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The higher education efficiency evaluation model using the data envelopment analysis method has interested many researchers. This paper uses bibliometric analysis on publications extracted from the Scopus database to provide a comprehensive overview of research publications on the measurement of higher education efficiency based on data envelopment analysis: its growth rate, major collaboration networks, the most important and popular research topic. A total of 169 related publications were collected and analyzed from 1988 to 2021. The analysis results show that: Publications published every year have increased sharply in the last six years; The quality of publications is relatively high as publications tend to be published in journals with high-ranking indexes; Countries with the most influence in studies on this topic are: Italy, China, Spain, the USA, and the United Kingdom; Authors with the most influence in this research direction are Agasisti T., Abbott M., Doucouliagos C., Avkiran N.K., and Johnes J.; The research cooperation among countries and among affiliations is not strong. Finally, the paper has provided recommendations for future studies based on the findings.

Given the importance of local scholars' understanding of research in their integration into global academia, this study explored the way scholars conceptualised and perceived the meaning of research and their identities as researchers. This article reports data from a qualitative case study using semi-structured interviews to explore the positioning and discursive identity of eight Vietnamese social science scholars. Findings revealed that researchers trained in Vietnam and the Soviet Union understood research as knowledge production, positioning themselves as creators of knowledge and critical thinkers. In contrast, researchers who studied in Western countries considered research a rigorous process, positioning themselves as producers and disseminators of research assessed against given standards in international peer-reviewed journals. This study suggests that in local contexts with a complicated history and unique culture like Vietnam, social science researchers should be encouraged to employ their various local methods to tap into the existing sources of local knowledge.

This paper investigates the relationship between firm‐level cybersecurity risk and merger and acquisition (M&A) activities of firms in the United States from 2007 to 2018. Using a novel measure of firm‐level cybersecurity risk and the multivariate regression analysis, we find empirical evidence of a positive association between M&A and cybersecurity risk. Interestingly, cybersecurity risk only increases with intangible assets acquisitions, but not with tangible assets acquisitions. Further empirical analysis shows that the impact of M&A on cybersecurity risk is moderated by technological intensity, with firms that have higher levels of research and development (R&D) intensity facing less pronounced cybersecurity risk. Our findings are robust to different variable measurements and endogeneity diagnoses. Our results deliver important implications for practitioners and policymakers and make a valuable contribution to the literature by providing a more comprehensive understanding of the relationship between M&A and cybersecurity risk and by highlighting the role of corporate innovation in mitigating this risk. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to systematically review the university social responsibility (USR) implementation from the empirical studies, which published during the period from 2004 to 2020. Design/methodology/approach: The bibliometric method has been employed to review prior empirical research on higher education social responsibility topics. Findings: These synthesis results confirmed that USR initiatives as an excellent tool to attain sustainability and enhance university performance worldwide. Universities in developed nations underline paying more attention to the core values in the long-term; meanwhile, their counterparts in transitional countries to pay more attention to short-term activities by focusing on stakeholders. Research limitations/implications: The notable limitation is that in terms of the number of empirical papers employed as the data to analyze in this manuscript. Practical implications: This paper's findings have described the USR implementations and how well to define USR adoption from the empirical studies globally. Thus, it has theoretical implications in enriching the USR knowledge and providing useful guidance for universities, then recommend new research directions in the future for other scholars. Originality/value: This research is an initial attempt to systematize studies on USR implementation in universities between developed countries and developing nations.

The Health Resources and Services Administration's (HRSA) Health Center Program provides health care to vulnerable persons across theUS, regardless of their ability to pay for health care.We examined characteristics of populations living within and outside a 30-minute drive-time to HRSA-supported health centers to establish a baseline to better understand the differences in these populations. Using a descriptive, cross-sectional study design and geographic information systems, we found that 94% of persons in the US live within a 30-minute drive-time of a health center. Of those outside a 30-minute drive-time to a health center, 11.7 million (60.11%) are rural and over 1.5 million households (20.32%) lack broadband internet access. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is linked to immune-mediated pathogenesis and a pro-inflammatory state, leading to accelerated atherosclerosis. This earlier onset of clinical cardiovascular disease poses significant morbidity and mortality. We sought to identify IHD mortality trends in individuals with IBD in the United States (US). Mortality due to ischemic heart diseases (IHD) as the underlying cause of death with the IBD as a contributor of death were queried from death certificates using the CDC database from 1999 to 2020. Yearly crude mortality rates (CMR) were estimated by dividing the death count by the respective population size, reported per 100,000 persons. Mortality rates were adjusted for age using the Direct method and compared by demographic subpopulations. Log-linear regression models were utilized to assess temporal variation (annual percentage change [APC]) in mortality. Age-adjusted mortality rates (AAMR) decreased from 0.11 in 1999 to 0.07 in 2020, primarily between 1999 and 2018 (APC -4.41, p < 0.001). AAMR was higher among male (AAMR 0.08) and White (AAMR 0.08) populations compared to female populations (AAMR 0.06) and Black (AAMR 0.04) populations, respectively. No significant differences were seen when comparing mortality between urban (AAMR 0.07) and rural (AAMR 0.08) regions. Southern US regions (AAMR 0.06) had the lowest mortality rates when compared to the other US census regions: Northeastern (AAMR 0.08), Midwestern (AAMR 0.08), and Western (AAMR 0.08). Disparities in IHD mortality exist among individuals with IBD in the US based on demographic factors, with an overall decline in mortality during the 22-year period. Further investigation is warranted to confirm these findings and evaluate for contributors to the observed disparities. [Display omitted] • Ischemic heart disease mortality in populations with inflammatory bowel disease has decreased in recent years. • Ischemic heart disease mortality disproportionally impacted male and White populations with inflammatory bowel disease. • Southern regions had the lowest ischemic heart disease mortality in populations with inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

Scholars have documented harm associated with positive stereotypes about groups that experience inequality. We surveyed five samples from the United States to explore antecedents to dominant group endorsement of positive stereotypes about women, gay men, Asian Americans, Black Americans, and Native Americans. We found more liberal participants, and those with more close contact with members of these groups, were more internally motivated to respond without prejudice, which was then associated with greater endorsement of positive stereotypes about women, gay men, Black Americans, and Native Americans. In contrast, more conservative participants were more likely to believe in system legitimacy, which was then associated with greater endorsement of positive stereotypes about women and Asian Americans. We theorize that positive stereotypes are used by dominant group members in divergent ways, sometimes to legitimate inequality and other times with concern about inequality. The latter likely involves naivety regarding the harmful nature of positive stereotypes. [ABSTRACT FROM AUTHOR]

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Early childhood (EC) education has usually involved in-person teaching and learning. However, the COVID-19 pandemic has imposed remote teaching on EC practitioners and complicated practicum students' fieldwork experiences. This study explored EC practicum students' fieldwork experiences in the U.S. during the pandemic and their preparedness for online teaching and technology employment and integration. Participants included 28 students enrolled in Directed Field Experience in Spring 2021. A mixed-methods approach incorporating multiple sources of data, including reflection papers, interviews, and questionnaires, was used. The findings showed that the EC practicum students changed their perceptions of and attitudes toward a remote field experience course and online teaching with young children over the semester. Additionally, EC practicum students' challenges and professional and academic growth were evident in their reporting. These findings have implications for the development of effective strategies for alleviating EC practicum students' challenges, facilitating their professional growth, and providing resources to integrate digital technology in their teaching in developmentally appropriate ways. [ABSTRACT FROM AUTHOR]

(1) Background: Hepatocellular carcinoma (HCC) contributes to the significant burden of cancer mortality in the United States (US). Despite highly efficacious antivirals, chronic viral hepatitis (CVH) remains an important cause of HCC. With advancements in therapeutic modalities, along with the aging of the population, we aimed to assess the contribution of CVH in HCC-related mortality in the US between 1999–2020. (2) Methods: We queried all deaths related to CVH and HCC in the multiple-causes-of-death files from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database between 1999–2020. Using the direct method of standardization, we adjusted all mortality information for age and compared the age-adjusted mortality rates (AAMRs) across demographic populations and by percentile rankings of social vulnerability. Temporal shifts in mortality were quantified using log-linear regression models. (3) Results: A total of 35,030 deaths were identified between 1999–2020. The overall crude mortality increased from 0.27 in 1999 to 8.32 in 2016, followed by a slight reduction to 7.04 in 2020. The cumulative AAMR during the study period was 4.43 (95% CI, 4.39–4.48). Males (AAMR 7.70) had higher mortality rates compared to females (AAMR 1.44). Mortality was higher among Hispanic populations (AAMR 6.72) compared to non-Hispanic populations (AAMR 4.18). Higher mortality was observed in US counties categorized as the most socially vulnerable (AAMR 5.20) compared to counties that are the least socially vulnerable (AAMR 2.53), with social vulnerability accounting for 2.67 excess deaths per 1,000,000 person-years. (4) Conclusions: Our epidemiological analysis revealed an overall increase in CVH-related HCC mortality between 1999–2008, followed by a stagnation period until 2020. CVH-related HCC mortality disproportionately affected males, Hispanic populations, and Black/African American populations, Western US regions, and socially vulnerable counties. These insights can help aid in the development of strategies to target vulnerable patients, focus on preventive efforts, and allocate resources to decrease HCC-related mortality. [ABSTRACT FROM AUTHOR]

This study investigated the quality of teacher--child interaction and its effects on children's classroom engagement and disaffection in Vietnamese kindergartens. The quality of teacher-child interaction was measured using the Classroom Assessment Scoring System. Children's classroom engagement and disaffection were assessed by Engagement versus Disaffection in Learning. There were 1474 kindergarten children and 60 teachers from 12 kindergartens in three cities in Vietnam participating in the study. The results indicated that classrooms in Vietnam kindergartens had a moderate quality of teacher-child interaction. Compared to the results from other countries published previously, teacher sensitivity and regard for student perspectives of Vietnamese samples were lower than those of Finland, Germany, the United States, and China. Productivity and the instructional learning format in Vietnamese kindergarten classrooms were higher than those of all the other countries except Finland. The results of fixed-effects and random-effects modelling suggested that children in better organised classrooms were more engaged in learning. Emotional support had a negative effect on children's classroom engagement. Children's classroom disaffection was not significantly affected by the quality of the teacher-child interaction.

University students often experience sleep disturbances and disorders. Personal digital technologies present a great opportunity for sleep health promotion targeting this population. However, studies that engage university students in designing and implementing digital sleep health technologies are scarce. This study sought to understand how we could build digital sleep health technologies that meet the needs of university students through a co-design process. We conducted three co-design workshops with 51 university students to identify design opportunities and to generate features for sleep health apps through workshop activities. The generated ideas were organized using the stage-based model of self-tracking so that our findings could be well-situated within the context of personal health informatics. Our findings contribute new design opportunities for sleep health technologies targeting university students along the dimensions of sleep environment optimization, online community, gamification, generative AI, materializing sleep with learning, and personalization. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is a significant global health concern, with over 90% of countries reporting such hesitancy. In the United States, vaccine hesitancy has risen significantly, with over 79 million cases and 950,000 deaths in 2022. This highlights the political importance of vaccine hesitancy in the coming years. Moral foundations are associated with political alignments on the left-right axis, but they do not extend to beliefs about political contexts. Populism, a belief in the power of the people to take back power from the elite, is particularly important in the COVID-19 pandemic. This study explores possible associations of vaccine hesitancy with both moral foundations and populism using survey research. Results from multiple regression analysis show that while moral foundations are not entirely accounted for, populism can impact vaccine hesitancy outside of its overlap with moral foundations. The study reveals a significant association between vaccine hesitancy and populism and four moral foundations. It suggests that vaccine hesitancy is linked to populist sentiment and moral orientations and suggests that further research could explore the relationship between these factors. The study also suggests that the challenge of vaccine hesitancy is not solely about vaccines, but rather exacerbated skepticism and lack of trust in institutions and elite knowledge. The findings could help policymakers and practitioners understand the motivational factors influencing vaccine hesitancy, focusing on moral reasoning and sociopolitical narratives rather than swaying people with scientific elite knowledge. Emphasizing messages about vaccination as a form of loyalty to family, friends, and country could be more effective. [ABSTRACT FROM AUTHOR]

Introduction: Endoscopy is a major part of surgical training. Accreditation Council for Graduate Medical Education (ACGME) has set standards regarding the minimum volume of endoscopy cases required for graduation. However, there is paucity of high-quality data on the number of cases that most surgical graduates perform. Methods: We conducted a retrospective analysis of operative case logs of all general surgery residents graduating from ACGME-accredited programs from 2010 to 2023. Data on mean number of endoscopy cases, including mean in each subcategory, were retrieved. Mann–Kendall trend test was used to investigate trends in endoscopy experience. Results: Between 2010 and 2023, the mean overall endoscopy procedures per resident remained stable, with 129.5 in 2010 and 132.1 in 2023 (t = 0.429; p-value = 0.037). The majority of these cases were performed as surgeon junior (76.6% in 2010; 80.9% in 2023), while the remaining cases were logged as surgeon chief. The most substantial contribution to the overall volume was from flexible colonoscopy (mean: 64.1 in 2010 and 67.2 in 2023). The volume for colonoscopy remained fairly stable (t = 0.429; p-value = 0.036). This was followed by esophagogastroduodenoscopy (mean: 35.3 in 2010 and 35.5 in 2023), which saw a significant increase in volume (t = 0.890; p-value ≤ 0.001). There was a significant increase in the number of overall upper endoscopic procedures (t = 0.791; p-value ≤ 0.001), while lower endoscopic procedures did not change significantly (t = 0.319; p-value = 0.125). The procedural volume for endoscopic retrograde cholangiography, sigmoidoscopy, cystoscopy/ureteroscopy, laryngoscopy, and bronchoscopy decreased significantly (p-value < 0.05 for all). Conclusion: The overall endoscopy volume for general surgery residents has largely remained stable, with a minor increase in esophagogastroduodenoscopy and no change in colonoscopy. Future research should investigate whether simulation-based exercises can bridge the gap between procedural volume and learning curve requirements for endoscopy. [ABSTRACT FROM AUTHOR]

To be effective, the battle against COVID-19 and other pandemics must address the social dimensions of the crisis. The objective of this study was to assess whether negative attitudes toward elite knowledge were associated with vaccine hesitancy in the United States during COVID-19. Attitudes toward elite knowledge were assessed using three measures: (a) the Epistemological Style Inventory's 'naive realism' subscale, (b) a measure about supporting education to foster understanding of politics, and (c) a populism scale. Vaccine hesitancy was measured using a 9-item adaptation of the Vaccine Hesitancy Scale used by the World Health Organization. Multiple regression results revealed that naïve realism (.184, p <.001) and populism (.356, p <.001) were positively associated with vaccine hesitancy, while support of political education (−.296, p <.001) was negatively associated with vaccine hesitancy. These results indicate that to fully understand vaccine hesitancy, the role of attitudes toward elite knowledge must be considered. [ABSTRACT FROM AUTHOR]

An unwelcoming policy climate can create barriers to health care access and produce a 'Chilling Effect' among immigrant communities. For undocumented immigrants, barriers may be unique and have a greater impact. We used administrative emergency department (ED) data from 2015 to 2019 for a Midwestern state provided under a data use agreement with the state hospital association. General linear modelling was used to estimate the impact of anti-immigrant rhetoric on ED visit intensity among non-elderly adults who were likely Hispanic/Latino with undocumented status. Compared to 2015, the average ED visit intensity among adults who were likely Hispanic/Latino with undocumented status was significantly higher during 2016–2019 when anti-immigrant rhetoric was heightened. The magnitude of this change increased over time (0.013, 0.014, 0.021, and 0.020, respectively). Additionally, this change over time was not observed in the comparison groups. Our findings suggest that anti-immigrant rhetoric may alter health care utilization for adults who are likely Hispanic/Latino with undocumented status. Limitations to our findings include the use of only those likely to be Hispanic/Latino, data from only one Midwestern state and the loss of data due to non-classification using the NYU ED algorithm. Further research should focus on validating these findings and investigating these identification methods and anti-immigrant rhetoric effects among other undocumented groups including children and adults of different race or ethnicity such as black, both those that identify as Hispanic/Latino and those that do not. Developing strategies to improve health care access for undocumented Hispanic/Latino adults also warrants future research. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes. [ABSTRACT FROM AUTHOR]

This study synthesizes two different methods for estimating hydraulic conductivity (K) at large scales. We derive analytical approaches that estimate K and apply them to the contiguous United States. We then compare these analytical approaches to three‐dimensional, national gridded K data products and three transmissivity (T) data products developed from publicly available sources. We evaluate these data products using multiple approaches: comparing their statistics qualitatively and quantitatively and with hydrologic model simulations. Some of these datasets were used as inputs for an integrated hydrologic model of the Upper Colorado River Basin and the comparison of the results with observations was used to further evaluate the K data products. Simulated average daily streamflow was compared to daily flow data from 10 USGS stream gages in the domain, and annually averaged simulated groundwater depths are compared to observations from nearly 2000 monitoring wells. We find streamflow predictions from analytically informed simulations to be similar in relative bias and Spearman's rho to the geologically informed simulations. R‐squared values for groundwater depth predictions are close between the best performing analytically and geologically informed simulations at 0.68 and 0.70 respectively, with RMSE values under 10 m. We also show that the analytical approach derived by this study produces estimates of K that are similar in spatial distribution, standard deviation, mean value, and modeling performance to geologically‐informed estimates. The results of this work are used to inform a follow‐on study that tests additional data‐driven approaches in multiple basins within the contiguous United States. [ABSTRACT FROM AUTHOR]

The expanding integration of artificial intelligence (AI) in various aspects of society makes the infosphere around us increasingly complex. Humanity already faces many obstacles trying to have a better understanding of our own minds, but now we have to continue finding ways to make sense of the minds of AI. The issue of AI's capability to have independent thinking is of special attention. When dealing with such an unfamiliar concept, people may rely on existing human properties, such as survival desire, to make assessments. Employing information-processing-based Bayesian Mindsponge Framework (BMF) analytics on a dataset of 266 residents in the United States, we found that the more people believe that an AI agent seeks continued functioning, the more they believe in that AI agent's capability of having a mind of its own. Moreover, we also found that the above association becomes stronger if a person is more familiar with personally interacting with AI. This suggests a directional pattern of value reinforcement in perceptions of AI. As the information processing of AI becomes even more sophisticated in the future, it will be much harder to set clear boundaries about what it means to have an autonomous mind. [ABSTRACT FROM AUTHOR]

We examined weight management counseling practices of Health Resources and Services Administration-funded health center (HC) providers for patients with overweight (POW) and obesity (POB) status, focusing on weight-related conditions, risk factors, and health care utilization. We used a nationally representative cross-sectional survey of HC patients and multilevel generalized structural equation logistic regression models to assess the association of provider counseling practices for POW and POB and by three obesity classes. Dependent variables included being told by the HC provider that weight was a problem, receiving a diet or exercise recommendation, referral to a nutritionist, or receiving weight loss prescriptions. Independent variables included weight-related conditions such as diabetes and hypertension, risk factors such as smoking, and health service utilization such as five or more primary care visits. All POB classes had higher odds of receiving all five counseling interventions than POW. Patients with diabetes and high cholesterol had higher odds of diet recommendations (OR = 1.8) and nutritionist referrals (OR = 2.3), while patients with cardiovascular disease had higher odds of nutritionist referral (OR = 2.0) and receiving weight loss prescriptions (OR = 2.6). Respondents with POB class III and diabetes had higher odds of receiving exercise recommendations (OR = 3.4), while POB class 1 and had hypertension had lower odds of nutritionist referral (OR = 0.3). Variations in HC primary care providers' weight management counseling practices between POW and POB present missed opportunities for consistent practice and early intervention. Assessing providers' counseling practices for patients with comorbid conditions is essential to the successful management of the obesity crisis. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales. Purpose: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care. Methods: We administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects. Results: Using several criteria, we improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring. Conclusion: We addressed several methodological issues with the CECSS and provided recommendations for improvement. [ABSTRACT FROM AUTHOR]

Seventy percent of tuberculosis (TB) cases in the United States occur among non-US-born persons; cases usually result from reactivation of latent TB infection (LTBI) likely acquired before the person's US arrival. We conducted a prospective study among US immigrant visa applicants undergoing the required overseas medical examination in Vietnam. Consenting applicants >15 years of age were offered an interferon-γ release assay (IGRA); those 12-14 years of age received an IGRA as part of the required examination. Eligible participants were offered LTBI treatment with 12 doses of weekly isoniazid and rifapentine. Of 5,311 immigrant visa applicants recruited, 2,438 (46%) consented to participate; 2,276 had an IGRA processed, and 484 (21%) tested positive. Among 452 participants eligible for treatment, 304 (67%) initiated treatment, and 268 (88%) completed treatment. We demonstrated that using the overseas medical examination to provide voluntary LTBI testing and treatment should be considered to advance US TB elimination efforts. [ABSTRACT FROM AUTHOR]

As geographical location can impact the gut microbiome, it is important to study region-specific microbiome signatures of various diseases. Therefore, we profiled the gut microbiome of breast cancer (BC) patients of the Midwestern region of the United States. The bacterial component of the gut microbiome was profiled utilizing 16S ribosomal RNA sequencing. Additionally, a gene pathway analysis was performed to assess the functional capabilities of the bacterial microbiome. Alpha diversity was not significantly different between BC and healthy controls (HC), however beta diversity revealed distinct clustering between the two groups at the species and genera level. Wilcoxon Rank Sum test revealed modulation of several gut bacteria in BC specifically reduced abundance of those linked with beneficial effects such as Faecalibacterium prausnitzii. Machine learning analysis confirmed the significance of several of the modulated bacteria found by the univariate analysis. The functional analysis showed a decreased abundance of SCFA (propionate) production in BC compared to HC. In conclusion, we observed gut dysbiosis in BC with the depletion of SCFA-producing gut bacteria suggesting their role in the pathobiology of breast cancer. Mechanistic understanding of gut bacterial dysbiosis in breast cancer could lead to refined prevention and treatment. [ABSTRACT FROM AUTHOR]

Introduction and Review of Literature.: Physical therapist (PT) and PT assistant (PTA) education programs have historically required preadmission observation hours (ObHr) as an admission requirement. The variability of conditions surrounding ObHr lends itself to investigation. The aims of this study were to (1) identify the perceived value of ObHr to Admission Committee (AC) members, Directors of Clinical Education, current Doctor of Physical Therapy (DPT) students, and PT clinicians, (2) examine the effect that ObHr have on the decision-making process of AC members, and (3) examine the effect that ObHr had on current DPT students' decisions to pursue a PT career. Subjects.: Four stakeholder groups were targeted (N = 4,471). Methods.: This descriptive, cross-sectional study utilized surveys to collect quantitative and qualitative data through closed-ended and open-ended questions. This article encompasses the analysis of the quantitative components by analyzing fixed responses on stakeholder surveys. Qualitative findings are reported in a separate article. Results.: Perceived purposes of ObHr by stakeholders were as follows: (1) to gain an accurate understanding of the depth and breadth of the profession, (2) to confirm a desire to pursue PT as a profession, and (3) to better understand the roles and responsibilities of PT. The number of necessary ObHr varied among the groups ranging from 0 to 100 hours. Student perception that completing more hours than required would assist in their favorability for acceptance was debunked. Discussion.: There was consensus among all groups regarding the perceived purposes. Variability of stakeholder perception of necessary ObHr to achieve goals was revealed. Doctor of Physical Therapy programs should be transparent and clarify the purpose and quantity of required ObHr. Conclusion.: Long-standing requirements could be taxing current resources and limiting entry into the profession. Determining the minimum number of necessary ObHr, considering virtual methods, and employing distinct transparency on how ObHr are used in the decision-making process are opportunities for further study to address these issues. [ABSTRACT FROM AUTHOR]

Background: Female physicians have a higher prevalence of infertility compared with the general population. Physician well-being can be significantly impacted by the physical and emotional challenges associated with this, including the high cost of fertility treatments, which are often not covered by health insurance. There are limited data on the current state of fertility coverage available for physicians. This study examines fertility insurance benefits offered for faculty at top U.S. medical schools. Methods: Between March and April 2021, we reviewed fertility benefits at medical schools ranked in the top 14 for research as identified by the US News & World Report 2021. The summary plan descriptions of benefits were collected from each institution's human resources (HR) website and direct phone call to HR representatives. We examined descriptions of coverage for fertility services including evaluation, treatments, medications, maximum lifetime coverage, and whether a formal diagnosis of infertility was required for benefit eligibility. Results: Fourteen institutions offer benefits for fertility evaluation and 13 offer benefits for treatment. Of the 13 institutions that offer treatment coverage, 11 cover in vitro fertilization, with 6 having limits on the number of cycles. Twelve offer medication coverage. Ten institutions specified maximum lifetime coverage for treatments and medications, ranging from $10,000 to $100,000. Only 1 school provided coverage for elective fertility preservation, and none covered surrogacy expenses. Half of the schools are in states where fertility benefits are mandated. Conclusion: There is wide variation in fertility benefits offered at top medical schools across the country. Many schools offered coverage for fertility evaluation and treatments; however, majority had restrictions and limitations to the benefits, suggesting that there is still inadequate coverage provided. This study's selected sample also does not reflect other medical schools across the country, which may not be as well-resourced in their provision of fertility benefits. [ABSTRACT FROM AUTHOR]

Policy PointsAs essential access points to primary care for almost 29 million US patients, of whom 47% are Medicaid enrollees, health centers are positioned to implement the population health management necessary in value‐based payment (VBP) contracts.Primary care payment reform requires multiple payment methodologies used together to provide flexibility to care providers, encourage investments in infrastructure and new services, and offer incentives for achieving better health outcomes.State policy and significant financial incentives from Medicaid agencies and Medicaid managed care plans will likely be required to increase health center participation in VBP, which is consistent with broader state efforts to expand investment in primary care. Context: Efforts are ongoing to advance value‐based payment (VBP), and health centers serve as essential access points to comprehensive primary care services for almost 29 million people in the United States. Therefore, it is important to assess the levels of health center participation in VBP, types of VBP contracts, characteristics of health centers participating in VBP, and variations in state policy environments that influence VBP participation. Methods: This mixed methods study combined qualitative research on state policy environments and health center participation in VBP with quantitative analysis of Uniform Data System and health center financial data in seven vanguard states: Oregon, Washington, California, Colorado, New York, Hawaii, and Kentucky. VBP contracts were classified into three layers: base payments being transformed from visit‐based to population‐based (Layer 1), infrastructure and care coordination payments (Layer 2), and performance incentive payments (Layer 3). Findings: Health centers in all seven states participated in Layer 2 and Layer 3 VBP, with VBP participation growing from 35% to 58% of all health centers in these states from 2013 to 2017. Among participating health centers, the average percentage of Medicaid revenue received as Layer 2 and Layer 3 VBP rose from 6.4% in 2013 to 9.1% in 2017. Oregon and Washington health centers participating in Layer 1 payment reforms received most of their Medicaid revenue in VBP. In 2017, VBP participation was associated with larger health center size in four states (P <.05), and higher average number of days cash on hand (P <.05) in three states. Conclusions: A multilayer payment model is useful for implementing and monitoring VBP adoption among health centers. State policy, financial incentives from Medicaid agencies and Medicaid managed plans, and health center–Medicaid collaboration under strong primary care association and health center leadership will likely be required to increase health center participation in VBP. [ABSTRACT FROM AUTHOR]

Simple Summary: Mormon crickets (Anabrus simplex) are native to the United States and can become devastating rangeland pests. These insects can form migratory bands numbering in the millions, which can traverse the western U.S., damaging agricultural crops, invading urban areas, and producing hazardous slicks on roadways. Current methods of managing these insects involve targeted applications of non-specific chemical insecticides, which can potentially have negative effects on the environment. In this study, we took the first steps toward developing RNA interference (RNAi) methods, a type of gene silencing technique that has potential for pest management, for Mormon crickets as a potential alternative to traditional broad-spectrum insecticides. We first generated genomic resources to identify several candidate genes and developed double-stranded RNA (dsRNA) for these genes, which could be injected into the insect to induce gene silencing. We performed RNAi experiments to characterize gene knockdown efficiencies and demonstrated that it is possible to elicit RNAi responses in the Mormon cricket by injection, but knockdown efficiencies varied according to the target genes and tissue types. We conclude that RNAi silencing is possible in Mormon cricket, but more work needs to be done before it can be effectively used as a population management method. Mormon crickets are a major rangeland pest in the western United States and are currently managed by targeted applications of non-specific chemical insecticides, which can potentially have negative effects on the environment. In this study, we took the first steps toward developing RNAi methods for Mormon crickets as a potential alternative to traditional broad-spectrum insecticides. To design an effective RNAi-based insecticide, we first generated a de novo transcriptome for the Mormon cricket and developed dsRNAs that could silence the expression of seven housekeeping genes. We then characterized the RNAi efficiencies and time-course of knockdown using these dsRNAs, and assessed their ability to induce mortality. We have demonstrated that it is possible to elicit RNAi responses in the Mormon cricket by injection, but knockdown efficiencies and the time course of RNAi response varied according to target genes and tissue types. We also show that one of the reasons for the poor knockdown efficiencies could be the presence of dsRNA-degrading enzymes in the hemolymph. RNAi silencing is possible in Mormon cricket, but more work needs to be done before it can be effectively used as a population management method. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction.: Inclusion of preadmission observation hours (ObHr) as one component of the admissions process is commonly required in physical therapy education programs. The purpose of this study was to describe the value and impact of ObHr on 4 key stakeholder groups: doctor of physical therapy students, physical therapy clinicians, directors of clinical education, and admissions committee (AC) members. Review of Literature.: The number of required and/or recommended ObHr and practice settings varies greatly. No previous study has explored a national dataset of key stakeholders' perspectives on ObHr experiences. Subjects.: Four key stakeholder groups were targeted in the study (N = 4,471). Methods.: Four stakeholder surveys were developed and distributed via email using a snowball sampling technique. Responses to the open-ended questions were analyzed using conventional content analysis for creating codes, categories, and themes within and across groups. Results.: Five main themes emerged: 1) ObHr have value in career decision making; 2) students driven by hours, but all stakeholders value variety; 3) use of ObHr for program admissions decisions varies; 4) as the number of hours and settings increase, so do the challenges for students; and 5) there is interest in developing alternative ObHr experiences. Discussion and Conclusion.: There was consensus among all stakeholder groups regarding ObHr's value for exploring the profession of physical therapy and helping applicants determine if the profession is a good fit. Respondents highlighted the value of observing in a variety of practice settings. Perspectives differed between AC members and students regarding the impact of ObHr on admissions decision making. Students reported a variety of personal and organizational challenges associated with ObHr completion. Physical therapy programs should reexamine their current ObHr practices and consider alternative methods that support all applicants in their pursuit of a career in physical therapy. [ABSTRACT FROM AUTHOR]

We examine the effect of foreign institutional investors on firm innovation. Using firm-level data across 26 non-U.S. economies between 2000 and 2010, we show that foreign institutional ownership has a positive, causal effect on firm innovation. We further explore three possible underlying mechanisms through which foreign institutions affect firm innovation: Foreign institutions act as active monitors, provide insurance for firm managers against innovation failures, and promote knowledge spillovers from high-innovation economies. Our article sheds new light on the real effects of foreign institutions on firm innovation. [ABSTRACT FROM PUBLISHER]

Little is known about representation in trials aimed at addressing Opioid Use Disorder. This is a crucial issue given high mortality rates overall and substantial differences in death rates across racial/ethnic groups. We analyzed data from clinical trials, data on Census population, data on new admissions to treatment facilities with a diagnosis of Opioid Use Disorder, and mortality data. We found that Native American people (who face the highest opioid-related mortality burden in the United States) were under-represented in clinical trials. Black people (who face the second highest mortality rate) were enrolled at levels that exceeded those expected. Our results suggest the need for increased efforts to include Native Americans in OUD clinical trials and also that researchers should consider the possibility that high levels of enrollment among black Americans may represent an undue burden. We found ambiguous results for Asian American and Hispanic people. Our analysis also suggests that White people were represented at levels below those expected, although they were a majority of clinical trials participants. Overall, these findings highlight the importance of equity in clinical trials and major gaps in terms of representation. • American Indians and Alaska Natives were under-represented in clinical trials dealing with Opioid Use Disorder. • Black Americans were enrolled in clinical trials for opioid use disorder at levels that exceeded those expected. • White people were enrolled in clinical trials for opioid use disorder at levels that were lower than those that were expected. [ABSTRACT FROM AUTHOR]

This article focuses on the political dimension of U.S. elections and uses anthropological methods to analyze racial politics in New Orleans and Louisiana. Situating the research within the color-blindness ideology in the Post-civil Rights Era, the article discusses the continuity of racial inequality in the United States. By presenting the case of U.S. Congressman Joseph Anh Cao (2009-2011), the article argues that although the colorblindness ideology has been deployed since the 1960s, skin color continues to be a variable for redistricting practice in the United States. The successful U.S. Congress run of Mr. Cao in the 2008 election should not be considered that American society has become nonbiased. Instead, his defeat in 2010 is an evidence that the United States has not yet been color-blind. [ABSTRACT FROM AUTHOR]

In this paper, we analysed the heavy-tailed behaviour in the dynamics of housing-price returns in the United States. We investigated the sources of heavy tails by estimating autoregressive models in which innovations can be subject to GARCH effects and/or non-Gaussianity. Using monthly data from January 1954 to September 2019, the properties of the models were assessed both within- and out-of-sample. We found strong evidence in favour of modelling both GARCH effects and non-Gaussianity. Accounting for these properties improves within-sample performance as well as point and density forecasts. [ABSTRACT FROM AUTHOR]

Aim: To determine whether alcohol use disorder (AUD) is associated with increased dementia risk among older women veterans. Design Cohort study. Setting: United States. Participants: Women veterans with AUD aged ≥ 55 years (n = 2207), receiving care from Veterans Health Administration medical centers from October 2004 to September 2015 with one or more follow‐up visit and an age‐matched sample of women veterans without AUD (n = 2207). Women at baseline with prevalent dementia or AUD in remission were excluded. Measurements AUD, substance use disorder (SUD), smoking, psychiatric (depression, anxiety, post‐traumatic stress disorder, anxiety) and medical comorbidities (diabetes, hypertension, stroke, chronic obstructive pulmonary disorder, traumatic brain disorder) and dementia determined by the International Classification of Diseases, 9th revision, Clinical Modification codes. Cox proportional hazards models were used to determine the association between AUD and dementia risk during follow‐up. Sensitivity analyses were performed by excluding women (n = 349) with comorbid SUD and by excluding women (n = 1568) currently smoking. Findings Veteran women had a mean [standard deviation (SD)] age of 65.0 (5.6) years at baseline. During follow‐up (median 4 years, interquartile range: 2–6) 3.7% of women (n = 82) with AUD developed dementia compared with 1.1% (n = 24) without AUD (P < 0.001). After adjustment for demographics, medical and psychiatric conditions and accounting for different Veteran's Integrated Service Networks, the adjusted hazard ratio (aHR) for dementia was 3.12 (95% CI = 1.90–5.12) for women with AUD compared with women without AUD. After removing women with SUD (aHR = 3.53, 95% CI = 2.13–5.85) and women currently smoking (aHR = 3.80, 95% CI = 2.11–6.84), results were similar. Conclusions: Alcohol use disorder among female US veterans aged more than 55 years appears to be associated with a more than threefold increase of dementia. [ABSTRACT FROM AUTHOR]

Aims: Cannabis is an increasingly common recreational substance used by teenagers. However, there is limited data probing association of cardiac arrhythmias with marijuana use in this population.Methods and Results: We provide prevalence trends, disease burden and healthcare utilization of cardiac arrhythmias associated with cannabis use disorder (CUD) in hospitalized teenagers (13-20 years) using a large national administrative database in the United States from 2003-2016. We used partial least square regression analysis for assessing trends in prevalence of cardiac arrhythmias and multiple logistic regression to elucidate independent predictors of arrhythmias associated with CUD. Among all CUD related hospitalizations (n = 876, 431), 0.5% had arrhythmias. Prevalence trends of arrhythmias among CUD increased six-fold during the study period (P < 0.001). CUD was more prevalent in males and older teens (both P < 0.001). There was a significant risk for mortality when CUD was associated with arrhythmia (7.4% vs. 0.1%, P < 0.001). While mean length-of-stay (LOS) was shorter (4.4 vs. 5.4 days, P < 0.001) for patients with CUD, they incurred three times higher mean hospitalization charges when compared to CUD patients without arrhythmia ($45 959 vs. $18 986, P < 0.001). Both LOS and hospitalization charges showed an uptrend during the study period (P < 0.001). Congenital heart disease, congestive heart failure, hypertension, and obesity independently predicted arrhythmias in CUD while other substance abuse did not change the risk of arrhythmia in CUD.Conclusion: Arrhythmia burden is increasing among teenagers with CUD, and co-occurrence of arrhythmia and CUD worsens hospital outcomes. [ABSTRACT FROM AUTHOR]

Topography is a fundamental input to hydrologic models critical for generating realistic streamflow networks as well as infiltration and groundwater flow. Although there exist several national topographic datasets for the United States, they may not be compatible with gridded models that require hydrologically consistent digital elevation models (DEMs). Here, we present a national topographic dataset developed to support gridded hydrologic simulations at 1 km and 250 m spatial resolution over the contiguous United States. The workflow is described step by step in two parts: (a) DEM processing using a Priority Flood algorithm to ensure hydrologically consistent drainage networks and (b) slope calculation and smoothing to improve drainage performance. The accuracy of the derived stream network is evaluated by comparing the derived drainage area to drainage areas reported by the national stream gage network. The slope smoothing steps are evaluated using the runoff simulations with an integrated hydrologic model. Our DEM product started from the National Water Model DEM to ensure our final datasets will be as consistent as possible with this existing national framework. Our analysis shows that the additional processing we provide improves the consistency of simulated drainage areas and the runoff simulations that simulate gridded overland flow (as opposed to a network routing scheme). The workflow uses an open-source R package, and all output datasets and processing scripts are available and fully documented. All of the output datasets and scripts for processing are published through CyVerse at 250 m and 1 km resolution. The DOI link for the dataset is 10.25739/e1ps-qy48 (Zhang and Condon, 2020). [ABSTRACT FROM AUTHOR]

A long‐term exposure outdoor microcosm study was conducted to evaluate the effects of zinc (Zn) on zooplankton, phytoplankton, and periphyton in a freshwater system. Five Zn treatment concentrations (nominal: 8, 20, 40, 80, and 160 μg/L Zn) and an untreated control with 3 replicates each were used. Various physical and chemical characteristics of the microcosms and biological assessment endpoints (e.g., total abundance, group abundance, species richness, chlorophyll a, etc.) were measured to determine the effects of Zn over time. In general, physical and chemical characteristics (e.g., total dissolved solids, total suspended solids, dissolved oxygen, pH, dissolved organic carbon) of water fluctuated over time, but they were not significantly different within treatments and controls during the study. Zinc significantly affected the population dynamics and community structure of plankton. The effects occurred 7 d after initial treatment exposures began and continued to the end of the treatment phase, especially at the high treatment concentrations. Total and group abundance, species richness, the Shannon index, and chlorophyll a concentrations for high Zn treatment concentrations were significantly lower than the controls during the treatment phase. The no‐observed‐effect, lowest‐observed‐effect, and median effect concentrations were generally lower than the literature‐reported results from single‐species toxicity tests for fish and invertebrates, suggesting that plankton are more sensitive to Zn than planktivores. Although primary producers play an important role in the ecosystem, they have not been consistently incorporated into numerical environmental quality criteria for freshwater organisms, at least in the United States. The results of the present study are useful for development of environmental quality guidelines for freshwater ecosystems and ecological risk assessment. Environ Toxicol Chem 2021;40:2053–2072. © 2021 SETAC [ABSTRACT FROM AUTHOR]

Blasting is an indispensable part of the open pit mining operations. It plays a vital role in preparing the rock mass for subsequent operations, such as loading/unloading, transporting, crushing, and dumping. However, adverse effects, especially blast-induced ground vibrations, are considered one of the most dangerous problems. In this study, artificial intelligence was supposed to predict the intensity of blast-induced ground vibration, which is represented by the peak particle velocity (PPV). Accordingly, an artificial neural network was designed to predict PPV at the Coc Sau open pit coal mine with 137 blasting events were collected. Aiming to optimize the ANN model, the modified version of the particle swarm optimization (MPSO) algorithm was applied to optimize the ANN model for predicting PPV, called the MPSO-ANN model. For the comparison purposes, two forms of empirical equations, namely United States Bureau of Mining (USBM) and U Langefors - Kihlstrom, were also developed to predict PPV and compared with the proposed MPSO-ANN model. The results showed that the proposed MPSO-ANN model provided a better performance with a mean absolute error (MAE) of 1.217, root-mean-squared error (RMSE) of 1.456, and coefficient of determination (R2) of 0.956. Meanwhile, the empirical models only provided poorer performances with an MAE of 1.830 and 2.012, RMSE of 2.268 and 2.464, and R2 of 0.874 and 0.852 for the USBM and U Langefors - Kihlstrom empirical models, respectively. [ABSTRACT FROM AUTHOR]

Objectives: Health Resources and Services Administration‐funded health centres (HCs) are an important source of dental services for low‐income and vulnerable patients in the United States. About 82% of HCs in 2018 had dental workforce, but it is unclear whether this workforce meets the oral health needs of HC patients. Thus, we first examined (a) whether dental workforce was associated with any dental visits vs none and (b) whether HC patients with any visits were more likely to have a visit at the HC vs elsewhere. We then examined (c) if need for oral health care and long‐term continuity at the HC were associated with dental visits and visits at the HC. Methods: This study used the 2014 Health Center Patient Survey, a nationally representative study of US HC patients, and the 2013 Uniform Data System, an administrative dataset of HC characteristics. We also used the 2013 Area Health Resource File to measure the contribution of local supply of dentists. We included working‐age adult patients (n = 5006) and used multilevel structural equation models with Poisson specification. Results: Larger dental workforce at the HC was significantly associated with 1% higher likelihood (relative risk [RR]: 1.01, 1.00‐1.02) of any visits and 10% higher likelihood of a visit at the HC among those with a visit (RR: 1.10, 1.06‐1.14). Patient self‐reported oral health need was positively associated with 157% higher likelihood of dental visits (RR: 2.57, 2.29‐2.88), and 42% higher likelihood of dental visit at the HC vs elsewhere (RR: 1.42, 1.19‐1.69). Long‐term continuity with the HC was not significantly associated with likelihood of dental visits, but was associated with 26% higher likelihood of visits at the HC among those who had any visits (RR: 1.26, 1.02‐1.56). Discussion: The findings highlight the potential impact of increasing dental workforce at HCs to promote access; the high level of need for oral health care at HCs; and the increased effort required to promote access among newer patients who may be less familiar with the availability of oral health care at HCs. Together, these findings reinforce the importance of addressing barriers of use of oral health services among low‐income and uninsured patients. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity has become a major global epidemic that causes substantial social and health burdens worldwide. The effectiveness of childhood obesity control and prevention depends largely on understanding the issue, including its current development and associated factors in a contextualized perspective. Objectives: Our study aimed to gauge this kind of understanding. Methods: We systematically searched the Web of Science database for studies concerning child obesity published up to 2017 and analyzed the volume of publications, growth rates, impact scores, collaborations, authors, affiliations, and journals. A total of 57,444 research papers were included. Results: The three subject categories with the highest number of papers (over 3,000) were (1) nutrition and dietetics, (2) pediatrics, and (3) public, environmental, and occupational health. We found a dramatic increase in the amount of scientific literature on childhood obesity in the past one or two decades, led by scholars from the USA – ranking at the top regarding the total number of papers (23,965 papers; 30.8%) and total number of citations (859,793 citations) – and multiple Western countries where the obesity epidemic is prevalent. Conclusions: The findings highlight the need for improving international and local research capacities and collaboration to accelerate knowledge production and translation into contextualized and effective childhood obesity prevention. [ABSTRACT FROM AUTHOR]

Background: In the United States, there are nearly 1,400 Health Resources and Services Administration-funded health centers (HCs) serving low-income and underserved populations and more than 600 of these HCs are located in rural areas. Disparities in quality of medical care in urban vs. rural areas exist but data on such differences between urban and rural HCs is limited in the literature. We examined whether urban and rural HCs differed in their performance on clinical quality measures before and after controlling for patient, organizational, and contextual characteristics. Methods and findings: We used the 2017 Uniform Data System to examine performance on clinical quality measures between urban and rural HCs (n = 1,373). We used generalized linear regression models with the logit link function and binomial distribution, controlling for confounding factors. After adjusting for potential confounders, we found on par performance between urban and rural HCs in all but one clinical quality measure. Rural HCs had lower rates of linking patients newly diagnosed with HIV to care (74% [95% CI: 69%, 80%] vs. 83% [95% CI: 80%, 86%]). We identified control variables that systematically accounted for eliminating urban vs. rural differences in performance on clinical quality measures. We also found that both urban and rural HCs had some clinical quality performance measures that were lower than available national benchmarks. Main limitations included potential discrepancy of urban or rural designation across all HC sites within a HC organization. Conclusions: Findings highlight HCs' contributions in addressing rural disparities in quality of care and identify opportunities for improvement. Performance in both rural and urban HCs may be improved by supporting programs that increase the availability of providers, training, and provision of technical resources. [ABSTRACT FROM AUTHOR]

Background: Burnout is being experienced by medical students, residents, and practicing physicians at significant rates. Higher levels of Hardiness and Emotional Intelligence may protect individuals against burnout symptoms. Previous studies have shown both Hardiness and Emotional IntelIigence protect against detrimental effects of stress and can be adapted through training; however, there is limited research on how training programs affect both simultaneously. Therefore, the objective of this study was to define the association of Hardiness and Emotional Intelligence and their potential improvement through hyper realistic immersion simulation training in military medical students. Methods: Participants in this study consisted of 68 second year medical students representing five medical schools who were concurrently enrolled in the United States military scholarship program. During a six day hyper-realistic surgical simulation training course, students rotated through different roles of a medical team and responded to several mass-casualty scenarios. Hardiness and Emotional Intelligence were assessed using the Hardiness Resilience Gauge (HRG) and the Emotional Quotient Inventory (EQ-I 2.0) respectively, at two time points: on arrival (pre-event) and after completion of the course (post-event). Results: Hardiness and Emotional Intelligence scores and sub scores consistently improved from pre-event to post-event assessments. No difference in training benefit was observed between genders but differences were observed by age where age was more often associated with Emotional Intelligence. In addition, factor analysis indicated that the HRG and EQ-I 2.0 assessment tools measured predominately different traits although they share some commonalities in some components. Conclusion: This study indicates that Hardiness and Emotional Intelligence scores can be improved through immersion training in military medical students. Results from this study support the use of training course interventions and prompt the need for long term evaluation of improvement strategies on mitigating burnout symptoms. [ABSTRACT FROM AUTHOR]

Topography is a fundamental input to hydrologic models critical for generating realistic streamflow networks as well as infiltration and groundwater flow. Although there exist several national topographic datasets for the United States, they may not be compatible with gridded models that require hydrologically consistent Digital Elevation Models (DEMs). Here, we present a national topographic dataset developed support physically based hydrologic simulations at 1km and 250m spatial resolution over contiguous United States. The workflow is described step-by-step in two parts (a) DEM processing using a Priority Flood algorithm to ensure hydrologically consistent drainage networks and (b) slope calculation and smoothing to improve drainage performance. The accuracy of derived stream network is evaluated by comparing the derived drainage area to drainage areas reported by the national stream gage network. The slope smoothing steps are evaluated using the runoff simulations with an integrated hydrologic model. The processed DEM is designed to capture the topographic features and improve the runoff simulations for the models solving partial differential equations. The workflow uses an open-source R package and all output datasets and processing scripts are available and fully documented here. All of the output datasets and scripts for processing are published through Cyverse at 250m and 1km resolution. [ABSTRACT FROM AUTHOR]

The rising prevalence of mental health conditions and substance use disorders (MH/SUD) underscores the important role of health centers (HCs) in caring for low-income and uninsured MH/SUD patients. This study used the 2014 Health Center Patient Survey and 2014 Uniform Data System to determine the independent association between delivery of MH/SUD integration and related interventions to patients that reported a MH/SUD condition (n=2714) with the number of HC visits, emergency department (ED) visits, and hospitalizations last year. Results showed that health education was associated with fewer predicted ED visits (1.8 vs. 2.3) and lower likelihood of hospitalizations (16% vs. 24%) among MH patients. Medical enabling services was associated with lower rates of ED visits (0.3 vs.1.9) and hospitalizations (< 1% vs. 13%) among SUD patients. The results indicate the utility of integration and related intervention services in primary care settings to improve service use and reduce ED and hospitalization among MH/SUD patients. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the effects of simulated and actual vessel motion at high seas on task load and surgical performance.Methods: This project was performed in phases. Phase I was a feasibility study. Phase II utilized a motion base simulator to replicate vessel motion. Phase III was conducted aboard the U.S. Naval Ship Brunswick. After performing surgical tasks on a surgical simulation mannequin, participants completed the Surgical Task Load Index (TLX) designed to collect workload data. Simulated surgeries were evaluated by subject matter experts.Results: TLX scores were higher in Phase III than Phase II, particularly at higher sea states. Surgical performance was not significantly different between Phase II (84%) and Phase III (89%). Simulated motions were comparable in both phases.Conclusions: Simulated motion was not associated with a significant difference in surgical performance or deck motion, suggesting that this simulator replicates the conditions experienced during surgery at sea on the U.S. Naval Ship Brunswick. However, Surgical TLX scores were dramatically different between the two phases, suggesting increased workload at sea, which may be the result of time at sea, the stress of travel, or other factors. Surgical performance was not affected by sea state in either phase. [ABSTRACT FROM AUTHOR]

Introduction: Attempting to expedite delivery of care to wounded war fighters, this study aimed to quantify the ability of medical and surgical teams to perform lifesaving damage control and resuscitation procedures aboard nontraditional US Navy Vessels on high seas. Specifically, it looked at the ability of the teams to perform procedures in shipboard operating and emergency rooms by analyzing motion of personnel during the procedures.Methods: One hundred and twelve damage control and resuscitation procedures were performed during a voyage of the US Naval Ship Brunswick in transit from Norfolk, Virginia, to San Diego, California. The ability of personnel to perform these procedures was quantified by the use of motion link analysis designed to track the movement of each participant as they completed their assigned tasks.Results: The link analysis showed no significant change in the number of movements of participants from the beginning to the end of the study. However, there was a learning effect observed during the study, with teams completing tasks faster at the end of the study than at the beginning.Conclusion: This shows that the working conditions aboard the US Naval Ship Brunswick were satisfactory for the assigned tasks, indicating that these medical operations may be feasible aboard nontraditional US Navy vessels. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) with its high burden on disability is known as one of the critical public health issues worldwide. Hence, providing comprehensive care and effective symptomatic treatment are becoming a challenge for many healthcare systems. Quality of life (QOL) has been identified as an important indicator to develop holistic care for people living with AD since it reflects treatment response, the progression of AD, and activities of daily living. This study aimed to identify research trends and landscapes as well as important factors in QOL studies in the field of AD. Summary: English research was extracted from the online database Web of Science to analyze research publications' growth rate and content on AD and QOL. VOSviewer was used to visualize the correlations between terms in titles and abstracts. Research topics were created using Latent Dirichlet Allocation of abstracts' content and disciplines. Major landscapes in the QOL assessment included care and treatment for AD in epidemiological studies and clinical trials. Besides, most studies were conducted in high-income countries, such as the USA or the United Kingdom. Findings of our study also identified a lack of contextualized factors and research gaps in terms of QOL among individuals with AD. Key Messages: Further studies should be conducted taking an effort to assess QOL among demented patients as well as advancing knowledge, attitude, and practice among family caregivers. [ABSTRACT FROM AUTHOR]

This is the second of a two-part special study examining the impact of the COVID-19 pandemic on municipal taxes in the United States. Municipal taxes are important for the delivery of basic public services, capital financing, and municipal credit ratings. For this discussion, municipalities broadly refer to all local governments with taxing authority, including counties, cities, towns, and villages. [ABSTRACT FROM AUTHOR]

Rationale and objective: To evaluate the relationship between receipt of annual physicals and the receipt of provider recommendation for preventive services, during a period when Medicare did not cover annual physicals (before 2011). Methods: Electronic medical records of patients aged 65 years and older from a US health care system were extracted for the 2001 to 2007 period. A fixed‐effects logistic model was used to assess the relationship between receipt of periodic health examination (PHE) and receipt of provider recommendation for mammogram screening for 6466 female Medicare beneficiaries. Logistic regression models were used to assess the relationship between receipt of PHE and receipt of provider recommendation for colonoscopy screening and pneumococcal vaccination for 10 318 Medicare beneficiaries. Nine primary care providers from the network were also interviewed, selected by random sampling stratified by care model. Results: Electronic medical record analyses suggest that patients with a PHE were more likely to obtain provider recommendations for mammogram screening (OR = 2.17, P < 0.0001), colonoscopy screening (OR = 1.54, P < 0.0001), and pneumococcal vaccination (OR = 1.10, P < 0.0001). Providers suggested that prevention care quality improves with the PHE because certain screening measures (eg, skin cancer screening, breast exam) would be neglected without it, and healthy patients could miss recommended preventive services entirely. Without the PHE, some providers reported having tried to incorporate discussions of preventive services by scheduling more frequent follow‐up chronic care visits than they would have otherwise, and some routinely charged Medicare for a more complex follow‐up visit than they would have charged without the preventive service discussions. Conclusion: Periodic health examination is important in connecting patients to recommended preventive services. Provider interviews suggested that, indirectly, Medicare ended up paying for the PHE via greater frequency of follow‐up visits or higher visit charges from providers integrating the services with other visits. [ABSTRACT FROM AUTHOR]

A systematic review was conducted to summarize and appraise the eHealth interventions addressing HIV/STI prevention among men who have sex with men (MSM), and characterize features of successful eHealth interventions. Fifty-five articles (17 pilots and 38 full efficacy trials) were included with the predominance of web-based interventions in the United States-based settings. Intervention modalities include web-based, short message service (SMS)/text messges/email reminder, online video-based, computer-assisted, multimedia-based, social network, live chat and chat room, virtual simulation intervention, and smartphone applications. Forty-nine eHealth interventions achieved a short-term behaviour change among participants. Four studies were conducted with 12-month follow-ups; and only one of them could maintain the behaviour change over this longer time period which could be due to the lack of booster interventions. Our study suggests that eHealth interventions can achieve short term behaviour change among MSM, however limited interventions could maintain behaviour change over 12 months. Further eHealth intervention strategies to promote HIV prevention among MSM should be conducted and rigorously evaluated. [ABSTRACT FROM AUTHOR]