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The aim of the present study is to examine factors affecting participation in telecollaborative language courses conducted in virtual world environments. From recordings of a course in sociolinguistics conducted in Second Life (SL), we determine degrees of linguistic participation (voice and chat), and triangulate these data with questionnaire responses and observations in order to elucidate demographic, behavioural, and contextual factors that may have affected the outcomes. Findings suggest that power relations in terms of educational level, the task design (creating engagement), the presence of the teacher (evening out participation), the medium--SL (both negative and positive) and technological issues (negative) are of primary importance.

In this paper, we develop an information distortion model (IDM) of social class differences in self-beliefs and values. The IDM combines psychological biases on frame-of-reference effects with sociological foci on ability stratification. This combination is hypothesized to lead to working-class children having more positive math self-beliefs and values than equally able salariat children. We further suggest that the same conditions that give rise to the working-class benefit in self-beliefs and values are associated with signaling effects that suppress educational aspirations and attainment. These hypotheses are tested in 1 cross-sectional multinational and 1 longitudinal study. The results in favor of the IDM challenge cultural models of social class differences and have implications for rational action theory.

We consider hypothesis testing in instrumental variable regression models with few included exogenous covariates but many instruments—possibly more than the number of observations. We show that a ridge-regularized version of the jackknifed Anderson and Rubin (henceforth AR) test controls asymptotic size in the presence of heteroscedasticity, and when the instruments may be arbitrarily weak. Asymptotic size control is established under weaker assumptions than those imposed for recently proposed jackknifed AR tests in the literature. Furthermore, ridge-regularization extends the scope of jackknifed AR tests to situations in which there are more instruments than observations. Monte Carlo simulations indicate that our method has favorable finite-sample size and power properties compared to recently proposed alternative approaches in the literature. An empirical application on the elasticity of substitution between immigrants and natives in the United States illustrates the usefulness of the proposed method for practitioners. [ABSTRACT FROM AUTHOR]

In this research note, we describe the results of the first validation study of the U.S. Census Bureau's new Community Resilience Estimates (CRE), which uses Census microdata to develop a tract-level vulnerability index for the United States. By employing administrative microdata to link Social Security Administration mortality records to CRE, we show that CRE quartiles provide more stable predictions of COVID-19 excess deaths than single demographic categorizations such as race or age, as well as other vulnerability measures including the U.S. Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) and the Federal Emergency Management Agency's National Risk Index (NRI). We also use machine learning techniques to show that CRE provides more predictive power of COVID-19 excess deaths than standard socioeconomic predictors of vulnerability such as poverty and unemployment, as well as SVI and NRI. We find that a 10-percentage-point increase in a key CRE risk measure is associated with one additional death per neighborhood during the initial outbreak of COVID-19 in the United States. We conclude that, compared with alternative measures, CRE provides a more accurate predictor of community vulnerability to a disaster such as a pandemic. [ABSTRACT FROM AUTHOR]

Policies about changing gender/sex on identity documents provide insights into definitions of gender/sex, and impact especially transgender and/or nonbinary lives. We investigated these on U.S. driver's licenses and birth certificates to understand variability in these policies, including in comparison to an earlier report in 2014, and to explore what kinds of "bio/logics" (decision rules rooted in biological or biologistic thinking) might be at play. Results show that the most common requirements in 2020 included proof of gender affirming surgery, a letter from a medical doctor, and hormone therapy. Compared to 2014, results showed an increase in requirements for hormone therapy and letters from therapists or medical doctors, and a decrease in requirements for gender affirming surgery. We highlight how this suggests a shift to "pubertal bio/logics": rooting gender/sex definitions in secondary sex characteristics. This contrasts with previous requirements that pointed to "newborn bio/logics": rooted in genital definitions of gender/sex affirmed by a surgico-medical authority. Both support policy framings of gender/sex as a biophenomenon, though with different impacts for trans and/or nonbinary livability. Our study provides insights into U.S. state definitions of gender/sex, and their multiple and contradictory biological views on gender/sex, with implications especially for transgender and/or nonbinary individuals' lives. [ABSTRACT FROM AUTHOR]

Sexual assault (SA) continues to be a serious problem on college campuses in the United States. This meta-analysis sought to identify correlates for SA victimization on college campuses, as well as examine if there were any differences in correlates for men and women. Database searches utilizing Boolean search terms were used to identify studies to be included in the meta-analysis. Studies were included if they provided quantitative data on correlates for SA victimization among college students. A total of 118 studies yielding 405 unique effect sizes were included in this study. The strongest correlates for SA victimization among college students were physical intimate partner violence (IPV) perpetration, physical IPV victimization, emotional IPV victimization, and prior SA victimization. Other significant correlates were related to mental health (e.g., hopelessness, suicidal ideation, trauma symptoms, anxiety symptoms, depressive symptoms), and factors related to a campus party culture (e.g., binge drinking, alcohol use, drug use, Greek membership). We were able to compare seven correlates between men and women. Results of the meta-analysis also highlight the need for future research to examine additional correlates for SA victimization, as well as examine race/ethnicity and gender as separate categories when trying to further understand correlates for SA victimization. [ABSTRACT FROM AUTHOR]

Type 1 collagen is an abundant structural protein with importance to the skin, eyes, bones, ligaments, tendons, and muscles. Shilajit supplementation has been shown to increase gene expression of collagen synthesis, however, it is unclear if increased gene expression translates to increases in circulating levels. Therefore, the purpose of the present study was to examine the effects of 8 weeks of daily supplementation with 500 mg·d-1 and 1000 mg·d-1 of Shilajit versus placebo on serum pro-c1α1, a biomarker of type 1 collagen synthesis. Thirty-five recreationally trained men (mean ± S D: age = 21.1 ± 1.8 yrs; body mass = 80.7 ± 12.4 kg; height = 180.9 ± 6.7 cm) volunteered to participate in this study. Mixed factorial and one-way ANOVAs were used to analyze mean differences between groups, with follow-up t-tests when necessary. Individual subject responses were assessed using the minimal clinically important difference and Chi-squared tests. There were significant (Low dose: p = 0.008, d = 1.2; High dose: p = 0.007, d = 1.3) increases in serum pro-c1α1 from pre- (Low dose: 42.5 ± 12.4 ng·mL-1; High dose: 42.7 ± 12.7 ng·mL-1) to post-supplementation (Low dose: 82.3 ± 46.5 ng·mL-1; High dose: 113.1 ± 78.7 ng·mL-1) for the low and high dose groups, however, no change (p > 0.05) for the placebo group. A greater proportion (p = 0.03) of subjects exhibited increases in pro-c1α1 that exceeded the minimal clinically important difference in the high dose Shilajit group (75%) compared to the placebo group (30%), but no differences (p = 0.06) between the low dose Shilajit group (69%) and placebo. In conclusion, 8 weeks of Shilajit supplementation with 500 and 1000 mg·d-1 increased type 1 collagen synthesis as indicated by serum levels of pro-c1α1. [ABSTRACT FROM AUTHOR]

Objective: Expressing (pumping) human milk is a widespread practice among breastfeeding parents in the United States. However, parents report receiving conflicting information from healthcare providers about pumping. Therefore, the purpose of this qualitative descriptive study was to explore lactation care providers' (LCPs) training, knowledge, and information needs related to pumping. Methods: Fifteen LCPs enrolled and participated in semistructured interviews that were analyzed by the authors to extract themes. Results: The authors identified three main themes: Gaining Knowledge , Confidence in Basic Principles , and Flange and Pump Uncertainties. These participants felt that they were taught the basic principles about pumping initially but did not feel they were provided enough initial formal training on hands-on skills related to pumping, especially flange fitting. Conclusion: More research and training are needed on flange fitting. New LCPs in the United States may need to seek additional training and mentorship to become competent in pumping support. [ABSTRACT FROM AUTHOR]

This study aimed to identify the multiple and intersecting identities adolescent parents manage, and the social supports and constraints that inform their adjustment. Adolescents (n = 13; 70% cisgender women; 100% Latinx; Mage = 19.37, SD = 0.92) who became parents between the ages of 14–18, their parents (n = 17; 82% cisgender women; 94% Latinx), and school staff (n = 7; 100% cisgender women; 71% White) provided triangulating information on adolescent parents' experiences. Using focus group methodology and Qual-to-Qual coding techniques, we found that adolescents inhabit intersecting social identities based on their parenting status, adolescence/youth, student role, child/family role, and gender. These intersecting social identities informed the social and developmental contexts that adolescents navigated, which were experienced as promotive or inhibiting environments. Adolescents described the demands to be engaged in multigenerational familial contexts (e.g., large coparenting teams, power differentials between adolescents and their parents), their exposure to stereotypes, assumptions, and discrimination based on their intersecting identities, and the high social demands/resources imposed on them by family and school supports. These experiences led to contextualized outcomes, such as an increase in growth and maturity. The participants often described their experiences as both stressors and sources of support; therefore, we discuss the duality of these experiences and the implications for future interventions. Highlights: This study explores adolescent parents' intersecting identities and how these identities inform their social and developmental contexts. Adolescents discussed five intersecting and often conflicting identities - parent, adolescent, student, child/family member, and gender. Adolescents discussed navigating multigenerational households, discrimination, and high demands/expectation from others. [ABSTRACT FROM AUTHOR]

Importance: There is an evidence-based need to assess the validity and reliability/precision of the revised American Occupational Therapy Association's Fieldwork Performance Evaluation (FWPE) items for the occupational therapy student (OTS) and the occupational therapy assistant student (OTAS). Objective: To evaluate evidence of validity in relation to response processes, internal structure, and precision of the FWPEs. Design: Cross-sectional study design. Setting: OTS and OTAS fieldwork practice settings, United States. Participants: Two hundred sixty-seven fieldwork educators participated in total, providing 228 OTS evaluations and 39 OTAS evaluations. Outcomes and Measures: A Rasch model was used to evaluate aspects of validity and precision. Results: The rating scales provided evidence of the tools' overall validity. Thirty-two of 37 items on the FWPE for the OTS, and 27 of 31 items on the FWPE for the OTAS demonstrated acceptable fit, but the evidence of unidimensionality in the subscales and in the total scales was not fully supported. The total/reduced FWPE scales were able to separate students into at least four distinct groups of fieldwork performance. The relationships between the current and revised FWPEs indicate that the new scales measure different but related constructs of student fieldwork performance, compared with the current version. Conclusions and Relevance: The findings support that the revised FWPEs for the OTS and OTAS demonstrate preliminary evidence of internal structure, response processes, and precision, supporting evidence-based practice in fieldwork evaluations. What This Article Adds: This article highlights evidence demonstrating the validity and precision of the revised American Occupational Therapy Association's Fieldwork Performance Evaluation items and supports academic and fieldwork settings for occupational therapy students and occupational therapy assistant students. This article highlights evidence demonstrating the validity and precision of the revised American Occupational Therapy Association's Fieldwork Performance Evaluation items and supports academic and fieldwork settings for occupational therapy students and occupational therapy assistant students. [ABSTRACT FROM AUTHOR]

The expert-performance approach guided the collection of survey data on the developmental history of elite professional ballet dancers from three different countries/cultures (USA, Mexico, and Russia). The level of ballet expertise attained by age 18 was found to be uniquely predicted by only two factors, namely the total number of accumulated hours of dance practice through age 17 and the age of first having the "idea of becoming a professional dancer." Older starting ages were associated with a more rapid increase of weekly training, so starting ages were not correlated with amount of practice accumulated at age 17 or attained ballet performance by age 18. Different detailed developmental paths leading to elite ballet performance are described and their theoretical implications discussed. (Contains 1 table and 4 figures.)

This phenomenographic study opens the classroom door to investigate teachers' experiences of students learning difficult computing topics. Three distinct themes are identified and analysed. "Why" do students succeed or fail to learn these concepts? "What" actions do teachers perceive will ameliorate the difficulties facing students? "Who" is responsible, and for what, in the learning situation? Theoretical work on threshold concepts and conceptual change deals with mechanisms and processes associated with learning difficult material [Meyer, J. and Land, R., 2005. Threshold concepts and troublesome knowledge (2): epistemological considerations and a conceptual framework for teaching and learning. "Higher Education", 49 (3), 373-388; Entwistle, N., 2007. Conceptions of learning and the experience of understanding: thresholds, contextual influences, and knowledge objects. "In:" S. Vosniadou, A. Baltas and X. Vamvakoussi, eds. "Re-framing the conceptual change approach in learning and instruction". Amsterdam, The Netherlands: Elsevier, chap. 11]. With this work as a background, we concentrate on the perceptions of teachers. Where do teachers feel that the difficulties lie when studying the troublesome knowledge in computing? Student and teacher-centric views of teaching reported in other literature are also to be seen in our results. The first two categories in the "what" and "who" themes are teacher-centric. Higher level categories in all themes show increasingly learner centred conceptions of the instructional role. However, the nature of the categories in the "why" theme reveals a new dimension dealing with teacher beliefs specific to the nature of troublesome knowledge in computing. A number of prior studies in tertiary teaching concentrate on approaches to teaching [Trigwell, K. and Prosser, M., 2004. Development and use of the approaches to teaching inventory. "Educational Psychology Review", 16 (4), 409-424], and attitudes to scholarship of teaching and learning [Ashwin, P. and Trigwell, K., 2004. Investigating educational development. "In: Making sense of staff and educational development", 117-131]. Our focus on learning difficult topics extends this work, investigating teacher conceptions of causality in relation to learning difficulties. We argue that teacher conceptions of enabling factors, for learning difficult computing topics, can act to limit the nature and scope of academics' pedagogical responses. Improved awareness of teacher's beliefs regarding student learning difficulties both extends and complements existing efforts to develop a more student-centred computing pedagogy. (Contains 2 notes, 1 table and 3 figures.)

Objective: The aim of this study was to perform a systematic review, meta-analysis and cost-consequence analysis of the single-use bronchoscope, Ambu aScopeTM 5 Broncho, in relation to reusable flexible bronchoscopes (RFB) available within three high procedure volume university hospitals and academic institutions in the USA. Methods: The primary outcome was incremental cost and the secondary outcome was incremental cross-infection risk of use for both the single-use flexible bronchoscope (SUFB) and RFBs. Cost estimates included capital, repair, and reprocessing costs derived from a prospective observational micro-costing approach within three large university hospitals and academic institutions. All costs were valued in 2022 US dollars (USD). A meta-analysis based on literature covering cross-contamination and infection from 2010 to 2020 investigated cross-infection risk following bronchoscopy procedures with RFBs. Capital costs were discounted at 3% over 5–8 years. All parameters were evaluated using both univariate deterministic and probabilistic sensitivity analyses. Results: In high-volume hospitals, RFBs were cost minimizing compared to SUFBs. Probabilistic sensitivity analysis showed that RFBs were cost saving in 88% of iterations. Univariate analyses illustrated sensitivity of the base-case result to the procedure volume. Data from sensitivity analyses suggest that the two interventions are cost neutral at a break-even point of 756 procedures per year or 46 procedures per bronchoscope per year. Conclusion: Assuming equivalent clinical performance, single-use flexible bronchoscopes are not cost minimizing when including the costs associated with cross-infection in high-volume US university hospitals and academic institutions. Overall, the benefits of conversion from RFBs to SUFBs are dependent on the annual procedure volume of individual hospitals, expected cross-infection risk, and purchase price of the aScope 5 Broncho. [ABSTRACT FROM AUTHOR]

Simple Summary: Corn and cotton that produce insecticidal toxins derived from Bacillus thuringiensis (Bt) are widely adopted in the United States to control corn earworm/cotton bollworm, Helicoverpa zea (Boddie), which has resulted in major benefits to growers and the general public. However, resistance evolution in H. zea populations has become a major threat to the sustainability of these crops. Bt sweet corn producing the same toxins as Bt field corn is more attractive to H. zea than field corn and, thus, can function as a sentinel plant to detect early stages of resistance. As part of an existing sentinel monitoring network, this study evaluated changes in H. zea resistance during 2020–2022 by estimating the phenotypic and resistance allele frequencies for toxins in sentinel Bt corn. Transgenic corn and cotton that produce Cry and Vip3Aa toxins derived from Bacillus thuringiensis (Bt) are widely planted in the United States to control lepidopteran pests. The sustainability of these Bt crops is threatened because the corn earworm/bollworm, Helicoverpa zea (Boddie), is evolving a resistance to these toxins. Using Bt sweet corn as a sentinel plant to monitor the evolution of resistance, collaborators established 146 trials in twenty-five states and five Canadian provinces during 2020–2022. The study evaluated overall changes in the phenotypic frequency of resistance (the ratio of larval densities in Bt ears relative to densities in non-Bt ears) in H. zea populations and the range of resistance allele frequencies for Cry1Ab and Vip3Aa. The results revealed a widespread resistance to Cry1Ab, Cry2Ab2, and Cry1A.105 Cry toxins, with higher numbers of larvae surviving in Bt ears than in non-Bt ears at many trial locations. Depending on assumptions about the inheritance of resistance, allele frequencies for Cry1Ab ranged from 0.465 (dominant resistance) to 0.995 (recessive resistance). Although Vip3Aa provided high control efficacy against H. zea, the results show a notable increase in ear damage and a number of surviving older larvae, particularly at southern locations. Assuming recessive resistance, the estimated resistance allele frequencies for Vip3Aa ranged from 0.115 in the Gulf states to 0.032 at more northern locations. These findings indicate that better resistance management practices are urgently needed to sustain efficacy the of corn and cotton that produce Vip3Aa. [ABSTRACT FROM AUTHOR]

The learning assistant (LA) model is a widely used and researched model for institutional and course transformation towards research-based instructional strategies (RBIS). The LA model leverages learning assistants, pedagogically trained students, to facilitate student learning in active learning environments. However, although the LA model has shown significant results when implemented in university contexts in the United States, there has as yet been little documentation of similar implementation or results in European higher education. In this study, we present the results of a three-semester design-based research project to implement the LA Model in a Scandinavian physics department. The three core elements of the LA model (pedagogical training, course content meetings, and teaching in active learning environments) were implemented and iteratively refined, with necessary adjustments due to the specific institutional and cultural contexts documented. Throughout all three semesters, data was collected on how participation in the LA model affected LAs' buy-in to RBIS using focus groups, pre/post surveys, and teaching observations. A thematic analysis of these data showed that participation in the LA model helped ensure LA buy-in to both the interactive engagement methods and goal of cultivating conceptual understanding that underlie most RBIS, and that the combination of teaching practice and pedagogical training seminars were key to this buy-in. We argue that these results demonstrate the potential usefulness of the LA model for creating institutional and cultural change in European higher education. [ABSTRACT FROM AUTHOR]

Interactive Simulated Patient (ISP) is a computer-based simulation tool designed to provide medical students with the opportunity to practice their clinical problem solving skills. The ISP system allows students to perform most clinical decision-making procedures in a simulated environment, including history taking in natural language, many hundreds of laboratory tests (e.g., images and endoscopy), and physical examination procedures. The system has been evaluated in a number of courses at three universities, Karolinska Institutet and Uppsala University in Sweden, and Stanford University in the United States. This article describes a study conducted in 2002, with an emphasis on results that pertain to collaboration between students. Results indicate that ISP is engaging and stimulates more active student involvement than traditional paper-based case presentation methods and that students seem to collaborate more easily when using ISP compared to traditional paper-based methods.

Given differences in public saving programs between Sweden and the United States, an examination of household private wealth accumulation in these two countries can be enlightening. In this paper we examine wealth inequality and mobility in Sweden and the United States over the past decade. We show that wealth inequality has been significantly greater in the United States than in Sweden and, while remaining relatively constant since the mid-I980s in Sweden, has increased in the United States. In addition to less inequality and a higher median wealth, we also show that wealth quintile mobility in the I990s has been 25.7 percent higher in Sweden, as measured by Shorrocks' index. Noting the role of various demographic components in shaping the patterns of wealth mobility as well as the importance of the initial wealth distribution, we utilize a matching algorithm that controls for these differences. Matching on the initial wealth distribution alone accounts for most of the mobility difference between the two countries and yields a Shorrocks' index in the United States 11.1 percent less than that in Sweden. Adjusting for the large degree of imputation in the Swedish data, the U.S. index is only 3.4 percent to 6.1 percent less than that of Sweden. Along with exploring the role of racial composition differences, we conclude that demographic variation between Sweden and the United States plays very little role in explaining wealth mobility beyond that explained by the initial wealth distribution. Despite the higher quintile mobility in Sweden, dollar mobility is still higher in the United States. (Contains 27 footnotes, 11 tables and 2 figures.)

Examines changes in first- and second-graders' reading motivation across the course of a school year in the United States and Finland. Explores possible developmental patterns in early reading motivation that operate universally across cultural contexts. Finds that in both countries first-graders' reading motivation increased significantly across the course of the school year, while second-graders' reading motivation did not. (SC)

Simple Summary: Prostate cancer (PCa) is the leading cancer in incidence and second leading cause of cancer mortality in US men. Recent data showed a 3% increase in PCa incidence rate each year from 2014 through 2019. African American (AA) men have 1.6-fold higher incidence and 2.2-fold higher PC mortality rates than European American (EA) men. Growing evidence shows that miRNAs are closely associated with aggressiveness and racial disparity in prostate cancer and might facilitate the prediction of prognosis and a treatment plan. In this study, we identified differentially expressed miRNAs, which are significantly correlated with the aggressiveness and health disparity of prostate cancer. These findings may assist personalized medicine, suggesting miRNAs as promising biomarkers for prostate cancer, especially in African American men. Prostate cancer is the leading cancer in incidence and second leading cause of cancer mortality in US men. African American men have significantly higher incidence and mortality rates from prostate cancer than European American men. Previous studies reported that the disparity in prostate cancer survival or mortality can be explained by different biological backgrounds. microRNAs (miRNAs) regulate gene expression of their cognate mRNAs in many cancers. Therefore, miRNAs may be a potentially promising diagnostic tool. The role of miRNAs in prostate cancer aggressiveness and racial disparity has not been fully established. The goal of this study is to identify miRNAs associated with aggressiveness and racial disparity in prostate cancer. Here we report miRNAs that are associated with tumor status and aggressiveness in prostate cancer using a profiling approach. Further, downregulated miRNAs in African American tissues were confirmed by qRT-PCR. These miRNAs have also been shown to negatively regulate the expression of the androgen receptor in prostate cancer cells. This report provides a novel insight into understanding tumor aggressiveness and racial disparities of prostate cancer. [ABSTRACT FROM AUTHOR]

Highlights This study demonstrates that initiation of glucagon‐like peptide‐1 receptor agonists among individuals with type 2 diabetes (T2D), including those with concomitant atherosclerotic cardiovascular disease (ASCVD), has remained low in the United States between 2014 and 2019, despite clinical evidence supporting their use for cardiovascular risk reduction. These findings add to the existing literature to highlight a gap in adherence to current practice guidelines, which suggests that most patients with T2D and ASCVD in the United States may not be receiving optimal risk‐reducing therapies. [ABSTRACT FROM AUTHOR]

Psychological sexual coercion is known to negatively impact those who experience it, yet sexual encounters where orgasm is present are often presumed to be positive and absent of coercion. In the present study, we conducted an online survey with women (n = 179) and men (n = 251) to test associations between sexually coercive experiences that include orgasm and negative psychological, sexual, and relationship outcomes. To do so, we focused on three experiences: having an orgasm during coerced sex (CS), having a coerced orgasm during desired sex (CO), and having a coerced orgasm during coerced sex (COS). Using structural equation modeling, we found that ever having any of these coercion-plus-orgasm experiences with a current partner predicted significantly higher avoidance motivations (i.e., engaging in sex to avoid conflict with one's partner), which in turn predicted significantly worse psychological distress, sexual satisfaction, relationship satisfaction, and sexual functioning (but not dyadic sexual desire). We also found that CS, CO, and COS predicted negative outcomes to a similar degree. However, testing gender/sex as a moderator clarified that CS predicted significantly lower sexual satisfaction, sexual functioning, and sexual desire for women but not men. Furthermore, CO predicted faking orgasms in women, but COS predicted faking orgasms in men. Together, results demonstrate that experiencing psychological sexual coercion and/or orgasm coercion is significantly associated with negative outcomes even if the coerced person's orgasm occurs. [ABSTRACT FROM AUTHOR]

Background: The Tandem Control-IQ (CIQ) system has demonstrated significant glycemic improvements in large randomized controlled and real-world trials. Use of this system is lower in people with type 1 diabetes (T1D) government-sponsored insurance and those with type 2 diabetes (T2D). This analysis aimed to evaluate the performance of CIQ in these groups. Methods and Materials: A retrospective analysis of CIQ users was performed. Users age ≥6 years with a t:slim X2 Pump and >30 days of continuous glucose monitoring (CGM) data pre-CIQ and >30 days post-CIQ technology initiation were included. Results: A total of 4243 Medicare and 1332 Medicaid CIQ users were analyzed among whom 5075 had T1D and 500 had T2D. After starting CIQ, the Medicare beneficiaries group saw significant improvement in time in target range 70-180 mg/dL (TIR; 64% vs. 74%; P < 0.0001), glucose management index (GMI; 7.3% vs. 7.0%; P < 0.0001), and the percentage of users meeting American Diabetes Association (ADA) CGM Glucometrics Guidelines (12.8% vs. 26.3%; P < 0.0001). The Medicaid group also saw significant improvement in TIR (46% vs. 60%; P < 0.0001), GMI (7.9% vs. 7.5%; P < 0.0001), and percentage meeting ADA guidelines (5.7% vs. 13.4%; P < 0.0001). Patients with T2D and either insurance saw significant glycemic improvements. Conclusions: The CIQ system was effective in the Medicare and Medicaid groups in improving glycemic control. The T2D subgroup also demonstrated improved glycemic control with CIQ use. Glucometrics achieved in this analysis are comparable with those seen in previous randomized controlled clinical trials with the CIQ system. [ABSTRACT FROM AUTHOR]

Fast-acting insulin aspart (faster aspart) is an ultra-rapid-acting formulation of insulin aspart developed to more closely match the prandial endogenous insulin profile, and its accelerated absorption kinetics are expected to provide clinical benefits for patients using insulin pump therapy. A head-to-head trial versus the original insulin aspart formulation in pump therapy did not demonstrate superiority of faster aspart in terms of A1C reduction, but pump settings were not optimized for the pharmacokinetic/pharmacodynamic profile of faster aspart. Nevertheless, meal test and continuous glucose monitoring data suggest that faster aspart is beneficial for postprandial glucose control, and a case study is presented illustrating excellent results using this insulin in pump therapy. Frequent blood glucose monitoring and appropriate patient education are vital for success. [ABSTRACT FROM AUTHOR]

In the United States, a public debate remains about the existence and effects of anthropogenic climate change. This skepticism is present in the agricultural sector, rendering climate science communication challenging. Due to the polarization of climate change issues and the concurrent need for agricultural adaptation, we sought to examine how scientists communicate in this sector. A survey, administered to climate scientists and pertinent U.S. federal agency staff (response rate = 43%), was conducted to examine perspectives on communicating with five agricultural stakeholder groups: agribusinesses, crop advisors, general public, producers, and policymakers. We focused on three aspects of the communication process with these stakeholders to evaluate if scientists, as messengers, were following best practices–communicator training, knowledge of stakeholder, and terminology use. We found scientists valued communication training; however, the majority had not attended formal training. Scientists had different views on climate change than producers and crop advisors but understood their perspective and were deliberate with their communication with different audiences. This suggests stakeholder knowledge and terminology use do not hinder communication between scientist and stakeholder. We also highlight three communication challenges present across stakeholder groups–stakeholder knowledge, timescale, and scientific uncertainty–and others that were specific to each stakeholder group. Future research should support scientists by identifying and resolving barriers to training and effective communication strategies for each stakeholder group that addresses these challenges. [ABSTRACT FROM AUTHOR]

Marburg virus (MARV) is a negative-sense, single-stranded RNA virus that belongs to the Filoviridae family. Despite having caused numerous outbreaks of severe hemorrhagic fever with high case fatality rates, there are still no clinically approved therapeutics or vaccines to treat or prevent MARV disease. Recombinant vesicular stomatitis viruses (rVSVs) expressing heterologous viral glycoproteins have shown remarkable promise as live-attenuated vaccine vectors, with an rVSV-based Ebola virus vaccine having received regulatory approval in the United States and numerous other countries. Analogous rVSV vaccine vectors have also been developed for MARV and have shown efficacy in several preclinical studies conducted in nonhuman primates. Here, we used a guinea pig model to confirm the protective efficacy of a cloned, rVSV-based candidate vaccine, termed PHV01, expressing the MARV variant Angola glycoprotein. Our results demonstrated that a single dose (2 × 106 PFU) of vaccine administered 28 days prior to challenge with a uniformly lethal dose of guinea-pig-adapted MARV variant Angola provided complete protection from death and disease. Moreover, protection was robust, with as little as 200 PFU of vaccine conferring significant protection. Not only does this study highlight the potential predictive value of the guinea pig model in the evaluation of MARV countermeasures, but it also demonstrates consistent and reproducible protection afforded by a clonal vaccine candidate. Indeed, this study identifies PHV01 as a suitable vaccine candidate for advanced development. [ABSTRACT FROM AUTHOR]

Agritourism is an example of a growing and important industry to rural communities in the United States seeking to leverage interest in their natural resource, agricultural, and other heritage assets. We use survey data and a flexible travel cost model to estimate the part-worth consumer surplus (CS) values of Western US agritourism trips for different regions, activities, and traveler types. Given the rural nature of agritourism may require interested travelers to come from long distances, we also pay particular attention to and compare travelers' marginal and cumulative travel costs to evaluate the impact on CS estimates. Results indicate that trip and traveler heterogeneity, if unaccounted for, may lead to misinformed policy and management decisions. [ABSTRACT FROM AUTHOR]

On June 16, 2021, rabies virus infection was confirmed in a dog included in a shipment of rescue animals imported into the United States from Azerbaijan. A multistate investigation was conducted to prevent secondary rabies cases, avoid reintroduction of a dog-maintained rabies virus variant (DMRVV), identify persons who might have been exposed and would be recommended to receive rabies postexposure prophylaxis, and investigate the cause of importation control failures. Results of a prospective serologic monitoring (PSM) protocol suggested that seven of 32 (22%) animals from the same shipment as the dog with confirmed rabies virus infection and who had available titer results after rabies vaccine booster had not been adequately vaccinated against rabies before importation. A requirement for rabies vaccination certificates alone will not adequately identify improper vaccination practices or fraudulent paperwork and are insufficient as a stand-alone rabies importation prevention measure. Serologic titers before importation would mitigate the risk for importing DMRVV. [ABSTRACT FROM AUTHOR]

Background and aims: Smoking is associated with increased risk for brain aging/atrophy and dementia. Few studies have examined early associations with brain aging. This study aimed to measure whether adult men with a history of heavier smoking in early mid‐life would have older than predicted brain age 16–28 years later. Design Prospective cohort observational study, utilizing smoking pack years data from average age 40 (early mid‐life) predicting predicted brain age difference scores (PBAD) at average ages 56, 62 (later mid‐life) and 68 years (early old age). Early mid‐life alcohol use was also evaluated. Setting: Population‐based United States sample. Participants/cases: Participants were male twins of predominantly European ancestry who served in the United States military between 1965 and 1975. Structural magnetic resonance imaging (MRI) began at average age 56. Subsequent study waves included most baseline participants; attrition replacement subjects were added at later waves. Measurements Self‐reported smoking information was used to calculate pack years smoked at ages 40, 56, 62, and 68. MRIs were processed with the Brain‐Age Regression Analysis and Computation Utility software (BARACUS) program to create PBAD scores (chronological age—predicted brain age) acquired at average ages 56 (n = 493; 2002–08), 62 (n = 408; 2009–14) and 68 (n = 499; 2016–19). Findings In structural equation modeling, age 40 pack years predicted more advanced age 56 PBAD [β = −0.144, P = 0.012, 95% confidence interval (CI) = –0.257, −0.032]. Age 40 pack years did not additionally predict PBAD at later ages. Age 40 alcohol consumption, but not a smoking × alcohol interaction, predicted more advanced PBAD at age 56 (β = −0.166, P = 0.001, 95% CI = –0.261, –0.070) with additional influences at age 62 (β = −0.115, P = 0.005, 95% CI = –0.195, –0.036). Age 40 alcohol did not predict age 68 PBAD. Within‐twin‐pair analyses suggested some genetic mechanism partially underlying effects of alcohol, but not smoking, on PBAD. Conclusions: Heavier smoking and alcohol consumption by age 40 appears to predict advanced brain aging by age 56 in men. [ABSTRACT FROM AUTHOR]

Simple Summary: Squamous-cell carcinoma of the anus, being a rare cancer, requires national and international collaborations, networking, organizational proficiency and leadership to overcome barriers towards the implementation of clinical trials to establish improved standards of care treatment strategies and the conduction of translational research projects to shed light into its biology and molecular characterization. The purpose of the present study is to obtain a global frame of the scientific literature related to anal cancer, through a bibliometric analysis of the published articles during the last 20 years (2000–2020), exploring trends and common patterns in research, tracking collaboration and networks to foresee future directions in basic and clinical research. Squamous-cell carcinoma of the anus (ASCC) is a rare disease. Barriers have been encountered to conduct clinical and translational research in this setting. Despite this, ASCC has been a prime example of collaboration amongst researchers. We performed a bibliometric analysis of ASCC-related literature of the last 20 years, exploring common patterns in research, tracking collaboration and identifying gaps. The electronic Scopus database was searched using the keywords "anal cancer", to include manuscripts published in English, between 2000 and 2020. Data analysis was performed using R-Studio 0.98.1091 software. A machine-learning bibliometric method was applied. The bibliometrix R package was used. A total of 2322 scientific documents was found. The average annual growth rate in publication was around 40% during 2000–2020. The five most productive countries were United States of America (USA), United Kingdom (UK), France, Italy and Australia. The USA and UK had the greatest link strength of international collaboration (22.6% and 19.0%). Two main clusters of keywords for published research were identified: (a) prevention and screening and (b) overall management. Emerging topics included imaging, biomarkers and patient-reported outcomes. Further efforts are required to increase collaboration and funding to sustain future research in the setting of ASCC. [ABSTRACT FROM AUTHOR]

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Objective: The objective of this study was to ascertain to what extent adults with migraine value an early onset of efficacy for preventive migraine treatments. Background: In placebo‐controlled clinical trials, treatment with eptinezumab resulted in a lower proportion of adults with migraine on the first day following infusion (day 1; 14% point‐reduction for chronic migraine [CM] in PROMISE‐2 and 8% point‐reduction for episodic migraine [EM] in PROMISE‐1). Methods: Adults with migraine completed an online preference‐elicitation thresholding exercise to ascertain to what extent they value not having a migraine on day 1 postdosing relative to a clinically relevant reduction in number of migraine days during the first month postdosing (≥2 migraine‐free days for CM and ≥1 migraine‐free days for EM). Results: One hundred and one participants (mean age, 50.6 ± 12.4 years; 81 [80%] women) were included. In participants with CM, 29 of 50 (58%) considered the eptinezumab‐generated reduction in the likelihood of migraine on day 1 postdosing to be at least as important as a clinically relevant reduction in number of migraine days the first month postdosing, whereas 37 of 50 (74%) considered a clinically relevant reduction of migraine days the first month postdosing to have a value equivalent to the eptinezumab‐generated reduction in the likelihood of migraine on day 1 postdosing. In participants with EM, 18 of 35 (51%) considered the eptinezumab‐generated reduction in the likelihood of migraine on day 1 postdosing to be at least as important as a clinically relevant reduction in migraine days the first month postdosing, whereas 24 of 35 (69%) considered a clinically relevant reduction of migraine days the first month postdosing to have a value equivalent to the eptinezumab‐generated reduction in the likelihood of migraine on day 1 postdosing. Conclusion: Most participants considered the reduction in the likelihood of migraine offered by eptinezumab on day 1 postdosing to be at least as important as a clinically relevant reduction in migraine days the first month postdosing. [ABSTRACT FROM AUTHOR]

In the low‐relief post‐glacial landscapes of the Central Lowlands of the United States, fluvial networks formed and expanded following deglaciation despite the low slopes and large fraction of the land surface occupied by closed depressions. Low relief topography allows for subtle surface water divides and increases the likelihood that groundwater divides do not coincide with surface water divides. We investigate how groundwater transfer across subtle surface water divides facilitates channel network expansion using a numerical model built on the Landlab platform. Our model simulates surface and subsurface water routing and fluvial erosion. We consider two end‐member scenarios for surface water routing, one in which surface water in closed depressions is forced to connect to basin outlets (routing) and one in which surface water in closed depressions is lost to evapotranspiration (no routing). Groundwater is modeled as fully saturated flow within a confined aquifer. Groundwater emerges as surface water where the landscape has eroded to a specified depth. We held the total water flux constant and varied the fraction of water introduced as groundwater versus precipitation. Channel growth is significantly faster in routing cases than no‐routing cases given identical groundwater fractions. In both routing and no‐routing cases, channel expansion is fastest when ~30% of the total water enters the system as groundwater. Groundwater contributions also produce distinctive morphology including steepened channel profiles below groundwater seeps. Groundwater head gradients evolve with topography and groundwater‐fed channels can grow more quickly than channels with larger surface water catchments. We conclude that rates of channel network growth in low‐relief post‐glacial areas are sensitive to groundwater contributions. More broadly, our findings suggest that landscape evolution models may benefit from more detailed representation of hydrologic processes. [ABSTRACT FROM AUTHOR]

Background: Postoperative complications continue to constitute a major issue for both the healthcare system and the individual patient and are associated with inferior outcomes and higher healthcare costs. The objective of this study was to evaluate the trends of postoperative complication rates over a 7-year period.Methods: The NSQIP datasets from 2012 to 2018 were used to assess 30-day complication incidence rates including mortality rate following surgical procedures within ten surgical subspecialties. Multivariable logistic regression was used to associate complication rates with dataset year, while adjusting for relevant confounders.Results: A total of 5,880,829 patients undergoing major surgery were included. Particularly the incidence rates of four complications were found to be decreasing: superficial SSI (1.9 to 1.3%), deep SSI (0.6 to 0.4%), urinary tract infection (1.6 to 1.2%) and patient unplanned return to the operating room (3.1 to 2.7%). Incidence rate for organ/space SSI exhibited an increase (1.1 to 1.5%). When adjusted, regression analyses indicated decreased odds ratios (OR) through the study period years for particularly deep SSI OR 0.92 [0.92-0.93], superficial SSI OR 0.94 [0.94-0.94] and acute renal failure OR 0.96 [0.95-0.96] as the predictor variable (study year) increased (p < 0.01). However, OR's for organ/space SSI 1.05 [1.05-1.06], myocardial infarction 1.01 [1.01-1.02] and sepsis 1.01 [1.01-1.02] increased slightly over time (all p < 0.01).Conclusions: Incidence rates for the complications exhibited a stable trend over the study period, with minor in or decreases observed. [ABSTRACT FROM AUTHOR]

COVID‐19 emerged in Wuhan, China, and began its worldwide journey. As the severity of the virus became known, the Chinese National Government mobilized resources, and their centralized management was critical to the containment of the epidemic. Healthcare agencies and providers were overwhelmed with patients, many of whom were critically ill and died. Nurses adapted to the work using personal protective equipment, but its initial scarcity contributed to stressful working conditions. Nurses in the United States can take several lessons from the experiences of their Chinese nurse colleagues, including the benefit of centralized management of the epidemic, the need for specialized treatment facilities, and the importance of a national stockpile of critical equipment and supplies. A fully funded United States Department of Health and Human Services Office of Pandemics and Emerging Threats is necessary. A nursing department within the office and a national mobilization plan to send nurses to support local efforts during a pandemic or other threat are likewise essential. Continuous training for nurses, especially caring for patients with infectious diseases in intensive care units, stress management, and how to comfort the dying, are also useful lessons. [ABSTRACT FROM AUTHOR]

Vermont's Legislative Assembly has the opportunity to invest in the long-term health of the State's democracy. In particular, it should enact readily available reforms: (1) transition to nonpartisan blanket primary and ranked-choice electoral structure for appropriate offices; (2) revitalize the State's defunct public campaign-financing program; and (3) create a study group to consider other creative methods to encourage voter engagement and augment the vibrancy of our State's civic tradition. The issue: Vermont rightly prides itself on a political tradition of civic engagement and responsive government through its citizen legislature. At the national level, however, signs of democratic decay are on the rise, and there are worrying signs that these maladies are overtaking states as well. The growing role of money in politics, in particular, appears to be shaking faith in public institutions. Additionally, voters may also be frustrated by the polarizing effect of the party primaries and by the inability to vote for a more representative candidate in the general election without "wasting" their vote on a long shot. At the close of the election, the public may again be disappointed to learn that the "victorious" candidate was in fact voted against by the majority of voters, due to a system that allows victory by plurality. Each of these issues frustrate members of the public, whose growing cynicism may discourage them from voting, further undermining democratic legitimacy. It is an unfortunate positive feedback loop, and one that is best addressed through proactive efforts to safeguard democratic legitimacy before problems become entrenched. Solution I: Electoral Structure Reforms. Many of the potential problems of unrepresentative candidates and officeholders are traceable to our current electoral structure. General election candidates are the product of what may be an ideologically polarizing primary process and face the "spoiler effect," discouraging voters from voting with their conscience by potentially putting an unpopular candidate in office when the opposition splits its vote. Well studied, constitutionally sound, and practical reforms are available, which have been successful in other jurisdictions. First, a transition to Ranked-Choice Voting (RCV) in the general election, which allows voters to rank candidates by relative preference, prevents a candidate from claiming victory until receiving the approval of at least 50% of the voters. This ensures that the victor has the support of the majority of the voters and did not win due to the "spoiler effect." Voters, in turn, may vote for their preferred long-shot candidate, knowing that their voice will still be heard even if their first choice is not victorious. Under the Vermont Constitution, this reform may be enacted for all offices except Governor, Lieutenant Governor, and Treasurer--unless there is a constitutional amendment. Second, under an RCV system, the current partisan primary could be replaced with a blanket nonpartisan primary. This avoids the potentially polarizing effect of the party primary system, which can exclude otherwise meritorious candidates with cross-party appeal from the general election ballot. Instead, a blanket nonpartisan primary would narrow the field of candidates to a reasonable number before the general election, while still presenting voters with a diverse menu of ideologies to choose from. Solution II: Campaign-Finance Public-Funding Revitalization. Running for office costs money. There is a reasonable concern among the electorate that those willing to supply those funds often expect something in return from the officeholders they help elect. Some spenders may even try to influence electoral outcomes by dominating the airwaves at a critical moment late in the campaign. On a related note, many worry that elected officials are forced to spend time courting donors at the expense of connecting with their constituents. Though the actual veracity of these various suspicions eludes easy quantification, the appearance of such distortions can engender public cynicism and damage democratic legitimacy. Under Supreme Court precedent, Vermont has few options to limit the flow of money into political campaigns. However, the Supreme Court has generally upheld public campaign financing programs, which can allow candidates to avoid private fundraising and focus on voters instead. This Article analyzes a variety of different options for public-financing programs before settling on the traditional block grant as currently the most administratively practical solution for Vermont. Vermont had such a program for candidates for Governor and Lieutenant Governor, but it fell into disuse as limited funding and onerous restrictions failed to keep pace with the realities of modern campaigning. A recently proposed bill, S.32, attempted to revive this program. This Article analyzes S.32 and other options for revitalizing Vermont's public-financing program. Because effective programs can be expensive, this Article recommends the Legislature consider a partial public-private scheme as an affordable alternative. This Article also recommends expanding the program to include other statewide offices. An Additional Thought: Voter Engagement. An overarching theme of this Article is that democratic distortions can quickly become exaggerated as they cause public cynicism and further depress voter engagement. This Article concludes that Vermont has already taken most available steps to remove barriers to the polls to increase engagement. A statewide vote-bymail program or a voting holiday might help, but this Article suggests an open-ended inquiry into more creative ways to encourage voter and overall civic engagement, based on the growing understanding of voting as a social behavior. Considering ways to support communities as they look for ways to rebuild norms of civic engagement could yield a wide variety of benefits. Conclusion. This Article concludes that Vermont's Legislature is in a good position to invest in the long-term vibrancy of its democracy and guard against the arrival of many of the ills increasingly plaguing politics around the nation. This Article proposes the following practical reforms: (a) transition to RCV voting with blanket nonpartisan primaries; (b) revitalizing Vermont's defunct public campaign financing system; and (c) commissioning a study group to consider further refinements to the State's election laws and opening a discussion of creative ways to encourage renewed civic engagement in the twenty-first century. [ABSTRACT FROM AUTHOR]

Although the scientific community has reached a consensus that anthropogenic climate change is a severe and pressing issue, climate change remains a contentious debate with the United States public. Through a survey (N = 273), we explored climate professionals' perspectives on their role and responsibility to promote climate change adaptation/mitigation strategies related to agroecosystems. They believed that climate professionals have a social responsibility to provide scientific input to both policymakers and the public. There was strong agreement that media, political, and public support is necessary for development, and near unanimous agreement for implementation, of climate change mitigation/adaptation strategies. This study highlights the climate professionals' perceptions of their responsibility to provide scientific input, but also demonstrates that they believe the responsibility does not rest solely on their shoulders. Further research should explore scientists' perceptions of their and others' policy roles and scientists' interactions with different influencers of adaptation/mitigation policy. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is one of the leading causes of death in the United States and obesity significantly increases the risk of cardiovascular disease. The measurement of blood pressure (BP) is critical in monitoring and managing cardiovascular disease hence new wearable devices are being developed to make BP more accessible to physicians and patients. Several wearables utilize photoplethysmography from the wrist vasculature to derive BP assessment although many of these devices are still at the experimental stage. With the ultimate goal of supporting instrument development, we have developed a model of the photoplethysmographic waveform derived from the radial artery at the volar surface of the wrist. To do so we have utilized the relation between vessel biomechanics through Finite Element Method and Monte Carlo light transport model. The model shows similar features to that seen in PPG waveform captured using an off the shelf device. We observe the influence of body mass index on the PPG signal. A degradation the PPG signal of up to 40% in AC to DC signal ratio was thus observed. [ABSTRACT FROM AUTHOR]

Introduction: Pulse Oximetry (PO) is widely used for the noninvasive detection of hypoxemia, particularly in the perioperative setting. Research regarding the perioperative assessment of nursing knowledge of PO continues to evolve. Prior evaluations have identified relative knowledge deficits among nurses regarding physiologic principles, data interpretation, and clinical application. Such deficits need identification and targeted education to prevent perioperative patient mismanagement. Aim: To assess nursing knowledge of PO in perioperative and critical care settings of a single center in the United States and to analyse identified knowledge deficits. Materials and Methods: A validated cross-sectional questionnaire, surveying PO principle consisting of 21 true/ false and 3 open-ended questions, was administered to 150 participants in the Post Anaesthesia Care Unit (PACU) and Medical Respiratory ICU (MRICU). Univariate analysis of nursing Total Knowledge Score (TKS), years of clinical experience, and current practice settings was performed. Significance was set at p<0.05. Before collecting data, this educational study was deemed not human subjects research by the Virginia Commonwealth University Institutional Review Board (VCU IRB). Results: A total of 51 questionnaires were completed, with a 34% response rate. The mean TKS for the true/false questionnaire was 16.4±2.0. There was no significant difference in TKS between PACU and MRICU nurses (16.5±1.7 vs. 16.2±2.5, respectively, p=0.27). Ninety-eight percent of all nurses scored >50% correct while 13.7% scored >90% (p=0.19 and p=0.74, respectively). The lowest percentages of correct responses (<50%) were seen in questions 3 and 16, which pertained to physiologic principles of PO. There was no significant difference in scoring percentiles between MRICU and PACU nurses, nor was there significant difference in TKS based on clinical experience. Conclusion: The mean TKS of nurses in the study was higher than the mean TKS of nurses in reference studies. There was no significant difference in TKS between PACU and MRICU nurses. Furthermore, clinical experience did not correlate with TKS scores. The authors believe analysing these knowledge deficits may offer educational opportunities in initial and continuing nursing education as well as routine postgraduate assessments. [ABSTRACT FROM AUTHOR]

Background: The changing technological environment is reflected in regular updates made to the everyday technology (ET) use questionnaire (ETUQ). Newly added ETs may not present comparable challenges across countries and diagnoses. Aims: To identify whether country context, or dementia diagnosis, impact ETs' challenge level. Material and methods: 315 older adults from three countries were included; Sweden (n = 73), United States (n = 114), England (n = 128), and had a confirmed diagnosis of mild dementia (n = 99) or no known cognitive impairment (n = 216). Differential Items Functioning (DIF) analysis was performed on 88 ETs included in the ETUQ by country and diagnosis. The impact of DIF was evaluated in a Differential Test Functioning (DTF) analysis. Results: Nine items (10.2%) in the ETUQ showed statistically significant DIF between countries; five of which were public space ETs and none of which were information and communication technologies (ICTs). Three ICT items, and no others, showed significant DIF by diagnosis. The items' DIF was shown to have no impact upon person measures of ability to use ET in the DTF. Conclusions and significance: The utility of the ETUQ in occupational therapy practice and research internationally is highlighted through the stability of the challenge hierarchy and lack of impact on person measures. [ABSTRACT FROM AUTHOR]

The article discusses that what can we learn from U.S. military nursing and COVID-19. Topics discussed include nurses have been on the frontline caring for the wounded and sick throughout history, nurses typically have been sheltered from the intense combat environment, and thus, few have been killed; and comprehensive planning includes assuring adequate facilities, equipment, supplies, and healthcare personal are available to meet the projected need.

The article offers information on vulnerability of nurse and physicians with COVID-19 pandemics. Topics include examines that the pandemic has led to illness, death and economic destruction and has challenged healthcare systems globally for a range of reasons as in developed economies, the focus on noncommunicable diseases rather than infectious diseases has caught us short.

Objectives: We aimed to evaluate the role of volumetric ADC (vADC) and volumetric venous enhancement (vVE) in predicting the grade of tumor differentiation in hepatocellular carcinoma (HCC).Methods: The study population included 136 HCC patients (188 lesions) who had baseline MR imaging and histopathological report. Measurements of vVE and vADC were performed on baseline MRI. Tumors were histologically classified into low-grade and high-grade groups. The parameters between the two groups were compared using Mann-Whitney U and chi-square tests for continuous and categorical parameters, respectively. Area under receiver operating characteristic (AUROC) was calculated to investigate the accuracy of vADC and vVE. Logistic regression and multivariable Cox regression were used to unveil the potential parameters associated with high-grade HCC and patient's survival, respectively.Results: Lesions with higher vADC values and a higher absolute vADC skewness were more likely to be high grade on histopathology assessment (p = 0.001 and p = 0.0291, respectively). Also, vVE showed a trend to be higher in low-grade lesions (p = 0.079). Adjusted multivariable model including vADC, vVE, and vADC skewness could strongly predict HCC degree of differentiation (AUROC = 83%). Additionally, a higher Child-Pugh score (HR = 2.39 [p = 0.02] for score 2 and HR = 3.47 [p = 0.001] for score 3), vADC skewness (HR = 1.52, p = 0.02; per increments in skewness), and tumor volume (HR = 1.1, p = 0.001; per 100 cm3 increments) showed the highest association with patients' survival.Conclusions: vADC and vVE have the potential to accurately predict HCC differentiation. Additionally, some imaging features in combination with patients' clinical characteristics can predict patient survival.Key Points: • Volumetric functional MRI metrics can be considered as non-invasive measures for determining tumor histopathology in HCC. • Estimating patient survival based on clinical and imaging parameters can be used for modifying management approach and preventing unnecessary adverse events. [ABSTRACT FROM AUTHOR]

Patient-generated health data (PGHD), or health-related data gathered from patients to help address a health concern, are used increasingly in oncology to make regulatory decisions and evaluate quality of care. PGHD include self-reported health and treatment histories, patient-reported outcomes (PROs), and biometric sensor data. Advances in wireless technology, smartphones, and the Internet of Things have facilitated new ways to collect PGHD during clinic visits and in daily life. The goal of the current review was to provide an overview of the current clinical, regulatory, technological, and analytic landscape as it relates to PGHD in oncology research and care. The review begins with a rationale for PGHD as described by the US Food and Drug Administration, the Institute of Medicine, and other regulatory and scientific organizations. The evidence base for clinic-based and remote symptom monitoring using PGHD is described, with an emphasis on PROs. An overview is presented of current approaches to digital phenotyping or device-based, real-time assessment of biometric, behavioral, self-report, and performance data. Analytic opportunities regarding PGHD are envisioned in the context of big data and artificial intelligence in medicine. Finally, challenges and solutions for the integration of PGHD into clinical care are presented. The challenges include electronic medical record integration of PROs and biometric data, analysis of large and complex biometric data sets, and potential clinic workflow redesign. In addition, there is currently more limited evidence for the use of biometric data relative to PROs. Despite these challenges, the potential benefits of PGHD make them increasingly likely to be integrated into oncology research and clinical care. [ABSTRACT FROM AUTHOR]

The article discusses issues on illegal immigration arrests in the U.S. by analyzing the Vermont perspective on immigration detainers, state law, and intergovernmental agreements. Also cited are the issue of legality of state participation in immigration enforcement through the use of detainers and Intergovernmental Service Agreements (IGSA), and the ruling by the Supreme Court in the 2017 case Lunn v. Commonwealth.

In this article, we engage with cultural sport psychology (CSP) to explore sexual exploitation in USA Gymnastics. Specifically, using critical reflexivity on the Larry Nassar case, we bring to life how systemic abuse in sport is more than a tragedy. We argue that perpetration of abuse persists in sport spaces largely because athletes train and compete in relations of force that privilege structures and practices to which athletes are subordinate. A return to recenter discussions on the significance of oppression and power in the larger discourse and ethical practice of CSP became imperative with the news of U.S. doctor Larry Nassar's sexual predation. As tools in our advocacy for the reduction of sport sexism and sexual exploitation and abuse, we offer four ethical commitments to the field as we examine the ways systemic gendered violence and oppressions in sport are perpetrated in systems, decision-making, and every practices. We invite CSP scholars and sport psychology practitioners to interrogate and disrupt systemic intersectional disempowerment and cultures of sexual exploitation. [ABSTRACT FROM AUTHOR]