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It is estimated that there are 65 million people globally – 19 million U.S. adults alone – who have long COVID, or persistent symptoms and conditions that continue or develop after an initial SARS-CoV-2 infection. Amidst their suffering and the ambiguity surrounding their health, people with long COVID engage processes of reintegrating from disruptions brought upon by their COVID-19 infection and its fallout, as well as the pandemic writ large. This process is communicative resilience (Buzzanell, 2010, 2017, 2019), and the purpose of this study is to document the experiences of people with long COVID as they sensemake, adapt, and transform their lives through communication. We employed longitudinal interviewing during the middle stages of the pandemic (Summer 2021 to Summer 2022), talking to 19 people with long COVID over the course of one year (five interviews each; 89 total interviews). Grounded in the six processes of communicative resilience, findings center the temporal and dialectic nature of resilience, with throughlines of grief, patience, and hope set against a tumultuous sociopolitical backdrop. Findings of this study have implications for how resilience is studied across time; how people learn to live with chronic illnesses; and how to support people living with long COVID and those who provide them care. [ABSTRACT FROM AUTHOR]

Nowadays, drug-induced liver toxicity (DILT) is one of the main contributing factors to severe liver disease. In the United States (US) alone, DILT is the cause of more than 50% of instances of acute liver failure. Prescription or over-the-counter drugs, xenobiotics, and herbal and nutritional supplements can cause DILT and could produce anomalies in hepatic function tests. Some drugs induce hepatotoxicity directly, and others induce it indirectly (i. e. through their toxic or reactive metabolites). Currently, the United States Food and Drug Administration (US FDA) has issued black box warnings for about 1279 drugs due to their hepatotoxicity. When we analyzed their mechanism in inducing hepatotoxicity, we found nearly 18 drugs causing hepatotoxicity by their toxic metabolites. In this review, we attempted to highlight the well-known drugs that induce hepatotoxicity indirectly through their toxic metabolites including the enzymes involved in the formation of these metabolites. The Cytochrome P-450 (CYP), Hypoxanthine phosphoribosyltransferase 1, Alcohol oxidase, Uridine diphosphate (UDP)-glucuronosyltransferases, Xanthine dehydrogenase, Purine-nucleoside phosphorylase, Xanthine oxidase, Thiopurine S-methyltransferase, Inosine-5'-monophosphate dehydrogenase, and aldehyde dehydrogenase are involving in the formation of toxic metabolites. The metabolic reactions and enzymes discussed in this review help toxicologists, pharmacologists, and chemists to design and develop hepatotoxicity-free pharmaceutical products containing the inhibitors of these enzymes to reduce hepatotoxicity and improve human health. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of body mass index on hearing outcomes, operative time and complication rates following stapes surgery. Method: This is a five-year retrospective review of 402 charts from a single tertiary otology referral centre from 2015 to 2020. Results: When the patient's shoulder was adjacent to the surgeon's dominant hand, the average operative time of 40 minutes increased to 70 minutes because of a significant positive association between higher body mass index and longer operative times (normal body mass index group (<25 kg/m2) r = 0.273, p = 0.032; overweight body mass index group (25–30 kg/m2) r = 0.265, p = 0.019). Operative times were not significantly longer upon comparison of low and high body mass index groups without stratification by laterality (54.9 ± 19.6 minutes vs 57.8 ± 19.2 minutes, p = 0.127). Conclusion: There is a clinically significant relationship between body mass index and operating times. This may be due to access limitations imposed by shoulder size. [ABSTRACT FROM AUTHOR]

Introduction: The current study, focusing on a significant US (United States) colorectal cancer (CRC) burden, employs machine learning for predicting future rates among young population. Methods: CDC WONDER data from 1999 to 2022 was analyzed for CRC-related mortality in patients younger than 56 years. Temporal trends in age-adjusted mortality rates (AAMRs) were assessed via Joinpoint software. Future mortality rates were forecasted using an optimal Autoregressive Integrated Moving Average (ARIMA) model. Results: From 1999 to 2022, we observed 150,908 deaths with CRC listed as the underlying cause, predominantly in males, with an upward trend in AAMR. The ARIMA model projects an increase in CRC mortality by 2035, estimating an average annual percent change (AAPC) of 1.3% overall, 1% for females, and 1.5% for males. Conclusion: Our study findings emphasize the need for more robust preventive measures to reduce future CRC mortality among younger population. These results have significant implications for public health policies, particularly for males under 56, and underscore the importance of early screening and lifestyle modifications. [ABSTRACT FROM AUTHOR]

Women's inequitable healthcare experiences are epistemic injustices by which women are discredited and harmed in their position as knowers of their health and their bodies. Drawing on the theory of communicative disenfranchisement (TCD), we sought to amplify voices of women experiencing communicative disenfranchisement (CD) and to unify their stories according to theoretical premises, namely, attention to power, material conditions, discourse, identities and relationships, and process. We interviewed 36 women living in the United States whose health issues have not been taken seriously by health care providers, friends, and family – pervasive sources of disenfranchising talk surrounding health. Mapping onto the TCD framework, our findings explicate the process of CD, including the material and immaterial consequences of disenfranchising talk and women's responses to such talk. CD unfolded as a protracted and often circular process of women seeking care but encountering health dismissals and minimalizations, blaming and shaming, normalizing of their pain, and psychologizing. We unpack how disenfranchising talk rendered women crazy and dehumanized them and inflicted shame and loss. Women responded to disenfranchising talk with silence, and they (re)claimed their voice by resisting psychogenic explanations for their problems, critiquing women's healthcare, asserting their needs, and advocating for others. We discuss the implications of this research for theory and praxis. [ABSTRACT FROM AUTHOR]

Background: Studies have suggested higher complication rates after endoscopic retrograde cholangiopancreatography (ERCP) in pregnancy. Aims: We performed a propensity-matched cohort analysis to assess the risk of ERCP-related complications among pregnant women in the United States. Methods: The TriNetX database was analyzed to identify pregnant and non-pregnant females between 18 and 50 years of age who underwent ERCP. One-to-one propensity score matching was performed for age and race. Outcomes included risk of post-ERCP pancreatitis (PEP), gastrointestinal (GI) bleeding, perforation within 7 days, and infections within 30 days of ERCP. Subgroup analysis was performed to assess the risk of PEP based on indication for ERCP. Results: The risk of PEP was higher in the pregnant cohort compared to controls, 10.3% vs 6.08%, adjusted odds ratio (aOR) 1.77, 95% confidence interval (CI) 1.20–2.61; p = 0.003. We found no difference in the risk of GI bleeding, perforation, and infections between the two cohorts. There was no difference in the risk of PEP in the pregnant cohort compared to controls who underwent ERCP for acute choledocholithiasis (4.2% vs 2.1%, aOR 1.98, 95% CI 0.97–4.03, p = 0.5) or ascending cholangitis (18.6% vs 14.7%, aOR 1.32, 95% CI 0.52–3.39, p = 0.55). There was no difference in the risk of PEP in the pregnant cohort after sensitivity analysis based on age, race, obesity, and indomethacin use. Conclusion: Pregnant females are at an increased risk of PEP but not GI bleeding, perforation, and infections when compared to non-pregnant controls. Clinicians should be cautious when proceeding with ERCP during pregnancy. [ABSTRACT FROM AUTHOR]

The case study discusses the entrepreneurship journey of Colombian dancer and choreographer Alberto Pérez (Pérez), who developed 'Zumba' that went on to become the world's largest branded fitness program. The case starts by giving a brief background on Pérez and how he came to develop Zumba. It then documents his early days in the United States and his journey to establishing Zumba Fitness, LLC with two young Colombian Americans, Alberto Perlman (Perlman) and Alberto Aghion (Aghion), who were on the lookout for business opportunities. Along with details of the trio's tryst with various business models for the company, it mentions Zumba Fitness' customer-centric strategies that focused on instructors who were considered to be the company's partners and brand ambassadors, which eventually benefitted the company. A brief glimpse is provided into the reasons for the cult-like following that Zumba has and the challenges that the company faced. Can Zumba Fitness continue to have a strong following in the fitness industry, which is characterized by fast-changing trends, considering the growing menace of counterfeiting? [ABSTRACT FROM AUTHOR]

Introduction: With more public interest in consuming locally grown produce, small specialty crop farms (SSCF) are a viable and growing segment of the food production chain in the United States. Methods: The goal of this study was to investigate the genomic diversity of Campylobacter isolated from dairy manure (n = 69) collected from 10 SSCF in Northeast Ohio between 2018 and 2020. Results: A total of 56 C. jejuni and 13 C. coli isolates were sequenced. Multi-locus sequence typing (MLST) identified 22 sequence types (STs), with ST-922 (18%) and ST-61 (13%) predominant in C. jejuni and ST-829 (62%) and ST-1068 (38%) predominant in C. coli. Interestingly, isolates with similar genomic and gene contents were detected within and between SSCF over time, suggesting that Campylobacter could be transmitted between farms and may persist in a given SSCF over time. Virulenceassociated genes (n = 35) involved in the uptake and utilization of potassium and organic compounds (succinate, gluconate, oxoglutarate, and malate) were detected only in the C. jejuni isolates, while 45 genes associated with increased resistance to environmental stresses (capsule production, cell envelope integrity, and iron uptake) were detected only in the C. coli isolates. Campylobacter coli isolates were also subdivided into two distinct clusters based on the presence of unique prophages (n = 21) or IncQ conjugative plasmid/type-IV secretion system genes (n = 15). Campylobacter coli isolates harbored genes associated with resistance to streptomycin (aadE-Cc; 54%) and quinolone (gyrA-T86I; 77%), while C. jejuni had resistance genes for kanamycin (aph3'-IIIa; 20%). Both species harbored resistance genes associated with β-lactam (especially, blaOXA-193; up to 100%) and tetracycline (tetO; up to 59%). Discussion/Conclusion: Our study demonstrated that Campylobacter genome plasticity associated with conjugative transfer might provide resistance to certain antimicrobials and viral infections via the acquisition of protein-encoding genes involved in mechanisms such as ribosomal protection and capsule modification. [ABSTRACT FROM AUTHOR]

Doubt is a common, yet challenging form of uncertainty to have about another's illness. Although navigating illness uncertainty is a process of continual (re)appraisal and management, existing research narrowly examines windows of uncertainty experience. To illustrate how uncertainty management in the context of doubt is recursive, nonlinear, and ongoing, we apply a process approach to communication to uncertainty management theory. Drawing on interviews with 33 U.S. adults, our findings explicate a prominently teleological (i.e., goal-driven) process wherein participants' uncertainty management served to accept or deny illness, depending on the extent individuals valued their own and the other's identity and the relationship. Participants generally moved through this process along one of three trajectories: growth, stagnation, or resentment. We also observed dialectical, evolutionary, and life cycle processes in the data. Findings demonstrate the heuristic value of studying uncertainty management as a multiple motor process. [ABSTRACT FROM AUTHOR]

Coronavirus-19, primarily a respiratory virus, also affects the nervous system. Acute ischemic stroke (AIS) is a well-known complication among COVID-19 infections, but large-scale studies evaluating AIS outcomes related to COVID-19 infection remain limited. We used the National Inpatient Sample database to compare acute ischemic stroke patients with and without COVID-19. A total of 329,240 patients were included in the study: acute ischemic stroke with COVID-19 (n = 6665, 2.0%) and acute ischemic stroke without COVID-19 (n = 322,575, 98.0%). The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation, vasopressor use, mechanical thrombectomy, thrombolysis, seizure, acute venous thromboembolism, acute myocardial infarction, cardiac arrest, septic shock, acute kidney injury requiring hemodialysis, length of stay, mean total hospitalization charge, and disposition. Acute ischemic stroke patients who were COVID-19-positive had significantly increased in-hospital mortality compared to acute ischemic stroke patients without COVID-19 (16.9% vs. 4.1%, aOR: 2.5 [95% CI 1.7–3.6], p < 0.001). This cohort also had significantly increased mechanical ventilation use, acute venous thromboembolism, acute myocardial infarction, cardiac arrest, septic shock, acute kidney injury, length of stay, and mean total hospitalization charge. Further research regarding vaccination and therapies will be vital in reducing worse outcomes in patients with acute ischemic stroke and COVID-19. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has created public health crisis and economic instability globally. However, the pandemic and the nationwide lockdown have a significant impact on the psychosocial status, emotional state, relationships of individuals, family, and community. Families were facing challenges due to lockdown and will do their best to develop adaptive behavior for attaining self-stability. The present study helps to understand the effect of lockdown on family well-being and the shift of intrafamilial relationships during the lockdown. Subjects and Methods: A cross-sectional study was done in an urban area of Kakinada from April to June 2020. A convenient sample of 300 families was selected by systematic random method. One parent and one adolescent child from each family, a total of 600 study participants were included under the study. Data were collected using a semi-structured questionnaire, entered in Microsoft Excel and analyzed using IBM SPSS. The mean, frequencies, proportion, and Chi-square test were used to analyze data. Results: Adaptability has increased during lockdown by sharing of household work, from 3% before to 91.7%. 97.3% were happy spending time with family members. Communication and satisfaction have increased by a decrease in conflicts, from 19.7% to 7% during the lockdown. Only 3.08% of adults were facing either physical or verbal abuse. Conclusions: During the lockdown period, the family members spent quality time together acquired new skills, and conflicts among them were reduced. Domestic violence is low in this particular study area and familial bonding is high. [ABSTRACT FROM AUTHOR]

Pancreatic cancer is a highly lethal disease associated with significant morbidity and mortality. In the United States (US), the overall 5-year relative survival rate for pancreatic cancer during the 2012–2018 period was 11.5%. However, the cancer stage at diagnosis strongly influences relative survival in these patients. Per the National Cancer Institute (NCI) statistics for 2012–2018, the 5-year relative survival rate for patients with localized disease was 43.9%, while it was 3.1% for patients with distant metastasis. The poor survival rates are primarily due to the late development of clinical signs and symptoms. Hence, early diagnosis is critical in improving treatment outcomes. In recent years, artificial intelligence (AI) has gained immense popularity in gastroenterology. AI-assisted endoscopic ultrasound (EUS) models have been touted as a breakthrough in the early detection of pancreatic cancer. These models may also accurately differentiate pancreatic cancer from chronic pancreatitis and autoimmune pancreatitis, which mimics pancreatic cancer on radiological imaging. In this review, we detail the application of AI-assisted EUS models for pancreatic cancer detection. We also highlight the utility of AI-assisted EUS models in differentiating pancreatic cancer from radiological mimickers. Furthermore, we discuss the current limitations and future applications of AI technology in EUS for pancreatic cancers. [ABSTRACT FROM AUTHOR]

Childhood obesity has affected the health of millions of children around the world despite vigorous efforts by health experts. The obesity epidemic in the United States has disproportionately afflicted certain racial and ethnic minority groups. African American children are more likely than other children to have obesity-related risk factors such as hyperlipidemia, diabetes, cardiovascular disease, and coronavirus disease (COVID-19). For the reduction in obesity-related health inequalities to be successful, it is essential to identify the variables affecting various groups. A notable advancement in epigenetic biology has been made over the past decade. Epigenetic changes like DNA methylation impact on many genes associated with obesity. Here, we evaluated the DNA methylation levels of the genes NRF1, FTO, and LEPR from the saliva of children using real-time quantitative PCR-based multiplex MethyLight technology. ALU was used as a reference gene, and the Percent of Methylated Reference (PMR) was calculated for each sample. European American children showed a significant increase in PMR of NRF1 and FTO in overweight/obese participants compared to normal weight, but not in African American children. After adjusting for maternal education and annual family income by regression analysis, the PMR of NRF1 and FTO was significantly associated with BMI z-score only in European American children. While for the gene LEPR, African American children had higher methylation in normal weight participants as compared to overweight/obese and no methylation difference in European American children. The PMR of LEPR was significantly negative associated with the obesity measures only in African American children. These findings contribute to a race-specific link between NRF1, FTO, and LEPR gene methylation and childhood obesity. [ABSTRACT FROM AUTHOR]

Introduction: Generic drug approval before patent expiration involves patent infringement petitions due to robust Life Cycle Management (LCM) strategies followed by Branded companies. They will extend the patent period of a product after expiration through Exclusivity rights, which act as a barrier for generic companies to launch the product immediately after patent expiration. This study focused on United States (US) generic market. Materials and Methods: The research was conducted on three major aspects where generic companies are facing major issues they are, Patent and Exclusivities, Paragraph IV certifications and Emerging Therapeutic areas. We performed a case study by statistical analysis on 2633 US-approved generic drugs on 12 pharma companies in India from 2009 to 2020. Results: In patent litigations, we found that Indian companies have the highest number of patent litigations related to secondary patents and new clinical indication exclusivity. In Paragraph IV certifications the Indian companies share was raised to 18%. A parallel study conducted on changes in therapeutic areas of these generic drugs from the past decade revealed that the production of cancer drugs was increased compared to cardiovascular and central nervous system drugs. Conclusion: This study will help in overcoming the above issues, where we explored the knowledge gaps between generic companies and branded companies that are needed to be addressed for successful marketing of generic drugs. [ABSTRACT FROM AUTHOR]

This article discusses the upcoming changes in the electricity industry including electrification, and the drive toward fossil-free generation, and the role of energy storage (ES) in electrification and the operation of a future electric grid without fossil fuels. Though our discussion is primarily focused on the United States electricity system, the issues affecting the operation of future electric grids are global. While the United States is prototypical of other highly developed and energy-intensive countries, variations in renewable energy production and storage, end energy usage, market structure, and policy, among other factors, make each country somewhat unique. [ABSTRACT FROM AUTHOR]

Context: Elevated concentrations of branched-chain amino acids (BCAA) are strong predictors of type 2 diabetes mellitus (T2DM). Their association with cardiovascular disease (CVD) remains uncertain, particularly in youth.Objective: We investigated the role of BCAA and aromatic amino acids (AAA) in obesity, their relationships with novel biomarkers of CVD, and response to a physical activity-based lifestyle intervention (PAL-I) in a randomized controlled study in youth with normal weight (NW) and obesity (OB).Methods: Age (14-18 years) and Tanner stage (≥IV) matched youth (OB, n = 15 and NW, n = 6) were studied; the 15 participants with OB underwent a 3-month randomized controlled PAL-I. Circulating amino acid profile, glucose, insulin, lipids, adiponectin, retinol binding protein-4, fibrinogen, high-sensitivity C-reactive protein, interleukin-6, and 25-hydroxy vitamin-D, along with body composition, were measured at baseline and after PAL-I. Independent t tests, analysis of covariance, and mixed-effect models were used for analysis of the data.Results: Compared with NW, the concentration of various amino acids, including BCAA and AAA, were altered in OB (P < 0.05). BCAA and AAA showed baseline correlations with body composition and novel biomarkers of CVD, particularly inflammatory factors (all P < 0.05). The PAL-I produced only negligible effects (P > 0.05) on BCAA and AAA. Glutamine, glycine, and aspartic acid decreased with PAL-I (all P < 0.05).Conclusion: The novel finding of the BCAA-inflammation relationship, along with strong correlations with nontraditional biomarkers of CVD, may raise the prospect of BCAA as a biomarker of CVD and evoke a potential link between obesity, T2DM, and CVD. [ABSTRACT FROM AUTHOR]

Literature regarding trends of incidence, mortality, and complications of acute exacerbation of chronic obstructive pulmonary disease (COPD) in the emergency departments (ED) is limited. What are trends of COPD exacerbation in ED? Data were obtained from the Nationwide Emergency Department Sample (NEDS) that constitutes a 20% sample of hospital-owned EDs and inpatient sample in the US. All ED encounters were included in the analysis. Complications of AECOPD were obtained by using ICD codes. Out of 1.082 billion ED encounters, 5,295,408 (mean age 63.31 ± 12.63 years, females 55%) presented with COPD exacerbation. Among these patients, 353,563(6.7%) had AECOPD-plus (features of pulmonary embolism, acute heart failure and/or pneumonia) while 4,941,845 (93.3%) had exacerbation without associated features or precipitating factors which we grouped as AECOPD. The AECOPD-plus group was associated with statistically significantly higher proportion of cardiovascular complications including AF (5.6% vs 3.5%; p < 0.001), VT/VF (0.14% vs 0.06%; p < 0.001), STEMI (0.22% vs 0.11%; p < 0.001) and NSTEMI (0.65% vs 0.2%; p < 0.001). The in-hospital mortality rates were greater in the AECOPD-plus population (0.7% vs 0.1%; p < 0.001). The incidence of both AECOPD and AECOPD-plus had worsened (p-trend 0.004 and 0.0003) and the trend of mortality had improved (p-trend 0.0055 and 0.003, respectively). The prevalence of smoking for among all COPD patients had increased (p-value 0.004), however, the prevalence trend of smoking among AECOPD groups was static over the years 2010–2018. There was an increasing trend of COPD exacerbation in conjunction with smoking; however, mortality trends improved significantly. Moreover, the rising burden of AECOPD would suggest improvement in diagnostics and policy making regarding management. [ABSTRACT FROM AUTHOR]

Foreign-born individuals immigrating to or residing in the United States are especially vulnerable to exploitation by traffickers. Being trafficked elevates the risk for a variety of physical and mental health problems; thus, victims will often come into contact with health professionals. Because there is a dearth of literature concerning the treatment of human trafficking victims, and especially foreign-born victims, we set out to describe the practical applications of a model that we use for the mental health treatment of victimization in this population. As has been suggested by leaders in the anti-human trafficking community, we employed a culturally sensitive version of Bronfrenbrenner's Ecological Systems Model to provide recommendations and educational resources for treatment at the individual, interpersonal, community, and societal levels. Our recommendations should serve to inform and improve the provision of care for foreign-born victims of human trafficking. [ABSTRACT FROM AUTHOR]

Brown stink bugs, Euschistus servus , are an important early-season pest of field corn in the southeastern United States. Feeding in the early stages of corn development can lead to a number of growth deformities and deficiencies and, ultimately, a reduction in yield. An observational and two experimentally manipulated trials were conducted in 2017 and 2018 to 1) determine optimal timing for assessing brown stink bug damage, 2) assess the level of damage from which yield compensation can occur, and 3) examine the relationship between brown stink bug density and early-season damage and yield. Fields were identified with infestations of brown stink bugs and a damage rating system for early stages of corn was established. Varying rates of brown stink bug densities were introduced using field cages and damage was assessed throughout the season. The density and duration of stink bug infestations were critical factors for damage potential, with each day of active feeding per plant resulting in a loss of ~14 kg/ha in yield. The level of damage in early stages of corn was categorized into easily identifiable groups, with only the most severe damage leading to a reduction in yield. Moderate and minimal feeding damage did not result in yield loss. This study emphasizes the need for early and frequent scouting of corn to determine the risk of damage and yield loss from brown stink bugs. Results from this study can be used to help develop management programs for brown stink bugs in the early vegetative stages of field corn. [ABSTRACT FROM AUTHOR]

Background Little is currently known about the effects of the coronavirus (COVID-19) pandemic on neurointerventional (NI) procedural volumes or its toll on physician wellness. Methods A 37- question online survey was designed and distributed to physician members of three NI physician organizations. Results A total of 151 individual survey responses were obtained. Reduced mechanical thrombectomy procedures compared with pre- pandemic were observed with 32% reporting a greater than 50% reduction in thrombectomy volumes. In concert with most (76%) reporting at least a 25% reduction in non- mechanical thrombectomy urgent NI procedures and a nearly unanimous (96%) cessation of non- urgent elective cases, 68% of physicians reported dramatic reductions (>50%) in overall NI procedural volume compared with pre- pandemic. Increased door- to- puncture times were reported by 79%. COVID-19- positive infections occurred in 1% of physician respondents: an additional 8% quarantined for suspected infection. Sixty- six percent of respondents reported increased career stress, 56% increased personal life/family stress, and 35% increased career burnout. Stress was significantly increased in physicians with COVID- positive family members (P<0.05). Conclusions This is the first study designed to understand the effects of the COVID-19 pandemic on NI physician practices, case volumes, compensation, personal/family stresses, and work- related burnout. Future studies examining these factors following the resumption of elective cases and relaxing of social distancing measures will be necessary to better understand these phenomena. [ABSTRACT FROM AUTHOR]

Brown stink bug, Euschistus servus (Say), is a damaging pest of corn, Zea mays L. (Cyperales: Poaceae), in the southeastern United States. In North Carolina, during the spring, winter-planted wheat, Triticum aestivum L. (Cyperales: Poaceae), serves as the earliest available crop host, and E. servus seems to prefer this crop over seedling corn. In the absence of wheat in the agroecosystem, weeds serve as a bridge host for a portion of overwintered E. servus populations until they move to corn and other subsequent crops. Our objective was to reduce densities of E. servus in corn by manipulating the weedy field borders with mowing and applications of dicamba herbicide. During the study, multiple species of stink bugs (n =16) were found associated with weed plots. However, E. servus was the predominant (>94%) stink bug species in the corn. In this farmscape, density of E. servus adults in the unmanaged weed plots began declining around the second week of May, followed by an increase in density in adjacent corn plots. This movement coincided with the seedling growth of corn. In 2016, applications of dicamba in the weedy field border resulted in a lower density of E. servus in herbicide-treated weed plots compared with untreated plots. Despite this difference, manipulations of weeds did not lead to any significant changes in density of E. servus adults in corn. Further evidence suggested that a prominent external source of E. servus, other than field-bordering weeds, in the farmscape was likely driving densities in corn. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Incinerability index or i - Index to quantify incinerability of MSW is formulated. • This tool quantifies incinerability incorporating the 3-E concept. • The formulation and applications of this tool are demonstrated. • Incinerability estimation facilitates feasibility assessment of MSW incineration. Abstract A technique to quantify the incinerability of municipal solid waste (MSW) called incinerability index or i - Index is formulated. Incorporating the 3-E concept (potential environmental impact, energy recovery and economic sustainability), the incinerability can be quantified into a unique number on a scale of 0–100. This helps to assess the feasibility of incineration of MSW and ascertain the sustainability of the waste management scheme. A detailed account of the formulation of i - Index is presented in this article. Being a complex multi-criteria decision-making problem (MCDM), the opinions of more than 200 experts were collected through the different stages of its formulation. The relative weighting of the parameters was determined through the analytic hierarchy process (AHP) and normalisation was done using rating curves. Incinerability of the MSW generated in countries belonging to three economic groups, namely, the United States of America (USA), China and India and the i - Index values were subsequently determined, which amounted to 72.38, 62.68 and 41.94 respectively. Being an increasing scale index, a high i -Index value indicates higher incinerability. This also substantiates how the variation in the composition of MSW across different economies affect the incinerability of the MSW. [ABSTRACT FROM AUTHOR]

The objective of this study was to measure linkage to care, retention in care, and suppressed viral load (VL) among American Indians/Alaska Natives (AIs/ANs) aged ≥13 years with diagnosed HIV infection. We used national HIV case surveillance data to measure linkage to care, defined as ≥1 CD4 or VL test ≤1 month after HIV diagnosis during 2013; retention in care, defined as ≥2 CD4 or VL tests ≥3 months apart during 2012; and suppressed VL, defined as <200 copies/mL at the most recent VL test during 2012. In 2013, 74.1% of AIs/ANs were linked to care. At year-end 2012, 46.9% of AIs/ANs were retained in care and 45.1% were virally suppressed. A lower percentage of females (41.3%), compared with males (46.5), were virally suppressed. By age group, the lowest percentage of virally suppressed AIs/ANs (37.5%) were aged 13-34 years. To improve individual health and to prevent HIV among AIs/ANs, outcomes must improve - particularly for female AIs/ANs and for AIs/ANs aged 13-34 years. Screening for HIV infection in accordance with Centers for Disease Control and Prevention's testing recommendations can lead to improvements along the continuum of HIV care. [ABSTRACT FROM AUTHOR]

Finite Mixture of Regressions (FMR) are among the most widely used models for dealing with heterogeneity in regression problems. FMR is a model-based clustering approach that models the data by assigning individual observations to one of the K latent regression clusters. In some applications, it is desired to cluster groups of observations together rather than individually. We present an extension to the regular FMR, that we call the Grouped Mixture of Regressions (GMR), which allows for a known group structure among observations, in addition to their possibly unknown heterogeneity. The research is motivated by a large financial longitudinal dataset from a brand of automotive dealerships across the United States. The task was to cluster the dealers based on their financial performance and also improve performance prediction for individual dealers. We derive a fast and salable algorithm for estimating the model parameters using Expectation–Maximization (EM). We also show how the group structure can improve prediction by sharing information among members of each group, as reflected in the posterior predictive density under GMR. The performance of the approach is assessed using both synthetic data as well as the dealership data. Among our findings are the superior predictive performance of GMR and the ability to correctly detect the number of clusters using simple cross-validation. • Performance evaluation of automotive dealerships and retail stores in general. • Clustering automotive dealerships and retail stores in general. • Finite mixture of regressions with group structure. • Posterior predictive density for FMR with group structure. [ABSTRACT FROM AUTHOR]

Objectives. To describe trends in HIV diagnoses and prevalence among persons who inject drugs (PWID), and trend variations by jurisdiction. Methods. We used National HIV Surveillance System data to estimate the number of HIV diagnoses made during 2008 through 2013, and measured trends by estimated annual percent change; and persons living with diagnosed HIV infection at year-end 2008 to 2012, and measured trends in prevalence by the 2012-2008 arithmetic difference. Results. During 2008 through 2013, the number of HIV diagnoses was stable among all persons (<2% per year), and decreased among PWID (> 10% per year) overall and in 10 jurisdictions. The Black-to-White PWID diagnosis ratio was 2 to 1. During 2008 through 2012, the number of persons living with diagnosed HIV infection increased overall, was stable among PWID, and decreased in 14 jurisdictions. Conclusions. Had the rate of decrease in diagnoses of HIV infection among PWID equaled that of all persons, an additional 1500 diagnoses would have occurred between 2008 and 2013. Prevalence was stable among PWID, and increased overall among all persons living with HIV infection. Pronounced racial inequities persist, particularly for Blacks, and appear to be diminishing. [ABSTRACT FROM AUTHOR]

Fuel economy improvements and battery energy savings can promote the adoption of parallel mild hybrids for urban driving conditions. The aim of this study is to establish these benefits through two operating modes: an energy saving mode and a fuel saving mode. The performances of a typical parallel mild hybrid using these modes were analysed over urban driving cycles, in the US, Europe, and India, with a particular focus on the Indian urban conditions. The energy pack available from the proposed energy-saving operating mode, in addition to the energy already available from the conventional mode, was observed to be the highest for the representative urban driving cycle of the US. The extra energy pack available was found to be approximately 21.9 times that available from the conventional mode. By employing the proposed fuel saving operating mode, the fuel economy improvement achievable in New York City was observed to be approximately 22.69% of the fuel economy with the conventional strategy. The energy saving strategy was found to possess the lowest payback periods and highest immunity to variations in various cost parameters. [ABSTRACT FROM AUTHOR]

Objectives. We aimed to determine whether the patterns and trends of HIV infections newly diagnosed within correctional and noncorrectional facilities differ. Methods. We classified persons newly diagnosed with HIV infection in the United States between 2008 and 2011 (n = 181 710) by correctional and noncorrectional facilities where diagnoses were first made, and stratified by sex, age group, race/ethnicity, transmission category, and diagnosis year. Results. An estimated 9187 persons were newly diagnosed with HIV infection in 2008 to 2011 while incarcerated, representing approximately 5.1% of the 181 710 HIV infections diagnosed in the United States during this period. Of these incarcerated persons, 84% were male, 30% were aged 30 to 39 years, 59% were Black/African American, and 51% of the men had been exposed through male-to-male sexual contact. Yearly numbers of diagnoses declined by 9.9% in correctional versus 0.3% in noncorrectional facilities. The percentage with a late HIV diagnosis was significantly lower in correctional than in noncorrectional facilities (prevalence ratio = 0.52; 95% confidence interval = 0.49, 0.55). Conclusions. Initial HIV diagnosis occurred sooner after HIV infection onset in correctional than in noncorrectional settings, pointing to the need for efficient referral systems after release. [ABSTRACT FROM AUTHOR]

Objective: Patients with repaired tetralogy of Fallot (TOF) are followed serially by cardiac magnetic resonance (CMR) for surveillance of RV dilation and dysfunction. We sought to define the prevalence of progressive RV disease and the optimal time interval between CMR evaluations.Methods: Candidates were selected from a multicentre TOF registry and were included if ≥2 CMR studies performed ≥6 months apart were available without interval cardiovascular interventions. Patients with 'disease progression' (defined as increase in RV end-diastolic volume index (RVEDVi) ≥30 mL/m(2), decrease in RVEF ≥10% or decrease in LVEF ≥10%) were compared with those with 'disease non-progression' (defined as RVEDVi increase ≤5 mL/m(2), RVEF decrease ≤3% and LVEF decrease ≤3%).Results: A total of 849 CMR studies in 339 patients (median age at first CMR 23.6 years) were analysed. Over a median interval of 2.2 years between CMR pairs, RVEDVi increased 4±18 mL/m(2) (p<0.001), RV end-systolic volume index increased 3±13 mL/m(2) (p<0.001), RVEF decreased 1%±6% (p=0.02) and LVEF decreased 1%±6% (p=0.001). Disease progression was observed in 15% (n=76) and non-progression in 26% (n=133). There were no significant differences between those with and without progression in baseline demographic, anatomic, ECG, exercise or baseline CMR characteristics. The optimal time interval between CMR studies for detection of progression was a 3-year interval (63% sensitivity, 65% specificity, area under the receiver operating characteristic curve 0.65).Conclusions: Although progressive RV dilation and decline in biventricular systolic function occur at a slow pace in the majority of adults with repaired TOF, 15% of patients experience rapid disease progression. The results of this study support the practice of serial CMR examinations to identify progressive disease at a time interval of up to 3 years. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the impact of loan securitization on entrepreneurial activity in the United States. We first provide evidence that securitization alters the lending strategy for small business by both small and large banks. In particular, we find a positive relation between the banks' overall credit supply to small businesses and the degree of securitization of their loan assets. We also find three potential channels through which banks' loan securitization contributes to the development of entrepreneurship. First, direct securitization of small business loans is positively related to increases in entrepreneurial activity. Second, the increased lending supply induced by securitization of non-small business loans also positively relates to business formation. Third, entrepreneurs appear to benefit from an increased ability to borrow from their real-estate holdings facilitated by mortgage loan securitization. Furthermore, we note that this positive influence is only evident during times of positive economic growth and that the relation was not significant in the 2007 to 2009 economic downturn. [ABSTRACT FROM AUTHOR]

Genetic similarities between patients from the United States and South African ( SA) Addison's Disease ( AD) strengthen evidence for genetic association. SA-AD ( n = 73), SA healthy controls ( N = 78), and US-AD patients ( N = 83) were genotyped for DQA1, DQB1, DRB1, and HLA-B alleles. Serum was tested for the quantity of 21OH-AA and IFNα-AA at the Barbara Davis Center. Although not as profound as in US-AD, in SA-AD 21OH-AA + subjects the predominantly associated risk haplotypes were DRB1*0301- DQB1*0201 ( DR3), DRB1*04xx- DQB1*0302 ( DR4), and the combined DR3/4 genotype. DQB1*0302 associated DRB1*04xx haplotypes conferred higher risk than those DRB1*04xx haplotypes associated with other DQB1 alleles. We found negative association in 21OH-AA + SA-AD for DQA1*0201- DQB1*0202 and DQA1*0101- DQB1*0501 vs SA controls, and positive association for DQA1*0401- DQB1*0402 vs US-AD. Apart from the class II DR3 haplotype, HLA-B8 did not have an independent effect; however together DR3 and HLA-B8 conferred the highest risk vs 21OH-AA negative SA-AD and SA-controls. HLA-B7 (often with DR4) conferred novel risk in 21OH-AA + SA-AD vs controls. This study represents the first comparison between South African and United States AD populations utilizing genotyping and serology performed at the same center. SA-AD and US-AD 21OH-AA + patients share common HLA risk haplotypes including DR4 (with HLA-B7) and DR3 (with HLA-B8), strengthening previously described HLA associations and implicating similar genetic etiology. [ABSTRACT FROM AUTHOR]

In the last six decades, India-US equation has gone through many ups and downs, mostly downswings till the 1990s. The transition of India-US relations from 'divergence' in essence in the 1950s to considerable "convergence" by the beginning of the 21st century is indeed a fascinating, complex and compelling story. Today, the two countries can be called "friends, not allies". By way of contrast, Pakistan and the US can be seen as "allies, not friends." Two decades of liberalization and globalization since 1990s has brought the two "estranged democracies" closer than ever before. As the reform process widened and deepened (under successive governments), the country moved closer to the US ideologically and politically at home and abroad. The most significant development in the growing proximity between the two countries since the 1990s is the India-US Nuclear Deal. However, Indo-US cooperation in this sector is at a dead end now. Since the time of President Clinton, the number, variety, scope of the ever-growing linkages (called initiatives, dialogues, agreements, partnerships, and joint military exercises, etc.) between the two sides are staggering indeed. Though the two countries have no territorial or fundamental conflicts to keep them apart, both governments are wary of each other on many counts and do not see eyeto- eye on most of the crucial challenges confronting the world today. Convergence at the cosmic level and divergence at the concrete level will continue to be the key hassle in India-US relations at the present and in the future. This paper takes a close look at the India-US equation in 21st century. [ABSTRACT FROM AUTHOR]

The present study enhances the Soil Conservation Service curve number (SCS-CN) predictions by improving the model structure, considering the following issues of concern: implementation of antecedent moisture condition procedure, fixation of initial abstraction ratio () at 0.2, usage of the potential maximum retention parameter, and incorporation of storm intensity or duration in runoff estimation. A five-parameter M3 model is proposed, with storm duration and a new parameter (potential maximum retention), to overcome most of the above limitations prevailing in the SCS-CN model. For simplicity and practical applications obviating storm-duration data, a four-parameter M4 model is also proposed. The performance of the suggested and the available models has been evaluated using the data of 82 small watersheds in the United States of America. As demonstrated, the M3 model performs the best, whereas the conventional SCS-CN model performs the poorest among all the models studied. [ABSTRACT FROM AUTHOR]

Abstract: A rapid and sensitive liquid chromatography–tandem mass spectrometric (LC–MS/MS) assay method has been developed and fully validated for the simultaneous quantification of telmisartan and amlodipine in human plasma. Carbamazepine was used as an internal standard. Analytes and the internal standard were extracted from human plasma by solid-phase extraction technique using Waters Oasis® HLB 1cm3 (30mg) extraction cartridge. The reconstituted samples were chromatographed on a Hypurity advance C18 column (50mm×4.6mm, 5μm) using a mixture of acetonitrile–5mM ammonium acetate buffer (pH-4.0) (50:50, v/v) as the mobile phase at a flow rate of 0.8mL/min. The calibration curve obtained was linear (r≥0.99) over the concentration range of 2.01–400.06ng/mL for telmisartan and 0.05–10.01ng/mL for amlodipine. Method validation was performed as per FDA guidelines and the results met the acceptance criteria. A run time of 2.5min for each sample made it possible to analyze more than 400 human plasma samples per day. The proposed method was found to be applicable to clinical studies. [Copyright &y& Elsevier]

Background: Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. Methods: A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. Results: A total of 1028 surveys were completed (31% response rate) by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%), laboratory tests (67%), referring patients to consultants (66%), or prescribing medications (40%). Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. Conclusions: Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States [ABSTRACT FROM AUTHOR]

Abstract: Background: Methadone has been used for many years in the clinical setting and has many well-described side effects. In recent years, the use of methadone and other opioids have been increasing throughout the United States (US), and presentations to US Emergency Departments (EDs) due to opioid use and abuse are increasing as well. Objectives: As methadone and opioid use increases, ED physicians should be aware of infrequently seen side effects and toxicities associated with the use of these drugs. Case Report: We report the case of a previously healthy 20-year-old man who presented with acute onset of bilateral hearing loss secondary to an unintentional methadone overdose. At follow-up, the patient’s hearing had returned to normal, with the only intervention being abstinence from methadone. Conclusion: Although bilateral hearing loss is a rare toxic finding of opioid ingestion, given the prevalence of opioid use, this etiology should be considered in any patient presenting with this chief complaint. [Copyright &y& Elsevier]

Continuous wars in the Indochina region from the French colonial times and the Vietnam war against the US had adverse effects on the development of the region. The US trade embargo against Vietnam during 1975-1994 and the national system of budget subsidies caused Vietnam's economy and tourism to collapse. Vietnam's launching of 'doi moi' in 1986 has given impetus to the tourism sector in Vietnam. The paper aims to provide an overview of Vietnam's tourism industry. It also looks into the problems and prospects of Vietnamese tourism despite the difficulties due to natural disasters, man-made calamities, serious pandemic diseases and global financial crisis. [ABSTRACT FROM AUTHOR]

In March of 2009, the US President announced a plan for the development of a rapid transit rail system that would eventually connect the continental US with a system of high-speed trains similar to those in the developed European countries. This paper explores the impact such a system could bring to tourism development through a focus on the rapid transit rail system proposed for the US Gulf Coast corridor. Historical insights gleaned from an extensive literature review are applied to anticipate the potential for key stakeholder groups in the Gulf Coast region to offer resistance or support for the project. The paper also summarizes results from a study which examined consumers' perceptions about, and anticipated uses of, the proposed rail system. Findings were overwhelmingly tourism-centric as participation in touristic activities was the primary reason identified for supporting the future use of a rapid rail transit system. Respondents were also positive about the potential for such a system to reduce traffic congestion and gas consumption while minimizing parking problems. In sum, the research supported the premise that opportunities for integrative tourism development existing during the early stages of rail system planning will be lost forever if not acted upon judiciously. [ABSTRACT FROM AUTHOR]

Objectives: Reports of Enterobacteriaceae resistant to all commonly used antimicrobial agents, including β-lactams, fluoroquinolones and aminoglycosides, are increasing in hospitals worldwide. The activity of ACHN-490, a next-generation aminoglycoside, was examined against clinical isolates of Escherichia coli and Klebsiella pneumoniae from hospitals in New York City, an area where multidrug-resistant organisms are endemic. [ABSTRACT FROM PUBLISHER]

Millions of cruise ship passengers sail each year from United States ports. Inevitably, some of these passengers will need to seek medical care on the ship. Yet, there is no choice of medical provider on the ship: needy passengers have to inevitably receive treatment from the physician appointed by the cruise line onboard. Traditionally, the majority view has been that cruise lines are not liable for the negligence of the ship's physician due to their lack of control and expertise for meaningful supervision of the physician. The minority view of owner liability for the negligence of the ship's physician is based on control and supervision of the physician, the need for medical care on a ship, the lack of choice of medical help, and the benefits the ship owners receive by the presence of a physician on the ship. This article examines the majority and minority legal views covering this topic, and the trends that may alter the legal situation in the future. [ABSTRACT FROM AUTHOR]

This document describes a simple and robust process for the synthesis of olmesartan medoxomil. This tailored process allows us to synthesize olmesartan medoxomil on a large scale with 50% overall yield. Also, our process has excellent control of the impurity profile in all the stages. [ABSTRACT FROM AUTHOR]

Incorporating the storm duration and a nonlinear relation for initial abstraction (Ia), this paper presents an enhanced version of the Soil Conservation Service curve number-based Mishra–Singh model. The proposed version is compared with existing formulations using a large set of storm rainfall-runoff events derived from the water database of the United States. The results of the paired t-test of related samples and standard error of estimate (Se) statistic comparison of split sampling-based calibration and validation and simulation on full data set show that the proposed version performs far better than all other existing versions. [ABSTRACT FROM AUTHOR]

Buprenorphine in sublingual formulation was recently introduced to the American market for treatment of opioid dependence. We report a series of 5 toddlers with respiratory and mental-status depression after unintentional buprenorphine exposure. Despite buprenorphine's partial agonist activity and ceiling effect on respiratory depression, all children required hospital admission and either opioid-antagonist therapy or mechanical ventilation. Results of routine urine toxicology screening for opioids were negative in all cases. Confirmatory testing was sent for 1 child and returned with a positive result. The increasing use of buprenorphine as a home-based therapy for opioid addiction in the United States raises public health concerns for the pediatric population. [ABSTRACT FROM AUTHOR]

The initial abstraction (Ia) versus maximum potential retention (S) relation in the Soil Conservation Service Curve Number (SCS-CN) methodology was revisited, and a new non-linear relation incorporating storm rainfall (P) and S was proposed and tested on a large set of storm rainfall-runoff events derived from the water database of United States Department of Agriculture-Agriculture Research Service (USDA-ARS). Employing root mean square error (RMSE), the performance of both the existing and proposed models was evaluated using the complete database, and for model calibration and validation, data were split into two groups: based on ordered rainfall (P-based) and runoff (Q-based). A specific formulation of the proposed model la = λS(P/(P + S))α with λ = 0.3 and α = 1.5 was found to generally perform better than the existing la = 0.2S, and therefore was recommended for field applications. When evaluated using the observed la data, the proposed version performed significantly better than the existing one. [ABSTRACT FROM AUTHOR]

This article discusses the evaluation of procedures and operations used by the Voter News Service for the 2000 U.S. presidential election. In the wake of the highly visible and consequential projection errors and retractions that occurred in the course of news coverage that night, concerns quickly emerged among network executives, other media observers, and the U.S. Congress as to precisely what happened and why. In response to these and other concerns, the Voter News Service Board (VNS) of Managers established two additional levels of review. First they passed a resolution that directed VNS management to conduct a thorough, impartial and scientific review of all information collected, analyzed, and transmitted on election night in all areas. Second, the board decided to commission a review of VNS, its operations and procedures by a set of outside experts from an independent statistical research organization. This article provides the results of the evaluation of the VNS sampling methods, which is based on a review of documentation provided by VNS staff, and an examination of the sampling and nonsampling errors in the Florida exit poll and Voter Profile Analysis samples relative to the total election-day and absentee votes based on the best information available from VNS at the time of the review.

Although cultures vary in terms of how their members appraise situations, communicate emotions, and act on them, little is known about how culture influences children's emotional reactions. This study examined beliefs about revealing emotion in 223 second-, fourth-, and fifth-grade children from three cultures (Brahman, Tamang, and the United States). Interviews yielded descriptions of how children would feel, whether they would want others to know their feelings, why they would or would not, and what they would do in difficult interpersonal situations. Findings revealed three distinct cultural patterns. Tamang were more likely to appraise difficult situations in terms of shame than were Brahman and U.S. children, who endorsed anger. Brahman children, however, were more likely to not communicate negative emotion than were Tamang and U.S. children. The responses of U.S. children appeared to be more problem focused and action oriented than those of Brahman and Tamang children. Age influenced the degree to which children used emotion-focused coping, and affected decisions about communicating anger in Tamang and U.S. children. Features of cultural contexts that influence children's sense of appropriate emotional behavior are discussed. [ABSTRACT FROM AUTHOR]

Examines the impeachment of former United States (U.S.) President Bill Clinton. Text and context of the U.S. constitution; Characterization of the process of impeachment; Race and class differentiation of the U.S. support base of Clinton during his impeachment.

PURPOSE: It has been suggested that cardiorespiratory fitness (CRF) is associated with favorable health outcomes independent of comorbidities, including obesity. However, relatively few studies have assessed the association between CRF and mortality risk in obese women. Thus, in the present work we aimed to assess the relationship between CRF and risk of mortality among obese women. METHODS: Female (N=39,556) US Veterans completed a symptom-limited exercise treadmill test (ETT) between 1999-2020 using the Bruce Protocol. Of those 28,681 were classified as obese based on body mass index (BMI) ≥30.0 kg/m²criteria. We established four CRF categories based on age-specific quartiles of peak metabolic equivalents (METs) achieved: Least-Fit (n=8,005), Low-Fit (n=12,475), Moderate-Fit (n=4,905) and High-Fit (n=3,296). Multivariate Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for death events across CRF categories. RESULTS: During the follow-up period (median=8.0 years), 1,174 women died (48.1 events/10,000 person-years of observation). Body weight in those within the Least-Fit CRF category was significantly higher when compared to women in the High-Fit category (90±17 vs. 78±11 kg, p<0.001). After adjustments for age, race, hypertension, diabetes, smoking status, major adverse cardiovascular event, breast or lung cancer and heart failure, mortality risk was 18% lower for each 1-MET increase in exercise capacity (HR: 0.82, 95% CI: 0.79-0.84). When CRF categories were considered, comparisons to the Least-Fit category (referent) revealed a progressive decline in risk with higher CRF status. Specifically, mortality risk was 32% lower for Low-Fit women (HR: 0.68, 95% CI: 0.62-0.76), 55% lower (HR: 0.45, 95% CI: 0.38-0.53) for Moderate-Fit, and 68% lower (HR: 0.32, 95% CI: 0.26-0.41) for those in the High-Fit category. CONCLUSIONS: In obese women, CRF was inversely associated with mortality risk and followed a dose-response pattern. These findings support the concept that adequate physical activity that leads to increased CRF is protective against premature mortality in obese women. [ABSTRACT FROM AUTHOR]

Investigates contagion effects from the two failures of First City Bancorporation, the only large regional bank to fail, before and after the Federal Deposit Insurance Corporation Improvement Act (FDICIA). Changes imposed by the FDICIA in the bank failure resolution process; Effect of First City's failure to other sound banks from 1985-1987; Absence of evidence on the risk spillover effect.