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Background: Individuals pursue teaching careers for numerous reasons, such as for instrumental or prosocial purposes. Aims: This study examined the personal (instrumental motivation) and social (prosocial motivation) utility of teaching as predictors of teaching quality in terms of clarity of instruction, classroom management, and cognitive activation. Sample: We used data from the Teaching and Learning International Survey (TALIS) 2018, which included 50,595 teachers from 1252 schools in 10 countries and regions. Methods: We performed a series of regression analyses to test a model of instrumental and prosocial motivation to predict three indicators of teaching quality (clarity of instruction, classroom management, and cognitive activation) while controlling for demographic characteristics (age, sex, educational level, and teaching experience). We examined this model in countries and regions from Eastern (Japan, Korea, Singapore, Shanghai and Taipei) and Western (Australia, Canada, New Zealand, United Kingdom and the United States of America) cultures. Results: Results demonstrated that instrumental motivation predicted clarity of instruction in the East and classroom management in both the East and West; prosocial motivation, however, was a more consistent predictor of all indicators of teaching quality, except classroom management in the West, across cultures. Conclusion: Teachers' prosocial motivation to benefit others and contribute to society must be considered to understand teaching quality across various cultural contexts. Implications for theory, practice and policy are discussed.

Immigrants, nearly half of whom prefer a language other than English (LOE), face structural barriers to healthcare. This subgroup is believed to be at increased risk for reduced access to quality healthcare, yet few studies have examined the health needs and utilization patterns of LOE-preferring patients who seek care in the Emergency Department (ED). Given that the ED is often an entry point to the health system, we sought to characterize the health patterns of this population in an urban ED setting. We conducted a retrospective chart review of the electronic medical records of 1,566 patients who utilized interpreter services in the ED or Urgent Care) at an urban safety net hospital. We found that LOE-preferring patients had high levels of chronic disease. We also found that the majority of these patients had not seen a primary care provider (PCP) within the study period. PCP visits were positively associated with ED utilization suggesting that those without a PCP are less likely to receive ED care. These findings point to a need for greater policy and community health solutions addressing the high burden of chronic disease and underutilization of healthcare for those with LOE preferences. [ABSTRACT FROM AUTHOR]

Objective: The systemic immunity-inflammation index (SII) is a newly developed biomarker that provides an integrated measure of inflammation in the body. We aim to evaluate the relationship between SII and body fat distribution. Methods: Adults from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 were included. The SII was computed using lymphocyte (LC), neutrophil (NC), and platelet (PC) counts as its components. Body fat distribution was assessed by (total, android, gynoid) percentage fat, total abdominal fat area, subcutaneous adipose tissue area, visceral adipose tissue area, and the ratio of visceral to subcutaneous adipose tissue area (V/S ratio). Multivariable weighted linear regression and subgroup analysis were use to examine the relationships between fat distribution and SII. Restricted cubic splines (RCS) and threshold effect analysis were used to examine analyze nonlinear associations. Results: After exclusions, a total of 11,192 adults with a weighted mean age of 38.46 ± 0.26 years were studied. In multivariable weighted linear regression, each level increase in log2SII was associated with increased of 0.23 SDs total percentage fat (95% CI = 0.03, 0.43) and 0.26 SDs android percentage fat (95% CI = 0.06, 0.47). Besides, the subgroup analysis showed that the positive association between SII and android percentage fat was mainly among obese individuals (BMI > 30 kg/m2) and non-obese individuals without DM or hypertension. Meanwhile, the relationship between SII and the V/S ratio was found to be significant in the female subgroup, the obese subgroup, individuals with non-alcoholic fatty liver disease (NAFLD), and those without diabetes mellitus. Finally, SII exhibited an inverted U-shaped relationship with total percentage fat, android percent fat and total abdominal fat. Accordingly, threshold effect analysis indicated a positive association between lower SII levels and total percentage fat, android percentage fat and total abdominal fat area. Conclusions: In the nationwide study, it was observed that the SII exhibited a significant correlation with higher levels of body fat, specifically android fat. This association was particularly noticeable within specific subgroups of the population. [ABSTRACT FROM AUTHOR]

Early childhood teacher candidates (TCs) need preparatory experiences using authentic assessments to inform their instructional practices with rural learners and their families. The shift to virtual field placements in response to COVID-19 restrictions pushed faculty in teacher preparation programs to reimagine how to engage TCs in meaningful experiences using authentic assessments with children and families. This study explores how TCs experienced authentic assessment practices using an online assessment management system, Assessment, Evaluation, and Programming System Interactive (AEPS i), during virtual field experiences. Fifty-five undergraduate and graduate TCs from 11 universities (10 U.S. & 1 international) completed a 45-item survey about their experience. Teacher candidates articulated knowledge and skills aligned with best practices underpinning authentic assessments. The virtual learning environment created opportunities for faculty to reimagine practices for promoting TCs' understandings of assessment in early childhood special education contexts. We discuss implications for training TCs in rural areas to use authentic assessment. [ABSTRACT FROM AUTHOR]

Background: Heart transplantation in the neonatal period is associated with excellent survival. However, outcomes data are scant and have been obtained primarily from two single‐center reports within the United States. We sought to analyze the outcomes of all neonatal heart transplants performed in the United States using the United Network for Organ Sharing (UNOS) dataset. Methods: The UNOS dataset was queried for patients who underwent infant heart transplantation from 1987 to 2021. Patients were divided into two groups based on age – neonates (<=31 days), and older infants (32 days–365 days). Demographic and clinical characteristics were analyzed and compared, along with follow up survival data. Results: Overall, 474 newborns have undergone heart transplantation in the United States since 1987. Freedom from death or re‐transplantation for neonates was 63.5%, 58.8% and 51.6% at 5, 10, and 20 years, respectively. Patients in the newborn group had lower unadjusted survival compared to older infants (p <.001), but conditional 1‐year survival was higher in neonates (p =.03). On multivariable analysis, there was no significant difference in survival between the two age groups (p =.43). Black race, congenital heart disease diagnosis, earlier surgical era, and preoperative mechanical circulatory support use were associated with lower survival among infant transplants (p <.05). Conclusions: Neonatal heart transplantation is associated with favorable long‐term clinical outcomes. Neonates do not have a significant survival advantage over older infants. Widespread applicability is limited by the small number of available donors. Efforts to expand the donor pool to include non‐standard donor populations ought to be considered. [ABSTRACT FROM AUTHOR]

Soils contribute 15%–75% of total atmospheric nitrogen oxide (NOx) emissions in agricultural regions during the growing season. However, the impacts of cropland fertilizer management on spatially heterogeneous, temporally episodic NOx emission patterns are highly uncertain. We examine the effects of liquid slurry dairy manure application practices on soil NOx emissions in rainfed, corn‐soybean rotations during spring 2016 and 2017. Daily soil NOx emissions and weekly soil inorganic N measurements were performed in a randomized split–split plot design for 1–4 weeks following manure applications. NOx emissions and soil N with shallow‐disk injection and chisel‐disk manure incorporation methods were compared with unincorporated broadcast practices. Injected manure and chisel‐disk incorporation exhibited two–four times larger mean NOx emissions than those with unincorporated broadcast manure. Larger soil NOx emissions with manure incorporation practices were driven by the predominance of nitrification in these treatments with evidence of soil nitrate production. Soil NOx emission differences between treatments were detectable across order of magnitude changes in daily NOx emissions during two growing seasons. Larger soil NOx emissions associated with manure incorporation practices compared with unincorporated broadcast practices occur alongside larger N2O and smaller NH3 emissions, highlighting important air quality and climate impact tradeoffs for cropland manure fertilizer management choices. Core Ideas: Soil NOx emissions were characterized following rainfed liquid dairy manure applications in the northeastern United States.Soil NOx emissions with manure incorporation were two–four times larger than with unincorporated broadcast manure.Larger soil NOx emissions with manure incorporation were associated with the predominance of nitrification. [ABSTRACT FROM AUTHOR]

Objectives Adult T-cell leukemia/lymphoma (ATLL) is a rare aggressive T-cell leukemia/lymphoma associated with human T lymphotropic virus type 1 infection. The patients might present with skin rash before, at, or after the diagnosis. The dermatopathologic finding might be diagnostically very challenging. Methods We retrospectively identified 110 patients with ATLL at a single institution in a 19-year period, with 19 patients having skin biopsies. Clinical, dermatopathologic, immunophenotypic, and molecular findings were studied. Results The cohort included 13 skin-first (5 acute, 5 lymphomatous, 2 chronic, 1 smoldering), 6 skin-second (4 acute, 1 lymphomatous, 1 smoldering), and 91 patients without skin biopsy. Some nonphotoprotected areas of body such as the forearm and lower lip were also seen. Skin manifestations included papular (5), erythroderma (1), nodulotumoral (3), plaques (1), patches (1), and a combination of skin rashes (2). Histopathologic findings included large pleomorphic cells, angiocentrism, epidermal infiltration with large Pautrier-like microabscesses, and folliculotropism. Fifteen (78.9%) cases showed CD4+/CD7–/CD25+. Next-generation sequencing study was conducted on 5 patients using either blood or bone marrow samples, revealing multiple genetic mutations across multiple signaling pathways. Conclusions Pleomorphic large, atypical cells with CD4+/CD25+/CD7– immunophenotype from a non–"bathing trunk" location, especially in a patient from endemic regions, raise suspicion for ATLL. T-cell receptor gene rearrangement is almost always positive, and the neoplasm usually demonstrates multiple mutations by next-generation sequencing study. [ABSTRACT FROM AUTHOR]

Background: Whether there is an association between dietary choline intake and non-alcoholic fatty liver disease (NAFLD) in American adults remains unclear. Methods: Data came from the National Health and Nutrition Examination Survey 2017–2018. Choline intake was defined by the mean amounts of two 24 h dietary recalls, and choline intake was categorized into three groups according to the quartiles: inadequate (P75). Hepatic steatosis was assessed with FibroScan®, in which VCTE was employed with controlled attenuation to derive the controlled attenuation parameter (CAP), and NAFLD was defined as a CAP score ≥285 dB/m. Multivariable linear regression was performed to assess the linear relationship between choline intake and CAP. Multivariable logistics regression models were conducted to assess the association between choline intake status and NAFLD in the final sample and subgroup analysis was then performed in men and women. Results: The amount of dietary choline was inversely associated with CAP score (β = −0.262, 95% CI: −0.280, −0.245). Compared to inadequate choline intake, optimal choline intake was related to a lower risk of NAFLD (OR: 0.705, 95% CI: 0.704–0.706) in the final sample. Subgroup analysis by gender revealed that the highest choline intake status was associated with a lower risk of NAFLD both in females (OR: 0.764, 95% CI: 0.762–0.766), and males (OR: 0.955, 95% CI: 0.953–0.958) when compared to the lowest choline intake. Conclusions: With the latest NHANES data, we found that higher dietary choline was associated with a lower risk of NAFLD in American adults, and such a relationship exists in both females and males. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer death in the United States and worldwide, and a major source of cancer health disparities. Lung cancer cell lines provide key in vitro models for molecular studies of lung cancer development and progression, and for pre-clinical drug testing. To ensure health equity, it is imperative that cell lines representing different lung cancer histological types, carrying different cancer driver genes, and representing different genders, races, and ethnicities should be available. This is particularly relevant for cell lines from Black men, who experience the highest lung cancer mortality in the United States. Here, we undertook a review of the available lung cancer cell lines and their racial and ethnic origin. We noted a marked imbalance in the availability of cell lines from different races and ethnicities. Cell lines from Black patients were strongly underrepresented, and we identified no cell lines from Hispanic/Latin(x) (H/L), American Indian/American Native (AI/AN), or Native Hawaiian or other Pacific Islander (NHOPI) patients. The majority of cell lines were derived from White and Asian patients. Also missing are cell lines representing the cells-oforigin of the major lung cancer histological types, which can be used to model lung cancer development and to study the effects of environmental exposures on lung tissues. To our knowledge, the few available immortalized alveolar epithelial cell lines are all derived from White subjects, and the race and ethnicity of a handful of cell lines derived from bronchial epithelial cells are unknown. The lack of an appropriately diverse collection of lung cancer cell lines and lung cancer cell-of-origin lines severely limits racially and ethnically inclusive lung cancer research. It impedes the ability to develop inclusive models, screen comprehensively for effective compounds, pre-clinically test new drugs, and optimize precision medicine. It thereby hinders the development of therapies that can increase the survival of minority and underserved patients. The noted lack of cell lines from underrepresented groups should constitute a call to action to establish additional cell lines and ensure adequate representation of all population groups in this critical pre-clinical research resource. [ABSTRACT FROM AUTHOR]

This study investigates the association between financial strain and psychological distress among middle-aged and older adults, exploring how this association is mediated by sleep problems and moderated by marital status. A subsample of 12,095 adults aged 50 and older was selected from the 2018 National Health Interview Survey. Results showed that financial strain was associated with higher psychological distress, and sleep problems partially mediated this association. Marital status moderated the association between sleep problems and psychological distress, and between financial strain and psychological distress, but not between financial strain and sleep problems. These findings partially support the stress-buffering role of marriage. The study offers valuable insights into the complex relationship between financial strain, sleep problems, marital status, and psychological distress among middle-aged and older adults in the United States, highlighting the need for interventions targeting financial stressors and sleep problems, especially for unmarried individuals, to improve mental health outcomes in this population. [ABSTRACT FROM AUTHOR]

During the 2022-23 influenza season, early increases in influenza activity, co-circulation of influenza with other respiratory viruses, and high influenza-associated hospitalization rates, particularly among children and adolescents, were observed. This report describes the 2022-23 influenza season among children and adolescents aged <18 years, including the seasonal severity assessment; estimates of U.S. influenzaassociated medical visits, hospitalizations, and deaths; and characteristics of influenza-associated hospitalizations. The 2022-23 influenza season had high severity among children and adolescents compared with thresholds based on previous seasons' influenza-associated outpatient visits, hospitalization rates, and deaths. Nationally, the incidences of influenzaassociated outpatient visits and hospitalization for the 2022-23 season were similar for children aged <5 years and higher for children and adolescents aged 5-17 years compared with previous seasons. Peak influenza-associated outpatient and hospitalization activity occurred in late November and early December. Among children and adolescents hospitalized with influenza during the 2022-23 season in hospitals participating in the Influenza Hospitalization Surveillance Network, a lower proportion were vaccinated (18.3%) compared with previous seasons (35.8%-41.8%). Early influenza circulation, before many children and adolescents had been vaccinated, might have contributed to the high hospitalization rates during the 2022-23 season. Among symptomatic hospitalized patients, receipt of influenza antiviral treatment (64.9%) was lower than during pre-COVID-19 pandemic seasons (80.8%-87.1%). CDC recommends that all persons aged =6 months without contraindications should receive the annual influenza vaccine, ideally by the end of October. [ABSTRACT FROM AUTHOR]

Two separate bodies of literature point to the link between family bereavement and cardiovascular health and between sleep quality and cardiovascular outcomes. However, less is known about the joint influence of family bereavement and sleep quality on cardiovascular functioning. The aims of this study were to examine the relationships between experiencing the death of a family member and heart rate variability (HRV) and to further explore whether these associations differ by sleep quality. Using data from the Midlife in the United States (MIDUS) Biomarker Project, the sample for this study included respondents who experienced the death of an immediate family member – father, mother, spouse, sibling, or child – within a year before the Biomarker project and those who did not experience any deaths (N = 962). We used two measures of HRV and sleep quality was measured using the Pittsburgh Sleep Quality Index. Results showed that experiencing the death of a family member was associated with worse HRV only among those with poor sleep quality and not for those with good sleep quality. These results suggest that poor sleep quality may indicate psychophysiological vulnerability for those who experienced the death of a family member. Interventions to improve sleep quality could be effective in enhancing cardiovascular health of bereaved individuals. [ABSTRACT FROM AUTHOR]

Hospital readmission shortly after discharge threatens the quality of patient care and leads to increased medical care costs. In the United States, hospitals with high readmission rates are subject to federal financial penalties. This concern calls for incentives for healthcare facilities to reduce their readmission rates by predicting patients who are at high risk of readmission. Conventional practices involve the use of rule-based assessment scores and traditional statistical methods, such as logistic regression, in developing risk prediction models. The recent advancements in machine learning driven by improved computing power and sophisticated algorithms have the potential to produce highly accurate predictions. However, the value of such models could be overrated. Meanwhile, the use of other flexible models that leverage simple algorithms offer great transparency in terms of feature interpretation, which is beneficial in clinical settings. This work presents an overview of the current trends in risk prediction models developed in the field of readmission. The various techniques adopted by researchers in recent years are described, and the topic of whether complex models outperform simple ones in readmission risk stratification is investigated. [ABSTRACT FROM AUTHOR]

Background: One of the most prominent features of living organisms is their circadian rhythm, which governs a wide range of physiological processes and plays a critical role in maintaining optimal health and function in response to daily environmental changes. This work applied bibliometric analysis to explore quantitative and qualitative trends in circadian rhythm in cardiovascular diseases (CVD). It also aims to identify research hotspots and provide fresh suggestions for future research. Methods: The Web of Science Core Collection was used to search the data on circadian rhythm in CVD. HistCite, CiteSpace, and VOSviewer were used for bibliometric analysis and visualization. The analysis included the overall distribution of yearly outputs, top nations, active institutions and authors, core journals, co-cited references, and keywords. To assess the quality and efficacy of publications, the total global citation score (TGCS) and total local citation score (TLCS) were calculated. Results: There were 2102 papers found to be associated with the circadian rhythm in CVD, with the overall number of publications increasing year after year. The United States had the most research citations and was the most prolific country. Hermida RC, Young ME, and Ayala DE were the top three writers. The three most notable journals on the subject were Chronobiology International, Hypertension Research, and Hypertension. In the early years, the major emphasis of circadian rhythm in CVD was hormones. Inflammation, atherosclerosis, and myocardial infarction were the top developing research hotspots. Conclusion: Circadian rhythm in CVD has recently received a lot of interest from the medical field. These topics, namely inflammation, atherosclerosis, and myocardial infarction, are critical areas of investigation for understanding the role of circadian rhythm in CVD. Although they may not be future research priorities, they remain of significant importance. In addition, how to implement these chronotherapy theories in clinical practice will depend on additional clinical trials to get sufficient trustworthy clinical evidence. [ABSTRACT FROM AUTHOR]

The ASCENT trial demonstrated the efficacy of sacituzumab govitecan for the treatment of advanced or metastatic triple-negative breast cancer (TNBC). The current study evaluated the cost-effectiveness of receiving sacituzumab govitecan compared with standard of care chemotherapy from the United States payer perspective. A partitioned survival approach was used to project the disease course of advanced or metastatic TNBC. Two survival modes were applied to analyze two groups of patients. The survival data were gathered from the ASCENT trial. Direct medical costs were derived from the data of Centers for Medicare & Medicaid Services. Utility data was collected from the published literature. The incremental cost-utility ratio (ICUR) was the primary outcome that measured the cost-effectiveness of therapy regimen. One-way sensitivity and probabilistic sensitivity analysis were implemented to explore the uncertainty and validate the stability of results. In the base-case, the ICUR of sacituzumab govitecan versus chemotherapy is $ 778,771.9/QALY and $ 702,281/QALY for full population group and brain metastatic-negative (BMN) group with the setting of classic survival mode. And in the setting of cure survival mode, the ICUR is $ 506,504.5/QALY for the full population group and $ 274,232.0/QALY for BMN population group. One-way sensitivity analyses revealed that the unit cost of sacituzumab govitecan and body weight were key roles that lower the ICUR value. Probabilistic sensitivity analyses also showed that reducing the unit price of sacituzumab govitecan can improve the likelihood of becoming cost-effective. The cost-effectiveness analysis suggested that from a US payer perspective, sacituzumab govitecan at current price is unlikely to be a preferred option for patients with advanced or metastatic TNBC at a threshold of $ 150,000/QALY. • Sacituzumab govitecan was better in the brain metastases-negative group than in the full population. • The survival benefit is more significant in the cure mode than in the classic mode. • The unit price of sacituzumab govitecan and the body weight could have a significant impact on the reduction in ICUR. • From a US payer perspective, sacituzumab govitecan is unlikely to be a preferred option for patients with advanced or metastatic TNBC. [ABSTRACT FROM AUTHOR]

Background and Objectives Within relationships, sexual motives and stress are independent determinants of psychological health, with notable gendered patterns. However, previous research largely focuses on young adults and different-sex couples. Both sexual motives and levels of stress may be uniquely important to psychological health in midlife, and in potentially different ways for same-sex and different-sex couples. This study examined how the associations between sexual motives, stress, and depressive symptoms differ for midlife men and women in same-sex and different-sex marriages. Research Design and Methods Using dyadic data from same-sex and different-sex midlife married couples (N = 830 individuals; 415 couples), we examined the associations of intrinsic (e.g. sex for enjoyment and pleasure) and extrinsic (e.g. sex to please one's spouse) motives for having sex with depressive symptoms and tested whether these associations differed by levels of stress for same-sex and different-sex spouses. Results Intrinsic sexual motives were associated with fewer depressive symptoms only for same-sex married couples under high stress. Extrinsic sexual motives were related to greater depressive symptoms for women in low-stress conditions and men in high-stress conditions, and this did not differ for same-sex compared to different-sex marriages. Discussion and Implications Results show that the interplay between sexual motives and stress varies for men and women in same-sex and different-sex marriages. These findings underscore the importance of considering both gender and sexuality in studying sexual motives in midlife and suggest sexual motives as a useful treatment focus for protecting the psychological health of midlife married couples. [ABSTRACT FROM AUTHOR]

Wheat is a globally important crop and one of the “big three” US field crops. But unlike the other two (maize and soybean), in the United States its development is commercially unattractive, and so its breeding takes place primarily in public universities. Troublingly, the incentive structures within these universities may be hindering genetic improvement just as climate change is complicating breeding efforts. “Business as usual” in the US public wheat-breeding infrastructure may not sustain productivity increases. To address this concern, we held a multidisciplinary conference in which researchers from 12 US (public) universities and one European university shared the current state of knowledge in their disciplines, aired concerns, and proposed initiatives that could facilitate maintaining genetic improvement of wheat in the face of climate change. We discovered that climate-change- oriented breeding efforts are currently considered too risky and/or costly for most university wheat breeders to undertake, leading to a relative lack of breeding efforts that focus on abiotic stressors such as drought and heat. We hypothesize that this risk/cost burden can be reduced through the development of appropriate germplasm, relevant screening mechanisms, consistent germplasm characterization, and innovative models predicting the performance of germplasm under projected future climate conditions. However, doing so will require coordinated, longer-term, inter-regional efforts to generate phenotype data, and the modification of incentive structures to consistently reward such efforts. [ABSTRACT FROM AUTHOR]

Background Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. Methods Influenza- and COVID-19–associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, 2 population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19–associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (1 October 2020–30 September 2021) was compared with influenza-associated hospitalization rates during the 2017–2018 through 2019–2020 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. Results Among children <18 years, the COVID-19–associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017–2018 (33.5), 2018–2019 (33.8), and 2019–2020 (41.7). The COVID-19–associated hospitalization rate was higher among adolescents 12–17 years old (COVID-19: 59.9; influenza range: 12.2–14.1), but similar or lower among children 5–11 (COVID-19: 25.0; influenza range: 24.3–31.7) and 0–4 (COVID-19: 66.8; influenza range: 70.9–91.5) years old. Among children <18 years, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; P <.01). Pediatric deaths were uncommon during both COVID-19– and influenza-associated hospitalizations (0.7% vs 0.5%; P =.28). Conclusions In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19–associated hospitalization rate during 2020–2021 was higher among adolescents and similar or lower among children <12 years compared with influenza during the 3 seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses. [ABSTRACT FROM AUTHOR]

Background: Positive airway pressure (PAP) is a highly effective treatment for obstructive sleep apnea (OSA), but adherence limits its efficacy. In addition, coverage of PAP by CMS (Centers for Medicare & Medicaid Services) and other insurers in the United States depends on adherence. This leaves many beneficiaries without PAP, disproportionally impacting non-white and low socioeconomic position patients with OSA and exacerbating sleep health disparities. Methods: An inter-professional, multidisciplinary, international committee with various stakeholders was formed. Three working groups (the historical policy origins, impact of current policy, and international PAP coverage models) met and performed literature reviews and discussions. Using surveys and an iterative discussion-based consensus process, the policy statement recommendations were created. Results: In this position paper, we advocate for policy change to CMS PAP coverage requirements to reduce inequities and align with patient-centered goals. We specifically call for eradicating repeat polysomnography, eliminating the 4-hour rule, and focusing on patient-oriented outcomes such as improved sleepiness and sleep quality. Conclusions: Modifications to the current policies for PAP insurance coverage could improve health disparities. [ABSTRACT FROM AUTHOR]

Background Cardiovascular disease is a critical public health issue and a growing body of literature on relationships and health point to individuals' interactions and involvement with family members as significant correlates of cardiovascular outcomes. However, less is known about the implications of daily encounters with family members on cardiovascular health outcomes and how the associations vary across adulthood. Purpose The aims of this study were to examine the associations of positive and negative daily experiences with family members with comprehensive measures of cardiovascular health and to further explore how age moderates these associations. Methods This study used data from the Midlife in the United States (MIDUS) II and MIDUS Refresher. The sample was composed of respondents who participated in two subprojects of MIDUS, namely the National Study of Daily Experiences (NSDE) and Biomarker Project (N = 1,312). Indices of cardiovascular health included inflammatory markers, autonomic functioning, and Life's Simple 7 scores. Results Results showed that the associations between daily family experiences and cardiovascular outcomes differed by age. Having more daily negative experiences with family members was associated with better cardiovascular health outcomes among young adults and worse cardiovascular outcomes among older adults. Having more daily positive experiences was also associated with lower heart rate variability for older adults. Conclusions Results revealed that contrary to the general assumption that negative experiences have health-damaging effects, frequent involvement with family members in daily life, even negative ones, may be indicative of active engagement in life that could be health promoting for younger adults. [ABSTRACT FROM AUTHOR]

Background Recent population-based data are limited regarding influenza-associated hospitalizations in US children. Methods We identified children <18 years hospitalized with laboratory-confirmed influenza during 2010–2019 seasons, through the Centers for Disease Control and Prevention's Influenza Hospitalization Surveillance Network. Adjusted hospitalization and in-hospital mortality rates were calculated, and multivariable logistic regression was conducted to evaluate risk factors for pneumonia, intensive care unit (ICU) admission, mechanical ventilation, and death. Results Over 9 seasons, adjusted influenza-associated hospitalization incidence rates ranged from 10 to 375 per 100 000 persons each season and were highest among infants <6 months old. Rates decreased with increasing age. The highest in-hospital mortality rates were observed in children <6 months old (0.73 per 100 000 persons). Over time, antiviral treatment significantly increased, from 56% to 85% (P <.001), and influenza vaccination rates increased from 33% to 44% (P =.003). Among the 13 235 hospitalized children, 2676 (20%) were admitted to the ICU, 2262 (17%) had pneumonia, 690 (5%) required mechanical ventilation, and 72 (0.5%) died during hospitalization. Compared with those <6 months of age, hospitalized children ≥13 years old had higher odds of pneumonia (adjusted odds ratio, 2.7 [95% confidence interval, 2.1–3.4], ICU admission (1.6 [1.3–1.9]), mechanical ventilation (1.6 [1.1–2.2]), and death (3.3 [1.2–9.3]). Conclusions Hospitalization and death rates were greatest in younger children at the population level. Among hospitalized children, however, older children had a higher risk of severe outcomes. Continued efforts to prevent and attenuate influenza in children are needed. [ABSTRACT FROM AUTHOR]

Purpose: According to the IMvigor130 trial, adding atezolizumab to platinumbased chemotherapy was effective in the treatment of metastatic urothelial cancer (mUC). Based on the perspective of the United States and China, the current study evaluated cost-effectiveness of atezolizumab plus chemotherapy for mUC patients in the first-line setting. Methods: A partitioned survival model was adopted for mUC patients. The survival data were derived from the IMvigor130 trial. Direct cost values were collected from the Centers for Medicare and Medicaid Services (CMS), Chinese Drug Bidding Database, and published literatures. The utility and toxicity data were gathered from related research studies and IMvigor130 trial. The incremental cost–utility ratios (ICURs) and incremental cost-effectiveness ratios (ICERs) were calculated and analyzed. Scenario analyses and sensitivity analyses were performed to observe the outputs and uncertainties. Results: The base-case analysis showed that the ICUR of atezolizumab plus chemotherapy versus chemotherapy in American and Chinese settings is $ 737,371 /QALY and $ 385,384 /QALY, respectively. One-way sensitivity analyses showed that the ICUR ranged from $ 555,372/QALY to $ 828,205/QALY for the United States. Also, the range was from $ 303,099/QALY to $ 433,849/QALY in the Chinese setting. A probabilistic sensitivity analysis showed the likelihood that atezolizumab plus chemotherapy becoming the preferred strategy was a little low even if the price reduction strategy was applied. Conclusion: Adding atezolizumab to chemotherapy improved survival time, but it is not a cost-saving option compared to chemotherapy for metastatic urothelial cancer patients in the American and Chinese settings. [ABSTRACT FROM AUTHOR]

Objectives: Using individual patient-level data from the phase 3 VIALE-A trial, this study assessed the cost-effectiveness of venetoclax in combination with azacitidine compared with azacitidine monotherapy for patients newly diagnosed with acute myeloid leukemia (AML) who are ineligible for intensive chemotherapy, from a United States (US) third-party payer perspective. Methods: A partitioned survival model with a 28-day cycle and three health states (event-free survival (EFS), progressive/relapsed disease, and death) was developed to estimate costs and effectiveness of venetoclax + azacitidine versus azacitidine over a lifetime (25-year) horizon. Efficacy inputs (overall survival (OS), EFS, and complete remission (CR)/CR with incomplete marrow recovery (CRi) rate) were estimated using VIALE-A data. Best-fit parametric models per Akaike Information Criterion were used to extrapolate OS until reaching EFS and extrapolate EFS until Year 5. Within EFS, the time spent in CR/CRi was estimated by applying the CR/CRi rate to the EFS curve. Past Year 5, patients still in EFS were considered cured and to have the same mortality as the US general population. Mean time on treatment (ToT) for both regimens was based on the time observed in VIALE-A. Costs of drug acquisition, drug administration (initial and subsequent treatments), subsequent stem cell transplant procedures, adverse events (AEs), and healthcare resource utilization (HRU) associated with health states were obtained from the literature/public data and inflated to 2021 US dollars. Health state utilities were estimated using EuroQol-5 dimension-5 level data from VIALE-A; AE disutilities were obtained from the literature. Incremental cost-effectiveness ratios (ICERs) per life-year (LY) and quality-adjusted life-year (QALY) gained were estimated. Deterministic sensitivity analyses (DSA), scenario analyses, and probabilistic sensitivity analyses (PSA) were also performed. Results: Over a lifetime horizon, venetoclax + azacitidine versus azacitidine led to gains of 1.89 LYs (2.99 vs. 1.10, respectively) and 1.45 QALYs (2.30 vs. 0.84, respectively). Patients receiving venetoclax + azacitidine incurred higher total lifetime costs ($250,486 vs. $110,034 (azacitidine)). The ICERs for venetoclax + azacitidine versus azacitidine were estimated at $74,141 per LY and $96,579 per QALY gained. Results from the DSA and scenario analyses supported the base-case findings, with ICERs ranging from $60,718 to $138,554 per QALY gained. The results were most sensitive to varying the parameters for the venetoclax + azacitidine base-case EFS parametric function (Gompertz), followed by alternative approaches for ToT estimation, treatment costs of venetoclax + azacitidine, standard mortality rate value and ToT estimation, alternative sources to inform HRU, different cure modeling assumptions, and the parameters for the venetoclax + azacitidine base-case OS parametric function (log-normal). Results from the PSA showed that, compared with azacitidine, venetoclax + azacitidine was cost-effective in 99.9% of cases at a willingness-to-pay threshold of $150,000 per QALY. Conclusions: This analysis suggests that venetoclax + azacitidine offers a cost-effective strategy in the treatment of patients with newly diagnosed AML who are ineligible for intensive chemotherapy from a US third-party payer perspective. Trial Registration: ClinicalTrials.gov, NCT02993523. Date of registration: 15 December 2016. [ABSTRACT FROM AUTHOR]

The first U.S. case of COVID-19 attributed to the Omicron variant of SARS-CoV-2 (the virus that causes COVID-19) was reported on December 1, 2021 (1), and by the week ending December 25, 2021, Omicron was the predominant circulating variant in the United States.* Although COVID-19-associated hospitalizations are more frequent among adults,† COVID-19 can lead to severe outcomes in children and adolescents (2). This report analyzes data from the Coronavirus Disease 19-Associated Hospitalization Surveillance Network (COVID-NET)§ to describe COVID-19-associated hospitalizations among U.S. children (aged 0-11 years) and adolescents (aged 12-17 years) during periods of Delta (July 1-December 18, 2021) and Omicron (December 19, 2021-January 22, 2022) predominance. During the Delta- and Omicron-predominant periods, rates of weekly COVID-19-associated hospitalizations per 100,000 children and adolescents peaked during the weeks ending September 11, 2021, and January 8, 2022, respectively. The Omicron variant peak (7.1 per 100,000) was four times that of the Delta variant peak (1.8), with the largest increase observed among children aged 0-4 years.¶ During December 2021, the monthly hospitalization rate among unvaccinated adolescents aged 12-17 years (23.5) was six times that among fully vaccinated adolescents (3.8). Strategies to prevent COVID-19 among children and adolescents, including vaccination of eligible persons, are critical.*. [ABSTRACT FROM AUTHOR]

Support from one's spouse has long been documented as a significant determinant of health for married individuals. However, non-spousal family support may play an important role in health particularly for unmarried individuals. Therefore, this study examined whether the association between non-spousal family support and diagnosis of heart problems differed by marital status and whether gender and education moderated these associations. Data came from the first two waves of the Midlife in the United States (MIDUS) study. This study selected respondents who participated in both waves of MIDUS and were not diagnosed with a heart problem at Wave 1 (N = 3,119). Participants reported whether they had any heart trouble. Discrete-time event history analysis was used to examine the risk of heart problems between MIDUS Waves 1 and 2. A higher level of non-spousal family support was associated with a lower risk of developing a heart problem only among unmarried women and unmarried individuals with high school education or less, and not for married individuals. Findings highlight the importance of considering specific sources of family support when studying heart health, and the health-protective role of non-spousal family support for those who are not married. [ABSTRACT FROM AUTHOR]

The purpose of this work was to explore the satisfaction‐and‐engagement conundrum by testing competing structural models. The specific development and function of interventions that influence both job satisfaction and employee engagement are deeply rooted in uncovering evidence that give insight into which is primary and secondary. A survey battery of job attitudes was deployed within a large, multifaceted conglomerate located in the Midwestern United States (N = 994). Results demonstrated that job satisfaction was an antecedent of employee engagement. Results provided theoretical and practical evidence for the usability of social exchange theory and extend the applicability of the job demands‐resources model to the domains of employee engagement and satisfaction. The originality of this contribution is the finding that job satisfaction was an antecedent of employee engagement; employee engagement was not an antecedent of job satisfaction. More, we provide evidence for the usability of social exchange theory within an employee engagement setting, in contradiction to current, mainstream employee engagement research in the human resource field. [ABSTRACT FROM AUTHOR]

There are limitations to the sensitivity and specificity of conventional two-dimensional echocardiograms in making an accurate diagnosis in certain patient populations. This led to the development of specific contrast-enhancing agents with the following characteristics: small enough to cross the pulmonary capillary bed, remain stable throughout the length of the procedure, do not dissolve in blood, and rapidly cleared from the body with low toxicity. Unfortunately, the use of contrast echocardiography has not taken off as expected. The low take-up rate among clinicians can largely be attributed to the black box warning by the United States Food and Drug Administration in 2007, after the coincidental occurrence of four patient deaths and about 190 severe cardiopulmonary reactions shortly after contrast agent administration. In this article, we address the clinical safety of contrast agents, share our institution's experience in using it and elaborate on the clinical indications of contrast echocardiography. [ABSTRACT FROM AUTHOR]

Objective. To estimate the relationship between obesity (defined by both BMI and SAD) and various levels of depressive symptoms in women in the United States. Methods. This is a cross-sectional design. All data were collected from NHANES 2011-2012 and 2013-2014. The Patient Health Questionnaire (PHQ-9) was the primary variable used to index depressive symptoms. SAD was assessed using an abdominal caliper. We stratified participates into three groups according to SAD (trisection): T1: low (11.8-18.4 cm), T2: middle (18.5-22.8 cm), and T3: high (22.9-40.1 cm). Other data were collected following the NHANES protocols. We aimed to investigate the effects of obesity on the depression in the NHANES populations. Results. A total of 4477 women were enrolled in the final study population. Participants with a high SAD had the highest risk of clinical depression symptoms (OR = 1.2 , 95% CI: 1.1-1.4), which was, in particular, the case for moderate-severe depression (OR = 1.4 , 95% CI: 1.1-1.7) and severe depression (OR = 1.4 , 95% CI: 1.0-1.9). We also found a significant relationship between SAD and BMI (r = 0.836). We did, however, not find a significant relationship between BMI and severe depression. Conclusions. SAD had a better correlation with clinical depression symptoms than BMI, especially regarding severe depression symptoms. [ABSTRACT FROM AUTHOR]

Background Respiratory syncytial virus (RSV) is a major cause of hospitalizations in young children. We estimated the burden of community-onset RSV-associated hospitalizations among US children aged <2 years by extrapolating rates of RSV-confirmed hospitalizations in 4 surveillance states and using probabilistic multipliers to adjust for ascertainment biases. Methods From October 2014 through April 2015, clinician-ordered RSV tests identified laboratory-confirmed RSV hospitalizations among children aged <2 years at 4 influenza hospitalization surveillance network sites. Surveillance populations were used to estimate age-specific rates of RSV-associated hospitalization, after adjusting for detection probabilities. We extrapolated these rates using US census data. Results We identified 1554 RSV-associated hospitalizations in children aged <2 years. Of these, 27% were admitted to an intensive care unit, 6% needed mechanical ventilation, and 5 died. Most cases (1047/1554; 67%) had no underlying condition. Adjusted age-specific RSV hospitalization rates per 100 000 population were 1970 (95% confidence interval [CI],1787 to 2177), 897 (95% CI, 761 to 1073), 531 (95% CI, 459 to 624), and 358 (95% CI, 317 to 405) for ages 0–2, 3–5, 6–11, and 12–23 months, respectively. Extrapolating to the US population, an estimated 49 509–59 867 community-onset RSV-associated hospitalizations among children aged <2 years occurred during the 2014–2015 season. Conclusions Our findings highlight the importance of RSV as a cause of hospitalization, especially among children aged <2 months. Our approach to estimating RSV-related hospitalizations could be used to provide a US baseline for assessing the impact of future interventions. [ABSTRACT FROM AUTHOR]

Background Genetic or pharmacological inhibition of de novo sphingolipid synthases prevented diabetes in animal studies. Objectives We sought to evaluate prospective associations of serum sphingolipids with incident diabetes in a population-based cohort. Methods We included 2010 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) aged 18–74 y who were free of diabetes and other major chronic diseases at baseline (2008–2011). Metabolomic profiling of fasting serum was performed using a global, untargeted approach. A total of 43 sphingolipids were quantified and, considering subclasses and chemical structures of individual species, 6 sphingolipid scores were constructed. Diabetes status was assessed using standard procedures including blood tests. Multivariable survey Poisson regressions were applied to estimate RR and 95% CI of incident diabetes associated with individual sphingolipids or sphingolipid scores. Results There were 224 incident cases of diabetes identified during, on average, 6 y of follow-up. After adjustment for socioeconomic and lifestyle factors, a ceramide score (RR Q4 versus Q1 = 2.40; 95% CI: 1.24, 4.65; P -trend = 0.003) and a score of sphingomyelins with fully saturated sphingoid-fatty acid pairs (RR Q4 versus Q1 = 3.15; 95% CI: 1.75, 5.67; P -trend <0.001) both were positively associated with risk of diabetes, whereas scores of glycosylceramides, lactosylceramides, or other unsaturated sphingomyelins (even if having an SFA base) were not associated with risk of diabetes. After additional adjustment for numerous traditional risk factors (especially triglycerides), both associations were attenuated and only the saturated-sphingomyelin score remained associated with risk of diabetes (RR Q4 versus Q1 = 1.98; 95% CI: 1.09, 3.59; P -trend = 0.031). Conclusions Our findings suggest that a cluster of saturated sphingomyelins may be associated with elevated risk of diabetes beyond traditional risk factors, which needs to be verified in other population studies. This study was registered at clinicaltrials.gov as NCT02060344. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationships between perceived family support and community support and the organizational citizenship behavior of international students in U.S. higher education institutions. It also examined the mediating effects of cross-cultural adjustment and engagement on the relationships. Data were collected from 1,436 international students in one university located in the southwestern United States. Building on previous studies that have used a top-down managerial approach, this study used a noninstitutional/person-based approach to validate two guiding theories (spillover theory and job demands-resources model) and related former empirical studies. The results help stakeholders visualize a holistic picture of the international student experience. Such knowledge enables higher education institutions to make data-driven decisions about how to strategically prioritize resources to assist international students. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is linked to cognitive decline and disorders (e.g., dementia). The evidence is based largely on older non-Latino White cohorts.Objective: Examine the association between global vascular risk and cognitive function among Hispanics/Latinos in the United States.Methods: We used data from a large sample of stroke- and cardiovascular disease-free, middle-aged and older Hispanics/Latinos with diverse backgrounds (n=7,650) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We compared associations between two measures of cardiovascular risk (CVR), the Framingham Cardiovascular Risk Score (FCRS) and the multiethnic Global Vascular Risk Score (GVRS), and cognitive performance using measures of global and domain specific cognitive function, and tested for modification by sex and age.Results: Higher FCRS and GVRS were associated with lower global cognition and higher probability of low mental status, after covariates adjustment. Both CVR indices were associated with lower performances in learning and memory, verbal fluency, and psychomotor speed. Higher GVRS presented stronger associations with lower cognitive function compared to the FCRS. Women and younger age (45-64 years) exhibited more pronounced associations between higher CVR and worse cognition, particularly so with the GVRS.Discussion: CVR is also a risk for compromised cognitive function and evident in middle-age among Hispanics/Latinos. The multiethnic GVRS, tailored to specific risks based on racial/ethnic background, is feasible to use in primary care settings and can provide important insight on cognitive risk. Even modest shifts in population toward cardiovascular health in the high-risk Hispanic/Latino population can have important positive impacts on healthy cognitive aging. [ABSTRACT FROM AUTHOR]

There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression. To date, only one randomised controlled trial (RCT) has been conducted with elevated depression symptoms being an inclusion criterion, with results showing that a diet intervention can reduce clinical levels of depression. No such RCTs have been performed in young adults. Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group). The primary and secondary outcome measures assessed at baseline and after the intervention included symptoms of depression (Centre for Epidemiological Studies Depression Scale; CESD-R; and Depression Anxiety and Stress Scale– 21 depression subscale; DASS-21-D), current mood (Profile of Mood States), self-efficacy (New General Self-Efficacy Scale) and memory (Hopkins Verbal Learning Test). Diet compliance was measured via self-report questionnaires and spectrophotometry. One-hundred-and-one individuals were enrolled in the study and randomly assigned to the Diet Group or the Control Group. Upon completion of the study, there was complete data for 38 individuals in each group. There was good compliance with the diet intervention recommendations assessed using self-report and spectrophotometry. The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen’s d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen’s d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression. The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the accuracy and precision of ultrasound shear wave elasticity measurements as a function of target elasticity and acquisition depth. Materials and methods: Using five ultrasound systems (VTQ, VTIQ, EPIQ 5, Aixplorer, and Aplio 500), two operators independently measured shear wave elasticities in two phantoms containing five different target elasticities (8±3, 14±4, 25±6, 45±8, and 80±12 kPa) at depths of 15, 30, 35, and 60 mm. Accuracy was assessed by evaluating measurement errors and the proportions of outliers, while factors affecting accuracy were assessed using logistic regression analysis. Measurement errors were defined as differences between the measured values and 1) the margins of the target elasticity, and 2) the median values of the target elasticity. Outliers were defined as measured values outside the margins of the target elasticity. Precision was assessed by calculating the reproducibility of measurements using the within-subject coefficient of variation (wCV). Results: Mean measurement errors and the proportions of outliers were higher for high than for low target elasticities (p<0.001), but did not differ in relation to acquisition depth, either within an elastography system or across the different systems. Logistic regression analysis showed that target elasticity (p<0.001) significantly affected accuracy, whereas acquisition depth (p>0.05) did not. The wCV for the 80±12 kPa target (31.33%) was significantly higher than that for lower elasticity targets (6.96–10.43 kPa; p<0.001). The wCV did not differ across acquisition depths. The individual elastography systems showed consistent results. Conclusions: Targets with high elasticity showed lower accuracy and lower precision than targets with low elasticity, while acquisition depth did not show consistent patterns in either accuracy or precision. [ABSTRACT FROM AUTHOR]

Background Accumulating evidence suggests the important role of the home food environment in an individual’s dietary intake. Objective This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). Design A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. Participants The analysis included 8,975 participants aged 19 to 65 years. Statistical analyses performed Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES’ complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. Results Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1.73) in the home compared with rural residents. Food desert status was not associated with home food availability. Conclusions The results show that SES at both individual (education, income) and neighborhood level was linked to home food availability, suggesting a need to improve the home food environment for socioeconomically disadvantaged individuals and neighborhoods. [ABSTRACT FROM AUTHOR]

This study applies the Gridpoint Statistical Interpolation (GSI) 3D-Var assimilation tool originally developed by the National Centers for Environmental Prediction (NCEP), to improve surface PM2:5 predictions over the contiguous United States (CONUS) by assimilating aerosol optical depth (AOD) and surface PM2.5 in version 5.1 of the Community Multi-scale Air Quality (CMAQ) modeling system. An optimal interpolation (OI) method implemented earlier (Tang et al., 2015) for the CMAQ modeling system is also tested for the same period (July 2011) over the same CONUS. Both GSI and OI methods assimilate surface PM2.5 observations at 00:00, 06:00, 12:00 and 18:00 UTC, and MODIS AOD at 18:00 UTC. The assimilations of observations using both GSI and OI generally help reduce the prediction biases and improve correlation between model predictions and observations. In the GSI experiments, assimilation of surface PM2.5 (particle matter with diameter< 2:5 µm) leads to stronger increments in surface PM2.5 compared to its MODIS AOD assimilation at the 550 nm wavelength. In contrast, we find a stronger OI impact of the MODIS AOD on surface aerosols at 18:00UTC compared to the surface PM2.5 OI method. GSI produces smoother result and yields overall better correlation coefficient and root mean squared error (RMSE). It should be noted that the 3D-Var and OI methods used here have several big differences besides the data assimilation schemes. For instance, the OI uses relatively big model uncertainties, which helps yield smaller mean biases, but sometimes causes the RMSE to increase. We also examine and discuss the sensitivity of the assimilation experiments' results to the AOD forward operators. [ABSTRACT FROM AUTHOR]

While many people view Asian Americans as 'model minorities' who excel in math, science and music, they are also negatively stereotyped as nerdy and unsociable. Research has shown that Asian Americans have to outperform other races academically to receive equal consideration by colleges. This study is the first to test whether this bias is directed towards all Asian Americans or only those who fit the model minority stereotype. The present experiment investigates the effect of race and stereotypes on perceptions of students in the college admission process. College admission officers ( N = 79) were randomly assigned to view a shortened version of a college application. The participants rated the student whose application they saw according to likelihood of being accepted into college, social competence, academic competence and contribution to a college's diversity. The stereotypical Asian American student was perceived to be significantly less likely to be accepted into college and had a lower perceived social competence than the other three students. Additionally, students who participated in counter-stereotypical Asian activities were perceived as being more likely to be accepted, more socially competent and to contribute more diversity than students who participated in stereotypical Asian activities. A multiple regression revealed that social competence was the only significant predictor of likely acceptance. This study suggests that rather than all Asian American students being disadvantaged in the college admissions process, it is only those who fit common stereotypes who are affected. [ABSTRACT FROM AUTHOR]

Considerable research has established the harmful impacts of the COVID-19 pandemic on children's and adolescents' health and well-being. However, the literature has been constrained by studies using less representative samples, hindering the generalization of the findings. This study aimed to investigate the associations of employment disruption and school closures during the pandemic with suicidal ideation and behavior in children and adolescents—and to consider the potential mediating effects of child psychological and physical abuse and subsequent mental health conditions. This study used the Adolescent Behaviors and Experiences data (n = 4692) — a nationally representative survey administered by the CDC of the United States from January to June 2021. Logistic regression models were conducted to investigate the associations. A series of multiple mediation models were performed. School closures directly reduced child psychological and physical abuse and suicidal ideation and behavior. Employment disruption did not directly predict suicidal ideation and behavior but primarily through child abuse. Mental health's mediation role was significant in the associations between child psychological abuse and suicidal ideation and behavior, but no evidence suggested the same mediating pattern for the physical abuse-suicidal ideation and behavior relationship. Within the covariates, sexual orientation was the most consistent and highest risk factor. This study contributes to current knowledge on disaster impact, child abuse, and suicidal ideation and behavior, and it can also provide policy and intervention awareness for social workers. • The most recent national representative survey in the United States about children and adolescents was analyzed. • The associations between COVID-19 impacts, child abuse, mental health and four suicidality measures were investigated. • School disruptions directly reduced child psychological and physical abuse experience and suicidal ideation and behaviors. • Employment disruption did not directly predict suicidal ideation and behavior but primarily through child abuse. • Mental health's mediation role was significant between psychological abuse and suicidality but not for physical abuse. [ABSTRACT FROM AUTHOR]

• COVID-19-caused resilience performance of metro rails was evaluated quantitatively. • Key characteristics of responses to the disturbance were modeled with multivariate multiple regression. • The applicability and rationality of developed models were validated with U.S. metro data. The metro rail system has proven to be the most efficient high-capacity carriers. During the unprecedented coronavirus disease 2019 (COVID-19) challenge, non-pharmaceutical interventions become a widely adopted strategy to limit physical movements and interactions. For situational awareness and decision support, data-driven analytics about serviceability are invaluable to metro agencies and decision-makers of cities. This paper presents a data-driven analytical framework that quantitatively evaluates COVID-19-caused resilience performance of metro rails. Several characteristics (e.g., vulnerability, robustness, rapidity, and degree to return) of the metro system's responses to the disturbance were identified and modeled with multivariate multiple regression. The applicability and rationality of the resilience evaluation model were validated by the metro transit data of the United States. The preliminary results disclosed that metro rail transit encountered more vulnerability (90.6%) in passenger trips than motorbus and light rail (around 70%). A set of statistical models were employed to disentangle the effect of socio-demographic variables and COVID-19-related factors on the metro transit. The disclosed emerging knowledge of resilience provides an in-depth understanding of mobility trends for the public and time-sensitive decision support for the policy effects, to further improve the service and management of the metro system under the spread of the epidemic. [ABSTRACT FROM AUTHOR]

Bank failure prediction is an important study for regulators in the banking industry because the failure of a bank leads to devastating consequences. If bank failures are correctly predicted, early warnings can be sent to the responsible authorities for precaution purposes. Therefore, a reliable bank failure prediction or early warning system is invaluable to avoid adverse repercussion effects on other banks and to prevent drastic confidence losses in the society. In this paper, we propose a novel self-organizing neural fuzzy inference system, which functions as an early warning system of bank failures. The system performs accurately based on the auto-generated fuzzy inference rule base. More importantly, the simplified rule base possesses a high level of interpretability, which makes it much easier for human users to comprehend. Three sets of experiments are conducted on a publicly available database, which consists of 3635 United States banks observed over a 21-year period. The experimental results of our proposed model are encouraging in terms of both accuracy and interpretability when benchmarked against other prediction models. [ABSTRACT FROM AUTHOR]

A speech from the University of Baltimore School of Law Center on Applied Feminism 8th Annual Feminist Legal Conference delivered by Chai Feldblum, Commissioner of the Equal Employment Opportunity Commission (EEOC), on antidiscrimination provision of Civil Rights Act of 1964 is presented.

This article presents an editorial in which the authors discuss the use of emerging biotechnology in dental, oral, and craniofacial regenerative medicine. They comment on the innovations in these fields, which utilize tissue engineering, regeneration, and bioengineering techniques. Information is also presented on resource centers in the DOC Tissue Regeneration Consortium (DOCTRC).

Hotel guest room energy management (GREM) systems are widely used throughout the world and the United States. The market for GREM has especially increased in the state of Nevada where guest room occupancy schedules vary at a high rate. Guests often leave their air conditioning equipment running during their absence. The GREM system determines the physical presence of guests by detecting infrared body heat. When a guest has left a room for a specified period, the system takes control from the normal thermostat and resets the room's temperature to energy conserving levels. Thus, installation of GREM control systems has been shown to reduce unnecessary energy consumption in unoccupied guest rooms. DNV GL conducted a GREM study at two hotels and casinos in Las Vegas Valley utilizing the INNCOM product. The primary objective of this assessment is to compare the energy use of GREM technology with existing technology, a conventional thermostat control. The selected sites were categorized by NV Energy service territories and types of HVAC equipment. Two types of fan coil units (FCU) were selected for this study—2-pipe and 4-pipe systems. Energy uses of the FCUs were measured in equal numbers of rooms with conventional thermostat control and GREM control. A data acquisition system was installed to record important parameters, such as supply/return temperatures of airside and waterside, relative humidity and fan power with one-minute intervals for an entire year. These parameters were then analyzed to gain insight into the behavior of the FCU performance. Conclusions are determined by the estimated prescriptive energy savings resulting from controlling the FCU in unoccupied guest rooms. The results will be used to assess the prescriptive incentive program the utility offers to their customers. While Nevada's climatic data are considered in this study, the conclusions are generally more applicable in the desert southwest portion of the United States. [ABSTRACT FROM PUBLISHER]

Objective. To characterize the extent to which state and national professional pharmacy associations have implemented formal policies addressing the sale of tobacco and alcohol products in community pharmacies. Methods: To determine existence of tobacco and alcohol policies, national professional pharmacy associations (n = 10) and state-level pharmacy associations (n = 86) affiliated with the American Pharmacists Association (APhA) and/or the American Society of Health-System Pharmacists (ASHP) were contacted via telephone and/or e-mail, and a search of the association websites was conducted. Results: Of 95 responding associations (99%), 14% have a formal policy opposing the sale of tobacco products in pharmacies and 5% have a formal policy opposing the sale of alcohol in pharmacies. Of the associations representing major tobacco-producing states, 40% have a formal policy against tobacco sales in pharmacies, significantly more than the 8% of non-tobacco state associations with such policies. Conclusion: Among national professional pharmacy associations, only APhA and ASHP have formal policy statements opposing the sale of both tobacco and alcohol in pharmacies. Most state-level professional pharmacy associations affiliated with these two national organizations have no formal policy statement or position. [ABSTRACT FROM AUTHOR]

Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine-obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic. [ABSTRACT FROM AUTHOR]

The National Air Quality Forecast Capability (NAQFC) project provides the US with operational and experimental real-time ozone predictions using two different versions of the three-dimensional Community Multi-scale Air Quality (CMAQ) modeling system. Routine evaluation using near-real-time AIRNow ozone measurements through 2011 showed better performance of the operational ozone predictions. In this work, quality-controlled and -assured Air Quality System (AQS) ozone and nitrogen dioxide (NO2) observations are used to evaluate the experimental predictions in 2010. It is found that both ozone and NO2 are overestimated over the contiguous US (CONUS), with annual biases of +5.6 and +5.1 ppbv, respectively. The annual root mean square errors (RMSEs) are 15.4 ppbv for ozone and 13.4 ppbv for NO2. For both species the overpredictions are most pronounced in the summer. The locations of the AQS monitoring sites are also utilized to stratify comparisons by the degree of urbanization. Comparisons for six predefined US regions show the highest annual biases for ozone predictions in Southeast (+10.5 ppbv) and for NO2 in the Lower Middle (+8.1 ppbv) and Pacific Coast (+7.1 ppbv) regions. The spatial distributions of the NO2 biases in August show distinctively high values in the Los Angeles, Houston, and New Orleans areas. In addition to the standard statistics metrics, daily maximum eight-hour ozone categorical statistics are calculated using the current US ambient air quality standard (75 ppbv) and another lower threshold (70 ppbv). Using the 75 ppbv standard, the hit rate and proportion of correct over CONUS for the entire year are 0.64 and 0.96, respectively. Summertime biases show distinctive weekly patterns for ozone and NO2. Diurnal comparisons show that ozone overestimation is most severe in the morning, from 07:00 to 10:00 local time. For NO2, the morning predictions agree with the AQS observations reasonably well, but nighttime concentrations are overpredicted by around 100%. [ABSTRACT FROM AUTHOR]

Unlike refugees, US asylees are not medically screened upon arrival in the United States. Asylees have similar infectious disease burden and vaccination needs as refugees. Asylees should be provided screening at the earliest opportunity to decrease disease risk to them and US communities.Background. Unlike US-bound refugees, asylum seekers (asylees) apply for asylum while residing in the United States and are not provided a medical screening. Infectious disease burden and vaccination needs have not been described among US asylees.Methods. We conducted a retrospective cohort study of 630 asylees and 151 refugees referred to the District of Columbia (DC) Department of Health screening program for an initial US medical screening during September 2003–August 2007. We assessed the prevalence of latent tuberculosis infection (tuberculin skin test reactivity ≥10 mm), human immunodeficiency virus (HIV) and hepatitis B seropositivity, intestinal parasite test positivity, need for vaccinations, and time from date of US arrival to receipt of screening.Results. Asylees in DC had a similar prevalence as refugees of latent tuberculosis infection (39% vs 38%, respectively, P = .83), pathogenic intestinal parasites (4% vs 2%, P = .36), and need for adult vaccinations (80% vs 80%, P = .95). Asylees were screened significantly later after US arrival compared with refugees (55 weeks vs 1 week, P < .001). Asylees had higher prevalence of latent tuberculosis infection, hepatitis B and HIV seropositivity, and child and adult vaccination needs than the US population (P < .001).Conclusions. This study of the infectious disease concerns of a US asylee population suggests that in DC, asylees have similar infectious disease burden and prevention needs as refugees and should be screened with the same urgency. Because applicants for US asylum are not linked to prompt medical screenings, DC asylees are typically screened much later, placing them and US communities at risk. [ABSTRACT FROM PUBLISHER]

Tuberculosis causes >1.7 million deaths worldwide each year and is frequently transmitted in hospitals. Outbreaks of multidrug-resistant tuberculosis have led to illness and death among health care workers (HCWs) in many countries. Some countries, such as the United States, implemented occupational health policies that substantially reduced tuberculosis rates among HCWs. Inadequate tuberculosis infection control in China may contribute to its high burden of tuberculosis and multidrug-resistant tuberculosis, which are both the second highest worldwide. Occupational health policies in China for tuberculosis control can be strengthened.We reviewed the development and content of tuberculosis infection control policies in the United States and China. Sources included published academic literature, Chinese Ministry of Health policies, US government agency reports, legal databases, personal observations of hospitals, review of internet discussion sites, and discussions with HCWs and health care and law experts.In the United States, slow acceptance of the tuberculosis problem in HCWs resulted in decades of inaction. Tuberculosis infection control policies, based mostly on expert opinion, were implemented only after tuberculosis resurged in the 1980s. Effective evidence-based policies were developed only after multiple cycles of policy implementation, evaluation and revision. These policies have now substantially reduced occupational tuberculosis. In China, tuberculosis has not been formally recognized as an occupational disease, and data regarding the burden in HCWs are sparse. Vagueness of current labour laws and suboptimal alignment of infection control authority and expertise result in varied and sometimes absent protection of HCWs against tuberculosis. Formal evaluations of occupational tuberculosis policies have not been reported.By collecting data on its current HCW tuberculosis burden and infection control practices, refining policies, continually evaluating its policies based on accumulated evidence and rapidly identifying unsuspected tuberculosis cases, China can develop a more comprehensive strategy to ensure the health of HCWs and reduce transmission of tuberculosis and multidrug-resistant tuberculosis. [ABSTRACT FROM AUTHOR]

The impacts of transported background (TBG) pollutants on western US ozone (Oe) distributions in summer 2008 are studied using the multi-scale Sulfur Transport and dEposition Modeling system. Forward sensitivity simulations show that TBG contributes ~30-35ppb to the surface Monthly mean Daily maximum 8-h Average O3 (MDA8) over Pacific Southwest (US Environmental Protection Agency (EPA) Region 9, including California, Nevada and Arizona) and Pacific Northwest (EPA Region 10, including Washington, Oregon and Idaho), and ~ 10-17 ppm-h to the secondary standard metric "W126 monthly index" over EPA Region 9 and ~3-4ppm-h over Region 10. The strongest TBG impacts on W126 occur over the grass/shrub-covered regions. Among TBG pollutants, Oe is the major contributor to surface O3, while peroxyacetyl nitrate is the most important O3 precursor species. W126 shows larger responses than MDA8 to perturbations in TBG and stronger non-linearity to the magnitude of perturbations. The TBG impacts on both metrics overall negatively correlate to model vertical resolution and positively correlate to the horizontal resolution. The mechanisms that determine TBG contributions and their variation are analyzed using trajectories and the receptor-based adjoint sensitivity analysis, which demonstrate the connection between the surface O3 and O3 aloft (at ~ 1-4 km) 1-2 days earlier. The probabilities of airmasses originating from Mt. Bachelor (2.7 km) and 2.5 km above Trinidad Head (THD) entraining into the boundary layer reach daily maxima of 66 % and 34 % at ~03:00 p.m. Pacific Daylight Time (PDT), respectively, and stay above 50 % during 09:00 a.m.-04:00 p.m. PDT for those originating 1.5 km above California's South Coast. Assimilation of the surface in-situ measurements significantly reduced the errors in the modeled surface O3 during a long-range transport episode by ~5ppb on average (up to ~17ppb) and increased the estimated TBG contributions by ~3 ppb. Available O3 vertical profiles from Tro-pospheric Emission Spectrometer (TES), Ozone Monitoring Instrument (OMI) and THD sonde identified this transport event, but assimilation of these observations in this case did not efficiently improve the O3 distributions except near the sampling locations, due to their limited spatiotemporal resolution and/or possible uncertainties. [ABSTRACT FROM AUTHOR]