (1.01) and nonmetropolitan areas (1.08) had higher AAMRs compared to Hispanic (0.62) and metropolitan (0.97) areas. Midwestern (1.11) and Western (1.13) US regions recorded the highest AAMRs. Conclusions: These findings highlight the need for interventions to address AF death disparities in patients with CKD. [ABSTRACT FROM AUTHOR]

This study investigated the relative impacts of three corporate social responsibility (CSR) types – namely corrective, compensating and cultivating CSR – on brand defense by considering customer–company's (C–C's) identification mediation role and CSR authenticity's moderation role in these relationships. A between-subject experiment was conducted on 573 coffee shop customers in the United States. The findings revealed corrective CSR is the strongest brand defense predictor, followed by compensating and cultivating CSR. The CSR types' relative effects are mediated by C–C identification, and as such, compensating CSR's indirect effects on brand defense through C–C identification are stronger than cultivating CSR's indirect effects on brand defense. When the CSR authenticity level is high, cultivating CSR has a significant indirect effect – through C–C identification – on brand defense that is stronger than when the CSR authenticity level is low. When the level is high, compensating CSR has an insignificant indirect effect – through C–C identification – on brand defense, similar to when the level is low. Finally, findings on moderated mediation revealed the indirect relationship between the three CSR types on brand defense – through C–C identification – is moderated by CSR authenticity. [ABSTRACT FROM AUTHOR]

Sentiment analysis plays a vital role in understanding public opinions and sentiments toward various topics. In recent years, the rise of social media platforms (SMPs) has provided a rich source of data for analyzing public opinions, particularly in the context of election-related conversations. Nevertheless, sentiment analysis of electionrelated tweets presents unique challenges due to the complex language used, including figurative expressions, sarcasm, and the spread of misinformation. To address these challenges, this paper proposes Election-focused Bidirectional Encoder Representations from Transformers (ElecBERT), a new model for sentiment analysis in the context of election-related tweets. Election-related tweets pose unique challenges for sentiment analysis due to their complex language, sarcasm, andmisinformation. ElecBERT is based on the Bidirectional Encoder Representations from Transformers (BERT) language model and is fine-tuned on two datasets: Election-Related Sentiment-Annotated Tweets (ElecSent)-Multi-Languages, containing 5.31 million labeled tweets in multiple languages, and ElecSent-English, containing 4.75 million labeled tweets in English. Themodel outperforms other machine learning models such as Support Vector Machines (SVM), Naïve Bayes (NB), and eXtreme Gradient Boosting (XGBoost), with an accuracy of 0.9905 and F1-score of 0.9816 on ElecSent-Multi-Languages, and an accuracy of 0.9930 and F1-score of 0.9899 on ElecSent-English. The performance of differentmodels was compared using the 2020 United States (US) Presidential Election as a case study. The ElecBERT-English and ElecBERT-Multi-Languages models outperformed BERTweet, with the ElecBERT-English model achieving aMean Absolute Error (MAE) of 6.13. This paper presents a valuable contribution to sentiment analysis in the context of election-related tweets, with potential applications in political analysis, social media management, and policymaking. [ABSTRACT FROM AUTHOR]